Biomedical Research and Therapy

Ki-67 status in patients with primary breast cancer and its relationship with other prognostic factors

2019-03-18T08:23:57+00:00

Introduction: Breast cancer (BC) is the most common cancer in women and is the second most common cause of fatality in patients with cancer in the world. Cell proliferation plays an important role in the clinical behavior of invasive BC. We aimed to assess the status of Ki-67 in patients with primary breast cancer and evaluate the association of this tumor marker with other clinico-pathologic and prognostic factors.

Methods: The current study recruited 220 patients with primary BC admitted to the oncology clinic of the Tabriz University of Medical Sciences. We evaluated Ki-67 IHC slides and reported the Ki-67 status and its relationship with other prognostic factors in breast cancer patients. Among 220 patients, 63.3% developed grade 2 tumors, and 63.8% were younger than 50-year-olds. 117 cases (53%) were Ki-67 positive with more than 1% tumor nuclei stained, and 53 cases (24%) had tumors with more than 15% of Ki-67 expression.

Results: There was no correlation between Ki-67 and patient's age (Spearman rho = 0.375, tau Kendall = 0.374), tumor size (Spearman rho = 0.558, tau Kendall = 0.548) and grade (Spearman rho = 0.570, tau Kendall = 0.568), however, there was a marginally significant relationship between lymph node status and Ki-67 expression (Spearman rho = 0.077, tau Kendall = 0.079). Based on the Mann -Whitney test, there was a significant correlation between the expression of estrogen receptor (ER) and progesterone receptor (PR) with Ki-67.

Conclusion: A reliable estimation of different prognostic factors in BC patients is required for the selection of an optimal therapeutic strategy. The attention has been focused on the markers of tumor biology.

The effect of wet-cupping on the severity of migraine headaches: Randomized controlled clinical trial

2019-03-18T08:23:56+00:00

Introduction: This study aimed to determine the effect of wet-cupping on pain intensity in patients with migraines.

Method: 132 patients were diagnosed with migraines. Pain intensity was evaluated based on the visual analogue scale. After homogenizing the data, patients were randomly divided into two (wet-cupping and control) groups. Paired t-test, Kruskal-Wallis and Mann-Whitney tests were used to analyze the data.

Results: The mean of pain intensity of wetcupping (7.61+/-1.29) and control (7.22+/-1.21) before the intervention showed no significant difference (p=0.401). There was a significant difference between the mean of pain relief intensity of wet-cupping (2.4+/-1.9) and control (0.6+/-0.8) groups before and after interventions (p<0.001).

Conclusion: Wet-cupping is an effective tool to treat migraine headaches.

Trial registration: Current Controlled Trials IRCT201110314495N2

Impaired oxidative-antioxidative balance during migraine attack

2019-03-18T08:23:55+00:00

Background: Recent evidence has suggested that oxidative stress may play a role in the pathophysiology of migraine. In this study, we aimed to evaluate the oxidative-antioxidative status in sera of migraine patients from an Iranian population during migraine attacks.

Methods: This study recruited 46 migraine patients with or without aura and 45 sex- and age-matched healthy controls. The levels of protein carbonyl (PC), malondialdehyde (MDA) and total oxidants status (TOS) were measured as the indicators of oxidative stress. The levels of total thiols (T-SH), reduced glutathione (GSH) and total antioxidant capacity (TAC) were determined as markers of antioxidant status. Oxidative stress index (OSI) was calculated by dividing TOS to TAC.

Results: The serum levels of MDA (4.10 +/- 0.70 vs. 3.20 +/- 0.62, P = 0.003), TOS (18.46 +/- 4.06 vs. 16.21 +/- 3.67, P = 0.007) and OSI (1.54 +/- 0.60 vs. 1.22 +/- 0.46, P = 0.006) were significantly higher in migraine group compared to controls, however, no statistically significant differences of PC levels were found between migraine patients and controls (0.615 +/- 0.161 vs. 0.517 +/- 0.126, P = 0.1). In contrast, the levels of T-SH (273 +/- 51.71 vs. 310.88 +/- 53.32, P = 0.001), GSH (28.08 +/- 6.20 vs. 32.13 +/- 5.8, P = 0.002) and TAC (1.27 +/- 0.226 vs. 1.41 +/- 0.26, P = 0.01) were significantly lower in migraine patients compared to healthy controls.

Conclusion: Our study showed higher levels of oxidative stress and lower levels of antioxidant status in migraine group compared to controls, which indicates the possible role of oxidative stress in triggering migraine attacks.

A randomized, double-blinded, controlled trial of herbal medicine combination for leg symptoms due to chronic venous disease

2019-03-18T08:23:52+00:00

Background: The herbal medicine combination (HMC) containing 2% Asiaticoside and 1% Acemannan, in a Beeswax encapsulation of 2% Acetylsalicylic acid base, was developed as a topical treatment option for mild-to-moderate chronic venous disease (CVD). For control (C), Beeswax encapsulation of 2% Acetylsalicylic acid base was used.

Methods: A double-blinded, randomized controlled trial comparing HMC with C was investigated among 42 CVD patients; 21 patients was allocated to receive either HMC or C, for a continuous 12-week treatment. To assess the efficacy, the following were employed: (i) Venous Clinical Severity Score (VCSS), (ii) Patients Self-Rating Symptoms Score (PSSS), and (iii) Short-form health-related quality of life score based on a Medical Outcomes Study 14-item Chronic Venous Disease (MOS CIVIQ14). The short-term safety was assessed by the patients' self-reported adverse events. The primary endpoint was a responder rate defined by a 50% reduction of the VCSS from baseline after 4 weeks of treatment. The secondary endpoints were assessed by improvement of overall disability after employing VCSS, PSSS, and MOS CIVIQ14, accordingly.

Results: CVD Thai patients (N=42), regardless of clinical severity of CEAP class (CEAP1/CEAP2)or co-morbidity, responded 57.14% to HMC (N=21) as compared with 9.52% to C (N=21) the responder rate was significantly dependent on intervention (p=0.003 and p=0.003, respectively). HMC reduced VCSS markedly better than C, over the 4 weeks: 11.9048 (6.4908) vs. 22.4702 (7.9438), p<0.001. HMC reduced VCSS and PSSS scores significantly better than C did: from baseline to 2 weeks (p=0.001 vs. p=0.017, respectively), from 2 to 4 weeks (p=0.001 vs. p=0.004, respectively), and from 8 to12 weeks (p=0.001 vs. p=0.003, respectively). After 12 weeks from baseline, from both the global and subscores for MOS CIVIQ14, treatment with HMC and C significantly improved scores (p<0.001 and p<0.001, respectively). For the adverse drug events reported, there were no statistically significantly differences between HMC and C from baseline to the end of the 12-week follow-up (p=0.756).

Conclusion: The herbal medicine combination (HMC), consisting of 2% Asiaticoside and 1% Acemannan in Beeswax encapsulation of 2% Acetylsalicylic acid, as a topical administration in optional medical management for Thai patients with leg symptoms due to chronic venous disease, provided a clinical responder rate that was better than that of control. In terms of short-term safety assessments, no significant statistical differences for adverse events were reported with regards to incidence for both HMC and C treatments. Further studies are warranted to explore and develop this herbal medicine base combination.

Trial registration no.: ISRCTN54360155

The efficacy of adding vitamin B12 to pegylated interferon and ribavirin treatment in Hepatitis C virus patients regarding the host and viral prognostic factors

2019-03-18T08:23:54+00:00

Introduction: Hepatitis C virus (HCV) infection affects almost 180 million people around the world. Even though the development of direct acting antivirals (DAAs) has significantly improved the treatment responses to HCV infection, treatment with pegylated interferon (PegIFN) in combination with ribavirin is considered the standard of care (SOC) for chronic HCV infection treatment in countries with limited medical resources. Considering the inhibitory effect of vitamin B12 on HCV replication, we have evaluated the effect of vitamin B12 supplementation along with SOC on treatment outcomes in patients with chronic HCV infection, who were antiviral treatment-naive.

Methods: In this regard, seventy-four HCV-infected patients, naïve to antiviral therapy, were randomly assigned to receive SOC or SOC in addition to vitamin B12 (SOC + B12). Viral response was evaluated at 4, 12, 24 and 48 weeks following the initiation of viral treatment and at 24 weeks after completing the treatment. Genotyping of the interleukin 28B (IL28B) polymorphisms was also performed. Demographic characteristics, clinical findings, fibroscan results and drug adverse effects were recorded.

Results: Our findings showed that rapid viral response was not significantly different between the two groups; however, the rates of complete early viral response (cEVR) (p=0.033), end-of-treatment viral response (ETVR) (p=0.001) and sustained virologic response (SVR) (p=0.0001) were significantly higher in SOC + B12 patients compared to SOC patients. Besides, in SOC + B12 patients, those with a higher baseline viral load and carriers of IL28B CC genotype showed significantly higher rate of SVR.

Conclusion: In conclusion, the addition of vitamin B12 significantly improved the rate of SVR in HCV-infected patients, who were naïve to antiviral therapy. As this treatment regimen is safe and inexpensive, it proposes an option for improving the effectiveness of the HCV treatment with SOC, particularly in resource-limited settings.

A proposition for a cancer treatment study using radioactive metal co-factor enzymes

2019-03-18T08:23:59+00:00

Cancer is a serious pathological condition of abnormal cells are gathered in tumors in the body's tissues or organs. Due to their accelerated metabolism, cancer cells require a great demand for energy, protein (cell structure substrates), and metabolic enzyme activity. If the body does not respond adequately to this demand, the metabolic processes of cancer cells will be hampered, and their growth will be limited or even stopped. It is possible to control the metabolic processes of the cancerous tumors by performing one or more of the following approaches: stopping the energy and cell structure substrate supply, inhibiting enzymic activity, and/or destroying cancer cells with external agents (such as radiation and/or chemicals). These approaches have been investigated either in single or combination modes, but so far the results obtained have not been on par with expectations. In this paper, we propose a method of cancer treatment which entails the use of a radioisotope instead of stable metal to break down the structure of metal co-factor enzyme and to deactivate its catalytic function. With a judicious choice of the metal radioisotope, this method is even able to perform all the above-mentioned approaches, and at the same time, giving a much better efficacy in cancer treatment.