Efficacy and Safety of Colchicine in Pediatric Pericarditis: A Systematic Review and Future Directions.

Pediatric pericarditis presents challenges in its management, necessitating effective therapeutic interventions. Colchicine, known for its efficacy in adults, requires further investigation for its application and safety in pediatric cohorts. A systematic search across renowned databases identified relevant literature on colchicine use in pediatric pericarditis. Twenty-nine articles underwent rigorous screening, with 18 studies meeting inclusion criteria. Data extraction, quality assessment, and synthesis were conducted meticulously. Included studies comprised case reports, case series, and retrospective cohort studies. Colchicine demonstrated efficacy in reducing recurrence rates and symptom burden, with doses ranging from 0.25 mg/day to 2 mg/day. Adverse events were minimal, predominantly gastrointestinal. Notably, nausea was the most common side effect reported. The safety profile of colchicine was favorable, with rare instances of hepatic and hematologic toxicity. Colchicine emerges as a promising therapeutic option for pediatric pericarditis, demonstrating efficacy in reducing recurrence rates and alleviating symptoms. Its favorable safety profile suggests potential as a preferred long-term therapy. However, further research, including randomized controlled trials, is warranted to confirm its efficacy and safety and explore potential combination therapies.

The effect of intensive blood pressure lowering on left ventricular hypertrophy in patients with hypertension: a systematic review and meta-analysis of randomized controlled trials.

Background: We conducted a comprehensive systematic review to examine the efficacy of intensive blood pressure lowering on the risk of left ventricular hypertrophy (LVH). Methods: We searched PubMed, Scopus, Web of Science, Cochrane Central, and EMBASE for all relevant randomized controlled trials. The primary outcome was the incidence of left ventricular hypertrophy. We used the risk ratio (RR) and hazard ratio (HR) with a 95% confidence interval as our effect sizes. Results: Four studies, comprising 20,747 patients, were included. Intensive blood pressure lowering was linked with a diminished LVH incidence (RR: 0.66, 95% CI [0.56-0.77]). We also found that intensive blood pressure lowering increased the risk of LVH regression in patients with baseline LVH (RR: 1.21, 95% CI [1.11-1.32]). Finally, intensive blood pressure lowering was linked with a reduced risk of cardiovascular disease (HR: 0.71, 95% CI [0.60-0.85]). No significant heterogeneity was seen in either outcome. Conclusion: Our study suggests that intensive blood pressure lowering effectively reduces the risk of LVH and cardiovascular disease. An interactive version of our analysis can be accessed here: https://databoard.shinyapps.io/lvh_hypertophy/.

Novel insights on the potential activity of propolis and wheat germ oil against chronic toxoplasmosis in experimentally infected mice.

The use of apitherapy and natural herbal medicines for combating toxoplasmosis has garnered major attention from many researchers. However, there is no available information regarding the potential use of a combination of propolis and wheat germ oil (WGO) in the treatment of toxoplasmosis. In the present study, the potential effects of propolis, WGO, and their combination in the treatment of chronic toxoplasmosis in Swiss albino mice were investigated. Following induction of chronic toxoplasmosis, the potential antiparasitic effects of these substances were evaluated by parasitological assessment and by counting of Toxoplasma cysts. Additionally, the effects of the treatments on parasite loads were analyzed using TaqMan real-time quantitative PCR targeting the Toxoplasma P29 gene followed by investigation of the major histopathological changes in the brain, uterus, and kidney. Interestingly, the combination of propolis and WGO significantly (P ≤ 0.05) decreased the parasite burden in experimental animals compared with burdens seen in groups treated with propolis or WGO alone. Furthermore, the quantification of the DNA concentrations of Toxoplasma P29 gene after the treatment with propolis and WGO revealed a reduction in parasite load in treated groups versus the control group (infected untreated animals). Importantly, the severity of histopathological lesions was significantly (P ≤ 0.05) improved following treatment with propolis and WGO. Collectively, the present study indicated a potential novel role for propolis and WGO as an active apitherapy and natural herbal medication for treating chronic toxoplasmosis, combat the disease, and which could also help overcome the side effects of chemical drugs.

The Role of Silver Nanoparticles in a Treatment Approach for Multidrug-Resistant Salmonella Species Isolates.

PURPOSE: The main objective of this study is to investigate the antibacterial activity of silver nanoparticles (AgNPs) against multidrug-resistant Salmonella isolates recovered from diarrheic  sheep and goats. METHODS: This study used chemical reduction synthesis of AgNPs to evaluate their antimicrobial effects by estimation of minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) for each isolate using the microplate dilution method and tetrazolium salt reduction test to detect the viability percentage. In vivo treatment efficacy was assessed in mice by determining the viable count of Salmonella Enteritidis recovered from feces and by hematologic, biochemical and histopathologic examinations to confirm that use of AgNPs has no toxic or pathologic effects and to evaluate its ability in tissue regeneration following treatment. RESULTS: All recovered strains were identified as MDR with a prevalence of 4% and 3.6% in sheep and goats, respectively. The results of TEM, DLS, Zeta potential, and FTIR revealed typical characteristics of the synthesized AgNPs. Silver nanoparticles showed antibacterial activity against all recovered strains with MIC of ≤0.02-0.313 µg/mL (mean average 0.085±0.126 µg/mL) and MBC of 0.078-1.250 µg/mL (average 0.508±0.315 µg/mL). In vivo efficacy of AgNPs was observed by a reduction in the number of viable S. Enteritidis recovered from feces in an S. Enteritidis infected mouse model, with complete shedding stopping between treatment days 4 and 6. Hematologic, serum biochemical, and histopathologic analyses proved the ability of AgNPs to suppress inflammatory reaction caused by S. Enteritidis infection. CONCLUSION: The study proved the effective ability of AgNPs to fight MDR Salmonella spp. in vitro and in vivo without adverse effects.

Q fever: A neglected disease of camels in Giza and Cairo Provinces, Egypt.

BACKGROUND AND AIM: Q fever is a zoonotic disease caused by Coxiella burnetii. Cattle, sheep, and goat are the main reservoir of C. burnetii. In Egypt, the epidemiological data about C. burnetii in camels are limited. Therefore, the current study was conducted to identify C. burnetii infection in camels by different molecular tools and to estimate its seropositivity through the detection of anti-C. burnetii antibodies in camel sera. MATERIALS AND METHODS: Blood samples were collected 112 from camels in Giza and Cairo Provinces, Egypt. All blood samples were screened by trans-quantitative polymerase chain reaction (trans-qPCR) for C. burnetii and positive samples subjected to standard PCR using the superoxide dismutase enzyme coding gene of C. burnetii. Sera of studied camels were examined for the presence of antibodies against C. burnetii using enzyme-linked immunosorbent assay. RESULTS: Out of 112 camels, 19 were positive for C. burnetii by qPCR with an overall prevalence of 16.9% (18.6% in Giza and 15.1% in Cairo Provinces, respectively). The seroprevalence of anti-C. burnetii IgG antibodies in the examined camels was 4.5% (5/112). CONCLUSIONS: Trans-qPCR assay is a rapid and sensitive tool for the detection of C. burnetii in acute stage. Camels should be considered one of the major reservoirs for C. burnetii in Egypt.

Seroprevalence, isolation, molecular detection and genetic diversity of Toxoplasma gondii from small ruminants in Egypt.

Toxoplasmosis is an infectious zoonotic disease caused by protozoan Toxoplasma gondii. Detection of T. gondii infection with touchy and particular strategies is a key advance to control and prevent toxoplasmosis. Genotyping can explain the virulence, epidemiology and setting up new methodologies for diagnosis and control in human and animals. The point of this study was to assess the seroprevalence of T. gondii in sheep and goat in Egypt and to comprehend the genetic variety of T. gondii isolates circling in Egypt. Blood samples were gathered from 113 ewes and 95 she-goats from three Egyptian governorates (Cairo, Giza and Al-Sharkia). Also blood and tissue samples were gathered from 193 sheep and 51 goats from Cairo and Giza abattoirs. All samples were assayed serologically utilizing ELISA and OnSite Toxo IgG/IgM Rapid test cassettes (OTRT) tests and the tissue samples of the seropositive animals were digested and microscopically examined then bio-assayed in mice as viability test. All the T. gondii isolates undergo molecular identification using PCR and genotyped utilizing nPCR/RFLP analysis of SAG2 gene. The total seropositivity of live sheep and goat was 47.15 and 39.2% utilizing ELISA and OTRT respectively. Concerning abattoirs, seropositivity, positive microscopic examination, mice viability from sheep samples were 47.1%, 37.3% and 44.1% respectively while that of goats were 45.5%, 33.3% and 48.6% respectively. Eighteen T. gondii isolates were affirmed utilizing PCR. Genotyping confirmed 10 isolates (55.5%) as type II, 6 (33.3%) as type III and 2 (11.1%) as atypical genotypes. Type II and III are the genotypes mostly circling among small ruminants in Egypt and this is most significance for the public health in Egypt.

Falls in the Elderly Secondary to Urinary Symptoms.

Falls and fractures have a significant impact on our patients, their families, and caregivers, and cost the health care system billions of dollars. Each year, millions of adults aged 65 and older fall. Falls can cause moderate to severe injuries, such as hip fractures and head traumas, and can increase the risk of early death. Fortunately, falls are a public health problem that is largely preventable. Because many patients with falls and subsequent fractures have urologic conditions, urologists are positioned to help with the prevention of these significant and costly injuries. This article discusses the epidemiology of falls and fractures, and the urologic comorbidities that increase their risk.