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1.
Cell Biochem Funct ; 42(3): e4009, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38597217

ABSTRACT

Atypical chemokine receptor 4 (ACKR4), also known as CCX-CKR, is a member of the chemokine receptor family that lacks typical G protein signaling activity. Instead, ACKR4 functions as a scavenger receptor that can bind and internalize a wide range of chemokines, influencing their availability and activity in the body. ACKR4 is involved in various physiological processes, such as immune cell trafficking and the development of thymus, spleen, and lymph nodes. Moreover, ACKR4 has been implicated in several pathological conditions, including cancer, heart and lung diseases. In cancer, ACKR4 plays a complex role, acting as a tumor suppressor or promoter depending on the type of cancer and the stage of the disease. For instance, ACKR4 may inhibit the growth and metastasis of breast cancer, but it may also promote the progression of hepatocellular carcinoma and gastric cancer. In inflammatory situations, ACKR4 has been found to modulate the recruitment and activation of immune cells, contributing to the pathogenesis of diseases such as myocardial infraction and pulmonary sarcoidosis. The study of ACKR4 is still ongoing, and further research is needed to fully understand its role in different physiological and pathological contexts. Nonetheless, ACKR4 represents a promising target for the development of novel therapeutic strategies for various diseases.


Subject(s)
Breast Neoplasms , Signal Transduction , Female , Humans
2.
Sensors (Basel) ; 24(11)2024 Jun 06.
Article in English | MEDLINE | ID: mdl-38894473

ABSTRACT

Sign language is an essential means of communication for individuals with hearing disabilities. However, there is a significant shortage of sign language interpreters in some languages, especially in Saudi Arabia. This shortage results in a large proportion of the hearing-impaired population being deprived of services, especially in public places. This paper aims to address this gap in accessibility by leveraging technology to develop systems capable of recognizing Arabic Sign Language (ArSL) using deep learning techniques. In this paper, we propose a hybrid model to capture the spatio-temporal aspects of sign language (i.e., letters and words). The hybrid model consists of a Convolutional Neural Network (CNN) classifier to extract spatial features from sign language data and a Long Short-Term Memory (LSTM) classifier to extract spatial and temporal characteristics to handle sequential data (i.e., hand movements). To demonstrate the feasibility of our proposed hybrid model, we created a dataset of 20 different words, resulting in 4000 images for ArSL: 10 static gesture words and 500 videos for 10 dynamic gesture words. Our proposed hybrid model demonstrates promising performance, with the CNN and LSTM classifiers achieving accuracy rates of 94.40% and 82.70%, respectively. These results indicate that our approach can significantly enhance communication accessibility for the hearing-impaired community in Saudi Arabia. Thus, this paper represents a major step toward promoting inclusivity and improving the quality of life for the hearing impaired.


Subject(s)
Deep Learning , Neural Networks, Computer , Sign Language , Humans , Saudi Arabia , Language , Gestures
3.
AAPS PharmSciTech ; 25(6): 140, 2024 Jun 18.
Article in English | MEDLINE | ID: mdl-38890191

ABSTRACT

Nanotechnology has significantly transformed cancer treatment by introducing innovative methods for delivering drugs effectively. This literature review provided an in-depth analysis of the role of nanocarriers in cancer therapy, with a particular focus on the critical concept of the 'stealth effect.' The stealth effect refers to the ability of nanocarriers to evade the immune system and overcome physiological barriers. The review investigated the design and composition of various nanocarriers, such as liposomes, micelles, and inorganic nanoparticles, highlighting the importance of surface modifications and functionalization. The complex interaction between the immune system, opsonization, phagocytosis, and the protein corona was examined to understand the stealth effect. The review carefully evaluated strategies to enhance the stealth effect, including surface coating with polymers, biomimetic camouflage, and targeting ligands. The in vivo behavior of stealth nanocarriers and their impact on pharmacokinetics, biodistribution, and toxicity were also systematically examined. Additionally, the review presented clinical applications, case studies of approved nanocarrier-based cancer therapies, and emerging formulations in clinical trials. Future directions and obstacles in the field, such as advancements in nanocarrier engineering, personalized nanomedicine, regulatory considerations, and ethical implications, were discussed in detail. The review concluded by summarizing key findings and emphasizing the transformative potential of stealth nanocarriers in revolutionizing cancer therapy. This review enhanced the comprehension of nanocarrier-based cancer therapies and their potential impact by providing insights into advanced studies, clinical applications, and regulatory considerations.


Subject(s)
Antineoplastic Agents , Drug Carriers , Nanoparticles , Neoplasms , Humans , Neoplasms/drug therapy , Drug Carriers/chemistry , Nanoparticles/chemistry , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/pharmacokinetics , Antineoplastic Agents/chemistry , Animals , Drug Delivery Systems/methods , Nanomedicine/methods , Liposomes , Micelles , Tissue Distribution
4.
Clin Endocrinol (Oxf) ; 97(5): 551-561, 2022 Nov.
Article in English | MEDLINE | ID: mdl-35781728

ABSTRACT

OBJECTIVE: Congenital adrenal hyperplasia (CAH) requires exogenous steroid replacement. Treatment is commonly monitored by measuring 17-OH progesterone (17OHP) and androstenedione (D4). DESIGN: Retrospective cohort study using real-world data to evaluate 17OHP and D4 in relation to hydrocortisone (HC) dose in CAH patients treated in 14 countries. PATIENTS: Pseudonymized data from children with 21-hydroxylase deficiency (21OHD) recorded in the International CAH Registry. MEASUREMENTS: Assessments between January 2000 and October 2020 in patients prescribed HC were reviewed to summarise biomarkers 17OHP and D4 and HC dose. Longitudinal assessment of measures was carried out using linear mixed-effects models (LMEM). RESULTS: Cohort of 345 patients, 52.2% female, median age 4.3 years (interquartile range: 3.1-9.2) were taking a median 11.3 mg/m2 /day (8.6-14.4) of HC. Median 17OHP was 35.7 nmol/l (3.0-104.0). Median D4 under 12 years was 0 nmol/L (0-2.0) and above 12 years was 10.5 nmol/L (3.9-21.0). There were significant differences in biomarker values between centres (p < 0.05). Correlation between D4 and 17OHP was good in multiple regression with age (p < 0.001, R2 = 0.29). In longitudinal assessment, 17OHP levels did not change with age, whereas D4 levels increased with age (p < 0.001, R2 = 0.08). Neither biomarker varied directly with dose or weight (p > 0.05). Multivariate LMEM showed HC dose decreasing by 1.0 mg/m2 /day for every 1 point increase in weight standard deviation score. DISCUSSION: Registry data show large variability in 17OHP and D4 between centres. 17OHP correlates with D4 well when accounting for age. Prescribed HC dose per body surface area decreased with weight gain.


Subject(s)
Adrenal Hyperplasia, Congenital , 17-alpha-Hydroxyprogesterone , Adrenal Hyperplasia, Congenital/drug therapy , Androstenedione , Child , Child, Preschool , Female , Humans , Hydrocortisone/therapeutic use , Male , Progesterone , Registries , Retrospective Studies
5.
Clin Trials ; 18(1): 39-50, 2021 02.
Article in English | MEDLINE | ID: mdl-33012180

ABSTRACT

BACKGROUND/AIMS: Given the extent of osteoporosis in people with Duchenne muscular dystrophy treated with glucocorticoids and the limited evidence of bone-protective therapies, clinical trials are needed. We conducted surveys to obtain the opinion of young people with Duchenne muscular dystrophy, parents/guardians and neuromuscular clinicians on the feasibility of osteoporosis clinical trials in this population. METHODS: Online surveys were sent to three groups: (a) people with a confirmed diagnosis of Duchenne muscular dystrophy (≥14 years), (b) parents and guardians and (c) neuromuscular clinicians in the UK NorthStar Clinical Network. Surveys (a) and (b) were distributed via the UK Duchenne muscular dystrophy Registry. RESULTS: Survey respondents included 52 people with Duchenne muscular dystrophy with a median age of 17 years (range: 14, 40) and 183 parents/guardians. Fourteen out of 23 (61%) NorthStar centres responded. Of the 52 people with Duchenne muscular dystrophy, 13 (25%) were very concerned about their bone health and 21 (40%) were slightly concerned. Of the 183 parents/guardians, 75 (41%) were very concerned about their son's bone health and 90 (49%) were slightly concerned. Fractures and quality of life were the top two main outcome measures identified by people with Duchenne muscular dystrophy. Fractures and bone density were the top two main outcome measures identified by parents/guardians and neuromuscular clinicians. Thirty percent of people with Duchenne muscular dystrophy and 40% of parents/guardians would not take part if an osteoporosis trial involved a placebo that was administered parenterally. Only 2 of the 14 NorthStar centres (14%) would enrol people with Duchenne muscular dystrophy if a parenteral placebo was used in an osteoporosis trial in Duchenne muscular dystrophy. CONCLUSION: There is great awareness of bone health and the need for bone-protective trials among people with Duchenne muscular dystrophy and their carers. However, a proportion of people with Duchenne muscular dystrophy and parents are reluctant to participate in a placebo-controlled osteoporosis trial that included a parenteral therapy. A larger proportion of health care experts are unwilling to enrol their patients in such a trial. Our finding is relevant for the design of bone-protective studies in Duchenne muscular dystrophy.


Subject(s)
Clinical Trials as Topic , Muscular Dystrophy, Duchenne , Osteoporosis , Adolescent , Feasibility Studies , Humans , Muscular Dystrophy, Duchenne/drug therapy , Osteoporosis/drug therapy , Patient Participation , Placebos , Quality of Life , Surveys and Questionnaires
6.
Clin Lab ; 67(2)2021 Feb 01.
Article in English | MEDLINE | ID: mdl-33616339

ABSTRACT

BACKGROUND: Host factors related to failure of eradication of Helicobacter pylori (H. pylori) are increasingly studied. This work aimed to study the influence of 25-hydroxy-vitamin D [25(OH)-vitD] status on the rate of H. pylori eradication. METHODS: One hundred and fifty patients infected with H. pylori were tested for serum 25(OH)-vitD level prior to 14 days clarithromycin-based triple eradication therapy. Accordingly, patients were divided into: group I (eradication successful) and group II (eradication failure). Both groups were compared regarding mean level of serum 25(OH)-vitD and number and percentage of patients with deficient 25 (OH)-vitD. RESULTS: Overall rate of eradication was 72%. Mean serum level of 25(OH)-vitD was higher in the eradication successful group compared to the group of eradication failure (28.12 ± 8.10 vs. 13.54 ± 6.37; p < 0.001). The percentage of patients with 25(OH)-vitD deficiency was higher in the group of eradication failure compared to the group of successful eradication [30 (71.5%) vs. 19 (17.5%); p < 0.001]. Patients with sufficient 25(OH)-vitD had a higher rate of eradication compared to patients with deficient 25(OH)-vitD (88% vs. 38.5%). CONCLUSIONS: This study suggested that deficiency of 25(OH)-vitD could be a risk factor for H. pylori eradication failure, and it recommends to investigate the effect of vitamin D supplementation on H. pylori eradication.


Subject(s)
Helicobacter Infections , Helicobacter pylori , Vitamin D Deficiency , Anti-Bacterial Agents/therapeutic use , Drug Therapy, Combination , Helicobacter Infections/diagnosis , Helicobacter Infections/drug therapy , Humans , Risk Factors , Vitamin D Deficiency/diagnosis , Vitamin D Deficiency/drug therapy , Vitamins
7.
J Intensive Care Med ; 35(7): 694-699, 2020 Jul.
Article in English | MEDLINE | ID: mdl-29788796

ABSTRACT

OBJECTIVE: To evaluate whether the off-hours admission has any effect on risk-adjusted mortality and length of stay for nonelective patients admitted to a pediatric intensive care unit (PICU) without 24-hour in-house intensivist coverage. DESIGN: Prospective cohort study. SETTING: A 34-bed tertiary PICU. PATIENTS: All consecutive nonelective patients aged 0 to 14 years admitted from January 2012 to June 2015. MEASUREMENTS AND MAIN RESULTS: A total of 1254 patients were nonelectively admitted to the PICU. They were categorized according to time of PICU admission as either office hours (07:30 to 16:30 from Sunday to Thursday and whenever an intensivist is present in the ICU) or off-hours (16:30 to 07:30, Friday and Saturday and public holidays). Standardized mortality rates (SMRs) of patients admitted during off-hours were compared to SMRs of patients admitted during office hours using Pediatric Risk of Mortality (PRISM2) score. Multivariate logistic regression was used to assess the effect of time of admission on outcome after adjustment for severity of illness using the PRISM2. The mortality observed in the office-hours group was 9.4% and in the off-hours group was 8.1%. The PRISM2-based SMR was 0.83 (95% confidence interval [CI]: 0.43-1.47) for the office-hours group and 0.68 (95% CI: 0.34-1.36) for the off-hours group. No significant differences in length of ICU stay or duration of mechanical ventilation were observed between patients admitted during off-hours and those admitted during office hours. In the logistic regression model, off-hours admission was not significantly associated with a higher mortality (odds ratio: 0.85, 95% CI: 0.57-1.27; P = .44). CONCLUSIONS: The absence of an in-house intensivist during off-hours is not associated with an increase in mortality, length of ICU stay, or duration of mechanical ventilation for patients admitted to our pediatric ICU.


Subject(s)
After-Hours Care/statistics & numerical data , Hospital Mortality , Intensive Care Units, Pediatric/statistics & numerical data , Patient Admission/statistics & numerical data , Workforce/statistics & numerical data , Adolescent , Child , Child, Preschool , Critical Care Outcomes , Female , Humans , Infant , Infant, Newborn , Logistic Models , Male , Prospective Studies , Time Factors
8.
Clin Lab ; 66(8)2020 Aug 01.
Article in English | MEDLINE | ID: mdl-32776730

ABSTRACT

BACKGROUND: Early detection of hepatocellular carcinoma is very important in the treatment which is feasible. Alpha-fetoprotein plus ultrasound in surveillance programs is controversial. GP73 is a protein. Golgi increase significantly in the sera of patients with hepatitis B virus and HCV-related HCC, providing a marker for its early detection. The aim is to detect serum Golgi protein 73 (GP73) in patients with cirrhosis and with hepatocellular carci-noma (HCC), and to determine its sensitivity and specificity as a screening tool for the detection of HCC. METHODS: A case control study was conducted in four groups of 32 participants each: 1- healthy controls; 2 - chronic liver disease; 3 - decompensated liver disease; 4 - HCC group. The HCC group included 25 males and 7 females with a mean age of 58 ± 7 years, fulfilling diagnostic criteria for HCC. GP73 was estimated in the serum samples taken from the HCC group and control groups. RESULTS: GP73 was elevated in patients with HCC and liver cirrhosis. Serum level was very high in HCC patients (p < 0.01) when compared with the other studied groups. GP73 had a sensitivity of 96.9% and specificity of 96.9% at a cutoff value of 17.5 ng/mL when compared with α-fetoprotein (AFP) that showed a sensitivity of 75% and specificity of 92% at a cutoff value of 9.4 ng/mL. CONCLUSIONS: GP73 can be used as a screening tool for the detection of HCC with higher diagnostic performance than AFP.


Subject(s)
Carcinoma, Hepatocellular , Liver Neoplasms , Aged , Biomarkers , Biomarkers, Tumor , Carcinoma, Hepatocellular/diagnosis , Case-Control Studies , Female , Humans , Liver Cirrhosis , Liver Neoplasms/diagnosis , Male , Membrane Proteins , Middle Aged , alpha-Fetoproteins
9.
J Shoulder Elbow Surg ; 29(5): 941-945, 2020 May.
Article in English | MEDLINE | ID: mdl-31759877

ABSTRACT

BACKGROUND: The lack of external rotation and shoulder abduction as sequelae of obstetric brachial plexus palsy requires a release of the subscapularis muscle associated with tendon transfer of the internal rotator of the shoulder. The aim of this study was to present the results of a teres major transfer to the infraspinatus tendon. METHODS: This study included 20 patients (9 boys and 11 girls) with a mean age of 3 years 8 months (range, 1.5-14 years). The average follow-up time was 42 months (range, 12-48 months) to determine whether external rotation weakness and internal rotation contracture sequelae were managed by anterior release of the subscapularis and teres major tendon transfer to the infraspinatus tendon. RESULTS: We found marked improvement in shoulder abduction from 67° before surgery to 158° after surgery. We also found marked improvements in active external rotation from 8° before surgery to 85° after surgery and in passive external rotation from 0° preoperatively to 72° postoperatively. Two cases showed a loss of the last degrees of internal rotation, but this improved after physiotherapy. CONCLUSIONS: Anterior release of the subscapularis tendon with a teres major transfer to the infraspinatus tendon significantly improves shoulder function in Erb palsy patients with internal rotation contracture.


Subject(s)
Brachial Plexus Neuropathies/surgery , Rotator Cuff/surgery , Shoulder Joint/surgery , Tendon Transfer/methods , Adolescent , Brachial Plexus Neuropathies/physiopathology , Child , Child, Preschool , Female , Humans , Infant , Male , Prospective Studies , Range of Motion, Articular/physiology , Rotation , Shoulder Joint/physiopathology
10.
Int Orthop ; 44(6): 1153-1157, 2020 06.
Article in English | MEDLINE | ID: mdl-32303792

ABSTRACT

PURPOSE: To investigate the union rate after lunatocapitate arthrodesis for the treatment of scaphoid nonunion advanced collapse (SNAC) wrists and to evaluate the clinical results of this technique. METHODS: We conducted a prospective study between January 2014 and July 2017. Fifteen males with painful stage III SNAC wrists (average age, 32 years, range, 20-37 years; average follow-up time, 25.2 months, range, 20-36 months) underwent scaphoid excision and lunatocapitate fusion. Lunatocapitate fusions were fixed with headless Herbert screws with K-wire fixation (retrograde direction). Radiographs, wrist range of motion, and Mayo wrist score were examined. RESULTS: All patients achieved radiographic and clinical union after lunatocapitate fusion during follow-up (average 10 months post-operatively). The flexion-extension arc was 70°, and the average Mayo wrist score was 74.3 points (eight with excellent, four with good, three with satisfactory, and one with poor result). Thirteen patients returned to work, whereas two with nonunion required surgical graft revision. Complete union was achieved at an average of 12 weeks after graft revision, with improved range of motion, and the patients returned to work with a change in their occupation. CONCLUSIONS: Lunatocapitate arthrodesis is a satisfactory therapeutic alternative to four-corner fusion for SNAC wrists.


Subject(s)
Wrist Joint/surgery , Adult , Arthrodesis/methods , Bone Wires , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Musculoskeletal Diseases , Pain , Prospective Studies , Radiography , Range of Motion, Articular , Scaphoid Bone/surgery , Wrist , Wrist Injuries/surgery
11.
Entropy (Basel) ; 22(5)2020 May 14.
Article in English | MEDLINE | ID: mdl-33286321

ABSTRACT

In this study, the analysis of the extreme sea level was carried out by using 10 years (2007-2016) of hourly tide gauge data of Karachi port station along the Pakistan coast. Observations revealed that the magnitudes of the tides usually exceeded the storm surges at this station. The main observation for this duration and the subsequent analysis showed that in June 2007 a tropical Cyclone "Yemyin" hit the Pakistan coast. The joint probability method (JPM) and the annual maximum method (AMM) were used for statistical analysis to find out the return periods of different extreme sea levels. According to the achieved results, the AMM and JPM methods erre compatible with each other for the Karachi coast and remained well within the range of 95% confidence. For the JPM method, the highest astronomical tide (HAT) of the Karachi coast was considered as the threshold and the sea levels above it were considered extreme sea levels. The 10 annual observed sea level maxima, in the recent past, showed an increasing trend for extreme sea levels. In the study period, the increment rates of 3.6 mm/year and 2.1 mm/year were observed for mean sea level and extreme sea level, respectively, along the Karachi coast. Tidal analysis, for the Karachi tide gauge data, showed less dependency of the extreme sea levels on the non-tidal residuals. By applying the Merrifield criteria of mean annual maximum water level ratio, it was found that the Karachi coast was tidally dominated and the non-tidal residual contribution was just 10%. The examination of the highest water level event (13 June 2014) during the study period, further favored the tidal dominance as compared to the non-tidal component along the Karachi coast.

12.
Int J Colorectal Dis ; 34(10): 1633-1652, 2019 Oct.
Article in English | MEDLINE | ID: mdl-31492986

ABSTRACT

OBJECTIVE: We aimed to evaluate the efficacy and safety of infliximab biosimilar, CT-P13, for patients with inflammatory bowel disease. METHODS: We searched PubMed, Scopus, Ovid, and Web of Science for relevant clinical trials discussing CT-P31 administration for IBD patients either naïve to biological therapy or switched from IFX therapy. Data of the rates of clinical response, clinical remission, and adverse events were extracted and pooled in a random effect model meta-analysis using CMA version 2. RESULTS: Thirty-two studies with a total of 3464 IBD patients treated with CT-P13 were identified. The pooled rates of clinical response among Crohn's disease (CD) and ulcerative colitis (UC) at 8-14 weeks were 0.81 (95% CI = 0.72 to 0.87) and 0.68 (95% CI = 0.63 to 0.72), respectively, and at 48-63 weeks were 0.69 (95% CI = 0.48 to 0.85) and 0.54 (95% CI = 0.45 to 0.63) respectively. After switching from IFX to CT-P13, the pooled rates of sustained clinical response among CD and UC at 30-32 weeks were 0.84 (95% CI = 0.57 to 0.96) and 0.96 (95% CI = 0.58 to 0.99), respectively, and at 48-63 weeks were 0.51 (95% CI = 0.22 to 0.79) and 0.83 (95% CI = 0.19 to 0.99) respectively. Moreover, adverse events were reported (CD = 0.10, 95% CI 0.04 to 0.22; UC = 0.18, 95% CI 0.05 to 0.15). CONCLUSION: CT-P13 is effective and well tolerated in short and long-term periods. Switching to CT-P13 is recommended for the management of IBD.


Subject(s)
Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal/therapeutic use , Biosimilar Pharmaceuticals/adverse effects , Biosimilar Pharmaceuticals/therapeutic use , Inflammatory Bowel Diseases/drug therapy , Infliximab/adverse effects , Infliximab/therapeutic use , Follow-Up Studies , Humans , Intestinal Mucosa/drug effects , Intestinal Mucosa/pathology , Observational Studies as Topic , Remission Induction , Reproducibility of Results , Treatment Outcome , Wound Healing/drug effects
13.
Knee Surg Sports Traumatol Arthrosc ; 26(8): 2395-2400, 2018 Aug.
Article in English | MEDLINE | ID: mdl-29159673

ABSTRACT

PURPOSE: A comparison of clinical outcomes between double-bundle (DB) and single-bundle (SB) anterior cruciate ligament (ACL) reconstruction for patients with ACL injury. METHODS: Sixty patients were treated with either SB (n = 30) or DB (n = 30) ACL reconstruction between 2011 and 2012. The hamstring tendons were autografted with suspensory fixation on the femoral side, while a bio-absorbable interference screw was used for fixation on the tibial side. These patients were evaluated using Lysholm score, International Knee Documentation Committee (IKDC) forms (both objective and subjective), Lachman test, pivot shift test, and KT 1000 arthrometer. RESULTS: After a median follow-up duration of 35.5 months (ranging between 30 and 42 months), the frequency of patients who had high objective IKDC scores was significantly higher in the DB group than those in the SB group. In terms of DB, the Lachman test was normal in 26 patients (86.7%), nearly normal in three patients (10%), and abnormal in one patient (3.3%); comparatively, in terms of SB, the Lachman test was normal in 20 patients (66.7%), nearly normal in eight patients (26.7%) and abnormal in two patients (6.6%). The pivot shift test was negative in 29 patients (96.7%) and 21 patients (70%) for DB and SB, respectively. The average KT-1000 side-to-side difference was 1.0 mm for DB and 1.5 mm for SB. The subjective IKDC and Lysholm score showed non-significant differences between both techniques. CONCLUSION: Double-bundle ACL reconstruction was found to have a significant advantage in anterior and rotational stability as well as objective IKDC than that of SB reconstruction. However, subjective measurements showed no statistical differences between the techniques. LEVEL OF EVIDENCE: II.


Subject(s)
Anterior Cruciate Ligament Injuries/surgery , Anterior Cruciate Ligament Reconstruction/methods , Adolescent , Adult , Bone Screws , Female , Femur/surgery , Hamstring Tendons/transplantation , Humans , Joint Instability/diagnosis , Male , Physical Examination , Tibia/surgery , Transplantation, Autologous , Treatment Outcome , Young Adult
14.
J Neurooncol ; 126(1): 165-174, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26468139

ABSTRACT

Myxopapillary ependymomas (MPEs) are rare spinal tumors in children. The natural history and clinical course of pediatric MPEs are largely unknown and the indication for adjuvant therapy remains to be clarified. We performed an IRB-approved, retrospective review of children with MPEs treated at the Dana-Farber/Boston Children's Cancer and Blood Disorder Center between 1982 and 2013. Eighteen children (age range 8-21 years, median age 14 years) met inclusion criteria. We reviewed the histopathology, magnetic resonance imaging, tumor location and stage, surgical management, adjuvant therapy, and clinical outcomes. The median follow-up duration was 9.4 years (range 1-30 years). Children most commonly presented with pain, scoliosis, and urinary symptoms. All primary tumors were located in the lower thoracic or lumbar spine. Nine children (50%) had leptomeningeal tumor seeding at presentation, most commonly located within the distal thecal sac. A gross-total resection was achieved in nine children (50%). Three children were treated with irradiation following initial surgery. No child received adjuvant chemotherapy at diagnosis. The 10-year event-free survival (EFS) was 26% ± 14.8. Children with disseminated disease trended towards inferior EFS compared to those with localized disease (10-year EFS 12.7% ± 12 vs. 57 ± 25%, p value 0.07). The 10-year overall survival was 100%. The efficacy of adjuvant irradiation could not be assessed due to the small sample size. Although children with MPEs frequently present with disseminated tumor and/or develop recurrent or progressive disease, their overall survival is excellent. Treatment should aim to minimize both tumor- and therapy-related morbidity.


Subject(s)
Central Nervous System Neoplasms/pathology , Central Nervous System Neoplasms/therapy , Ependymoma/pathology , Ependymoma/therapy , Magnetic Resonance Imaging , Treatment Outcome , Adolescent , Child , Cohort Studies , Disease-Free Survival , Female , Humans , Male , Young Adult
15.
J Ayub Med Coll Abbottabad ; 28(1): 206-9, 2016.
Article in English | MEDLINE | ID: mdl-27323599

ABSTRACT

Scalp masses are commonly seen in clinical practice. They range from simple sebaceous cyst to malignant neoplasms. Clinical presentation is straight forward in most of the cases. Simple subcutaneous swelling till erosion of scalp and skull all can occur. However very few intracranial masses present with exophytic scalp swelling. This is because they have to erode dura, thick skull bone and all the layers of scalp to appear out on scalp. It is very unusual that an intracranial mass present like a scalp swelling. Some of the intracranial masses have tendency to erode skull. Dermoid & meningioma are among the most common.


Subject(s)
Meningeal Neoplasms/pathology , Meningioma/pathology , Scalp/pathology , Humans , Male , Meningeal Neoplasms/surgery , Meningioma/surgery , Middle Aged , Neoplasm Invasiveness , Scalp/surgery
16.
J Ayub Med Coll Abbottabad ; 27(2): 482-5, 2015.
Article in English | MEDLINE | ID: mdl-26411146

ABSTRACT

Significant proportion of sellar masses is seen in clinical practice. They range from most common pituitary adenomas to rare inflammatory lesions. Presentation can vary and depends if it secretes any hormone or imparts a pressure effect upon the surrounding vital structures. Radiological imaging coupled with histopathology is important tools of diagnosis. Management options depend upon type of disease.


Subject(s)
Autoimmune Diseases/immunology , Glucocorticoids/therapeutic use , Pituitary Diseases/immunology , Pituitary Gland/pathology , Adult , Autoimmune Diseases/diagnosis , Autoimmune Diseases/drug therapy , Female , Humans , Magnetic Resonance Imaging , Pituitary Diseases/diagnosis , Pituitary Diseases/drug therapy
17.
Article in English | MEDLINE | ID: mdl-38896209

ABSTRACT

BACKGROUND: Although many health problems, including sleep disorders, have been associated with video gaming, further studies are required to establish the validity of these connections. This study aimed to determine the prevalence of gaming addiction among medical students and its association with poor sleep quality, which may be reflected in academic performance. METHOD: A cross-sectional survey was conducted between January and June 2023 among medical students at the institution under study. An online survey was conducted and was divided into three sections. The first section included the demographic data, the second section included the 7-item Gaming Addiction Scale (GAS), and the third section included the Pittsburgh Sleep Quality Index. Using the GAS, and based on the total score, gamers were classified as addicted, problematic, engaged, or normal. Hence, abnormal gamers include engaged, problematic, and addicted gamers. RESULT: There were 356 participants with a mean age of 22.5 -/+ 1.8 years, and 75.3% were males. The data showed that 38.8% of the study population were abnormal gamers: 40 (11.2%) engaged gamers, 81 (22.8%) problematic gamers, and 17 (4.8%) addicted gamers. Furthermore, abnormal gaming was linked to poor sleep quality when comparing abnormal gamers with normal gamers (92% vs. 80.3%, p = 0.002). Further comparison between the types of abnormal gamers revealed that addicted gamers were found to rely on sleep medication to help them sleep at night and took longer time to fall asleep (p = 0.050 and p = 0.045, respectively). CONCLUSION: Abnormal gamers are common among medical students and strongly associated with poor sleep quality compared to normal gamers.

18.
Mol Neurobiol ; 2024 Mar 23.
Article in English | MEDLINE | ID: mdl-38520611

ABSTRACT

Parkinson's disease (PD) is one of the most prevalent diseases of central nervous system that is caused by degeneration of the substantia nigra's dopamine-producing neurons through apoptosis. Apoptosis is regulated by initiators' and executioners' caspases both in intrinsic and extrinsic pathways, further resulting in neuronal damage. In that context, targeting apoptosis appears as a promising therapeutic approach for treating neurodegenerative diseases. Non-coding RNAs-more especially, microRNAs, or miRNAs-are a promising target for the therapy of neurodegenerative diseases because they are essential for a number of cellular processes, including signaling, apoptosis, cell proliferation, and gene regulation. It is estimated that a substantial portion of coding genes (more than 60%) are regulated by miRNAs. These small regulatory molecules can have wide-reaching consequences on cellular processes like apoptosis, both in terms of intrinsic and extrinsic pathways. Furthermore, it was recommended that a disruption in miRNA expression levels could also result in perturbation of typical apoptosis pathways, which may be a factor in certain diseases like PD. The latest research on miRNAs and their impact on neural cell injury in PD models by regulating the apoptosis pathway is summarized in this review article. Furthermore, the importance of lncRNA/circRNA-miRNA-mRNA network for regulating apoptosis pathways in PD models and treatment is explored. These results can be utilized for developing new strategies in PD treatment.

19.
Noncoding RNA Res ; 9(3): 970-994, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38770106

ABSTRACT

Cancer cells exhibit altered metabolic pathways, prominently featuring enhanced glycolytic activity to sustain their rapid growth and proliferation. Dysregulation of glycolysis is a well-established hallmark of cancer and contributes to tumor progression and resistance to therapy. Increased glycolysis supplies the energy necessary for increased proliferation and creates an acidic milieu, which in turn encourages tumor cells' infiltration, metastasis, and chemoresistance. Circular RNAs (circRNAs) have emerged as pivotal players in diverse biological processes, including cancer development and metabolic reprogramming. The interplay between circRNAs and glycolysis is explored, illuminating how circRNAs regulate key glycolysis-associated genes and enzymes, thereby influencing tumor metabolic profiles. In this overview, we highlight the mechanisms by which circRNAs regulate glycolytic enzymes and modulate glycolysis. In addition, we discuss the clinical implications of dysregulated circRNAs in cancer glycolysis, including their potential use as diagnostic and prognostic biomarkers. All in all, in this overview, we provide the most recent findings on how circRNAs operate at the molecular level to control glycolysis in various types of cancer, including hepatocellular carcinoma (HCC), prostate cancer (PCa), colorectal cancer (CRC), cervical cancer (CC), glioma, non-small cell lung cancer (NSCLC), breast cancer, and gastric cancer (GC). In conclusion, this review provides a comprehensive overview of the significance of circRNAs in cancer glycolysis, shedding light on their intricate roles in tumor development and presenting innovative therapeutic avenues.

20.
Pathol Res Pract ; 253: 154999, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38118218

ABSTRACT

It is becoming more and more apparent that many of the genetic alterations associated with cancer are located in areas that do not encode proteins. lncRNAs are a class of RNAs that do not code for proteins but play a crucial role in maintaining cell function and regulating various cellular processes. By doing this, they have recently introduced what may be a brand-new and essential layer of biological control. These have more than 200 nucleotides and are linked to several diseases; as a result, they have become potential tools for therapeutic intervention. Emerging technologies suggest the presence of mutations on genomic loci that give rise to lncRNAs rather than proteins in a disease as complex as cancer. These lncRNAs play essential parts in gene regulation, which impacts several cellular homeostasis processes, including proliferation, survival, migration, and genomic stability. The leading cause of death in the world today is cancer. Delays in diagnosis and a lack of standard and efficient treatments are the leading causes of the high death rate. Clinically, surgery is frequently used successfully to remove cancers that have not spread, but it is less successful in treating metastatic cancer, which has a drastically lower chance of survival. Chemotherapeutic drugs are a typical therapy to treat the cancer that has spread to other organs. Drug resistance to chemotherapy, however, presents a significant challenge to achieving positive outcomes and is frequently the cause of treatment failure. A substantial barrier to progress in medical oncology is cancer drug resistance. Resistance can develop clinically either before or after cancer treatment. According to this study, lncRNAs influence drug resistance through several different methods. LncRNAs often impact drug resistance by controlling the expression of a few intermediary regulatory variables rather than by directly affecting drug resistance. Additionally, lncRNAs have a variety of roles in cancer medication resistance. Most lncRNAs induce drug resistance when overexpressed; however, other lncRNAs have inhibitory effects. This study provides an overview of the current understanding of lncRNAs, relevance to cancer, and potential therapeutic applications.


Subject(s)
Neoplasms , RNA, Long Noncoding , Humans , RNA, Long Noncoding/genetics , RNA, Long Noncoding/metabolism , Neoplasms/drug therapy , Neoplasms/genetics , Neoplasms/pathology , Drug Resistance, Neoplasm/genetics , Signal Transduction/genetics
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