Purpose: Invasive fungal infections are an important cause of morbidity and mortality in children with febrile neutropenia. Although liposomal amphotericin B (L-AMB) is used safely due to its broad antifungal activity, it causes important side effects such as nephrotoxicity and hypokalemia. Methods: Medical records of 45 children with hematological malignancies who were given empirical L-AMB for febrile neutropenia between November 2011 and December 2019 were reviewed retrospectively. The estimated glomerular filtration rate (eGFR), serum creatinine and potassium levels were compared before and after 7th day of L-AMB treatment. Results: 62 febrile neutropenic attacks of 45 children were evaluated. The median age of the patients was 8.25 (3.5-13) years, and the number of attacks per patient was between 1-5. The median duration of treatment with L-AMB was 14 (range 9-21) days. Nephrotoxicity developed in 16 attacks (26%), and hypokalemia developed in 26 attacks (42%). In those who developed nephrotoxicity, eGFR was lower and creatinine level was higher after 7th day of L-AMB treatment, compared to their values before treatment. The frequency of hypokalemia was low in attacks where nephrotoxicity has been developed. High eGFR, and low creatinine level were risk factors with borderline significance from the point of development of nephrotoxicity. Conclusion: Potassium level should be carefully monitored and appropriate replacement therapy should be administered in febrile neutropenic children with hematological malignancy receiving L-AMB therapy. Parenteral hydration before L-AMB administration does not prevent nephrotoxicity, however it positively affects the frequency of nephrotoxicity.
Glioblastoma multiforme (GBM) is one of the most deadly tumors; even with aggressive radiochemotherapy, mean survival rates are only around 14 to 16 months post diagnose. Here we present the follow-up of 15 patients with GBM that have received concomitant cannabidiol (CBD) in addition to standard therapy, and that have been reported in details two years ago. The survival time of patients is presented together with prognostic factors such as age at diagnose, molecular markers and dose of CBD. The actual median survival time is 28 months, the arithmetic mean is 30.9 months, therefore about three to five times longer than expected. When comparing the group of patients surviving less than 28 months with those who lived longer, we found that all subjects who received a low dose of CBD (200mg per day) were in the group surviving less than 28 months. Apart from the daily dose of CBD, no striking difference was observed for other prognostic factors. It is concluded that CBD contributed to the long term survival of GBM patients, and that this effect depends on the dose.
Most common urinary system cancer is the Bladder cancer(BC), more common in men (M/F: 3), is associated with both genetic and environmental factors.,two most well-known environmental factors are smoking and occupational exposures.Smoking is associated with 25-65% of BC cases, %50 average. Urothelial cancers are common in occupations that use paint, textiles, rubber and petroleum products. Among the chemical substances; O-toluidine, 2-naphthylamine, benzidine, 4-amino-biphenyl and nitrosamines are particularly related with the BC. Our objective in this systematic review is to indicate the value and aid of CT and MRI in the diagnosis of bladder cancer.
Introduction: Oral carcinogenesis is a multistage process, featuring genetic and molecular alterations leading to rapid cell division, invasion, metastasis, and increased cell survival. Many of these alterations are due to perturbations in the cell signaling networks, which in turn lead to constitutive deregulation of the proteins involved in the regulatory pathways. Our recent reports show that the silencing of dentin sialophosphoprotein (DSPP) and its cognate matrix metalloproteinases 20 (MMP20) alters key tumorigenic hallmarks of oral squamous cell carcinoma (OSCC). Objective: This study, intended to advance our recent findings, focuses on determining the effects of silencing DSPP and its cognate MMP20 on the signaling pathways that control cell proliferation, differentiation, invasion and metastasis. Materials and Methods: DSPP and MMP20 were silenced individually and in combination, using adenovirus-mediated short hairpin RNA (shRNA) in OSCC cell line, OSC2, and the effects of silencing on the following pathways: EFGR; RAS-RAF; MEK; MAPK; ERK; JNK; NF-kB; TGFβ; and GSK3β, were analysed by western blot. Results: DSPP and MMP20 silencing decreased EGFR, KRAS, MEK1/2, MAPK, ERK, MEEK1, JNK, CREBP, p300, NF-kB,TGF β, SMAD7, GSK3 β, and β-catenin expressions. In contrast, the expression of IKKα and SMAD4 were increased in DSPP/MMP20-silenced group, compared with control group. Furthermore, DSPP-silencing alone was more effective than MMP20, or combined DSPP-MM20 silencing, in altering the levels of key proteins of each signaling pathway investigated. Conclusion: Our findings provide the basis for further studies aimed at verifying the effects of these alterations in the profiles of these proteins on the various hallmarks of oral carcinogenesis, and for understanding the molecular role of DSPP and MMP20 in OSCC. This is with a view to evaluating their diagnostic and prognostic utility as well as the values of DSPP/MMP20 as potential targets for design of chemotherapeutic agents for the treatment of OSCC patients.
Thymic carcinoma (TC) is a rare epithelial malignancy often distinguished by significant local invasion and propensity for distant metastases. Representing approximately 20% of all thymic neoplasms, the primary therapeutic intervention for resectable tumors remains surgical resection. For those that are unresectable or metastatic, palliative platinum-based chemotherapy is standard. Despite these interventions, approximately 30% of these malignancies are already advanced upon initial presentation. The current 5-year survival rate for metastatic TC stands at approximately 38%, with a definitive optimal treatment regimen yet to be established. This case report delineates a comprehensive five-year clinical trajectory of a patient with advanced TC who exhibited resistance to systemic treatments but showed favorable response to stereotactic body radiation therapy (SBRT). Through this case, we underscore the potential of SBRT as a viable therapeutic alternative for select metastatic TC patients. In our case, SBRT exhibited reliable local tumor control in each treated site with minimal side effects. To better understand the possibility of treatment options for disseminated TC more cases should be collected.
