Seroepidemiological Studies of Arboviruses in Africa

The literature on sero-epidemiological studies of flaviviral infections in the African continent is quite scarce. Much of the viral epidemiology studies have been focussing on diseases such as HIV/AIDS because of their sheer magnitude and impact on the lives of people in the various affected countries. Increasingly disease outbreaks caused by arboviruses such as the recent cases of chikungunya virus, dengue virus and yellow fever virus have prompted renewed interest in studying these viruses. International agencies from the US, several EU nations and China are starting to build collaborations to build capacity in many African countries together with established institutions to conduct these studies. The Tofo Advanced Study Week (TASW) was established to bring the best scientists from the world to the tiny seaside town of Praia do Tofo to rub shoulders with African virologists and discuss cutting-edge science and listen to the work of researchers in the field. In 2015 the 1st TASW focussed on Ebola virus. The collections of abstracts from participants at the 2nd TASW which focused on Dengue and Zika virus as well as presentations on other arboviruses are collated in this chapter.

Impact of transitional care on endocrine and anthropometric parameters in Prader-Willi syndrome

CONTEXT

The transition of patients with Prader-Willi syndrome (PWS) to adult life for medical care is challenging because of multiple comorbidities, including hormone deficiencies, obesity and cognitive and behavioral disabilities.

OBJECTIVE

To assess endocrine management, and metabolic and anthropometric parameters of PWS adults who received (n = 31) or not (n = 64) transitional care, defined as specialized pediatric care followed by a structured care pathway to a multidisciplinary adult team.

PATIENTS AND STUDY DESIGN

Hormonal and metabolic parameters were retrospectively recorded in 95 adults with PWS (mean ± s.d. age 24.7 ± 8.2 years, BMI: 39.8 ± 12.1 kg/m²) referred to our Reference Center and compared according to transition.

RESULTS

Among the entire cohort, 35.8% received growth hormone (GH) during childhood and 16.8% had a GH stimulation test after completion of growth. In adulthood, 14.7% were treated with GH, 56.8% received sex-hormone therapy, whereas 91.1% were hypogonadic and 37.9% had undergone valid screening of the corticotropic axis. The main reason for suboptimal endocrine management was marked behavioral disorders. Patients receiving transitional care were more likely to have had a GH stimulation test and hormonal substitutions in childhood. They also had a lower BMI, percentage of fat mass, improved metabolic parameters and fewer antidepressant treatments. Transitional care remained significantly associated with these parameters in multivariate analysis when adjusted on GH treatment.

CONCLUSION

A coordinated care pathway with specialized pediatric care and transition to a multidisciplinary adult team accustomed to managing complex disability including psychiatric troubles are associated with a better health status in adults with PWS.

Kaolin modulates ABA and IAA dynamics and physiology of grapevine under Mediterranean summer stress

The foliar exogenous application of kaolin, a radiation-reflecting inert mineral, has proven to be an effective short-term climate change mitigation strategy for Mediterranean vineyards. In this work, we address the hypothesis that kaolin could improve both the hormonal dynamics and physiological responses of grapevines growing in Douro Region, northern Portugal. For this purpose, the leaf water potential, gas exchange and chlorophyll a fluorescence parameters were monitored, as well as the abscisic acid (ABA) and indole-3-acetic acid (IAA) quantification and immunolocalization were assessed. The study revealed a slight decrease in ABA and an increase in IAA in the kaolin treatment, which in turn were associated with the improvement of physiological performance. A month after spraying, kaolin improves the water potential respectively, 30% and 17% in the predawn and midday periods. Besides, plants treated with kaolin showed higher values of stomatal conductance, net CO₂ assimilation rate and intrinsic water use efficiency. Kaolin also ameliorates the effective PSII efficiency (67%), as well as the maximum quantum efficiency of photosystem II and the photosynthetic electron transport rate (>73%). These results were consistent with the higher photochemical quenching and the lower non-photochemical quenching observed in treated leaves and with the better performance obtained by the JIP test parameters. Physiological and hormonal analysis confirmed that kaolin effectively enhance grapevine summer stress tolerance.

Cyto- and genotoxic profile of groundwater used as drinking water supply before and after disinfection

The assessment of the toxicological properties of raw groundwater may be useful to predict the type and quality of tap water. Contaminants in groundwater are known to be able to affect the disinfection process, resulting in the formation of substances that are cytotoxic and/or genotoxic. Though the European directive (98/83/EC, which establishes maximum levels for contaminants in raw water (RW)) provides threshold levels for acute exposure to toxic compounds, the law does not take into account chronic exposure at low doses of pollutants present in complex mixture. The purpose of this study was to evaluate the cyto- and genotoxic load in the groundwater of two water treatment plants in Northern Italy. Water samples induced cytotoxic effects, mainly observed when human cells were treated with RW. Moreover, results indicated that the disinfection process reduced cell toxicity, independent of the biocidal used. The induction of genotoxic effects was found, in particular, when the micronucleus assay was carried out on raw groundwater. These results suggest that it is important to include bio-toxicological assays as additional parameters in water quality monitoring programs, as their use would allow the evaluation of the potential risk of groundwater for humans.

Abstract P5-17-10: Claudin -4 expression in carcinoma in situ and its association with local recurrence, clinical and immunohistochemistry characteristics

Introduction: Claudins are tight junction molecules and have been associated to breast cancer prognosis. Claudin-low intrinsic subtype of invasive carcinoma was described recently and has been related to high grade carcinoma, low junction molecules expression and worse chemotherapy response. However, it is unknown whether Claudins expression could be associated to carcinoma in situ prognostic. The aim of this study was evaluated the Claudin – 4 expression in carcinoma in situ and its association with local recurrence, clinical and immunohistochemistry characteristics.

Methods: A tissue microarray (TMA) block was constructed, using region of interesting, with 137 pure carcinoma in situ paraffin blocks of patients treated in the Women 's Hospital Prof. Dr. José Aristodemo Pinotti – UNICAMP from 1999 to 2009. The TMA was submitted to immunohistochemistry analyze to: Claudin-4, beta-catenin, e-caderin, estrogen receptor (ER), progesterone receptor (PR), HER-2 and Ki-67. It was calculated Claudin-4 score based in percentage and intensity of expression and categorized in: Claudin-4 low and Claudin – 4 high. The clinical data, treatment data (surgery, radiotherapy and tamoxifen use), local recurrence data (date and type) and death of each patient were reviewed in the medical records. The statistical analyze used Kaplan-Meier curve and log-rank test to disease free survival; qui-square and Fisher test to compare others variables; significance level of 5 % was used.

Results: It was possible to evaluate Claudin-4 expression in 86 cases, 88.4% were Claudin-4 high and 11.6% Claudin-4 low. The follow up mean was 69 months and local recurrence rate was 10.5 %. There was no significant difference in local recurrence rate between Claudin-4 high and Claudin-4 low (10.0% x 10.5% , p=1.0).The disease free survival was similar between Claudin-4 low and Claudin-4 high (p=0.559). The Claudin- 4 high was significantly more frequent in beta-catenin positive patients (p=0.048). There was no association significantly between Claudin-4 expression and: age (p=0.66), histology type (p=0.75), surgery (p=0.102), radiotherapy (p=0.29), tamoxifen use (p=0.432), ER (p=0.33), PR (p=1.0), HER-2 (p=0.23) and e-caderin (p=0.21).

Conclusion: Despite the Claudins are related to invasive carcinoma prognosis, our outcome did not show difference in local recurrence and disease free survival between Claudin-4 low and high in carcinoma in situ. The beta-catenin and claudin-4 expressions were significantly associated.

Citation Format: Duarte GM, Toucchet F, Espinola JP, Barreto CR, Paiva Silva GR, Almeida NR, Soares F, Pinto G, Marshall P. Claudin -4 expression in carcinoma in situ and its association with local recurrence, clinical and immunohistochemistry characteristics. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-17-10.

Characterization and prevalence of severe primary IGF1 deficiency in a large cohort of French children with short stature

OBJECTIVE

The prevalence of severe primary IGF1 deficiency (IGFD) is unclear. IGFD must be identified promptly as treatment with recombinant human IGF1 (rhIGF1) is now available. Our objective was to characterize and assess the prevalence of severe primary IGFD in a large cohort of patients evaluated for short stature at a pediatric endocrinology unit in France.

DESIGN

Observational study in a prospective cohort.

METHODS

Consecutive patients referred to our unit between 2004 and 2009 for suspected slow statural growth were included. Patients were classified into eight etiological categories. IGFD was defined by height ≤-3 SDS, serum IGF1 levels <2.5th percentile, GH sufficiency, and absence of causes of secondary IGFD.

RESULTS

Out of 2546 patients included, 337 (13.5%) were born small for gestational age and 424 (16.9%) had idiopathic short stature. In these two categories, we identified 30 patients who met our criterion for IGFD (30/2546, 1.2%). In these 30 patients, we assessed the response to IGF1 generation test, time course of IGF1 levels, and efficiency of GH replacement therapy. The results indicated that only four of the 30 children were definite or possible candidates for rhIGF1 replacement therapy.

CONCLUSION

The prevalence of severe primary IGFD defined using the standard criterion for rhIGF1 treatment was 1.2%, and only 0.2% of patients were eligible for rhIGF1 therapy.

Unexpected high frequency of skeletal dysplasia in idiopathic short stature and small for gestational age patients

OBJECTIVE

To assess the prevalence of skeletal dysplasias (SDs) in patients with idiopathic short stature (ISS) or small for gestational age (SGA) status.

SETTING

Rare Endocrine/Growth Diseases Center in Paris, France.

DESIGN

A prospective study on consecutive patients with ISS and SGA enrolled from 2004 to 2009.

METHOD

We used a standardized workup to classify patients into well-established diagnostic categories. Of 713 patients with ISS (n=417) or SGA status (n=296), 50.9% underwent a skeletal survey. We chose patients labeled normal or with a prepubertal slowdown of growth as a comparison group.

RESULTS

Diagnoses were ISS (16.9%), SGA (13.5%), normal growth (24.5%), transient growth rate slowing (17.3%), endocrine dysfunction (12%), genetic syndrome (8.9%), chronic disease (5.1%), and known SD (1.8%). SD was found in 20.9% of SGA and 21.8% ISS patients and in only 13.2% in our comparison group. SD prevalence was significantly higher in the ISS group than in the comparison group, especially (50%) for patients having at least one parent whose height was <-2 SDS. Dyschondrosteosis and hypochondroplasia were the most frequently identified SD, and genetic anomaly was found in 61.5 and 30% respectively. Subtle SD was found equally in the three groups and require long-term growth follow-up to evaluate the impact on final height.

CONCLUSION

SD may explain more than 20% of cases of growth retardation ascribed to ISS or SGA, and this proportion is higher when parental height is <-2 SDS. A skeletal survey should be obtained in patients with delayed growth in a context of ISS or SGA.

Childhood craniopharyngioma: hypothalamus-sparing surgery decreases the risk of obesity

CONTEXT

Craniopharyngioma is a brain tumor whose high local recurrence rate has for a long time led to a preference for extensive surgery. Limited surgery minimizing hypothalamic damage may decrease the severe obesity rate at the expense of the need for radiotherapy to complete the treatment.

OBJECTIVE

We compared weight gain and local recurrence rates after extensive resection surgery (ERS) and hypothalamus-sparing surgery (HSS).

DESIGN

Our observational study compared a historical cohort managed with ERS between 1985 and 2002 to a prospective cohort managed with HSS between 2002 and 2010.

SETTING

The patients were treated in a pediatric teaching hospital in Paris, France.

PATIENTS

Thirty-seven boys and 23 girls were managed with ERS (median age, 8 years); 38 boys and 27 girls were managed with HSS (median age, 9.3 years).

MAIN OUTCOME MEASURES

Data were collected before and 6 months to 7 years after surgery. Body mass index (BMI) Z-score was used to assess obesity and the number of surgical procedures to assess local recurrence rate.

RESULTS

Mean BMI Z-score before surgery was comparable in the 2 cohorts (0.756 after ERS vs 0.747 after HSS; P = .528). At any time after surgery, mean BMI Z-score was significantly lower after HSS (eg, 1.889 SD vs 2.915 SD, P = .004 at 1 year). At last follow-up, the HSS cohort had a significantly lower prevalence of severe obesity (28% vs 54%, P < .05) and higher prevalence of normal BMI (38% vs 17%, P < .01). Mean number of surgical procedures was not significantly different in the 2 cohorts.

CONCLUSIONS

Hypothalamus-sparing surgery decreases the occurrence of severe obesity without increasing the local recurrence rate.