RESUMEN
The aim of this work is to trace how rheumatologists all over Egypt are approaching the COVID-19 pandemic and what changes it has brought about in the patients' care with special attention to its effect on vulnerable rheumatic disease (RD) patients. This survey further aims to help inform the rheumatology community about the changes in practice during the COVID-19 pandemic. The survey included 26 questions distributed to University staff members across Egypt members of the Egyptian College of Rheumatology (ECR). It takes 5-10 min to fill out. The practice setting of participating rheumatologists included University Teaching Hospitals that are the main rheumatology and clinical immunology service providers for adults and children RD patients. There was an overall agreement across the country in the responses to the survey that took a median time of 7 min to fill in. Potential changes in rheumatology outpatient practice by staff members evolved since the COVID-19 pandemic. None of the university rheumatology staff members has prescribed chloroquine or HCQ to prevent or treat COVID-19 in a non-hospitalized patient who was not previously on it. Twenty-three recommended decrease/avoid NSAIDs if the RD patient had confirmed COVID-19 or symptoms. There is an agreement to the key emerging frontline role of rheumatologists in treating COVID-19. During the pandemic, RD cases requiring admission were dealt with by several modified strategies. The overall agreement among the different university rheumatology departments during such critical situation has provoked the ECR to consider providing provisional guidelines for dealing with RD patients during this global catastrophe.
Asunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Antirreumáticos/uso terapéutico , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Pautas de la Práctica en Medicina/estadística & datos numéricos , Enfermedades Reumáticas/tratamiento farmacológico , Reumatólogos/estadística & datos numéricos , Atención Ambulatoria/estadística & datos numéricos , Antirreumáticos/provisión & distribución , Betacoronavirus , COVID-19 , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/prevención & control , Deprescripciones , Egipto/epidemiología , Humanos , Hidroxicloroquina/provisión & distribución , Hidroxicloroquina/uso terapéutico , Pandemias/prevención & control , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/prevención & control , Reumatología , SARS-CoV-2 , Encuestas y Cuestionarios , Tratamiento Farmacológico de COVID-19RESUMEN
OBJECTIVE: To examine the potential therapeutic effect of mesenchymal stem cells (MSCs) for experimental scleroderma. MATERIALS AND METHODS: Fifty-four mice six-week-old (30-35 g) were studied. Hypochlorous acid (HOCl) induced scleroderma was considered. Mice were divided into 3 groups: (I) Control: Six mice did not receive any treatment and were sacrificed at the end of the experiment; (II) HOCl mice (induced scleroderma as a positive control): (III) MSCs-treated HOCl mice: Thirty six HOCl-induced mice were injected with MSCs (7.5 × 105) intravenous every week for 3 weeks. Skin pieces were taken from the backs of mice and lung tissue pieces. a smooth muscle actin (α-SMA) and transforming growth factor-ß (TGF-ß1) were analysed or fixed in 10 % formalin for skin and lung tissue histopathological analysis. Plasma nitric oxide (NO) was also assayed. RESULTS: There was a significant rise in the NO level and of the cutaneous and lung tissue α-SMA and TGF-ß1 in untreated scleroderma-induced mice. The values significantly normalized after MSC therapy over the 7 weeks duration of the study. The altered histopathology of the skin and lung tissues in the scleroderma-induced mice showed a remarkable tendency to normalization of the skin and lung parenchyma and vasculature. CONCLUSION: There was a significant rise in the level of NO and skin and lung tissue α-SMA and TGF-ß1 in untreated scleroderma-induced mice and values were significantly normalized after MSC therapy over the 7 weeks duration of the study. Altered histopathology of the skin and lung appeared nearly normal after MSC therapy.
Asunto(s)
Trasplante de Células Madre Mesenquimatosas , Células Madre Mesenquimatosas/citología , Esclerodermia Sistémica/terapia , Animales , Modelos Animales de Enfermedad , Humanos , Ratones , Óxido Nítrico/sangre , Esclerodermia Sistémica/sangre , Piel/patología , Factor de Crecimiento Transformador beta/metabolismoRESUMEN
BACKGROUND AND STUDY AIMS: Cytokines play a pivotal role in the induction of host immune responses against tumour growth and are involved in the development and progression of colorectal cancer in humans. The role of IL-23 in colorectal cancer is still unclear. Thus, we aimed to determine IL-23 levels in the development and progression of colorectal (CRC) cancer. PATIENTS AND METHODS: Thirty two patients with colorectal cancer aged 60.4⯱â¯3.5â¯years. and 20 age, sex and BMI matched healthy control subjects were included in the study. Serum IL-23 levels were determined using enzyme linked immunosorbent assay. C-reactive protein (CRP) levels were determined using a turbidimetric immunoassay. Carcinoembryonic antigen (CEA) and carbohydrate antigen (CA 19-9) were measured by radioimmunoassay. RESULTS: IL-23 levels were found significantly higher in patients relative to the control subjects (pâ¯<â¯0.001) and were gradually increased with TNM tumour stage progression. The mean CRP, CEA and CA-19-9 levels also were significantly higher in patients (pâ¯<â¯0.001). There was a significant correlation between the serum levels of IL-23 and the other measured parameters in CRC patients. The area under receiver operating characteristic curve (ROC) for serum IL-23 was 0.955 at cut off value ≥57.15 with sensitivity 96% and specificity 100%. CONCLUSION: The observed results suggest that IL-23 may have a potential role in the pathogenesis and progression of colorectal malignancy and may be a good marker of colorectal cancer and stage progression.