Serum apelin in early-onset neonatal sepsis: is it diagnostic?

OBJECTIVE: To evaluate the diagnostic value of serum apelin in early-onset neonatal sepsis in full term neonates. Apelin is a proinflammatory adipocyte-derived factor that participates in vascular wall inflammation. STUDY DESIGN: Case-control study was conducted on 60 full term neonates, 30 cases with early-onset neonatal sepsis and 30 healthy matched controls. Complete blood counts, C-reactive protein, blood cultures, plasma lactate, and serum apelin concentrations (measured by enzyme-linked immunosorbent assay) were determined initially at the time of sepsis diagnosis and 4 days after starting treatment for cases. Only basal serum apelin concentrations were measured for control group. RESULTS: Apelin was detected in all neonates and concentrations were positively correlated to sepsis scores, plasma lactate and CRP. Neonates with sepsis had significantly elevated concentrations (8 folds increase) of serum apelin concnetration as compared to controls [median (IQR): 65.16(46.90) and 7.969(11.36) pg/ml, respectively]. Moreover initial serum apelin concentration measured in cases with culture proven neonatal sepsis was significantly higher than those with negative-culture clinical sepsis (mean ± SD: 73.53 ± 31.77 and 45.22 ± 5.9 respectively, p = 0.0001). The best cutoff value of serum apelin to diagnose early-onset neonatal sepsis was 30.225 pg/ml with a sensitivity of 100% and a specificity of 97%. CONCLUSION: Serum apelin may have a diagnostic value in early-onset neonatal sepsis.

Relationship between maternal characteristics and neonatal birth size in Egypt.

This study in Egypt investigated the influence of selected maternal factors on neonatal birth size. Data were collected after delivery from 782 apparently healthy pregnant women and their neonates. A questionnaire on personal, medical, socioeconomic status, smoking habits and exposure to smoking was completed. Maternal weight and height, food frequency intake during pregnancy and haemoglobin levels were recorded for 594, 234 and 246 of the mothers respectively. Neonatal birth weight, length and head circumferences were measured. A significant positive correlation between maternal anthropometric variables with neonatal birth dimensions was observed and the effect was more evident in girls than boys for BMI and head circumference. Statistically significant negative correlations were found between maternal haemoglobin levels and birth size. Birth size was strongly correlated with maternal consumption of micronutrient-rich food at all stages of gestation. Passive smoking significantly affected birth weight and BMI of girls more than boys.

Head circumference reference data for Egyptian children and adolescents.

Data from a cross-sectional study of 27,826 healthy children in Cairo, Egypt, were used to construct standard growth charts of head circumference and reference values of relative head circumference to length/height for each sex. The sample was collected during the Egyptian Growth Curve Project for children and adolescents in 2002. Values were obtained for each month cohort for children aged 1-24 months, then for each year cohort until age 18 years. The values were compared with those of other populations. The constructed growth standards are suitable for growth monitoring programmes throughout Egypt.

Waist circumference and central fatness of Egyptian primary-school children.

This cross-sectional study of 1283 healthy children (681 boys, 602 girls) aged 6-11 years tested the degree of correlation between waist circumference measurements and adiposity. The children were classified as normal, overweight or obese according to their body mass index (BMI). For both sexes a highly positive correlation was found between waist circumference and BMI, percentage of body fat, subscapular and suprailiac skinfold thicknesses, and the sum of skinfold measures. Central overweight and obesity were indicators for central fatness for both overweight boys and girls and for obese girls except in age group 6.5 +/- 1 years. Waist circumference was a good indicator of central fatness (overweight and obesity) in children aged 8.5 +/- years and 10.5 +/- 1 years.

Waist circumference and central fatness of Egyptian primary-school children

This cross-sectional study of 1283 healthy children [681 boys, 602 girls] aged 6-11 years tested the degree of correlation between waist circumference measurements and adiposity. The children were classified as normal, overweight or obese according to their body mass index [BMI]. For both sexes a highly positive correlation was found between waist circumference and BMI, percentage of body fat, subscapular and suprailiac skinfold thicknesses, and the sum of skinfold measures. Central overweight and obesity were indicators for central fatness for both overweight boys and girls and for obese girls except in age group 6.5 +/- 1 years. Waist circumference was a good indicator of central fatness [overweight and obesity] in children aged 8.5 +/- years and 10.5 +/- 1 years

Head circumference reference data for Egyptian children and adolescents

Data from a cross-sectional study of 27 826 healthy children in Cairo, Egypt, were used to construct standard growth charts of head circumference and reference values of relative head circumference to length/height for each sex. The sample was collected during the Egyptian Growth Curve Project for children and adolescents in 2002. Values were obtained for each month cohort for children aged 1-24 months, then for each year cohort until age 18 years. The values were compared with those of other populations. The constructed growth standards are suitable for growth monitoring programmes throughout Egypt

Immunochemical characterization and diagnostic potential of a 63-kilodalton Schistosoma antigen.

Schistosoma circulating antigens were used for the detection of active infection. Anti-S. mansoni IgG2a monoclonal antibody (MAb) designated C5C4 was generated. The target epitope of this MAb was detected in adult worms, eggs, and cercariae antigenic extracts of S. mansoni and S. haematobium, had a molecular size of 63 kD, and was not detected in Fasciola hepatica and Ascaris. In addition, a 50-kD degradation product was identified only in the urine of infected individuals. Analysis by high-performance liquid chromatography of the purified antigen demonstrated only one peak. The 63-kD antigen was characterized as a protein containing 40.4% hydrophobic, 7.5% acidic, and 8.8% basic amino acids. The C5C4 MAb was used in a Fast Dot-ELISA for rapid and simple diagnosis of human schistosomiasis. The 63-kD circulating antigen was detected in 92% of urine samples from 330 S. mansoni-infected individuals, with 16% false-positive results among 130 noninfected individuals.

Rapid detection of a Schistosoma mansoni circulating antigen excreted in urine of infected individuals by using a monoclonal antibody.

Schistosoma circulating antigens were used to indicate the infection intensity and to assess cure. An immunoglobulin G2a (IgG2a) mouse monoclonal antibody was used in a fast dot-enzyme-linked immunosorbent assay (ELISA; FDA) for rapid and simple diagnosis of schistosomiasis in the field. Seven hundred Egyptians were parasitologically examined for Schistosoma mansoni and other parasitic infections. A rectal biopsy was done as a "gold standard" for individuals showing no S. mansoni eggs in their feces. Egg counts were obtained by the Kato smear method for only 100 of 152 individuals with eggs in their feces. Specific anti-schistosome IgG antibodies were evaluated in sera by ELISA. Urine samples from the 700 individuals were tested by FDA for detection of the circulating antigen. The assay showed a sensitivity of 93% among 433 infected individuals and a specificity of 89% among 267 noninfected individuals. FDA showed the highest efficiency of antigen detection (91%) compared with the efficiency of antibody detection by ELISA (75%) and stool analysis (60%). In addition, FDA detected infected patients with 20 eggs/g of feces. Also, the sensitivity of FDA ranged from 90 to 94% among samples from patients with different clinical stages of schistosomiasis. All the assay steps can be completed within 30 min at room temperature for 96 urine samples. The monoclonal antibody identified a 74-kDa antigen in different antigenic extracts of S. mansoni and Schistosoma haematobium and in the urine of infected individuals. In addition, a 30-kDa degradation product was identified only in the urine samples. On the basis of these results, FDA should be used as a rapid tool for the sensitive and specific diagnosis of Schistosoma infection.

Immunochemical purification and characterization of a 74.0-kDa Schistosoma mansoni antigen.

A polypeptide antigen of 74.0 kDa molecular weight was detected in the antigenic extracts of the 3 developmental stages of Schistosoma mansoni (eggs, cercariae, and adult worms) by western blotting using BRL4 monoclonal antibody (mAb) that significantly protected mice at the levels of 51.6%, 42%, and 53.8% against challenge S. mansoni infection in 3 separate experiments. This antigen was isolated and purified from crude soluble worm antigen preparation by immunoaffinity chromatography using CNBr-activated sepharose-4B beads coupled with the BRL4 mAb. The purified antigen showed a single peak when analyzed by both high-performance liquid chromatography and high-performance capillary electrophoresis. The 74-kDa antigen was characterized as a protein in nature with 56.9% hydrophilic amino acids and 43.1% hydrophobic amino acids. This antigen was detected in 93% of urine samples from infected cases with specificity of 89% among noninfected cases using an enzyme immunoassay-fast dot-enzyme-linked immunosorbent assay based on BRL4 mAb.

Fast-Dot ELISA using urine, a rapid and dependable field assay for diagnosis of schistosomiasis.

The fast dot-enzyme linked immunosorbent assay (FD-ELISA) was used as a field applicable tool for rapid diagnosis of schistosomiasis. Seven hundreds faecal specimens were parasitologically examined for detection of S. mansoni eggs and other parasitic infection. Egg count was done for 100 infected patients. Rectal biopsies (394) were taken from individuals with no S. mansoni egg in their stool where it was used as a golden standard for diagnosis of schistosomiasis. Cross-reactivity with other parasites was studied. Serum samples were tested by ELISA technique for detection of human IgG anti-schistosomal antibodies. Seven hundreds urine samples (433 S. mansoni infected patients and 267 healthy individuals) were tested by FD-ELISA for detection of a schistosomal antigen excreted in urine using BRLF4 mouse monoclonal antibody. FD-ELISA results were compared with ELISA detecting antischistosomal IgG and stool analysis where, it showed highest efficiency (91%), compared with 81% and 60% for ELISA and stool analysis respectively. The sensitivity of FD-ELISA was high ranging from 90-94% in the four different clinical stages of schistosomiasis (Simple intestinal. Hepatosplenomegaly, Shrunken liver & Splenomegaly, and Shrunken liver-splenomegaly & ascites). FD-ELISA was highly sensitive, detecting infection cases with 20 eggs/gm faeces and its specificity was 89%. The antigen was characterized as a protein with a molecular weight of 74 KDa using western blot technique.

Evaluation of Fasciola excretory-secretory (E/S) product in diagnosis of acute human fasciolosis by IgM ELISA.

Diagnosis of fasciolosis in the acute phase depends on a sensitive and accurate serological test. The present study is an evaluation of the efficacy of excretory-secretory Fasciola gigantica adult worm antigen by IgM ELISA. Thirty eight patients with acute fasciolosis and 14 in the chronic phase together with 23 patients with different parasitic infections were introduced in the study. Seventeen healthy, parasite free individuals, were served as controls. A crude excretory-secretory antigen and its fractions I and II (obtained by gel filtration chromatography on Sephadex G-200) were tested. The crude antigen revealed 100% sensitivity, 94% specificity and 98% accuracy at the cut off level of 0.3 in acute infection. It gave positive results in 77% of chronic cases. Cross reactions with Schistosoma and Toxoplasma were negligible. A significant positive correlation between IHA titres and ELISA O.D. readings was observed. Fractions I and II proved of no diagnostic significance. The test system F. gigantica E/S product by IgM ELISA is highly recommended for diagnosis of acute fasciolosis.

Arm muscle and fat areas vs. weight/length ratio in the assessment of protein energy malnutrition.

A cross-sectional sample was examined of 68 male and 63 female malnourished Egyptian children, 1-3 years of age, attending the Malnutrition Unit of the Children's Hospital of Cairo University. Body weight, length, left mid-upper arm circumference, and the triceps skinfold thickness were measured. Arm muscle and fat areas were calculated as was the weight for length ratio. Comparisons were attempted between arm muscle and fat areas and weight/age, length/age, and weight/length ratios relative to the clinical picture of protein energy malnutrition (PEM). The results revealed that arm muscle area is a better diagnostic indicator of PEM, particularly in boys, whereas the weight/length ratio is a better choice for girls. Although arm fat area is a very sensitive indicator of energy deficit, it cannot serve alone as an adequate index of general nutritional status. © 1993 Wiley-Liss, Inc.

Hepatitis B surface antigen in Cimex lectularius.

Bedbug (Cimex lectularius) samples adult and nymphs either engorged or starved from Central Security Forces sleeping wards, laboratory animal house and control samples from laboratory reared colonies were ground and subjected to ELISA test of hepatitis B surface antigen together with 276 serum samples from the recruits slept in those wards. In the camp 7 out of 30 samples of engorged adult bedbugs were positive to HBSAg and 5 out of 30 samples of starved bedbugs were positive. Regarding nymphs 4 out of 30 engorged samples showed positive results. One of five samples of engorged adult bedbugs from the laboratory animal farm was positive. The control samples were negative. Serum samples of 276 recruits showed 3.6% positive results of HBSAg.