Evaluating circulating cell-free DNA and DNA integrity index as biomarkers in non-small cell lung cancer.

BACKGROUND: Analysis of free DNA molecules shed from tumour cells in plasma of patients referred as circulating tumour DNA (ctDNA) with reference to physiological circulating cell-free DNA (cfDNA) is nowadays exploited as liquid biopsy and is considered a new emerging promising biomarker for diagnosis, selection of proper treatment, and prognosis of cancer. DNA integrity index (DII) is assessed by calculating the ratio between the concentration of long cfDNA strands released from tumour cells (ALU247) and the short strands released from normal cells (ALU115). The aim of the current study was to evaluate DII as a potential diagnostic and prognostic biomarker of NSCLC. METHODS: Our study included 48 NSCLC patients diagnosed as primary NSCLC before starting treatment, 30 COPD patients diagnosed clinically, radiologically, and subjected to chest high-resolution computerized tomography, and 40 healthy controls. cfDNA concentration and DII were measured by quantitative real-time polymerase chain reaction (qPCR). RESULTS: ALU115, ALU247, and DII were significantly higher in NSCLC compared to COPD patients (p < 0.0001) and controls (p < 0.0001) and in COPD patients compared to control subjects (p < 0.0001). DII positively correlated with the stage of tumour (p = 0.01), tumour metastasis (p = 0.004), and with adenocarcinoma compared to other histopathological types (p = 0.02). To evaluate clinical utility of DII in NSCLC, ROC curve analysis demonstrated an AUC of 0.91 at a cut-off value of 0.44 with total accuracy = 85.6%, sensitivity = 90%, specificity = 83%, PPV = 78.1%, and NPV = 92.1%. CONCLUSION: cfDNA and DII represent a promising diagnostic and prognostic tool in NSCLC. This type of noninvasive liquid biopsy revealed its chance in the screening, early diagnosis, and monitoring of NSCLC.

Evaluation of health-related quality of life and its domains in pediatric patients with cancer.

BACKGROUND: Health-related quality of life has emerged as a significant component in pediatric oncology research during the last several decades. Measures of health-related quality of life provide a thorough assessment of the child's response to medical therapy, disease course, and adjustment outcomes in the context of pediatric oncology. METHODS: The aim of the present study was to assess the cancer-specific health-related quality of life in cancer pediatric patients and to evaluate the contribution of its domains and some of the anthropometric, sociodemographic, and treatment-related variables on the overall quality of life, by using the PedsQL™ 3.0 Cancer Module. RESULTS: The study included 110 cases. The mean value of the PedsQL™ 3.0 Cancer Module score was 49.3 ± 12.0. The lowest mean score of quality of life was for the "procedure anxiety" (8.7 ± 23.9), followed by the "worry" domains (16.6 ± 28.5). Higher "frequency of hospital visits" was associated with increased feeling of pain and treatment anxiety yet decrease in suffering from nausea and vice versa. The longer period of hospital admission for more than half of the recommended treatment period was associated with reduced pain suffering on the expense of increase in feeling of worry as well as communication problems. The perceived physical appearance was better among those patients who spent a treatment period for 3-6 months when compared to those who spent a treatment period less than 3 months or more than 6 months. There was a highly significant association between all the eight-cancer-specific quality-of-life domains except the pain domain- and the overall quality-of-life log scores. Nausea problem followed by worry and cognitive problems was the most effective domains on the overall quality-of-life score. CONCLUSION: Cancer pediatric patients suffered low quality of life especially for anxiety procedure and worry domains with special consideration for the impact of nausea, worry, and cognitive problems on their perception of quality of life.

Prevalence of Visual Impairment and Refractive Errors in Children of South Sinai, Egypt.

PURPOSE: To assess the prevalence and causes of visual impairment in children of South Sinai, and to evaluate outcomes of rehabilitation programs. METHODS: Population-based, cross-sectional analysis of 2070 healthy school children screened for visual impairment from 2009 through 2010 in cities of South Sinai and their surrounding Bedouin settlements. Visual acuity (VA) was tested using Snellen charts followed by cycloplegic autorefractometry for cases with presenting VA ≤ 6/9. Appropriate eyeglasses were prescribed and VA re-evaluated. RESULTS: This study included 1047 boys and 1023 girls, mean age 10.7 ± 3.1 years. Visual impairment (uncorrected VA ≤ 6/9) was detected in 29.4% of children, while 2.0% had moderate-severe visual impairment (uncorrected VA ≤ 6/24). There were statistically significant differences in prevalence of visual impairment between the studied cities (p < 0.05), with the highest prevalence in Abu Redis. Prevalence of visual impairment was significantly higher among girls (p < 0.05) and those with positive consanguinity (p < 0.05). Bedouin children showed significantly lower prevalences of visual impairment. Only age was a reliable predictor of visual impairment (odds ratio 0.94, p < 0.0001). Ophthalmic examination revealed other disorders, e.g. dry eye (4.74%), squint (2.37%), exophthalmos (1.58%) and ptosis (0.79%). VA significantly improved in children who received spectacles (p < 0.001). CONCLUSION: A total of 29.4% of South Sinai children had some form of visual impairment, 90.32% of which comprised refractive errors (mainly astigmatism) which were significantly corrected with eyeglasses. VA screening and correction of refractive errors are of the utmost importance for ensuring better visual outcomes and improved school performance.