New Insights on Non-B non-C Hepatocellular Carcinoma in Mid Delta Region,Egypt

Purpose

The rate of hepatocellular carcinoma (HCC) is increasing worldwide, including in Egypt. Hepatitis B (HBV) and C (HCV) viruses are major risks. Non-B non-C HCC was reported in some countries. We investigated non-B non-C HCC-independent risk factors and associated profiles in viral hepatitis endemic region.

Methods

In a consecutive series, 281 patients were diagnosed with HCC and received for management, at Tanta University Hospitals, within the past 3 years. Demographic variables and environmental exposures were recorded by direct application of a modified questionnaire. Sera were tested for HCV (antibodies by ELISA and RNA by RT-PCR) and HBV (HBs Ag by ELISA and HBV DNA). Antinuclear antibody, serum copper, and iron were assessed in non-viral HCC. Liver biopsy was performed for HCC diagnosis and grading and liver tissue in all patients by histopathological and immunohistochemical methods to assess HBV and/or HCV etiology.

Results

Non-B non-C HCC patients were 13.87 % of the total and were associated with multiple risks, predominantly pesticides (100 %, p?<?0.001) and super phosphate and ammonium sulfate fertilizers (94.87 %, p?<?0.001) with significant exposure in industry, farming, and residence. Their tumors were mainly solitary, smaller sizes, and of lower alpha-fetoprotein titers. The study showed insignificant increase in prevalence of non-B non-C HCC and had special characters. Multivariate analysis showed significance of pesticides and smoking as independent risks for non-B non-C HCC.

Conclusions

Pesticides and smoking heavy exposure can be considered as primary risks for non-B non-C HCC. Phosphate and ammonium sulfate fertilizers were associations. The study will increase awareness for better prevention and management.     

Treating advanced hepatocellular carcinoma: How to get out of first gear

Hepatocellular carcinoma is a common malignancy with a poor prognosis. Sorafenib is the only systemic therapy known to improve the overall survival of patients with advanced disease. The clinical benefit of sorafenib is modest and the mechanistic basis for its activity is unknown. Four phase 3 clinical trials have failed to improve on sorafenib in the frontline setting and no agent has been shown to impact outcomes after sorafenib failure. Several factors have contributed to this recent stall in drug development but new approaches hold promise and currently are being investigated. This review will focus on the current pipeline of experimental therapeutics for patients with advanced hepatocellular carcinoma and shed a light on scientific limitations that hamper the advancement of new therapies for this disease, and ways around it. Cancer 2014;120:3122–3130. © 2014 American Cancer Society.     

Fluconazole prophylaxis is associated with a decreased rate of coagulase-negative Staphylococcal infections in a subset of extremely low birth weight neonates

Fluconazole prophylaxis is being used efficaciously in the neonatal intensive care unit (NICU) for fungal prophylaxis in very low birth weight and extremely low birth weight (ELBW) neonates. Little is known about the effect of fluconazole prophylaxis on bacterial infections. The purpose of this study was to examine that issue in a subset of ELBW, those weighing ≤900 g at birth. This is a retrospective study conducted in a level III NICU at state-designated children hospital in New Jersey (USA). We examined the data from our records of neonates ≤900 g birth weight during the period March 1, 2007–February 28, 2011. Inclusion in the study was all infants ≤900 g before (n = 67) and after (n = 81) the institution of fluconazole prophylaxis. Fluconazole prophylaxis was accompanied by a significant decrease in both the rate and number of days of bacterial infections as well as co-infections. We found that the incidence of coagulase-negative Staphylococcus (CONS) decreased from 46.2 to 24.7 % (OR 2.63; 95 % CI 1.31–5.27). Similarly, days of infection also decreased significantly (p < 0.0001). These data suggest that fluconazole prophylaxis may be associated with a reduction in CONS infections in that subset of ELBW neonates.     

Évaluation de l’activité antiasthmatique et antitussive de Combretum molle, plante médicinale de la pharmacopée ivoirienne

In this work, we studied the inhibitory effects of Combretum molle extract on respiratory disturbances and coughs. Injection of 3.33 mg/kg and 7.14 mg/kg of Combretum molle had no effect on a rabbit’s breathing. Injection of acetylcholine (0.2 ml; 714.10^?3 mg/kg) induced a percentage estimated at ?100%. But a combined injection of acetylcholine and increasing doses of Combretum molle reduced this percentage from ?100% to ?20 ± 0.5%. We also studied the inhibitory effects of the crude extract on coughs. Guinea pigs which were not treated produced 10.25 ± 0.95 in 10 minutes. But treating the guinea-pigs with 3 mg/kg of crude extract resulted in 8.25 ± 0.45 coughs for 10 min. With 30 mg/kg, however, coughing was reduced to 4.5 ± 0.25. We could therefore conclude that the extract presents some inhibitory effects on coughing and bronchial contraction induced by acetylcholine.