Cancer Research by Samasca Gabriel
Pharmaceuticals, 2024
Researchers have performed numerous studies on immunotherapy because of the high death rate assoc... more Researchers have performed numerous studies on immunotherapy because of the high death rate associated with gastric cancer (GC). GC immunotherapy research has made tremendous progress, and we wanted to provide an update on this topic. On the basis of this update, we suggest performing a new medical evaluation before initiating immunotherapy in patients with GC to increase the success rate of immunotherapies. We propose that before patients start GC immunotherapy, they should be evaluated and given a score of one to two points for the following factors: immunopathological features, molecular and genomic features, potential consequences for bacterial pathogens, potential immunotherapeutic resistance and hyperprogressive illness, and the potential to use biomarkers to gauge their prognosis and immunotherapy responses to optimize immunotherapy following surgery. The proposed scoring system could also help in the diagnosis of GC. With all the advances in genetics, immunology, and microbiology, the diagnosis of GC could be improved, not changed. Currently, patients diagnosed with GC undergo surgical resection as the only permanent solution. Patients who meet the maximum score from the presented proposal could be eligible immediately after diagnosis for immunotherapy. Therefore, immunotherapy could be a first-line option for clinicians.
Cancers, 2024
Simple Summary
The incidence of gastric cancer (GC) is increasing. Many people receive an advance... more Simple Summary
The incidence of gastric cancer (GC) is increasing. Many people receive an advanced diagnosis of GC. Furthermore, a large number of patients are surgically inoperable and are unresponsive to preoperative chemotherapy. Patients with GC do not currently have an immunotherapy option. Our study’s objective was to provide insight into extracellular vesicles (EVs) and GC. EVs in GC can be studied, as this article explains. EVs screening, which is available for all patients, is an option for combatting GC.
Abstract
Extracellular vesicles, or EVs, are membrane-bound nanocompartments produced by tumor cells. EVs carry proteins and nucleic acids from host cells to target cells, where they can transfer lipids, proteomes, and genetic material to change the function of target cells. EVs serve as reservoirs for mobile cellular signals. The collection of EVs using less invasive processes has piqued the interest of many researchers. Exosomes carry substances that can suppress the immune system. If the results of exosome screening are negative, immunotherapy will be beneficial for GC patients. In this study, we provide an update on EVs and GC based on ongoing review papers and clinical trials.
Diagnostics, 2024
Many studies on gastric cancer treatment have identified predictors of immunotherapy benefits. Th... more Many studies on gastric cancer treatment have identified predictors of immunotherapy benefits. This article provides an update on the major developments in research related to predictive factors of immunotherapy for gastric cancer. We used the search term "predictive factors, immunotherapy, gastric cancer" to find the most current publications in the PubMed database related to predictive factors of immunotherapy in gastric cancer. Programmed cell death, genetic, and immunological factors are the main study topics of immunotherapy's predictive factors in gastric cancer. Other preventive factors for immunotherapy in gastric cancer were also found, including clinical factors, tumor microenvironment factors, imaging factors, and extracellular factors. Since there is currently no effective treatment for gastric cancer, we strongly propose that these studies be prioritized.
Cancers, 2024
Numerous studies have been performed on Helicobacter pylori infection because of the high death r... more Numerous studies have been performed on Helicobacter pylori infection because of the high death rate linked to this illness and gastric cancer. An update on the key developments in recent years in the investigation of Helicobacter pylori and gastric cancer is the goal of this review.
Using the search term “Helicobacter pylori, gastric cancer”, the PubMed database was searched. Only papers published in 2024 fulfilled the inclusion criteria. Because case report papers were not part
of our investigation, they satisfied the exclusion criteria. Most of the research on the variable genes of Helicobacter pylori is guided by genetics to determine potential treatments. Studies on clinical treatments for the eradication of H. pylori with promising therapeutic options are needed. We found the fewest studies related to the immunopathology of H. pylori infection, which is still unknown. In conclusion, priority should be given to this kind of research.
Cancers, 2024
Due to the high death rate associated with gastric cancer, a great deal of research has been cond... more Due to the high death rate associated with gastric cancer, a great deal of research has been conducted on this disease. The goal of this paper was to start a trimestral review of 2024 for the year that had just started. The scientific literature from 1 January 2024 was chosen with consideration of
the the guidelines of the European Society of Medical Oncology (ESMO), which are updated with new findings but not systematically reviewed annually. We used the search term “gastric cancer” to find the most current publications in the PubMed database related to the prognosis and treatment of gastric cancer. As previously said, the only articles that satisfied the inclusion criteria were those from 2024. Articles with case reports were eliminated since they had nothing to do with our research.
The treatment of gastric cancer is the focus of the majority of articles from 2024. The primary research axes include surgery and immunonutrition, immunotherapy and Helicobacter pylori, and therapeutic
targets. Patients with GC may experience less psychological, social, and financial hardship if the recently identified markers discovered in circulation are better assessed and validated. This could be achieved by either including the markers in an artificial intelligence-based diagnostic score or by using them in conjunction with traditional diagnostic methods. Due to the rising death rate associated with GC, funding for research into diagnosis, prognosis, therapy, and therapeutic targets is essential.
Nanomaterials, 2022
Mounting evidence shows that supplementation with vitamin D and K or their analogs induces benefi... more Mounting evidence shows that supplementation with vitamin D and K or their analogs induces beneficial effects in various diseases, e.g., osteoarticular, cardiovascular, or carcinogenesis. The use of drugs delivery systems via organic and inorganic nanocarriers increases the bioavailability of vitamins and analogs, enhancing their cellular delivery and effects. The nanotechnology-based dietary supplements and drugs produced by the food and pharmaceutical industries overcome the issues associated with vitamin administration, such as stability, absorption or low bioavailability. Consequently, there is a continuous interest in optimizing the carriers’ systems in order to make them more efficient and specific for the targeted tissue. In this pioneer review, we try to circumscribe the most relevant aspects related to nanocarriers for drug delivery, compare different types of nanoparticles for vitamin D and K transportation, and critically address their benefits and disadvantages.
Biology, 2022
Background: Vitamin K-dependent proteins (VKDPs) and the epidermal growth factor receptor (EGFR) ... more Background: Vitamin K-dependent proteins (VKDPs) and the epidermal growth factor receptor (EGFR) are involved in lung cancer progression. Therefore, we aimed to study the serum concentration of Matrix Gla protein (MGP), Growth Arrest-specific 6 (Gas6), and EGFR before and after the first cycle of chemotherapy and to investigate how MGP, Gas6, and EGFR are modified after one cycle of chemotherapy. Methods: We performed an observational study on twenty patients diagnosed with lung cancer, by assessing the serum concentration of vitaminK1 (VitK1), MGP, Gas6, and EGFR using the ELISA technique before and after three weeks of the first cycle of chemotherapy. Patients were evaluated using RECIST 1.1 criteria. Results: Serum levels of MGP, Gas6, EGFR, and VK1 before and after treatment were not changed significantly. Regarding the pre-treatment correlation of the MGP values, we found a strong positive relationship between MGP and VK1 pre-treatment values (r = 0.821, 95%CI 0.523; 0.954, p < 0.001). Furthermore, there was a moderately negative correlation between VK1 and EGFR pre-treatment values, with the relationship between them being marginally significant (r = −0.430, 95%CI −0.772; 0.001, p = 0.058). Post-treatment, we found a strong positive relationship between MGP and VK1 post-treatment values (r = 0.758, 95%CI 0.436; 0.900, p < 0.001). We also found a moderate positive relationship between Gas6 and EGFR post-treatment values, but the correlation was only marginally significant (r = 0.442, p = 0.051).
Life, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Acta Clinica Belgica, 2021
Background: Colorectal cancer (CRC) represents a major public health problem owing to the fact th... more Background: Colorectal cancer (CRC) represents a major public health problem owing to the fact that many patients are diagnosed in locally advanced or metastatic stage when chemotherapy is the only remaining option. However, treatment response is still unpredictable and depends upon a diversity of factors such as tumor inherited or acquired drug resistance and the host immune response to the malignant cells. The aim of this study was to evaluate the serum levels of interleukin 6, 8, 10 (IL-6, 8, 10) as possible predictive factors for response to chemotherapy and the correlation between the cytokines and the psychological distress. Methods: Forty-nine patients undergoing chemotherapy for locally advanced or metastatic CRC were included, for each patient IL-6, 8 and 10 were assessed through ELISA. Depression and anxiety were quantified through questionnaires. Statistical data were performed with GraphPad. Results: Patients with CRC had high serum levels of IL-8 and IL-6 compared to the healthy control group. High levels of IL-8 before treatment were correlated with progressive disease. There was a high incidence of psychological complication in CRC patients, especially in young male patients, from an urban area, with a positive correlation between serum levels of IL-8 and depression. Conclusions: These results indicate that high serum levels of IL-8 are predictive factors in CRC patients that undergo chemotherapy, but also could be useful in identifying psychological distress associated with this pathology.
Journal of Clinical Medicine, 2020
Chimeric antigen receptor (CAR) T-cell therapy represents a new genetically engineered method of ... more Chimeric antigen receptor (CAR) T-cell therapy represents a new genetically engineered method of immunotherapy for cancer. The patient's T-cells are modified to express a specific receptor that sticks to the tumor antigen. This modified cell is then reintroduced into the patient's body to fight the resilient cancer cells. After exhibiting positive results in hematological malignancies, this therapy is being proposed for solid tumors like colorectal cancer. The clinical data of CAR T-cell therapy in colorectal cancer is rather scarce. In this review, we summarize the current state of knowledge, challenges, and future perspectives of CAR T-cell therapy in colorectal cancer. A total of 22 articles were included in this review. Eligible studies were selected and reviewed by two researchers from 49 articles found on Pubmed, Web of Science, and clinicaltrials.gov. This therapy, at the moment, provides modest benefits in solid tumors. Not taking into consideration the high manufacturing and retail prices, there are still limitations like increased toxicities, relapses, and unfavorable tumor microenvironment for CAR T-cell therapy in colorectal cancer.
Expert Review of Proteomics, 2019
Introduction: The liver is the main location for metastasization in stage IV colorectal cancers. ... more Introduction: The liver is the main location for metastasization in stage IV colorectal cancers. Areas covered: This review intends to comprehensively present the most important studies conducted in the past few years concerning the role of miRNAs in colorectal cancer liver metastases, trying to clarify some aspects regarding tumor biology and favorite liver metastasization site. Expert commentary; Recent advances in tissue and serum RNA extraction has considerably improved the field of microRNAs studies. These molecules known to play a crucial role in the metastatic stage indicate a starting point in the development of clinical biomarkers with a possible role in the stratification of high-risk patients for adequate treatment.
Expert Review of Molecular Diagnostics, 2019
Introduction: Colorectal cancer is an important global health burden marked by a high mortality r... more Introduction: Colorectal cancer is an important global health burden marked by a high mortality rate. Medical attention is drawn more often by the new targeted therapies, but also by the concept of liquid biopsy. Tumor's genetic profile is the major indicator of the response to targeted therapies and the risk for metastatic relapse. Therefore, analysis of tumor-linked genetic alterations holds a great importance, both for diagnostic and prognostic purposes. Areas covered: The present paper highlights the molecular basis of the liquid biopsy concept and its major clinical applications in colorectal cancer. This consists in circulating tumor cells (CTC) and cell-free tumor DNA (cfDNA) and is described in manuscripts as an alternative to tissue samples, providing more information about tumor heterogeneity and tumor evolution in dynamic. Expert opinion: Liquid biopsy is an innovative, minimally invasive method which enables real-time monitoring of tumor's genetic heterogeneity, being an important step towards personalized medicine. However, despite the large number of detection methods available, it is necessary to standardize them regarding the blood collection processing and sample storage, analysis in order to be implemented in clinical guidelines.
Journal of B.U.ON.: official journal of the Balkan Union of Oncology, 2018
*These authors contributed equally to this work. Summary Purpose: Cytokines like IL-6, IL-10 and ... more *These authors contributed equally to this work. Summary Purpose: Cytokines like IL-6, IL-10 and other factors like CRP are involved in the postoperative inflammatory-stress response. The association between IL-6, IL-10, CRP, albumin and early postoperative complications and deaths was analyzed on a cohort of cancer patient. Methods: The plasma levels of IL-6, IL-10 and serum levels of c-reactive protein (CRP) and albumin were measured in 85 patients undergoing surgical resection of pancreatic, hepatic and gastric tumors. The measurement of the studied biochemical parameters was made at three time points: before the operation, and on the 1 st and 3 rd day after the operation. Results: Of the 85 patients, 28 suffered early postopera-tive complications (14 gastric cancer patients; 11 pancreatic cancer patients; 3 liver cancer patients) and 9 patients died in the early postoperative period (5 gastric cancer patients; 4 pancreatic cancer patients; 0 liver cancer patients). Patients with elevated levels of serum CRP on the 3 rd postoperative day had a significant increased risk of death. Also, patients with higher levels of IL-10 on the 3 rd postoperative day demonstrated a significantly increased risk of early postoperative complications. Conclusion: This study demonstrates that plasma IL-10 concentration is positively associated with postoperative complications.
WORLD JOURNAL OF PHARMACY AND PHARMACEUTICAL SCIENCES, 2018
In the US, colorectal cancer (CRC) is the third most frequent type of cancer and the third cause ... more In the US, colorectal cancer (CRC) is the third most frequent type of cancer and the third cause of mortality related to cancers. Actual treatment strategies consist of surgery as the only curative therapy for early stages, adjuvant chemotherapy as a standard option for stage III disease, biologic agents in combination with chemotherapy regims for metastatic disease and palliative care for untreatable diseases. Today, the 5-year survival rate for stage IV of CRC is around 10% and this is why we must find solutions to improve survival rates for advanced stages. Some of the new promising perspectives for the treatment of advanced stages of CRC are represented by intracellular anti-EGFR agents, stimulation of the anti-tumor immunity and the use of nanotechnologies for targeted ablation or as a delivery system for siRNA. KEYWORDS: In the US, colorectal delivery system for siRNA. BACKGROUND
Colorectal cancer remains a frequent disease to which screening and target therapy exist, but des... more Colorectal cancer remains a frequent disease to which screening and target therapy exist, but despite this is still marked by a high mortality rate. Even though radical surgery may be performed in many cases, patients relapse with metastatic disease. Circulating tumor cells were incriminated for tumor recurrence, that's why vigorous research started on their field. Owning prognostic and predictive value, it was revealed their usefulness in disease monitoring. Moreover, they may serve as liquid biopsies for genetic tests in cases where tissue biopsy is contraindicated or cannot be performed. In spite of these advantages, they were not included in clinical guidelines, despite CellSearch and many other detection methods were developed to ease the identification of circulating tumor cells. This review highlights the implication of circulating tumor cells in metastasis cascade, intrinsic tumor cells mechanisms and correlations with clinical parameters along with their utility for medical practice and detection techniques.
Pancreatic cancer has attracted a great deal of attention owing to the poor outcome, increasing p... more Pancreatic cancer has attracted a great deal of attention owing to the poor outcome, increasing prevalence in the last years and delay diagnosis. Known as a complex disease, it involves genetic mutations, changes in tumour microenvironment and inflammatory component dominated by interleukin-6 and its activated pathways, like Janus Kinase-Signal Transducer and Activator of Translation3, Mitogen Activated Protein Kinase and Androgen receptor. The pro-inflammatory cytokine, plays a central role in oncogenesis, cancer progression, invasiveness, microenvironment changes, treatment resistance, prognosis and associated co morbidities like cachexia and depression. Fulfilling these roles IL-6 requires special attention to understand its complexity in PC development.
Background and aims. The aim of this study was to investigate the value of serum carcinoembryonic... more Background and aims. The aim of this study was to investigate the value of serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA 19-9) correlated with some tissue molecules as predictive markers for recurrence in colon cancer. Methods. A total of 30 patients diagnosed with colon cancer stage II or III who underwent optimal surgery were enrolled in study. Tumor markers CEA and CA 19-9 were determined before surgery. Tumor samples were prepared using tissue microarray kit (TMA) then stained for different cellular markers (Ki 67, HER2, BCL2, CD56, CD4, CD8) and analyzed using Inforatio programme for quantitative determination. All patients received standard adjuvant treatment, which consisted of eight cycles chemotherapy type XELOX. The patients were followed up for 3 years. Results. Upon 3 years follow-up, 67% of patients developed tumor relapse, the most common site of metastasis being the liver. No correlations were observed between either serum or tissue tumor markers and the risk of tumor relapse. Conclusion. Over 50% of patients with colon cancer who had optimal treatment developed metastasis. No statistically significant predictive value for investigated molecules was found. Future studies are needed to confirm the use of molecular markers in monitoring patients with colorectal cancer
Pseudomyxoma peritonei (PP) is a rare disease characterized by the presence of mucinous ascites a... more Pseudomyxoma peritonei (PP) is a rare disease characterized by the presence of mucinous ascites and low and progressive accumulation of peritoneal implants. We report the case of a 44-year-old man presented with ascites, imaging evaluations suggesting the diagnosis of gelatinous peritoneal carcinomato-sis. The patient underwent laparoscopy with extensive cytoreductive surgery combined with hyperther-mic intraoperative peritoneal chemotherapy (HIPEC). Microscopic features confirmed the diagnosis of low-grade PP. Nine months later the patients developed left pleural effusion and cytological examination releaved the intrathoracic extension of PP. The treatment consisted in extensive intrathoracic cytoreduc-tive surgery in combination with hyperthermic intrathoracic chemotherapy perfusion (HITOC). Further surgery was requiered due to intra-abdominal recurrence and finally, the patient developed hepatic and pulmonary metastases treated by systemic chemotherapy, with good tolerability and complete response.
Celiac Disease by Samasca Gabriel
Central European Journal of Public Health, 2022
Celiac disease (CD) is a disorder that affects both children and adults. Over the few last decade... more Celiac disease (CD) is a disorder that affects both children and adults. Over the few last decades, several new atypical cases have been identified through improved diagnostic tools. On the other hand, the onset of CD at a later age, including atypical CD forms whose clinical picture overlaps with other autoimmune diseases, shows that currently there are several unknown gene mutations, which could be responsible for the disease development. Non-celiac gluten sensitivity (NCGS) is entity included by the ingestion of gluten leading to intestinal, or extraintestinal symptoms that improve once the gluten is removed from the nutrition. In this article relationships between genetically modified rodent animals with previously unknown multiple organ changes and CD, respectively NCGS are reviewed. Relationships between the small bowel histological changes and other organs pathology are discussed. Results of research document that changes have similar genetic background and can develop to serious autoimmune systematic diseases, including small bowel inflammation resembling atypical CD or NCGS. These may have extra-intestinal symptomatology but without a clear explanation of causes and differences in their manifestations. Research on animal models helps to discover links between several disorders associated with gastrointestinal damage. New methods based on individual gene mutations can help in atypical adult CD and NCGS recognitions in the future.
Journal of Translational Autoimmunity, 2021
Background: The COVID-19 pandemic has had an impact on global health. Design: The impact of the C... more Background: The COVID-19 pandemic has had an impact on global health. Design: The impact of the COVID-19 pandemic on patients with coeliac disease was assessed in the present review. Results: The incidence of coeliac disease and the problems associated with coeliac disease increased during the COVID-19 pandemic. Adherence to the diet is crucial for the patient's health and quality of life since the only approved therapy for coeliac disease is a gluten withdrawal. Conclusions: A gluten-free diet should be promoted by the therapeutic team and implemented among these categories of patients.
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Cancer Research by Samasca Gabriel
The incidence of gastric cancer (GC) is increasing. Many people receive an advanced diagnosis of GC. Furthermore, a large number of patients are surgically inoperable and are unresponsive to preoperative chemotherapy. Patients with GC do not currently have an immunotherapy option. Our study’s objective was to provide insight into extracellular vesicles (EVs) and GC. EVs in GC can be studied, as this article explains. EVs screening, which is available for all patients, is an option for combatting GC.
Abstract
Extracellular vesicles, or EVs, are membrane-bound nanocompartments produced by tumor cells. EVs carry proteins and nucleic acids from host cells to target cells, where they can transfer lipids, proteomes, and genetic material to change the function of target cells. EVs serve as reservoirs for mobile cellular signals. The collection of EVs using less invasive processes has piqued the interest of many researchers. Exosomes carry substances that can suppress the immune system. If the results of exosome screening are negative, immunotherapy will be beneficial for GC patients. In this study, we provide an update on EVs and GC based on ongoing review papers and clinical trials.
Using the search term “Helicobacter pylori, gastric cancer”, the PubMed database was searched. Only papers published in 2024 fulfilled the inclusion criteria. Because case report papers were not part
of our investigation, they satisfied the exclusion criteria. Most of the research on the variable genes of Helicobacter pylori is guided by genetics to determine potential treatments. Studies on clinical treatments for the eradication of H. pylori with promising therapeutic options are needed. We found the fewest studies related to the immunopathology of H. pylori infection, which is still unknown. In conclusion, priority should be given to this kind of research.
the the guidelines of the European Society of Medical Oncology (ESMO), which are updated with new findings but not systematically reviewed annually. We used the search term “gastric cancer” to find the most current publications in the PubMed database related to the prognosis and treatment of gastric cancer. As previously said, the only articles that satisfied the inclusion criteria were those from 2024. Articles with case reports were eliminated since they had nothing to do with our research.
The treatment of gastric cancer is the focus of the majority of articles from 2024. The primary research axes include surgery and immunonutrition, immunotherapy and Helicobacter pylori, and therapeutic
targets. Patients with GC may experience less psychological, social, and financial hardship if the recently identified markers discovered in circulation are better assessed and validated. This could be achieved by either including the markers in an artificial intelligence-based diagnostic score or by using them in conjunction with traditional diagnostic methods. Due to the rising death rate associated with GC, funding for research into diagnosis, prognosis, therapy, and therapeutic targets is essential.
Celiac Disease by Samasca Gabriel
The incidence of gastric cancer (GC) is increasing. Many people receive an advanced diagnosis of GC. Furthermore, a large number of patients are surgically inoperable and are unresponsive to preoperative chemotherapy. Patients with GC do not currently have an immunotherapy option. Our study’s objective was to provide insight into extracellular vesicles (EVs) and GC. EVs in GC can be studied, as this article explains. EVs screening, which is available for all patients, is an option for combatting GC.
Abstract
Extracellular vesicles, or EVs, are membrane-bound nanocompartments produced by tumor cells. EVs carry proteins and nucleic acids from host cells to target cells, where they can transfer lipids, proteomes, and genetic material to change the function of target cells. EVs serve as reservoirs for mobile cellular signals. The collection of EVs using less invasive processes has piqued the interest of many researchers. Exosomes carry substances that can suppress the immune system. If the results of exosome screening are negative, immunotherapy will be beneficial for GC patients. In this study, we provide an update on EVs and GC based on ongoing review papers and clinical trials.
Using the search term “Helicobacter pylori, gastric cancer”, the PubMed database was searched. Only papers published in 2024 fulfilled the inclusion criteria. Because case report papers were not part
of our investigation, they satisfied the exclusion criteria. Most of the research on the variable genes of Helicobacter pylori is guided by genetics to determine potential treatments. Studies on clinical treatments for the eradication of H. pylori with promising therapeutic options are needed. We found the fewest studies related to the immunopathology of H. pylori infection, which is still unknown. In conclusion, priority should be given to this kind of research.
the the guidelines of the European Society of Medical Oncology (ESMO), which are updated with new findings but not systematically reviewed annually. We used the search term “gastric cancer” to find the most current publications in the PubMed database related to the prognosis and treatment of gastric cancer. As previously said, the only articles that satisfied the inclusion criteria were those from 2024. Articles with case reports were eliminated since they had nothing to do with our research.
The treatment of gastric cancer is the focus of the majority of articles from 2024. The primary research axes include surgery and immunonutrition, immunotherapy and Helicobacter pylori, and therapeutic
targets. Patients with GC may experience less psychological, social, and financial hardship if the recently identified markers discovered in circulation are better assessed and validated. This could be achieved by either including the markers in an artificial intelligence-based diagnostic score or by using them in conjunction with traditional diagnostic methods. Due to the rising death rate associated with GC, funding for research into diagnosis, prognosis, therapy, and therapeutic targets is essential.
in patients with HLA DQ2 / DQ8 negative genotype is even rarer. Most patients develop first diabetes and celiac disease afterward. We present
the case of two brothers: the younger brother (aged 4 years 2 months) came first at the 2nd Clinic of Pediatrics in 2011 and was diagnosed with
celiac disease. Then the older brother (aged 9 years 3 months) was investigated too, even though he was clinically asymptomatic. We found that he accomplished the laboratory criteria for celiac disease. We determined the HLA DQ genotype in both brothers. The younger brother was HLA DQ 7 positive and the older brother tested negative for HLA DQ. One year after diagnosis and initiation of gluten-free diet, the older brother was diagnosed with type I diabetes. We determined also the HLA DR and the result was that the younger brother had a protective genotype and the older brother was the carrier of a genotype that predisposes to autoimmune diseases. These cases were outstanding because celiac disease is rarely diagnosed in the absence of predisposing HLA alleles. Consistent with previous studies, the brother who had the predisposing genotype, presented more than one autoimmune disease and the one with the protective genotype developed celiac disease.
Objectives. The study of the clinical and paraclinical evolution of dilated cardiomyopathies in children, unresponsive to conventional treatment with angiotensin converting enzyme inhibitors, diuretics, digoxin, requiring the association of carvedilol; the study of the pharmacokinetics of carvedilol in children.
Materials and metods. 16 children with severe dilated cardiomyopathy and left ventricular ejection fraction
≤ 31% were clinically evaluated according to the ROSS / NYHA score and echocardiographical. The measurement of carvedilol in human plasma, high performance liquid chromatography associated with mass spectrometry the external standard method, was used for 7 patients.
Results. Of the 16 children with dilated cardiomyopathies treated with carvedilol as adjuvant medication to
conventional therapy, 14 evolved towards clinical and echocardiographic improvement and two towards
death. Clinically, the children tolerated carvedilol well, the NYHA score improved and the left ventricular
ejection fraction increased from 31% to more than 40%. The study of the pharmacokinetics of carvedilol was
performed for 7 subjects. It was demonstrated that the absorption rate does not change with the increase of
the administered dose. The time to reach peak concentration is identical for all subjects. The mean half-time
is 2.88 hours, being much shorter than in adults. The mean residence time of carvedilol in the body varies
similarly, 4.28±1.52 hours.
Conclusions. At the pediatric age, dilated cardiomyopathies unresponsive to conventional treatment with angiotensin-converting enzyme inhibitors, diuretics and digoxin benefi ted from the association of betablocking medication – carvedilol, with the improvement of the NYHA/ROSS score and of the left ventricular ejection fraction. The study of the pharmacokinetics of carvedilol in children evidenced a mean half-time of 2.88 hours and a mean residence time in the body of 4.28±1.52 hours.
Methods: We have studied 80 children with chronic hepatitis B (30 female; mean age 12.31 4.13 years). For each patient we performed haematological and biochemical tests and in 41 patients we analyzed the liver histology. The immunological parameters analyzed were: circulating immune complexes (CIC), complement, and the serum levels of immunoglobulin G, A, and M. We analysed by indirect fluorescence the presence of ANA and other autoantibodies. The response to treatment (hepatoprotectors, interferon and Lamivudine) was established depending on seroconversion to HBeAb and HBsAb.
Results: Positive ANA were found at baseline in 15% of the patients and during follow-up in 21.25%. In ANA-positive patients compared to those without autoantibodies we found lower levels of haemoglobin and platelet numbers (p = 0.0245, p = 0.0236, respectively), higher gamma-glutamyl-transferase level (p = 0.040) and higher CIC level (p = 0.0155). During interferon treatment 13.79% of those who initially tested ANA-negative presented ANA, compared to 2.56% in those without interferon (p = 0.042). There was no difference in response to interferon treatment according to the presence of ANA (p = 0.4201).
Conclusions: Searching for ANA in children with chronic hepatitis B is a key element in describing the evolution of these patients, especially when considering interferon therapy. Interferon treatment stimulates the development of ANA, but their presence does not influence the response to this particular treatment. The role of autoimmune processes in the evolution and response to treatment of chronic hepatitis B patients remains controversial.
years old all diagnosed with pneumonia by clinical and radiological features. we applied various laboratory methods (serologic, bacteriologic: bronchial aspirate, sputum, pleural effusion and blood culture) in order to identify a pathogen agent that caused pneumonia. statistics used statistical Package for social science. An etiology was established in 68.92 % of all cases included in the study, as follows:
in 33.93 % viral etiology, in 25.13 % we identified Streptococcus pneumoniae, in 20.2 % Mycoplasma
pneumoniae, Klebsiella pneumoniae in 8.29 %, Staphylococcus aureus in 7.51 %, Haemophilus
influenzae in 4.92 %. Mixed bacterial and viral infection was identified in 4.40 % of all cases. A potential causative agent of childhood pneumonia was determined in most cases, S. pneumoniae being the main agent involved in community acquired childhood pneumonia in our country.
clones. Superantigens are potent activators of CD4+ T cells, causing rapid and massive proliferation of cells and
cytokine production. Superantigen administration is able to significantly enhance ineffective anti-tumor immune
responses, resulting in potent and long-lived protective anti-tumor immunity. Superantigens are more well-known
for the role they play in diseases. Some studies argue that in multiple sclerosis superantigens can induce severe
relapses and activate auto-reactive T cells not involved in the initial bout of disease. Superantigens are produced by
pathogenic microbes (bacteria, viruses and mycoplasma) into the cells and then are released outside the cells as
mature toxins. There are two types of super-antigens: endogenous (viral) and exogenous (bacterial). They escape
intracellular processing by binding directly to MHC II, outside the conventional site where antigens bind. Interaction
of super antigens with T lymphocyte can produce the inhibition of the cellular response to energy. Superantigens
may be involved in T cell apoptosis. Best known super-antigens are: staphylococcus aureus enterotoxins A and B
and the streptococcus exotoxins A-G, streptococcus wall M protein, exotoxins produced by Clostridium perfringens,
Yersinia enterocolitica. Recently it was ascertained that super-antigens play an important role in human pathology,
with a dramatic effect on the immune system. These molecules are involved in various diseases, such as: Toxic
shock syndrome, Kawasaki disease, Eczema, Guttate psoriasis, Rheumatoid arthtritis, Diabetes mellitus, Scarlet
fever, Nasal polyps.
generated during DNA replication. MLH1 absence has been observed in human gastrointestinal tumours as well as tumours of the female reproductive tract. We describe the functions of MLH1 in cell cycle regulation and DNA mismatch repair. In this sense we discuss foriegn knowledges, in which the canine colon adencarcinoma is less frequently diagnosed in Czech and Slovak regions. We briefly described a molecular mechanism of evolution of MSI+ and MSI- colorectal carcinomas in human, and this was confronted with the current opinion of canine colon adenocarcinomas. We suppose that canine colon adenocarcinomas may occur in higher frequency, but they are underdiagnosed in the clinical veterinary practice. At the end, we describe two cases of dogs diagnosed with colorectal adenocarcinoma. The authors propose the centralized collection of colon adenocarcinoma samples from dogs, in one reference veterinary histopathological laboratory, which would analyse mismatch repair proteins.
cutaneous and subcutaneous tissue is called angioedema. Urticaria is characterized as the appearance of
erythematous, circumscribed, elevated, pruritic, edematous swelling of the upper dermal tissue. Urticaria may occur
in any part of the body, whereas angioedema often involves face, extremities or genitalia. Urticaria is considered
acute if symptoms are present for less than 6 weeks. In chronic urticaria symptoms are longer than 6 weeks. Acute
urticaria has been reported to be the common type in childhood and chronic urticaria is more frequent in adults.
Urticaria and angioedema are a frequent cause of emergency room visit but few patients need to be admitted.
The basic mechanism involves the release of diverse vasoactive mediators that arise from the activation of cells or
enzymatic pathways. Histamine is the best known of these substances, and response consisting of vasodilatation
(erythema), increased vascular permeability (edema) and an axon reflex that increases reaction. The most common
etiological factors for angioedema and urticaria have been identified as infection, physical urticaria, food allergy, drug
adverse reaction, parasitic infestation and papular urticaria. The aim of this study is to define, describe and discuss
etiology, diagnostic, treatment and severity.
on quality of life and activity. Typical manifestations of urticaria are not difficult to diagnose. Association of urticaria
with angioedema is relatively common, about 50% of cases. This association can be life-threatening requiring
intensive care. Urticaria treatment is not easy and when angioedema associated therapeutic measures should be
complex. Etiological treatment is the most desirable option for physician and patient, but in many cases the cause
cannot be identified. Non-sedating H1
-antihistamines are considered first-line treatment of urticaria.
Anaphylaxis can be quickly diagnosed if we recognize respiratory and circulatory manifestations and we correctly
assess mental status. The first and most important treatment is epinephrine. After successful therapy, the clinician’s
attention must be directed toward preventing recurrences- biphasic anaphylaxis and to elucidate the causes. The
patient will need to be explained the importance of preventing relapse and needs to be equipped with epinephrine,
which to use in critical situations. There are differences concerning therapeutic approach, recognition of symptoms
and patient education, depending on physician’s experience, on patient’s education level and on socio-economic
level of their country.
Dravet syndrome was suspected due to the clinical context of the seizures and was confirmed by genetic testing. The brain MRI was found to be normal. Throughout the course of disease progression, the patient
showed no signs of neurological degradation. The patient was found to have a mutation in the SCN1A gene with a peculiar course, which had not been reported previously. The normal psychomotor development, as
seen in this case, highlights the different possibilities related to disease progression in Dravet syndrome.
Patients and methods. Over a period of 4 years, 26 patients presented at our clinic with drug-induced esophageal ulcerations. All patients were diagnosed by means of endoscopy and treated with proton-pump inhibitors and prokinetics. The mean age of the children was 10.76 years.
Results. The ulcers were frequently located at the mid-esophagus. Odynophagea, retrosternal pain and dysphagia were the most common presenting symptoms. All children took pills (non- steroidal anti-inflammatory drugs, antibiotics – Doxycycline and ferrous sulfate) with little water and at bed time. The mean elapse between the drug intake and endoscopy was 4.96 days. The symptoms resolved within a
maximum of one week of antireflux therapy.
Conclusions. In pediatric cases treated by tablets or capsules, the possibility of medication-induced esophagitis should always be considered. The drug-induced esophagitis should be suspected in all patients presenting with chest pain and dysphagia. Physicians must warn the patients to take the pills and capsules with enough water and in the upright position.
Methods: Fifty-one children and adolescents (31 males) aged 11.65 ± 4.1 years with DM1 were enrolled in the study. Twenty-seven healthy children, age- and gender-matched, were enrolled as controls. Patients and controls underwent the 8iPGF2α assessment through an ELISA serum method.
Results: The mean 8iPGF2α value was 2090.6 ± 3536.5 in the DM1 patient group and 509.9 ± 493.5 in controls (p = 0.03). The mean 8iPGF2α value was 2178.19 ± 4017.05 in patients with DM1 who did not suffer from other associated autoimmune diseases (n = 38) vs. 1834.95 ± 1504.73 in patients with DM1 and other associated autoimmune diseases (n = 13) (p = 0.76). The correlation between the 8iPGF2α and the HbA1c values was determined by obtaining a correlation coefficient r = 0.38 and p = 0.0057. No correlation was observed between GAD65 and 8iPGF2α (r = 0.3; p = 0.29), IA2 and 8iPGF2α (r = -0.02; p = 0.92), IAA and 8iPGF2α (r = 0.4; p = 0.12).
Conclusions: Oxidative stress reactions are more intense in patients with diabetes mellitus type 1 than in healthy patients. Similar results were obtained in patients associating other autoimmune diseases. 8iPGF2α can be an ideal marker for determining oxidative reactions in vivo.
The aim of our study was to examine the possible differences in paraoxonase 1 enzymatic activities in diabetic children associated other autoimmune diseases versus a control group. Another objective of the study was to determine if there is any difference according to the gender in paraoxonase 1 activities (arylesterase and paraoxonase activities). Paraoxonase 1 activities were determined in
51 diabetic children and 36 healthy controls. In diabetic children we determined also the C-peptide level. The paraoxonase 1 arylesterase activity was lower in diabetic females compared with diabetic males. The level of C-peptide is in an inverse correlation with the years of the disease. The paraoxonase activities have a correlation with the level of insulin antibodies in type I diabetic children. Our data suggest that paraoxonase enzymatic pattern may be different in these two activities. PON1 arylesterase activity may exhibit a tendency to low levels in women in comparison to men. The
C-peptide level is a valuable tool in assessing the restant b cell function.
is associated with improvement in
some abnormalities present in hemodialysis
(HD) patients.
Objective. The study aim was to
analyze the effect of oral L-carnitine
supplementation on endothelial dysfunction
(ED), oxidative stress (OS), inflammation
and anemia in HD patients.
Design. A prospective, longitudinal
and observational study was performed in a
single dialysis unit.
Subjects and methods.We studied 31
HD patients: 21 patients formed the Lcarnitine
supplementation group (group 1) and
10 entered the control group (group 2). At
baseline and after 3 months of L-carnitine
supplementation (500mg/day) we determined
endothelial-dependent flow-mediated vasodilatation
(FMD) and nitroglycerin induced
endothelium independent vasodilatation,
involving ultrasonographic brachial artery
measurements, serum visfatin, malondialdehyde,
body mass index, systolic blood
pressure, diastolic blood pressure, interdialytic
body weight gain, C-reactive protein, albumin, cholesterol, HDL-cholesterol,
LDL-cholesterol, triglycerides, ferritin,
transferrin saturation, hemoglobin,
erythropoietin dose, calcium (Ca),
phosphorus (P), parathormone and Kt/V .
Results. In group 1, FMD (8.9 (4.5-12.5)
to 10.6 (6.7-18), p=0.04) and Ca (8.4±0.6 to
8.8±0.5 mg/dL, p<0.001) significantly
increased after L-carnitine supplementation,
while visfatin (1.0 (0.2-1.3) to 0.4 (0-0.9)
pg/mL, p=0.03), malondialdehyde (2.8 (2.4-
3.2) to 1.3 (1.2-1.5) nmol/mL, p<0.001) and P
(5.6±1.3 to 5.0±1.2 mg/dL, p=0.005)
significantly decreased. Albumin increased
significantly in both groups (3.9±0.3 to 4.2±0.3
mg/dL, p<0.001 in group 1 and 3.7±0.3 to
4.0±0.3 mg/dL, p=0.02 in group 2). There
were no other significant variations of the
studied parameters.
Conclusions. L-carnitine supplementation
reduces ED, visfatin levels and
markers of OS, but has no effect on
inflammation, nutrition and anemia in HD
patients.
calcification, calcium phosphate or hydroxyapatite crystals can form asymptomatic deposits in joints or periarticular tissues, contributing to the pathophysiology of osteoarthritis, rheumatoid arthritis,
ankylosing spondylitis, tendinitis, and bursitis. The risk factors and sequence of events that initiate ectopic calcification, as well as the mechanisms that prevent the development of this pathology,
are still topics of debate. Consequently, in this review, we focus on the nexus of the mechanisms underlying vascular and cartilaginous calcifications, trying to circumscribe the similarities and
disparities between them to provide more clarity in this regard.
(adjusted OR = 1.43, 95% CI: (1.10, 1.86)) were significantly associated with higher odds of VDD. In conclusion, the study revealed a significant difference in the frequency of VDD and VDI among pediatric patients older than six years, with a significant difference according to sex and season, being more pronounced among girls and during the winter and spring seasons.
The detection of sideroblastic anemia in a newborn may suggest developing Pearson syndrome. The prognosis of these patients is severe and death occurs in the first 3 years of life, so it is important to find new ways of diagnosis.
Case Presentation:
In the case of our patient the diagnosis was supported only at the age of 5 months, highlighting the difficulties of diagnosis at this age.
Conclusions:
The diagnosis of Pearson syndrome with neonatal onset is difficult to sustain or even impossible at that age. This diagnosis can be confirmed and supported during disease progression.