ABSTRACT
Background: a potential role of toxoplasmosis for immune dysfunction has been suggested in Autism spectrum disorder [ASD]. The imbalances in pro- and anti-inflammatory processes could markedly hinder. host defense mechanisms important for immune control of the Toxoplasmosis. To test this hypothesis, we investigated evidence of differential cytokines release in plasma samples obtained from 3 to 10 year-old children with ASD compared with age-matched typically developing [TD] children with toxoplasmosis and without toxoplasmosis
Methodology: twenty four [18 boys and 6 girls] autistic children were included in this study. Their age ranged from 3- 10 years old [mean = 69.25 +/- 25.6 month]. There were diagnosed according to DSM 1V criteria. Control group included eighteen non-autistic children. The control group was divided in to two groups 1] control with toxoplasmosis [9 children]. 2] Control without toxoplasmosis [9 children]. All were subjected to uull history, clinical examination, and estimation of serum Toxoplasma IgG, serum TNF- alpha, INF -gamma and catalaze enzyme
Results: sex autistic children were Toxoplasma IgG positive [25%]]. Level of catalase enzyme was significantly lower in all patient than the control [P =0.048] with no significant differences of TNF- alpha and INF-gamma [P = 0.272, = 0.137] respectively. Serum TNF- alpha -level in autistic children with toxoplasmosis was highly significantly correlated with severity of autistic criteria assessed by Childhood Autistic Rating Scale [CARS] [r = 0.986, P=.0.000]. There was no significant correlation of INF-gamma and catalase level with severity of autistic criteria [r= 0.312, P= 0.5] [r= 0.720, P= 0.189]. INF-gamma and catalase levels were significantly correlated with severity of autism [r= - 0.496, P= 0.036] and [r= 0.650, P= 0.004] its autistic children without toxoplasmosis. TNF level was not significantly correlated with total CARS [r =000, P=l] in the same group
Conclusion: toxoplasmosis may result in immune modulation among ASD patients. These fluctuations in cytokines could result in a recurrent profuse multiplication of Toxoplasma gonadi in the brain associated with persistent neuroinflammation
ABSTRACT
Bronchoscopy has evolved considerably in our hospital. During recent years, we implemented the concept of interventional bronchoscopy [IB] for the first time in Egypt. IB is defined as a diagnostic and invasive therapeutic interventions that extend beyond routine Flexible bronchoscopy. In this article, we will review our clinical experience with IB during the last five years as regards methodology requirements, available equipments, clinical applications and presentation of selected research outcomes. We retrospectively reviewed all available reports of therapeutic IB performed in our bronchoscopy unit to determine the indications, application sites, methods of disobliteration and complications of therapeutic IB. In addition, recent interesting research work done on endobronchial ultrasound, autofluorescence bronchoscopy, Nd: YAG laser bronchoscopy and endobronchial electrocautery was reviewed. In order to perform an interventional procedure, well-equipped facilities, trained personnel, preprocedure evaluation, and monitoring are mandatory. More than 500 invasive therapeutic interventions were performed in the past 5 years. The results and analysis of these IB were reviewed. We concluded from the presented data that IB has quickly gained recognition and drawn interest with its promising results. Much effort is needed to overcome challenges facing IB awareness, financial concerns, training and verification of competency in our country