Abstract LB-221: Aggresome-based classification is a promising prognostic marker for pediatric choroid plexus tumors

Protein misfolding and aggregation result in proteotoxic stress, and underlie the pathogenesis of many diseases. To overcome proteotoxicity, cells compartmentalize misfolded and aggregated proteins in different inclusion bodies. Aggresome is a paranuclear inclusion body that functions as a storage compartment for misfolded proteins. Our previous work revealed the presence of aggresomes in pediatric choroid plexus tumors (CPT). CPTs are rare neoplasms comprised of three pathological subgroups; choroid plexus carcinoma (CPC), a grade III tumor, atypical choroid plexus papilloma (ACPP), a grade II tumor, and choroid plexus papilloma (CPP), a grade I tumor. In the current study, we aimed to investigate the prognostic value of aggresomes-positivity and if it could be used to improve the disease subclassification. Forty two pediatric CPT tumor samples were stratified into two molecular subgroups; Cluster “A", and “B”, using Illumina Infinium Methylation EPIC BeadChip array. Kaplan Meier analysis showed that “cluster B” is associated with significantly shorter overall survival (OS) and event free survival (EFS) with P= 0.008 and P =0.007 respectively. Aggresomes were detected in 64.2% of samples using immunohistochemistry and they were distributed among different pathological and molecular subgroups. The presence of aggresomes significantly correlated with patient outcome in both OS (P = 0.057) and EFS (P = 0.051). The survival-based cutoff determination was performed using various percentages of aggresomes; ranging from 10% to 50%. Aggresome presence maintained significance at all cutoffs, yet the 25% cutoff had the highest impact in OS and EFS (P = 0.001). Moreover, the classification based on the 25% cutoff concurred with the methylation signature of low-risk “A” and high-risk “B” clusters. Hence, the detection of aggresomes in CPTs provides a new prognostic marker supporting histopathological tumor classification.

Citation Format: Nada Amer, Hala Taha, Dina Hesham, Noura Mahmoud, Moatasem Elayadi, Amal Mossab, Ayda Youssef, Mohamed Elbeltagy, Mohamed Saad Zaghloul, Ahmad Abdel Azziz, Shahenda El-Naggar. Aggresome-based classification is a promising prognostic marker for pediatric choroid plexus tumors [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr LB-221.

Selection criteria for resuscitation and survivability rates for neonates at the limit of viability

AIM

To evaluate outcomes of a cohort of infants born at 23 weeks' gestational age after introducing a new selection score for resuscitation in the delivery room (DR).

METHODS

This was a retrospective charts review study using data from the maternal and newborn registry funded by the Qatar National Research Fund. Parents were consulted prenatally and their wishes were honored. The plan of resuscitation was based on the new selection score. The seven components of the score were four antenatal and three immediate postnatal in the DR. Each component received a score of zero, one, or two according to its presence, uncertainty or absence, respectively. Only a score of≥7 would receive active resuscitation unless specified otherwise during prenatal consultation.

RESULTS

The study reviewed 60 infants that were delivered over a two year period. The DR death rate was 23 of 60 (38%). Thirty-seven infants (61%) were admitted to the NICU. The score was applied only on 37 infants where all score criteria were reported in their files. Twenty infants had score <7; of them 13 (65%) died in the DR and 7 were admitted to NICU of whom two (29%) survived to discharge. Seventeen babies with scores≥7 admitted to NICU of whom nine (51%) survived to discharge. The survival rate to discharge was 13 of 37(35%). A satisfaction survey included 33 neonatal physicians; 32 neonatologists stated the score was easy to comprehend, 26 voted for easy to implement, and 30 voted for ethical relief and moral comfort.

CONCLUSIONS

Using a resuscitation score of seven was associated with improved survival until the discharge of those infants resuscitated. NICU physicians described the score as functional and convenient.

Oral Health Knowledge, Attitude, and Practices of Sharjah Mothers of Preschool Children, United Arab Emirates

Objective:

The improvement of children's oral health, a world global health target, is essential to general health and quality of life. Hence, the aim of this study was to assess the knowledge, attitude, and practices of mothers toward their children's oral health in Sharjah, United Arab Emirates (UAE).

Materials and Methods:

A cross-sectional interview-based study was conducted among 383 mothers of preschool children (average age 3.49 [+1.63 years]) attending Sharjah Dental Center, UAE. Statistical analysis was performed using SPSS software for Windows, version 20.0 (SPSS Inc., Chicago, IL, USA).

Results:

Adequate knowledge was found among 58.2% of mothers, 99% exhibited excellent attitude, and only 20% followed good practices toward their children's oral health. Poor knowledge and practice of mothers were significantly associated with mothers' occupation and education. Employed mothers had a significantly higher score of knowledge. Mothers with secondary education and university qualifications had significantly higher scores of practice compared with mothers with primary education.

Conclusions:

Although mothers had better than average knowledge and excellent attitude toward their children's oral health issues; most of them carried out improper practices. Mothers’ educational and employment backgrounds were significant influencing factors.

Adalimumab for the Treatment of Refractory Sciatica Induced by Disc Prolapse

Ten patients with back pain and sciatica were selected according to certain inclusion criteria for a study to assess the efficacy of the Anti TNF agent Adalimumab in the treatment of refractory sciatica pain induced by a lumbar disc prolapse in patients who failed to improve following lumbar epidural steroid or disc surgery. Each was given a subcutaneous injection of 40mg Adalimumab repeated after two weeks. Patients were assessed regularly on weeks 0, 2, 4 and 8 employing the Visual Analogue Score (VAS) for leg pain and back pain and the Straight Leg Raising (SLR) test. The median improvement of the leg pain VAS was 55. Median improvements of back pain VAS was 37. Median improvement of the SLR was 45. The study demonstrated the beneficial effect of adalimumab therapy in reducing the back and leg pain associated with sciatica in this difficult to treat group of patients. The improvement of leg pain was more significant than that of back pain. The response was better in patients with symptoms of shorter duration and with less SLR restriction at base line.

Phytoaccumulation of heavy metals by aquatic plants

Three aquatic plants were examined for their ability to remove heavy metals from contaminated water: parrot feather (Myriophylhum aquaticum), creeping primrose (Ludwigina palustris), and water mint (Mentha aquatic). The plants were obtained from a Solar Aquatic System treating municipal wastewater. All the three plants were able to remove Fe, Zn, Cu, and Hg from the contaminated water. The average removal efficiency for the three plant species was 99.8%, 76.7%, 41.62%, and 33.9% of Hg, Fe, Cu, and Zn, respectively. The removal rates of zinc and copper were constant (0.48 mg/l/day for Zn and 0.11 mg/l/day for Cu), whereas those of iron and mercury were dependent on the concentration of these elements in the contaminated water and ranged from 7.00 to 0.41 mg/l/day for Fe and 0.0787 to 0.0002 mg/l/day for Hg. Parrot feather showed greater tolerance to toxicity followed by water mint and creeping primrose. The growth of creeping primrose was significantly affected by heavy metal toxicity. The selectivity of heavy metals for the three plant species was the same (Hg>Fe>Cu>Zn). The mass balance preformed on the system showed that about 60.45-82.61% of the zinc and 38.96-60.75% of the copper were removed by precipitation as zinc phosphate and copper phosphate, respectively.