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Sehsah R, Wu W, Ichihara S, Hashimoto N, Zong C, Yamazaki K, Sato H, Itoh K, Yamamoto M, Elsayed AA, El-Bestar S, Kamel E, Ichihara G. Protective role of Nrf2 in zinc oxide nanoparticles-induced lung inflammation in female mice and sexual dimorphism in susceptibility. Toxicol Lett 2022; 370:24-34. [PMID: 36100149 DOI: 10.1016/j.toxlet.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 08/14/2022] [Accepted: 09/09/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Zinc oxide nanoparticles (ZnO-NPs) are currently employed in various products such as rubber, paint, and cosmetics. Our group reported recently that Nrf2 protein provides protection against pulmonary inflammation induced by ZnO-NPs in male mice. The current study investigated the effect of Nrf2 deletion on the lung inflammatory response in female mice exposed to ZnO-NPs. METHODS An equal number of female Nrf2-/- mice and female Nrf2+/+ mice (24 each) were allocated into three equal groups, and each was exposed to ZnO-NPs at either 0, 10 or 30 µg ZnO-NPs/mouse through pharyngeal aspiration. Bronchoalveolar lavage fluid (BALF) and lungs were examined 14 days later to determine the number of inflammatory cells, the protein level, and for scoring inflammation histopathologically. The mRNA levels of Nrf2-dependent antioxidant enzymes and proinflammatory cytokine in lung tissue were also measured. RESULTS Exposure to ZnO-NPs increased all types of BALF cells and lung inflammation scores in both of female Nrf2-null (Nrf2-/-) and wild-type (Nrf2+/+) mice, and Nrf2 deletion enhanced ZnO-NPs-induced increase in the number of eosinophils in BALF. Exposure to ZnO-NPs dose-dependently increased the level of oxidized glutathione (GSSG), and mRNA levels of proinflammatory cytokines/chemokines; KC, MIP-2, IL-6, IL-1β and MCP-1 only in wild-type mice. Nrf2 deletion decreased total glutathione levels and basal mRNA levels of SOD1 and NQO1, and increased the basal mRNA level of above proinflammatory cytokines/chemokines. Nrf2 deletion enhanced ZnO-NPs-induced downregulation of GcLc, GR and TGF-β and upregulation of HO-1 and TNF-α. Taken together with our previous results in male mice, our results showed a lower susceptibility of females to lung tissue inflammation, relative to males, irrespective of Nrf2 deletion, and that enhancement of ZnO-NPs-induced upregulation of HO-1 and TNF-α and downregulation of GcLc, GR and TGF-β by deletion of Nrf2 is specific to female mice. CONCLUSION We conclude that Nrf2 provides protection in female mice against increase in BALF eosinophils, probably through down-regulation of proinflammatory cytokines/chemokines and upregulation of oxidative stress-related genes. The study also suggests lower susceptibility to lung tissue inflammation in female mice relative to their male counterparts and the synergistic effects of Nrf2 and exposure to ZnO-NPs on mRNA expression of GcLc, GR, HO-1, TGF-β or TNF-α in female mice.
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Affiliation(s)
- Radwa Sehsah
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Public Health and Community Medicine, Mansoura Faculty of Medicine, Mansoura, Egypt.
| | - Wenting Wu
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Sahoko Ichihara
- Department of Environmental and Preventive Medicine, Jichi Medical University, Shimotsuke, Japan.
| | - Naozumi Hashimoto
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Cai Zong
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Occupational and Environmental Health, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Japan.
| | - Kyoka Yamazaki
- Department of Occupational and Environmental Health, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Japan.
| | - Harue Sato
- Department of Occupational and Environmental Health, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Japan.
| | - Ken Itoh
- Department of Stress Response Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
| | - Masayuki Yamamoto
- Department of Molecular Biochemistry, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Ahmed Ali Elsayed
- Department of Pathology, Mansoura Faculty of Medicine, Mansoura, Egypt.
| | - Soheir El-Bestar
- Department of Public Health and Community Medicine, Mansoura Faculty of Medicine, Mansoura, Egypt.
| | - Emily Kamel
- Department of Public Health and Community Medicine, Mansoura Faculty of Medicine, Mansoura, Egypt.
| | - Gaku Ichihara
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Occupational and Environmental Health, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Japan; Center for Health Management, Tokyo University of Science, Shinjuku, Tokyo.
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Alawamy A, Hassanien M, Talaat E, Kamel E. THU0453 THIRD OCCIPITAL NERVE RADIO-FREQUENCY UNDER FLUOROSCOPIC GUIDANCE IN MANAGEMENT OF CERVICOGENIC HEADACHE IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Rheumatoid arthritis is a common type of autoimmune arthritis characterized by chronic inflammation. Cervical spine is often affected specially in long lasting diseaseObjectives:Evaluate efficacy of Third occipital nerve Radiofrequency under fluoroscopic guidance to treat refractory cervicogenic headache in RA patients.Methods:The current study was revised and approved from the local ethical committee of Faculty of Medicine; Assiut University, then registered in the clinical trials under the number ofNCT03852355. Inclusion criteria included, Patients who fulfilled the American College of Rheumatology (ACR) (2010) criteria for RA and suffering from upper neck pain and/or headache due to bilateral 3rd occipital nerve involvement, excluding other local cervical spine pathologies was confirmed by MRI and previously failed conservative treatment for at least three months prior to enrollment. Sixty adult patients were randomly assigned to one of the two studied groups Group 1 (RF, n = 30), received bilateral Third occipital nerve Radiofrequency under fluoroscopic guidance or Group 2 (control group, n = 30), received oral prednisolone 10 mg/day. The two groups were then followed-up with neck disability index (NDI), nocturnal neck pain VAS score and headache score every two weeks for three months. Sleep disturbance, sleep disability index were reassessed six months post intervention. Post interventional assessment was done by pain physician who were kept blind to the grouping process.Results:Neck disability index (1ry outcome), Nocturnal pain VAS, and severity of headache showed significant differences during the whole post-interventional study period. The patients in RF group demonstrated significant improvement of pain in comparison to baseline value over the whole six months with p-value < 0.001 as regard to the fore-mentioned three parameters. On the other aspect, the control group patients showed significant improvement in comparison to its baseline value after the 2nd, 12th and 24th weeks only as follows: (0.001,0.003, 0.003 for the NDI) (p values of 0.02,0.01, 0.01 for the nocturnal pain VAS), (0.001 0.009, 0.005 for the headache VAS severity.Conclusion:Radiofrequency of 3rd occipital nerve is effective in treatment of refractory cervicogenic headache in RA.Disclosure of Interests: :None declared
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Sehsah R, Wu W, Ichihara S, Hashimoto N, Hasegawa Y, Zong C, Itoh K, Yamamoto M, Elsayed AA, El-Bestar S, Kamel E, Ichihara G. Role of Nrf2 in inflammatory response in lung of mice exposed to zinc oxide nanoparticles. Part Fibre Toxicol 2019; 16:47. [PMID: 31842927 PMCID: PMC6915997 DOI: 10.1186/s12989-019-0328-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 10/31/2019] [Indexed: 12/25/2022] Open
Abstract
Background Zinc oxide nanoparticles (ZnO-NPs) are widely used in many industrial sectors and previous studies have reported that exposure of the lungs to ZnO-NPs induces both acute and/or chronic pulmonary inflammation, but the exact mechanism underlying such response remains elusive. This study investigated the role of nuclear factor-erythroid 2-related factor (Nrf2) in pulmonary inflammation induced by exposure to ZnO-NPs using Nrf2 null (Nrf2−/−) mice. Methods Twenty-four male Nrf2−/− mice and thirty male wild type C57BL/6 J mice were divided into three groups of eight and ten each respectively, and exposed once to ZnO-NPs at 0, 10, 30 μg/mouse by pharyngeal aspiration. At 14 days after the exposure to ZnO-NPs, bronchoalveolar lavage fluid (BALF) and lungs were collected to quantify protein level and the number of inflammatory cells. The mRNA levels of Nrf2-dependent antioxidant enzymes and inflammatory cytokines in lung tissue were measured. Results Exposure to ZnO-NPs dose-dependently increased the number of total cells, macrophages, lymphocytes and eosinophils in BALF both in Nrf2−/− mice and wild type mice, but the magnitude of increase was significantly higher in Nrf2−/− mice than wild type mice. The number of neutrophils in BALF increased in Nrf2−/− mice, being accompanied by marginal trend of increase in mRNA expression of MIP-2, neutrophil chemoattractant, but such changes were not observed in wild type mice. Exposure to ZnO-NPs did not dose-dependently increase mRNA level of Nrf2-dependent antioxidant enzymes both in Nrf2−/− mice and wild type mice. Conclusion Pharyngeal aspiration of ZnO-NPs induced infiltration of inflammatory cells in the lung of mice, but minimally induced Nrf2-dependent antioxidant enzymes. The results suggest that Nrf2 play a role in negative regulation on ZnO-NP exposure-induced neutrophil migration, but does not demonstrate that the regulation is through suppression of oxidative stress.
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Affiliation(s)
- Radwa Sehsah
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Public Health and Community Medicine, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Wenting Wu
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sahoko Ichihara
- Department of Environmental and Preventive Medicine, School of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Naozumi Hashimoto
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshinori Hasegawa
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Cai Zong
- Department of Occupational and Environmental Health, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Japan
| | - Ken Itoh
- Department of Stress Response Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Masayuki Yamamoto
- Department of Medical Biochemistry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ahmed Ali Elsayed
- Department of Pathology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Soheir El-Bestar
- Department of Public Health and Community Medicine, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Emily Kamel
- Department of Public Health and Community Medicine, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Gaku Ichihara
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, Nagoya, Japan. .,Department of Occupational and Environmental Health, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Japan.
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El-Azız NA, Mohamed S, Kamel E, Elgohary G. Feasibility of the Arabic version of distress thermometer for Egyptian patients with solid cancers and hematological malignancies. Leuk Res 2019. [DOI: 10.1016/s0145-2126(19)30266-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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El-Bendary M, Neamatallah M, Elalfy H, Besheer T, Kamel E, Mousa H, Eladl AH, El-Setouhy M, El-Gilany AH, El-Waseef A, Esmat G. HLA Class II-DRB1 Alleles with Hepatitis C Virus Infection Outcome in Egypt: A Multicentre Family-based Study. Ann Hepatol 2019; 18:68-77. [PMID: 31113612 DOI: 10.5604/01.3001.0012.7864] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 12/11/2017] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND AIM Hepatitis C virus (HCV) infection is a global medical problem. HLA -DRB1 alleles have an important role in immune response against HCV. The aim of this study is to clarify the contribution of HLA -DRB1 alleles in HCV susceptibility in a multicentre family-based study. MATERIAL AND METHODS A total of 162 Egyptian families were recruited in this study with a total of 951 individuals (255 with chronic hepatitis C (CHC), 588 persons in the control group(-ve household contact to HCV) and 108 persons who spontaneously cleared the virus (SVC). All subjects were genotyped for HLA -DRB1 alleles by SSP-PCR and sequence based typing (SBT) methods. RESULTS The carriage of alleles 3:01:01 and 13:01:01 were highly significant in CHC when compared to that of control and SVC groups [OR of 3 family = 5.1289, PC (Bonferroni correction ) = 0.0002 and 5.9847, PC = 0.0001 and OR of 13 family = 4.6860, PC = 0.0002 and OR = 6.5987, PC = 0.0001 respectively]. While DRB1*040501, DRB1*040101, DRB1*7:01:01 and DRB1*110101 alleles were more frequent in SVC group than CHC patients (OR = 0.4052, PC = 0.03, OR: OR = 0.0916,PC = 0.0006, OR = 0.1833,PC = 0.0006 and OR = 0.4061, PC = 0.0001 respectively). CONCLUSIONS It was concluded that among the Egyptian families, HLA-DRB1*030101, and DRB1*130101 alleles associated with the risk of progression to CHC infection, while DRB1*040101, DRB1*040501, DRB1*7:01:01and DRB1*110101 act as protective alleles against HCV infection.
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Affiliation(s)
- Mahmoud El-Bendary
- Tropical Medicine & Hepatology, Mansoura Faculty Of Medicine, Mansoura University, Mansoura,Dakahlyia, Egypt.
| | - Mustafa Neamatallah
- Medical Biochemistry, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Dakahlyia, Egypt
| | - Hatem Elalfy
- Tropical Medicine & Hepatology, Mansoura Faculty Of Medicine, Mansoura University, Mansoura,Dakahlyia, Egypt
| | - Tarek Besheer
- Tropical Medicine & Hepatology, Mansoura Faculty Of Medicine, Mansoura University, Mansoura,Dakahlyia, Egypt
| | - Emily Kamel
- Public Health & Preventive Medicine, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Dakahlyia, Egypt
| | - Hend Mousa
- Biochemistry, Mansoura Faculty of Science, Mansoura University, Mansoura, Dakahlyia, Egypt
| | - Abdel-Hamid Eladl
- Internal Medicine Department, Alazhar Faculty of Medicine-Assiut University, Assiut, Egypt
| | - Maged El-Setouhy
- Department of Community and Occupational Medicine, Ain Shams Faculty of Medicine. Ain Shams University, Cairo, Egypt
| | - Abdel-Hady El-Gilany
- Public Health & Preventive Medicine, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Dakahlyia, Egypt
| | - Ahmed El-Waseef
- Biochemistry, Mansoura Faculty of Science, Mansoura University, Mansoura, Dakahlyia, Egypt
| | - Gamal Esmat
- Tropical Medicine & Hepatology, Cairo Faculty of Medicine
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El-Bendary M, Neamatallah M, Elalfy H, Besheer T, El-Setouhy M, Kasim N, Abou El-Khier NT, Kamel E, Eladl AH, El-Waseef A, Abdel-Aziz AAF, Esmat G. Association of interferon gamma gene polymorphism and susceptibility to hepatitis C virus infection in Egyptian patients: A multicenter, family-based study. JGH Open 2017; 1:140-147. [PMID: 30483551 PMCID: PMC6207041 DOI: 10.1002/jgh3.12024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 09/17/2017] [Accepted: 10/03/2017] [Indexed: 12/17/2022]
Abstract
Background and Aim Polymorphisms in some genes may influence the persistence of hepatitis C virus (HCV) infection, clinical outcome, HCV replication, and liver damage. This study was conducted to investigate the role of the interferon gamma (IFN‐γ) gene at (+874 T/A, −764 G/C, −179 C/A) single‐nucleotide polymorphisms (SNPs) and its receptor (IFN‐γR2) at (rs 2786067 A/C) SNP in the susceptibility of Egyptian families to HCV infection with high‐resolution techniques. Methods In total, 517 Egyptian families, with 2246 subjects, were recruited to this study from the Upper and Lower Egypt governorates and were classified into three groups: 1034 patients with chronic hepatitis C virus, 108 subjects with spontaneous virus clearance (SVC), and 1104 subjects as a healthy control group. All subjects were genotyped for (+874 T/A, rs2430561, −764 G/C, rs2069707, −179 C/A, rs2069709, and rs 27860067, A/C) SNPs of the IFN‐γ gene using the allelic discrimination real‐time polymerase chain reaction technique and were confirmed using sequence‐based typing. Results The carriage of T allele of (+874) IFN‐γ is a risky allele and was significantly higher in chronic hepatitis C more than other two groups (odds ratio [OR]: 2.6646, P < 0.0002). On the other hand, the C allele of (−764, rs2069707) is a protective allele and was higher in SVC than the other two groups (OR: 0.2709, P < 0.0001). However, both (−179 C/A, rs 2069709) and (rs 27860067, A/C) SNPs are not polymorphic enough to be studied in the Egyptian population. Conclusions HCV infection is associated with the T allele of (+874 rs2430561), while SVC of HCV is associated with the C allele of (−764, rs2069707) of the IFN‐γ gene.
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Affiliation(s)
- Mahmoud El-Bendary
- Tropical Medicine and Hepatology Department, Mansoura Faculty of Medicine Mansoura University Mansoura Egypt
| | - Mustafa Neamatallah
- Medical Biochemistry Department, Mansoura Faculty of Medicine Mansoura University Mansoura Egypt
| | - Hatem Elalfy
- Tropical Medicine and Hepatology Department, Mansoura Faculty of Medicine Mansoura University Mansoura Egypt
| | - Tarek Besheer
- Tropical Medicine and Hepatology Department, Mansoura Faculty of Medicine Mansoura University Mansoura Egypt
| | - Maged El-Setouhy
- Department of Community, Environmental and Occupational Medicine, Ain-Shams Faculty of Medicine Ain-Shams University Cairo Egypt.,Substance Abuse Research Center (SARC) Jazan University Jazan Kingdom of Saudi Arabia
| | - Nihal Kasim
- Biochemistry Department, Faculty of Science Mansoura University Mansoura Egypt
| | - Noha T Abou El-Khier
- Medical Microbiology and Immunology Department, Faculty of Medicine Mansoura University Mansoura Egypt
| | - Emily Kamel
- Public Health and Preventive Medicine Department, Mansoura Faculty of Medicine Mansoura University Mansoura Egypt
| | - Abdel-Hamid Eladl
- Internal Medicine Department, Alazhar Faculty of Medicine Assiut University Assiut Egypt
| | - Ahmad El-Waseef
- Biochemistry Department, Faculty of Science Mansoura University Mansoura Egypt
| | | | - Gamal Esmat
- Tropical Medicine and Hepatology Department, Cairo Faculty of Medicine Cairo University Giza Egypt
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Atta A, El-Sayed H, El-Hadaky A, Kamel E, Sdeek FA. Pharmacokinetics of cefquinome following intravenous and intramuscular injection in camels. J CAMEL PRACT RES 2017. [DOI: 10.5958/2277-8934.2017.00041.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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El-Bendary M, Neamatallah M, Esmat G, Kamel E, Elalfy H, Besheer T, Eldeib D, Eladl AH, El-Setouhy M, El-Gilany AH, El-Waseef A. Associations of human leucocyte antigen class II-DQB1 alleles with hepatitis C virus infection in Egyptian population: a multicentre family-based study. J Viral Hepat 2016; 23:961-970. [PMID: 27599887 DOI: 10.1111/jvh.12573] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 06/07/2016] [Indexed: 12/14/2022]
Abstract
Hepatitis C infection is a global pandemic. HLA-DQB1 alleles are believed to have an effective role in immune response against HCV including susceptibility to or protection from this infection. The aim of this study was to investigate the contribution of HLA-DQB1 alleles in the outcome of HCV genotype-4 infection through a family-based association study. Egyptian families with HCV (324) were recruited for this study (324 index positive for RNA-HCV, 225 positive relatives representing chronic hepatitis C cases and 582 family members negative for HCV-RNA [control], 63 of whom spontaneously cleared the virus. All subjects were genotyped for HLA-DQB1 alleles by sequence-specific primers (SSP-PCR) and sequence-based typing (SBT) methods. The frequency of DQB1*02:01:01 carriage was significantly higher in infected patients when compared to controls and those who spontaneously cleared virus (OR=5.47, P<.0001 and OR= 6.5234, P<.0001, respectively), and the carriage of the DQB1*03:01:01:01 allele was significantly higher in those who cleared and controls when compared to the infected patients (OR=0.2889, P<.0001 and OR=0.3016, P<.0001, respectively). On the other hand, the frequency of DQB1*06:01:01 and QB1*05:01:01:01 alleles was not associated with infection (comparison of infected and cleared patients showed OR of 2.1598 [P<.01]), but it becomes nonsignificant after adjustments with the Bonferroni formula (PC >0.05) and OR= 1.3523, P>.05, respectively. This study shows that clearance of HCV is associated with DQB1*03:01:01:01 allele and chronicity of HCV infection associated with the risk allele: DQB1*02:01:01.
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Affiliation(s)
- M El-Bendary
- Tropical Medicine & Hepatology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - M Neamatallah
- Medical Biochemistry, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - G Esmat
- Tropical Medicine & Hepatology, Cairo Faculty of Medicine, Cairo, Egypt
| | - E Kamel
- Public Health & Preventive Medicine Department, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - H Elalfy
- Tropical Medicine & Hepatology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - T Besheer
- Tropical Medicine & Hepatology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - D Eldeib
- Biochemistry, Faculty of Science, Mansoura University, Mansoura, Egypt
| | - A-H Eladl
- Internal Medicine Department, Alazhar Faculty of Medicine- Assiut University, Assiut, Egypt
| | - M El-Setouhy
- Department of Community, Environmental and Occupational Medicine, Ain Shams Faculty of Medicine, Cairo, Egypt
| | - A-H El-Gilany
- Public Health & Preventive Medicine Department, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - A El-Waseef
- Biochemistry, Faculty of Science, Mansoura University, Mansoura, Egypt
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Lohiniva AL, Bassim H, Hafez S, Kamel E, Ahmed E, Saeed T, Talaat M. Determinants of hand hygiene compliance in Egypt: building blocks for a communication strategy. East Mediterr Health J 2015; 21:665-70. [PMID: 26450863 DOI: 10.26719/2015.21.9.665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 05/02/2012] [Indexed: 11/09/2022]
Abstract
Hand hygiene of health-care staff is one of the most important interventions in reducing transmission of nosocomial infections. This qualitative study aimed to understand the behavioural determinants of hand hygiene in order to develop sustainable interventions to promote hand hygiene in hospitals. Fourteen focus group discussions were conducted with nurses in 2 university hospitals in Egypt. The interviews were tape recorded and transcribed. Thematic analysis was conducted by 2 independent investigators. The findings highlighted that nurses did not perceive the benefits of hand hygiene, and that they linked the need to wash hands to a sense of dirtiness. Knowledge of hand hygiene and related products was limited and preference for water and soap was obvious. Environmental constraints, lack of role models and social control were identified as barriers for compliance with hand hygiene. A multi-faceted hand hygiene strategy was developed based on existing cultural concepts valued by the hospital staff.
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Affiliation(s)
- A-L Lohiniva
- United States Naval Medical Research Unit No. 3, Cairo, Egypt
| | - H Bassim
- Department of Microbiology and Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - S Hafez
- Alexandria University Hospitals, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - E Kamel
- Department of Microbiology and Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - E Ahmed
- Alexandria University Hospitals, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - T Saeed
- United States Naval Medical Research Unit No. 3, Cairo, Egypt
| | - M Talaat
- United States Naval Medical Research Unit No. 3, Cairo, Egypt
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El-Bendary M, Esmat G, Neamatallah M, Kamel E, Besheer T, Elalfy H, El-Setouhy M, Omran D. Epidemiological Aspects of Intrafamilial Spread of HCV Infection in Egyptian Population: A Pilot Study. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ojgas.2014.45034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Shoemaker W, Zelman W, Wo C, Chen D, Kamel E, Chen L, Ramicone E, Berlzberg H, Thangaturia D, Lamb P. [Prognosis of severe trauma outcome using noninvasive monitoring]. Anesteziol Reanimatol 2003:8-13. [PMID: 14991969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The purpose of the case study was, firstly, to evaluate (starting from the time the patients are admitted to the intensive care unit--ICU) a type of cardiac, pulmonary and peripheral microcirculation in patients with severe traumas by using a multi-component and invasion-free monitoring; the second purpose was to measure quantitatively the changes in the cardiac, pulmonary and peripheral hemodynamics leading to recovery or death; and finally, it was to investigate the effectiveness of applying the discriminative analysis for the sake of assessing the biological value of the controllable changes and of forecast outcome. The invasion-free monitoring system comprising the below tools was in use: an improved bio-impedance method (evaluation of the cardiac output), pulsometry (examination of the pulmonary function), transcutaneous oxygen pressure (tissue perfusion function) and arterial blood pressure (ABP--general circulation status). The results of continuously controllable invasion-free measurements were used for a prospective evaluation at the emergency unit of the county hospital, which was supervised by the university. The accumulated integral values of the deficit or excess of each controllable parameter were calculated by using the differences between the normal values and the values obtained for each patient and for the groups of survivors and dead. A probable outcome and a degree of the deficit of the pulmonary and cardiac functions as well as of the tissue-perfusion function were analyzed by using the discriminant function. The values of pure aggregate deficits (-) or excesses (+) were for the survivors and dead, respectively, as follows: cardiac index--(+)93 +/- 49.8 l/m2 versus -232 +/- 138 l/m2 (p < 0.07); mean ABD(-)-12 +/- 12.4 mm Hg versus -57 +/- 23.5 mm Hg (p < 0.066); arterial saturation(-)-1 +/- 0.09% h versus -9 +/- 2.6% h (p < 0.001): and tissue perfusion--(+)311 +/- 87 tor/h versus 793 +/- 175 tor/h (p < 0.0001). The pure aggregate value of reduced circulation, tissue perfusion and of hypoxemia degree was found to be higher in the dead versus the survivors. The invasion-free monitoring systems secure a constant real-time control over the data, which makes the circulatory malfunction revealed as soon as possible in emergency settings. The mentioned systems can be used to describe, for each patients, a temporal hemodynamic model and to evaluate quantitatively a functional-deficit severity; they also provide for composing a clear-cut and successive treatment scheme from the emergency stage to the intensive care unit.
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Buck A, Kamel E. [Clinical impact of 18F-fluorodeoxyglucose positron emission tomography in the diagnosis of brain diseases]. Acta Med Austriaca 2003; 29:156-61. [PMID: 12506766 DOI: 10.1046/j.1563-2571.2002.02041.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In this review it will be discussed in which neurological disorders positron emission tomography can yield important diagnostic information. Because positron emission tomography is an expensive method indications have to be clearly defined. One important question concerns the differentiation of tumor recurrence and scar due to radiation therapy or an operation. The grading of brain tumors is another application. In HIV patients fluorodeoxyglucose positron emission tomography can separate lymphoma and toxoplasmosis. In the evaluation of dementia positron emission tomography can help to clarify the differential diagnosis. Another important area is the presurgical evaluation of epilepsy patients and patients with cerebrovascular disease in whom a surgical revascularisation procedure is planned. In extrapyramidal disorders, positron emission tomography can often help to establish the final diagnosis.
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Affiliation(s)
- A Buck
- PET-Zentrum, Nuklearmedizin des Universitätsspitals Zürich, Rämistrasse 100, CH-8091 Zürich, Schweiz.
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Kaim AH, Burger C, Ganter CC, Goerres GW, Kamel E, Weishaupt D, Dizendorf E, Schaffner A, von Schulthess GK. PET-CT-guided percutaneous puncture of an infected cyst in autosomal dominant polycystic kidney disease: case report. Radiology 2001; 221:818-21. [PMID: 11719684 DOI: 10.1148/radiol.2213010445] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
An infected cyst in autosomal dominant polycystic kidney disease was identified with a combined positron emission tomographic (PET) and computed tomographic (CT) system, an experimental setup mimicking an integrated CT-PET scanner. Image fusion of fluorine 18 fluorodeoxyglucose PET and CT images allowed exact localization of the infected cyst among many cysts identified on previous CT and magnetic resonance images. Confirmation was obtained instantly, followed by CT-guided percutaneous puncture. Integrated imaging systems hold promise for direct PET-guided puncture of areas of increased fluorodeoxyglucose uptake by using the anatomic accuracy of CT.
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Affiliation(s)
- A H Kaim
- Department of Nuclear Medicine, University Hospital of Zurich, Rämistrasse 100, CH-8091 Zurich, Switzerland.
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Velmahos GC, Chan LS, Kamel E, Murray JA, Yassa N, Kahaku D, Berne TV, Demetriades D. Nonoperative management of splenic injuries: have we gone too far? Arch Surg 2000; 135:674-9; discussion 679-81. [PMID: 10843363 DOI: 10.1001/archsurg.135.6.674] [Citation(s) in RCA: 93] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
HYPOTHESIS Patients with severe blunt injuries to the spleen have a high likelihood of failing nonoperative management of splenic injuries (NOMSI). DESIGN Review of medical records, helical computed tomographic imaging data, and trauma registry data. SETTING Academic level I trauma center at a large county hospital. PATIENTS A total of 105 patients with blunt trauma to the spleen, admitted between January 1995 and December 1998, who survived more than 48 hours and had complete records. Of these patients, 53 (56%) were selected for NOMSI. The splenic injury was graded by the Organ Injury Scale of the American Association for the Surgery of Trauma (grades I to V, with grade V being the worst possible injury). MAIN OUTCOME MEASURES Failure of NOMSI, defined as the need for operation to the spleen after a period of nonoperative management. RESULTS Compared with patients who had successful NOMSI, the 29 patients (52%) in whom NOMSI failed were older and more severely injured. They also required extra-abdominal operations more frequently, underwent transfusion with more units of blood while being managed nonoperatively, and had higher grades of splenic injury. Splenic injury grade III or higher and transfusion of more than 1 U of blood were identified as independent risk factors for failure of NOMSI. The existence of both risk factors predicted failure in 97% of cases. The grading by computed tomography correlated well with the actual injury to the spleen as seen at operation. CONCLUSIONS In patients with high-grade splenic injuries who require a transfusion of more than 1 U of blood, NOMSI is very likely to fail. Decreasing the threshold for operation or intensifying the monitoring is highly recommended for such patients.
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Affiliation(s)
- G C Velmahos
- Department of Surgery, University of Southern California and the Los Angeles County/University of Southern California Medical Center, 90033, USA.
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Velmahos GC, Kamel E, Chan LS, Hanpeter D, Asensio JA, Murray JA, Berne TV, Demetriades D. Complex repair for the management of duodenal injuries. Am Surg 1999; 65:972-5. [PMID: 10515546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
The management of duodenal injuries is a subject of ongoing debate. In this study we attempt to describe duodenum-related morbidity (DRM) after primary repair or complex repair (CR) and to identify risk factors for development of complications. The medical records of 145 consecutive patients admitted to Los Angeles County + University of Southern California Medical Center with duodenal injuries between January 1991 and December 1997 were reviewed. Fifty-four (37%) died within 24 hours of admission because of associated injuries. The remaining 91 were subjected to univariate and multivariate analysis. Of them, 66 (72.5%) developed complications and 3 (3%) died. CR was used in 32 (35%) patients and with increasing frequency as the grade of duodenal injury increased. DRM rate was overall low (9%) and not different between low-grade and high-grade duodenal injuries. This occurred despite a significant increase in Injury Severity Score and abdominal Abbreviated Injury Score in patients with more severe duodenal injuries. Patients with overall complications had higher Injury Severity Scores, higher abdominal Abbreviated Injury Scores, and more severe duodenal injuries. We conclude that duodenal injuries are frequently associated with other highly lethal injuries. Liberal use of CR in patients with more severe duodenal injuries prevents DRM.
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Affiliation(s)
- G C Velmahos
- Department of Surgery, Los Angeles County+University of Southern California Medical Center, Los Angeles 90033-4525, USA
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Velmahos GC, Kamel E, Berne TV, Yassa N, Ramicone E, Song Z, Demetriades D. Abdominal computed tomography for the diagnosis of intra-abdominal sepsis in critically injured patients: fishing in murky waters. Arch Surg 1999; 134:831-6; discussion 836-8. [PMID: 10443805 DOI: 10.1001/archsurg.134.8.831] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
HYPOTHESIS Abdominal computed tomographic (ACT) scans are useful in the evaluation of sepsis of unknown origin in patients with major trauma. DESIGN Prospective case series of consecutive patients. SETTING Intensive care unit of level I academic trauma center. PATIENTS Eighty-five critically injured patients admitted to the intensive care unit in 32 months (6% of all intensive care unit admissions) who developed sepsis of unknown origin. INTERVENTIONS One hundred sixty-one ACT scans. MAIN OUTCOME MEASURES Sensitivity and specificity of the ACT scans, number of patients subjected to changes in treatment following an ACT scan. RESULTS Forty-nine patients (58%) had an intraabdominal focus of infection identified on ACT scan. Penetrating trauma and emergent laparotomy were the only independent factors associated with abnormal findings on ACT scan. The sensitivity and specificity of the test were 97.5% and 61.5%, respectively. Overall, 59 patients (69%) benefited from treatment changes after an ACT scan. CONCLUSION Abdominal computed tomographic scans reliably identify intra-abdominal foci of infection in patients with major trauma evaluated for sepsis of unknown origin.
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Affiliation(s)
- G C Velmahos
- Department of Surgery, University of Southern California, Los Angeles, USA.
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Kamel E, Legrand R. [Topical application of antimicrobial agents in periodontics. Current status of the problem]. Rev Med Liege 1994; 49:649-655. [PMID: 7817055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- E Kamel
- Service de Chirurgie orale et implantaire-Parodontologie, Université de Liège
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