Molecular characterization of hypermucoviscous carbapenemase-encoding Klebsiella pneumoniae isolates from an Egyptian hospital.

This study aimed to screen antibiotic resistance and virulence genes in carbapenem-resistant hypermucoviscous Klebsiella pneumoniae isolates from an Egyptian hospital. Among 38 previously confirmed carbapenem-nonsusceptible K. pneumoniae isolates, a string test identified three isolates as positive for hypermucoviscosity.

Use of a mobile health application by adult non-congenital cardiac surgery patients: A feasibility study.

Mobile Health (mHealth) technologies are becoming integral to our healthcare system. This study evaluated the feasibility (compliance, usability and user satisfaction) of a mHealth application (app) for delivering Enhanced Recovery Protocols (ERPs) information to Cardiac Surgery (CS) patients peri-operatively. This single centre, prospective cohort study involved patients undergoing CS.

Patient Engagement in the Design of a Mobile Health App That Supports Enhanced Recovery Protocols for Cardiac Surgery: Development Study.

Background: Despite the importance of their perspectives, end users (eg, patients, caregivers) are not typically engaged by academic researchers in the development of mobile health (mHealth) apps for perioperative cardiac surgery settings.

Objective: The aim of this study was to describe a process for and the impact of patient engagement in the development of an mHealth app that supports patient and caregiver involvement with enhanced recovery protocols during the perioperative period of cardiac surgery.

Methods: Engagement occurred at the level of consultation and took the form of an advisory panel.

Genetic support of carbapenemases: a One Health systematic review and meta-analysis of current trends in Africa.

Antimicrobial resistance (AMR) is a public health threat globally. Carbapenems are β-lactam antibiotics used as last-resort agents for treating antibiotic-resistant infections. Mobile genetic elements (MGEs) play an important role in the dissemination and expression of antimicrobial resistance genes (ARGs), including the mobilization of ARGs within and between species.

Diagnostic accuracy of the "4 A's Test" delirium screening tool for the postoperative cardiac surgery ward.

Background: Delirium is prevalent and underdetected among cardiac surgery patients on the postoperative ward. This study aimed to validate the 4 A's Test delirium screening tool and evaluate its accuracy both when used by research assistants and when subsequently implemented by nursing staff on the ward.

Methods: This single-center, prospective observational study evaluated the performance of the 4 A's Test administered by research assistants (phase 1) and nursing staff (phase 2).

Can Radiation Dose Burden of CT Angiography be Reduced While Still Accurately Diagnosing Etiology of Acute Chest Pain?

Background: Multidetector-row computed tomography is often used as a first-line test in the diagnostic evaluation of cardiovascular diseases including aortic dissection, coronary artery disease and pulmonary embolism. This study evaluated the impact of reducing the tube potential from 120 kVp to 100 kVp in a selected group of patients presenting to the Emergency Room with acute chest pain. The primary end point was how the reduction of radiation dose affected image quality.

Phenotypic and Genotypic Features of Harboring Carbapenemases in Egypt: OXA-48-Like Carbapenemases as an Investigated Model.

This study aimed at the characterization of carbapenem-resistant isolates focusing on typing of the genes. Additionally, the correlation between the resistance pattern and biofilm formation capacity of the carbapenem-resistant isolates was studied. The collected isolates were assessed for their antimicrobial resistance and carbapenemases production by a modified Hodge test and inhibitor-based tests.

Impact of Rutin and Vitamin C combination on oxidative stress and glycemic control in patients with type 2 diabetes.

Aim: This study aimed to investigate the effect of Vitamin C alone and in combination with Rutin on the glycemic control, insulin resistance, lipid profile and oxidative stress markers in patients with type 2 diabetes.

Methods: A prospective, randomized, controlled study conducted on 53 type 2 diabetes patients randomized into 3 groups; (group A) 20 received Rutin with vitamin C, (group B) 20receivedvitamin C and (group C)13 received antidiabetic treatment only. Fasting Blood Glucose (FBG), Hemoglobin A1c (HbA1c), fasting insulin, Malondialdehyde, Superoxide dismutase, Lipid profile and patients' quality of life (QOL) using SF-36 questionnaire were assessed in all patients at baseline and after 8 weeks.

Polymerase Chain Reaction/Rapid Methods Are Gaining a Foothold in Developing Countries.

Unlabelled: Detection of microbial contamination in pharmaceutical raw materials and finished products is a critical factor to guarantee their safety, stability, and potency. Rapid microbiological methods-such as polymerase chain reaction-have been widely applied to clinical and food quality control analysis. However, polymerase chain reaction applications to pharmaceutical quality control have been rather slow and sporadic.

Autoantibodies to agrin in myasthenia gravis patients.

To determine if patients with myasthenia gravis (MG) have antibodies to agrin, a proteoglycan released by motor neurons and is critical for neuromuscular junction (NMJ) formation, we collected serum samples from 93 patients with MG with known status of antibodies to acetylcholine receptor (AChR), muscle specific kinase (MuSK) and lipoprotein-related 4 (LRP4) and samples from control subjects (healthy individuals and individuals with other diseases). Sera were assayed for antibodies to agrin. We found antibodies to agrin in 7 serum samples of MG patients.

Ectopic germinal centers, BAFF and anti-B-cell therapy in myasthenia gravis.

Myasthenia gravis (MG) is an autoimmune disease mediated by antibodies directed to molecules of the endplate of the neuromuscular junction. B cells play a major role in MG disease since they produce the pathogenic antibodies and therapies targeting B cells are effective. The aim of this article was to review the role of B cells in myasthenia gravis.

The role of B cell-activating factor in autoimmune myasthenia gravis.

B cell-activating factor (BAFF) is important in the development and maturation of B cells and their progeny-plasma blasts and plasma cells. There is increasing evidence that BAFF is involved in the pathogenesis of several autoimmune diseases including myasthenia gravis. Increased expression of BAFF and receptors for BAFF have been demonstrated in thymus of patients with myasthenia gravis, and an increase in serum levels of BAFF have been reported in patients with myasthenia gravis.

The application of uniplex, duplex, and multiplex PCR for the absence of specified microorganism testing of pharmaceutical excipients and drug products.

Unlabelled: Notable progress has been made in methods that encourage the use of polymerase chain reaction (PCR) as a rapid and accurate tool in microbiological testing of pharmaceuticals. In this study, the detection of the four main specified microorganisms according to the pharmacopeial recommendations, Salmonella spp, Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus, was optimized in different pharmaceutical dosage forms and raw materials. Uniplex PCR was performed for the detection of each microorganism individually targeting the conserved region in each bacterial genome.

Secretory products of multiple sclerosis B cells are cytotoxic to oligodendroglia in vitro.

B cells are important in the pathogenesis of multiple sclerosis (MS) and some of the effects are not dependent on maturation of B cells into immunoglobulin (Ig) producing plasmablasts and plasma cells. B cells present antigen, activate T cells, and are involved in immunoregulation and cytokine secretion. To determine if B cells from MS patients secrete products that have deleterious effects on glial cells not mediated by Ig, and to compare effects with secretory products of normal controls (NC), we isolated B cells from 7 patients with relapsing remitting MS (RRMS) and 4 NC.

B-cell-activating factor and autoimmune myasthenia gravis.

BAFF is a potent B-cell survival factor, and it plays an essential role in B-cell homeostasis and B-cell function in the periphery. Both normal and autoreactive B cells are BAFF dependent; however, excess BAFF promotes the survival, growth, and maturation of autoreactive B cells. When overexpressed, BAFF protects B cells from apoptosis, thereby contributing to autoimmunity.

Autoantibodies to lipoprotein-related protein 4 in patients with double-seronegative myasthenia gravis.

Objectives: To determine whether patients with myasthenia gravis (MG) have serum antibodies to lipoprotein-related protein 4 (LRP4), a newly identified receptor for agrin that is essential for neuromuscular junction formation, and to establish whether such antibodies contribute to MG pathogenesis.

Design: Serum samples from patients with MG with known status of serum antibodies to the acetylcholine receptor (AChR) and muscle-specific kinase (MuSK) and serum samples from control subjects (healthy individuals and individuals with other diseases) were tested for antibodies to LRP4. Serum samples with such antibodies were tested to determine whether they had the ability to inhibit 2 different functions of LRP4 at the neuromuscular junction.

Multiple sclerosis: BAFF and CXCL13 in cerebrospinal fluid.

Background: There is increasing evidence of B-cell involvement in the pathogenesis of multiple sclerosis (MS). B-cell activating factor (BAFF) has an essential role in B-cell homeostasis. The chemokine CXCL13 has an important role in the formation and maintenance of B-cell follicles.

A potential role for B-cell activating factor in the pathogenesis of autoimmune myasthenia gravis.

Objective: To compare serum B-cell activating factor (BAFF) levels in patients with myasthenia gravis (MG) with those in control subjects without MG.

Design: Case-control study. Subjects Forty-three patients with MG were compared with control subjects without MG.

Myasthenia gravis patients, but not healthy subjects, recognize epitopes that are unique to the epsilon-subunit of the acetylcholine receptor.

Myasthenia gravis (MG) is an autoimmune disease characterized by deficits in neuromuscular transmission due to antibody-mediated damage of the acetylcholine receptor (AChR). We examined the in vitro immune response of peripheral blood mononuclear cells isolated from MG patients (n=38) and healthy nonmyasthenic subjects (n=31) to epitopes on the alpha-, epsilon-, and gamma-chains of the AChR. The epsilon- and gamma-epitopes tested represent regions with little sequence homology to the alpha-chain, and little sequence homology between the epsilon- and gamma-chains.

The thymus and myasthenia gravis.

Self acetylcholine receptor (AchR) is targeted by a wayward immune response in myasthenia gravis (MG). The current understanding of the pathogenesis of the AChR-directed immune response is reviewed. Furthermore, the thymus is suspected of initiating and perpetuating the disease process in the majority of patients; its role as a central and peripheral lymphoid organ in MG is discussed.

Long-term therapy with glatiramer acetate in multiple sclerosis: effect on T-cells.

Glatiramer acetate (GA) is an immunotherapeutic drug for multiple sclerosis (MS). Several mechanisms of action have been demonstrated which target and affect T-cells that are specific for myelin antigen epitopes. We measured the in vitro proliferation of GA-responsive T-cells from untreated MS patients and from normal healthy subjects; in addition, we determined the effect of prolonged GA therapy or interferon-beta therapy on the in vitro proliferation of GA-responsive T-cells of MS patients.