Apparently Healthy Individuals Research Articles

Galectin-3 (Gal-3) and the tissue inhibitor of matrix metalloproteinase (TIMP-2) as potential biomarkers for the clinical evolution of chronic Chagas cardiomyopathy

BackgroundChronic Chagas cardiomyopathy (CCC) is responsible for the highest morbidity and worst prognosis in Chagas disease patients. However, predicting factors that correlate with disease progression, morbidity, and mortality is challenging. It is necessary to have simple, quantitative, and economical risk biomarkers that add value to conventional methods and assist in the diagnosis and prognosis of patients with CCC or in evolution. ObjectivesWe evaluated molecules related to cardiac remodeling and fibrosis, such as MMP-2, MMP-9, TIMP-2, TIMP-1, PICP, CTXI, and Gal-3, and correlated these biomarkers with echocardiographic variables (LVDD, LVEF, and E/e' ratio). MethodsBlood samples from Chagasic patients without apparent cardiopathy (WAC), CCC patients, and healthy individuals were used to perform plasma molecule dosages using Luminex or ELISA. ResultsMMP-2 and TIMP-2 presented higher levels in CCC; in these patients, the inhibitory role of TIMP-2 over MMP-2 was reinforced. The ratio of MMP-2/TIMP-2 in WAC patients showed a bias in favor of the gelatinase pathway. MMP-9 and TIMP-1 showed higher levels in Chagas patients compared to healthy subjects. PICP and CTXI are not associated with cardiac deterioration in Chagas disease. Increased levels of Gal-3 are associated with worse cardiac function in CCC. Receiver operating characteristic (ROC) curve analysis identified Gal-3 and TIMP-2 as putative biomarkers to discriminate WAC from cardiac patients. ConclusionsAmong the molecules evaluated, Gal-3 and TIMP-2 have the potential to be used as biomarkers of cardiac remodeling and progressive myocardial fibrosis in Chagas disease.

Prevalence and Risk Factors of Abnormal Carotid Artery in Young Adults without Overt Cardiovascular Disease.

ObjectiveThe current study was to evaluate the prevalence of increased carotid artery intimal-medial thickness (IMT) and carotid plaque in young individuals and factors associated with increased IMT and carotid plaque were also assessed.MethodsIndividuals between 18 and 44 years old who underwent an annual health examination and without cardiovascular disease were included. The value of IMT ≥0.1 cm was defined as increased IMT and IMT ≥0.15 cm was defined as carotid plaque. Based on the IMT, participants were divided into normal and abnormal groups.ResultsA total of 551 individuals were included and the mean age was 38.9 years old, with women accounting for 32.5% (n=179) and 238 (43.2%) individuals with abnormal IMT. Those with abnormal IMT was older, more likely to be male and smoking, had higher blood pressure (BP) and body mass index (BMI). Individuals with abnormal MIT also had worse lipid profiles, higher serum levels of fasting plasma glucose (FPG), HbA1c, homocysteine, and uric acid. Age, male sex, elevated systolic and diastolic BP, BMI, HbA1c, FPG, triglyceride, total cholesterol, LDL-C, homocysteine, and uric acid were positively correlated with IMT, while HDL-C was negatively correlated with IMT. Factors associated with increased IMT and carotid plaque included age, male sex, BMI, triglyceride, LDL-C, homocysteine, uric acid, and smoking.ConclusionAmong apparent healthy young individuals, the prevalence of increased IMT was high and there were several factors associated with increased IMT. Further studies are needed to evaluate how to be better in preventing the development of subclinical atherosclerosis among young individuals.

Evaluating the Role of Calprotectin in Pathogenesis of Acne Vulgaris in Zagazig University Hospital

Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. The cardinal pathogenic factors include increased sebum secretion, follicular hyperkeratinization and microbial colonization by Cutibacterium acnes. Calprotectin is released from activated neutrophils, and can be detected in serum or other body fluids. Aim: The aim of the present study was to clarify if calprotectin plays a role in acne vulgaris pathogenesis. Subject and Methods: This study is a case control study included 42 patients complaining of acne vulgaris compared with42 apparent healthy individuals matching in age and sex with control group. Human calprotectin level in the serum was measured using enzyme linked immunosorbent assay (ELISA). Results: The results showed that serum calprotectin level was higher in patients than controls but the difference was statistically insignificant(P=0.12). However, there was statistically significant correlation between serum calprotectin level in severe acne subtype and mild to moderate subtypes (P=0.026). The patients with acute onset had a higher serum calprotectin level than the patients with gradual onset (P=0.42), the difference was statistically insignificant. The male acne patients had higher statistically significant serum calprotectin level than female patients (P=0.03) Conclusion: Serum calprotectin level was higher in patients with acne vulgaris than controls, and is positively correlated with disease severity, therefore, might help in the evaluation of acne vulgaris severity and can help to evaluate the response to treatment.

Seroprevalence of COVID-19 IgM and IgG antibodies among asymptomatic individuals in Khartoum State-2020

Background: Seroprevalence detection of antibodies to severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) in apparent healthy individuals will be critical for the public health response to the coronavirus disease 2019 pandemic. The aim of this study was to investigate the prevalence of IgM and IgG to covid-19 in Khartoum State. Patients and methods: A cross-sectional retrospective laboratory-based investigation was conducted in Khartoum State 2020. Apparent healthy individuals without obvious respiratory conditions, and in order to obtain a travel license were exempted; however individuals who fulfilled the participation requirements were allowed to participate. After informed consent and fitting eligibility qualifications, a blood sample was taken from each respondent and used to identify SARS-CoV-2 IgM and IgG antibody tests in COVID-19 suspected informants using a snibe system model Maglumi 800. The Statistical Package for Social Sciences (SPSS) version 23 was used for statistical analysis in form of frequencies. Results: In the state of Khartoum, a total of 1000 samples were collected from participants to determine seroprevalence of covid-19; of these, 224 were reactive and 776 were nonreactive. There were 158 reactive IgG and 66 reactive IgM within that reactive covid-19 patient. Conclusion: There was a high prevalence of SARS-CoV-2 antibodies among asymptomatic respondents in Khartoum state.

THE IMPLICATION OF SOLUBLE MOLECULES OF CELLULAR ADHESION IN THE PROGRESSION OF COPD IN OVERWEIGHT PATIENTS

Abstract. Due to the high prevalence rates, severity, high risk of disability and death, chronic obstructive pulmonary disease (COPD) still remains an extremely important medical and economic problem not only in Ukraine but also worldwide. According to the WHO estimates, at least 65 million people on our planet suffer from moderate or severe COPD. The severity of the disease and its prognosis are often determined by the influence of concomitant pathology on the frequency of exacerbations, so the problem of comorbidity is becoming increasingly important. Recently, the number of patients with a combination of COPD and overweight is increasing, which is considered as a mutual aggravating factor and negatively affects the prognosis of the disease in such patients. The basis of treatment of patients with COPD is to reduce symptoms, prevent and treat exacerbations, improve exercise tolerance and prevent the progression of the pathology.
 The objective of the research: to assess the value of sICAM-1 in blood serum as a marker of inflammation and criterion for the treatment of the destabilization phase in COPD III degree of bronchial obstruction in overweight patients.
 112 patients with chronic obstructive pulmonary disease (COPD GOLD III) were examined in different phases of pathological process. The main treatment group involved 45 patients suffering from COPD ІІІ degree of bronchial obstruction (subgroup I included 18 patients (40%) with stable phase of pathological process, subgroup II involved 27 patients (60%) at exacerbation phase), and the experimental group consisted of 67 COPD patients with ІІІ degree of bronchial obstruction (subgroup I included 25 patients (37.3%) with stable phase of pathological process; subgroup II involved 42 patients (62.7%) at exacerbation phase).
 The control group involved 23 apparently healthy individuals (AHI). The pulmonary function (PF) test was performed by means of “SPIROKOM” device (Ukraine). The degree of overweight was determined by calculating the body mass index (BMI) using the formula І = m/h² (m – body mass in kilograms, h – height, square of the height in meters (kg/m²). The levels of systemic inflammatory markers were determined by quantitative methods in blood serum: levels of sICAM-1 were identified using ELISA kits (Dialcone, France). While evaluating these indices in the complex therapy of COPD of III degree of bronchial obstruction in patients with overweight, a positive dynamics of its levels was observed on the 10th day. But more significant changes were observed three months after the treatment in those patients who agreed to modify their lifestyle as part of the comprehensive treatment of COPD III degree of bronchial obstruction. According to the research, we found an increase in sICAM-1, more significant in overweight patients, which is one of the manifestations of systemic inflammation in COPD III degree of bronchial obstruction, and complex therapy of this pathology is more effective when modifying the lifestyle of patients.

Pathogenetic relationship and ways of correction of H. pylori in patients with gastric and duodenal peptic ulcers in the combination of arterial hypertension and type 2 diabetes mellitus. Treatment of patient with H. pylori in presence of toxicogenic stra

Objective — to investigate the functional state of endothelium and methods of correction of endothelial dysfunction in patients with gastric and duodenal peptic ulcers (GPU and DPU) in combination with hypertension (AH) and type 2 diabetes mellitus (DM2).
 Materials and methods. The investigation involved 100 patients, who were divided into the groups: group 1 consisted of 20 apparently healthy individuals (AHI), group 2 included 40 patients with GPU (n = 23) and DPU (n = 17) without signs of AH and DM2, group 3 involved 40 patients with GPU (n = 15) and DPU (n = 25) in combination with hypertension and DM2. The groups were sub‑divided into subgroups A and B depending on the H. pylori strains’ toxigenicity: group A included patients with CagA+ VacA+ strains’ combination, groups B — infected with H. pylori with a combination of strains of CagA+ or VacA+. All patients were administered the traditional antihelicobacter therapy (AHBT) (esomeprazole 20 mg twice daily + amoxicillin 1.0 g twice daily + clarithromycin 500 mg twice daily for 10 days). To increase the effectiveness of eradication therapy, 40 patients in addition to AHBT, received a combined probiotic (Bifidobacterium bifidum, B. lactis, Enterococcusus acidophilus, L. paracasei, L. plantarum, L. rhamnosus, L. salivarius) 1 sachet twice a day for 1 month. Eradication control was monitored 4 weeks after completion of treatment.
 Results. The increased expression of the vascular cell adhesion molecule‑1 (VCAM‑1) and the number of desquamated endothelial cells (DEK) and improvement of the oxidant‑antioxidant system have been established. Before the treatment, in comparison with the levels in AHI, levels of sVCAM exceeded in 5.88 times (р < 0.05), of erythrocytic malondialdehyde in 1.92 times (р < 0.05), and levels of the reduced glutathione was lower by 46.39 % (р < 0.05). The use of triple therapy improved the endothelial condition and the state of the oxidative‑antioxidant system, and additional application of probiotic promoted more effective correction of the indices of endothelial state and oxidative‑antioxidant system by means of maximal decrease of the levels of sVCAM and erythrocytic malondialdehyde and increase of the reduced glutathione levels.
 Conclusions. The presence of H. pylori, in particular its toxigenic strains, results in the development of endothelial disfunction in patients with GPU and DPU, combined with arterial hypertension and DM 2. When combined with hypertension and DM2, the course of GPU and DPU is accompanied with «mutual burden» syndrome resulting in the exhaustion of the antioxidant defense system and increased indexes of the glutathione system.

THE COURSE OF CHRONIC KIDNEY DISEASE (CHRONIC PYELONEPHRITIS) IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE AND OBESITY

The aim of the research: to investigate the features of the comorbid course of chronic kidney disease (CKD) (chronic pyelonephritis), non-alcoholic fatty liver disease and obesity, depending on the stage of CKD. To achieve this goal, 250 patients with chronic kidney disease (CKD) (chronic bilateral pyelonephritis) stage I–III were examined, of which 160 patients had concomitant NASH and class 1 obesity (1 group) and 90 people had CKD stage I–III without NASH and obesity (group 2). Depending on the stage of CKD, patients of group 1 were divided into 3 subgroups: with CKD stage I – 63 patients, with CKD stage II – 52 patients, with CKD stage III – 45 patients. Patients of group 2 were also divided into 3 subgroups: with CKD stage I – 32 patients, with CKD stage II – 31 patients, with CKD stage III – 27 patients. The control group included 30 apparently healthy individuals (AHIs). The average age of patients was 49.8 ± 5.8 years. The study did not include patients with CKD stage I–III with nephrotic syndrome and patients with chronic uncomplicated pyelonephritis in the phase of exacerbation. According to the results of our study, we noted a probable effect of nonalcoholic steatosis and steatohepatitis on the functional state of the kidneys in patients with stage I–III CKD: significant changes in glomerular filtration rate, nitrogen excretory function, increased hypoalbuminemia, increased protein in the urine, erythrocytes, leukocytes, the presence of bacteria, compared with patients with CKD without comorbidity. There was a significant correlation between a decrease in glomerular filtration rate (GFR), an increase in the intensity of oxidative stress, a decrease in blood glutathione, hydrogen sulfide, hyperproduction of homocysteine, cytokeratin-18, connective tissue components (collagen, sialic acids). In patients with CKD stage I–II without comorbid NASH and obesity, we found a significantly higher renal functional reserve in response to water-electrolyte stimulation, which is sufficient in both groups of patients (increase in GFR by 28–37% vs. 19–31% for comorbidity with NASH). In patients with CKD stage III with nonalcoholic steatohepatitis we found a significantly reduced functional reserve of the kidneys (increase in GFR by 8.9% vs. 17.5% in patients without NASH), and in 4.9% of patients with comorbidity ­– no functional reserve of the kidneys (p > 0.05), indicating irreversible changes in the functional state of the kidneys.

Association between Arg16Gly Polymorphism in the <i>Β<sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"></i>-Adrenergic Receptor Gene and Obesity Risk in Patients with Bronchial Asthma

The objective of our study was to investigate the association between the Arg16Gly polymorphism in the β2-АR gene and body mass index (BMI) in patients with bronchial asthma (BA) with regard to the age of onset. Materials and methods: 553 patients were examined. The control group consisted of 95 apparently healthy individuals. The patients were divided into 2 groups depending on the age of BA onset: 282 patients with late onset (Group I) and 271 patients with early onset (Group II). Arg16Gly polymorphism in the β2-АR gene (rs1042713) was determined using polymerase chain reaction- restriction fragment length polymorphism analysis. Statistical analysis of obtained results was performed using SPSS–17 program. Results: There was no significant difference in the distribution of genotypes for Arg16Gly polymorphism in the β2-AR gene depending on BMI (χ2 = 5.74; р = 0.22), and no association was found with obesity risks disregarding the age of BA onset. The study on the frequency of genotypes for this polymorphism with regard to the age of asthma onset and BMI found statistically significant differences between early-onset (χ2 = 11.27; p = 0.02) and late-onset (χ2 = 10.66; p = 0.03) asthma. It was found that the risk of obesity in Group I patients was 1.57 times higher in the additive model and 2.67 times higher—in the recessive model of inheritance. In patients with late-onset asthma, Gly16 allele in the recessive model of inheritance was found to have a protective role against obesity. Conclusions: There was no significant difference in the distribution of genotypes for Arg16Gly polymorphism in the β2-AR gene with regard to BMI, and no association was found with obesity risks in BA patients disregarding the age of BA onset. The risk of obesity in patients with early-onset asthma was 1.6 times higher in the additive model and 2.7 times higher—in the recessive model of inheritance.

Quality of life, fatigue and seizure severity in people living with epilepsy in a selected Nigerian population

BackgroundEpilepsy, a chronic seizure disorder, can cause elevated fatigue and reduced quality of life (QOL) of the sufferers. Hence, improving QOL, seizure severity (SS) and fatigue are important areas of therapeutic interventions for people living with epilepsy (PLWE). Therefore, there is need to ascertain the levels and interrelationships among these constructs in PLWE. ObjectiveThis study compared fatigue and QOL of PLWE with those of apparently healthy individuals (AHIs) and also determined the interrelationships between fatigue, QOL and SS in PLWE. MethodThis cross-sectional survey involved 91 PLWE and 101 AHIs consecutively recruited from purposively selected hospitals and hosting communities. The Short-form Health Survey (SF-36) questionnaire, the Fatigue Severity Scale, the Modified Fatigue Impact Scale and the Seizure Severity Questionnaire were used to evaluate QOL, fatigue severity (FS), fatigue impact (FI) and SS respectively. Data was analyzed using frequency count, proportions, mean and standard deviation, range, Chi-square test, Mann-Whitney U test and Spearman-rank order correlation. Alpha level was set at 0.05. ResultsPLWE had significantly lower QOL compared to AHIs (U = 3057.00;p < 0.01). The two groups however experienced similar fatigue severity, but PWE suffered greater fatigue impact (U = 2798.00;p < 0.01). Significant relationships existed among FI, FS, SS and QOL in PLWE (p < 0.01). ConclusionCompared with AHIs, PLWE had poorer QOL, similar FS, and higher FI. QOL of PLWE was negatively associated with SS, FI and FS. Clinical interventions geared towards minimizing seizure, severity and impact of fatigue may improve the QOL of PLWE.

Prevalence, Risk Factors and Antibiotic Susceptibility Pattern of Shigella spp Isolated from Gastroenteritis Patients attending some Hospitals in Kano State, Nigeria

Shigella spp are among the major causes of gastroenteritis, some of which have become multidrug resistant (MDR), making the infection a public health threat. The study was aimed at determining the prevalence, risk factors and antibiotic susceptibility pattern of Shigella spp isolated from gastroenteritis patients. A total of 540 stool samples were collected, involving 450 from gastroenteritis patients (GEPs) and 90 from apparently healthy individuals (AHIs). The isolates were identified based on conventional microbiological techniques and their susceptibility patterns were determined by using Kirby-Bauer method. The patients’ information and demographics were obtained by administering questionnaire. The overall prevalence recorded was 0.9%, with 1.1% and 0% in GEPs and AHIs respectively (Odd ratio= 2.246; 95%CI= 0.1225-40.7708 Significance Level = 0.5873). The highest (2.4%) and lowest (0%) prevalence was recorded among patients who presented with diarrhoea and formed stool respectively (p=0.0487). The prevalence was higher among those who presented with bloody stool (23.1%), compared to those whose appeared normal (0.23%) (p=0.00001). Additionally, prevalence of 4.8% and 0% was observed among those who experienced fever and headache respectively, and the observed differences were significant (P=0.0097). However, neither age nor gender was found to be a risk factor. All the isolates were susceptible to augmentin, and 60% of the isolates showed significant Multiple Antibiotic Resistance (MAR) index. It was concluded that the prevalence of shigellosis was comparatively low and most of the patients presented with bloody diarrhoea and fever. Augmentin was the drug of choice and a possible sign of inappropriate use of antibiotics was observed among the subjects.&#x0D;

Gastrointestinal parasites of captive and free range non-human primates in savanna zone of Nigeria

Primates being reservoirs of parasites that cause major problems to humans, livestock and under stressful conditions to themselves is a major concern to wildlife conservation, our study compared the gastrointestinal parasites of some Non-human Primates at University of Ilorin Zoological Garden (Unilorin Zoo) and Kainji Lake National Park (KLNP), Nigeria in order to determine the level of their prevalence and possibility of infection on tourists visiting the sites. Species sampled were restricted to those common to both sites; Papio anubis, Erythrocebus patas and Chlorocebus aethiops tantalus. A total of 128 faecal samples were screened from apparent healthy individuals. Samples were processed using sedimentation, sugar floatation technique, Stoll's dilution technique, cultured and infective larvae were recovered using Baermann technique.110 (85.7%) samples were positive for infestation of at least one eggs. Among the positive samples were three species of nematodes; Strongyloides spp., Ascaris spp., Ancyclostoma spp. Primates on free-range had higher prevalence of infection. However, under both conditions, there is no significant difference in the prevalence and intensity of parasites harboured over seasonst (4) = 1.968, p =0.120).

The Relationship between Diabetes Mellitus and Renal Failure in Babylon Province

This study was done at medical merjan city that included 70 blood samples have been collected from chronic renal failure patients and compared with 30 samples from apparent healthy individuals as control group, Which were collected between November, 2015 and January, 2016. The samples of patients comprised of 42 male and 28 female at the ages range from( 24-84) years while the control group included 15 female and 15 male those aged( 23-81)years. This study estimated the level of blood Urea, serum Creatinine, and fasting blood Glucose in patients who had the renal problem in diabetes case. There were high significant correlation between S. Ur and S. Cr, and non significant correlation between B. Ur and S. Glu. Aim of the study 1-Estimating the level of blood urea ,serum creatinine and fasting serum glucose in patients have chronic renal failure and diabetes mellitus compared with the same parameters in normal healthy controls and study the correlation between diabetes mellitus and renal failure .

Haematological profiles of Sudanese Traditional Bakery workers exposed to biomass burning hazards

Background and Aim: Approximately one-third of the world’s population in the developing countries are still dependent on Solid Biomass Fuel for cooking, heating and other household activities. This study aims to determine the Haematological profiles of Sudanese Traditional Bakeries workers exposed to wood-burning and compared with the non-exposed. Methods: A case-control study conducted at Kosti, Rabak, and Kenana, during the middle of 2017. Two hundred participants recruited in this study. One hundred traditional bakeries workers represented the case group and another hundred non-exposed apparent healthy matching individuals were chosen as a control group. 2.5 ml venous blood was collected into an EDTA container and the two groups were exposed to full blood counts (FBC). Results: The mean of Haemoglobin, Haematocrit, Mean Cell Volume, Mean Cell Haemoglobin Mean Corpuscular Haemoglobin Concentration, Platelet counts, and Neutrophil count values among bakeries group compared to control group were statistically significantly decreased :12.58 g/dl (±2.15) vs. 15.5 g/dl (±0.95); 42.71 l/l (±6.14) vs. 44.72l/l (±4.15);83.49 fl (±6.43) vs. 89.18 fl (±7.15); 27.72 pg (2.83) vs. 29.41 pg (±1.88); 30.75% (±2.64) vs. 32.33% (±2.26); 205.29×103/l (±51.49) vs. 238.11×103/l (±59.56); 49.59% (±16.43) vs. 57.36% (±13.93) respectively. The mean of TWBC counts 6.77×103/l (±1.71) vs. 6.17×103/l (±1.50) and Lymphocyte counts 36.21% (±13.52) vs. 29.98% (±5.70) were statistically significantly increased in bakeries. No significant differences were observed in the RBC counts between the study group and control group. Conclusions: There was a clear and significant effect of exposure to wood-burning smoke on most of the haematological values, among workers of the traditional bakeries.

Establishment of a rapid and simple liquid chromatography tandem mass spectrometry method for measuring aldosterone in urine

Aldosterone (ALD) measurement plays a critical role in screening and diagnosis of primary aldosteronism. A variety of liquid chromatography tandem mass spectrometry (LC-MS/MS) methods for serum ALD have been developed. However, the few LC-MS/MS methods for 24 h urinary ALD that have been reported require tedious sample pretreatment procedure. This study aimed to establish a novel method for quantification of ALD in urine by LC-MS/MS. Urine samples from study participants were hydrolyzed and subjected to anion exchange solid phase extraction (SPE) followed by the detection of eluates by the negative electro-spray ionization and multiple reaction monitor modes. The established method was compared with two CLIA methods and 114 participants (M:39, F:75) were recruited to study the distribution of urinary ALD in an apparently healthy population. The pretreatment time was reduced to 4 h and the total run time for each sample was 4.5 min. The linearity of the method was in the range of 2–2000 pg/mL (r > 0.999); within laboratory coefficient variation (CV) and repeatability were both <5% and recovery was within 100% ± 10%. The established method showed good consistency with two CLIA methods with the correlation coefficients of 0.993(DiaSorin) and 0.980(Auto), respectively. In the 114 apparent healthy individuals, urinary ALD was 0.74–17.09 μg/24 h (P2.5–P97.5). The method showed an excellent performance of the method, prompting us to conclude that this method may be adopted in the clinic for routine testing and analysis of ALD in urine samples.

Multiparametric Analysis of Connective Tissue Disease Specific Autoantibodies Using a Spot Immunoassay.

Based on advances over several decades, a significant number of autoantibodies are aiding the diagnosis, differential diagnosis and even prognostic estimates of patients with connective tissue diseases (CTD). Based on cost and time constraints, multiplex assays are used more and more in routine practice. Here we describe the evaluation results of a novel spot immunoassay (SeraSpot® ANA) for multiplex analysis of the main CTD specific autoantibodies, which is based on autoantigens immobilized on microtitration plates. For evaluation of the ANA spot immunoassay, comprising dsDNA, histone, nucleosome, Scl-70, U1-RNP (mixture of U1-RNP-A, C, and 70k), Sm (SmD), RibP (P0), Ro52/TRIM21, Ro60, La/SS-B, CENP-B, Jo-1, PM/ Scl-100, and Ku as target antigens, sera of 489 patients with systemic autoimmune rheumatic disease (SARD), sera of 54 patients with herpes virus infections, and sera of 202 apparently healthy individuals (AHI) were tested. The concordance between the SeraSpot and EIA results of disease specific autoantibodies (AABs) was high (94 - 97% for CENP-B, Jo-1, Scl-70, Sm, La, Ro52 and Ro60 antibodies) to moderate (86.7% for dsDNA antibodies), and no major differences in the frequency of these AABs in patients with CTD were observed. In SLE patients, the SeraSpot results of dsDNA antibodies correlate better with CLIFT results and HEp-2 cell pattern than the EIA results. The diagnostic specificities of SLE, SSc, SjS, and myositis specific AABs are very high (96.5 - 100%) compared to apparently healthy individuals, but lower with regard to serological differentiation of the SARD entities (86.6 - 99.1%). However, very high positive likelihood ratios (10 up to infinite) could be obtained by disease specific AAB profiles. The SeraSpot® ANA assay allows the detection of 14 AAB specificities used for the diagnosis and dif-ferentiation of CTD in one approach. Although the concordance between the SeraSpot® assay and EIA is moderate for most of the tested AAB specificities, defined AAB profiles are suitable for the correct diagnosis of the CTD entities. If time matters, the authors suggest the parallel employment of immunofluorescence on HEp-2 cells and the SeraSpot® ANA assay for screening and specific AAB determination of patients with suspected CTD.

Estimation of Serum Interleukin-18 and Hs-CRP in Chronic Hepatitis C Infected Patients at Assuit Governorate, Egypt

Hepatitis C virus (HCV) infection is a global health problem. Egypt has the highest prevalence of hepatitis C virus (HCV) in the world. Interleukin-18 (IL-18) as a critical multipotent inducer of innate and acquired immune responses. This study aimed to estimate IL-18 and hs-CRP levels in patients at different stages of chronic HCV infection and to evaluate IL-18 as a non-invasive marker of the severity of liver damage in chronic hepatitis C patients, and to investigate the characteristics of hs-CRP and its correlation to chronic HCV infection. This study included 50 chronic HCV patients and 20 healthy. They were subjected to history taking, liver function tests, real-time PCR test and other laboratory tests. Serum IL-18 levels were assayed by an enzyme-linked immunosorbent assay. Our study was conducted on 70 subjects with their ages ranging between 9-70 years. 50 HCV chronically infected patients, were 42 (84.0%) males and 8 (16.0%) female. Twenty apparent healthy individuals without HCV infection used as a control, they were 18 (90%) males and 2 (10%) females. Serum IL-18 and Hs-CRP levels were higher in chronic HCV patients compared to healthy. Responders to interferon treatment had higher interleukin-18 levels than non-responders. However, Serum Hs-CRP were higher in non-responders than Responders to interferon treatment. Patients with hepatocellular carcinoma had higher interleukin-18 and Hs-CRP levels than those without hepatocellular carcinoma. Serum IL-18 could be a significant predictor for the severity of HCV infection and monitoring of therapy response in chronic HCV patients with other tests.

The distribution of plasma renin concentration and its characteristics in patients with hypertension

Objective To explore the distribution characteristics of plasma renin concentration in patients with hypertension and the possibly methodological problems. Methods The subjects including 361 patients with hypertension[male: 184 cases, average age: (45.16±13.74)years old; female: 177 cases, average age: (51.04±12.68) years old]and 187 apparent healthy individuals[male: 92 cases, average age: (46.74±13.17)years old; female: 95 cases, average age: (47.33±13.18) years old]were recruited from Departments of Healthy Check-up and outpatients for hypertension in Tangshan Gongren Hospital. The plasma renin concentration was detected by chemiluminescence-Immunoassay. Results The plasma renin concentration shows log-transformed normal distribution both in healthy group and hypertension group. The range of plasma renin concentration in hypertension group is from 0.05 to 574.07 pg/ml, while that in apparent healthy group is from 3.24 to 120.40 pg/ml. The plasma renin concentration in both groups is higher in male than female (Hypertension t=2.19, P=0.029; Healthy people t=2.85, P=0.005). The average concentration of plasma renin in hypertension group is slightly higher, and the width of density distribution is larger in comparison with healthy group although there is no significant difference between them. However, the percentage of plasma renin abnormality was 26.59% (96/361) in hypertension group with 13.85%(50/361)of low renin subtype and 12.74%(46/361)of high renin subtype. Conclusions The plasma renin concentration measured by Chemiluminescence-Immunoassay can be used as an effective tool for hypertension screening.(Chin J Lab Med, 2017, 40: 447-450) Key words: Hypertension; Renin; Luminescent measurements

THE EFFECT OF THE SURROUNDING ENVIRONMENTAL TEMPERATURE ON CARDIAC PROPERTIES OF NORMAL INDIVIDUALS

Cardiovascular disease is the most prominent circulation disorder around the world and one of the leading cause of disease burden in developing countries as the three fourth of the global deaths due to coronary heart disease occur in the middle income countries. Extreme cold episodes significantly has its impact on health ,especially on the cardiovascular system by different mechanisms. This is a community based study aimed to detect the influence of the surrounding environmental temperature on cardiac function. Apparent healthy individuals submitted for longitudinal study along winter and Summer seasons. All subjects undergo specified inclusion and exclusion criteria. All subjects will be exposed to the following investigations at one of the coldest day in Winter (below 14 o C) and one the hottest day in Summer (above 34 o C ): -measurement of arterial blood pressure. -local examination of heart. -recording electrocardiograph ( ECG). Results of the present study show significant elevation in the blood pressure, associated with cold weather.On the other hand there were no- significant changes in the heart rate or other ECG findings. From our results we can conclude that apparently healthy individuals display adaptive functional changes in the cardiovascular system during seasonal variation. Cold weather is associated with slight increase in thearterial blood pressure (systolic and diastolic).

Molecular characterization of clinical isolates of Cyclospora cayetanensis from patients with diarrhea in India

Purpose:Cyclospora cayetanensis is an intestinal coccidian protozoan that has emerged as an important cause of both epidemic and endemic protracted diarrhea worldwide. Though humans appear to be the only natural hosts; the role of animals as natural reservoir is uncertain but of increasing concern. The present study aimed to study the prevalence of coccidian in different groups such as immunocompromised, clinically apparent immunocompetent and healthy individuals. Also, the study isolates were assessed for heterogeneity among the sequences. Materials and Methods: Stool samples from different groups of patients were collected. The parasite was detected in stool by different diagnostic tools such as light microscopy and nested PCR-restriction fragment length polymorphism using 18S ribosomal RNA as the target gene. Results: The prevalence of C. cayetanensis was 2.4% (19/800) in the present study. The PCR assay amplified Cyclospora cayetanensis DNA in only 89% (17/19) isolates. Further, sequencing revealed no significant difference among the study isolates and the non-primates. Phylogenetic analysis of the study isolates however, formed two clusters. While one cluster showed close evolutionary association with the C. cayetanensis strains, the other cluster showed evolutionary association with the two non-primate species. Conclusion: The methods described here for detection of C. cayetanensis oocysts are simple, efficient, specific, and sensitive and therefore can be effectively applied for laboratory diagnosis and environmental assessment of fresh produce and water sources. Clinicians should include Cyclospora infection in the differential diagnosis of prolonged or relapsing diarrheal illness even in clinically apparent immunocompetent individuals.

P691 KEY PATTERNS OF HBsAg MUTATIONS CORRELATE WITH MECHANISMS UNDERLYING LEVELS OF SERUM HBVDNA

Background and Aims: Every year globally WHO reports nearly 20 million Hepatitis E virus (HEV) infections. The disease has potential to cause massive epidemics. The reservoir of HEV during interepidemic period in India is not well characterized, with evidences of deficient zoonotic links. Further, the sporadic cases usually lack history of contact with clinically overt HEV patients. In the present context the occurrence of subclinical HEV as a possible reservoir of infection in endemic region was evaluated. Methods: Blood samples were collected from 67 apparently-healthy individuals and 10 acute viral hepatitis (AVH) patients during two HEV outbreaks in North India. The serum samples were tested for anti-HEV IgM, IgG, HEV-IgG avidity-index, HEV viral-load and conventional-PCR followed by sequencing and phylogenetic analysis. Results: A total of 14 (20.89%) apparently-healthy individuals showed presence of both anti-HEV IgM and IgG. Based on HEVIgG avidity-index, 9 apparently-healthy individuals (64.28%) had secondary-exposure, 4 (28.57%) had primary-exposure, while one patient had intermediate-avidity. Subclinical subjects with primaryexposure had significantly higher anti-HEV IgM index as compared to secondary-exposure. Viral-load in clinically jaundiced patients was significantly higher as compared to subclinical subjects (p < 0.0001). Phylogenetic analysis showed HEV sequences retrieved from subclinical individuals (Genotype 1a) clustered along with AVH patients reported in the same outbreak suggesting matched origin. The significantly low viral-load in subclinical subjects hints towards the dose dependency for progression of clinical manifestation. Conclusions: We document subclinical passage of HEV occurs without producing clinically overt hepatitis goes un-noticed which, in turn helps maintaining the virus in nature possibly leading to its endemicity.