The Evaluation of Multidrug Resistance-Related Protein 1 as a Prognostic Factor in the Pediatric B-cell Acute Lymphoblastic Leukemia: A Pilot Study

Objective:Acute lymphoblastic leukemia (ALL) is the most prevalent type of cancer in children. Minimal residual disease (MRD) is still the most important indicator of clinical results and relapse after chemotherapy. Multidrug resistance is the main obstacle to successful treatment. Multidrug resistance-related protein 1 (MRP1) may play a key role in throwing the chemical drug out of cells leading to therapy resistance. This study aims to detect MRP1 protein in the bone marrow cells of children with B-ALL and determine its value as a prognostic factor in comparison with other factors such as DNA index and MRD obtained by flow cytometric measurement.Methods:Bone marrow samples were obtained from children who are diagnosed as B-ALL (n=20) at day 0 (diagnosis) and 15 of therapy. Risk groups’ classification is based on discrimination of age and white cell count on day 0. The expressions of MRP1 levels and DNA index at diagnosis and MRD on the 15th day of treatment in the bone marrow were detected by using flow cytometry. The B-ALL blast cells were stained using anti-CD10, -CD19, -CD20, -CD34, -CD45 monoclonal antibodies. MRP1 content of cells was detected in an intracellular manner.Results:There was no statistically significant difference in MRP1 expression between risk groups and the other prognostic factor as Flow MRD and DNA index.Conclusion:The utilization of MRP1 as a predictive factor may not provide information on the B-ALL prognosis. Our results can help to better understand the nature of MRP1 in B-ALL patients

International Travelers’ Behaviors and Knowledge of Travel Health, Travel-Related Diseases, and Vaccinations: A Cross-Sectional Study

Introduction: Travel health centers offer very important health services for individuals traveling abroad. Little is known about the health status and knowledge of travel health, travel-related diseases, and vaccinations of individuals who travel abroad and visit travel health centers. This research studied travelers who visited a travel health center in order to evaluate their behavior and knowledge of travel health, travel-related diseases, and vaccinations. Methods: This cross-sectional study was conducted with 407 participants between June and September 2018, the busiest time for international travel. It was administered at a travel health center attached to the Directorate General of Health for Border and Coastal Areas of Turkey. Results: The results indicated that 78.6% of participants did not obtain travel health insurance before their trip, and 63.6% did not prepare a travel health kit for their trip. Moreover, 61.4% reported that they did not know about the health conditions and practices of their destination country. Individuals traveling for business did more research on travel-related diseases compared to those traveling for other reasons. Additionally, 61.3% of individuals who rated themselves healthy sought information about the health conditions at their travel destinations. Conclusion: The current study showed that the knowledge and healthcare practices among international travelers are inadequate. Raising awareness is needed to create a positive behavioral change in people’s travel health practices

The value of echocardiography versus cardiac troponin i levels in the early detection of anthracycline cardiotoxicity in childhood acute leukemia: Prospective evaluation of a 7-year-long clinical follow-up

The present study was designed to evaluate the significance of echocardiography versus cardiac troponin I levels in early detection of anthracycline dependent cardiotoxicity in acute lymphoblastic leukemia (ALL) patients. A total of 276 pediatric ALL patients were included in the study prospectively along 3 phases of data collection lasted from 2002 to 2009; including phase I (March 2002 to February 2003; n = 25; 53.3% females), phase II (September 2003 to April 2004; n = 35; 57.1% females), and phase III (January 2005 to June 2009; n = 216; 52.7% females) with respect to cumulative anthracycline doses applied. Anthracyclinewas administered in accordance with berlin-Franfurt-Munich (BFM)-2000 protocol in doses of 30 to 350 mg/m(2) (in the first phase) and 30 to 240 mg/m(2) (in the following phases). Evaluation of cardiotoxicity was performed via echocardiography and measurement of cardiac troponin I levels. Patients in each phase were homogenous in terms of gender and age. Diastolic dysfunction determined via reduction E/A ratio below the cutoff value was demonstrated to deteriorate earlier than systolic functions and alteration in cardiac enzymes. Being similar between dose groups, cTnI levels were shown to rise in the presence of congestive heart failure. In conclusion, anthracycline cardiotoxicity appears to be detected in an earlier stage by using diastolic parameters compared to systolic parameters and cardiac enzymes