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Khadiga SM Salama,1 Eman M Moazen,1 Sawsan B Elsawy,1 Sanaa F Kotb,1 Eid M Mohammed,2 Sara A Tahoun,3 Marwa A A Ramadan,3 Samar M Abd Elhamid,3 Rania H M Bahi,4 Etemad A Mohammad5 1Chest Diseases Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 2Chest Diseases Department Faculty of Medicine for Men’s, Al-Azhar University, Cairo, Egypt; 3Clinical Pathology Department Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 4Chest Diseases Department Faculty of Medicine, Zagazig University, Zagazig, Egypt; 5Chest Diseases Department Faculty of Medicine, Benha University, Benha, EgyptCorrespondence: Sawsan B Elsawy, Chest Diseases Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt, Email Sawsan.bakr79@gmail.comBackground and Aim: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has profound effects on disease progression and patients’ quality of life. Emerging evidence suggests an association between alterations in the respiratory microbiome flora species and airway inflammation in patients with AECOPD. The present study aimed to describe the inflammatory cells and bacterial microbiome distributions in respiratory tract in Egyptian patients with AECOPD.Subjects and Methods: The present cross-sectional study included 208 patients with AECOPD. Sputum and broncho-alveolar lavage samples from the studied patients were submitted to microbial cultures using appropriate media. Total and differential leukocytic counts and were done via automated cell counter.Results: The present study included 208 AECOPD patients. They comprised 167 males (80.3%) and 41 females (19.7%) with an age of 57.9 ± 4.9 years. AECOPD was categorized as mild, moderate and severe in 30.8%, 43.3% and 26%, respectively. Sputum samples had significantly higher TLC, neutrophil percent and eosinophil percent when compared with BAL samples. In contrast, lymphocyte percent was significantly higher in BAL samples. Sputum specimens had significantly lower frequency of positive growths (70.2% versus 86.5%, p = 0.001). Among the identified organisms, sputum specimens had significantly lower frequency of Strept. pneumoniae (14.4% versus 30.3%, p = 0.001), Klebsiella pneumoniae (19.7% versus 31.7%, p = 0.024), Haemophilus influenzae (12.5% versus 26.9%, p = 0.011), Pseudomonas aeruginosa (2.9% versus 10%, p = 0.019) and Acinetobacter spp. (1.9% versus 7.2%, p = 0.012) growths when compared with BAL samples.Conclusion: The present study could identify a distinctive pattern of inflammatory cell distribution in sputum and BAL samples of AECOPD patients. The most commonly isolated organisms were Klebsiella pneumoniae and Strept. pneumoniae.Keywords: chronic obstructive pulmonary disease, COPD exacerbation, inflammatory cells, bacterial microbiome, sputum culture, bronchoalveolar culture

Zirconium nitride (ZrN) thin films were deposited by reactive RF magnetron sputtering on Ti-6Al-4V and Si (100) substrates for potential use in biomedical applications. The tribological behaviour was evaluated against bovine bone in dry condition using a pin-on-disc apparatus. Abrasion is the primary wear mechanism observed in ZrN/bone contact. The corrosion properties were determined through two electrochemical techniques: potentiodynamic polarization and electrochemical impedance spectroscopy. The coatings with reduced oxygen content provided: (i) good resistance against corrosion when exposed to physiological solution and (ii) better anti-bioadhesion against Staphylococcus aureus bacteria. [ABSTRACT FROM AUTHOR]

The Doppler shift of the near and far Waves due to the electromagnetic source in motion is investigated. Using the decomposition of Green's function for the wave in the case of classical oscillating electron motion, it is found that there are some regulative conditions of the phenomena. The present theory proves that the shift is undefined in the adjacent area. In fact, in the vicinity of the source the wave number is very small so that the delay effects become negligible and the phase is imprecise. Actually, the spectrum of the radiation field in the adjacent area is ambiguous. The current theory establishes a regular Doppler effect in the distant area. In fact, the wave number can never be achieved. Taking account of the source motion, the immobile observer can in all way stay sometime in the far field zone to obtain all the information on the field. Bearing in mind that the propagator coupled with the electric field takes a shifted frequency. Once, the relationship between the far-field frequency, the oscillating dynamic source have been established, the spectrum exists and can be analyzed.. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify, evaluate, and rank suitable safety innovations developed during the COVID-19 pandemic in Latin American and Caribbean (LAC) radiation oncology centers., Methods: We conducted a multimodal participatory engagement collaboration with the Latin-American and Caribbean Society of Medical Oncology. The study consisted of four phases. Innovations were collected from a panel of radiotherapy experts representing a diverse group of 11 countries from LAC (Phase I). Next, a medical scientific team compared the innovations against international standards regarding their potential impact on risk of infection, clinical operation, and continuity of quality cancer care (Phase II). Their findings were supplied to the country representatives who rated the innovations for acceptability in their cancer centers (Phase III), resulting in a final report of the panel's recommendations (Phase IV)., Results: A total of 81 innovations were reported by the country representatives and merged by the medical scientific team into 24 innovations that combined similar innovations. The 24 innovations were grouped into six categories including practices aimed at (1) reducing clinic crowding (n = 3), (2) increasing screening and vaccinations for COVID-19 disease (n = 5), (3) implementing social distancing (n = 6), (4) strengthening personal infection equipment and disinfection (n = 6), (5) avoiding delaying or shortening treatment protocols (n = 2), and (6) mixed procedures (n = 2). The medical scientific team found nearly all innovations were supported by international recommendations and rated as safe, efficient, and acceptable., Conclusion: By using the lessons learned from the Community-Led Action Research in Oncology: Pandemic-Appropriate Radiotherapy Innovations Evaluated study, a manual of scalable practices in radiation oncology clinics may be developed to guide actions during future large-scale public health crises in low- and middle-income countries of LAC.

Introduction: Immunity in cancer patients is modified both by the cancer itself and by oncospecific treatments. Whether a patient's adaptive immunity is impaired depends on their levels of naive lymphocytes and other cell populations. During the COVID-19 pandemic, cancer patients are at greater risk of progressing to severe forms of the disease and have higher mortality rates than individuals without cancer, particularly while they are receiving cancer-specific therapies. An individual's protection against infection, their response to vaccines, and even the tests that determine the humoral immune response to SARS-CoV-2, depend on lymphocyte populations, meriting their study., Objective: Estimate blood concentrations of lymphocytes involved in the immune response to new pathogens in cancer patients., Methods: We carried out an analytical study of 218 cancer patients; 124 women and 94 men, 26-93 years of age, who were treated at the National Oncology and Radiobiology Institute in Havana, Cuba, March-June, 2020. Patients were divided into five groups: (1) those with controlled disease who were not undergoing cancer-specific treatment; (2) those undergoing debulking surgery; (3) patients undergoing chemotherapy; (4) patients undergoing radiation therapy and (5) patients currently battling infection. We evaluated the following peripheral blood lymphocyte subpopulations via flow cytometry: B lymphocytes (total, naive, transitional, memory, plasmablasts and plasma cells); T lymphocytes (total, helper, cytotoxic and their respective naive, activated, central memory and effector memory subsets); and total, secretory and cytotoxic natural killer cells and T natural killer cells. We also estimated neutrophil/lymphocyte ratios. Lymphocyte concentrations were associated with controlled disease and standard cancer therapy. For variables that did not fall within a normal distribution, ranges were set by medians and 2.5-97.5 percentiles. The two-tailed Mann-Whitney U test was used to measure the effect of sex and to compare lymphocyte populations. We calculated odds ratios to estimate lymphopenia risk., Results: All cancer patients had lower values of naive helper and cytotoxic T lymphocyte populations, naive B lymphocytes, and natural killer cells than normal reference medians. Naive helper T cells were the most affected subpopulation. Memory B cells, plasmablasts, plasma cells, activated T helper cells, and cytotoxic central memory T cells were increased. Patients undergoing treatment had lower levels of naive lymphocytes than untreated patients, particularly during radiation therapy. The risk of B lymphopenia was higher in patients in treatment. The odds ratio for B lymphopenia was 8.0 in patients who underwent surgery, 12.9 in those undergoing chemotherapy, and 13.9 in patients in radiotherapy., Conclusions: Cancer and conventional cancer therapies significantly affect peripheral blood B lymphocyte levels, particularly transitional T helper lymphocytes, reducing the immune system's ability to trigger primary immune responses against new antigens.

Background and Purpose: There is a clear need for innovation in anti-tuberculosis drug development. The zebrafish larva is an attractive disease model in tuberculosis research. To translate pharmacological findings to higher vertebrates, including humans, the internal exposure of drugs needs to be quantified and linked to observed response., Experimental Approach: In zebrafish studies, drugs are usually dissolved in the external water, posing a challenge to quantify internal exposure. We developed experimental methods to quantify internal exposure, including nanoscale blood sampling, and to quantify the bacterial burden, using automated fluorescence imaging analysis, with isoniazid as the test compound. We used pharmacokinetic-pharmacodynamic modelling to quantify the exposure-response relationship responsible for the antibiotic response. To translate isoniazid response to humans, quantitative exposure-response relationships in zebrafish were linked to simulated concentration-time profiles in humans, and two quantitative translational factors on sensitivity to isoniazid and stage of infection were included., Key Results: Blood concentration was only 20% of the external drug concentration. The bacterial burden increased exponentially, and an isoniazid dose corresponding to 15 mg·L -1 internal concentration (minimum inhibitory concentration) leads to bacteriostasis of the mycobacterial infection in the zebrafish. The concentration-effect relationship was quantified, and based on that relationship and the translational factors, the isoniazid response was translated to humans, which correlated well with observed data., Conclusions and Implications: This proof of concept study confirmed the potential of zebrafish larvae as tuberculosis disease models in translational pharmacology and contributes to innovative anti-tuberculosis drug development, which is very clearly needed., (© 2020 The Authors. British Journal of Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.)

Actinobaculum schaalii is a rarely reported, anaerobic, Gram-positive bacterium which role as uropathogen is emerging. We report here the case of a 47 year old HIV-1 infected woman presented with five recurrent episodes of obstructive pyelonephritis in the context of multiple renal stones. No bacteria was found until the fifth episode, during which prolonged urinary cultures as well as 16S rDNA sequencing allowed the diagnosis of A. schaalii infection. She had developed a life-threatening condition with severe renal failure. A right nephrectomy was performed and found that the intrarenal stones were attributed to the antiretroviral therapy. The renal parenchyma corresponded to an end-stage renal disease with chronic pyelonephritis without abcesses or granules. The situation improved after six months of amoxicillin therapy., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: The RENAL nephrometry score (RNS) allows description of the anatomy and the complexity of renal masses. This study aimed to investigate the interobserver reproducibility of the RNS between a radiologist and a urologist., Methods: The computed tomography (CT) scans of patients undergoing partial nephrectomy in the authors' department between June 2010 and June 2013 were analyzed for determination of the RNS by a urologist and a radiologist blinded to the medical records. Cohen's kappa coefficient was used for interobserver reproducibility assessment. Correlations with per- and postoperative complication rates and renal function were assessed., Results: The study included 52 consecutive patients with a mean age of 55 years. The average score was 7.4 ± 1.7 for the urologist and 7.3 ± 1.5 for the radiologist. The Cohen's kappa was 0.81 for R, 0.47 for E, 0.63 for N, 0.28 for A, and 0.21 for L. The Pearson's coefficient for the total RNS was 0.70. The operative time and the occurrence of major complications were significantly correlated with the complexity assessed by the score of both observers. In the univariate analysis, the RNS, the American Society of Anesthesiologists score, and the patient's age were significantly associated with major complication rates. In the multivariate analysis, the RNS remained significantly associated with major complications. No significant difference in postoperative renal function according to complexity group was found by either the urologist or the radiologist., Conclusions: The reproducibility of the RNS between the radiologist and the urologist was not very good, especially for some items referring to the location of the tumor, although the major complication rates were significantly associated with the RNS for both observers.

The prognosis of patients with advanced head and neck cancer remain dismal. For this tumor type, elevated levels of EGFR are associated with a shorter disease free survival and time to treatment failure, reflecting a more aggressive phenotype. Nimotuzumab is a humanized monoclonal antibody that recognizes domain III of the extracellular region of the EGFR, within an area that overlaps with both the surface patch recognized by cetuximab and the binding site for EGF. In order to assess the efficacy of nimotuzumab in combination with radiotherapy, a controlled, double blind, randomized clinical trial was conducted in 106 advanced squamous cell carcinoma of the head and neck patients, mostly, unfit for chemoradiotherapy. Control patients received a placebo and radiotherapy. Treatment was safe and the most frequent adverse events consisted on grade I or II asthenia, fever, headache and chills. No skin rash was detected. A significant complete response rate improvement was found in the group of patients treated with nimotuzumab as compared to the placebo. In the intent to treat analysis, a trend towards survival benefit for nimotuzumab treated subjects was found. The survival benefit became significant when applying the Harrington-Fleming test, a weighted log-rank that underscores the detection of differences deferred on time. In addition, a preliminary biomarker investigation showed a significant survival improvement for nimotuzumab treated patients as compared to controls for subjects with EGFR positive tumors. All patients showed a quality of life improvement and a reduction of the general and specific symptoms of the disease.