Pregnancy outcome in rheumatic mitral stenosis patients with and without surgical correction: a prospective cohort study

Background: The aim of the current study is to assess the maternal and fetal outcomes of pregnant females with and without surgically corrected mitral stenosis (MS).Methods: A cross sectional study was carried out at Assiut Women's Health Hospital, Egypt between February 2016 and December 2016. All pregnant women diagnosed with rheumatic heart disease attending the antenatal care clinic were enrolled in the study. They were divided into two groups according to previous surgical correction of MS or not. All women were followed up during pregnancy till the end of puerperium. The primary outcome of the study was the difference in the rate of maternal cardiac complications during pregnancy between both groups.Results: The study included 48 patients (39%) with surgically corrected MS and 75 patients (61%) with uncorrected MS. All cardiac complications were significantly higher in the uncorrected MS group (p <0.05). No difference between both groups in the mode of delivery (p=0.52). Postpartum hemorrhage is more common with the corrected MS group than the uncorrected group (25% vs. 9.3% respectively, p=0.003), while the need for postpartum admission to ICU was significantly higher in the uncorrected group (p=0.006). The mean birth weight was higher in the corrected MS group (p=0.000). The percentage of stillbirths and the rate of admission to PCU was higher in the uncorrected MS group (p=0.003).Conclusions: Surgical correction of MS significantly improves the maternal and fetal outcomes of rheumatic heart pregnant females with MS

Comparison between two different regimens of anticoagulants for pregnant women with prosthetic heart valves

Background: The current study aims to assess the maternal and fetal outcomes of pregnant females with prosthetic heart valves receiving oral anticoagulants only versus the sequential regimen of heparin and OA throughout pregnancy.Methods: An observational was carried out at Assiut Women's Health Hospital, Egypt between February and December 2016. All pregnant women with prosthetic heart valves attending the emergency department during the study period were enrolled in the study. All included patients were classified into two groups; women who receive low molecular weight heparin (LMWH) during the first trimester then shift to warfarin till 36 weeks of gestation then continue on LMWH till delivery (Group I) and those who continue the all period of pregnancy on warfarin (Group II). The primary outcome of the study was the difference in the rate of maternal cardiac complications during labor between both groups.Results: The study included 72 patients have prosthetic valve replacement and on anticoagulants. Twenty-one were on oral anticoagulant; warfarin (Group II) and 51 pregnant women were on sequential regimen. Both groups were comparable in their basic and clinical data on admission. No difference between both groups in the mode of delivery (p=0.52), postpartum hemorrhage (0.09), sub rectal hematomas (p=0.08), the need for postpartum admission to ICU (p=0.93) and the duration of hospital stay (p=0.47). Additionally, no statistical significant difference between both groups as regard the mean birth weight (p=0.97), Apgar score (p=0.62), fetal sex (p=0.92) and congenital anomalies (p=0.08).Conclusions: The use of sequential LMWH and oral anticoagulants appears to be a safe option for those women although there is no difference in maternal and fetal outcomes with the use of continuous oral anticoagulants throughout the pregnancy

Distribution of \u3ci\u3eEscherichia coli\u3c/i\u3e Passaged through Processing Equipment during Ground Beef Production Using Inoculated Trimmings

The contamination of raw ground beef by Escherichia coli O157:H7 is not only a public health issue but also an economic concern to meat processors. When E. coli O157:H7 is detected in a ground beef sample, the product lots made immediately before and after the lot represented by the positive sample are discarded or diverted to lethality treatment. However, there is little data to base decisions on how much product must be diverted. Therefore, five 2,000-lb (907-kg) combo bins of beef trimmings were processed into 10-lb (4.54-kg) chubs of raw ground beef, wherein the second combo of meat was contaminated with a green fluorescent protein (GFP)–expressing strain of E. coli. This was performed at two different commercial ground beef processing facilities, and at a third establishment where ground beef chubs from the second grinding establishment were mechanically split and repackaged into 3-lb (1.36-kg) loaves in trays. The GFP E. coli was tracked through the production of 10-lb (4.54-kg) chubs and the strain could not be detected after 26.5% more material (500 lb or 227 kg) and 87.8% more material (1,840 lb or 835 kg) followed the contaminated combo at each establishment, respectively. Three-pound (1.36-kg) loaves were no longer positive after just 8.6% more initially noncontaminated material (72 lb or 33 kg) was processed. The GFP strain could not be detected postprocessing in any residual meat or fat collected from the equipment used in the three trials. These results indicate that diversion to a safe end point (lethality or rendering) of the positive lot of ground beef, plus the lot before and lot after should remove contaminated ground beef, and as such provides support for the current industry practice. Further, the distribution and flow of E. coli on beef trimmings through various commercial equipment was different; thus, each establishment needs to consider this data when segregating lots of ground beef and establishing sampling protocols to monitor production

Modulatory role of vitamin A on the Candida albicans-induced immune response in human monocytes

Beyond its well-documented role in reproduction, embryogenesis and maintenance of body tissues, vitamin A has attracted considerable attention due to its immunomodulatory effects on both the innate and the adaptive immune responses. In infectious diseases, vitamin A has been shown to have a host-protective effect in infections of bacterial, viral or protozoan origin. Nevertheless, its impact in fungal infections remains unknown. Meanwhile, the frequency of invasive mycoses keeps on growing, with Candida albicans being the major opportunistic fungal pathogen and associated with high mortality. In the present work, we explored the impact of all-trans retinoic acid (atRA), the most active metabolite of vitamin A, on the innate immune response against C.albicans in human monocytes. Our results show a strong immunomodulatory role for atRA, leading to a significant down-regulation of the fungi-induced expression and secretion of the pro-inflammatory cytokines TNFα, IL6 and IL12. Moreover, atRA significantly suppressed the expression of Dectin-1, a major fungal pattern recognition receptor, as well as the Dectin-1-dependent cytokine production. Both RAR-dependent and RAR-independent mechanisms seem to play a role in the atRA-mediated immunomodulation. Our findings open a new direction to elucidate the role of vitamin A on the immune function during fungal infections. Electronic supplementary material The online version of this article (doi:10.1007/s00430-014-0351-4) contains supplementary material, which is available to authorized users

Executive Function in Autism: Association with ADHD and ASD Symptoms

There is substantial comorbidity between autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD), and there are well-documented executive functioning (EF) deficits in both populations. An important question concerns whether EF deficits in children with ASD are related to severity of ASD, ADHD, or both. We examined ADHD and ASD symptoms in relation to ratings of EF in the home and classroom. The sample comprised 64 children (55 males) diagnosed with ASD (mean age = 9.26 years; mean FSIQ = 92). Analyses indicated that parent and teacher ratings of EF (except Shift and Emotional Control) were consistently related to ADHD symptom severity, but not to ASD severity. Thus, functioning in the domains of Shift and Emotional control appear relatively spared, whereas performance in all other EF was impaired in relation to ADHD symptoms

Mutations in GATA2 cause primary lymphedema associated with a predisposition to acute myeloid leukemia (Emberger syndrome).

We report an allelic series of eight mutations in GATA2 underlying Emberger syndrome, an autosomal dominant primary lymphedema associated with a predisposition to acute myeloid leukemia. GATA2 is a transcription factor that plays an essential role in gene regulation during vascular development and hematopoietic differentiation. Our findings indicate that haploinsufficiency of GATA2 underlies primary lymphedema and predisposes to acute myeloid leukemia in this syndrome

Plasma Science in Planetary Entry

Spacecraft entering a planetary atmosphere dissipate a great deal of energy into the surrounding gas. In the frame of reference of the vehicle, the atmospheric gas suddenly decelerates from hypersonic (Mach ~5-50) to subsonic velocities. The kinetic energy of the gas is rapidly converted to thermal and chemical energy, forming a bow shock behind which a plasma with energies on the order of one electron volt (eV) is produced. The resulting shock layer relaxes from strong thermal non-equilibrium that is translationally hot but internally cold and un-ionized toward a thermochemically equilibrated plasma over a distance of a few centimeters. Composition is dependent upon the planetary atmosphere Air for Earth, CO2/N2 for Mars and Venus, N2/CH4 for Titan and H2/He/CH4 for Saturn, Neptune and Jupiter. Typical velocities of entry may range from 3-7 km/s (4-25 MJ/kg) for Titan/Mars, 8-14 km/s (30-100 MJ/kg) for Earth/Venus, and 25-40 km/s (300-800 MJ/kg) for outer planets. The equilibrium plasmas produced from these conditions are highly dissociated (up to and above 99%) and ionized (0.1- 15%), with temperatures from 7,000-15,000K and pressures from 0.1-1.0 bar. Understanding the behavior of these plasmas the way in which they approach equilibrium, how they radiate, and how they interact with materials is an active area of research necessitated by requirements to predict and test the performance of thermal protection systems (TPS) that enable spacecraft to deliver scientific instruments, and people, to foreign worlds and back to Earth. The endeavor is a multi-physics problem, with key processes highlighted in Fig. 1. This white paper describes the current state of the art in simulating shock layer plasmas both computationally and in ground test facilities. Gaps requiring further research and development are identified

Estimating the Prevalence of Foodborne Pathogen Campylobacter jejuni in Chicken and Its Control via Sorghum Extracts

Campylobacter jejuni is a Gram-negative bacterium which is considered as the most reported cause of foodborne infection, especially for poultry species. The object of this work is to evaluate the occurrence of C. jejuni in chicken meat as well its control via three types of sorghum extracts (white sorghum (WS), yellow sorghum (YS), and red sorghum (RS)); antibacterial activity, antioxidant power, and cytotoxicity of sorghum extracts were also assessed. It was found that C. jejuni is very abundant in chicken meat, especially breast and thigh. WS extract showed more effectiveness than both yellow and red ones. Lyophilized WS extract offered high total phenolic compounds (TPCs) and total flavonoid compounds (TFCs) of 64.2 ± 0.8 mg gallic acid equivalent (GAE/g) and 33.9 ± 0.4 mg catechol equivalent (CE)/g, respectively. Concerning the antibacterial and antioxidant activities, WS showed high and significant antibacterial activity (p < 0.001); hence, WS displayed a minimum inhibitory concentration (MIC) of 6.25%, and revealed an inhibition zone of 7.8 ± 0.3 mm; it also showed an IC50 at a concentration of 34.6 μg/mL. In our study, different samples of chicken fillet were collected and inoculated with pathogenic C. jejuni and stored at 4 °C. Inoculated samples were treated with lyophilized WS extract at (2%, 4%, and 6%), the 2% treatment showed a full reduction in C. jejuni on the 10th day, the 4% treatment showed a full reduction in C. jejuni on the 8th day, while the 6% treatment showed a full reduction in C. jejuni on the 6th day. Additionally, 2%, 4%, and 6% WS extracts were applied on un-inoculated grilled chicken fillet, which enhanced its sensory attributes. In sum, WS extract is a promising natural preservative for chicken meat with accepted sensory evaluation results thanks to its high antibacterial and antioxidant potentials

Vimentin regulates mitochondrial ROS production and inflammatory responses of neutrophils

The intermediate filament vimentin is present in immune cells and is implicated in proinflammatory immune responses. Whether and how it supports antimicrobial activities of neutrophils are not well established. Here, we developed an immortalized neutrophil model to examine the requirement of vimentin. We demonstrate that vimentin restricts the production of proinflammatory cytokines and reactive oxygen species (ROS), but enhances phagocytosis and swarming. We observe that vimentin is dispensable for neutrophil extracellular trap (NET) formation, degranulation, and inflammasome activation. Moreover, gene expression analysis demonstrated that the presence of vimentin was associated with changes in expression of multiple genes required for mitochondrial function and ROS overproduction. Treatment of wild-type cells with rotenone, an inhibitor for complex I of the electron transport chain, increases the ROS levels. Likewise, treatment with mitoTEMPO, a SOD mimetic, rescues the ROS production in cells lacking vimentin. Together, these data show vimentin regulates neutrophil antimicrobial functions and alters ROS levels through regulation of mitochondrial activity