Associations between Demographics and Quality of Life in Children in the First Year of Cancer Treatment

Symptom distress and decreased quality of life (QOL) among children with cancer are well documented. Research is emerging on the child’s voice in QOL-symptom reports, but existing QOL questionnaires are burdensome and objective biologic markers are lacking. We examined children’s symptoms and QOL from parent and child perspectives and compared the results to one biologic marker (body posture). A cross-sectional secondary analysis of prospective data from children receiving creative arts therapy explored potential associations among demographics with and between QOL measures (PedsQL, Faces Scale, posture). Children (n = 98) ranged in age from 3-17 years (M = 7.8) and were in the first year of cancer treatment. No significant associations were found among the child’s sex, race/ethnicity, socioeconomic status (SES), or distance from hospital and total PedsQL. Older age was associated with worse total PedsQL, pain, nausea, worry, and posture (all ps < .05). Greater worry (β = 0.51) and worse posture (β = 0.41) were the QOL variables most strongly correlated with older age. Poorer posture was associated with worse child PedsQL (total score, nausea, treatment anxiety, cognitive) and parent PedsQL (pain, nausea). Worse scores on the Faces Scale, PedsQL, and posture were all correlated (rs = .21 - .39, all ps < .05). Interventions to improve QOL could target nausea, worry, and older patients. Accuracy and interpretation of symptom distress in children is problematic. The Faces Scale and posture may be suitable, readily obtained measures of QOL in pediatric oncology that hold promise.

Application of Fluorescence in Situ Hybridization to Detect MYCN Amplification on Paraffin-embedded Tissue Sections of Neuroblastoma - Single Institute Study.

BackgroundNeuroblastoma is the most common extracranial solid tumour in children. Amplification of the MYCN gene was observed in approximately 20-30% of tumours. It is strongly correlated with advanced stage of disease, rapid tumour progression, resistant to chemotherapy and poor outcome independent of patient age and stage of advanced disease. Amplification of the MYCN identify high-risk patients.MethodsTo assess neuroblastoma tumours with MYCN amplification we used paraffin-embedded tissue sections in 57 patients by fluorescent in situ hybridization (FISH). ResultsTwenty-eight (49,1%) of patients had localized neuroblastoma (1–3 stages), 5,3% stage 4S, and 45,6% stage 4 disease. Thirty-eight (66,7%) of patients had got abdominal/adrenal mass at diagnosis. Twenty-seven (47,4%) patients were <18 month of age, thirty (52,6%) patients were >18 month of age. MYCN amplification appeared in 12 (21%) tumour specimens. ConclusionsFluorescent in situ hybridization is a high-sensitive, useful technique for detecting MYCN amplification on paraffin- embedded tissue section of neuroblastoma tumours thus facilitating therapeutic decisions based on the presence or absence of this important biologic marker.

Treatment of non-erosive reflux disease and dynamics of the esophageal microbiome: a prospective multicenter study

Non-erosive reflux disease (NERD) pathogenesis has not been thoroughly evaluated. Here, we assessed the response of patients with NERD to proton pump inhibitor (PPI) therapy; changes in the microbiome and biologic marker expression in the esophageal mucosa were also evaluated. Patients with NERD (n = 55) received esomeprazole (20 mg) for eight weeks. The treatment response was evaluated at baseline, week four, and week eight. Esophageal mucosal markers and oropharyngeal and esophageal microbiomes were analyzed in patients who underwent upper gastrointestinal endoscopy at screening (n = 18). Complete and partial response rates at week eight were 60.0% and 32.7% for heartburn, and 61.8% and 29.1% for regurgitation, respectively. The expressions of several inflammatory cytokines, including IL-6, IL-8, and NF-κB, were decreased at week eight. Streptococcus, Haemophilus, Prevotella, Veillonella, Neisseria, and Granulicatella were prevalent regardless of the time-point (baseline vs. week eight) and organ (oropharynx vs. esophagus). The overall composition of oropharyngeal and esophageal microbiomes showed significant difference (P = 0.004), which disappeared after PPI therapy. In conclusion, half-dose PPI therapy for eight weeks could effectively control NERD symptoms. The expression of several inflammatory cytokines was reduced in the esophagus, and oropharyngeal and esophageal microbiomes in patients with NERD showed significant difference. However, the microbial compositions in the oropharynx and esophagus were not affected by PPI therapy in this study. Impact of PPI on the microbiome in patients with NERD should be more investigated in future studies.

Clinicohistopathological study of astrocytomas along with Ki-67 proliferative index

Background: Astrocytomas form the largest group of gliomas (>75%) and diffusely infiltrating accounting for more than 60% of all the primary brain tumors. The ki67 proliferative index is a potent biologic marker that estimates the growth of neoplasms quantitatively and thus will aid in identifying the prognosis for patients with neoplasms. The aim of the research work was to study various histopathological and clinical features of Astrocytomas in detail, to evaluate Ki-67 proliferative index in patients of Astrocytomas and to compare the results of Immunohistochemistry with histological grade of Astrocytomas.Methods: A total number of 40 cases of Astrocytomas were included in the study. Ki-67 immunostaining was done on all cases and compared with WHO histological grading of astrocytomas.Results: The mean Ki‑67 LI in Grade I astrocytomas was 4.66, range 4-5 , in Grade II astrocytomas mean was 8.07, range 5-12 ,in Grade III astrocytomas mean was 13.5 , range 8-20, in Grade IV astrocytomas mean was 22.93, range 15-50. There was a highly significant correlation between the histopathological grade of astrocytomas and Ki-67 LI (p<0.05).Conclusions: The monoclonal antibody Ki-67 has proven its prognostic and diagnostic power in astrocytic tumors. Ki-67 LI is the simplest and the most reliable method for evaluating cell proliferation. Ki-67 LI increased with histological grade and the difference between low grade (I and II astrocytomas) and high grade (grade III and IV) is significant. In the present study Ki-67 LI is not dependent on factors like age and sex and is solely dependent on histological grade.

The Role of Progesterone Induced Blocking Factor in Threatened Abortion

Objective: To determine the role of progesterone-induced blocking factor (PIBF) in women with threatened abortion. Methods: This was a cross-sectional study. The blood serum of two groups, the first one was women with normal gestation of  20 weeks, and the second one was those with imminent abortion in Prof. Dr. R.D. Kandou Hospital, and Subcenter Hospital in Manado, was collected. Samples were processed with PIBF ELISA-kit. Results: PIBF serum value of women in normal gestation  20 weeks is (47.15323.830)ng/ml and threatened abortion is (11.540 4.892) ng/ml, with p value = 0.000. Conclusion: PIBF serum value of women with threatened abortion is significantly lower compared to women of normal gestation  20 weeks. This study showed that PIBF has an important role in maintaining pregnancy and can be used as a biologic marker of a pathologic process in pregnancy.Keywords: early pregnancy, pregnancy immunology, progesteroneinducedblocking factor, threatened abortion

Detection of (1,3)-β-d-Glucan in Cerebrospinal Fluid in Histoplasma Meningitis

Background Central nervous system (CNS) histoplasmosis is a life-threatening condition, and represents a diagnostic and therapeutic challenge. Although CSF (1,3)-β-d-glucan (CSF BDG) is available as a biologic marker for diagnosis of fungal meningitis, there are limited data on its use for diagnosis of Histoplasma meningitis. We evaluated CSF BDG detection using the Fungitell assay in patients with CNS histoplasmosis and controls. Methods Patients were classified as cases if there was CNS inflammation (CSF WBC ≥ 5 mm3/ml) plus laboratory confirmation of H. capsulatumin CNS samples or from extra-CNS sites with no alternative etiology for CSF pleocytosis. Controls were patients with histoplasmosis but no evidence of CNS involvement, an alternative diagnosis, or other fungal meningitis. Results In total, 47 cases and 153 controls were evaluated (Table 1). Forty-nine percent of patients with CNS histoplasmosis and 43.8% of controls were immunocompromised. CSF BDG was positive in 25 (53.2%) cases using a level of ≥80 pg/ml, the median CSF BDG level was 140.5 pg/ml (range from &lt;31 to 500 pg/ml). The detection of CSF BDG level ≥80 pg/ml was not associated with positive CSF Histoplasma antigen (P = 0.28) or positive CSF Histoplasma culture (P = 0.56). The sensitivity for detection of CSF BDG was 53.2% and the specificity was 87.3%, compared with 78.7% &#x2028;(P = 0.009) and 96.4% (P = 0.003), respectively, for detection of antigen. CSF BDG was positive in 20 of 153 (13.1%) patients in the control group. Seven of 11 (63.6%) other CNS fungal meningitis cases (five Cryptococcus, two Aspergillus, two Blastomyces, one Candida, and one suspected fungal meningitis) had CSF BDG ≥80 pg/ml. Conclusion A positive CSF BDG supports the diagnosis of fungal meningitis but cannot distinguish among the different etiologies. The sensitivity and specificity of detection of CSF BDG was lower than that of antigen detection. Disclosures L. J. Wheat, MiraVista: President and owner, equity and Salary