Assessing the level of breast cancer awareness among recently diagnosed patients in Ain Shams University Hospital

Breast cancer is the leading female malignancy among Egyptian women. The majority of Egyptian breast cancer patients present at late stages of the disease with a large tumor size compared to Western countries. Low breast cancer awareness, social and cultural factors were suggested to play crucial role in late presentation of breast cancer among Egyptians. The aim of our present study is to establish a questionnaire-based survey that can assess levels of breast cancer awareness among Egyptians. Patients enrolled were interviewed and answered 60 questions related to knowledge, symptoms, risk factors, prevention and management options of breast cancer. We evaluated our interactions with breast cancer patients and defined the level of awareness gained from education and culture of Egyptian women. Our results described that Egyptian breast cancer patients lack knowledge about their illness and condition. The lowest levels of awareness were related to age, education and culture. We concluded that breast cancer public awareness and women education programs covering factors identified in our study is warranted among Egyptian population. Overview

OBJECTIVE

To assess breast cancer awareness among recently diagnosed breast cancer Egyptian patients.

SUBJECTS AND METHODS

Among 289 interviewed breast cancer patients we enrolled 45 patients who fulfilled the study inclusion criteria. Participants were asked to answer a validated 60-item questionnaire that inquires about socio-demographic characteristics, knowledge of breast cancer symptoms, risk factors, symptoms, prevention, general management and willingness to participate in awareness campaigns. The average of interview time was about 45 min, depending on patient's age and education level.

RESULTS

The mean age of included patients was 48.2 ± 10.19 years. Geographical distribution revealed that 66.7% patients were from Cairo and the rest were from other governorates, including Aswan, Sharqia, Mansora, Qena, Kalyobia, Elminya and Sohag. Among interviewed patients 85% were non-working housewives, 42.2% of them were illiterate. Questions about knowledge of breast cancer revealed that 53.33% of patients knew an acquaintance with breast cancer; however, they spent a median time of 3 months to seek medical advice after recognizing the first symptom with a delay range between a month and 72 months. We found that 73% of the participants presented to a physician with the same first recognized symptom and 75.6% didn't think of cancer then as a possible diagnosis. Total breast cancer knowledge scores had an average of 13.3 (out of 35 knowledge points), with 93% of the patients recognizing "painless breast mass" as a breast cancer symptom and 44% only recognized the concept of breast self examination. Interestingly, 61.4% identified breastfeeding as a risk factor for breast cancer, 60% did not recognize mammography as an early detection method, and 57.7% agreed that clinical breast examination (CBE) is important for early detection. Regarding management, 75% said breast cancer was potentially curable and 60% said medical care could be helpful regardless the age of presentation.

CONCLUSION

Egyptian breast cancer patients knew little about their condition. Less awareness was related to age and education level. Low knowledge of risk factors, early detection and management of breast cancer should be addressed by designing patient education programs, where less educated patients are supported by health care professionals to participate in the management of breast cancer. Moreover, we found that 67% and 97% of enrolled breast cancer patients were willing as well to participate in spreading awareness among their community and among their own families, respectively.

Extractive determination of ephedrine hydrochloride and bromhexine hydrochloride in pure solutions, pharmaceutical dosage form and urine samples

Simple, rapid, sensitive, precise and accurate spectrophotometeric methods for the determination of ephedrine hydrochloride (E-HCl) and bromhexine hydrochloride (Br-HCl) in bulk samples, dosage form and in spiked urine samples were investigated. The methods are based on the formation of a yellow colored ion-associates due to the interaction between the examined drugs with picric acid (PA), chlorophyllin coppered trisodium salt (CLPH), alizarin red (AR) and ammonium reineckate (Rk) reagents. A buffer solution had been used and the extraction was carried out using organic solvent, the ion associates exhibit absorption maxima at 410, 410, 430 and 530 nm of (Br-HCl)with PA, CLPH, AR and Rk respectively; 410, 410, 435 and 530 of (E-HCl) with PA, CLPH, AR and Rk respectively. (E-HCl) and (Br-HCl) could be determined up to 13, 121, 120 and 160; 25, 200, 92 and 206 μg mL(-1), using PA, CLPH, AR and Rk respectively. The optimum reaction conditions for quantitative analysis were investigated. In addition, the molar absorptivity, Sandell sensitivity were determined for the investigated drug. The correlation coefficient was ≥0.995 (n=6) with a relative standard deviation (RSD) ≤1.15 for five selected concentrations of the reagents. Therefore the concentration of Br-HCl and E-HCl drugs in their pharmaceutical formulations and spiked urine samples had been determined successfully.

Antibody levels against hepatitis B virus after hepatitis B vaccination in Egyptian diabetic children and adolescents

BACKGROUND

The remarkable effectiveness of universal infantile hepatitis B (HB) vaccination is well documented in many countries. Nevertheless, the influence of insulin-dependent diabetes mellitus (IDDM) on the sero-protective level of antibody to hepatitis B surface antigen (anti-HBs) after HB vaccination has not been investigated in Egyptian children. The aim of this study was to investigate long-term anti-HBs sero-protective levels after infantile HB vaccination in Egyptian IDDM children.

RESULTS

The mean age of the healthy children was 10.86 ± 1.21 y (range, 5.5-15 y); 49 (45.8%) were boys and 58 (54.2%) were girls. The mean age of the IDDM children was 10.29 ± 3.04 y (range, 4-17 y); 32 (50.8%) were boys and 31 (49.2%) were girls. There were no significant differences between the healthy and IDDM children with respect to age and sex (p>0.05). Among the 107 healthy children, 43 (40%) did not have a protective anti-HBs level (anti-HBs<10 IU/L) and 64 (60%) had a protective level (anti-HBs ≥ 10 IU/L). In contrast, among the IDDM children, 44 (69.8%) and 19 (30.2%) did not and did have protective anti-HBs levels, respectively. This difference in anti-HBs concentration between healthy and diabetic children was highly significant (p<0.001). None of the vaccinated healthy or IDDM children was reactive to HBsAg or total anti-HBc.

PATIENTS AND METHODS

A total of 170 children (81 boys, 89 girls) who had been routinely vaccinated against HB were included. Their mean age was 10 ± 2.1 y. The enrolled children were divided into healthy (n = 107) and IDDM (n = 63) cohorts. Body Mass Index and levels of hepatitis B surface antigen (HBsAg), total antibody to hepatitis B core antigen (anti-HBc), and anti-HBs were evaluated in all children. In addition, the duration of diabetes mellitus (DM) and levels of glycated hemoglobin (HbA1c) were measured in IDDM children.

CONCLUSION

Our results are alarming. It appears that the majority of Egyptian diabetic children vaccinated against HB may not have sufficient anti-HBs levels to protect them from HB. Moreover, this study emphasizes the need for a population-based strategy for the management of patients without an anti-HBs protective level after HB vaccination and justifies the need to elucidate the heritability of those children.

Esophageal motility pattern and gastro-esophageal reflux in chronic obstructive pulmonary disease

BACKGROUND/AIMS

The association of esophageal motility and gastroesophageal reflux symptoms with respiratory symptoms is not well established in patients with chronic obstructive pulmonary disease (COPD). The aim of this work is to study the abnormalities of esophageal function in COPD patients and study its relation to smoking index, body mass index and indices of hyperinflation.

METHODOLOGY

This study included 40 male COPD patients and 10 healthy controls. The patients and controls were subjected to spirometry, body plethysmography, esophageal manometry and 24hr pH-metry.

RESULTS

Upper gastrointestinal symptoms were found in 55% of patients, hypotensive upper esophageal sphincter pressure in 65% of patients and hypotensive lower esophageal sphincter pressure in 52.5% of patients. Pathological acid reflux was found in 35% of patients. The severity of GERD increased with increased age, smoking index and body mass index, p<0.005. There was negative correlation between LESP and UESP compared with indices of hyperinflation, p<0.001.

CONCLUSIONS

There was high prevalence of esophageal motility disorders in COPD patients, LESP and UESP were significantly negatively correlated to indices of hyperinflation. There was a high prevalence of GERD in COPD patents especially elderly, severe stage of COPD, high smoking index and high body mass index (BMI).

The validity of testicular aspirate cytology and DNA image-analysis of the aspirate in the assessment of infertile men

Objective

To assess the possibility of using cytological examination and DNA image-analysis of testicular fine-needle aspirates instead of open surgical biopsy in the investigation of infertile men, as testicular biopsy has long been used for investigating infertility but the interpretation of histological slides is usually subjective.

Patients and methods

Thirty-three men (aged 22–36 years) were evaluated for infertility and underwent both open biopsy and fine-needle aspiration of their testes. Subsequently, the needle aspirates were assessed histopathologically and cytologically, and by DNA image cytometry. The percentages of haploid, diploid and tetraploid cells were determined for each patient.

Results

The cases were divided into four categories: (1) Complete spermatogenesis, with a DNA pattern of 1n > 2n > 4n; (2) Maturation arrest, with a DNA pattern of 2n > 4n with no haploid cells; (3) Sertoli cell-only syndrome, with a DNA pattern of only 2n, with no haploid or tetraploid cells; (4) Hypospermatogenesis, with a variable DNA pattern, i.e. mild with 1n > 2n, moderate with 2n > 1n > 4n, and marked where the DNA pattern was 2n > 4n > 1n. From the cytological and DNA image-analysis of the aspirate a diagnosis was possible that had a strong correlation with the histological diagnosis of the same case. From image analysis we could exclude interstitial cells, Sertoli cells and sperms on the static image, and differentiate between spermatozoa and spermatids based on morphological characteristics in the cytological smear. This technique can therefore be used to quantitatively determine the percentages of various cell types within the seminiferous tubules. By coupling image ploidy analysis and cytological examination of a cytological smear, spermatogenesis can be assessed accurately.

Conclusion

Image cytometry could be used to exclude interstitial cells, Sertoli cells and sperms on the static image and so produce an accurate assessment of spermatogenesis. A combination of ploidy and cell morphology characteristics in cytological smears provides an accurate, reproducible and easily used alternative to open testicular biopsy.

Severe hypertension and pulmonary edema associated with systemic absorption of topical phenylephrine in a child during retinal surgery

Topical phenylephrine solutions are widely used in eye procedures to promote pupil dilation without cycloplegia. We report a case of intraoperative severe hypertension and acute pulmonary edema occurring in a child during retinal surgery after possible systemic absorption of topical phenylephrine eyedrops. Our objective is to discuss the proper treatment and preventive strategies for such a complication. A 4-year-old, male patient, 18.4 kg in weight, physical status ASA I was admitted for right retinal detachment surgery. Anesthesia was induced with sevoflurane in oxygen, followed by glycopyrrolate (5.0 μg/kg), propofol 25 mg, fentanyl 50 μg and cisatracurium 0.15 mg/kg given intravenously. Anesthesia was maintained with sevoflurane 2-2.5% in a mixture of nitrous oxide and oxygen (60%:40%). After incision, two drops of 10% aqueous phenylephrine were administered topically by the surgeon to the right eye for further pupil dilation. Few minutes later, the noninvasive blood pressure rose to 220/120 mmHg and the heart rate increased to 140 beats/min. Oxygen saturation (SpO₂) dropped from 99% (with an inspired oxygen concentration (FiO₂) of 0.4) to 82%. Auscultation revealed crepitations throughout the chest and a blood-stained frothy fluid was aspirated from the trachea with possible development of acute pulmonary edema. Hydralazine (5 mg) and furosemide (10 mg) were administered intravenously. Seven minutes later, the blood pressure returned to normal and the SpO₂ increased to 92% on FiO₂ of 1.0, with decreased intratracheal secretions. After approximately 20 minutes, the SpO₂ had improved to 99%, with a FiO₂ of 1.0 and the blood pressure was 109/63 mmHg and heart rate was 121 beats/min. The FiO₂ gradually reduced back to 0.4 over 30 min with no further desaturation. The patient was discharged from the post anesthesia care unit 5 h after surgery with adequate spontaneous breathing, SpO₂ 99% on room air, normal blood pressure and pulmonary auscultation. Anesthesiologists and ophthalmologists should be aware of the possible cardiovascular side-effects of topical phenylephrine, and it should be used cautiously with appropriate intraoperative monitoring of hemodynamic variables. Moreover, preventive strategies to minimize systemic absorption of the drug should be taken.

Synthesis and characterisation of new modified anti‐corrosive polyesteramide resins by partial replacement of the ingredient source of the polybasic acid for organic surface coatings

Purpose

Polymeric systems based on polyesteramides (PEA) are high performance materials, which combine the useful properties of polyester and polyamide resins, and find many applications, most importantly as protective surface coatings. The purpose of this paper is to characterise and evaluate new modified anti‐corrosive PEA resins for use in protective coating formulations.

Design/methodology/approach

In the study report here, new modified PEA compositions were prepared and evaluated as vehicles for surface coating. The PEA resins were obtained by means of a condensation polymerisation reaction between phthalic anhydride (PA) and N,N‐bis‐(2‐hydroxyethyl) linseed oil fatty acid amide (HELA) as the ingredient source of the polyol used. The phthalic anhydride was partially replaced with N‐phthaloylglutamic acid NPGA as the ingredient source of the dibasic acid. The structure of the resin was confirmed by FT‐IR spectral studies. Coatings of 50±5 μm thickness were applied to the surface of glass panels and mild steel strips by means of a brush. The coating performance of the resins was evaluated using international standard test methods and involved the measurement of phyisco‐mechanical properties and chemical resistance.

Findings

The tests carried out revealed that the modified PEA based on N‐phthaloylglutamic acid (NPGA) enhanced both phyisco‐mechanical and chemical properties. Also, the resins were incorporated within primer formulations and evaluated as anti‐corrosive single coatings. The results illustrate that the introduction of N‐phthaloylglutamic acid, within the resin structure, improved the film performance and enhances the corrosion resistance performance of PEA resins.

Practical implications

The modified PEA compounds can be used as binder in paint formulations to improve chemical, physical and corrosion resistance properties.

Originality/value

Modified PEA resins are cheaper and can be used to replace other more expensive binders. These modified PEA resins can compensate successfully for the presence of many the anticorrosive paint formulations and thus lower the costs. The main advantage of these binders is that they combine the properties of both polyester and polyamide resins based on nitrogenous compound, are of lower cost, and they also overcome the disadvantages of both its counterparts. Also, they can be applied in other industrial applications.

Antimicrobial activity of the solvent fractions from Bulbine natalensis Tuber

Bulbine natalensis Baker has been acclaimed to be used as an antimicrobial agent in the folklore medicine of South Africa without scientific evidence to substantiate or refute this claim. In view of this, the in vitro antimicrobial activity of solvent fractions (ethanol, ethyl acetate, n-butanol and water) from Bulbine natalensis Tuber against 4 Gram positive and 12 Gram negative bacteria as well as 3 fungal species were investigated using agar dilution. The ethanolic extract, n-butanol and ethyl acetate fractions inhibited 75, 87.5 and 100% respectively of the bacterial species in this study. The ethanolic, n-butanol and ethyl acetate fractions produced growth inhibition at MIC range of 1-10, 3-10 as well as 1 and 5 mg/ml respectively whereas the water fraction did not inhibit the growth of any of the bacterial species. Again, it was only the ethyl acetate fraction that inhibited the growth of Shigelli flexneri, Staphyloccus aureus and Escherichia coli. The ethanolic, ethyl acetate and n-butanolic fractions dose dependently inhibited the growth of Aspergillus niger and A. flavus whereas the water fraction produced 100% growth inhibition of the Aspergillus species at all the doses investigated. In contrast, no growth inhibition was produced on Candida albicans. The growth inhibition produced by the solvent fractions of B. natalensis Tuber in this study thus justifies the acclaimed use of the plant as an antimicrobial agent. The ethyl acetate fraction was the most potent.

Endovascular management of early hepatic artery thrombosis after living donor liver transplantation

To study the feasibility of endovascular management of early hepatic artery thrombosis (HAT) after living-donor liver transplantation (LDLT) and to clarify its role as a less invasive alternative to open surgery. A retrospective review of 360 recipients who underwent LDLT. Early HAT developed in 13 cases (3.6%). Diagnosis was performed using Doppler, CT angiography, and digital subtraction angiography. Intra-arterial thrombolysis (IAT) was performed using streptokinase or tPA. In case of underlying stricture, PTA was attempted. If the artery did not recanalize, continuous infusion was performed and monitored using Doppler US. Initial surgical revascularization was successful in 2/13 cases. IAT was performed in 11/13 cases. The initial success rate was 81.8% (9/11), the failure rate was 18.2% (2/11). Rebound thrombosis developed in 33.3% (3/9). Hemorrhage developed after IAT in 2/11 cases (18.2%). Definite endovascular treatment of HAT was achieved in 6/11 cases (54.5%) and definite treatment (surgical, endovascular or combined) in 9/13 cases (69%). (Follow-up 4 months-4 years). Endovascular management of early HAT after LDLT is a feasible and reliable alternative to open surgery. It plays a role as a less invasive approach with definite endovascular treatment rate of 54.5%.

Abstract 5510: Assessing the level of breast cancer awareness among recently diagnosed patients in Ain Shams University Hospital

Introduction: 97% of Egyptian breast cancer patients are diagnosed at advanced stage, 70.6% possess positive lymph node metastasis on diagnosis while only 29.4% are free of metastasis reflecting late presentation of Egyptian patients. PURPOSE: Assess the level of knowledge about breast cancer among recently diagnosed breast cancer patients at Ain Shams University Hospitals. METHODS: In a cross-sectional, analytical observational study, we randomly enrolled 289 breast cancer patients with 45 of them who were recently diagnosed at Ain Shams University Hospitals meeting our inclusion criteria.Recurring patients or those unaware of diagnosis were excluded. Patients were interviewed using a specially designed questionnaire -of 75 questions over 60 minutes. Questionnaire gathered socio-demographic information, maternity history and tested knowledge of risk factors, signs and symptoms, screening options, management and prognosis of breast cancer was tested. Data was correlated to TNM staging. RESULTS: Patients’ age ranged between 30-72 years (mean 48±10.19). 40% were illiterate and only 15.6% finished higher education with 6-month average delay in seeking medical attention. Among the 45, TNM staging was assessed in 19 patients. Although 93% knew painless mass was symptom of breast cancer, 69% presented with painless mass and 47% knew someone with breast cancer prior to diagnosis, yet 24% thought they might have breast cancer. Regarding regular clinical breast exam 58% agreed to have it but 60% didn't know what was mammography, 56% didn't hear about breast self-exam and only 22% knew breast cancer had risk factors. Moreover, 58% thought treatment caused patients to be very ill, 29% thought breast cancer had good survival, yet 75% thought breast cancer is curable. Total breast cancer knowledge scores were low, with a median of 13 (out of 35) and mean of 12.64 ±5.12. CONCLUSIONS: Patients had acceptable awareness about breast cancer symptoms yet displayed gross ignorance about risk factors and poor awareness about screening, management and prognosis, correlating with their advanced TNM score. Therefore, raising breast cancer awareness and promoting education and early detection among our community is important.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5510. doi:1538-7445.AM2012-5510

Biotransformation of extracted digitoxin from Digitalis lanata by Streptomyces

The biotransformation of digitoxin and some of its derivatives extracted from Digitalis lanata by Streptomyces isolated species was investigated. Cultures of a Streptomyces strain designated EUSA2003B, isolated from an Egyptian soil sample, efficiently induced selective 12beta-hydroxylation of the steroid aglycone of digitoxin (DT) and its alpha-acetyl and beta-methyl derivatives. The transformation reaction was performed within a 5-day fermentation process, products were isolated and their aglycone moiety was obtained by acid hydrolysis and their structures were elucidated by 13C and 1H NMR. The biotransformation resulted mainly digoxin (DG, approximately 87%), meanwhile, digoxigenone (DGON, approximately 7.0%) was also afforded as a side product. The present study revealed that: 1-Streptomyces isolate EUSA2003B harbors its specific 12beta-hydroxlase and has the capability to transform DT and it's alpha-acetyl and beta-methyl derivatives into their corresponding digoxins at reasonable yields. 2-The minor structural differences in the trisaccharide side chain seemed ineffective on the transformational capability of this organism. 3-The Streptomyces might also possess a specific glycosidase that splits the saccharidic side chain beside another dehydrogenase that oxidizes C3 at the steroid nucleus into its ketone form (DGON).

Stability of transition metal complexes involving three isomeric quinolyl hydrazones

The stability constants of three isomeric quinolyl hydrazones; {4,6-(para); 4,7-(meta) and 4,8-MeBHQ(ortho)} towards some bivalent metal ions have been determined in 75% solvent (dioxane, isopropanol, ethanol and methanol)-water by a pH-titrimetry. The insertion of the Me-group in the 8-position decreases the stability of the complexes to a great extent. The complexation of the ortho-derivative is endothermic, whereas that of the para-derivative is exothermic. Using the solvent parameters, the stability constants of the para-derivative towards Co(II), Ni(II) and Cu(II) ions were evaluated in aqueous medium by five different methods. Also, the electronic absorption spectra of the ortho-hydrazone have been studied in solvents of various polarities to investigate the dependence of the band shift (Δύ) on the solvent parameters viz. 1/D, Z, E(T), DN, AN and (α, β, π*). The interaction of the hydrazones with CoCl(2)·6H(2)O afforded an octahedral complex in case of the ortho-hydrazone and square planar complexes in case of the meta- and para-hydrazones.

Thyroid hormone patterns in elderly patients undergoing elective coronary procedures

BACKGROUND AND OBJECTIVES

Thyroid dysfunction is common in the elderly. We sought to explore thyroid hormone patterns in a series of elderly patients undergoing elective coronary procedures and their relation to the extent of coronary artery disease.

MATERIALS AND METHODS

We enrolled 81 consecutive elderly patients admitted to undergo elective diagnostic or interventional coronary procedures. Samples were collected for assay of free thyroxin, free tri-iodothyronine, thyroid stimulating hormone, anti-thyroglobulin and anti-thyroid peroxidase antibodies. According to the number of coronary arteries affected by significant stenosis (> or = 70% luminal obstruction), we classified patients into a group with insignificant coronary disease, another with single vessel disease, and a third group with multi-vessel disease.

RESULTS

Forty one (50.6%) patients were euthyroid, two patients (2.5%) had subclinical hypothyroidism, and 12 (14.8%) had clinical hypothyroidism. Yet, neither subclinical nor clinical hypothyroidism was statistically different among the 3 groups, (p > 0.05 for both). Additionally, 3 patients (3.7%) had subclinical, and 2 (2.5%) had clinical hyperthyroidism. Finally, 21 patients (25.9%) had sick euthyroid syndrome. Again, all were statistically similar between the study groups, (p > 0.5 for all). Similarly, both anti-thyroglobulin antibodies and anti-thyroid peroxidase antibodies were statistically similar among the 3 groups (p > 0.05 for both).

CONCLUSION

Thyroid hormone disturbances are quite frequent in elderly patients undergoing elective coronary procedures, chiefly in the form of a hypothyroid state. These data do not support that thyroid hormone patterns relate to the extent of coronary artery disease in the elderly.

Renal Doppler indices in diabetic children with insulin resistance syndrome

End-stage renal failure is still a leading cause of mortality among type 1 diabetes patients. Insulin resistance plays a larger role in type 1 diabetes disease process than is commonly recognized. Detection of diabetic nephropathy as early as possible currently offers the best chance of delaying or possibly preventing progression to end-stage disease. Renal resistive index (RI) and pulsatility index (PI), measured using renal Doppler ultrasonography, reflect intrarenal vascular resistance. The present work aimed at examining renal Doppler indices (RI and PI) in type 1 diabetic children and their relation to features of insulin resistance and other established parameters of early diabetic nephropathy as microalbuminuria. One hundred diabetic children with a mean age of 13.4 ± 2.9 yr and an average diabetes duration of (7.2 ± 2.5 yr) were included. Thirty healthy children served as controls. All renal Doppler indices were significantly higher in children with type 1 diabetes mellitus (p ≤ 0.01). The worst parameters were observed in children diagnosed with insulin resistance syndrome (IRS) (38%), hypertensive (12%), and obese (4%) children. Resistive index showed a significant correlation to blood pressure (r = 0.2, p = 0.04), waist-hip ratio (r = 0.5, p = 0.02), insulin dose (r = 0.2, p = 0.02) and estimated glucose disposal rate (r = -0.5, p = 0.01). No correlation was noted to microalbuminuria, HbA1c, or duration of diabetes. The present work concluded that renal Doppler indices are worse in diabetic children and particularly those with IRS. These children appear to be at graver risk for diabetic nephropathy. In these patients adding renal Doppler assessment to their work up, might diagnose diabetic nephropathy at a prealbuminuric stage.

Autologous hematopoietic stem cell transplantation in 48 patients with end-stage chronic liver diseases

The only presently viable treatment for end-stage liver disease is whole organ transplantation. However, there are insufficient livers available. The aim of the present study is to provide autologous bone marrow-derived stem cells as a potential therapeutic for patients with end-stage cirrhosis. This is a retrospective chart review of autologous stem cell treatment in 48 patients, 36 with chronic end-stage hepatitis C-induced liver disease and 12 with end-stage autoimmune liver disease. For all patients, granulocyte colony-stimulating factor was administered to mobilize their hematopoietic stem cells. Following leukapheresis, CD34(+) stem cells were isolated, amplified, and partially differentiated in culture, then reinjected into each subject via their hepatic artery or portal vein. Treatment was generally well tolerated with the expected moderate but transient bone pain from G-CSF in less than half of the patients. Three patients had serious treatment-related complications, and only 20.8% of these end-stage liver disease patients died during 12 months of follow up. For all patients there was a statistically significant decrease in ascites. There was clinical and biochemical improvement in a large percentage of patients who received the transplantation. In the viral group, there were marked changes in albumin (p = 0.0003), bilirubin (p = 0.04), INR (p = 0.0003), and ALT levels (p = 0.02). In the autoimmune group, values also improved significantly for albumin (p = 0.001), bilirubin (p = 0.002), INR (p = .0005), and ALT levels (p = 0.003). These results suggest that autologous CD34(+) stem cell transplantation may be safely administered and appears to offer some therapeutic benefit to patients with both viral and autoimmune-induced end-stage liver disease.

Genotoxicity of two pathogenic strains of zoosporic fungi (Achlya klebsiana and Aphanomyces laevis) on erythrocytes of Nile tilapia Oreochromis niloticus niloticus

In the present work we have described the genotoxic potential of two pathogenic strains of zoosporic fungi (Achlya klebsiana and Aphanomyces laevis) on erythrocytes of Nile tilapia Oreochromis niloticus niloticus for the first time by three complementary tests: micronucleus test (MN), nuclear lesions (NL) and comet assay (CA). The groups exposed to the zoosporic fungi subjected to the MN and NL test showed statistically significant differences in MN and NL frequencies with respect to the control one. Also, a significant increase (p<0.001) in micronuclei and nuclear lesions frequencies were recorded with the increase in exposure time. A correlation was observed between the frequencies of MN and NL, suggesting the importance for recording this anomaly in order to improve the information obtained with the MN test. Therefore, our results suggest that the nuclear lesions found here should be considered indicators of genotoxicity, in addition to the typical micronuclei forms. The result of the comet assay showed a significant difference in the percentages of the damaged DNA in the comet tail (%TDNA) of the treated groups comparing to the control. A significant (p<0.001) increase in the DNA damage of the treated groups with the increase in exposure time was recorded, confirming the results of the MN and the NL tests. The results of the current study will be useful for future work involving the biomonitoring of regions where Nile tilapia survive. These data allow us to consider O. niloticus niloticus as a good bioindicator of the effects of genotoxic agents that might be present in the aquatic habitat.