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Liquidity status can impact monetary policy decisions and therefore the macroeconomic framework as a whole. This highlights the importance of accurately defining the liquidity status of the economy at any point of time. The ‘money gap’ concept is gaining attention and being employed to measure excess liquidity. The purpose of this article is to investigate whether the ‘money gap’ in this regard is reliable or not. Our methodology consisted of two stages. The first was a critical literature review of the different interpretations of the ‘money gap’. The review revealed that; the money gap, as a measurement of excess liquidity, is misleading. This is because, it benchmarks liquidity status to a base period or to long term equilibrium; both benchmarks don’t reflect the current macroeconomic needs. Therefore, we moved to stage two; we developed a framework of analysis to inform monetary authorities, in inflation targeting regimes, regarding current liquidity status. This framework didn’t only consider the Marshallian K, in liquidity analysis, as established in literature, but also, originally, simultaneously considered the inflation level relative to the target. This is through linking the different possible values of the Marshallian K to the different possible levels of inflation in an inflation targeting regime. Such linkage enabled to classify, within each liquidity status, different levels of inflationary pressures. This framework can help monetary authorities, in inflation targeting regimes; accurately timely define liquidity status and the relative level of inflationary pressures, this is to make accurate timely policy choices, especially needed in crisis time.

The output gap measurement helps assess a country’s growth performance, fiscal space and to forecast inflationary pressures. It is measured based on the ‘potential output’. The latter captures the notion that there is an equilibrium level of production and policymakers try to reach an economic environment consistent with the operation of the economy at this equilibrium. This article put the non-inflationary potential output approach in question. This is because, a non-inflationary long term equilibrium would require in the short run a non-inflationary economic environment which entails, according to Phillips curve, a stable unemployment rate implying then that some people who can and are willing to work will not find jobs. The alternative methodology we proposed, to measure the potential output, and therefore the output gap, relied on the hypothesis that labor is the production factor that produces and uses capital as well as develops technology. Thus, the economy will reach its potential output when the unemployment rate is zero. This methodology enables to align macroeconomic policies objectives in order to support employment. The unemployed willingness to work won’t be offended by macroeconomic policies that put a non-inflationary equilibrium as an ultimate objective. Besides, this methodology suggests that; policies aiming to increase the labor force as well as policies aiming to increase the real productivity by worker can expand the production capacity of the economy i.e., its potential output. It also suggests that; policies aiming to reduce the unemployment rate can help the economy reach full employment i.e., its full capacity.

Background : Cisplatin-based combination chemotherapy before surgery is the standard of care for muscle-invasive bladder cancer. However, the optimal chemotherapy modalities have not been precisely defined to date. Patients and Methods : In the VESPER trial, patients received after randomization either gemcitabine and cisplatin (GC, 4 cycles) or methotrexate, vinblastine, doxorubicin and cisplatin (dose dense [dd]-MVAC, 6 cycles). Creatinine clearance (CrCl) was calculated before each cycle according to the Cockroft and Gault formula. Definition criteria for local control after neoadjuvant chemotherapy included pathological complete response (ypT0N0), pathological downstaging ( Results : A total of 2,128 cycles of chemotherapy were delivered, including 2,120 (99.6%) with cisplatin. Full doses of cisplatin were given in 1866 (88%) cycles. Twenty-three (4.7%) patients had to stop chemotherapy (12 GC, 11 dd-MVAC) because of renal failure. No difference in CrCl median values was observed between the two regimens during the first four cycles. A mild decrease occurred thereafter in patients treated with two additional cycles of dd-MVAC. A minimum total dose of 270 mg/m2 for cisplatin was mandatory to optimize pathological complete responses. Conclusion : At least 4 cycles of cisplatin-based chemotherapy should be delivered before cystectomy. Increasing the number of cycles beyond 4 cycles does not lead to a clinically significant deterioration in renal function but without obvious gain on local control. MicroAbstractCGC : A deep analysis of data from a randomized trial of perioperative chemotherapy in muscle-invasive bladder cancer shows that a minimum number of 4 cycles is required to optimize the chances of pathological complete response at cystectomy. Increasing the number beyond 4 cycles does not lead to a clinically significant deterioration in renal function without any obvious gain on pathological complete response.

Background: Colorectal Cancer (CRC) is the most common type affecting the gastrointestinal tract accounting for about 13% of all malignancy diagnosed each year. Although Surgery stays the most effective treatment in managing colorectal carcinoma, there is a rapid increase in the use of preoperative radiotherapy and chemotherapy. Objective: So, the present study was conducted to identify the different therapeutic modalities used in the treatment. Patients and Methods: This study was a retrospective study that included CRC patients treated at the Clinical Oncology Department, Zagazig University Hospital during the period from 2012 to 2017. Medical records of 385 patients, who were referred to the Clinical Oncology Department after being diagnosed with CRC were obtained and used to collect data about different treatments and then analyzed. Results: Chemotherapy regimen FOLFOX was received in (45.5%) of cases and partial response in 41 % of cases was observed. Patients received at least one line of chemotherapy with either adjuvant or palliative intent. Rectal cancer patients who received neoadjuvant concurrent chemo& radiotherapy showed a partial response in 45.5 % of cases. Xeloda was the most common chemotherapy received in most cases who received either adjuvant or neoadjuvant CCRT. Recurrence occurred in (81%) of cases. Conclusion: Chemotherapy regimen FOLFOX was received in most cases. Patients received at least one line of chemotherapy with either adjuvant or palliative intent, FOLFOX was the most chosen protocol. Xeloda was the most common chemotherapy received in most cases

Amal A Mohamed,1 Alshymaa Hassnine,2 Amr Elsayed,2 Mahmoud Montaser,3 Yasmeen Ismail,4 Ahmed El-Demery,5 Eman Sultan,6 Rania S Abdel Aziz,7 Eman Eldemiry,8 Radwa Hagag,9 Amal A El-Kholy,10 Eman Salah11 1Biochemistry and Molecular Biology Department, National Hepatology & Tropical Medicine Research Institute, Cairo, Egypt; 2Gastroenterology and Tropical Medicine Department, Faculty of Medicine, Minia University, Minia, Egypt; 3Department of Dermatology, Andrology and STDs, Faculty of Medicine, Minia University, Minia, Egypt; 4Clinical Pharmacology Department, Faculty of Medicine, Benha University, Benha, Egypt; 5Biochemistry Department, Faculty of Medicine, October 6 University, 6th of October City, Egypt; 6Clinical Nutrition Department, National Nutrition Institute, Cairo, Egypt; 7Clinical and Chemical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt; 8Faculty of Pharmacy, Fellow of Clinical Pharmacology, Cairo University Hospitals, Giza, Egypt; 9Pharmacy Practice and Clinical Pharmacy Department, Faculty of Pharmacy, Egyptian Russian University, Badr City, Egypt; 10Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt; 11Department of Dermatology, Andrology, Sexual Medicine and STDs, Faculty of Medicine, Helwan University, Cairo, EgyptCorrespondence: Amal A El-KholyClinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, EgyptTel +201060355448Email Amal.elkhouly@pharma.asu.edu.egBackground: Acne vulgaris (AV) is a chronic inflammatory disease that affects the pilosebaceous unit. Leptin (LEP) gene polymorphisms is associated with higher risk of multiple disorders. Insulin-like growth factor-1 (IGF-1) exerts comedogenic effect by stimulating the sebaceous glands. Isotretinoin is an effective oral therapy for AV with many side effects including hyperlipidemia and increased serum levels of liver enzymes.Purpose: To evaluate the impact of LEP gene rs7799039 polymorphism in acne patients’ clinical response lipid profile and liver enzymes following 6 months oral isotretinoin therapy in Egyptian AV patients.Methods: One hundred eligible AV patients received 0.5 mg/kg oral isotretinoin for 6 months. Patients’ demographics and clinical data were obtained. Body mass index (BMI), lipid profile, liver enzymes and IGF-1 were measured at baseline and after 6 months of therapy. Genotyping was done for LEP gene rs 7799039.Results: Six month administration of oral isotretinoin in Egyptian AV patients is associated with significantly elevated aspartate transaminase (AST) in CC and AC genotypes (P< 0.001). Significant alanine aminotransferase (ALT) elevation was observed in CC, AC and AA genotypes (P < 0.001, 0.004, 0.002, respectively). Total cholesterol (TC), triglycerides (TG) and low density lipoprotein (LDL) were elevated significantly P< 0.001) in the three genotypes. IGF-1 was decreased significantly in CC and AC genotypes (P< 0.001). CC genotype is associated with highest response (P< 0.001).Conclusion: LEP rs7799039 gene had an impact on the clinical response, lipid profile and liver enzymes in AV patients treated with oral isotretinoin. LEP rs7799039 CC genotype is predicted to be the treatment candidate for 6 month oral isotretinoin.Keywords: leptin, IGF-1, lipid, isotretinoin, liver enzymes, LEP, insulin-like growth factor-1

Hepatitis B and C viruses are leading causes of liver cirrhosis and hepatocellular carcinoma (HCC). Toll-like receptor 7 (TLR-7) has been implicated in the pathogenesis of HCC linked to hepatitis B. We hypothesised a role of leukocyte TLR-7 mRNA in hepatitis C related liver cirrhosis and HCC, using alpha-fetoprotein (AFP) and liver function tests as comparators.We recruited 102 patients with HCV-related HCC, 97 with HCV-related liver cirrhosis and 60 healthy controls. Quantification of TLR-7 mRNA was performed using real-time PCR, AFP and routine LFTs by standard techniques.TLR-7 mRNA levels were significantly lower in HCC patients compared to cirrhotic patients and lower again in healthy controls (p 0.001 for trend). In multivariate analysis, age, aspartate transaminase (AST), AFP, and TLR-7 mRNA were significant predictors of HCC. The ROCC/AUC for age, AST and TLR-7 mRNA were all between 0.64 and 0.78 (allThe combination of TLR-7 mRNA levels with age and AST improves the performance of TLR-7 in HCC diagnosis, out-performs alpha-fetoprotein and predicts early HCC.

Background and purpose: Colorectal Cancer (CRC) is the third most common cancer worldwide and in Egypt the 7th most common cancer in men and 4th most common cancer in women. It is the second leading cause of cancer-related deaths. So the present study was conducted to identify the epidemiological and clinico pathological features of colorectal cancers as studying these characteristics can improve patients’ survival rates. Patients and Method: This study is a retrospective study that included CRC patients treated at clinical oncology department, Zagazig University Hospital in the duration from 2012 to 2017. Medical records of 385 patients, who were referred to clinical oncology department after proven diagnosis with CRC and underwent colonoscopy, or discovered during emergency laparotomy were collected and analyzed. Results: The highest incidence (19.2%) was in 2017. The male & female cases were almost the same. About where (40%) of cases were presented with rectal and ano-rectal lesions, the majority of cases (46.7%) had fungating tumor mass and (91.5%) of cases had Adenocarcinoma and (76.1%) of cases were of grade II by histological grading. Least percentage of metastatic cases was noticed in patients with rectal and ano-rectal masses (10.8-14.8%). About (50%) of patients were node negative by operation pathology, while 50% of patients were of pathological stage III. Conclusion: The present study demonstrated a high prevalence of CRC among the studied patients, advance stage at presentation of this type of cancer, high probability of recurrence, and it significantly correlated with poor survival.

Background: Chronic spontaneous urticaria (CSU) is a common skin disorder affecting negatively patients' lives. Vitamin D deficiency has been reported to be associated to many allergic skin disorders.Objective: This study aimed to evaluate the association between the serum level of 25 hydroxy vitamin D and CSU and to assess the efficacy and safety of active vitamin D in management of CSU.Methods: The study was conducted on 77 patients with CSU and 67 healthy controls, then the 77 CSU patients were randomized to either the study group that received 0.25 µg alfacalcidol daily or the placebo group that received oral placebo for 12 weeks.Results: Serum 25(OH) D was significantly lower in CSU as compared to healthy controls and was negatively correlated to the urticarial severity. After alfacalcidol administration, the study group showed significant higher level of 25(OH) D compared to the placebo group. In addition, the mean serum level of IL6, hsCRP and TNFα significantly decreased in the study group in comparison to the placebo group and as compared to their baseline results.Conclusion: Vitamin D deficiency is more common in CSU patients as compared to healthy people and hence, alfacalcidol might have a beneficial role as add on therapy in CSU management with no reported side effects.

The main objective of the French GETUG/AFU V05 VESPER randomized phase III study was to assess the efficacy of dd-MVAC and GC in term of progression-free survival in patients for whom chemotherapy has been decided, before or after surgery.A total of 500 patients have been randomized in 28 reference centers. Inclusion criteria were urothelial carcinoma without neuro-endocrine variant, disease defined by a T2, T3 or T4a N0 (pelvic lymph node ≤ 10 mm on CT scan) M0 staging for patients receiving neoadjuvant chemotherapy or pT3 or pT4 or pN+ and M0 for patients receiving adjuvant chemotherapy. Secondary endpoints include overall survival, safety, response rate. The peri-operative chemotherapy schedule was experimental arm dd-MVAC for a total of 6 cycles versus standard arm GC 4 cycles. The toxicity was evaluated according to NCI CTCAE (v 4.0). The progression-free survival rate will be estimated at 3 years by the Kaplan-Meier method. All the patients will be followed for 5 years.The last patient was randomized in March 2018 and the primary endpoint results are expected for mid-2021. As the dd-MVAC schedule is associated with higher response rates in metastatic disease, the real question today is to confirm such benefit in the peri-operative setting, taking also in consideration the chemotherapy toxicity. Tomorrow, the challenge may be the best chemotherapy and immunotherapy association, the authors hope that final Vesper Trial results will help to determine the gold standard chemotherapy. Keywords: Bladder cancer, Peri-operative chemotherapy

Stem cell therapy is a promising approach for the treatment of type 1 diabetes mellitus (T1D). Previous studies recommended regular exercise for the control of T1D. Experimental studies showed that a combination of stem cells and exercise yielded a better outcome. Yet, the effect of exercise programs following stem cell transplantation in patients with T1D has not been investigated. Thus, the current study aimed to examine the effect of a combined exercise program on measures of glycemic control in patients with T1D who received autologous bone marrow stem cell transplantation (ABMSCT). Thirty patients with controlled T1D were assigned into two equal groups. Both groups underwent ABMSCT and received insulin therapy and a diabetic diet regime. Only the exercise group followed the combined exercise program. Outcome measures of glycemic control (i.e. fasting blood glucose level [FBG], post-prandial blood glucose level [PPG], HbA1c, daily insulin dosage, and C-peptide levels) were tested before and after a 3-month rehabilitation period. There were significant (

Because of the great need of using natural food additives nowadays, so, this work was conducted to utilize of propolis and turmeric powders at different levels (1.5, 2 and 2.5 %) as natural preservites during preparation of minced beef stored at refrigeration temperature (7 ± 1oC). The obtained results revealed that, propolis and turmeric had considerable effectiveness in decreasing aerobic plate count (APC) as well as some chemical indices as pH and thiobarbituric acid (TBA). Also, results indicated that the bacterial counts, pH and TBA values decrease as a function of increasing the concentration of the tested powder since the concentration of (2.5%) gives the best effectiveness. The antioxidant and antibacterial activities of the added propolis powder were higher than those of turmeric powder. In conclusion, propolis and turmeric can play an important role as antioxidant and antibacterial agents in refrigerated minced beef, but propolis powder is seems to be better one.

The present study was carried out to utilize different levels of germinated pumpkin seed flour (GPSF), as a source of protein and minerals in fortification of wheat flour for making pan bread. Organoleptic properties of prepared pan bread and its biological effect on lipids profile of rats fed on hypercholesterolemic diet were studied. Pan bread was prepared with GPSF at different levels. The results showed a significant decrease in fat content and an increase in protein, fiber contents and caloric value by increasing defatted GPSF replacement level. Biological assay indicated that food intake, protein intake, feed efficiency ratio and protein efficiency ratio of rats were not significantly affected by defatted GPSF replacement. Serum TC, TG and LDL-C were significantly decreased by replacement with 20% defatted GPSF while HDL-C increased and caused a beneficial effect in improving the lipids profile of rats fed on hypercholesterolemic diet.

Item does not contain fulltext BACKGROUND: In clinical trials, the use of intermediate time-to-event end points (TEEs) is increasingly common, yet their choice and definitions are not standardized. This limits the usefulness for comparing treatment effects between studies. The aim of the DATECAN Kidney project is to clarify and recommend definitions of TEE in renal cell cancer (RCC) through a formal consensus method for end point definitions. MATERIALS AND METHODS: A formal modified Delphi method was used for establishing consensus. From a 2006-2009 literature review, the Steering Committee (SC) selected 9 TEE and 15 events in the nonmetastatic (NM) and metastatic/advanced (MA) RCC disease settings. Events were scored on the range of 1 (totally disagree to include) to 9 (totally agree to include) in the definition of each end point. Rating Committee (RC) experts were contacted for the scoring rounds. From these results, final recommendations were established for selecting pertinent end points and the associated events. RESULTS: Thirty-four experts scored 121 events for 9 end points. Consensus was reached for 31%, 43% and 85% events during the first, second and third rounds, respectively. The expert recommend the use of three and two endpoints in NM and MA setting, respectively. In the NM setting: disease-free survival (contralateral RCC, appearance of metastases, local or regional recurrence, death from RCC or protocol treatment), metastasis-free survival (appearance of metastases, regional recurrence, death from RCC); and local-regional-free survival (local or regional recurrence, death from RCC). In the MA setting: kidney cancer-specific survival (death from RCC or protocol treatment) and progression-free survival (death from RCC, local, regional, or metastatic progression). CONCLUSIONS: The consensus method revealed that intermediate end points have not been well defined, because all of the selected end points had at least one event definition for which no consensus was obtained. These clarified definitions of TEE should become standard practice in all RCC clinical trials, thus facilitating reporting and increasing precision in between trial comparisons.

Background: Type 1 diabetes (T1D) results from the autoimmune destruction of islet s-cells. Recent studies have shown that cell therapy shows promise in combating this. However, many problems are associated with the systemic administration of these cells, including nonspecific accumulation of cells in an organ other than the target organ. The objective of this study was to evaluate the safety and efficacy of autologous bone marrow-derived mononuclear cells (A-BMMNCs) via Direct Trans-gastric Intra-pancreatic (DTI) delivery as a potential treatment for Egyptian patients with T1D. Methods: 17 patients whose ages ranged between 2 and 30 years were assigned to receive a single administration of A-BMMNCs via DTI delivery and followed up for 1 year. The main outcome was assessment of safety. We also assessed islet cells and insulin antibodies pre-transplantation and, in patients who were serologically positive for these, again 6 months post-transplantation. Glycated hemoglobin (HbA1c) and fasting and 2 h postprandial C-peptide levels (FCP, 2h-CP) were also measured to evaluate s-cell function. Finally, we determined insulin doses. Results: No complications were recorded during the study across all patients. Islet cell antibodies were undetectable pre-transplantation for all patients. 10/17 patients were positive for anti-insulin antibodies pretransplantation and 7/17 were negative; of those who were positive, 6 converted to being negative for anti-insulin antibodies and 4 were still positive for anti-insulin antibodies) within 1 year post-transplantation. HbA1c and insulin doses were significantly lower at 5 months post-transplantation compared with baseline. FCP levels rose significantly in the first 2 months with little change in 2h-CP levels. Conclusions: A-BMMNCs transplantation via DTI delivery route is a simple, safe and innovative procedure. It can temporarily modify the course of T1D, could be a beneficial treatment modality in the future to control the progression of the disease and potentially opening a new way to cure diabetes (ISRCTN15591075).

Purpose Median age for the diagnosis of metastatic bladder cancer (MBC) is 73 years. The feasibility of chemotherapy in older patients is controversial. Our objectives were to assess associations linking age to first line chemotherapy regimen selection, early chemotherapy discontinuation, and 1-year mortality in everyday practice. Materials and methods Between 1999 and 2011, 197 consecutive patients aged≥70 years with MBC referred to 4 hospitals were included in the AGEVIM multicenter cohort. At baseline, we recorded performance status (PS); tumor characteristics; the Charlson Comorbidity Index; and plasma creatinine, hemoglobin, and albumin. Early discontinuation data were available for 193 patients, and overall 1-year mortality for 180 patients. We assessed the probabilities of initial cisplatin-based combination chemotherapy (CCC), early discontinuation (≤2 cycles), and 1-year mortality, using multivariate logistic regression and Cox proportional hazards modeling. Results Among the 193 patients (mean age: 76±4.3 y), with 2 metastatic site in median 43.5% received CCC, 36.3% gemcitabine and carboplatin, and 20.2% gemcitabine alone. The probability of CCC decreased with age independently from sex, PS, creatinine clearance, and Charlson Comorbidity Index (P Independent predictors of 1-year mortality (median = 9.6 mo) were early discontinuation (adjusted hazard ratio [aHR] = 4.77 [2.85–7.96] when PS Conclusion Less than half of older patients with MBC received initial CCC and 25% had≤2 cycles of chemotherapy. Older age was associated with decreased CCC prescription, independently from known contraindications, and with global chemotherapy early discontinuation, but not with 1-year mortality.