Bone metabolism and hand grip strength response to aerobic versus resistance exercise training in non-insulin dependent diabetic patients

BackgroundDiabetes mellitus has been shown in many studies to be associated with reduced bone mass and an increased risk of fracture. Currently, our understanding of how to use exercise effectively in diabetic patients in prevention of osteoporosis is incomplete and has prompted our interest to identify the type of effective osteogenic exercise.ObjectiveThe aim of this study was to compare the changes in handgrip strength and bone metabolism after 6 months between aerobic and resistance exercise training in non-insulin dependent diabetic patients in Jeddah area.ResultsThe mean values of serum calcium and Hand grip strength were significantly increased, while the mean values of parathyroid hormone were significantly decreased in both groups .Also, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) after treatment.ConclusionAerobic exercise training on treadmill is appropriate to improve markers of bone metabolism and hand grip strength in non-insulin dependent diabetic patients.     

Expression of HLA-G in cancer bladder

This study comprised 42 patients with cancer bladder, who underwent radical cystectomy. The aim of work is to determine if HLA-G is expressed on tumor cells, derived from cancer bladder. We studied HLA-G-mRNA expression using RT-PCR and HLA-G cell surface expression by immunohistochemistry (IHC) staining technique. HLA-G was expressed in 28.6 % of cancer cases as determined by PCR and on 16.7% of cases determined by IHC staining. The sensitivity, specificity and accuracy of IHC were 58.3%, 96% and 81.7% respectively as compared to PCR results. There was a highly significant increase in the expression of HLA-G on cancer bladder cases with metastatic prostate infiltration (P= 0.021). It is concluded that HLA-G is ectopically expressed on cancer bladder malignant cells both at molecular and protein levels. However, it is not significantly associated with histologic type, tumor grade, stage, T category, schistosomiasis and lymph node involvement.     

Serum pentraxin 3 and interleukin-6 are associated with subclinical atherosclerosis in recent-onset rheumatoid arthritis

Subclinical atherosclerosis is increased in patients with rheumatoid arthritis (RA), as chronic systemic inflammation leads to accelerate atherosclerosis and increase arterial stiffness in theses patients. This study aimed to evaluate the association of serum interleukin-6 (sIL-6) and serum pentraxin 3(sPTX3) with subclinical atherosclerotic in patients with recent-onset rheumatoid arthritis. Sixty patients with recent onset RA (12-24 months) and 20 controls were investigated. Carotid ultrasound examination, assays for lipid profile, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor, sPTX3 and sIL-6 were done. RA patients demonstrated significantly higher carotid intima-media thickness (cIMT) values and increased carotid plaques than the control (P < 0.001 and P = 0.02, respectively). Levels of ESR, CRP, sPTX 3 and sIL-6 were significantly higher in RA patients than controls. RA related risk factors (disease duration, CRP, ESR, and duration of treatment with steroids), as well as sPTX 3, sIL-6 and cIMT were significantly higher in RA with atherosclerotic carotid plaques compared to those without atherosclerotic carotid plaques (all < 0.05). It is concluded that accelerated atherosclerosis in patients with recent-onset RA is associated with elevated levels of CRP, sPTX 3 and sIL-6.     

Nephron-sparing surgery for renal tumors

PurposeTo report National Cancer Institute (NCI) experience in managing various benign and malignant renal tumors with nephron sparing surgery (NSS), and to assess its safety and feasibility.Patients and methodsLiterature review for NSS, and reviewing of the patients records who underwent NSS between the period from January-2000 to December-2009 at NCI-Cairo University was done. Tumor related characteristics, indication for NSS, operative techniques, postoperative complications, full histopathological data, and follow up results were reviewed.ResultsThe total number of patients was 15. Median age at surgery was 32 years (range from 1.5 to 65 years). Five patients had bilateral tumors. The mean radiologic tumor size was 4.7 ± 5.2 cm. All patients had normal preoperative kidney functions. Six patients had an absolute indication for NSS, while 6 patients had a relative indication, and 3 patients were elective. All 5 patients with bilateral tumors underwent bilateral simultaneous surgery. Cold ischemia was used in 7 patients, 1 patient was exposed to warm ischemia. Manual compression was used in 2 patients, and no vascular control was applied in 5 patients. Complications were encountered in 2 patients, one of them had urinary leakage which needed reoperation, and the other had subcutaneous hematoma which was treated conservatively. Histopathological analysis revealed Wilm’s tumor (7 patients), angiomyolipoma (4 patients), renal cell carcinoma (RCC) (3 patients), and Hydatid cyst (1 patient). All patients had negative surgical margin. For patients with Wilm’s tumor, the median follow up was 24.4 months (range from 5 to 94 months), two patients had local recurrence, and 1 patient had distant metastasis.For patients with RCC, The median follow up was 14.7 months (range from 5 to 33 months) with no local recurrence or distant metastasis. All patients had normal kidney functions during postoperative and follow up periods.ConclusionNSS is a feasible safe procedure that could be done with acceptable complications. It provides a good solution for patients with bilateral benign tumors and early localized RCC.     

Initial experience with off-pump left ventricular assist device implantation in single center: retrospective analysis

Background  

We hypothesize that implantation of left ventricular assist device through off-pump technique is feasible and has a comparable result to implantation on cardiopulmonary bypass and could improve one-year survival.     

Study of infective endocarditis in Alexandria main university hospitals

ObjectivesTo describe the incidence, clinical characteristics, microbiological profile and in-hospital outcome of infective endocarditis (IE) in our center.MethodsA prospective study that was conducted on 50 consecutive patients admitted to our cardiology department diagnosed as Duke definite IE. The study was conducted for a period of one year and started on the 1st of September 2009 till the end of August 2010. All patients were subjected to detailed history taking, clinical examination, blood culture and echocardiography.ResultsThe study was carried out on 29 males (58%) and 21 females (42%) with a mean age of 33 years. The mean duration of delay from onset of symptoms till diagnosis was 54 days. Native valve endocarditis was found in 34 patients (68%). Blood cultures were positive in 27 patients (54%). Staphylococci were the prevalent microorganisms (52%). In-hospital events included: heart failure in 29 patients (58%), systemic embolization in 13 patients (26%), para-valvular abscess in 8 patients (16%), septic pulmonary emboli in 7 patients (14%), dehiscence of prosthetic valves in 5 patients (10%) and renal failure in 2 patients (4%). Surgical intervention was indicated in 41 patients (82%). Only 16 patients (39%) had early surgical intervention. In-hospital mortality was 22%. However, the mortality rate improved in the patients who had undergone early surgical intervention (18.75% versus 32%).ConclusionsInfective endocarditis remains a major health problem. It carries high in-hospital events with a high mortality rate. Delayed diagnosis of the disease and culture negative IE are common. Staphylococci are the prevalent microorganisms. Early surgical intervention improves survival.