Combined gray scale ultrasonography and doppler diagnostic tools with strain elastography in assessment of inflammatory bowel disease in pediatrics patients.

BACKGROUND: Intestinal changes in inflammatory bowel disease (IBD) are frequently observed on ultrasound. Invasive diagnostic procedures are often employed to differentiate between the main types of IBD and detect complications. Ultrasound Strain Elastography (SE) is a promising non-invasive technique for detecting intestinal changes and assessing inflammatory activity in pediatric IBD. AIM OF THE STUDY: This research aims to evaluate the diagnostic performance of conventional ultrasound, color Doppler, and SE in assessing inflammatory bowel disease in pediatric patients, both separately and in combination as additional tools. PATIENTS AND METHODS: Forty patients (18 females and 22 males) initially diagnosed with IBD through clinical and endoscopic biopsy, along with 20 healthy controls, underwent conventional ultrasound, color Doppler, SE, and laboratory evaluations, including CBC, ESR, CRP, Fecal calprotectin, and assessment of IBD activity using PIBDAI. RESULTS: Conventional ultrasound, color Doppler, and SE significantly contributed to detecting disease activity and intestinal changes in IBD (p < 0.001; 95% CI 0.79-1.100), demonstrating better sensitivity in combination compared to each method individually. The combined approach showed 100% sensitivity, 84% specificity, 78.6% precision (Positive Predictive Value), 100% Negative Predictive Value, and an overall accuracy of 92%. CONCLUSION: The addition of Color Doppler and SE parameters to grayscale ultrasound provides diagnostic value comparable to endoscopy, histopathology, and laboratory markers in detecting inflammatory activity and intestinal changes in IBD. This combined approach can help avoid unnecessary invasive techniques for follow-up.

Extensive Study on Hematological, Immunological, Inflammatory Markers, and Biochemical Profile to Identify the Risk Factors in COVID-19 Patients.

Background: Tissue damage caused by COVID-19 could be detected by several clinical indicators including hematological, immunological, biochemical, and inflammatory markers. This study was to detect these clinical parameters to reveal the correlation between the factors and their roles in the development of COVID-19, to explore the hazard factors in severe cases. Materials and Methods: A total of 200 participants of both sexes were included in the study, with an age range of (25-72) years, categorized into three main groups: 50 healthy individuals, 62 mild infected patients, and 88 severe infected patients with pneumonia. Different hematological and clinical parameters were included in the analysis (Basrah city, Iraq). Serum levels of interleukin-6 (IL-6), ferritin, and high-sensitivity C-reactive protein (hs-CRP) were assessed for all participants using an enzyme-linked immunosorbent assay (ELISA). The liver, renal, and cardiac functions were assessed by clinical chemistry testing. Results: COVID-19 patients had leukocytosis, with an increased number of neutrophils and a decreased lymphocyte count, according to our findings. In regard to inflammatory parameters, both ESR and hs-CRP showed significant differences between the two groups, whereas IL-6 was significantly higher in the total severe group compared to the other two groups. Biochemical results revealed that each lactate dehydrogenase (LDH), ferritin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) had significant changes in the total severe group. Among pneumonic with an O2 requirement and pneumonic without an O2 requirement, there were significant differences in immunological and inflammatory markers (p > 0.05). The neutrophils-lymphocytes ratio (NLR) was highly elevated in severe who required O2. Moreover, IL-6, lymphocytes, and neutrophils were possible risk factors for COVID-19 infection, with the strongest influence of IL-6 with a high odds ratio (OR: 24.138, 95% CI: 8.437-30.65, p < 0.01). Furthermore, there were significant correlations among the indicators. Conclusion: Each of IL-6, lymphocytes, and neutrophils might represent major factors in the severity of COVID-19 and IL-6 plays the main role in inducing the inflammatory and pathophysiology process that is known as the cytokine storm.

Long-Term Use of Omeprazole: Effect on Haematological and Biochemical Parameters.

BACKGROUND: Long-term use of proton pump inhibitors (PPIs) is believed to have various potential adverse events. Omeprazole is a part of PPIs most commonly prescribed worldwide; it irreversibly binds to H+-K+ ATPase enzyme system in the gastric parietal cells to reduce secretion of H+ ions into the lumen of stomach. The main objective of the current work is to assess the adverse effects of omeprazole medication on certain haematological and biochemical parameters in patients who were on treatment for one year and more. METHODS: We conducted a comparative cross-sectional study between October 2021 and March 2022. A total of 90 participants of both sexes were enrolled in this study, aged between 25-58 years. The participants were categorized into two groups: 40 patients on long-term omeprazole medication (40 mg) as a patients group and 50 healthy subjects as a healthy group who did not use omeprazole. Complete blood count and biochemical parameters were measured for both groups. RESULTS: Patients of a group 1 had remarkable significant reductions in the number of red blood cells (RBCs) (p<0.001) and the indices. Omeprazole elevated the cholesterol level (p<0.001) and triglyceride (p<0.001) as well as low-density lipoprotein (p<0.01). However, no impact was found with high-density lipoprotein (HDL) (p>0.05). Alkaline phosphatase (ALKP) (p<0.001) and aspartate aminotransferase (ASAT) (p<0.01) levels were elevated in long-term patients treated with omeprazole. In contrast, no significant change was found in the level of alanine aminotransferase (ALAT) (p>0.05). Creatinine level (p<0.001) and nitrogen blood urea (p<0.0001) were significantly increased in patients group treated with omeprazole medication. The results also showed that group 1 had a high significant decline in serum ferritin (p<0.0001), vitamin D3 (p<0.01) and calcium levels (p<0.001) than that of healthy group. CONCLUSION: Prolonged use of omeprazole might result in adverse effect on hematological profile, particularly RBCs and their indices leading to develop anemia in patients on this medication. Furthermore, it might result in disturbances in biochemical profile, levels of minerals and vitamins as consequences of affected absorption.

Comparing three models of arousal in the human brain.

The bipolar valence-arousal model is assumed by many to be an underlying structure of conscious experience of core affect and emotion. In this work, we compare three versions of the bipolar valence-arousal model at the neural domain, using functional magnetic resonance imaging (fMRI). Specifically, we systematically contrast three models of arousal: model 1-'arousal as a separate quale from valence', model 2-'arousal as intensity of bipolar valence' and model 3-'arousal as a linear combination of unipolar pleasant and unpleasant'. Using parametric modulation analysis, we estimated the ability of each model to predict activation in arousal-related brain regions, in response to affective stimuli. The results suggest that arousal is not separable from valence in its ability to predict arousal-related neural activity. The relevance of the results to the theory of conscious affect is discussed.

Dissociating affective and semantic valence.

We examined the possible dissociation between two modes of valence: affective valence (valence of e emotional response) and semantic valence (stored knowledge about valence of an object or event). In Experiment 1, 50 participants viewed affective pictures that were repeatedly presented while their facial electromyography (EMG) activation and heart rate response were continuously recorded. Half of the participants provided self-report ratings about the valence of their feelings and half about the valence of the stimulus. Next, all participants performed an affective Simon task. In Experiment 2, 30 new participants performed the affective Simon task with the repeated exposure embedded within the task. The results showed that measures related to affective valence (feelings-focused self-reports, heart rate, and facial EMG activations) attenuated with repeated exposure to pleasant and unpleasant pictures, whereas measures related to semantic valence (knowledge-focused self-reports and congruency effect of affective Simon task) did not. These findings strongly suggest that affective and semantic valence represent two distinct psychological constructs. (PsycINFO Database Record

Relationship of treatment satisfaction to health-related quality of life among Palestinian patients with type 2 diabetes mellitus: Findings from a cross-sectional study.

OBJECTIVES: The aims of the current study were to assess the association between health-related quality of life (HRQoL) and treatment satisfaction in a sample of diabetic patients from Palestine, and to determine the influence of socio-demographic and clinical factors on HRQoL. METHODS: It was a cross-sectional study performed during the period June 2013 to October 2013. The Arabic version of Treatment Satisfaction Questionnaire for Medication (TSQM 1.4) was used to assess treatment satisfaction, and the Arabic version of European Quality of Life scale (EQ-5D-5L) was used to assess HRQoL. Multiple linear regression was used to estimate which variables were the most important related to HRQoL. RESULTS: A total of 385 diabetic patients were included. There were modest positive correlations between the total score on the Overall Satisfaction domain and EQ-5D-5L (r = 0.14; p = 0.005). After adjusting multiple covariates by multiple linear regression, the association between the Overall Satisfaction and HRQoL was not statistically significant (p = 0.075); (R = 0.495; adjusted R2 = 0.245; F = 10.3; df = 12; p < 0.001). The results showed that elderly patients, being unemployed, and number of comorbid diseases, were significantly associated with HRQoL. CONCLUSIONS: Overall, these results indicate that elderly patients, being unemployed, and those with comorbid diseases, are independent risk factors for poor HRQoL. Furthermore, it emerges that HRQoL and treatment satisfaction are both probably influenced by socio-demographic and clinical characteristics. In fact, to improve diabetic patients' quality of life, elderly patients were recommended to receive more attention in their health and economic status.

Transcription of the Streptococcus pyogenes hyaluronic acid capsule biosynthesis operon is regulated by previously unknown upstream elements.

The important human pathogen Streptococcus pyogenes (group A Streptococcus [GAS]) produces a hyaluronic acid (HA) capsule that plays critical roles in immune evasion. Previous studies showed that the hasABC operon encoding the capsule biosynthesis enzymes is under the control of a single promoter, P1, which is negatively regulated by the two-component regulatory system CovR/S. In this work, we characterize the sequence upstream of P1 and identify a novel regulatory region controlling transcription of the capsule biosynthesis operon in the M1 serotype strain MGAS2221. This region consists of a promoter, P2, which initiates transcription of a novel small RNA, HasS, an intrinsic transcriptional terminator that inefficiently terminates HasS, permitting read-through transcription of hasABC, and a putative promoter which lies upstream of P2. Electrophoretic mobility shift assays, quantitative reverse transcription-PCR, and transcriptional reporter data identified CovR as a negative regulator of P2. We found that the P1 and P2 promoters are completely repressed by CovR, and capsule expression is regulated by the putative promoter upstream of P2. Deletion of hasS or of the terminator eliminates CovR-binding sequences, relieving repression and increasing read-through, hasA transcription, and capsule production. Sequence analysis of 44 GAS genomes revealed a high level of polymorphism in the HasS sequence region. Most of the HasS variations were located in the terminator sequences, suggesting that this region is under strong selective pressure. We discovered that the terminator deletion mutant is highly resistant to neutrophil-mediated killing and is significantly more virulent in a mouse model of GAS invasive disease than the wild-type strain. Together, these results are consistent with the naturally occurring mutations in this region modulating GAS virulence.