Bone morphogenetic protein (BMP)9 in cancer development: mechanistic, diagnostic, and therapeutic approaches?

Bone morphogenetic protein (BMP)-9 is considered a member of the transforming growth factor (TGF)ß superfamily. It was first found as an inducer of bone and cartilage formation and then discovered that this factor mediates several physiologic functions and hemostasis. Besides physiological conditions, BMP9 has also been elucidated that it is involved in several pathological situations, especially cancer. In various cancers, dysregulation of BMP9 has raised the issue that BMP9 might play a conflicting role in tumour development. BMP9 binding to its receptors (BMPRs), including ALKs and BMPRII, induces canonical SMAD-dependent and non-canonical PI3K/AKT and MAPK signalling pathways in tumour cells. BMP9, via inducing apoptosis, inhibiting tumour-promoting cell signalling pathways, suppressing epithelial-mesenchymal transition (EMT) process, blocking angiogenesis, and preventing cross-talk in the tumour microenvironment, mainly exerts tumour-suppressive functions. In contrast, BMP9 triggers tumour-supportive signalling pathways, promotes EMT, and enhances angiogenesis, suggesting that BMP9 is also involved in tumour development. It has been demonstrated that modulating BMP9 expression and functions might be a promising approach to cancer treatment. It has also been indicated that evaluating BMP9 expression in cancers might be a biomarker for predicting cancer prognosis. Overall, BMP9 would provide a promising target in cancer management.

DNA barcoding of marine macroalgae as bioindicators of heavy metal pollution.

Metal pollution in the marine coastal environment is an important topical issue. In this study, the water quality in five locations along the Alexandria coast (Eastern Harbor, El-Tabia pumping station, El Mex Bay, Sidi Bishir, and Abu Talat) was assessed by measuring physicochemical parameters from water samples. Depending on the morphological classification of macroalgae, the collected morphotypes were related to Ulva fasciata, Ulva compressa, Corallina officinalis, Corallina elongata, and Petrocladia capillaceae. Corallina officinalis and Corallina elongata demonstrated a high capacity for Cd, Pb, and Ni accumulation, and the highest values of Fe, Cu, and Mn were reported in Ulva fasciata and Ulva compressa. Two standard markers were applied, and results showed that the morphological classification matched the molecular data. Moreover, the analysis of algae can only reflect the accumulation of metals. The conclusion is that Ulva compressa and Corallina officinalis are potentially suitable indicators of localized short-term heavy metal pollution.

Enhancing drought stress tolerance in Camelina (Camelina sativa L.) through exogenous application of potassium.

The current study was performed under controlled conditions to study the effects of exogenous potassium application on carotenoid contents and drought tolerance in Camelina. Water deficit levels such as 100% FC (control) and 40% FC (drought stress) were imposed after germination of Camelina plants grown to maturity, and different treatments of exogenous K+ were applied at the vegetative stage. We have reported 17 traits of plant growth, physiology, antioxidant enzyme activity, focusing on carotenoids in Camelina to explore their potential yield and yield components. For this purpose, we used multivariate analysis techniques (descriptive statistics, correlation matrix, analysis of variance [ANOVA] and principal components analysis [PCA] to determine the best relation between potassium and studied traits). The results showed a large number of variations in the studied trait under control and water deficit condition. Plant fresh weight (g) was negatively correlated with shoot length and SOD insignificantly correlated with plant fresh weight (g) under water deficit conditions. Potassium loading predicted that foliar application (3 mM K2 SO4 ), foliar application (6 mM KNO3 ), foliar application (12 mM KNO3 ) and foliar application (12 mM K2 SO4 ) are the important doses that contribute the most to enhance the growth, physiological and biochemical activities and carotenoids to improve the Camelina yield under water deficit condition. These doses should be considered in the future to improve the Camelina yield under semi-arid conditions with increased genetic diversity (varietal selection).

Advancement of Nanofibrous Mats and Common Useful Drug Delivery Applications.

Electrospinning enables simple and cost-effective production of polymer nanofibers from different polymer materials. Drug delivery systems are capable of achieving maximum drug treatment benefits by significantly reducing adverse complications. Electrospun nanofibers have recently attracted considerable attention owing to their distinctive properties, including flexibility and biocompatibility. The implementation of functional constituents within nanostructure fibers blends is an effective technique for the administration of a variety of drugs in animal research, broadening the nanofiber capability and reliability. The nanofibrous mesh and its various application purposes are discussed in terms of a summary of recent research, emphasizing the ease of streaming and a large number of combinations of this approach, which could lead to a breakthrough in targeted therapy.

Additional Imaging is of Limited Value in Traumatic Hip Fractures With a History of Distant Malignancy and No Suspicious Lesion on Plain Radiographs.

OBJECTIVE: To determine the value of obtaining additional preoperative imaging in patients with a traumatic hip fracture and a history of malignancy in whom plain radiographs show no lesion suspicious for metastases. DESIGN: Retrospective review. SETTING: Teaching NHS Trust in the United Kingdom, over an 8-year period treating 4421 hip fractures. PATIENTS/PARTICIPANTS: Three hundred sixty-seven patients with hip fracture and a history of malignancy at a site distant to the hip. Three hundred thirty patients had a history of trauma and no lesion on the plain radiograph suspicious for metastases. MAIN OUTCOMES MEASUREMENTS: Whether obtaining additional imaging preoperatively (MRI, CT, and bone scan) identified metastases or affected management. RESULTS: 32/330 patients had further preoperative imaging, none of which demonstrated a pathological fracture secondary to malignancy. On follow-up, 3/330 (0.9%) cases were found to have occult metastasis at the hip fracture site. All 3 had only plain radiographs before surgery. In 2, this was identified on histological examination of intraoperative samples, and in 1, radiologically as a metastatic metaphyseal lesion 18 months after a hemiarthroplasty. Only in the latter case, preoperative identification of hip metastasis could have altered surgical management. Patients undergoing further preoperative imaging waited significantly longer for surgery (35 ± 26 vs. 51 ± 26 hours, P = 0.0011). CONCLUSIONS: In the absence of a suspicious metastatic lesion on initial plain radiographs, further preoperative imaging is unlikely to identify a lesion that will affect management and confers significant delays to surgery. Sending intraoperative histological samples may help guide postoperative oncological management, but further work is needed to prove its utility. LEVEL OF EVIDENCE: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Epidemiological, demographic and outcomes of burns among females at reproductive age in Baghdad/Iraq.

BACKGROUND: Burns remained a major health problem in most developing countries which have increased the mortality and morbidity among the people. This study aimed to describe the epidemiology and outcomes of burn among females at reproductive age and investigate the factors that associated with mortality during the study period in in Baghdad/Iraq. METHODS: A retrospective cohort study was undertaken at Al-Karama academic Hospital in Baghdad. Four hundred and thirty-seven females were admitted to this center from 1st of January 2017 to the end of October 2018. Data were collected from the records and patient file at the department of statistics. The information was including the age, education, marital status, occupation, TBSA, degree of burn, length of stay in hospital, causes, and patient condition. Software of STATA version 13 was used to analysis this data. RESULTS: The mean age was 27.1 and SD 0.34 with 95% CI (26.4358 to 27.8067). the fire 64.8% (283/437) were the most cause of burn among females. Housewives 65% (284/437) were more probably exposed to burn than others with the mechanism of burning and females with primary education 42.8% (187/437) were more probability of burn than others group. Regard to length of stay, the mean was 7 days and the 95% CI [6.489-7.629]. Thus, 79.2% (346/437) of females that stayed in the hospital for less than 10 days had higher percentage of burn comparing with another period. Mean and SE of TBSA was 57.8 and 1.2 with the 95% CI [55.4051-60.2516]. A significant relationship was found between occupation, education status, TBSA, length of stay, causes of burn and outcomes at the p. value <0.05. The time at risk was 3085 with the incidence rate. 14. The survivor function in one day (Kaplan Meier estimate) was 0.8970 and SE 0.0144 with 95% CI [0.8645-0.9221]. CONCLUSION: The patients at age 26-45 years have equal hazard ratio of death (HR=1) at all the times of follow-upping. There is not statistically significant have been found at the (p. value =0.486), the 95% CI for the HR includes the null value of 1. As well the causes of burn, the patients with fire cause have a higher hazard of death HR=1.1 with the (p. value =0.012). Half of cases were single. A significant relationship has been found between the marital status and the age groups of the p. value 0.000. Also, a significant result of the intent status with causes of burn at the p. value 0.000.

Prevalence of xerostomia in patients attending Shorish dental speciality in Sulaimani city.

OBJECTIVES: The aim of this study was to investigate the prevalence of xerostomia among dental patients and explore the possible risk factors and symptoms associated with this condition. PATIENT AND METHODS: The prevalence of xerostomia and its associations were investigated among patients (n=1132) who were visiting the department of oral medicine at shorish dental speciality in sulaimani city. The age range was between 10-79 years. 512 (45.2%) of participants were males and 620 (54.8%) were females. The data collected were age, sex, systemic diseases, medications and habit of smoking. Logistic regression models to estimate odds ratios and 95% confidence intervals were used to investigate the association of xerostomia with age, systemic diseases and medications and Chi Square test was also used to analyze the data. RESULTS: Prevalence of xerostomia was 16.07%. Prevalence of xerostomia was significantly higher among females (19.51%) than males (11.91%) (P=0.001). The most common diseases with the highest prevalence of xerostomia were psychological disorders (57.14%) followed by diabetes mellitus (53.84%), neurological disorders (40%), thyroid disorders (37.5%) and hypertension (36.48%). The most common medication with the highest prevalence of xerostomia was antihistamine (66.66%) followed by psychotherapeutic medications (60%), pain medications (55.88%), endocrinologic agents (51.21%), antidyslipidic agents (50%) and antihypertensive medication (38.98%). Xerostomia was significantly associated with ageing (OR: 1.02, P=0.000), systemic diseases (OR: 2.80, P=0.000) and medications (OR: 5.17, P=0.000). There was a high prevalence of reported symptoms of xerostomia and these symptoms were more prevalent among females, Prevalence of xerostomia was higher in heavy smoker patients (19.48%) than non smoker patients but not significantly (16.14%) (p= 0.44). CONCLUSIONS: There was a high prevalence of xerostomia among dental patients; xerostomia was significantly more prevalent among females and significantly associated with age, systemic diseases and medications; xerostomia adversely affects oral functions; dentist must be familial with sign and symptoms of xerostomia and can have an active role in the management of xerostomia and preventing or treating complications. Key words:Ageing, medications, xerostomia, prevalence.

Prevalence of recurrent aphthous ulceration experience in patients attending Piramird dental speciality in Sulaimani City.

OBJECTIVE: The aim of this study is to report the prevalence and risk factors of recurrent aphthous ulceration (RAU) in patients attending Piramird dental speciality for seeking dental treatment. STUDY DESIGN: A cross-sectional survey was carried out among patients (n=1100) who were visiting the department of oral medicine at Piramird dental speciality center in Sulaimani from December 2011-February 2012. The age range of the patients were between 10-79 years, with mean age of (34.27±14.14). 446 (44.6%) of participants were males and 554 (55.4%) were females, with male/female ratios of 0.80:1. All individuals had to answer specific questions including personal data (age, sex), level of education, occupation and smoking habit; etc. Additional questions were related to the risk factors that might be related to the condition. Chi Square test was used to analyze the data. RESULT: The life time prevalence of RAU experience was 28.2% (n=282). It was highly significantly more common among females (31.76%) (p<0.004). The most commonly affected age group was 20-29 years (36.28%). The highest prevalence of RAU experience was seen among mere students (36.8%); Among non smokers there were highly significantly more patients with RAU experience (30%) than in heavy smoker patients (12.22%), (p=0.000). 34.4% of patients had family history of RAU. Lips and buccal mucosae were the commonest sites of ulcerations (73.10%), and the major risk factor was stress (43.3%). CONCLUSION: This study has provided information about the epidemiologic aspects of recurrent aphthous ulceration, Based on the finding of this study, RAU is a common, recurrent painful oral ulceration. This study point to the importance of a thorough history taking to identify the patient's main risk factors to get preventive measures, therefore treatment will be tailored for each patient accordingly. And the author concluded that stress was the major risk factor, thus, stress-management interventions suggested to be beneficial in reducing RAU recurrence episodes. Key words:Recurrent aphthous ulceration, prevalence, stress.

Echocardiographic evaluation, management and outcomes of bilateral arterial ducts and complex congenital heart disease: 16 years' experience.

Bilateral arterial ducts represent an uncommon form of pulmonary or systemic blood supply associated with complex congenital cardiac disease. We sought to determine the role of high-resolution cross-sectional echocardiography and color flow Doppler ultrasonography in assessing this condition, as well as to describe the management and outcome in a group of patients. A retrospective review was conducted of 11 newborns identified over a 16-year period as having bilateral arterial ducts. Pulmonary atresia associated with non-confluent pulmonary arteries was the dominant lesion, with the heterotaxy syndrome also frequently being recognized. Echocardiography best identified the source of blood supply to either the pulmonary or systemic circulations, allowing differentiation from collateral vessels. Stenosis of the right or left pulmonary artery at the initial site of ductal insertion needs careful evaluation on follow-up. Management of patients with this condition remains a challenge, as indicated by the poor outcomes observed in our series.

Impact of the characteristics of patients and their clinical management on outcomes in children with homozygous familial hypercholesterolemia.

OBJECTIVE: To relate clinical factors to the development of cardiovascular atherosclerosis for patients with homozygous familial hypercholesterolemia. BACKGROUND: Homozygous familial hypercholesterolemia is associated with extreme elevations in levels of cholesterol causing aggressive atherosclerosis. METHODS: We reviewed 10 children, 8 of whom were male, assessed at a single institution. We found that individual characteristics, levels of lipid, cardiovascular investigations, and management were related to the activity of low density lipoprotein receptors. RESULTS: Activity of low density lipoprotein receptors was defined as absent, being less than 2% of normal, in 4 patients who presented at the ages of 0.3, 1.4, 1.8, and 4.5 years, respectively. The activity was minimal, representing 5%-30% of normal, in another 4 patients presenting at the ages of 6.1, 9.6, 9.9, and 12 years, and was undetermined in 2 patients who presented at the ages of 3.5, and 12.1 years. Levels of low density lipoprotein cholesterol at presentation ranged from 12.2 to 24 millimoles per litre. Plasmapheresis was performed bi-weekly in 9 patients. Patients with absence of receptor activity were less likely to have a serial decrease in the levels of low density lipoprotein cholesterol prior to plasmapheresis, and one of these patients was increased to weekly plasmapheresis. In addition, they had more aggressive cardiovascular involvement of the coronary arteries, aortic valve and aorta, requiring surgical intervention at the age of 8 and 12 years in 2 patients, with sudden death at the age of 3.1 years in one patient. In contrast, 1 patient with minimal receptor activity had surgical intervention at the age of 16.6 years and another patient died suddenly at the age of 33.6 years. CONCLUSION: Complete cardiac assessment is recommended at presentation. The frequency of plasmapheresis should be adjusted according to the activity of low density lipoprotein receptors and the individual response of the patient.