Isolation and propagation of an Egyptian Theileria annulata infected cell line and evaluation of its use as a vaccine to protect cattle against field challenge.

Tropical theileriosis is an important protozoan tick-borne disease in cattle. Vaccination using attenuated schizont-infected cell lines is one of the methods used for controlling the disease. This study describes the production of attenuated schizont-infected cell lines from Egypt and an evaluation of its use as a vaccine to protect calves against clinical disease upon field challenge. Two groups of exotic and crossbred male calves were divided into vaccinated and control groups. The vaccinated groups were inoculated with 4 ml (1 × 106 cells/ml) of the attenuated cell line. Three weeks after vaccination, calves of both groups were transported to the New Valley Governorate (Egyptian oasis) where they were kept under field conditions and exposed to the natural Theileria annulata challenge. All animals in the control group showed severe clinical signs and died despite treatment with buparvaquone, which was administered after two days of persistent fever due to a severe drop in packed cell volume (PCV). Animals in the vaccinated group became seropositive without developing severe clinical signs other than transient fever. Post-mortem examinations revealed enlarged and fragile lymph nodes, spleen, and liver with necrosis and hemorrhages. These findings indicate that the Egyptian attenuated cell line was successful in protecting both exotic and crossbred animals against tropical theileriosis under field conditions.

Accuracy of the risk of malignancy index-I in diagnosing ovarian malignancy in menopausal women.

Introduction: To detect the accuracy of the risk of malignancy index-I (RMI-I) in diagnosing ovarian malignancy in menopausal women. Material and methods: Eighty-two menopausal women with suspected ovarian masses (OMs) scheduled for surgery were included in this study. Blood samples were preoperatively collected from participants to measure the CA-125, followed by transvaginal sonography to evaluate the suspected OMs regarding the consistency, whether the OMs were unilateral or bilateral, unilocular or multilocular, and for extra-ovarian metastasis. The preoperative RMIs were compared to the postoperative histology of the excised OMs to detect the accuracy of RMI-I at a cut-off value of 200 in diagnosing ovarian malignancy. The receiver operating characteristic curve was also used to detect the cut-off value of RMI-I with the highest sensitivity and specificity in diagnosing ovarian malignancy in menopausal women. Results: The incidence of benign and malignant OMs in the studied menopausal women was 59.8% and 40.2%, respectively. The risk of malignancy index-I at a cut-off value 200 in this study had 75.8% sensitivity, 91.8% specificity, 86.2% positive predictive value (PPV), and 84.9% negative predictive value (NPV) in diagnosing ovarian malignancy in menopausal women. The receiver operating characteristic curve showed that the RMI-I at a cut-off value of > 241.5 had 96% sensitivity and 94.74% specificity in diagnosing ovarian malignancy in menopausal women (AUC 0.98, 95% CI: 0.92-0.99, p < 0.001). Conclusions: The risk of malignancy index I at a cut-off value of 200 had 75.8% sensitivity, 91.8% specificity, 86.2% PPV, and 84.9% NPV in diagnosing ovarian malignancy in menopausal women. The receiver operating characteristic curve showed that the RMI-I at a cut-off value > 241.5 had 96% sensitivity and 94.74% specificity in diagnosing ovarian malignancy in menopausal women.

Dienogest versus norethisterone acetate in management of endometrial hyperplasia without atypia.

OBJECTIVES: To compare the effectiveness of dienogest (DIE) and norethisterone acetate (NETA) regimens in the treatment of endometrial hyperplasia (EH) without atypia. METHODS: Participants were premenopausal women with irregular uterine bleeding, and endometrial hyperplasia without atypia on endometrial biopsy. Enrolled patients were randomly allocated into two groups: group I got DIE 2 mg/day (orally Visanne) for 14 days (10th to the 25th day of cycle) while group II received between the 16th and 25th day of the cycle, norethisterone acetate (NETA) 15 mg/d (orally Primolut Nor) was administered for 10 days. Both groups continued the therapy for six months. RESULTS: The DIE group showed a higher resolution (32.7%) and regression (57.7%) than NETA group (31% & 37.9%, respectively) with significant regression (p = 0.039). No progression in DIE group while four (6.9%) women in NETA group were recorded a progression to complex type without a significance. Also, NETA group showed a significant persistence rate (22.5%) than DIE group (3.8%) (p = 0.005). Also number in NETA group managed by hysterectomy with significant difference (p = 0.042). CONCLUSION: If used as first-line treatment, Dienogest produces a better rate of regression and a lower incidence of hysterectomy than Norethisterone Acetate does when used in EH without atypia.

Maternal Interleukin-17 and disease activity influence pregnancy outcomes in women with psoriatic arthritis and ankylosing spondylitis.

OBJECTIVE: We aimed in this study to evaluate the impact of maternal interleukin -17A and the activity of the illness on pregnancy outcomes in Psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients. METHODS: This prospective cohort research was carried out on 48 Psoriatic arthritis and ankylosing spondylitis pregnant women attending the inpatient and outpatient clinics of the Rheumatology & Rehabilitation and Obstetrics & Gynecology Departments, Faculty of Medicine, Zagazig University Hospitals in Egypt and 30 apparently healthy age- and sex-matched pregnant women between January 1,2018, and December 31, 2019. RESULTS: The study group patients had a higher risk of preterm labour (32-36 weeks gestation) (aRR 1.80, 95% CI 0.79-4.17), oligohydramnios (aRR 3.15, 95% CI 1.26-8.42), Caesarean delivery (aRR 1.57, 95% CI 1.41-2.68), and delivering infants small for gestational age (aRR 7.04, 95% CI 2.36-12.42). There was significant difference between the control group and the study groups regarding the level of IL-17A. CONCLUSION: Many females with PsA and AS have uninhibited pregnancy with regard to adverse events, but in comparison with normal pregnancies particularly with high IL-17A during the third trimester we noticed a growing risk of preterm labour, oligohydramnios and cesarean section. Further studies are needed to evaluate high maternal IL-17A levels and fetal outcomes.

Virtual brain grafting: Enabling whole brain parcellation in the presence of large lesions.

Brain atlases and templates are at the heart of neuroimaging analyses, for which they facilitate multimodal registration, enable group comparisons and provide anatomical reference. However, as atlas-based approaches rely on correspondence mapping between images they perform poorly in the presence of structural pathology. Whilst several strategies exist to overcome this problem, their performance is often dependent on the type, size and homogeneity of any lesions present. We therefore propose a new solution, referred to as Virtual Brain Grafting (VBG), which is a fully-automated, open-source workflow to reliably parcellate magnetic resonance imaging (MRI) datasets in the presence of a broad spectrum of focal brain pathologies, including large, bilateral, intra- and extra-axial, heterogeneous lesions with and without mass effect. The core of the VBG approach is the generation of a lesion-free T1-weighted image, which enables further image processing operations that would otherwise fail. Here we validated our solution based on Freesurfer recon-all parcellation in a group of 10 patients with heterogeneous gliomatous lesions, and a realistic synthetic cohort of glioma patients (n = 100) derived from healthy control data and patient data. We demonstrate that VBG outperforms a non-VBG approach assessed qualitatively by expert neuroradiologists and Mann-Whitney U tests to compare corresponding parcellations (real patients U(6,6) = 33, z = 2.738, P < .010, synthetic-patients U(48,48) = 2076, z = 7.336, P < .001). Results were also quantitatively evaluated by comparing mean dice scores from the synthetic-patients using one-way ANOVA (unilateral VBG = 0.894, bilateral VBG = 0.903, and non-VBG = 0.617, P < .001). Additionally, we used linear regression to show the influence of lesion volume, lesion overlap with, and distance from the Freesurfer volumes of interest, on labeling accuracy. VBG may benefit the neuroimaging community by enabling automated state-of-the-art MRI analyses in clinical populations using methods such as FreeSurfer, CAT12, SPM, Connectome Workbench, as well as structural and functional connectomics. To fully maximize its availability, VBG is provided as open software under a Mozilla 2.0 license (https://github.com/KUL-Radneuron/KUL_VBG).