Red blood cell derived extracellular vesicles during the process of autologous blood doping.

The purpose of this pilot study was to investigate the effects of the transfusion of one erythrocyte concentrate on the number of circulating red blood cell extracellular vesicles (RBC-EVs) and their clearance time. Six, healthy volunteers donated their blood and were transfused with their RBC concentrate after 35-36 days of storage. One K2 EDTA and one serum sample were collected before donation, at four timepoints after donation and at another six timepoints after transfusion. RBC-EVs were analyzed on a Cytek Aurora flow cytometer. A highly significant increase (p < 0.001) of RBC-EVs from an average of 60.1 ± 19.8 (103 /µL) at baseline to 179.3 ± 84.7 (103 /µL) in the first 1-3 h after transfusion could be observed. Individual differences in the response to transfusion became apparent with one volunteer showing no increase and another an increased concentration at one timepoint after donation due to an influenza infection. We concluded that in an individualized passport approach, increased RBC-EVs might be considered as additional evidence when interpreting suspicious Athletes Biological Passport (ABPs) but for this additional research related to sample collection and transport processes as well as method development and harmonization would be necessary.

p16INK4A and p14ARF gene promoter hypermethylation as prognostic biomarker in oral and oropharyngeal squamous cell carcinoma: a review.

Head and neck squamous cell carcinoma is a heterogeneous group of tumors with each subtype having a distinct histopathological and molecular profile. Most tumors share, to some extent, the same multistep carcinogenic pathways, which include a wide variety of genetic and epigenetic changes. Epigenetic alterations represent all changes in gene expression patterns that do not alter the actual DNA sequence. Recently, it has become clear that silencing of cancer related genes is not exclusively a result of genetic changes such as mutations or deletions, but it can also be regulated on epigenetic level, mostly by means of gene promoter hypermethylation. Results from recent studies have demonstrated that DNA methylation patterns contain tumor-type-specific signatures, which could serve as biomarkers for clinical outcome in the near future. The topic of this review discusses gene promoter hypermethylation in oral and oropharyngeal squamous cell carcinoma (OSCC). The main objective is to analyse the available data on gene promoter hypermethylation of the cell cycle regulatory proteins p16(INK4A) and p14(ARF) and to investigate their clinical significance as novel biomarkers in OSCC. Hypermethylation of both genes seems to possess predictive properties for several clinicopathological outcomes. We conclude that the methylation status of p16(INK4A) is definitely a promising candidate biomarker for predicting clinical outcome of OSCC, especially for recurrence-free survival.

Asthma and respiratory symptoms among school children in United Arab Emirates.

OBJECTIVES: To determine the prevalence of asthma, wheezing, hay fever, and eczema among primary school children aged 6-13 years in United Arab Emirates (UAE). DESIGN: A cross-sectional study on school children was performed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires. SETTING: Government primary school children in seven Emirates, in UAE. SUBJECTS: Subjects were selected by a multi-stage stratified sampling design. 4200 children targeted for this study, but only 3200 children aged 6-13 years were agreed to participate and responded to the study. The overall response rate was 69.8%. RESULTS: The prevalence of physician diagnosed asthma was 13%, in addition, the wheeze by history was 15.6%. Furthermore, the prevalence of nocturnal cough was 21%. On the other hand, the prevalence of eczema was 11% and hay fever was 14.9%. Parental asthma but not parental atopy was associated with an increased risk of asthma and wheezing in children. CONCLUSIONS: The prevalence of asthma and wheezing in UAE is consistent with that in neighbouring Gulf countries.

Should doctors inform terminally ill patients? The opinions of nationals and doctors in the United Arab Emirates.

OBJECTIVES: To study the opinions of nationals (Emiratis) and doctors practising in the United Arab Emirates (UAE) with regard to informing terminally ill patients. DESIGN: Structured questionnaires administered during January 1995. SETTING: The UAE, a federation of small, rich, developing Arabian Gulf states. PARTICIPANTS: Convenience samples of 100 Emiratis (minimum age 15 years) and of 50 doctors practising in government hospitals and clinics. RESULTS: Doctors emerged as consistently less in favour of informing than the Emiratis were, whether the patient was described as almost certain to die during the next six months or as having a 50% chance of surviving, and even when it was specified that the patient was requesting information. In the latter situation, a third of doctors maintained that the patient should not be told. Increasing survival odds reduced the number of doctors selecting to inform; but it had no significant impact on Emiratis' choices. When Emiratis were asked whether they would personally want to be informed if they had only a short time to live, less than half responded in the way they had done to the in principle question. CONCLUSIONS: The doctors' responses are of concern because of the lack of reference to ethical principles or dilemmas, the disregard of patients' wishes and dependency on survival odds. The heterogeneity of Emiratis' responses calls into question the usefulness of invoking norms to explain inter-society differences. In the current study, people's in principle choices did not provide a useful guide to how they said they would personally wish to be treated.

Does sharing a mother-tongue affect how closely patients and nurses agree when rating the patient's pain, worry and knowledge?

A convenience sample of 50 hospitalized patients who had experienced major care from two nurses, one of whom shared their mother-tongue (Arabic) and one of whom did not, were asked to rate, using 10-point visual analogue scales, their current pain, worry about their medical condition, and knowledge about the medical investigations carried out. The two nurses nominated by each patient were asked to rate their patient's pain, worry and knowledge using the same scales. Pain assessments by the three respondent groups did not differ significantly; but only nurses sharing a mother-tongue with the patient provided pain ratings which correlated significantly with those of their patients. Both groups of nurses consistently rated patients as being more worried and more knowledgable than patients rated themselves. Nurses, unlike patients, associated greater knowledge with greater worry. The limitations of the study undertaken are reviewed. Discussion centres on the implications of these findings for optimizing nursing care, including situations where nurse and patient do not share a cultural background and cannot converse readily.