Insulin resistance and its fibrogenic effect in chronic hepatitis C virus patients: role of tumor necrosis factor alpha activation

Insulin resistance [IR] is one of the extrahepatic complications that occur in chronic hepatitis C virus infection [HCV], and is claimed as one of the fibrogenic factors which cause more rapid fibrosis progression. We examined the effect of HCV infection on insulin resistance states, and the possible link between IR, tumor necrosis factor-alpha [TNF-alpha] activation and development of hepatic fibrosis. Thirty patients with chronic hepatitis C infection divided into 2 groups according to presence or absence of fibrosis, 15 apparently healthy volunteer and 15 patients with hepatic fibrosis due to causes other than HCV were studied. Laboratory assessment of liver functions, fasting glucose, insulin levels, homeostasis model assessment of insulin resistance [HOMA-IR] and soluble tumor necrosis factor receptors 2 [sTNFR2] were done. HOMA-IR and sTNFR2 levels were significantly increased in patients with chronic HCV without fibrosis as compared with healthy control [p<0.01, p<0.001, respectively], and in patients with HCV induced fibrosis compared to HCV patients without fibrosis [p<0.001], and non HCV fibrosis [p<0.001, p< 0.05, respectively]. HOMA-IR was significantly correlated with sTNFR2 and fibrosis stage [p< 0.001]. IR was associated with increased risk of developing hepatic fibrosis in chronic HCV infection [OR 8.0, 95% CI 1.5-42]. Insulin resistance can be induced by chronic HCV infection per se and is correlated to fibrosis stages. Its fibrogenic role may be mediated by TNF-alpha activation

Role of non contrast helical CT in predicting the outcome of extracorporeal shock wave lithotripsy

To evaluate the usefulness of urinary calculi attenuation values from non-contrast computed tomography [NCCT] in predicting the outcome of treatment by extracorporeal shock wave lithotripsy [ESWL]. Between 1[st] January 2007 and 30[th] June 2008, we evaluated 178 patients undergoing ESWL for solitary urinary calculi. All patients had NCCT at 120 Kv and 240mA on a helical CT scanner. During each ESWL session 3000 shock waves were given to a maximum of 3.0Kv.A final plain X-ray of the kidney, ureters and bladder was taken 12 weeks after the last ESWL session. Fragments of /= 750HU, 52 [84%] needed three or fewer ESWL sessions and 57[92%] had complete clearance. Of patints with calculi of>750HU, 40 [74%] required three or more ESWL sessions, and 32[60%] had complete clearance. The best outcome was in patients with calculus diameters of<1.1 cm and mean densities of 750HU and diameter of > 1.1cm; 18[75%] needed three or more ESWL sessions and the clearance rate was only 50%. The calculus density was a stronger predictor of outcome than size alone The HU measurement of urinary calculi [stone density] on pretreatment non contrast CT predicts the stone free rates after ESWL. This might help in planning alternative treatment in patients with a probable poor outcome, and to increase the efficiency of ESWL, thus decreasing the cost of treatment

Antibody isotypes in urethral swabs of symptomatic and asymptomatic men infected with trichomonas vaginalis

Trichomoniasis may be asymptomatic or symptomatic in both sexes. The outcome of infection depends on the virulence factors of T vaginalis, but these factors remain unclear. Genetic variability of the isolates and the host's immune response are likely to be key factors in that respect. Symptomatic and asymptomatic males infected with T. vaginalis were compared regarding the differences in antibody subclasses response in the urethral samples. In symptomatic cases there was a significant elevation in IgM, IgG1 and IgG2b levels in urethral samples, and a little, non-significant rise in IgG2a levels. However, there were no statistically significant differences between levels of IgA, IgG3 and IgG4. The results showed that specific IgG1 and IgM and to a lesser extent IgG2 may be involved in established symptomatic trichomoniasis in men, compared to asymptomatic ones

Reproductive activity of the heat stressed rabbit bucks and its improvement using vitamin E and selenium under subtropical Egyptian condition [with 5 tables and 4 plates]

Forty bucks and fifty one New-Zealand White rabbit [NZW] does were used. In the summer, heat- stressed rabbit bucks were divided into four groups [10 each]. The first group was kept as control. The second, third and fourth groups [treated], were injected intramuscularly with vitamin E [100 IU/ head], selenium [0.1 mg/ Kg body weight] or selenium plus vitamin E weakly at the same dose of the previous groups, respectively. Body thermoregulation, testicular measurements, libido, physical and chemical semen characteristics, fertility rate and histological status of the testis of the summer heat- stressed rabbit bucks in the control and treated groups, were recorded. The results showed that, rectal temperature was significantly [P<0.05] lower, while skin temperature and ear lobe temperature were insignificantly lower of the summer heat stressed NZW rabbit bucks injected with Vit. E or Se alone and Vit. E plus Se than the control group, whereas respiration rate was significantly [P<0.05] lower with the bucks injected by Vit. E plus Se only. Libido, semen-ejaculate volume, percentage of sperm motility, sperm-cell concentration and total-sperm output were significantly [P<0.05] better, while the percentages of dead spermatozoa, sperm abnormalities and acrosomal damage of spermatozoa were significantly [P<0.05] lower of the summer heat-stressed NZW rabbit bucks injected with Vit. E or Se alone and Vit. E plus Se than the control group. Seminal pH was insignificantly lower, while initial fructose concentration was significantly [P<0.05] higher of the summer heat-stressed NZW rabbit bucks semen injected with Vit. E or Se alone and Vit. E plus Se than the control group. Seminal sodium concentration was significantly [P<0.05] lower, while calcium, potassium and total phosphorus concentrations were significantly [P<0.05] higher of the summer heat-stressed NZW rabbit bucks injected with Vit. E or Se alone and Vit. E plus Se than the control group. Testis weight [gm], epididymis weight [gm], accessory glands weight [gm], testicular volume [cm[3]] testis tone firmer score and scrotal circumference [cm] were significantly [P<0.05] improved of the summer heat-stressed NZW rabbit bucks injected with Vit. E or Se alone and Vit. E plus Se than the control group. Histological status of the testes of the summer heat- stressed NZW rabbit bucks injected with Vit. E or Se alone and Vit. E plus Se were improved as compared to the control group. Fertility rate of NZW rabbit does mated with the summer heat-stressed bucks injected with Vit. E plus Se was significantly [P<0.05] higher [60.87%] than the control group [42.86%]

TT Virus outbreak among workers in wastewater treatment plants

The role of TT virus [TTV] as a human pathogen and the mode of transmission are unclear. To determine the prevalence of TTV infection and possible fecal-oral route of transmission, 24 wastewater samples from wastewater treatment plants was collected. Fecal samples were obtained from 60 workers in twaste water treatment plants and 15 healthy persons; all fecal samples were from persons non-transfused blood or blood products. TTV in tested samples were detected by nested PCR, using the NG primer sets. DNA sequences were analyzed from PCR products in both directions. TTV-DNA in water samples was 12.5% [3/24]. While, the overall prevalence of TTV in fecal excretion were 11.66% [7/60], and 6.6% [1/15] in workers and control group; respectively. A total of 100 bp PCR fragments were sequenced and compared to sequences derived from the corresponding TTV genome region deposited in GenBank. Present sequencing was most closely related to TTV-like mini virus, complete genome [Accession NC 002195], at nucleotide number 955 to 1021, suggesting related environmental sources of TTV infection. The phylogenetic analysis suggested that present strain might be sub-strain or mutation from the parent gene of TTV-like mini virus. The present of TTV in wastewater workers may be due to the interaction with contaminated environment and increased susceptibility to infectious agents

Relating circulating thyroid hormone to concentrations serum interleukins-6 and -10 In association with non- thyroidal illness

Aim: Alterations in the circulating thyroid hormone concentrations constituting the euthyroid sick syndrome [ESS] are frequently associated with systemic non-thyroidal diseases. However, the underlying mechanism [s] remains illusive. The role of cytokines, including interleukins, was highlighted because of their participation in the pathogenesis of systemic diseases. We aimed in this research to elucidate the possible relation between two interleukins [IL] [IL-6 and IL-10] and any documented change in the levels of thyroid hormones in a cohort of patients with non-thyroidal illness [NTI]. Subjects and Sixty patients were recruited consecutively from the in-patients departments including those of the intensive care unit [ICU] in addition to twenty healthy volunteers who served as a study control group. The patients were subdivided into three equal subgroups depending on their underlying systemic disorder. They included 20 patients with chronic renal insufficiency [CRI], 20 patients with congestive heart failure [CHF], and 20 ICU patients. Determination of the circulating serum levels of IL-6 and IL-10, thyroid stimulating hormone [TSH], as well as thyroid hormones including the total T4 and T3 was carried out. In the whole group of patients, we have detected a reduction in the circulating T3 levels compared to the corresponding level in their 20 healthy control subjects [0.938 +/- 0.477 vs 1.345 +/- 0.44 nmol/l] and this degree of reduction was noted to be a statistically significant one [P= 0.001]. This lowered level of T3 was concomitant with another significant reduction in the circulating total T4 level [47.9 +/- 28.41 vs 108 +/- 19.49 nmol/l, and a P=5.546E-06] with a serum TSH level [1.08+0.518] that maintained within the normal reference values of the employed immunoassay [0.49 +/- 4.67 micro lU/l]. Furthermore, IL-6 concentrations rose in the whole group of patients with NTI to a very highly statistically significant level above the one detected in the healthy controls [105.18 +/- 72.01 vs 3.35 +/- 1.18 ng/l, and P=1.468E-08]. Similarly, IL-10 measurements were very highly statistically significantly elevated above the corresponding measurements observed in the control subjects [74.13 +/- 52.99 vs 2.64 +/- 09;> rig/ml P=5.669E-08]. In addition, we have observed a negative correlation between the serum IL- 6 and serum T3 as well as T4 levels and this inverse association was statistically significant [r = 0.620, P=7.0E-307 and r = -0.267, P=3.0E-151, respectively] Likewise, IL-10 was found to be negatively and significantly correlated with the detected lowered level of T3 in all the NTI-patients [r = -0.512, P = -5.0E-303] However no link was seen between the observed IL-10 concentrations and the other two thyroid function parameters, T4 and TSH. Interestingly, both interleukins; IL-6 and IL-10 were positively and significantly correlated with each other [r = 0.770, P = 0.001]. Moreover, by linear regression analysis, IL-6 [Unstandardized Coefficient [B] +/- Standard Error [SE] = 3.72E-03 +/- 0.001, R2=0.338, P =0.001] and not IL-10 [B +/- SE=-7.512E-04 +/- 0.001, R2=0.338, P = 0.631] was shown as a predictor of T3 reduction with only a borderline degree of significance for IL-6 as a potential risk factor for total T4 reduction [B +/- SE= -0,144 +/- 0.079, R2=0.082, P = 0.071]. By subgroup analysis, we have noticed a highly statistically significant reduction in T3 and T4 concentrations among the three subgroups of patients with NTI and their controls using ANOVA single-factor test [P =3.294E-05 and P = 9.816E-05, respectively]. They differ significantly as well, in both IL-6 as well as IL-10 elevations [P = 5 684E-34 and P = 2.110E-18, respectively]. Importantly, the proportion of patients with subnormal serum T3, total T4 and TSH levels was highest in the ICU patients [70%, 70%, and 72%, respectively] and they displayed the highest mean IL-6 and IL-10 concentrations [192.5 +/- 45.1 ng/l and 122.95 +/- 46.1 ng/l, respectively] compared with the corresponding figures seen in the subgroup of patients with CHF [82.95 +/- 28.9 ng/l and 69.05 +/- 44.0 ng/l, respectively] and that with "CRI [40.05 +/- 28.9 ng/l and 30.4 +/- 10.6 ng/l, respectively] Surprising was our observation that CRI patients showed the least disturbance in their circulating IL-6 as well as IL-10 measurements despite the exhibition of lower than normal levels of T3, T4, and TSH in a higher proportion