Publications by authors named "Noha Azab"

18 Publications

  • Page 1 of 1

Acute Invasive Fungal Rhinosinusitis and Coronavirus Disease 2019.

J Craniofac Surg 2021 Sep 22. Epub 2021 Sep 22.

Department of Otolaryngology Department of Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University, Cairo, Egypt.

Abstract: Acute invasive fungal rhinosinusitis (mucormycosis) is a rare, highly fatal disease. This opportunistic fungal infection causes angioinvasion and ischemic tissue necrosis. It mainly affects immunocompromised patients. Since the coronavirus disease 2019 (COVID-19) outbreak, many case reports have described the rhino-orbital-cerebral mucormycosis associated with COVID-19. However, the underlying predisposing factors are unknown. Several factors, other than diabetes, which is the most well-known contributing factor, may be involved in causing this severe fungal infection in COVID-19 patients. These factors may include steroid therapy, which is being used in severely dyspneic patients, the use of broad-spectrum antibiotics that may cause fungal flare-ups, and hospitalization with possible nosocomial infections. In addition, increased serum ferritin levels, possible endothelial damage, and pancreatic islets affection among COVID-19 patients may be implicated. Head and neck surgeons should be aware of the increasing prevalence of craniofacial mucormycosis among COVID-19 patients, as early diagnosis and prompt treatment are essential to improve the outcomes.
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http://dx.doi.org/10.1097/SCS.0000000000008231DOI Listing
September 2021

Quality control of dietary supplements: An economic green spectrofluorimetric assay of Raspberry ketone and its application to weight variation testing.

Spectrochim Acta A Mol Biomol Spectrosc 2021 Nov 29;261:120032. Epub 2021 May 29.

Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.

Although Dietary supplements are readily accessible and extensively used worldwide, they are inadequately regulated and consumers are victims of manufacturers' fraud. Thus, quality regulations are required to ensure safety of products available to the public. We propose the first native spectrofluorimetric quality control assay of raspberry ketone, a popular dietary supplement ingredient for weight loss. This work relies on the constant wavelength synchronous scan of the Raspberry Ketone native fluorescence, overcoming the demerits of conventional excitation/ emission spectra. For the best measurement conditions, several parameters were optimized including Δλ value, diluting solvent, medium pH and the effect of surfactants/ macromolecules. In aqueous medium (Δλ = 110 nm), a linear relationship exists between synchronous fluorescence intensity at peak maximum 405.6 nm and solution concentration in the range 300-1500 ng/mL. Method sensitivity was recorded with LOD and LOQ values 60.63 and 183.72 ng/mL; respectively. Validation was done in accordance to International Conference on Harmonization (ICH) guidelines. This simple procedure was successfully applied to the analysis of Raspberry Ketone in commercially available dietary supplement capsules with average recovery 98.67% ± 1.74 and further extended to weight variation testing following the official United States Pharmacopeial (USP) guidelines. Finally, green assessment was done using the ''Analytical Eco-scale'' tool. The total score was 89/100 points revealing excellent greenness of our proposal. Our proposal is simple, eco-friendly and cheap. It can be conveniently adopted for routine quality control practices especially in developing countries.
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http://dx.doi.org/10.1016/j.saa.2021.120032DOI Listing
November 2021

Investigation of a QuEChERS Based Method for Determination of Polycyclic Aromatic Hydrocarbons in Rat Plasma by GC/MS.

J Anal Toxicol 2021 Mar 12. Epub 2021 Mar 12.

Pharmaceutical Analytical Chemistry Department, Faculty of pharmacy, Ain Shams University, Cairo, Egypt.

Owing to their toxic effects on humans and the environment, sensitive biomonitoring of polycyclic aromatic hydrocarbons (PAHs) is essential and significant. In this work, a sensitive, simple and rapid bioanalytical method was established for the simultaneous determination of thirteen (PAHs) in rat plasma depending on QuEChERS as a preliminary step and gas chromatography/mass spectrometry (GC/MS) for identification. QuEChERS procedure was optimized where acetonitrile was employed for plasma samples extraction which was further cleaned using primary secondary amine as the sorbent material. Optimization of GC/MS conditions was performed to produce optimum selectivity of the proposed method. The method was fully validated for rat plasma samples where recoveries, matrix effects, limit of quantitation, linearity, and precision were evaluated. Linearity range was 5.0-100.0 ng/mL for most of the thirteen analytes. Average recoveries of the thirteen PAHs ranged between 85.57 % to 109.64 % in fortified rat plasma with standard deviations (SDs) less than 8.91 except for anthracene which showed 19.24. The limits of detection (LODs) and quantitation (LOQs) for the thirteen compounds ranged from 0.045 to 0.372 ppb and from 0.137 to 1.128 ppb respectively. The established method was successfully implemented to perform a minor toxicokinetic study in intraperitoneally dosed rats (0.25 and 2 mg/kg in vegetable oil). The thirteen PAHs were tracked in rat plasma samples for 6 h after administration, and most of the target compounds were recognized in plasma samples only at the higher dose.
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http://dx.doi.org/10.1093/jat/bkab027DOI Listing
March 2021

Subjective Smell Assessment as An Office-based Rapid Procedure In COVID-19 Era.

J Craniofac Surg 2021 Jul-Aug 01;32(5):e439-e441

Department of Rheumatology and Rehabilitation, Cairo University, Egypt.

Abstract: A recent history of smell disorder may be a potential predictor for COVID-19. The authors used a subjective olfaction score that was demonstrated on a hard paper-bar. The authors examined 480 patients who were attending the outpatient clinic. Ninety-seven patients (20.2%) demonstrated variable degrees of recent smell disorder. For those patients, lab testing including nasopharyngeal swab for real-time polymerase chain reaction (RT-PCR) was performed. Eighty-eight of them (90.7%) have been confirmed to be COVID-19 positive. Although psychophysical testing is more reliable, subjective assessment of smell is a rapid procedure and can be used as an office-based method for patients' screening in COVID-19 era. Smell disorder could be an alarming sign for COVID-19 even with absent characteristic symptoms.
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http://dx.doi.org/10.1097/SCS.0000000000007245DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8237839PMC
July 2021

Interferon gamma and interleukin 8 gene polymorphisms in patients with hepatitis C virus related oral lichen planus.

Arch Oral Biol 2018 Dec 26;96:189-194. Epub 2018 Sep 26.

Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Egypt.

Objectives: This study aimed to determine the association of rs2430561 and rs4073 polymorphisms in the Interferon gamma (IFN-ɤ) and Interleukin 8 (IL-8) genes, respectively, with hepatitis C virus-related oral lichen planus and disease severity.

Design: This is a case-control study. 60 subjects were equally divided into patients with and without oral lichen planus. They were further subdivided into hepatitis C virus seropositive and seronegative patients. All patients were genotyped for IFN-γ rs2430561 thymine to adenine (T > A) and IL-8 rs4073 adenine to thymine (A > T) polymorphisms. All patients with oral lichen planus had their lesions measured and documented using the Escudier scoring system.

Results: Disease activity was significantly higher in the "oral lichen planus/hepatitis C virus-positive" patients than in the "oral lichen planus/hepatitis C virus-negative" patients (P = 0.003). IFN-γ rs2430561 T > A and IL-8 rs4073 A > T genotypes and allele frequencies were not associated with the oral lichen planus group or the normal group. Stratification of the two groups into HCV and non-HCV-infected patients or into erosive and non-erosive types revealed no significant associations. The "A-allele-containing" genotypes of IL-8 rs4073 A > T were significantly more prevalent in the patients with oral lichen planus than in those without.

Conclusion: Hepatitis C virus infection is associated with the development of erosive oral lichen planus. The A-allele of IL-8 rs4073 A > T may have a role in the development and progression of oral lichen planus.
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http://dx.doi.org/10.1016/j.archoralbio.2018.09.015DOI Listing
December 2018

Cervical osteophytosis and spine posture: contribution to swallow disorders and symptoms.

Curr Opin Otolaryngol Head Neck Surg 2018 Dec;26(6):375-381

Department of Otolaryngology.

Purpose Of Review: The article reviews the effects of cervical osteophytosis and spine posture on swallowing, and how they can cause dysphagia.

Recent Findings: Cerivical osteophytosis which is a bony overgrowth of the cervical spines, it affects the swallowing through different mechanisms, including direct mechanical compression of the pharynx and esophagus, disturbances of normal epiglottic tilt over the inlet of the larynx by the osteophytes at C3-C4 level, inflammatory reactions in the tissues around the esophagus and cricopharyngeal spasm. Also, cervical spine posture in normal individuals could affect the swallowing mechanism by disturbance of the sphincteric action of the larynx and upper esophageal sphincter.

Summary: Cervical osteophytosis and abnormal cervical curvature may be overlooked by the Otolaryngologists as causes of swallowing disorders. The diagnosis is usually confirmed by radiologic study for the cervical spine. Cervical abnormality should be kept in mind while we are investigating patients with swallowing problem, and postural modification may help in treatment of such cases.
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http://dx.doi.org/10.1097/MOO.0000000000000488DOI Listing
December 2018

Novel potentiometric sensors for the determination of the dinotefuran insecticide residue levels in cucumber and soil samples.

Talanta 2017 Mar 9;164:518-528. Epub 2016 Dec 9.

Pharmaceutical Analytical Chemistry Department, Faculty of pharmacy, Ain Shams University, Cairo, Egypt. Electronic address:

Five new potentiometric membrane sensors for the determination of the dinotefuran levels in cucumber and soil samples have been developed. Four of these sensors were based on a newly designed molecularly imprinted polymer (MIP) material consisting of acrylamide or methacrylic acid as a functional monomer in a plasticized PVC (polyvinyl chloride) membrane before and after elution of the template. A fifth sensor, a carboxylated PVC-based sensor plasticized with dioctyl phthalate, was also prepared and tested. Sensor 1 (acrylamide washed) and sensor 3 (methacrylic acid washed) exhibited significantly enhanced responses towards dinotefuran over the concentration range of 10-10molL. The limit of detection (LOD) for both sensors was 0.35µgL. The response was near-Nernstian, with average slopes of 66.3 and 50.8mV/decade for sensors 1 and 3 respectively. Sensors 2 (acrylamide non-washed), 4 (methacrylic acid non-washed) and 5 (carboxylated-PVC) exhibited non-Nernstian responses over the concentration range of 10-10molL, with LODs of 10.07, 6.90, and 4.30µgL, respectively, as well as average slopes of 39.1, 27.2 and 33mV/decade, respectively. The application of the proposed sensors to the determination of the dinotefuran levels in spiked soil and cucumber samples was demonstrated. The average recoveries from the cucumber samples were from 7.93% to 106.43%, with a standard deviation of less than 13.73%, and recoveries from soil samples were from 97.46% to 108.71%, with a standard deviation of less than 10.66%. The sensors were applied successfully to the determination of the dinotefuran residue, its rate of disappearance and its half-life in cucumbers in soil in which a safety pre-harvest interval for dinotefuran was suggested.
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http://dx.doi.org/10.1016/j.talanta.2016.12.019DOI Listing
March 2017

Swallowing disorders among patients with diffuse idiopathic skeletal hyperostosis.

Acta Otolaryngol 2017 Jun 13;137(6):623-626. Epub 2017 Jan 13.

c Department of Otolaryngology , Beni Suef University , Egypt.

Conclusion: Diffuse idiopathic skeletal hyperostosis (DISH) is a cause of swallowing disorders in elderly, and otolaryngologists should be aware of the disease on dealing with old patients complaining of dysphagia. The condition may be treated conservatively in most patients; however, surgical reduction of cervical osteophytes may be needed in severe cases.

Objective: Large cervical osteophytes may cause dysphagia; they compress the pharynx leading to mechanical impairment of swallowing. DISH is characterized by ossification of the anterior longitudinal spinal ligament with formation of osteophytes. The aim was to investigate swallowing disorders among patients with DISH.

Method: The study included 139 patients with DISH. Their swallowing was evaluated using the eating assessment tool (EAT-10), and patients with swallowing disorders were subjected to fiber-optic endoscopic evaluation of swallowing (FEES), they received conservative treatment for 6 months. Patients were assessed again after treatment using the same measures that were employed before treatment.

Results: Twenty-three patients (16.5%) demonstrated swallowing disorder, and FEES showed residues of food in the pharynx after swallow in all of them. Significant overall improvement after conservative treatment was achieved, with two patients resuming their normal regular diet. However, one patient demonstrated no improvement, and he needed surgical reduction of his large cervical osteophytes.
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http://dx.doi.org/10.1080/00016489.2016.1272136DOI Listing
June 2017

Multiresidue Analysis of Five Neonicotinoid Insecticides and Their Primary Metabolite in Cucumbers and Soil Using High-Performance Liquid Chromatography with Diode-Array Detection.

J AOAC Int 2017 Jan 19;100(1):176-188. Epub 2016 Oct 19.

Ain Shams University, Faculty of Pharmacy, Pharmaceutical Analytical Chemistry Department, Cairo, Egypt.

A sensitive, selective, and validated HPLC-diode-array detection method was developed for the simultaneous determination of five neonicotinoid insecticides-acetamiprid, imidacloprid, nitenpyram, flonicamid, and thiacloprid-and their primary metabolite, 6-chloronicotinic acid, in cucumbers and soil based on the quick, easy, cheap, effective, rugged, and safe (QuEChERS) technique as a pretreatment procedure. In the QuEChERS procedure, cucumber samples were extracted with acetonitrile and cleaned using C18, whereas soil samples were extracted with an acetonitrile-dichloromethane mixture (1 + 2). The HPLC conditions were optimized by separating neonicotinoids using an acetonitrile-water mixture (25 + 75) and a Synergi Hydro RP C18 column. Matrix-matched calibration standards were prepared in cucumber and soil to eliminate any matrix interference. RSDs were ≤9% in all recovery tests. LODs and LOQs for the five neonicotinoids were in the ranges of 0.006-0.122 and 0.018-0.366 μg/g, respectively. This method was successfully applied to determine residues, the rate of disappearance of the five neonicotinoids from cucumber and soil, and the half-lives of the neonicotinoids.
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http://dx.doi.org/10.5740/jaoacint.16-0162DOI Listing
January 2017

Simultaneous determination of eight neonicotinoid insecticide residues and two primary metabolites in cucumbers and soil by liquid chromatography-tandem mass spectrometry coupled with QuEChERS.

J Chromatogr B Analyt Technol Biomed Life Sci 2016 Sep 16;1031:15-28. Epub 2016 Jun 16.

Department of Chemistry, Humboldt-Universität zu Berlin, Berlin, Germany.

A new, rapid, sensitive, precise and validated high performance liquid chromatography coupled to tandem mass spectrometry (HPLC-MS/MS) method was developed for the simultaneous determination of eight neonicotinoid insecticides with their two primary metabolites in cucumbers and soil based on QuEChERS as a pretreatment procedure. In QuEChERS procedure, cucumber samples were extracted with acetonitrile and cleaned using (C18 sorbent material), while soil samples were extracted with a mixture of acetonitrile:dichloromethane (8.3:16.7v:v). The LC-MS/MS conditions were optimized to provide good selectivity and specificity of the developed method where neonicotinoids were separated using gradient elution of water and acetonitrile both containing 0.1% formic acid with Gemini C18 column where the last compound was eluted at 9.5min. Average recoveries of the eight neonicotinoids and their metabolites ranged between 81.6% and 95.7% in fortified cucumber samples with relative standard deviations (RSDs) lower than 13.18% and between 80.3% and 104% in fortified soil samples with relative standard deviations (RSDs) lower than 8.44%. The limits of detection (LODs) and quantification (LOQs) for the ten compounds were in the ranges of (0.08-6.06ng/g) and (0.26-20ng/g), respectively. The method was applied successfully to determine residues and rate of disappearance of the eight neonicotinoids from cucumber and soil and their half-lives where a safety pre-harvest interval of 5days for acetampirid, 12days for imidacloprid, 15days for nitenpyram, 12days for thiamethoxam, 5days for flonicamid, 8days for clothianidin, 2days for Dinotefuran, and 1day for thiacloprid were suggested.
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http://dx.doi.org/10.1016/j.jchromb.2016.06.020DOI Listing
September 2016

The association of Varicella zoster virus reactivation with Bell's palsy in children.

Int J Pediatr Otorhinolaryngol 2015 Mar 31;79(3):328-31. Epub 2014 Dec 31.

Department of Otolaryngology, Beni Suef University, Beni Suef, Egypt.

Objectives: Bell's palsy is considered the most common cause of facial nerve paralysis in children. Although different theories have been postulated for its diagnosis, reactivation of the Varicella zoster virus (VZV) has been implicated as one of the causes of Bell's palsy. The aim of the study was to evaluate the association of Varicella-zoster virus infection with Bell's palsy and its outcome in children.

Methods: A total of 30 children with Bell's palsy were recruited and were assayed for evidence of VZV infection. The severity of facial nerve dysfunction and the recovery rate were evaluated according to House-Brackmann Facial Nerve Grading Scale (HB FGS). Paired whole blood samples from all patients were obtained at their initial visit and 3 weeks later, and serum samples were analyzed for VZV IgG and IgM antibodies using ELISA.

Results: A significantly higher percentage of Bell's palsy patients were seropositive for VZV IgM antibodies than controls (36.6% of patients vs 10% of controls) while for VZV IgG antibodies the difference was statistically nonsignificant. HB FGS in Bell's palsy patients with serologic evidence of VZV recent infection or reactivation showed a statistiacally significant less cure rate than other patients.

Conclusions: VZV reactivation may be an important cause of acute peripheral facial paralysis in children. The appropriate diagnosis of VZV reactivation should be done to improve the outcome and the cure rate by the early use of antiviral treatment.
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http://dx.doi.org/10.1016/j.ijporl.2014.12.010DOI Listing
March 2015

Diminished soluble levels of growth arrest specific protein 6 and tyrosine kinase receptor Axl in patients with rheumatoid arthritis.

Int J Rheum Dis 2017 Jan 7;20(1):53-59. Epub 2014 Apr 7.

Medical Microbiology and Immunology, Faculty of Medicine, El-Fayoum University, Cairo, Egypt.

Aim: Growth arrest specific protein 6 (Gas-6) and its tyrosine kinase receptor Axl plays an important role in apoptosis, and regulation of innate immune response, therefore, we investigated their plasma concentrations in Rheumatoid arthritis (RA) patients and correlated them to clinical, laboratory and radiological parameters of the disease.

Methods: Plasma from 77 RA patients and 50 normal healthy subjects were assayed for plasma Gas6 and Axl levels. Demographic, clinical and serological data were prospectively assessed. Rheumatoid arthritis disease activity was assessed using 28-joint Disease Activity Score (DAS-28) and functional capacity by modified health assessment questionnaire (mHAQ). Standardized x-rays for hands and feet were done to all participants.

Results: The level of Gas6 and Axl were significantly decreased in the RA patients compared to those of the healthy control subjects. Levels of Gas6 correlated positively with Axl levels in both patients and healthy control. Gas6 levels were remarkably reduced in those patients with erosive RA than those without. Levels of Gas6 were found to be negatively correlated with the presence of erosive disease and positively correlated with DAS-28, ESR, Leucocytosis and IL6.

Conclusion: The plasma concentrations of Gas6 and Axl are altered in RA patients and thus may have a role in RA pathogenesis. Further mechanistic studies on the involvement of all TAM receptors tyrosine kinases pathway in RA are needed to help in understanding the pathogenesis and possibly aid in diagnosis and future treatments of RA especially for patients with erosive disease.
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http://dx.doi.org/10.1111/1756-185X.12367DOI Listing
January 2017

New HPLC and fluorometric methods for the determination of pyriproxyfen and pyridalyl insecticide residues in tomatoes.

J AOAC Int 2014 Jan-Feb;97(1):188-96

Two sensitive, selective, and precise methods for the determination of pyriproxyfen and pyridalyl insecticide residues in tomatoes have been developed. The first method is HPLC with UV detection in which pyriproxyfen and pyridalyl were extracted with ethyl acetate and acetone, respectively, followed by cleanup using column chromatography. The recoveries ranged from 86.03 to 94.55 for pyriproxyfen and 95.08 to 99.38% for pyridalyl in tomato samples. The LOD of the method was 0.217 ppm for pyriproxyfen and 0.1866 ppm for pyridalyl. The second method depends on direct fluorometric determination of pyriproxyfen and pyridalyl in acetic and sulfuric acid at excitation and emission wavelengths of 320 and 646 nm, respectively. The recoveries of pyriproxyfen and pyridalyl in tomato samples ranged from 88 to 98% and 86 to 93%, respectively. The LOD of the method was 0.146 ppm for pyriproxyfen and 0.078 ppm for pyridalyl. Both methods were applied successfully to determine residues and rate of disappearance of pyriproxyfen and pyridalyl from tomatoes.
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http://dx.doi.org/10.5740/jaoacint.12-354DOI Listing
May 2014

Otolaryngologic manifestations of diffuse idiopathic skeletal hyperostosis.

Eur Arch Otorhinolaryngol 2014 Jun 22;271(6):1785-90. Epub 2013 Nov 22.

Department of Otolaryngology, Cairo University, 2 el-salam st., King Faisal, Above El-baraka Bank, Giza, Cairo, Egypt,

Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by formation of large cervical osteophytes that may compress the posterior wall of the aerodigestive tract. It is a rare cause of dysphagia in the elderly. The aim of this study was to investigate the various otolaryngologic manifestations of DISH. Eleven elderly patients with DISH were included in the study. All patients presented with dysphagia that was graded on the swallowing screening tool (EAT-10), and the diagnosis of DISH was based on computed tomographic criteria. The patients were subjected to otolaryngologic examination and flexible laryngoscopy. Polysomnography was used for patients with excessive daytime sleepiness for detection of obstructive sleep apnea (OSA). In addition to dysphagia of varying severity, OSA was found in nine patients, change of voice in six, globus sensation in seven, aspiration in three, and cervical pain in seven. Flexible laryngoscopy showed bulging of the posterior pharyngeal wall in all patients. DISH may be an unrecognized contributory factor to both dysphagia and OSA in the elderly. Change of voice, aspiration, globus sensation, and cervical pain are other otolaryngologic manifestations that may be encountered symptoms of the disease. An otolaryngologist should be aware of the disease that may be overlooked, and computed tomography is a confirmatory diagnostic method.
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http://dx.doi.org/10.1007/s00405-013-2827-zDOI Listing
June 2014

Elevated serum TRAIL levels in scleroderma patients and its possible association with pulmonary involvement.

Clin Rheumatol 2012 Sep 23;31(9):1359-64. Epub 2012 Jun 23.

Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) has been reported to be involved in the pathophysiology of some autoimmune diseases as systemic lupus erythematosus, ankylosing spondylitis, and multiple sclerosis. The aim of this study was to assess serum TRAIL concentration in systemic sclerosis (SSc) patients and to investigate its possible association with various disease parameters. Thirty SSc patients as well as 25 rheumatoid arthritis (RA) patients and 25 healthy volunteers were included in the present study. Organ system involvement in SSc patients was investigated. Pulmonary function tests as well as chest high-resolution computed tomography (HRCT) were done to detect pulmonary involvement in our patients. TRAIL concentrations were measured in the sera of SSc patients, RA patients and healthy controls by enzyme-linked immunosorbent assay. Mean serum TRAIL levels were significantly higher in SSc patients than in the control RA patients and in healthy controls (p < 0.001) while they were not significantly different between patients with diffuse cutaneous SSc and patients with limited cutaneous scleroderma. Serum TRAIL levels were significantly higher in SSc patients with pulmonary involvement and were significantly correlated with HRCT scores. Serum TRAIL levels are significantly elevated in SSc patients and are associated with SSc-associated pulmonary involvement denoting a possible role of TRAIL in the pathogenesis of SSc. Further studies may be needed to confirm these findings and the possible use of TRAIL in detection and possibly treatment of SSc-associated pulmonary disease.
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http://dx.doi.org/10.1007/s10067-012-2023-3DOI Listing
September 2012

Laryngeal involvement in juvenile idiopathic arthritis patients.

Clin Rheumatol 2011 Sep 26;30(9):1251-6. Epub 2011 May 26.

Department of Otolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt.

Juvenile idiopathic arthritis (JIA) is an autoimmune diseases characterized by chronic arthritis and systemic manifestations. Autoimmune diseases can affect the upper airways including the larynx. The aim of this study was to investigate laryngeal involvement in JIA patients and its possible association with JIA disease parameters. Fifty consecutive JIA patients were screened for laryngeal abnormalities using flexible fiberoptic laryngoscope and laryngeal computerized tomography. Laryngeal abnormalities were detected in nine (18%) of our cases, with cricoarytenoiditis in six cases (12%) and a rheumatoid nodule in the pyriform fossa in only one case (2%). Diffuse congestion and edema of the posterior part of the larynx with normal vocal cord mobility was detected in two cases (4%). In our study, laryngeal abnormalities were significantly higher in patients with polyarticular seropositive disease subtype and also were significantly higher in patients with longer disease duration, higher disease activity scores, and those with erosive disease. JIA may affect the larynx. Laryngeal involvement in JIA patients is more in polyarticular seropositive cases. JIA patients have to be subjected to thorough otolaryngologic examination for early diagnosis and prompt management.
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http://dx.doi.org/10.1007/s10067-011-1781-7DOI Listing
September 2011

Elevated serum levels of a proliferation-inducing ligand in patients with systemic sclerosis: possible association with myositis?

Joint Bone Spine 2011 Jan 6;78(1):56-61. Epub 2010 Jul 6.

Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Objective: A proliferation-inducing ligand (APRIL) is a new member of the tumour necrosis factor family which is intimately connected to the regulation of cellular pathways. The aim of this study was to assess serum concentrations of APRIL in systemic sclerosis patients, and to correlate them with the main clinical and serological features of the disease.

Methods: Sera from 35 patients with systemic sclerosis, 25 had limited cutaneous and 10 had diffuse cutaneous subtypes, and 35 normal healthy subjects were assayed for APRIL by Enzyme Linked Immunosorbant Assay. Demographic, clinical, autoantibodies and serological data were prospectively assessed.

Results: Serum APRIL concentrations were higher in patients with systemic sclerosis and in both its subtypes compared to the healthy controls (p<0.0001 in all). Patients with elevated APRIL levels had significantly higher incidences of myositis than those with normal levels (p=0.04). We did not find significant differences in other organ involvement prevalence between systemic sclerosis patients with elevated vs. normal APRIL levels. In addition, the frequencies of autoantibodies (i.e., anti-topoisomerase I, anti-centromere) were comparable between both groups. Serum APRIL levels were correlated with serum γ-globulins concentrations (r=0.404, p=0.016) but not with C-reactive protein, skin score, nor pulmonary functions. Serum APRIL was also correlated with creatine kinase levels only in systemic sclerosis patients with myositis (r=0.786, p=0.02).

Conclusion: Our preliminary results suggest increased serum APRIL levels in systemic sclerosis patients, particularly in those associated with myositis and hypergammaglobinemia. To confirm our results, we propose that larger scale, multicentre studies with longer evaluation periods are needed.
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http://dx.doi.org/10.1016/j.jbspin.2010.05.004DOI Listing
January 2011

A case of Schwartz-Jampel syndrome with cleft palate.

Int J Pediatr Otorhinolaryngol 2009 Nov 4;73(11):1601-3. Epub 2009 Sep 4.

Department of Otolaryngology, Faculty of Medicine, Cairo University, Egypt.

Schwartz-Jampel syndrome is a rare inherited autosomal recessive disorder characterized by generalized myotonia, joint contractures, skeletal abnormalities and facial dysmorphism. The gene defect involves the 1p34-p36.1 region of chromosome 1. Also, one of the candidate genes for orofacial clefting is the 1p36 region. Cleft palate is the most common congenital anomaly in the head and neck. Despite both diseases share a genetic defect in chromosome 1p36 region, the association of both conditions has not yet been investigated. Feeding problems due to the presence of the cleft may add to the growth retardation that is already present in those patients, so palatoplasty is mandatory. We described a case of Schwartz-Jampel syndrome with cleft palate.
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http://dx.doi.org/10.1016/j.ijporl.2009.08.012DOI Listing
November 2009
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