Infecciones del tracto urinario en neonatos sin explicación. Hiperbilirrubinemia: Prevalencia y predictivo factores de riesgo / Urinary tract infections in unexplained neonatal hyperbilirubinemia: Prevalence and predictive risk factors

Introduction: Urinary tract infections (UTIs) are widespread clinical disorder among early neonates. Neonates with UTIs were susceptible to higher rates of morbidity and mortality, particularly when presented with hyperbilirubinemia. Early diagnosis may help in complete recoveryrather than being threatened in terms of complications. The study aimed at determining the prevalence and predictive risk factors of UTIs in neonates with an unexplained hyperbilirubinemia. Method: A cross-sectional study was carried out in the NICU of Aswan University Hospital, Egypt from August 2018 to February 2019. The study was conducted on 140 newborns who were diagnosed with indirect hyperbilirubinemia in the first 4 weeks of life after exclusion of unrelated criteria. Demographic and clinical data were collected by an interview questionnaire. Biochemical markers including bilirubin level, CBC, urine analysis and urine cultures and sensitivity were determined. Results: The prevalence rate of UTIs in the studied newborns was 25%. Escherichia -coli was the dominant organism isolated. Amikacin was the most common antibiotic sensitive to the isolates. There was a significant difference between the UTI positive and negative neonates in the univariate analysis regarding some studied variables. While, an increase in the number of WBCs in the blood (OR = 6.90, P = 0.001), small for gestational age (OR = 4.07, P = 0.021), prolonged phototherapy (OR = 3.50, P = 0.034), and presence of maternal complications (OR = 2.92, P = 0.001) were statistically associated with a positive urine culture in multivariate analysis. Conclusions and recommendations: The prevalence rate of UTIs was 25%. The study indicated the importance of routine screening of UTI (urine culture) as part of the clinical assessment of unexplained hyperbilirubinemia in neonates with an increase in the number of WBCs in their blood, small for gestational age, prolonged duration of phototherapy, and neonates born from mothers who had a history of obstetric complications

Bee Honey Modulates the Oxidant-Antioxidant Imbalance in Diethyl nitrosamine-Initiated Rat Hepatocellular Carcinoma.

Oxidative stress reflects the mechanism that contributes to initiation and progression of hepatic injury in a variety of liver disturbance. From here, there is a great demand for the expansion of agents with a potent antioxidant effect. The aim of this work is to approximate the efficiency of bee honey as a hepatoprotective and an antioxidant agent versus diethyl nitrosamine (DEN) motivate hepatocellular damage. The single intrapritoneal (IP) management of diethyl nitrosamine (50mg/kg followed by 2ml/kg CCl4) to rats, referred for the histopathological examination of liver sections of rats after induction and before treatment with honey showed that many well differentiated tumor cells were formed in the liver of rats also, the examined sections showed disorganization of hepatic lobular architecture and obvious cellular damage. A significant lift in the enzymatic activity of liver functions (AST, ALT, ALP), and gamma glutamyltransferase (GGT) which is a signal of hepatocellular damage. DEN stimulates oxidative stress, which was assured by increase lipid peroxidation level and hindrance in antioxidant enzymes (SOD, CAT, GPx, and GST) activities in the liver. The position of non-enzymatic antioxidants comparable reduced glutathione (GSH) was likewise set up to be slimmed down significantly in DEN inoculated rats. Also, we have studied the underlying mechanism and /or (s) of the therapeutic role of bee honey as hepatocarcinogenesis remediation through investigation the inflammatory biomarkers; α-fetoprotein (AFP) and α-fucosidase (AFU). The current results clearly showed that bee honey demonstrates good ameliorative and antioxidant capacity toward diethyl nitrosamine induced hepatocellular damage in rats.

CCl4-induced hepatonephrotoxicity: protective effect of nutraceuticals on inflammatory factors and antioxidative status in rat.

The present study was undertaken to investigate the possible protective effect of two edible parts (leaves and stems) of Rumex dentatus L. on inflammatory factors and oxidant/antioxidative status of rat. Determination of total phenolic content of the two parts and isolation of bioactive secondary metabolites from the promising leaves extract were carried out. The hepatic antioxidant parameters; glutathione, catalase, superoxide dismutase, glutathione peroxidase, nitric oxide and malondialdehyde were measured. Liver marker enzymes and hepatic function enzymes; aspartate and alanine aminotransferases as well as cholestatic markers; alkaline phosphatase, gamma glutamyltransferase, serum total protein content, urea, creatinine were evaluated. In addition, inflammatory markers; interleukin (IL)-2, IL-6, C-reactive protein, and tumor necrosis factor were estimated. Histopathological investigation was also examined. The ethanolic extract of leaves and stems showed antioxidant properties and anti-inflammatory properties. An improvement of liver and kidney functions was also observed. Extract of leaves showed relatively higher biological activity than that of stems, a fact which may be related to their higher total phenolic content. This extract was subjected to chromatographic and spectroscopic analysis. Phytochemical investigation has afforded emodin (1), chrysophanic acid (2), 1,5-dihydroxy-3-methyl-9,10- anthraquinone (3), quercetin-3-rhamnoside (4), quercetin-3-rhamnosyl-(1→6)-galactoside (5), Isorhamnetin-3- rhamnoside (6), catechin (7) and daucosterol (8). Compounds 3-7 were isolated for the first time from this species. In conclusion, the plant parts extract represents a promising candidate for the treatment of liver fibrosis and renal injury. The isolated bioactive phytochemicals was suggested to be responsible for the pronounced pharmacological activity.

Significance of apoptotic markers Bcl-2, CD4+ T cells, hepatocyte growth factor and metalloproteinase -9 in infected patients with HCV.

To examine the possible involvement of human B-cll leukemia /lymphoma 2(Bcl2) , CD 4+ cells , hepatocyte growth factor (HGF) and metalloproteinase -9 ( MMP-9), in the development of liver diseases caused by HCV infection, serum activities of these biomarkers were demonstrated by quantitave detemination of Enzyme Linked Immunosorbant Assay(ELISA) . Two groups of subjects (60 for each) were examined in this study: healthy control and patients with chronic hepatitis C(HCV) The results showed significant decrease in Bcl-2 (P≤ 0.0001) , and CD 4+ (P≤0.001) , while significant increase in HGF and MMP-9(P≤0.05). These findings imply an influence of these biomarkers by the existence of virus that might influence the following progression of liver disease, and a distinction between the pathological mechanisms of HCV. Since the serum MMP-9 activity were significantly varied between each stage of liver disease, an individual profile of these parameters might serve as an easy accessing serum marker to monitor the progression of liver disease.

Biomphalaria alexandrina snails as immunogens against Schistosoma mansoni infection in mice

Despite effective chemotherapy, schistosomiasis remains the second largest public health problem in the developing world. Currently, vaccination is the new strategy for schistosomiasis control. The presence of common antigenic fractions between Schistosoma mansoni and its intermediate host provides a source for the preparation of a proper vaccine. The objective of this paper is to evaluate the nucleoprotein extracted from either susceptible or resistant snails to protect against schistosomiasis. The vaccination schedule consisted of a subcutaneous injection of 50 µg protein of each antigen followed by another inoculation 15 days later. Analyses of marker enzymes for different cell organelles [succinate dehydrogenase, lactate dehydrogenase (LDH), glucose-6-phosphatase, acid phosphatase and 5'-nucleotidase] were carried out. Energetic parameters (ATP, ADP, AMP, phosphate potentials, inorganic phosphate, amino acids and LDH isoenzymes) were also investigated. The work was extended to record worm and ova counts, oogram determination in the liver and intestine and the histopathological pattern of the liver. The nucleoprotein of susceptible snails showed reduction in worm and ova counts by 70.96 percent and 51.31 percent, respectively, whereas the nucleoprotein of resistant snails showed reductions of 9.67 percent and 16.77 percent, respectively. In conclusion, we found that the nucleoprotein of susceptible snails was more effective in protecting against schistosomiasis.

Coronary artery bypass grafting using arterial conduits

The use of arterial conduits in CABG showed better results and higher patency in long term follow-up. Complete myocardial revascularization using only arterial conduits can be accomplished by using multiple arterial conduits with one directed to each distal site, or 3 arterial conduits with the use of sequential anastomoses. Finally, the advent of T- graft or Y- graft has allowed complete revascularization with only 2 conduits. In the last few years, off-pump CABG has progressed and showed more and more popularity. This technique allowed surgeons to operate on high risk groups with better patient outcome. The aim of this study is to assess our results with these new techniques. In addition, different techniques of myocardial protection have been used for comparison. The patient population consisted of 50 patients. Patients' profiles are explained in the text and in table 1. Inclusion criteria include the use of two or more arterial conduits and isolated coronary surgery. On the other hand, exclusion criteria include less than two arterial conduits or associated valvular surgery. We used different techniques of myocardial protection; warm intermittent blood cardioplegia in 14 patients [28 percent], crystalloid cardioplegia in 22 patients [44 percent], fibrillating heart with or without intermittent cross clamping in seven patients [14 percent] and OPCAB in seven patients. These patients were studied immediately after operation by hemodynamic monitoring, complete laboratory investigation, myocardial serum enzymes and daily ECG for 3 days. Three months later, these patients were studied by a complete clinical work-up, Echo and stress ECG. All the patients were stable hemodynamically. They were put on minimal vasopressor support and liberal use of nitroglycerine. Intraaortic balloon pumping was not used. We had few complications; two patients developed preoperative myocardial infarction [4 percent], and two others [4 percent] developed neurological problems, one of them died and this was the only mortality in this series [2 percent]. All techniques of myocardial protection used could be the same in some patients, but there are certainly some subsets of patients need special precautions. Chronic renal disease, elderly patients and redo CABG are better operated upon by off-pump CABG. Patients having bad left ventricular function may need warm blood cardioplegia for better myocardial protection. Therefore, every surgeon should be able to handle different techniques