RESUMEN
The chance of getting colorectal cancer (CRC) is higher in people with chronic ulcerative colitis (UC). The impact of parasitic infections on UC is underappreciated. The purpose of this study was to look into the effect of intestinal protozoal infections on the dysplastic changes generated by UC. The research included 152 adult patients with histologically confirmed UC and 152 healthy controls. Fecal samples were examined for the presence of parasites and fecal calprotectin (FC). The enzyme-linked immunosorbent assay measured serum anti-p53 antibodies (p53Abs) and metallothioneins (MTs). The advanced oxidation protein products (AOPPs) and reduced glutathione (GSH) levels were measured by a spectrophotometric method in all subjects. Serum C-reactive protein (CRP) and IL-6 were also measured. In addition, histopathological and immunohistochemical investigations of intestinal tissue were done. Our results exhibited significant increases in FC and CRP, IL-6, AOPPs, MTs, and p53Abs in ulcerative colitis patients with parasitic infections compared to those without parasites. In contrast, GSH levels showed a significant decrease in the same group compared with other groups. Histopathological and immunohistochemical assessments of intestinal tissue signified severe inflammation and strong expression of PD-L1 in patients with parasitic infections compared to others without parasitic infections. Our research indicated a greater frequency of intestinal protozoa in UC patients with elevated inflammatory and dysplastic biomarker levels. This suggests that these parasites may be involved in the etiology of chronic UC and the associated carcinogenetic process. This is the first report of a link between parasitic infections and dysplastic alterations in UC patients.
Asunto(s)
Colitis Ulcerosa , Enfermedades Parasitarias , Adulto , Humanos , Colitis Ulcerosa/complicaciones , Productos Avanzados de Oxidación de Proteínas , Interleucina-6 , Anticuerpos , Biomarcadores , HecesRESUMEN
BACKGROUND: The plethysmography variability index (PVI) is a non-invasive, real-time, and automated parameter for evaluating fluid responsiveness, but it does not reliably predict fluid responsiveness during low tidal volume (VT) ventilation. We hypothesized that in a 'tidal volume challenge' with a transient increase in tidal volume from 6 to 8 ml Kg- 1, the changes in PVI could predict fluid responsiveness reliably. METHOD: We performed a prospective interventional study in adult patients undergoing hepatobiliary or pancreatic tumor resections and receiving controlled low VT ventilation. The values for PVI, perfusion index, stroke volume variation, and stroke volume index (SVI) were recorded at baseline VT of 6 ml Kg- 1, 1 min after the VT challenge (8 ml Kg- 1), 1 min after VT 6 ml Kg- 1 reduced back again, and then 5 min after crystalloid fluid bolus 6 ml kg- 1 (actual body weight) administered over 10 min. The fluid responders were identified by SVI rise ≥ 10% after the fluid bolus. RESULTS: The area under the receiver operating characteristic curve for PVI value change (ΔPVI6-8) after increasing VT from 6 to 8 ml Kg- 1 was 0.86 (95% confidence interval, 0.76-0.96), P < 0.001, 95% sensitivity, 68% specificity, and with best cut-off value of absolute change (ΔPVI6-8) = 2.5%. CONCLUSION: In hepatobiliary and pancreatic surgeries, tidal volume challenge improves the reliability of PVI for predicting fluid responsiveness and changes in PVI values obtained after tidal volume challenge are comparable to the changes in SVI.
Asunto(s)
Fluidoterapia , Respiración Artificial , Adulto , Humanos , Volumen de Ventilación Pulmonar , Estudios Prospectivos , Reproducibilidad de los Resultados , Volumen Sistólico , Curva ROC , Pletismografía , Hemodinámica , Presión SanguíneaRESUMEN
Background: COVID 19 may affect organs other than lungs, including liver, leading to parenchymal changes. These changes are best assessed by unenhanced computed tomography (CT). We aim to investigate the effect of COVID 19 on liver parenchyma by measuring the attenuation in CT scan Hounsfield unit (HU). Materials and Methods: A cohort of patients, who tested COVID 19 polymerase chain reaction positive, were enrolled and divided into two groups: fatty liver (FL) group (HU ≤ 40) and nonfatty liver (NFL) group (HU > 40) according to liver parenchyma attenuation measurements by high resolution noncontrast CT scan. The CT scan was performed on admission and on follow up (10-14 days later). Liver enzyme tests were submitted on admission and follow up. Results: Three hundred and two patients were enrolled. Liver HU increased significantly from 48.9 on admission to 53.4 on follow up CT scan (P<0.001) in all patients. This increase was more significant in the FL group (increased from 31.9 to 42.9 [P =0.018]) Liver enzymes were abnormal in 22.6% of the full cohort. However, there was no significant change in liver enzymes between the admission and follow up in both groups. Conclusion: The use of unenhanced CT scan for assessment of liver parenchymal represents an objective and noninvasive method. The significant changes in parenchymal HU are not always accompanied by significant changes in liver enzymes. Increased HU values caused by COVID 19 may be due to either a decrease in the fat or an increase in the fibrosis in the liver.
RESUMEN
Campylobacter fetus causes in humans mostly gastroenteritis. Systemic infection occurs almost exclusively in immunocompromised patients with chronic debilitating diseases. We report the case of a Campylobacter fetus meningitis in a woman aged 48 years with a history of systemic lupus erythematosus treated with corticosteroids and immunosuppressive drugs. Cerebrospinal fluid culture was positive for Campylobacter fetus. The evolution was favorable using imipenem and ciprofloxacin.
RESUMEN
BACKGROUND AND STUDY AIM: Bile duct injuries are not infrequently seen during hepatobiliary surgery, particularly after liver transplantation and cholecystectomy. The current study aims to figure out the frequency of postcholecystectomy biliary injuries (PCBI) and the role of early versus late endoscopic retrograde cholangiopancreatography (ERCP) in their management. PATIENTS AND METHODS: Totally 960 cases operated by both laparoscopic and open cholecystectomy were evaluated in the current study. In total, 942 cases were operated in our institutes, by both laparoscopic (n = 925) and open (n = 17) cholecystectomy, and the frequency of PCBI among patients operated in our institutes was (9/942) 0.95%. Additional 18 cases of PCBI referred to our centers were included in the study. One patient was treated by repair during the surgery, in the remaining 26 patients, ERCP management was attempted. The full details of the 26 patients regarding ERCP management were discussed. RESULTS: The overall success rate of ERCP management was 88.46% (23/26), whereas 11.54% of cases were treated surgically by choledochal-jejunal anastomosis due to complete common bile duct ligation. There were no differences between patients treated by early (first week) versus late (after the first week) ERCP regarding the needed interventions, type of PCBI, type and diameter of the inserted stents, and the overall success. There were no adverse events associated with ERCP management. CONCLUSIONS: ERCP was valuable in the treatment of 88.46% of injured cases. There were no differences between early and late ERCP in the treatment of PCBI. Furthermore, ERCP management was not associated with adverse events.
Asunto(s)
Enfermedades de los Conductos Biliares , Colecistectomía Laparoscópica , Laparoscopía , Colangiopancreatografia Retrógrada Endoscópica/efectos adversos , Colecistectomía/efectos adversos , Colecistectomía Laparoscópica/efectos adversos , Conducto Colédoco/diagnóstico por imagen , Conducto Colédoco/cirugía , Humanos , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiologíaRESUMEN
BACKGROUND: Colorectal carcinoma (CRC) is the third most common human cancer. Twist, a basic helix-loop-helix (bHLH) transcription factor, is an epithelial-mesenchymal transition ((EMT) inducer that has been involved in carcinogenesis and chemoresistance. Also, the enhancer of Zeste homolologue2 (EZH2), a member of the polycomb group of genes, had been associated with poor prognosis in several malignancies. OBJECTIVE: To evaluate the expression of Twist1 and EZH2 in colon carcinoma in Egyptian patients and its relation to clinicopathological parameters, prognosis, and survival. METHODS: Twist1 and EZH2 expressions were evaluated immunohistochemically in 50 cases of colorectal tumors (12 colon adenomas and 38 colon carcinomas) and 20 samples from normal colonic mucosa. RESULTS: The expression of Twist1 and EZH2 was significantly higher in colon adenoma and carcinoma than that in normal colonic mucosa (P < 0.05). Twist1 and EZH2 expressions were associated with decreased tumor differentiation, advanced stage, and lymph node metastasis. Twist1 and EZH2 expressions were significantly related to 3-year disease-free survival (P = 0.005 and 0.002 respectively) and 3-year overall survival (P = 0.045 and 0.039, respectively). CONCLUSIONS: Twist1 and EZH2 may serve as prognostic predictors for colon carcinoma and may have a potential role as therapeutic targets in patients with colon carcinoma in the future.
Asunto(s)
Biomarcadores de Tumor/metabolismo , Carcinoma/mortalidad , Neoplasias del Colon/mortalidad , Proteína Potenciadora del Homólogo Zeste 2/metabolismo , Recurrencia Local de Neoplasia/epidemiología , Proteínas Nucleares/metabolismo , Proteína 1 Relacionada con Twist/metabolismo , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biomarcadores de Tumor/análisis , Carcinoma/diagnóstico , Carcinoma/tratamiento farmacológico , Carcinoma/genética , Neoplasias del Colon/diagnóstico , Neoplasias del Colon/tratamiento farmacológico , Neoplasias del Colon/genética , Supervivencia sin Enfermedad , Egipto/epidemiología , Proteína Potenciadora del Homólogo Zeste 2/análisis , Transición Epitelial-Mesenquimal/genética , Femenino , Fluorouracilo/uso terapéutico , Regulación Neoplásica de la Expresión Génica , Humanos , Inmunohistoquímica , Leucovorina/uso terapéutico , Metástasis Linfática/genética , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/genética , Recurrencia Local de Neoplasia/patología , Estadificación de Neoplasias , Proteínas Nucleares/análisis , Compuestos Organoplatinos/uso terapéutico , Pronóstico , Estudios Prospectivos , Medición de Riesgo/métodos , Proteína 1 Relacionada con Twist/análisis , Adulto JovenRESUMEN
In multiple sclerosis and experimental autoimmune encephalomyelitis (EAE), myeloid cells comprise a major part of the inflammatory infiltrate in the central nervous system (CNS). We previously described that motile sperm domain-containing protein 2 (MOSPD2) is expressed on human myeloid cells and regulates monocyte migration in vitro. The role of MOSPD2 in EAE pathogenesis was studied by generating MOSPD2 knock-out (KO) mice and monoclonal antibodies directed against MOSPD2. We found that EAE development in MOSPD2 KO mice was significantly suppressed. While frequency representation of leukocyte subsets in lymphoid tissues was comparable, the ratio of inflammatory monocytes in the blood was markedly reduced in MOSPD2 KO mice. In addition, T cells from MOSPD2 KO mice displayed reduced secretion of proinflammatory cytokines and increased production of interleukin (IL)-4. Prophylactic and post-onset treatment using monoclonal antibodies (mAbs) generated against MOSPD2 abrogated development and reduced EAE severity. These results suggest that MOSPD2 is key in regulating migration of inflammatory monocytes, and that anti-MOSPD2 mAbs constitute a potential therapy for the treatment of CNS inflammatory diseases.
Asunto(s)
Sistema Nervioso Central/inmunología , Encefalomielitis Autoinmune Experimental/metabolismo , Inflamación/metabolismo , Proteínas de la Membrana/metabolismo , Monocitos/inmunología , Esclerosis Múltiple/metabolismo , Receptores de Quimiocina/metabolismo , Linfocitos T/inmunología , Animales , Movimiento Celular , Células Cultivadas , Modelos Animales de Enfermedad , Encefalomielitis Autoinmune Experimental/genética , Encefalomielitis Autoinmune Experimental/terapia , Femenino , Humanos , Inflamación/genética , Inflamación/terapia , Interleucina-4/metabolismo , Proteínas de la Membrana/genética , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Esclerosis Múltiple/genética , Esclerosis Múltiple/terapia , Receptores de Quimiocina/genética , Balance Th1 - Th2RESUMEN
@#Introduction: A food label is an important tool that provides nutritional information which influences consumers by promoting awareness on their diet and improving health status. This study aimed to assess nutrition knowledge level, food label usage, and the barriers that hinder the use of food labels among students in Health Colleges at the Princess Nourah Bint Abdulrahman University (PNU). Methods: A cross-sectional study was conducted among Health College students at PNU in Riyadh (Saudi Arabia). A total of 572 participants were interviewed through a validated questionnaire on social demographic characteristics, nutrition knowledge level, food label use, and barriers that hinder food label use. Statistical analysis was performed using SPSS (version 21), with statistical significance set at p-value <0.05. Results: Only 27.4% of the participants stated that they always or usually use food labels when purchasing food products. Majority of the participants (59.4%) had moderate nutrition knowledge. Factors significantly associated to food label use were nutrition knowledge (R2=0.21), attitude towards health value of the products (R2=0.35), and taste (R2=-0.22). About 41.0% of the participants indicated that time constraint was the main barrier for not using food labels, followed by no interest (31.3%), no need (27.8%), and difficult to use (24.8%). Conclusion: This study found that food label use was low among the participants. Nutrition knowledge supported food label use while time constraint was the main barrier that hindered the use of food label among them. Raising students’ nutrition knowledge level through nutrition education programmes could promote food label use.
RESUMEN
AIM: This paper aimed to assess and follow up the course of resolved HBV (hepatitis B virus) during and after treatment with direct-acting antiviral drugs (DAAs). BACKGROUND: Co-infection with hepatitis B and hepatitis C is increasingly recognized in patients with chronic hepatitis. Resolved HBV in patients with chronic HCV (hepatitis C virus) infection has been investigated during interferon therapy, and the investigators suggest a possible correlation with a lower response to anti-viral treatment, higher grades of liver histological changes, and development of hepatocellular carcinoma. METHODS: Three hundred and thirteen patients were included in our observational and prospective study; two hundred and fifty-three patients had chronic hepatitis C (CHC) (group I), and sixty patients had both CHC and resolved HBV-infection (group II). They all were eligible for treatment with DAAs therapy for chronic HCV in our hepatology unit, Internal Medicine Department, Zagazig University Hospitals from December 2017 to September 2018. They were subjected to thorough history taking, full clinical examination, routine laboratory investigations, HCV antibody, HCV RNA, HBV surface antigen (HBsAg), HBV surface antibody (anti-HBs) HBV core antibody (anti-HBc), and HBV-DNA quantitative levels. All patients were followed up at baseline, at the end of week 4 of anti-viral therapy, at the end of treatment and 12 weeks after treatment. RESULTS: Assessment at 28 days showed significant decreases in ALT and AST levels in both groups, with stabilization of these levels on follow-up at 12 and 24 weeks. The efficacy of treatment was comparable in both groups. No case of ALT flare was observed in either group. Similar outcomes regarding AST and ALT levels were found in patients with diseases associated with immune derangement. CONCLUSION: The risk of resolved HBV reactivation during or after treatment with DAAs is low.
RESUMEN
BACKGROUND: Cancer stem cells proved to have a vital role in cell migration, invasion, metastasis, and treatment resistance of colorectal cancer (CRC) that subsequently lead to poor clinical outcomes. These stem cells may be a novel therapeutic target for the management of CRC progression. Signals of the Notch-1 pathway are responsible for acquisition of stem cell characters. ALDH1 and CD44 are usually detected in stem cells in colorectal cancer. AIM: The aims of this work are to evaluate the immunohistochemical expression of cancer stem cell markers ALDH1, Notch1, and CD44 in colorectal cancer and investigate their correlation with clinicopathological characters and patient survival. METHODS: Paraffin-embedded specimens of 70 patients with primary colorectal carcinoma were analyzed for Notch 1, ALDH1, and CD44 expressions by immunohistochemistry. RESULTS: Notch1 was mainly located in the cytoplasm of CRC tissues, rarely expressed in adjacent normal tissues. A highly statistically significant relationship was found between grading, lymphovascular invasion, the degree of lymphocytic infiltration, peritumoral budding, lymph node ratio, lymph node metastasis, and Notch1 expression (p < 0.001). There was a highly statistically significant relationship found between AJCC stage and Notch1 expression (p < 0.001). CD44 was mainly located in the cell membrane of CRC tissues. A highly statistically significant relationship was found between grading (p = 0.006), lymphovascular invasion, the degree of lymphocytic infiltration, peritumoral budding, lymph node metastasis, lymph node ratio, and CD44 expression (p < 0.001). There was a highly statistically significant relationship found between AJCC stage and CD44 expression (p < 0.001). ALDH1 was detected in the cytoplasm of the CRC tissue. A highly statistically significant relationship was found between grading, lymphovascular invasion, the degree of lymphocytic infiltration, peritumoral budding, lymph node metastasis, lymph node ratio, and ALDH1 expression (p < 0.001). There was a highly statistically significant relationship found between AJCC stage and ALDH1 expression (p < 0.001). There is a highly statistically significant direct correlation between Notch1, CD44 expression, and ALDH1 expression (p < 0.001). CONCLUSIONS: There is a substantial correlation between Notch 1, ALDH1, and CD44 as cancer stem cell markers and lymph node metastasis, advanced stage and tumor recurrence in colorectal carcinoma. CONCLUSION: Expression of stem cell markers ALDH1, Notch1, and CD44 correlates with poor prognosis in a CRC and represents an independent prognostic factor. They are associated with a feature of epithelial-mesenchymal transition evidenced by their association with high tumor burden.
Asunto(s)
Biomarcadores de Tumor/análisis , Neoplasias Colorrectales/mortalidad , Metástasis Linfática/patología , Recurrencia Local de Neoplasia/diagnóstico , Células Madre Neoplásicas/patología , Adulto , Anciano , Familia de Aldehído Deshidrogenasa 1/análisis , Familia de Aldehído Deshidrogenasa 1/metabolismo , Biomarcadores de Tumor/metabolismo , Neoplasias Colorrectales/patología , Supervivencia sin Enfermedad , Transición Epitelial-Mesenquimal , Femenino , Estudios de Seguimiento , Humanos , Receptores de Hialuranos/análisis , Receptores de Hialuranos/metabolismo , Inmunohistoquímica , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Estadificación de Neoplasias , Células Madre Neoplásicas/metabolismo , Pronóstico , Receptor Notch1/análisis , Receptor Notch1/metabolismo , Estudios Retrospectivos , Carga TumoralRESUMEN
INTRODUCTION: Colorectal cancer (CRC) incidence is increasing globally. It is ranked as the second most common cancer in women and the third most in men. Angiogenesis plays a significant role in the development and spread of colorectal cancer. Angiogenesis has been proposed as a prognostic marker in a variety of human neoplasms. In this regard, markers of angiogenic endothelial cells are emerging as targets for cancer therapy. AIM OF THE WORK: The aim of this study is to evaluate the prognostic impact of tumor angiogenesis assessed by microvessel density (MVD) counting using CD31 and CD105 along with VEGF immunostaining in colorectal cancer patients. METHODS: VEGF, CD31, and CD105 expressions were evaluated using immunohistochemical staining in 50 patients with colorectal cancer. The relationship between their expressions and clinicopathological factors and outcome of patients were analyzed. RESULTS: The VEGF expression (70% of the cases) correlated significantly with larger tumor size, higher grade, and advanced tumor stage (p = 0.006, p < 0.001, p < 0.001), respectively. The mean MVD was 24.2 ± VMD by CD105 (p = 0.10.65 019 for CD105, 19.2 ± 8.41 for CD31, respectively. MVD by CD31 (p = 0.023)) and was significant predictive factors for overall survival. Furthermore, the VEGF expression (p = < 0.001) was a significant predictive factor for DFS. There was a statistically significant association between the recurrence rates with both VEGF and CD105 (p < 0.001) but not significant with CD31. CONCLUSION: CRC patients with high VEGF, CD105, and CD31 expression showed poor prognosis. The immunohistochemical markers could be used for stratification of patients into low-risk and high-risk groups.
Asunto(s)
Endoglina/metabolismo , Molécula-1 de Adhesión Celular Endotelial de Plaqueta/metabolismo , Factor A de Crecimiento Endotelial Vascular/metabolismo , Adulto , Anciano , Neoplasias Colorrectales , Femenino , Humanos , Masculino , Persona de Mediana Edad , PronósticoRESUMEN
BACKGROUND: Worldwide, gastric carcinoma (GC) is the 5th most common malignancies in both sexes representing 6.8% of the total fatalities and is the 3rd leading cause of cancer death representing 8.8% of total fatalities. In Egypt, GC considers the 12th leading cause of cancer death representing 2.2% of the total cancer mortality. A growing body of evidence supports that cancer stem cells (CSCs) are resistant to chemotherapy or radiation, and the cell adhesion molecule CD44 has been identified as a cell surface marker associated with cancer stem cell in several types of tumors including gastric cancer. CD44 regulates gastric stem cell proliferation by increasing cyclin D1 expression which represents an important regulatory protein in the cell cycle transition from G1 phase to S phase. This study aimed to investigate whether cyclin D1 and CD44 can be used as prognostic indicators in gastric cancer. MATERIAL AND METHODS: Forty formalin-fixed and paraffin-embedded gastric tissues, obtained from patients who underwent endoscopic resection or surgical resection, constituted the group of our study. The immunohistochemical expression of cyclin D1 and CD44 was examined and correlated with clinical-pathological parameters and outcome of the patients. RESULTS: Overexpression of CD44 and cyclin D1 was noted (in of 55 and 50% respectively). Cyclin D1 and CD44 positive expressions in GC were positively correlated with tumor differentiation (p = 0.020, p = 0.004 respectively), TNM stage (p < 0.001 for both), poor survival (p < 0.001 for both), and with increased rate of recurrence (p = 0.020, p = 0.005 respectively). CONCLUSION: CD44 and cyclin D1 were associated with poor prognosis in gastric cancer, and so, they comprise an attractive target for anticancer drug development.
Asunto(s)
Adenocarcinoma/patología , Biomarcadores de Tumor/metabolismo , Ciclina D1/metabolismo , Receptores de Hialuranos/metabolismo , Recurrencia Local de Neoplasia/patología , Neoplasias Gástricas/patología , Adenocarcinoma/metabolismo , Adenocarcinoma/cirugía , Adulto , Estudios de Casos y Controles , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/metabolismo , Recurrencia Local de Neoplasia/cirugía , Pronóstico , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/cirugía , Tasa de SupervivenciaRESUMEN
Hepatitis C virus (HCV) infection remains the main risk factor for chronic hepatitis (CHC), liver cirrhosis, and hepatocellular carcinoma (HCC). Changes in microRNA (miRNA) profiles can be associated with HCV infection and may either favor or inhibit the virus and/or its complication. Moreover, miRNAs have emerged as key regulators of various cancers including HCC. The aim of this work was to investigate the potentail role of miRNA-27a and miRNA-18b expression levels as non-invasive predictive biomarkers of hepatitis C virus-associated HCC. Furthermore, we aimed to explore potential association of these miRNAs expressions with HCC clinicopathological features' in Egyptian cases. This case control study included 200 participants [60 CHC patients, 39 post-HCV cirrhosis patients, 51 HCC cases], and 50 healthy volunteers. The serum miRNA-27a and miRNA-18b expression profiles were measured using quantitative real time-polymerase chain reaction (qRT-PCR). miRNA-27a and miRNA-18b expression levels were significantly increased in post-hepatitis C cirrhosis cases compared to control and CHC groups. In HCC group, only miRNA-27a expression levels were significantly increased. Moreover, miRNA-27a and miRNA-18b expression levels were positively correlated with distant metastasis, Child-Pugh grade, and lymph node metastasis. Logistic regression analysis revealed that miRNA-27a expression was an independent predictor of cirrhosis among CHC. Receiver operating characteristic (ROC) analyses showed that miRNA-27a and miRNA-18b expression levels were useful biomarkers discriminating cirrhosis from CHC (AUC were 0.672 and 0.487, respectively), and in differentiating HCC from post-hepatitis C cirrhosis (AUC were 0.897 and 0.723, respectively). By combined ROC analysis, power of miRNA-27a and miRNA-18b expression levels as discriminator between HCC from post-hepatitis C cirrhosis was high (AUC = 0.0.821). Serum microRNA-27a and miRNA-18b expression levels are promising diagnostic and non-invasive biomarkers of CHC, post-CHC cirrhosis, and HCC.
Asunto(s)
Biomarcadores de Tumor/sangre , Carcinoma Hepatocelular/sangre , Hepatitis C/sangre , Neoplasias Hepáticas/sangre , MicroARNs/administración & dosificación , MicroARNs/sangre , ARN Neoplásico/sangre , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Cirrosis Hepática/sangre , Masculino , Persona de Mediana EdadRESUMEN
A simple, accurate and valid ion-pairing chromatographic method was developed for the simultaneous determination of formoterol fumarate (FF) and budesonide (BUD) epimers in metered dose inhaler. The separation was performed on C-18 column using mobile phase consisting of acetonitrile:0.05 M sodium acetate buffer (40:60% v/v) containing 0.03% sodium dodecyl sulfate adjusted to pH 3.1 using increasing volumes of either TEA or orthophosphoric acid isocratically eluted at 1.0 mL/min. Quantitation was achieved with UV detection at 214 nm. The retention times were 3.22, 6.41 and 6.91 min for formoterol fumarate, budesonide epimers B and A, respectively. The linearity range was 0.05-5.0 µg/mL for formoterol fumarate and 0.5-50.0 µg/mL for budesonide. The method was validated for, linearity; lower limit of quantification, lower limit of detection accuracy and precision. The proposed method is rapid (7 min), reproducible (RSD < 2.0%) and achieves satisfactory resolution between FF and BUD B (resolution factor = 12.07). The mean recoveries of the analytes in metered dose inhaler (99.97 and 99.83% for FF and BUD, respectively) were satisfactory.
Asunto(s)
Budesonida/análisis , Cromatografía Líquida de Alta Presión/métodos , Fumarato de Formoterol/análisis , Inhaladores de Dosis Medida , Budesonida/química , Budesonida/aislamiento & purificación , Cromatografía en Capa Delgada/métodos , Fumarato de Formoterol/química , Fumarato de Formoterol/aislamiento & purificación , Límite de Detección , Modelos Lineales , Reproducibilidad de los Resultados , EstereoisomerismoRESUMEN
BACKGROUND: Epithelial-mesenchymal transition (EMT) is one of the main events in colorectal cancer (CRC) spread. Snail-1 is a zinc transcription factor that mediates EMT in tumor cells probably by down-regulation of E-cadherin and claudin-1. OBJECTIVES: To detect the expression of epithelial markers (claudin-1 and E-cadherin) and mesenchymal markers (snail-1 and vimentin) in primary cancer colon. Also, to select stage II cancer patients of a high risk that can benefit from postoperative adjuvant chemotherapy. METHODS: Reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemical analysis were performed to investigate snail-1, claudin-1, E-cadherin and vimentin expressions at mRNA and protein levels in fresh tissues of cancer colon and normal colonic mucosa. The correlations between the expression of these markers and clinicopathological parameters were performed. RESULTS: Normal colonic mucosa revealed complete membranous expression of claudin-1, preserved E-cadherin and negative snail-1 and vimentin expressions. Compared to control, the expression of snail-1 and vimentin mRNA in cancer colon was significantly up-regulated while the expression of claudin-1 and E-cadherin mRNA was significantly down-regulated. These changes were significantly associated with stage and lymph node involvement at both mRNA and protein levels (p< 0.05). There were significant negative correlations between vimentin and each of E-cadherin and claudin-1 gene expression and between snail-1 and each of E-cadherin and claudin-1 gene expression. Moreover, these changes were independent predictors of recurrence of stage II cancer colon cases. CONCLUSION: There is a clinical significance of snail-1, claudin-1, E-cadherin and vimentin as possible markers for recognizing patients with lymph node involvement, advanced stage and high incidence of tumor recurrence in cancer colon.
Asunto(s)
Biomarcadores de Tumor/genética , Neoplasias Colorrectales/genética , Transición Epitelial-Mesenquimal/genética , Regulación Neoplásica de la Expresión Génica , Adulto , Anciano , Biomarcadores de Tumor/metabolismo , Cadherinas/genética , Cadherinas/metabolismo , Claudina-1/genética , Claudina-1/metabolismo , Neoplasias Colorrectales/metabolismo , Neoplasias Colorrectales/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Pronóstico , Factores de Transcripción de la Familia Snail/genética , Factores de Transcripción de la Familia Snail/metabolismo , Vimentina/genética , Vimentina/metabolismo , Adulto JovenRESUMEN
AIM: Assessment of short term changes in portal blood flow and long term changes in liver functions in cirrhotic patients who chose to fast during the month of Ramadan in summer. BACKGROUND: During Ramadan, healthy Muslims obligated to fast from predawn to sunset. PATIENTS AND METHODS: Forty cirrhotic patients intended to fast during the month of Ramadan in the year 2014, were examined by Congestion index (CI) as a non-invasive indicator of short term changes in the portal blood flow, while liver function tests were determined as an indicator of long term changes in liver functions. RESULTS: A total of 38 patients completed the whole month fasting and two patients discontinued fasting due to variceal bleeding. The complicated patients were 7. CI showed a statistically significant increase from fasting to postprandial status (P<0.001), with statistically significant increases from fasting to postprandial status in Child class A (P<0.001), and B (P<0.001). We did not find a statistical significance between patients with complications and those without complications (P=0.6). There was a statistically significant rise in the serum bilirubin after Ramadan. Deterioration noticed as advanced Child classes, development of lower limb edema, increasing ascites, increasing jaundice and overt encephalopathy. CONCLUSION: Cirrhotic patients showed significant short-term changes in the portal blood flow. However, these changes are not linked to complications or deterioration of liver functions and accommodated especially in patients with Child class A and B. Child class C patients should not fast.
RESUMEN
Two simple, rapid, sensitive and precise spectrophotometric and spectrofluorimetric methods were developed for the determination of indacaterol maleate in bulk powder and capsules. Both methods were based on the direct measurement of the drug in methanol. In the spectrophotometric method (Method I) the absorbance was measured at 259 nm. The absorbance-concentration plot was rectilinear over the range 1.0-10.0 µg mL(-1) with a lower detection limit (LOD) of 0.078 µg mL(-1) and lower quantification limit (LOQ) of 0.238 µg mL(-1). Meanwhile in the spectrofluorimetric method (Method II) the native fluorescence was measured at 358 nm after excitation at 258 nm. The fluorescence-concentration plot was rectilinear over the range of 1.0-40.0 ng mL(-1) with an LOD of 0.075 ng mL(-1) and an LOQ of 0.226 ng mL(-1). The proposed methods were successfully applied to the determination of indacaterol maleate in capsules with average percent recoveries ± RSD% of 99.94 ± 0.96 for Method I and 99.97 ± 0.81 for Method II. In addition, the proposed methods were extended to a content uniformity test according to the United States Pharmacopoeia (USP) guidelines and were accurate, precise for the capsules studied with acceptance value 3.98 for Method I and 2.616 for Method II.
Asunto(s)
Indanos/análisis , Indanos/química , Quinolonas/análisis , Quinolonas/química , Espectrometría de Fluorescencia/métodos , Calibración , Cápsulas/análisis , Estabilidad de Medicamentos , Concentración de Iones de Hidrógeno , Límite de Detección , Polvos/análisis , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Solventes/química , Tensoactivos/químicaRESUMEN
Lactococcus lactis cremoris is rarely involved in human pathology. A thirty two-year old pregnant woman with premature rupture of membrane history presented with chorioamnionitis due to L. lactis cremoris. She underwent an emergency caesarian section and was treated with antibiotics including the association of amoxicillin and clavulanic acid. She was completely recovered. This is the first case to our knowledge of chorioamnionitis due to this organism.
RESUMEN
INTRODUCTION: The eradication rate of Helicobacter pylori following the standard triple therapy is declining. This study was conducted to test whether the addition of Lactobacillus reuteri to the standard triple therapy improves the eradication rates as well as the clinical and pathological aspects in H. pylori infection. METHODS: A total of 70 treatment-naïve patients were randomly assigned into group A (the L. reuteri treated group) and group B (the placebo control group). Patients were treated by the standard triple therapy for 2 weeks and either L. reuteri or placebo for 4 weeks. They were examined by symptom questionnaire, H. pylori antigen in stool, upper endoscopy with biopsies for rapid urease test and histopathological examination before treatment and 4 weeks after treatment. RESULTS: The eradication rate of H. pylori infection was 74.3% and 65.7% for both L. reuteri and placebo treated groups, respectively. There was a significant difference regarding the reported side effects, where patients treated with L. reuteri reported less diarrhea and taste disorders than placebo group. A significant difference within each group was observed after treatment regarding Gastrointestinal Symptom Rating Scale (GSRS) scores; patients treated with L. reuteri showed more improvement of gastrointestinal symptoms than the placebo treated group. The severity and activity of H. pylori associated gastritis were reduced after 4 weeks of therapy in both groups. The L. reuteri treated group showed significant improvement compared with the placebo treated group. CONCLUSION: Triple therapy of H. pylori supplemented with L. reuteri increased eradication rate by 8.6%, improved the GSRS score, reduced the reported side effects and improved the histological features of H. pylori infection when compared with placebo-supplemented triple therapy.