Nailfold Capillaroscopy Findings in Patients With Psoriasis Vulgaris and Different Domains of Psoriatic Arthritis.

Background: Psoriasis is a chronic autoimmune disease with longtime activity and multisystem affection. Nailfold capillaroscopy (NC) is a simple noninvasive microscopic tool useful for identification of nailfold microvasculopathy. Objective: The present study aimed to compare NC findings in patients with psoriasis vulgaris (PsV) and psoriatic arthritis (PsA) with different clinical domains. Methods: The present cross-sectional study included 200 psoriasis patients classified into five 40-patient groups: group I (GI) included PsA patients with predominant peripheral arthritis; group II (GII) included PsA patients with predominant peripheral arthritis and dactylitis and/or enthesitis; group III (GIII) included PsA patients with predominant axial affection; group IV (GIV) patients included PsA patients with predominant axial affection and dactylitis and/or enthesitis and group V (GV) included patients with PsV. In addition, there were 40 age and sex-matched healthy controls (GVI). Results: The studied patients had capillary density of 6.7 ± 3.5/mm with 90 patients (45.0 %) having reduced capillary density. GI-GIV patients had significantly lower capillary density and higher frequency of patients with reduced capillary density as compared to GV patients. The reported capillary dimension in the studied patients is 15.7 ± 7.9 µm and 55 patients (27.5 %) had large/giant capillaries. Patients in GV had significantly lower capillary dimension in comparison to GI-GIV patients. There were 64 patients (32.0 %) with abnormal capillary morphology and 47 patients (23.5 %) with capillary hemorrhages. Conclusions: PsA patients of all domains have lower capillary density and larger capillary dimensions as compared to PsV patients.

'A case of autoimmune hepatitis associated with the PCSK9 inhibitor alirocumab'.

This is a case of a 61-year-old lady who presented to the lipid clinic with possible familial hypercholesterolaemia (Simon Broome Criteria). She was commenced on atorvastatin; however, 4 weeks later, she developed hepatitis, and therefore her atorvastatin was discontinued. Following that, her liver function tests normalized, and she was diagnosed with statin-induced hepatitis. Three years later, she was seen again in the lipid clinic with an uncontrolled lipid profile, and she was commenced on alirocumab, a Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) inhibitor. A few days later, she developed hepatitis, and subsequently, the alirocumab was discontinued. She underwent a liver biopsy, which confirmed that she had Autoimmune Hepatitis (AIH) with presumed superimposed drug injury. This is the first reported case of autoimmune hepatitis associated with alirocumab.

Impact of green antioxidants on decreasing the aflatoxins percentage in peanut oil seed (Arachis hypogaea L.) during storage.

The present study conducted an experimental investigation to impede the degradation of peanut (Arachis hypogaea L.) seeds and enhance their quality while being stored. The efficacy of eco-friendly chemicals such as ascorbic acid, salicylic acid, acetic acid, and propionic acid in seed preservation was evaluated over a period of six months. After a period of six months of storage in a greenhouse, an examination was conducted on peanut seeds that had undergone treatment. Rhizoctonia was observed after Cephalothorax, whereas Aspergillus, Fusarium, and Penicillium were the prevailing fungi throughout the storage period. The optimal outcomes were obtained from the conversion of acetic acid to propionic acid. The study observed a decline in seed oil, protein, carbohydrates, germination percentage, energy, index, length, vigour index, dead and rotten seeds, rotted seedlings, and surviving healthy seedlings, with an increase in storage duration ranging from zero to six months. The application of 100% propionic acid to peanut seeds throughout the storage duration resulted in decreased occurrences of deceased seeds, decaying seeds, and deteriorated seedlings. Peanut seeds that underwent treatment with green chemical agents of moderate and high intensity were found to be free of aflatoxin B1. The highest levels of chlorophylls a and b, carotenoids, and total phenols were observed in seeds stored in greenhouses and treated with 100% propionic acid and acetic acid extract. The application of propionic acid 100%, acetic acid 100%, salicylic acid 4 g/l and ascorbic acid 4 g/l proved to be the most effective treatments for peanut seeds, exhibiting the lowest total aflatoxin level of 0.40. The correlation coefficient between shoot fresh weight and shoot dry weight was found to be 0.99, whereas the correlation coefficient between root dry weight and shoot length was 0.67. The seed chemical analysis, seedling characteristics, and germination characteristics were subjected to clustering analysis, resulting in the formation of two distinct groups. The first group consisted of germination percentage and energy levels across all time points (0-6 months), while the second group consisted of the remaining characteristics. The findings of this research propose the utilisation of 100% propionic acid as a viable method for preserving peanut seeds and preventing their deterioration during storage. The application of 100% acetic acid has been found to be effective in enhancing the quality of seeds and minimising losses.

Validation of New ELISA Technique for Detection of Aflatoxin B1 Contamination in Food Products versus HPLC and VICAM.

Toxin-contaminated foods and beverages are a major source of illness, may cause death, and have a significant negative economic impact worldwide. Aflatoxin B1 (AFB1) is a potent toxin that may induce cancer after chronic low-level exposure. This study developed a quantitative recombinant AflR gene antiserum ELISA technique for aflatoxin B1 detection in contaminated food products. Aflatoxin B1 residuals from 36 food samples were analyzed with HPLC and VICAM. DNA was extracted from aflatoxin-contaminated samples and the AflR gene amplified using PCR. PCR products were purified and ligated into the pGEM-T vector. Recombinant plasmids were sequenced and transformed into competent E. coli (BL21). Molecular size and B-cell epitope prediction for the recombinant protein were assessed. The purified protein was used to induce the production of IgG antibodies in rabbits. Serum IgG was purified and labeled with alkaline phosphatase. Finally, indirect-ELISA was used to test the effectiveness of polyclonal antibodies for detection of aflatoxin B1 in food samples.

Crude Citric Acid of Trichoderma asperellum: Tomato Growth Promotor and Suppressor of Fusarium oxysporum f. sp. lycopersici.

Presently, the bioprocessing of agricultural residues to various bioactive compounds is of great concern, with the potential to be used as plant growth promoters and as a reductive of various diseases. Lycopersiconesculentum, one of the most consumed crops in the human diet, is attacked by Fusarium wilt disease, so the main aim is to biocontrol the pathogen. Several fungal species were isolated from decayed maize stover (MS). Trichodermaasperellum was chosen based on its organic acid productivity and was molecularly identified (GenBank accession number is MW195019). Citric acid (CA) was the major detected organic acid by HPLC. In vitro, CA of T.asperellum at 75% completely repressed the growth of Fusariumoxysporum f. sp. lycopersici (FOL). In vivo, soaking tomato seeds in CA enhanced the seed germination and vigor index. T. asperellum and/or its CA suppressed the wilt disease caused by FOL compared to control. There was a proportional increment of plant growth and yield, as well as improvements in the biochemical parameters (chlorophyll pigments, total phenolic contents and peroxidase, and polyphenol oxidase activities), suggesting targeting both the bioconversion of MS into CA and biological control of FOL.

Combined therapy of plantar warts with topical bleomycin and microneedling: a comparative controlled study .

Background: The aim of this study was to assess the efficacy of combination between microneedling with dermapen and topical bleomycin in the treatment of plantar warts in comparison with intralesional bleomycin and intralesional saline (placebo).Methods: Fifty-four patients were assigned into three groups, each containing 18 patients. The first group treated by micro-needling phenotype with topical bleomycin at 2 weeks interval, the second group received intralesional bleomycin at 3 weeks interval and the control group was intralesional saline for a maximum of four weeks.Results: Complete clearance of warts in 16 patients in the micro-needling group (88.9%) versus 15 patients (83.3%) in the intralesional bleomycin group versus one patient (5.6%) in the control group .Conclusions: Microneedling assisted topical bleomycin spraying seems to be a promising effective and noninvasive therapeutic modality for recalcitrant plantar warts that facilitates delivery and absorption of bleomycin into the lesion .

A Partial Anomalous Pulmonary Venous Connection in a Severely Symptomatic Patient, Is Surgery Always Recommended?

Partial anomalous pulmonary venous connection (PAPVC) is a rare cardiac anomaly occurring when a pulmonary vein drains into the right atrium, coronary sinus or a systemic vein creating a left-to-right shunt. Symptoms develop from right-sided fluid overload and pulmonary vascular disease. We report a rare case of a severely symptomatic patient with an incidentally discovered PAPVC in the setting of underlying severe pulmonary hypertension from multifactorial severe restrictive lung disease. Despite his worsening symptoms, a multi-disciplinary meeting decided against surgical intervention. Nine months after the decision was made, the patient showed no signs or symptoms of clinical deterioration. Prior studies recommend surgery for PAPVCs with evidence of right ventricular dilation, mild-to-moderate tricuspid regurgitation, or early stages of pulmonary vascular disease. However, our case demonstrates how decision making should consider the shunt's contribution to the overall clinical picture and underlying comorbidities. If a decision is made to defer surgical intervention, strict follow up and repeat re-evaluations for possible risk re-stratification and surgery reconsideration are warranted.

Spatial working memory in neurofibromatosis 1: Altered neural activity and functional connectivity.

BACKGROUND: Neurofibromatosis Type 1 (NF1) is a genetic disorder that disrupts central nervous system development and neuronal function. Cognitively, NF1 is characterized by difficulties with executive control and visuospatial abilities. Little is known about the neural substrates underlying these deficits. The current study utilized Blood-Oxygen-Level-Dependent (BOLD) functional MRI (fMRI) to explore the neural correlates of spatial working memory (WM) deficits in patients with NF1. METHODS: BOLD images were acquired from 23 adults with NF1 (age M = 32.69; 61% male) and 25 matched healthy controls (age M = 33.08; 64% male) during an in-scanner visuo-spatial WM task. Whole brain functional and psycho-physiological interaction analyses were utilized to investigate neural activity and functional connectivity, respectively, during visuo-spatial WM performance. Participants also completed behavioral measures of spatial reasoning and verbal WM. RESULTS: Relative to healthy controls, participants with NF1 showed reduced recruitment of key components of WM circuitry, the left dorsolateral prefrontal cortex and right parietal cortex. In addition, healthy controls exhibited greater simultaneous deactivation between the posterior cingulate cortex (PCC) and temporal regions than NF1 patients. In contrast, NF1 patients showed greater PCC and bilateral parietal connectivity with visual cortices as well as between the PCC and the cerebellum. In NF1 participants, increased functional coupling of the PCC with frontal and parietal regions was associated with better spatial reasoning and WM performance, respectively; these relationships were not observed in controls. CONCLUSIONS: Dysfunctional engagement of WM circuitry, and aberrant functional connectivity of 'task-negative' regions in NF1 patients may underlie spatial WM difficulties characteristic of the disorder.

Outcome of colonoscopy in elderly African-American patients.

BACKGROUND: Average-risk individuals should be offered a screening colonoscopy beginning at 50 years of age. However, there is no clear consensus on an age at which patients should no longer be offered a screening colonoscopy. The purpose of this study was to analyze the outcome of colonoscopy in elderly individuals based on the preprocedure indication. METHODS: A retrospective chart review was performed of all patients who underwent colonoscopy at Howard University Hospital from Jan 1, 2001 to Dec 31, 2005. Patients older than age 75 years were then stratified into two groups: one group classified as average risk for colon cancer and a second group classified as higher risk for finding cancer based on indication. Significant findings from colonoscopy were assigned if the patient was found to have an advanced adenoma, such as villous attributes, high-grade dysplasia, adenoma C1 cm, or cancer. All others findings at colonoscopy were categorized as having nonsignificant findings. RESULTS: During this period, 922 elderly patients (75 years of age or older) underwent colonoscopy. Based on preprocedure indications, 606 patients were considered higher risk and 316 average risk. Among the preprocedure higher-risk patients, 532 had nonsignificant findings include hemorrhoids, diverticulosis, telangiectasias, lipomas, and inflammatory polyps. Among the preprocedure average-risk patients, 286 had nonsignificant findings. From the 110 patients who underwent screening colonoscopy, 99 patients had nonsignificant findings. Malignancy was found in 42 patients: 33 who had higher-risk indications and 9 who had average-risk indications. CONCLUSION: Average-risk patients are less likely to have significant findings, including cancer, on colonoscopy.

Antibiotic therapy for Helicobacter pylori.

Helicobacter pylori is one of the most common bacterial infections in the world. H pylori infection of the gastric mucosa is the most common cause of peptic ulcers and is believed to be responsible for 50% to 60% of all gastric carcinomas. This infection is difficult to treat because the bacterium is located within the gastric lumen in the mucus and not within the gastric tissue. Antimicrobial therapy for H pylori includes two or three antibiotics plus either a proton pump inhibitor or a histamine receptor antagonist. H pylori readily develops resistance to antibiotics; therefore, if the initial treatment is unsuccessful, repeat treatment should include different antibiotics.