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Background The defective clearance of apoptotic bodies in juvenile-onset systemic lupus erythematosus (jSLE) potentially leads to the persistence of autoreactive lymphocytes and the perpetuation of the autoimmune response. These factors contribute to the disturbance in lymphocyte apoptosis and show potential as key determinants in the clinical course and severity of jSLE. This study evaluates the role of peripheral blood (PB) lymphocyte apoptosis in prognosis of jSLE and as a predictor for disease activity. Methods The study involved 100 jSLE patients and 50 healthy controls. Flow cytometry was used to analyze percentages of lymphocyte apoptosis in PB of all study participants. Plasma levels of pro-inflammatory cytokines were determined using ELISA. Results Our results showed that percentages of lymphocyte apoptosis in PB of jSLE patients are significantly higher than those of healthy controls. These percentages are significantly positively associated with disease activity of patients (SLEDAI-2 K). Furthermore, plasma cytokine levels (IL-17, IFN-γ and TNF-α) are significantly elevated in jSLE patients compared to their levels in healthy controls. Also, there are weak significant positive correlations between percentages of PB lymphocyte apoptosis and each of IL-17 and IFN-γ plasma levels in jSLE patients. Moreover, PB lymphocyte apoptosis percentages among jSLE patients are higher in the presence of some clinical and laboratory features than those in their absence. Conclusion Peripheral apoptotic lymphocytes could contribute to the prognosis of jSLE and could be used as a predictor for disease activity in jSLE patients.

Recurrent and severe infections occurred in children with Down Syndrome (DS) due to immunological parameter defects have been reported. The aim of the study is to evaluate the importance of using T-cell receptor excision circle (TREC) and kappa-deleting recombination excision circle (KREC) as molecular markers for immunological investigation of children with DS. The study included 40 non-disjunction trisomy 21 confirmed DS children, and 25 healthy controls. Peripheral blood (PB) was analyzed for lymphocyte subpopulations by flow cytometry, serum immunoglobulin levels, and TREC and KREC copy numbers using quantitative real-time PCR. DS patients showed significantly lower absolute counts of PB T lymphocytes, T helper lymphocytes, T cytotoxic lymphocytes, B lymphocytes, and Natural killer cells, and lower serum IgA, IgG, and IgM levels compared to healthy controls. Copy number of TREC and KREC showed no significant differences between DS patients and healthy controls. There is a significant positive correlation between TREC copy number with a percentage and absolute count of helper T lymphocytes in patients. Also, the KREC copy number was significantly negatively correlated with the age of patients. These findings suggest that copy numbers of TREC and KREC could be useful as molecular markers for immunological evaluation of patients with DS.

Factor H expression pattern was examined in blood of all subjects using quantitative real-time polymerase chain reaction and the frequency of factor H autoantibodies was estimated in plasma using enzyme-linked immunosorbent assay. All patients fulfilled the 2012 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for SLE.30 Demographic and cumulative clinical manifestations were recorded, and laboratory investigations included complete blood count (CBC), erythrocyte sedimentation rate (ESR), urine analysis, serum creatinine, liver function tests, serum complement C3 and C4, antinuclear antibody (ANA) and anti-double stranded deoxyribonucleic acid (anti-dsDNA), as well as 24-h urinary protein. Disease activity at the last visit was assessed through the Systemic Lupus Erythematosus Disease Activity Index2000 (SLEDAI-2K).31 Disease damage index was determined through SLICC Damage Index (SDI)/ American College of Rheumatology (ACR) Damage Index (DI).32 Lupus nephritis (LN) was defined as clinical and laboratory manifestations meeting the American College of Rheumatology (ACR) renal criteria (persistent proteinuria >0.5 g per day (24-h urinary protein) or greater than 3+ dipstick, cellular casts including red cell, hemoglobin, granular, tubular or mixed, and renal biopsy for histopathological examination demonstrating immune complex-mediated glomerulonephritis compatible with LN).33 Healthy controls were selected from age- and sex-matched individuals. Ribonucleic acid (RNA) extraction and quantitative real-time polymerase chain reaction (qRT-PCR) Total RNA was extracted and isolated from fresh blood of all individuals of the study populations using the QIAamp RNA Blood Mini Kit (Qiagen GmbH, Hilden, Germany) according to the manufacturer's instructions.

Knee osteoarthritis (KOA) is an important cause of disability in the world and it denotes a public health defiance of the upcoming years. Aim  To examine the connection between ADAMTS14 gene rs4747096 polymorphism and KOA and to assess risk factors associated with KOA. Methods  A case control study was conducted on 158 patients with KOA and 120 controls with comparable age and sex randomly recruited from National Research Centre employees. All participants were subjected to full history taking, assessment of KOA severity using WOMAC scoring system, and thorough clinical examination. Blood sample was collected for detection of ADAMTS14/rs4747096 gene polymorphism. Results  The frequency of ADAMTS14 gene rs4747096 genotypes among patients with KOA was 73.5% for AA, 25.7% for AG, and 0.7% for GG compared to controls 963%, 31.3%, and 5.6% respectively and the frequency of alleles among patients was 86.4% for A and 78.7% for G compared to controls (78.7% and 21.3% respectively, P  < 0.05. The study found that the median levels of total WOMAC score and its domains were significantly higher among KOA patients than controls. The logistic regression analysis revealed that age ≥ 50 years, BMI ≥ 35, and long standing at work were predictive factors for KOA ( P  < 0.05). Regarding different genetic patterns, only the A recessive pattern of inheritance was found to be a predictive risk factor for KOA. Conclusion  For ADAMTS14 rs4747096 genotype, the AA and AG genotypes significantly increased the risk of KOA. The recessive pattern of inheritance, older age, morbid obesity, and prolonged standing at work were the predictive risk factors for KOA. Further studies with larger sample size are encouraged to investigate the mechanism by which this genotype can affect the development of KOA.

Respiratory diseases, including pneumonia, asthma, bronchiolitis, and croup, remain the leading causes of pediatric morbidity and mortality worldwide. Diagnostic challenges persist, especially in low-resource settings lacking specialized tools. Artificial intelligence (AI)-based analysis of cough sounds has emerged as a promising, noninvasive diagnostic alternative. This systematic review synthesizes evidence on the predictive ability of AI algorithms for diagnosing specific pediatric respiratory diseases using cough sounds, evaluating their diagnostic performance, clinical applicability, and methodological quality. Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines, six studies were included from 270 records identified in PubMed, Scopus, Web of Science, and IEEE Xplore databases. Eligible studies evaluated AI models such as logistic regression, convolutional neural networks (CNNs), support vector machines (SVMs), and hybrid feature-based approaches that combined acoustic and spectral features for disease classification. Techniques like wavelet-based feature extraction and late fusion, where outputs from multiple models are combined at the decision level, were reported to improve diagnostic accuracy. Sensitivity ranged from 82% to 94%, and specificity from 71% to 91% across studies, indicating high diagnostic potential, with some AI models outperforming conventional diagnostic methods such as the World Health Organization (WHO) clinical algorithms. Risk-of-bias assessment using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) revealed concerns in four studies (67%), mainly due to retrospective designs, small sample sizes (ranging from 65 to 585 participants), and lack of external validation. Study limitations included heterogeneous outcome definitions and insufficient reporting of model calibration. Overall, AI-driven cough sound analysis demonstrates significant promise as a rapid, scalable diagnostic tool for pediatric respiratory diseases, particularly in resource-limited settings. Future research should focus on prospective multicenter validation, transparent reporting of methodological details and performance metrics, and integration into clinical workflows to ensure safe and effective real-world implementation.

Objective The aim was to investigate the existence of immunoglobulin (Ig)G antibody against Helicobacter pylori ( H. pylori ) in blood sample from patients having laryngeal lesions and comparing its level in benign versus malignant lesions. Patients and Methods Under general anesthesia, direct laryngoscopy was performed for patients having laryngeal lesions, and biopsy was taken and sent for histopathology. Anti- H. pylori IgG antibodies were measured by enzyme-linked immunosorbent assay from venous blood samples from each patient. Results Within the included 56 patients, 30 had benign lesion and 26 (46%) had squamous cell carcinoma (SCC). Overall, 73.3% of patient with benign lesions were seropositive and 92.3% of patient with laryngeal SCC were seropositive. The mean anti- H. pylori IgG antibody level was significantly ( P =0.0041) higher in patients who had SCC (23.93±19.6) than patients who had benign laryngeal lesions (38.9±27.5). Conclusion Laryngeal lesions are commonly associated with H. Pylori infection and showed significantly higher level in laryngeal SCC than benign lesions, reflecting more association of larynx cancer with H. pylori infection.

Objectives: This study aimed to evaluate the expression pattern of Deoxyribonuclease1-Like 3 (DNase1L3), an endonuclease that catalyses the degradation of chromatin within apoptotic or necrotic cells, at the mRNA and protein levels and their association with the disease activity and inflammatory markers in Juvenile-onset systemic lupus erythematosus (jSLE) patients. Methods: 36 Juvenile-onset systemic lupus erythematosus patients and 25 healthy controls were included in the study. DNase1L3 and Interleukin (IL)-1beta expression in peripheral blood were determined using qRT-PCR, while ELISA was used to determine plasma levels of DNase1L3 and tumour necrosis factor (TNF)-alpha. Results: DNase1L3 expression pattern at the mRNA and protein levels was significantly lower while IL-1beta and TNF-a levels were significantly higher in Juvenile-onset systemic lupus erythematosus patients than healthy controls. There were significant negative associations between DNase1L3 expression at mRNA and protein levels with SLEDAI-2K of patients. Also, DNase1L3 plasma levels of patients were inversely correlated with IL-1beta levels in a significant manner. Conclusion: DNase1L3 could be involved in the immune regulation of jSLE patients and could be considered as a potential regulator of immune activation in those patients.

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by familial aggregation and genetic predisposition. MicroRNAs (MiRNAs) serve as critical biomarkers in lupus patients because of their aberrant expression in different SLE stages. The study aimed to investigate the correlation of miR-31 and miR-21 with IL-2 in SLE patients as regulatory biomarkers in the activation of T lymphocytes of Egyptian lupus patients. Quantitative RT-PCR is carried out to estimate the expressions of miR-31 and miR-21, and IL-2 levels were determined using ELISA in plasma of 40 patients with SLE, 20 of their first-degree relatives and 20 healthy controls. The study also determined the systemic lupus erythematosus disease activity index (SLEDAI) score and proteinuria in SLE patients. The results revealed that miR-31 was lower expressed, while miR-21 was high expressed in SLE patients compared to their first-degree relatives and controls. MiR-31 was negatively correlated with SLEDAI and proteinuria in lupus patients, while miR-21 showed positive correlation with them. Also we found that there is a significant positive correlation between miR-31 and IL-2 in SLE patients, while miR-21 was negatively correlated with IL-2 level in patients. In conclusion, the study disclosed a significant association between miR-31 and miR-21 expression with IL-2 level in SLE patients. The regulatory biomarkers of miR-31 and miR-21 might have an impact on regulating IL-2 pathway expression and in turn on the activation of T lymphocytes in SLE.

Objective The aim was to investigate the existence of immunoglobulin (Ig)G antibody against Helicobacter pylori (H. pylori) in blood sample from patients having laryngeal lesions and comparing its level in benign versus malignant lesions. Patients and methods Under general anesthesia, direct laryngoscopy was performed for patients having laryngeal lesions, and biopsy was taken and sent for histopathology. Anti-H. pylori IgG antibodies were measured by enzyme-linked immunosorbent assay from venous blood samples from each patient. Results Within the included 56 patients, 30 had benign lesion and 26 (46%) had squamous cell carcinoma (SCC). Overall, 73.3% of patient with benign lesions were seropositive and 92.3% of patient with laryngeal SCC were seropositive. The mean anti-H. pylori IgG antibody level was significantly (P=0.0041) higher in patients who had SCC (23.93±19.6) than patients who had benign laryngeal lesions (38.9±27.5). Conclusion Laryngeal lesions are commonly associated with H. Pylori infection and showed significantly higher level in laryngeal SCC than benign lesions, reflecting more association of larynx cancer with H. pylori infection.

Objective Testosterone levels are frequently low in men with type 2 diabetes mellitus (DM), and the majority of these men have symptoms of hypogonadism. Obesity is associated with low testosterone levels in diabetic men. The aim of our work was to study the link between type 2 DM in men aged 40-50 years and the increased incidence of hypogonadism. Patients and methods Our study included two groups of patients: group A, which included 40 male diabetic patients (type 2) aged 40-50 years, and group B, which included 40 healthy age-matched control individuals. All patients and controls were subjected to a medical questionnaire and examination of BMI, waist-hip ratio (WHR), and laboratory investigations for evaluation of total testosterone, free testosterone, sex hormone binding globulin (SHBG), luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, and glycosylated Hb (HbA1c). Results The patient group showed a significant decrease in serum total testosterone (3.83 ± 2.18 ng/ml), free testosterone (4.15 ± 2.08 pg/ml), and SHBG (27.48 ± 10.07 nmol/l) in comparison with the control group (6.14 ± 1.37 ng/ml, 13.82 ± 5.14 pg/ml, and 62.85 ± 9.17 nmol/l, respectively), a highly significant decrease in LH and FSH (2.35 ± 1.98 mIU/ml and 4.79 ± 2.72 IU/ml, respectively, vs. 4.56 ± 1.22 mIU/ml and 6.88 ± 1.69 IU/ml in the control group), and significant increase in prolactin and HbA1c (19.014 ± 8.65 ng/ml and 6.85 ± 2.12%, respectively, vs. 6.51 ± 2.2 and 4.3 ± 1.16 in the control group). In addition, there was a significant increase in BMI (35.2 ± 3.56 kg/m 2 ) and WHR (1.02 ± 0.12) in comparison with the control group (22.22 ± 1.76 kg/m 2 and 0.8 ± 0.04, respectively). Total testosterone concentration showed a positive nonsignificant correlation with SHBG (r = 0.076) but significant positive correlation with FSH and LH (r = 0.672 and 0.696, respectively) and significant negative correlation with serum HbA1c, BMI, and WHR (r = −0.324, −0.442, and −0.306, respectively) and highly significant negative correlation with prolactin (r = −0.783) in male patients with type 2 DM. Free testosterone showed a nonsignificant negative correlation with SHBG (r = −0.0229) and significant negative correlation with HbA1c, BMI, and WHR (r = −0.311, −0.373, and −0.374, respectively) but a highly significant negative correlation with prolactin (r = −0.740) and a highly significant positive correlation with FSH and LH (r = 0.798 and 0.762) in male patients with type 2 DM. Conclusion This study demonstrates that significant number of men with type 2 DM aged between 40 and 50 years have testosterone insufficiency and symptoms of hypogonadism.