Complete regression of visceral Kaposi's sarcoma after conversion to sirolimus

The prevalence of Kaposi's sarcoma (KS) is much greater in organ transplant recipients than it is in the general population. Its etiology appears to be related to geographic, genetic, and viral factors. Treatment of transplant-related KS has, until now, consisted mainly of reduction of, or withholding of, immunosuppression, often with deleterious effects on both graft and patient survival. In recent years, the immunosuppressive drug, sirolimus, has been demonstrated as possessing anti-neoplastic properties in both in vitro and animal models. In view of these properties and some preliminary clinical experience, we postulated that sirolimus would be beneficial in our patients who developed transplant-related KS. Here, we report the first case of a patient with both cutaneous and visceral KS who was successfully treated in the Middle East by conversion from a cyclosporine-based to a sirolimus-based immunosuppression regimen. The KS regressed completely within a few months after the conversion. The chronologic events and the extensive documentation, which included repeat computed tomography scans, are very suggestive of a selective anti-neoplastic effect of sirolimus.     

The use of psychoactive substances by female Egyptian university students, compared with their male colleagues on selected items

A standardized questionnaire, with satisfactory retake item reliabilities and well established validities, was administered to a representative sample of female university students (N = 2366), drawn from Cairo and Ein-Shams Universities, both located in Greater Cairo. Results, relevant to demographic and drug related items, are presented. Where meaningful, comparisons are made with previously published corresponding data obtained on male university students. Among the interesting findings are the following: Female students, compared with males, had better educated parents with jobs higher on social prestige hierarchy. But more boys than girls had personal sources of income and, relatively, big amounts of pocket money. Very few girls smoked cigarettes and used natural narcotics. Tranquilizers and hypnotics were taken by, almost, equal percentages of both sexes. But stimulants were consumed by more boys. Girls did not start experimentation with narcotics before the age of 16, whereas boys began such experimentation before reaching 12 years of age. Girls tried alcohol much more than they experimented with any other psychoactive substance. Among girls as well as boys we found a measurable trend for users to be more exposed than nonusers to what we call 'drug culture'. In the case of girls, close relatives have more weight than personal friends as sources of information about drugs. For boys, it is the opposite. Similarities as well as disparities were discussed and implications were emphasized.     

Sonographic evaluation of resting gallbladder volume and postprandial emptying in patients with gallstones

We investigated fasting gallbladder volume and gallbladder emptying in response to a fatty meal in 20 patients with asymptomatic gallstones and compared the results with findings from healthy controls. Compared with control subjects without gallstones, the majority of patients with gallstones exhibited a higher resting gallbladder volume, less fractional emptying after a fatty meal, and a higher postmeal residual volume. These abnormalities all appeared to stem from an abnormally high resting gallbladder volume. Whether the increased gallbladder volume and decreased postprandial fractional emptying in the gallstone patients represents a primary or secondary abnormality remains to be determined. The results suggest that in some patients decreased gallbladder contractility may contribute to gallstone development or proliferation.     

Hepatitis C infection, Cognition, and inflammation in an Egyptian sample

Chronic hepatitis C (HCV) infection is associated with cognitive impairments which might be mediated through a secondary inflammatory cascade. Egypt has an unusually high prevalence of HCV monoinfections and is an ideal site for the study of the isolated effects of HCV infection. Therefore, in a hospital‐based cross‐sectional study based in Egypt, this study compared cognitive functioning and serum markers of inflammation in 11 HCV positive cases and 14 HCV negative controls. The Wisconsin Card Sorting Test was used to assess cognitive flexibility and the Brief Visuospatial Memory Test‐Revised was used to assess learning and memory. Circulating levels of soluble tumor necrosis factor receptor II (sTNFR‐II), monocyte chemotactic protein‐1 (MCP‐1/CCL2), and soluble CD14 (sCD14) were determined as indices of inflammation. HCV positive cases had higher levels of sTNFR‐II (t = ?3.5, P = 0.002). HCV positive cases also had significantly worse cognitive flexibility with higher number of total errors (t = ?2.18, P = 0.04), and preservative responses (t = ?2.12, P = 0.05), and lower number of conceptual level responses (t = 1.32, P = 0.04) on the Wisconsin Card Sorting test. In conclusion, results from this pilot study indicate that HCV+ patients have worse cognitive performance and somewhat greater inflammatory activity as compared to controls. The increased inflammation may be associated with the cognitive impairments observed in these HCV+ patients. J. Med. Virol. 83:261–266, 2011. © 2010 Wiley‐Liss, Inc.     

Predicting Parkinson disease in the community using a nonmotor risk score

European Journal of Epidemiology - At present, there are no validated methods to identify persons who are at increased risk for Parkinson Disease (PD) from the general population. We investigated...     

Coronary heart disease,heart failure,and the risk of dementia: A systematic review and meta-analysis

Introduction

Cardiovascular risk factors are closely linked with dementia risk, but whether heart disease predisposes to dementia is uncertain.

Raised serum level of APRIL in patients with systemic lupus erythematosus: Correlations with disease activity indices

The aim of the present study is to assess serum APRIL levels in SLE patients versus rheumatoid arthritis (RA) patients and normal control and to correlate serum APRIL levels in SLE patients with disease activity indices. Serum APRIL levels was measured in 40 SLE patients, 20 patients with RA and 20 healthy volunteers who served as control group. Disease activity in SLE patients was assessed by the British Isles Lupus Assessment Group (BILAG) index and SLE disease activity index (SLEDAI), and results were correlated with serum APRIL levels. Significantly higher serum APRIL levels was observed in SLE patients compared to RA patients and normal controls (p = 0.003 and p ≤ 0.001, respectively). Positive correlations were found between serum APRIL levels and total BILAG index (r = 0.486 and p = 0.001), BILAG musculoskeletal score (r = 0.848 and p ≤ 0.001) and BILAG cardiorespiratory score (r = 0.326 and 0.04). Serum APRIL was higher in SLE patients compared to RA patients and normal control subjects and positively correlates with BILAG index and higher levels may be associated with musculoskeletal manifestations of the disease. APRIL antagonism could be a potential therapeutic target in SLE.