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Prognostic Impact of IL17 A Gene Polymorphismson Egyptian Patients with Multiple Myeloma

Asian Pac J Cancer Prev. 2023 Jul 1;24(7):2421-2425. doi: 10.31557/APJCP.2023.24.7.2421.

ABSTRACT

INTRODUCTION: Multiple myeloma (MM) is a B-cell lymphoproliferative disease in which the bone marrow microenvironment plays an important role in pathogenesis. The T helper (Th-17) cell plays an important role in the development of cancer by releasing pro-inflammatory cytokines such as IL-17A and IL-17F. Th-17 cells have been studied in a variety of solid tumors, as well as few hematological malignancies, including acute myeloid leukemia, non-Hodgkin lymphoma, and monoclonal gammopathy of unknown significance.

AIM: Our study aimed to assess the association between IL-17A polymorphism and MM risk and other MM characteristics in Egyptian patients.

PATIENTS & METHODS: a prospective study involving 77 patients with MM (mean age 54.6 years; males 53.2%; females 46.8%) and a healthy control group of same age and gender. It was performed at the Mansoura University Oncology Center (OCMU). The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) approach was used to detect IL17A 197 G/A (rs2275913) genotypes in genomic DNA from MM patients and healthy controls.

RESULTS: The IL-17A polymorphism may not be associated to myeloma predilection in the Egyptians as a whole. There was also no significant correlation in statistical study between gender and the IL-17A polymorphism. (p 0.14), a number of clinical and laboratory characteristics, including hypercalcemia (p 0.28), hypoalbuminemia (p 0.49), renal impairment (p 0.13), high LDH (p 0.62), osteolytic bone lesions (p 0.26), and pathological fracture (p 0.96), are also present. Nevertheless, no statistically significant difference in the OS of MM patients was detected for the IL-17A polymorphism (p 0.83).

CONCLUSION: Our research demonstrated that IL-17A polymorphism may not be linked to multiple myeloma susceptibility in our population and did not influence its different clinical and laboratory features. IL-17A polymorphism had no effect on OS in MM patients.

PMID:37505775 | DOI:10.31557/APJCP.2023.24.7.2421

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The MAGE A1-A10 Expression associated with Histopathological Findings of Malignant or Non-Malignant Cells in Peripheral Lung Tumors

Asian Pac J Cancer Prev. 2023 Jul 1;24(7):2329-2335. doi: 10.31557/APJCP.2023.24.7.2329.

ABSTRACT

OBJECTIVE: The objective was to evaluate the expression of melanoma antigen (MAGE) A from A1 to 10 (A1-10) and the individual MAGE A family in the peripheral lung tumors and to analyze its association with histopathological findings.

METHODS: A cross-sectional study was conducted on 67 samples of peripheral lung tumor obtained by core biopsies from patients with clinical diagnoses such as lung and mediastinal tumors. The specimens were divided into two, one to perform histopathological diagnosis and the last for mRNA MAGE A examination. A Nested polymerase chain reaction (PCR) was performed using universal primer, MF10/MR10 and MF10/MR12. The collected data were analyzed by appropriate statistical techniques.

RESULT: The histopathological finding showed 41 (61.2 %) of specimens as malignant cells and 26 (38.8 %) of specimens as non-malignant cells. MAGE A1-10 was expressed at 47 (70.1 %) and MAGE A1-6 was expressed at 25 (37.3 %) of specimens. In a malignant cell, MAGE A1-10 and MAGE A1-6 were expressed at 33 (80.5 %) and 19 (46.3 %), respectively. In non-malignant cells, MAGE A1-10 and MAGE A1-6 were expressed at 14 (53.9 %) and 6 (23.1 %,) respectively. The MAGE A1-10 and MAGE A8 expressions were significantly associated with histopathological findings of malignant or non-malignant cells. The sensitivity, specificity, and diagnostic accuracy of MAGE A1-10 were 80.5 %, 46.2 %, and 67.2 %, respectively; while for MAGE A8 were 41.5 %, 88.5 %, and 59.7 %, respectively.

CONCLUSION: The MAGE A1-10 expression was the most commonly detected and associated with the histopathological finding. Moreover, it was more sensitive and specific and had higher diagnostic accuracy than others. Therefore, the MAGE A1-10 assay may improve the accuracy of the diagnosis of malignancy in peripheral lung tumors.

PMID:37505763 | DOI:10.31557/APJCP.2023.24.7.2329

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Psychosocial Support and Cost Burden of Cancer Among Patients Attending Tertiary Oncology Clinics in Lagos State, Nigeria

Asian Pac J Cancer Prev. 2023 Jul 1;24(7):2313-2319. doi: 10.31557/APJCP.2023.24.7.2313.

ABSTRACT

BACKGROUND: Cancer management brings about changes in patients’ paths of life, in their daily activities, work, relationships, and family roles, and it is associated with a high level of patient psychological stress and financial toxicity. The objective of this study was to assess the psychosocial support and financial burden of cancer patients and determine socioeconomic factors that impact them. Methodology and Methods: This was a descriptive cross-sectional study among 240 cancer patients in Lagos University Teaching Hospital (LUTH) and Lagos State University Teaching Hospital (LASUTH) in Nigeria. The respondents were recruited consecutively and data was collected using structured, adapted, interviewer administered questionnaires. The data was analyzed using epi info software version 7.1 with chi-square used to test for associations and the level of significance was set at p<0.05.

RESULTS: Overall, 74.6% of respondents had perceived psychosocial support scores higher than 50 out of 100. The family was the most common source of support across the emotional, financial and tangible support dimension’s (91.7%, 83.8% and 85.4%) while healthcare professionals (60%) were the commonest for informational support. Overall, 69.6% had COST scores less than 50% indicating worse financial toxicity. Statistical associations were found between cost burden and cancer type (p=0.01), age (p<0.0001) and financial support (p<0.0001). Older patients, those who had financial support, and those with gynecological cancers had a decreased financial burden For psychosocial support associations were seen with employment status (p=0.02), and treatment (p<0.0001). Higher psychosocial support for patients who were employed and had begun treatment.

CONCLUSION: The majority of respondents experienced high levels of financial toxicity but adequate psychosocial support. More research is needed, as well as the inclusion of support groups into clinics and the availability of loans to help with the initial costs.

PMID:37505761 | DOI:10.31557/APJCP.2023.24.7.2313

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Expression of Programmed Death Ligand1 (PD-L1) in Gastric Carcinoma (Histopathological and Immunohistochemical Study)

Asian Pac J Cancer Prev. 2023 Jul 1;24(7):2295-2303. doi: 10.31557/APJCP.2023.24.7.2295.

ABSTRACT

OBJECTIVES: To evaluate immunohistochemical expression of PD-L1 in cases of gastric adenocarcinoma. To correlate PD-L1 immuno-histochemical expression with other available clinico-pathological parameters such as age, sex, grade, stage, lymph node (L.N) metastasis and others.

MATERIAL AND METHODS: The present retrospective study retrieved the data and archived paraffin blocks of 60 cases of Gastric carcinoma. Immunohistochemical evaluation was done to assess the expressions of PD-L1 in the tumor cells (TC), tumor infiltrated lymphocytes (TILs) and combined positive score (CPS).

RESULTS: TC PD-L1 expression was detected in 56.7% of cases, TILs PD-L1 expression was detected in 53.3 % of cases and CPS PD-L1 expression was detected in 63.3% of case, with no statistically significant correlation with clinico-pathological parameters except TILs PD-L1 expression showed statistically significant correlation with positive TILs (P value ˂0.019).

CONCLUSION: Our findings supported the expression of PD-L1 by TC, TILs, and CPS in gastric cancer, with increased expression in a subpopulation of TILs rich in PD-L1 identifying them as potential targets for PD-1/PD-L1 therapy.

PMID:37505759 | DOI:10.31557/APJCP.2023.24.7.2295

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Expression and Alteration Value of Long Noncoding RNA AB073614 and FER1L4 in Patients with Acute Myeloid Leukemia (AML)

Asian Pac J Cancer Prev. 2023 Jul 1;24(7):2271-2277. doi: 10.31557/APJCP.2023.24.7.2271.

ABSTRACT

BACKGROUND: Numerous studies have probed the deregulation of the long noncoding RNA AB073614 and FER1L4, which have been discovered in a variety of cancers. However, the precise expression pattern of these lncRNAs and their clinical implications in acute myeloid leukemia (AML) remain elusive. Considering the involvement of the PI3K axis in AML pathogenesis, an investigation into the expression of AB073614 and FER1L4 targets of this pathway has been proposed, aiming to elucidate a potential mechanism underlying AML development.

METHODS: The expression levels of lncRNA AB073614 and FER1L4 were assessed in 30 newly diagnosed AML patients and 12 healthy individuals using quantitative reverse transcription-polymerase chain reaction techniques. A statistical analysis was conducted to determine the association of AB073614 and FER1L4 expression levels with clinicopathological features.

RESULTS: A significant upregulation of AB073614 was observed in AML patients compared to the control group (p < 0.05). Moreover, a notable increase in AB073614 expression levels coincided with a significant reduction in FER1L4 expression levels in AML samples (p < 0.05). The diagnostic value of these lncRNAs was validated using the receiver operating characteristic (ROC) curve and area under the curve (AUC) calculations. Sensitivity values of AB073614 and FER1L4 gene expression were 96.7% and 100%, respectively, using cut-off relative quantification of 1.045 and 0.770. Additionally, specificity values were observed to be 100%.

CONCLUSIONS: The present study indicates that AB073614 and FER1L4 might serve as prognosis biomarkers in AML patients. However, further detailed examinations in this field are warranted. It is proposed that the likely mechanism of imbalanced PI3K and PTEN activity, triggered by the deregulation of AB073614 and FER1L4, may have a crucial role in AML pathogenesis. Any component of this pathway could potentially serve as a new target for more insightful treatment approaches.

PMID:37505756 | DOI:10.31557/APJCP.2023.24.7.2271

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Risk factors and incidence of peripheral venous catheters-related phlebitis between 2017 and 2021: A multicentre study (Flebitis Zero Project)

J Vasc Access. 2023 Jul 28:11297298231189963. doi: 10.1177/11297298231189963. Online ahead of print.

ABSTRACT

BACKGROUND: The peripheral venous catheter is one of the most frequently used devices in inpatient units worldwide. The risk of complications arising from use of peripheral venous catheters is low, but phlebitis frequently develops.

METHODS: A multicentre, prospective cohort study was conducted in 65 Spanish hospitals on 10,247 inpatients who had had a total of 38,430 peripheral venous catheters inserted. Data were collected for 15 consecutive days in 2017, 2018, 2019, 2020 and 2021. Central tendency and dispersion were measured, cumulative incidence and incidence density were determined and odds ratios (OR) were also calculated using binary logistic regression.

RESULTS: The incidence density of phlebitis, during the period from 2017 to 2021, was 1.82 cases of phlebitis per 100 venous catheter-days. The difference between average cumulative incidence of phlebitis per year was statistically significant as determined by ANOVA test results (F = 10.51; df = 4; p < 0.000). Unequivocal risk factors for phlebitis were revealed to be hospitals with more than 500 beds (OR = 1.507; p < 0.001), patients suffering from neoplastic disease (OR = 1.234; p < 0.001) and the first 3-4 days after insertion (OR = 1.159; p < 0.001).

CONCLUSIONS: A correct knowledge of insertion technique and venous catheter maintenance is likely to reduce the incidence of phlebitis and other complications, and hence continuing education of nurses is essential.

PMID:37503714 | DOI:10.1177/11297298231189963

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Treatment Results of Multidrug-Resistant Tuberculosis Patients in the Aegean Region

Thorac Res Pract. 2023 Mar;24(2):103-108. doi: 10.5152/ThoracResPract.2023.22087.

ABSTRACT

OBJECTIVE: We aimed to evaluate 109 rifampicin-resistant or multidrug-resistant tuberculosis patients who are treated in Izmir Chest Diseases MDR Tuberculosis Centre.

MATERIAL AND METHODS: The patient profile, side effects, treatment success, and mortality of rifampicin-resistant or multidrugresistant tuberculosis patients who were followed up and treated in our hospital’s tuberculosis service between 2010 and 2018 were analyzed retrospectively.

RESULTS: Of the rifampicin-resistant or multidrug-resistant tuberculosis patients, 83 (76.1%) were male and the mean age was 46.3 ± 16.3 years. Of the cases 13 (11.9%) had rifampicin resistance without isoniazid. Since 5 out of 109 patients diagnosed with multidrugresistant tuberculosis emigrated to other countries, the treatment results of 104 patients were evaluated. As a result of the treatment, the cure was achieved in 81 (77.9%) patients and treatment was completed in 13 (12.5%). Treatment success was found as 90.4%. No patient experienced recurrence. The mortality rate was determined as 9.6%. The cure rate of patients treated with ≥6 drugs (90.9%) was statistically significantly (P = .029) higher than the group treated with ≤5 drugs (71.8%).

CONCLUSIONS: Multidrug-resistant tuberculosis treatment is a long-term, financially burdensome practice that may cause serious side effects and complications, and it requires strict discipline. The fight against tuberculosis can be successful with tuberculosis control programs that are pursued with determination.

PMID:37503647 | DOI:10.5152/ThoracResPract.2023.22087

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Does Pneumococcal Vaccination Have an Effect on Hospital Costs?

Thorac Res Pract. 2023 May;24(3):165-169. doi: 10.5152/ThoracResPract.2023.22171.

ABSTRACT

OBJECTIVE: It is known that inpatient hospital costs are much higher than outpatient services. It was aimed to investigate the effect of pneumococcal vaccination on hospitalizations.

MATERIAL AND METHODS: The direct hospitalization costs, length of stay, and factors of the vaccinated and unvaccinated patients in the same hospital during the 12-month follow-up of the patients who received pneumococcal vaccine between November 15, 2018, and November 15, 2020, in 3 chest diseases and thoracic surgery training and research hospitals were analyzed by obtaining Hospital Information Management System records. Data were collected with Statistical Package for the Social Sciences version 23 program (IBM Corp.; Armonk, NY, USA) , and statistical evaluation was made.

RESULTS: The mean age of 800 hospitalized patients, of whom 400 were unvaccinated and 400 were vaccinated, was 68.48 ± 11.97. There was no significant difference in the mean age of vaccinated and unvaccinated patients (P > .05). Five hundred sixty-six patients (70.8%) were aged 65 and over. Two hundred eighty (51.2%) of men were vaccinated and 120 (47.2%) of women were vaccinated, and there was no significant difference (P > .05). The mean hospital stay of these patients was 11.01 days, and those in the vaccinated group had an average mean hospital stay of 9.11 days and those in the unvaccinated group had a mean hospital stay less than 12.91 days (P < .001). Total 1-year hospitalization costs were $501.653.53 and the cost per person was calculated as $627.07. The cost per capita for the vaccinated group was $550.52, which was lower than the average cost of the unvaccinated group ($703.62) (P < .05). When comparing the status of being vaccinated, comorbidity, mortality, mean length of stay, chronic obstructive pulmonary disease, and heart disease were found to be statistically significant (P < .05).

CONCLUSION: In our study, it was revealed that vaccination of patients hospitalized in chest disease hospitals with the pneumococcal vaccine reduced the average length of hospital stay by 41.7% and the cost of hospitalization by 27.8%.

PMID:37503619 | DOI:10.5152/ThoracResPract.2023.22171

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Public Health Interventions Guided by Houston’s Wastewater Surveillance Program During the COVID-19 Pandemic

Public Health Rep. 2023 Jul 28:333549231185625. doi: 10.1177/00333549231185625. Online ahead of print.

ABSTRACT

Since the start of the COVID-19 pandemic, wastewater surveillance has emerged as a powerful tool used by public health authorities to track SARS-CoV-2 infections in communities. In May 2020, the Houston Health Department began working with a coalition of municipal and academic partners to develop a wastewater monitoring and reporting system for the city of Houston, Texas. Data collected from the system are integrated with other COVID-19 surveillance data and communicated through different channels to local authorities and the general public. This information is used to shape policies and inform actions to mitigate and prevent the spread of COVID-19 at municipal, institutional, and individual levels. Based on the success of this monitoring and reporting system to drive public health protection efforts, the wastewater surveillance program is likely to become a standard part of the public health toolkit for responding to infectious diseases and, potentially, other disease-causing outbreaks.

PMID:37503606 | DOI:10.1177/00333549231185625

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Trends and Outcomes of Cardiogenic Shock in Patients With End-Stage Renal Disease: Insights From USRDS Database

Circ Heart Fail. 2023 Jul 28:e010462. doi: 10.1161/CIRCHEARTFAILURE.122.010462. Online ahead of print.

ABSTRACT

BACKGROUND: There is a paucity of data regarding epidemiology, temporal trends, and outcomes of patients with cardiogenic shock (CS) and end-stage renal disease (chronic kidney disease stage V on hemodialysis).

METHODS: This is a retrospective cohort study using the United States Renal Data System database from January 1, 2006 to December 31, 2019. We analyzed trends of CS, percutaneous mechanical support (intraaortic balloon pump, percutaneous ventricular assist device [Impella and Tandemheart], and extracorporeal membrane oxygenation) utilization, index mortality, 30-day mortality, and 1-year all-cause mortality in end-stage renal disease patients.

RESULTS: A total of 43 825 end-stage renal disease patients were hospitalized with CS (median age, 67.8 years [IQR, 59.4-75.8] and 59.1% men). From 2006 to 2019, the incidence of CS increased from 275 to 578 per 100 000 patients (Ptrend<0.001). The index mortality rate declined from 54.1% in 2006 to 40.8% in 2019 (Ptrend=0.44), and the 1-year all-cause mortality decreased from 63% in 2006 to 61.8% in 2018 (Ptrend=0.73), but neither trend was statistically significant. There was a significantly decreased utilization of intra-aortic balloon pumps from 17 832 to 7992 (Ptrend<0.001), increased utilization of percutaneous ventricular assist device from 137 to 5201 (Ptrend<0.001) and increase in extracorporeal membrane oxygenation use from 69 to 904 per 100 000 patients (Ptrend<0.001). After adjusting for covariates, there was no significant difference in index mortality between CS patients requiring percutaneous mechanical support versus those not requiring percutaneous mechanical support (odds ratio, 0.97 [CI, 0.91-1.02]; P=0.22). On multivariable regression analysis, older age, peripheral vascular disease, diabetes, and time on dialysis were independent predictors of higher index mortality.

CONCLUSIONS: The incidence of CS in end-stage renal disease patients has doubled without significant change in the trend of index mortality despite the use of percutaneous mechanical support.

PMID:37503601 | DOI:10.1161/CIRCHEARTFAILURE.122.010462