Differential associations between abnormal cardiac left ventricular geometry types and cerebral white matter disease

OBJECTIVES

Reduced cardiac outflow due to left ventricular hypertrophy has been suggested as a potential risk factor for development of cerebral white matter disease. Our study aimed to examine the correlation between left ventricular geometry and white matter disease volume to establish a clearer understanding of their relationship, as it is currently not well-established.

METHODS

Consecutive patients from 2016 to 2021 who were ≥18 years and underwent echocardiography, cardiac MRI, and brain MRI within one year were included. Four categories of left ventricular geometry were defined based on left ventricular mass index and relative wall thickness on echocardiography. White matter disease volume was quantified using an automated algorithm applied to axial T2 FLAIR images and compared across left ventricular geometry categories.

RESULTS

We identified 112 patients of which 34.8 % had normal left ventricular geometry, 20.5 % had eccentric hypertrophy, 21.4 % had concentric remodeling, and 23.2 % had concentric hypertrophy. White matter disease volume was highest in patients with concentric hypertrophy and concentric remodeling, compared to eccentric hypertrophy and normal morphology with a trend-P value of 0.028. Patients with higher relative wall thickness had higher white matter disease volume (10.73 ± 10.29 cc vs 5.89 ± 6.46 cc, P = 0.003), compared to those with normal relative wall thickness.

CONCLUSION

Our results showed that abnormal left ventricular geometry is associated with higher white matter disease burden, particularly among those with abnormal relative wall thickness. Future studies are needed to explore causative relationships and potential therapeutic options that may mediate the adverse left ventricular remodeling and its effect in slowing white matter disease progression.

Vascular access challenges in hemodialysis children

BACKGROUND

Hemodialysis (HD) success is dependent mainly on vascular access (VA). The aim of this study is to share the experience of Pediatric Nephrology Unit (PNU), Cairo University Children's Hospital (CUCH), with VA-related obstacles in end stage kidney disease (ESKD) HD children.

METHODS

This is a retrospective analysis of VA related data of 187 ESKD children received regular HD over 3 year duration (2019-2021). Kaplan-Meier curves were used to present arteriovenous fistula (AVF) and cuffed catheters survivals.

RESULTS

Uncuffed central venous catheter (CVC) was the primary VA for HD in up to 97.3% with 2.7% of patients had AVF performed and attained maturation before initiation of regular HD. Fifty-six (29.9%) patients have inserted 120 tunneled CVCs. AVFs & AV grafts (AVF) were performed in 79 (42.2%) and 6 (3.2%) patients respectively. There were 112 uncuffed CVCs implanted beneath the screen in Rt internal jugular vein (IJV) (44%) Lt IJV (17%), right internal mammary vein (2.7%) while Trans hepatic (TH) technique was used to place 39 uncuffed CVCs (34%) in the inferior vena cava (IVC). Catheter-related bacteremia (CRB) was the most frequent complication in uncuffed and cuffed CVCs (2.58 / 100 catheters day and 10.1 /1000 catheter days respectively). AVFs achieved a high success rate (83%) after 757.71 ± 512.3 functioning days.

CONCLUSION

Native AVF is the preferred VA for pediatric HD but its creation is limited by the small sized vessels where non-cuffed CVC could be a reasonable relatively long-term alternative. Challenging situations (occluded central veins) could benefit from TH technique of CVC insertion in IVC.

Association between left atrial enlargement and poor cerebral collaterals in large vessel occlusion

OBJECTIVES

Left atrial enlargement (LAE) is a known risk factor for atrial fibrillation, a common cause of large vessel occlusion (LVO) leading to ischemic stroke. While robust cerebral collaterals protect penumbral tissue from infarction, the effect of structural heart disease on cerebral collaterals remains uncertain. This study aims to investigate the association between LAE and cerebral collaterals in patients with acute LVO stroke.

MATERIALS AND METHODS

We conducted a retrospective study of consecutive patients with middle cerebral and/or internal carotid LVO who underwent endovascular thrombectomy (EVT) between 2012 to 2020. Consecutive patients with echocardiography and computed tomography angiography (CTA) of the head were included. Multivariate logistic regression analysis was performed to evaluate the relationship between LAE and poor cerebral collaterals, adjusting for demographics (age, sex, race) and vascular risk factors (hypertension, diabetes and smoking).

RESULTS

The study included 235 patients with mean age of 69±15 years and an initial mean National Institutes of Health Stroke Scale score of 18. Of these, 89 (37.9 %) had LAE, and 105 (44.7 %) had poor collaterals. Patients with LAE were more likely to have poor collaterals compared to those without LAE (58.4 % vs 36.3 %, P = 0.001). LAE was independently associated with higher odds of poor collaterals (odds ratio, 2.47; P = 0.001), even after adjusting for covariables (odds ratio 1.84, P = 0.048).

CONCLUSIONS

Our study demonstrated a significant association between LAE and poor cerebral collaterals in patients with LVO stroke undergoing EVT. Further research is warranted to explore potential shared mechanisms, such as endothelial dysfunction, underlying this heart-brain association.

Serum brain-derived neurotrophic factor and vitamin D: Two concordant players controlling depression among alopecia areata and vitiligo patients: A case-control study

BACKGROUND

Depression is a common psychiatric comorbidity among chronic dermatology patients. There is extreme lacking in the research studying biomarkers responsible for it. Both brain-derived neurotrophic factor (BDNF) and vitamin D have a significant role in the development of depression.

AIM

To assess BDNF and vitamin D serum levels in different clinical verities of alopecia areata (AA) and vitiligo patients, correlating them with depression prevalence and quality of life.

METHODS

In all, 30 AA patients, 30 vitiligo patients, and 30 healthy volunteers were included. Both alopecia and vitiligo severity and activity were evaluated using the suitable clinical scores. Depression was assessed using Beck depression inventory (BDI) scale and quality of life was recorded using Dermatology Life Quality Index (DLQI). Both serum BDNF and vitamin D levels were investigated using ELISA.

RESULTS

In both alopecia and vitiligo patients, serum BDNF and serum vitamin D were significantly lower compared to controls (p = 0.001 for both). Both were associated and negatively correlated with BDI and DLQI. Regarding alopecia, they showed a significant decline in more sever disease and with longer disease duration. However, in vitiligo, BDNF (p = 0.001) and vitamin D (p = 0.03) correlated negatively with disease activity, but not with disease severity. Serum BDNF and vitamin D correlated positively with each other (p = 0.001) in both AA and vitiligo cases.

CONCLUSION

The inverse association of both serum BDNF and vitamin D with depression, and the positive correlation noted between their serum levels, may indicate a potential combined effect of these two players on development of depression and its negative health-related outcomes.

Interferon-γ inducible protein-10 and interleukin 28B gene polymorphism as predictive markers for genotype 4 hepatitis C virus treatment response

HCV genotype 4 dominates the HCV epidemic in Egypt. Drug resistance was the most serious side effect that reflects bad clinical outcome. Several studies had demonstrated that baseline serum interferon-γ-inducible-protein 10 (IP-10) levels and interleukin 28B polymorphisms were associated with the resistance to the standard of care pegylated interferon alpha and ribavirin (PEG-IFNα/RBV) therapy and development of post-treatment relapse. Our purpose was to assess the predictive value of combining IP-10 levels and IL28B genotypes to PEG-IFNα/RBV therapy response in Egyptian chronic HCV infection patients with genotype 4. Ninety Egyptian patients chronically infected by HCV genotype-4 treated with pegylated interferon alpha and ribavirin (PEG-IFNα/RBV) therapy were enrolled. Serum IP-10 levels were determined by enzyme linked immunosorbent assay pre- and post- treatment. IL-28B (rs12979860 and rs8099917) polymorphisms were performed by PCR-RFLP in all patients. Overall, 38 patients (42.2%) achieved sustained virologic response (SVR) and 52 (57.8%) patients have non-viral response (NVR). Pretreatment serum IP-10 mean levels were significantly lower in patients who achieved SVR than in NVR (P<0.05). CC genotype in IL28B polymorphism (rs12979860) was the favorable genotype as 65.8% achieved SVR, while TT genotype in IL-28B polymorphism (rs8099917) was the favorable genotype as 81.5% achieved SVR. Baseline IP-10 was significantly correlated to genotypes CC in rs12979860 and TT in rs8099917. Combined use of serum baseline IP-10 levels with IL-28B polymorphisms could improve the prediction of SVR to PEG-IFNα/RBV therapy in Egyptian chronic HCV infection patients with genotype 4.

Comparison of Adiponectin Levels During the Menstrual Cycle Between Normal Weight and Overweight/Obese Young Females

To compare serum adiponectin changes across the menstrual cycle between normal weight and overweight/obese young women and its correlation with serum estradiol. Young women (n=56) with regular menstrual cycle had been grouped according to their BMI into normal weight group (n=26) and overweight /obese group (n=30). Blood samples were drawn during early follicular (FP), pre-ovulatory (OP) and luteal phases (LP) of menstrual cycle for serum adiponectin and estradiol levels determination using enzyme-linked immunosorbent assay. Adiponectin serum level showed a significant decreasing pattern across the phases of menstrual cycle in normal weight group. This pattern was absent in the overweight/obese group. In addition, serum adiponectin was lower in overweight/obese group compared to normal weight subjects through all phases of menstrual cycle. No correlation was found between adiponectin and estradiol levels in both groups. A significant variation of serum adiponectin level was detected across the menstrual cycle in females with normal weight. In comparison, overweight/obese group showed a relatively stable adiponectin level throughout the cycle. This lack of adiponectin variation might be added to the complex mechanisms lies behind obesity-related female infertility.

Investigating the addition of collagen and its integrin binding sequence (RGD) to glass polyalkenoate: In terms of material and cellular properties to explore a more biocompatible method of root caries restoration

AIMS

Placement of a restoration to treat root caries disrupts many tissues. There is scope for the restorative material to interact with these to augment reductions in micro leakage afforded by an adhesive restorative material.

OBJECTIVES

1) To investigate the effects of incorporating bioactive molecules into a glass polyalkenoate (GPA) 2) To quantify the changes in physical properties of the material.

METHODS

Biocompatibility of the GPA cement (Chemfil Superior, Dentsply De Trey, Konstanz, Germany) in unmodified and modified forms was ascertained using cell culture techniques. The optimum concentration of bioactive components required to promote cell attachment was determined indirectly by quantification and localisation of the fibroblast marker vimentin. The properties of surface hardness, compressive strength and adhesive bond strength were also determined prior to and following addition of the bio-additives: collagen type I and a pentapeptide containing Arg-Gly-Asp (RGD).

RESULTS

Addition of Type I Collagen (100μg/ml) and RGD (5mg/ml) to ChemFil Superior had no statistically significant effect upon the compressive strength and bond strength to bovine enamel but significantly (P<0.05) increased the materials shore hardness. The addition of RGD to ChemFil Superior increased most the expression of vimentin, indicating that the cells had become more fibroblastic. This may be indicative of increased synthesis of extracellular matrix macromolecules with the potential to foster adhesion of the modified glass polyalkenoate to distracted gingival tissues.

CONCLUSIONS

The results suggest that addition of bioactive molecules to GPA cement for subgingival restorations has potential clinical applications.

CLINICAL SIGNIFICANCE

It is possible to envisage that the additions, as described in this paper, could foster the attachment of displaced gingival tissues to GPA restorative materials placed subgingivally where root caries has been treated. This would offer potential to form a seal around the restoration by the attached gingival tissues avoiding a periodontal pocket and depriving residual cariogenic bacteria of a nutrient supply. Further investigation of the effects upon other similar materials of such additions is warranted.

Spectroscopic and structural studies of the Schiff base 3-methoxy-N-salicylidene-o-amino phenol complexes with some transition metal ions and their antibacterial, antifungal activities

Spectroscopic (IR, Raman, NMR, UV-visible, and ESR), and structural studies of the ligand 3-methoxy-N-salicylidene-o-amino phenol (H2L) and its synthesized complexes with some transition metal ions (Mn(II), Co(II), Ni(II)), Cu(II) and Zn(II)) were recorded and analyzed. The magnetic properties and thermal gravimetric analysis (TGA and DTA) were also measured for the complexes. The metal complexes were found to have The structural formula ML⋅H2O and the metal ions Mn(II), Co(II), Ni(II)) and Zn(II) were found to form tetrahedral complexes with the ligand whereas Cu(II) formed a square planar one. Antimicrobial activity of the ligand and its complexes were also investigated and discussed.

Differential display analysis of mRNAs in chronic myelogenous leukaemia

Analysis of expressed mRNAs with differential display-polymerase chain reaction (DD-PCR) is a powerful tool for the characterization of genes involved in malignant pathways and might identify markers for different phases of chronic myelogenous leukaemia (CML). We examined the presence of BCR-ABL transcripts in 25 CML patients in either the chronic phase or blast crisis. We then analysed the expression of leukocytic RNA transcripts in CML phases. DD-PCR technique was used to examine CML cases with BCR-ABL in comparison with CML cases lacking detectable BCR-ABL transcripts. Our results support the use of differential display not only for characterization of the CML differentially expressed genes but also to locate patterns that can be implemented as valuable fingerprints for each phase of CML.

Eosinophil cationic protein as a serological marker of disease activity in childhood bronchial asthma

To study the value of eosinophil cationic protein (ECP) as a serological marker of disease activity in childhood bronchial asthma, ECP levels were measured in 20 healthy control children and 25 asthmatic children, during and 2 weeks after acute exacerbation. The mean serum ECP level of all asthmatic patients, during and after exacerbation, was significantly higher than the control group and was significantly higher during attacks than 2 weeks after their termination. ECP levels were highest in severe attacks, but did not differ between mild and moderate attacks. ECP levels in asthmatic patients 2 weeks after mild and moderate attacks were comparable to normal; after severe attacks levels remained higher than normal. Measurement of serum ECP will be helpful in determining asthma activity and deciding the use of anti-asthma drugs.

Allosteric control of 6-phosphofructo-1-kinase from rat lung

1. The regulation of 6-phosphofructo-1-kinase (PFK) in the rat lung of normally fed (control), 72 hr-starved and streptozotocin-induced diabetic rats was investigated. 2. No significant changes in the total enzyme activities and the activity ratios [activity at 0.5 mM fructose 6-phosphate at pH 7.0/activity at pH 8.0 (v0.5/V)] of rat lung were observed between the control and 72 hr-starved or streptozotocin-induced diabetic rats. 3. Rat lung PFK was highly stimulated by fructose 2,6-bisphosphate (Fru-2,6-P2) as the affinity of the enzyme for fructose 6-phosphate was highly increased by this metabolite and the enzyme inhibition by ATP was released. 4. Although rat liver and mucosal PFK were found to be highly sensitive to stimulation by Fru-2,6-P2, lung PFK was significantly more sensitive to the stimulation by this metabolite than the other tissues. 5. The enzyme was highly inhibited by citrate and was only slightly inhibited by phosphocreatine. 6. ADP, AMP and c-AMP were shown to be activators of lung PFK with c-AMP being the most effective activator. 7. As a rate limiting enzyme of glycolysis, rat lung PFK is highly controlled by its allosteric effectors, especially Fru-2,6-P2, possibly for surfactant lipid synthesis which usually requires a high rate of glycolysis.

Regulation of 6-phosphofructo-1-kinase in the placenta and small intestine of pregnant streptozotocin-induced diabetic rats

Changes in the activities of 6-phosphofructo-1-kinase (PFK, EC 2.7.1.11) in the placenta and jejunal mucosa of pregnant rats during the onset of experimental diabetes induced by streptozotocin were investigated. The concentrations of fructose 2,6-bisphosphate were significantly decreased in the placenta and small intestine of the streptozotocin-induced diabetic rats. The total activities and the activity ratios (activity at 0.5 mM fructose 6-phosphate at pH 7.0/activity at pH 8.0 (v0.5/V] of placental and jejunal PFK of diabetic pregnant and virgin rats were markedly diminished as compared to normal control rats. Also the susceptibility of jejunal and placental PFK to inhibition by ATP was increased in the diabetic virgin and pregnant rats. Administration of insulin in vivo completely reversed the effects of diabetes on the regulatory properties and on the total activities of placental and jejunal PFK. It is suggested that the diminished activity of PFK in the placenta and small intestine of streptozotocin-induced diabetic rats could be the result of the decreased concentrations of fructose 2,6-bisphosphate as well as the effect of insulin on the activity of PFK.

6-Phosphofructo-1-kinase of rat placenta

6-Phosphofructo-1-kinase (PFK) of rat placenta was purified to homogeneity with a recovery of 56% of the enzyme activity in the original extract. The purified enzyme is a tetramer and the Mr value of the subunit is 85,000 +/- 1500 as shown by gel filtration and sodium dodecyl sulphate-polyacrylamide gel electrophoresis. Considering the properties of the native rat placental PFK isoenzyme, it is clear that this tissue is a complex mixture of homotetramer and heterotetramer. Purified placenta PFK displayed little cooperativity at pH 7.0 with respect to fructose 6-phosphate and was markedly inhibited with high concentrations of ATP. The affinity of the enzyme for fructose 6-phosphate was increased by fructose 2,6-biphosphate. The purified enzyme was highly inhibited by citrate, whereas it was only slightly inhibited by phosphoenol pyruvate. ADP, AMP and fructose 2,6-bisphosphate showed little stimulation towards placental PFK. The present study suggests that the placental PFK is a relatively active enzymic form and it is also probably characterized with a high rate of glycolysis possibly because this tissue requires a high energy production for the development and maintenance of the fetus as the placenta tends to be a semipermeable membrane through which substances are exchanged between mother and fetus.

Natural infections of Leishmania major in domestic dogs from Alexandria, Egypt

Two leishmanial isolates from dogs from Alexandria, Egypt, were typed serologically and biochemically as Leishmania major. This is the second time that L. major has been shown to occur in dogs. The significance of these findings as a misleading phenomenon in relation to the relatively recent outbreak of infantile kala-azar in the area of Alexandria is discussed.

Antimicrobial properties of 2 aliphatic amines and chlorhexidine in vitro and in saliva

The surfactants tetradecylamine, hexadecylamine and chlorhexidine have been compared with regard to their ability to inhibit microbial growth. Antibacterial activity was assessed by tube dilution methods. Tetradecylamine and chlorhexidine were similar in antibacterial activity, being effective at low concentrations against most organisms tested. Hexadecylamine also inhibited growth but at higher concentrations. Viable counts of salivary organisms were monitored in volunteers over 48 h after one rinse with the agents. The initial reduction in numbers of total viable salivary bacteria and streptococci by tetradecylamine and of streptococci by hexadecylamine had disappeared 3 h after a single mouth rinse, but the reduction in numbers of all salivary bacteria by chlorhexidine was more prolonged.

Canine and rodent leishmanial isolates from Egypt

Two leishmanial stocks isolated in Egypt, one from a dog and the other from Rattus norvegicus, were typed according to their excreted factor (EF) serotype and the electrophoretic mobility of their glucose phosphate isomerase. The canine isolate was indistinguishable from L. donovani (= L. infantum ) strains. The rat isolate appeared to be different from L. donovani, L. tropica and L. major.