Thrombophilic risk factors in breast cancer patients

Activation of the coagulation system in cancer patients is a long known but still poorly understood phenomenon. To clarify the role of some thrombophilic risk factors in cancer patients, activated protein C sensitivity ratio [APC-SR], protein C activity and antithrombin III [AT III] activity, protein S activity as well as antiphospholipid activity [IgG, IgM] were assessed in 24 women with lymph node positive breast carcinoma, 12 of them had proven distant metastases and another 12 of them had no evidence of distant metastases, in addition to 20 matched healthy control subjects. From this study, there is significant decrease in APC-SR, protein C activity, protein S activity in breast cancer patients compared to control group. Also, there is a significant decrease in the same parameters in patients with metastases compared to those without metastases. The odds ratio for risk of thrombosis associated with breast cancer patients in presence of APC resistance phenotype is 3 and 95% confidence interval [C.l.] is 0.633- 16.89. From this study, we can conclude that APC-resistant phenotype is the most frequent thrombophilic risk factor in cancer breast patients. So, screening assay of APC-SR should be encouraged in cancer breast patients especially those having distant metastases, aiming to reduce the risk of thrombosis

Subclinical pulmonary involvement in children with juvenile rheumatoid arthritis and systemic lupus erythematosus: Clinical, functional, high-resolution computed tomographic and laboratory findings

Early detection of collagen-associated pulmonary disease could have an important effect on prognosis and therapeutic strategies to prevent irreversible pulmonary damage. The aim of this study was to determine the prevalence and characteristics of pulmonary involvement in children with juvenile rheumatoid arthritis [JRA] and systemic lupus erythematosus [SLE] of less than 2-year duration and without prior clinical evidence of lung disease. Twenty-eight patients with JRA [18M and 1OF, mean age 10.3 +/- 2.8 years] and twenty with SLE [6M and 14F, mean age 12.9 +/- 3.1 years] and twenty age- and gender-matched controls were studied. Patients were evaluated using the following measures: clinical, pulmonary function testing [PFT], chest radiography [CXR], high resolution computed tomogram [HRCT], induced sputum cells, phospholipids [PLs] and surfactant protein-A [SP-A] concentrations were also measured in 19 JRA and 12 SLE patients. Results: Measurements of PFT and sputum cellular and biochemical variable were significantly different in study patients as compared to controls. Abnormalities in PFTs, CXR, HRCT and sputum cells and SP-A/PL in JRA were 21.4%, 0.0%, 32.2%, 52.6% and 31.6%, respectively; and in SLE were 30%, 10%, 45%, 54.8% and 33.3%, respectively. Restrictive pattern was the commonest PFT abnormality. PFT results correlated significantly only with age in JRA and with hematological data in SLE. HRCT findings correlated significantly in JRA patients with seropositve disease, high activity grade, and diminished diffusion lung capacity [DLCO], and in SLE with PFTs: FVC, FEVI,FEF25-75% and DLco. Neutrophic alveolitis was closely associated with HRCT changes, low DLco and low sputum SP-A values. Pulmonary changes in children with recent onset JRA and SLE are frequent. The significance of these changes is being determined in a longitudinal study