Place du prelevement ganglionnaire dans le traitement des cancers differencies de la thyroide n0 clinique

Objectif :  Mots-clés : Cancer différencié, thyroïde, prélèvement ganglionnaireDémontrer l’intérêt du prélèvement ganglionnaire sus-claviculaire et jugulaire inférieur dans la prise en charge des cancers différentiés de la thyroïde (CDT) N0 clinique. Matériel et méthodes : Nous rapportons une étude rétrospective à propos de 170 patients colligés sur 12 ans (1994-2005). Tous les patients ont eu une thyroïdectomie totale en 1 ou 2 temps. Le curage médiastino-récurrentiel a été pratiqué soit systématiquement soit en cas de découverte d’adénopathies en peropératoire. Le curage latéral a été réalisé soit de principe soit après un prélèvement ganglionnaire sus-claviculaire et jugulaire inférieur positif à l’examen extemporané. Des doses ablatives d’iode radioactif ont été administrées en cas d’élévation du taux de la thyroglobuline ou d’une fixation d’iode lors du balayage cervico-thoracique. Résultats : L’examen anatomopathologique trouvait un carcinome papillaire (74,1%), vésiculaire (16,5%) ou papillaire à composante vésiculaire (9,4%). Trente patients ont eu un curage fonctionnel systématique uni ou bilatéral, une métastase ganglionnaire a été notée chez 9 d’entre eux. Cent quarante patients ont eu un prélèvement ganglionnaire uni ou bilatéral, un curage fonctionnel a été pratiqué chez 6 d’entre eux devant un examen extemporané positif. Les taux de rémission, de récidive et de métastases étaient respectivement de 83,3%, 6,7% et 10% dans le premier groupe, et de 89,3%, 4,3% et 6,4% dans le deuxième groupe. Par ailleurs, un décés a été observé chez deux patients du deuxième groupe (1,4%) . Aucune différence statistiquement significative n’a été retrouvée entre les différents taux. Conclusion : Les résultats de notre série mettent en évidence l’intérêt du prélèvement sus-claviculaire et jugulaire inférieur permettant d’éviter le curage fonctionnel systématique

Cow’s milk protein elimination in autistic children: language, cognitive and behavioral outcome

Background: Behavioral modification and structured education are necessary in autism but rather insufficient. Various dietary restrictions have been suggested as important prerequisites to benefit from other interventions in this disorder. Objective: This study was designed to highlight the degree of benefit in various aspects of development of autistic children upon elimination of cow's milk protein (CMP) from their diet and assess the level of specific IgE for CMP in their sera. Methods: The current study was conducted on 22 autistic children who were compared to 30 age and sex matched healthy children. Enrolled autistic children were randomly assigned to one of two groups. The parents of first group were instructed to eliminate cow milk (CM) from the diet of their children throughout the study period while patients of the second group were allowed to eat without restrictions. Each enrolled child was subjected to complete dietetic history taking, clinical examination and measurement of IgE for CM antigen in their sera by enzyme immunoassay. Autistic patients underwent a Childhood Autism Rating Scale (CARS) test. The patients were also subjected to language and intelligent quotient (IQ) testing, social and mental age assessment and child psychiatric evaluation. The autistic children received an interventional program for six months and were then re-evaluated using the previous clinical parameters. Results: The first group achieved significantly lower CARS test results (p < 0.01), significantly higher language age (p < 0.05) and significantly higher rate of change of CARS, language, social age, mental age and IQ (p < 0.001, <0.05, <0.05, <0.01 and <0.05 respectively) compared to the second group after 6 months of follow up. There was also a significantly higher mean specific IgE level to CMP in the autistic patients as compared to the controls. Additionally, 45.5% of patients who were on CM elimination diet went one CARS category down compared to only 36.4% of the second group. Conclusion: We report improvement in language, cognition and behavioral capabilities upon CM elimination in a group of autistic children. The higher CM specific IgE in these children may suggest that such adverse reaction to CM may have an allergic basis. Wider scale studies are needed to justify this adjuvant therapeutic option in autistic children hoping for better achievement from the current interventional programs. Keywords: Allergy – Autism – CARS – Cow milk – IgE – IQEgypt J Pediatr Allergy Immunol 2006; 4(1): 15-2

In vitro differentiation of human umbilical cord blood mesenchymal stem cells into functioning hepatocytes

Mesenchymal stem cells (MSCs) were isolated by gradient density centrifugation from umbilical cord blood. Spindle-shaped adherent cells were permitted to grow to 70% confluence in primary culture media which was reached by day 12. Induction of differentiation started by culturing cells with differentiation medium containing FGF-4 and HGF. Under hepatogenic conditions few cuboidal cells appeared in culture on day 7. From day 21 to day 28, most of cells became small and round. The control negative cells cultured in serum free media showed fibroblast-like morphology. Urea production and protein secretion by the differentiated hepatocyte-like cells were detected on day 21 and increased on day 28. Protein was significantly increased in comparison with control by day 28. The cells became positive for AFP at day 7 and positive cells could still be detected at days 21 and 28. The cells in the control group were stained negative for AFP. The cells expressed albumin gene at the 14th day that became markedly increased at the 28th day of culture with HGF and FGF-4. No albumin expression was observed in the 7th day sample and the control. This study demonstrated that UCB-derived MSCs had the ability to differentiate into functioning hepatocyte-like cells starting from the 7th day after culturing under hepatogenic conditions and became well functioning at days 21 and 28. These data indicated that UCB-derived MSCs can be a promising source of cell therapy for intractable liver diseases.Keywords: Umbilical cord blood; Mesenchymal stem cells; Culture; Hepatocytes; HGF; FGF-

Low platelet to lymphocyte ratio and high platelet distribution width have an inferior outcome in chronic lymphocytic leukaemia patients

Introduction.  Chronic lymphocytic leukaemia (CLL) is an incurable disease of the elderly, characterised by gradual accu­mulation of small mature B lymphocytes which escape apoptosis through inflammatory signals from the microenviron­ment. Elevated inflammatory markers are associated with very poor prognosis in different types of cancer. Therefore, we examined retrospectively the impact of platelet lymphocyte ratio (PLR) and platelet distribution width (PDW) on 180 CLL patients’ outcome. Materials and methods.  This retrospective study included 180 patients with CLL who were diagnosed and selected among cases referred to the Oncology Center Mansoura University between January 1st, 2008 and June 30th, 2016. All the relevant information was collected from the electronic medical records of the selected patients. Results.  Our results revealed that low PLR (<2.5) was more frequently observed in patients with stage C (p < 0.001), with 17p deletion (p = 0.017), and CD38 expression (p = 0.08), but not with seropositive HCV patients (p = 0.2). High PDW (≥18.5 fl) was more frequently associated with intention to treat population (p = 0.038), and CD38 expression (p = 0.068), but not with 17p deletion (p = 0.25) and seropositive HCV patients (p = 0.4). Multivariate analysis for overall survival showed that stage A and low PDW were independent factors for overall survival (p = 0.014 and 0.04 respectively), while high PLR (p = 0.05), and seronegative HCV patients (p = 0.1) lost their significance. Conclusion.  Our data showed that low PLR and high PDW were associated with poor prognostic markers. Stage C-CLL and high PDW were independent predictors of survival

REDUCTION OF ACRYLAMIDE FORMATION IN POTATO CHIPS BY AQUEOUS EXTRACT OF ROSELLE

Acrylamide (AA) is an industrial chemical formed in some foods; particularly starchy foods, during heating process such as frying, baking and roasting. AA is proven to be carcinogenic in animals and a probable human carcinogen formed in foods by the reaction of free amino acid with reducing sugars as part of the Maillard reaction during heating under high temperature and low moisture conditions. Therefore, the aim of this study was to use aqueous extract of roselle as a natural source of antioxidants to reduce AA formed in potato chips. The results showed that the percentages of reduction of AA were 10.1% and 12.92% in samples that were treated with 1% of aqueous extract of roselle and soaked at 10 and 20 mins respectively. There was observed increase in AA reduction by it was 75.41% and 82.46% after soaking  at 10 and 20 mins respectively with 5% extract. Conclusively, the aqueous extract of roselle is effective in reducing the AA formed in potato chips due as it contains of antioxidant compounds. Keywords: acrylamide (AA), potato, roselle, soaking and reduction Â

Insight into Fucoidan-based PEGylated PLGA Nanoparticles Encapsulating Methyl Anthranilic Acid: In Vitro Evaluation and In Vivo Anti-inflammatory Study

A potential fucoidan-based PEGylated PLGA nanoparticles (NPs) offering a proper delivery of N-methyl anthranilic acid (MA, a model of hydrophobic anti-inflammatory drug) have been developed via the formation of fucoidan aqueous coating surrounding PEGylated PLGA NPs. The optimum formulation (FuP2) composed of fucoidan:m-PEG-PLGA (1:0.5 w/w) with particle size(365 ± 20.76 nm), zeta potential (-22.30 ± 2.56 mV), % entrapment efficiency (85.45 ± 7.41), drug loading (51.36 ± 4.75 µg/mg of NPs), % initial burst (47.91 ± 5.89), and % cumulative release (102.79 ± 6.89) has been further investigated for the anti-inflammatory in vivo study. This effect of FuP2 was assessed in rats’ carrageenan-induced acute inflammation model. The average weight of the paw edema was significantly lowered (p ≤ 0.05) by treatment with FuP2. Moreover, cyclooxygenase-2 and tumor necrosis factor-alpha immunostaining were decreased in FuP2 treated group compared to the other groups. The levels of prostaglandin E2, nitric oxide, and malondialdehyde were significantly reduced (p ≤ 0.05) in the FuP2-treated group. A significant reduction (p ≤ 0.05) in the expression of interleukins (IL-1b and IL-6) with an improvement of the histological findings of the paw tissues was observed in the FuP2-treated group. Thus, fucoidan-based PEGylated PLGA–MA NPs are a promising anti-inflammatory delivery system that can be applied for other similar drugs potentiating their pharmacological and pharmacokinetic properties

Diagnostic Performances of an Occupational Burnout Detection Method Designed for Healthcare Professionals.

We aimed to assess the validity (criterion and cross-cultural validity) and reliability of the first occupational burnout (OB) detection tool designed for healthcare professionals in Belgium in the context of Swiss medical practice. First, we assessed the sensitivity and specificity of the Tool. We developed this tool based on the consultation reports of 42 patients and compared its detection to the results of the Oldenburg Burnout Inventory (OLBI), filled-in by patients before a consultation. Second, we performed an inter-rater reliability (IRR) assessment on the OB symptoms and detection reached by the Tool between a psychiatrist, two psychologists, and an occupational physician. The Tool correctly identified over 80% of patients with OB, regardless of the cutoff value used for OLBI scores, reflecting its high sensitivity. Conversely, its specificity strongly varied depending on the OLBI cutoff. There was a slight to fair overall agreement between the four raters on the detection of OB and the number of OB symptoms. Around 41% of symptoms showed a substantial to an almost perfect agreement, and 36% showed a slight to a moderate agreement. The Tool seems useful for identifying OB of moderate and strong severity in both the Belgian and Swiss contexts

Evaluation et prise en charge de l’envahissement mandibulaire dans les carcinomes epidermoïdes de la cavite orale et de l’oropharynx

Objectif : Le but de notre étude est l’évaluation de l’atteinte mandibulaire dans les carcinomes épidermoïdes de la cavité orale et de l’oropharynx. Matériel et méthodes : Il s’agit d’une étude rétrospective à propos de 34 patients colligés sur 6 ans (1999-2004) et ayant un carcinome épidermoïde de la cavité orale et/ou de l’oropharynx avec envahissement mandibulaire confirmé à l’anatomopathologie. L’atteinte mandibulaire a été évaluée par l’examen clinique,  l’orthopantomographie, la tomodensitométrie, et par les constatations peropératoires du chirurgien. Tous les patients ont eu un évidement ganglionnaire, une exérèse tumorale associée à une mandibulectomie segmentaire interruptrice ou conservatrice. Résultats : L’envahissement mandibulaire a été suspecté cliniquement chez 70,5% des patients devant l’adhérence de la tumeur à l’os. Après examen clinique et imagerie, cette atteinte a été diagnostiquée chez 88,2% des patients. Dans 11,8% des cas, l’atteinte n’a été suspectée qu’en peropératoire. L’examen histologique a confirmé l’atteinte osseuse chez tous les patients. La mandibulectomie segmentaire a été pratiquée chez 17 patients devant l’atteinte du canal mandibulaire. Vingt-huit patients ont eu une radiothérapie postopératoire à la dose moyenne de 64 Gy. Les taux de récidive, de métastase et de décès étaient respectivement de 11,7%, 17,6% et 17,6% pour les patients qui ont eu une mandibulectomie segmentaire, et de 23,5%, 17,6% et 23,5% pour ceux qui ont eu une mandibulectomie conservatrice. Par ailleurs, 76,5% et 29,5% des patients ayant eu respectivement une mandibulectomie segmentaire et une mandibulectomie conservatrice avaient une gêne fonctionnelle importante lors de l’alimentation. Conclusion : L’examen clinique, l’imagerie et l’examen peropératoire sont d’un apport capital dans l’évaluation de l’atteinte mandibulaire. Une atteinte épargnant le canal mandibulaire justifie une mandibulectomie conservatrice permettant d’avoir de meilleurs résultats esthétiques et fonctionnels tout en assurant un contrôle carcinologiquement satisfaisant.Mots clés : envahissement mandibulaire, carcinome épidermoïde, cavité orale, oropharynx, mandibulectomie segmentaire, mandibulectomie conservatric