Predictors of recurrence of peritoneal carcinomatosis among patients with colorectal cancer following cytoreductive surgery alone versus cytoreductive surgery plus HIPEC

Background: Peritoneal carcinomatosis (PC) is a lethal regional progression in patients with colorectal cancer (CRC). Treatment with complete cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) achieves better local control than systemic palliative chemotherapy. Objectives: To assess the efficacy on the prognosis of CRS and HIPEC compared with CRS only and to identify possible clinicopathological factors associated with the recurrence of PC. Methods: The present retrospective study included all colorectal carcinoma cases with PC subjected to CRS with or without HIPC from January 2009 to June 2018 at the National Cancer Institute (NCI), Cairo University, Cairo, Egypt. The outcome is evaluated in terms of recurrence-free survival (RFS) and its predictors. Results: Out of the 61 patients, 45 patients (73.8%) underwent CRS plus HIPEC, and 16 (26.2%) underwent CRS alone. The 1-year RFS was 55.7%, with a median of 12 months. The risk factors for recurrence identified in the univariate analysis were T4 primary tumor, high-grade, positive lymphovascular invasion (LVI), positive extracapsular nodal spread, and patients treated with CRS only, without HIPEC. In the multivariate analysis, the independent risk factors for recurrence were high grade and patients treated with CRS only. Conclusion: T4 primary tumor, high grade, positive LVI, and positive extracapsular nodal spread seemed to be important predictors of recurrence following the treatment of PC. Our study also demonstrated that the addition of HIPEC to CRS improved the RFS. (AU)

Association of Endothelial Nitric Oxide Synthase Gene Polymorphisms T-786c & 27bp (4b/4a) with Obesity in Egypt

Background and Objective:Endothelial nitric oxide synthase gene polymorphism (eNOS) is one of threeisoformsthat synthesizenitric oxide(NO), that participates in several biological processes have been associated with obesity. This study was undertaken to determine if eNOS gene (T786C) and 27bp (4b/4a) were associated with susceptibility of obesity. Materials and Methods: The study was carried out on 200 cases divided into 100 obese patient and 100 healthy as control. The mean age cases was (27.02 ± 10.90) they include 79 female and 21 males. All participants were subjected to an estimation of their body mass index (BMI), weight hip ratio (WHR), in addition to random blood sugar (RBS), total cholesterol, triglyceride (TG), and lactate dehydrogenase enzyme (LDH). DNA was amplified using PCR-SSP for detection of relation between polymorphism and endothelial nitric oxide synthase gene in two parts T786C and 27bp (4b/4a).Results:All cases showed that there were significant difference between cases and controls regarding to their chemical lab’s analysis (TG, Cholesterol, LDL and HDL).All cases showed significant frequency of T786C TT, CC, TC vs. controls (p<0.001) these was considered risk factor for disease. On the other hand there no significant difference between 27bp aa, bb, and ab (p=0.618) vs. controls. Conclusion:The polymorphism T786C not the 27bp in eNOS was associated with obesity

[The] crosstalk between interferon and transforming growth factor beta signaling pathways in hepatitis c patients

Background: there is an increasing interest in using microRNAs [miRNAs] as biomarkers in liver disease. Diagnostic biomarkers in hepatitis C serve as a great benefit for the early treatment of HCV

Aim of the Work: the aim of this study was to evaluate the expression of miRNA-16 in Egyptian patients infected with HCV and their relation to different biochemical and clinicopathological parameters

Patients and Methods: twenty-five subjects were chosen, 16 HCV infected and 9 healthy controls. Collection, processing and storage of serum for evaluation of miRNA16 using RT-qPCR was done. We evaluated the power of miRNA as a diagnostic tool using ROC curve analysis. The prognostic significance of the investigated parameters in HCV patients was explored

Results: there is a highly significant difference of miRNA 16 expression between HCV patients and healthy controls. miRNA 16 has great sensitivity and specificity for differentiating between patients with HCV and healthy controls

Conclusion: miRNA 16 can be used as a potential diagnostic biomarker for HCV. In addition, it could be used for staging of the disease

Erectile dysfunction in patients with nonalcoholic fatty liver disease

Background and study aims: There is a lack of studies on erectile dysfunction [ED] in patients diagnosed with nonalcoholic fatty liver disease [NAFLD]. The present study aimed to estimate the prevalence of ED in patients with NAFLD and to determine the independent predictors of ED in these patients

Patients and methods: We conducted a prospective, hospital-based study of 192 consecutive male patients with NAFLD. All patients underwent clinical evaluation; abdominal ultrasonography; test for viral hepatitis markers; and estimation of liver chemistry panel, complete blood count, prothrombin time, serum lipids panel, serum testosterone, and fasting serum levels of glucose, insulin, and C-peptide

Results: The mean age of the study population was 42.4 +/- 7.7 years [79.1% >/= 40 years]. Of the 192 patients with NAFLD, 88 [45.8%] had ED, 28 [14.6%] had metabolic syndrome, 25 [13%] had type-2 diabetes mellitus [DM], and 131 [68.2%] had insulin resistance [IR]. The mean level of serum testosterone was 3.17 +/- 2.94 ng/mL, while the mean insulin resistance index was 2.9 +/- 1.7. Mild ED [38.6%] was the most frequent grade of ED. Age >/= 40 years [odds ratio [OR] 6.4; 95% confidence interval [CI] 1.7-24.1; p- 0.006], IR [OR 5.9; 95% CI 1.7-20.6; p- 0.005], and low serum testosterone [OR 5.1; 95% CI 1.5-17.1; p- 0.009] were the predictors of ED

Conclusions: ED is a common disorder in male patients with NAFLD; both IR and low serum testosterone contribute to its development. Treatment of IR may carry a dual benefit of improving erectile function and decreasing the grade of hepatic steatosis

Vitamin D insufficiency and deficiency in children with chronic kidney disease

Hypovitaminosis D is a frequent condition in normal populations. Children with chronic kidney disease [CKD] present a high risk of developing complications due to hypovitaminosis D. Our aim was to determine the frequency of vitamin D insufficiency/deficiency in children with different stages of CKD who were followed up at King Abdulaziz University Hospital [KAUH], Jeddah, Saudi Arabia. University hospital-based case-control study of children followed up between March 2010 and March 2011. Blood was extracted from children with CKD to measure urea, creatinine, hemoglobin, calcium, phosphorus, alkaline phosphatase, intact parathyroid hormone [iPTH], and vitamin D3 levels. We calculated correlations between iPTH and vitamin D levels, and association between vitamin D levels and CKD stages. The frequency of vitamin D insufficiency/deficiency was high among the cases and controls. Children with CKD had significantly lower levels of vitamin D than their peers with normal kidney function [P=.05] with a mean [SD] level of 17.5 [9.9] ng/mL versus 21.0 [13.4] ng/mL for the control group. Among the children with CKD, 36 [45.0%] had vitamin D insufficiency, 24 [30.0%] had vitamin D deficiency, and 10 [12.5%] had severe deficiency. There was a positive correlation between vitamin D3 level and CKD stages [Kendall tau=0.22, P=.003]. A significant association existed between glomerular filtration rate and vitamin D3 deficiency [P=.002]. There was a significant negative correlation between iPTH and vitamin D3 concentrations [Spearman correlation coefficient= -0.27, P=.01]. A significant association existed between age and vitamin D3 level [P<.0001]. Vitamin D insufficiency/deficiency is more frequent in children with CKD than in those with normal kidney function

Role of computed tomography in localization and management of perforated uterine contraceptive devices

To define the role of computed tomography [CT] in localization of the perforated uterine devices [UDs]. The study included 30 patients referred to the diagnostic imaging department for localization of missed UDs that were proved to be present in the body by plain X-ray, Ultrasonography showed improper location of UDs. Each patient was subjected to non-contrast axial CT examination according to the site of the device that was seen in the topogram of abdomen and pelvis. CT determined the site of perforated UDs with sensitivity 100%. There were five devices partially perforating the uterus. Three of them were partly in the uterine cavity, myometrium and peritoneal cavity. Two of them were partly in myometrium and peritoneal cavity. One patient had two perforating devices at the same time rendering the number of missed devices 31. The remaining 26 devices were completely perforating the uterus with only one of them perforated the colon. CT localization of perforated contraceptive devices is mandatory before surgical extraction. It can determine the type of perforation whether partial or complete. It can detect associated adhesions or visceral involvement

Nonreversed saphenous vein bypass for lower limb arterial reconstruction

This study was performed on nine cases had non-reversed saphenous vein bypass performed when the ipsilateral vein was not suitable for use. Patency rate at one year was 79% and limb salvage rate was 89%. The technique and advantages of this type of bypass were discussed. The non-reversed saphenous vein bypass was a useful modification for lower limb revascularization and should be considered for use amongst the armamentarium of the available procedures