A study of Some Hormones and Antioxidant ‎Systems Disturbances in Older Men

تتميز ظاهرة التقدم بالعمر بحصول العديد من الاضطرابات خاصة في الميكانيكيات الفسلجية اللازمة  لإدامة الاتزان البدني. وضعت الدراسة الحالية لبحث منظومتين يعتقد انهما ذات اهمية في حصول تقدم العمر وهما بعض الهرمونات ومضادات الاكسدة .شمل العدد الكلي لأشخاص الدراسة انتخاب خمسون رجلا من الاصحاء وقد قسموا حسب اعمارهم الى مجموعتين شملت المجموعة الاولى خمس وعشرين رجلا من الشباب(Younger men) تراوحت اعمارهم بين21- 30 سنه في حين شملت المجموعة الثانية خمس عشرون رجلا مسنا ( Older men) تراوحت اعمارهم بين 61-   70 سنة . سجلت النتائج المستحصلة من الدراسة الحالية حصول انخفاض معنوي (p˂0.05)  في مستوى الهرمون المحفز للدرقية(TSH)  وبنفس الوقت حصول ارتفاع معنوي (p˂0.05) في مستوى هرموني الدرقية(T3,T4) عند الاشخاص المسنين عند مقارنتهم مع الاشخاص الشباب  , وبخصوص  هرموني التستوستيرون (Testosterone) والكورتيزول (Cortisol) ,فقد بينت النتائج حصول انخفاض معنوي  (p˂0.05) في تراكيز كلا الهرمونين في الرجال المسنين عند مقارنتهم مع الرجال غير المسنين ( الشباب) . سجلت قيم مركب المالونديهايد (MDA) ارتفاعا معنويا (p˂0.05) لدى الرجال المسنين عند مقارنتهم مع الرجال الشباب في حين لوحظ حصول انخفاض معنوي في مستوى العوامل المضادة للأكسدة  مثل  الكلوتاثيون  بيروكسيديز    (GPX)     والكلوثايون   المختزل   (GSH)  والكاتليز(Catalase) لدى الرجال المسنين عند مقارنتهم مع الرجال الشباب . كما بينت النتائج عدم حصول ارتباط معنوي (p>0.05) بين كل من هرموني T3 و هرمون Testosterone من جهة و مركب MDA وفعالية  انزيم GPX من جهة اخرى  .                           من النتائج المستحصلة من هذه الدراسة يمكن الاستنتاج بانه مع تقدم العمر تحصل العديد من الاضطرابات والتقلبات في محاور جسم  تحت المهاد و الدرقية والكظرية والتي تكون مصحوبة بانخفاض المنظومات المضادة للأكسدة والتي قد تودي الى ارتفاع مستوى الجذور الحرة والتي بدورها تسبب اضطراب للعديد من الوظائف  الفسلجية للجسم على مستوى الاجهزة والخلايا     Ageing is a physiological phenomenon that manifested itself with disturbances of many homeostatic regulating mechanisms of the body . The present study was conducted and employed to investigate two major systems( hormones and antioxidant systems) that can be implicated in progress of aging .The total number of subjects included in the present study was fifty (50) healthy men and classified according to their ages into two groups, the first group included 25 younger men (control group) and their ages ranged between 21 to 30 years old whereas the second group included 25 older men and their ages were between 61 to 70 years old.  Data obtained from this study indicated a significant decrease(p<0.05) in the levels of thyroid stimulating hormone (TSH) which is associated with marked elevation (p<0.05) of triiodothyronine(T3) and tetraiodothyronine(T4) of older men when compared with younger men. In regard to levels of cortisol and testosterone hormones were significantly decreased (p<0.05) in aged men when matched with their counterparts of younger men.  Concerning concentrations of malondehyde (MDA) ,a final product of lipid peroxidation, confirmed a remarkable elevation (p<0.05) in older men compared to younger men and these results were associated with significant lowering (p<0.05) in the activities of antioxidant components including glutathione peroxidase (GPX), reduced glutathione (GSH) and catalase . In addition , there are no significant  correlations(p>0.05) occurring among hormones( testosterone  , T3) and glutathione peroxidase and of malondehyde .   From these results ,one can be concluded that with ageing there are many disturbances and fluctuations of hypothalamic-adrenal and thyroid axis that accompanied with drop of essential antioxidant components that may be lead to suppress of defense against free radicals and the present study concluded that the changes occurring in studied hormones have not relations and effects on the antioxidant systems

Nutritional Assessment of Hip and Neck of Femur Fractures among Elderly Patients in Qatar

Introduction: Femoral neck fractures is one of the most common traumatic injuries in elderly and increasing continuously worldwide. The study aims to assess malnutrition among elderly admitted with hip and femur fracture in Qatar using different variables before and after surgery. Materials and methods: Cross sectional study of 93 patients (42 males, 51 females) with femur fracture (elderly over 65 years) admitted to Hamad General Hospital HGH for surgery within the study period. Malnutrition assessed using, Anthropometric measurements, Biochemical laboratory values before and after surgery. Food intake measured through tray percentage consumption of lunch tray and Geriatric Nutrition Risk Index (GNRI) calculated from variables collected. Results: Using GNRI 26.44% of patients were malnourished and increased to 46.91% after surgery. All variables decreased with age; females have higher anthropometric values than males, but significant difference only found for MUAMC (p value <0.05). Widowed females and married males have more tendency for femur fracture/malnutrition. Biochemical laboratory values decreased significantly after surgery except lymphocyte count. Laboratory values strongly correlated with each other except lymph count, negative correlation between age and anthropometric measurements positive correlation between BMI and anthropometric measurements. Conclusion: Laboratory values and food consumption were underestimated since blood transfer for some patients were not considered and those who did not eat were not included in calculation. All malnutrition assessment tools consider several variables to assess malnutrition the more variables assessed the better assessment tool. Keywords: Malnutrition, femur fracture, elderly, anthropometric measurements. DOI: 10.7176/JHMN/105-04 Publication date: January 31st 202

The Relationship Between Serum Albumin Level and Nutritional Parameters with Mortality Rate, For Icu-Covid-19 Patients at Hazem Mebaireek General Hospital (HMGH), State of Qatar (March to September / 2020)

There is limited information available describing the clinical and epidemiological features of COVID-19 patients at (HMGH) in Qatar, also there is lack of reporting about temporal association of Malnutrition and severity of COVID-19. This study was aimed to describe the relationship between serum albumin levels and certain nutritional parameter with mortality rate for ICU-COVID-19 patients. The study was conducted retrospectively on a group of adult patients, who were admitted to ICU at HMGH, from 01/04/ 2020 to 30/09/ 2020, who’s discharged from the hospital, whether recovered or expired, if they met the following inclusion criteria: ICU patients, ≥ 18 years of age, laboratory confirmed positive of COVID-19. Data of ICU-COVID-19 patients at HMGH will be extracted from electronic medical record (EMR). Total of 1059 patients, among them 78 (7.4%) patients were females and 981(92.6%) of them were males. Comparing with nationality 93(8.78%) patients were Qatari and 966(91.21%) were non-Qatari, 951 (89.8%) was survived & 108 (10.2%) were non survived, furthermore 12 (11.1 %) patients from the non-survived patients were Qatari & 96 (88.9 %) were non-Qatari. In the results it found that 136 (12.8%) of patients had Hyperlipidemia, 75 (7.1%) had obesity, 577 (54.5%) with diabetes, 513 (48.41%) with hypertension, & 129 (12.2%) had chronic lung disease. 581 patients had albumin value below 35 gm/L on admission and 768 had below 35 gm/L before discharge. 478 patients had albumin level above 35 gm/L on admission and 291 patients had above 35 gm/L albumin level before discharge. Among non-survived patients who 108 (100%) of them had low serum albumin levels before death and 80 (74.1%) of them had below 35 gm/L albumin and 28 (25.9%) patients had 35 gm/L and above albumin levels on admission. In Qatar there were adequate implementation of interventions, protections & management to face COVID-19 prevention.  Our study concluded that male patients & hypoalbuminemia were significantly risk of mortality associated with COVID-19. Keywords: hypoalbuminemia, nutritional parameter, mortality rate. DOI: 10.7176/FSQM/111-01 Publication date:October 31st 202

The Effect of Ramadan Fasting on Body Composition of Overweight and Obese Male Staff in Hazm Mebaireek General Hospital, State of Qatar

Background:  Fasting during the holy month of Ramadan causes Muslims to change their lifestyle as well as food habits. Muslims who observe fasting consume 2 meals per day, Iftar at sunset which is a relatively big meal, and Sohor before dawn. The aim of this study is to investigate the effects of Ramadan fasting on body weight and body composition. Method: The body weight and composition were measured and analyzed 4 days prior to the month of Ramadan (prefasting) and 4 days before the completion of Ramadan (fasting). Height was measured by using a weighing scale, the waist circumference was measured with a non-stretchable tape, whereas body weight, body mass index (BMI), basal metabolic rate (BMR), biological age, and body composition parameter (water, fat percentage, fat-free mass, and muscle mass) was estimated by using body composition analyzer based on bio-electrical impedance. Result: 107 subjects were involved in this study, the comparison between the prefasting and fasting measurements shows that body weight (89.112 ± 14.7651) vs (87.033 ± 14.5363) kg, BMI (29.453 ± 3.8516) vs (28.759 ± 3.8289) kg/m2, waist circumference (101.338 ± 9.6535) vs (97.869 ± 9.4920) cm P<0.05) was significantly decreased, while the body fat percentage  (27.771 ± 4.6771) vs (27.021 ± 4.8103), fat mass (25.290 ± 8.6062) vs (24.035 ± 8.4310)kg, muscle mass (60.731 ± 7.4130) vs (59.916 ± 7.3193) illustrated a significant decrease, however fat-free mass decrease insignificantly (63.527  ± 7.5559) vs (63.022 ± 7.6758) kg. Additionally, metabolic age (50.308 ± 8.4143) vs (49.290 ± 8.7997) years, basal metabolic rate (1897.935 ± 247.8362) vs (1872.140 ± 253.8423) kcal showed significant decrease, more so, total body water was significantly increase (52.798 SD 3.3674) vs (53.215 SD 3.4511) kg. Conclusion: According to the result, Ramadan fasting provides an opportunity to lose weight among overweight and obese individuals. Further studies are required to investigate whether these changes can be a result of the restriction in meal frequencies, and total energy intake or if it is related to other factors. Keywords: Ramadan fasting, body composition, biological age, bio-electrical impedance. DOI: 10.7176/JHMN/105-08 Publication date: January 31st 202

Impact of fusion gene status versus histology on riskâ stratification for rhabdomyosarcoma: Retrospective analyses of patients on UK trials

BackgroundLongâ term toxicities from current treatments are a major issue in paediatric cancer. Previous studies, including our own, have shown prognostic value for the presence of PAX3/7â FOXO1 fusion genes in rhabdomyosarcoma (RMS). It is proposed to introduce PAX3/7â FOXO1 positivity as a component of risk stratification, rather than alveolar histology, in future clinical trials.ProcedureTo assess the potential impact of this reclassification, we have determined the changes to risk category assignment of 210 histologically reviewed patients treated in the UK from previous malignant mesenchymal tumour clinical trials for nonâ metastatic RMS based on identification of PAX3/7â FOXO1 by fluorescence in situ hybridisation and/or reverse transcription PCR.ResultsUsing fusion gene positivity in the current risk stratification would reassign 7% of patients to different European Paediatric Soft Tissue Sarcoma Study Group (EpSSG) risk groups. The next European trial would have 80% power to detect differences in eventâ free survival of 15% over 10 years and 20% over 5 years in reassigned patients. This would decrease treatment for over a quarter of patients with alveolar histology tumours that lack PAX3/7â FOXO1.ConclusionsFusion gene status used in stratification may result in significant numbers of patients benefitting from lower treatmentâ associated toxicity. Prospective testing to show this reassignment maintains current survival rates is now required and is shown to be feasible based on estimated recruitment to a future EpSSG trial. Together with developing novel therapeutic strategies for patients identified as higher risk, this may ultimately improve the outcome and quality of life for patients with RMS.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137481/1/pbc26386_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137481/2/pbc26386.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137481/3/pbc26386-sup-0002-FigureS2.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137481/4/pbc26386-sup-0001-FigureS1.pd

Outcomes of patients with Wilms' tumour stage III due to positive resection margins only: An analysis of patients treated on the SIOP-WT-2001 protocol in the UK-CCLG and GPOH studies.

Stage III Wilms' tumour (WT) represents a heterogeneous group which includes different criteria, but all stage III patients are treated according to the same study regiment. The aim of the study was to retrospectively analyse outcomes in patients with stage III due to positive resection margins (RM) only, sub-grouped in RM with viable (RM-v) and nonviable (RM-nv) tumour. Patients were treated pre- and postoperatively according to the SIOP-WT-2001 protocol in the UK-CCLG and GPOH WT trials and studies (2001-2020). There were 197 patients, including 134 with localised, abdominal stage III and 63 with overall stage IV, but abdominal stage III. Stage III due to RM-v had 126 patients, and due to RM-nv 71 patients. The overall 5-year local-relapse-free survival (RFS), event-free (EFS) and overall survival (OS) estimates for all patients with abdominal stage III RM were 95.7% (±SE1.5%), 85.1 (±SE2.6%) and 90.3% (±SE2.2%), respectively. Patients with stage III RM-nv had significantly better RFS and EFS than patients with RM-v (P = .027 and P = .003, respectively). A multivariate analysis showed that RM-v remained a significant factor for EFS when adjusted for age, presence of metastasis at diagnosis, histological risk group and overall stage in Cox regression analysis (P = .006). Patients with stage III due to RM-nv only exhibited no local recurrence and have a significantly better RFS and EFS than patients with RM-v. The results suggest that exclusion of RM-nv as a stage III criterion in the UMBRELLA staging system and consequent treatment reduction is warranted

Outcomes of patients with Wilms' tumour stage III due to positive resection margins only: An analysis of patients treated on the SIOP-WT-2001 protocol in the UK-CCLG and GPOH studies

Stage III Wilms' tumour (WT) represents a heterogeneous group which includes different criteria, but all stage III patients are treated according to the same study regiment. The aim of the study was to retrospectively analyse outcomes in patients with stage III due to positive resection margins (RM) only, sub-grouped in RM with viable (RM-v) and nonviable (RM-nv) tumour. Patients were treated pre- and postoperatively according to the SIOP-WT-2001 protocol in the UK-CCLG and GPOH WT trials and studies (2001-2020). There were 197 patients, including 134 with localised, abdominal stage III and 63 with overall stage IV, but abdominal stage III. Stage III due to RM-v had 126 patients, and due to RM-nv 71 patients. The overall 5-year local-relapse-free survival (RFS), event-free (EFS) and overall survival (OS) estimates for all patients with abdominal stage III RM were 95.7% (±SE1.5%), 85.1 (±SE2.6%) and 90.3% (±SE2.2%), respectively. Patients with stage III RM-nv had significantly better RFS and EFS than patients with RM-v (P = .027 and P = .003, respectively). A multivariate analysis showed that RM-v remained a significant factor for EFS when adjusted for age, presence of metastasis at diagnosis, histological risk group and overall stage in Cox regression analysis (P = .006). Patients with stage III due to RM-nv only exhibited no local recurrence and have a significantly better RFS and EFS than patients with RM-v. The results suggest that exclusion of RM-nv as a stage III criterion in the UMBRELLA staging system and consequent treatment reduction is warranted

Somatic TP53 Mutations Are Detectable in Circulating Tumor DNA from Children with Anaplastic Wilms Tumors.

BACKGROUND: Diffuse anaplastic Wilms tumor (DAWT) is a rare, high-risk subtype that is often missed on diagnostic needle biopsy. Somatic mutations in TP53 are associated with the development of anaplasia and with poorer survival, particularly in advanced-stage disease. Early identification of DAWT harboring TP53 abnormalities could improve risk stratification of initial therapy and monitoring for recurrence. METHODS: Droplet digital polymerase chain reaction (ddPCR) was used to evaluate 21 samples from 4 patients with DAWT. For each patient, we assessed TP53 status in frozen tumor, matched germline DNA, and circulating tumor DNA (ctDNA) from plasma, serum, and urine collected throughout treatment. RESULTS: Mutant TP53 was detectable in ctDNA from plasma and serum in all patients. We did not detect variant TP53 in the same volume (200 μl) of urine. One patient displayed heterogeneity of TP53 in the tumor despite both histological sections displaying anaplasia. Concentration of ctDNA from plasma/serum taken prenephrectomy varied significantly between patients, ranging from 0.44 (0.05-0.90) to 125.25 (109.75-140.25) copies/μl. We observed variation in ctDNA throughout treatment, and in all but one patient, ctDNA levels fell significantly following nephrectomy. CONCLUSION: We demonstrate for the first time that ddPCR is an effective method for detection of mutant TP53 in ctDNA from children with DAWT even when there is intratumoral somatic heterogeneity. This should be further explored in a larger cohort of patients, as early detection of circulating variant TP53 may have significant clinical impact on future risk stratification and surveillance

Outcome of Stage IV Completely Necrotic Wilms Tumour and Local Stage III Treated According to the SIOP 2001 Protocol

Objective: Wilms tumour (WT) patients with a localised completely necrotic nephroblastoma after preoperative chemotherapy are a favourable outcome group. Since the introduction of the SIOP 2001 protocol, the SIOP– Renal Tumour Study Group (SIOP–RTSG) has omitted radiotherapy for such patients with low-risk, local stage III in an attempt to reduce treatment burden. However, for metastatic patients with local stage III, completely necrotic WT, the recommendations led to ambiguous use. The purpose of this descriptive study is to demonstrate the outcomes of patients with metastatic, completely necrotic and local stage III WT in relation to the application of radiotherapy or not. Methods and materials: all metastatic patients with local stage III, completely necrotic WT after 6 weeks of preoperative chemotherapy who were registered in the SIOP 2001 study were included in this analysis. The pattern of recurrence according to the usage of radiation treatment and 5 year event-free survival (EFS) and overall survival (OS) was analysed. Results: seven hundred and three metastatic WT patients were registered in the SIOP 2001 database. Of them, 47 patients had a completely necrotic, local stage III WT: 45 lung metastases (11 combined localisations), 1 liver/peritoneal, and 1 tumour thrombus in the renal vein and the inferior vena cava with bilateral pulmonary arterial embolism. Abdominal radiotherapy was administered in 29 patients (62%; 29 flank/abdominal irradiation and 9 combined with lung irradiation). Eighteen patients did not receive radiotherapy. Median follow-up was 6.6 years (range 1–151 months). Two of the 47 patients (4%) developed disease recurrence in the lung (one combined with abdominal relapse) and eventually died of the disease. Both patients had received abdominal radiotherapy, one of them combined with lung irradiation. Five-year EFS and OS were 95% and 95%, respectively. Conclusions: the outcome of patients with stage IV, local stage III, completely necrotic Wilms tumours is excellent. Our results suggest that abdominal irradiation in this patient category may not be of added value in first-line treatment, consistent with the current recommendation in the SIOP–RTSG 2016 UMBRELLA protocol