Prevalence of community-acquired methicillin-resistant Staphylococcus aureus in Taif social correctional center, Saudi Arabia.

INTRODUCTION: Community-acquired methicillin-resistant strains of Staphylococcus aureus are primarily distinguished through their genetic characteristics. These strains carry the smaller types of staphylococcal cassette chromosome, specifically types IV and V. These infections occur mostly in healthy younger patients, and have been linked to such severe clinical conditions as necrotizing pneumonia and sepsis. A higher risk of methicillin-resistant Staphylococcus aureus contagion exists among incarcerated sub-populations; therefore, this study investigated colonization rate and risk factors among the residents of the Taif Social Correctional Center. METHODOLOGY: The study included 93 inmates and 19 employees. Specimens were collected from participants' noses and hands and from different environmental locations. The isolated organisms were identified according to standard microbiological methods. Methicillin resistance was evaluated using the standard cefoxitin disk diffusion method and oxacillin screen agar procedure. Methicillin resistance was further confirmed by multiplex polymerase chain reaction. RESULTS: High methicillin-resistant Staphylococcus aureus colonization rate was found among the center residents (24.7%) and employees (15.8%). Long duration of residence in the correctional institution and bad hand hygiene emerged as prominent risk factors for this colonization. An antibiogram categorized the isolated strains into six phenotypes, with a predominance of two antibiotic-resistant patterns suggesting cross-contamination and the presence of local foci of dissemination. CONCLUSIONS: Taif Social Correctional Center residents exhibited a higher prevalence of methicillin-resistant Staphylococcus aureus colonization than was found in similar institutions. Poor personal hygiene and infection control measures are likely the major contributors to the problem.

Fascin expression in urinary bladder urothelial carcinoma correlates with unfavourable prognosis.

BACKGROUND: Urinary bladder crothelial carcinoma (UCB) is the most common urinary bladder neoplasm. The present study aims at investigating immunostaining of fascin in UCB in relation to clinicopathologiccriteria in Saudi Arabia. METHODS: This study utilised 122 UCB and 25 apparently normal urothelium archival pathologic samples prior to local or systemic therapy. Tissue microarrays were constructed and the generated TMA blocks were used for Immunohistochemical staining. The mouse anti-fascin monoclonal antibody was used. A 25% was used to specify low and high fascin immunostaining. RESULTS: Fascin immunostaining was detected in UCB and apparently normal urothelium. High immunostaining was statistically less frequent than low fascin immunostaining (P≤0.001). In UCB, high fascin immunostaining was associated with older patients (P=0.005) and local disease recurrence (P=0.002). High fascin immunostaining was an independent predictor of local disease recurrence (P=0.002) and associated with poor overall survival (P=0.027). CONCLUSION: High fascin immunostaining in UCB was associated with adverse prognostic factors and may be used as an independent prognostic marker. Fascin was detected in apparently normal urothelium and may contribute to UCB carcinogenesis. Further investigations (molecular and clinical) are required to understand the molecular interaction of fascin with UCB and its possible therapeutic applications.

Comprehensive molecular biomarker identification in breast cancer brain metastases.

BACKGROUND: Breast cancer brain metastases (BCBM) develop in about 20-30% of breast cancer (BC) patients. BCBM are associated with dismal prognosis not at least due to lack of valuable molecular therapeutic targets. The aim of the study was to identify new molecular biomarkers and targets in BCBM by using complementary state-of-the-art techniques. METHODS: We compared array expression profiles of three BCBM with 16 non-brain metastatic BC and 16 primary brain tumors (prBT) using a false discovery rate (FDR) p < 0.05 and fold change (FC) > 2. Biofunctional analysis was conducted on the differentially expressed probe sets. High-density arrays were employed to detect copy number variations (CNVs) and whole exome sequencing (WES) with paired-end reads of 150 bp was utilized to detect gene mutations in the three BCBM. RESULTS: The top 370 probe sets that were differentially expressed between BCBM and both BC and prBT were in the majority comparably overexpressed in BCBM and included, e.g. the coding genes BCL3, BNIP3, BNIP3P1, BRIP1, CASP14, CDC25A, DMBT1, IDH2, E2F1, MYCN, RAD51, RAD54L, and VDR. A number of small nucleolar RNAs (snoRNAs) were comparably overexpressed in BCBM and included SNORA1, SNORA2A, SNORA9, SNORA10, SNORA22, SNORA24, SNORA30, SNORA37, SNORA38, SNORA52, SNORA71A, SNORA71B, SNORA71C, SNORD13P2, SNORD15A, SNORD34, SNORD35A, SNORD41, SNORD53, and SCARNA22. The top canonical pathway was entitled, role of BRCA1 in DNA damage response. Network analysis revealed key nodes as Akt, ERK1/2, NFkB, and Ras in a predicted activation stage. Downregulated genes in a data set that was shared between BCBM and prBT comprised, e.g. BC cell line invasion markers JUN, MMP3, TFF1, and HAS2. Important cancer genes affected by CNVs included TP53, BRCA1, BRCA2, ERBB2, IDH1, and IDH2. WES detected numerous mutations, some of which affecting BC associated genes as CDH1, HEPACAM, and LOXHD1. CONCLUSIONS: Using complementary molecular genetic techniques, this study identified shared and unshared molecular events in three highly aberrant BCBM emphasizing the challenge to detect new molecular biomarkers and targets with translational implications. Among new findings with the capacity to gain clinical relevance is the detection of overexpressed snoRNAs known to regulate some critical cellular functions as ribosome biogenesis.

Microarray expression profiling identifies genes, including cytokines, and biofunctions, as diapedesis, associated with a brain metastasis from a papillary thyroid carcinoma.

Brain metastatic papillary thyroid carcinomas (PTCs) are afflicted with unfavorable prognosis; however, the underlying molecular genetics of these rare metastases are virtually unknown. In this study, we compared whole transcript microarray expression profiles of a BRAF mutant, brain metastasis from a PTC, including its technical replicate (TR), with eight non-brain metastatic PTCs and eight primary brain tumors. The top 95 probe sets (false discovery rate (FDR) p-value < 0.05 and fold change (FC) > 2) that were differentially expressed between the brain metastatic PTC, including the TR, and both, non-brain metastatic PTCs and primary brain tumors were in the vast majority upregulated and comprise, e.g. ROS1, MYBPH, SLC18A3, HP, SAA2-SAA4, CP, CCL20, GFAP, RNU1-120P, DMBT1, XDH, CXCL1, PI3, and NAPSA. Cytokines were represented by 10 members in the top 95 probe sets. Pathway and network analysis (p-value < 0.05 and FC > 2) identified granulocytes adhesion and diapedesis as top canonical pathway. Most significant upstream regulators were lipopolysaccharide, TNF, NKkB (complex), IL1A, and CSF2. Top networks categorized under diseases & functions were entitled migration of cells, cell movement, cell survival, apoptosis, and proliferation of cells. Probe sets that were significantly shared between the brain metastatic PTC, the TR, and primary brain tumors include CASP1, CASP4, C1R, CC2D2B, RNY1P16, WDR72, LRRC2, ZHX2, CITED1, and the noncoding transcript AK128523. Taken together, this study identified a set of candidate genes and biofunctions implicated in, so far nearly uncharacterized, molecular processes of a brain metastasis from a PTC.

Microarray Expression Data Identify DCC as a Candidate Gene for Early Meningioma Progression.

Meningiomas are the most common primary brain tumors bearing in a minority of cases an aggressive phenotype. Although meningiomas are stratified according to their histology and clinical behavior, the underlying molecular genetics predicting aggressiveness are not thoroughly understood. We performed whole transcript expression profiling in 10 grade I and four grade II meningiomas, three of which invaded the brain. Microarray expression analysis identified deleted in colorectal cancer (DCC) as a differentially expressed gene (DEG) enabling us to cluster meningiomas into DCC low expression (3 grade I and 3 grade II tumors), DCC medium expression (2 grade I and 1 grade II tumors), and DCC high expression (5 grade I tumors) groups. Comparison between the DCC low expression and DCC high expression groups resulted in 416 DEGs (p-value<0.05; fold change>2). The most significantly downregulated genes in the DCC low expression group comprised DCC, phosphodiesterase 1C (PDE1C), calmodulin-dependent 70kDa olfactomedin 2 (OLFM2), glutathione S-transferase mu 5 (GSTM5), phosphotyrosine interaction domain containing 1 (PID1), sema domain, transmembrane domain (TM) and cytoplasmic domain, (semaphorin) 6D (SEMA6D), and indolethylamine N-methyltransferase (INMT). The most significantly upregulated genes comprised chromosome 5 open reading frame 63 (C5orf63), homeodomain interacting protein kinase 2 (HIPK2), and basic helix-loop-helix family, member e40 (BHLHE40). Biofunctional analysis identified as predicted top upstream regulators beta-estradiol, TGFB1, Tgf beta complex, LY294002, and dexamethasone and as predicted top regulator effectors NFkB, PIK3R1, and CREBBP. The microarray expression data served also for a comparison between meningiomas from female and male patients and for a comparison between brain invasive and non-invasive meningiomas resulting in a number of significant DEGs and related biofunctions. In conclusion, based on its expression levels, DCC may constitute a valid biomarker to identify those benign meningiomas at risk for progression.

Amoeboma in a Saudi resident: a case report.

INTRODUCTION: Amoebiasis is the third most frequent cause of mortality after malaria and schistosomiasis. In developed countries, amebiasis is also seen in migrants who have travelled to endemic areas. The factors responsible for its progression from intestinal amebiasis to an amebic liver abscess are not fully understood. CASE PRESENTATION: A 54-year-old man presented with abdominal pain, fever and diarrhoea. Laparotomy confirmed an inflammatory mass involving the right colon, and he underwent a right hemicolectomy. He later developed abdominal distenstion due to an amoebic liver abscess and died from secondary nosocomial bacterial infection and surgical complications. CONCLUSION: Amoeboma is an uncommon manifestation of amoebiasis, and can mimic both carcinoma and inflammatory bowel disease; so, distinguishing between these two conditions is the key to providing appropriate therapy. Hepatic amoebiasis is the most common extraintestinal disease of invasive amoebiasis. This clinical report presents a case of an uncommon parasitic disease in Saudi Arabia and discusses the difficulties encountered while attempting to establish the correct diagnosis. Hence, a high index of suspicion is crucial for diagnosing Entamoeba histolytica to avoid unnecessary surgery and further complications.

Ovarian mucinous cystadenocarcinoma of low malignant potential associated with a mature cystic teratoma.

The development of mucinous cystadenocarcinoma of low malignant potential in a mature cystic teratoma is rare. We report a 36-year-old single female presented with abdominal distension and was found to have a huge pelvic/abdominal mass. Ultrasound revealed a huge cystic ovarian mass with no ascites. Laparotomy and left oophorectomy was performed to the mass. Histology revealed mucinous cystadenocarcinoma of low malignant potential in a mature cystic teratoma.