The Heart in Systemic Autoimmune Disorders

Egypt J Pediatr Allergy Immunol 2005; 3(2): 44-5

Patent arterial duct

Patent arterial duct (PAD) is a congenital heart abnormality defined as persistent patency in term infants older than three months. Isolated PAD is found in around 1 in 2000 full term infants. A higher prevalence is found in preterm infants, especially those with low birth weight. The female to male ratio is 2:1. Most patients are asymptomatic when the duct is small. With a moderate-to-large duct, a characteristic continuous heart murmur (loudest in the left upper chest or infraclavicular area) is typical. The precordium may be hyperactive and peripheral pulses are bounding with a wide pulse pressure. Tachycardia, exertional dyspnoea, laboured breathing, fatigue or poor growth are common. Large shunts may lead to failure to thrive, recurrent infection of the upper respiratory tract and congestive heart failure. In the majority of cases of PAD there is no identifiable cause. Persistence of the duct is associated with chromosomal aberrations, asphyxia at birth, birth at high altitude and congenital rubella. Occasional cases are associated with specific genetic defects (trisomy 21 and 18, and the Rubinstein-Taybi and CHARGE syndromes). Familial occurrence of PAD is uncommon and the usual mechanism of inheritance is considered to be polygenic with a recurrence risk of 3%. Rare families with isolated PAD have been described in which the mode of inheritance appears to be dominant or recessive. Familial incidence of PAD has also been linked to Char syndrome, familial thoracic aortic aneurysm/dissection associated with patent arterial duct, and familial patent arterial duct and bicuspid aortic valve associated with hand abnormalities. Diagnosis is based on clinical examination and confirmed with transthoracic echocardiography. Assessment of ductal blood flow can be made using colour flow mapping and pulsed wave Doppler. Antenatal diagnosis is not possible, as PAD is a normal structure during antenatal life. Conditions with signs and symptoms of pulmonary overcirculation secondary to a left-to-right shunt must be excluded. Coronary, systemic and pulmonary arteriovenous fistula, peripheral pulmonary stenosis and ventricular septal defect with aortic regurgitation and collateral vessels must be differentiated from PAD on echocardiogram. In preterm infants with symptomatic heart failure secondary to PAD, treatment may be achieved by surgical ligation or with medical therapy blocking prostaglandin synthesis (indomethacin or ibuprofen). Transcatheter closure of the duct is usually indicated in older children. PAD in preterm and low birth weight infants is associated with significant co-morbidity and mortality due to haemodynamic instability. Asymptomatic patients with a small duct have a normal vital prognosis but have a lifetime risk of endocarditis. Patients with moderate-to-large ducts with significant haemodynamic alterations may develop irreversible changes to pulmonary vascularity and pulmonary hypertension

QuickXsort: Efficient Sorting with n log n - 1.399n +o(n) Comparisons on Average

In this paper we generalize the idea of QuickHeapsort leading to the notion of QuickXsort. Given some external sorting algorithm X, QuickXsort yields an internal sorting algorithm if X satisfies certain natural conditions. With QuickWeakHeapsort and QuickMergesort we present two examples for the QuickXsort-construction. Both are efficient algorithms that incur approximately n log n - 1.26n +o(n) comparisons on the average. A worst case of n log n + O(n) comparisons can be achieved without significantly affecting the average case. Furthermore, we describe an implementation of MergeInsertion for small n. Taking MergeInsertion as a base case for QuickMergesort, we establish a worst-case efficient sorting algorithm calling for n log n - 1.3999n + o(n) comparisons on average. QuickMergesort with constant size base cases shows the best performance on practical inputs: when sorting integers it is slower by only 15% to STL-Introsort

Better Heat And Power Integration Of An Existing Gas-oil Plant In Egypt Through Revamping The Design And Organic Rankine Cycle

Objective: The current study aims mainly to Maximize Condensate Recovery (NGLs), focusing on a gas processing train of Gas-Oil Separation Plant (GOSP) located in Egypt with a capacity of 4,230 kmole/h. Methods: The research study accounts for the constraint of Reid Vapor Pressure (RVP) specification, which makes the storage in floating roof tanks is of a great risk. The study proposes the installation of the cryogenic train that recovers condensates (C4+). This train comprises of compression unit, expansion unit, three-phase separators and a re-boiled absorber. The problem of RVP will no longer exist because of the re-boiled absorber achieving RVP according to export specifications (RVP below 82.74 kPa). Heat integration is applied over the whole process to minimize the reliability of the external utilities. Further, an Organic Rankine cycle (ORC) is introduced to the existing unit for more heat integration to develop useful work from process waste heat. Furthermore, both environmental emissions of CO2 and economic implications are investigated. Results: Energy integration played a vital role in decreasing the compressing power by about 31%, the cooling load by about 81%, and eliminating the heating load leading to zero CO2 emissions. Conclusion: The new energy-integrated retrofit scenarios exceed the recommended revamping schemes by previous works and base case in all aspects of condensate recovery, energy-saving, environmental concerning and economics

Immunomodulatory effects of food

There is a strong consensus that nutrition plays a role in modulating immune function and that the immune system needs adequate supply of nutrients to function properly. The complexity of the immune system supports this idea because its optimal functioning involves a variety of biological activities including cell division and proliferation, energy metabolism, and production of proteins. The micronutrients most often cited as being important to immune function include vitamins A, C, E, and B6, folate, iron, zinc, and selenium. Other nutrients mentioned as playing a role in immune function include beta-carotene (a precursor to vitamin A), vitamin B12, and vitamin D. On the other hand, over-activation of the immune system can lead to detrimental effects such as chronic inflammation or autoimmune diseases. In persons with allergies, a normally harmless material can be mistaken as an antigen. Some individuals develop an exaggerated immune response to food through developing food allergy which may be IgE mediated, non-IgE mediated, or mixed. This review will highlight the interaction between the immune system and some foods and food components in terms of modulation of immune functions by a variety of mechanisms.Egypt J Pediatr Allergy Immunol 2011;9(1):3-1

Phylogenetic characterization of two echinoid species of the southeastern Mediterranean, off Egypt

AbstractIn this study we investigated the phylogenetics of two sea urchin species, Arbacia lixula and Paracentrotus lividus from the Mediterranean Sea. Specimens were collected from the east coast of Alexandria City, Egypt. Pigmentation examination showed four sympatric color morphotypes (black, purple, reddish brown, and olive green). Mitochondrial DNA was extracted from specimens and mitochondrial cytochrome oxidase subunit I (COI) and 16S ribosomal RNA (16S) were sequenced. The results showed that all black specimens constituted the species A. lixula. All other colors belonged to P. lividus, with no apparent differentiation between color morphotypes. Moreover, P. lividus showed high haplotype diversity (COI; H=0.9500 and 16S; H=0.8580) and low values of nucleotide diversity (COI; π=0.0075 and 16S; π=0.0049), indicating a high degree of polymorphism within this species. This study represents the first attempt at DNA barcoding of echinoid species in the southeast Mediterranean off the Egyptian coast, and will provide a base for future phylogenetic analyses

Deep Learning Algorithms for the Detection of Suspicious Pigmented Skin Lesions in Primary Care Settings: A Systematic Review and Meta- Analysis

Early detection of suspicious pigmented skin lesions is crucial for improving the outcomes and survival rates of skin cancers. However, the accuracy of clinical diagnosis by primary care physicians (PCPs) is suboptimal, leading to unnecessary referrals and biopsies. In recent years, deep learning (DL) algorithms have shown promising results in the automated detection and classification of skin lesions. This systematic review and meta-analysis aimed to evaluate the diagnostic performance of DL algorithms for the detection of suspicious pigmented skin lesions in primary care settings. A comprehensive literature search was conducted using electronic databases, including PubMed, Scopus, IEEE Xplore, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science. Data from eligible studies were extracted, including study characteristics, sample size, algorithm type, sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and receiver operating characteristic curve analysis. Three studies were included. The results showed that DL algorithms had a high sensitivity (90%, 95% CI: 90-91%) and specificity (85%, 95% CI: 84-86%) for detecting suspicious pigmented skin lesions in primary care settings. Significant heterogeneity was observed in both sensitivity (p = 0.0062, I² = 80.3%) and specificity (p < 0.001, I² = 98.8%). The analysis of DOR and PLR further demonstrated the strong diagnostic performance of DL algorithms. The DOR was 26.39, indicating a strong overall diagnostic performance of DL algorithms. The PLR was 4.30, highlighting the ability of these algorithms to influence diagnostic outcomes positively. The NLR was 0.16, indicating that a negative test result decreased the odds of misdiagnosis. The area under the curve of DL algorithms was 0.95, indicating excellent discriminative ability in distinguishing between benign and malignant pigmented skin lesions. DL algorithms have the potential to significantly improve the detection of suspicious pigmented skin lesions in primary care settings. Our analysis showed that DL exhibited promising performance in the early detection of suspicious pigmented skin lesions. However, further studies are needed

Approach for the classification of polliniferous vegetation using multispectral imaging and neural networks

Beekeeping has suffered a serious deterioration in the regions of the world. The possibility of nectar-polliniferous resources has decreased and, therefore, the feeding of bees, with the consequent decrease in production. There is, therefore, a need to improve marketing and diversification systems and to update production techniques and the management of the production process by beekeepers to obtain the quality of honey required by the market [1]. This work proposes the use of spectral information to identify the different pollen-producing plants using remote vision, image processing, and artificial neural networks

An Epidemiological and Clinical Analysis of Cutaneous Adverse Drug Reactions Seen in a Tertiary Care Outpatient Clinic in Cairo, Egypt

A cutaneous adverse drug reaction (CADR) is any undesirable change in the structure or function of the skin, its appendages, or mucous membranes caused by a drug. The frequency of CADRs is variable, with only few studies evaluating it. Our aim was to identify the clinical spectrum of CADRs and document the epidemiological data of different types of drug eruptions among Egyptian patients attending a tertiary care center. An observational hospital-based analytical study was planned for a period of six months (January-June 2015). All patients attending the outpatient Dermatology Clinic at Kasr El Aini hospital were examined to detect patients with CADRs, who were subjected to a detailed questionnaire with a detailed drug history. A skin biopsy was taken to confirm the diagnosis and to detect the type of CADRs. The primary incidence of CADRs reported in our study was 0.28% (78 patients) from a total number of 27,093 patients. The most common CADRs were SJS/TEN in 12 patients (15.3%) and lichenoid drug eruptions in 12 patients (15.3%), followed by exanthematous drug eruptions in 11 patients (14.1%) and vasculitic drug eruptions in 9 patients (11.5%). The most common drug incriminated was ibuprofen in 6 patients (7.6%), followed by penicillin in 4 patients (5.1%) and aspirin in 3 patients (3.8%). In conclusion, incidence of CADRs in our study was similar to incidence reported in different countries; however, the incidence of life-threatening reactions such as SJS/TEN was higher compared with studies conducted abroad.</p