Exists a role for serum irisin in Egyptian Behcet's patients with subclinical atherosclerosis?

OBJECTIVES: To examine the serum irisin level in a group of Behcet's disease patients, its association with illness parameters, and its utility in diagnosing subclinical atherosclerosis. METHODS: This randomized case-control study included 50 patients and 50 age- and sex-matched controls. Carotid Doppler ultrasound for the measurement of the carotid artery intima-media thickness (CIMT) and ankle-brachial pressure index (ABPI) were performed. A clinical evaluation, lipogram, and serum irisin were also performed. RESULTS: Between the patients and the control group, there was a significant difference in CIMT, S. irisin level, and ankle-brachial pressure index; however, gender and BMI did not significantly affect CIMT, ABPI, or S. irisin level. CIMT demonstrated a substantial negative correlation with both S. irisin and ABPI (r = - 0.62, P 0.0001). With a sensitivity of up to 94.30% and a specificity of 93.30%, the ROC analysis revealed that a decrease in S. irisin level in Behcet's patients was indicative of subclinical atherosclerosis. The drop in the ABPI level demonstrated a sensitivity of up to 94.30% and a specificity of 100%. CONCLUSION: Subclinical atherosclerosis is prevalent among Egyptian Behcet's patients, and S. irisin can be employed as a biomarker for diagnosing subclinical atherosclerosis in Behcet's illness. Key Points • Serum irisin has been studied in numerous autoimmune disorders as a marker for subclinical atherosclerosis, although its importance in Behcet's disease remains unclear (BD). • We examined the change in serum irisin levels in Behcet's disease patients and healthy controls. In addition, its association with carotid artery intima-media thickness (CIMT) and ankle-brachial pressure index was investigated (ABPI). • Changes in serum irisin levels are significant in BD, and a decrease in irisin level indicates subclinical atherosclerosis.

Reliability of shear wave elastography in the evaluation of diffuse thyroid diseases in children and adolescents.

PURPOSE: Thyroid diseases are common yet serious in children that lead to many metabolic and growth disorders; the most common among these are diffuse thyroid diseases (DTD). This study aimed to evaluate the reliability of shear wave elastography (SWE) to differentiate and diagnose DTD from normal thyroid tissue. METHOD: This prospective study included normal participants and patients with DTD. The subjects were assessed by clinical evaluation, laboratory investigation, conventional ultrasound, and Doppler examination, followed by SWE assessments. Statistical analysis was performed using the t-test and one-way ANOVA test, as appropriate. Receiver operating characteristic (ROC) curves were used to determine the best cutoff values to differentiate healthy participants from those with DTD and to differentiate between different types of DTD. RESULTS: The study included 74 patients with DTD and 20 healthy participants. The mean SWE values were 10.9 ± 1.78, 12.8 ± 2.1, 15.31 ± 2.95, and 17.26 ± 4.2 kPa for the normal participants and for patients with simple goiter, Hashimoto's thyroiditis (HT), or Grave's disease (GD), respectively. Statistically significant differences were noted between the mean SWE of the normal participants and that of patients with DTD, as well as between the mean SWE of patients with different types of DTD (P < 0.05). The best SWE cutoff values to differentiate a normal thyroid from DTD, HT from GD, HT from simple goiter, and GD from simple goiter were 12.8, 17.8, 13.4, and 13.9 kPa, respectively. CONCLUSIONS: SWE is a reliable diagnostic tool for differentiating normal thyroid tissue from DTD, as well as for differentiating between different types of DTD.

Effect of Direct-Acting Antiviral Therapy on Thrombocytopenic Patients with Hepatitis C Virus-Related Chronic Liver Disease.

BACKGROUND AND AIMS: Thrombocytopenia is a common complication in patients with chronic hepatitis C virus (HCV) that increases the risk of bleeding. We aimed to analyze the hematologic effects of the new direct-acting antiviral (DAA) therapy, particularly on the platelet count in chronic HCV-infected patients with thrombocytopenia. Patients and Methods. One hundred thrombocytopenic patients chronically infected with HCV were included in a prospective study. All patients were eligible for receiving anti-HCV treatment with sofosbuvir-based regimens for 12 weeks, according to the protocol of the National Program for treatment of HCV in Egypt sponsored by the Ministry of Health. RESULTS: At the end of treatment (EOT), there was a highly significant increase in platelet count (p < 0.001), a significant increase in white blood cells (WBCs) count (p ≤ 0.032), and a highly significant decrease in hemoglobin level (p < 0.001) as compared to pretreatment levels. Patients with mild to moderate hepatic fibrosis had significantly higher median and interquartile range (IQR) platelet count at baseline and EOT than those with advanced fibrosis and cirrhosis (p ≤ 0.023 and p < 0.001, respectively). There was more elevation in platelet count at EOT in patients with mild to moderate fibrosis than those with advanced fibrosis and cirrhosis. Out of the hundred patients, 73% showed improvement of platelet count, while 27% showed no improvement or even decrease in the platelet count. CONCLUSION: Sofosbuvir-based DAA therapy is a highly effective and safe treatment regimen that results in the improvement of platelet count in thrombocytopenic patients, particularly in mild to moderate stages of hepatic fibrosis.

Scrotal ultrasonographic findings in obese infertile patients and their correlations to semen and hormonal profile.

OBJECTIVE: The aim of this prospective study was to compare scrotal ultrasonographic findings in obese and normal weight infertile men and correlate these findings with semen parameters and hormonal profile. MATERIAL AND METHODS: A total of 188 men presented for infertility evaluation were included in this study. They were divided according to body mass indices into obese (n=96) and normal weight infertile patients (n=92). Basic infertility evaluation, semen analysis and scrotal duplex ultrasound examination in addition to measurement of serum levels of follicular stimulating hormone, testosterone and estradiol were done for all cases. The ratio between testicular size measured by scrotal ultrasound and body mass index were calculated. RESULTS: Any significant differences were not observed in semen parameters, serum levels of follicular stimulating hormone and testosterone between obese and normal weight infertile men (p>0.05). Serum estradiol level was significantly higher in obese than normal weight infertile men (p<0.001). There is significant increase in subclinical varicocele, hydrocele and testicular microlithiasis detected by scrotal ultrasound in obese infertile men than nonobese patients (p<0.05). Despite having comparable testicular size detected on scrotal ultrasound, infertile obese men had significantly lower total testicular volume to body mass index ratio and this ratio correlated positively with semen volume, sperm concentration, total sperm count and serum testosterone but negatively with serum follicular stimulating hormone and estradiol levels. CONCLUSION: We therefore conclude that the incidence of subclinical varicocele, hydrocele and testicular microlithiasis was higher in obese infertile patients and the ratio between testicular volume assessed by scrotal ultrasound and body mass index may be a new parameter that correlates with subfertility status in these men.