Pulmonary Functions and Oxidative Stress Biomarkers Among Silica-Exposed Foundry Workers.

OBJECTIVE: To investigate the changes of the ventilatory function tests and the oxidative stress biomarkers among silica-exposed foundry workers. METHODS: The exposed group included 70 workers in an iron foundry. The nonexposed group included 40 subjects from Kasralainy outpatient clinic. Both groups were subjected to history taking, clinical examination, chest radiograph, spirometry, urinary silica, serum malondialdehyde (MDA), glutathione peroxidase (GPx), and 8-hydroxydeoxyguanosine (8-HdG). RESULTS: Higher urinary silica, serum MDA and serum 8-HdG, whereas lower serum GPx and ventilatory functions were detected in the exposed group compared with the controls. All parameters correlated with urinary silica. The exposed silicotic subgroup had increased work duration, urinary silica, serum MDA, and serum 8-HdG, and decreased serum GPx and ventilatory functions compared with non-silicotic subgroup. CONCLUSION: Oxidative stress biomarkers were abnormal with impairment of ventilatory functions among silica-exposed workers.

Pretransplant donor-specific anti-human leukocyte antigen antibodies despite a negative complement-dependent lymphocytotoxicity crossmatch: Is it wise to desensitize before kidney transplant?

The significance of pretransplant donor-specific antibodies (DSAs) despite negative complement-dependent lymphocytotoxicity crossmatch (CDC-XM) would be useful for clinical decision-making. Hence, we aimed to determine the impact of pretransplant DSA despite negative crossmatch on the outcome of kidney transplantation. One hundred and eleven kidney recipients were prospectively enrolled in this study after being transplanted at Hamed Al-Essa Organ Transplant Center of Kuwait between January 2011 and December 2013. Of them, 50 recipients with positive DSA at the time of transplant were subjected to desensitization (Group 1). Three local protocols were utilized; first included plasma exchange, high-dose intravenous immunoglobulin (IVIG), and rituximab; second included immunoadsorption plus RTX, and the third included high-dose IVIG and rituximab. The second group included 61 recipients with negative DSA. All recipients had negative CDC-XM and flow cytometry crossmatch at the time of transplant. Panel-reactive antibody (±DSA) levels with mean fluorescence intensity and graft function were monitored along the first 24 months for all patients. There were no statistically significant differences between the two groups regarding early posttransplant graft function, patient and graft survivals. Pretransplant DSA with negative CXM carries a minimal clinical risk with optimized immunosuppression.

Assessment of hepatic fibrosis by fibroscan in egyptian chronic hemodialysis patients with chronic Hepatitis C (genotype 4): A single-center study.

Assessing hepatic fibrosis in hemodialysis patients with chronic hepatitis C (CHC) can help to evaluate the long-term prognosis, complications of hepatitis C virus (HCV) as well as eligibility for renal transplantation,. Our aim was to assess liver fibrosis in Egyptian hemodialysis (HD) patients infected with CHC genotype 4 using a fibroscan. This cross-sectional observational study was conducted over two years on a cohort of 134 Egyptian patients on prevalent HD at Kasr Al Ainy Hospital. All patients were subjected to routine laboratory evaluation including, hepatitis B surface antigen, hepatitis B core antibody, hepatitis Be antigen, hepatitis C antibody (HCVAb) and human immunodeficiency virus antibody, quantitative polymerase chain reaction (PCR) for both HCV and hepatitis B virus (HBV), serum hyaluronic acid level, and alpha-fetoprotein (AFP). Fibroscan was performed on all HCV-positive patients. The mean age was 47.43 ± 12.65 years, 50.7% were male, and 49.3% were female. The most common causes of end-stage renal disease were hypertensive nephropathy (32.1%) and diabetic nephropathy (18.7%). HCVAb was positive in 57.5% of the patients and HBV was positive in 3%. Forty HCV-positive patients (57.1%) who underwent fibroscan had mild to significant fibrosis, and thirty patients (42.9%) had advanced fibrosis. There was significant correlation between HCV PCR and duration on HD, number of blood transfusions, and hyaluronic acid (HA) level. In addition, there was a significant correlation between serum HA and HD duration as well as liver fibrosis. No significant correlation was found between duration on HD and fibrosis stage (P = 0.619); also, no significant correlation was noted between the age of the patients and HA level or stage of fibrosis (P = 0.970). Fibro-scan is a simple noninvasive test that can be used to assess liver fibrosis in HD patients with CHC. Most of the study patients had mild to significant fibrosis.