Background:Early definitive diagnosis and effective treatment are mandatory in rheumatoid arthritis (RA) as it can halt the disease progression and subsequent joints destruction.Objective:To investigate the diagnostic and prognostic value of anti-mutated citrullinated vimentin (anti-MCV) and its correlation with disease activity, peripheral and axial skeleton affection in RA patients.Patients and methods:A total of 123 patients with different rheumatic diseases were enrolled in a prospective-two year study at Ain Shams University hospital: 64 patients with RA and 59 patients with other rheumatic diseases as controls. RA patients were fulfilling the traditional and the new ACR/EULAR diagnostic criteria for RA. They have been followed up for two years. At baseline, all RA patients were subjected to: Clinical assessment of disease activity by taking full histories, general and local examination, measurement of 28 joint count of tender and swollen joints with calculation of disease activity score (DAS-28) for each patient. Complete blood count, erythrocytes sedimentation rate, C-reactive protein and rheumatoid factor titers were performed. Anti-MCV IgG immunoglobulins’ assay was performed at the study endpoint by ELISA. RA patients were then classified into; anti-MCV positive and anti-MCV negative groups for statistical comparison. Plain X-ray was performed on the peripheral joints and scored by the Simple Erosion Narrowing score (SEN-score). Magnetic Resonance Imaging (MRI) scans were carried out to 22 RA patients on cervical and lumbosacral regions.Results:Anti-MCV antibodies were found to be of high sensitivity (79.6%) and specificity (96.6%) in diagnosing RA. The area under the curve was 0.893 at 95% confidence interval (CI), confers an odds ratio of 23.5. Anti-MCV positive RA patients had significantly higher DAS-28 and SEN-scores than anti-MCV negative patients; who were found to have more benign disease with lower incidence of erosions (P < 0.05). MRI scans revealed that; 17/22 (77%) had cervical joints involvement while, 8 (36%) had lumbo-sacral joint lesions (P < 0.05), both were correlated significantly with aggressive peripheral joint disease.Conclusion:Anti-MCV antibodies are promising diagnostic and prognostic marker in RA, with high sensitivity and specificity. They may identify a subset of RA patients with aggressive early erosive disease. The axial skeleton—especially the cervical spine—could be affected in RA and this was correlated with aggressive peripheral joints’ disease. MRI scanning is a sensitive method for detecting axial skeleton involvement in RA, in attempt for better disease control and outcomes.

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The linear attenuation coefficient of normal weight concrete containing nanoparticles has been simulated using Monte Carlo transport code MCNP5 to evaluate their shielding performance. The outcomes of the numerical simulations were compared to the experimental samples computed with Cesium 137 (0.662 MeV) and XCOM program results. Three different nanoparticles mainly nano silica (NS), nano ceramic (NC), and nano metakaolin (NMK), and their hybridization were used in the present research. Slump test, density, water absorption, compressive strength and tensile strength were investigated. Moreover, the scanning electron microscopy technique (SEM), X ray diffraction analysis (XRD) were used to prove the improvement in the microstructure of concrete as a result of the use of NS, NC, NMK, and their hybridization. The results in the present study indicate that the inclusion of single nanomaterials as a replacement of cement improves the mechanical, physical, properties and the linear attenuation coefficient of concrete, while the results of the hybrid nano inclusion showed a slight improvement of the properties of concrete. In addition, the results of the simulation of the linear attenuation coefficient using the Monte Carlo simulation were in good agreement with the experimental and XCOM program results.

Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver. The lack of efficient and precise HCC biomarkers prevents early detection resulting in a poor prognosis. Recently, mean platelet volume (MPV) and MPV/platelet count (PC) ratio have been proposed as potential markers of HCC. This study was carried out to verify MPV and MPV/PC ratio in diagnosis of HCC in Egyptian patients with chronic hepatitis C related liver cirrhosis. One hundred and fifty chronic hepatitis C (CHC) patients with chronic hepatitis, cirrhosis or HCC were enrolled in the study. The levels of alphe feto protein (AFP), MPV and MPV/PC ratio were determined compared to 50 healthy persons. MPV and MPV/CP ratio were higher in patients with cirrhosis and those with HCC. The cut off level for MPV for detection of HCC was 10.1 fl, with sensitivity of 70% and specificity of 57%. At a cut off level of 0.82, the sensitivity of MPV/CP ratio was 79.6% and specificity was 72.7%. AFP showed sensitivity 80% and specificity 82% at cut-off level of 16.9 ng/dl. MPV and MPV/PC ratio are less sensitive and specific than AFP as markers for HCC; they may be used only in association with other markers to improve sensitivity of tumor detection.

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