There is a traditional belief in the Middle East that regular consumption of camel milk may aid in prevention and control of diabetes. The aim of this work was to evaluate the efficacy of camel milk as an adjuvant therapy in young type 1 diabetics. This 16-week randomized study enrolled 54 type 1 diabetic patients (average age 20 years) selected from those attending the outpatient diabetes clinic of the Menofia University Hospital, affiliated with Egypt's National Cancer Institute. Subjects were randomly divided into two groups of 27 patients: one received usual management (diet, exercise, and insulin), whereas the other received 500 mL of camel milk daily in addition to standard management. A control group of 10 healthy subjects was also assessed. The following parameters were evaluated at baseline and at 4 and 16 weeks: hemoglobin A1c (HbA1c), human C-peptide, lipid profile, serum insulin, anti-insulin antibodies, creatinine clearance, albumin in 24-hour urine, body mass index, and Diabetes Quality of Life score. The following parameters were significantly different between the usual-management group versus the camel milk group after 16 weeks: fasting blood sugar (227.2 +/- 17.7 vs. 98.9 +/- 16.2 mg/dL), HbA1c (9.59 +/- 2.05[%] vs. 7.16 +/- 1.84[%]), serum anti-insulin antibodies (26.20 +/- 7.69 vs. 20.92 +/- 5.45 microU/mL), urinary albumin excretion (25.17 +/- 5.43 vs. 14.54 +/- 5.62 mg/dL/24 hours), daily insulin dose (48.1 +/- 6.95 vs. 23 +/- 4.05 units), and body mass index (18.43 +/- 3.59 vs. 24.3 +/- 2.95 kg/m(2)). Most notably, C-peptide levels were markedly higher in the camel milk group (0.28 +/- 0.6 vs. 2.30 +/- 0.51 pmol/mL). These results suggest that, as an adjunct to standard management, daily ingestion of camel milk can aid metabolic control in young type 1 diabetics, at least in part by boosting endogenous insulin secretion.
The incidence of TNBC in our study is similar to other studies. TNBC patients showed an early major recurrence surge peaking at approximately year 2.5. Regional variation of clinicopathologic features indicates a need for molecular studies to define underlying molecular features and its impact on survival.
In the current pilot study, only the lymphovascular invasion in the area of the primary tumor was found to be significantly related to the nonsentinel lymph node metastasis. There was a tendency toward higher incidence of nonsentinel lymph node metastasis associated with the number of positive SLN and capsular invasion of SLN, though this did not reach the statistical significance. This could be attributed to the small number of patients recruited. Further evaluation of the predictors of nonsentinel lymph node metastasis on a larger number of patients is required. The validation of these predictors in prospective studies may enable approximately half of early stage breast cancer patients with positive SLN to be staged with SLNB alone while avoiding the morbidity of unnecessary ALND.
4948 Treatment of early stage classical Hodgkin's lymphoma (CHL) I&II had been changed over the last decades. This study evaluated the treatment outcome for early stages CHL patients who were treated by 6 versus 4 ABVD cycles with or without radiotherapy (RT) to the residual or bulky sites. The study retrospectively analyzed cases with early stage CHL patients diagnosed & treated in Kuwait Cancer Control Center from 2001–2010. Staging confirmed by computed tomography, nuclear studies:Gallium or recently Positron emission tomography. Data analyzed by SPSS version 15 & described using mean and standard deviation (SD) or frequencies according to data type. Chi square test was used for comparison of qualitative variables; survival analysis was performed by Kaplan-Meir analysis and regression model performed with Cox regression model. Significance considered if p ≤0.05 & highly significant if ≤0.01. The study included 105 patients that were further subdivided into Group A included 34 patients treated with 4 cycles and group B included 71 patients were treated by 6 cycles. Table(1)demonstrated cases characteristics. There were 61 males and 44 female with male:female ratio 1.3:1. Nodular sclerosis attributed to 66.6%, mixed cellularity 26.6%, lymphocyte rich 5.7% and lymphocyte depleted 0.9% of cases.Table (1):Characteristic Differences between group A & B.ParametersGroup A n=34Group B n=71pAge mean±SD37.41±16.15928.44±11.4740.005Sex female/males n (%)13(38.2)/21(61.7)31(43.6)/40(56.3)0.675B symptoms positive n (%)6 (17.6)32 (45)0.009Stage I n (%) II n (%)13 (38.2) 21 (61.7)7 (9.8) 64 (90.1)0.001IA 18 (17.1%)12 (35.2)6 (8.4)IIA 49 (46.6%)16 (47)33 (46.4)IB 2 (1.9%)1 (2.9)1 (1.4)IIB 36 (24%)5 (14.7)31 (43.6)Presence of Bulky disease n (%)5 (14.7)21 (29.5)0.146Presence of Extranodal site n (%)4 (11.7)4 (5.6)0.329Groups of lymph node ≥412(35.3)41(57.7%)ESR ≥ 50mm/hr n (%)36(34.28)6(17.6)30(42.2)mean±SDmean±SDTLC X109/L8.09± 3.10810.42±4.4580.007HB g/L12.36±2.1211.67±1.900.09Plat X109/L349.21±88.429400.17±151.4880.033Lymphocytes X109/L1.65±0.6711.74±0.7900.491ESR mm/hr28.21±22.15347.69±33.4500.001Max mass size by CM4.94±2.7955.39±3.0260.464Albumin g/L39.59±4.65936.62±6.0320.013LDH IU/L178.41±46.639183.90±85.3420.727 Age was significantly lower in group B (p=0.005), that may attributed to the heterogeneity of population. Group B significantly had more B symptoms, higher platelets, ESR, TLC & lower albumin level. RT was delivered to total 60(57.1%) cases; 28(82.3%) in group A and 32(45%) in group B. Thirty six of cases received 30 Gy and 20 received 36 Gy. The commonly radiated sites were cervical nodes 53.3% followed by the mediastinum in 41.6%. Complete remission (CR) achieved in 84 (80%) of cases, while 6 (5.7%) showed residual disease (RD) & progression (PD) on therapy and 15 (14.3%) of cases developed relapse on follow up. In group A; 82.2% of patients achieved CR compared to 76.1%. Relapse incidence was 16.9%(12) in group B compared to 8.8%(3) in group A. Thirteen patients were treated by high dose chemotherapy followed by ASCT; 7 with relapse (2 from A & 5 from B) & 6 cases with SD/PD (1 from A & 5 from B). Among relapsed cases 6 died (4 from group B & 2 from group A). Four patients with RD/PD died (3 from group B, 1 from group A). No significant difference was found between the two groups regarding CR, PD or relapse incidence (p=0.40). Kaplan-Mayer survival study showed 5-years survival rate was 86%; without significant difference between group A 85 % or group B 87% (p=0.51). Those without B symptoms had significantly better 5-years survival rate 92% compared to those with B symptoms 73 % (p=0.02). Although those patients with bulky disease showed inferior 5-years survival rate 77 % compared to those without bulky disease 89%,the difference was not statistically significant (p=0.1). Lower ESR < 50 mm/hr had better 5-years survival 89 % compared to high ESR ≥ 50 mm/hr 82 % with no significant difference (p=0.51). Events free survival time was difficult to determine attributed to minor events among patients. There were no cardiopulmonary toxicities or secondary malignancy detected in patients on 5-years follows up. This suggests that treatment of early stage CHL by combined chemo-radiotherapy associated with better survival. ABVD 4 cycles is adequate as 6 cycles in early stages. Disclosures: No relevant conflicts of interest to declare.
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