Positive CD Research Articles

Risk of rehospitalization due to Clostridioides difficile infection among hospitalized patients with Clostridioides difficile: a cohort study.

Reducing rehospitalization has been a primary focus of hospitals and payors. Recurrence of Clostridioides difficile infection (CDI) is common and often results in rehospitalization. Factors that influence rehospitalization for CDI are not well understood. To determine the risk factors that influence rehospitalization caused by CDI. A retrospective cohort study from January 1, 2018, to December 31, 2018, of patients aged ≥18 who tested positive for C. difficile while hospitalized. Academic hospital. The risk of rehospitalization was assessed across exposures during and after the index hospitalization using a Cox proportional hazards model. The primary outcome of this study was 60-day CDI-related rehospitalization. There were 559 hospitalized patients with a positive CD test during the study period, and 408 patients were included for analysis. All-cause rehospitalization was 46.1% within 60 days of the index hospital discharge. Within 60 days of discharge, 68 patients developed CDI, of which 72.5% (49 of 68) were rehospitalized specifically for the management of CDI. The risk of rehospitalization in patients with CDI was higher among patients who were exposed to systemic antibiotics ([adjusted hazard ratio] aHR: 2.78; 95% CI, 1.36-5.64) and lower among patients who had post-discharge follow-up addressing C. difficile (aHR: 0.53; 95% CI, 0.28-0.98). Exposure to systemic antibiotics increased the risk of rehospitalization due to CDI, while post-discharge follow-up decreased the risk of rehospitalization due to CDI. Comprehensive transitions of care for hospitalized patients with C. difficile may reduce the risk of CDI-related rehospitalization.

Novel Chiral Self-Assembled Nano-Fluorescence Materials with AIE Characteristics for Specific Enantioselective Recognition of L-Lysine.

In this paper, two aggregation-induced emission (AIE) chiral fluorescent materials, S-1 and S-2, were synthesized. The two materials are based on BINOL and H8-BINOL backbones, respectively, and large electron-absorbing groups are attached to the chiral backbones through the Knoevenagel reaction. At the same time, the CD signals of these two chiral fluorescent materials are gradually weakened (fw gradually increases) as they continue to aggregate. However, S-2 underwent a flip-flop from a negative to positive chiral CD signal at fw ≥ 90. And both materials also showed significant enantioselective recognition of lysine, demonstrating their potential as novel chiral fluorescent probes. Among them, the enantioselective fluorescence enhancement ratios (ef) of S-1 and S-2 for lysine were 10.0 and 10.3, respectively, while different degrees of blue shifts were produced by the ICT mechanism during the recognition process. In addition, the self-assembled morphology of the two nanomaterials is different; S-1 comprises hollow-core vesicles that are more likely to aggregate to form larger self-assembled vesicles, whereas S-2 is a solid block structure. When L/D-lysine was added alone, the morphology of S-1 was more distinctly different compared to S-2. With the addition of L-lysine, S-1 was dispersed and regularly spherical, whereas with the addition of D-lysine, S-1 itself remained in the form of aggregated large vesicles. This suggests that both S-1 and S-2 are important in the fields of chiral optics, chiral recognition, and nanoscale self-assembly.

P1045 Comparative Efficacy of Fecal Microbiota Transplantation for Clostridioides Difficile Infection in Patients with and without Inflammatory Bowel Disease: A Retrospective Cohort Study

Abstract Background Clostridioides difficile infection (CDI) significantly exacerbates and worsens the prognosis of inflammatory bowel disease (IBD). While fecal microbiota transplantation (FMT) is recognized as a safe and efficacious therapy for patients battling recurrent or refractory CDI, but comparative studies focusing on the success rates in IBD and non-IBD patients remain scarce. Our study aims to shed light on this gap in knowledge. Methods In this retrospective cohort study conducted at Chang Gung Memorial Hospital between April 2019 and February 2023, patients undergoing FMT via colonoscopy for recurrent or refractory CDI were enrolled. Participants were categorized into IBD and non-IBD groups based on their underlying conditions. We compared baseline characteristics and clinical outcomes at one-month and one-year follow-up intervals. CDI diagnosis was confirmed through positive CD toxin A/B genes and associated clinical symptoms. Donor specimens were sourced from Chang Gung Microbiota Therapy Center's fecal bank. Results Our study included 88 patients who received FMT, comprising 30 in the IBD group and 58 in the non-IBD group. The indications were recurrent CDI in 31 patients, refractory CDI in 54, and both conditions in 3 patients. Among the IBD subgroup, 20 patients had ulcerative colitis, and 10 had Crohn's disease. In the baseline comparison, the IBD group was significantly younger (mean±SD, 45.23±16.45 years vs. 61.90±24.40 years, P = 0.001) and had fewer comorbidities such as hypertension (10.0% vs. 55.2%, P < 0.001), diabetes mellitus (6.7% vs. 31.0%, P = 0.014), and cancer (3.3% vs. 31.0%, P = 0.012) than the non-IBD group. Additionally, the IBD group had less prior Fidaxomin use (6.9% vs. 26.3%, P = 0.021) and fewer HMG-CoA reductase inhibitor users (0.0% vs. 15.5%, P = 0.025). Post-FMT, IBD severity indices showed significant improvement at one month. The mean partial Mayo score in the IBD group decreased by 2.9 points, the endoscopic Mayo subscore decreased by 0.7 points, and the Crohn’s Disease Activity Index decreased by 79.98 points. At this time, the IBD group showed a similar percentage of negative CDI toxin A/B tests (83.3% vs. 63.8%, P = 0.174) but had lower clinical remission rates (79.5% vs. 96.5%, P = 0.006) compared to the non-IBD group. However, at the one-year follow-up, the eradication rate (94.4% vs. 73.9%, P = 0.112) and clinical remission rate (84.2% vs. 90.3%, P = 0.661) were comparable between both groups. No safety issues or adverse effects were reported in any of the patients. Conclusion FMT demonstrates safety and efficacy in treating recurrent or refractory CDI in both IBD and non-IBD patients, also aiding in mitigating IBD-associated inflammation.

Clinical and prognostic significance of CD27 and CD44 expression patterns in Egyptian pediatric patients with B-precursor acute lymphoblastic leukemia

IntroductionThe expression pattern of CD27 and CD44 was found to correlate with the differentiation stages of B cell precursors, which were known to be involved in a variety of immunological responses. Aim of the studyThis study aimed to determine the biological significance of CD27 and CD44 expression in patients with B-precursor acute lymphoblastic leukemia (B-ALL), as well as their association with standard prognostic factors and therapeutic response. Patients and methodsThis case-control study included 60 pediatric patients newly diagnosed with B-ALL and 30 pediatric controls. The patient CD27 and CD44 levels were measured using the Beckman Coulter Navios Flow Cytometer. ResultsMost malignant cells (91.6 %) expressed CD44, but only 50 % of the patients had CD27 expressed. The positive CD 44 expression was associated with unfavorable prognostic markers, including a decrease

Case Report: A very rare case of a Pleural Effusion revealing Multiple Myeloma

Multiple myeloma is a common malignant bone-based disease. Pleural effusions reported in these patients remain rare. It is commonly due to congestive heart disease, pulmonary embolism, nephrotic syndrome or a second neoplasia. The true myelomatous pleural effusion resulting from a direct tumoral invasion of the pleural are extremely rare. We report here the case of a massive pleural effusion revealing multiple myeloma in a 71-year-old patient. The chest ultrasound showed a massive pleural effusion in the left side with a multinodular thickening of the pleura. The medical thoracoscopy showed a grape-cluster appearance. The diagnosis was made by pleural guided biopsy revealing abnormal plasma cells with an intense positive CD 138 (plasma cell marker) and MUM1 (multiple myeloma oncogene1) staining with a light kappa chain in the protein electrophoresis associated with a myeloma. Unfortunately, our patient died one month after the initial diagnosis. We present also a review of the recent literature in order to highlight the clinical presentations of the myelomatous pleural effusion, the diagnostic tools, the therapeutic strategies as well as the outcomes.

Case Report: A very rare case of a pleural effusion revealing multiple myeloma

Multiple myeloma is a common malignant bone-based disease. Pleural effusions reported in these patients remain rare. It is commonly due to congestive heart disease, pulmonary embolism, nephrotic syndrome or a second neoplasia. The true myelomatous pleural effusion resulting from a direct tumoral invasion of the pleural are extremely rare. We report here the case of a massive pleural effusion revealing multiple myeloma in a 71-year-old patient. The chest ultrasound showed a massive pleural effusion in the left side with a multinodular thickening of the pleura. The medical thoracoscopy showed a grape-cluster appearance. The diagnosis was made by pleural guided biopsy revealing abnormal plasma cells with an intense positive CD 138 (plasma cell marker) and MUM1 (multiple myeloma oncogene1) staining with a light kappa chain in the protein electrophoresis associated with a myeloma. Unfortunately, our patient died one month after the initial diagnosis. We present also a review of the recent literature in order to highlight the clinical presentations of the myelomatous pleural effusion, the diagnostic tools, the therapeutic strategies as well as the outcomes.

Primary Non Hodgkin Lymphoma on the left breast of a 53 year old woman: A rare case report

Primary breast lymphoma (PBL) is a rare but distinct subtype of extranodal lymphoma, comprising 0.5% of breast malignancies, approximately 1% of all non-Hodgkin's lymphomas (NHL) and <3% of extranodal lymphomas. Because the cases are rare, the diagnosis is difficult to establish by routine histopathological examination alone. This paper reports a case of a 53-year-old woman, complaining of a lump in the left breast. The lump is said to have been noticed since approximately 2 years ago on the nipple. The patient said that initially the lump was the size of a grape and then realized that it had enlarged since 3 weeks ago with a more chewy texture. Ultrasound of the left mammary, heterogeneous solid lesion with indistinct borders with dilatation of the drawerous duct with the appearance of intraductal calcification filling the superolateral and superomedial quadrants of the left mammary suggestively malignant (BIRADS 5). The microscopic appearance of the FNAB suggested a malignant round cell tumor. Based on the results of the biopsy and immunohistochemical examination, the results were positive CD 45, CD 20 positive, CD 3 negative, and Ki67 positive in 90% of tumor cell nuclei. It was concluded that it was a non-Hodgkin's lymphoma, with a large diffuse pattern. The patient was reported did not survive.

Relationship between low vitamin D levels with Hashimoto thyroiditis

Introduction/Objective. Vitamin D not only plays a role in calcium and phosphorus metabolism, but also has antiproliferative, prodifferentiation, anti-inflammatory and immunomodulatory effects. The aim of this study was to investigate the association between vitamin D deficiency in individuals with autoimmune Hashimoto?s thyroiditis. Methods. A total of 156 patients were enrolled and divided into two groups. First group included 108 patients with 25 (OH) D insufficiency, and second included 48 individuals with normal 25 (OH) D levels. All participants underwent a detailed clinical examination, laboratory tests for thyroid function [T3, fT4, TSH, thyroid antibodies (TPO-Ab, and TG-Ab)], as well as ultrasound scanning (thyroid volume and Doppler characteristics). Results. The patients with vitamin D insufficiency (n = 108 (69.2%)) were predominantly female and had a higher body mass index than the patients with normal vitamin D levels. The group with vitamin D insufficiency had statistically significantly higher TSH levels. The prevalence of positive thyroid antibodies was higher in the vitamin D insufficiency group, while thyroid volume, superior thyroid artery, and inferior thyroid arteries resistance index, as well as the prevalence of positive circular dichroism signals, were significantly higher in the vitamin D insufficiency group. Out of the 156 subjects, 44 were diagnosed with thyroiditis (28.2%). The mean serum level of 25 (OH) D was statistically notably lower in patients with thyroiditis (20.23 ? 8.10 ng/mL) than in the group without thyroiditis (25.44 ? 8.38 ng/mL), p < 0.001. Conclusion. There was an association between vitamin D insufficiency and hypothyroidism in subjects with Hashimoto?s thyroiditis.

The effectiveness of intrauterine antibiotic infusion versus oral antibiotic therapy in the treatment of chronic endometritis in patients during IVF (in vitro fertilization) procedures

BackgroundChronic Endometritis (CE) is a subtle pathology, likely infectious in most cases, with a negative impact on the female fertility, but often overlooked even among fertility specialists. The purpose of the study is to demonstrate the predominant infectious nature of CE and to find the best therapeutic option by comparing the results of oral antibiotic therapy versus intrauterine antibiotic infusion in patients with CE undergoing IVF procedures. The objective was to compare the cure rate of CE—defined as the percentage of patients without CE at the test of cure, between the two groups and, the hysteroscopic aspect with the positive CD 138 staining.MethodsThis was a prospective, case—control study that took place in a single university fertility clinic, in Oradea, Romania and included 57 patients with CE divided into 2 groups: orally administered antibiotics group who received a combination of antibiotics compared to intrauterine infusion group who received intrauterine infusion of antibiotic. Chronic Endometritis was diagnosed through hysteroscopy and immunohistochemistry for CD 138. Patients in both groups were tested for CE twice to evaluate the cure rate after oral combination antibiotic therapy versus intrauterine infusion of antibiotic.ResultsOut of 115 patients with endometrial biopsies 57 tested positive for CE, with a 49.6% chronic endometritis prevalence. Among the group that was administered oral antibiotics, 11 patients (45.83%) experienced CE resolution after triple antibiotic therapy. Of the intrauterine infusion group, 25 patients (89.29%) presented negative results (p 0.0020). The normal hysteroscopic aspect had a similar prevalence in the patients with immunohistochemical positive and negative CD 138.ConclusionsOur study demonstrated the effectiveness and superiority of intrauterine antibiotic infusion over the use of oral combination antibiotic therapy for CE cure.Trial Registration: ISRCTN17542620/14.09.2022.

SOLITARY BONE PLASMACYTOMA OF THE LEFT ZYGOMA REGION: A RARE CASE REPORT

Background: Solitary Bone Plasmacytoma (SBP) is a characterized by a mass composed of monoclonal plasma cells in bone without any proof of systemic disease attributing to myeloma. It is a rare form of plasma cells in bone that represents only 5 – 10% of all plasma cell neoplasm. The diagnosis requires solitary bone lesion conrmed by skeletal survey, plasma cell inltration proven by biopsy, normal bone marrow biopsy, and no myeloma-related organ failure. Reporting one rare case of solitary bonePurpose: plasmacytoma of the left zygoma region treated with surgical excision followed by radiotherapy. A 61 years old male came withCase Report: complains of swelling in the left cheek for 2 years. Histopathological examination by ne needle aspiration biopsy of the left zygoma region showed atypical plasmacytoid cell with suspected plasmacytoma which then conrmed by positive CD 138 staining. Clinical Question: What is the management of solitary bone plasmacytoma of the zygoma region? Searching for literature evidence through GoogleReview Method: Scholar. The search obtained 11 journals that met the inclusion and exclusion criteria. There were similarities in clinical symptoms andResult: management with this reported case. In the reported case, the clinical features of SBP are swelling or mass in the zygoma boneDiscussion: spreading to maxillary bone with intermittent mild pain with no ear, nose, or throat complain, and no myeloma related organ dysfunction. The diagnosis was determined by history taking, physical examination, and supporting examination by ne needle aspiration biopsy which was conrmed by the pathology anatomy feature of the post-surgical specimen and CT imaging. Solitary bone plasmacytoma manifestsConclusion: itself as a single osteolytic lesion without plasma cytosis of bone marrow and constitutes approximately 5% of all plasma cell neoplasms. SBP reinforces for the meticulous diagnostic work up. In this case, surgical excision followed radiation is the treatment of choice, as plasma cell neoplasm are highly radiosensitive.

Primary Gastric Lymphoma: A Silent Assassin

The gastrointestinal (GI) tract is the predominant site of extra nodal lymphoma involvement. Gastric lymphoma is the most common extra nodal site of lymphoma. Most of these lesions are either extra nodal marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT) type or diffuse large B cell lymphoma (DLBCL). Primary gastric lymphoma accounts for less than 5% of gastric cancers. They are usually non-Hodgkin’s lymphomas (NHL), but have been considered as a separate entity from NHLs of peripheral nodes. The diagnosis of primary lymphoma of stomach requires histological confirmation without any evidence of peripheral lymphadenopathy or organomegaly. Secondary gastric lymphoma indicates the involvement of the stomach by a diffuse lymphoma developed elsewhere. We report a 60 years old male presented with intermittent vomiting and reflux symptoms. Upper GI endoscopy showed large hard mass with superficial ulceration in the fundus of stomach. Histopathology showed lymphoproliferative disorder. Immunohistochemistry confirmed positive CD 20 and BCL 2 suggestive of extranodal marginal zone B cell lymphoma. Subsequently, he was referred to surgery and oncology department for further management.

Immunohistochemical Evaluation of CD3, CD4, CD8, and CD20 in Decidual and Trophoblastic Tissue Specimens of Patients with Recurrent Pregnancy Loss.

Recurrent miscarriages affect up to 5% of couples. CD3+ (T-lymphocytes), CD4+ (helper T-lymphocytes), CD8+ (cytotoxic T-lymphocytes), and CD20+ (B-lymphocytes) cells may participate in the pathophysiology of recurrent pregnancy loss (RPL). The aim of this study was to investigate the complicity of these molecules in RPL. The experimental specimens were obtained from 20 females who underwent miscarriages in the first gestational trimester, while the control group’s specimens consisted of 20 females who proceeded with voluntary pregnancy termination during the same period. Tissue samples were taken from the decidua basalis, decidua parietalis, and trophoblast (placental chorionic villi) and were studied using immunohistochemical methods. Monoclonal antibodies were used against CD3, CD4, CD8, and CD20 cells. The lymphocyte levels in the decidua parietalis displayed profound disparities among the two groups. The decidua basalis and trophoblast exhibited almost the same disparities regarding positive CD cells. The comparison of CD4+ and CD8+ cells in the endometrial tissue revealed a significant difference between the two groups of study. The analysis uncovered a strong relationship between RPL and the presence of CD3+, CD4+, CD8+, and CD20+ cells in the decidua parietalis tissue. The number of positive T cells was decreased in the decidual basalis and chorionic villi, proving that their absence significantly disrupts the balance of the immunological environment.

Novel tetrahydropyrimidinyl-substituted benzimidazoles and benzothiazoles: synthesis, antibacterial activity, DNA interactions and ADME profiling.

A series of tetrahydropyrimidinyl-substituted benzimidazoles attached to various aliphatic or aromatic residues via phenoxymethylene were synthesised to investigate their antibacterial activities against selected Gram-positive and Gram-negative bacteria. The influence of the type of substituent at the C-3 and C-4 positions of the phenoxymethylene linker on the antibacterial activity was observed, showing that the aromatic moiety improved the antibacterial potency. Of all the evaluated compounds, benzoyl-substituted benzimidazole derivative 15a was the most active compound, particularly against the Gram-negative pathogens E. coli (MIC = 1 μg mL-1) and M. catarrhalis (MIC = 2 μg mL-1). Compound 15a also exhibited the most promising antibacterial activity against sensitive and resistant strains of S. pyogenes (MIC = 2 μg mL-1). Significant stabilization effects and positive induced CD bands strongly support the binding of the most biologically active benzimidazoles inside the minor grooves of AT-rich DNA, in line with docking studies. The predicted physico-chemical and ADME properties lie within drug-like space except for low membrane permeability, which needs further optimization. Our findings encourage further development of novel structurally related 5(6)-tetrahydropyrimidinyl substituted benzimidazoles in order to optimize their antibacterial effect against common respiratory pathogens.

Manifestação oral de mieloma múltiplo: um estudo de caso

Multiple myeloma (MM) is a relatively uncommon oncohematological condition characterized by abnormal proliferation of plasma cells. Oral manifestations of MM can occur in soft and intraosseous parts. We present a case of a 69-year-old man diagnosed with MM and undergoing chemotherapy, referred to the dental service complaining of a nodular swelling in the maxilla. An incisional biopsy was conducted and the histopathological analysis showed a monoclonal proliferation of plasma cells with a positive CD 138 immunophenotype, which allowed the diagnosis of extramedullary plasmacytoma. The outcome of the case was unfavorable and the patient died. We emphasize the importance of diagnosing MM extramedullary disease in the maxillofacial region.

Prevalence of Detection of Clostridioides difficile Among Asymptomatic Children

Detection of Clostridioides difficile has frequently been described in asymptomatic infants and children, but accurate estimates across the age spectrum are unavailable. To assess the prevalence of C difficile detection among asymptomatic children across the age spectrum. This systematic review and meta-analysis included a search of the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, Scopus, and Web of Science for articles published from January 1, 1990, to December 31, 2020. Search terms included Clostridium difficile, Peptoclostridium difficile, Clostridioides difficile, CDF OR CDI OR c diff OR c difficile, Clostridium infections OR cd positive diarrhea OR cd positive diarrhea OR Clostridium difficile OR Peptoclostridium difficile OR pseudomembranous colitis OR pseudomembranous enterocolitis, enterocolitis, and pseudomembranous. These were combined with the following terms: bacterial colonization and colonization OR colonized OR colonizing OR epidemiology OR prevalence OR seroprevalence. Studies were screened independently by 2 authors. Studies were included if they reported testing for C difficile among asymptomatic children (ie, children without diarrhea) younger than 18 years. Data were extracted independently and in duplicate by 2 reviewers. Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines were used. Data were pooled using a random-effects model. The primary outcome was prevalence of C difficile detection among asymptomatic children. Secondary outcomes included prevalence of toxigenic vs nontoxigenic strains of C difficile and prevalence of C difficile detection stratified by geographic region, income status, testing method, and year of testing. A total of 95 studies with 19 186 participants were included. Rates of detection of toxigenic or nontoxigenic C difficile were greatest among infants aged 6 to 12 months (41%; 95% CI, 32%-50%) and decreased to 12% (95% CI, 7%-18%) among children aged 5 to 18 years. The prevalence of toxigenic C difficile colonization was lower, peaking at 14% (95% CI, 8%-21%) among infants aged 6 to 12 months and decreasing to 6% (95% CI, 2%-11%) among children older than 5 years. Although prevalence differed by geographic region (ie, North and South America vs Europe: β, -0.151, P = .001; North and South America vs Western Pacific: β, 0.136, P = .007), there was no difference by testing method (ie, culture vs polymerase chain reaction: β, 0.069, P = .052; culture vs enzyme immunoassay: β, -0.178, P = .051), income class (low-middle income vs high income: β, -0.144, P = .23; upper-middle vs high income: β, -0.020, P = .64), or period (before 1990 vs 2010-2020: β, -0.125, P = .19; 1990-1999 vs 2010-2020: β, -0.037, P = .42; 2000-2009 vs 2010-2020: β, -0.006, P = .86). In this systematic review and meta-analysis, C difficile colonization rates among children were greatest at 6 to 12 months of age and decreased thereafter. These estimates may provide context for interpreting C difficile test results among young children.

Trends in Clostridioides difficile diagnosis before and after a change in testing algorithm

Clostridioides difficile (Clostridium difficile) (CD) infection remains a challenging diagnosis in hospitalized patients given the myriad of testing procedures and array of alternative causes for diarrhea. We identified 100 consecutive inpatients with positive CD testing in a single tertiary center before and after changing from nucleic acid amplification testing (NAAT) alone to a two-step algorithm involving Glutamate Dehydrogenase enzyme immunoassays (GDHEIA) followed by an enzyme immunoassay for CD toxins (EIA). Detailed clinical information was obtained retrospectively to assess for risk factors, clinical features, and treatment outcomes to correlate test results with clinical cases. We demonstrate that using a 2-step testing algorithm identifies patients with a consistent clinical illness for CD disease significantly more often than nucleic acid amplification testing alone without an increase in cases of severe CD disease. Our data suggest that NAAT alone results in an increase in unnecessary treatment of CD colonization.

Solitary Fibrous Tumor Low Rectum Simulating Cancer

Introduction: The solitary fibrous tumor is a benign mesenchymal tumor of rare extra-pleural location. We report a case of solitary fibrous tumor observed in the lower rectum simulating cancer. The objective was to discuss the diagnostic and therapeutic management of the solitary fibrous in Madagascar. Observation: This is a sixty-five-year-old man, seen in consultation for dyskinesia, with no family history of neoplasia. The digital rectal examination revealed a large, non-budding, firm mass at the level of the right posterolateral surface with a lower pole located 2 cm from the anal margin, the remains of the physical examination are normal. Abdominal computed tomography showed a mass measuring 8 × 7 × 5.5 cm at the expense of the rectal wall of regular tissue density, without a mesenteric node or secondary localization. the biopsy had not found any malignant cells. This result is due to insufficiently deep biopsy samples of the mass, which led us to perform a complete surgical excision by coloprotectomy. The operative follow-up to which was simple. Immunohistochemical study of the surgical specimen confirmed the diagnosis with a positive CD 34 marker. The outcome was favourable without metastasis or recurrence after a six-month follow-up. Conclusion: The rectal localization of the solitary fibrous tumor is exceptional. The diagnosis is histological confirmed by the immunohistochemical study with a positive CD 34 marker.

Platelet-Rich Plasma in the Management of Chronic Endometritis Treatment in Women with Reproductive Health Disorders

Background: Chronic endometritis (CE) is one of aggressive factor of infertility and reproductive losses.
 Objective: We aimed to assess the effectiveness of using platelet-rich plasma (PRP) treatment of chronic endometritis (CE) treatment in women with infertility (PI) and recurrent pregnancy losses (RPL).
 Material and methods: In this non-randomized clinical trial, women aged 22-45 years with CE diagnosed by positive CD 138 between February 2017 and December 2019 were included. Were investigated 65 women - 30 patients with RPL and 35 women with PI and unsuccessful attempts at IVF. PRP therapy was performed paracervical ( 6 ml) and intrauterus ( 1,5 ml) once a week for 4 -8 weeks. Control of the treatment of CE was performed by endometrial biopsy pipelines 15-20 days after the last PRP.
 Results: After carrying out 4 procedures of combined paracervical and intrauterine PRP, CE was cured in 70-77% of women (p <0.05); after 8 procedures - 97% (p <0.01).
 Conclusions: Combined intrauterine and paracervical PRP therapy is an effective treatment for CE in women with PI and RPL.

Negative nonlinear CD-<italic>ee</italic> dependence in dibenzoyltartaric acid induced aggregates of perylenebisimide

Supramolecular chirality of aggregates can be described in terms of the CD signals of the aggregates as a function of the enantiomeric excess of the chiral building block or chiral inducer. While many examples have been reported that show a positive nonlinear CD- ee relationship, indicating chiral amplification, the negative nonlinear dependence has rarely been observed. We recently proposed to build such supramolecular aggregates by using the mesomer of the enantiomeric inducers. Indeed we found that in the presence of enantiomeric dibenzoyltartaric acids (DboTar), achiral perylenebisimide (PBI) dye equipped with two terminal guanidinium groups in alkaline aqueous buffer solution is induced to form chiral supramolecular aggregates, via the known guanidinium-carboxylate salt bridge, that show a positive nonlinear CD- ee relationship, and is turned into negatively nonlinear when 40% or more molar fraction of meso -DboTar was introduced. Absorption and CD spectral titrations suggest that the aggregates led by enantiomers and by mesomer are similar in terms of the supramolecular structure and stability, and when the two kinds of aggregates are mixed no molecular exchange occurs between them. Fluorescence spectral traces of the aggregates show that the mesomer is more powerful in inducing the aggregation of the PBI dyes, and thus dominates the aggregation. Our findings that the mesomer of the enantiomeric inducer could lead to aggregates to exhibit a negative nonlinear CD- ee relationship provide a promising approach to such supramolecular aggregates, which could be of significance for better insight into the mechanism leading to the negative nonlinear dependence and eventually a comprehensive understanding of the supramolecular chirality.

Prognostic Value of Soluble HLA-G and CD38 Expression in Patients with Chronic Lymphocytic Leukemia in Egypt

Background: Chronic lymphatic leukemia (CLL) is the most common hematological malignancy in adults presenting with varied clinical courses. There is an increased demand for establishing known prognostic factors for stratifying CLL patients. Aim of the work: To investigate the expression of soluble form of human leucocyte antigen-G (HLA-G) & CD 38 in CLL and to correlate our findings with a variety of clinical and laboratory variables. Patients and methods: The study included thirty newly diagnosed CLL patients. They were 18 males and 12 females with age ranged from 49–65 (a mean of 57.5 years old). Diagnosis of CLL was confirmed by flow cytometric immunophenotyping using standard lymphoma panel. CD38 expression was determined by flow cytometry. S. HLAG was measured by ELISA method. Results: Positive CD38 expression was significantly associated with lower Hb and platelets (p = 0.008 and 0.025 respectively) also with higher Beta2 microglobulin (p = 0.012). Soluble HLA G was positively correlated with the platelets count(r = 0.400, p = 0.02). Higher level of soluble form HLA-G was significantly more frequent in patients of 60 years or older (p = 0.001). The cumulative overall survival was 83.3%. Positive CD 38 expression was associated with significantly worse survival (p < 0.005). HB count < 10 gm/dl was associated with significantly worse survival (p < 0.001). Conclusion: CD38 expressions are considered powerful prognostic markers in predicting overall survival for Egyptian CLL patients and they should be assessed to decide the patient's therapy and to determine disease prognosis. Expression of soluble form of HLA-G in CLL patients by ELISA get no extra prognostic importance.