: Breast cancer has the highest incidence among all female patients with different cancer types. It is a lethal disease which threaten women's health. There are many prognostic and predictive factors that implicated in breast cancer. The expression of Ki-67 is strongly associated with cancer proliferation and is a known indicator of breast cancer prognosis and outcome. Ki-67 expression levels are also useful to inform treatment decision making in some cases. As a result, measurement of Ki-67 is routinely done during pathological tumor evaluation.

In radiotherapy treatment couches, rigid carbon fiber couch inserts reduce set-up errors caused by couch sagging. These inserts have been described in several studies as radio-translucent with negligible radiation field attenuation. The majority of these tests were carried out with the radiation field normally incident on the center of the couch, and there appears to be no evidence in the literature of the effect of the thickest region (edge of the couch) on the attenuation and dose distribution during external beam radiotherapy. In this study, we evaluated and improved the calculated dose attenuation for the under-couch fields to reduce the skin surface dose. Using the difference between the measured and calculated attenuation doses obtained using the ion chamber and the “TPS” treatment planning system; an algorithm that identifies the influence of couch attenuation on patient dose verification. According to our results, the attenuation is affected by the gantry angle, where the maximum attenuation was at 180°, the angle at which the couch attenuates the 6 MV photon beam by 9.3 % for 10×10 cm2 field sizes, while the attenuation at 1600 and 1400 was less where the lowest attenuation recorded at 1400 at which angle the couch attenuated the 6 MV photon beam by 2.4. It would appear, therefore, that Connexion central opening couch with posterior beams results in significant decreases in the dose delivered to the target. The measured data were compared to the calculated values from the Monaco Treatment Planning System, and computed using the Monte Carlo (MC) and Collapsed Cone (CC) algorithms. The most minor agreement was observed at an angle of 1800 between the calculated and the measured attenuation for the 5 x 5 cm² field size with 6 MV and 10 MV photon beam energy where the difference was 5.3 % and 4 % for the MC and CC algorithm, respectively. Excellent agreement was observed at an angle of 160 between calculated and measured attenuation with the field sizes of 10 x 10 cm² for 6 MV, in which the difference (lose dose) was ±1.5 %.

Background: An impaired immune system in the perioperative period has important clinical implications in patients with cancer. Despite the immunosuppressive properties of opioid therapy, it is still commonly utilized in the intrathecal or epidural space for the treatment of postoperative pain. Also, intrathecal dexmedetomidine has extended analgesic efficacy in postoperative pain; it can significantly affect immune function in perioperative patients.

Objective: To investigate the effect of intrathecal morphine, dexmedetomidine, or both in combination with bupivacaine on cellular immunity and cytokine production in cancer surgical patients.

Study Design: A prospective randomized clinical study.

Setting: South Egypt Cancer Institute, Assiut University.

Methods: Ninety patients were randomly assigned to receive intrathecal morphine 0.5 mg (Group M, n= 30), dexmedetomidine 0.5 µg/kg (Group D, n= 30) or morphine 0.5 mg with dexmedetomidine 0.5 µg/kg (Group MD n= 30); 2 mL bupivacaine 0.5% was added to injected drugs in all groups. Blood samples were collected preoperative (T0), immediate postoperative (T1), 4 hours postoperative (T2), and 24 hours postoperative (T3) for measurement of CD3, CD4, CD4/CD8 and CD16+ 56 (NK), interleukin (IL)-1beta (IL-1β), IL-6, IL-10 and tumor necrosis factor alpha (TNF-α).

Results: A significant reduction in cellular immunity (CD3, CD4, CD8, CD4/CD8, CD 16+ 56) was noticed in the 24-hour postoperative period in all 3 studied groups, with a marked reduction in Group M in comparison to Group MD and Group D. Regarding inflammatory mediators, IL-10 and IL-1β showed significant reduction in Group M in …

The objective was to compare analgesic effect of combined epidural morphine-midazolam with either drug alone on postoperative pain in patients undergoing major abdominal cancer surgery.

Materials and Methods:

Eighty-four patients were allocated in prospective randomized double-blind study to receive epidural analgesia. Patients received 5 mg morphine in morphine (Mor) group, 5 mg midazolam in midazolam (Mid) group, 5 mg morphine+ 5 mg midazolam in morphine-midazolam (MM) group, 0.25% bupivacaine was added to injected solution with same volume in all groups. All groups were compared with time of first analgesic request, total analgesic consumption, number of epidural doses, postoperative Visual Analog Scale score, and adverse events.

Immune thrombocytopenia (ITP) is an acquired autoimmune disease. This study’s objective was to estimate the variations in the population of CD4⁺CD25^+High FoxP3⁺ cells (CD4⁺ regulatory T-lymphocytes; Tregs) in previously untreated children with chronic ITP managed in Assiut University Hospitals, as well as to evaluate the efficacy of high-dose dexamethasone (HD-DXM) in these patients.

Methods

In this study, we investigated the frequencies of T-lymphocyte subsets in 27 untreated children with chronic ITP.

Results

Prior to treatment, the percentages of CD4⁺CD25^High cells and Tregs were significantly lower in the chronic ITP group compared to the control group (p = 0.018 and p < 0.0001, respectively). After treatment with HD-DXM, Tregs and platelets were significantly increased in these patients (p < 0.0001 for both).

Conclusions

Our results suggest that Tregs are deficient in children with

Invasive fungal infections (IFIs) are important cause of mortality in acute myeloid leukemia (AML) patients on treatment with intensive induction chemotherapy. Toll-like receptors, mainly Toll-like receptors 2 and 4 (TLR2 and TLR4), play a considerable role in the host defense against microorganisms. The involvement of TLR signaling in modulation of innate immune response is extensively discussed, but the TLR expressions profiling on adaptive immune cells are not specified. Also, the expressions of TLRs and their association with the occurrence of IFIs in patients with AML are not studied. So, the novel aim of this study was to investigate the associations between the T-lymphocyte expression of TLR2 and TLR4 and the occurrence of IFIs in AML patients treated with intensive induction chemotherapy.

We aimed to determine the levels of follicular helper T (Tfh) and follicular regulatory T (Tfr) cells in COVID-19 patients and determine whether their levels correlated with disease severity and presence of hyperglycemia. This study was carried out in 34 hospitalized COVID-19 patients and 20 healthy controls. Levels of total circulating Tfh, inducible T-cell costimulator (ICOS)+ activated Tfh, and Tfr cells were assessed in all participants by flow cytometry. Total CD4+CXCR5+ Tfh cells and ICOS+Foxp3-activated Tfh cells increased and ICOS+Foxp3+ Tfr cells decreased in COVID-19 patients, especially in diabetic patients and those with severe disease. Activated ICOS+ Tfh cells were directly correlated with lactate dehydrogenase, D-dimer, ferritin, and respiratory rate and inversely correlated with the partial pressure of carbon dioxide. COVID-19 is associated with marked activation of Tfh cells and a profound drop in Tfr …