Assessment of Interleukin-27 and Chemokine RANTES as Biomarkers for Early Onset Neonatal Sepsis.

Early-onset neonatal sepsis (EONS) is a global health problem with high morbidity and mortality rates. Early diagnosis is a critical issue in determining treatment strategies. There is no single diagnostic test that can fulfill all requirements of the ideal biomarker yet. The current study enrolled 47 cases with EONS, admitted to the Neonatal Intensive Care Units at Beni-Suef University teaching Hospital from February 2017 to November 2017 and 37 apparently healthy controls. All were subjected to routine laboratory tests and serum concentration of IL-27 and regulation on activation normal T-cell expressed and secreted (RANTES) were measured. Significantly higher concentrations of IL-27 were observed in the septic group while RANTES were significantly lower in comparison to the controls. Moreover, there were no significant correlations between levels of IL-27 and RANTES either in the septic or the control group. Sensitivity, specificity, positive and negative predictive values for IL-27 were 93.6%, 81.1%, 86.3% and 90.9, respectively while for RANTES such values were 68.1%, 78.4%, 80% and 65.9%, respectively. A combination of both markers showed 97.3% specificity for sepsis. In conclusion, IL-27 is a useful and sensitive biomarker either individually or combined with other candidate biomarkers like RANTES.

Trichilemmal pilar tumor of the scalp: a case report.

Proliferating trichilemmal tumors (PTTs) are uncommon exuberant growths of cells derived from the external root sheath. They tend to occur in older women, with a predilection for the scalp. Wide local excision has been the standard treatment. Recent reports have described a rare malignant variant with an aggressive clinical course and a propensity for nodal and distant metastases which, therefore, merits aggressive treatment.

Hyperfractionated radiation therapy and concurrent chemotherapy for advanced head and neck cancer.

PURPOSE: To investigate the feasibility of combining hyperfractionated radiotherapy regimen with concomitant chemotherapy and to assess its toxicity in patients with advanced head and neck carcinoma (HNC). Progression free survival (PFS) and overall survival (OS) were set as secondary end points. PATIENTS AND METHODS: Between November 2003 and November 2007, 48 patients with stage III and IV HNC who met the eligibility criteria were enrolled in the study. Hyperfractionated Radiation consisted of 120 Gys twice daily, 6 hours apart, for a total of 69.6 Gys in 58 fractions over 6 weeks and boost of 6 Gys in 3 fractions in case of residual disease. Three cycles of concurrent chemotherapy in the form of Cisplatin 75 mg/ m² on day 1 and Fluorouracil 750 mg/m² 24 hour infusion on day 1-4 during weeks 1, 4 and 6 of irradiation. RESULTS: 48 patients have completed the treatment to date. The median radiation dose was 72 Gys including the boost to residual lymph node or primary site. The treatment was delivered in a median overall period of 54 days, with a recorded median delay of 7 days. Grade 4 skin toxicity was experienced by 4.1% of patients only. Therapy was well tolerated (grade 3 mucositis in 21%, grade 4 in 26%, grade 3 leukopenia in 10%). Weight loss of more than 10 kg was reported in 10 (16.7%) of the cases. The most common late toxicity was mild to moderate xerostomia which was encountered in 34 (70.8%) cases and improved thereafter. Hypothyroidism was encountered in 7 (14.6%) of the cases. Complete response (CR) was observed in 40 patients (83.3%). Partial response (PR) was achieved in the remaining 8 patients (16.7%). Disease relapse occurred in 9 patients (18.8%) after complete response and 2 patients developed progressive disease after partial response. 3 patients relapsed locally, 5 patients developed distant metastasis and 1 patient developed both local and distant metastasis. 2 patients (4.1%) died of treatment complications, 8 patients (16.7%) died with progressive locoregional, and metastatic disease. The 2- year disease free survival was 77% and the 2- year overall survival was 79%. CONCLUSION: Hyperfractionated radiotherapy and concurrent chemotherapy is tolerable. Results regarding LC and OS are encouraging as compared to conventional radiotherapy and concurrent chemotherapy.

Comparison of whole body scintigraphy with Tc-99m-methoxyisobutylisonitrile and iodine-131 NA in patients with differentiated thyroid cancer.

UNLABELLED: In this study we compared whole body scintigraphy with Tc-99m-methoxyisobutylisonitrile (MIBI) and Iodine-131 NA (131I) for detection of residual and/or metastatic disease in well differentiated thyroid carcinoma. METHODS: MIBI and I-131 scans were obtained in 60 patients. TSH measurements were done in all the patients prior to scintigraphy. RESULTS: Out of 60 patients, for whom both I-131 and MIBI scans were done, I-131 scans were positive in 59 (98.3%) patients, whereas MIBI scans were positive in only 17 (27%) patients. There was only one patient in which I-131 scan was negative and MIBI scan was positive. CONCLUSION: I-131 scintigraphy still remains the best way to successfully detect residual/metastatic disease in differentiated thyroid carcinoma.