circRNAs in drug resistance of breast cancer

Breast cancer (BC) is the most common heterogeneous disease in women and one of the leading causes of cancer-related death. Surgery, chemotherapy, radiotherapy, hormone, and targeted therapy are the gold standards for BC treatment. One of the significant challenges during the treatment of BC represents resistance to chemotherapeutics, resistance that severely limits the use and effectiveness of the drugs used for BC treatment. Therefore, it is essential to develop new strategies to improve therapeutic efficacy. Circular RNAs (circRNAs) are a large group of non-coding RNAs that covalently form closed circular loops by joining their 5′, and 3′; ends. Accumulating evidence suggests that circRNAs have a vital role in cancer development, progression, and BC resistance to chemotherapy. The purpose of this review is to discuss the biological properties of circRNAs, and how circRNAs induce resistance to conventional therapeutic anti-cancer drugs used in BC treatment, by emphasizing and summarizing the potential roles of circRNAs in mechanisms of drug resistance, such as drug efflux, apoptosis dysfunction, autophagy, and DNA damage repair. CircRNAs are associated with drug resistance via ATP-binding cassette (ABC) efflux transporters, while some others by inhibition of cell apoptosis, thus leading to resistance to tamoxifen in BC cells. In contrast, others are involved in the promotion of BC cells chemoresistance by doxorubicininduced autophagy. CircRNAs may have clinical significance in regulating or overcoming BC drug resistance and may give directions towards a novel approach to personalized BC treatment. CircRNAs may significantly contribute to the identification of new therapeutic targets for the prevention of BC chemoresistance.     

Therapeutic efficacy of sequential and simultaneous treatments with interferon-α and lamivudine in children with chronic hepatitis B

BACKGROUND: Interferon (IFN)-alpha and lamivudine (LAM), a nucleoside analog, are frequently used drugs for the treatment of chronic hepatitis B (CHB), and their combined therapy has been shown to be effective. The purpose of the present study was to examine the therapeutic efficacy of sequential and simultaneous combination therapies of IFN-alpha and LAM in children with CHB. METHODS: A total of 45 children with CHB, whose antibody status was positive for hepatitis B surface antigen (HBsAg), hepatitis B envelope antigen (HBeAg), and HBV-DNA at least for 6 months; who had alanine aminotransferase (ALT) levels 1.5-fold higher than normal and hepatic activity index scores higher than 6, were allocated to two groups. The first group included 24 children who were given standard dose IFN-alpha (5 MU/m(2) s.c., thrice weekly) for 6 months, followed by LAM (4 mg/kg per day per oral, maximum 100 mg/day) for an additional 6 months (sequential therapy group). The second group included 21 children who were given IFN-alpha and LAM therapy simultaneously for 6 months and who continued with LAM alone for another 6 months (simultaneous therapy group). Partial response was defined as normalization of ALT and eradication of HBV-DNA. Complete response was defined as normalization of ALT, eradication of HBV-DNA and e seroconversion. Non-responders were defined as having positive HBV-DNA and abnormal ALT levels. Sustained response was defined as absence of HBsAg and presence of hepatitis B surface antibody (anti-HBs). RESULTS: The mean age of the sequential therapy group was 12.7 +/- 4.1 years, and 16 (66.7%) of the patients were male. The mean age of the simultaneous therapy group was 14.8 +/- 4.6 years, and 15 (71.4%) were male. In the first group, 13 patients (54.2%) were non-responders; partial response was observed in five patients (20.8%), and complete response was seen in six patients (25%). Despite the occurrence of e seroconversion, normalization of ALT was not achieved in one case. In the second group, which consisted of 21 patients, 11 subjects (52.4%) were non-responders; partial response was observed in one case (4.8%), and complete response was seen in seven (33.3%). Sustained response was found in two patients (9.5%). There were no significant differences between the groups (P > 0.05). CONCLUSION: When the therapeutic efficiency of two different treatment regimens applied for 1 year was evaluated in childhood CHB therapy, it was remarkable that there was a sustained response and a higher complete response in group 2, although there was no considerable difference between the therapy results of both groups.     

Acute Hemorrhagic Edema of Infancy: A Case Report

Abstract: Acute hemorrhagic edema of infancy is a rare vasculitic syndrome affecting young children. Although presentation is dramatic and striking, it is a benign disorder. A 9‐month‐old boy with fever, rinorrhea, edema, and purpuric lesions involving the face, oral mucosa, ears, and extremities was presented.     

Hypernatremic dehydration in the newborn period and long-term follow up

BACKGROUND: Hypernatremic dehydration due to inadequate fluid intake can be a significant problem during the neonatal period and thereafter. The objective of the present study was to evaluate the term newborn infants admitted to Gazi University Hospital neonatal intensive care unit (NICU) for hypernatremic dehydration between June 2001 and June 2003 and compare the results with those of the literature search performed via MEDLINE for infants with the same diagnosis. METHODS: Infants with weight loss > or =10% were evaluated for hypernatremia and the ones with serum Na level > or =150 mEq/L were admitted to NICU. Long-term follow-up evaluations were performed using Bayley Scales of Infant Development I (BSID I) and Bayley Infant Neurodevelopmental Screener (BINS) tests. RESULTS: Between June 2001 and June 2003, 28 newborns were admitted to NICU with hypernatremic dehydration. Literature review found 178 newborns with the same diagnosis since 1979 and detailed information was available for 150 patients. In the study and MEDLINE groups, respectively mean days of admission were 3.39 and 11.7; mean serum sodium, 156.5 and 178.6 mEq/L; and mean % weight loss, 11.5 and 25.7. Long-term follow up was performed in 15 patients from the study group, and two patients were found to be severely neurologically delayed. Five patients were found to have moderate risk scores by BINS tests. CONCLUSIONS: Early follow-up visits of newborns soon after discharge are important to determine risk for hypernatremic dehydration. Long-term follow up of this group of babies is also required to gather knowledge about the repercussions of early hypernatremic dehydration later in life.