Morphological alterations in the jejunal mucosa of aged rats and the possible protective role of green tea

Introduction. Gastrointestinal disorders become more prevalent with ageing. This study is aimed to describe morphological changes that occur in the jejunal mucosa of male albino rats as a result of ageing and the protec­tive effect of green tea (GT) extract. Material and methods. The experiment was performed on sixty rats: thirty young-adult (6-month old, body mass 200–220 g) and thirty old (24-month-old, body mass 220–260 g) animals. Each group was further divided into two subgroups (n = 15 each): control rats and GT-treated rats that received 1.5 mL (300 mg/kg/day) of GT extract for 14 weeks by oral gavage. Sections of the jejunum were stained with hematoxylin and eosin, periodic acid Schiff, toluidine blue and Mallory trichrome methods. The presence of proliferating cell nuclear antigen (PCNA)- and CD68-positive cells was evaluated by immunohistochemical staining. Ultrathin sections were prepared and examined by a transmission electron microscope (TEM). Results. Jejunal sections of the old control rats showed distortion of submucosa and attenuated muscularis externa with decreased height of intestinal villi. The villi also showed partial loss of acidophilic brush border with wide spaces between enterocytes. Swollen, short, blunt or broad villi with abundant mononuclear cell infiltration of lamina propria and congested blood vessels were evident both by light and electron microscopy. The number of PCNA- and CD68-positive cells in jejunal mucosa of old rats was higher than in young rats. The activity of glutathione peroxidase (GPX) and total antioxidant capacity (TAC) in the mucosa of old control rats were lower, whereas malondialdehyde (MDA) levels were higher in the jejunal homogenates of old rats as compared to young control rats. Administration of GT extract protected the jejunal mucosa from age-related changes by restoring its histological structure. The treatment of old rats with GT extract significantly decreased MDA levels in the jejunum and increased TAC and GPX activity. Conclusions. The age-related changes of the morphology of rat jejunum could be ameliorated by prolonged supplementation of the green tea extract

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The predictive value of uterine blood flow in detecting the risk of adverse pregnancy outcome in patients with polycystic ovary syndrome

Objectives: To assess the value of uterine artery Doppler screening during pregnancy in predicting adverse pregnancy outcomes in women with polycystic ovary syndrome (PCOS). Design: A prospective case control study. Setting: Obstetrics and Gynecology and Medical Biochemistry departments, Zagazig University Hospital, Egypt. Method: Forty pregnant women with ovulatory PCOS (PCOS group) and 40 age- and body mass index-matched healthy pregnant controls (control group) underwent serial Doppler velocimetry measurements of the uterine artery, measurements of free androgen index and fasting glucose/insulin ratio during first and late second trimesters. Main outcome measures: Blood flow impedance indices, free androgen index, fasting glucose/insulin ratio and pregnancy outcomes. Student’s t-test, χ2-test, and specificity and sensitivity tests were used for statistical analysis of the data. Results: Patients with PCOS had a significantly higher level of testosterone, androstenedione, dehydroepiandrosterone sulfate, free androgen index, fasting glucose/fasting insulin level in the first and late second trimesters (P ⩽ 0.05). A significantly (P < 0.05) higher PI value was observed in the PCOS group than in the control group in the first and late second trimesters. At 26 weeks of gestation 27.2% of pregnant patients with PCOS had a notch on either side, comparing with 12.8% of the control group. The rate of adverse pregnancy outcomes was significantly higher in pregnant patients with PCOS 45% versus 10% in the control group. Conclusions: Uterine artery Doppler indices have a higher predictive value for abnormal pregnancy outcomes in pregnant patients with PCOS

Thyroid dysfunction and inflammatory biomarkers in chronic obstructive pulmonary disease: Relation to severity and exacerbation

Background: Thyroid dysfunction or non-thyroidal illness syndrome (NTIS) is frequently detected in chronic, systemic diseases. The systemic manifestations of chronic obstructive pulmonary disease (COPD) include a number of endocrine disorders. The severity of hypoxia and airway obstruction in COPD patients might cause alterations in thyroid function. The aim of this study is to assess serum levels of thyroid hormones and the inflammatory biomarkers; IL-6, TNF-α in COPD patients during stability and acute exacerbation of the disease, and also to assess the relation between severity of COPD and levels of thyroid hormones. Subjects and methods: Forty stable COPD patients and twenty COPD patients with acute exacerbation were included in this study as patient groups and twenty healthy age-matched non smoker subjects with normal pulmonary function as a control group. The diagnosis of COPD and acute exacerbation of COPD were established according to GOLD (2011) criteria. Stable COPD patients were further subdivided into Mild-to-moderate COPD patient group (FEV1 ⩾ 50% of predicted value, which included 14 patients) and Severe COPD patient group (FEV1 < 50% of predicted value, which included 26 patients). All enrolled patients were subjected to measurements of pulmonary function tests (FEV1%, FVC% and FEV1/FVC ratio), arterial blood gases (ABGs) (PaO2, PaCO2, pH), serum levels of thyroid hormones (TSH, total T3, total T4, free T3 and free T4) and the inflammatory biomarkers IL-6 and TNF-α on the first day of admission to RICU or first visit to the outpatient clinics. Results: There was a significant decrease in serum total T3 and free T3 levels in stable COPD patients when compared to control subjects. Also, there was a significant decrease in serum total T3, free T3, TSH levels and TT3/TT4 ratio in the COPD exacerbation patient group when compared to control subjects and when compared to stable COPD patients. There were no statistically significant differences in serum levels of total T4, free T4 between the studied groups. Regarding disease severity, serum total T3, free T3 levels and TT3/TT4 ratio were significantly decreased in severe COPD patients when compared to mild-to-moderate COPD patients. There were significant positive correlations between PaO2 and both serum total T3 and TT3/TT4 ratio in the stable COPD group. Serum IL-6 and TNF-α levels were significantly increased in both stable and exacerbation phase COPD patient groups when compared to control subjects. Conclusion: COPD is a systemic disease that may produce significant alterations in serum levels of thyroid hormones, especially in severe COPD patients and during exacerbation phases of COPD where NTIS is more evident. There was a significant decrease in serum total T3 and free T3 levels in stable COPD patients and this decrease was more significantly evident with a superadded significant decrease in serum TSH levels during the exacerbation phase of COPD. The hormonal alterations are especially related to severity of the disease and hypoxemia. Serum IL-6 and TNF-α levels were increased even in stable COPD and this rise is magnified with increased disease severity and during exacerbation phases of COPD

Urinary N-acetyl-&#946;-D-glucosaminidase: as a marker for early detection of renal tubular disturbance in patients with IDDM (type 1)

No Abstract. The Egyptian Journal of Biochemistry and Molecular Biology Vol. 22(2) 2004: 55-7

Electrospun polyvinyl alcohol/<i>Withania </i><i>somnifera</i> extract nanofibers incorporating tadalafil-loaded nanoparticles for diabetic ulcers - supplementary figures

Background: Impaired inflammation and vascularization are common reasons for delayed diabetic wound healing. Nanoparticles (NPs)-in-nanofibers composites can manage diabetic wounds. A multifunctional scaffold was developed based on tadalafil (TDF)-loaded NPs incorporated into polyvinyl alcohol/Withania somnifera extract nanofibers. Materials & methods: TDF-loaded NPs were prepared and fully characterized in terms of their physicochemical properties. Extract of ashwagandha was prepared and a blend composed of TDF-loaded NPs, herbal extract and polyvinyl alcohol was used to prepare the whole composite. Results: The whole composite exhibited improved wound closure in a diabetic rat model in terms of reduced inflammation and enhanced angiogenesis. Conclusion: Results suggest that this multifunctional composite could serve as a promising diabetic wound dressing.</p