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21.

Background  

Neutrophil elastase level/activity is elevated in a variety of diseases such as atherosclerosis, systolic hypertension and obstructive pulmonary disease. It is unknown whether obese individuals with prehypertension also have elevated neutrophil elastase, and if so, whether it has a deleterious effect on pulmonary function. Objectives: To determine neutrophil elastase levels in obese prehypertensive women and investigate correlations with pulmonary function tests.  相似文献   
22.

Objectives

To evaluate the safety of using the stiff end of a coronary wire to perforate an atretic pulmonary valve (PV) in patients with pulmonary atresia with intact ventricular septum (PAIVS).

Background

Radiofrequency perforation is an accepted modality to perforate the PV in patients PAIVS. However, the high cost precludes its widespread use.

Patients and methods

This is a single-center experience that spanned from March 2013 to January 2016 and involved 13 neonates who were severely cyanotic with PAIVS and with ductal-dependent pulmonary circulation. The stiff end of a coronary wire was used to perforate the atretic PV anterogradely, followed by balloon pulmonary valvuloplasty.

Results

The mean age of patients was 3.9?±?2.7?days and their mean weight was 2.8?±?0.19?kg. The mean oxygen saturation was 77.1?±?3.2%. All had membranous pulmonary atresia, with patent infundibulum and tripartite right ventricle. The valve was successfully perforated in 11 out of 13 patients. Death occurred in two patients (15.4%) owing to heart failure and sepsis. Patent ductus arteriosus stenting was performed 2?days after the procedure in one patient because of cyanosis followed by one and half ventricle repair at of age 5?months. Two patients (15.4%) had one and a half ventricle repair at age of 5?months and 6?months owing to insufficient anterograde pulmonary flow. Two patients (15.4%) underwent second intervention with balloon dilatation of the valve. The remaining seven patients (53.8%) had no further intervention. Two cases (15.4%) had femoral artery thrombosis treated with streptokinase. The mean duration of follow-up was 13.17?±?7?months. There was significant improvement in the degree of tricuspid incompetence. There was a significant growth in the tricuspid valve annulus during the follow-up (the mean Z score increased from ?0.8?±?0.9 to 0.1?±?0.9) (p?=?0.003). There was also a significant increase in the tricuspid valve annulus/mitral valve annulus ratio as its mean increased from 0.73?±?0.10 to 0.86?±?0.11 during follow-up (p?<?0.001).

Conclusion

Perforation of the atretic PV in selected cases with membranous atresia and patent infundibulum using the stiff end of a coronary wire is an effective alternative to using radiofrequency perforation.  相似文献   
23.

Background

Systemic sclerosis (SSc) is an autoimmune connective tissue disease with vascular, fibrotic and immune changes of skin and some internal organs. Anti-heterogeneous nuclear ribonucleoproteins (anti-hnRNP) were found in SSc patients.

Aim of the work

To assess anti-hnRNP A1 and A2 autoantibodies in limited SSc patients and to find their relation to clinical and hand radiographic characteristics.

Patients and methods

26 limited SSc patients and 16 matched control were studied. Skin thickness was scored according to the modified Rodnan skin score method (mRss) and radiologic examination by plain X-ray of the hand and wrist was performed anti-hnRNP A1 and A2 were measured in patients and control.

Results

All patients were females with a mean age of 37.5 ± 11.24 years and mean disease duration of 7.84 ± 1.19 years. 96.2% of cases showed juxta-articular osteoporosis, 38.5% with marginal erosions, 73.1% with surface erosions, 42.3% with subchondral cyst, 42.3% with metacarpophalangeal subluxation, 11.5% with marginal sclerosis, 80.8% with resorption of distal phalanges, 38.5% with resorption of distal ulna and 34.6% with calcinosis. Anti-hnRNPA1 was positive in all the patients but the anti-hnRNPA2 was positive in 21 (80.8%). Anti-hnRNP A1 and A2 showed significant difference between patients and control (5.66 ± 4.18 ng/ml vs 2.88 ± 0.82; p < 0.01 and 1.82 ± 0.36 vs 0.73 ± 0.08; p < 0.02, respectively). There was no significant correlation between the markers with the mRss or radiographic changes.

Conclusion

Joint affection in SSc is more frequent than expected. Anti-hnRNP A1 and anti hnRNP A2 antigens may be useful markers for SSc patient although no significant relation was found with radiologic findings.  相似文献   
24.

Background and study aims

Hepatitis C virus (HCV) infection is a severe problem among patients on maintenance haemodialysis who are at particular risk for blood-borne infections because of prolonged vascular access and potential for exposure to contaminated equipment. Occult hepatitis C virus infection (OCI) is defined as the presence of HCV RNA in liver or peripheral blood mononuclear cells (PBMCs) in the absence of detectable HCV antibody or HCV RNA in the serum. In this study, we aimed to investigate the existence of occult hepatitis C virus infection in PBMCs of haemodialysis (HD) patients in one center. Moreover, we tried to link the condition to risk factors associated with HCV infection in those patients.

Patients and methods

We included 40 patients with renal diseases undergoing regular haemodialysis who were repeatedly anti-HCV negative. HCV RNA detection was tested by Quantitative Real time PCR in serum and PBMCs.

Results

The results of this study revealed that 23% of our haemodialysis patients have occult hepatitis C virus infection. There was a highly significant increase in ALT levels in patients with OCI versus the negative group. Also, there is a significant increase of history of blood transfusion in patients with occult HCV (p?=?0.03) while the duration of haemodialysis showed no statistical significant difference between both groups. The viral load of the occult hepatitis C virus infection subjects ranged from 581to 74,307 copies/ml.

Conclusion

These results highlight the potential risk of hepatitis C virus transmission from patients within haemodialysis units in Egypt. Isolation of patients on dialysis machines depending on the results of hepatitis serological markers is not enough. Testing for hepatitis C virus -RNA in peripheral blood mononuclear cells is more reliable in identifying patients with an OCI when a liver biopsy is not available.  相似文献   
25.
Chlorinated pesticide residues in human breast milk from five southern Jordan districts were analyzed in 2012/2013. The total number of samples from all districts was 100. The number of samples gathered from each district was collected according to their population densities. The present study shows that 59% of the samples which contained pesticides’ residues were p,p’-DDE, 30% contained β-HCH, 10% contained p,p′-DDT, 6% contained α-HCH, 2% contained heptachlor and 1% contained endrin. These human milk samples were free of aldrin, dieldrin, α-endosulfan, β-endosulfan, HCB, γ-HCH, o,p′-DDD, o,p′-DDT and o,p′-DDE. The levels of the six mentioned compounds detected in all mother’s milk samples were higher in Ghor El-Safi district compared with the other four districts. In this study, it is recommended to continue the pesticides residues monitoring in all parts of Jordan, particularly in Ghor El-Safi district and other regions in the cultivated Jordan Valley.  相似文献   
26.
27.
Clinical Rheumatology - Biologics are indicated in rheumatoid arthritis (RA) in case of persistent high disease activity despite conventional disease-modifying anti-rheumatic drugs (cDMARDs) or...  相似文献   
28.
LH pulses during the progesterone (P)-induced LH surge were examined in ovariectomized and estrogen-treated female monkeys. Animals received a 2.5-mg P or oil injection 24 h after administration of 30 micrograms estradiol benzoate. The animals were fitted with jugular catheters connected to a tether-swivel system. Blood samples were collected at 10-min intervals starting 3-4 h before and ending 12-20 h after P or oil injection. Plasma LH was measured by both bioassay and RIA. LH pulses were determined by the PULSAR program. P administration induced a BIA-LH surge with a latency of 71 +/- 10 min in all seven animals. The P-induced bioassayable LH (BIA-LH) surge consisted of an ascending phase (204 +/- 24 min), a plateau period (174 +/- 32 min), and a descending phase (376 +/- 60 min). Oil injection did not cause a LH surge (n = 4). BIA-LH release before P and that during the P-induced LH surge were pulsatile. Pulse intervals of BIA-LH before P treatment (57.1 +/- 5.2 min) were not different from those before (55.0 +/- 11.7 min) and after (62.9 +/- 16.3 min) oil injection. In contrast, pulse intervals during the ascending phase (35.0 +/- 4.0 min), plateau period (34.6 +/- 2.6 min), and descending phase (45.0 +/- 3.1 min) were significantly shorter (P less than 0.02) than those before P. Pulse amplitudes of BIA-LH during the ascending phase (125.3 +/- 28.7 ng/ml) and plateau period (253.9 +/- 27.0 ng/ml) were significantly (P less than 0.001) higher than those (44.7 +/- 12.6 ng/ml) before P and during the descending phase (66.9 +/- 11.1 ng/ml). Radioimmunoassayable LH results were quite similar to those for BIA-LH, except that amplitude changes in radioimmunoassayable LH after P treatment were smaller than those in BIA-LH. It was concluded, therefore, that both the frequency and amplitude of pulsatile LH release increase during the P-induced LH surge, especially during the ascending phase and plateau period, in female rhesus monkeys. Furthermore, the present results support our previous conclusion that P facilitates pulsatile LHRH release with increases in frequency and amplitude in ovariectomized and estrogen-treated monkeys.  相似文献   
29.
Twenty-one patients undergoing coronary artery bypass grafting were prospectively evaluated by conventional selective coronary angiography and electron-beam computed tomography. Eighty bypass grafts (60 saphenous vein and 20 left or right internal mammary artery) were evaluated for patency. The sensitivity and specificity of electron-beam computed tomography were 72% and 100%, respectively; positive and negative predictive values were 100% and 92.5%, respectively. Sensitivity and specificity according to coronary region were: left anterior descending artery, 33% and 100%; diagonal artery, 67% and 100%; circumflex artery, 75% and 100%; right coronary artery, 100% and 100%. Electron-beam computed tomography is relatively accurate and a promising tool for noninvasive evaluation of graft patency after coronary artery bypass graft surgery.  相似文献   
30.

Objectives

To assess safety, efficacy and follow-up results of transcatheter closure of ventricular septal defect (VSD) using Nit-Occlud_ Lê VSD Coil (pfm medical, KÖln, Germany).

Background

Transcatheter VSD closure has achieved encouraging results but more follow-up studies are needed.

Patients and methods

Between January 2012 and December 2013 in the cardiology department, Tanta University Hospital, Tanta, Egypt, 80 patients underwent percutaneous VSD closure using Nit-Occlud_ Lê VSD Coil. Early and mid- term follow-up was done for 3 years, follow-up was concluded in 2016.

Results

The mean age of patients was 5.34?±?3 years, and their mean weight was 17.24?±?8.17 kg. Overall, 77 of 80 patients had perimembranous VSD with aneurysmal tissue; eight had multiple right ventricular exits, 14 had deficient aortic rim, two had high outlet muscular, and one had Gerbode defect. The procedure was successful in 98.75% of patients, and was aborted in one patient because of the development of complete heart block and the coil had to be removed. The mean procedure time was 104.98?±?9.50 minutes. The mean fluoroscopy time was 30.58?±?2.79 minutes. The immediate complete occlusion rate was 62%, which increased to 82.3% on the second day, and 94.9% by the 3rd month, and 97.5% by 1 year. There was a significant decrease in mitral incompetence after 6 months of follow-up (p?=?0.002), and only one patient had trivial aortic incompetence prior to the procedure that remained the same during follow-up period.

Conclusion

Using Nit-Occlud_ Lê VSD-Coil to close VSD is safe and feasible in VSDs with various morphology.  相似文献   
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