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Abstract Background Bladder cancer is a common malignancy in Egypt. A history of urinary tract infection can be considered as a risk factor for bladder cancer. Escherichia coli (E. coli) infection is responsible for 70% of urinary tract infection. This study aimed to evaluate the role of chronic E. coli infection during bladder carcinogenesis. In order to achieve this aim, we investigated the histopathological changes in bladder tissue and measured the level of nuclear factor kappa p65 (NF-κBp65), Bcl-2 and interleukin 6 (IL-6) in four groups each consisting of 25 male albino rats except of control group consisting of 20 rats. The first group was normal control group, the second group was infected with E. coli, the third group was administered nitrosamine precursor, and the forth group was infected with E. coli and administered nitrosamine precursor. Results The histopathological examination revealed that E. coli infected group was able alone to produce some histopathological changes in bladder tissue and that nitrosamine precursor plus E. coli group showed highest incidences of urinary bladder lesions than the nitrosamine precursor group. NF-κBp65, Bcl-2 and IL-6 levels were significantly higher in nitrosamine precursor plus E. coli group than the other groups. Conclusion These findings suggested that urinary bladder infection by E. coli may play a major additive and synergistic role during bladder carcinogenesis.

Dysregulation in microRNA expression is a common feature in colorectal cancer. Due to the inconsistent results regarding serum miR-92a expression pattern and the insufficient studies on serum miR-375 and miR-760, we aimed in this study to investigate their expression profile and diagnostic and prognostic power in Egyptian colorectal cancer patients. The expression profile of miR-92a, miR-375, and miR-760 was determined in the sera of 64 colorectal cancer patients using quantitative real-time reverse transcription polymerase chain reaction in comparison to 27 healthy control subjects. The expression fold change of the studied microRNAs was correlated with patients' clinicopathological features. Receiver operating characteristic curve analysis was done to determine the role of these microRNAs in colorectal cancer diagnosis and follow-up according to the yielded area under the curve. The expression pattern of miR-92a was significantly upregulated (3.38 ± 2.52, p < 0.0001), while both of miR-375 and 760 were significantly downregulated (-1.250 ± 1.80, p< 0.0001; -1.710 ± 1.88, p < 0.0001, respectively) in colorectal cancer than the control. MiR-92a was positively correlated (r = 0.671, p = 0.0001), while miR-375 and miR-760 were inversely correlated (r = -0.414, p = 0.001; r = -0.644, p = 0.0001) with advanced colorectal cancer stages. Receiver operating characteristic curve analysis disclosed the highest diagnostic potential for miR-760 to discriminate colorectal cancer patients and early-stage colorectal cancer from the control (area under the curve = 0.922 and 0.875, respectively), while the highest prognostic potential for discrimination between colorectal cancer stages was for miR-92a. In conclusion, serum level of miR-92a, miR-375, and miR-760 may serve as biomarkers of colorectal cancer in Egyptian patients with high diagnostic power for miR-760 and high prognostic power for miR-92a. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to find an association between serum concentration of vitamin D and vitamin D receptor ( VDR) polymorphisms to achieve a sustained virological response (SVR). Methods We conducted a case-control study in which 250 participants were recruited and divided into three groups (100 chronic hepatitis C [CHC] patients who achieved SVR, 100 CHC patients who did not achieve SVR and 50 apparently healthy individuals as controls). Blood samples were collected to measure serum vitamin D concentration, and four VDR polymorphisms ( FokI, ApaI, TaqI, and BsmI) were detected using polymerase chain reaction-restriction fragment length polymorphism. Results Non-responders were found to have significantly low vitamin D concentration compared with responders and control groups. Concerning VDR polymorphisms, both FokI and TaqI polymorphisms were associated with successful treatment. Conclusion Vitamin D concentration, FokI, and TaqI may be considered as the predictors for the response of CHC patients to a combination therapy of pegylated interferon and ribavirin. [ABSTRACT FROM AUTHOR]

Introduction: Adiponectin is an adipose tissue-specific protein with insulin-sensitizing properties. Many investigators have explored the association between adiponectin single nucleotide polymorphisms (SNPs) and type 2 diabetes mellitus (T2DM) in different ethnic populations from different regions. Leptin is a protein hormone constituting an important signal in the regulation of adipose tissue mass and body weight. The aim of this study was to explore potential associations between SNP +45 T>G of the adiponectin gene and SNP 2548G/A of leptin with T2DM and the effect of SNPs on serum adiponectin and leptin levels.Material and Methods: From the Egyptian population, we enrolled 110 T2DM patients and 90 non-diabetic controls. Serum lipid profile, blood glucose, serum adiponectin, and leptin were measured. Genotyping for two common SNPs of the adiponectin and leptin genes was performed by polymerase chain reaction-restriction fragment length polymorphism.Results: The G allele and TG/GG genotype of SNP 45 occurred more frequently than the T allele and TT genotype in T2DM patients compares to the controls. Subjects with the GG + TG genotype of SNP 45 were at increased risk for T2DM (OR = 6.476; 95% CI: 3.401-12.33) and associated with a low serum adiponectin level compared with the TT genotype. The serum leptin concentration of GA + AA genotype carriers was not significantly different from that of the GG genotype in the diabetic group.Conclusions: The G allele carriers who have reduced plasma concentrations of adiponectin may have an association with T2DM, while leptin SNP 2548 G/A is not associated with the risk of development of T2DM in the Egyptian population. [ABSTRACT FROM AUTHOR]

B Learning Objectives: b Rhombencephalitis (RE) is a rare but dangerous condition in pediatrics. In a single study, flu-related neurological complications occurred in 7.7% of H1N1 flu positive children with a median age of 5.1 years, though RE was not typically diagnosed. [Extracted from the article]

B Learning Objectives: b Methimazole (MMI) is a standard therapy for pediatric Graves' disease. B Methods: b A 4-year-old female with a history of Graves' disease refractory to treatment with MMI who presented in thyroid storm with severe neutropenia (thought to be secondary to MMI, which was then held). In our case of thyroid storm and MMI-induced AIN, plasmapheresis was the key treatment modality. [Extracted from the article]

B Learning Objectives: b The American Association of Poison Control Centers reported that overdoses of cardiovascular medications were second only to psychotropic medication in mortality. We report a rare case of a massive diltiazem overdose successfully treated with high-dose insulin therapy (HDIT) and veno-arterial extracorporeal life support (VA-ECLS). Calcium, glucagon, vasopressors, HDIT, and lipid emulsion are rescue therapies in cases of CCB and beta-blocker overdose. [Extracted from the article]

Within 12 hours, she was emergently placed on femoral VA-ECMO due to circulatory collapse, marked lactic acidosis and multi-organ dysfunction, despite antibiotics, maximal vasoactive and inotropic support and stress-dose steroids. B Results: b Multi-organ dysfunction in the setting of respiratory failure and cardiovascular collapse steered our initial management towards septic shock of unclear etiology. Long elimination half-life and delayed onset of effects likely explains collapse almost 24 hours after ingestion of amlodipine. [Extracted from the article]

B Learning Objectives: b Cardiac strangulation, progressive myocardial entrapment by a pacing lead during growth, is a very rare complication of epicardial pacing wires in children, with few globally reported cases. Cardiopulmonary resuscitation (CPR) was initiated for pulseless electrical activity (PEA) with return of spontaneous circulation (ROSC). B Results: b Cardiac strangulation is a rare complication of epicardial pacing wires which, over years, can cause progressive or acute myocardial ischemia and arrhythmias. [Extracted from the article]

B Learning Objectives: b Hemorrhagic shock (HS) accompanied by circulatory failure is a major cause of morbidity and mortality, and is often complicated by acute kidney injury (AKI). Hemorrhage was induced by withdrawing blood to a mean arterial pressure (MAP) of 35 mm Hg for 30 minutes, after which resuscitation was performed with either normal saline (NS), high-dose centhaquin (0.1 mg/kg), or low-dose centhaquin (0.01 mg/kg), to reach 100% of the shed blood volume. B Results: b Low-dose centhaquin was more effective in improving MAP in both male and female rats compared to NS or high-dose centhaquin. [Extracted from the article]

Objetive: To evaluate the frequency and timing of sustained drug-free remission (SDFR) in patients with giant cell arteritis (GCA) and to identify potential predictive factors of this outcome., Methods: Retrospective review of all patients included in the large Spanish multicentre registry for GCA (ARTESER) with at least two years of follow-up. SDFR was defined as the absence of typical signs, symptoms, or other features of active GCA for ≥12 months after discontinuation of treatment., Results: We included 872 patients. Forty-seven percent had received concomitant treatment with tocilizumab and/or immunosuppressants, mainly methotrexate.SDFR was achieved in 21.2% (185/872) of the patients. The cumulative rates of patients achieving SDFR at 2, 3, and 4 years were 6.3%, 20.5%, and 25.3%, respectively.Patients who achieved SDFR could reduce their prednisone dosage to 10 mg/day (p = 0.090) and 5 mg/day (p = 0.002) more quickly than those who did not. Relapses were less frequent in patients with SDFR (p = 0.006).The presence of relapses (incident rate ratio: 0.492, p < 0.001) and the need for intravenous methylprednisolone boluses at diagnosis (IRR: 0.575, p = 0.003) were significantly associated with a decreased likelihood of achieving SDFR.Only 5 patients (2.7%) experienced a recurrence, with a median onset of 19 months after achieving SDFR (IQR 25th-75th: 14-35 months)., Conclusion: Within 3-4 years of diagnosis, only one-quarter of patients with GCA successfully reached the SDFR. Once the SDFR was achieved, the likelihood of experiencing recurrence was low. Relapses and the need for glucocorticoid boluses appear to be predictors of long-term GC need., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Dysregulation in microRNA expression is a common feature in colorectal cancer. Due to the inconsistent results regarding serum miR-92a expression pattern and the insufficient studies on serum miR-375 and miR-760, we aimed in this study to investigate their expression profile and diagnostic and prognostic power in Egyptian colorectal cancer patients. The expression profile of miR-92a, miR-375, and miR-760 was determined in the sera of 64 colorectal cancer patients using quantitative real-time reverse transcription polymerase chain reaction in comparison to 27 healthy control subjects. The expression fold change of the studied microRNAs was correlated with patients' clinicopathological features. Receiver operating characteristic curve analysis was done to determine the role of these microRNAs in colorectal cancer diagnosis and follow-up according to the yielded area under the curve. The expression pattern of miR-92a was significantly upregulated (3.38 ± 2.52, p < 0.0001), while both of miR-375 and 760 were significantly downregulated (-1.250 ± 1.80, p< 0.0001; -1.710 ± 1.88, p < 0.0001, respectively) in colorectal cancer than the control. MiR-92a was positively correlated ( r = 0.671, p = 0.0001), while miR-375 and miR-760 were inversely correlated ( r = -0.414, p = 0.001; r = -0.644, p = 0.0001) with advanced colorectal cancer stages. Receiver operating characteristic curve analysis disclosed the highest diagnostic potential for miR-760 to discriminate colorectal cancer patients and early-stage colorectal cancer from the control (area under the curve = 0.922 and 0.875, respectively), while the highest prognostic potential for discrimination between colorectal cancer stages was for miR-92a. In conclusion, serum level of miR-92a, miR-375, and miR-760 may serve as biomarkers of colorectal cancer in Egyptian patients with high diagnostic power for miR-760 and high prognostic power for miR-92a.

Throughout human history, plant products have been used for many purposes including as medicines. Herbal products and spices can be used as preventive agents against cancer due to their antimicrobial, antioxidant and antitumorigenic properties. This study was designed to evaluate the potential protective effect of curcum in rats administered nitrosamine precursors; dibutylamine (DBA) and sodium nitrate (NaNO3); and infected with Escherichia coli (E. coli) and also to monitor changes in nuclear factor the Kappa B p65 (NF-κB p56) pathway and its downstream products, Bcl-2 and interleukin-6 (IL-6), in parallel with nitrosamine precursors, E. coli and curcum treatment. Rats were divided into three groups (n=25 each; except of control group, n+20). Group I a normal control group, group II administered DBA/NaNO3 in drinking water and infected with E. coli and group III was administered DBA/NaNO3 in drinking water, infected with E. coli and receiving standard diet containing 1% curcum powder. Histopathological examination reflected that the curcum treated group featured a lower incidence of urinary bladder lesions,and lower levels of NF-κB, Bcl-2 and IL-6, than the group receiving nitrosamine precursor and infected with E. coli. These findings suggested that curcum may have a protective role during the process of bladder carcinogenesis by inhibiting the NF-κB pathway and its downstream products.

Aims and Background: Human leukocyte antigen-G and interleukin-2 receptor play pivotal roles in the proliferation of lymphocytes, and thus generation of immune responses. Their overexpression has been evidenced in different malignant hematopoietic diseases. This study aimed to validate serum soluble human leukocyte antigen-G (sHLA-G) and serum soluble interleukin-2 receptor (sIL-2R) as an additional tool for the diagnosis and follow up of acute lymphoblastic leukemia (ALL)., Subjects and Methods: Both markers were determined by ELISA in the serum of 33 ALL pediatric patients before treatment and after intensification phase of chemotherapy as well as in the serum of 14 healthy donors that were selected as a control group., Results: ALL patients showed abnormal CBC and high serum lactate dehydrogenase, which were improved after chemotherapy. Also, there was a non-significant increase in serum sHLA-G in ALL patients compared with the control group. However, after chemotherapy, sHLA-G was increased significantly compared with before treatment. On the other hand, serum sIL-2R in ALL patients was increased significantly compared with the control group. After chemotherapy, sIL-2R decreased significantly compared with before treatment., Conclusions: From these results it could be suggested that measurement of serum sHLA-G might be helpful in diagnosis of ALL, while sIL-2R might be useful in diagnosis and follow-up of ALL in pediatric patients.