Colorectal cancer patients' outcome in correlation with dietary and nutritional status: a systematic review.

Colorectal cancer (CRC) is one of the most common cancers worldwide and it involves various biomolecular and cellular levels. CRC has possibly happened due to aging, urbanization, and diet. Different foods have varying effects on the gastrointestinal cells, that's why additional research is necessary to create effective medical interventions. This review aimed to evaluate the correlation between dietary and nutritional status on the outcome of CRC patients. Study results showed that a healthy diet such as fruit and vegetables is the best diet for improving colorectal cancer outcomes. Moreover, nutritional status affected CRC patients' outcomes, where high BMI increases the risk of having CRC. However, low BMI was associated with CRC progression and poor quality of life.

COVID-19 Infection in Chronic Myeloid Leukemia Patients Receiving Tyrosine Kinase Inhibitor in Makassar, Indonesia: A Six-Case Report and Literature Review.

Management of chronic myeloid leukemia (CML) in patients who are infected with COVID-19 is a challenging task due to disease-related or treatment-related factors that place such patients at a higher risk of complications. However, a low-infectivity-rate mechanism has been proposed by some researchers. In CML patients with COVID-19 infection, the most important treatment-related factor involves tyrosine kinase inhibitors (TKIs). In this case report, six patients with chronic-phase CML who experienced COVID-19 of mild-moderate severity all continued to receive TKI treatment for CML concurrently with COVID-19 treatment. All patients fully recovered. In the present study, we also review four other cases of COVID-19 infection in CML patients. Outcomes for TKI-treated CML patients who contract COVID-19 are influenced by many factors. Tyrosine kinase inhibitor therapy may benefit CML patients due to its antiviral effect, but the interaction between TKIs and drugs used for COVID-19 treatment requires careful monitoring. An individual approach is needed in every case.

Bevacizumab side effects and adverse clinical complications in colorectal cancer patients: review article.

This review aimed to evaluate the effect of bevacizumab on adverse events and the quality of life (QoL) from colorectal cancer (CRC) patient. Methods: A literature search was conducted from PUBMED, MEDLINE databases and some valid literatures from another databases that published in the last 10 years, and the design is an observational and randomized controlled trial (RCT). Results: CRC is a malignancy, which happens in the colon or rectum. One of the therapy for CRC is by using bevacizumab, a monoclonal antibody. However, the usage of bevacizumab is still become a controversy because of its clinical complications. Several studies showed that bevacizumab could cause some adverse events in the cardiovascular, gastrointestinal, hematology, and others body systems and affect the CRC patient QoL. However, the clinical complication of this drug is also affected by the combination therapy regimen used. Conclusions: The use of bevacizumab could cause some adverse event in different aspects, including cardiovascular, gastrointestinal, hematology, and others. Some of those are significant, but others are not. Besides that, using bevacizumab as a treatment regiment could also affect the QoL of CRC patients, but it is also affected by the combination therapy regimen used.

Interleukine-2 serum level in breast cancer patients.

Background: Breast cancer is a form of cancer that typically affects females. In general, cancer is caused by an imbalance between oncogene and supressor gene factors, including immunity factors against cancer cells. This study aims to compare the levels of IL-2 between breast cancer patients and healthy women, and also compare the levels of IL-2 between HER-2 positive and HER-2 negative, ER/PR positive and ER/PR negative, and among different malignancy grades of breast cancer patients. Methods: This is an observational study using case control method. We include 46 breast cancer patients and 40 healthy women. Blood samples were taken from 46 breast cancer patients (20 HER-2 negative and 26 HER-2 positive patients); 40 of them received hormonal status (29 ER/PR negative and 11 ER/PR positive patients); and from 46 breast cancer patients, 37 of them were divided into malignancy grade. The level of IL-2 was compared between cases and controls and also among the breast cancer patients with HER-2 negative and positive; ER/PR negative and positive; and breast cancer with low, moderate and high grade. Results: IL-2 level was higher in breast cancer patients than in controls (9.400 pg/mL and 3.990 pg/mL respectively, P=0.003). IL-2 level is significantly higher in the breast cancer cases with positive HER-2 compared to negative HER-2 expression (11.154pg/mL and 7.120pg/mL respectively, P=0.001. No association between ER/PR expression nor breast cancer grading with IL-2 level. Conclusion: IL-2 level is higher in breast cancer patients, especially breast cancer patients with HER-2 positive expression.

Profiles of endoglin and vascular endothelial growth factor based on staging and histological grading of colorectal cancer and their relationship with bevacizumab therapy / Perfis da endoglina e do fator de crescimento endotelial vascular com base no estadiamento e na graduação histológica do câncer colorretal e sua relação coma terapia com bevacizumabe

Objective: The present study evaluated the profile of endoglin (CD105) and vascular endothelial growth factor (VEGF) based on staging and histopathological grading of colorectal cancer as well as their relationship with bevacizumab therapy. Methods: A total of 88 cases of colorectal adenocarcinoma were included in the present study. The levels of VEGF and CD105 protein were evaluated with enzymelinked immunosorbent assay (ELISA). Results: There was a significant difference in the level of CD105 (p=0.002) between metastases and non-metastases subjects, showing that CD105 was higher in metastases subjects (4.59 ng/ml). Therewas no significant difference in the level of VEGF based on the presence of metastasis (p=0.625). There was a significant difference in the levels of CD105 (p=0.038) and VEGF (p=0.010) between the subjects who received chemotherapy and those who did not. The CD105 level was higher in the subjects who received chemotherapy (4.43 ng/ml); conversely, the level of VEGF was lower in subjects who received chemotherapy (543.65 pg/ml). There was a statistically significant difference in the levels of CD105 (p=0.003) and VEGF (p=0.002) between subjects who received bevacizumab therapy and subjects who did not. The levels of CD105 were higher in subjects who received bevacizumab therapy (5.11 ng/ml); in contrast, the level of VEGF was higher in subjects who did not receive bevacizumab therapy (645.92 pg/ml). There was a significant positive correlation between CD105 and VEGF in subjects who did not receive bevacizumab (p<0.01). Conclusion: The results of this study support a hypothesis of "escape mechanism" in the failure of anti-angiogenesis therapy (anti-VEGF). (AU)

Objetivo: Este estudo avaliou o perfil da endoglina (CD105) e do fator de crescimento endotelial vascular (FCEV) com base no estadiamento e graduação histopatológica do câncer colorretal, assim como sua relação com a terapia com bevacizumabe. Métodos: No total, 88 casos de adenocarcinoma colorretal foram incluídos no presente estudo. Os níveis das proteínas FCEV e CD105 foram avaliados com ensaio imunoenzimático (ELISA, na sigla em inglês). Resultados Houve uma diferença significativa no nível de CD105 (p=0,002) entre indivíduos commetástases e semmetástases, que indicou que o nível de CD105 émais alto em indivíduos com metástases (4,59 ng/ml). Não houve diferença significativa no nível de FCEV com base na presença de metástases (p=0,625). Houve diferença significativa nos níveis de CD105 (p=0,038) e de FCEV (p=0,010) entre os indivíduos que receberam quimioterapia e os que não receberam. Encontrou-se um nível de CD105 mais alto nos indivíduos que submetidos a quimioterapia (4,43 ng/ml); Em contrapartida, encontrou-se um nível de FCEV mais baixo em indivíduos que submetidos a quimioterapia (543,65 pg/ml). Houve uma diferença estatisticamente significativa nos níveis de CD105 (p=0,003) e de FCEV (p=0,002) entre os indivíduos submetidos e não submetidos à terapia com bevacizumabe. Os níveis de CD105 foram mais elevados em indivíduos submetidos à terapia combevacizumab (5,11 ng/ml); em contraste, observou-se um nível de FCEV mais alto em indivíduos que não foram submetidos à terapia com bevacizumabe (645,92 pg/ml). Houve uma correlação positiva significativa entre CD105 e FCEV em indivíduos que não receberam bevacizumabe (p<0.01). Conclusão: Os resultados deste estudo corroboram a hipótese de "mecanismo de escape" na falha da terapia anti-angiogênica (anti-FCEV). (AU)

Impact of age to ferritin and neutrophil-lymphocyte ratio as biomarkers for intensive care requirement and mortality risk in COVID-19 patients in Makassar, Indonesia.

Inflammation plays a substantial role in COVID-19 pathophysiology. Ferritin and neutrophil-lymphocyte ratio (NLR) are significant prognostic biomarkers used in COVID-19 patients, although they are affected by other factors such as comorbidities and age. Aging changes the immune system through immunosenescence and inflammaging; however, there are limited number of studies evaluating its effect on ferritin and NLR as part of the complete assessment for intensive care requirement and mortality risk. A single-center retrospective cohort study of 295 COVID-19 patients was performed at the Siloam Hospitals Makassar, South Sulawesi, Indonesia from April to August 2020. After admission, all patients were followed up for clinical outcomes. Patients were grouped into strata based on age (<50 years vs. ≥50 years) and risk groups (low-risk ferritin vs. high-risk ferritin; low-risk NLR vs. high-risk NLR). The endpoints of the study were the intensive care requirements and mortality. Among the 295 COVID-19 patients, 264 survived and 31 deceased. Ferritin and NLR had higher area under curve (AUC) values than other inflammatory parameters and had significantly different outcomes in both mortality and intensive care requirement groups. The combination of ferritin and NLR showed higher AUC values for intensive care requirement and mortality (AUC, 0.783; 95% confidence interval, 0.703-0.864). Multivariate analysis showed that both endpoints were strongly affected by age, ferritin level, and NLR. Age significantly multiplied clinical endpoints in low-risk group patients but not in high-risk group patients. The combination of ferritin and NLR had a better predictive value for intensive care requirement and mortality risk. However, age strongly affects clinical outcome in low-risk groups of both ferritin and NLR groups; hence, it should be considered as an early predictive factor of COVID-19 disease progression.