Detection of HER-2/neu, c-myc amplification and p53 inactivation by FISH in Egyptian patients with breast cancer

Breast cancer is a leading cause of cancer-related deaths in women worldwide. The clinical course of this disease is highly variable and clinicians continuously search for prognostic parameters that can accurately predict prognosis, and indicate a suitable adjuvant therapy for each patient. Amplification of the two oncogenes HER-2/neu and c-myc and inactivation of the tumor suppressor gene p53 are frequently encountered in breast carcinomas. The purpose of this study was to use the fluorescence in situ hybridization (FISH) for the assessment of HER-2/neu and c-myc amplification and p53 inactivation and to relate these molecular markers with the commonly used clinical and pathological factors. The study was conducted on 34 tissue samples obtained from 33 females and 1 male with breast carcinomas and 17 samples obtained from 16 females and 1 male with benign breast lesions. Results revealed that the level of HER-2/neu, c-myc and p53 in the malignant group was significantly increased as compared to the benign group. On relating the level of the molecular markers to clinicopathological factors, p53 was significantly associated with increased patient’s age. The sensitivity of the investigated markers significantly increased with larger tumor size. Concerning tumor grade, HER-2/neu and p53 showed a significant increase in low-grade tumors whereas c-myc showed a highly significant increase in high-grade tumors. With regard to disease staging, HER-2/neu and c-myc were the only markers that showed significant increase at late stages of disease. p53 and HER-2/neu were significantly associated with positive lymph nodal status. A significant correlation was obtained between the levels of the three biomarkers to each other. Conclusively, the combination of HER-2/neu, c-myc and p53 can stratify patients into different risk groups

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

CD200/CD200 receptor axis in psoriasis vulgaris.

BACKGROUND:Psoriasis is a chronic inflammatory multisystem disease with imbalance between the Th17 and T regulatory sub-populations. CD200/CD200R is an anti-inflammatory/immune-suppressive axis that might contribute to its pathogenesis given its relation to the Tregs induction. The current study aimed to investigate the status of the CD200/CD200R axis in the blood of psoriasis vulgaris patients versus healthy controls. METHODS:In this comparative cross sectional study, the blood levels of sCD200 and CD200R levels were measured in 25 psoriasis vulgaris patients and an age and sex matched 25 healthy controls using ELISA and flow-cytometry respectively. Their levels were tested for correlation to disease severity. RESULTS:sCD200 was significantly higher while CD200R was significantly lower in psoriasis vulgaris patients than in controls. They did not correlate to each other or to psoriasis severity although they differed significantly among cases of different severities. CONCLUSION:Aberrant expression of CD200/CD200R might play a role in psoriasis vulgaris pathophysiology and disease severity. It might constitute a future target of therapy, but cannot be used as a marker of disease severity

Morphological, radiographic, three-dimensional computed tomographic, and histological features of the primary upstroke and downstroke muscles and bones in the domestic duck (Anas platyrhynchos domesticus) and the cattle egret (Bubulcus ibis, Linnaeus, 1758), reflecting the evolutionary transition towards the irreversible flightlessness

Abstract Background The purpose of this study was to explore whether domestication could lead to evolutionary changes towards flightlessness in the domestic duck (Anas platyrhynchos domesticus) compared to the cattle egret (Bubulcus ibis) as a nonflying and flying biological model, respectively. Bones of the pectoral girdle (scapula, clavicle, and coracoid) and the foramen triosseum were comparatively assessed using anatomical, radiographic, and 3D computed tomographic (CT) studies. Additionally, the muscles pectoralis and the supracoracoideus were histologically and immunohistochemically assessed. Results Among the differences observed, radiographically, the distance between the paired clavicles was significantly wider (p < 0.05) in the domestic duck (mean ± SD 1.43 ± 0.23 cm) compared with the cattle egret (0.96 ± 0.13 cm). Unlike cattle egrets, there was no connection between the sternum and the hypocladium of furcula in domestic ducks. The scapula, clavicle, coracoid, sternum, and humerus were considerably longer in domestic ducks than in cattle egrets. The foramen triosseum appeared significantly (p < 0.01) wider in domestic ducks (0.7 ± 1.17 cm) compared to cattle egrets (0.49 ± 0.03 cm). Histologically, compared to cattle egrets, the muscle fibers in domestic ducks were loosely connected and contained fewer nuclei and perimysial/endomysial spaces. A higher myoglobin expression was evident in cattle egrets compared with domestic ducks. Conclusions Results of this study indicate that the bones and muscles of the pectoral girdle generally show specific morphological and structural changes reflective of the loss of prerequisites associated with flight behavior in domestic ducks due to domestication effects compared to cattle egrets

Biochemical and neurological effects of obesity on primary school girls

The prevalence of childhood obesity has increased considerably worldwide. As with adults, obesity in childhood is strongly related to hypertension, dyslipidemia, type II diabetes, and insulin resistance. Also, obese children are at increased risk of becoming obese adults. Therefore, obese children tend to develop serious medical and psychosocial complications, and have a greater risk of adult morbidity and mortality. The principal goal of this study was to investigate the effects of obesity on the levels of some biomarkers and their relation to the cognitive function in elementary school obese girls. The current study was conducted on 45 obese girls (mean age 10.53 ± 1.29 years; mean BMI 28.43 ± 4.62 kg/m 2 ) and 45 normal age-matched girls (mean age 10.36 ± 1.53 years; mean BMI 19.07 ± 3.47 kg/m 2 ). Estimation of serum adrenomedullin (AM) and substance P (SP), and plasma noradrenaline (NA) and acetylcholine (ACh) were carried out. Cognitive function tests (auditory vigilance, digit span, coding and visual memory) were done for all subjects. The levels of serum AM and SP as well as plasma NA were highly significantly increased (P&lt;0.01) in the obese group as compared with the control group. The total right response of auditory vigilance (TR) showed insignificant decrease while the total wrong response to auditory vigilance test (TW) showed a significant increase (P&lt;0.05) in the obese group as compared with the control group. Digit span and visual memory classification showed a highly significant decrease (P&lt;0.01) while coding showed a significant increase (P&lt;0.05). Our study showed that obesity affected the measured biomarkers and, to some extent, has an adverse effect on cognitive function in primary school girls

Fenofibrate and Diosmetin in a rat model of testicular toxicity: New insight on their protective mechanism through PPAR-α/NRF-2/HO-1 signaling pathway

One of the most significant chemotherapeutic side effects of cisplatin (Cis) that limits its use and efficacy is testicular toxicity. Thus, the objective of the present study was to investigate the possible ameliorative effect of Fenofibrate (Fen), Diosmetin (D), and their combination against cis-mediated testicular damage. Fifty-four adult male albino rats were randomly allocated into nine groups (6 rats each): Control group, Fen (100 mg/kg), D20 (20 mg/kg), D40 (40 mg/kg), Cis group (7 mg/kg), Cis +Fen group (7 mg/kg+100 mg/kg), Cis+D20 group (7 mg/kg+20 mg/kg), Cis+D40 group (7 mg/kg+40 mg/kg), Cis+Fen+D40 treated group (7 mg/kg+100 mg/kg+40 mg/kg). Relative testicular weight, epididymal sperm count and viability, serum testosterone level, testicular oxidative stress indices, mRNA expression of peroxisome proliferator-activated receptor alpha (PPAR-α), nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase 1 (HO-1), histopathological, and immunohistochemical alterations were assessed. Our results revealed that cis administration induced testicular oxidative and inflammatory damage as indicated by a substantial reduction in relative testicular weight, sperm parameters, serum testosterone levels, the antioxidant enzyme activity of catalase, and Johnson's histopathological score, PPAR-α/NRF-2/HO-1 and proliferating cell nuclear antigen (PCNA) immunoexpression with marked increment in malondialdehyde (MDA), Cosentino's score, nuclear factor kappa B (NF-κβ p65), interleukin (IL)− 1β and caspase 3 in testicular tissue. Interestingly, Fen and D diminished the harmful effects of cis on testes via upregulation of the antioxidant activities and downregulation of lipid peroxidation, apoptosis, and inflammation. Moreover, the combination therapy Fen/D40 also exhibited a more pronounced enhancement of previous markers than either treatment alone. In conclusion, because of their antioxidant, anti-inflammatory, and anti-apoptotic properties, cotreatment with Fen or D or their combination could be beneficial in reducing the harmful impacts of cis on testicular tissue, particularly in patients that receive cis chemotherapy

Barriers to breast cancer screening among a sample of Egyptian females

Background: Breast cancer (BC) is usually diagnosed in late stages in countries with limited resources. Early detection of BC is likely to improve the outcome of the disease for women in these areas. Objective: The aim of this study was to understand the possible personal, economic, and systems barriers to BC screening in a sample of Egyptian women. Materials and Methods: A cross-sectional study was conducted in family health centers representing the seven districts of Alexandria governorate, Egypt. A total of 612 women were randomly selected from the chosen centers. Results: In this sample of Egyptian women, the most frequently identified potential barriers to BC screening were the following: 81.8% would not seek care until they were ill, 77% were unwilling to have a mammogram until it was recommended by the doctor, 71.4% blamed the, lack of privacy, 69.2% thought that medical checkups were not worthwhile, and 64.6% blamed the cost of services. The study further revealed that women of lower education, women in the lower income category, women who did not do paid work, those who had poor knowledge of the risks of BC, and women with no family history of BC were more likely to perceive different screening barriers compared with their counterparts. Conclusion: Many potential personal, economic, and health system barriers were identified. Addressing these barriers by increasing the awareness of BC and dealing with the misconceptions that the women have can help the policy makers to design more culturally relevant strategies to motivate women to utilize screening services

Possible Factors Driving Groundwater Quality and Its Vulnerability to Land Use, Floods, and Droughts Using Hydrochemical Analysis and GIS Approaches

Land use and climate change always induce significant changes in various parameters of the hydrologic cycle (e.g., surface runoff, infiltration, evapotranspiration). The Wadi El-Assiuti downstream area in the Eastern Desert of Egypt is one of the most promising areas for development that is suffering from insufficient water availability and inadequate water quality for different purposes. The main goal of this research is to evaluate the changes in groundwater quality, land use, and climate in association with geology and flooding during three periods within the years 1997&ndash;2019 in the downstream portion of Wadi El-Assiuti in the Eastern Desert of Egypt, using spatiotemporal variation associated with groundwater hydrochemical analysis and GIS techniques. About 133 groundwater samples were collected to examine groundwater quality changes over time. Different groundwater quality indices were calculated, and the results show that TDS levels of groundwater in the study area ranged between 1080&ndash;2780 mg/L, 672&ndash;4564 mg/L, and 811&ndash;6084 mg/L, while SAR levels varied within 6.15&ndash;15.34, 1.83&ndash;28.87, and 1.43&ndash;30.57 for the years 1997, 2007, and 2019, respectively. Both RSBC and SSP values exhibited significantly increasing trends over time. KR values were within 1.36&ndash;4.06 in 1997, 0.58&ndash;14.09 in 2007, and 0.35&ndash;14.92 in 2019; MAR values were within 6.9&ndash;45.2 in 1997, 20.79&ndash;71.5 in 2007, and 17.71&ndash;75.81 in 2019; and PI values were within 60.16&ndash;83 in 1997, 45.56&ndash;101.03 in 2007, and 42.51&ndash;148.88 in 2019. Across the entire study area, ongoing land use changes increased from 1.1% in 1997 to 4.1% in 2019. Findings pointed to the significant contribution of the deep Nubian Sandstone Aquifer to the groundwater aquifer at Wadi El-Assiuti through fractures and deep faults. Given the climatic conditions from 1997&ndash;2019, these changes may have affected water quality in shallow aquifers, especially with increasing evaporation. Realizing the spatiotemporal variation of the aquifer recharge system, land use development, and climate change clearly would help in water resource management. This study revealed that flooding events, deep-seated geologic structures, and land use development associated with human activities have the highest impact on groundwater quality