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Article
Childhood nephritic syndrome Clinical manifestations and histopathlogical spectrum

Author: Nariman-F. -Ahmed FICMS Raghad Ibrahim FICMS د. نريمان فهمي احمد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2007 Volume: 49 Issue: 3 Pages: 304-306
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Nephrotic syndrome in children is a clinical manifestation of different histopathological subtypes.Objectives: The objectives were to study the different histopathological subtypes of idiopathic nephrotic syndrome and to study their clinical and biochemical parameters at the time of diagnosis for children admitted to Children Welfare Teaching Hospital.Methods: A Retrospective study M’as done on 160 children with idiopathic nephrotic syndrome who were diagnosed and/or treated at Children Welfare Teaching Hospital and were followed up in the pediatric nephrology consultation clinic betM'een April 2004 and April 2006.Results: The study group included 40 children with idiopathic nephrotic syndrome r Who underwent renal biopsy. There were 26(68.7%) males and 14(31.2%) females.Age at onset ranged between (1-15) years, median age (3.5) years. Facial oedema M’as fcnmd in 90%, hypertension in 45% patients, gross hematuria in 27.5 and persistent microhematuria in 45%. Sixteen (40%) patients had focal and segmental glomemlosclerosis on renal biopsy, nine (22.5%) patients minimal change nephrotic syndrome, eight (20%) patients mesangioproliferative glomerulonephritis, and seven (17.5%) patients had membranoproliferative glomerulonephritis.Conclusion: Focal and segmental glomemlosclerosis was the most common histopathological subtype in our study group. Further large studies is needed to find out changing trends of histopathology in childhood nephrotic syndromeKey words: Nephrotic syndrome, Children, Histopahological subtypes


Article
Sociodemographic and Medical Factors of Preterm Delivery According to the Clinical Subtypes of Prematurity

Author: Sijal Fadhil Farhood Al‑Joborae, Farah Wajid Alwan
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2018 Volume: 15 Issue: 4 Pages: 341-348
Publisher: Babylon University جامعة بابل

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Abstract

Background: Preterm delivery is defined as childbirth occurring at <37 completed weeks. Preterm birth remains one of the most importantproblems in pregnancy, as it is still a major health problem worldwide, which results in 75% of neonatal mortality. Often, the cause of pretermdelivery is unknown; however, several etiological risk factors have been identified. Objective: The objective of this study was to examinesociodemographic and medical risk factors of preterm delivery in relation to clinical subtypes as follows: extremely preterm (<28 weeks), verypreterm (28 up to 32 weeks), and moderate‑to‑late preterm (32 up to 37 weeks). Materials and Methods: It is a descriptive hospital‑basedcross‑sectional study which was carried out on a convenient sample of 200 preterm babies who were cared for in the neonatal care units inBabylon Maternity and Pediatrics Hospital, Hilla General Teaching Hospital whose mothers accepted to participate in this study. This studywas conducted over 5 months from March 1, 2018 to August 1, 2018. Results: Thirty‑nine percent of respondent mothers had a history ofabortion and (18.0%) had a history of recurrent preterm birth. Spontaneous preterm delivery (premature rupture of membrane) was the mode ofdelivery in (53.5%) of mothers and (49.5%) of respondents were multigravida. As high as (43.5%) of respondent mothers had current medicalillnesses, hypertension representing (33.33%) of these illnesses. Forty percent of mothers had irregular ANC and (15.5%) did not have anyantenatal care at all. Conclusion: Several significant risk associations between preterm birth according to clinical subtypes of prematurity andthe following risk factors were identified as follows: maternal age, gravidity, birth order, BMI, educational level, mode of delivery, history ofabortion, contraceptive use before pregnancy, and genetic defects.


Article
Role of Topoisomerase II Alpha Gene Status on Selection of Anthracycline Therapy in Triple Negative Breast Cancer

Author: Mohammed Fawzi Abdulmehdi Alqanbar
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2017 Volume: 14 Issue: 1 Pages: 189 -197
Publisher: Babylon University جامعة بابل

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Abstract

Triple negative breast carcinoma [TNC], is peculiar to have hormone receptors negative [ER and PR] and lose HER2 receptor reactivity by immunostaining. Generally, TNC tumors carry a bad prognosis. Little is to be perceived about TOP2A gene amplification in triple negative breast cancer. This information may be of importance for the expectation of the influence of therapy. Thus the objective of this study is to evaluate topoisomerase II alpha gene status in triple negative breast cancer. A cross sectional study was done, from July 2014 to February 2015 in Oncology hospital of Baghdad Medical Complex. Only 28 patients with triple negative breast cancer were included [ER-, PR-, her2/neu-] other molecular types of breast cancer were excluded. All 28 cases were successfully hybridized using dual-color chromogenic in situ hybridization [DC-CISH][Zyto- Vision] probe kit for determination of topoisomerase II alpha gene status Patients mean age was [47.7 ± 8.8 SD]. Tumor stage was intermediate [stage II] in [57%] while 36% of cases were in stage III. Tumor grade was 46% for grade II and 54% for grade III. Regarding Ki-67, 54% of cases express Ki-67 more than 14% in comparison to 46% of them the expression was less than 14%.Regarding topoisomerase II alpha gene amplification, gene amplification was noticed in single case only as [3.6%] and it was low amplification. So TNBC is always associated with insignificant alterations of topoisomerase 2 alpha gene and thus may predicts poor response to anthracycline therapy in this molecular group of breast cancer.


Article
Utility of CA 15-3 in diagnosis of Breast Cancer Recurrence. An Observational Study
فائدة CA 15-3 في تشخيص تكرار سرطان الثدي. دراسة قائمة على الملاحظة

Author: Musaab R. Al-Bayati مصعب راجي البياتي
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2018 Volume: 14 Issue: 25 Pages: 41-49
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

Background : CA 15-3 is the commonest tumor marker for breast cancer. Elevated serum levels of this marker was shown to be a predictor of disease recurrence in patients with localized breast cancer. This study aimed to determine the sensitivity of serum CA 15-3 level in the detection of breast cancer recurrence in relation to the molecular subtype of breast cancer, type of recurrence and the number and sites of distant metastasis.Methods : Retrospective observational study of patients with localized breast cancer followed until relapse. Serum level of CA 15-3 at first documentation of relapse was compared between patients in respect to the molecular subtype of breast cancer, type of recurrence and the number and sites of metastasis. Results : Elevation of CA 15-3 were found in 56% of patients at relapse. Only 6% of patients with locoregional relapse shows elevation of this marker compared with 62% of patients with distant metastasis. Elevation of CA 15-3 were more sensitive for detection of relapse in patients with luminal subtype (62%) than in patients with HER2 enriched (45%) and triple negative (35%) breast cancers. The test was more sensitive in patients with bone (69%), lung (65%) and liver (62%) metastasis than in patients with brain metastasis (25%). Conclusions : CA 15-3 is a relatively sensitive marker for detection of breast cancer recurrence. However, this sensitivity may be hampered in patients with isolated locoregional relapses and in patients with HER2 enriched and triple negative breast cancers

خلفية: CA 15-3 هو علامة الورم الأكثر شيوعا لسرطان الثدي. تبين أن ارتفاع مستويات المصل في هذه العلامة يعد مؤشراً على تكرار المرض لدى مرضى سرطان الثدي الموضعي. تهدف هذه الدراسة إلى تحديد حساسية مستوى المصل CA 15-3 في الكشف عن تكرار الإصابة بسرطان الثدي بالنسبة إلى النوع الفرعي الجزيئي لسرطان الثدي ، ونوع التكرار وعدد ومواقع ورم خبيث بعيد.الطريقة: دراسة استعادية بأثر رجعي للمرضى الذين يعانون من سرطان الثدي المترجمة يتبع حتى الانتكاس. وتمت مقارنة مستوى المصل من CA 15-3 في أول وثائق الانتكاس بين المرضى فيما يتعلق النوع الفرعي الجزيئي لسرطان الثدي ، ونوع تكرار وعدد ومواقع ورم خبيث.النتائج: تم العثور على ارتفاع CA 15-3 في 56 ٪ من المرضى في الانتكاس. فقط 6 ٪ من المرضى الذين يعانون من الانتكاس الموضعي يظهر ارتفاع هذه العلامة مقارنة مع 62 ٪ من المرضى الذين يعانون من ورم خبيث بعيد. كان ارتفاع CA 15-3 أكثر حساسية للكشف عن الانتكاس في المرضى الذين يعانون من النوع الفرعي اللمعي (62 ٪) من المرضى الذين يعانون من HER2 المخصب (45 ٪) وسرطان الثدي الثلاثي السلبي (35 ٪). كان الاختبار أكثر حساسية في المرضى الذين يعانون من العظام (69 ٪) والرئة (65 ٪) والكبد (62 ٪) ورم خبيث من المرضى الذين يعانون من ورم خبيث في الدماغ (25 ٪).الاستنتاجات: CA 15-3 هو علامة حساسة نسبيا للكشف عن تكرار سرطان الثدي. ومع ذلك ، قد يتم إعاقة هذه الحساسية في المرضى الذين يعانون من الانتكاسات الموضعية المعزولة وفي المرضى الذين يعانون من سرطان الثدي المخصب HER2 وثلاثي السلبيات


Article
Breast Cancer Subtypes among Iraqi Patients: Identified by Their ER PR and HER2 Status
تحدديد النوع الفرعي لسرطان الثدي عند المرضي العراقيين باستخدام معلمات الأورام ER, PR, HER2

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Abstract

Background: Breast cancer ranks the first among the Iraqi population since three decades and is currently forming a major public health problem being the second cause of death women. Novel management of breast cancer depends upon precise evaluation of their molecular subtypes; identified by Hormone (Estrogen and Progesterone) receptors and HER2 contents of the primary tumor.Objective: To assess the rates of the different molecular breast cancer subtypes in the examined tissue specimens belonging to females diagnosed with breast cancer in Iraq; correlating the findings with those reported in the literature at the regional and global levels.Patients and Methods: This retrospective study documented the findings of tissue biopsy examination belonging to 686 female patients diagnosed with breast cancer. Formalin fixed paraffin-embedded blocks were utilized to assess the availability of Estrogen receptors (ER), Progesterone receptors (PR) and HER2 expressions through semi quantitative immuno-histochemical staining technique. Breast carcinomas were classified into four main molecular subtypes: Luminal A: ER/PR(+) / HER2(-), Luminal B/Triple Positive: ER/PR(+) / HER2(+), Non-Luminal HER-2 enriched: ER/PR(-) / HER2(+) and Non-Luminal/Triple Negative: ER/PR(-) and HER2(-). Other phenotypes included: ER(+)/PR(-) / HER2(+), ER(-)/PR(+) / HER2 (+), ER (+)/PR (-) / HER2 (-) and ER (-)/PR (+) / HER2 (-).Results: Out of the exanimated cases of breast carcinomas, the registered rates of positive ER, PR and HER2 tumor contents in this study were 67.8%, 65.3% and 29.4% respectively. The main identified phenotype was the Luminal A in 309 cases (45%). That was followed by the Triple Negative in 107 cases (15.6%) and Triple Positive/Luminal B (96 cases, 14%), while 71 cases (10.3%) were HER2 enriched. The corresponding rates of the (E+/P-/H+), (E-/P+/H+), (E+/P-/H-) and (E-/P+/H-) subtypes were 3.1%, 2.0%., 5.7% and 4.2% respectively. Differences in in the expressions of these IHC molecular markers are illustrated among different countries.Conclusions: Due to the displayed variations in the socio-demographic characteristics and biological risk factors among patients in different populations, it is mandatory to identify the molecular marker subtypes of breast cancer expressions in order to assess the impact of management and response to therapy. The routine documentation of their patterns in the cancer registry reports and published research ensures the validity and reliability of the presented clinical data.Keywords: Breast, Cancer, Subtypes, ER, PR, HER2, Iraqi Patients.

الخلاصةالخلفية: سرطان الثدي يحتل المرتبة الأولى بين السكان العراقيين منذ ثلاثة عقود، ويشكل حاليا مشكلة صحية رئيسية حيث يعتبر السبب الثاني للوفاة عند النساء. تعتمد أسس العلاج الجديدة لسرطان الثدي على التقييم الدقيق لأنواعها الفرعية الجزيئية و التي تحددها مستويات مستقبلات هرمون (الاستروجين والبروجسترون) ومحتويات HER2 في الورم الرئيسي.الهدف من الدراسة: تقييم معدلات مختلف الأنواع الفرعية لسرطان الثدي الجزيئي في عينات الأنسجة التي تم فحصها والتي تخص الإناث المصابات بسرطان الثدي في العراق؛ وربط النتائج مع تلك المسجلة على الصعيدين الإقليمي والعالميالمرضى والطرق: وثقت هذه الدراسة بأثر رجعي نتائج فحص خزعة الأنسجة التي تنتمي إلى 686 مريضة مشخصة بسرطان الثدي. واستخدمت لتقييم توافر مستقبلات الاستروجين (ER)، مستقبلات البروجسترون (PR) والتعبيرات HER2 من خلال تقنية الطيخ المناعي شبه الكمي. تم تصنيف سرطان الثدي إلى أربعة أنواع فرعية جزيئية رئيسية: Luminal A: ER/PR(+) / HER2(-), Luminal B/Triple Positive: ER/PR(+) / HER2(+), Non-Luminal HER-2 enriched: ER/PR(-) / HER2(+) and Non-Luminal/Triple Negative: ER/PR(-) and HER2(-). و انواع اخرى ER(+)/PR(-) / HER2(+), ER(-)/PR(+) / HER2 (+), ER (+)/PR (-) / HER2 (-) and ER (-)/PR (+) / HER2 (-).النتائج: من بين حالات سرطان الثدي المهددة، كانت المعدلات المسجلة لمحتوى الأورام الموجبة ER, PR و HER2 في هذه الدراسة 67.8٪ و 65.3٪ و 29.4٪ على التوالي. وكان النمط الظاهري المحدد الرئيسي اللمعية A في 309 حالات (45٪). وأعقب ذلك السلبي الثلاثي في 107 حالات (15.6٪) وثلاثية إيجابية / لومينال B (96 حالة، 14٪)، في حين أن 71 حالة (10.3٪) كانت HER2 المخصب. وكانت المعدلات المقابلة من (E + / P- / H +)، (E / P + / H +)، (E + / P- / H-) و (E / P + / H-) فرعية 3.1٪، 2.0٪. ، و 5.7٪ و 4.2٪ على التوالي. وتظهر الاختلافات في التعبير عن هذه العلامات الجزيئية بين مختلف البلدان.الاستنتاجات والتوصيات: نظرا للاختلافات المعروضة في الخصائص الاجتماعية الديموغرافية وعوامل الخطر البيولوجية بين المرضى في مختلف السكان، فمن الضروري تحديد الأنواع الفرعية الجزيئية من تعبيرات سرطان الثدي من أجل تقييم تأثير الاستجابة للعلاج . ان التوثيق الروتيني لأنماط سرطان الثدي في تقارير سجل السرطان والبحوث المنشورة يضمن صحة ودقة البيانات السريرية ذات العلاقة.مفتاح الكلمات: سرطان الثدي ، الانواع الفرعية ، ER, PR, HER2 ، المرضى العراقيين.

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