Background: Cardiac complications are the major cause of mortality and morbidity in thalassemic children. Iron deposition in myocardium is the key factor leading to poor cardiac functions. Myocardial performance index (MPI) by echocardiography (ECHO) can be used for an early recognition of ventricular dysfunctions. Objectives: To assess the MPI in children with ?-thalassemia major and to establish their relationship with serum ferritin. Methods: Fifty-five children of Thalassemia major in age group of 4-20 years who were on regular blood transfusion and on oral iron chelators from thalassemia unit of tertiary hospital were enrolled.After blood transfusion, serum ferritin estimation was done. Two dimensional ECHO with color Doppler was done to estimate the cardiac functions and then MPI by various parameters was calculated. Results: Out of 55 children, most were in the age group of 4 to 8 years. Mean rate of blood transfusion in subjects was 157.01 ± 21.33 ml/kg/year and mean duration of chelation therapy was 2.34 ± 1.86 years. Mean serum ferritin of subjects was 2130 ± 859.5 ng/ml. Mean ejection fraction was 61 ± 6.2%. Mean MPI of subjects was 0.60 ± 0.14. The MPI was abnormal at all levels of more than 1000 ng/ml serum ferritin (p=0.001). There was a positive correlation between MPI and serum ferritin (Pearson’s bivariate correlation coefficient r=+0.93). Conclusion: In poorlychelated thalassemic children, MPI was abnormally high despite normal ejection fraction, which can be used as an early marker of ventricular dysfunction.
Introduction Nasal masses are an intriguing arena for a rhinologist. With diagnostic advancement from anterior rhinoscopy to three-dimensional endoscopic view at a blazing speed in rhinology, it has become easier to diagnose a nasal mass. Early detection is a key for better management. Incidence of an entity varies over time because of the ever-changing environmental scenario and availability of advanced diagnostics. Incidence of nasal masses is still of importance because the pathophysiology of the nasal masses is still under research. This study will bring into notice of a rhinologist the relative incidence of various nasal masses highlighting the areas of concern and hence bringing our focus to a better management. Materials and methods It is a prospective study with a sample size of 200. All the modern diagnostic facilities were used, including a computed tomography scan can and nasal endoscopy, to reach a presumptive diagnosis of various nasal masses, and histopathology was done to establish the final diagnosis. Results In the present study, 62% were males (124) while 38% were females (76). Majority of the patients were in age-group of 21–40 years (42.5%, n = 85), followed by 40% (n = 80) in the age-group 41–60 years, and 14.5% (n = 29) in 10–20-year age-group. Around 6 (3%) cases were in less than 10 years of age-group. Out of 200 cases, 160 cases were non-neoplastic masses. Out of 40 neoplastic masses, 24 were benign and 16 were malignant. The most common mass was nasal polyps (144 of 200). Conclusion Nasal polyps are still the most common nasal masses. Improvement in diagnostic modality mandates a more active research to understand their molecular biology for better management. How to cite this article Singh J, Bhardwaj B, Singh T. Relative Incidence of Nasal Masses: A Tertiary Care Hospital Experience. Clin Rhinol An Int J 2019;12(1):16–20.
Background: Our understanding of mediators of immune infiltration in breast cancer and normal breast tissue remains limited. We hypothesize that patient factors known to be associated with inflammation and immune subsets, including body mass index, alcohol intake, and age and diagnosis, may play an important role in the tumor-immune microenvironment. Analyses of immune gene expression and signatures facilitate interrogation of the immune microenvironment in large patient cohorts. Methods: Participants from the Nurses' Health Study cohorts I and II diagnosed with invasive breast cancer were included. Total RNA extracted and microarray performed for 882 tumor and 695 tumor-adjacent samples, of which 623 tumors have matched tumor-adjacent data. CD8+ T-cell expression metrics were assessed: CD8A single gene expression (CD8Agene), a CD8 T-cell signature (CD8sig), and a tumor infiltrating lymphocyte signature derived from the GeparSixto clinical trial (GSAct). Standard clinicopathologic features were evaluated, as well as body mass index (BMI) one year prior to diagnosis, cumulative average alcohol intake, and age at diagnosis. Results: Overall, tumor and adjacent normal tissue demonstrated positive correlation of CD8Agene, CD8sig, and GSAct (n=623 pairs, Pearson's r = 0.46, 0.36, 0.31, respectively; all p<0.001). Similar correlations were present in TCGA breast cancer, an independent cohort (n=112 pairs, Pearson's r = 0.34, 0.17, 0.45, respectively; all p<0.001). We evaluated paired tumor and adjacent normal samples within individual immunohistochemical (IHC) subtype or PAM50 subtype by Wilcoxon signed-rank test. There was not a consistent trend for CD8Agene, CD8sig, nor GSAct to be greater in tumor or normal within subtypes. We then evaluated patient features/exposures and tumor immune expression metrics. For tumor-adjacent normal, there was no significant association of alcohol intake, BMI, or age at diagnosis with CD8 gene/expression metrics. For tumor tissue, a multivariate model demonstrated that BMI one year before diagnosis was significantly associated with CD8Agene expression. There was no significant association of alcohol intake or age at diagnosis with CD8 gene/expression metrics. We are currently evaluating the association of these CD8 T-cell gene expression signatures with CD8 T-cell immunohistochemistry in a subset of patients, which will be reported at the time of abstract presentation. Conclusion: In this cohort of over 600 tumor:normal pairs and a separate validation cohort, multiple distinct CD8+ T-cell expression metrics are correlated between breast cancer and tumor-adjacent normal breast tissue. This suggests that the adjacent normal breast may reflect an altered immune microenvironment in the context of breast cancer. While age at diagnosis and alcohol intake are not significantly associated with tumor CD8 expression metrics, BMI was significantly associated with tumor CD8Agene expression in a multivariate model. Citation Format: Damicis A, Heng YJ, Kensler K, Asad S, Adams E, Singh J, Zhang Y, Nock W, Wesolowski R, Williams N, Reinbolt R, Sardesai S, VanDeusen J, Noonan A, Lustberg MB, Ramaswamy B, Eliassen AH, Hankinson SE, Tamimi R, Stover DG. CD8+ T-cell gene expression and signatures in breast cancer and adjacent normal breast tissue: Association with body mass index, alcohol intake, and age at diagnosis [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-09-01.
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