Risk of Lymphoma and Leukemia in Thyroid Cancer Patients: A Retrospective Cohort Study in Germany.

Thyroid cancer is the ninth most common cancer worldwide. While differentiated thyroid cancer (DTC) has a high survival rate, concerns arise regarding optimal treatment strategies and potential long-term risks, including second primary malignancies (SPMs), associated with therapies such as radioiodine (RAI). The aim of the present study was to investigate the association between thyroid cancer and the incidence of subsequent lymphoma and leukemia in Germany. This retrospective cohort study used the IQVIA TM Disease Analyzer database and included adults with a first documented diagnosis of thyroid cancer between January 2005 and December 2021 as well as propensity score matched individuals without thyroid cancer in 1284 general practices. Univariate Cox regression models were performed to examine the association between thyroid cancer and the incidence of subsequent lymphoma and leukemia. A total of 4232 thyroid cancer patients (mean age: 54.2 years; 73.6% female) and 21 160 controls (mean age: 54.2 years; 72.6% female) were available for analyses. Thyroid cancer was significantly associated with a higher lymphoma incidence (HR: 3.35, 95% CI: 2.04-5.52), especially in men (HR: 5.37) and those aged 61-70 years. Leukemia incidence was not significantly associated with thyroid cancer (HR: 1.79, 95% CI: 0.91-3.53), although associations were notable in younger age groups. Thyroid cancer is positively associated with a risk of subsequent lymphoma, highlighting the need for vigilant surveillance and tailored treatment strategies. While the association with leukemia is less pronounced, close surveillance remains critical, especially in younger patients.

The role of pressure on lattice thermal conductivity and its related thermodynamical parameters in In0.53Ga0.47As nanofilms.

Lattice thermal conductivity (LTC) for In0.53Ga0.47As alloy films, with thicknesses ranging from 10 nm to 1.4 µm, was investigated under pressures of up to 11 GPa and temperatures between 1 and 450 K, utilizing the modified Debye-Callaway model. The effects of structural and thermodynamical parameters, as well as phonon interactions, on LTC were examined. The Clapeyron, Murnaghan, and Post equations were applied to determine the pressure dependence of the melting temperature, lattice volume, and Debye temperature, respectively. A novel derivative form of the bulk modulus, suitable for nanomaterials, has been introduced. It was found that decreasing the film thickness increases the Gruneisen parameter, while increasing pressure decreases it. The LTC of nanofilms is significantly affected by their thickness and pressure strength; notably, under 11 GPa, films with a thickness of 10 nm exhibit a substantial decrease in LTC. LTCmax declines due to the greater influence of boundary scattering compared to dislocations. These findings suggest potential applications in managing nanofilm temperature and size, which are key to advancing nanomaterials and enhancing the efficiency of electronic devices.

Self-management approaches among hypertensive residents in nursing homes in Malaysia.

INTRODUCTION: The prevalence of hypertension in Malaysia is increasing and an effective management of hypertension is important to reduce cardiovascular morbidity and mortality. OBJECTIVE: To determine the knowledge, awareness and perception towards hypertension among residents in nursing homes as well as the roles of caregivers in hypertension management. METHODS: A face-to-face survey with 200 hypertensive residents and 30 caregivers from 24 nursing homes in Kuala Lumpur and Selangor, Malaysia was conducted. RESULTS: Of all the hypertensive residents, 90.5% (n = 181) knew that lowering their blood pressure could improve their health. Most residents strongly believed that taking antihypertensive drugs is important for keeping their high blood pressure under control (n = 162, 81%). Taking medication was perceived as the most important factor in controlling the high blood pressure (58%, n = 116) compared to lifestyle or diet modification. The majority of the caregivers reported that they played a major role in managing hypertension, especially with regards to medication-taking. task (66.7%, n = 20). CONCLUSION: The knowledge, attitude and perceptions of hypertension play a relatively major role in the self-management of hypertension. The role of caregivers also needed to be recognised in managing hypertension in nursing homes.

Bladder Sparing Approaches for Muscle-Invasive Bladder Cancers.

OPINION STATEMENT: Organ preservation has been increasingly utilised in the management of muscle-invasive bladder cancer. Multiple bladder preservation options exist, although the approach of maximal TURBT performed along with chemoradiation is the most favoured. Phase III trials have shown superiority of chemoradiotherapy compared to radiotherapy alone. Concurrent chemoradiotherapy gives local control outcomes comparable to those of radical surgery, but seemingly more superior when considering quality of life. Bladder-preserving techniques represent an alternative for patients who are unfit for cystectomy or decline major surgical intervention; however, these patients will need lifelong rigorous surveillance. It is important to emphasise to the patients opting for organ preservation the need for lifelong bladder surveillance as risk of recurrence remains even years after radical chemoradiotherapy treatment. No randomised control trials have yet directly compared radical cystectomy with bladder-preserving chemoradiation, leaving the age-old question of superiority of one modality over another unanswered. Radical cystectomy and chemoradiation, however, must be seen as complimentary treatments rather than competing treatments. Meticulous patient selection is vital in treatment modality selection with the success of recent trials within the field of bladder preservation only being possible through this application of meticulous selection criteria compared to previous decades. A multidisciplinary approach with radiation oncologists, medical oncologists, and urologists is needed to closely monitor patients who undergo bladder preservation in order to optimise outcomes.

Bladder reconstruction: The past, present and future.

Ileal conduit urinary diversion is the gold standard treatment for urinary tract reconstruction following cystectomy. This procedure uses gastrointestinal segments for bladder augmentation, a technique that is often associated with significant complications. The substantial progression in the fields of tissue engineering and regenerative medicine over the previous two decades has resulted in the development of techniques that may lead to the construction of functional de novo urinary bladder substitutes. The present review identifies and discusses the complications associated with current treatment options post-cystectomy. The current techniques, achievements and perspectives of the use of biomaterials and stem cells in the field of urinary bladder reconstruction are also reviewed.

Detection of 8-hydroxydeoxyguanosine enzyme in recurrent pterygium raising a question on its role on recurrence.

AIM: To detect the presence of 8-hydroxydeoxyguanosine enzyme (8-OHdG) in recurrent pterygium and its role on recurrence. METHODS: Ninty-two samples were collected of which 55 from primary pterygium, 12 from recurrent and 25 from normal conjunctiva. A cross sectional study was embarked to detect the presence of the 8-OHdG enzyme in primary, recurrent pterygium and the normal conjunctival tissue by immunohistochemistry test. RESULTS: THE IMMUNOHISTOCHEMISTRY TEST SHOWED POSITIVE RESULTS: 35 in primary, 2 in recurrent pterygia and 4 in normal conjunctiva, respectively. Significant association between primary pterygium and 8-OHdG enzyme (63.6% of samples are positive) and no significant relation was detected with recurrent pterygium (16.7% of samples are positive). CONCLUSION: 8-OHdG enzyme is associated with primary pterygium. It is also present in normal conjunctival tissue. For the first time it is detected in recurrent pterygia. This may raise question whether 8-OHdG enzyme has a role in recurrence of pterygium.

Field evaluation of two diagnostic antigen tests for Wuchereria bancrofti infection among Indian expatriates in Saudi Arabia.

Two commercially available diagnostic tools (Tro-Bio ELISA and ICT card test) were used to detect circulating filarial antigen of Wuchereria bancrofti infections among Indian expatriate workers in Saudi Arabia. Daytime serum samples collected from 302 individuals (210 men and 92 women) were tested. Night blood surveys for microfilaraemia were restricted to those individuals who became positive for the trop-Bio assay test. The overall prevalence of filarial antigeaemia was 10.6% (32 individuals). Of these 32 antigen positive cases, microfilariae were found in 10 men (31.3%), with a mean microfilarial count of 105 mff/ml. No positive antigen results were found in control sera from 200 native healthy Saudis or from patients with helminthic infections (schistosomiasis, echinicoccosis, hookworm, ascariasis and trichuriasis). All 32 positive sera with the Trop-Bio ELISA showed a positive ICT card reaction (specificity and sensitivity 100%). It is concluded that, in Saudi Arabia and other Gulf states, where a continuous flow of south- and southeastern workers coming from areas endemic for bancroftian filariasis, the ICT card test may be useful in monitoring the potential risk of introducing bacncroftian filariasis to the host countries.

Synthesis and evaluation of N-acetylprolinate esters - novel skin penetration enhancers.

A series of N-acetylproline esters (alkyl side chain length, 5-18) were synthesized and tested for potential skin penetration enhancement activity using modified Franz diffusion cells and hairless mouse skin as the penetration barrier. Benazepril and hydrocortisone were used as model drugs and were applied as saturated solutions in propylene glycol. The enhancers were added at a concentration of 5% (w/v). Drug flux, permeability coefficient and enhancement ratios for permeability coefficient were determined. Azone was used as the positive control. While all the compounds tested increased the skin penetration of hydrocortisone, the 5- and 8- carbon esters had no significant effect on the skin penetration of benazepril. The highest fluxes were obtained with 11, 12, and 18-carbon esters and they were comparable to Azone. There was no significant difference between the fluxes obtained with 2 and 5% (w/v) concentrations of the 12-carbon ester on hydrocortisone permeation. The 16-carbon ester, where ethanol was used as a cosolvent, significantly increased the fluxes of both the drugs compared to the control. Differential scanning calorimetric studies suggested that the enhancers may be acting on the lipids of the stratum corneum and their effect was similar to that of Azone. The membrane/vehicle partition coefficient studies indicated an increase in benazepril partition coefficient with enhancer treatment compared to the control. Maximum flux increase was obtained with the 11 and 12 carbon (alkyl chain length) esters for both benazepril and hydrocortisone. The 18- carbon ester which has a cis-double bond in the alkyl side chain, also increased the flux significantly.

A survey of bancroftian filariasis among South-East Asian expatriate workers in Saudi Arabia.

In a survey of bancroftian filariasis among expatriate workers from five South-East Asian countries (India, Bangladesh, Sri Lanka, Thailand and the Philippines) where human filariasis is endemic, 762 individuals were examined in the Abha area (Asir) of south-western Saudi Arabia. A prevalence of microfilaraemia of 3.5% and a mean mf density of 6.0/20 mm3 of blood was found among 259 Indian males only. In three out of 9 microfilaraemic cases, clinical signs suggestive of filariasis were observed. The only species identified was Wuchereria bancrofti showing strict nocturnal periodicity. Preliminary laboratory studies on the susceptibility of local mosquitoes to infection with W. bancrofti in which laboratory-bred Culex (C.) pipiens was fed directly on a microfilaraemic volunteer from Madras, South India, revealed that this species was highly susceptible to the Madras strain of the parasite with an average infection rate of 57 (range 41-75)% and a worm burden of 3.5 L3/infective mosquito. This is the first report that local Cx. pipiens mosquitoes may act as a potential vector of introduced bancroftian filariasis in Saudi Arabia. The potential danger of bancroftian filariasis importation and, more importantly, the establishment of new self-sustained foci of the disease is likely to depend upon the abundance of mf carriers and density of vector mosquitoes feeding on carriers.

Onchocerca fasciata: histochemical demonstration of succinate and NADH dehydrogenase.

The activities of selected enzymes of the respiratory chain system in Onchocerca fasciata (Filarioidea: Onchocercidae) have been investigated histochemically. Thus, the localization and distributions of NADH dehydrogenase (EC 1.6.99.3), succinate dehydrogenase (SDH) (EC 1.3.99.1) and cytochrome oxidase (EC 1.9.3.1) were investigated in various tissues of the adult female worm by employing MTT, Nitro BT (dehydrogenases) and DAB (cytochrome oxidase). Different tissues varied considerably in their enzymatic activities. The hypodermis and reproductive tissues showed strong and identical localization of NADH and SDH dehydrogenase activities reflecting high metabolic rates. Little or no dehydrogenase activities were observed in the intestine and cuticle. In contrast to the two dehyrogenases, no activity was observed for cytochrome oxidase in any of the tissues in adult or embryonic stages of the worm. The significance of these results with respect to the energy metabolism of the worm is discussed. It is suggested that O. fasciata lacks a classical, mammalian-type respiratory pathway and that oxidative phosphorylation is of no importance as an energy generating pathway in this essentially anaerobic parasite.

Onchocerca fasciata: enzyme histochemistry and tissue distribution of various dehydrogenases in the adult female worm.

Histochemistry studies of key dehydrogenases in the glycolytic pathway and related enzymes and the tricarboxylic acid (TCA)-cycle enzymes were carried out on adult female Onchocerca fasciata. The distribution pattern and enzymatic activities of 6-phosphogluconate dehydrogenase (6-GPDH), lactate dehydrogenase (LDH), mitochondrial glycerol-3-phosphate dehydrogenase (GPDH), nicotinamide adenine dinucleotide (phosphate) [NAD+(P)]-linked isocitrate dehydrogenase (ICDH), and NAD+(P)-linked malate dehydrogenase (MDH) in various tissues of the worm were determined. Moderate to intense enzyme activities were localized in three main areas, namely, the hypodermis, body-wall muscle, and reproductive tissues. Activity of the formazan reaction product was very low, if at all present, in the intestinal epithelium and was completely absent in the cuticle. On the basis of the present results and earlier observations, it is suggested that glycolysis leading to the end product lactate is the main energy-generating pathway in O. fasciata. The presence of significant activity of 6-GPDH indicates that the pentose-phosphate pathway might be operative in O. fasciata. In light of the activity of some of the TCA-cycle enzymes, ICDH and MDH, demonstrable in O. fasciata, it is possible that an additional pathway (pyruvate-succinate) of glucose metabolism via a reverse sequence of the TCA cycle may also be operative in the worm. The possible functional significance of the enzymes detected is discussed with respect to their location.

The relationship of water sources and other determinants to prevalence of intestinal protozoal infections in a rural community of Saudi Arabia.

A study was carried out in a rural area of Asir region in Southwest of Saudi Arabia where information on the types of domestic water supply and sociodemography in relation to intestinal protozoal infections were obtained from 1417 inhabitants (81.4% of the total) of nine villages. Stool samples were collected from the study population and examined for intestinal parasites. Overall, the prevalence rates of infection with the common water-borne parasites, Giardia lamblia and Entamoeba histolytica were 18.9% and 9.2% respectively, which were high compared to other endemic areas of the Kingdom. The sociodemographic factors including age, sex, degree of education, intrafamilial clustering and crowding index were found to be non significant determinants of both protozoal infections. The source of domestic water was the sole factor significantly associated with the high prevalence rates of infection in the community. This relationship was confirmed by multiple logistic regression analysis. A significantly high risk of contracting the infection with both parasites was observed among individuals who drank jar water (OR = 2.973, 95%CI:1.515-4.402 and OR = 2.831, 95%CI:1.414-3.915, for G. lamblia and E. histolytica respectively) or well water (OR = 2.153, 95%CI:1.211-3.913 and OR = 2.117, 95%CI:1.341-3.715, for G. lamblia and E. histolytica respectively). Those who used desalinated water for drinking seems to have the lowest degree of exposure to the risk of infection (OR = 0.689, 95%CI:0.501-0.849 and OR = 0.793, 95% CI:0.518-0.912, for G. lamblia and E. histolytica respectively). The results indicate that the use of improved water supply, including protection of community wells and domestic storage tanks, together with mandatory inspection measures during transportation and distribution of commercial water should reduce the rate of infection with the two protozoal parasites in this rural community.

Histochemical localization of key glycolytic and related enzymes in adult Onchocerca fasciata.

The activities of some key enzymes of the glycolytic and pentose phosphate pathways were investigated histochemically in adult female Onchocerca fasciata (Nematoda: Filarioidea). The distribution patterns of phosphofructokinase (PFK), aldolase (ALD), glyceraldehyde 3-phosphate dehydrogenase (G3PDH) and glucose 6-phosphate dehydrogenase (G6PDH) in different tissues of the worm were determined by employing NitroBlue Tetrazolium (NBT). The glycolytic enzymes PFK, ALD, and G3PDH were distributed throughout the hypodermal tissue, somatic muscles and reproductive organs. These enzyme activities were predominantly expressed in the hypodermal and reproductive tissues, both of which appeared to be metabolically more active than adjacent tissues. The high activities of the enzymes studied in the hypodermal tissue when compared with the minimal or low activity in the intestinal epithelium support the assumption that the worm's intestine, in contrast to the body wall, plays no significant role in the nutrient acquisition process. The results emphasize that both the glycolytic and hexose monophosphate pathways of carbohydrate metabolism are active components in energy production and biosynthetic processes in the various tissues of the worm. The functional significance of these glucose-metabolizing enzymes has been discussed with regard to their location in the tissues concerned.

Histochemical distribution of hydrolytic enzymes in adult Onchocerca fasciata (Filarioidea: Onchocercidae).

Histochemical techniques were employed to study the tissue distribution of hydrolytic enzymes in adult female Onchocerca fasciata (Filarioidea: Onchocercidae). Different tissues differed considerably in the localization and distribution of the six enzymes studied. Acid phosphatase (AcPase) activity was detected in the cuticle, hypodermis and reproductive organs. Alkaline phosphatase (AlkPase) activity was largely absent. Adenosine triphosphatase (ATPase) was found in the somatic musculature and muscles of the uterine ducts, whereas 5'-nucleotidase (5'-Nu) was restricted to young oocytes and dividing embryos in the female worm. Strong glucose-6-phosphatase (G-6-Pase) activity was demonstrated in the uterine epithelial cells and microfilariae, as was weak activity in the hypodermis. Naphthylamidase (NAM) activity was detected in the hypodermis, with lower activity occurring in the somatic musculature. The possible functions of these enzymes are discussed with respect to their location. The hydrolytic enzymes AcPase and NAM in the body wall are probably involved in absorptive-digestive functions, NAM in the somatic musculature may be concerned with tissue protein turnover, and ATPase, 5'-Nu and G-6-Pase may have a role in active transport and energy metabolism.

Acceptability and usage of permethrin-impregnated mosquito bed nets in rural southwestern Saudi Arabia.

In 1989 a total of 2,320 sets of locally-made durable permethrin-impregnated bed nets and support frames were provided for the first time to 410 families (2,485 individuals) in Al-Fateeha area in the malarious region of Tihamat Asir, southwestern Saudi Arabia. In interviews carried out with a sample of the heads of the families two years later, most of them said to have used bed nets regularly (78.3%) and a majority started using them shortly after sunset (73.9%). Most heads of families expressed willingness to encourage their friends and neighbours to get bed nets (94.4%) and use them regularly (92.9%). Public requests for bed nets were received from neighbouring areas. These results indicate that impregnated bed nets can be successfully integrated into a malaria control programme provided that they are of a durable type and accompanied with support devices to facilitate their use while sleeping outdoors. Records of the primary health care centre serving the trial area indicated that the incidence of malaria decreased progressively from 277.4 per thousand in 1988 to 124.4 in 1991. The possible contribution of mosquito nets--as a major newly introduced variable--to this decrease is suggested but was not directly measured.

Histochemical distribution of esterases in adult Onchocerca fasciata (Filarioidea: Onchocercidae).

The localization and distribution patterns of non-specific esterases (NSE) and acetylcholinesterase (AChE) activities in adult female Onchocerca fasciata (Filarioidea: Onchocercidae) have been determined using enzyme histochemical techniques. NSE activity was highest in the hypodermis and mild to moderate in the somatic musculature and uterine epithelium. The intensity of the reaction was decreased but not eliminated by sodium fluoride. AChE activity was found in the hypodermis and cuticle of the female worm, highest in fully formed microfilariae in the uterus, whereas early oocytes and embryonic forms were negative. Butyrylcholinesterase activity showed similar but less intense staining reactions at the same sites. Eserine-treated sections showed no AChE activity in all areas where it is usually present. The present techniques failed to demonstrate AChE activity in the nervous tissue including the hypodermal nerve trunks and neuromuscular junctions of the worm. The possible functional significance of the demonstrable enzymes was discussed with respect to their location. NSE activity may be involved in lipid metabolism, whereas AChE activity may have a role in host-parasite relationship.

Cutaneous myiasis caused by tumbu fly larvae, Cordylobia anthropophaga in southwestern Saudi Arabia.

Seven cases of human cutaneous myiasis caused by maggots of the tumbu fly, Cordylobia anthropophaga are reported from Asir region, southwestern Saudi Arabia. Boil-like swellings infested with individual fly larvae, varied from one to four and occurred in both unprotected and usually protected areas of the skin. Twenty five fly maggots were retrieved from separate furunculoid lesions on the body surface of a massive case of a 4-year old boy. The present observations confirm that this calliphorine species is not restricted to tropical Africa.

Giardiasis and amoebiasis infections in three Saudi closed communities.

Two hundred and eighteen residents (131 healthy and 87 mentally or physically retarded) of a children's nursery, a foster house and a rehabilitation centre for the handicapped in Abha, southwestern Saudi Arabia, were examined for intestinal parasitism. About 30% of the population of the three communities were found to harbour asymptomatic infections with either Giardia lamblia and/or Entamoeba spp. Giardia cysts were identified in 19.3% of those examined. Entamoeba histolytica was found in 18.4% of the residents of the rehabilitation centre only. Entamoeba coli infections were found in residents of both the foster house and rehabilitation centre (6.0 and 25.3% respectively). The prevalence of infection with the three parasites was significantly higher in the rehabilitation centre than in the children's nursery and foster house.