Serum plasminogen activator inhibitor-1 levels in patients with major depressive disorder vs. healthy controls: a systematic review and meta-analysis

Abstract Introduction Major depressive disorder (MDD) is a severe mental health condition that affects millions of people worldwide. Etiologically, several factors may play a role in its development. Previous studies have reported elevated plasminogen activator inhibitor-1 (PAI-1) levels in patients with depression, suggesting that PAI-1 levels might be linked to the etiology of MDD. Methods We systematically searched the following online databases: MEDLINE, Scopus, and Web of Science up to September 10, 2020, to identify studies in which PAI-1 levels were reported in subjects with MDD. Subsequently we used RevMan 5.3 to perform a meta-analysis of data extracted from the included studies using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and PICO criteria for the search and analysis. Results Six studies that reported mean ± standard deviation (SD) were included in the analysis, with a total of 507 MDD patients and 3,453 controls. The overall standardized mean difference (SMD) was 0.27 (95% confidence interval [95% CI] 0.01-0.53). PAI-1 serum levels were 0.27 SDs higher in MDD patients than in controls. The test for overall effect was significant (z = 2.04, p = 0.04). Substantial heterogeneity was detected among the studies, demonstrated by the inconsistency test (I2 = 72%) and the chi-square test (χ2 = 18.32; p = 0.003). Conclusion This systematic review and meta-analysis showed that MDD might be related to elevated PAI-1 levels. We propose larger prospective clinical studies to further investigate this clinical correlation and validate the clinical significance of these observations.

Impact of COVID-19 on Cardiothoracic Surgery: Experience of Alexandria (Egypt) Main University Hospital

ABSTRACT Introduction: The current coronavirus pandemic has greatly strained the limited resources that had previously maintained the sustainability of the high-cost cardiothoracic surgeries in low-income countries like Egypt. Methods: Hospital databases and patients' records were reviewed to evaluate the impact of the pandemic on the workflow and waiting lists. Postoperative patients were contacted by telephone for follow-up, as well as preoperative patients whose operations were cancelled. Regular virtual meetings were held, and residents were asked to discuss the stresses, challenges, and their suggestions for the gradual resumption of services. Residents' logbooks were evaluated to assess the disruption of the surgical exposure compared to 2019. Results: While thoracic surgeries have continued to thrive, cardiac surgeries have witnessed the worst consequences, including cancellation of all surgeries, expansion of waiting lists, patients' non-compliance with follow-up, and impaired surgical exposure of junior residents. Conclusion: The gradual recovery of cardiac surgery services in Alexandria (Egypt) is being carefully planned, taking into consideration the backlog of cases and the shortage of screening kits. Careful tiering and triaging of patients by a multidisciplinary team, as well as seeking alternative assessment tools for trainees, are the main lines of our action plan.

Vascular endothelial growth factor correlation with clinicopathological parameters in ovarian cancer

Epithelial ovarian cancer (EOC) is one of the most lethal gynaecologic malignancies with an increasing incidence worldwide; there is an increasing need for the identification of novel prognostic biomarkers in EOC patients. Given the key role of angiogenesis and growth factors in the biology of tumorigenesis, vascular endothelial growth factor (VEGF) is considered a milestone in the process of ovarian cancer progression and invasiveness. Authors aimed in the present study to evaluate the relevance of serum level of VEGF with clinicopathological parameters in patients with EOC. VEGF is reported to be correlated with variable parameters in EOC patients including International Federation of Gynecology and Obstetrics (FIGO) classification, lymph nodal involvement and ascites formation. In the following review, authors discussed these correlations and distinguished the possible future role of VEGF as a promising prognostic biomarker for EOC patients.

Effects of high flux versus low flux on serum c-reactive protein a as an inflammatory biomarker in hemodialysis patients

Background: Traditional low-flux dialysis cannot improve micro-inflammatory status, while new high-flux dialysis can improve the micro-inflammation and lipid metabolism, it helps to improve the quality of life and survival rate of patients, so how to improve the micro-inflammatory status are a focus for researchers

Objective: was to observe the effect of high flux hemodialysis [HFHD] with Gambro polyflux 170H dialyser and low flux hemodialysis [LFPD] with polyflux 17L dialyser on high-sensitivity C-reactive protein in patients with maintenance hemodialysis

Methods: 60 patients with maintenance hemodialysis were randomly divided into HFHD group and LFHD group. Another 20 cases for physical examinations served as normal control group. The maintenance hemodialysis patients were treated with HFHD using 170H dialyser dliahyser and LFHD using 17L dialyser, three times per week, 4 hours once. After 6 months of the treatment, high-sensitive C-reactive protein was determined in patients as well as normal controls before and after treatment

Results and Conclusion: in two groups, the levels of high-sensitive C-reactive protein before the treatment were higher than normal control [P< 0.001]

In HFHD group, serum high-sensitive C-reactive protein markedly decreased [P <0.01]. In LFHD group, these indices remained unchanged after the dialysis for 6 months. HFHD with 170H polysulfone dialyser is effective in improving micro-inflammation in maintained hemodialysis patients

Comparison of immunochromatographic test and microscopy in the detection of some enteric protozoa in stool samples

Infection with pathogenic intestinal protozoa as Giardia lamblia, Entamoeba histolytica and Cryptosporidium parvum cause considerable gastrointestinal morbidity, malnutrition and mortality worldwide, especially among young children in developing countries. The present study was carried out on 71 cases [44 males and 27 females] chosen from Pediatric and Internal Medicine Inpatient and Outpatient Clinics of Zagazig University Hospitals, complaining of different gastrointestinal troubles with an age range of 6-60 years. Also, 20 apparently healthy individuals [11 males and 9 females] cross matched were considered as a control negative group. All stool samples were examined by direct wet smears, concentration techniques, staining of the smears using trichrome stain and Modified Ziehi-Neelsen method. Copro-antigen detection in faecal sample was by using quick immunochromatographic test. A total of 71 cases suffering from different GIT manifestations showed G. lamblia [30.7%], Cryptosporidium parvum [19.8%], Entamoeba histolytica /E. dispar [11%] and mixed infection of three protozoa [6.6%]. However, by copro-antigen G. lamblia was positive in [31.8%] of C. parvum in [20.9%]; E. hisiolytica/E. dispar in [11%] of cases. lmmunochromatography/copro-antigen test recorded sensitivity and specificity of [100%] and [96.6%] respectively in G. lamblia detection. For C. parvum, sensitivity vas [100%] and specificity was [97.1%] while for E. histolytica/E. dispar sensitivity and specificity were [100%] for both. lmniunochrornatographic assay proved to be simple, easy and useful in confirming absence or the presence of intestinal protozoan infection in clinically suspected cues with negative stool examination

Clinical pulmonary infection score and C-reactive protein in the prediction of early ventilator associated pneumonia

The risk of ventilator-associated pneumonia [VAP] is highest early in the course of hospital stay. Most clinicians continue to rely on a clinical diagnosis of hospital-acquired pneumonia [HAP] because it is convenient. In an effort to improve the specificity of clinical diagnosis, the clinical pulmonary infection score [CPIS] was developed. Serum C-reactive protein [CRP] measurements in intensive care unit [ICU] patients enabled the early diagnosis of sepsis. The aim of this work was to evaluate the role of the clinical pulmonary infection score and C-reactive protein in the prediction of early ventilator associated pneumonia. Eighty patients recently were intubated and mechanically ventilated with no manifestations of infection; no infiltrates on chest X-ray for 48 h after intubation and had normal serum CRP at the first day of intubation. All patients were admitted to the intensive care unit in the Chest Department, Alexandria University Hospital and enrolled after obtaining informed consents. All patients were subjected to the following: full history taking, thorough clinical examination, laboratory investigations including total and differential white blood count, radiological evaluation, daily serum CRP assessment during the first 5 days of intubation and the calculation of CPIS at the onset of rising CRP. In this study, the age of all patients ranged from 34 years to 65 years with a mean age of 50.1 +/- 8.7 years. There were 44 male patients representing [55%]and 36 female patients representing [45%] of the study population. Serum CRP ranged from 0.8 to 3 mg/1 with a mean of 1.1 +/- 0.4 mg/1 on the first day of intubation and from 3.1 to 5 mg/1 with a mean of 4.2 +/- 0.4 mg/1 on the second day of intubation for all patients. On the third day of intubation, serum CRP ranged from 18 to 38 mg/1 with a mean of 27.0 +/- 4.7 mg/1 in 11 patients while on the fourth day of intubation serum CRP ranged from 32 to 59 mg/1 with a mean of 46.2 +/- 6.9 mg/1 in 12 patients. Lastly, serum CRP ranged from 50 to 66 mg/1 with a mean of 60.7 +/- 2.6 mg/1 on the fifth day of intubation in 9 patients. Therefore, serum CRP increased in 32 patients. CPIS of the studied patients at the onset of rising serum CRP ranged from 7 to 10 in 24 patients. In the first 5 days of intubation, 32 patients out of 80 patients had high CRP, those were 40% of the study population and 24 patients of those 32 patients had high CPIS; those were 30% of the study population and 75% of patients had high CRP. When the CPIS exceeded 6, there was an association with the presence of pneumonia which was confirmed by microbiological culture furthermore serum CRP is an easy, available and cheap test so daily serum CRP measurements to ICU patients enabled the early diagnosis of pneumonia and enhanced the value of the CPIS. Further studies of CPIS are needed with particular attention to how its variability might affect therapeutic choices