Incidence of Hepatitis C Virus (HCV), Hepatitis B Virus (HBV) and Dual Infection in Egyptian Patients on Haemodialysis

Hepatitis viral infections are important causes of morbidity and mortality in haemodialysis patients. The aim of the present work is to study the prevalence and possible risk factors of hepatitis C virus (HCV), hepatitis B virus (HBV) and dual infection in haemodialysis patients. Three hundred forty patients with end-stage renal disease, 266 males (78.2%) with mean age of 50.9?±?11.6 years and 74 females (21.8%) with mean age of 53.5?±?10.5 years on haemodialysis, were recruited from four haemodialysis units. They were screened for the presence of HCV, HBV and dual HCV and HBV infections and possible risk factors for acquiring these infections in those patients during the period between June 2007 and August 2009. One hundred ninety-six (57.7%) patients were HCV positive while 12 (3.5%) patients had HBV infection. A dual infection with both viruses was observed in 26 patients (7.6%).There was a significant difference in the number of blood transfusions among HCV-positive, HBV-positive and dual infection patients and negative patients (12.4?±?7.6, 13.8?±?6.8, 13.5?±?8.3 vs. 5.2?±?3.4 transfusions, p?<?0.01). HCV, HBV and dual HCV and HBV patients have been on dialysis for a longer period than the negative patients (7.5?±?5, 6.2?±?3.6, 7.5?±?5.4 vs. 4.4?±?4 years, p?<?0.01). Higher HCV was associated with longer haemodialysis duration and history of previous blood transfusion and not associated with dialysis in multicentres. HBV and dual infection is less prevalent than HCV in haemodialysis units.     

Musculoskeletal manifestations in patients with malignant disease

To detect and describe the incidence of musculoskeletal manifestations in different malignant diseases as well as their relation to the treatment received whether by chemotherapy or radiation therapy. Sixty patients with different malignant diseases were included in this study, 45 with solid tumors and 15 patients with hematological malignancy. The mean age was 46.55 ± 11.04 years and the mean disease duration was 2 ± 0.75 years. The patients were fully examined for any rheumatologic involvement, laboratory investigations were performed as well as dual energy X-ray absorptiometry study for bone densitometry. Treatment strategies were assessed including the chemotherapeutics, radiation therapy, and/or surgery. Myalgias and arthralgias were the most frequent followed by flexor tenosynovitis, frozen shoulder, and fibromyalgia syndrome. Hypertrophic osteoarthropathy was seen in five patients, cutaneous vasculitis in two patients as well as arthritis. Osteonecrosis was present in one of the lunate carpal bones of a patient with non-Hodgkin’s lymphoma (1.67%) and receiving high dose steroids. Rheumatoid factor was positive in four patients, three of which had hepatitis C virus positivity and cryoglobulins. Anti-neutrophil cytoplasmic antibody was negative in all the studied patients. The bone mineral density was significantly reduced in the patients with malignancy compared to the control. Mild to moderate osteoporosis was present, being more evident in the spine and forearm. The bone loss was higher in those with solid tumors and even more obvious in those receiving aromatase inhibitors. Musculoskeletal manifestations occurring during malignancies and following the treatment represent a significant percentage of symptoms and signs which may raise a clue to differential diagnosis.     

A Penrose Drain to Help Reflect the Resected “Specimen Side” Jejunum Beneath the Mesenteric Vessels During a Pancreaticoduodenectomy

Introduction  

Reflecting the resected portion of the proximal jejunum behind the mesenteric vessels during a pancreaticoduodenectomy (Whipple) procedure can be a challenging maneuver.     

Clinical Implications of Adiponectin and Inflammatory Biomarkers in Type 2 Diabetes Mellitus

Objectives: To study the interrelationships of adiponectin, C-reactive protein (CRP) and fibrinogen with each other in T2DM patients with (T2DM-C) and without complications (T2DM-NC) among healthy individuals. Design and methods: The study comprised of 120 T2DM-C, 59 T2DM-NC patients and 40 healthy volunteers. Biochemical markers were determined in the serum. Results: Positivity rates of CRP and fibrinogen were significantly increased in T2DM-C as compared to T2DM-NC or controls, whereas adiponectin showed highest level in healthy individuals. Inflammatory biomarkers were inversely correlated with adiponectin (P < 0.01). Lipid profiles, kidney functions and BMI, showed positive significant correlation with CRP and fibrinogen but negative correlation with adiponectin. For better detection of T2DM, the combined sensitivity (98.9%) and specificity (92.5%) of fibrinogen and adiponectin was higher than the combined sensitivity and specificity of fibrinogen and CRP or adiponectin and CRP or than that of the biomarkers alone. Conclusion: Elevated levels of CRP and fibrinogen and reduced level of adiponectin can be used for early diagnosis of T2DM and can predict diabetic complications.     

Antiproliferative potential of sarcophine and its semisynthetic sulfur-containing derivatives against human mammary carcinoma cell lines

The marine-derived cembranoid sarcophine (1) and its sulfur-containing semisynthetic derivatives (2–6) were evaluated for anticancer potential using cell cycle progression markers. No effect on MCF-7 cell viability or apoptosis was seen with these derivatives at concentrations of up to 100 μM after 72 h of incubation. At 100 μM, sarcophine and its derivatives 2–5 arrested the MCF-7 cells in G0/G1 phase, with concomitant decrease in the cell populations at S and G2+M phases. MDA-MB-231 cells were not responsive to any of the derivatives. Our preliminary results suggest that the sulfur-containing derivatives of sarcophine, especially 2 and 3, show potent and cell-specific antiproliferative activity.     

Impact of treatment of dyslipidemia on renal function,fat deposits and scarring in patients with persistent nephrotic syndrome

In this study 43 patients with idiopathic nephrotic syndrome were randomly distributed into 2 age- and sex-matched groups. The first group was given fluvastatin while the second was used as control. The cases in the 2 groups were evaluated clinically, biochemically (creatinine clearance, albumin, 24-hour proteinuria, and lipogram), neurologically, and histopathologically (examination of renal biopsies obtained basally and after 1 year of treatment with fluvastatin). In the fluvastatin-treated group but not in the control group, we observed a significant reduction in cholesterol, low-density lipoprotein, and triglyceride. Clinical and laboratory assessment showed satisfactory tolerance of the drug by the patients. Proteinuria, serum albumin and creatinine clearance values were significantly better in the statin-treated patients. There was no difference in glomerular sclerosis between the 2 groups while interstitial fibrosis and renal fat deposits were less in the statin-treated group. The reduction in renal fat deposits in the statin-treated group was highly significant, while that of interstitial fibrosis was not. We conclude that: (1) statin can be safely and effectively used in the treatment of dyslipidemia in patients with persistent idiopathic nephrotic syndrome; (2) control of dyslipidemia in nephrotic patients is associated with better control of proteinuria and creatinine clearance; (3) statin treatment may cause regression of renal fat deposits in patients with nephrotic syndrome, and (4) longer term studies are still required to study further possible beneficial effects on renal histology and disease progression.