The risk of secondary cancer in pediatric medulloblastoma patients due to three-dimensional conformal radiotherapy and intensity-modulated radiotherapy

BACKGROUND: Craniospinal irradiation (CSI) is the standard radiation therapy treatment for medulloblastoma. The aim of this study was to estimate and compare the lifetime risk of radiation-induced secondary cancer in pediatric medulloblastoma patients using three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT). MATERIALS AND METHODS: 3D-CRT and IMRT plans were performed for 10 CSI pediatric patients. The average absorbed doses for organs at risk (OARs) was calculated from dose-volume histograms on the treatment planning system. The average lifetime risk of radiation-induced secondary cancer was then calculated. RESULTS: Lifetime risk of secondary cancer for CSI pediatric patients treated using IMRT decreases in some OARs compared with those treated using 3D-CRT. This is attributable to the decrease in the average absorbed dose in some OARs when using IMRT technique. CONCLUSION: Follow-up of medulloblastoma pediatric patients should be performed after ending the treatment course in order to diagnose early secondary tumors. IMRT technique is substantially better than 3D-CRT in terms of lifetime risk of radiation-induced secondary cancer, probably due to reduced dose to OARs especially to the thyroid, which is the most sensitive organ to radiation.

Pharmacological and chemical properties of some marine echinoderms

Abstract Echinoderms have attracted the attention of scientists over the past few years after identifying a variety of unique structures endowed by interesting biological properties. However, the Moroccan coast biodiversity is still uninvestigated. In our ongoing attempts to valorize the rich Moroccan marine environment, this study aimed at assessing the antimicrobial activity of extracts obtained from three echinoderms Astropecten irregularis, Luidia sarsi and Ophiura albida against the human pathogens: Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Salmonella enterica and Bacillus subtilis. Moreover, their antioxidant activities were tested using standard methods in addition to the antidiabetic activity which has been evaluated in vitro against α-amylase and α-glucosidase enzymes. HPLC-DAD-QTOF-MS analysis revealed a significant content of some phenolic compounds such as pyrogallol, gallic, sinapic, ferulic, p-hydroxybenzoic and salicylic acids whose existence can be related to the endophytic fungi and/or dietary intake whereas GC-MS analysis exhibited diverse chemical structures such as cholesterol, oleic acid and glycerol 1-palmitate.

Serum vitamin D level as a predictor of bronchial asthma in Egyptian children

This study was designed to assess the relationship between the serum level of 25-hydroxyvitamin D and the clinical, functional severity and the level of asthma control among Egyptian asthmatic children. This case-control cross-sectional study was conducted on 50 asthmatic patients from those regularly attending the Pediatric Chest Clinic, Children's Hospital, Ain Shams University. Twenty healthy children of matched age and sex were recruited as the control group. Pulmonary function tests were significantly decreased in the asthmatic cases compared with the control [P < 0.01]. The serum vitamin D level was found to be significantly decreased in asthmatic children compared with the control group [P < 0.001]. Out of the 50 asthmatic children, 20 had a serum vitamin D level of less than 25 ng/ml, and were considered to be 'vitamin D deficient', whereas the remaining 30 children had a level ranging between >25 ng/ml and

Metabolic syndrome: a reality in obese children and adolescents

The aim of the present study is to contribute to the understanding of metabolic syndrome [MS] risk factors during childhood by examining the diagnostic patterns of MS in obese children. Thirty one obese children and adolescents with BMI >/= 95th percentile were recruited and investigated as group I, in addition to 22 matched age and sex children and adolescents were served as control [group II]. Anthropometric measurements as well as blood pressure were measured. Plasma cortisol, ACTH and suppression test were assessed in all patients. Fasting plasma glucose, insulin, C peptide and lipids profile in addition to glucose tolerance test were analyzed. The metabolic syndrome in children was classified according to modified version of the National Cholesterol Education Program's Adult Treatment Panel III [NCEP-ATP III]. The degree of insulin resistance was determined with the use of a homeostatic model assessment: insulin resistance. Out of the 31 patients assessed, 25.8% of the patients met the diagnostic criteria of metabolic syndrome. Forty percent of the females and 6.25% of the males had 3 or more risk factors. No one of the non-obese control subject met the criteria for the metabolic syndrome. Metabolic syndrome is already a reality for many obese children. Furthermore, there is an urgent need for a clinically useful consensus definition of pediatric metabolic syndrome and national guidelines for proper screening, evaluation and treatment of children at risk for metabolic syndrome

Diagnostic and prognostic value of ST segment elevation in lead III greater than in lead II in patients with acute inferior wall myocardial infarction

To evaluate the diagnostic and prognostic value of ST segment elevation in lead III greater than lead II in patients with acute inferior myocardial infarction for predicting in hospital mortality and associated RV myocardial infarction, 40 patients with acute inferior myocardial infraction were included in this study. ECG, echocardiography and coronary angiography were performed for all patients. The presence o f ST-segment elevation in lead III lead > II from admission ECC defined the presence of RV infarction with sensitivity of 85.7% and specificity of 89.5%. During the hospital course, the prevalence of heart failure, post infarction angina, conduction defects and mortality were higher in patients with ST-segment elevation in lead III > lead II. The study concluded that ST-segment elevation in lead III more than lead II is more sensitive and specific than V3R, V4R in diagnosis RVMI. It is an excellent screening tool for RVMI given its universal availability on all electrocardiograms. Moreover, ST-segment elevation in lead III more than lead II is a significant predictor of in-hospital mortality and post-MI complications

Assessment of left atrial appendage function before and after percutaneous balloon mitral valvuloplasty [TEE study]

This study was carried out on thirty patients with severe MS for PBMV, 24 patients in sinus rhythm and 6 patients in atrial fibrillation. All patients underwent transthoracic and transesophageal echocardiography before and 24-48 hours after the procedure. LAAEF was evaluated by planimetry and LAA Doppler flow pattern by pulsed Doppler interrogation

Maternal weight, height, gestational weight gain and pregnancy outcome in adolescent females

To evaluate the effects of maternal weight, height and gestational weight gain on pregnancy outcome in adolescent females, 100 adolescent pregnant mothers below 20 years and 50 adult pregnant mothers 20-25 years, as control group, and their outcome were examined through a longitudinal study carried out in Egypt. Cases were followed up during pregnancy at delivery and till the end of first month of neonatal life. Original formulae were used to estimate pre- pregnancy weight and gestational weight gain. There was a positive relation between adolescent mothers weight, height and gestational weight gain and birth weight of their outcome and to a lesser extent with birth length and head circumference. All measurements of neonates of adolescent mothers were at the 10th percentile but weight was compensated later and reached a good increment after one month. It seems that, the classical neonatal risk factors associated with maternal young age could be minimized later in infancy with postpartum adequate nutrition

Incidence of arm swelling following mastectomy and axillary clearance for breast cancer

Arm swelling was measured using volume determination in 60 patients following mastectomy with axillary clearance. The mean age was 50.5 years and the median follow up was 13.5 months. Axillary clearance removed level III nodes. Axillary irradiation was given to only three patients with extensive [more than 75%] modal involvement. The incidence of early postoperative complications was 18.3%. The incidence of lymphedema was 8.3%. Arm circumference differences correlated poorly with volume differences

Predicting diabetic nephropathy in insulin dependent diabetic children

Urinary microalbumin and B2 microglobulin were estimated by radioimmunoassay in fifteen insulin dependent diabetic children [IDD] and another fifteen healthy controls. The results showed highly significant increase in urinary microalbumin and B2 microglobulin in IDD patients compared to control [P < 0.005]. After diabetic control, urinary microalbumin and B2 microglobulin were significantly decreased [P < 0.005]. In conclusion, early diagnosis and good control of diabetes associated with screening tests for microalbuminuria would prevent the progression of diabetic nephropathy

Serum fructosamine and lipids profile in children with acute lymphocytic leukemia

Serum lipid fractions [TC, TG, HDL, LDL and VLDL] and AF concentrations were estimated in twenty newly diagnosed leukemic children prior to initiation of therapy and ten healthy controls. The leukemic patients showed highly significant increase in TC, TG, HDL, LDL and VLDL values [p< 0.005] with highly significant decrease in HDL value [p< 0.005] compared to control. The fructosamine value showed significant decrease compared to control [p< 0.005]. The results suggest an abnormality in systemic lipid metabolism and abnormal serum protein turnover

Urinary fibrinogen degradation products in children with hematuria

Urinary fibrinogen degradation product [U-FDP] concentrations were determined in 60 pediatric patients with hematuria using the latex particle agglutination test [LPAT] to assess the value of this test for the localization of the site of hematuria. The cases were divided into 2 groups, 30 cases each, according to the site of origin of hematuria. Only 4 cases [13.3%] with glomerular hematuria showed marked increase in U-FDP concentrations >0.25 ug/ml while, 26 cases [86.7%] with nonglomerular hematuria showed such high concentrations or more. The sensitivity and specificity of using U-FDP levels in localizing the site of hematuria was 86.7% both, which seems to be compensated with combined urine analysis for erythrocyte cylindruria. In conclusion, U-FDP concentrations by LPAT can help in localizing the site of bleeding in cases of hematuria

Socioeconomic factors affecting the nutritional status of children in Egypt

A cross sectional study was carried out on 175 and 125 children diagnosed clinically as having mild/moderate and severely undernutrtion respectively. The incidence and severity of undernutrtion were found to be higher among urban than rural children. Severe undernutrtion increases with the increase of birth order. There is a high prevalence of undernutrition in children whose mothers are below 25 or above 35 years of age. Mother's education seems to be more important than that of father's. occupation of the parents is another facto that may influence the nutritional status of children. The prevalence of undernutrition in children increases with low family income. Improper pregnancy spacing and overpopulation reduces the mother's capacity for giving care for the new child and in turn affects its health. Availability of electricity bottled gases and safe water supply reflects the socioeconomic status of the family which in turn affects the nutritional status on the child. Exposure to learning or educational facilities increases the exposure to health and nutritional information with results less severity or low prevalence of undernutrition. Some hygienic personal habits were found to be more practiced among families of mild moderate undernutrition children than among families of severe ones. Ignorance of mothers about supplementary feeding and weaning practices proved also to have its effect on the nutritional status of the child