Pub Date : 2021-01-01DOI: 10.1080/20905068.2021.1987111
Mohamed Mamdouh Elsayed, M. Zeid, A. Fayed, Ehab Elreweny, N. H. Zakaria, A. Baess
ABSTRACT Introduction Among the main causes of mortality in COVID-19 patients is cytokine storm (CS) state. Few treatment options with variable efficacy results are available for its management. We aimed to illustrate the efficacy of Therapeutic Plasma Exchange (TPE) treatment in COVID-19 patients with resistant CS. Material and methods This research is a prospective pilot study which included ten COVID-19 positive patients with CS state with no response after two doses of tocilizumab. Each patient received three to five TPE sessions according to his/her response. Respiratory status {oxygen (O2) requirements and data of mechanical ventilation} and laboratory markers (IL-6, CRP, ferritin, D dimer, LDH) were assessed before and after TPE. We reported mortality at 28 day of illness. Results Six males and four females were enrolled in the study with a mean age of (52.9 years). Seven patients (70%) were on mechanical ventilation (MV). After TPE, oxygenation parameters and most laboratory markers improved significantly in all patients (p < 0.05). Four patients survived and were discharged (40%). One was on MV and three were not. The four patients had better hypoxic index (PaO2/FiO2 ratio) (˃100 vs <100), started TPE sooner after tocilizumab failure (2–3 vs 5–6 days), needed fewer TPE sessions (3 vs 4–5, p = 0.03), and less duration in ICU (6.5 vs 12.5 days) compared to those who did not benefit. Conclusions In patients with CS state who did not respond well to tocilizumab and steroids, TPE could be a good option. Larger randomized clinical trials are needed to support its use. Clinical trials registration ClinicalTrials.gov Identifier:NCT04457349
{"title":"Does therapeutic plasma exchange have a role in resistant cytokine storm state of COVID-19 infection?","authors":"Mohamed Mamdouh Elsayed, M. Zeid, A. Fayed, Ehab Elreweny, N. H. Zakaria, A. Baess","doi":"10.1080/20905068.2021.1987111","DOIUrl":"https://doi.org/10.1080/20905068.2021.1987111","url":null,"abstract":"ABSTRACT Introduction Among the main causes of mortality in COVID-19 patients is cytokine storm (CS) state. Few treatment options with variable efficacy results are available for its management. We aimed to illustrate the efficacy of Therapeutic Plasma Exchange (TPE) treatment in COVID-19 patients with resistant CS. Material and methods This research is a prospective pilot study which included ten COVID-19 positive patients with CS state with no response after two doses of tocilizumab. Each patient received three to five TPE sessions according to his/her response. Respiratory status {oxygen (O2) requirements and data of mechanical ventilation} and laboratory markers (IL-6, CRP, ferritin, D dimer, LDH) were assessed before and after TPE. We reported mortality at 28 day of illness. Results Six males and four females were enrolled in the study with a mean age of (52.9 years). Seven patients (70%) were on mechanical ventilation (MV). After TPE, oxygenation parameters and most laboratory markers improved significantly in all patients (p < 0.05). Four patients survived and were discharged (40%). One was on MV and three were not. The four patients had better hypoxic index (PaO2/FiO2 ratio) (˃100 vs <100), started TPE sooner after tocilizumab failure (2–3 vs 5–6 days), needed fewer TPE sessions (3 vs 4–5, p = 0.03), and less duration in ICU (6.5 vs 12.5 days) compared to those who did not benefit. Conclusions In patients with CS state who did not respond well to tocilizumab and steroids, TPE could be a good option. Larger randomized clinical trials are needed to support its use. Clinical trials registration ClinicalTrials.gov Identifier:NCT04457349","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"57 1","pages":"235 - 239"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46487415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-31DOI: 10.1080/20905068.2020.1851441
Kenneth Ssekatawa, D. Byarugaba, C. Kato, E. Wampande, F. Ejobi, R. Tweyongyere, J. Nakavuma
ABSTRACT Background: For over a decade, resistance to newly synthesized antibiotics has been observed worldwide. The challenge of antibiotic resistance has led to several pharmaceutical companies to abandon the synthesis of new drugs in fear of bacteria developing resistance in a short period hence limiting initial investment return. To this effect, alternative approaches such as the use of bacteriophages to treat bacterial infections are being explored. This review explores the recent advances in phage-mediated antibacterial applications and their limitations. Methods: We conducted a comprehensive literature search of PubMed, Lib Hub and Google Scholar databases from January 2019 to November 2019. The search key words used were the application of bacteriophages to inhibit bacterial growth and human phage therapy to extract full-text research articles and proceedings from International Conferences published only in English. Results: The search generated 709 articles of which 95 full-text research articles fulfilled the inclusion guidelines. Transmission Electron Microscopy morphological characterization conducted in 23 studies registered Myoviruses, Siphoviruses, Podoviruses, and Cytoviruses phage families while molecular characterization revealed that some phages were not safe to use as they harbored undesirable genes. All in vivo phage therapy studies in humans and model animals against multidrug-resistant (MDR) bacterial infection provided 100% protection. Ex vivo and in vitro phage therapy experiments exhibited overwhelming results as they registered high efficacies of up to 100% against MDR clinical isolates. Phage-mediated bio-preservation of foods and beverages and bio-sanitization of surfaces were highly successful with bacterial growth suppression of up to 100%. Phage endolysins revealed efficacies statistically comparable to those of phages and restored normal ethanol production by completely eradicating lactic acid bacteria in ethanol fermenters. Furthermore, the average multiplicity of infection was highest in ex vivo phage therapy (557,291.8) followed by in vivo (155,612.4) and in vitro (434.5).
{"title":"A review of phage mediated antibacterial applications","authors":"Kenneth Ssekatawa, D. Byarugaba, C. Kato, E. Wampande, F. Ejobi, R. Tweyongyere, J. Nakavuma","doi":"10.1080/20905068.2020.1851441","DOIUrl":"https://doi.org/10.1080/20905068.2020.1851441","url":null,"abstract":"ABSTRACT Background: For over a decade, resistance to newly synthesized antibiotics has been observed worldwide. The challenge of antibiotic resistance has led to several pharmaceutical companies to abandon the synthesis of new drugs in fear of bacteria developing resistance in a short period hence limiting initial investment return. To this effect, alternative approaches such as the use of bacteriophages to treat bacterial infections are being explored. This review explores the recent advances in phage-mediated antibacterial applications and their limitations. Methods: We conducted a comprehensive literature search of PubMed, Lib Hub and Google Scholar databases from January 2019 to November 2019. The search key words used were the application of bacteriophages to inhibit bacterial growth and human phage therapy to extract full-text research articles and proceedings from International Conferences published only in English. Results: The search generated 709 articles of which 95 full-text research articles fulfilled the inclusion guidelines. Transmission Electron Microscopy morphological characterization conducted in 23 studies registered Myoviruses, Siphoviruses, Podoviruses, and Cytoviruses phage families while molecular characterization revealed that some phages were not safe to use as they harbored undesirable genes. All in vivo phage therapy studies in humans and model animals against multidrug-resistant (MDR) bacterial infection provided 100% protection. Ex vivo and in vitro phage therapy experiments exhibited overwhelming results as they registered high efficacies of up to 100% against MDR clinical isolates. Phage-mediated bio-preservation of foods and beverages and bio-sanitization of surfaces were highly successful with bacterial growth suppression of up to 100%. Phage endolysins revealed efficacies statistically comparable to those of phages and restored normal ethanol production by completely eradicating lactic acid bacteria in ethanol fermenters. Furthermore, the average multiplicity of infection was highest in ex vivo phage therapy (557,291.8) followed by in vivo (155,612.4) and in vitro (434.5).","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"57 1","pages":"1 - 20"},"PeriodicalIF":0.9,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1851441","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41784337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1720970
A. Babayo, I. Abdullahi, Mansur Bala Safiyanu, H. Adekola, J. Usman
ABSTRACT Introduction: Human T-cell lymphotropic virus (HTLV) is associated with shorter survival of HIV co-infected persons due to masked immunosuppression. Since both retroviruses share similar routes of transmission, there is a need to determine risk factors associated with these pathogens. This study aimed to assess the risk factors associated with HTLV-1/-2 and HIV co-infected among persons attending a secondary hospital in Ningi, Bauchi State, Nigeria. Methods: Blood samples were collected from 182 HIV infected persons and analysed for anti-HTLV-1/2 IgM and IgG antibodies using commercial Enzyme-Linked Immunosorbent Assay (ELISA) kits. Interviewer-based questionnaire were used to collate sociodemographic and risk factor data of the subjects and clinical history were obtained from participants’ medical records. Results: The seroprevalence of anti-HTLV-1/-2 IgM and IgG were 9.9% and 19.8%, respectively. Out of the 80 ART-naïve, 25 (31.3%) were IgM seropositive. Out of 102 ART-experienced, 11 (10.8%) were anti-HTLV-1/-2 IgM positive. There was a significant association between ART status and seroprevalence of anti-HTLV-1/-2 IgM (p=0.009). However, there was no significance association between seroprevalence of HTLV IgM and gender of the subjects (p=0.06). There was a significant association between the seroprevalence of anti-HTLV-1/-2 IgG and education level of subjects (p=0.039). However, no association between anti-HTLV-1/-2 IgG and other sociodemographic variables studied (p˃ 0.05). History of injury from sharp objects (aOR: 5.3, p<0.0001) and consistent protective sexual practice (aOR: 2.27, p=0.033) were associated with seroprevalence of anti-HTLV-1/-2 IgM. Discussion: High seroprevalence of HTLV-1/-2 and HIV co-infection was reported. ART status, protective sexual intercourse and injuries with sharp objects were identified risk factors of co-infection. It’s recommended to consider HTLV screening for all HIV infected persons and vice versa.
{"title":"Assessment of risk factors associated with HTLV-1/-2 infection among people living with HIV/AIDS in Bauchi State, Nigeria","authors":"A. Babayo, I. Abdullahi, Mansur Bala Safiyanu, H. Adekola, J. Usman","doi":"10.1080/20905068.2020.1720970","DOIUrl":"https://doi.org/10.1080/20905068.2020.1720970","url":null,"abstract":"ABSTRACT Introduction: Human T-cell lymphotropic virus (HTLV) is associated with shorter survival of HIV co-infected persons due to masked immunosuppression. Since both retroviruses share similar routes of transmission, there is a need to determine risk factors associated with these pathogens. This study aimed to assess the risk factors associated with HTLV-1/-2 and HIV co-infected among persons attending a secondary hospital in Ningi, Bauchi State, Nigeria. Methods: Blood samples were collected from 182 HIV infected persons and analysed for anti-HTLV-1/2 IgM and IgG antibodies using commercial Enzyme-Linked Immunosorbent Assay (ELISA) kits. Interviewer-based questionnaire were used to collate sociodemographic and risk factor data of the subjects and clinical history were obtained from participants’ medical records. Results: The seroprevalence of anti-HTLV-1/-2 IgM and IgG were 9.9% and 19.8%, respectively. Out of the 80 ART-naïve, 25 (31.3%) were IgM seropositive. Out of 102 ART-experienced, 11 (10.8%) were anti-HTLV-1/-2 IgM positive. There was a significant association between ART status and seroprevalence of anti-HTLV-1/-2 IgM (p=0.009). However, there was no significance association between seroprevalence of HTLV IgM and gender of the subjects (p=0.06). There was a significant association between the seroprevalence of anti-HTLV-1/-2 IgG and education level of subjects (p=0.039). However, no association between anti-HTLV-1/-2 IgG and other sociodemographic variables studied (p˃ 0.05). History of injury from sharp objects (aOR: 5.3, p<0.0001) and consistent protective sexual practice (aOR: 2.27, p=0.033) were associated with seroprevalence of anti-HTLV-1/-2 IgM. Discussion: High seroprevalence of HTLV-1/-2 and HIV co-infection was reported. ART status, protective sexual intercourse and injuries with sharp objects were identified risk factors of co-infection. It’s recommended to consider HTLV screening for all HIV infected persons and vice versa.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"56 1","pages":"27 - 31"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1720970","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42942626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1838749
Ahmed Emira, L. Madkour, N. Seif, R. Dwedar
ABSTRACT Introduction Carbapenemase-producing Gram-negative bacilli have been major culprits in hospital-associated infections (HAIs), particularly in critically ill patients suffering device-associated infections (DAIs). The current study aimed to investigate the performance of the modified Hodge test (MHT) as a phenotypic confirmatory method for the detection of carbapenemase-producing Gram-negative bacilli and to compare it to the gold standard PCR for the detection of carbapenemase production in both non-susceptible and phenotypically susceptible isolates. The latter were expected to harbor silent carbapenemase genes, as suspected from the inappropriate response to carbapenem therapy. Methods Ninety-five bacterial isolates from 75 critically ill patients were collected over 6 months from several ICUs at Cairo University Hospitals. The isolates were subjected to antibiotic susceptibility testing (AST) for carbapenems and were further screened by MHT, followed by genotypic analysis via multiplex PCR. Results Enterobacteriaceae were the most commonly isolated pathogens (55.8% of the total isolates), followed by Acinetobacter spp. (24%). Lower respiratory tract infections were the most common HAIs (42.11%), followed by surgical site infections (27.37%). All isolates demonstrating carbapenem resistance by AST were found to harbor at least one of the following carbapenemase genes: blaKPC, blaOXA-48, blaIPM, blaVIM, and blaNDM-1 . Alarmingly, 97.8% of the isolates which exhibited carbapenem-susceptible profile and negative MHT were harboring carbapenemase genes as confirmed by multiplex PCR. With the exception of one isolate (E. coli) which was not harboring any carbapenemase gene, the remaining 94 bacterial isolates were found to carry either a single or multiple carbapenemase genes. Conclusion The silent dissemination of different classes of carbapenemases even in isolates with negative MHT is a daunting challenge. It necessitates the implementation of strict antibiotic stewardship along with updated and actionable approach to detect non-expressed carbapenemase genes in phenotypically susceptible isolates.
{"title":"Expressed and Silent Carbapenemase Genes Detected by Multiplex PCR in both Carbapenem-Resistant and Phenotypically-Susceptible Gram Negative Bacilli","authors":"Ahmed Emira, L. Madkour, N. Seif, R. Dwedar","doi":"10.1080/20905068.2020.1838749","DOIUrl":"https://doi.org/10.1080/20905068.2020.1838749","url":null,"abstract":"ABSTRACT Introduction Carbapenemase-producing Gram-negative bacilli have been major culprits in hospital-associated infections (HAIs), particularly in critically ill patients suffering device-associated infections (DAIs). The current study aimed to investigate the performance of the modified Hodge test (MHT) as a phenotypic confirmatory method for the detection of carbapenemase-producing Gram-negative bacilli and to compare it to the gold standard PCR for the detection of carbapenemase production in both non-susceptible and phenotypically susceptible isolates. The latter were expected to harbor silent carbapenemase genes, as suspected from the inappropriate response to carbapenem therapy. Methods Ninety-five bacterial isolates from 75 critically ill patients were collected over 6 months from several ICUs at Cairo University Hospitals. The isolates were subjected to antibiotic susceptibility testing (AST) for carbapenems and were further screened by MHT, followed by genotypic analysis via multiplex PCR. Results Enterobacteriaceae were the most commonly isolated pathogens (55.8% of the total isolates), followed by Acinetobacter spp. (24%). Lower respiratory tract infections were the most common HAIs (42.11%), followed by surgical site infections (27.37%). All isolates demonstrating carbapenem resistance by AST were found to harbor at least one of the following carbapenemase genes: blaKPC, blaOXA-48, blaIPM, blaVIM, and blaNDM-1 . Alarmingly, 97.8% of the isolates which exhibited carbapenem-susceptible profile and negative MHT were harboring carbapenemase genes as confirmed by multiplex PCR. With the exception of one isolate (E. coli) which was not harboring any carbapenemase gene, the remaining 94 bacterial isolates were found to carry either a single or multiple carbapenemase genes. Conclusion The silent dissemination of different classes of carbapenemases even in isolates with negative MHT is a daunting challenge. It necessitates the implementation of strict antibiotic stewardship along with updated and actionable approach to detect non-expressed carbapenemase genes in phenotypically susceptible isolates.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"56 1","pages":"181 - 188"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1838749","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45410089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1750863
M. A. Helmy, Adham F. Mohamed, H. Rasheed, Amira I. Fayad
ABSTRACT Background: Adipose tissue (AT) is a rich source of mesenchymal stem cells (MSCs), however, there is no standardized protocol for stem cell isolation and culture. This leads to inconsistency of the results and limits the comparison of the data from different laboratories. Our aim was to provide an applied protocol for ASCS isolation and expansion, study the cell behavior and define their cellular surface markers. ASCs were cultured from both resected adipose tissue (RAT) obtained following abdominoplasty or breast reduction and lipoaspirates (LPA) following laser-free liposuction. Method: the protocol entailed coculturing of stromal vascular fraction (SVF) with RAT as raw pieces using DMEM medium with varying glucose concentration. The coculture protocol aimed to mimic the normal physiological conditions required for cell growth. ASCs were immunophenotyped to define their MSCs surface markers by flowcytometry. Results: ASCs were isolated from coculturing RAT with SVF with fibroblast-like adherent cells morphology. The ASCs yield isolated from LPA was significantly greater than from RAT on day 14 and 28 (p = 0.002, <0.001, respectively). Significant increase in ASCs proliferation rate was detected when ASCs were cultured under high glucose (4.5 g/L) compared to low glucose (1 g/L) condition on day 7 and 14 (p = 0.04, 0.015, respectively). ASCs isolated from both protocols were positive for CD34, CD49d, CD73, CD90 and CD105 and negative for CD3, CD14, CD19, CD45 and HLA-DR. Conclusion: We concluded that the cells harvested by our protocol were ASCs. Hence, our method can be an efficient isolation tool to obtain primary ASCs under culture conditions mimicking normal physiological status. This will help in providing ASCs which can be similar to cells in human tissue for further study.
{"title":"A protocol for primary isolation and culture of adipose-derived stem cells and their phenotypic profile","authors":"M. A. Helmy, Adham F. Mohamed, H. Rasheed, Amira I. Fayad","doi":"10.1080/20905068.2020.1750863","DOIUrl":"https://doi.org/10.1080/20905068.2020.1750863","url":null,"abstract":"ABSTRACT Background: Adipose tissue (AT) is a rich source of mesenchymal stem cells (MSCs), however, there is no standardized protocol for stem cell isolation and culture. This leads to inconsistency of the results and limits the comparison of the data from different laboratories. Our aim was to provide an applied protocol for ASCS isolation and expansion, study the cell behavior and define their cellular surface markers. ASCs were cultured from both resected adipose tissue (RAT) obtained following abdominoplasty or breast reduction and lipoaspirates (LPA) following laser-free liposuction. Method: the protocol entailed coculturing of stromal vascular fraction (SVF) with RAT as raw pieces using DMEM medium with varying glucose concentration. The coculture protocol aimed to mimic the normal physiological conditions required for cell growth. ASCs were immunophenotyped to define their MSCs surface markers by flowcytometry. Results: ASCs were isolated from coculturing RAT with SVF with fibroblast-like adherent cells morphology. The ASCs yield isolated from LPA was significantly greater than from RAT on day 14 and 28 (p = 0.002, <0.001, respectively). Significant increase in ASCs proliferation rate was detected when ASCs were cultured under high glucose (4.5 g/L) compared to low glucose (1 g/L) condition on day 7 and 14 (p = 0.04, 0.015, respectively). ASCs isolated from both protocols were positive for CD34, CD49d, CD73, CD90 and CD105 and negative for CD3, CD14, CD19, CD45 and HLA-DR. Conclusion: We concluded that the cells harvested by our protocol were ASCs. Hence, our method can be an efficient isolation tool to obtain primary ASCs under culture conditions mimicking normal physiological status. This will help in providing ASCs which can be similar to cells in human tissue for further study.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"56 1","pages":"42 - 50"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1750863","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44394037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1769391
S. Gaber, R. Bassyouni, Mohamed Masoud, F. Ahmed
ABSTRACT Introduction Colonized Healthcare workers (HCWs) are an essential reservoir of nosocomial infections. This study aims to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carriage rate among HCWs, to evaluate at Fayoum University Hospital the susceptibility of isolates to mupirocin and Chlorhexidine and to investigate the antimicrobial effect of different vinegars on MRSA as a natural decolonizing agent. Methods Nasal and hand swabs were collected from 124 HCWs at Fayoum University Surgical Hospital. Isolates were identified using the standard microbiological methods. Susceptibilities to mupirocin and Chlorhexidine were determined by disk diffusion and broth micro-dilution. Screening antimicrobial effect of commercial vinegars was determined by agar well-diffusion method and microdilution method. Results About one tenth 11.3% (14/124) of HCWs showed nasal carriage of MRSA. Workers were the predominant carriers (P = 0.013). The overall non-nasal carriage rate of MRSA was 6.5% (8/124). Among MRSA isolates Low-level Mupirocin resistance (LLMR) showed in (36.4%, 8/22). MICs ranged from 0.25 to 32 µg/ml. Also, (13.6 %, 3/22) showed Chlorhexidine resistance, MICs ranged from 0.039 to 5 µg/ml. Apple vinegar showed the highest susceptibility among vinegars (p < 0.0001) with MIC values varied from 0.058 to 1.87 μg/ml Discussion The emergence of mupirocin (36.4%) and Chlorhexidine (13.6%) resistant Staphylococcus aureus among HCWs should be of excessive concern. Apple vinegar has a promising antimicrobial effect against MRSA isolates and could be used as a decolonizing agent.
{"title":"Promising anti-microbial effect of apple vinegar as a natural decolonizing agent in healthcare workers","authors":"S. Gaber, R. Bassyouni, Mohamed Masoud, F. Ahmed","doi":"10.1080/20905068.2020.1769391","DOIUrl":"https://doi.org/10.1080/20905068.2020.1769391","url":null,"abstract":"ABSTRACT Introduction Colonized Healthcare workers (HCWs) are an essential reservoir of nosocomial infections. This study aims to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carriage rate among HCWs, to evaluate at Fayoum University Hospital the susceptibility of isolates to mupirocin and Chlorhexidine and to investigate the antimicrobial effect of different vinegars on MRSA as a natural decolonizing agent. Methods Nasal and hand swabs were collected from 124 HCWs at Fayoum University Surgical Hospital. Isolates were identified using the standard microbiological methods. Susceptibilities to mupirocin and Chlorhexidine were determined by disk diffusion and broth micro-dilution. Screening antimicrobial effect of commercial vinegars was determined by agar well-diffusion method and microdilution method. Results About one tenth 11.3% (14/124) of HCWs showed nasal carriage of MRSA. Workers were the predominant carriers (P = 0.013). The overall non-nasal carriage rate of MRSA was 6.5% (8/124). Among MRSA isolates Low-level Mupirocin resistance (LLMR) showed in (36.4%, 8/22). MICs ranged from 0.25 to 32 µg/ml. Also, (13.6 %, 3/22) showed Chlorhexidine resistance, MICs ranged from 0.039 to 5 µg/ml. Apple vinegar showed the highest susceptibility among vinegars (p < 0.0001) with MIC values varied from 0.058 to 1.87 μg/ml Discussion The emergence of mupirocin (36.4%) and Chlorhexidine (13.6%) resistant Staphylococcus aureus among HCWs should be of excessive concern. Apple vinegar has a promising antimicrobial effect against MRSA isolates and could be used as a decolonizing agent.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"56 1","pages":"73 - 80"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1769391","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45901622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1827944
R. Dwedar, Noha Omar, S. Eissa, Abdelrahman Younes Aly Badawy, D. El-Kareem, Lamiaa Abd El-Fattah Ahmed Madkour
ABSTRACT Introduction Human papillomavirus (HPV) is identified as a culprit in a subset of head and neck squamous cell carcinomas (HNSCCs). The clinicopathologic profile displayed by this subset diverges from that of HPV-negative HNSCCs. Despite a variety of available tests, there is no consensus on which technique is the best for detection of HPV in HNSCCs. Although this field has received substantial interest within different continents, African and Egyptian populations are not yet well studied within the literature. Methods This cross-sectional study was carried out to detect HPV prevalence in HNSSC and to correlate the viral prevalence with different clinicopathologic parameters as well as with the patients’ outcome. For 51 patients with HNSCC, HPV-16 DNA was determined via PCR, while E6/E7 mRNA was detected employing real-time PCR. Immunohistochemistry (IHC) was performed to assess p16 status. Results P16 was overexpressed in 49% of cases, while HPV-16 DNA was detected in 52.9% of cases, and likewise, E6/E7 mRNA was found in 52.9% of cases. There was a very good agreement between HPV16 DNA and RNA results (κ = 0.843, P-value <0.001). Meanwhile, a good agreement was revealed between HPV16 DNA and p16 IHC results (κ = 0.608, P-value <0.001). Similarly, there was a good agreement between HPV RNA results and p16 IHC results (κ = 0.608, P-value <0.001). By the end of the study period, 13.7% of the enrolled patients died, with the overall survival of the studied patients being 17.29 months. Of note, there was no statistically significant correlation between the overall survival and HPV status. Conclusion The present study highlights the significant role played by HPV in HNSCC. Furthermore, it reveals that although p16 has been a marker of HPV existence in HNSCC, it should not be the sole determinant of HPV role in tumorigenesis.
{"title":"Diagnostic and prognostic impact of E6/E7 mRNA compared to HPV DNA and p16 expression in head and neck cancers: an Egyptian study","authors":"R. Dwedar, Noha Omar, S. Eissa, Abdelrahman Younes Aly Badawy, D. El-Kareem, Lamiaa Abd El-Fattah Ahmed Madkour","doi":"10.1080/20905068.2020.1827944","DOIUrl":"https://doi.org/10.1080/20905068.2020.1827944","url":null,"abstract":"ABSTRACT Introduction Human papillomavirus (HPV) is identified as a culprit in a subset of head and neck squamous cell carcinomas (HNSCCs). The clinicopathologic profile displayed by this subset diverges from that of HPV-negative HNSCCs. Despite a variety of available tests, there is no consensus on which technique is the best for detection of HPV in HNSCCs. Although this field has received substantial interest within different continents, African and Egyptian populations are not yet well studied within the literature. Methods This cross-sectional study was carried out to detect HPV prevalence in HNSSC and to correlate the viral prevalence with different clinicopathologic parameters as well as with the patients’ outcome. For 51 patients with HNSCC, HPV-16 DNA was determined via PCR, while E6/E7 mRNA was detected employing real-time PCR. Immunohistochemistry (IHC) was performed to assess p16 status. Results P16 was overexpressed in 49% of cases, while HPV-16 DNA was detected in 52.9% of cases, and likewise, E6/E7 mRNA was found in 52.9% of cases. There was a very good agreement between HPV16 DNA and RNA results (κ = 0.843, P-value <0.001). Meanwhile, a good agreement was revealed between HPV16 DNA and p16 IHC results (κ = 0.608, P-value <0.001). Similarly, there was a good agreement between HPV RNA results and p16 IHC results (κ = 0.608, P-value <0.001). By the end of the study period, 13.7% of the enrolled patients died, with the overall survival of the studied patients being 17.29 months. Of note, there was no statistically significant correlation between the overall survival and HPV status. Conclusion The present study highlights the significant role played by HPV in HNSCC. Furthermore, it reveals that although p16 has been a marker of HPV existence in HNSCC, it should not be the sole determinant of HPV role in tumorigenesis.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"56 1","pages":"155 - 165"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1827944","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44098070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1832648
Eman Samy Ibrahim Foda, A. Ibrahim, Aida Mohey Mohamed Ali, Ahmed M El-Menshawy, H. Elweshahi
ABSTRACT Background Patient safety culture (PSC) is a vital feature to assess the ability of any healthcare setting in addressing and reducing patients harm. This study attempted to assess the PSC in Intensive Care Units (ICUs) at Alexandria Main University Hospital (AMUH) from the point of view of physicians and nurses. Methods A cross-sectional study was implemented in two ICUs at AMUH over period of six months. Seventy-two participants were interviewed using the Hospital Patient Safety Scale, customized by the Agency for Healthcare Research and Quality (AHRQ). Results The average positive response to individual items in the patient safety scale ranged from 2.7% to 79.2%. The “Teamwork within Units” dimension had the utmost average percentage positive score (63.5%) amongst all participants, on the other hand, the “Non-Punitive Response to Errors” dimension had the lowest one (12.0%). Less than half (45.8%) of the interviewed participants rated patient’s safety at the hospital as accepted. Conclusions PSC is friable in targeted ICUs, much of work is needed to raise the responsiveness of health care givers regarding this issue. Executives and supervisors need to encourage the practices of PS through a blame free culture.
{"title":"Assessment of patient safety culture perception among healthcare workers in intensive care units of Alexandria Main University Hospital, Egypt","authors":"Eman Samy Ibrahim Foda, A. Ibrahim, Aida Mohey Mohamed Ali, Ahmed M El-Menshawy, H. Elweshahi","doi":"10.1080/20905068.2020.1832648","DOIUrl":"https://doi.org/10.1080/20905068.2020.1832648","url":null,"abstract":"ABSTRACT Background Patient safety culture (PSC) is a vital feature to assess the ability of any healthcare setting in addressing and reducing patients harm. This study attempted to assess the PSC in Intensive Care Units (ICUs) at Alexandria Main University Hospital (AMUH) from the point of view of physicians and nurses. Methods A cross-sectional study was implemented in two ICUs at AMUH over period of six months. Seventy-two participants were interviewed using the Hospital Patient Safety Scale, customized by the Agency for Healthcare Research and Quality (AHRQ). Results The average positive response to individual items in the patient safety scale ranged from 2.7% to 79.2%. The “Teamwork within Units” dimension had the utmost average percentage positive score (63.5%) amongst all participants, on the other hand, the “Non-Punitive Response to Errors” dimension had the lowest one (12.0%). Less than half (45.8%) of the interviewed participants rated patient’s safety at the hospital as accepted. Conclusions PSC is friable in targeted ICUs, much of work is needed to raise the responsiveness of health care givers regarding this issue. Executives and supervisors need to encourage the practices of PS through a blame free culture.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"56 1","pages":"173 - 180"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1832648","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48939580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1779992
H. Verma, Y. K. Ratre, P. Mazzone, S. Laurino, L. Bhaskar
ABSTRACT Introduction In spite of the substantial advances in clinical practice, Gastric cancer (GC) remains the third leading cause of cancer death worldwide. The incidence of drug resistance remains a hindrance to effective treatment for GC. Although the molecular mechanisms of chemoresistance have broadly studied, the gene regulation and expression mechanisms of miRNA have not entirely understood. Methods Online databases of PubMed, Scopus, Google Scholar, and Embase databases were searched to retrieve relevant publications. The following keywords were used: MicroRNA, Non-coding RNA, miRNA, Gastric cancer, drug resistance, and chemoresistance. Results miRNAs play a pivotal role in the initiation, progression of tumor and metastasis, as well as in the development of pathways mediating resistance to chemotherapy in GC. Unluckily, to date, there is no consistent, reliable biomarker available to predict the response of chemotherapy before the start of the treatment. Discussion In this review, we would like to provide an overview of the miRNAs and miRNA facilitated chemoresistance machinery in GC to develop a personalized treatment to overcome GC drug resistance.
{"title":"Micro RNA facilitated chemoresistance in gastric cancer: a novel biomarkers and potential therapeutics","authors":"H. Verma, Y. K. Ratre, P. Mazzone, S. Laurino, L. Bhaskar","doi":"10.1080/20905068.2020.1779992","DOIUrl":"https://doi.org/10.1080/20905068.2020.1779992","url":null,"abstract":"ABSTRACT Introduction In spite of the substantial advances in clinical practice, Gastric cancer (GC) remains the third leading cause of cancer death worldwide. The incidence of drug resistance remains a hindrance to effective treatment for GC. Although the molecular mechanisms of chemoresistance have broadly studied, the gene regulation and expression mechanisms of miRNA have not entirely understood. Methods Online databases of PubMed, Scopus, Google Scholar, and Embase databases were searched to retrieve relevant publications. The following keywords were used: MicroRNA, Non-coding RNA, miRNA, Gastric cancer, drug resistance, and chemoresistance. Results miRNAs play a pivotal role in the initiation, progression of tumor and metastasis, as well as in the development of pathways mediating resistance to chemotherapy in GC. Unluckily, to date, there is no consistent, reliable biomarker available to predict the response of chemotherapy before the start of the treatment. Discussion In this review, we would like to provide an overview of the miRNAs and miRNA facilitated chemoresistance machinery in GC to develop a personalized treatment to overcome GC drug resistance.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"56 1","pages":"81 - 92"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1779992","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46109757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1778417
H. Assaad, S. Assaad-Khalil
ABSTRACT Introduction As the coronavirus disease (COVID-19) spreads worldwide, awaiting the development of a vaccine, researchers are looking among the arsenal of available drugs, for a potential cure or medication to improve patients’ outcome. A highly elevated levels of cytokines in COVID-19 patients requiring ICU admission, has suggested that a “cytokine storm” was associated with disease severity. Methods We summarize published key findings about imatinib, aiming to rationalize its use as a potential pharmacologic treatment for COVID-19. Results Data from cellular, animal models and clinical trials, showed a beneficial role of tyrosine kinase inhibitors in the regulation of inflammation, the maintenance of endothelial barrier integrity, as well as the expression of antiviral properties. This data is especially derived from imatinib, the most studied Abl family kinase inhibitor, that is currently in clinical use for multiple medical conditions. Discussion Based on this encouraging data, we hypothesize that imatinib might be beneficial for the treatment of patients with SARS-CoV-2 pneumonia, in the aim of preventing disease progression into the severe phenotype of hypoxic respiratory failure and acute respiratory distress syndrome. This concept can be considered for evaluation in a randomized controlled study.
{"title":"Imatinib a Tyrosine Kinase Inhibitor: a potential treatment for SARS- COV-2 induced pneumonia","authors":"H. Assaad, S. Assaad-Khalil","doi":"10.1080/20905068.2020.1778417","DOIUrl":"https://doi.org/10.1080/20905068.2020.1778417","url":null,"abstract":"ABSTRACT Introduction As the coronavirus disease (COVID-19) spreads worldwide, awaiting the development of a vaccine, researchers are looking among the arsenal of available drugs, for a potential cure or medication to improve patients’ outcome. A highly elevated levels of cytokines in COVID-19 patients requiring ICU admission, has suggested that a “cytokine storm” was associated with disease severity. Methods We summarize published key findings about imatinib, aiming to rationalize its use as a potential pharmacologic treatment for COVID-19. Results Data from cellular, animal models and clinical trials, showed a beneficial role of tyrosine kinase inhibitors in the regulation of inflammation, the maintenance of endothelial barrier integrity, as well as the expression of antiviral properties. This data is especially derived from imatinib, the most studied Abl family kinase inhibitor, that is currently in clinical use for multiple medical conditions. Discussion Based on this encouraging data, we hypothesize that imatinib might be beneficial for the treatment of patients with SARS-CoV-2 pneumonia, in the aim of preventing disease progression into the severe phenotype of hypoxic respiratory failure and acute respiratory distress syndrome. This concept can be considered for evaluation in a randomized controlled study.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"56 1","pages":"68 - 72"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1778417","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42551759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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