The relationship between sonographic fetal thymus size and the components of the systemic fetal inflammatory response syndrome in women with preterm prelabour rupture of membranes DO El-Haieg, a Objective To assess the relation between sonographic fetal thymus size and the components of fetal inflammatory response syndrome (FIRS) in women with preterm prelabour rupture of membranes (PPROM).Design Prospective cohort study.Setting University hospital from January through October 2006.Population Fifty-six women with PPROM.Methods In these women, fetal thymus perimeter was measured sonographically. At birth, cord venous plasma interleukin-6 (IL-6) level estimation and histopathological examination of the placentas and umbilical cords were performed.Main outcome measures Small thymus size (<5th percentile for gestational age) and its association with FIRS.Results From the 56 women with PPROM, 54% had chorioamnionitis (CA), 23% had funisitis. IL-6 level was >11 pg/ml in 52% of women and >18 pg/ml in 41%. A small thymus was more associated with male fetuses, shorter preterm prelabour rupture of membranes delivery interval, higher IL-6 level, higher frequency of funisitis and CA. When data were regressed for confounding, only IL-6 level and funisitis remained significant independent factors that influence the thymus size. In the subset of women (n = 19) who delivered within 1 week of first measurements, a small thymus had sensitivity and positive predictive value of 93%, specificity and negative predictive value of 75% and accuracy of 89% in the identification of FIRS (IL-6 >18 pg/ml and/or funisitis).Conclusions An association exists between fetal thymic involution and components of FIRS in women with PPROM. Small fetal thymus size may be considered a reliable sonographic marker of fetal involvement in the inflammatory response.Keywords Fetal sonography, fetal thymus, FIRS, PPROM.Please cite this paper as: El-Haieg D, Zidan A, El-Nemr M. The relationship between sonographic fetal thymus size and the components of the systemic fetal inflammatory response syndrome in women with preterm prelabour rupture of membranes.

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Ácido úrico sérico e sua associação com hipertensão, nefropatia precoce e doença renal crônica em pacientes diabéticos tipo 2 Introdução: A detecção precoce da nefropatia diabética (ND) é importante. O áci-do úrico sérico (AUS) tem um papel ainda desconhecido no desenvolvimento de ND. Objetivo: Estudar a relação entre AUS e hipertensão, nefropatia precoce e progressão da doença renal crônica (DRC) no diabetes mellitus tipo 2 (DM2). Métodos: O estudo contou com 986 participantes, de acordo com a presença e a duração do diabetes, os pacientes foram classificados em três grupos. O Grupo I incluiu 250 participantes saudá-veis. O Grupo II incluiu 352 pacientes com início de diabetes < 5 anos. O Grupo III incluiu 384 pacientes com o aparecimento de diabetes > 5 anos. Todos os participantes foram submetidos a exame clínico completo, medidas antropométricas, exames laboratoriais -incluindo hemoglobina glicosilada (HbA1C), bem como a razão entre triglicé-rides e lipoproteína de alta densidade (TG/ HDL-C), AUS, razão creatinina/albumina (RCA) urinária, e taxa estimada de filtração glomerular (eTFG). Resultados: A razão AUS, PA, HbA1c, TG/HDL-C e RCA foi significativamente maior no grupo III do que no grupo I, II e em II do que I. A eTFG foi significativamente menor no grupo III do que nos grupos I, II e no II do que no I (p < 0,001). Idade, IMC, PA, HbA1c, razão TG/ HDL-C, RCA, foram positivamente correlacionados com AUS, enquanto que a TFG esteve negativamente correlacionada. O AUS a níveis > 6,1 mg/dl, > 6,2 mg/dl e > 6,5 mg/dl apresentou maior sensibilidade e especificidade para identificar hipertensão, nefropatia precoce e declínio da eTFG, respectivamente. Conclusão: Mesmo elevados níveis de AUS, foi associado ao risco de hipertensão, nefropatia precoce e declínio da eTFG. Além disso, o nível de AUS pode identificar o iní-cio da hipertensão, nefropatia precoce e progressão da DRC em DM2. ResumoPalavras-chave: ácido úrico; diabetes mellitus tipo 2; hipertensão; nefropatias diabéticas. Introduction:Early detection diabetic nephropathy (DN) is important. Whether serum uric acid (SUA) has a role in the development of DN is not known. Objective: To study the relationship between SUA and hypertension, early nephropathy and progression of chronic kidney disease (CKD) in type 2 diabetes mellitus (T2DM). Methods: The total number of the study was 986 participants, according to presence and duration of diabetes were classified into three groups. Group I; including 250 healthy participants. Group II; including 352 with onset of diabetes < 5 years. Group III; including 384, with the onset of diabetes > 5 years. All participants were submitted to complete clinical examination, anthropometric measurements, laboratory investigations, including glycosylated hemoglobin (HbA1C), as well triglycerides to high-density lipoprotein ratios (TG/HDL-C), SUA, urinary albumin/creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR). Results: SUA, BP, HbA1c, TG/HDL-C ratio, and ACR levels were significantly higher in group III tha...

Background. Childhood cancer survivors treated with anthracyclines and mediastinal irradiation are at risk for late onset cardiotoxicity. Aims of the Study. To assess the role of N-terminal pro-brain natriuretic peptide (NT-proBNP) and tissue Doppler imaging (TDI) as early predictors of late onset cardiotoxicity in asymptomatic survivors of childhood cancer treated with doxorubicin with or without mediastinal irradiation. Methods. A cross-sectional study on 58 asymptomatic survivors of childhood cancer who received doxorubicin in their treatment protocols and 32 asymptomatic Hodgkin's lymphoma survivors who received anthracycline and mediastinal irradiation. Levels of NT-proBNP, TDI, and conventional echocardiography were determined. Results. Thirty percent of survivors had abnormal NT-proBNP levels. It was significantly related to age at diagnosis, duration of follow-up, and cumulative dose of doxorubicin. TDI detected myocardial affection in 20% more than conventional echocardiography. Furthermore, abnormalities in TDI and NT-pro-BNP levels were more common in Hodgkin lymphoma survivors receiving both chemotherapy and radiotherapy. Conclusions. TDI could detect early cardiac dysfunction even in those with normal conventional echocardiography. Measurement of NT-proBNP represents an interesting strategy for detecting subclinical cardiotoxicity. We recommend prospective and multicenter studies to validate the role of NT-proBNP as an early marker for late onset doxorubicin-induced cardiotoxicity.

occurred in (29%) of patients. Diabetes was the second common risk factor for vascular failure as it occurred in (17%) of patients. Conclusion: Stenosis and infection are the most common complications of the vascular access. DM is an important risk factor for the incidence of infection. Other risk factors for dialysis CRBSI include older age, low serum albumin, high BUN and decreasing the duration of dialysis.

Through its proinflammatory cytokines, IL-22 plays a role in the inflammatory process of PR.

Aim of study: To identify and report various type of primary immunodeficiency disorders in children at Zagazig university hospitals, and their characteristic features, clinical manifestations and laboratory profiles. Patients and methods; patients with history,clinical findings and laboratory findings matching with any of eight classes of primary immunodeficiency were included in this study, also we used ten warning signs,immunodediciency disease related score in evaluation of patients. Results: Fifty patients were diagnosed with different primary immunodeficiency disorders in Pediatric department, Zagazig University Hospital during period from July 2011 to July 2013. The spectrum of PIDs in our center was as follow: predominantly antibody deficiency was the most common category (46%) followed by combined immunodeficiency (22%) then well defined syndromes (20%), auto inflammatory disorders (8%), complement disorders (4%). No cases were diagnosed in any category of phagocytic disorders, innate immunity or immune dysregulation. Selective IgA deficiency was the most frequent disease type. Median age of onset of symptoms was 7 months, the median age of diagnosis lag was 24 months.Pneumonia was the most common presentation. Consanguinity rate was 60%. Mortality rate was 20% mostly duo to bronchopneumonia. Conclusion: primary immunodeficiency disorders are not rare in our center ,but under diagnosed.