The interplay between vitamin D and COVID-19: protective or bystander?

The world is currently facing the COVID-19 pandemic, caused by the novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Due to a lack of specific treatment and prophylaxis, protective health measures that can reduce infection severity and COVID-19 mortality are urgently required. Clinical and epidemiological studies have shown that vitamin D deficiency can be linked to an increased risk of viral infection, including COVID-19. Therefore, in this review, we looked at various possible roles of vitamin D in reducing the risk of COVID-19 infection and severity. We describe in this article that individuals at high risk of vitamin D deficiency should consider taking vitamin D supplements to keep optimal concentrations. Moreover, we discuss different possible mechanisms by which vitamin D can efficiently reduce the risk of infections through modulation of innate and adaptive immunity against various types of infections. It is advisable to perform further studies addressing the observed influence of vitamin D levels to reduce the risk of COVID-19 infection and mortality.

Circulating Tumor Cells and Cancer Stem Cells: Clinical Implications in Nonmetastatic Breast Cancer.

PURPOSE: Despite the therapeutic advances, disease recurrence remains an ever-present threat to the health and well-being of breast cancer survivors. Assessment of circulating tumor cells (CTCs) and cancer stem cells (CSCs) during and after treatment may be of value in refining treatment. METHODS: Three 5 mL blood samples were taken from each patient: the first, at diagnosis; the second, after completion of neoadjuvant anthracyclin-based chemotherapy; and the third, a month after surgery and completion of adjuvant radiotherapy. The absolute numbers of CTCs were identified as CD45-cytokeratin+ cells. CTCs per 5 mL of blood were determined by recording all events in the whole suspension. CSCs were identified as cytokeratin+CD44+CD24-/CD45- cells. The CSCs were expressed as a percentage of CTCs. RESULTS: Univariate analysis identified the measurements of baseline CTCs and CSCs, taken after chemotherapy and one month after the cessation of radiotherapy, as prognostic factors for both four-year disease-free survival and four-year overall survival. Multivariable analysis identified the third measurement of CSCs, taken one month after the completion of radiotherapy, as the only independent prognostic factor for the four-year disease-free survival (P < 0.002, hazard ratio [HR] = 1.231, 95% CI 1.077-1.407). The initial CTC measurement was the one factor that reached significance on multivariate analysis (P < 0.03, HR 1.969, 95% CI 1.092-3.551) for the four-year overall survival. Correlation was higher between CTC and CSC counts at diagnosis (r = 0.654, P < 0.001) than after chemotherapy (r = 0.317, P < 0.03), because of the more rapid decrease in the mean CTC count with chemotherapy. CONCLUSION: The CTC count could be suitable as one of the measures for monitoring response to chemotherapy, while persistence of CSC after cessation of the treatment of nonmetastatic breast cancer, except hormonal therapy when indicated, may be a reason to consider additional therapy in the future. These findings need confirmation in larger randomized trials.

Clinical, laboratory and genetic assessment of patients with congenital bilateral absent vas deferens.

The aim of this study was to assess the prevalence of Δ-F508 mutation and 5T allele in a sample of Egyptian patients having congenital bilateral absent vas deferens (CBAVD), to correlate between genotype and phenotypic genital pattern, and to demonstrate the value of micro-assisted reproduction in them. The study included thirty patients with CBAVD and 30 fertile controls. Clinical, laboratory and radiological examinations of the patients were performed. Genetic assessment of patients and controls as regards Δ-F508 mutation and 5T allele was done. Trials of testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI) were carried out for the patients. Δ-F508 mutation was present in 40% and 5T allele was detected in 46.6% of the patients. On the other hand, all the control group was negative as regards Δ-F508 mutation, while 5T allele was detected in 10% of them. The total fertilisation rate was 75% and pregnancy rate was 60% with no significant difference in fertilisation and pregnancy rates between cases positive for Δ-F508 or 5T allele and others. It is evident that Δ-F508 mutation and 5T allele play important roles in the pathogenesis of CBAVD in Egyptians. TESE/ICSI is a beneficial method to enable these patients to father children of their own.

Non-Tensile Tunica Albuginea Plication for the Correction of Penile Curvature

Objective: To evaluate the efficacy of non-tensile tunica albuginea plication (NTTAP) using nonabsorbable sutures for the correction of congenital and acquired penile curvature and to determine the key points for a successful outcome of this procedure. Patients and Methods: From June 2004 to July 2007; 43 patients with penile curvature (35 congenital and 8 secondary to Peyronie's disease) underwent surgical correction by NTTAP. The indications were difficult or impossible vaginal penetration; and a cosmetically unacceptable penis. For tunica albuginea plication (TAP) we applied the 16 dot procedure using non-absorbable sutures (Tycronr 2/0 polyester fiber). Results: After a mean follow-up period of 18 months; successful results with respect to penile straightening; normal erection; penetration and sensation; confirmed both subjectively and objectively; were achieved in all patients. Post-operative penile shortening of less than 1.5 cm was present in 50of the cases; but did not affect intercourse. Post-operative complications were mild and reversible; they consisted of penile skin necrosis after circumcising incisions and post-operative pain upon nocturnal erection that subsided after a few weeks with the frequent use of ice compresses. The overall satisfaction rate was nearly 100(35/43 very satisfied and 8/43 satisfied). Conclusion:NTTAP is a simple and effective method for the correction of congenital and acquired penile curvature. The key points for successful appropriate expectations; and careful discussion of the location of the suture sites. There is no need for mobilization of the urethra or neurovascular bundle; which adds a great advantage to this easy and simple technique. Cutting through the tunica albuginea; which may prevent postoperative erectile dysfunction; is not necessary. A disadvantage of this procedure is that it cannot correct hour-glass deformity

Post-irradiation effect of Broncho-Vaxom, OM-85 BV, and its relationship to anti-oxidant activities.

This study was conducted to test the efficacy of Broncho-Vaxom (OM-85 BV) in rats after exposure to radiation-induced oxidative stress. Daily administration of Broncho-Vaxom (2.5 mg/kg/day) to rats for a period of 28 days produced a progressive significant increase in the activities of superoxide dismutase (SOD) and catalase in lungs and erythrocytes. No changes were recorded in reduced glutathione (GSH) content in lungs, while an increase was recorded in erythrocytes. Significant increase was also observed in serum gamma-globulin content. Intraperitoneal administration of Broncho-Vaxom to rats for 11 days before gamma-irradiation and daily during the period of irradiation, delivered as 1 Gy every other day to reach 9 Gy, significantly reduced radiation-induced lipid peroxidation (LPO) measured as thiobarbituric acid-reactive substances (TBARS) in the lungs and erythrocytes. Treatment with Broncho-Vaxom modified the radiation-induced decrease of serum gamma-globulins contents. It is postulated that Broncho-Vaxom, by enhancing the antioxidant system and increasing serum gamma-globulin content, could play an important role in modifying radiation-induced oxidative stress.