Abstract
Background
Hepatitis C virus (HCV) infection is linked to a higher mortality rate in hemodialysis (HD) patients. We aimed to see if HCV eradication using interferon-free direct acting ...antivirals (DAAs) can affect bone-mineral and anemia biochemical parameters such as serum calcium (Ca
++
), phosphorus (PO
4
+
), parathormone (PTH), fibroblast growth factor 23 (FGF23), hemoglobin (HB), and ferritin in HD patients and also peripheral insulin resistance by monitoring serum fasting insulin and HOMA insulin resistance (HOMA-IR).
Methods
Three hundred and thirty-four adults on regular HD with positive HCV genotype 4 (191 male and 143 female) were included; 157 of them had seroconversion during HD. All were hepatitis B virus (HBV) negative and received treatment with DAAs. All cases were examined for body mass index (BMI), HB, ferritin level, transferrin saturation (TSAT), Ca
++
, PO
4
+
, PTH, FGF23, serum albumin, alanine transaminase (ALT), fasting insulin level, and HOMA-IR at the beginning and then were measured after 6 and 12 months from a sustained virological response (SVR).
Results
After 6 and 12 months from SVR, there was a significant increase in serum Ca despite no change in oral calcium dose requirement over that period (
p
= 0001), a significant increase in HB, serum iron (
p
= 0001), and a significant reduction in serum ferritin, PO4, PTH, and FGF23 (
p
= 0001). Both fasting insulin level and HOMA-IR were statistically significantly dropped.
Conclusion
HCV eradication with interferon-free DAAs showed a statistically significant impact on hemodialysis patients regarding hemoglobin, ferritin level, bone-mineral parameters, and improvement in peripheral insulin resistance.
Our study aimed to assess mandibular osseous changes using radiomorphometric indices by Cone-Beam Computed Tomography (CBCT) in patients with end-stage renal failure (ESRF) to evaluate their jaw bone ...quality versus a healthy sex- and age-matching population. Twenty-six patients were included in this study. They were divided equally into two groups. The first group (study group) included 13 ESRF patients and the second group (control group) included 13 patients free from any condition that could affect bone metabolism. All of the 26 participants were scanned using CBCT scanner then five indices were obtained from the reformatted panoramic images and the cross-sectional images of each mandible bilaterally mandibular cortical index (MCI), panoramic mandibular index (PMI), mental index (MI), gonial index (GI), and antegonial index (AI). There was no significant difference between MCI, MI, AI, GI and PMI of patients with ESRF and that of the control group. The assessment of intra-observer and inter-observer reliability regarding all measurements (GI, AGI, MI, and PMI) showed very strong agreement except MCI showed substantial agreement. Bone quality assessment of patients, investigated in the current study, with ESRF was not different from those of healthy sex- and age-matching dental patients using radiomorphometric indices. Quantitative radiomorphometric indices (MI, AI, GI, and PMI) are more reliable than qualitative radiomorphometric index (MCI) in the assessment of jawbones.
AIM: To investigate the association of the functional monocyte chemotactic protein-1(MCP-1) promoter polymorphism(A-2518G) with spontaneous bacterial peritonitis(SBP).METHODS: Fifty patients with ...post-hepatitis C liver cirrhosis and ascites were categorized into two groups; group Ⅰ included 25 patients with SBP and group Ⅱ included 25 patients free from SBP. In addition, a group of 20 healthy volunteers were included. We assessed the MCP-1 gene polymorphism and gene expression as well as interleukin(IL)-10 levels in both blood and ascitic fluid. RESULTS: A significant MCP-1 gene polymorphism was detected in groups Ⅰ and Ⅱ(P = 0.001 and 0.02 respectively). Group Ⅰ was associated with a significantly higher frequency of AG genotype control 8(40%) vs SBP 19(76.0%), P < 0.001, and group Ⅱ was associated with a significantly higher frequency of GG genotype when compared to healthy volunteers control 1(5%) vs cirrhotic 16(64%), P < 0.001. Accordingly, the frequency of G allele was significantly higher in both groups(Ⅰ and Ⅱ) control 10(25%) vs SBP 27(54%), P < 0.001 and vs cirrhotic 37(74.0%), P < 0.001, respectively. The total blood and ascetic fluid levels of IL-10 and MCP-1 gene expression were significantly higher in group Ⅰ than in group Ⅱ. Group Ⅰ showed significant reductions in the levels of MCP-1 gene expression and IL-10 in the whole blood and ascetic fluid after therapy. CONCLUSION: MCP-1 GG genotype and G allele may predispose HCV infected patients to a more progressive disease course, while AG genotype may increase the susceptibility to SBP. Patients carrying these genotypes should be under supervision to prevent or restrict further complications.
Background
Tomosynthesis is a recent advancement of full-field digital mammography involves transforming two-dimensional (2D) breast images into three dimensions (3D) images. It reduces the adverse ...effect of tissue superimposition on conventional 2D- mammography, therefore having high potential enhancing identification and assessment of asymmetric breast densities. The aim of the study was to assess and compare the diagnostic performance of breast ultrasound and 3D digital breast tomosynthesis in the assessment of asymmetric breast densities.
Results
In the current study, 80 patients with 80 mammographically and/or tomosynthesized breast asymmetries were included. The patients' ages ranged from 30 to 70 years old, with a mean age of 47.2 ± 9.2 SD. Breast ultrasound outperformed digital breast tomosynthesis in terms of diagnostic performance. Tomosynthesis had a sensitivity of 86.4%, specificity of 93.1%, positive predictive value of 82.6%, negative predictive value of 94.7%, and accuracy of 91.3% compared to ultrasounds' sensitivity of 100.00%, specificity of 93.1%, positive predictive value of 84.6%, negative predictive value of 100.00%, and accuracy of 95%.
Conclusions
Incorporating ultrasonography in the assessment of asymmetric breast densities outperformed tomosynthesis and shown to be more precise in characterisation of lesions underlying asymmetric breast density.
Conducting polymers were deposited on the surface of platinum and glassy carbon electrodes. The monomers used were N-methyl pyrrole and 3-methyl thiophene. The electrochemical synthesis of the ...polymer was achieved using constant applied potential or cyclic polarization techniques in acetonitrile as a solvent and tetra-alkyl ammonium salts as supporting electrolyte. The resulting conducting polymeric film was modified with an inorganic metal complex, namely, Cu–phthalocyanine or Co–phthalocyanine. Two different approaches were adopted for the modification: (1) the first was to directly apply the metal–phthalocyanine layer on the surface of the polymer, and (2) the second was by the inclusion of the metal–phthalocyanine in a sol–gel matrix that was in turn applied to the conducting polymer film. In the first part of this work, we studied the effect of changing the type of polymer matrix and the central metal of the inorganic complex on the electrochemical behavior of the resulting film. We also found that changing the method of metal–phthalocyanine application to the polymer film affected the electrochemical response and kinetics at the electrode surface. The new electrode was tested for the reduction of hydrogen peroxide and showed better conversion efficiency compared to conventional surfaces, which suggests its use in fuel cell applications.
Conducting polymers were modified with Cu-phthalocyanine or Co-phthalocyanine embedded in a sol–gel matrix. The resulting films were characterized using electrochemical impedance spectroscopy, ...Fourier transform infrared spectroscopy and scanning electron microscopy. Electrochemical impedance spectroscopy data showed that the application of the sol–gel layer to the conductive polymer caused a noticeable increase in the impedance of the film across the frequency ranges studied. The hydrophobic character of the film was greatly influenced by the sol–gel and caused an increase in its capacitance. A modified ‘Randles’ equivalent cell was used to correlate the electrochemical parameters of the films. Elemental analysis and infrared data confirmed the presence of the phthalocyanine moieties in the film and the empirical formula of the film was estimated. The surface morphology of the sol–gel-modified conducting polymer was distinctly amorphous compared to the poly(3-methyl thiophene).
BACKGROUND: Acute kidney injury (AKI) is one of the most common complications affecting patients admitted to intensive care unit (ICU) worldwide. In response to injury, both kidneys and liver ...secrete acute phase reactants as a mechanism of protection. Oncostatin M (OSM) is a member of the interleukin-6 family of cytokines which was found to be elevated during renal injury as in diabetic nephropathy, glomerulonephritis, and obstructive nephropathy. AIM: The study aimed to assess the role of OSM as an early biomarker of AKI in critically ill patients. PATIENTS AND METHODS: We conducted a prospective case–control study that included 202 patients admitted to ICU within Kasr El-Aini University hospitals during the period between January 2022 and August 2022. Eligible patients were divided into two groups according to the occurrence of AKI, and Oncostatin was assessed in the sera of the included patients. RESULTS: Our findings showed that the AKI group had statistically significant lower OSM levels compared to the control group, especially among those patients who had poor clinical outcomes and non-survivors. We also found that OSM is a good predictive tool for the prediction of mortality among patients admitted to ICU with sepsis complicated with AKI (Area under the curve = 0.673, 95% confidence interval: 0.532–0.814) with a sensitivity of 83.8% and specificity of 61.4%. CONCLUSION: OSM plays an important role among critically ill patients who are admitted to the ICU with sepsis, it can significantly predict AKI development and subsequent mortality.
This prospective cohort study aimed to assess the influence of stem cell therapy (SCT) on health-related quality of life (HRQOL) by using the SF-36 v2 and to elucidate the influence of objective ...clinical variables on subjective HRQOL.
The study included 100 chronic liver disease patients (50 received SCT, and 50 received supportive medical treatment (SMT)). Both groups completed a modified SF-36 v2 form before therapy and at 1-, 3-, 6-, and 12-month intervals. Fifty healthy Egyptian volunteers were enrolled in the study and completed the SF-36 v2 form once.
Both SCT and SMT groups showed significantly lower pretherapy SF 36 v2 scores compared with healthy volunteers. In SCT-treated patients, limited complications were encountered (SF-36 v2 scores showed significant improvement in all domains throughout the follow-up period) compared with the deterioration shown by SMT patients after therapy. A significant association was detected between SF-36 v2 scores and laboratory data in SCT patients during the first month after therapy. The grade of ascites improved during the follow-up in SCT compared with SMT patients. The mean survival time was 277.56 days (95% CI, 246.217 to 308.903) for SMT and 359.300 days (95% CI, 353.022 to 365.578) for SCT patients (log rank, 0.00). Stem cell-treated patients showed no malignancies.
SCT positively affects health-related quality of life in cirrhosis patients. The survival rate was significantly improved after SCT.
Egypt has one of the highest prevalences of hepatitis C virus (HCV) infection worldwide. Although the IL28B gene polymorphism has been shown to modify the course of chronic HCV infection, this has ...not been properly assessed in the Egyptian population.
The IL28B rs12979860 single nucleotide polymorphism (SNP) was therefore examined in 256 HCV-infected Egyptian patients (group II) at different stages of disease progression and in 48 healthy volunteers (group I). Group II was subdivided into GII-A (chronic hepatitis patients, n=119), GII-B (post hepatitis cirrhosis, n=66) and GII-C (HCC on top of cirrhosis, n=71).
The C/T genotype was the commonest in all groups. It was more frequent in GI (52%) than in GII (48%). There was no significant difference in the frequency of C/T and C/C or T/T genotypes between groups and subgroups (p=0.82). Within the subgroups; the C/C genotype was more common in GII-B while C/T and T/T genotypes were more common in GII-C, though with no significant difference (p=0.59 and p=0.80). There was no significant association between IL28B rs12979860 SNP and viral load, ALT, AFP level, METAVIR scores for necro-inflammation and fibrosis, and Child-Pugh classification.
1) IL28Brs12979860 C/T genotype is the commonest genotype in HCV-associated CH and HCC in Egypt. 2) IL28Brs12979860 polymorphisms are not associated with disease progression or aggression (histological staging, severity of fibrosis in CH or the incidence of post-HCV HCC). 3) Differences in IL28Brs12979860 genotypes could be a consequence of environmental or ethnic variation.
As HCV lymphotropism was ascertained, this study was carried out to verify the possible involvement of the spleen in HCV-related chronic hepatitis.
A cross-sectional study was conducted on 97 HCV ...infected patients attending for treatment with interferon, categorised as follows; before treatment (group I, n=49), non-responders (group II, n=18), responders (group III, n=18) and group IV (n=12) including patients with HCV RNA below detection limit after 24weeks of treatment. A control group of healthy blood donors (n=19) was enrolled in our study. Conventional ultrasonography was carried out on all participants. Splenic volume was measured and compared between the groups, and its relationship to HCV RNA concentration was investigated.
It was found that the splenic volume of patients of both groups I and II is significantly greater than that of the control group (p-values : 0.004 and 0.009, respectively) and, of patients of both groups III and IV. The latter are not significantly greater than that of the control group (p-value: 0.8 and 0.6, respectively). A significant positive relationship was detected between the splenic volume and the HCV RNA concentration in group I (r=0.56, p-value=0.00) but this is insignificant in group II. There is no significant relationship between the splenic longitudinal diameter and the HCV RNA concentration in any of the studied groups.
The splenic volume positively correlated with HCV RNA concentration in HCV positive patients, but this become insignificant in non-responders to interferon therapy. The successful response to interferon therapy matches with near normal splenic volume whilst non-responders to Interferon therapy matches with increased splenic volume. The change in the viral load leads to a corresponding change in the splenic volume and does not affect the splenic longitudinal diameter.
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