15 research outputs found
Alarming Antibiotic Resistance in Pediatric Oncology Patients: A Three-Year Prospective Cohort Study from Oman
No full textAbeer Al Battashi,1 Bishara Al Harrassi,2 Nawal Al Maskari,3 Hilal Al Hashami,3 Salah Al Awaidy4 1Department of Pediatric Hematology and Oncology, The National Oncology Centre, Royal Hospital, Ministry of Health, Muscat, Oman; 2Oman Medical Specialty Board, Muscat, Oman; 3Pediatric Infectious Diseases, Child Health Department, Royal Hospital, Ministry of Health, Muscat, Oman; 4Office of Health Affairs, Ministry of Health, Muscat, OmanCorrespondence: Salah Al Awaidy, Office of Health Affairs, Ministry of Health, Al Khuwair Street, Muscat, Oman, Tel +968 99315063, Fax +968 24946381, Email [email protected]: Bloodstream infections (BSI) are severe and challenging oncological complications, with a consequent high morbidity and mortality in the immunocompromised. We reviewed the profile and susceptibility of bacteria associated with infections in children under 13 years of age receiving chemotherapy.Methods: Prospective cohort study of pediatric oncology patients was conducted between January 2015 and October 2017 at the Royal Hospital in Oman. Patient demographics, clinical data, laboratory parameters, microbial etiology and susceptibility, and outcomes were retrieved and analyzed.Results: A total of 74 episodes of positive bacterial blood cultures were detected in 38 oncology patients (positive blood culture rate of 51%). Fifty-seven percent were positive for gram-negative organisms with Klebsiella (21%) being the most common gram-negative organism cultured, and the most common gram-positive organism was Staphylococcus (coagulase negative Staphylococcus (CONs) and S. Aureus) (30%). The majority of patients had gastrointestinal complaints (74%), and almost half (51%) had prolonged periods of neutropenia (> 7 days). One third of gram-negative organisms were resistant to four or more antibiotics with a major resistance of 31% to piperacillin-tazobactam. Of the gram-positive organisms, 38% were resistant to at least four antibiotics and 30% were pan-resistant (except for vancomycin).Conclusion: The gram-negative organisms were dominant in BSIs with Klebsiella being the most common culprit. Bacteremia was prevalent, however, high resistance to first-line antibiotics was documented amongst gram-negative isolates, demanding strategies to ensure our patients’ safety.Keywords: neutropenia, pediatric oncology, bloodstream infections, antibiotic susceptibility, Oma
High-throughput screen to uncover the role of microRNAs in Tamoxifen resistance and cell growth of ER-positive breast cancer
No full textBreast cancer is a significant global health issue, impacting millions of women worldwide. ER-positive breast cancer, the most common subtype, accounts for over 70% of cases. While hormone-based therapies like tamoxifen are effective, resistance develops in many patients, posing clinical challenges. Recent research has focused on the molecular mechanisms behind this resistance, aiming to identify new therapeutic targets.This thesis investigates the regulatory role of microRNAs (miRNAs) in ER-positive breast cancer, particularly their impact on ER expression, cell proliferation, and tamoxifen sensitivity. Through a genome-wide miRNA high-throughput screen, we analysed regulatory networks involving miRNAs to understand their mechanisms better.Two miRNAs affected ER expression in MCF7 cells, including miR-130a and miR-18b/miR-106a. MiR-18b was highlighted as a key regulator, influencing ER expression and cell proliferation. Analysis of potential targets of miR-18b identified amongst others target genes like ESR1, HMGCS1, and SON, supporting a role of miR-18b in these processes.Additionally, we identified five miRNAs associated with tamoxifen resistance and validated their role in response to tamoxifen for miR-130a, let-7g, and miR-15b/miR-16-2. For miR-130a, 20 genes, including ESR1 and AIB1, were identified as predicted targets influencing tamoxifen sensitivity. Downregulation of ESR1 and AIB1 by miR-130a was confirmed via Western blotting.These findings underscore the importance of miRNA regulation in ER-positive breast cancer and pave the way for potential miRNA-based therapeutic strategies to improve treatment outcomes. The research also highlights the complexity of miRNA-mediated regulation and the need for further studies to validate these findings across different breast cancer models
Two cases and a review of Streptococcus pyogenes endocarditis in children
No full textAbstract
Background
Infective endocarditis is a rare diagnosis in pediatrics. Group A beta-hemolytic Streptococcus pyogenes is known to cause a range of type and severity of infections in childhood. However, S. pyogenes is a rarely described cause of endocarditis in children. This paper presents two cases of S. pyogenes endocarditis and the largest and most up-to-date review of cases previously reported in the literature.
Case presentation
Here we describe two pediatric cases of S. pyogenes endocarditis with associated toxic shock. Case 1 was a previously well Caucasian 6-year-old female who presented with sepsis. Case 2 was an 8-month-old South Asian female who presented with sepsis and pneumonia. We present a review of the literature since the beginning of the antibiotic era of this unusual cause of bacterial endocarditis in children.
Conclusion
In addition to the two cases presented here, a total of 13 children have been reported since 1940 with endocarditis caused by S. pyogenes for which clinical details are available. Although few cases exist, literature review reveals a high mortality rate (27%) and the majority of patients who recovered had residual morbidities. We emphasize the importance of considering a diagnosis of endocarditis in cases of S. pyogenes sepsis or toxic shock in order to ensure early diagnosis and timely treatment, which are necessary for good outcomes. This information is relevant to both general and subspecialty pediatricians, especially emergency room and infectious disease physicians
P-072: COST COMPARISON OF TRANSFUSION CHOICES IN OMAN FOR PATIENTS SUFFERING FROM SICKLE CELL DISEASE.
No full text5567917 COST COMPARISON OF TRANSFUSION CHOICES IN OMAN FOR PATIENTS SUFFERING FROM SICKLE CELL DISEASE
No full text
Operating Costs for Trucks
No full textThis study estimates the operating costs for commercial vehicle operators in Minnesota. A survey of firms that undertake commercial truck road movements was performed. The average operating cost per kilometer for commercial vehicle operators was calculated from the survey responses. Results show that the translog and Cobb-Douglas models have approximately equal explanatory power in estimating the total cost from the data. The models also revealed the presence of nearly constant returns to scale, a finding consistent with earlier studies; an increase in output (total truckloads) of 1% increases total costs by 1.04%.
miRNA-dependent resistance mechanisms to anti-hormonal therapies in estrogen receptor-positive breast cancer patients
No full textThe estrogen receptor (ERα) is expressed in 70%-80% of breast cancers and is a target of endocrine therapy. However, resistance to endocrine therapy poses a significant clinical challenge. MicroRNAs (miRNAs) have emerged as critical players in oncogenesis and as modulators of therapy response. This review provides an overview of miRNAs that modulate anti-hormonal drug responses. We identified 56 miRNAs associated with resistance to endocrine therapy. These miRNAs had a total of 40 proven target genes that were grouped based on their function under currently known resistance mechanisms, including ER modulation, signaling pathway activation, cell-cycle modulation, and other mechanisms. For a limited number of miRNA-target gene interactions, the relevance of the identified target gene(s) was confirmed by copy or rescue of the miRNA-induced phenotype. Overall, this review highlights critical roles of miRNAs as crucial mediators of resistance to anti-hormonal therapy. The identified miRNA-target gene interactions can serve as a foundation for future functional studies exploring the potential of selected miRNAs in overcoming drug resistance, which might improve outcomes for breast cancer patients.</p
