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Background Acute gastrointestinal bleeding (AGIB) is common in older patients but the use of iron in this context remains understudied. Aims This study aimed to evaluate prospectively the efficacy of ferric carboxymaltose to treat anaemia in older patients after AGIB. Methods This randomised double-blinded placebo-controlled clinical trial was conducted in 10 French centres. Eligible patients were 65 years or more, had controlled upper or lower gastrointestinal bleeding and a haemoglobin level of 9–11 g/dl. Patients were randomly assigned, in a 1:1 ratio, to receive either one intravenous iron injection of ferric carboxymaltose or one injection of saline solution. The primary endpoint was the difference in haemoglobin level between day 0 and day 42. Secondary endpoints were treatment-emergent adverse events, serious adverse events, rehospitalisation and improvement of quality of life (QOL) at day 180. Results From January 2013 to January 2017, 59 patients were included. The median age of patients was 81.9 [75.8, 87.3] years. At day 42, a significant difference in haemoglobin level increase was observed (2.49 g/dl in the ferric carboxymaltose group vs. 1.56 g/dl in the placebo group, P  = 0.02). At day 180, QOL, measured on European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, improved by 10.5 points in the ferric carboxymaltose group and by 8.2 points in the placebo group (P  = 0.56). Rates of adverse events and rehospitalisation were similar in the two groups. Conclusions Intravenous iron seems safe and effective to treat anaemia in older patients after AGIB and should be considered as a standard-of-care treatment. ClinicalTrials.gov (NCT01690585). [ABSTRACT FROM AUTHOR]

Context Several meta-analyses have been conducted on the effect of nutritional interventions on various factors related to muscle damage. However, the strength of the evidence and its clinical significance are unclear. Objectives This umbrella review aimed to provide an evidence-based overview of nutritional interventions for exercise-induced muscle damage (EIMD). Data sources PubMed, Scopus, and ISI Web of Science were systematically searched up to May 2022. Data Extraction Systematic reviews and meta-analyses of randomized controlled trials investigating nutritional interventions' effects on recovery following EIMD were included. The certainty of the evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results Fifty-three randomized controlled trial meta-analyses were included, evaluating 24 nutritional interventions on 10 different outcomes. The results revealed a significant effect of hydroxymethylbutyrate (HMB) supplementation and l -carnitine supplementation for reducing postexercise creatine kinase; HMB supplementation for reducing lactate dehydrogenase; branched-chain amino acids and leaf extract supplementation for reducing the delayed onset of muscle soreness; and l -carnitine, curcumin, ginseng, polyphenols, and anthocyanins for reducing muscle soreness, all with moderate certainty of evidence. Conclusions Supplementation with HMB, l -carnitine, branched-chain amino acids, curcumin, ginseng, leaf extract, polyphenols, and anthocyanins showed favorable effects on some EIMD-related outcomes. Protocol Registration PROSPERO registration no. CRD42022352565. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES Serratus anterior plane block (SAPB) and paravertebral block (PVB) are well known to reduce pain levels after video-assisted thoracoscopic surgery (VATS). However, the relative efficacies of each block and a combination of the 2 have not been fully characterized. The objective of the present study was to assess the efficacy of PVB alone, SAPB alone and the combination of PVB and SAPB with regard to the occurrence and intensity of pain after VATS. METHODS We conducted the THORACOSOPIC single-centre, double-blind, randomized trial in adult patients due to undergo elective VATS lung resection. The participants were randomized to PVB only, SAPB only and PVB + SAPB groups. The primary end-point was pain on coughing on admission to the postanaesthesia care unit. The secondary end-points were postoperative pain at rest and on coughing at other time points and the cumulative opioid consumption. Pain was scored on a visual analogue scale. RESULTS One-hundred and fifty-six patients (52 in each group) were included. On admission to the postanaesthesia care unit, the 3 groups did not differ significantly with regard to the pain on coughing: the visual analogue scale score was 3 (0–6), 4 (0–8) and 2 (0–6) in the PVB, SAPB and PVB + SAPB groups, respectively (P  =   0.204). During postoperative care, the overall pain score was significantly lower in the SABP + PVP group at rest and on cough. CONCLUSIONS The combination of SABP + PVB could be beneficial for pain management in VATS in comparison to SABP or PVB alone. [ABSTRACT FROM AUTHOR]

Burn injuries comprise the most common accidents worldwide. The delivery of burn care has been adversely affected by the absence of effective burn management and aesthetic services. This study attempts to address the attitude of Saudi residents of plastic surgery toward obtaining a burn fellowship and to examine the factors that might influence their decisions in this regard. An online survey was sent to 39 plastic surgery residents in Saudi Arabia including levels from PGY 1 to 6 in the academic year of 2019. The questionnaire was used to demonstrate interest, knowledge, and major factors influencing or discouraging residents from choosing Burn as a subspecialty in their future career. Residents responded to knowledge questions on a scale of 3 (below average/average/above average). The response rate was 84%. Thirty-three residents completed the questionnaire. The age group was between 30 and 34 years. Only 27% of the respondents expressing interest in burn practice. The main factors that make the plastic surgery resident avoid pursuing burn fellowship were multiple operations sessions, lifestyle, financial outcome, and emotional aspects. On the other hand, the paucity of burn surgeons and being involved in the humanitarian mission were attracting factors. Most of the residents believe that burn must be obligatory and continue to be part of all plastic surgery training programs (100%). In Saudi Arabia, the relative paucity of specialist mentors on plastic surgery programs may limit residents' exposure to subspecialties such as burn during plastic surgery rotational experiences. The findings from this survey may help plastic surgery program directors or burn surgeons, in particular, to find out strategies to attract future trainees. [ABSTRACT FROM AUTHOR]

Endorsement of African-centered theory and practice are widespread within Black communities across the United States. The usage of African-centered frameworks is also common among many Black social workers. However, past research suggests that African-centered theory and subsequent models of practice are marginalized within social work literature and curricula. Since advocacy began for the inclusion of African-centered approaches to practice during the mid to late 1990s, there have been no strategic analyses tracing how African-centered scholarship has advanced within social work. This study sought to examine to what extent the African-centered framework is included within scholarship among prominent social work journals. A content analysis was conducted of articles in six major social work journals published between 2000 and 2019. A total of 42 articles met the criteria for inclusion. While there has been a level of change in the number of published articles of African-centered social work, findings suggest that relative to other practice modalities/models, African-centered scholarship is noticeably lacking in social work literature. The article concludes with implications to advance culturally responsive research and practice with communities of African descent. [ABSTRACT FROM AUTHOR]

Aims Readmission is frequent among patients with cirrhosis and is a complex multifactorial process. To examine the association of alcohol use disorder (AUD) and risk of readmission in patients with alcohol-associated cirrhosis. Methods and Results National Readmission Dataset (2016–2017) was used to extract a retrospective cohort of 53,348 patients with primary or secondary discharge diagnosis code of alcohol-associated cirrhosis with their first admission (26,674 patients with vs. propensity matched 26,674 without a primary or secondary discharge diagnosis code of AUD). Readmission within 30-day was lower (43.9 vs. 48%, P  < 0.001) among patients identified to have AUD at the time of discharge. In a conditional logistic regression model, a diagnosis of AUD was associated with 15% reduced odds of 30-day readmission, 0.85 (0.83–0.88). Furthermore, the reason for readmission among patients identified vs. not identified to have AUD was less likely to be liver disease complication. The findings remained similar in a matched cohort of patients where the AUD diagnosis at discharge was listed as one of the secondary diagnoses only. Conclusion Although, our study findings suggest that identification of AUD at the time of discharge among patients hospitalized for alcohol-associated cirrhosis reduces the risk of 30-day readmission, unavailable information on patient counseling, referral for mental health specialist and treatment received for AUD limit the causality assessment. Future studies are needed overcoming the inherent limitations of the database to establish the role of identification and treatment of AUD in reducing readmission and liver decompensation in patients with alcohol-associated cirrhosis. [ABSTRACT FROM AUTHOR]

Background: Risk stratification is an important and essential component in proper patient counseling when dealing with complex coronary anatomy and decision making between either coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI). The SYNTAX score was pioneered as an anatomical-based risk score that aided in this decision-making process. Objective: To develop an electronic registry for patients with complex coronary anatomy with intermediate to high SYNTAX score undergoing non-emergent PCI who were indicated for CABG but either they were rejected by the surgeons or they refused it. Patients and Methods: Our registry was conducted on 193 patients presented during eight months from the first of July 2021 till the end of February 2022 to Ain Shams University Hospitals and underwent PCI. Results: comparing the intermediate to high SYNTAX score groups, there is a statistically significant increase in the in hospital and short term MACE and mortality with high SYNTAX score patients, while there was no difference regarding in hospital CIN. Regarding MACE it significantly increases in patients with anemia, CKD, LV dysfunction. For multivariate analysis it is shown that both incomplete revascularization and clinical SYNTAX II are independent predictors for the occurrence of short term MACE. Conclusion: Both incomplete revascularization and clinical SYNTAX II score are independent predictors of short term (6 months) occurrence of MACE. [ABSTRACT FROM AUTHOR]

Alcohol consumption represents a major factor of morbidity and mortality, with a wide range of adverse medical implications that practically affect every organ system. It is the fifth major cause of deaths in men and women and causes up to 139 million disability-adjusted life years. Solid evidence places the risk as undoubtedly correlated to the length of time and amount of alcohol consumption. While alcohol-related liver disease represents one of the most studied and well-known consequences of alcohol use, the term itself embodies a wide spectrum of progressive disease stages that are responsible for almost half of the liver-related mortality worldwide. We discuss the staged alcohol-related fatty liver, alcohol-related steatohepatitis and, finally, fibrosis and cirrhosis, which ultimately may end up in a hepatocellular carcinoma. Other comorbidities such as acute and chronic pancreatitis; central nervous system; cardiovascular, respiratory and endocrine system; renal disease; urological pathologies; type 2 diabetes mellitus and even infectious diseases are reviewed in their relation to alcohol consumption. This article reviews the impact of alcohol use on different systems and organs, summarizing available evidence regarding its medical implications. It examines current basic and clinical data regarding mechanisms to highlight factors and processes that may be targetable to improve patient outcomes. Although alcohol use is a part of many cultural and social practices, as healthcare providers we must identify populations at high risk of alcohol abuse, educate patients about the potential alcohol-related harm and provide appropriate treatment. [ABSTRACT FROM AUTHOR]

In the present work, tandem dispersive liquid–liquid microextraction (TDLLME) coupled with liquid chromatography was used for the determination of the two antidepressant drugs citalopram (CIT) and sertraline (SER) in complicated matrices. Indeed, the present approach was used to improve the suitability and appropriateness of the dispersive liquid–liquid microextraction (DLLME) method in complicated matrices. Firstly, 10 mL of the sample solution containing the two understudied drugs was extracted into an organic solvent (200 μL of 1,2-dichloromethane) using the DLLME method. Then the extracted analytes were back-extracted into 100 μL of an aqueous acceptor phase. The total extraction time of this method is about 6 min. To achieve the best efficiency for this method, efficient parameters like the kind and volume of the organic solvent and the effect of the ionic strength on the effectiveness of extraction were reviewed and improved. Under the optimized experimental conditions, TDLLME showed good linearity in the range of 100.0–7000.0 ng mL−1. The limits of detection were found to be 10.0 ng mL−1 for CIT and 2.0 ng mL−1 for SER. The relative standard deviation (RSD) is obtained in the range of 0.7–4.1%. [ABSTRACT FROM AUTHOR]

Position-specific scoring matrix (PSSM), also called profile, is broadly used for representing the evolutionary history of a given protein sequence. Several investigations reported that the PSSM-based feature descriptors can improve the prediction of various protein attributes such as interaction, function, subcellular localization, secondary structure, disorder regions, and accessible surface area. While plenty of algorithms have been suggested for extracting evolutionary features from PSSM in recent years, there is not any integrated standalone tool for providing these descriptors. Here, we introduce PSSMCOOL, a flexible comprehensive R package that generates 38 PSSM-based feature vectors. To our best knowledge, PSSMCOOL is the first PSSM-based feature extraction tool implemented in R. With the growing demand for exploiting machine-learning algorithms in computational biology, this package would be a practical tool for machine-learning predictions. [ABSTRACT FROM AUTHOR]

Due to climate change, sessile oak (Quercus petraea) seedlings experience an increasing risk of drought during regeneration of forest stands by management practices. The present study was aimed at elucidating the potential of sessile oak seedlings originating from sites with different aridity and nitrogen (N) supply to acclimate to contrasting water availability. For this purpose, a free-air cross-exchange experiment was conducted between a dry and a humid forest stand with high and low soil N contents, respectively, during two consecutive years differing in aridity before harvest. Almost all structural and physiological foliar traits analyzed did not differ consistently between seed origins during both years, when cultivated at the same site. As an exception, the arid provenance upregulated foliar ascorbate contents under drought, whereas the humid provenance accumulated the phenolic antioxidants vescalagin and castalagin (VC) under favorable weather conditions and consumed VC upon drought. Apparently, differences in long-term aridity at the forest sites resulted in only few genetically fixed differences in foliar traits between the provenances. However, structural and physiological traits strongly responded to soil N contents and weather conditions before harvest. Foliar N contents and their partitioning were mostly determined by the differences in soil N availability at the sites, but still were modulated by weather conditions before harvest. In the first year, differences in aridity before harvest resulted in differences between most foliar traits. In the second year, when weather conditions at both sites were considerably similar and more arid compared to the first year, differences in foliar traits were almost negligible. This pattern was observed irrespective of seed origin. These results support the view that leaves of sessile oak seedlings generally possess a high plasticity to cope with extreme differences in aridity by immediate acclimation responses that are even better developed in plants of arid origin. [ABSTRACT FROM AUTHOR]

Objective Impairments present in chronic pain conditions have been reported not to be limited to the painful region. Pain-free regions have also been proposed to be adversely affected as a cause or consequence of the painful condition. The aim of this study was to investigate the association between muscle strength in painful and pain-free regions and chronic neck pain. Design A cross-sectional study. Setting Rehabilitation hospital laboratory. Subjects One hundred twenty-two patients with chronic neck pain (87 female) and 98 asymptomatic volunteers (52 female) were included in the study. Methods Maximal isometric strength measures of the neck, scapulothoracic, shoulder, trunk, and hip muscles were assessed using a hand-held dynamometer in all participants. Pain intensity and pain-related disability were also assessed in patients through visual analog scale and Neck Disability Index scores, respectively. Results Principal component analysis revealed one component for each of the studied regions. Multivariate analysis of variance found neck (d  =   0.46), scapulothoracic (d  =   0.46), shoulder (d  =   0.60), trunk flexor (d  =   0.38), extensor (d  =   0.36), and hip (d  =   0.51) strength components to be lower in the neck pain patients compared with asymptomatic participants (P  <   0.01). Logistic and linear regression analyses found the shoulder strength component both to be a significant predictor for neck pain occurrence (β = 0.53, P  <   0.01) and to have a considerable effect on pain intensity score (β=–0.20, P  =   0.02), respectively. Conclusions The results found that some pain-free regions in addition to the cervical spine to exhibit lower levels of muscular strength in neck pain patients. These findings support the regional interdependence theory, which proposes that impairments are not limited to the painful area and are possibly mediated by central mechanisms. [ABSTRACT FROM AUTHOR]

Walnut production is challenged by climate change and abiotic stresses. Elucidating the genomic basis of adaptation to climate is essential to breeding drought-tolerant cultivars for enhanced productivity in arid and semi-arid regions. Here, we aimed to identify loci potentially involved in water use efficiency (WUE) and adaptation to drought in Persian walnut using a diverse panel of 95 walnut families (950 seedlings) from Iran, which show contrasting levels of water availability in their native habitats. We analyzed associations between phenotypic, genotypic, and environmental variables from data sets of 609 000 high-quality single nucleotide polymorphisms (SNPs), three categories of phenotypic traits [WUE-related traits under drought, their drought stress index, and principal components (PCs)], and 21 climate variables and their combination (first three PCs). Our genotype–phenotype analysis identified 22 significant and 266 suggestive associations, some of which were for multiple traits, suggesting their correlation and a possible common genetic control. Also, genotype–environment association analysis found 115 significant and 265 suggestive SNP loci that displayed potential signals of local adaptation. Several sets of stress-responsive genes were found in the genomic regions significantly associated with the aforementioned traits. Most of the candidate genes identified are involved in abscisic acid signaling, stomatal regulation, transduction of environmental signals, antioxidant defense system, osmotic adjustment, and leaf growth and development. Upon validation, the marker–trait associations identified for drought tolerance-related traits would allow the selection and development of new walnut rootstocks or scion cultivars with superior WUE. [ABSTRACT FROM AUTHOR]

Objectives Recently, ribavirin has been suggested as a therapeutic approach in Crimean–Congo haemorrhagic fever (CCHF) patients; however, there are controversial findings about its efficacy. In the current study, a meta-analysis was systematically performed to assess the effectiveness of ribavirin administration regarding CCHF patient survival and to explore the most important influential parameters for its efficacy. Methods All of the outcomes of the clinically studied CCHF patients who were treated with ribavirin were included in the meta-analysis. Results Overall, 24 studies met our criteria. Although the studies did not have high quality there was no heterogeneity and publication bias across studies. The results indicated that the administration of ribavirin to CCHF patients significantly decreased the mortality rate (by 1.7-fold) compared with those who did not receive this medication. Furthermore, it was found that the prescription of ribavirin in the initial phase of disease was more effective, and a delay in the start of treatment resulted in a 1.6-fold increase in mortality rate. In addition, interventional therapy resulted in an ∼2.3-fold reduction in the mortality rate of those who received ribavirin along with corticosteroids compared with those who were treated with ribavirin monotherapy. Conclusions This meta-analysis reveals that ribavirin should be considered as a crucial antiviral drug in the therapeutic approach used for CCHF patients, especially in early phases of the disease. Additionally, it seems that the administration of corticosteroids alongside ribavirin can play an effective role in alleviation of the disease status, particularly in haemorrhagic phases. [ABSTRACT FROM AUTHOR]

Objective: Health literacy has become a global issue, and it is important that patients and individuals are able to use information technology to access health information and educational services. The research objective is to develop a Saudi e-health literacy scale (SeHL) for measuring e-health literacy among Saudis suffering from non-communicable diseases (NCD).Methods: Overall, 14 relevant papers in related interdisciplinary fields were reviewed to select the most useful literacy dimensions. From these articles, we extracted the most common dimensions used to measure e-health literacy across the disciplines. Multiple workshops with multidisciplinary team members reviewed and evaluated items for SeHL.Results: Four key aspects of e-health literacy-use of technology/media, information-seeking, usefulness and confidence-were identified and integrated as e-health literacy dimensions. These will be used to measure e-health literacy among Saudi patients with NCDs. A translation from Arabic to English was performed in order to ensure that translation process was accurate. A SeHL scale was developed to measure e-health literacy among Saudi patients. By understanding e-health literacy levels, we will be able to create a patient-education system to be used by patients in Saudi Arabia.Conclusions: As information technology is increasingly used by people of all ages all over the world, e-health literacy has been identified as a key factor in determining health outcomes. To date, no comprehensive scale exists to assess e-health literacy levels among speakers of Arabic, particularly among people with NCD such as diabetes, cardiovascular diseases and hypertension. [ABSTRACT FROM AUTHOR]

The open access to epinephrine autoinjectors has resulted in an increased number of reports related to accidental injection into the digits. The appropriate management after accidental injection remains controversial. This study presents the first case in Saudi Arabia of a young man who accidentally injected epinephrine into the thumb and a literature review of the treatment options available. A 19-year-old man presented with accidental injection of 300 mcg of epinephrine into the volar pulp of his right thumb while treating an allergic reaction. The embedded needle was removed by countertraction and irrigation. The examination results were normal. The patient was discharged with prophylactic antibiotic and analgesia. Later, the puncture wound healed and vascularity and sensation remained intact. Conservative management and observation are advantageous in certain cases if vascular function is uncompromised. This case highlights the importance of education about the correct handling and administration of the epinephrine injection. [ABSTRACT FROM AUTHOR]

Study Question: Do the stage and grade of malignancy affect the fertility preservation outcome in females?Summary Answer: Patients with high-grade cancer have a decreased number of retrieved mature oocytes and cryopreserved embryos.What Is Known Already: Cancer has local and systemic effects on the host. The effects of cancer spread and aggressiveness on the ovarian function and stimulation response remain unclear.Study Design, Size, Duration: Retrospective cohort study evaluating data of all fertility preservation treatment cycles among women with cancer at the reproductive unit of the McGill University Health Centre in the period from 2008 to 2017.Participants/materials, Setting, Methods: Study inclusion criteria were age 18-38 years, first stimulation cycle, GnRH-antagonist protocol and early follicular phase stimulation start. Only one stimulation cycle per patient was included. Patients with ovarian pathology, previous ovarian surgery and previous chemo- or radiotherapy were excluded. The outcomes of women with low-stage cancer (local tumor Stage I-II, no lymph node involvement, no metastases) were compared with those with high-stage disease (local tumor Stage III-IV, lymph node involvement or metastases). Similarly we compared those with low-grade (G1-2) and high-grade (G3-4) malignancies. The primary outcome measure was the number of mature oocytes retrieved. The secondary outcomes included the total number of retrieved oocytes, the number of vitrified oocytes, and the number of frozen embryos. We used Student's t-test for normally distributed data and Wilcoxon test for skewed data. To determine factors associated with good fertility preservation outcome defined as over 10 retrieved mature oocytes, we used multivariate logistic regression.Main Results and the Role Of Chance: A total of 147 patients were included in the final analysis. Age, body mass index, ovarian reserve parameters of the study groups in stage- and grade-based analyses were similar. Compared to women with low-stage cancer (n = 83), those with high-stage cancer (n = 64) required a higher dose of gonadotropin (P = 0.02). The number of retrieved mature oocytes (9 (7-13) versus 8 (5-12); P = 0.37) and vitrified oocytes (10 (7-15) versus 10 (7-13); P = 0.53) were similar between the two groups. However, in cycles where fertilization of all retrieved oocytes was performed, the fertilization rate (82.7% versus 71.5%; P = 0.03) and the number of vitrified embryos (6.2 ± 3.2 versus 4.3 ± 2.1; P = 0.01) were higher in the low-stage group. Compared to patients with low-grade cancer (n = 62), those with high-grade disease (n = 85) had significantly lower number of retrieved mature oocytes (11 (7-15) versus 8 (5-11); P = 0.002) and vitrified oocytes (12 (8-15) versus 10 (7-11); P = 0.005). The number of vitrified embryos was lower in high-grade group (6.5 ± 3.5 versus 4.6 ± 2.3; P = 0.03) in cycles where the fertilization was performed. In multivariate logistical analysis, the low-grade cancer was significantly associated with retrieval of over 10 mature oocytes (OR = 4.26; 95% CI 1.82-9.98; P = 0.0009).Limitations, Reasons For Caution: The main limitations of the study include its retrospective design and the relatively small sample size in the embryological outcome analysis. The results of our study should be viewed with caution as different malignancy types were included in the study groups, although their distribution between the study groups was similar.Wider Implications Of the Findings: Cancer grade seems to have a negative impact on the fertility preservation outcome and the ovarian stimulation response.Study Funding/competing Interest(s): Authors have not received any funding to support this study. There are no conflicts of interest to declare. [ABSTRACT FROM AUTHOR]

Aims: The current study aimed to investigate the ability of lactic acid bacteria (LABs) in removing four polycyclic aromatic hydrocarbons (PAHs) namely, benzo(a)pyrene (BaP), benz(a)anthracene (BaA), chrysene (Chr) and benzo(b)fluoranthene (BbF) from contaminated phosphate buffer saline (PBS). Method and Results: The effect of initial PAH concentrations (5, 10, 15, 20 μg ml−1), bacterial population (107, 108, 109, 1010CFU per ml) and pH (3, 5, 7) was studied to evaluate bacterial binding ability. All the tested bacteria could remove BaA, Chr, BbF and BaP from phosphate buffer solution and in almost all assays, removing of PAHs was as follows: BaP>Chr>BaA>BaF. Bifidobacterium lactis BB‐12 had the lowest binding rate for all four PAHs, while the highest binding ability was related to Lactobacillus acidophilus LA‐5. Moreover, cell viability was not required for the binding ability and even acid‐treated, heat‐treated and ultrasonic‐treated bacterial cells showed more binding ability. The results showed that the bacteria–PAH complex was irreversible after washing with PBS. Conclusions: The removal of PAHs was significantly related to pH of media, strains of bacteria, type and concentration of PAHs Significance and Impact of the Study: This study has been focused on the reduction of polycyclic aromatic hydrocarbons using LABs and probiotics. Our results showed that not only live strains but also inactivated tested strains are able to remove PAHs from aqueous media, presenting new methods to diminish the amount of these contaminants in foods. Furthermore, the results of this study can be used in future research on evaluating the effects of oral administration of probiotic supplements and even dead probiotic strains on reducing PAHs in humans. [ABSTRACT FROM AUTHOR]

Termite mounds have intrigued humans for millennia. Despite great interest in their beautiful and often complex structures, the question of why termites acquired mound-building behaviour has received little attention. Here, we focus on two Australian lineages of the Nasutitermitinae (composed primarily of Nasutitermes and Tumulitermes spp.), which have evolved mound-building behaviour in parallel from arboreal and soil/wood-nesting ancestors, respectively. We used environmental niche modelling and ancestral niche reconstructions to investigate whether abiotic factors, including precipitation, temperature and soil composition, were associated with the repeated acquisition of mound building. Although we found strong evidence for ecological speciation leading to niche divergence in the nasutes, ultimately no abiotic variable was consistently correlated with mound-building behaviour. We also observed no trend in the variables limiting the environmental tolerances of mound builders. This suggests a more complex evolutionary history of mound building that cannot be explained by the abiotic factors we examined. Instead, biotic factors not considered here, e.g. colony expansion and protection, might have played a key role in the acquisition of this trait. [ABSTRACT FROM AUTHOR]

Background This review aims to explore the healthcare needs and access to healthcare services among Syrian refugees in Jordan. Furthermore, it identifies possible ways of responding to such needs within the framework of the structural challenges faced in this particular context. Methods Through qualitative techniques, this study systematically reviewed nine articles identified in academic and international organizations' databases. Six articles are from scholarly sources, while three are published reports or commentary articles; thus, there are variations in methodological rigour. An analysis of the articles was performed based on the Critical Appraisal Skills Programme check tool to systematically assess the trustworthiness, relevance and results of the included papers. Results The overall access to healthcare is relatively good for most registered Syrian refugees. However, some groups lack access due to financial and structural barriers, such as not possessing the appropriate civil documentation and/or not having the means to pay out-of-pocket expenses to access adequate services. A key challenge relates to access of inpatient care. Accessing care for non-communicable/chronic diseases requires not only legal documentation but also long-term access and continuity of care in an already overburdened health care system. Conclusion The healthcare needs of the refugee, as well as the host population in Jordan, cannot be adequately met without the international society acknowledging a collective responsibility, including a financial commitment. One effort that could solve a major structural problem for those not able to access healthcare is increased flexibility in regards to documentation. [ABSTRACT FROM AUTHOR]

Improving estimates of individuals' dietary intakes is key to obtaining more reliable evidence for diet-health relationships from nutritional cohort studies. One approach to improvement is combining information from different self-report instruments. Previous work evaluated the gains obtained from combining information from a food frequency questionnaire (FFQ) and multiple 24-hour recalls (24HRs), based on assuming that 24HRs provide unbiased measures of individual intakes. Here we evaluate the same approach of combining instruments but base it on the better assumption that recovery biomarkers provide unbiased measures of individual intakes. Our analysis uses data from the 5 large validation studies included in the Validation Studies Pooling Project: the Observing Protein and Energy Nutrition Study (1999–2000), the Automated Multiple-Pass Method validation study (2002–2004), the Energetics Study (2006–2009), the Nutrition Biomarker Study (2004–2005), and the Nutrition and Physical Activity Assessment Study (2007–2009). The data included intakes of energy, protein, potassium, and sodium. Under a time-varying usual-intake model analysis, the combination of an FFQ with 4 24HRs improved correlations with true intake for predicted protein density, potassium density, and sodium density (range, 0.39–0.61) in comparison with use of a single FFQ (range, 0.34–0.50). Absolute increases in correlation ranged from 0.02 to 0.26, depending on nutrient and sex, with an average increase of 0.14. Based on unbiased recovery biomarker evaluation for these nutrients, we confirm that combining an FFQ with multiple 24HRs modestly improves the accuracy of estimates of individual intakes. [ABSTRACT FROM AUTHOR]

Following the acceptance of plate tectonics theory in the latter half of the 20th century, vicariance became the dominant explanation for the distributions of many plant and animal groups. In recent years, however, molecular-clock analyses have challenged a number of well-accepted hypotheses of vicariance. As a widespread group of insects with a fossil record dating back 300 My, cockroaches provide an ideal model for testing hypotheses of vicariance through plate tectonics versus transoceanic dispersal. However, their evolutionary history remains poorly understood, in part due to unresolved relationships among the nine recognized families. Here, we present a phylogenetic estimate of all extant cockroach families, as well as a timescale for their evolution, based on the complete mitochondrial genomes of 119 cockroach species. Divergence dating analyses indicated that the last common ancestor of all extant cockroaches appeared ~235 Ma, ~95 My prior to the appearance of fossils that can be assigned to extant families, and before the breakup of Pangaea began. We reconstructed the geographic ranges of ancestral cockroaches and found tentative support for vicariance through plate tectonics within and between several major lineages. We also found evidence of transoceanic dispersal in lineages found across the Australian, Indo-Malayan, African, and Madagascan regions. Our analyses provide evidence that both vicariance and dispersal have played important roles in shaping the distribution and diversity of these insects. [ABSTRACT FROM AUTHOR]

An improved microextraction method is proposed on the basis of ultrasound-assisted surfactant-enhanced emulsification and solidification of a floating organic droplet procedure combined with high performance liquid chromatography for the preconcentration and quantification of alprazolam (ALP) and chlordiazepoxide (CHL) present in a number of human serum samples. Several parameters affecting the extraction efficiency were investigated by the Plackett -Burman factorial design as the screening design. Then the response surface methodology based on the Box-Behnken design was used to optimize the effective parameters in the proposed procedure. The limits of detection for the proposed method were found to be 3.0 and 3.1 ng mL-1 for CHL and ALP, respectively. The calibration curves obtained for the method were linear in the ranges of 10.0-3,500.0 and 10.0-3,000.0 ng mL-1 for CHL and ALP, respectively, with a good determination coefficient. The recoveries of the drugs in the spiked human serum samples were above 93.0%. The developed method was successfully applied to the analysis of these studied drugs in human serum samples. The pre-treatment of the serum samples was performed using acetonitrile to remove the proteins. The proposed procedure was an accurate and reliable one for the determination and preconcentration of these drugs in blood samples. [ABSTRACT FROM AUTHOR]

Calibrating dietary self-report instruments is recommended as a way to adjust for measurement error when estimating diet-disease associations. Because biomarkers available for calibration are limited, most investigators use self-reports (e.g., 24-hour recalls (24HRs)) as the reference instrument. We evaluated the performance of 24HRs as reference instruments for calibrating food frequency questionnaires (FFQs), using data from the Validation Studies Pooling Project, comprising 5 large validation studies using recovery biomarkers. Using 24HRs as reference instruments, we estimated attenuation factors, correlations with truth, and calibration equations for FFQ-reported intakes of energy and for protein, potassium, and sodium and their densities, and we compared them with values derived using biomarkers. Based on 24HRs, FFQ attenuation factors were substantially overestimated for energy and sodium intakes, less for protein and potassium, and minimally for nutrient densities. FFQ correlations with truth, based on 24HRs, were substantially overestimated for all dietary components. Calibration equations did not capture dependencies on body mass index. We also compared predicted bias in estimated relative risks adjusted using 24HRs as reference instruments with bias when making no adjustment. In disease models with energy and 1 or more nutrient intakes, predicted bias in estimated nutrient relative risks was reduced on average, but bias in the energy risk coefficient was unchanged. [ABSTRACT FROM AUTHOR]

European mistletoe (Viscum album L.) has largely infested Central European forests and causes high mortality probability particularly in dry years. However, little information is available about the consequences of mistletoe infestation for metabolic processes in bark and wood of its host, despite their important roles in infestation defense. We analyzed the tissue hydration, carbohydrate composition, phytohormone profile, reactive oxygen species and anti-oxidant levels in bark and wood of Scots pines (Pinus sylvestris L.), as dependent on mistletoe infestation. As a consequence of mistletoe infestation, host bark and wood showed impaired hydration and reduced total carbon content. In the bark, soluble sugar and lignin contents increased, apparently at the expense of holo-cellulose. Hydrogen peroxide accumulation was accompanied by increased glutathione and decreased reduced ascorbic acid levels. Mistletoe infestation mediated alteration of the phytohormone profile in bark and wood of its host. Cytokinins, jasmonic acid and abscisic acid levels increased in both tissues, whereas salicylic acid and indole-3-acetic acid, which were only detected in the bark, declined. The present results show that mistletoe infestation affects both the host's anti-oxidative defense system and the phytohormone profile after establishment of the xylem tapping haustorium. The significance of these processes for the development of the woody mistletoe stem and the haustorium is discussed. [ABSTRACT FROM AUTHOR]

We report the identification of human L- lactate dehydrogenase B (LDHB) as a novel Bax suppressor. Yeast heterologously expressing LDHB is also resistant to the lethal effects of copper indicating that it is a general suppressor of stress mediated cell death. To identify potential LDHB targets, LDHB was expressed in yeast mutants defective in apoptosis, necrosis and autophagy. The absence of functional PCD regulators including MCA1, YBH3, cyclophilin (CPR3) and VMA3, as well as the absence of the pro-survival autophagic pathway (ATG1,7) did not interfere with the LDHB mediated protection against copper indicating that LDHB functions independently of known PCD regulators or by simply blocking or stimulating a common PCD promoting or inhibitory pathway. Measurements of lactate levels revealed that short-term copper stress (1.6 mM, 4 h), does not increase intracellular levels of lactate, instead a three-fold increase in extracellular lactate was observed. Thus, yeast cells resemble mammalian cells where different stresses are known to lead to increased lactate production leading to lactic acidosis. In agreement with this, we found that the addition of exogenous lactic acid to growth media was sufficient to induce cell death that could be inhibited by the expression of LDHB. Taken together our results suggest that lactate dehydrogenase is a general suppressor of PCD in yeast. [ABSTRACT FROM AUTHOR]

We determine the deep structure of the eastern Algerian basin and its southern margin in the Annaba region (easternmost Algeria), to better constrain the plate kinematic reconstruction in this region. This study is based on new geophysical data collected during the SPIRAL cruise in 2009, which included a wide-angle, 240-km-long, onshore-offshore seismic profile, multichannel seismic reflection lines and gravity and magnetic data, complemented by the available geophysical data for the study area. The analysis and modelling of the wide-angle seismic data including refracted and reflected arrival travel times, and integrated with the multichannel seismic reflection lines, reveal the detailed structure of an ocean-to-continent transition. In the deep basin, there is an ~5.5-km-thick oceanic crust that is composed of two layers. The upper layer of the crust is defined by a high velocity gradient and P-wave velocities between 4.8 and 6.0 km s-1, from the top to the bottom. The lower crust is defined by a lower velocity gradient and P-wave velocity between 6.0 and 7.1 km s-1. The Poisson ratio in the lower crust deduced from S-wave modelling is 0.28, which indicates that the lower crust is composed mainly of gabbros. Below the continental edge, a typical continental crust with P-wave velocities between 5.2 and 7.0 km s-1, from the top to the bottom, shows a gradual seaward thinning of ~15 km over an ~35-km distance. This thinning is regularly distributed between the upper and lower crusts, and it characterizes a rifted margin, which has resulted from backarc extension at the rear of the Kabylian block, here represented by the Edough Massif at the shoreline. Above the continental basement, an ~2-km-thick, pre-Messinian sediment layer with a complex internal structure is interpreted as allochthonous nappes of flysch backthrusted on the margin during the collision of Kabylia with the African margin. The crustal structure, moreover, provides evidence for Miocene emplacement of magmatic intrusions in both the deep basin and the continental margin. Based on the crustal structure, we propose that the eastern Algerian basin opened during the southeastward migration of the European forearc before the collision, along a NW-SE elongated spreading centre that ran perpendicular to the subduction trend. Such an atypical geometry is explained by the diverging directions of the subduction rollback during the backarc opening: eastward for the Corsica-Sardinia block, and southward for the Kabylian blocks. This geometry of the forearc can be interpreted as the surface expression of a slab tear at depth, which is responsible for atypical magmatism in the overlying backarc oceanic basin. [ABSTRACT FROM AUTHOR]

Objectives Darunavir is a protease inhibitor that is administered with low-dose ritonavir to enhance its bioavailability. It is prescribed at standard dosage regimens of 600/100 mg twice daily in treatment-experienced patients and 800/100 mg once daily in naive patients. A population pharmacokinetic approach was used to characterize the pharmacokinetics of both drugs and their interaction in a cohort of unselected patients and to compare darunavir exposure expected under alternative dosage regimens. Methods The study population included 105 HIV-infected individuals who provided darunavir and ritonavir plasma concentrations. Firstly, a population pharmacokinetic analysis for darunavir and ritonavir was conducted, with inclusion of patients' demographic, clinical and genetic characteristics as potential covariates (NONMEM®). Then, the interaction between darunavir and ritonavir was studied while incorporating levels of both drugs into different inhibitory models. Finally, model-based simulations were performed to compare trough concentrations (Cmin) between the recommended dosage regimen and alternative combinations of darunavir and ritonavir. Results A one-compartment model with first-order absorption adequately characterized darunavir and ritonavir pharmacokinetics. The between-subject variability in both compounds was important [coefficient of variation (CV%) 34% and 47% for darunavir and ritonavir clearance, respectively]. Lopinavir and ritonavir exposure (AUC) affected darunavir clearance, while body weight and darunavir AUC influenced ritonavir elimination. None of the tested genetic variants showed any influence on darunavir or ritonavir pharmacokinetics. The simulations predicted darunavir Cmin much higher than the IC50 thresholds for wild-type and protease inhibitor-resistant HIV-1 strains (55 and 550 ng/mL, respectively) under standard dosing in >98% of experienced and naive patients. Alternative regimens of darunavir/ritonavir 1200/100 or 1200/200 mg once daily also had predicted adequate Cmin (>550 ng/mL) in 84% and 93% of patients, respectively. Reduction of darunavir/ritonavir dosage to 600/50 mg twice daily led to a 23% reduction in average Cmin, still with only 3.8% of patients having concentrations below the IC50 for resistant strains. Conclusions The important variability in darunavir and ritonavir pharmacokinetics is poorly explained by clinical covariates and genetic influences. In experienced patients, treatment simplification strategies guided by drug level measurements and adherence monitoring could be proposed. [ABSTRACT FROM PUBLISHER]

Motivation: The interactions among proteins and the resulting networks of such interactions have a central role in cell biology. Aligning these networks gives us important information, such as conserved complexes and evolutionary relationships. Although there have been several publications on the global alignment of protein networks; however, none of proposed methods are able to produce a highly conserved and meaningful alignment. Moreover, time complexity of current algorithms makes them impossible to use for multiple alignment of several large networks together.Results: We present a novel algorithm for the global alignment of protein–protein interaction networks. It uses a greedy method, based on the alignment scoring matrix, which is derived from both biological and topological information of input networks to find the best global network alignment. NETAL outperforms other global alignment methods in terms of several measurements, such as Edge Correctness, Largest Common Connected Subgraphs and the number of common Gene Ontology terms between aligned proteins. As the running time of NETAL is much less than other available methods, NETAL can be easily expanded to multiple alignment algorithm. Furthermore, NETAL overpowers all other existing algorithms in term of performance so that the short running time of NETAL allowed us to implement it as the first server for global alignment of protein–protein interaction networks.Availability: Binaries supported on linux are freely available for download at http://www.bioinf.cs.ipm.ir/software/netal.Contact: sh.arab@modares.ac.irSupplementary information: Supplementary data are available at Bioinformatics online. [ABSTRACT FROM AUTHOR]

The risk of developing tuberculosis (TB) may be related to nutritional status. To determine the impact of nutritional status on TB incidence, the authors analyzed data from the First National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study (NHEFS). NHANES I collected information on a probability sample of the US population in 1971–1975. Adults were followed up in 1982–1992. Incident TB cases were ascertained through interviews, medical records, and death certificates. TB incidences were compared across different levels of nutritional status after controlling for potential confounding using proportional hazards regression appropriate to the complex sample design. TB incidence among adults with normal body mass index was 24.7 per 100,000 person-years (95% confidence interval (CI): 13.0, 36.3). In contrast, among persons who were underweight, overweight, and obese, estimated TB incidence rates were 260.2 (95% CI: 98.6, 421.8), 8.9 (95% CI: 2.2, 15.6), and 5.1 (95% CI: 0.0, 10.5) per 100,000 person-years, respectively. Adjusted hazard ratios were 12.43 (95% CI: 5.75, 26.95), 0.28 (95% CI: 0.13, 0.63), and 0.20 (95% CI: 0.07, 0.62), respectively, after controlling for demographic, socioeconomic, and medical characteristics. A low serum albumin level also increased the risk of TB, but low vitamin A, thiamine, riboflavin, and iron status did not. A population's nutritional profile is an important determinant of its TB incidence. [ABSTRACT FROM PUBLISHER]

Solitary fibrous tumours of the pleura are rare. They are mesenchymal in origin. Initially, they were described in the pleura, but lately they have been reported in many other sites. Although the majority of these tumours are benign, some of them are malignant. Their unpredictable clinical course is probably related to their histological and morphological characteristics. The benign tumours may remain unproblematic for several years before changing into a malignant form. In order to define more accurately the clinical behaviour, diagnosis, management and outcome of these rare tumours, we reviewed the literature with particular attention to clinical presentation, methods of diagnosis, treatment and outcome. Furthermore, a modified algorithm was proposed for the management of these tumours. [ABSTRACT FROM AUTHOR]

Metastatic melanoma is a fatal disease due to the lack of successful therapies and biomarkers for early detection and its incidence has been increasing. Genetic studies have defined recurrent chromosomal aberrations, suggesting the location of either tumor suppressor genes or oncogenes. Transcription factor 21 (TCF21) belongs to the class A of the basic helix-loop-helix family with reported functions in early lung and kidney development as well as tumor suppressor function in the malignancies of the lung and head and neck. In this study, we combined quantitative DNA methylation analysis in patient biopsies and in their derived cell lines to demonstrate that TCF21 expression is downregulated in metastatic melanoma by promoter hypermethylation and TCF21 promoter DNA methylation is correlated with decreased survival in metastatic skin melanoma patients. In addition, the chromosomal location of TCF21 on 6q23–q24 coincides with the location of a postulated metastasis suppressor in melanoma. Functionally, TCF21 binds the promoter of the melanoma metastasis-suppressing gene, KiSS1, and enhances its gene expression through interaction with E12, a TCF3 isoform and with TCF12. Loss of TCF21 expression results in loss of KISS1 expression through loss of direct interaction of TCF21 at the KISS1 promoter. Finally, overexpression of TCF21 inhibits motility of C8161 melanoma cells. These data suggest that epigenetic downregulation of TCF21 is functionally involved in melanoma progression and that it may serve as a biomarker for aggressive tumor behavior. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Sternoclavicular joint (SCJ) infections are rarely encountered and their management is not well standardised. We reviewed our experience with the management of this condition in order to evaluate the role of surgery in the management of the SCJ infection and to provide an algorithm for its treatment. Methods: It is a multicentre study in which we retrospectively reviewed the data files of the patients who were referred to us for surgical management of SCI infection. Results: From March 2003 to June 2009, 14 patients (12 men and two women) were treated surgically for infected SCJ. No patients were found in the paediatric age group. Mean age was 49.8 years with a range between 26 and 77 years. All patients were symptomatic. The prevalent symptom was either anterior chest wall swelling (21%) or pain (29%); while 50% of them presented with both swelling and pain. Associated risk factors were elicited in 12 patients (86%) while it could not be identified in two patients (14%). These risk factors were in the form of drug addiction in three patients, diabetes mellitus (DM) in four, chronic renal failure (CRF) in three patients and two patients had both DM and CRF. Surgical management was performed in all patients in the form of either incision and drainage in two patients (14%); or SCJ curettage in three patients (21%), while resection of the SCJ was done in nine patients (62%). Mean postoperative hospital stay period (PHS) was 8.1 days (range: 5–30 days). All of them are alive and free of symptoms in follow-up. Conclusion: Surgery was found to be curative with good results for those patients with SCJ infection that did not respond to a full course of intravenous antibiotic therapy. Surgical options include incision and drainage, curettage or SCJ resection. The type of surgical procedure depends on the radiological findings, presentation, severity of the infection and intra-operative findings. In our experience, complex muscle flap reconstruction was not necessary following SCJ resection. [Copyright &y& Elsevier]

The impact of DNA damage commonly thought to be involved in chronic degenerative disease causation is particularly detrimental during fetal development. Within a multicenter study, we analyzed 77 white blood cell (WBC) samples from mother–newborn child pairs to see if imprinting of DNA damage in mother and newborn shows a similar pattern. Two adducts 1,N6-ethenodeoxyadenosine (ɛdA) and 3,N4-ethenodeoxycytidine (ɛdC) were measured by our ultrasensitive immunoaffinity 32P-post-labeling method. These miscoding etheno-DNA adducts are generated by the reaction of lipid peroxidation (LPO) end products such as 4-hydroxy-2-nonenal with DNA bases. Mean ɛdA and ɛdC levels when expressed per 109 parent nucleotides in WBC-DNA from cord blood were 138 and 354, respectively; in maternal WBC-DNA, the respective values were 317 and 916. Thus, the DNA-etheno adduct levels were reliably detectable and about two times lower in child cord blood, the difference being significant at P < 0.0004. Analysis of ɛdA and ɛdC levels in cord versus maternal blood WBC showed strong positive correlations (R2 ≈ 0.9, P < 0.00001). In conclusion, LPO-induced DNA damage arising from endogenous reactive aldehydes in WBC of both mother and newborn can be reliably assessed by ɛdA and ɛdC as biomarkers. The high correlation of etheno adduct levels in mother and child WBC suggests that a typical signature of DNA damage is induced similarly in fetus and mother. Prospective cohort studies have to reveal whether these two WBC-DNA adducts could serve as risk indicator for developing hematopoietic cancers and other disorders later in life. [ABSTRACT FROM PUBLISHER]

Background: Surgical site infection (SSI) is the most commonly reported nosocomial infection. Surgical site infections are responsible for increase in cost, morbidity, and mortality related to surgical operations. Surveillance with information feedback to surgeons and other medical staff has been shown to be an important element in the overall strategy to reduce the numbers of SSIs. Objectives: To determine the incidence and factors responsible for, causative micro-organisms and effective antibiotics for surgical site infections following emergency abdominal operations. Patients and methods: a total of 252 patients were enrolled in the current study and were retrospectively followed till the tenth day post-operatively. Data collection sheets were filled in for all the patients. If any symptom or sign of infection appear during this period then proper investigation was instituted for the diagnosis of infection and to assess the type and severity of the infection. If any collection of pus identified it was drained out and sent for culture and sensitivity test. Proper antibiotic was given to every patient both preoperative and post-operative periods. Antibiotic was changed where necessary after getting the report of culture and sensitivity test. Results: Surveillance of SSIs in the current study revealed an SSI incidence of 21.4%. The most frequent organisms detected by wound swab cultures were E. coli (55.5%), followed by Klebsiella and coagulase negative staphylococci, with the emergence of resistant strains like MDR, AMPC, ESBL strains. Sensitivity to antiobiotics showed Colistin, Polymyxin B, Vancomycin and Tigecycline to be fully functional, next in sensitivity was piperacillin tazobactam, then meropenem, followed by imipenem and amikacin. SSI was found to be increased with the advancement in age, Smoking cigarettes and HCV positive cases. The fourth post-operative day was the commonest day for the occurrence of SSI with discharge from the wound being the most prevalent sign. Conclusion: A surveillance system for SSI with feedback of appropriate data to surgeons and hospital authorities is highly recommended to reduce the SSI rate General Surgical Departments at Ain Shams Specialized Hospital - Police Hospital and other Departments as well. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases represent the leading cause of mortality worldwide. Ischemic heart disease is one of the main causes of diastolic heart failure and its presence predicts a poor prognosis in ischemic heart patients. Most cardiovascular diseases can be prevented by addressing behavioral risk factors such as overweight and obesity. Leptin –also known as satiety hormone- helps in inhibiting hunger and regulate energy balance (1). Objective: to correlate leptin level with ischemic heart disease with or without diastolic dysfunction by comparing it in lean and obese patients. Material and Methods: from June 2019 to November 2019, 140 ischemic patients documented with CA, MSCT or history of PCI AND 35 Control subjects were enrolled from both Ain Shams University, Cardiology department wards and outpatient clinic and Misr University for science and technology, cardiology department wards and outpatient clinic. All participants subjected to history, clinical examination, Duke CAD index to estimate the severity of ischemia, calculation of their BMI, blood sampling for measuring their serum leptin level and echocardiography for detecting the diastolic function. Patients were divided into four groups according to their BMI and Diastolic function in addition to the control group. Groups were demonstrated as follow Group A lean ischemic patients without significant diastolic dysfunction, Group B lean ischemic patients with diastolic dysfunction (II-IV), Group C obese ischemic patients without significant diastolic dysfunction, Group D obese ischemic patients with diastolic dysfunction(II-IV), Group E is a control group lean non ischemic without diastolic dysfunction . Results: There were significant positive correlations between serum leptin and Duke score in all ischemic groups (n=140) (p<0.001). Serum leptin abnormality was significantly more frequent in diastolic dysfunction groups (n=70) than in non-dysfunction groups (N=70) (Group B 25.7%, group D 28.6% vs group A 5.7% group C 8.6%, also was lowest in control group (n=35) 0.0%. serum leptin was significantly positive correlated with ischemia as in group A17.8±2.1ng/mL group B 23.4±11.1ng/mL group C 55.4±10.9 ng/mL group D 65.2±10.8 ng/mL vs control group E 13.1±2.7 ng/mL. Conclusion: leptin is an independent risk factor for coronary heart disease. Also elevated plasma leptin levels are associated with impaired left ventricular diastolic function in patients with CAD independently of obesity and other confounding variables. [ABSTRACT FROM AUTHOR]

Chromium intake may increase insulin sensitivity, glucose tolerance, and the ratio of high density lipoprotein cholesterol to low density lipoprotein cholesterol. However, the epidemiologic evidence on the association between chromium and cardiovascular disease is very limited. To determine whether low toenail chromium concentrations were associated with risk of nonfatal myocardial infarction, the authors conducted an incident, population-based, case-control study in eight European countries and Israel in 1991–1992. Cases (n = 684) were men with a first diagnosis of myocardial infarction recruited from the coronary units of participating hospitals. Controls (n = 724) were men selected randomly from population registers (five study centers) or through other sources, such as hospitalized patients (three centers), general practitioners' practices (one center), or relatives or friends of cases (one center). Toenail chromium concentration was assessed by neutron activation analysis. Average toenail chromium concentrations were 1.10 μg/g in cases (95% confidence interval: 1.01, 1.18) and 1.30 μg/g in controls (95% CI: 1.21, 1.40). Multivariate odds ratios for quintiles 2–5 were 0.82 (95% CI: 0.52, 1.31), 0.68 (95% CI: 0.43, 1.08), 0.60 (95% CI: 0.37, 0.97), and 0.59 (95% CI: 0.37, 0.95). Toenail chromium concentration was inversely associated with the risk of a first myocardial infarction in men. These results add to an increasing body of evidence that points to the importance of chromium for cardiovascular health. [ABSTRACT FROM AUTHOR]

Tocopherols are lipid-soluble antioxidants that may protect against some conditions of aging. The authors examined associations between radiographic knee osteoarthritis and serum levels of alpha-, delta-, and gamma-tocopherol and the alpha:gamma-tocopherol ratio in African-American and White adults from the Johnston County Osteoarthritis Project (North Carolina, 1991-1997). Two hundred cases with radiographic knee osteoarthritis (Kellgren-Lawrence grades > or = 2) and 200 controls (Kellgren-Lawrence grade 0) were randomly selected and matched by age, ethnicity, and sex. Serum tocopherol levels were measured by high performance liquid chromatography. Conditional logistic regression was used to estimate associations between radiographic knee osteoarthritis and tertiles of each tocopherol measure, independent of confounders. Persons in the highest tertile of the alpha:gamma-tocopherol ratio had half the odds of radiographic knee osteoarthritis as those in the lowest tertile (adjusted odds ratio = 0.5, 95% confidence interval: 0.2, 1.2). This inverse association occurred in all ethnic and sex subgroups, significantly in African Americans and men. Radiographic knee osteoarthritis was inversely associated with serum alpha-tocopherol in African Americans and men, positively associated with serum gamma-tocopherol in men, and unassociated with serum delta-tocopherol. Associations between radiographic knee osteoarthritis and tocopherol isoforms are complex and may vary by ethnicity and sex. [ABSTRACT FROM AUTHOR]

Headspace solvent microextraction (HSME) into a single drop is developed for the determination of six trihalomethanes, CH2Cl2, CHCl3, C4H9Cl, CCl4, C2HCl3, and C2Cl4, in aqueous solution. A drop of benzyl alcohol containing bromoform, as an internal standard, is used for extraction. The analytes are extracted by suspending a 3-&um:L drop directly from the needle of a microsyringe. The needle passes through the septum of a vessel, and the needle tip appears above the surface of the solution. After the prescribed extraction time, the drop is drawn back into the syringe. The syringe is then removed, and its content is injected directly into a gas chromatography column for analysis. The main parameters affecting the HSME process, such as stirring speed, microdrop volume, sample solution temperature, microsyringe needle temperature, sample volume, sampling time, solution pH, extracting solvent, and ionic strength of the solution, are studied. Also, the linear range and precision of the method are examined. [ABSTRACT FROM AUTHOR]

This meta-analysis of tea consumption in relation to stroke, myocardial infarction, and all coronary heart disease is based on 10 cohort studies and seven case-control studies. The study-specific effect estimates for stroke and coronary heart disease were too heterogeneous to be summarized (homogeneity p < 0.02 for stroke, p < 0.001 for coronary heart disease). Only the relative risk estimates for myocardial infarction (seven studies) appeared reasonably homogeneous (homogeneity p = 0.20). The incidence rate of myocardial infarction is estimated to decrease by 11% with an increase in tea consumption of 3 cups per day (fixed-effects relative risk estimate = 0.89, 95% confidence interval: 0.79, 1.01) (1 cup = 237 ml). However, evidence of bias toward preferential publication of smaller studies that suggest protective effects urges caution in interpreting this result. The geographic region where the studies were conducted appeared to explain much of the heterogeneity among coronary heart disease, myocardial infarction, and probably stroke results. With increasing tea consumption, the risk increased for coronary heart disease in the United Kingdom and for stroke in Australia, whereas the risk decreased in other regions, particularly in continental Europe. [ABSTRACT FROM PUBLISHER]