The degree of safety of family replacement donors versus voluntary non-remunerated donors in an Egyptian population: a comparative study.

BACKGROUND: Screening donated blood for transfusion-transmissible infections is considered an important strategy for maximising the safety of blood transfusions. MATERIALS AND METHODS: A total of 17,118 donors, classified into two groups--family replacement donors and voluntary non-remunerated donors--were investigated for hepatitis B virus (HBV) surface antigen and antibodies against hepatitis C virus (HCV), human immunodeficiency virus (HIV) and Treponema pallidum. In addition cytomegalovirus (CMV) antibodies were searched for in 160 donors (80 from each group). All the laboratory tests were done using enzyme-linked immunosorbent assays. RESULTS: Of the total cohort of donors, 87.7% were family donors and 12.3% were voluntary non-remunerated donors. There was a highly significant difference in age and gender between the two types of donors with voluntary donors being much younger and including a much higher proportion of male donors than female donors. The prevalences of HBV, HCV and CMV IgG were much higher in family donors than in voluntary donors, with the differences being highly statistically significant. There was also a significantly higher prevalence of syphilis among family replacement donors. As regards HIV and CMV IgM, significant differences were not detected between the two groups. DISCUSSION: The results of our study clearly showed that the prevalence of transfusion-transmissible infections is much higher among family replacement donors than among voluntary donors, and that voluntary donors are the best way of achieving safer blood.

Effect of narrow band-ultraviolet B on CD4(+) CD25(high) FoxP3(+) T-lymphocytes in the peripheral blood of vitiligo patients.

BACKGROUND: It is widely believed that an imbalance between activated CD8(+) T cells and regulatory T cells (Tregs) exists in patients with vitiligo. Although there is evidence that narrow band ultraviolet (NB-UVB) irradiation can induce Tregs' number and activity, but up to our knowledge, none of the published studies involved the possible effect of NB-UVB on Tregs in vitiligo. OBJECTIVE: To evaluate the effect of NB-UVB on circulating CD4(+) CD25(high) FoxP3(+) regulatory T cells (FoxP3(+) Tregs) in vitiligo. METHODS: This prospective analytic study included 20 patients with active non-segmental vitiligo and 20 healthy controls. The patients were exposed to NB-UVB therapy three times per week for 30 sessions. Blood sampling before and after NB-UVB phototherapy was done to evaluate circulating CD4(+) CD25(high) Tregs and Foxp3(+) Tregs. RESULTS: The CD4(+) CD25(high) Tregs% and FoxP3(+) Tregs% were significantly higher in vitiligo patients compared with controls. NB-UVB therapy decreased both of them in patients, but they did not reach those of controls. Each of circulating CD4(+) CD25(high) Tregs% and FoxP3(+) Tregs% didn't correlate with either extent or activity of vitiligo before or after NB-UVB. CONCLUSION: Tregs functional defect is probably having an impact on NSV. NB-UVB may improve the function of Tregs. Understanding the mechanisms through which NB-UVB exert its effect on reducing the number of circulating Tregs would help open up the paths for future therapeutic options.

Inherited thrombophilia in pediatric ischemic stroke: an Egyptian study.

Pediatric stroke is relatively uncommon, with often subtle clinical presentations. Numerous predisposing risk factors can be both inherited and acquired, including cardiac disease, vascular abnormalities, infectious diseases, collagen tissue diseases, inborn errors of metabolism, anticardiolipin antibody, lupus anticoagulant, deficiencies of protein C, protein S, antithrombin, or plasminogen, and prothrombotic mutations. We explored risk factors, clinical features, and neuroimaging among Egyptian children with ischemic stroke, and estimated the prevalence of inherited thrombophilia. We included 20 children with ischemic stroke, recruited from the Pediatric Neurology Outpatient Clinic (Ain Shams University). Basic clinical evaluations for stroke and genotyping for factor V 1691 G-A (factor V Leiden), prothrombin 20210 G-A mutations, and methylenetetrahydrofolate reductase 677 C-T polymorphisms were performed using real-time polymerase chain reaction, with fluorescent melting curve detection analysis. Ten patients (50%) manifested methylenetetrahydrofolate reductase polymorphisms (six homozygotes and four heterozygotes). Heterozygous factor V Leiden was present in five (25%), whereas prothrombin mutation was present in only one (5%). Five patients (25%) manifested combined prothrombotic abnormalities. Thirteen demonstrated evidence of inherited thrombophilic disorder; 25% manifested more than one mutation. For appropriate risk assessment, even in the presence of overt acquired thrombotic risk factors, physicians should request complete thrombophilia screening for patients with stroke.

Growth hormone deficiency in children and adolescents with cerebral palsy: relation to gross motor function and degree of spasticity.

Children with Cerebral Palsy (CP) often have poor linear growth during childhood with short final height. Thus, we aimed to assess serum growth hormone (GH), insulin like growth factor-1 (IGF-1) and insulin like growth factor binding protein-3 (IGFBP-3) levels among CP patients and their relation to each of gross motor function and degree of spasticity. Fifty CP children and adolescents were studied in comparison to 50 healthy age-, sex- and pubertal stage-matched children and adolescents. All subjects were subjected to clinical evaluation, Intelligence Quotient (IQ) assessment and measurement of serum GH, IGF-1 and IGFBP-3. All auxological and hormonal parameters were significantly lower among cases. Fifty two% of cases were GH-deficient and 62% had reduced IGF-land IGFBP-3 levels. Gross Motor Function Measure- 88 (GMFM-88) score correlated negatively with each of basal (r = -0.71, p = 0.02) and peak stimulated GH (r =-0.88, p = <0.001); IGF-1 (r = -0.64, p = 0.04) and IGFBP-3 (r = -0.69, p = 0.031). There were significant negative correlations between the degree of spasticity assessed by Modified Ashworth Scale and each of basal (r = -0.61, p = 0.032) and peak stimulated GH (r = -0.78, p = 0.01); IGF-1 (r = -0.65, p = 0.041) and IGFBP-3 (r = -0.62, p = 0.035). Growth Hormone Deficiency (GHD) is prevalent in children with CP and could be one of the causes of their short stature.

Basal and adrenocorticotropic hormone stimulated plasma cortisol levels among Egyptian autistic children: relation to disease severity.

BACKGROUND: Autism is a disorder of early childhood characterized by social impairment, communication abnormalities and stereotyped behaviors. The hypothalamic-pituitary-adrenocortical (HPA) axis deserves special attention, since it is the basis for emotions and social interactions that are affected in autism. AIM: To assess basal and stimulated plasma cortisol, and adrenocorticotropic hormone (ACTH) levels in autistic children and their relationship to disease characteristics. METHODS: Fifty autistic children were studied in comparison to 50 healthy age-, sex- and pubertal stage- matched children. All subjects were subjected to clinical evaluation and measurement of plasma cortisol (basal and stimulated) and ACTH. In addition, electroencephalography (EEG) and intelligence quotient (IQ) assessment were done for all autistic children. RESULTS: Sixteen% of autistic patients had high ACTH, 10% had low basal cortisol and 10% did not show adequate cortisol response to ACTH stimulation. Autistic patients had lower basal (p = 0.032) and stimulated cortisol (p = 0.04) and higher ACTH (p = 0.01) than controls. Childhood Autism Rating Scale (CARS) score correlated positively with ACTH (r = 0.71, p = 0.02) and negatively with each of basal (r = -0.64, p = 0.04) and stimulated cortisol (r = -0.88, p < 0.001). Hormonal profile did not differ in relation to EEG abnormalities, IQ and self- aggressive symptoms. CONCLUSIONS: The observed hormonal changes may be due to a dysfunction in the HPA axis in autistic individuals. Further studies are warranted regarding the role of HPA axis dysfunction in the pathogenesis of autism.

Prognostic value of lipoprotein lipase expression among egyptian B-chronic lymphocytic leukemia patients.

BACKGROUND: B-cell chronic lymphocytic leukemia (B-CLL) is a heterogeneous disease with a highly variable clinical course. Some patients may survive for years without need for therapy while others, although they had early treatment, the outcome is unsatisfactory. The motive to find more reliable prognostic factors apart from stage, age, tumor volume and immunoglobulin heavy chain mutations is of clinical interest. MATERIAL AND METHODS: The study was carried out on 25 CLL patients attending Hematology Clinic at Ain Shams University Hospitals. Peripheral blood sample was taken from each patient for surface CD38 and cytoplasmic zeta-chain-associated protein tyrosine kinase (ZAP-70) by flow cytometry and lipoprotein lipase (LPL) expression by real time PCR. RESULTS: We demonstrated statistically significant association between high level of LPL expression and significantly high LDH level, poor cytogenetic risk, ZAP- 70 expression and response to therapy (p=0.01, 0.02, 0.04 and 0.001 respectively). CONCLUSIONS: LPL expression can serve as a new surrogate prognostic factor for CLL patients and can be used to detect patients who need early treatment. KEYWORDS: Lipoprotein lipase - ZAP-70 - Chronic lymphocytic leukemia.

High frequency, direct shoot regeneration from greenhouse-derived leaf disks of six strawberry cultivars.

Leaf disks derived from either two-month-old GreenHouse-grown (GHD) strawberry plants or in vitro plantlets were cultured on MS media amended with 2 mg L(-1) Thidiazuron (TDZ), incubated for four weeks in the dark then for another four weeks under 16/8 h light regime. Regeneration capacity of leaf disks was compared to meristem-derived propagules in six strawberry cultivars. Direct shoot regeneration occurred in all tested cultivars with different frequencies depending on explant source. From GDH leaf disks, the cultivars Camarosa, Gaviota and Seascape produced the highest number of shoots/explant (38, 31 and 31 shoots, respectively). However, optimum number of shoots/explant from in vitro leaf disks was achieved in the cultivars Carlsbad, Chandler and Sweet Charlie (13.3, 12.6 and 12.3 shoots, respectively). In general, regeneration capacity of GHD leaf discs was more than two-folds of that obtained from in vitro leaf disks. The efficiency of meristem culture was intermediate between the above two systems. Rooted plantlets were successfully acclimatized under mist. The only morphological abnormality detected was a white streaked variant observed out of 456 Camarosa plants derived from meristem culture. SDS-PAGE of protein profile proved consistency in banding patterns of mother plants and those derived from direct regeneration or meristem proliferation.