Outcome of Combination Antiviral Therapy in Chronic Hepatitis C Virus Infection During Therapy of Acute Lymphoblastic Leukemia

Chronic hepatitis C virus (HCV) infection is not uncommon in patients with acute leukemia due to frequent blood transfusions. The treatment of HCV in patients with acute leukemia can produce profound immune dysfunction with the risk of severe cytopenia. We report the case of a young man who was treated with combined therapy of peginterferon α 2a and ribavirin for HCV while he was on maintenance anti-leukemic treatment. The patient required reduction in the dose of peginterferon α 2a and the addition of filgrastim due to neutropenia. Therapy for HCV was continued for 72 weeks and at the end of therapy, the patient had undetectable HCV RNA. The patient maintained a sustained viral response two years after the end of therapy and developed complete remission of leukemia, whereupon his anti-leukemic therapy was also discontinued. We recommend conducting further large prospective studies in HCV patients treated for leukemia to determine the safety and efficacy of antiviral therapy in this group of patients.     

Subjective assessment of a new moisturizing mouthwash for the symptomatic management of dry mouth

OBJECTIVE: A randomized clinical trial and consumer usage test were conducted to evaluate the acceptability and benefits of OASIS Moisturizing Mouthwash in subjects experiencing symptoms of dry mouth. METHODOLOGY: Study 1: A randomized, double blind, two-period crossover clinical trial was conducted in 49 subjects to evaluate OASIS Moisturizing Mouthwash and an experimental mouthwash formulation. Following a three-day acclimatization phase, subjects used both products at home for three days. Each treatment phase was separated by a three-day washout period. Study 2: Subjects participated in a one- to two-week home usage consumer test using OASIS Moisturizing Mouthwash, after which they completed a 52-question online survey exploring sensory benefits and resultant quality of life attributes of the product. RESULTS: Study 1: A total of 46 adults with a mean age of 64 years completed the study. On average, subjects used the test products three times per day. OASIS Moisturizing Mouthwash was found to be beneficial in managing dry mouth, and was well-liked by the study population, as evidenced by a statistically significant improvement over subjects' normal remedies for managing dry mouth for strength of flavor, taste, freshening breath, immediate and long lasting lubrication, and moisturization. Both products were well-tolerated. Study 2: Three-hundred and twenty-three subjects completed a one- to two-week consumer home usage test followed by an online questionnaire. On a five-point scale, over 80% of respondents perceived the OASIS Moisturizing Mouthwash as "excellent" or "very good" on sensory attributes such as taste and texture, and 70-80% gave the product an "excellent" or "very good" rating on benefit attributes. CONCLUSION: These studies showed that OASIS Moisturizing Mouthwash was beneficial in managing dry mouth, and was well-liked by the study population.     

The effect of experimental streptococcus infection in myocarditis on some biochemical and inflammatory markers in albino rats

Background

Myocarditis is an uncommon disease that presents with a wide range of symptoms in children and adults. It is histologically characterized by varying degrees of myocardialnecrosis, edema and cellular infiltration myocardial inflammation is a nonspecificresponse to many triggers such as bacterial infection, cardio toxic agents, ormechanical injury.

Objective

This study was carried out to investigate the experimental Streptococcus faecalis induction of myocarditis and its effect on some blood parameters, inflammatory markers and histopathological changes in male albino rats.

Methods

Rats were infected by intraperitoneal injection of 10 8 CFU/ml of Streptococcus faecalis and sacrificed after one, two and seven days post infection. Biochemical analyses of blood were carried out to investigate the serum biomarkers of inflammation, liver function tests, cardiac enzymes & kidney function tests.

Results

All biochemical analyses showed statistically significant increase in the measured parameters due to bacterial infections except for blood urea which appear to be normal. A significant positive correlation was observed between lactate dehydrogenase enzyme (LDH) with creatinine (r =0.778, P<0.01). In the 7 days group, there were significant positive correlations between aspartate aminotransferase (AST) and alanine aminotransferase (ALT) (r=0.675, P<0.05), erythrocyte sedimentation rate (ESR) with Urea (r=0.659, P<0.05) and alkaline phosphatase (ALP) with C-reactive protein (CRP) (r=0.765, p<0.01).

Conclusion

Many of these biomarkers will provide important new insights into pathophysiology and aid in the diagnosis and management of cardiovascular patients.     

Fetuin-A levels in obesity: differences in relation to metabolic syndrome and correlation with clinical and laboratory variables

Introduction

Fetuin-A is an important player in the enhancement of insulin resistance. There are very limited data available concerning the relationships between fetuin-A, weight status and features of the metabolic syndrome (Met S) in obese Egyptian subjects, and especially in children. The aim of the study was to evaluate fetuin-A serum level in subjects with obesity and its possible association with other laboratory and clinical variables.

Material and methods

A total of 140 obese subjects and 50 controls aged 10-40 years were recruited. Demographic, anthropometric and biochemical features were collected according to a standard protocol. Serum fetuin-A levels were measured using ELISA and the modified Third Report of the National Cholesterol Education Program (NCEP-ATP III) criteria were adopted to diagnose Met S.

Results

A higher level of serum fetuin-A was detected in obese subjects. Met S cases were also significantly associated with higher serum fetuin-A. Fetuin-A correlated significantly with BMI (r = 0.437), systolic (r = 0.228) and diastolic blood pressure (r = 0.295), waist circumference (r = 0.332), insulin resistance calculated by the homeostasis model (HOMA-IR) (r = 0.295) and high-density lipoprotein (HDL) (r = 0.362).

Conclusions

Fetuin-A levels were higher in adults and children with obesity and Met S. They were related to insulin resistance and to features of the Met S in cross-sectional analyses. Our study demonstrates a novel association between human fetuin-A and the Met S among obese subject. Therefore, fetuin-A might be a new promising link between obesity and its comorbidities.     

Purkinje cell dendrites in staggerer ↔ wild type mouse chimeras lack the aberrant morphologies found in lurcher ↔ wild type chimeras

In lurcher ? wild type mouse chimeras (lurcher chimeras), mutant Purkinje cells are transiently present and probably provide target support for afferent granule cells during the sensitive period of target-dependent cell death. Previous studies demonstrate that wild type Purkinje cells in the cerebella of mature lurcher chimeras often have atrophic dendritic morphologies, leading to the hypothesis that development deafferentation of wild type Purkinje cells occurs uniquely in lurcher chimeras following the period of mutant Purkinje cell loss. Other studies document the survival of a disproportionately large number of granule cells in these animals. Based on cell birthdate analyses, the hypothesis further proposes that deafferentation induces an up-regulation of trophic activity among the Purkinje cell population and the consequent rescue of late generated granule cells that might otherwise be lost to target related cell death. In the present study, we take advantage of phenotypic differences between the staggerer and lurcher mutations to test this hypothesis. While staggerer ? wild type chimeras (staggerer chimeras) resemble lurcher chimeras in several respects, including extensive cell loss, they differ in that staggerer Purkinje cells never provide target support for granule cells. Hence the hypothesis predicts that Purkinje cells in these animals should not exhibit the atrophic morphologies found in lurcher chimeras. We have developed a new semiquantitative method for scoring dendritic morphology in a large number of Golgi-impregnated cells. We have used this method to characterize the distribution of wild type Pukinje cell morphologies in staggerer chimeras, and to compare these with the corresponding distributions of morphologies in lurcher chimeras and wild type ? wild type chimeras. We find that morphologies in staggerer chimeras closely resemble those in control chimeras. Furthermore, Purkinje cells in both staggerer and wild type chimeras differ significantly from those in lurcher chimeras. These results confirm a direct prediction of the hypothesis. © 1993 Wiley-Liss, Inc.     

The role of glutathione S- transferase M1 and T1 gene polymorphisms and oxidative stress-related parameters in Egyptian patients with essential hypertension

BackgroundEssential hypertension is a complex, multifactorial, polygenic disease in which the underlying genetic components remain unknown. Glutathione S-transferase (GST) enzyme is involved in detoxification of reactive oxygen species. This study aimed to investigate GSTM1 and GSTT1 gene polymorphisms in Egyptian essential hypertensive patients and their relationship with oxidative stress-related parameters.MethodsThe study included 40 newly-diagnosed, untreated, essential hypertensive patients and 40 normotensive subjects. Plasma levels of malondialdehyde (MDA), and nitrate/nitrite and erythrocyte reduced glutathione (GSH), activities of catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and glutathione S-transferase (GST) were measured. Genotyping for GSTM1 and GSTT1 was performed.ResultsThe frequency of GSTM1+ve/GSTT1+ve in hypertensives (5%) was lower than in normotensives (37.5%).The frequency of GSTM1?ve/GSTT1?ve was elevated in hypertensives (35%) as compared to normotensives (7.5%). Plasma MDA was higher and nitrate/nitrite was lower in hypertensives than in normotensives. Erythrocyte GSH, activities of CAT, SOD, GSH-Px, and GST of hypertensives were lower than normotensives. Moreover, GST activity was lower in subjects with GSTM1?ve/GSTT1?ve than in those with GSTM1+ve/GSTT1+ve. In hypertensives, both systolic and diastolic blood pressures were negatively correlated with activities of CAT, GSH-Px, and GST.ConclusionsGSTM1?ve/GSTT1?ve is a potential genetic factor to predict development of essential hypertension and permit early therapeutic intervention. The significant association between blood pressure and oxidative stress-related parameters indicates the pathogenic role of oxidative stress in hypertension. Antioxidants could be useful in the management of essential hypertension to prevent progressive deterioration and target organ damage however, further studies involving long-term clinical trials may help to assess the efficacy of these therapeutic agents.