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PURPOSE: High interest in triple-negative breast cancers is not surprising as this category of patients benefits neither from hormonal therapies nor from anti HER2 treatments. Blockade of angiogenesis by metronomic chemotherapy as well as other antiangiogenics might improve outcomes in this group of patients. This study aims to evaluate the tolerability and efficacy of metronomic capecitabine as extended adjuvant treatment for women with triple-negative breast cancer. Methods: This is a prospective phase II study that included 41 patients diagnosed with triple-negative breast cancer and who were indicated for adjuvant chemotherapy. They received capecitabine 500 mg PO twice daily and continuously for six months after finishing six cycles of adjuvant FEC100 +/- postoperative radiotherapy. Results: Forty-one patients were enrolled in this study between June 2010 and December 2013. Median age was 50 years ranging from 27 to 67 years. Treatment was well tolerated. Adverse effects were grade 1 palmar plantar erythrodysesthesia in 13 patients [31.7%]; grade 1 diarrhea in five patients [12.2%]; and grade 1 vomiting in two patients [4.9%]. Estimated median follow-up duration was 34 months. Estimated mean disease-free survival [DFS] was 42.4 months [95% CI, 39.0245.79], while median DFS was not reached. Estimated mean overall survival was 44.34 months [95% CI 41.946.9]. Conclusion: Extended adjuvant metronomic capecitabine is well tolerated with patient compliance. These results need to be compared in a study with control arm, larger sample, as well as longer follow-up
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Minimal hepatic encephalopathy [MHE] is a subtle complication of cirrhosis that may have a detrimental effect on daily functioning and may progress to overt hepatic encephalopathy [HE]. The aims of this study were to identify MHE and assess neuropsychological changes in those patients. A case-control study was conducted in 35 cirrhotic patients. MHE was identified by brain [hydrogen-1] magnetic resonance spectroscopy [1H-MRS]. Neuropsychological changes were evaluated using cognitive abilities screening instrument [CASI] test, Hamilton depression scale, and soft neurological sign assessment. Of the patients, 16 [45.7%] had significant brain 1H-MRS findings suggesting MHE in the form of decreased myo-Inositol/creatine [mI/Cr] and choline/creatine [Cho/Cr] ratios and increased glutamine-glutamate/creatine [Glx/Cr] ratios in white and grey matters compared to patients without MHE and healthy controls. Patients with MHE had significantly lower abstract thinking subset and total CASI score in comparison to patients without MHE [p = 0.03 and p = 0.05, respectively] and controls [p = 0.003 andp = 0.02, respectively]. No statistically significant differences were observed amongst different groups regarding other CASI subsets, depression, and soft neurological assessment in spite of a tendency towards increased values in patients with MHE. MHE associated with neurophysiological changes demonstrated by 1H-MRS preceded neuropsychological changes. Thus, 1H-MRS may be considered as a potential tool for diagnosis of cirrhosis-associated cerebral dysfunction and a promising method for prioritisation of subjects awaiting liver transplantation
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Considerable evidence indicates that increased oxidative stress and induction of apoptosis signaled through the Fas pathway appear to play an important role in the pathogenesis of autoimmune diabetes. The present study aimed to detect the soluble Fas [sFas] as apoptotic marker and the total antioxidant capacity [TAC] in type 1 diabetes [T1D] and high-risk group children and whether it is altered by antioxidant vitamin supplement. Forty-five participants were included in the study and divided into three groups: group 1 comprised 15 children with new onset diabetes; group 2 included 15 diabetic children with long-standing diabetes; and group 3 comprised 15 individuals of patient's relatives. Serum levels of sFas and TAC were measured and compared between groups before and after antioxidant vitamin supplementation. The highest level of sFas was found in group 2 [2196.7 +/- 579 pg/ml], however, with no statistical significance; after vitamins supplementation, its level showed significant decrease to reach 1156.6 +/- 460.8 pg/ml [P = 0.01]. Similar tendency of serum Fas decrease was observed in the group of relatives after vitamins supplementation [2088.3 +/- 396.5 vs. 1426.7 +/- 140.9, P < 0.01]. TAC was significantly lower in group 2 than in the other two groups, and it showed a significant increase after vitamin intake [0.29 +/- 0.06 vs. 0.40 +/- 0.05 micromol/l, P < 0.05]. One month of treatment with antioxidants vitamins supplement increased the antioxidant activity in long-standing T1D children and resulted in significant reduction in sFas level, suggesting the importance of this therapeutics in reducing apoptosis changes in children with T1D
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Epilepsy is very prevalent in Egypt, approaching 6.98 per 1000 population. This study was designed to assess the knowledge and attitudes towards epilepsy among guardians of Egyptian high school students. A cross-sectional study was made among guardians [parents/guardians] of high school students in Assiut city, Egypt. A 15-item questionnaire was self-administered by 1257 students' guardians who were randomly selected. All recruited parents/guardians of high school students had heard about epilepsy. Families with a patient with epilepsy [PWE] had significantly better information about epilepsy and its aetiology than other families. The predictors of negative attitudes towards PWE were: age group ranging from 40 to 49 years, no work, skilled work, male sex and incorrect knowledge. Having a patient with epilepsy is a predictor to having greater knowledge and a better attitude towards epilepsy. However, people still have a concept that PWE are stigmatized and are different from others. Raising awareness about epilepsy and its aetiology will increase the knowledge and improve the attitudes towards PWE
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Data on demographic, social and behavioural characteristics of female sex workers in greater Cairo are very scarce. A cross-sectional study was conducted with 431 randomly selected sex workers after mapping of sites where they gather. Data collection was performed by direct interviewing using a questionnaire sheet covering sociodemographic data and sexual history with paying and non-paying partners. More than one half of participants [52.7%] were aged < 30 years. Only 39.3% were exclusively working as sex workers while the rest had other jobs beside sex work. Almost 70% were responsible for dependants. The age of first selling sex was <15 years for 4.7% of the women and 15-25 years for 58.7%. Unwanted pregnancies were experienced by 36.2% and 34.8% had had an abortion. Many participants had ever been arrested by the police [71.2%]. The study has provided some useful background data for further studies in this very sensitive area of research
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Humanos , Femenino , Infecciones por VIH , Encuestas y Cuestionarios , Estudios TransversalesRESUMEN
Although illegal in Egypt, prostitution exists. The prevalence of HIV infection among female sex workers [FSWs] in Cairo is not precisely known. This cross-sectional study investigated the high-risk behaviour for HIV infection and HIV prevalence among FSWs in greater Cairo. A total of 431 FSWs were interviewed about their sexual history with paid and unpaid partners, condom use and risky behaviour for HIV infection; all were tested for HIV. Use of alcohol and drugs was reported by 39.9% and 49.0% of the women respectively; 37.6% only used such substances while with a client. Male condoms were known by 72.6% but their use in the previous month was low [32.8%] and only 22.4% had used one with their last client. The main reasons for not using condoms were not thinking of it [40.6%] and client refusal [20.5%]. All the women tested negative for HIV infection. The high-risk behaviour of many FSWs necessitates intervention programmes to reduce their risk of HIV infection
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Humanos , Femenino , Asunción de Riesgos , Trabajadores Sexuales , Prevalencia , Estudios Transversales , CondonesRESUMEN
Drug-resistant epilepsy, despite the advancement in epilepsy treatment, continues to be a major clinical problem with devastating consequences. Identification of the prevalence of intractable epilepsy, as well as causes of intractability. Total population of 62,583 persons were screened through door to door survey, including every door. All suspected cases of epilepsy were subjected to complete history taking, meticulous examination, conventional EEG, and Stanford-Binnet intelligence scale. Monitoring of serum level of AEDs was done for those with possible intractable seizures to ensure adequate dose compliance. Patients have an average seizure frequency of one or more per month during the last 6 months despite optimal and suitable use of AED were considered truly intractable Ohtsuka et al [2001]. They were subjected to video monitoring EEG, and brain MRI. In this study, 437 epileptic patients were identified with a life time prevalence rate of epilepsy 6.98/1000, out of whom, 11.4% [n = 50/134] of patients were intractable with a prevalence rate 0.8/1000. Possible aetiology of intractable epilepsy was determined among 46% of cases [Remote symptomatic], while 58% of cases had unknown causes [idiopathic and cryptogenic]. Symptomatic and cryptogenic causes had signicantly lower IQ than idiopathic group Perinatal complications should be better avoided and/or managed to avoid a large sector of intractable epilepsy
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Humanos , Masculino , Femenino , Resistencia a la Enfermedad , Prevalencia , Causalidad , Epilepsia/etiologíaRESUMEN
In this study we use 20 sheep divided into four groups [one group was injected with the vaccine, the second was taken the vaccine and ampicillin, the third group was taken the vaccine and cephalosporin and the fourth act as a control]. The immunity was measured humoral immunity to sheep pox virus vaccine by neutralization test and cell mediated immunity by lymphocyte transformation assay as well as phagocytosis. The results revealed that an increase of the immune status in group injected with antibiotics with vaccine than that received the vaccine only and than the control group. There were an increase of lymphocyte transformation test, neutralization test and phagocytosis. It could be concluded that ampicillin and cephalosporin directly increase the immune status in sheep vaccinated with sheep poxvirus vaccine
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Animales , Inmunomodulación/efectos de los fármacos , Ampicilina/farmacología , Cefalosporinas/farmacología , Capripoxvirus/inmunología , Vacunas Virales , Transformación Celular Viral/efectos de los fármacos , Colorimetría/métodosRESUMEN
The effect of some plants on liver function and lipid profile was investigated. Fourty male albino rats, Sprague Dawley strain were used. The rats were divided into five groups of eight rats each with similar 156-158g.mean total weight. The rats were fed the experimental diets at 14% protein level with different types of tested plants [chicory, sonchus and moringa] for four weeks. Food and water were provided adlibitum. At the end of the experiment, rats were sacrificed under ether anesthesia and blood sample was taken from hepatic portal vein from each rat. Blood samples were subjected to the determination of serum and liver lipid profile, serum ALT, AST, ALP, MDA and erythrocyte-SOD .The results indicated that different types of tested plants had a great effect in all parametars studied. The lowest mean value for serum total lipids, triacylglycerols, total cholesterol and VLDL-cholesterol was found in group of rats fed high fat and high cholesterol diet [HFC. diet and moringa leaves] as compared with positive control group fed HFC. diet. But the lowest mean value for serum LDLcholesterol and highest mean value for serum HDL-cholesterol was found in group of rats fed [HFC diet and sonchus] as compared with positive control group. While lipid pattern in liver showed a significant decrease in group of rats fed [HFC diet and moringa leaves] as compared with positive control group and other plant groups. Also, the lowest mean value in serum ALT, AST, ALP and MDA was found in group of rats fed [HFC diet and sonchus], but the highest mean value in erythrocyte-SOD was found in group of rats fed [HFC diet and sonchus] as compared with positive control group
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Animales de Laboratorio , Lípidos/sangre , Plantas , Moringa , Cichorium intybusRESUMEN
The aim of the present work is to study the protective effect of some antioxidants and trace elements against the hazardous effects of carbon tetrachloride [CCI[4]] on hamsters for the possibility of further application on humans. One hundred twenty hamsters weighing 104-128g were divided into 13 groups as follows: 1-Negative Control group fed standard diet, 2-positive control group given carbon tetrachloride CCI[4] only, 3-CC1[4] + zinc, 4 - CCI[4] + beta-carotene,9- CCI[4] + alpha- tocopherol, 6- CCI[4] + selenium. 7- CCI[4] + vitamin C,8- CCI[4] + zinc + beta - carotene, 9- CCI[4] + zinc + vitamin C, 10- CCI[4] + zinc + alpha-tocopheral, 11- CCI[4] + selenium + beta-carotene, 12- CCI[4] + selenium + vitamin C and 13- CCI[4] + selenium + alpha-tocopheral. Carbon tetrachloride [CCI[4] has a direct toxic effect on liver and kidney. Depending on biochemical results, the more antioxidants of liver protection against [CCI[4] toxicity are a tocopherol, followed by selenium, selenium + beta - carotene, vitamin C, zinc + beta - carotene and selenium + alpha tocopherol. The more antioxidant for kidney protection against CCI[4] toxicity is beta -carotene followed by selenium, zinc + beta - carotene, zinc + alpha tocopherol, and zinc + vitamin C. Trace elements should not be given individually especially zinc or selenium as deleterious effects, in spite of its protective effect
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Masculino , Animales de Laboratorio , Tetracloruro de Carbono/toxicidad , Hígado/patología , Cricetinae/sangre , Sustancias Protectoras , Ácido Ascórbico , Selenio , Antioxidantes , Carotenoides , Tocoferoles , ZincRESUMEN
A sensitive high performance liquid chromatographic method using ultraviolet detector has been developed for the determination of methomyl insecticide residues on tomato and cucumber fruits. The developed method consisted of extraction with ethyl acetate, adsorption clean up [by adsorbing mixture consisting of charcoal/celite in ratio 2: 1], followed by high performance liquid chromatographic determination using methanol: water [1: 1] as a mobile phase and UV detection at 233 nm. The range of percentage recovery was between 88.2% and 90.4% for both plant samples. [These recoveries are good for those types of extraction of pesticides traces from plant materials, refer to [1] to compare recoveries]. The method was applied to determine residues and rate of decline of methomyl from fruits of tomatoes and cucumber [open field and greenhouse treatment, with methomyl formulation [Lannate 90% SP] for 100 liter water]. The insecticide incorporated into the plants decreased rapidly with a half-life around 1 day in winter and 0.5 day in summer
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Solanum lycopersicum/toxicidad , Cucumis sativus/toxicidad , Insecticidas/aislamiento & purificación , /métodosRESUMEN
Forty - five packaged random samples of cooked and half cooked chicken meat products represented by chicken shawarma, fillet and wings [15 for each] were collected from different retail markets in Cairo and Giza. The incidence of S. aureus, E. coli and C. perfringens in fillet was 26.66%, 20%, 26.66%, respectively, while equals 0.0%, 13.33%, 20%, in shawarma, respectively. The incidence in wings reaches to 13.33%, 20%, 6.66%, respectively. Six number of S. aureus strains were isolated from fillet and wings examined for enterotoxin production and revealed that only one strain isolated from wings had the ability to produce enterotoxin types A, B, C and D [multiproducer]. While S.aureus failed to be isolated from shawarma. Concerning C. perfringens 5 toxigenic strains classified as 3 C. perfringens type A and 2 C. perfringens type D, while 3 strains were non- toxigenic. For E. coli the serological typing revealed 8 untypable strains which were not enterotoxigenic
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Animales de Laboratorio , Animales , Pollos , Enfermedades Transmitidas por los Alimentos/microbiología , Enterococcus , Enterotoxinas , Incidencia , Staphylococcus aureus , Clostridium perfringens , Escherichia coliRESUMEN
Facet joint is a main source of chronic low back pain with a prevalence of 16.7%. Clinical examination and imaging are insufficient to diagnose facet joint syndrome [30% accuracy and 45% false positives]. Facet joint block is the gold standard in diagnosis of facet joint syndrome. It can also relieve pain for up to 6 months. It can be done under computed tomography [CT] or fluoroscopy. To identify which imaging modality is more suitable to guide the procedure of lumbar facet joint block, fluoroscopy or CT. Thirty four lumbar facet joints represented by 12 patients were injected in the radiology department, Suez Canal University Hospital, Ismailia, Egypt from 1/2005 to 1/2006. All cases were suspected of having facet joint syndrome based on clinical or radiological data. After clinical examination and reviewing lumbar images to identify target facets, every patient underwent facet joint block under either CT or fluoroscopy. Fluoroscopy was more successful in guiding the injections [success rate 77.7% compared with 31.25% in CT guidance]. It is also faster [6.6 minutes per joint compared with 10.9 minutes for CT guidance]. Less number of trials were required [1.7 trial compared with 6.6 trials with CT guidance]. Fluoroscopy exposed the patients and the radiologist to much irradiation [21.3 rad compared to 0.3 rad in CT guidance]. Decreased bone density and laminectomy impair fluoroscopy guidance. CT guidance is difficult in patients with marked arthropathy and coronally oriented joints [8 trials compared with 5.6 for normally appearing joints]. Fluoroscopy should be the primary choice for guiding lumbar facet joint block. It is more successful and faster. Its disadvantages include much irradiation to patients and radiologists, and difficulty in patients with laminectomy and decreased bone density. CT can then be used to guide the block
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Humanos , Masculino , Femenino , Vértebras Lumbares/diagnóstico , Tomografía Computarizada por Rayos X , Fluoroscopía , Bupivacaína , Metilprednisolona , Complicaciones PosoperatoriasRESUMEN
This study was designed to assess some cognitive functions among adult male patients with generalized tonic-clonic seizures of idiopathic epilepsy. Forty-nine right-handed male patients with generalized [tonic - clonic] idiopathic epilepsy were recruited from outpatient epileptic clinic, Assuit University hospitals. Another 42 subjects of the same age and sex-matched adults were chosen as a control group. Each participating subject was subjected to assessment of cognitive function using Stanford-Binet [4[th] edition], complete medical history, clinical examination [with special emphasis on epilepsy-related factors and drug - related factors] and EEG records [for epileptic patients only]. Epileptic patients reported highly significant impairment across all measured cognitive functions compared with the healthy group. Polytherapy epileptic group was the worst one followed by carbamazepine monotherapy epileptic group and the least was valporate monotherapy epileptic group. Early age of onset, increased severity of seizure, and prolonged duration of treatment [years] showed significant negative correlation in some studied cognitive functions subscales. Adult males with generalized tonic-clonic idiopathic epilepsy experience cognitive function deterioration. Polytherapy, early age at onset, increase severity of seizure and prolonged duration of treatment increase the risk for negative cognitive dysfunction
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Humanos , Masculino , Trastornos del Conocimiento , Electroencefalografía , Factores de Riesgo , Combinación de Medicamentos , Pruebas de Inteligencia , Pruebas NeuropsicológicasRESUMEN
Objectives: To investigate the effect of high fat diet on inflammatory markers monocyte chemoattractant protein-1 [MCP-1] and C-reactive protein [CRP] in rats. And to investigate changes in these markers during weight reduction with diet control and orlistat treatment
Setting: Biochemistry Department, Faculty of Pharmacy and Faculty of Medicine, Suez Canal University
Design: Case control study
Materials and Methods: This study was conducted on sixty female albino rats, 15 rats received normal diet for three months and act as control. Remaining rats received high fat diet for three months and divided equally into three groups, one group continue on high fat diet, second group returned to normal diet and the third group returned to normal diet and treated with orlistat for two months. Body weight, scrum lipid profile, plasma free fatty acids [FFA] were assessed by High performance liquid chromatography [HPLC]. MCP-1 and C-reactive protein were evaluated using ELISA. Results: Feeding with high fat diet for 3 months induced significant increase in body weight [247.0 +/- 14.66] compared to control group [126. 37 +/- 23.26]. Serum total cholesterol [TC], triacylglyceroles [TAG], FFA , MCP-1 and CRP were significantly elevated in obese compared to control rats. Reduction of body weight by diet control and tetrahydrolipstatin [orlistat] treatment successfully reduced the level of MCP-1 and CRP
Conclusion: Our data showed that obesity increases chemokine levels and inflammation. Intervention to reduce these markers may help in avoidance of obesity related complications
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Elderly patients with acute lymphoblastic leukemia [ALL] have only rarely been included in clinical trials. The aim of this work was to investigate some of the biologic characteristics of ALL in the elderly by cytogenetic analysis and by studying of P-glycoprotein [P-gp] or multidrug resistance [MDR-1] protein expression at initial presentation. Twenty patients with newly-diagnosed beta-lineage ALL were accrued to the study. They were divided into two groups; group I: ten patients aged <60 years, and group II: ten patients aged >/= 60 years. They were subjected to history taking, clinical examination, complete blood count [CBC] and bone marrow [BM] aspiration with immunophenotyping to establish the diagnosis. Cytogenetic analysis was done by the G-banding technique and estimation of P-gp in ALL blast cells was performed by flow cytometry. All patients were in a good performance status and induction chemotherapy was instituted according to standard protocol for ALL. Complete remission [CR] was achieved in 50% of patients in group I and 40% in group II. No significant difference was found between the two groups regarding P-gp expression in pretreatment samples. However, a highly significant difference was noted on comparing CR and non-CR patients in both groups as regards P-gp expression [t=20.89, p=0.00]. Cytogenetic analysis revealed that 20% of patients in group I and 60% of cases in group II had cytogenetic abnormalities. No significant difference was found between CR and non-CR patients as regards the cytogenetic status. Also, there was no significant difference between patients with normal and those with abnormal karyotypes as regards P-gp expression. Failure to respond to chemotherapeutic drugs in ALL in the elderly seems to be a multifactorial phenomenon. Further clinical trials evaluating the disease features, outcome, and new therapeutic approaches are warranted
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Humanos , Masculino , Femenino , Anciano/tratamiento farmacológico , Miembro 1 de la Subfamilia B de Casetes de Unión a ATP , Análisis Citogenético , Resistencia a Múltiples Medicamentos , Cariotipificación , Aberraciones CromosómicasRESUMEN
Efforts to prevent myocardial ischemia have focused on findings ways to block events associated with irreversible ischemic injury. The discovery of the endogenous cellular protective mechanism known as ischemic preconditioning [ipc] has risen hoping that natural pathways could be activated to help cells to overcome necrosis. Pharmacologic preconditioning has been tried to simulate ipc in cardio protection against ischemia. Aim: the aim of the present study is to assess the possible protective capacities of both [ipc] and the synthetic -opioid receptor agonist dadle in an experimental model of hypothermic ischemia and reperfusion [hir] in isolated rat heart, and to assess whether the effects of both protective measures are similarly mediated via k[atp] channels. Isolated rat hearts were divided into 7 groups: g1: is control normothermic [37°C] perfused hearts. G2 hearts were subjected to 45 min of hypothermic ischemia at 30°C, followed by 25 min of normothermic reperfusion [hir]. G3: ipc for 3 min followed by 5 min normothermic reperfusion then hir as g2. G4: dadle pretreatment [1 mg/kg] 30 min before isolated heart preparation, then the protocol of g2 was done. G5: DADLE pretreatment, then the protocol of G3. G6: glibenclamide [0.3 mg/kg] 60 min pretreatment followed by DADLE after 30 min, then the protocol of g2 was done g7: glibenclamide and dalde pretreatment, followed by protocol of g3. Both ipc and DADLE pretreatment and their combination in groups 3, 4, and 5, respectively, improved the post ischemic recovery in the form of significant increase in heart rate [hr], myocardial contractility, coronary flow [cf], and significant decrease in creative kinas [ck] in coronary effluent with a significant reduction of infarct size [is] to 6.6 +/- 1.5, 3.1 +/- 1.3, and 2.8 +/- 1.2%, respectively, when compared with g1 and g2 with is 17.2 +/- 2.2%. Glibenclamide pretreatment in g6 and g7 abolished this improvement in the post ischemic recovery when compared with groups 3, 4 and 5. The results of the present study indicate that ischemic prerconditioning [ipc] improves post ischemic recovery and reduces myocardial infract size in isolated rat heart. Pretreatment with -opioid receptor agnist DADLE mimicked the cardio protection induced by ipc, indicating an opiod receptor-mediated mechanism. Pharmacologic preconditioning by dasle and ipc has additional effects in improving the post ischemic recovery. Lastly, this cardioprotection induced by both can be abolished by the k[ATP] channel antagonist glibenclamide suggesting an involvement of the k[ATP] channel most probably mitochondrial k[ATP], as an important end-effecter of this potent cardio protective effect
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Animales de Laboratorio , Daño por Reperfusión , Gliburida/farmacología , Receptores Opioides delta , Creatina Quinasa , Precondicionamiento Isquémico , Ratas , Reperfusión Miocárdica , Adenosina Trifosfato , Canales de Potasio , Leucina Encefalina-2-AlaninaRESUMEN
A total of 100 children with GHD of both sexes were included in this study. They were 29 females [29%] and 71 males [71%], and age ranged from 6.5-14 years. They were below 3 SDS for age and sex, growth velocity [cm/year] below the tenth centile for age and sex, growth hormone level below 10ng/ml [by two provocative tests]. Another 100 of normal children of both sexes, 25 females [25%] and 75 males [75%] and age ranged from 7-15 years as a control group. Both groups were subjected to the following: Full history taking and clinical examination, full anthropometric assessment that include the following: Target height, midparental height, height and growth velocity in cm/year. Skeletal maturity and bone age determination. Thyroid profile [free T3, T4. TSH], CBC, renal and liver function tests, karyotyping and cranial CT or MRI was done to exclude other causes of short stature. GH secretion by two provocative tests [clonidine and insulin tolerance tests] at one-week interval. IGF-I and IGFBP-3 were determined at diagnosis and after GH therapy for one year. Height SDS improved from -3.69 to-3.12 after GH therapy. The correlation between GH basal or peak and IGF-l or IGFBP-3 were not significant. We found also that IGF-l was highly specific for GH specially in the age groups [6-8 Y], [8-10Y] and [12-14 Y] and were 100%, 100% and 94.6% respectively, but on the other hand it was less sensitive in all age group except age group [10-12 Y] it was 75%. As regard IGFBP-3 it was highly specific in age group [12-14 Y] and [6-8 Y], 97.3% and 91.7% respectively and moderate to less specific in other age group, but it was less sensitive in all age group. we concluded that GH dose and schedule of GH injections used in the study for GHD patients is associated with a catch up growth followed by a period of steady growth. Both IGF-I and IGFBP-3 have high specificity in most age groups and this means that they can rule in GHD, but they can not rule out GHD because of low sensitivity. Combined screening for GHD using both IGF-l and IGFBP-3 may add some diagnostic information in comparison with the use of either test alone
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Humanos , Masculino , Femenino , Factor I del Crecimiento Similar a la Insulina , Proteína 3 de Unión a Factor de Crecimiento Similar a la Insulina , Hormona del Crecimiento/deficiencia , Antropometría , Pruebas de Función de la Tiroides , Pruebas de Función Hepática , Pruebas de Función Renal , NiñoRESUMEN
Until the early 1990 endoscopic retrograde Cholangiography [ERC] was considered the investigation of first choice in patients with evidence of cholestasis, offering also therapeutic intervention. With the innovation of magnetic resonance techniques, imaging of the biliary tree without either invasive intervention or dye complications became possible. This study correlates MRCP with ERCP findings in order to determine the efficacy of MRCP in visualizing and diagnosing diseases of the pancreatic and biliary ducts. Twenty consecutive patients [10 males and 10 females] diagnosed as obstructive jaundice cases by demonstration of dilatation of any portion of biliary tree by abdominal ultrasound], in the period from September 1998 till November 1999, were included in this study. The age ranged between 34 years and 71 years, with mean of 42 years. All 20 patients were divided into two groups based on laboratory results and abdominal ultrasonographic findings, as follows: Group [A] was subjected to ERCP. This group included 10 patients [50%]. Group [B] was subjected to MRCP. This group included 10 patients [50%]. As regarding group A, ERCP was attempted in 10 patients of this group, ERCP was done successfully in 9 [90%], while failure of cannulation of the papilla occurred in one case [10%], because of having the papillary orifice in a diverticulum. In all 9 patients, endoscopic sphincterotomy was done at the same endoscopic session. As regarding group B, MRCP was attempted in 10 patients of this group. Five patients [50%] of this group diagnosed to have choledocholithiasis. Five [50%] cases of MRC group diagnosed to have malignant obstruction: Two cases [20%] diagnosed as carcinoma of the head of pancreas, one case [10%] ampullary carcinoma, one case as cholangiocarcinoma [10%], and one case [10%] as hilar carcinoma. Although, the diagnostic outcome of both modalities is fairly comparable in the present study, ERCP still offers the therapeutic, minimally invasive potential over MRC