Circulating MiRNA-373 as a Predictor of Response to Super-selective Transarterial Chemoembolization Bridging Therapy in Hepatocellular Carcinoma Patients Awaiting Liver Transplantation.

BACKGROUND: Super selective transarterial chemoembolization (TACE) has emerged as a bridging therapy for early hepatocellular carcinoma (HCC) patients awaiting liver transplantation. This study aimed at assessing the expression profiles of circulating MiR-210 and MiR-373 as potential predictors of response to TACE bridging therapy in a group of Egyptian HCC cases on top of chronic hepatitis-C infection, awaiting liver transplantation. METHODS: Fifty-three HCC cases awaiting liver transplantation referred for TACE, were followed up for three months, resulting in forty-five responders and eight non-responders based on modified response evaluation criteria in solid tumors (mRECIST). Circulating pre TACE MiR-210 and MiR-373 expressions were determined using reverse transcription quantitative polymerase chain reaction. RESULTS: Circulating pre TACE MiR-373, but not MiR-210, was significantly higher in non-responders than responders. Receiver operating characteristics (ROC) curve analysis of MiR-373, pre-TACE tumor volume, inflammatory score, and albumin bilirubin (ALBI) grade revealed highest sensitivity for pre-TACE tumor volume (cutoff>11.49 cm3) and highest specificity for pre-TACE MiR-373 (cutoff>1.46-fold change). Multivariate logistic regression revealed pre TACE MiR-373 as a significant independent predictor of TACE response after adjusting for pre TACE tumor volume. CONCLUSION: Circulating pre-TACE MiR-373 could assist as a noninvasive predictor marker of response to TACE bridging therapy in early HCC patients awaiting liver transplantation.

Association between different levels of maternal vitamin-D status during pregnancy and maternal outcomes.

BACKGROUND AND AIMS: Maternal vitamin-D deficiency is a significant health concern among pregnant women in the Middle East. Vitamin-D deficiency during pregnancy has been associated with adverse maternal outcomes and an increased risk of pregnancy complications. This study aimed to identify the level of vitamin-D during pregnancy and examine the effect of different vitamin-D levels during pregnancy on maternal outcomes. METHODS: A descriptive correctional design was utilized in this research. This study was conducted at the obstetrics and gynecology outpatient clinics at Shaqra general hospital, Saudi Arabia. A purposive sample of 221 pregnant women. Four tools were used: (1) a structured interviewing questionnaire; (2) laboratory records; (3) a vitamin-D risk factors assessment questionnaire; and (4) a follow-up sheet for maternal outcomes. RESULTS: Nearly half of the study sample (46.2%) had insufficient vitamin-D in the blood, 40.3% had sufficient level of vitamin-D, and (13.6%) had a vitamin-D deficiency. The non-modifiable risk factors for vitamin D deficiency during pregnancy were maternal age, dark skin pigmentation, hyperglycemia, anemia, mal-absorption syndrome, and genetic mutation. While the modifiable risk factors were inadequate sun exposure, middle-income status, low vitamin-D diet, obesity, and low consumption of milk products during pregnancy. There was a relationship between adverse pregnancy outcomes and a vitamin-D deficiency during pregnancy (p < 0.001). CONCLUSION: Maternal vitamin-D deficiency is significantly associated with a high risk for emergency c-section and complications during pregnancy and labor. Preconception intervention programs should focus on raising vitamin-D levels among pregnant women in Saudi Arabia to prevent vitamin-D deficient-linked adverse pregnancy outcomes.

The burden of multiple sclerosis among postpartum women and self management's challenges: Pilot study of supportive program.

BACKGROUND: This study aims to determine the effect of multiple sclerosis supportive programs on mothers' self-management during postpartum. STUDY DESIGN: A quasi-experimental, nonequivalent group design was utilized. Primigravida pregnant women between 35-37 weeks of gestation and recently diagnosed with multiple sclerosis participated in two preparation sessions. While the first session during pregnancy was an open conversation about the delivery, the key topics of the second session were the nature of the postpartum cycle and the expected relapses. RESULTS: Seventy pregnant women with multiple sclerosis participated in this research. Results denoted a statistical difference between both groups regarding self-management in 6th and 12th weeks postpartum. The improvements were related to mothers' relationships with their health care providers and knowledge and information about multiple sclerosis during this transitional phase. On the other hand, there were no differences among both groups related to their levels of functional activities at 6th and 12th weeks postpartum. Although there was a slight deterioration in motor ability score among both groups at 12th week's postpartum, 54.3% of the intervention group vs. 49% of the non-intervention group reported 100% absolute independence. Moreover, the total relapses in the three-month postpartum ranged between 1-6, increasing the frequency of relapses during the three-month postpartum with no statistically significant differences between both groups. CONCLUSION: Conducting a multidisciplinary program to follow and counsel mothers with MS helps enhance self-management throughout the three-month postpartum period.

Assessment of Serum CoQ10 Levels and other Antioxidant Markers in Breast Cancer.

BACKGROUND: The balance of the oxidative state in the body is fundamental for the maintenance of homeostasis. It has been implicated in the onset and progression of several diseases including breast cancer. The way in which the Reactive Oxygen Species (ROS) / antioxidants balance leads to or responds to disease is still controversial. In this study, TAC is used as a reference for the total antioxidant power of the body and Coenzyme Q10 (CoQ10) for its vital importance in cellular antioxidant action and being the only lipid soluble antioxidant synthesized endogenously. Copper and zinc were measured as trace elements reflecting the antioxidant micronutrient profile of the body. METHODS: After approval of the ethical committee, 60 recently diagnosed non-intervened breast cancer patients were recruited from the Medical Research Institute hospital, Alexandria University along with 20 apparently healthy volunteers as control group. Full patient history was taken including breastfeeding history, parity, hormone replacement therapy use, body mass index, pathological examination, metastatic work up results, past medical history and drug use. CA 15-3 and laboratory investigations evaluating blood glucose, kidney and liver functions were performed. Q10 levels were measured by HPLC using a kit from Recipe®. TAC was assayed spectrophotometrically (Biodiagnostics®). Copper and Zinc levels were determined by inductively coupled plasma-optical emission spectrometry. RESULTS: There was a statistically significant increase in the CoQ10, TAC and copper levels in the breast cancer group when compared to the control group. Zinc showed no statistically significant difference between the studied groups. CONCLUSION: Inspite of the fact that a high antioxidant level is usually considered as a favourable state, TAC, CoQ10 and copper levels showed significantly higher levels in the breast cancer group when compared to the control group. It is worth mentioning that the cancer group were all recently diagnosed, non-intervened and showed no signs of metastasis. It is still unclear whether the increased antioxidant levels offer a selective growth advantage to tumor cells over their surrounding normal cells or serve as a protective measure by the body in an attempt to correct the assault triggered by the ROS.