Intra-arterial chemotherapy has shown promising results and improved the prognosis of retinoblastoma in the developed countries. Here, we aim to report our initial experience, in Egypt, in the treatment of all stages of naïve retinoblastoma with ophthalmic artery chemosurgery (OAC), using melphalan.
The technique was successful in 23 out of 26 eyes. Overall, a total of 63 treatment sessions were performed. Ophthalmic artery catheterization was performed in 59 treatment sessions, whereas middle meningeal artery catheterization was performed in 4 treatment sessions. Adequate tumor control was achieved in 95.6%. Progression has developed in one eye after the third OAC session. The mean follow-up period was 18.5 months. Recurrence of the main tumor as well as vitreous and subretinal seeds was reported in one eye after 19-month duration. A globe salvage rate of 91.3% was attained. No metastasis was recorded, and all patients were alive within the stated follow-up period.
A high globe salvage rate along with metastasis free survival and mild complications were achieved. Therefore, our initial experience with OAC in primary retinoblastoma proved to be safe and effective.
Inflammatory bowel disease (IBD) has systemic consequences that extend beyond the gastrointestinal tract. While nailfold capillaroscopy (NFC) is widely utilized in many rheumatological disorders, its significance in evaluating microvascular changes in IBD remains unknown. This study aimed to standardize NFC use in IBD patients and relate NFC results to clinical and laboratory criteria.
This observational case–control study included histology- and colonoscopy-diagnosed IBD patients. We performed NFC on eight fingers of each subject using a Dino-Lite digital microscope, adhering to European Alliance of Associations for Rheumatology guidelines. Capillary characteristics, including density, morphology, and dimensions, as well as microhemorrhages, were assessed at 200×.
The study included 50 IBD patients and 30 healthy controls. IBD patients had significantly lower capillary density (7.52 ± 0.68 capillaries/mm) than controls (8.18 ± 0.63 capillaries/mm, p < 0.001), with 26% of IBD patients exhibiting densities below seven capillaries/mm. In IBD patients, microhemorrhages were more prevalent than in controls (p = 0.032). Raynaud's phenomenon was more commonly detected in patients with low mean capillary density (p = 0.04).
IBD patients had reduced mean capillary density and increased microhemorrhages. These changes suggested that NFC could be a non-invasive way provides unique insights into IBD microvascular health.
Doxorubicin (DOX) is a commonly used chemotherapeutic medication for treating malignancies, although its cardiotoxicity limits its use. There is growing evidence that alteration of the mitochondrial fission/fusion dynamic processes accompanied by excessive reactive oxygen species (ROS) production and alteration of calcium Ca2+ homeostasis are potential underlying mechanisms of DOX-induced cardiotoxicity (DIC). Metformin (Met) is an AMP-activated protein kinase (AMPK) activator that has antioxidant properties and cardioprotective effects. The purpose of the study is to assess Met's possible cardioprotective benefits against DOX-induced cardiotoxicity. The study included 32 adult male rats. They were randomly divided into four groups: administered saline, DOX, Met, or DOX combined with Met respectively. Heart tissues were used for biochemical assays that measured oxidative stress markers, malondialdehyde (MDA), reduced glutathione (GSH), mitochondrial dynamics markers, optic atrophy-1(OPA-1) and dynamin-1-like protein (Drp1), calcineurin and caspase-3. Serum levels of myocardial injury markers, cardiac troponin I (cTn-I), and aspartate aminotransferase (AST), were also measured. The results revealed that DOX intoxication was associated with a significant increase in the levels of serum cTn-I and AST, increased cardiac MDA level, increased cardiac Drp1, calcineurin, and caspase-3 expressions, as well as reduced cardiac GSH level and cardiac OPA-1 expression. On the other hand, Met treatment significantly reduced DIC by decreasing oxidative stress, apoptosis, and improving mitochondrial and calcium balance. Finally, this study shows that Met may be able to protect the heart from damage caused by DOX by working as an antioxidant and anti-apoptotic agent and keeping the balance of calcium and mitochondria.