Background: We aim to analyze the additive value of repeated transthoracic echocardiography (TTE) within a 1-week interval after a baseline TTE to diagnose infective endocarditis (IE) in patients admitted with Staphylococcus aureus bacteremia (SAB). Methods: We prospectively enrolled consecutive patients with SAB who were referred for TTE and transesophageal echocardiography (TEE) to exclude IE between January 2017 to December 2019. All patients underwent a second TTE within 5 to 7 days. We excluded patients with poor echo windows, previous IE, valve repair/replacement, and those with cardiac devices or a dialysis catheter in place. Results: A total of 105 patients were enrolled, of which 40 (38.1%) were female. The mean age was 52 ± 14 years.Sixty-four patients (61%) had a defined source of infection, and 36 (34.3%) were intravenous drug users. The majority (n = 74, 70.5%), had methicillin-sensitive S. aureus. Sixteen patients (15.2%) were diagnosed with definite IE based on TEE findings as follows: eight tricuspid valve IE, four mitral valve IE, three aortic valve IE, and one with double valve IE (mitral and tricuspid). The mortality rate was 7.6% (two patients with definite IE and six without IE). Vegetations were not detected in one patient on the first TTE, compared to TEE and the second TTE. The baseline TTE had a sensitivity of 93.8%, specificity of 87.6% and accuracy of 88.6% in identifying echocardiographic evidence of IE. The addition of second TTE findings increased the sensitivity to 100%, specificity to 95.5%, and diagnostic accuracy to 96.2% in comparison to TEE for the detection of IE. Conclusions A repeat TTE within 5 to 7 days of an initial study significantly enhances diagnostic accuracy for detecting IE in patients with SAB and may help reduce the need for TEE in selected low-risk cases.

Post-stroke depression is the most common neuropsychiatric complication of stroke, and can occur early too late after stroke. However, having depression as an isolated clinical manifestation of stroke is extremely rare in the literature. We report the case of an ischemic vascular accident revealed by sudden onset depression in a 59-year-old female patient. On the basis of this report and a review of the literature we discuss the different hypotheses that may explain the underlying mechanisms.

OBJECTIVE: This study investigated cytotoxicity and induction of apoptosis in human cervical cancer cells (HELA) and prostate cancer cells (PC-3) using the most active fraction of Moringa peregrina seed extract. METHODS: Dried and powdered seeds were extracted using 95% ethanol. The total ethanolic extract was further dissolved in distilled water and separated into petroleum ether, chloroform, ethyl acetate and aqueous extracts. Based on the results of in vitro anticancer studies of all extracts, the most highly active extract was selected for evaluation of apoptosis induction and cell cycle analysis on HELA and PC-3 cells at its half maximal inhibitory concentration using flow cytometry; DNA fragmentation by agarose gel electrophoresis and the expression of protein were measured by Western blot. RESULTS: The chloroform fraction from the ethanolic extract of M. peregrina (CFEE) was the most active antitumor fraction. The selectivity index, determined using the normal Vero cell line, indicated that CFEE had a high degree of selectivity against HELA and PC-3 cells. CFEE induced apoptosis, confirmed by cell cycle arrest at sub-G phase and DNA fragmentation. CFEE induced an increase in mRNA expression of caspase-3, a decrease in Bcl-2 mRNA expression, and decreased ATP levels. CFEE increased protein expression of caspase-3 and decreased protein expression of poly-ADP-ribose polymerase-1 (PARP-1). Flow cytometric analysis showed an appreciable increase in the number of cells in the early apoptotic stage in CFEE-treated HELA and PC-3 cells. CFEE treatment significantly increased lipid peroxidation (malondialdehyde level) in HELA and PC-3 cells. CONCLUSION Seed extract of M. peregrina displayed a significant antitumor effect through apoptosis induction in HELA and PC-3 cells.

Aim: Production of lactulose and other oligosaccharides by Lactobacillus acidophilus NRRL 4495 β-galactosidase and their biological activity. Methodology and Results: The transgalactosylation activity of Lactobacillus acidophilus NRRL 4495 β-galactosidase was investigated under different conditions for synthesis of lactulose and oligosaccharides. The synthesis was optimized with respect to pH; time; enzyme concentration and substrates ratio (lactose: fructose). Maximum production for lactulose was found to be 25 g/L at pH 6.6 with 40: 20% (w/v) lactose to fructose, respectively and enzyme concentration 4 IU/mL after 7 h. With respect to the other oligosaccharides the maximum yield (19 .68 g/L) was obtained under the same conditions but with enzyme concentration 2 IU/mL and after 10 h. As a new pharmaceutical application the produced lactulose and oligosaccharide and their sulfated derivative were found to have fibrinolytic activity, but they failed to act as anticoagulant. Conclusion significance and impact of study: the research leads to increase the production of lactulose and other oligosaccharides with a significant yield and discovered a new pharmaceutical application for all the products.

The removal efficiency of the heavy metals Zn, Pb and Cd by the zoosporic fungal species Saprolegnia delica and the terrestrial fungus Trichoderma viride, isolated from polluted water drainages in the Delta of Nile in Egypt, as affected by various ranges of pH values and different temperature degrees,was extensively investigated. The maximum removal efficiency of S. delica for Zn(II) and Cd(II) was obtained at pH 8 and for Pb(II) was at pH 6 whilst the removal efficiency of T. viride was found to be optimum at pH 6 for the three applied heavy metals. Regardless the median lethal doses of the three heavy metals, Zn recorded the highest bioaccumulation potency by S. delica at all pH values except at pH 4, followed by Pb whereas Cd showed the lowest removal potency by the fungal species and vice versa in case of T. viride. The optimum biomass dry weight production by S. delica was found when the fungus was grown in the medium treated with the heavy metal Pb at pH 6, followed by Zn at pH 8 and Cd at pH 8. The optimum biomass dry weight yield by T. viride amended with Zn,Pb and Cd was obtained at pH 6 for the three heavy metals with the maximum value at Zn. The highest yield of biomass dry weight was found when T. viride treated with Cd at all different pH values followed by Pb whilst Zn output was the lowest and this result was reversed in case of S. delica. The maximum removal efficiency and the biomass dry weight production for the three tested heavy metals was obtained at the incubation temperature 20degrees C in case of S. delica while it was 25degrees C for T. viride. Incubation of T. viride at higher temperatures (30degrees C and 35degrees C) enhanced the removal efficiency of Pb and Cd than low temperatures (15degrees C and 20degrees C) and vice versa in case of Zn removal. At all tested incubation temperatures, the maximum yield of biomass dry weight was attained at Zn treatment by the two tested fungal species. The bioaccumulation potency of S. delica for Zn was higher than that for Pb at all temperature degrees of incubation and Cd bioaccumulation was the lowest whereas T. viride showed the highest removal efficiency for Pb followed by Cd and Zn was the minor of the heavy metals.
Biomass ; Egypt ; Fungi ; Hydrogen-Ion Concentration* ; Metals, Heavy* ; Protons ; Saprolegnia* ; Trichoderma*

The main aim of this study is to evaluate the efficiency of two biologically active compounds (Strom and F-760) in control of wheat root rot disease and its causal organisms. Fusarium graminearum, F. oxysporum, F. solani and Bipolaris sorokiniana were used as target organisms. In vitro, the two compounds showed fungicidal effect on all investigated pathogens resulted in suppression of radial growth and mycelial dry weight of them. Under greenhouse conditions, treatment of wheat grains with either Strom or F-760 before cultivation significantly reduced the percent of disease distribution as well as the mean disease rating of plants in both seedling and flowering stages. Fresh and dry weights of plants as well as water maintenance capacity were increased as the result of applying these compounds as seed dressing. Also data showed that the membrane stability of plants was injured as a result of infection with all investigated organisms, while this injury was alleviated when F-760 and Strom were applied. The K+ efflux and the leakage of UV-absorbing metabolites was stimulated with fungal infection. However, F-760 and Storm treatment partially retarded the stimulatory effect on leakage of K+ and UV-absorbing metabolites of fungal infected plants. On the other side, the fungal infection had inhibitory effects on pigment fractions (chlorophyll a, b, and carotenoids) biosynthesis in wheat leaves. This retarding effect was partially or completely alleviated as the grains were treated with the applied compounds.
Bandages ; Edible Grain ; Flowers ; Fusarium ; Membranes ; Seedlings ; Triticum* ; Water ; Weights and Measures