Impact of cellular CD71 (transferrin receptor 1) expression in Egyptian acute leukemia: correlation with clinicopathologic features

Cellular transferrin receptor 1 (CD71) has been identified as a proliferation marker. Inferior outcome with higher expression was observed in many solid tumors. This study objected to assess the expression of CD71 in patients with acute leukemia and to address its prognostic significance and relations to clinicopathologic features. The study included 34 acute myeloid leukemia (AML) and 64 acute lymphoblastic leukemia (ALL) newly diagnosed cases from Mansoura Oncology Center. CD71 was analyzed on blast cells by flow cytometry. CD71 expression was significantly elevated in both AML and ALL. Antigen expression apparently increased in T-ALL, while in AML there was a trend toward a gradual increase of antigen expression in relation to maturation evidence of myeloid subtypes. CD71 expression correlated positively with total leukocyte count in ALL cases and negatively with platelet count in AML cases. In ALL, higher CD71 expression was associated with higher relapse rate and was an independent prognostic factor of overall survival (HR 1.8; 95 % CI 1.2–4.1). In conclusion, CD71 is overexpressed in acute leukemia; it predicts adverse clinical outcome in ALL. In addition, CD71 antagonism could be a possible therapeutic target in acute leukemia.     

Healing Acceleration of Acetic Acid-induced Colitis by Marigold (Calendula officinalis) in Male Rats

Background/Aim:

Ulcerative colitis (UC) is a type of chronic inflammatory bowel disease with unknown etiology. Several therapeutic strategies such as consumption of medicinal plants have been used for its treatment. The aim of this study was to evaluate healing effects of Calendula officinalis hydroalcoholic extract in experimentally induced UC in rat.

Materials and Methods:

Ninety-six rats, weighing 200 ± 20 g, were randomly divided into eight equal groups. UC induced by 3% acetic acid and oral doses of C. officinalis extract, 1500 and 3000 mg/kg, and enema (gel 10% and 20%) were given. Two groups as positive controls were given asacol (enema) and oral mesalamine. Negative control groups were given normal saline and base gel. On days 3 and 7, intestinal histopathology and weight changes, plus oxidative stress indices including malondialdehyde (MDA) level and myeloperoxidase (MPO) activity were assayed.

Results:

A significant increase in the body weight of rats was seen in the group given C. officinalis extract 3000 mg/kg orally, oral mesalamine, and 20% intracolonic gel form of marigold extract compared with negative control and base gel groups during the experimental period. Acute inflammation and granular atrophy after UC induction were resolved completely completely by both 20% intracolonic gel and 3000 mg/kg orally. An increase in MPO activity and a decrease in MDA level in response to oral and intracolonic gel form of C. officinalis were observed 3 and and 7 days after treatment (P < 0.05).

Conclusion:

Our results indicate that oral and enema forms of hydroalcoholic extract of C. officinalis can be offered as are potential therapeutic agents for UC induced in rats.Key Words: Histopathology, marigold, oxidative stress, ulcerative colitisUlcerative colitis (UC) is an idiopathic inflammatory bowel disease. It is an interaction between including genetic, immunological, reactive oxygen species, and environmental factors, which affects the large intestine. It is clinically characterized by diarrhea, abdominal pain or rectal pain, fever, weight loss, and blood in the stool.[1] Although UC is most commonly detected in young adulthood,[2] the condition can affect patients of any age and both genders. Also this disease affects women slightly more than men.[3] Loftus et al. reported that the incidence of UC is about 10–20 per 10⁶ per year with a prevalence of 100–200 per 10⁶ in Western countries.[4] Overall, the rate of UC is higher in developed countries than in developing countries due to their lifestyle,[5] whereas it is increasing in Iran[6] and Taiwan.[7]It is suggested that environmental conditions are more effective than genetics. Other factors such as intestinal microflora, mucosal immune response, autoimmune reactions, and especially oxidative stress are also important in the pathophysiology of UC.[8] Medical and surgical therapies are the current modalities for treatment of UC, but surgery is indicated for those who are unresponsive to medical therapy. Although bacterial bowel flora such as Shigella, Clostridium difficile, and Escherichia coli 0157:H7 may be one of the contributing factors in the pathogenesis of chronic mucosal inflammation, antibiotics treatment has no established role in UC.[9]The use of no effectiveness of usual treatments, the use of alternative medicines, mainly of herbal treatments, for UC is increasing.[10] The effects of many medicinal plants in UC have been investigated in the past decades. These include Strawberry,[11] Vitex negund,[12] licorice,[13,14] Ginkgo biloba,[15] Oroxylum indicu,[1] Origanum onites,[16] and Calendula officinalis[17,18] in rats, Polygonum multiflorum in mice,[19] Fragaria vesca[20] and Moringa olifera in albino rats,[12] Teucrium polium[21] and Calendula Officinalis in dog,[22] and C. officinalis in mice.[23]C. officinalis, also known as Marigold, is an annual herb native to the Mediterranean region,[24] and an important medicinal plant in the family Asteraceae. In traditional medicine, it is used for the treatment of fever and cancer.[25] It is hypothesized to be effective in treating this disease due to its antioxidant[26,27,28] and anti-inflammatory[29,30] compounds. C. officinalis extract decreases lipid peroxidation and inhibits edema. It is also used for gastrointestinal,[28] gynecological, eye, and skin diseases.[31] The plant is rich in several pharmaceutically active ingredients such as sterols, flavonoids, carotenoids, and glycosides.[32]This study has been undertaken to compare the effects of oral and enema forms of hydroalcohol extract of C. Officinalis on improvement of acetic acid-induced UC in adult male rats.     

Synthesis of 2‐(methylsulfonyl)‐5‐(4‐(methylsulfonyl) phenyl)‐4‐phenyl‐1H‐[5‐14C]imidazole,a selective COX‐2 inhibitor,via asymmetrical benzoins

4,5‐Diarylimidazoles labeled with carbon‐14 in the 5‐position of the imidazole ring were prepared as a part of three‐step sequence from 2‐hydroxy‐1‐(4‐(methylthio)phenyl)‐2‐phenyl[1‐¹⁴C]ethanone as a key synthetic intermediate which has been synthesized from potassium [¹⁴C]cyanide.     

The Management of Surgical Patients with Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a leading public health problem in both developed and developing nations. However, awareness regarding diagnostic options, management, and consequences of untreated OSA remains inadequate in the perioperative period. Adverse surgical outcomes appear to be more frequent in OSA patients. Immediate postoperative complications may be partially attributed to the negative effects of sedative, analgesic, and anesthetic agents that can worsen OSA by decreasing pharyngeal tone and the arousal responses to hypoxia, hypercarbia, and obstruction. Rebound rapid eye movement sleep after anesthesia and the use of opioids may contribute to adverse events in the postoperative period. Even though data to guide clinicians in the perioperative period is scarce, heightened awareness is recommended.     

Highlights from the III International Symposium of Thrombosis and Anticoagulation (ISTA), October 14?C16, 2010, S?o Paulo, Brazil

To discuss and share knowledge around advances in the care of patients with thrombotic disorders, the Third International Symposium of Thrombosis and Anticoagulation was held in S?o Paulo, Brazil, from October 14-16, 2010. This scientific program was developed by clinicians for clinicians, and was promoted by four major clinical research institutes: the Brazilian Clinical Research Institute, the Duke Clinical Research Institute of the Duke University School of Medicine, the Canadian VIGOUR Centre, and the Uppsala Clinical Research Center. Comprising 3?days of academic presentations and open discussion, the symposium had as its primary goal to educate, motivate, and inspire internists, cardiologists, hematologists, and other physicians by convening national and international visionaries, thought-leaders, and dedicated clinician-scientists. This paper summarizes the symposium proceedings.     

Two hour bivalirudin infusion after PCI for ST elevation myocardial infarction

The standard of care for STEMI PCI for the past decade has been aspirin, clopidogrel, heparin, and a glycoprotein IIbIIIa receptor inhibitor (GPI). A bivalirudin strategy was shown to be superior to a GPI strategy in the HORIZONS AMI trial for net adverse clinical events (combined MACE and bleeding). An increased risk of acute stent thrombosis in the bivalirudin arm may have prevented broader adoption of bivalirudin for this indication. We hypothesized that acute stent thrombosis risk could be ameliorated by a 2 h infusion of bivalirudin following STEMI PCI. We implemented a multicenter, prospective registry for all STEMI patients in Vermont treated at a single PCI center. Each patient was routinely pre-loaded with dual antiplatelet therapy and 75% received an unfractionated heparin bolus prior to PCI. The utilization of bivalirudin bolus and continued 2 h infusion after PCI was routine with GPI bailout optional. 128 consecutive STEMI patients underwent primary PCI from October 1, 2008 to September 30, 2009. 92% of primary PCI patients received bivalrudin during and after the procedure with a 9% rate of bail out GPI. There was one case of probable or definite acute stent thrombosis (0.7%), and this single case occurred despite use of bailout GPI. Despite the prolonged infusion of bivalirudin, major bleeding occurred in only 1.7% of STEMI patients. In conclusion, prolonging bivalirudin for 2 h after STEMI PCI may be a promising method to alleviate acute stent thrombosis risk without losing the bleeding complication benefit of the bivalirudin strategy.     

The prevalence of low sex steroid hormone concentrations in men in the Third National Health and Nutrition Examination Survey (NHANES III)

Background Physiologic processes during ageing leading to multi‐morbidity and diseases that increase risk of premature death may be influenced by ageing‐associated changes in endogenous hormone production. Objective To evaluate the decline in sex steroid hormone levels across age and estimate the number of US men 40+ years old who may have low hormone levels. Design We measured serum testosterone, oestradiol and sex hormone binding globulin by immunoassay in 1351 men 20+ years old in Third National Health and Nutrition Examination Survey. We estimated free hormones by mass action. Results Free testosterone declined most rapidly with age (a 2% decline in geometric mean concentration occurred after ageing 1·3 years), followed by total testosterone (2·4 years), free oestradiol (4·1 years) and total oestradiol (8·1 years). These hormone changes with age translated into 25·0% and 30·2% of men 70+ years old having low total (which we defined as <10·4 nm ) and free (<0·17 nm ) testosterone, respectively, and 8·3% and 23·9% having low total (<73·4 pm ) and free (<2·2 pm ) oestradiol. Using population size projections between the 2000 and 2010 Censuses, we estimated that 8·4 (95% CI 4·7–12·2), 6·2 (3·1–9·2) and 6·0 (3·1–9·0) million men 40+ years old may have low total testosterone, free testosterone and free oestradiol, respectively. The prevalences were only modestly lower in men without prevalent chronic diseases. Conclusion Although no consensus exists for defining low hormone levels in ageing men, a substantial number of US men may have low sex steroid hormone levels, possibly putting them at risk for adverse health consequences and premature death.