Antipyrine clearance in comparison to conventional liver function tests in hepatitis C virus patients

In this study, 15 healthy volunteers and 96 patients with hepatitis C virus, classified according to Child-Pugh into 36 Child-A, 31 Child-B and 29 Child-C, were examined. All subjects ingested 600 mg antipyrine in the form of hard gelatinous capsules after overnight fasting. One milliliter of saliva was collected at 4 and 24 h after ingestion of antipyrine and analyzed using high-performance liquid chromatography. Blood samples were collected from all subjects for examination, using conventional liver function tests. The pharmacokinetic variables for antipyrine were determined using the two concentration time points selected. A cut-off value of 0.34 ml/min/kg was used to distinguish between cirrhotic and non-cirrhotic patients. Alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase values were significantly higher with significantly lower antipyrine clearance in Child-A, B, and C patients than in normal volunteers. The total protein concentration was significantly lower in Child-B and C patients. Moreover, AST was significantly higher in Child-C patients and antipyrine clearance was lower in Child-B and C patients than in Child-A patients. Antipyrine clearance showed a significant negative correlation with Child-Pugh scores, total protein, the international normalization ratio of prothrombin time and globulin, and a positive correlation with albumin and albumin-to-globulin ratio. Unlike most of the conventional liver function tests, antipyrine clearance, which represents the intrinsic clearance capacity of the liver, measured using saliva, proved to be a sensitive marker of liver function. It was significantly impaired in the Child-Pugh group A patients with the least hepatic impairment. The international normalization ratio of prothrombin time was just as informative as antipyrine clearance in identifying minimal hepatic impairment.     

Relapse of Hodgkin lymphoma after autologous hematopoietic cell transplantation: A current management perspective

Hodgkin lymphoma (HL) is a highly responsive disease with nearly 70% of patients experiencing cure after front-line chemotherapy. Patients who experience disease relapse receive salvage chemotherapy followed by consolidation with autologous hematopoietic cell transplantation (auto-HCT). Nearly 50% of patients relapse after an auto-HCT and constitute a subgroup with poor prognosis. Novel treatments such as immune checkpoint inhibitors and an anti-CD30 monoclonal antibody are currently approved for patients relapsing after auto-HCT; however, the duration of remission with these therapies remains limited. Allogeneic HCT is currently the only potentially curative treatment modality for patients relapsing after a prior auto-HCT. Early clinical trials with chimeric antigen receptor T-cell therapy targeting CD30 are underway for patients with relapsed/refractory HL and are already demonstrating safety and promising efficacy.     

Essential oil from halophyte Lobularia maritima: protective effects against CCl4-induced hepatic oxidative damage in rats and inhibition of the production of proinflammatory gene expression by lipopolysaccharide-stimulated RAW 264.7 macrophages

The present study evaluates the chemical profiling of the essential oil of a halophyte, L. maritima (LmEO), and its protective potential against CCl₄-induced oxidative stress in rats. Forty compounds have been identified in LmEO. The major components are α-pinene (3.51%), benzyl alcohol (8.65%), linalool (22.43%), pulegone (3.33%), 1-phenyl butanone (7.33%), globulol (4.32%), γ-terpinene (6.15%), terpinen-4-ol (4.31%), α-terpineol (3.9%), ledol (3.59%), epi-α-cadinol (3.05%) and α-cadinol (4.91%). In comparison with the CCl₄-intoxicated group, LmEO treatment resulted in decreased liver serum marker enzymes, decreased lipid peroxidation and increased antioxidant enzyme levels, with overall further amelioration of oxidative stress. The administration of LmEO to CCl₄-treated rats at a dose of 250 mg kg⁻¹ body weight significantly reduced the toxic effects and the oxidative stress on the liver, thus validating the traditional medicinal claim of this plant. Moreover, the anti-inflammatory activity of LmEO was evaluated in lipopolysaccharide-stimulated murine RAW 264.7 cells. Our oil could modulate the inflammatory mode of the macrophages by causing reduction in iNOS and COX₂ enzymes as well as in IL-1β, IL-6, and TNF-α cytokine levels. These findings suggest that LmEO exerts anti-inflammatory effects by regulating the expression of inflammatory cytokines.

The present study evaluates the chemical profiling of the essential oil of a halophyte, L. maritima (LmEO), and its protective potential against CCl₄-induced oxidative stress in rats.     

Synthesis and Gastroprotective Evaluation of New Synthetic Indole Imines on Animal Models

Pharmaceutical Chemistry Journal - The present study was designed to carry out the synthesis of targeted N-arylindole imines (derived from 4,5,6-trimethoxy-2,3-diphenyl-1H-indole-7-carbaldehyde),...     

Outcome of pediatric parameningeal rhabdomyosarcoma. The Children Cancer Hospital,Egypt, experience

BackgroundPM RMS represents a diagnostic and therapeutic problem as it is less visible than other superficial head and neck sites, and has tendency to local and intracranial extension.ObjectivesThe aim of this work is to study the treatment outcome, overall survival (OS) and event free survival (EFS) of pediatric PM RMS patients diagnosed and treated at the Children Cancer Hospital-Egypt [CCHE-57357] during a 4 year period.MethodsRetrospective review of charts of newly diagnosed pediatric PM RMS patients diagnosed and treated in CCHE during the period between July 2007 and the end of June 2011.ResultsForty-two pediatric patients with PM RMS with age ranging from 3 months to 17.7 years (median 6.9 years) were studied. The follow up period ranged from 4 to 55 months with a median of 24.8 months.Twenty-one patients [50%] were stage III, while 11 patients [26.1%] were stage IV.The 3-year overall survival (OS) was 58.4 ± 8.9%. OS was 65.9 ± 10% for non metastatic tumors while it was 35.8 ± 16.2% for the metastatic ones (p = 0.039).The 3-year event-free survival (EFS) was 48 ± 8.6% for the whole group. The non-metastatic and metastatic patients had 3-year EFS of 56.5 ± 9.7% and 24.9 ± 14.9% respectively. This difference was not statistically significant (p = 0.127).ConclusionPM RMS remains a diagnostic and therapeutic problem. Late presentation and advanced local disease compromise treatment options and decrease OS and EFS.     

Patterns of Uveitis in a Tertiary Care Referral Institute in Saudi Arabia

Purpose: To present the pattern, causes and complications of uveitis in one of the tertiary eye centers in Saudi Arabia.

Methods: In this retrospective study, clinical records of randomly selected cases of uveitis attending the King Khaled Eye Specialist Hospital, Saudi Arabia, from 2001 to 2010, were reviewed.

Results: Our series included 888 out of 1286 cases of uveitis. Among them, there were 390 men (43.9%) with a mean age of 39.6 ± 11 (range: 6–94 years). The prevalence of uveitis among all eye patients was 1.5% and the annual incidence was 129 cases. Uveitis was bilateral in 567 patients (63.8%), mainly anterior in 27.3%, intermediate in 12.7%, posterior in 7.1%, while 52.9% were panuveitis. Infective etiology was seen in 180 patients (20.3%), of which presumed tuberculous uveitis (PTU) was the commonest cause in 94 patients (52%), followed by herpetic in 46 (26%) and toxoplasmosis in 29 (16%). Vogt–Koyanagi–Harada (VKH) 22%, Behçet uveitis (BU) 14.6%, idiopathic anterior uveitis 12.5%, presumed tuberculous uveitis (PTU) 10.6%, and idiopathic intermediate uveitis (10.1%) accounted for the majority of cases, whereas other diagnostic entities accounted for 30%. The most common cause of anterior uveitis was idiopathic uveitis (101; 41.7%), followed by herpetic (46; 19%). Toxoplasmosis was the most frequent cause of posterior uveitis (29; 46.3%). Intermediate uveitis was most commonly idiopathic (86; 76.1%). VKH disease was the most common cause of panuveitis (195; 41.5%), followed by Behçet disease (118; 25.1%). The common complications of uveitis were glaucoma (34.1%), posterior synechiae (22.3%) and cataract (15.1%).

Conclusions: The most common anatomic diagnosis was panuveitis. VKH disease and Behçet disease were the most frequent causes and glaucoma was the most common complication of uveitis.     

Barrett＇s esophagus： Prevalence and risk factors in patients with chronic GERD in Upper Egypt

AIM： To determine the prevalence and possible risk factors of Barrett＇s esophagus （BE） in patients with chronic gastroesophageal reflux disease （GERD） in EI Minya and Assuit, Upper Egypt. METHODS： One thousand consecutive patients with chronic GERD symptoms were included in the study over 2 years. They were subjected to history taking including a questionnaire for GERD symptoms, clinical examination and upper digestive tract endoscopy. Endoscopic signs suggestive of columnar-lined esophagus （CLE） were defined as mucosal tongues or an upward shift of the squamocolumnar junction. BF was diagnosed by pathological examination when specialized intestinal metaplasia was detected histologically in suspected CLE. pH was monitored in 40 patients. RESULTS： BE was present in 7.3% of patients with chronic GERD symptoms, with a mean age of 48.3 ± 8.2 years, which was significantly higher than patients with GERD without BE （37.4 ± 13.6 years）. Adenocarcinoma was detected in eight cases （0.8%）, six of them in BE patients. There was no significant difference between patients with BE and GERD regarding sex, smoking, alcohol consumption or symptoms of GERD. Patients with BE had significantly longer esophageal acid exposure time in the supine position, measured by pH monitoring. CONCLUSION： The prevalence of BE in patients with GERD who were referred for endoscopy was 7.3%. BE seems to be associated with older age and more in patients with nocturnal gastroesophageal reflux.     

Abnormal frontoparietal synaptic gain mediating the P300 in patients with psychotic disorder and their unaffected relatives

The “dysconnection hypothesis” of psychosis suggests that a disruption of functional integration underlies cognitive deficits and clinical symptoms. Impairments in the P300 potential are well documented in psychosis. Intrinsic (self‐)connectivity in a frontoparietal cortical hierarchy during a P300 experiment was investigated. Dynamic Causal Modeling was used to estimate how evoked activity results from the dynamics of coupled neural populations and how neural coupling changes with the experimental factors. Twenty‐four patients with psychotic disorder, twenty‐four unaffected relatives, and twenty‐five controls underwent EEG recordings during an auditory oddball paradigm. Sixteen frontoparietal network models (including primary auditory, superior parietal, and superior frontal sources) were analyzed and an optimal model of neural coupling, explaining diagnosis and genetic risk effects, as well as their interactions with task condition were identified. The winning model included changes in connectivity at all three hierarchical levels. Patients showed decreased self‐inhibition—that is, increased cortical excitability—in left superior frontal gyrus across task conditions, compared with unaffected participants. Relatives had similar increases in excitability in left superior frontal and right superior parietal sources, and a reversal of the normal synaptic gain changes in response to targets relative to standard tones. It was confirmed that both subjects with psychotic disorder and their relatives show a context‐independent loss of synaptic gain control at the highest hierarchy levels. The relatives also showed abnormal gain modulation responses to task‐relevant stimuli. These may be caused by NMDA‐receptor and/or GABAergic pathologies that change the excitability of superficial pyramidal cells and may be a potential biological marker for psychosis. Hum Brain Mapp 38:3262–3276, 2017. © 2017 Wiley Periodicals, Inc.