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How ‘sleeper cell’ cancer stem cells are maintained in chronic myelogenous leukaemia

Most patients with chronic myelogenous leukaemia can be treated with tyrosine kinase inhibitors. These drugs are highly effective and lead to deep remission and prolonged survival. Yet quiescent leukaemic stem cells persist in these patients, and they therefore must continue inhibitor treatment to maintain remission.

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Discovery may lead to precision-based strategy for triple negative breast cancer

According to the paper now available online, TP53 is the most frequently mutated gene in triple negative breast cancer, meaning it is fuelling the growth of this aggressive form of breast cancer. However, the problem with trying to target mutated TP53, specifically, is that it is not a druggable target, because of its potential toxicity – or ability to kill – nearby healthy cells.

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Dr Khaled Mohamed Aly
Dr Khaled Mohamed Aly is a medical specialist MBBCH; M.S.C Cairo University; ACLS -EP; ATLS-SL (South Africa) Critical care course program-USA Disastrous medicine; STEMI-certificate AHA Hospital management and infection control diplomas Cairo University. Author of Critical Care Professional Handbook. Dr Khalad is Head of CME in Egypt for MEMP Ltd.
Dr Khaled Mohamed Aly
Dr Khaled Mohamed Aly
Dr Khaled Mohamed Aly
Dr Khaled Mohamed Aly is a medical specialist MBBCH; M.S.C Cairo University; ACLS -EP; ATLS-SL (South Africa) Critical care course program-USA Disastrous medicine; STEMI-certificate AHA Hospital management and infection control diplomas Cairo University. Author of Critical Care Professional Handbook. Dr Khalad is Head of CME in Egypt for MEMP Ltd.

Approach to vasopressor medications in shock states

Vasopressors are medications that causes vasoconstriction; some of them have additional inotropic effect. By maintaining end-organ perfusion; the role of vasopressors remains critical to prevent irreversible organ injury and failure, and their use is usually accompanied by fluid resuscitation for adequate patient outcomes. Vasopressor agents are used clinically in the treatment of arterial hypotension in shock states. Shock is best defined as inadequate blood flow to meet the metabolic needs of the tissues. The most common reasons for shock are the cardiac output is low relative to the global demand, despite increased O2 extraction by the tissues; or perfusion pressure is inadequate such that blood flow distribution to metabolically active tissues is inadequate, despite an otherwise adequate cardiac output.

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View references

1. Jentzer JC, Coons JC, Link CB, Schmidhofer M. Pharmacotherapy update on the use of vasopressors and inotropes in the intensive care unit. Journal of cardiovascular pharmacology and therapeutics. 20(3):249-60. 2015.

2. Senz A, Nunnink L. Review article: inotrope and vasopressor use in the emergency department. Emerg Med Australas. 2009 Oct;21(5):342-51.

3. Bangash MN, Kong ML, Pearse RM. Use of inotropes and vasopressor agents in critically ill patients. Br J Pharmacol. 2012 Apr;165(7):2015-33.

4. Tisdale JE, Patel RV, Webb CR, Borzak S, Zarowitz BJ. Proarrhythmic effects of intravenous vasopressors. Ann Pharmacother. 1995 Mar. 29(3):269-81.

5. Hollenberg SM. Vasoactive drugs in circulatory shock. American journal of respiratory and critical care medicine. 183(7):847-55. 2011.

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Treatment of abnormal menstrual bleeding in adolescents

Dr Bedei, Dr Delisle, Dr Hofmann-Werther, and Dr Pour Mirza highlight how to treat abnormal menstrual bleeding in adolescents.

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Deborah Kobewka
Deborah Kobewka was appointed as Managing Director of Healthcare UK in March 2016. Deborah has over 30 years’ experience in healthcare, beginning her career in the pharmaceutical industry and most recently having run her own management consulting company, serving clients in healthcare business intelligence and informatics.
Deborah Kobewka
Deborah Kobewka
Deborah Kobewka
Deborah Kobewka was appointed as Managing Director of Healthcare UK in March 2016. Deborah has over 30 years’ experience in healthcare, beginning her career in the pharmaceutical industry and most recently having run her own management consulting company, serving clients in healthcare business intelligence and informatics.

Progressing world-class healthcare in the Gulf states: what does the Hospital of the Future look like?

Deborah Kobewka, Managing Director of Healthcare UK, shares insights from the UK’s National Health Service, on how healthcare authorities and operators in the Gulf states can build, design, and operate the ‘Hospital of the Future’.

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Prenatal diagnosis of Turner syndrome

Dr Ivonne Bedei, Dr Amelie Hofmann-Werther, and Dr Afshin Pour Mirza provide detailed information about the prenatal diagnosis of Turner syndrome.

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View references

  1. Jeon KC, Chen L-S. Decision to abort after a prenatal diagnosis of sex chromosome abnormality: a systematic review of the literature. Genet Med 2012:14(1):27-38)

2. Sävendahl L, Davenport ML. Delayed diagnosis of Turner´s syndrome: proposed guidelines for change. J Pediatr. 2000;137(4):455-459).

3. Dondorp W, de Wert G, Bombard Y, et al. Non-invasive prenatal testing for aneuploidy and beyond: challenges of responsible innovation in prenatal screening. Eur J Hum Genet. 2015;23:1438-1450.

4. Schmid M, Klaritsch P, Arzt W, Burkhardt T, Duba H, Häusler M, et al. Cell-free DNA testing for fetal chromosomal anomalies in clinical practice: Austrian-German-Swiss recommendations for non-invasive prenatal tests (NIPT). Ultraschall Med – Eur J Ultrasound 2015;36:507–10).

5. Murdock DR, Donovan FX, Chandrasekharappa SC, Banks N, Bondy C, Muenke M, et al. Whole-exome Sequencing for Diagnosis of Turner syndrome: Towards Next Generation Sequencing and Newborn Screening. J Clin Endocrinol Metab. 2017

6. Hook EB, Warburton D. The distribution of chromosomal genotypes associated with Turner´s syndrome: livebirth prevalence rates and evidence for diminished fetal mortality and severity in genotypes associated with structural X abnormalities or mosaicism. Hum Genet. 1983;64:24-7

7. Alpman A, Cogulu O, Akgul M, Arikan EA, Durmaz B, Karaca E, Sadol S, Ozkinay C, Ozkinay F 2009 Prenatally diagnosed Turner syndrome and cystic hygroma: incidence and reasons for referrals. Fetal Diagn Ther 25:58-61)

8. Bondy C. Recent Developments in Diagnosis and Care for girls with Turner syndrome. Advances in Endocrinology Volume 2014, Article ID 231089.

9. Ibarra-Ramirez M, Martinez-de-Villareal LE. Clinical and genetic aspects of Turner´s syndrome. Medicina Universitaria. 2016;18(70):42-48).

10. Viuff MH, Stochholm K, Uldbjerg N, Nielsen BB, the Danish Fetal Medicine Study Group, and Gravholt CH. Only a minority of sex chromosome abnormalities are detected by a national prenatal sceening program for Down syndrome.Human Reproduction, Vol.30, No 10pp.2419-2426,2015).

11. Sybert VP, McCauley E. Turner´s Syndrome N Engl J Med 2004; 351:1227-1238,

12. Chang HJ, Clark RD, Bachman H. The Phenotype of 45,X/46,XY Mosaicism: An Analysis of 92 Prenatally Diagnosed Cases. Am. J. Genet. 46:156-167, 1990).

13. Gil MM, Accurti V, Santacruz B, Plana MN, Nicolaides KH. Analysis of cell-free DNA in maternal blood in screening for aneuploidies: updated meta-analysis. Ultrasound Obstet Gynecol 2017; 50:302-314).

14. Reiss RE, Discenza M, Foster J, Dobson L, Wilkins-Haug L. Sex chromosome aneuploidy detection by noninvasive prenatal testing: helpful or hazardous? Prenatal Diagnosis 2017, 37; 515-520

15. Grati FR, Bajaj K, Zanalfa V, Malvestiti F, Malvestiti B, Marcato L. Implications of fetoplacental mosaicism on cell-free DNA testing for sex chromosome aneuploidies. Prenatal Diagnosis 2017. 37. 1017-1027).

16. Malvestiti F, Agrati C, Grimi B, et al. Interpreting mosaicism in chorionic vili: results of a monocentric series of 1001 mosaics in chorionic villi with follow-up amniocentesis. Prenatal Diagnosis 2015, 35, 1117-1127)

17. Russell LM, Strike P, Browne CE, Jacobs PA. X Chromosome loss and aging. Cytogenet Genome Res 116:181-185(2007).

18. Zhang B, Lu B-Y, Zheng F-X, Zhou Q, Cheng Y-P, Zhang X-Q. Noninvasive prenatal screening for fetal common sex chromosome aneuploidies from maternal blood. J Med Res. 2017 Apr; 45(2): 621-630.

19. Bevilacqua E, Ordonez E, Hurtado I, Rueda L, Mazzone E, Cirigliano V, Jani JC. Screening for Sex Chromosome Aneuploidy by Cell-Free DNA Testing: Patient Choice and Performance. Fetal Diagn Ther DOI: 10.1159/000479507.

20. Chitty LS, Hudgins L, Norton ME. Current controversies in prenatal diagnosis 2: Cell-free DNA prenatal screening should be used to identify all chromosome abnormalities. Prenatal Diagnosis. 2018;38:160-165)

21. Samango-Sprouse C, Banjevic M, Ryan A, Sigurjonsson S, Zimmermann B, Hill M, Hall MP, Westmeyer M, Saucier J, Demko Z, Rabinowitz M. SNP-based non-invasive prenatal testing detects sex chromosome aneuploidies with high accuracy. Prenat Diagn. 2013 July; 33(7): 643-649.

22. Bronstein M, Zimmer EZ & Blazer S. A characteristic cluster of fetal sonographic markers that are predictive of fetal Turner syndrome in early pregnancy. American Journal of Obstetrics and Gynecology 2003 188 1016-1020.

23. Gravholt CH et al. Clinical practice guideline for the care of girls and women with Turner syndrome: proceedings from the 2016 Cincinnati International Turner syndrome Meeting. European Journal of Endocrinology 2017;177:3 G1-G70).

Dr Hina Naveed
Hina is the Marketing Manager at the Middle East Medical Portal. She is an experienced Pharmacist, writer, and speaker. Hina lives in the United Arab Emirates.
Dr Hina Naveed
Dr Hina Naveed
Dr Hina Naveed
Hina is the Marketing Manager at the Middle East Medical Portal. She is an experienced Pharmacist, writer, and speaker. Hina lives in the United Arab Emirates.

Thyroid and infertility in women

According to a Harvard Medical School study, having even a slightly underactive thyroid may interfere with a woman’s ability to get pregnant. Dr Hina Naveed provides further information about thyroid diseases and fertility.

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Dr Hoda Yousry, MD, PhD, DHPE
Dr Hoda is a Lecturer of Medical Genetics; Director of Information & Technology Unit, FOMSCU; Training Coordinator, CEMCM and the Founder & Entrepreneur at MED PREDICT Inc. She has received many awards for her work including Scientific Excellence awards and Best Scientific Research Awards at the Faculty of Medicine, Suez Canal University.
Dr Hoda Yousry, MD, PhD, DHPE
Dr Hoda Yousry, MD, PhD, DHPE
Dr Hoda Yousry, MD, PhD, DHPE
Dr Hoda is a Lecturer of Medical Genetics; Director of Information & Technology Unit, FOMSCU; Training Coordinator, CEMCM and the Founder & Entrepreneur at MED PREDICT Inc. She has received many awards for her work including Scientific Excellence awards and Best Scientific Research Awards at the Faculty of Medicine, Suez Canal University.

LifeTime initiative for revolutionizing global health care

Dr Hoda, attended the 2018 Falling Walls international conference on future breakthroughs in science and society in Berlin, Germany. Along with other 20 eminent participants from various backgrounds and expertise; she was invited to discuss the LifeTime initiative vision from different angles.

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Ahmed Salem
Ahmed is currently studying Biotechnology at Faculty of Science, Mansoura University. He's a Researcher, Youtuber, and Writer. Ahmed is the youngest member of a team which aim to create the first molecular Map for Spinal Cord Injury which is a joint project between Mansoura University and LCSB - Luxembourg Centre for Systems Biomedicine, University of Luxembourg.
Ahmed Salem
Ahmed Salem
Ahmed Salem
Ahmed is currently studying Biotechnology at Faculty of Science, Mansoura University. He's a Researcher, Youtuber, and Writer. Ahmed is the youngest member of a team which aim to create the first molecular Map for Spinal Cord Injury which is a joint project between Mansoura University and LCSB - Luxembourg Centre for Systems Biomedicine, University of Luxembourg.

An overview of chromosomal aberrations

Ahmed Salem provides an overview of chromosome aberrations, including: Down syndrome, Edwards syndrome, Turner syndrome (xo) syndrome, Klinefelter syndrome, Triple X syndrome, Williams syndrome, 22q11.2 deletion syndrome, and Tetraploidy.

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View references

  1. Center for Arab Genomic Studies Cags.org.ae. (2019). [online] Available at: http://www.cags.org.ae/Down%20Syndrome-English.pdf 

2. NDSS. (2019). What is Down Syndrome? | National Down Syndrome Society. [online] Available at: https://www.ndss.org/about-down-syndrome/down-syndrome/

3.  nhs.uk. (2019). Patau’s syndrome. [online] Available at: https://www.nhs.uk/conditions/pataus-syndrome/

4.Trisomy 13. [online] Genetics Home Reference. Available at: https://ghr.nlm.nih.gov/condition/trisomy-13#genes

5. Genetics Home Reference. Available at: https://ghr.nlm.nih.gov/condition/trisomy-18#statistics

6. Genetics Home Reference. Available at: https://ghr.nlm.nih.gov/condition/turner-syndrome

7.Genetics Home Reference. Available at: https://ghr.nlm.nih.gov/condition/klinefelter-syndrome#genes

8. Genetics Home Reference. Available at: https://ghr.nlm.nih.gov/condition/triple-x-syndrome

9. Genetics Home Reference. Available at: https://ghr.nlm.nih.gov/condition/williams-syndrome

10. Genetics Home Reference. Available at: https://ghr.nlm.nih.gov/condition/22q112-deletion-syndrome#genes

11. https://rarediseases.info.nih.gov/diseases/5151/tetraploidy

Brian de Francesca
Brian is an international expert in the use of digitalization and connectivity to improve all aspects of healthcare. He speaks and writes regularly on a wide range of topics including: telemedicine, artificial intelligence, quantum computing, bio-sensors, and many more interrelated and innovative digital topics that are changing the face of medicine world-wide.
Brian de Francesca
Brian de Francesca
Brian de Francesca
Brian is an international expert in the use of digitalization and connectivity to improve all aspects of healthcare. He speaks and writes regularly on a wide range of topics including: telemedicine, artificial intelligence, quantum computing, bio-sensors, and many more interrelated and innovative digital topics that are changing the face of medicine world-wide.

“The greatest humanitarian aid initiative in history”

Whilst volunteering in a refugee camp, Brian de Francesca’s mission became clear; to use telemedicine, AI, and blockchain to help 65 million global refugees.

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