Rhabdomyosarcoma (RMS) is a small round blue cell malignant tumor, representing 7% of childhood malignancies, and over 50% of all soft tissue sarcomas. Cyclophosphamide (CPA) is a prodrug and is the ...mainstay of RMS treatment. CYP2B6 is a highly polymorphic drug metabolizing enzyme involved in CPA bioactivation. The influence of CYP2B6 single nucleotide polymorphisms (SNPs) on the survival of RMS is still unknown.
We genotyped CYP2B6SNPs rs2279343, rs3745274, and rs3211371 by restriction fragment polymorphism (RFLP) after PCR amplification in a cohort of 73 pediatric RMS patients treated with CPA-based first line treatment. We then analyzed the association between those genotypes and survival outcome of RMS.
The frequencies of CYP2B6 rs2279343, rs3745274, and rs3211371 were 63%, 45.2%, and 5.5%, respectively. There was no association between rs3745274, rs3211371 genotypes and survival outcomes of RMS. However, the carriers of at least one mutant allele CYP2B6rs2279343 had significantly longer event-free survival (p-value = 0.03).
Our results demonstrated that CYP2B6 rs2279343 may predict EFS in RMS patients and warrants future studies to clarify the pharmacogenetics of CPA in pediatrics. If validated, integration of genetic factors with clinical and molecular characteristics could be used for a composite algorithm to better stratify risk prior to treatment.
The goal was to directly deliver curcumin, a natural polyphenolic anticancer and anti-inflammatory compound, to the lung tissues with minimal systemic exposure through the fabrication of ...proliposomes, overcoming its poor aqueous solubility and oral bioavailability.
Nano-spray drying was employed to prepare proliposomes using hydroxypropyl beta-cyclodextrin as a carrier. Lecithin and cholesterol were used as lipids, stearylamine and Poloxamer 188 were added as positive charge inducer and a surfactant, respectively. Different characterization parameters were evaluated like percentage yield, entrapment efficiency, drug loading, aerodynamic particle size, in vitro release besides morphological examination. Cytotoxicity studies on cell line A549 lung tumor cells as well as in vivo lung pharmacokinetic studies were also carried.
The optimized formulations showed superior aerosolization properties coupled their enhanced ability to reach deep lung tissues with a high % of fine particle fraction. Cytotoxicity studies using MTT assay demonstrated enhanced growth inhibitory effect on lung tumor cells A549 and significant reduction of proinflammatory cytokines such as tumor necrosis factor-α, interleukin-6 and interleukin-10 compared to the pure drug. Results of lung pharmacokinetic tests confirmed the superiority of proliposomal curcumin over curcumin powder in both, the rate and extent of lung tissue absorption, as well as the mean residence time within the lung tissues.
The pulmonary delivery of curcumin-loaded proliposomes as dry powder provides a direct approach to lung tissues targeting while avoiding the limitations of the oral route and offering a non-invasive alternative to the parenteral one.
Background
Maternal omega-3 consumption during pregnancy has been positively linked with a positive impact on maternal health and fetal growth. However, the results of individual studies are ...inconsistent and conflicting.
Objective
Examine the effect of supplementation with DHA, and/or EPA, and/or ALA throughout pregnancy on offspring’s growth and pregnancy outcomes.
Design
A systematic review and meta-analysis.
Population
Pregnant women.
Methods
According to (PRISMA) statement and the Cochrane Handbook guidelines. Human trials (RCT or quasi-RCT) which involved oral omega-3 supplementation at least twice a week during pregnancy were included and comparing it with control groups with no supplementation or placebo administration. Data were extracted and directed using RevMan software. Fifty-nine randomized controlled trials were eligible for inclusion in the meta-analysis. Performed in MEDLINE, PubMed, Scopus, Google Scholar, and the Cochrane Library comparing omega 3 with control groups, from 1990 to 2020.
The main outcome measures
The primary outcome measures were pregnancy-induced hypertension, preeclampsia, gestational duration, preterm birth, early preterm birth, birth weight, low birth weight, neonatal length, and head circumference. The secondary outcomes were neonatal intensive care unit, infant death, prenatal death, and cesarean section.
Results
In 24 comparisons (21,919 women) n-3 fatty acids played a protective role against the risk of preeclampsia (RR = 0.84, 95% CI 0.74–0.96
p
= 0.008; I
2
= 24%). In 46 comparisons (16,254 women) n-3 fatty acids were associated with a significantly greater duration of pregnancy (MD = 1.35, 95% CI 0.65–2.05,
p
= 0.0002; I
2
= 59%). 27 comparisons (15,510 women) was accompanied by a significant decrease in pre-term birth less than 37 weeks (RR = 0.86, 95% CI 0.77–0.95,
p
= 0.005; I
2
= 0%). 12 comparisons (11,774 women) was accompanied by a significant decrease in early pre-term birth less than 34 weeks (RR = 0.77, 95% CI 0.63–0.95,
p
= 0.01; I
2
= 40%). 38 comparisons (16,505 infants) had a significant increase in birth weight (MD = 49.19, 95% CI 28.47–69.91,
p
< 0.00001; I
2
= 100%). Finally, 14 comparisons (8,449 infants) had a borderline significance in increase in low birth weight (RR = 0.88, 95% CI 0.78–1.00,
p
= 0.05; I
2
= 28%).
Conclusions
Supplementation with omega-3 in prgnancy can prevent preeclampsia, increase gestational duration, increase birth weight and decrease the risk of low birth weight and preterm birth.
Graphical abstract
Introduction
The OM‐85 (Broncho‐Vaxom) consumption has drawn considerable attention in the prevention of recurrent respiratory tract infections. However, it has been reported that the relationship ...between OM‐85 consumption and recurrent respiratory tract infections is variable. This meta‐analysis was performed to evaluate this relationship.
Methods
A systematic literature search up‐to May 2020 was performed and 14 studies were detected with 1859 paediatric subjects, of them 890 consumed OM‐85. They were reporting relationships between OM‐85 consumption and recurrent respiratory tract infections. Odds ratio (OR) or mean differences (MD) with 95% confidence intervals (CIs) was calculated to evaluate the prognostic role of OM‐85 consumption and recurrent respiratory tract infections using the dichotomous or continuous method with a random or fixed‐effect model.
Results
OM‐85 consumption was significantly related to lower frequency of respiratory tract infections (MD, −1.16; 95% CI, −1.66 to −0.65, P < .001); lower total duration of respiratory tract infections (MD, −19.51; 95% CI, −23.00 to −16.01, P < .001); lower incidence of respiratory tract infections (OR, 0.40; 95% CI, 0.21‐0.77, P = .006); lower number of antibiotic courses (MD, −1.40; 95% CI, −2.63 to 0.17, P = .03); and lower antibiotic use (OR, 0.38; 95% CI, 0.29‐0.52, P < .001). However, OM‐85 consumption was not significantly related to adverse event rate (OR, 1.02; 95% CI, 0.52‐2.03, P = .94); or to wheezing attacks frequency (MD, −0.25; 95% CI, −0.59 to 0.08, P = .14).
Conclusions
The impact of OM‐85 consumption on recurrent respiratory tract infections may have a great effect as a tool to improve subjects’ immunity against recurrent respiratory tract infections, which could be helpful in crucial situations, eg, COVID‐19 pandemic. OM‐85 non‐consumers had an independent risk relationship with recurrent respiratory tract infections. This relationship forces us to recommend OM‐85 consumption with those with a high risk of recurrent respiratory tract infections to avoid any possible complications.
•COVID-19 is affecting different countries all over the world with great variation in infection rate and death ratio.•Some reports suggested a relation between the Bacillus Calmette-Guérin (BCG) ...vaccine and the malaria treatment to the infection prevention.•Some reports related infant's lower-susceptibility to the BCG vaccine. Some other reports a higher risk in males compared to females in such a COVI-19 pandemic.•Some other reports claimed the possible use of chloroquine and hydroxychloroquine as prophylactic in such a pandemic.•The-present commentary is to discuss the possible relation between those-factors and SARS-CoV-2 infection.
COVID-19 is affecting different countries all over the world with great variation in infection rate and death ratio. Some reports suggested a relation between the Bacillus Calmette-Guérin (BCG) vaccine and the malaria treatment to the prevention of SARS-CoV-2 infection. Some reports related infant's lower susceptibility to the COVID-19. Some other reports a higher risk in males compared to females in such COVID-19 pandemic. Also, some other reports claimed the possible use of chloroquine and hydroxychloroquine as prophylactic in such a pandemic. The present commentary is to discuss the possible relation between those factors and SARS-CoV-2 infection.
Background
Clinical symptoms of adults and paediatric inpatients with COVID‐19 disease are conflicting. This meta‐analysis was conducted to assess the effect of age of COVID‐19 inpatient on the ...severity of the disease.
Methods
A systematic literature search up to January 2021 was performed and 5 studies included 910 inpatients with COVID‐19 disease at the baseline of the study; 773 of them were adult inpatients, and 137 of them were paediatric inpatients. They reported a comparison between adults and children with COVID‐19 in the level of symptomatic severity, clinical features, computed tomography (CT) results and laboratory results. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated assessing the effect of age of COVID‐19 inpatient on the severity of the disease using the dichotomous method with a random or fixed‐effect model.
Results
Adults with COVID‐19 disease had significantly lower number of mild cases (OR, 0.18; 95% CI, 0.04‐0.77, P = .02); higher number severe cases (OR, 4.90; 95% CI, 2.03‐11.83, P < .001); higher number of cases with fever (OR, 4.14; 95% CI, 2.31‐7.43, P < .001); and higher number of cases with CT positive COVID‐19 disease (OR, 2.04; 95% CI, 1.17‐3.55, P = .001) compared with children. However, no significant difference was found between adults and children in number of cases with shortness of breath (OR, 1.44; 95% CI, 0.41‐5.04, P = .57); dry cough (OR, 1.77; 95% CI, 0.64‐4.93, P = .27); leukopenia (OR, 0.89; 95% CI, 0.47‐1.66, P = .71); lymphopenia (OR, 0.96; 95% CI, 0.49‐1.88, P = .91); high platelets (OR, 0.41; 95% CI, 0.17‐1.02, P = .05); and high D‐dimer (OR, 0.82; 95% CI, 0.43‐1.56, P = .54).
Conclusions
Adults with COVID‐19 disease have a much higher level of symptomatic severity, fever and CT‐positive COVID‐19 disease than children. However, as shown in our results, the laboratory data were similar in both groups.
Coronavirus disease 2019 (COVID‐19) has had different waves within the same country. The spread rate and severity showed different properties within the COVID‐19 different waves. The present work ...aims to compare the spread and the severity of the different waves using the available data of confirmed COVID‐19 cases and death cases. Real‐data sets collected from the Johns Hopkins University Center for Systems Science were used to perform a comparative study between COVID‐19 different waves in 12 countries with the highest total performed tests for severe acute respiratory syndrome coronavirus 2 detection in the world (Italy, Brazil, Japan, Germany, Spain, India, USA, UAE, Poland, Colombia, Turkey, and Switzerland). The total number of confirmed cases and death cases in different waves of COVID‐19 were compared to that of the previous one for equivalent periods. The total number of death cases in each wave was presented as a percentage of the total number of confirmed cases for the same periods. In all the selected 12 countries, Wave 2 had a much higher number of confirmed cases than that in Wave 1. However, the death cases increase was not comparable with that of the confirmed cases to the extent that some countries had lower death cases than in Wave 1, UAE, and Spain. The death cases as a percentage of the total number of confirmed cases in Wave 1 were much higher than that in Wave 2. Some countries have had Waves 3 and 4. Waves 3 and 4 have had lower confirmed cases than Wave 2, however, the death cases were variable in different countries. The death cases in Waves 3 and 4 were similar to or higher than Wave 2 in most countries. Wave 2 of COVID‐19 had a much higher spread rate but much lower severity resulting in a lower death rate in Wave 2 compared with that of the first wave. Waves 3 and 4 have had lower confirmed cases than Wave 2; that could be due to the presence of appropriate treatment and vaccination. However, that was not reflected in the death cases, which were similar to or higher than Wave 2 in most countries. Further studies are needed to explain these findings.
Asthma advanced counseling using smartphone applications has recently become one of the most effective and commonly used methods among adults and children with asthma.
We aimed to compare the ...advanced counseling effectiveness between adults and children with asthma.
A cohort prospective parallel study was performed on a group of adults and children nonsmoking patients with asthma, using a pressurized metered dose inhaler (pMDI). The patients were divided into two groups namely adults with asthma with ages ranging from 19 to 60 years and Children with asthma with ages ranging from 11 to 18 years, the two groups received a 2-month course of advanced counseling using "Asthma software" and "Asthma Dodge" smartphone applications, during which the two groups were monitored using the forced expiratory volume in the first second to the forced vital capacity (FEV1/FVC) ratio and asthma control test (ACT). The study has obtained ethical approval with the serial number REC-H-PhBSU-23002, adhering to the principles outlined in The Declaration of Helsinki, from the Ethical Approval Committee of Beni-Suef University Faculty of Pharmacy.
With a total of 60 patients with asthma (
= 60), 31 adults (
= 31), and 29 children (
= 29), We found that starting from the first-month visit of counseling the children group showed superiority over the adult group in terms of the pulmonary function improvement
= .006. Also, regarding ACT scores the children group showed a superiority over the adult group this significance started from the first-month visit and continued to the second-month visit with
values = .032 and .011, respectively.
The advanced counseling achieved better asthma control and pulmonary function improvement in children and adults; however, the improvement was much better in children with asthma than adults with asthma.
Green tea is related to the reduction of liver enzymes, lipoprotein, and body mass index. However, some reports related green tea to the risk of developing liver cancer, but their outcomes were ...conflicting. Hence, the present study aimed to determine the relationship between green tea intake and lipoprotein, liver enzymes, body mass index, and liver cancer.
A systematic literature search up to January 2022 was performed and 22 studies with a total of 169599 subjects participated in the studies with 97316 subjects of them used green tea intake. Odds ratio (OR) or standardized mean difference (MD) with 95% confidence intervals (CIs) was calculated to evaluate the relationship between green tea intake and lipoprotein, liver enzymes, body mass index, and liver cancer using the dichotomous or the contentious method with a random effect model.
Green tea intake significantly lowered the risk of developing liver cancer (OR, 0.85; 95% CI, 0.74 to 0.97, p = 0.02), and body mass index (MD, −0.69; 95% CI, −0.95to −0.42, p < 0.001) compared to no green tea intake. Also, there was a significant lowering effect of green tea intake on liver enzymes including alanine aminotransferase (MD, −0.65; 95% CI, −0.92 to −0.38, p < 0.001), and aspartate aminotransferase (MD, −0.77; 95% CI, −1.40 to −0.14, p = 0.02) compared to no green tea intake. There was also a significant lowering effect of green tea intake on lipoprotein including triglycerides (MD, −0.70; 95% CI, −1.35 to −0.04, p = 0.04), total cholesterol (MD, −0.39; 95% CI, −0.74 to −0.04, p = 0.03) and law-density lipoprotein (MD, −0.44; 95% CI, −0.69- −0.19, p < 0.001) compared to no green tea intake. However, no significant different was found between green tea intake and no green tea intake on high-density lipoprotein (MD, 0.16; 95% CI, −0.11 to 0.44, p = 0.24).
Based on this meta-analysis, green tea intake had a significant lowering effect on the risk of developing liver cancer and had a significantly improving effect on body mass index, liver enzymes, and lipoprotein compared to no green tea intake. These results suggest that green tea may be added to the daily dietary program to improve cardiovascular status with no possible risk of liver cancer. It even may have a protecting effect against liver cancer in the usual daily number of cups.
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