Novel analytical techniques for HIV-1 infection of CD4 + T cells on fractional order in mathematical biology.

In this research, we present an analytical analysis of HIV-1 infection of CD4 + T cells with a conformable derivative model (CDM) in biology. An improved Υ'/Υ-expansion method is used to investigate this model analytically to construct a new exact traveling wave solution, namely, exponential function, trigonometric function, and the hyperbolic function, which can be further studied for more (FNEE) fractional nonlinear evolution equations in biology. Also, we provide some graphs in 2D plots that demonstrate how accurate the results will be produced using analytical approaches.

Prevalence and resistance profile of bacteria isolated from wound infections among a group of patients in upper Egypt: a descriptive cross-sectional study.

AIM: This cross-sectional survey aimed to identify aerobic bacteria, antimicrobial resistance, and multi-drug resistance profiles of bacteria isolated from different wound infections among a group of Egyptian patients. RESULTS: Of 120 positive samples, 170 isolates were identified. Polymicrobial infections were determined in 55% of samples. The dominant Gram-positive isolated strains were Staphylococcus aureus, especially from wound infections because of accidents (71.8%). Piperacillin, methicillin, ampicillin/sulbactam, and amoxicillin/clavulanic acid were all highly resistant to S. aureus and Coagulase-negative Staphylococci. The prevalence of methicillin-resistant S. aureus in wound infections was 89.9%. S. aureus showed superior sensitivity to vancomycin (85.3%) and linezolid (81.3%). The highest prevalence of Gram-negative isolates was for Pseudomonas aeruginosa (40%), which was highly sensitive to ciprofloxacin (79.2%) and highly resistant to levofloxacin (83.3%). Several isolates revealed a multi-drug resistance profile (52.4%). The overall MDR rate of Gram-positive and Gram-negative isolates were 50% and 54.9%, respectively. CONCLUSION: The prevalence of MRSA isolated from various wound infections and MDR is a warning issue in Upper Egypt. It should implement a health education strategy and hygiene measures to prevent the spread of wound infection-causing organisms in the community.

[Serum and synovial adiponectin, resistin, and visfatin levels in rheumatoid arthritis patients. Relation to disease activity]. / Adiponectin, Resistin und Visfatin in Serum und Gelenkflüssigkeit bei Patienten mit rheumatoider Arthritis. Zusammenhang mit der Krankheitsaktivität.

BACKGROUND: Recent data provided evidence on the implication of the adipocytokines adiponectin, visfatin, and resistin in inflammation, immune response, and tissue destruction and revealed several links between them and arthritis. AIM OF THE STUDY: The purpose of this study was to assess the levels of adiponectin, visfatin, and resistin in serum and synovial fluid of patients with rheumatoid arthritis (RA) and their relationship with disease activity. SUBJECTS AND METHODS: A total of 70 female patients with RA and 30 age- and sex-matched healthy controls were enrolled. The clinical activity of RA patients was assessed according to the 28 joint count Disease Activity Score and patients were classified into two groups: 39 patients with active disease (group A) and 31 patients in remission (group B). Synovial fluid was obtained by arthrocentesis of the affected knee joints from 39 patients with active disease. Serum adiponectin, visfatin, and resistin concentrations were measured in RA patients and controls, while a specific enzyme-linked immunosorbent assay was used to measure the synovial concentrations of adiponectin, visfatin, and resistin in the group of patients with active RA. RESULTS: Serum levels of adiponectin and visfatin were significantly higher in all RA patients and patients with active disease compared to the control group and patients in remission. No significant difference was observed in the resistin level between patients and controls. Serum and synovial adiponectin and visfatin were positively correlated with DAS28-ESR in RA patients with active disease. CONCLUSION: Our data demonstrated that adiponectin and visfatin are related to disease activity in RA patients and might be involved in the progression of RA. The English full-text version of this article is available at SpringerLink (under "Supplemental").

Reconstruction following excision of sacrococcygeal pilonidal sinus with a perforator-based fasciocutaneous Limberg flap.

UNLABELLED: Many procedures have been proposed for the management of sacrococcygeal pilonidal sinus disease. The aim of this work is to evaluate the superiorly based flap (used before for reconstruction of pressure sore) for reconstruction after excision of sacrococcygeal pilonidal sinus. PATIENTS AND METHODS: Between January 2004 and February 2007, 25 male patients of ages between 14 and 29 years(median age: 23 years), who had recurrent pilonidal sinus, underwent surgical treatment by the Limberg flap technique. The mean duration of symptoms was 5.2 + or - 4.5 years (range 3-6 years). Rhombic-shaped excision of the sinus-bearing skin and subcutaneous tissue up to the presacral fascia guided by electrocautery was performed, followed by reconstruction of the defect by perforator-based Limberg flap (based on the superior gluteal and sacral perforators). RESULTS: Primary healing occurred in 22 patients. Two patients (8%) had seroma with negative bacterial cultures, which healed completely with bedside drainage and conservative treatment. Another patient (4%) had superficial wound infection that were treated by appropriate antimicrobial therapy. Complete healing of all cases occurred without recurrence during the follow-up period. The mean operative time was 40min (ranging between 30 and 45min according to the size of the lesion). There was no ischaemia or necrosis of the flaps, and all flaps remained viable. The mean length of hospital stay was 2 days, ranging between 1 and 6 days. CONCLUSION: The use of superiorly based Limberg flap in reconstruction after excision of sacrococcygeal pilonidal sinus is reliable, easily performed, associated with complete cure and low postoperative complications.

Bipedicled flap in reconstruction of exposed tibia.

AIM OF THE WORK: To evaluate the feasibility of using the bipedicled flap in the reconstruction of an exposed tibia. PATIENTS AND METHODS: Twenty-three patients underwent reconstruction of the exposed tibia using the fasciocutaneous bipedicled flap from the medial of the leg (in 12 patients), from the lateral aspect (in 9 patients) and from both the medial and the lateral (in 2 patients). In all cases, the donor site of the flap was covered by split-thickness skin graft. RESULTS: In 23 patients, 25 fasciocutaneous bipedicled flaps were used, a single flap in 21 patients, and double flaps in two patients. Twenty-three flaps were completely viable and healed totally. One of the remaining flaps (which were used to cover an exposed tibia after excision of a chronic leg ulcer) was complicated by partial necrosis due to superficial necrosis of its lateral edge which healed conservatively. The last flap was severely infected resulting in necrosis which required debridement and reconstruction using a free forearm flap. CONCLUSION: The bipedicled flap has advantages of dual blood supply, achievement of sensitivity in the damaged area and acceptable aesthetic appearance.

Effect of different types of fish on rats suffering from diabetes.

The present work was conducted to study the beneficial effect of different types of fish on diabetic rats and diabetic rats treated with insulin. This study investigated the chemical composition of four types of fish (Mackerel, Sardines, Smoked herring and Bolti) and also the effects of these types on the nutritional value and the levels of serum (glucose, lipid fractions, kidney and liver functions) of diabetic rats. The chemical composition "on dry bases matter" of processed fish types revealed that the bolti fish had the highly percent of protein, while the highest percent of fat was found in mackerel and sardines. The mackerel had the highest percentage of polyunsaturated fatty acid, followed by sardines, herring and bolti. Seventyfive male Albino rats used in this study, weighing (150 +/- 5 g) were divided into three main groups (n = 25). The first main group was considered negative control. The second main group was injected with 150-mg/kg-body weight of recrystallized alloxan to induce hyperglycemia. The third main group was injected with 150-mg/kg-body weight of recrystallized alloxan to induce hyperglycemia and treated with insulin injection. Each main group was divided into five subgroups. The first subgroup from each main group fed on a casein diet, while the second, third, fourth and fifth subgroups fed on basal diet containing mackerel, sardines, herring and bolti, respectively. Feeding diabetic rats with the different types of diet (fish diet) resulted in an improvement of the nutritional parameters. The mean values of serum glucose, cholesterol, triglycerides, LDL-c, HDL-c, VLDL-c, uric acid, urea nitrogen, aspartate amino transferase (AST) and alanine amino transferase (ALT) decreased in all treated groups especially with the mackerel and sardine diet, followed by bolti, as compared to the positive control groups (fed on a casein diet), while the levels of serum cholesterol and LDL-c increased in the groups fed on the herring diet. On the other hand, diabetic rats that were treated with a low insulin dose and fed on the mackerel diet, showed non-significant differences in the levels of all parameters, as compared to non-diabetic rats.

Plasma catecholamines in pulmonary tuberculosis.

Fifty pulmonary tuberculous patients (minimal; moderate and far-advanced), 18 TB-healed persons and 15 healthy control subjects were examined for plasma levels of adrenaline (AD), noradrenaline (NA), dopamine (DA), ACTH and cortisol. The estimated hormones were found to be increased significantly with the severity of the disease suggesting that the stress of infection plays a role in induction of enzymes responsible for catecholamines synthesis with subsequent stimulation of ACTH and cortisol secretion. Noradrenaline appeared the most effective in this respect.

Adenohypophyseal activity in relation to suprarenal function in tuberculosis.

This work was carried out on 150 subjects. They were classified into four groups: group I: Bronchogenic pulmonary T. B. (n = 96); group II: Haematogenous T. B. (n = 15); group III: Healed T. B. (n = 16), group IV: Healthy control (n = 23). Insulin tolerance test was done for each subject to assess the hypothalamo-hypophyseal axis. Glucose, ACTH, cortisol, GH, and PRL levels were estimated during fasting and over three hours after insulin administration. In group I and II the patients exhibited higher fasting levels of anti-insulin hormones and they respond greater than normals to insulin-induced hypoglycaemia. This might indicate early affection of the pituitary gland by TB infection, yet insulin-induced hypoglycaemia assured efficient function of the gland. In healed TB patients, no significant changes were obtained in the different hormonal behaviour, whether in the fasting state or after stimulation. This might be explained by improvement of the health condition of the patients, and relief of the stress induced by TB infection.

Calcium homeostasis in untreated pulmonary tuberculosis II--dynamic study.

Oral calcium tolerance test was done for 17 normal subjects and 26 pulmonary tuberculous patients. Ingestion of 1 gm calcium did not alter serum calcium levels significantly, while urinary calcium significantly increased in normal controls (p less than 0.001) and significantly decreased in tuberculous patients. The decrease in urinary calcium in untreated TB patients may be attributed to the associated decrease in serum concentration of 25-hydroxyvitamin D. Serum PTH and nephrogenous cAMP showed insignificant changes both in controls and TB patients. Meanwhile, these changes are antiparallel to serum calcium, denoting a normal response (function) of parathyroid gland to serum calcium alterations.

Calcium homeostasis in untreated pulmonary tuberculosis. I--Basic study.

This study has been done to evaluate serum calcium, phosphorus (P), magnesium, parathyroid hormone (PTH), calcitonin (CT), and cyclic adenosine monophosphate (cAMP) in recently diagnosed pulmonary tuberculous patient, (n = 61) and the results were compared with the healthy control group (n = 22). Twenty four hours urine was collected for estimation of these electrolytes as well as cAMP. Nephrogenous cAMP (NcAMP) was calculated. Serum Ca and PTH were significantly reduced in TB groups, but CT was elevated. Serum Mg, P and cAMP as well as urinary Ca and Mg in TB groups were similar to that of the control group. Urinary P, cAMP NcAMP were increased in patient groups compared with the control. The reduced serum Ca could be due to impaired intestinal absorption of Ca, or deficient intake as a result of anorexia, decreased plasma albumin, decreased active metabolites of vitamin D or elevated CT. The rise in serum CT in TB might be due to increased CT secreted from the bronchial K-cells. Increased NcAMP might be due to the associated increase in serum antidiuretic hormone (ADH). The elevated urinary P in TB could be attributed to tissue breakdown, decreased serum PTH or increased CT.

Unsuitability of blood culture media containing sodium polyanetholesulfonate for the detection of fastidious microorganism in CSF and other blood-free body fluids.

The suitability of well known conventional blood culture media for the detection of microorganisms in CSF and other blood-free body fluids has been tested. It was demonstrated that such media are unsuitable for the cultivation of fastidious and/or anticoagulant-sensitive microorganisms which are frequently isolated from CSF and other blood-free body-fluids. On the contrary, the recently-developed MOPS electrolyte broth A which proved to be a suitable cultivation and back-up medium for aerobic and facultative anaerobic microorganisms in CSF and other blood-free body fluids is not suitable for the detection of microorganisms in blood, because it is free of anticoagulants.

[Comparative study with 2 new and 8 known nutrient media for cultivation of fastidious and nonfastidious microbial agents from cerebrospinal fluid and other body fluids]. / Vergleichsuntersuchungen mit 2 neuen und 8 bekannten Nährmedien zur Anzüchtung anspruchsvoller und anspruchsloser Erreger aus Liquor und anderen Körperflüssigkeiten.

Rapid physical, biochemical and immunological methods may be useful in the detection of microbial agents in cerebrospinal fluid and in other body fluids. However, these methods are no substitution for the cultivation of the microbial agents. Microorganisms which are most frequently responsible for meningitis are fastidious in their growth requirements. Their detection with the help of conventional blood culture media which are not supplemented with blood or its components, leads to a high quota of false-negative results. Taking this problem into consideration, the authors developed the following two new media: "MOPS Electrolyte Broth A" for culturing obligate aerobic and facultative anerobic microorganisms, and "MOPS Electrolyte Broth AN" for culturing facultative anaerobic and obligate anaerobic bacteria. Performance tests have been carried out with the two above mentioned media and eight commercially manufactured blood culture media in original bottles. Twenty representative test strains including the most important and fastidious microbial agents of meningitis have been considered in this study. The inoculum size was about 10(2) CFU per culture bottle. The two new media, which were not supplemented with blood or body fluids, proved to be more effective than the conventional blood culture media supplemented with 10% fresh human blood for culturing the considered spectrum of microorganisms.

[New culture method for the diagnosis of bacteriurias]. / Neues kulturelles Verfahren zum Nachweis von Bakteriurien.

The aim of this study is to check the clinical relevance of a new cultural method for the detection of urinary tract infection especially in urine samples containing residue of antimicrobial agents. The new procedure concerns a urine collecting and cultivating cup (UCCC Biotest Serum Institute), containing a recovery agar (RA5) with incorporated chemotherapeutica antagonists. The efficiency of the UCCC is compared with the familiar dip slide coated with cystein lactose electrolyte deficient (CLED) agar and MacConkey agar. A collective of 305 children is considered in this study. The investigation was carried out before starting, three to five days after starting and three to five days after stopping the chemotherapy. The highest correlation between the microbial count in urine samples and the whole clinical diagnosis was achieved with RA5. The lowest correlation was attained with MacConkey agar. With CLED agar a good correlation was determined before starting therapy, a modest correlation during therapy and very good correlation after stopping therapy. Regarding relapses and reinfections the detection quote of relevant bacteriuria during therapy amounted to 90% as RA5 was used, 62% with CLED agar and 34,5% with MacConkey. RA5 proved very useful for follow-up purposes, especially during treatment with antimicrobial agents and may be considered as a susceptibility testing in vivo.

[Effect of anaerobiosis in 6 blood-culture media on the recovery rate of aerobic microorganisms (author's transl)]. / Auswirkung der Anaerobiose in 6 Blutkulturmedien auf die Wiederfindungsrate aerober Erreger.

Commercially manufactured blood-culture bottles with 6 different culture media have been considered in this study. The bottles were respectively supplemented with 10% fresh human blood and inoculated with obligate aerobic and facultative anaerobic microorganisms known to cause bacteremia and fungemia. The inoculum size ranged from less than 10 to 10(2) CFU per blood-culture bottle. The study was carried out by alternately incubating one set of bottles anaerobically for two days before being vented, while the other set was vented immediately after inoculation. The effect of anaerobic and aerobic atmospheres on growth intensity, recovery rate and survival durability of the 11 microbial strains has been studied. The maintenance of anaerobic atmosphere for 2 days before venting the blood-culture bottles caused: a) 2 to 4 days delay in detecting nonfastidious bacteria and fungi; b) rapid death of acid-sensitive bacteria in poorly buffered culture media; c) inability of fastidious bacteria to grow in any of the 6 culture media. On the other hand venting the blood-culture bottles immediately after inoculation enabled: a) rapid detection of bacteria by an early subculture after 8 hours of incubation; b) diagnostic advantage of at least 2 days with rapidly growing bacteria which make more than 50% of the whole microbial spectrum; c) good growth of fastidious bacteria. Collectively, brain heart dipeptone broth proved to be the most effective culture medium for detection of obligate aerobic microorganisms responsible for bacteremia.

Effect of Triiodothyronine on Bronchial Asthma. III.

In two previous communications we demonstrated that triiodothyronine (T3) improved cases of chronic bronchial asthma (CBA). In this communication we administered T3 in a dose of 40 microgram/day for a period of sixty days to twelve cases of CBA aged less than 38 years who had had the condition for more than 5 years and were not on steroids or chromoglycate. All were outpatients. Respiratory functions including vital capacity and timed expiratory volume were tested before and after the period of drug administration. Patients were also advised to record the number of attacks and amount of bronchodilators used. All patients had their % T3 uptake and thyroxine (T4) serum level examined before the experiment. Ten normal persons of matching ages and sexes had their blood examined for % T3 uptake and levels as control. The results have shown that the patients had normal % T3 uptake and T4 levels in blood. Their vital capacity increased by an average of 4.27%, their first-second expiratory volume by 17.58% (P less than 0.0025), their second-second expiratory volume by 13.74% (P less than 0.0025%), and their maximal ventilatory volume by 12.95% (P less than 0.0025). Five cases had an increase of over 20% and 5 cases had practically no increase or a mild reduction. Subjective improvement and reduction in amount of bronchodilators used correlated well with the improvement in ventilation. It is argued that T3 acts through having the capacity to increase cAMP, a main messenger in bronchodilation that is known to be deficient in asthmatics.

[Blood cultures. Comparative study with 7 known and 2 new nutrient media for the detection of aerobic and anaerobic microorganisms (author's transl)]. / Blutkulturen. Vergleichsuntersuchungen mit 7 bekannten und 2 neuen Nährmedien zum Nachweis von aeroben und anaeroben Mikroorganismen.

The growth promoting properties of seven commercially manufactured and two recently developed culture media are compared according to a standardized method. The study is carried out alternately without and with the addition of 10% fresh human blood to the culture media. The carefully selected test strains include 20 species of bacteria and 2 species of yeasts which represent obligatory aerobic, facultative anaerobic and obligatory anaerobic microorganisms with quite different nutritional and atmospherical requirements. The 9 tested media are good enough for the purpose of culturing nonfastidious bacteria. However, most of the commercially prepared media failed to detect small inocula of very fastidious microbial agents, especially when no blood is added. Collectively, thiol broth is the most noneffective medium. The last but one is thioglycollate medium. Three culture media based on brain heart infusion formula prove to be effective. Those are the commercial brain heart dextrose and the two media recently developed by the authors, namely brain heart dipeptone (BHD) and brain heart dipeptone cysteine (BHDC). BHD is the most suitable medium for the detection of obligatory aerobic and facultative anaerobic fastidious microorganisms. BHDC detects anaerobic fastidious bacteria quite effectively. The other media, namely Columbia, trypticase soy, trypticase soy sucrose, and Rosenow are of limited value with regard to the detection of small inocula of fastidious microorganisms. The causes of the unsatisfactory results with different commercial media are discussed in detail. The authors point out to the possible use of hypertonic media in special cases. Properties that should be fulfilled by blood culture media are proposed.

[Urinary tract infections. Therapeutic failures and course monitoring (author's transl)]. / Harnwegsinfektionen. Therapieversagen und Verlaufskontrolle.

The proportion of reinfections and relapses in urinary tract infections amounts to about 35-70%. Hydrokinetic conditions (e.g. size of bladder, frequency of micturition, rate of multiplication of the pathogens, adhesiveness of bacteria) not seldom lead to a discrepancy between the in vivo response of the pathogen to the chemotherapeutic agent and the corresponding MIC determined in vitro. Ten causes for the therapeutic failure are discussed in greater detail. Monitoring the course in good time with due regard to the risks is essential. A scheme for microbiological monitoring investigations before beginning therapy, during treatment and after discontinuing the medicament, as well as for long term therapy is suggested.