Zoonotic Transmission of Avian Influenza Virus (H5N1), Egypt, 2006�C2009

During March 2006–March 2009, a total of 6,355 suspected cases of avian influenza (H5N1) were reported to the Ministry of Health in Egypt. Sixty-three (1%) patients had confirmed infections; 24 (38%) died. Risk factors for death included female sex, age >15 years, and receiving the first dose of oseltamivir >2 days after illness onset. All but 2 case-patients reported exposure to domestic poultry probably infected with avian influenza virus (H5N1). No cases of human-to-human transmission were found. Greatest risks for infection and death were reported among women >15 years of age, who accounted for 38% of infections and 83% of deaths. The lower case-fatality rate in Egypt could be caused by a less virulent virus clade. However, the lower mortality rate seems to be caused by the large number of infected children who were identified early, received prompt treatment, and had less severe clinical disease.     

Experimental infections with <Emphasis Type="Italic">Fasciola</Emphasis> in snails,mice and rabbits

Experimental infection trails of Lymnaea (cailliaudi) natalensis snails with miracidia of Fasciola hepatica revealed neither cercariae nor larval stages shed. Infection of white mice with metacercariae from field-collected snails proved to be negative for Fasciola eggs and immature juveniles or adults after 84 days post infection. The infection of eight rabbits (Oryctolagus cuniculus) has succeeded; two rabbits were infected, with a very low infection rate. Faeces of rabbits were negative for eggs. The worm burden was one and three worms from 40 fed metacercariae. The obtained fluke measures 23 mm in length by 4 mm in width. The tegument is covered with sharp-ending spines. The uterus contains few eggs. The intrauterine eggs measured 158 μm × 80 μm. According to the morphological characters of these flukes, they belong to F. gigantica.     

Loneliness among women with rheumatoid arthritis: a cross-cultural study in the Netherlands and Egypt

The objective of this study was to explain loneliness as experienced by women with rheumatoid arthritis (RA) in a cross-cultural context. We studied 36 Egyptian female RA patients and 140 female Dutch RA patients.. Self-report data were collected about loneliness, physical and psychological health status, social support and social network, needs for help, attitudes and feelings of guilt. Loneliness was significantly higher among Egyptian (44.2 +/- 32.3) than Dutch (12.9 +/- 18.9) female RA patients (F = 54.3, p < 0.001). In Egypt, 36% of the variance of loneliness could be explained by worse affect (anxiety and depression; beta = 0.51), fewer children (beta = 0.31), and higher negative social support for the patients (beta = 0.28) in multiple regression analysis. In the Netherlands, 35% of feeling lonely could be explained by worse affect scores (beta = 0.52), less positive social support for the patients (beta = 0.24), and a higher degree of disability (beta = 0.21). Age of the patients and disease duration only explained 4% and 3% of the loneliness of RA patients in Egypt and the Netherlands, respectively. Female Egyptian RA patients experienced more loneliness than Dutch patients. Affect is the most important and constant variable in explaining loneliness in both countries. The role of the family in perceived loneliness is greater in Egypt than the Netherlands. Low social support received by patients is important in explaining loneliness in the Netherlands but not in Egypt.     

QT interval dispersion pattern in patients with acute ischemic stroke: Does the site of infarction matter?

BACKGROUND:

QT interval dispersion (QTD) is an independent predictor of outcome following acute neurological events.

OBJECTIVES:

To explore QTD patterns and their relation to the affected cerebral region in patients with acute ischemic stroke.

METHODS:

Thirty patients with first acute ischemic stroke (the first stroke the patients had ever experienced) (study group) and 30 healthy controls (control group) were enrolled. Patients underwent magnetic resonance imaging to confirm and localize cerebral damage. Patients in the study group were further subdivided according to the site of infarction into four subgroups – namely, cortical, subcortical, brain stem and cerebellar infarctions, as well as according to insular involvement. All included subjects underwent 12-lead electrocardiography to measure QTD and corrected QT dispersion (QTcD).

RESULTS:

In the study group, both QTD and QTcD on the first hospitalization day were significantly higher than in the control group (P<0.05 for both). Similarly, in the study group, both QTD and QTcD values on the first hospitalization day were significantly higher than the respective values on the third day (P<0.001 for both). No significant differences were found among the four territorial subgroups, or between right- and left-sided subgroups, regarding QT interval measurements, whether on the first or third day (P>0.05 for all). However, ‘first-day’ QTD and QTcD of patients with insular involvement were significantly higher than in those without such involvement (P<0.001 for both).

CONCLUSIONS:

Both QTD and QTcD increased significantly in patients with acute ischemic stroke during the first hospitalization day. This increase of ‘first-day’ QTD and QTcD was significantly higher in patients with insular involvement than in those without such involvement.     

Graphene nanosheet-sandwiched platinum nanoparticles deposited on a graphite pencil electrode as an ultrasensitive sensor for dopamine

An ultra-sensitive sensor of dopamine is introduced. The sensor is constructed by encapsulating platinum nanoparticles (PtNPs) between reduced graphene oxide (GR) nanosheets. The sandwiched PtNPs between GR layers acted as a spacer to prevent aggregation and provided a fine connection between the GR nanosheets to provide fast charge transfer. This specific orientation of the GR nanosheets and PtNPs on the graphite pencil electrode (GPE) substantially improved the electrocatalytic activity of the sensor. The synthesized graphene oxide and the fabricated sensor were comprehensively characterized by Fourier-transform infrared spectroscopy (FTIR), Raman spectroscopy, field emission-scanning electron microscopy (FE-SEM), electrochemical impedance spectroscopy (EIS), cyclic voltammetry (CV), and square wave voltammetry (SWV). The value of the charge transfer coefficient (α), apparent heterogeneous electron transfer rate constant (k_s), and electroactive surface area for dopamine were found to be about 0.57, 8.99 s⁻¹, and 0.81 cm², respectively. The developed sensor is highly sensitive towards dopamine, and the detection limit is 9.0 nM. The sensor response is linear for dopamine concentration from 0.06 to 20 μM (R² = 0.9991). The behavior of the sensor for dopamine in the presence of a high concentration of l(+) Ascorbic acid and other potential interferents was satisfactory. High recovery percentage between 90% and 105% in the human urine sample, good reproducibility, and facile fabrication of the electrode make it a good candidate for dopamine sensing.

An efficient, highly sensitive, and selective electrochemical sensor using PtNPs sandwiched graphene layered modified graphite pencil electrode.     

Hypovitaminosis D in female patients with chronic low back pain

Chronic low back pain (LBP) is an extremely common problem in practice, where it is often labeled idiopathic. No sufficient studies have been conducted to analyze the contribution of hypovitaminosis D to the etiology of chronic LBP in populations wherein vitamin D deficiency is endemic. The present study was, therefore, carried out to examine hypovitaminosis D and its determinants in female patients with chronic LBP during the childbearing period. Sixty female patients complaining of LBP lasting more than 3 months were clinically studied rheumatologically and neurologically. Questionnaires and indices quantifying risk factors associated with vitamin D deficiency were utilized. Biochemical assays of serum calcium, phosphorus, alkaline phosphatase (ALP), parathormone (PTH), and 25-hydroxyvitamin D (25 OHD) were performed and compared to those of 20 matched healthy controls. The determinants of vitamin D levels in patients were examined by stepwise regression. Patients with LBP had significantly lower 25 OHD levels (p < 0.05) and significantly higher PTH (p < 0.05) and ALP (p < 0.001) than controls, although there were no significant group differences in calcium and phosphorus. Hypovitaminosis D (25 OHD < 40 ng/ml) was found in 49/60 patients (81%) and 12/20 (60%) of controls, with an odds ratio of 2.97. Although many risk factors related to sun exposure, clothing, diet, and pregnancy were significantly correlated with vitamin D levels in patients, only limited duration of sun exposure, contributing 55% to the variance of 25 OHD, limited areas of skin exposed (13%), and increased number of pregnancies (2%), were significant determinants of vitamin D levels in patients. Despite the sunny climate, hypovitaminosis D is prevalent among Egyptian women in the childbearing period, especially those presenting with chronic LBP, where it is associated with hyperphosphatasia and hyperparathyroidism, without alterations in serum calcium. The major determinant of hypovitaminosis D in our patients is limited sun exposure.     

A comparison of two recently developed health status instruments for patients with arthritis: Dutch-AIMS2 and IRGL. Arthritis Impact Measurement Scales. Impact of Rheumatic diseases on General health and Lifestyle

Two multidimensional health status instruments of rheumatic diseases, the Dutch-AIMS2 and the IRGL (Impact of Rheumatic diseases on General health and Lifestyle), were compared in a sample of 284 rheumatoid arthritis patients with regard to their measurement properties and usefulness for research purposes. Both questionnaires showed an excellent reliability (Cronbach's alpha), and were highly comparable with regard to their construct and convergent validity. Second-order factor analysis confirmed the physical, psychological and social health dimensions for both questionnaires. The comparability between the instruments was established by high intercorrelations between the physical and psychological health dimensions. Sufficient convergent validity was indicated by the strong correlations between the physical functioning scales and clinical and laboratory measures. The main differences between both questionnaires relate to their length and emphasis on health aspects. The Dutch-AIMS2 is characterized by a more extensive assessment of the physical dimension and the additional measurement of general health aspects. The shorter IRGL exclusively assesses the main health dimensions with a more comprehensive measurement of the psychological and social dimensions. The instrument that reflects the subject in question most adequately should be chosen.      

New Carriers for Representative Peptides and Peptide Drugs

3,5-Disubstituted tetrahydro-2H-1,3,5-thiadiazine-2-thione (THTT) derivatives; 4a–g were prepared and found to be a promising prodrug approach for peptide drugs. The pH profile for their degradation in aqueous buffer solutions was determined using HPLC technique and accounted for, in terms of specific base-catalyzed reactions. All of the compounds however, showed high acid-stability. Enzymatic (human serum) hydrolysis of the different derivatives offered an advantageous range of t_1/2's, the property that permits controlling onset and duration of actions of drugs.