Combination of Procalcitonin, CRP and CD11b Biomarkers in Early Detection of Neonatal Sepsis.

The study aimed at comparing the diagnostic performances of CRP, PCT and CD11b in neonatal sepsis and evaluating the effectiveness of the sepsis score system when using a combination of various biomarkers. The study was conducted on 90 neonates divided into 3 equal groups; a group with proven sepsis, suspected sepsis and healthy newborns. All were subjected to measurement of CPR by Latex agglutination, serum Procalcitonin by ELISA and CD11b by flow cytometry. On comparing the three biomarkers; PCT (Serum procalcitonin) was associated with the highest (AUC) area under the curve followed by CD11b and CRP recording the smallest value. However, the AUC of the combined sepsis score was much higher than individual biomarkers. Although the sensitivity of individual biomarkers from procalcitonin to CD11b and lastly CRP but the sensitivity and specificity of the sepsis score showed higher values compared to those of individual biomarkers. In conclusion, the study demonstrate that combination of CRP, CD11b and, procalcitonin can enhance diagnostic discriminative power over traditional tests and overcome the drawbacks of each test alone with greater diagnostic accuracy.

Anti-PLA2R and anti-THSD7A as Diagnostic Serological Markers of Idiopathic Membranous Nephropathy: A Single Centre Study.

Idiopathic Membranous Nephropathy (IMN) is a renal-limited autoimmune disease and accounts for approximately 80% of MNs. This study aimed to evaluate the role of circulating Anti-PLA2R and anti-THSD7A autoantibodies in the diagnosis and differentiation between primary and secondary MN. This study was conducted on 58 adult patients with biopsy-proven membranous glomerulopathy (MGN). All were subjected to measurement of Anti-PLA2R1 by an Enzyme-Linked Immunosorbent Assay and anti-THSD7A was detected by an indirect immunofluorescence assay. Among the 58 patients, 79.3% were diagnosed as IMN, and 20.7% as secondary membranous glomerulopathy (SMN). Among IMN patients, 32 patients (69.6%) showed positive anti-PLA2R1 antibodies, 2 patients (4.3%) were positive for anti-THSD7A antibodies and the remaining 12 patients (26.1%) were negative for both types of antibodies. Patients with SMN were negative for the two antibodies. The IMN patients had lower serum creatinine compared to the SMN patients (P=0.017). In conclusion, the study demonstrates that approximately 70% of patients with idiopathic membranous nephropathy have antibodies against PLA2R indicating that Anti-PLA2R may be fast, easy, relatively sensitive, and non-invasive test for diagnosis of IMN..

Transfusion-transmitted virus infection in hemodialysis patients in Arar, Saudi Arabia: Prevalence, predictors and genotyping.

Transfusion-transmitted virus (TTV) is a single-stranded DNA virus that was identified in patients with post-transfusion hepatitis of non-A-to-G type. Patients with chronic renal failure on maintenance hemodialysis (HD) have a higher risk of viral infections, and the prevalence of TTV infection is common. The aim of our study was to detect TTV-DNA and its genotype in HD patients. A case-control study compromising of 63 patients on maintenance HD therapy at the Nephrology Center of Central Arar Hospital and 100 healthy individuals who were tested for TTVDNA and its genotype by semi nested-polymerase chain reaction with primers derived from the conserved open reading frame 1 (ORF1) region followed by digestion with NdeI and PstI restriction enzyme. The results show that the prevalence of TTV in HD patients was high and statistically significant; 42.9% compared with 19% in the control group. History of blood transfusion was the only significant predictor, and we found that age of patients, duration of HD, hepatitis B and C infection, aspartate aminotransferase and alanine aminotransferase levels were not significant predictors of TT virus positivity in HD patients. TTV genotype 1 (G1) was found to be the most common genotype among both HD and healthy controls. The prevalence of TTV among HD patients was significantly higher than that in healthy individuals. History of blood transfusion was the only significant predictor of TTV positivity among them. Genotype 1 was the most predominant type among HD and healthy individuals. Further studies on TTV in peritoneal dialysis patients and transplant patients are needed.

Use of 4-factor prothrombin complex concentrate in the treatment of a gastrointestinal hemorrhage complicated by dabigatran.

Target-specific oral anticoagulants (TSOACs) provide patients and healthcare providers with an alternative to vitamin K antagonists (VKA). The TSOACs are of similar or superior efficacy to warfarin, but unlike VKAs, there are no approved 'antidotes' for rapid reversal of life-threatening bleeding on therapy. We report here the case of an 83-year-old gentleman, who presented to the emergency department with severe gastrointestinal hemorrhage and coagulopathy (hemoglobin: 5.3 g/dL and INR: 2.2) while on the direct thrombin inhibitor dabigatran. His coagulopathy reversed rapidly after administration of 4-factor prothrombin complex concentrate (4 F-PCC), and after initial administration of 2 units of packed red blood cells, no further product transfusions were required. He was discharged 4 days later without further complications.

Effect of maternal vitamin A deficiency during pregnancy on neonatal kidney size.

BACKGROUND AND AIMS: In animal studies, vitamin A deficiency (VAD) during pregnancy has been shown to be associated with a decrease in nephron number and kidney weight of the offspring. At present, it is unclear whether these observations are pertinent to humans. Thus, this study was performed to assess the vitamin A status of a cohort of Egyptian pregnant women and their newborns and to determine the potential effect of maternal VAD during pregnancy on the neonatal kidney size. METHODS: The maternal and cord blood samples were collected for the measurement of serum retinol concentration.Within the first 3 days after delivery, an abdominal ultrasound was performed in all newborns to determine the renal dimensions and volume. RESULTS: Sixteen (20%) mothers had VAD. The newborns delivered to VAD mothers had significantly lower mean values of cord retinol concentrations and dimensions of both kidneys than the newborns delivered to mothers with vitamin A sufficiency. The maternal serum retinol concentrations were positively correlated with the cord retinol concentrations, the dimensions of both kidneys, and the combined renal volume of their respective newborns. CONCLUSION: Maternal VAD during pregnancy may decrease renal size in the infant at birth. The functional implications of this effect warrant further study.

Significance of p53 and CD31 in astrogliomas.

BACKGROUND: Astrogliomas are the most common primary brain tumor. Its progression is the result of activation of oncogenes, inactivation of tumor suppressor genes (TSGs), and expression of various growth factors. The angiogenesis and p53 in astrogliomas play an important role in its grading, treatment strategies, and hence its clinical outcome. OBJECTIVES: To analyze the frequency of presentation and the possible co-expression of p53 and angiogenesis marker (CD31) and their clinical implications in astrogliomas. MATERIAL AND METHODS: This retrograde study included 45 cases with astrocytomas in the form of paraffin blocks. Sections were stained with hematoxylin and eosin to determine the type and histological grade according to WHO (2007) classification of CNS tumors. Immunostaining was done using anti p53 and CD31 and the results were measured as labeling index (LI) using image analyzer system CAS-200. RESULTS: Both p53 and CD31 expressions were correlated well with the histopathological grades of different subtypes of astrogliomas with good discrimination between low and high grades. Overall, a highly significant statistical correlation was observed between the grades of astrocytomas and the p53 and CD31 labeling indices. The expressions of p53 and CD31 were markedly increased in glioblastoma multiforme (GBM) with mean values (59.7 +/- 13.5) (P = 0.0001) and (40.7 +/- 8.9) (P = 0.001), respectively. Obviously, these observations demonstrate that the co-expression and increased levels of p53 and CD31 in astrogliomas are increasing as the tumor grade is increasing. CONCLUSION: The estimation of p53 and CD31 could be used as good tools to assess the grade, prognosis, and aggressiveness of the astroglial tumors. Thus, the two markers can be used as adjunct to the diagnosis and stratification of the high grade from the low-grade intrinsic brain astrogliomas.