Lack of association of CTLA-4 + 49 A/G polymorphism with predisposition to type 1 diabetes in a cohort of Egyptian families

Type 1 diabetes is one of the most common chronic childhood illnesses. Interplay between genetic susceptibility and environmental factors is thought to provide the fundamental element for the disease. Apart from the Major Histocompatibility locus which is the main contributor to risk susceptibility, more than 40 loci are recognized. One among these is the CTLA-4, however data from the literature are controversial. The aim of our study was to investigate the role of CTLA4 49 A/G as a risk susceptibility factor for the development of type 1 diabetes in a cohort of Egyptian families. This is a case control study including 88 Egyptian families with one or more index cases [< 18 years]. The control group comprised 369 healthy unrelated subjects with no family history of diabetes or autoimmune disease. Using PCR-RFLP methodology, CTLA4 49 A/G was analyzed in 738 samples representing 88 families [88 patients, 125 siblings and 156 parents] and 369 control. The age of onset was 6 days-12.5 years with a mean of 5.3 +/- 3.6 and a median of 5 years. The mode of presentation was classic symptoms in 51 and diabetic ketoacidosis in 37 cases. Twenty-two cases had a history of viral infection or exanthematous disease and four had associated autoimmune diseases. No significant differences were encountered between the different groups with regard to CTLA4 +49 A/G genotype or allele frequencies. Neither was there a relation between the various genotypes and age of onset or the mode of presentation. CTLA4 49 A/G polymorphism was not recognized as a risk susceptibility factor in our cohort. This may be attributed to the low co-incidence of autoimmune diseases. Up to our best knowledge, this is the first study involving families. We recommend that all studies performed on risk susceptibility to type 1 diabetes should include proper investigation for other autoimmune diseases to exclude their confounding effect on data analysis

Serum interleukin-18 levels in patients with systemic lupus erythematosus: relation with disease activity and lupus nephritis

To further investigate the possible role of IL-18 in the pathogenesis of systemic lupus erythematosus [SLE] and development of lupus nephritis [LN], and to explore its relationship with pathological classes of LN, degree of acute renal activity and chronic damage. Forty-one SLE patients with LN, thirty-one lupus non-nephritis patients and fifteen age and sex matched healthy controls were enrolled in this study. SLE patients were subjected to disease activity assessment by SLEDAI, renal disease activity assessment by the Systemic Lupus International Collaborating Clinics [SLICC] Renal Activity Score, laboratory investigations including measurement of serum interleukin-18 using Enzyme Linked Immunosorbent Assay. Renal biopsy was obtained from LN patients and pathological classification was made according to World Health Organization [WHO] criteria. Analysis of activity and chronicity indices was done on these biopsy specimens. Serum levels of IL-18 were significantly higher in patients with LN than lupus non-nephritis patients and healthy controls [p < 0.001]. There were significant correlations between IL-18 and SLEDAI [p = 0.002], proteinuria [p = 0.027], renal activity score [p = 0.003] and activity index [p = 0.039] in patients with LN. There was no significant difference in the serum levels of IL-18 between WHO classes of LN IL-18 appears to have a pathogenic role in the development of SLE and plays a crucial role in triggering inflammation in LN. Serum IL-18 levels could be a useful biomarker to assess the activity of renal disease in SLE

Magnesium concentration in acute asthmatic children

[Mg] is thought to be an important element in the pathogenesis of acute asthma attacks. We hypothesized that erythrocytic Mg would be decreased during an acute asthma exacerbation. We aimed at investigating plasma and erythrocytic Mg in acute asthmatic children. This case-control study included 30 Egyptian outpatients with acute asthma. Thirty healthy matched children were included as controls. All candidates had measurements of plasma and erythrocytic Mg levels before and after treatment. No significant differences were detected in plasma Mg levels between cases and controls [1.53 +/- 0.33 mmol/L versus 1.67 +/- 0.50 mmol/L respectively, P =0.2]. However, erythrocytic Mg levels were significantly reduced in cases when compared to controls [1.06 +/- 0.43 mmol/L versus 2.57 +/- 0.59 mmol/L respectively, P<0.001]. Plasma Mg levels did not significantly change in acute asthmatics before and after their rescue treatment [1.53 +/- 0.33 mmol/L versus 1.68 +/- 0.31mmol/L respectively, P=0.07]. In contrast, the study detected a significant increase in erythrocytic Mg levels in cases after their treatment from acute attacks [1.06 +/- 0.43 mmol/L versus 1.56 +/- 0.23 mmol/L respectively, P<0.001], with significant negative correlation with severity of attack [Spearman's rho=-0.647, P<0.001]. Erythrocytic Mg levels were significantly lower during the acute asthma, and were negatively correlated with severity of exacerbation, while plasma Mg did not significantly change. Only erythrocytic Mg levels were significantly elevated after receiving rescue treatment

Screening of body mass index [BMI] and blood pressure in Egyptian school children

Childhood overweight and obesity are global problems that are on the rise. Obesity in children appears to increase the risk of subsequent morbidity, whether or not obesity persists into adulthood. Outcomes related to childhood obesity include hypertension, type 2 diabetes mellitus, dyslipidemia. Left ventricular hypertrophy, non-alcoholic steatohepatitis, obstructive sleep apnea and orthopedic and psychosocial problems. For this we aimed to study BMI and BP among Egyptian children. A cross sectional study on 816 students [425 boys and 391 girls], aged 6 to 18 years [mean age 11.4 +/- 2.8 year], almost of the same socioeconomic status. Anthropometric measurement [weight, height BMI and SDS], blood pressure four blood pressure measurements were calculated: Systolic blood pressure [SBP], diastolic blood pressure [DBP], mean arterial pressure [MAP] and pulse pressure. Questionnaire for some variables as family history of obesity, hypertension and smoking, salty diet, physical activity of children were studied to all children. Prevalence of obesity and overweight was [1.5%and 2.9%], prehypertension and hypertension [1.1% and 10.5%] with no stastical significant difference among both sex. BMI SDS was positively correlated with age, SBP, MAP and pulse pressure. The risk of developing hypertension in obese children .was 1.7 higher than the risk in non obese children [Odds ratio=1.7, CI 0.4-8.0]. Given the presence of an increase of BMI SDS with age in our study, the elevated B.P values with age can be attributable to a parallel change in BMI. So children with evaluated blood pressure and high BMI will be confronted with problem of hypertension and obesity as adult with all their morbidities

Prognostic significance of Bcl-2, Bax and p53 expression in breast cancer

Aim: of this study was to investigate the significance of apoptosis-related genes bcl-2 and Bax in breast carcinoma cases treated with radical surgery plus radiotherapy and adjuvant chemotherapy for at least 1 year and their relation with expression of p53

Methods: After surgical resection imunohistochemistry was performed to determine Bcl-2, Bax, p53 and estrogen receptor [ER] expression in paraffin-embedded tissues of 50 invasive breast cancers. And overall survival was assessed

Results: Bcl-2, Bax, P53 and ER immunostaining displayed a positive relation with increasing histologic grade [P=0.000] and negative relation with time staging. Bcl-2 displayed a negative relation with p53 [P=0.035] and a positive relation with Bax and ER [P= 0.003 and P= 0.011 respectively]. Expression of Bc12 was associated significant improvement in overall survival [P=0.01]

Conclusion: regulation of apoptosis is important in invasive ductal carcinoma. These results indicate that bcl-2 expression is significantly associated with hormonal receptor status so it is good prognostic marker, and that p53 is a significant prognostic marker. No significant relation between Bax and overall survival in relation to the stage, p53 or ER

Eating behaviors in adolescent Egyptian girls

The present cross-sectional study was designed to assess the prevalence of disordered eating attitudes and behaviors in school-based girls in Cairo, in which a modified Eating Attitudes Test was used. Documenting the development of dieting preoccupation in young children may help with early identification and perhaps lead to intervention strategies. The study included 137 student girls [age range 12-17 years]: first group, [54] with age range 12-14 years and a mean age of 13.1 +/- 1.2 years and second group, [83] with age range 15-17 years and a mean age of 16.2 +/- 0.8 years group. Only 1.5% of the students scored >/= 20 on the ChEAT, which is the cut-off score for anorexia nervosa for the EAT-26. These were all in the 15-17 years old group, 2.4% scored >/= 20. The overall mean ChEAT score was more in the second older group 10.2 +/- 4.9 with a range of 3 to 28 compared to the first younger group 5.9 +/- 2.6 with a range of 2 to 12 [p<0.001]. We have no scores in both groups in the item "Eat diet food" and "Have the impulse to vomit after meals". Girls in the second group were more "scared about being overweight", "Preoccupied with a desire to be thinner", "Engaged in dieting behavior" and "Feel that food control there life"; whereas girls in the first group were more claimed that "others would like them to eat more" and "others think that they are too thin"

Doppler echocardiographic assessment of aortic stiffness and myocardial performance index in insulin dependent diabetics

Type I diabetes is characterized by diffuse arterial wall stiffening and thickening which progress with the severity of the disease but could be detected also in the absence of any diabetic-related complications. The stiffening of aorta and other central arteries is a potential risk factor for increased cardiovascular morbidity and mortality. In this study, we aimed to assess the aortic stiffness index, aortic strain, aortic pulse wave velocity [PWV] and myocardial performance index [MPI] in insulin dependent diabetic children and adolescents non invasively using Doppler echocardiography, correlating it with disease duration, state of glycemic control, and lipid profile. Thirty normotensive insulin dependent diabetics and 33 healthy control group were studied. 2D, M-mode and Doppler echocardiography was performed. Calculation of aortic strain, aortic stiffness index and MPI were done. Measurement of glycosylated hemoglobin [HbA1c] and microalbuminuria were performed. The results proved that the aortic stiffness index and aortic strain were significantly higher in diabetics than in the control group [p=0.02] and [p=0.001] respectively. Aortic strain correlated positively with HbA1c [p=0.05, r=0.4]. Aortic PWV and MPI were significantly higher in the cases [p=0.0001] and [p=0.003] respectively

Conclusion: Insulin dependent diabetic children and adolescents had stiffer aortic arteries than control subjects, Aortic strain correlated positively with state of glycemic control. Myocardial performance index was significantly higher in the cases in spite of the normal ejection fraction that may denote an early sign of left ventricular systolic dysfunction

Some histochemical stromal characterizations in colorectal epithelial tumors

Stroml changes may play an important role in progression, invasion and prognosis of colorectal tumors. Biopsy specimens of colorectal tumors were evaluated for stromal char- acterizations. Section stained with Haematoxyline and eosin [HandE] were examined as regard the presence of tumor infiltrating lymphocytes [TILs] and tumor associated eosinophilic infiltrate [TE]. The number of TILs were larger in earliest stages of colorectal cancers and decreased with the presence of metastasis. The prognosis of carcinomas was better for those with higher eosinophilic infiltration Expression of gelatinase A type of Matrix Metalloproteinases [MMP2] was assessed histochemical in both adenomas and carcinomas. Cytoplasmic expression of MMP-2 is significantly high in colorectal carcinomas [56%] compared to adenomas [20%]. [p=0.006]. A positive relation- ship between MMP-2 expression and tumor grade, Dukes' stage and nodal status was reported. The staining in density of MMP-2 in adenomas was either moderate [50%] or weak [50%]. On the other hand, 28.6% of carcinomas were strongly stained, 39.3% were moderately stained and 32.1% were weakly stained

Macrophage colony stimulating factor and serum lipid profile in patients with aplastic anemia

The study was carried out on 22 patients with congenital aplastic anemia, 24 patients with acquired aplastic anemia and 20 patients with ITP in comparison to a control group of 15 healthy children. Estimation of MCSF and serum lipid profile was carried out in the patients. MCSF levels proved to be elevated while lipids were low among cases of aplastic anemia. However these levels failed to reach statistically significant values to justify their use as diagnostic or prognostic criteria in aplastic anemia. The two parameters did not show any relation to the severity of anemia or response to treatment. MCSF also proved to be elevated in patients with ITP