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Background Cytomegalovirus (CMV), a common virus with double-stranded DNA, causes complications and occasional death post-liver transplantation. The pre-transplant donor's and recipient's serological status is the primary potential factor for CMV reactivation. Our research aimed to assess risk factors that predict the possibility of CMV infection in post-liver transplant patients. Methods This retrospective study included 194 adult patients with hepatitis C-related end-stage liver disease (ESLD) who received liver transplants at the Ain Shams Center for Organ Transplantation between January 2014 and December 2018. The data were collected and analyzed regarding demographics, lab results, surgery details, and post-transplant outcomes to determine the rate of post-transplant CMV infection and identify its risk factors. Results The graft rejection was more common among recipients who developed CMV infection (31.8%) compared to those without infection (11.3%). CMV infection appeared to be more frequent among patients receiving cyclosporine-based immunosuppressive therapy. Recipients with higher Model for End-Stage Liver Disease (MELD) scores showed increased incidence of post-transplant CMV infection. CMV IgM seropositivity pre-transplant was associated with post-transplant CMV infection. Conclusion Cyclosporine-based immunosuppressants, younger recipient age, a higher MELD score, and pre-transplant positive CMV IgM status were found to be risk factors associated with post-transplant CMV infection. CMV infection appeared to be associated with graft rejection.

Liver transplantation (LT) is the only effective radical cure for all types of end-stage liver diseases. Major advances have been made in the field of liver transplantation due to improvements in surgical techniques and organ conservation as well as optimization of intensive care and immunosuppressive management. We aimed to assess the influence of ABCB1 gene polymorphism of liver transplant recipients on blood level and dose requirements of oral tacrolimus, in an attempt to help in designing an individualized tacrolimus regimen for Egyptian liver transplant recipient. The study included 25 liver transplant recipients and their respective 25 donors. All subjects of this study were subjected to full medical history, clinical evaluation, laboratory investigations, and ABCB1 gene polymorphism evaluation by RT-PCR. Tacrolimus concentration was evaluated for all the recipients during the first 3 months post transplantation. The present study revealed that the presence of CC genotype was significantly correlated to the effect on tacrolimus C/D ratio and weight-adjusted tacrolimus dose during the first week of the first and 2nd months (Z = -2.108, P <0.05) but not the 3rd month post transplantation (p-value >0.05). Subjects carrying CC genotype required higher doses of tacrolimus to achieve the desired trough levels compared to subjects carrying CT and TT genotypes. The same effect was observed over the whole period of the study but the results were statistically non-significant (p-value>0.05). Recipients who received liver tissue from donors carrying CC genotype also required higher doses of tacrolimus and reached lower levels of blood tacrolimus trough levels. The present study revealed that ABCB1 CC genotype of both recipients and donors of liver transplantation was significantly associated with increased required tacrolimus dose early after liver transplantation reaching statistically significant level in the first week of the first and second months.

(1) Background: Hepatotoxicity is a common health problem, and oxidative stress plays a crucial role in its underlying mechanisms. We inspected the possible effect of retinoic acid (RA) in the potentiation of hepatoprotective effect of bone marrow mesenchymal stem cells (BM-MSCs) against Cisplatin (Cis)-induced hepatotoxicity. (2) Methods: 60 male Sprague Dawley rats (SD) were separated randomly and designated to six main equal groups as follows: (1) Control group, (2) Cis group (rats got Cis 7 mg/Kg i.p.), (3) Cis + vehicle group (as group 2, but rats received the (vehicle) culture media of BM-MSCs), (4) Cis as in group 2 + BM-MSCs (1x106), (5) Cis as for group 2 + RA 1 mg/Kg i.p., and (6) Cis and BM-MSCs as for group 3 + RA as for group 4. Liver injury was assessed by measuring liver enzymes (ALT, AST), while liver toxicity was evaluated by histopathological examination. Apoptotic marker caspase-3 protein was detected immunohistochemically. Real time PCR was performed to detect NADPH oxidase and TNF-α at transcription levels. Oxidative stress was investigated by colorimetric measurement of MDA, GSH and catalase. (3) Results: Contrary to the Cis group (p < 0.05), BM-MSCs/RA supplementation resulted in a substantial decrease in serum levels of hepatic impairment indicators such as ALT, AST and oxidative stress markers such as MDA, as well as an increase in hepatic GSH, Catalase, and a decrease in expression of TNF-α and downregulation of NADPH oxidase. The improvement after therapy with BM-MSCs/RA was confirmed by histopathological examination. Moreover, the downregulation of caspase-3 in liver tissue after BM-MSCs/RA treatment was validated by immunohistochemistry investigation. (4) Conclusions: BM-MSCs and RA attenuated Cis induced hepatotoxicity through downregulation of oxidative stress resulted in modulation of anti-inflammatory TNF-α and apoptosis caspase-3 indicating a promising role in hepatotoxicity.

Multidetector Computed Tomography (MDCT) imaging is a noninvasive tool that does not necessitate sedation and allows accurate assessment of the variceal site and size. Patients experience better tolerance when using MDCT than upper GI endoscopy (EGD). The present study aimed to assess the efficacy of MDCT in evaluating esophageal varices. We conducted a thorough search of international databases (Web of Science, PubMed, Embase, and Scopus) and extracted studies using the appropriate keywords to investigate the efficacy of MDCT in evaluating esophageal varices. The collected data were analyzed using the random and fixed-effects model and STATA (version 15). 17 articles aligned with the inclusion criteria, published between 2008 and 2022, were included in the study. The pooled data of 15 articles on MDCT sensitivity and specificity were 0.87 and 0.82, with 95% CI of 0.85-0.89 and 0.81-0.84, respectively. The meta-analysis of the data from fourteen articles showed a pooled PPV of 0.85 and a pooled NPV of 0.84, with 95% CI of 0.83-0.87 and 0.82-0.85, respectively. Also, our meta-analysis of eight surveys that reported accuracy revealed a high pooled accuracy of 0.92 (95% CI: 0.90-0.93), underscoring the reliability of MDCT in evaluating esophageal varices. These findings strongly suggest that MDCT holds considerable potential as a valuable diagnostic tool for clinicians managing patients with liver cirrhosis and suspected esophageal varices, paving the way for more effective patient care.

Background Hepatocellular carcinoma is considered one of the most common cancers occurring in human population all over the world. It became an increasingly threatening malignancy due to both morbidity and mortality. Chronic viral hepatitis B and hepatitis C are two risk factors, which account for 80–90% of all HCC cases worldwide. Alfa Feto protien is used as a tumor marker for HCC diagnosis and prognosis prediction; however, its false negative rate when used alone is as high as 40% for patients with early-stage HCC. AFP levels remain normal in 15–30% of all the patients, even patients with advanced HCC. It has been demonstrated that miRNAs (MicroRNAs) are an important class of non-coding RNAs. They act as tumor oncogenes or suppressors and are involved in the HCC development. MiRNAs are endogenous nucleotides that can be found in intra- and extracellular spaces, such as the blood, urine, and saliva. The study evaluated the miRNA 21 as a novel biomarker in patients with HCV related hepatocellular carcinoma. Results The study was conducted on three groups. Group (1) included 25 patients with liver cirrhosis due to hepatitis C virus infection. Group (2) included 25 patients with hepatocellular carcinoma (HCC) on top of liver cirrhosis due to hepatitis C virus infection. Group (3) included 10 normal control subjects. There was a significant difference in the mean level of miRNA between the three groups with p value < 0.001 with the highest value in group 2 ( 8.28 ± 2.55), then in group1 (5.04 ± 2.11) and the lowest in group 3 (control) (1.02 ± 0.07). MiRNA 21 has a sensitivity of 68% and a specificity of 96%, to differentiate between the liver cirrhosis group and HCC group. Conclusion miRNA 21 can be a promising marker for detection of patients with HCV-related hepatocellular carcinoma, with higher specificity compared to α feto protein; however, its cost is higher.

Group A Streptococcus pyogenes (GAS), a β-hemolytic Gram-positive bacterium, is one of the most significant human pathogens globally. It is the primary causative agent of bacterial pharyngitis, a common condition that affects millions of individuals annually, particularly children aged 5–15 years. GAS pharyngitis accounts for approximately 20–30% of sore throat cases in pediatric populations and 5–15% in adults [1]. The clinical relevance of GAS infections extends beyond the acute illness, as untreated or inadequately treated pharyngitis can lead to immune-mediated complications such as acute rheumatic fever, rheumatic heart disease, and post-streptococcal glomerulonephritis, all of which pose substantial public health burdens, particularly in low-resource settings [2,3].