Work stress and hypertension: A call from research into intervention

Annals of Behavioral Medicine -     

Evaluation of daily avanafil efficacy in improving the endothelial function in Egyptian males with erectile dysfunction

Avanafil is a highly selective and potent oral phosphodiesterase type 5 inhibitor. However, its impact on the soluble markers of endothelial function has not been investigated yet. This study was conducted to assess the effect of daily avanafil on the endothelial markers' serum level and erectile function in patients with erectile dysfunction. In this work, we randomly divided 140 males with erectile dysfunction and other diseases commonly associated with endothelial dysfunction like diabetes mellitus, hypertension and dyslipidaemia into two equal groups: treatment group, treated with 50mg daily oral avanafil, and control group, treated with placebo. The International Index of Erectile Function-5 score and the serum levels of nitric oxide, cyclic guanosine monophosphate and endothelin-1 as markers of endothelial function were measured at baseline and after four weeks of treatment in both groups. At the end of treatment period, those randomised to avanafil achieved statistically significant improvement in erectile function, nitric oxide, cyclic guanosine monophosphate and endothelin-1 levels from baseline versus placebo regardless the type and duration of associated comorbidity as well as the duration and severity of erectile dysfunction. These results permitted us to suggest that daily avanafil can improve the impaired endothelial function associated with the erectile dysfunction.     

Multiple myeloma: a descriptive study of 217 Egyptian patients

Multiple myeloma is a neoplasm of plasma cells that results in the overproduction of light and heavy chain monoclonal immunoglobulins. The incidence rate increases with age, particularly after 40 years, and is higher in men. To determine the clinical and laboratory characteristics and survival of diagnosed Egyptian multiple myeloma patients admitted to the Haemato-Oncology Department between 2000 and 2010. Records of all patients in whom multiple myeloma was diagnosed at the Kasr Al Aini Hospital between 2000 and 2010 were included in this retrospective study. The mean age of patients was 58.5 years (range, 27–80 years). Fifty-nine percent were males. The majority of patients (73 %) had an immunoglobulin G monoclonal band and 70 % were Kappa chain-positive. Mean overall survival was 37.5 months (range, 1–84 months). Survival analysis was statistically insignificant with respect to age, sex, International Staging System and type of treatment (p?>?0.05). Our records were largely comparable to those reported in Chinese studies but different from those noted in Western and Arabic countries.     

Validity and reliability of wheelchair sitting posture measures using Coach’s Eye in abled subjects

People in wheelchairs spend a long time in the sitting position and often incur alignment problems resulting in neck and back pain. This study: (1) assessed the validity/reliability of Coach’s Eye (CE) smart device application, (2) examined the effect of seat to back support angle adjustments on head, neck, and shoulder posture in the sitting position, and (3) compared changes in cervical rotation at each back support angle. Abled subjects sat in a wheelchair with back support angles positioned at 90°, 100°, and 110°. CE, as well as ImageJ software, was used to analyze three angles: sagittal head angle (SHA), cervical angle (CVA), and shoulder angle (SA). There were highly significant differences for CVA and SA (p < 0.001) among the three seat to back support angles. Validity of CE was examined by correlating CE with ImageJ scores. CE had high validity for all angles (r = 0.99, 0.98, 0.99 respectively, p < 0.001). Inter-rater reliability for SHA, CVA, and SA was high (intraclass correlation coefficient [ICC] ranged from 0.95 to 0.99). Head (CVA) and shoulder (SA) alignment was closest to neutral posture with back support angles set at 110° and 90°, respectively.     

Characteristics,evolution, and outcome of patients with non-infectious uveitis referred for rheumatologic assessment and management: an Egyptian multicenter retrospective study

Clinical Rheumatology - To investigate the characteristics, evolution, and visual outcome of non-infectious uveitis. Records of 201 patients with non-infectious uveitis (136 (67.7%) males and 84...     

Peripheral blood mononuclear cell CD62L and CD11a expression and soluble interstitial cell adhesion molecule-1 levels following infused isoproterenol in hypertension

OBJECTIVES : Increasingly, studies indicate that alterations in leukocyte and endothelial cell adhesion molecules may enhance atherosclerotic processes in human hypertension. beta-adrenergic receptor activation has long been implicated in the aetiology and/or maintenance of hypertension and also has significant effects on leukocyte and endothelial adhesion molecules. This study therefore examined the effects of hypertension on peripheral blood mononuclear cell CD62L and CD11a expression and circulating soluble interstitial cell adhesion molecule (ICAM)-1 (sCD54) levels following infusion of the non-specific beta-adrenergic agonist isoproterenol. DESIGN : In the setting of a General Clinical Research Center, 15 hypertensive and 20 normotensive subjects underwent an infusion of isoproterenol consisting of two sequential 15 min fixed-order doses of 20 and 40 ng/kg per min. Flow cytometry was used to quantify lymphocyte and monocyte populations and adhesion molecules, and ELISA was used to quantify sCD54 levels. RESULTS : As expected, isoproterenol led to a significant increase in the number of circulating lymphocytes (P < 0.001) and monocytes (P < 0.01). The number of circulating CD3+CD8+CD62Llow T cytotoxic cells increased following isoproterenol (P < 0.001) and this increase was greater in hypertensives than in normotensives (P < 0.05). Isoproterenol led to a decrease in surface density of CD62L (P < 0.001) and an increase in surface density of CD11a (P < 0.001) in all subjects. Hypertensives had a significantly lower CD62L density (P = 0.01) and higher CD11a density on lymphocytes (P = 0.002) compared to normotensives. sCD54 levels were unchanged following isoproterenol but were elevated in hypertensives (P < 0.05). CONCLUSIONS : A beta-adrenergic-induced environment of increased CD62Llow/CD11ahigh leukocytes, coupled with existing endothelial CD54 activation, could support basic atherosclerotic processes of increased peripheral blood mononuclear cell-endothelial adhesion in hypertension.     

Factor V G1691A (Leiden) and prothrombin G20210A single-nucleotide polymorphisms in type 2 diabetes mellitus

The association of the single nucleotide polymorphisms (SNPs) G1691A in coagulation factor V (FV)-Leiden and G20210A in prothrombin (PRT) genes with type 2 diabetes mellitus (T2DM) were analyzed in 112 T2DM patients (58 males, 54 females; mean age 55.24 +/- 13.5 years) and 249 healthy control subjects (118 males, 131 females; mean age 53.03 +/- 13.8 years). No association was found for FV-Leiden with T2DM, as the frequency of the G/G (82.1% vs. 85.5%), G/A (17.0% vs. 14.1%), and A/A (0.9% vs. 0.4%) genotypes was not different between patients and controls, respectively (P = 0.644). Similarly, lack of association of PRT G20210A with T2DM was seen among the population studied, and the frequency of the G/G (92.9% vs. 97.2%), G/A (6.3% vs. 2.8%), and A/A (0.9% vs. 0.0%) genotypes was similar among patients and controls, respectively (P = 0.094). Neither FV-Leiden nor PRT G20210A was associated with, and no evidence for interactions between these mutations was seen in, T2DM.