MicroRNA-146a expression as a potential biomarker for rheumatoid arthritis in Egypt

Background: MicroRNAs [miRNAs] are small non-coding RNAs, whose role in regulating diverse immune functions, suggests they might play a role as biomarkers for immune medi-ated disorders. Studies showed that miRNA-146a [miR-146a] expression is increased by proinflammatory cytokines and is an important modulator of differentiation and function of cells of innate and adaptive immunity

Aim of the work: The current study aimed to evaluate the expression of miR-146a as a potential biomarker for diagnosis of rheumatoid arthritis [RA] and to explore its association with disease activity

Subjects and methods: The study enrolled 50 Egyptian subjects divided into a patient group, which comprised 25 RA patients, and a control group which comprised 25 healthy individuals

The disease activity for the patients' group was determined by simplified disease activity index. Relative quantification of miR-146a expression in whole blood was determined using reverse tran-scriptase quantitative real time polymerase chain reaction

Results: There were highly significant statistical differences between patients and healthy controls as regards miR-146a relative expression, erythrocyte sedimentation rate [ESR] and anti-cyclic citrullinated peptide [anti-CCP] [p < 0.001]. Highly significant statistical differences [p < 0.001] were also found between different patients' subgroups as regards miR-146a relative expression and ESR. rm'R-146a levels correlated positively with those of ESR, C-reactive protein and anti-CCP [p < 0.001]

miR-146a illustrated best performance in diagnosing RA, showing the highest sensitivity and specificity [96% and 100%, respectively] [AUC: 0.992 at a cut off value of >/=2.16] compared to anti-CCP [sensitivity: 68%, specificity: 100% and AUC: 0.87 at a cut off value of >/= 22 U/ml] and RF [sensitivity: 56%, specificity: 80% and AUC: 0.992 at a cut off value of >/=13 U/ml]

Conclusion: This study demonstrated that miR-146a expression was highly significantly elevated in whole blood of patients with RA. Its diagnostic performance was better than anti-CCP and RF and its level of expression correlates with disease activity

Occurrence of bacteriuria and bacteraemia after urodynamic study

Urodynamic studies [UDS] are multi-channel pressure flow techniques which are accepted as standard diagnostic tool in the evaluation of lower urinary tract dysfunctions. But UDS are invasive procedures that involve urethral catheterization. Further more, water or radio opaque dye are infused or pumped into the urinary bladder during UDS for pressure volume studies. This study was conducted to assess the incidence of the female urinary tract infections and bacteraemia after UDS. One hundred seventy women complaining of lower urinary dysfunction elected for UDS were enrolled in this work. Bacteriuria was detected in 13 out of 170 cases. E.coli was detected in 9 cases while coagulase negative Staphylococci was detected in 4 cases. We also found no positive blood culture after UDS without use of routine prophylactic antibiotics. There is no need to use prophylactic antibiotics before UDS as the risk of developing complication is infrequent

Prevalence of class 1 ntegron-carrying enterobacteriaceae species and pseudomonas aeruginosa in intensive care units of ain shams original university hospitals

This study was conducted to study the prevalence of class 1 integron carrying Enterobacteriacae spp. and P.aeruginosa isolated from ICU patients and to determine factors associated with integron presence as well to determine the association between integron carriage and multidrug resistance [MDR] expression. Fifty urine and 70 respiratory specimens were collected from 100 lCU patients and processed for microbiological examination. The isolated pathogens were identified by standard techniques thereafter tested for antibiotic susceptibility by disk diffusion and broth microdilution methods. Class 1 integron was detected by PCR targeting a specific fragment in intl1 gene. Twenty five Enterobacteriaceae spp. and 17 P.aerugmnosa isolates were recovered. About 79% [33/42] of the tested organisms were integron positive. The presence of class 1 integron in Enterobacteriaceae spp. was significantly associated with resistance to 14 from the 18 tested antibiotics, while in P. aeruginosa significance was confined to resistance to 5 from 11 tested antibiotics. There was a strong association between wide range resistance expression [resistant >/= 7 antibiotics] and the presence of integron. A significant association between production of new beta-lactamases [ESBLs, AmpC, Carbapenemases] and the presence of integron has been found where 72.7% [24/33] of integron positive isolates were beta-lactamase producers. Hospital-acquired infections, prolonged hospital stay, invasive procedures and non responsiveness to antimicrobial therapy were significantly associated with infections with integron positive organisms. Prevalence of integron positive organisms with wide range antibiotic resistance in our ICUs is high that mandates proper implementation of infection control measures and antibiotic policy to control their presence and dissemination