Fetuin-A: a relevant novel serum biomarker for non-invasive diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD): a retrospective case-control study.

OBJECTIVES: To determine how fetuin-A contributes to diagnosing and assessing MASLD severity. METHODS: Fifty MASLD patients and fifty healthy control participants were involved in this retrospective case-control research. Abdominal ultrasonography, fibroscan with controlled attenuated parameter scan (CAP scan), laboratory investigation (including fetuin-A assessment), clinical examination, and history-taking were performed on every case. RESULTS: Fetuin-A level was considerably higher in the Cases group (1154.85 ± 629.89) than in the Control group (505.29 ± 150.4) (p < 0.001). Fetuin-A had significant validity in the prediction of MASLD at a cut-off > 702.5 with 82% sensitivity, 90% specificity, and 86% overall accuracy. CONCLUSION: One possible marker for MASLD diagnosis could be fetuin-A. Furthermore, a substantial association between such marker and the severity of the disease as it revealed a significant correlation with ultrasound grading and fibroscan with controlled attenuated parameters. Trial registration 1- Pan African Clinical Trial Registry. Unique Identifying number/registration ID: PACTR202309644280965. URL: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=26860 . Registration Approval date: 21/09/2023. 2- ClinicalTrials.gov. Unique Identifying number /registration ID: NCT06097039. URL: https://clinicaltrials.gov/study/NCT06097039?cond=NCT06097039&rank=1 . Registration Approval date: 25/10/2023.

Myocardial function using two dimension speckle-tracking echocardiography in children with celiac disease.

The prevalence of cardiac complications linked to celiac disease (CD) is on expanding. This study aimed to evaluate the cardiac function in children with CD using two dimensional speckle tracking echocardiography (2D-STE) to detect early myocardial dysfunction, if any. This cross-sectional study included 40 children with CD as the patient group and 40 healthy age- and sex-matched children served as the control group. High sensitive troponin T (Hs-troponin T), anti-tissue transglutaminase immunoglobulin A (tTG-IgA), hemoglobin, ferritin, albumin, and vitamin D levels were measured in all participants. Conventional, tissue Doppler imaging (TDI), and 2D-STE were performed for all included children. Conventional echocardiographic parameters showed no significant difference between the two groups. Left ventricular global longitudinal strain (LV GLS) obtained by 2D-STE was substantially lower in children with CD than the control group; however, myocardial performance index (MPI) obtained by TDI was significantly higher in children with CD. Hs-troponin T levels were comparable in both groups. LV GLS was positively correlated with hemoglobin, ferritin, and albumin level, but it was inversely correlated with the duration of the disease and anti tTG-IgA.    Conclusion: 2D-STE can detect subclinical early cardiac dysfunction in children with CD and this cardiac injury correlated to the duration and severity of the disease and some nutritional deficiency in these children. What is Known: • The prevalence of cardiac complications linked to celiac disease (CD) is on expanding. • Only one study evaluated cardiac function in children with CD using two dimensional speckle tracking echocardiography (2D-STE). What is New: • Our study found that 2D-STE can detect early subclinical cardiac dysfunction in children with CD. Cardiac injury in theses children correlated to the duration and severity of the disease, hemglobin, ferritin, and albumin levels.

Micro RNA 146a gene variant / TNF-α / IL-6 / IL-1 ß; A cross-link axis inbetween oxidative stress, endothelial dysfunction and neuro-inflammation in acute ischemic stroke and chronic schizophrenic patients.

This work was purposed to speculate the possible association of rs2910164hsa-miR-146a C>G gene single nucleotide polymorphism in the pathogenesis of schizophrenia and subsequently their relevance to neuro-inflammatory, vascular and oxidative stress pathways as acute ischemic stroke (AIS) risk factors in chronic schizophrenic patients. 450 subjects, 150 healthy controls (group I), 150 chronic schizophrenic patients without any evidences of stroke (group II) and 150 chronic schizophrenic patients with AIS (group III) were included. Genotypes (CC, CG&GG) for hsa-mir-146a gene polymorphism were identified using polymerase chain reaction-restriction fragment length polymorphism PCR-RFLP technique. Tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), interleukin 1ß (IL-1 ß), plasminogen activator-inhibitor 1 (PAI-1), thrombomodulin (TM) and 8-Hydroxy-2-deoxyguanosine (8-OHdG) serum levels were immunoassayed. Complete lipid profile was estimated. The CG and GG hsa-miR-146a genotypes were associated with increased risk of both schizophrenia and AIS in schizophrenic patients with thrombomodulin levels decrement in group II& III. On the other side, the risk genotypes were associated significantly with positive and negative syndrome scale PANSS scores, TNF-α, IL-6, IL-1 ß, PAI-1, and 8-OHdG increment levels in both groups II & III. By contrast, the CG and GG hsa-miR-146a genotypes did not affect the neuro-inflammatory and oxidative stress markers in healthy controls. These findings illustrate a new mechanism strengthening the occurrence of oxidative stress and DNA damage as a result of the neuro-inflammatory and endothelial dysfunction status originated from the hsa-miR-146a C>G gene single nucleotide polymorphism, thus, confirming their role in the pathogenesis of schizophrenia and its AIS risk.

DKK-1 in psoriatic arthritis: Correlation with disease activity and enthesopathy.

BACKGROUND: Psoriatic arthritis (PsA) is a complex inflammatory disease with varied clinical characteristics. A pathognomonic characteristic of PsA is enthesitis. Entheseal inflammation ultimately leads to the production of new bone (enthesophytes). Dickkopf-related protein-1 (DKK-1) is a wingless (Wnt) inhibitor that inhibits osteoblast function. OBJECTIVES: Assessment of the serum level of DKK-1 and its association with disease activity and enthesopathy in PsA patients. METHODS: This observational case-control study included 50 PsA patients and 50 healthy volunteers matched for age and gender. All participants were subjected to full medical history, clinical assessment, PSA activity using Disease Activity Index for Psoriatic Arthritis (DAPSA) score, the severity and extent of psoriasis were determined by the Psoriasis Area and Severity Index (PASI). Ultrasonographic assessment of the entheses was done in accordance with the Madrid Sonographic Enthesitis Index (MASEI). Serum level of DKK-1 and correlation with disease activity and enthesopathy in PsA patients were assessed. RESULTS: There was no significant difference between patients and controls regarding age and sex. The mean value of SPARCC index, DAPSA score and PASI score were 6.74±4.58, 33.24±15.26, and 8.35±10.93, respectively. There was significant difference between patients and controls regarding the serum levels of DKK-1 and MASEI score (p<0.0001). There was a significant positive correlation between serum DKK-1 and MASEI (r: 0.43527, p: 0.00158), MASEI inflammatory (r: 0.37958, p: 0.00655), and MASEI damage (r: 0.38384, p: 0.00593). CONCLUSIONS: Serum DKK-1 levels were elevated in PsA patients and were found to be correlated with MASEI score for enthesopathy.

The association of bacterial biofilm and middle ear mucosa in patients with mucosal chronic suppurative otitis media.

OBJECTIVES: To evaluate the bacterial biofilm's role in mucosal chronic suppurative otitis media (CSOM) utilizing scanning electron microscopy (SEM). METHODS: This study involved 123 participating patients with active and inactive mucosal CSOM who underwent tympanomastoid surgery. SEM was used to examine middle ear mucosa biopsies for the development of biofilms. Middle ear discharge or mucosal swabs from patients were cultured to detect any bacterial growth. The biofilm formation was correlated to the culture results. RESULTS: The biofilm was present in 69.9 % of patients (59% of them were with active mucosal CSOM) and absent in 30.1% of the patients (70% of them were with inactive mucosal CSOM), being more statistically significant in active mucosal CSOM (p-value = 0.003). A correlation that was statistically significant was found between active mucosal CSOM and higher grades (3 and 4) of biofilms (p-value <0.05). The mucosal CSOM type and the results of the culture had a relationship that was statistically significant (p-value <0.001). 60% of patients had positive culture (70% of them were with active mucosal CSOM). There was a statistically significant relation between Pseudomonas aeruginosa bacterial growth and active mucosal CSOM (p-value = 0.004) as well as higher grades of biofilms in mucosal CSOM. CONCLUSION: Mucosal CSOM, especially the active type, is a biofilm-related disease. There is a significant relation between the state of mucosal CSOM (active or inactive) and culture results with predominance of Pseudomonas aeruginosa bacterial growth in active mucosal CSOM and in higher grades of biofilms in mucosal CSOM.

Comparative Study between Nd-YAG laser, fractional CO2 Laser, and combined Nd-YAG with fractional CO2 Laser in the Management of keloid: clinical and molecular Study.

BACKGROUND: Fractional CO2 laser and Nd-YAG laser have been reported to have promising results in the management of keloids. So far, there have been no comparative studies between these laser modalities. AIMS: The study aimed to compare the efficacy of fractional CO2, Nd-YAG, and a combination of both in the management of keloids. PATIENTS AND METHODS: Forty-five keloid patients were divided into 3 equal groups: the first received fractional CO2 only, the second received Nd-YAG only, and the third received a combination of both lasers. Each group received its designated treatment every 4 weeks for 4 sessions. The improvement was evaluated by the "Patient and Observer Scar Assessment Scale" (POSAS). Detection of procollagen I mRNA by RT-PCR analysis was done. RESULTS: The assessment by POSAS showed the most significant clinical improvement in the combination group and a less significant improvement in the fractional CO2 group, while the least improvement was seen in the Nd-YAG group. Molecular assessment via procollagen I yielded matching results. CONCLUSION: The study showed that the combination of fractional CO2 and Nd-YAG lasers has a synergistic effect being the most effective in the management of keloids, fractional CO2 being more effective than ND-YAG and Nd-YAG being the least effective.

Early Biomarkers in Neonatal Necrotizing Enterocolitis: A Pilot Study.

BACKGROUND: Necrotizing enterocolitis (NEC) is a frequent serious disease of the digestive system in neonates. It is considered as an important cause of serious neonatal complication and death. Therefore, its early suspicion and proper management are important. AIM: Early and sensitive detection of neonatal NEC through determination of levels of fecal calprotectin (FCP), serum levels of procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), epithelial neutrophil activating peptide-78 (ENA-78), and interleukin 18 (IL-18). METHOD: This prospective case control study was conducted in Tanta University Hospital from June 2016 to March 2018. The study included 20 healthy neonates (control group) and 20 NEC newborn patients. They were all subjected to the measurement of levels of FCP and serum levels of hs-CRP, PCT, ENA-78, IL-18, Malondialdehyde (MDA), and total antioxidant capacity (TAC). Receiver operating characteristic (ROC) curve analysis was conducted for FCP, ENA-78, PCT, hs-CRP, and IL-18. RESULTS: The study found a detectable increase in FCP level and serum levels of hs-CRP, PCT, ENA-78, IL-18, and MDA in NEC group in comparison to their levels in the control group. Also, it found a detectable decline in the levels of TAC in comparison to its level in the control group. CONCLUSION: FCP, ENA-78, and PCT can be considered as early markers for diagnosis of NEC.

DKK-1 in psoriatic arthritis: Correlation with disease activity and enthesopathy / DKK-1 en artritis psoriásica: correlación con la actividad de la enfermedad y la entesopatía

Background: Psoriatic arthritis (PsA) is a complex inflammatory disease with varied clinical characteristics. A pathognomonic characteristic of PsA is enthesitis. Entheseal inflammation ultimately leads to the production of new bone (enthesophytes). Dickkopf-related protein-1 (DKK-1) is a wingless (Wnt) inhibitor that inhibits osteoblast function. Objectives: Assessment of the serum level of DKK-1 and its association with disease activity and enthesopathy in PsA patients. Methods: This observational case–control study included 50 PsA patients and 50 healthy volunteers matched for age and gender. All participants were subjected to full medical history, clinical assessment, PSA activity using Disease Activity Index for Psoriatic Arthritis (DAPSA) score, the severity and extent of psoriasis were determined by the Psoriasis Area and Severity Index (PASI). Ultrasonographic assessment of the entheses was done in accordance with the Madrid Sonographic Enthesitis Index (MASEI). Serum level of DKK-1 and correlation with disease activity and enthesopathy in PsA patients were assessed. Results: There was no significant difference between patients and controls regarding age and sex. The mean value of SPARCC index, DAPSA score and PASI score were 6.74±4.58, 33.24±15.26, and 8.35±10.93, respectively. There was significant difference between patients and controls regarding the serum levels of DKK-1 and MASEI score (p<0.0001). There was a significant positive correlation between serum DKK-1 and MASEI (r: 0.43527, p: 0.00158), MASEI inflammatory (r: 0.37958, p: 0.00655), and MASEI damage (r: 0.38384, p: 0.00593). Conclusions: Serum DKK-1 levels were elevated in PsA patients and were found to be correlated with MASEI score for enthesopathy.(AU)

Antecedentes: La artritis psoriásica (APs) es una enfermedad inflamatoria compleja con características clínicas variadas. Una característica patognomónica de la artritis psoriásica es la entesitis. La inflamación entesófila finalmente conduce a la producción de hueso nuevo (entesófitos). La proteína 1 relacionada con dickkopf (DKK-1) es un inhibidor sin alas (Wnt) que inhibe la función de los osteoblastos. Objetivos: Evaluación del nivel sérico de DKK-1 y su asociación con la actividad de la enfermedad y la entesopatía en pacientes con APs. Métodos: Este estudio observacional de casos y controles; incluyó a 50 pacientes con artritis psoriásica y 50 voluntarios sanos emparejados por edad y sexo. Todos los participantes fueron sometidos a historia clínica completa, evaluación clínica, actividad de APs utilizando la puntuación del Índice de Actividad de la Enfermedad para la Artritis Psoriásica (DAPSA), la gravedad y la extensión de la psoriasis fueron determinadas por el área de psoriasis y el índice de gravedad (PASI). La evaluación ultrasonográfica de las entesis se realizó de acuerdo con el índice de entesitis sonográfica de Madrid (MASEI). Se evaluó el nivel sérico de DKK-1 y la correlación con la actividad de la enfermedad y la entesopatía en pacientes con artritis psoriásica. Resultados: No hubo diferencias significativas entre los pacientes y los controles con respecto a la edad y el sexo. El valor medio del índice SPARCC, la puntuación DAPSA y la puntuación PASI fueron 6,74±4,58, 33,24±15,26 y 8,35±10,93 respectivamente. Hubo diferencia significativa entre pacientes y controles con respecto a los niveles séricos de DKK-1 y la puntuación MASEI (p <0,0001). Hubo correlación positiva significativa entre DKK-1 sérico y MASEI (r: 0,43527, p = 0,00158), y daño MASEI (r: 0.38384, p = 0,00593). Conclusiones: Los niveles séricos de DKK-1 se elevaron en pacientes con APs y se encontró que estaban correlacionados con la puntuación MASEI para la entesopatía.(AU)