Soluble Triggering Receptor Expressed on Myeloid Cells-1 as a marker to differentiate septic from aseptic meningitis in children: comparison with procalcitonin and C-reactive protein

Background: Differentiating between septic and aseptic meningitis remains a challenge. Procalcitonin (PCT) was suggested by many researchers as a sensitive marker for early diagnosis of septic meningitis but with varying discriminative power. Triggering receptor expressed on myeloid cells-1 (TREM-1), a neutrophil and monocyte receptor, is up-regulated during infection with potential role during sepsis. Objectives: The aim of this study was to evaluate the diagnostic accuracy of soluble TREM-1 in comparison to PCT and C-reactive protein (CRP) in early diagnosis of septic meningitis and its usefulness to distinguish between septic and aseptic meningitis in children. Study design: Fifty-one children aged 2 to 162 months identified as possible cases of meningitis were included in this case control study. Beside Gram staining, cultures of blood and cerebrospinal fluid (CSF) and latex agglutination test of CSF, CRP, serum PCT and soluble TREM-1 (sTREM-1) measurement was done on admission, and after 48-72 hours of treatment. Results: Septic meningitis was diagnosed in 16 (44%) of the studied cases. Although patients with septic meningitis had a significant increase in serum sTREM-1 and PCT levels at the time of admission (median, 25.2 ng/ml and 79.1ng/ml, respectively) in comparison with patients with aseptic meningitis (4.6 ng/ml and 0.7 ng/ml, respectively) and control group (4.1 ng/ml and 0.3 ng/ml, respectively) (p < 0.0001), sTREM-1 showed significantly higher sensitivity (93.7%) and specificity (94.3%) in the early prediction of sepsis with an area under the Receiver Operator Characteristic (ROC) curve (95% CI) of 0.94 (0.84 - 0.99) at a cutoff value of 12.4 ng/ml. Moreover, sTREM-1 but not PCT or CRP concentration was significantly lower (P=0.007) at admission in patients with poor outcome than in those with good prognosis. Conclusions: Both serum PCT and sTREM-1 are valuable in early distinguishing septic from aseptic meningitis in children but with markedly higher diagnostic discriminatory power for sTREM-1. Moreover, sTREM-1 has a significant value in predicting the prognosis of cases with septic meningitis. Keywords: Soluble Triggering Receptor Expressed on Myeloid Cells-1 – Procalcitonin- C-Reactive Protein - Septic meningitisEgypt J Pediatr Allergy Immunol 2011;9(2):77-8

真菌由来インドールプレニル基転移酵素を用いたプレニルβ-カルボリンの酵素生成

富山大学・富医薬博甲第401号・Sherif Ahmed Muhammed Ahmed Hamdy・2022/08/31公表論文1.Hamdy, S.A., Kodama, T., Nakashima, Y. et al. Enzymatic formation of a prenyl β-carboline by a fungal indole prenyltransferase. J Nat Med 76, 873–879 (2022). https://doi.org/10.1007/s11418-022-01635-02.Sherif Ahmed Hamdy, Takeshi Kodama, Yu Nakashima, Xiaojie Han, Hiroyuki Morita,Catalytic potential of a fungal indole prenyltransferase toward β-carbolines, harmine and harman, and their prenylation effects on antibacterial activity,Journal of Bioscience and Bioengineering,Volume 134, Issue 4,2022,Pages 311-317,ISSN 1389-1723,https://doi.org/10.1016/j.jbiosc.2022.07.004.富山大

High-Content Lignocellulosic Fibers Reinforcing Starch-Based Biodegradable Composites: Properties and Applications

Natural source-based composites became promising substitutes and synthetic petrochemical-based counterparts. So far, thermoplastic starch and lignocellulosic fibers are the most common materials for making such eco-friendly ?green? materials. Low cost, abundance, and renewability are the factors that lead to deploying these two types of materials. In this chapter, we are conducting further analysis for previously published results of six types of high-content natural fiber-reinforced starch-based composites. All composites were prepared by compression molding under pressure from 5 to 20 MPa and temperature from 130 to 160°C. Composites exhibited highest tensile strength and modulus of elasticity at fiber weight content from 50 to 70%, and then mechanical properties deteriorated significantly at 80% fiber content due to the insufficient starch resin. For instance, the tensile strength was boosted up from 2-12 MPa for thermoplastic starch to reach 55, 45, 32, 28, 44, 365 MPa for flax, bagasse, date palm fiber (DPF), banana, bamboo, and hemp composites, when fiber content was increased from 0% to the optimum fiber content (50-70%). Kelly-Tyson (random 2d) was the optimum model to predict random fiber composite. Increasing the fiber content and choosing a fiber with high cellulose content significantly improve the moisture resistance of the composites. Fick’s law of diffusion predicted the water uptake property successfully. The thermal stability of composites was improved with increasing the fiber weight content as well. This is attributed to the high thermal stability of cellulose when compared to starch. Properties exhibited by starch-based high-content natural fiber composite are promising for many industrial and biomedical applications

Arthroscopic Assisted Reduction and Internal Fixation of Tibial Plateau Fractures

BACKGROUND: Tibial plateau fractures present an important entity in orthopaedic fractures. Arthroscopic-assisted reduction and internal fixation is a good alternative to ORIF as it has the advantage of direct visualisation of the articular surface of the plateau, direct assessment of the reduction of the articular surface, and managing any associated intra-articular pathology. AIM: Our study aim is to determine the results of arthroscopic assisted reduction and internal fixation of tibial plateau fractures. METHODS: This study involved 25 patients with tibial plateau fractures presenting to the emergency department of Cairo University Hospitals between the periods of November 2016 and May 2017. The patients were followed up for an average of 14 months (11-18 months). According to Schatzker’s classification, five patients had type I, eleven had type II, and nine patients had type III fractures. RESULTS: The average time to full union in Schatzker type I was 9.1 weeks, in type II was 10.2 weeks, and in type III it was 9.4. The mean clinical Rasmussen score among the 25 patients was 26 (range, 24-30). A group of 19 patients (76%) had excellent results, (4 type I, 8 types II, and 7 types III) 6 patients (24 %) had good results (1 type I, 3 types II, 2 types III). Radiologic results were excellent in (14 cases) 56.0% and good results (11 cases) 44%. CONCLUSION: Arthroscopic assisted reduction and fixation of tibial plateau fractures have the advantages of checking the adequacy of reduction, avoiding the need for detachment of the meniscus, and allowing for accurate diagnosis and management of associated knee injuries. Therefore, we recommend that arthroscopic assisted reduction and fixation of tibial plateau fractures should be used more often

Case Study in Refractory Non-Hodgkin's Lymphoma: Successful Treatment with Plerixafor

The present case study describes our experience in treating a young woman diagnosed with a relapsing case of diffuse large cell lymphoma, who was heavily pre-treated with chemotherapy and radiotherapy. Our only chance to improve her survival was by using high-dose chemotherapy, followed by peripheral stem cell rescue. Unfortunately, in this patient, collecting sufficient stem cells for bone marrow transplantation proved to be very difficult since she had already been heavily treated with chemotherapy and radiotherapy. Currently, granulocyte colony-stimulating factor (G-CSF) alone or G-CSF plus chemotherapy are the most commonly used treatments for stem cell mobilization. However, 5–30% of patients do not respond to these agents. Plerixafor is a new hematopoietic stem cell-mobilizing drug that antagonizes the binding of chemokine stromal cell-derived factor-1α to CXC chemokine receptor 4. It is indicated in combination with G-CSF to mobilize hematopoietic stem cells to the peripheral blood for collection and subsequent autologous transplantation in patients with non-Hodgkin's lymphoma and multiple myeloma [Kessans et al.: Pharmacotherapy 2010;30:485–492; Jantunen: Expert Opin Biol Ther 2011;11:1241–1248]. Based on our findings, we consider plerixafor to be a very efficient and practical solution to mobilize and collect stem cells among all patients in such a situation, enabling us to proceed to autologous bone marrow transplantation and peripheral stem cell rescue in order to improve the patients’ overall survival

Neonatal Auditory Screening is a Necessity in The Neonatal Intensive Care Unit: Single Center Study

Background: Hearing impairment early in life interferes with normal healthy psychosocial, linguistic and educational development. Neonatal morbidities might be complicated by increased hearing impairment. Aim of the Work: To study the frequency of hearing loss among neonates with morbidities necessitating admission to neonatal intensive care units. Materials and Methods: This cross-sectional study involved screening of 250 neonate on day of discharge from Neonatal Intensive Care Unit (NICU), Children Hospital, Cairo University Hospitals, Egypt during 2020 using evoked otoacoustic emission (EOAE). Automated auditory brain stem response (AABR) was used as a confirmatory test for those who failed EOAE. Results: among the 250 neonates, 70 (28%) failed the screening by EOAE, and hearing loss was confirmed by AABR among 35(14%). Morbidity risk factors that contributed to hearing impairment was prematurity (p = 0.001), low birth weight (p = 0.003), low APGAR score at 1 and 5 minutes (p = 0.004), long NICU stay duration (p = 0.001), complications of pregnancy and delivery (p = 0.001 and p = 0.006 respectively), hypoxic ischemic encephalopathy (p = 0.001), intracranial hemorrhage (p = 0.001), meningitis (p = 0.003), mechanical ventilation for more than 5 days (p = 0.005), ototoxic drug use (p = 0.007) and hyperbilirubinemia at level of exchange transfusion (p = 0.001). Conclusion: EOAE and confirmatory AABR non- invasively and objectively detected 14% hearing loss among neonates admitted to NICU. Implementation of screening for hearing impairment among those with morbidity risk factors is a necessity to allow prompt diagnosis and early management of hearing loss

Notable changes in geochemical and mineralogical characteristics of different phases of episyenitization: insights on the radioactive and shielding of the late phase

Kab Amiri granites are submitted to post-magmatic hydrothermal solutions through fracture and faults, causing several alteration processes. The most common processes are episyenitization, saussuritization, hematitization, sericitization, kaolinization, albitization, chloritization, silicification, and muscovitization. Kab Amiri granites are vuggy, with the vugs partially to completely refilled with new constituents. The least episyenitized granites have elevated amounts of Fe, P, Zr, Ni, U, Th, Ba, Y, Hf, Nb, and As, which are correlated with their mobilization from biotite, k-feldspar, plagioclase and metamict zircon. These elemental changes are related the partial albitization, muscovitization, desilicification and chloritizatiom, which lead to the mobilization of these elements and forming of specific mineral association in the least altered granites such as autonite, tripiolite, columbite, Zircon and galena. On the second stage, granites were subjected to intense alteration processes by mineralizing fluids, causing wholly muscovitization of biotite and feldspar, albitization of plagioclase, carbonitization and apatitization. Many elements were mobilized from these altered minerals, including Ti, Al, Mn, Mg, Ca, Na, K, Mo, Cu, Pb, Zn, Ag, Co, Sr, V, Cr, Sn, Rb, Ta, Li, Sc, W, S, In, and Tl, leading to definite mineralization as kaslite, monazite, xenotime, polycrase and apatite. The mineralizing fluids in the least and highly episyenitized granites are incorporated in some ore minerals like uranophane, fergusonite, bazzite and garnet. Notably, the presence of elements such as U, Th, and other heavy metals in Kab Amiri granites highlights the potential for these rocks in radiation shielding applications. The unique combination of elements and minerals resulting from the alteration processes can be leveraged for developing new materials or enhancing existing materials used in radiation shielding

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London