Progression after First-Line Cyclin-Dependent Kinase 4/6 Inhibitor Treatment: Analysis of Molecular Mechanisms and Clinical Data

Cyclin-dependent kinase 4/6 inhibitors (CDK4/6iss) are widely used in first-line metastatic breast cancer. For patients with progression under CDK4/6is, there is currently no standard treatment recommended at the category 1 level in international guidelines. The purpose of this article is to review the cellular mechanisms underlying the resistance to CDK4/6is, as well as treatment strategies and the clinical data about the efficacy of subsequent treatments after CDK4/6is-based therapy. In the first part, this review mainly discusses cell-cycle-specific and cell-cycle-non-specific resistance to CDK4/6is, with a focus on early and late progression. In the second part, this review analyzes potential therapeutic approaches and the available clinical data on them: switching to other CDK4/6is, to another single hormonal therapy, to other target therapies (PI3K, mTOR and AKT) and to chemotherapy.

Whole-Blood Transcriptional Profiles Enable Early Prediction of the Presence of Coronary Atherosclerosis and High-Risk Plaque Features at Coronary CT Angiography

Existing tools to estimate cardiovascular (CV) risk have sub-optimal predictive capacities. In this setting, non-invasive imaging techniques and omics biomarkers could improve risk-prediction models for CV events. This study aimed to identify gene expression patterns in whole blood that could differentiate patients with severe coronary atherosclerosis from subjects with a complete absence of detectable coronary artery disease and to assess associations of gene expression patterns with plaque features in coronary CT angiography (CCTA). Patients undergoing CCTA for suspected coronary artery disease (CAD) were enrolled. Coronary stenosis was quantified and CCTA plaque features were assessed. The whole-blood transcriptome was analyzed with RNA sequencing. We detected highly significant differences in the circulating transcriptome between patients with high-degree coronary stenosis (≥70%) in the CCTA and subjects with an absence of coronary plaque. Notably, regression analysis revealed expression signatures associated with the Leaman score, the segment involved score, the segment stenosis score, and plaque volume with density <150 HU at CCTA. This pilot study shows that patients with significant coronary stenosis are characterized by whole-blood transcriptome profiles that may discriminate them from patients without CAD. Furthermore, our results suggest that whole-blood transcriptional profiles may predict plaque characteristics.

Circulating MicroRNAs as Novel Biomarkers in Risk Assessment and Prognosis of Coronary Artery Disease

Coronary artery disease is among the leading causes of death worldwide. Nevertheless, available cardiovascular risk prediction algorithms still miss a significant portion of individuals at-risk. Thus, the search for novel non-invasive biomarkers to refine cardiovascular risk assessment is both an urgent need and an attractive topic, which may lead to a more accurate risk stratification and/or prognostic score definition for coronary artery disease. A new class of such non-invasive biomarkers is represented by extracellular microRNAs (miRNAs) circulating in the blood. MiRNAs are non-coding RNA of 22–25 nucleotides in length that play a significant role in both cardiovascular physiology and pathophysiology. Given their high stability and conservation, resistance to degradative enzymes, and detectability in body fluids, circulating miRNAs are promising emerging biomarkers, and specific expression patterns have already been associated with a wide range of cardiovascular conditions. In this review, an overview of the role of blood miRNAs in risk assessment and prognosis of coronary artery disease is given.

Correlations Between Physical Activity Level, Quality of Life, and Cognitive Performance in Elderly Individuals Engaging in Multi-Year Dance Activities

INTRODUCTION

It is well-acknowledged that cognitive and physical decline associated with aging can be prevented or reduced with the engagement in regular physical activity (PA). Dance activities combine cardiovascular, cognitive, and coordinative demands, providing a popular leisure PA among elderly. This study examined the correlations between quality of life (QoL), cognitive and physical performance, and PA level in older adults who participated in at least 10 years of amateur ballroom dancing.

METHODS

The study was designed as an observational study. A sample of 20 (10 men; age range: 65 to 80 years; BMI: 26.3 ± 3.0 kg/m2) amateur senior dancers were compared with a sample of 18 (8 men; age range: 65 to 75 years; BMI: 25.5 ± 2.4 kg/m2) non-sedentary individuals (control group) following an adapted PA program. Quality of life and cognitive functioning assessment tools were administered: 36 Health Status Survey (SF-36v2), Montreal Cognitive Assessment (MoCA), and Cognitive Reserve Index questionnaire (CRIq). Physical performance was measured with their preferred walking speed (PWS), and level of moderate to vigorous physical activity (MVPA) was evaluated using a multi-sensor activity monitor.

RESULTS

Participants presented a good SF-36v2 physical component and a very good mental component summary, a total MoCA score within the limits, and an average total CRIq score. Their PWS and daily MVPA were high. Differences neither in the three questionnaires nor in PWS and PA level were observed between groups. A significant, moderate, and positive correlation was found between PWS and SF-36v2 physical component summary score.

CONCLUSION

Ballroom dancing seems to allow elderly individuals to maintain good cognitive and physical abilities, QoL, an acceptable normal cognitive reserve, notable physical performance, and PA level to the same extent as an adapted PA program. Both types of PA seem to be able to contrast the mental and physical decline associated with aging.

In-vivo degradation of poly(carbonate-urethane) based spine implants

Fourteen explanted Dynesys® spinal devices were analyzed for biostability and compared with a reference, never implanted, control. Both poly(carbonate-urethane) (PCU) spacers and polyethylene-terephthalate (PET) cords were analyzed. The effect of implantation was evaluated through the observation of physical alterations of the device surfaces, evaluation of the chemical degradation and fluids absorption on the devices and examination of the morphological and mechanical features. PCU spacers exhibited a variety of surface damage mechanisms, the most significant being abrasion and localized, microscopic surface cracks. Evidence of oxidation and chain scission were detected on PCU spacers ATR-FTIR. ATR-FTIR, DSC and hardness measurements also showed a slight heterogeneity in the composition of PCU. The extraction carried out on the PCU spacers revealed the presence of extractable polycarbonate segments. One spacer and all PET cords visually exhibited the presence of adherent biological material (proteins), confirmed by the ATR-FTIR results. GC/MS analyses of the extracts from PET cords revealed the presence of biological fluids residues, mainly cholesterol derivatives and fatty acids, probably trapped into the fiber network. No further chemical alterations were observed on the PET cords. Although the observed physical and chemical damage can be considered superficial, greater attention must be paid to the chemical degradation mechanisms of PCU and to the effect of byproducts on the body.

[Sudden death caused by freon 22?]

Case report of a plumber's fatal work accident. Investigations on the causes of death made at post mortem showed that the worker had absorbed a large quantity of freon 22 (chlorodifluoromethane) which is known to be a narcotic agent and capable of inducing cardiac arrhythmia. It is believed freon inhalation was the cause of loss of consciousness with consequent death from drowning in the water issuing from the pipes. It is concluded that preventive measures need to be reinforced by adequate information to the workforce on the risks connected to this type of gas.

Estimation of rotavirus immunoglobulin G antibodies in human serum samples by enzyme-linked immunosorbent assay: expression of results as units derived from a standard curve

A method for estimating rotavirus immunoglobulin G (IgG) antibodies by assay of human serum samples at a single serum dilution was studied. Antibody was measured by enzyme-linked immunosorbent assay (ELISA). The optical density of the reaction with a 1:100 dilution of each serum was expressed as ELISA units of antirotavirus IgG by reference to a standard curve. This standard curve was obtained by incorporation in each assay of five dilutions of a serum containing an arbitrary number of units of antirotavirus IgG. Test serum samples found to contain high amounts of antirotavirus IgG were reassayed at a 1:1,000 dilution. There was good correlation between antirotavirus IgG ELISA units in 45 serum samples and endpoint titers of the same samples (Spearman rank correlation coefficient rs, 0.95). Seroconversion during rotavirus infection was defined as an increase in antirotavirus IgG ELISA units per milliliter of greater than 28% (2 X intra-run coefficient of variation of the assay) in consecutive serum samples from the same child. Paired serum samples from nine children with diarrhea not due to rotavirus infection showed no seroconversions. Paired samples from eight children with rotavirus infection showed seroconversions. Estimation of antirotavirus IgG ELISA units in serum is simple, rapid, reproducible, and economical of serum samples. Standardization of results could be achieved by worldwide distribution of a standard serum. Its use would facilitate epidemiological surveys to evaluate potential rotavirus vaccines.

Clinical immunity after neonatal rotavirus infection. A prospective longitudinal study in young children

To determine whether rotavirus infection in newborn babies conferred immunity to postneonatal rotavirus infection, we studied 81 babies at birth and kept them under clinical and serologic study for three years. During the first 14 days of life, 44 of the infants excreted rotavirus, and 37 did not. Fifty-five per cent of those with neonatal infection and 54 per cent of those without it had rotavirus infection during the next three years. Symptoms associated with postneonatal rotavirus infection were significantly less frequent and less severe in the infants who had had neonatal infection (P = 0.003) than in those who had not. Thirty-eight per cent of the former group (9 of 24 infants) had symptoms of mild (3 infants) or moderate (6) severity during the first postneonatal infection. In contrast, 85 per cent of the latter group (17 of 20 infants) had mild (3), moderate (6), or severe (8) symptoms. We conclude that neonatal rotavirus infection does not confer immunity against reinfection but does protect against the development of clinically severe disease during reinfection.