[Long Noncoding RNAs MEG3, TUG1, and hsa-miR-21-3p Are Potential Diagnostic Biomarkers for Coronary Artery Disease].

Peripheral blood biomarkers are of particular importance to diagnose certain diseases including coronary artery disease (CAD) due to their non-invasiveness. Investigating the expression of noncoding RNAs (ncRNAs) paves the way to early disease diagnosis, prognosis, and treatment. Consequently, in this research, we aimed to investigate a panel of ncRNAs as potential biomarkers in patients with coronary artery disease. Two different groups have been designed (control and CAD). All participants were subjected to interviews and clinical examinations. Peripheral blood samples were collected, and plasma was extracted. At the same time, target ncRNAs have been selected based on literature review and bioinformatic analysis, and later they underwent investigation using quantitative real-time PCR. The selected panel encompassed the long non-coding RNAs (lncRNAs) MEG3, TUG1, and SRA1, and one related microRNA (miRNA): hsa-miR-21-3p. We observed statistically significant upregulation in MEG3, TUG1, and hsa-miR21-3p in CAD patients compared to control participants (p-value < 0.01). Nevertheless, SRA1 exhibited downregulation with no statistical significance (p-value > 0.05). All ncRNAs under study displayed a significantly strong correlation with disease incidence, age, and smoking. Network construction revealed a strong relationship between MEG3 and TUG1. ROC analysis indicated high potentiality for hsa-miR-21-3p to be a promising biomarker for CAD. Moreover, MEG3 and TUG1 displayed distinguished diagnostic discrimination but less than hsa-miR-21-3p, all of them exhibited strong statistical significance differences between CAD and control groups. Conclusively, this research pinpointed that MEG3, TUG1, and hsa-miR-21-3p are potential biomarkers of CAD incidence and diagnosis.

Prevalence of extended-spectrum ß-lactamase-producing Enterobacterales in retail sheep meat from Zagazig city, Egypt.

BACKGROUND: The goal of this study was to investigate the prevalence of extended-spectrum ß-lactamase production in Enterobacterales isolated from retail sheep meat in Zagazig, Egypt. METHODS: One hundred random samples of sheep meat were collected from different retail butcher shops (n = 5) in the city of Zagazig, Egypt. Bacterial isolates were identified by MALDI-TOF MS and screened for antibiotic susceptibility by disk diffusion; further genotypic characterization of ß-lactamase-encoding genes was performed with Real-Time PCR. E. coli strains were phylotyped with the Clermont triplex PCR method. RESULTS: Of the total of 101 bacterial isolates recovered from retail sheep meat samples, 93 were E. coli, six were Enterobacter cloacae and two were Proteus mirabilis. As many as 17% of these 100 samples showed ESBL phenotypes, all were E. coli. The blaCTX-M genes were detected in seven isolates (six were blaCTX-M-15 and one was blaCTX-M-14), three isolates harboured blaTEM (all were blaTEM-one), and two carried genes of the blaSHV family (both were blaSHV-12). Eight E. coli isolates expressed ESBL phenotype but no blaTEM, blaSHV or blaCTX-M genes were detected by PCR. ESBL- positive E. coli isolates were nearly equally distributed over the commensal groups A/B1 and the virulent group D. CONCLUSION: Nearly one in five sheep meat samples was contaminated with ESBL-E. coli. This further corroborates the potential role played by contaminated meat in the increasing resistance rates that have been reported worldwide.

The synbiotic mixture of Bacillus licheniformis and Saccharomyces cerevisiae extract aggravates dextran sulfate sodium induced colitis in rats.

BACKGROUND: Uncertain effects of probiotics and/or prebiotics have been reported in experimental and clinical colitis. This study aims to examine the effects of a synbiotic combination comprising Bacillus licheniformis DSM 17236 and Saccharomyces cerevisiae cell wall extract on dextran sulfate sodium (DSS)-induced colitis in Sprague Dawley rats. METHODS: Acute colitis was induced in rats by oral administration of DSS 3.5% for 7 days. Fifty rats were divided equally into five groups; one control group and the other groups were induced with colitis and treated with or without the tested synbiotic, mixed with diet, for 28 days and sulfasalazine (100 mg/kg) via intragastric tube once daily for 14 days. RESULTS: Symptomatically, the synbiotic administration raised the disease activity index (DAI) to comparable scores of the DSS group, specially from the 2nd to 7th days post DSS intoxication. It also induced a significant (p < 0.05) amplification of WBCs, myeloperoxidase (MPO), malondialdehyde (MDA), nuclear factor kappa B (NF-kB) expression and proinflammatory cytokines tumor necrosis factor alpha (TNFα), interferon gamma (INFγ), and interleukin-1 beta (IL-1ß) while depressed the antioxidant enzymes glutathione peroxidase (GPx), catalase (CAT), and superoxide dismutase (SOD) when compared with the DSS and control groups. The DSS intoxicated and Synbiotic+DSS groups showed desquamations of the covering epithelium, noticeable diffuse leukocytic infiltrations, sever catarrhal enteritis, ischemic colitis with diffuse coagulative necrosis of the entire colonic mucosa. Contrarily, sulfasalazine proved to be effective in the reduction of the tested inflammatory markers and the pathological degenerative changes of the DSS ulcerative colitis. CONCLUSION: The examined synbiotic did not ameliorate but aggravated the DSS-induced colitis, so it should be subjected to intensive experimental and clinical testing before their use in animals and human.

In Vitro and In Silico Pharmacological and Cosmeceutical Potential of Ten Essential Oils from Aromatic Medicinal Plants from the Mascarene Islands.

In this study, 10 essential oils (EOs), from nine plants (Cinnamomum camphora, Curcuma longa, Citrus aurantium, Morinda citrifolia, Petroselinum crispum, Plectranthus amboinicus, Pittosporum senacia, Syzygium coriaceum, and Syzygium samarangense) were assessed for their antimicrobial, antiaging and antiproliferative properties. While only S. coriaceum, P. amboinicus (MIC: 0.50 mg/mL) and M. citrifolia (MIC: 2 mg/mL) EOs showed activity against Cutibacterium acnes, all EOs except S. samarangense EO demonstrated activity against Mycobacterium smegmatis (MIC: 0.125-0.50 mg/mL). The EOs were either fungistatic or fungicidal against one or both tested Candida species with minimum inhibitory/fungicidal concentrations of 0.016-32 mg/mL. The EOs also inhibited one or both key enzymes involved in skin aging, elastase and collagenase (IC50: 89.22-459.2 µg/mL; 0.17-0.18 mg/mL, respectively). Turmerone, previously identified in the C. longa EO, showed the highest binding affinity with the enzymes (binding energy: -5.11 and -6.64 kcal/mol). Only C. aurantium leaf, C. longa, P. amboinicus, P. senacia, S. coriaceum, and S. samarangense EOs were cytotoxic to the human malignant melanoma cells, UCT-MEL1 (IC50: 88.91-277.25 µg/mL). All the EOs, except M. citrifolia EO, were also cytotoxic to the human keratinocytes non-tumorigenic cells, HaCat (IC50: 33.73-250.90 µg/mL). Altogether, some interesting therapeutic properties of the EOs of pharmacological/cosmeceutical interests were observed, which warrants further investigations.

Comorbidities, mortality and survival in patients with pyoderma gangrenosum: a Danish nationwide registry-nested case-control study.

BACKGROUND: Pyoderma gangrenosum (PG) is an ulcerative skin disease associated with comorbidities and increased mortality; however, the literature on this topic is scarce. OBJECTIVES: To investigate the mortality, prevalence and risk of comorbidities in patients with PG. METHODS: This nationwide registry nested case-control study included all inpatients and outpatients diagnosed with PG in tertiary dermatology centres in Denmark between 1 January 1994 and 31 December 2016. Each case was matched on date of birth and sex with 10 unique controls. The Danish National Patient Registry was used to identify all patients and to gather information on comorbidity. Information on age, sex, vital status and emigration was obtained from the Danish Civil Registration System. The outcomes were 19 different comorbidities and all-cause mortality. Prevalence was assessed from odds ratios (ORs) for specific comorbidities at the time of PG diagnosis. The risk of developing specific comorbidities and death was assessed using hazard ratios (HRs) obtained using the Cox proportional-hazards model. RESULTS: A total of 1604 patients with PG were matched with 16 039 controls. Some associations were known, e.g. inflammatory bowel disease [OR 19·15 (15·27-24·02), HR 6·51 (4·24-10·01)], while others have not been described previously, e.g. osteoporosis [OR 1·57 (1·22-2·02), HR 2·59 (2·08-3·22)]. Mortality was significantly increased among patients with PG [HR 2·79 (2·57-3·03)]. CONCLUSIONS: Patients with PG have increased mortality and an increased prevalence and risk of both previously reported and novel comorbidities that may have severe consequences if left undiagnosed. Our findings are mainly related to moderate and severe PG.

Search for γ-Ray Line Signals from Dark Matter Annihilations in the Inner Galactic Halo from 10 Years of Observations with H.E.S.S.

Spectral lines are among the most powerful signatures for dark matter (DM) annihilation searches in very-high-energy γ rays. The central region of the Milky Way halo is one of the most promising targets given its large amount of DM and proximity to Earth. We report on a search for a monoenergetic spectral line from self-annihilations of DM particles in the energy range from 300 GeV to 70 TeV using a two-dimensional maximum likelihood method taking advantage of both the spectral and spatial features of the signal versus background. The analysis makes use of Galactic center observations accumulated over ten years (2004-2014) with the H.E.S.S. array of ground-based Cherenkov telescopes. No significant γ-ray excess above the background is found. We derive upper limits on the annihilation cross section ⟨σv⟩ for monoenergetic DM lines at the level of 4×10^{-28} cm^{3} s^{-1} at 1 TeV, assuming an Einasto DM profile for the Milky Way halo. For a DM mass of 1 TeV, they improve over the previous ones by a factor of 6. The present constraints are the strongest obtained so far for DM particles in the mass range 300 GeV-70 TeV. Ground-based γ-ray observations have reached sufficient sensitivity to explore relevant velocity-averaged cross sections for DM annihilation into two γ-ray photons at the level expected from the thermal relic density for TeV DM particles.

The effects of the dietary supplementation of Echinacea purpurea extract and/or vitamin C on the intestinal histomorphology, phagocytic activity, and gene expression of the Nile tilapia.

In this study, the influence of the dietary incorporation of Echinacea purpurea (EP) extract and/or vitamin C on the intestinal histomorphology and some immunological indices were tested in the Nile tilapia (Oreochromis niloticus Linn.). O. niloticus were randomly divided into four groups. The control group G1 was fed on a basal diet, while the G2 and G3 were fed on basal diets, supplemented with EP extract and vitamin C at the doses of 500 mg kg-1 and 400 mg kg-1, respectively. Meanwhile, G4 was fed on a basal diet, supplemented with a mixture of EP extract and vitamin C. After 28 days of feeding, the intestinal tissues were collected for histological observation and immune status, was based on an assay for measuring the phagocytic activity. Furthermore, the expression of the transforming growth factor-beta 1 (TGF-ß1), interleukin-1beta (IL-1ß), and tumor necrosis factor alpha (TNF-α) genes was evaluated in intestine and head kidney. The results revealed that the G4 successfully surpassed the other groups in terms of the heights of intestinal villi, the number of goblet cells and intraepithelial lymphocytes (IELs), and the phagocytic activity, followed by the G3 and G2. The expression of the IL-1ß and TNF-α genes were up regulated only in G4 but in the G3 only the expression of the IL-1ß gene was up regulated. Hence, EP extract along with vitamin C could be used as a feed additive in order to improve the structure of the intestinal mucosal epithelium and immune response in tilapia.

Sequential analysis and staging of a diethylnitrosamine-induced hepatocellular carcinoma in male Wistar albino rat model.

Hepatocellular carcinoma (HCC) is one of the most life-threatening cancers. The present study was designed to chronologically analyze the HCC chemically induced by diethylnitrosamine (DEN) in male Wistar rats during a 27-week period. DEN was given to rats in drinking water (100 mg/L) to induce HCC. In the present study, the DEN-administered groups recorded dramatic results in the tumor markers, oxidative stress, lipid profile, liver function, and hematological parameters at all intervals when compared with their corresponding values in the control groups. In addition, the morphometric analysis of livers of the DEN-administered groups (from 9 to 27 weeks) showed gradual enlargement and several grayish white nodules and foci on the peripheral surface of the liver as the features of HCC. In conclusion, the present sequential model chronologically analyzes all steps of hepatocarcinogenesis and presents a new staging system for classification of HCC that may be valuable for investigating the effects of anticarcinogenic compounds at varying stages of hepatocarcinogenesis in vivo.

Search for Dark Matter Annihilations towards the Inner Galactic Halo from 10 Years of Observations with H.E.S.S.

The inner region of the Milky Way halo harbors a large amount of dark matter (DM). Given its proximity, it is one of the most promising targets to look for DM. We report on a search for the annihilations of DM particles using γ-ray observations towards the inner 300 pc of the Milky Way, with the H.E.S.S. array of ground-based Cherenkov telescopes. The analysis is based on a 2D maximum likelihood method using Galactic Center (GC) data accumulated by H.E.S.S. over the last 10 years (2004-2014), and does not show any significant γ-ray signal above background. Assuming Einasto and Navarro-Frenk-White DM density profiles at the GC, we derive upper limits on the annihilation cross section ⟨σv⟩. These constraints are the strongest obtained so far in the TeV DM mass range and improve upon previous limits by a factor 5. For the Einasto profile, the constraints reach ⟨σv⟩ values of 6×10^{-26} cm^{3} s^{-1} in the W^{+}W^{-} channel for a DM particle mass of 1.5 TeV, and 2×10^{-26} cm^{3} s^{-1} in the τ^{+}τ^{-} channel for a 1 TeV mass. For the first time, ground-based γ-ray observations have reached sufficient sensitivity to probe ⟨σv⟩ values expected from the thermal relic density for TeV DM particles.

Theoretical prediction of experimental jump and pull-in dynamics in a MEMS sensor.

The present research study deals with an electrically actuated MEMS device. An experimental investigation is performed, via frequency sweeps in a neighbourhood of the first natural frequency. Resonant behavior is explored, with special attention devoted to jump and pull-in dynamics. A theoretical single degree-of-freedom spring-mass model is derived. Classical numerical simulations are observed to properly predict the main nonlinear features. Nevertheless, some discrepancies arise, which are particularly visible in the resonant branch. They mainly concern the practical range of existence of each attractor and the final outcome after its disappearance. These differences are likely due to disturbances, which are unavoidable in practice, but have not been included in the model. To take disturbances into account, in addition to the classical local investigations, we consider the global dynamics and explore the robustness of the obtained results by performing a dynamical integrity analysis. Our aim is that of developing an applicable confident estimate of the system response. Integrity profiles and integrity charts are built to detect the parameter range where reliability is practically strong and where it becomes weak. Integrity curves exactly follow the experimental data. They inform about the practical range of actuality. We discuss the combined use of integrity charts in the engineering design. Although we refer to a particular case-study, the approach is very general.

Isolated laryngeal tuberculosis: A diagnostic dilemma.

INTRODUCTION AND IMPORTANCE: Primary laryngeal tuberculosis (PLTB) is a rare condition. The symptoms and findings are not specific in most of the cases. Patients are diagnosed essentially based on histopathological examination and mycobacterial culture. CASE REPORT: We report the case of a 42-year-old woman who presented to our hospital with dysphonia and dysphagia. Direct laryngoscopy revealed a lesion of the supraglottis. CT scan found a diffuse thickening of the entire surface of the larynx. A biopsy confirmed the diagnosis of tuberculosis. CLINICAL DISCUSSION: Primary laryngeal tuberculosis is a rare clinical entity despite its close anatomical and physiological proximity to the lungs. CONCLUSION: Clinician should keep in mind the existence of primary laryngeal tuberculosis to avoid delayed diagnosis and treatment, which can lead to high morbidity and mortality.

Numerical investigation of sand erosion rate in a horizontal axis wind turbine.

Renewable energy represents an important alternative solution for many energy problems nowadays and a tool for a healthier environment by reducing carbon footprints resulting from burning fossil fuels. However, more work needs to be done towards maximizing the energy produced from renewable energy methods and making sure that the infrastructure used stays in service for a longer duration. Sand erosion phenomena is responsible for the degradation of the wind turbine blades and hence the decrease in their performance and life. In the current research, a numerical study of both performance and sand erosion of a Small-Scale Horizontal Axis Wind Turbine (SS-HAWT) is carried out. This study introduces new sights of instantaneous and forecasted erosion rates within the blade of the wind turbines. Three-dimensional E216 airfoil blades of radius 0.5 m are established according to blade element momentum theory. Sand particles with different mass flow rates of 0.001, 0.002 and 0.003 kg/s and uniform diameters of 50, 100 and 200 µm have been selected as eroding particles under two different average air velocities of 8 m/s and 10 m/s. The results indicate that the performance of wind turbines is enhanced as the flow separation at the suction side is shifted to the trailing edge. Furthermore, the optimum tip speed ratio is about 5 at an air velocity of 8 m/s with a power coefficient of 0.432. In terms of erosion findings, V-shaped scars are reported near the leading edge of the blades. In addition, the instantaneous erosion rate grows exponentially with the tip speed ratio. Therefore, the yearly prediction of maximum erosion depth at the optimum operating conditions is obtained to be 5.7 mm/year in some spots of the turbine blades.

Potential antioxidant, α-glucosidase, butyrylcholinesterase and acetylcholinesterase inhibitory activities of major constituents isolated from Alpinia officinarum hance rhizomes: computational studies and in vitro validation.

Alpinia officinarum is a commonly used spice with proven folk uses in various traditional medicines. In the current study, six compounds were isolated from its rhizomes, compounds 1-3 were identified as diarylheptanoids, while 4-6 were identified as flavonoids and phenolic acids. The isolated compounds were subjected to virtual screening against α-glucosidase, butyrylcholinesterase (BChE), and acetylcholinesterase (AChE) enzymes to evaluate their potential antidiabetic and anti-Alzheimer's activities. Molecular docking and dynamics studies revealed that 3 exhibited a strong binding affinity to human a α- glucosidase crystal structure compared to acarbose. Furthermore, 2 and 5 demonstrated high potency against AChE. The virtual screening results were further supported by in vitro assays, which assessed the compounds' effects on α-glucosidase, cholinesterases, and their antioxidant activities. 5-Hydroxy-7-(4-hydroxy-3-methoxyphenyl)-1-phenylheptan-3-one (2) showed potent antioxidant effect in both ABTs and ORAC assays, while p-hydroxy cinnamic acid (6) was the most potent in the ORAC assay. In contrary, kaempferide (4) and galangin (5) showed the most potent effect in metal chelation assay. 5-Hydroxy-1,7-diphenylhepta-4,6-dien-3-one (3) and 6 revealed the most potent effect as α-glucosidase inhibitors where compound 3 showed more potent effect compared to acarbose. Galangin (5) revealed a higher selectivity to BChE, while 2 showed the most potent activity to (AChE).

Cardioprotective Effects of α-Asarone Against Hexavalent Chromium-Induced Oxidative Damage in Mice.

Introduction: This comprehensive study investigated the therapeutic potential of α-asarone in mitigating myocardial oxidative damage, primarily induced by hexavalent chromium (Cr(VI)) exposure in mice. Methods: In this experiment, 24 mice were divided into four groups to assess the cardioprotective role of α-asarone. The study focused on two treatment groups, receiving 25 mg and 50 mg of α-asarone, respectively. These groups were compared against a control group subjected to Cr(VI) without α-asarone treatment, and a normal control negative group. The key biochemical parameters evaluated included serum levels of Creatine Kinase-MB (CK-MB) and Troponin I, markers indicative of myocardial damage. Additionally, the levels of Malondialdehyde (MDA) were measured to assess lipid peroxidation, alongside the evaluation of key inflammatory biomarkers in cardiac tissue homogenates, such as Tumor Necrosis Factor-α (TNF-α) and Interleukin-1ß (IL-1ß). Results Remarkably, α-asarone treatment resulted in a significant reduction in these markers compared to the control group. The treatment also elevated the activity of cardinal antioxidant enzymes like catalase (CAT) and superoxide dismutase (SOD), and reduced the glutathione (GSH). Furthermore, a notable upregulation of Peroxisome Proliferator-Activated Receptor Gamma (PPAR-γ) in cardiac tissue homogenates was observed, highlighting a potential pathway through which α-asarone exerts its protective effects. Histopathological analysis of cardiac tissues revealed that α-asarone ameliorated the structural lesions induced by Cr(VI). The study thus provides substantial evidence that α-asarone ameliorates Cr(VI)-induced cardiotoxicity through a multifaceted approach. It enhances cardiac enzyme function, modulates free radical generation, improves antioxidant status, and mitigates histopathological damage in cardiac tissues. Given these findings, α-asarone emerges as a promising agent against Cr(VI)-induced myocardial injury. Purpose: This study paves the way for further research into the cardioprotective properties of α-asarone and its potential application in clinical settings by specifically exploring the protective efficacy of α-asarone against Cr(VI)-induced cardiotoxicity and delineating the underlying biochemical and molecular mechanisms involved.

Cross-sectional study of cattle lice infestation in the region of Nabeul in north-east Tunisia.

This cross-sectional study is the first to estimate the prevalence of cattle pediculosis in Tunisia. A total of 39 cattle farms in the region of Nabeul in north-east Tunisia were visited and lice were collected by intensively brushing 789 cattle. The prevalence was estimated to be 20.5% on the farms (8/39) and 4.7% in animals (37/789). Collected parasites were examined under a stereomicroscope and three lice species were identified: Bovicola bovis, Linognathus vituli and Haematopinus eurysternus. Thirty-two animals were infested with the chewing lice B. bovis (4%), three with H. eurysternus (0.4%) and two with L. vituli (0.2%). The infestation prevalence was higher in calves under eight months of age (21.6%)than in adults (0.8%). Decision-makers in animal health should consider this parasitic disease in their control and eradication programmes.

Ameliorative Effects of some Natural Antioxidants against Blood and Cardiovascular Toxicity of Oral Subchronic Exposure to Silicon Dioxide, Aluminum Oxide, or Zinc Oxide Nanoparticles in Wistar Rats.

The present study determines the possible protective role of fig fruit extract with olive oil and date palm fruit extract (FOD) in decreasing the oral subchronic blood and cardiovascular toxicity of SiO2NPs, Al2O3NPs, or ZnONPs. The present study used 80 male Wistar rats (8 groups, n = 10) distributed according to the treatment. The FOD treatments were used at their recommended antioxidant doses. All nanoparticles (NPs) were given orally and daily at doses of 100 mg/kg for 75 days. The oral administration of different NPs alone led to dramatic, oxidative stress, inflammatory markers, blood coagulation, endothelial dysfunction markers, myocardial enzymes, hematological parameters, lipid profile, and histopathological features compared with the control group. The FOD-NP-treated groups recorded significantly ameliorated blood and cardiovascular toxicity hazards compared to the groups administered with the NPs alone. In conclusion, the administration of FOD provides considerable chemopreventive and ameliorative effects against NP toxicity.

Epidemiological manifestations and impact of healthcare-associated infections in Libyan national hospitals.

BACKGROUND: Healthcare-associated infection is a serious global problem, particularly in developing countries. In North African countries, comprehensive research on the incidence and effects of such infections is rare. This study evaluated the epidemiology and determined the impact of healthcare-associated infections in Libyan national teaching hospitals. METHODS: A prospective longitudinal study was carried out in Libya's four largest teaching and referral hospitals (Tripoli Medical Center, Tripoli-Central Hospital, Benghazi Medical Center, and Sabha Medical Center) from November 1, 2021, to October 31, 2022. The epidemiological events and the parameters incorporated in this study were based on the data published by the Libyan Centers for Disease Control. The surveillance was carried out on all patients admitted to the wards of medicine, surgery, intensive care, gynecology & obstetrics, and pediatrics in all four hospitals. Trained staff reviewed the medical records and compared the percentages of patients with healthcare-associated infections. Bio-statistical and multivariable logistic regression analyses were carried out to test the variables associated with healthcare-associated infections and the resulting deaths. RESULTS: A total of 22,170 hospitalized patients in four hospitals were included in the study. Hospital-acquired infection was reported in 3037 patients (13.7%; 95% CI: 12.9-14.4%). The highest incidence was in Benghazi Medical Center (17.9%; 95% CI: 16.9-18.7%), followed by Sabha Medical Center (14.8%; 95% CI:14.9-16.51%). Surgical site infection was the most prevalent (31.3%), followed by ventilator-associated pneumonia (29.3%), urinary tract infection (26.8%), and bloodstream infection (12.6%). Patients with healthcare-associated infections experienced severe morbidity requiring intervention. New antimicrobial regimens were needed for 1836 patients (93%), and 752 patients (34%) required admission to intensive care. Surgical intervention, respiratory support, and inotropes were also needed as a consequence of HAI events. CONCLUSIONS: The high incidence of healthcare-associated infections in Libyan hospitals should be considered a major problem and a serious burden. This should alert healthcare authorities at the national and hospital levels to the urgent need for preventive and control strategies to combat hospital-acquired infections.

A randomized, double-blind study of larazotide acetate to prevent the activation of celiac disease during gluten challenge.

OBJECTIVES: In patients with celiac disease, enteropathy is caused by the entry of gluten peptides into the lamina propria of the intestine, in which their immunogenicity is potentiated by tissue transglutaminase (tTG) and T-helper type 1-mediated immune responses are triggered. Tight junction disassembly and paracellular permeability are believed to have an important role in the transport of gluten peptides to the lamina propria. Larazotide acetate is a tight-junction regulator peptide that, in vitro, prevents the opening of intestinal epithelial tight junctions. The aim of this study was to evaluate the efficacy and tolerability of larazotide acetate in protecting against gluten-induced intestinal permeability and gastrointestinal symptom severity in patients with celiac disease. METHODS: In this dose-ranging, placebo-controlled study, 86 patients with celiac disease controlled through diet were randomly assigned to larazotide acetate (0.25, 1, 4, or 8 mg) or placebo three times per day with or without gluten challenge (2.4 g/day) for 14 days. The primary efficacy outcome was the urinary lactulose/mannitol (LAMA) fractional excretion ratio. Secondary endpoints included gastrointestinal symptom severity, quality-of-life measures, and antibodies to tTG. RESULTS: LAMA measurements were highly variable in the outpatient setting. The increase in LAMA ratio associated with the gluten challenge was not statistically significantly greater than the increase in the gluten-free control. Among patients receiving the gluten challenge, the difference in the LAMA ratios for the larazotide acetate and placebo groups was not statistically significant. However, larazotide acetate appeared to limit gluten-induced worsening of gastrointestinal symptom severity as measured by the Gastrointestinal Symptom Rating Scale at some lower doses but not at the higher dose. Symptoms worsened significantly in the gluten challenge-placebo arm compared with the placebo-placebo arm, suggesting that 2.4 g of gluten per day is sufficient to induce reproducible gluten toxicity. Larazotide acetate was generally well tolerated. No serious adverse events were observed. The most common adverse events were headache and urinary tract infection. CONCLUSIONS: LAMA variability in the outpatient setting precluded accurate assessment of the effect of larazotide acetate on intestinal permeability. However, some lower doses of larazotide acetate appeared to prevent the increase in gastrointestinal symptom severity induced by gluten challenge.

Treatment of premature ejaculation by glans penis augmentation using hyaluronic acid gel: a pilot study.

Premature ejaculation (PE) is by far the most common male sexual complaint, with millions of men affected all over the world. It is estimated that up to 20-30% of all men may be suffering from various forms of PE. A variety of filler materials are widely used nowadays for soft tissue augmentation. The appropriate filler can restore symmetry, volume and create a smooth skin surface The aim of this pilot study was to evaluate the therapeutic effect of hyaluronic acid gel injection in patients with PE. Sixty men with self-reported PE who were referred to our outpatient andrology clinic (between January 2007 and January 2008) were included in this study. Participants were randomly assigned using random sampling numbers into two distinct groups. Group A (n = 30) received a single injection of 2 ml of hyaluronic acid gel (Hyalift 3.5% micronised hyaluronic acid) using the previously described fan technique. Group B (n = 30) received a single injection of 2 ml of hyaluronic acid gel using the multiple puncture technique. Twenty-three patients (46.9%) received injection by the fan technique, while 26 patients (53.1%) received it through the multiple-point technique. The mean intravaginal ejaculation latency time (IELT) increased significantly from 2.12 ± 1.16 to 7.71 ± 7.86 min, after 1 month of injection and then dropped to 5.32 ± 3.52 min, but still remaining significantly higher than the baseline values. Results from our present pilot study demonstrated the usefulness of the application of hyaluronic acid dermal fillers in the treatment of PE; however, further investigations in large cohorts with longer follow-up are definitely needed to obtain more consistent results.