Effect of Splenectomy on Coagulation and Platelet Function in Adult Liver Transplant Recipients Assessed With Rotational Thromboelastometry and Standard Coagulation Tests.

OBJECTIVES: Splenectomy during liver transplant can affect platelet function. In this study, our primary aim was to assess the perioperative platelet function by rotational thromboelastometry and the effects of splenectomy on platelet function. MATERIALS AND METHODS: We studied 40 consecutive liver transplant recipients with end-stage liver disease (50% as a result of hepatitis C). Patients with splenectomy were compared with patients without splenectomy (n = 20/group). Three platelet function parameters by rotational thromboelastometry were studied: platelet activation with arachidonic acid, platelet activation with adenosine diphosphate, and platelet activation with thrombin receptor-activating peptide 6. Patients were monitored perioperatively and until postoperative day 21. Heparin was infused for 2 days postoperatively (60-180 U/kg/day), followed by administration of subcutaneous low-molecular-weight heparin (40 mg/24 h) on postoperative days 2 and 3 and oral acetylsalicylic acid when platelet count was >50 × 103/µL. RESULTS: Liver disease contributed to low perioperative platelet count and function. Patients showed significant improvement by postoperative day 14 and day 21, particularly after splenectomy. Platelet count was significantly correlated with the 3 platelet function parameters by rotational thromboelastometry (P < .001). Acetyl salicylic acid was required earlier (postoperative day 3) for patients with splenectomy (8/20) but only affected the platelet function represented by platelet activation with arachidonic acid, whereas other platelet activation pathways were less affected. Patients received no transfusions of platelet units. CONCLUSIONS: End-stage liver disease significantly contributed to low platelet function and counts before transplant. Two weeks were required for recovery of patients posttransplant, with further enhancement by splenectomy. Some recipients showed recovery that exceeded the normal reference range, which warranted monitoring. Acetyl salicylic acid only affected 1 platelet activation receptor.

Recursive bit assignment with neural reference adaptive step (RNA) MPPT algorithm for photovoltaic system.

Recent research has focused on photovoltaic (PV) systems due to their important properties. The efficiency of the PV system can be enhanced by many Maximum Power Point Tracking (MPPT) algorithms proposals. MPPT algorithms are used to achieve maximum PV output power by optimizing the duty cycle of the DC-DC buck/boost converter. This paper introduces an RNA algorithm as an efficient MPPT algorithm for the photovoltaic system. This proposed RNA algorithm consists of two main segments. The first segment is an artificial neural network for generating reference power. The second segment is a proposed Recursive Bit Assignment (RBA) network to allow variable step size of the boost converter duty cycle. The instant PV power adopts the RBA network to produce the variable duty cycle increment value. Additionally, the neural network is implemented in such a way to obtain the best performance. Many simulation results using MATLAB to test the system performance are presented. The performance characteristics of the photovoltaic system with variable irradiance and variable temperature are simulated. From results, the proposed RNA algorithm achieves fast tracking time, high energy efficiency, true maximum power point and acceptable ripple. Additionally, comparisons between the RNA algorithm and other related algorithms such as Perturb and Observe, the Neural Network and the Adaptive Neural Inference System Algorithms are executed. The proposed RNA algorithm achieves the best performance in all case studies such as; irradiance profile variation, severe temperature and irradiance diversions, and partial shading conditions. Besides, the experimental circuit of the PV system is also presented.

Effects of aflatoxin B1 on human breast cancer (MCF-7) cells: cytotoxicity, oxidative damage, metabolic, and immune-modulatory transcriptomic changes.

Aflatoxin B1 (AFB1) is a potent mycotoxin that is commonly produced by molds such as Aspergillus (A.) flavus and A. parasiticus. AFB1 is associated with several health adverse effects in humans including mutagenesis and carcinogenesis. Aflatoxin is commonly secreted in the milk leading to deleterious effects on breast tissue and potential nursing infants. However, the effects of aflatoxins, particularly AFB1, on the breast cells are less investigated. In this study, AFB1-associated effects on human breast cancer cell lines (MCF-7) were investigated. AFB1 caused significant cytotoxicity on MCF-7 cells. Such cytotoxicity had a positive correlation with the induction of oxidative stress. In addition, AFB1 caused significant transcriptomic alterations in xenobiotics and drug-metabolizing enzymes, transporters, and antioxidant enzymes. Besides, AFB1 upregulated pro-inflammatory markers such as tumor necrosis factor-α and cyclooxygenase-2 with a significant reduction of mRNA expressions of the immunity-related genes including interleukins 8 and 10.

Carbapenem-Resistant Gram-Negative Bacilli Causing Ventilator Associated Pneumonia: Study of MASTDISCS Combi Carba Plus for Detection of Carbapenemase Producing Enterobacterales.

Background: Ventilator-associated pneumonia (VAP) caused by carbapenem-resistant gram-negative bacteria has been proven to be an escalating public health challenge in Egypt owing to its high mortality rate and raised health care costs. Purpose: Detection of carbapenem-resistant gram-negative bacilli among VAP patients, genotypic identification of carbapenemase genes in the isolated strains with evaluation of their impact on patient outcome and detection of carbapenemase-producing enterobacterales by MASTDISCS combi Carba plus disc system. Methods: Broncho-alveolar lavage fluid (BALF) and endotracheal aspirate were collected aseptically from clinically suspected VAP patients. Pathogen identification and antibiotic sensitivity testing were done. Carbapenemase-encoding genes (bla KPC, bla NDM, and bla OXA-48) were tested by PCR in all carbapenem-resistant gram-negative isolates. Performance of MASTDISCS combi Carba plus in isolated Enterobacterales was assessed in relation to the PCR results. Results: Eighty-three carbapenem-resistant gram-negative isolates were detected. The most frequent pathogens were Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa representing 34.9%, 20.5% and 18.1%, respectively. bla KPC was the predominant gene. Patients with persistent mechanical ventilation less than 15 days and Pseudomonas aeruginosa infection were significantly associated with a higher death rate. MAST-Carba plus had the highest sensitivity, specificity, positive and negative predictive values for detecting OXA-48 carbapenemases representing 81.8%, 92.5%, 75% and 94.9%, respectively. Conclusion: Worse outcome in VAP patients was associated with carbapenem-resistant gram-negative bacilli. MASTDISCS combi Carba plus is an efficient simple method for identification of different carbapenemases among enterobacterales.

Neuroprotective effects of onion and garlic root extracts against Alzheimer's disease in rats: antimicrobial, histopathological, and molecular studies.

Alzheimer's disease (AD) is a brain disorder and the main reason for dementia. In this regard, there is a need to understand the alterations that occur during aging to develop treatment strategies to mitigate or prevent neurodegenerative consequences. Onion and garlic root extracts contain natural polyphenols with high antioxidant capacity; therefore, the present study aimed to investigate the protective effect of these extracts free from mycotoxin contamination on a rat model of AD. Antifungal and antibacterial assays were performed for onion and garlic extracts. Several groups of AD-induced rats were administered 1, 2, and 3 mg/kg onion or garlic extract through intragastric intubation for 30 days. After treatment, histopathological analysis, expression of apoptosis-related genes, and analyses of DNA damage and reactive oxygen species (ROS) generation were conducted in the brain tissues. The results indicate that treatment of AD-induced rats with several doses of onion and garlic root extracts decreased histopathological lesions, the expression levels of apoptotic genes, and the rate of DNA damage and inhibited intracellular ROS generation in the brain tissues. The results suggest that the protective role of onion root extract could be attributed to its content of flavonoids and flavonoid compounds through the improvement of antioxidant capacity and regulation of gene expression patterns. The higher activity levels of free radical scavenging of azino-bis (3-ethylbenzothiazoline-6-sulphonic acid (ABTS) and antioxidant ferric reducing antioxidant power (FRAP) levels found in garlic root extract are most probably responsible for its protective effect against neurodegenerative damage.

Needle-stick and sharps injuries: awareness, prevalence and risk factors of a global problem in healthcare workers at Tanta University Hospitals, Egypt.

Objectives. This study aimed to assess the level of awareness, prevalence and risk factors of needle-stick and sharps injuries (NSSIs) in Tanta University Hospitals, Egypt to develop a well-established preventive strategy. Methods. A total of 662 healthcare workers (HCWs), including nurses and physicians, who attended work during the last 6 months of 2019 were included. Data were collected on a structured questionnaire distributed during their working time. Results. Of 662 participating HCWs, 486 were nurses and 176 were physicians. Good awareness (86.1 and 83.1%) of the participants about safe injection policy and sharp disposal after use was observed. Nurses showed a significantly higher percentage of poor awareness score (79.1%) than physicians (20.9%). NSSIs in our hospitals reached 60.4%. Nurses (67.9%) had higher risk of NSSIs than physicians (39.8%; p < 0.001). NSSIs were significantly less likely to occur for HCWs who were aware of safe injection and sharp disposal policies. NSSIs were frequent with specimen collection (16.4%), injections (15.5%) and sharp disposal (14.6%). Only 110 (27.5%) have reported their injuries. Conclusion. A comprehensive program that addresses institutional, behavioral and device-related factors that contribute to the occurrence of NSSIs and reporting systems is needed.

Determination of Antioxidant and Antifungal Activities in Cookies Fortified with Solar Dried Prickly Pear Peels Powder.

BACKGROUND AND OBJECTIVE: The fortification of bakery products by new materials that attain various goals is considered a challenging that finally gains useful health amelioration. This study was planned to assess the effect of incorporation of solar dried prickly pear peels powder in qaraqeesh (Egyptian cookies) with respect to increase shelf life, sensory palatability and nutritional value. Prickly pear cactus (Opuntia ficus-indica) beside distributed in arid and semiarid regions proved to have phytochemical compounds with high antioxidants capacity. MATERIALS AND METHODS: Fungi colonies were isolated from prickly pear peels. Three levels (1, 3 and 5%) of dried peels powder were added to wheat flour along with other ingredients to make cookies samples. Mycological analysis was assessed in yeast with the three concentrations of peels powder as well as the fresh peels and negative control. The total phenolics, flavonoids, tannins, anthocyanins and carotenoids as well as the antioxidant activity were evaluated in fresh and dried cactus peels. RESULTS: Findings showed that the prickly pear peels powder (PPPP) antioxidant activity was not much affected by the solar drying conditions. The effect of different extracting solvents at different polarties and pH on the phenolic and flavonoids contents of PPPP was studied. Aflatoxins production by aflatoxignicity A. flavus (ATCC 28542) was inhibited by adding different concentrations of PPPP to cookies. Sensory evaluation of fortified cookies was done. All the evaluated characteristics of cookies were given nearly the same values for all levels of dried peels powder. CONCLUSION: Addition of 5% dried cactus peel had lower overall quality and color than the control. Adding 3% of PPPP to cookies (qaraqeesh) showed the highest sensory score. Dried cactus peels may improve quality, nutritional value and shelf life of cookies.

Application of zeolite prepared from Egyptian kaolin for the removal of heavy metals: II. Isotherm models.

In this study, the adsorption behavior of zeolites A and X, which are prepared from very cheap local Egyptian clay (kaolin), with respect to Cu(2+), Cd(+2), Cr(+2), Ni(+2) and Zn(2+) has been studied. The batch method has been employed, using metal solutions ranging from 100 to 400 mg/L. The distribution coefficients (K(d)) and adsorption percent were determined for the adsorption system as a function of sorbate concentration. In the uptake evaluation part of the study, adsorption ratios of metal cations on zeolites A and X match to Langmuir, Freundlich, and Dubinin-Kaganer-Radushkevich (DKR) adsorption isotherm data. Also, every cation exchange capacity for metals has been calculated. According to the equilibrium studies, the selectivity sequence can be given as Pb(2+)>Cd(2+)>Cu(2+)>Zn(2+)>Ni(2+). It was found that the uptake depend on hydrated ion diameter. This study may attract more interest due to the presence of large reservoirs of very cheap kaolin in Egypt from which both zeolite types were prepared.

The adjuvant effects of IL-12 and BCG on autoclaved Leishmania major vaccine in experimental cutaneous leishmaniasis.

Cutaneous leishmaniasis is a universal disease causing skin ulceration and deformity. A reliable vaccine remains to be a possible practical means of control. The amastigotes multiply intracellulary in macrophages provoking a cell-mediated type of immune response. IL-12 is the central cytokine of CMI. It is produced by sensitized macrophages, stimulates both Th1 and NK cells to secrete IFN-gamma which in turn activates the intracellular killing of Leishmania in macrophages via increased oxygen radicals. This work aimed mainly at studying the adjuvant effect of IL-12 on autoclaved L. major (ALM) vaccine, compared to that of BCG in L. major infection. The material included five groups of Swiss albino mice; the test group infected after receiving ALM+IL-12, a non-infected control group, and three other control groups infected after receiving ALM+BCG, IL-12 alone and BCG alone L. major was cultured to provide promastigotes for vaccine and infection. The measured parameters included the lesion size, type and progress; the parasite density and the level of IFN-gamma in serum. The results showed that the best protection against challenge infection was obtained by ALM + IL-12 followed by ALM + BCG. The former is recommended for use as a vaccine with regards to its proved efficacy and known safety.

Effect of dietary honey on intestinal microflora and toxicity of mycotoxins in mice.

BACKGROUND: Bee honey is a functional food which has a unique composition, antimicrobial properties and bifidogenic effect. In order to assess whether honey can inhibit the toxic effect of mycotoxins, the present study was undertaken. METHODS: Production of biomass and toxins by Aspergillus parasiticus and Aspergillus ochraceus were followed in media without and with honey. Although aflatoxins and ochratoxin A. were administrated to male Swiss albino mice up to 1 mug and 10 ng/kg body weight/day respectively. The experimental animals were fed diets without our with 10% honey for two months. The changes in colonic probiotic bacteria, determintal colon enzyme glucuronidases, and genotoxicity were followed. RESULTS: Addition of 32% in its media increased the biomass of A parasiticus, while the biomass of A. ochraceus decreased and Ochratoxin A. was not produced. When the honey was added at the ratio of 32 and 48% in the medium. No relationship was found between mycelium weight and production of mycotoxins. Oral administration of aflatoxins (mixture of B1, B2, G1 and G2) and Ochratoxin A. induced structural and numerical chromosomal aberrations in bone marrow and germ cells of male mice, whereas, honey treatment reduced the genotoxicity of mycotoxins. Also both toxins induced histopathological changes in liver and kidney. Feeding on diet supplemented with honey improved the histopathological changes in case of aflatoxin group, but not in the case of ochratoxin A. group (except of kidney in two cases). No significant differences were found in the activity of colon beta-glucuronidase between group fed diet with or without honey. On the other hand, the colon bifido bacteria and lactobacilli counts were increased markedly in group receiving diet supplemented with honey. CONCLUSION: Substituting sugars with honey in processed food can inhibit the harmful and genotoxic effects of mycotoxins, and improve the gut microflora.