The Role of Transferrin and Laminin Biomarkers in the Diagnosis of Diabetic Nephropathy in Type II Diabetic Patients

Background/Aim: Diabetic nephropathy is one of the most important microvascular complications associated with type II diabetic patients. It occurs in 20-40% patients with diabetes mellitus, and microalbuminuria is still considered as the first sign of diabetic nephropathy. Low sensitivity and specificity of microalbuminuria leads to more sensitive biomarkers that may be used to detect diabetic nephropathy at an earlier stage with higher accuracy. This study was carried out to detect the validity of using serum Transferrin and Laminin as a diagnostic biomarkers for diabetic nephropathy in type ΙΙ diabetic patients. Methods: Egyptian patients (n=96) included 72 type 2 diabetic patients who were classified into three groups: group 1 - normoalbuminuric patients (uACR up to 30 mg/g), group 2 - microalbuminuric patients (uACR from 30 – 300 mg/g), group 3 - macroalbuminuric patients (uACR from >300 mg/g) and 24 healthy control were surveyed in a cross-sectional study over a period of 6 months at biochemistry department, KASR ALAINY Hospital of Cairo University. Patients were subjected to measurement of Albumin creatinine ratio, eGFR, Serum creatinine, glycosylated hemoglobin (HbA1c) and lipid profile. The serum concentrations of transferrin and lamnin were measured using a highly sensitive one-step sandwich enzyme immunoassay kit. Results: Serum laminin was significantly higher in macroalbuminuric patients than in the microalbuminuric and in microalbuminuric patients than in the normoalbuminuric and healthy control subject. By comparing these goups according to serum laminin concentration we found statistically significant positive correlation (p value <0.001, r= 0.670), serum transferrin was significantly lower in macroalbuminuric patients than in the microalbuminuric and in microalbuminuric patients than in the normoalbuminuric and healthy control subject. By comparing these goups according to serum transferrin concentration we found statistically significant inverse correlation (p value <0.001, r= -0.579). There was no correlation between level of serum transferrin /laminin and glycoregulation, and statistically significant positive correlation was found between serum laminin and duration of diabetes and statistically significant inverse correlation was found between serum transferrin and duration of diabetes. Conclusions: The results from this study provide the evidence that serum laminin and transferrin could be used as a diagnostic markers of diabetic nephropathy.

Motor Imagery Training of Reaching-to-Grasp Movement Supplemented by a Virtual Environment in an Individual With Congenital Bilateral Transverse Upper-Limb Deficiency

This study explored the effect of kinesthetic motor imagery training on reaching-to-grasp movement supplemented by a virtual environment in a patient with congenital bilateral transverse upper-limb deficiency. Based on a theoretical assumption, it is possible to conduct such training in this patient. The aim of this study was to evaluate whether cortical activity related to motor imagery of reaching and motor imagery of grasping of the right upper limb was changed by computer-aided imagery training (CAIT) in a patient who was born without upper limbs compared to a healthy control subject, as characterized by multi-channel electroencephalography (EEG) signals recorded before and 4, 8, and 12 weeks after CAIT. The main task during CAIT was to kinesthetically imagine the execution of reaching-to-grasp movements without any muscle activation, supplemented by computer visualization of movements provided by a special headset. Our experiment showed that CAIT can be conducted in the patient with higher vividness of imagery for reaching than grasping tasks. Our results confirm that CAIT can change brain activation patterns in areas related to motor planning and the execution of reaching and grasping movements, and that the effect was more pronounced in the patient than in the healthy control subject. The results show that CAIT has a different effect on the cortical activity related to the motor imagery of a reaching task than on the cortical activity related to the motor imagery of a grasping task. The change observed in the activation patterns could indicate CAIT-induced neuroplasticity, which could potentially be useful in rehabilitation or brain-computer interface purposes for such patients, especially before and after transplantation. This study was part of a registered experiment (ID: NCT04048083).

Design and Biomechanical Evaluation Methodology of Pneumatic Ergonomic Crutch

Lofstrand, or forearm, crutch users experience a concerning amount of force in their wrists that can approach 30% of body weight during swing-through gait, along with hyperextension of the wrist [1]. Such repetitive large loads and poor wrist posture could cause joint pain, injury and carpal tunnel syndrome in long-term crutch users [2]. To address these issues in Lofstrand crutch users, we previously reported two different designs. The first involved attaching a passive orthosis to the grip handle and shaft that directly supported the wrist [3]. The second proposed a soft pneumatic sleeve attached to the forearm cuff of the crutch along with a concept to harvest pneumatic energy during walking via a piston pump at the crutch tip, i.e., the Pneumatic Ergonomic Crutch (PEC) [4]. This paper first describes the full system design of the PEC, which contains an improved pneumatic sleeve orthosis, an energy-harvesting shock-absorbing crutch tip, and a control system with three modes of operation and safety protection. We also present pilot data from one healthy control subject performing a proposed biomechanical evaluation of the pneumatic sleeve orthosis. More tests will be conducted with a group of able-bodied subjects to evaluate the overall effectiveness of the PEC.

HLA-DRβ2 and IgM Rheumatoid Factor (RF) Positive Rheumatoid Arthritis (RA)

48 patients suffering from classic erosive RA with conditions persisting for more than 6 years were examined together with 69 healthy control subject with regard to associations to supertypic HLA-D specificities. We found a significant increase of HLA-DRw53 in patients with RF positive RA (22/31 pat. = 71%,Chi2 = 13.2, p<0.01). Our results confirm the hypothesis that the HLA-DRβ2 chain gene is closer related to the disease susceptibility of seropositive RA than the DRβ1 chain gene (DR4).