Human embryonic mesenchymal lung-conditioned medium promotes differentiation to myofibroblast and loss of stemness phenotype in lung adenocarcinoma cell lines

Background

When genes responsible for normal embryonic development are abnormally expressed in adults, it can lead to tumor development. This can suggest that the same mechanism that controls embryonic differentiation can also control tumor differentiation. We hypothesize that the malignant phenotype of lung cancer cells could acquire benign characteristics when in contact with an embryonic lung microenvironment. We cultured two lung cancer cell lines in embryonic lung mesenchyme-conditioned medium and evaluated morphological, functional and molecular changes.

Methods

The human embryonic mesenchymal lung-conditioned medium (hEML-CM) was obtained by culturing lung cells from embryos in the pseudoglandular stage of development. The NSCLC cell lines A549 and H1299 we cultured in the hEML-CM and in a tumor-conditioned medium. Morphological changes were analyzed with optical and transmission electron microscopy. To evaluate the functional effect of conditioned medium in tumor cells, we analyzed cell proliferation, migration, colony formation capacity in 2D and 3D and in vivo tumor growth capacity. The expression of the pluripotency genes OSKM, the adenocarcinoma marker NKX2-1, the lung surfactant proteins SFTP, the myofibroblast marker MYH and DNMT3A/3B was analyzed with qRT-PCR and the presence of the myofibroblast markers vimentin and α-SMA with immunofluorescence. Transcriptomic analysis was performed using Affymetrix arrays.

Results

The A549 and H1299 cells cultured in hEML-CM lost their epithelial morphology, acquired mesodermal characteristics, and decreased proliferation, migration, and colony formation capacity in 2D and 3D, as well as reduced its capacity to growth in vivo. The expression of OSKM, NKX2-1 and SFTP decreased, while that of DNMT3A/3B, vimentin, α-SMA and MYH increased. Distant matrix analysis based on transcriptomic profile showed that conditioned cells were closer to myoblast and human lung fibroblast than to normal epithelial immortalized lung cells. A total of 1631 for A549 and 866 for H1299 differentially expressed genes between control and conditioned cells were identified.

Conclusions

To the best of our knowledge, this is the first study to report that stimuli from the embryonic lung can modulate the malignant phenotype of lung cancer cells, control their growth capacity and activate their differentiation into myofibroblasts. These findings could lead to new strategies for lung cancer management.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13046-021-02206-z.

Monitoring HOTTIP levels on extracellular vesicles for predicting recurrence in surgical non-small cell lung cancer patients

•

EV HOTTIP analysis during post-surgical follow-up allows early recurrence detection.

•

Detection of an increment of EV HOTTIP level in first post-surgical sample predicts recurrence with a sensitivity of 87.5% and specificity of 90.9%.

•

Detection of an increment of EV HOTTIP level in first post-surgical sample predicts worse patient outcome.

•

EV HOTTIP could be considered as a follow-up biomarker for monitoring recurrence in NSCLC.

In resected non-small cell lung cancer (NSCLC), postsurgical recurrence is the major factor affecting long-term survival. The identification of biomarkers in extracellular vesicles (EV) obtained from serial blood samples after surgery could enhance early detection of relapse and improve NSCLC outcome. Since EV cargo contains long non-coding RNAs (lncRNAs), we aimed to analyze whether the oncogenic lncRNA HOTTIP, which higher expression in tumor tissue was related to worse outcome in NSCLC, could be detected in EV from NSCLC patients and serve as recurrence biomarker. After purification of EVs by ultracentrifugation in 52 serial samples from 18 NSCLC patients, RNA was isolated and HOTTIP was quantified by Real time PCR. We observed that patients that relapsed after surgery displayed increased postsurgical EV HOTTIP levels in comparison with presurgical levels. In the relapsed patients with several samples available between surgery and relapse, we observed an increment in the EV HOTTIP levels when approaching to relapse, which indicated its potential utility for monitoring disease recurrence. When we focused in EV HOTTIP levels in the first post-surgical sample, we observed that the detection of an increment of the expression levels in comparison to presurgical sample, predicted recurrence with high sensitivity (85.7%) and specificity (90.9%) and that patients had shorter time to relapse and shorter overall survival. In conclusion, our pilot study showed that EV HOTTIP is a potential biomarker for monitoring disease recurrence after surgery in NSCLC.

Role of the epithelial-mesenchymal transition-related circular RNA, circ-10720, in non-small-cell lung cancer

Background

Circular RNAs (circRNAs) are non-coding RNAs with a circular structure that have recently emerged as important regulators of tumorogenesis. Recently, several circRNAS, including circ-10720 have been related to epithelial-mesenchymal transition (EMT) process. In the present study, we have analyzed the role of circ-10720 in non-small-cell lung cancer (NSCLC) and studied its prognostic relevance in resected stage I-IIIa NSCLC patients.

Methods

Circ-10720 expression was analyzed using a custom TaqMan assay in four NSCLC cell lines (HCC44, A549, H23 and H1299) and in the normal immortalized lung cell line BEAS2B. Silencing of circ-10720 was performed using two custom siRNAs which were transfected using lipofectamine 2000. Protein levels were evaluated by Western blot and immunofluorescence. Wound healing and invasion assays were performed to evaluate the impact the circRNA on cell motility. Apoptosis was analyzed by evaluation of Caspase 3-7 activity and proliferation by MTS assay. Moreover, the expression levels of the circRNA were studied in 119 resected NSCLC patients. The expression in tumor tissue was correlated with the main clinicopathological characteristics and with time to relapse (TTR).

Results

Circ-10720 was overexpressed in HCC44 and A549 and underexpressed in H23 and H1299 NSCLC cell lines in comparison to BEAS2B normal immortalized lung cell line. CircRNA knockdown in the two circ-10720 overexpressing cell lines was associated with a decrease of Vimentin (VIM) and an increase of E-cadherin (CDH1) protein levels, loss of mesenchymal phenotype, and a significant reduction of migration and invasion capacity. After silencing circ-10720, the apoptosis rate increased and the proliferation was significantly reduced. Furthermore, circ-10720 was upregulated in tumor vs. normal tissue from 119 resected NSCLC patients. In the group of patients not receiving adjuvant treatment, those with high levels of circ-10720 had a shorter TTR than those with low levels and emerged as an independent prognostic value in the multivariate analysis. In tumor tissue, circ-10720 levels positively correlated with the EMT gene Twist1 levels.

Conclusions

Circ-10720 regulates EMT, apoptosis and proliferation and acts as a biomarker of relapse in NSCLC.

LncRNA Quantification from Extracellular Vesicles Isolated from Blood Plasma or Conditioned Media

During the last years, the study of extracellular vesicles (EVs) and its cargo has gained interest in the scientific media. EVs have been found in all biofluids and it is postulated that all cells are capable to secrete a wide variety of these vesicles, which play a key role in different cell-to-cell communication processes as well as in the microenvironment modulation. In the EV cargo, DNA, protein, and RNA molecules can be found, including long noncoding RNAs (lncRNAs). Several authors consider the study of EV lncRNAs an ideal source of biomarkers due to the easy sampling of EVs in different biofluids and the high specificity of the lncRNA expression pattern.In the present chapter, a detailed explanation of the EV isolation workflow followed by RNA isolation and lncRNA gene expression study is provided for two sample sources: blood plasma and cell culture conditioned media. EVs from both plasma samples and cell cultured media are isolated using sequential ultracentrifugation method (UC), which has been reported as one of the best methods available to date in terms of purity. UC is followed by RNA extraction based on the combination of phenol/guanidine-based lysis of samples with silica-membrane-based purification of total RNA. LncRNA quantification is performed by qRT-PCR. This chapter includes detailed discussion on lncRNA quantification using hydrolysis probes, recommended housekeeping genes and evaluation of methods for comparing lncRNA levels between EVs and its parental cells. In summary, we describe here the main steps for a successful isolation of the EVs-lncRNA cargo, paying attention to how overcome the different challenges found in the experimental procedure and in the data analysis of lncRNA expression from this source.

LincRNA-p21 Levels Relates to Survival and Post-Operative Radiotherapy Benefit in Rectal Cancer Patients

LincRNA-p21 is a long non-coding RNA involved in the p53 pathway and angiogenesis regulation that acts as prognostic marker in several tumors. In the present study, we aimed to analyze the clinical value of lincRNA-p21 in 177 resected stage I–III colorectal cancer (CRC) patients. Tumor and normal paired tissue and plasma samples from tumor-draining mesenteric veins and paired peripheral veins were analyzed. LincRNA-p21 expression was determined by RTqPCR and correlated with disease-free (DFS) and overall survival (OS). LincRNA-p21 was downregulated in tumor versus normal tissue (p = 0.0012). CRC patients with high lincRNA-p21 expression had shorter DFS (p = 0.0372) and shorter OS (p = 0.0465). Of note, the major prognostic impact was observed in the subset of rectal cancer patients where patients with high lincRNA-p21 levels had worse DFS (p = 0.0226) and OS (p = 0.0457). Interestingly, rectal cancer patients with high lincRNA-p21 benefited from post-operative chemoradiotherapy, as indicated by a longer OS in the group of high lincRNA-p21 patients receiving post-operative chemoradiotherapy (p = 0.04). Finally, patients with high lincRNA-p21 levels in mesenteric vein (MV) had shorter OS (p = 0.0329). LincRNA-p21 is a marker of advanced disease and worse outcome in CRC. Moreover, rectal cancer patients with high lincRNA-p21 levels could benefit from post-operative chemoradiotherapy, and plasmatic-lincRNA-p21 is a promising liquid biopsy biomarker.

KRAS mutations by digital PCR in circulating tumor cells isolated from the mesenteric vein are associated with residual disease and overall survival in resected colorectal cancer patients

PURPOSE

In colorectal cancer (CRC), circulating tumor cells (CTCs) are released into the mesenteric veins (MV). We chose to determine whether KRAS mutations detected in CTCs from blood obtained at the time of surgery could be a marker of survival.

METHODS

From 52 surgically resected CRC patients who later relapsed, samples of tumor tissue, normal tissue, and blood from the peripheral vein (PV) and MV were obtained from each patient at the time of surgery. KRAS mutations were assessed by Sanger sequencing and digital PCR (DGPCR) in tissue samples and by DGPCR in CTCs. Mutant KRAS copy number was assessed in CTCs. Results were correlated with overall survival (OS).

RESULTS

Sanger sequencing detected KRAS mutations in ten tumor samples (19.2%), while DGPCR detected mutations in 30 (58%). Mutations were detected in CTCs in 21 MV samples (40.4%) and 18 PV samples (34.6%). Patients with G13D mutations in CTCs from the MV had shorter OS than those with G12D mutations (28.1 vs 54.6 months; p = 0.025). Patients with a high mutant KRAS copy number in CTCs had shorter OS than those with a low mutant KRAS copy number (MV: 20.5 vs 43.7 months; p = 0.002; PV: 15.1 vs 38.2 months; p = 0.027).

CONCLUSION

DGPCR is more efficient than Sanger sequencing for detecting KRAS mutations. KRAS G13D mutations and high mutant KRAS copy number are associated with shorter OS. The analysis of KRAS mutations in CTCs from blood obtained at the time of surgery can identify patients with a higher risk of relapse.

Long Non-Coding RNA NANCI/NKX2-1 Duplex Impacts Prognosis in Stage I Non-Small-Cell Lung Cancer

BACKGROUND

NANCI, an intergenic long non-coding RNA (lncRNA) is essential for buffering NKX2-1 expression during embryonic development and in adult tissue. We analyzed NANCI and NKX2-1 in human lung embryonic samples and adult lung tissues and evaluated their potential as prognostic markers in stage I non-small cell lung cancer (NSCLC).

METHODS AND RESULTS

NANCI and NKX2-1 expression was assessed by TaqMan assays in 18 human embryonic samples from 8 to 13 weeks, 59 non-tumoral (NT) lung tissue samples, and 98 stage I NSCLC tumor samples. NANCI and NKX2-1 expression in embryonic and NSCLC samples were downregulated in comparison to adult NT tissue. Patients with low expression of NANCI had shorter disease-free survival (DFS) and overall survival (OS) than those with high levels (47.6 vs 69.3 months, P=0.032 and 57.7 vs 77.6 months, P=0.021, respectively). When the expression levels of NANCI and NKX2-1 were evaluated in combination, four groups were identified (high NANCI/high NKX2-1, low NANCI/high NKX2-1, high NANCI/low NKX2-1 and low NANCI/low NKX2-1) with differential impact on DFS (P=0.042) and OS (P=0.024). Interestingly, the high NANCI/high NKX2-1 duplex group had longer DFS and OS than the other three groups (71.25 vs 46.3 months, P=0.009 and 81.3 vs 56.1 months, P=0.004, respectively). In the multivariate analysis, the high NANCI/high NKX2-1 duplex was identified as an independent prognostic factor for longer DFS (HR 0.346, 95% CI, 0.169-0.709; P=0.004) and OS (HR 0.309, 95% CI, 0.121-0.786; P=0.014).

CONCLUSIONS

NANCI and the NANCI-NKX2-1 duplex impacts prognosis in stage I NSCLC patients.

Clinical significance of long non-coding RNA HOTTIP in early-stage non-small-cell lung cancer

Background

HOTTIP, a long non-coding RNA located in the HOXA cluster, plays a role in the patterning of tissues with mesodermal components, including the lung. Overexpression of HOXA genes, including HOTTIP, has been associated with a more aggressive phenotype in several cancers. However, the prognostic impact of HOTTIP has not yet been explored in non-small-cell lung cancer (NSCLC). We have correlated HOTTIP expression with time to relapse (TTR) and overall survival (OS) in early-stage NSCLC patients.

Methods

Ninety-nine early-stage NSCLC patients who underwent surgical resection in our center from June 2007 to November 2013 were included in the study. Mean age was 66; 77.8% were males; 73.7% had stage I disease; and 55.5% had adenocarcinoma. A validation data set comprised stage I-II patients from The Cancer Genome Atlas (TCGA) Research Network.

Results

HOTTIP was expressed in all tumor samples and was overexpressed in squamous cell carcinoma (p = 0.007) and in smokers (p = 0.018). Patients with high levels of HOTTIP had shorter TTR (78.3 vs 58 months; p = 0.048) and shorter OS (81.2 vs 61 months; p = 0.023) than those with low levels. In the multivariate analysis, HOTTIP emerged as an independent prognostic marker for TTR (OR: 2.05, 95%CI: 1–4.2; p = 0.05), and for OS (OR: 2.31, 95%CI: 1.04–5.1; p = 0.04). HOTTIP was validated as a prognostic marker for OS in the TCGA adenocarcinoma cohort (p = 0.025). Moreover, we identified a 1203-mRNA and a 61-miRNA signature that correlated with HOTTIP expression.

Conclusions

The lncRNA HOTTIP can be considered a prognostic biomarker in early-stage NSCLC.

Electronic supplementary material

The online version of this article (10.1186/s12890-019-0816-8) contains supplementary material, which is available to authorized users.

Climatic adaptation of chromosomal inversions in Drosophila subobscura

Drosophila subobscura is a species with a rich chromosomal polymorphism which is adaptive to different climatic conditions. Five samples of the Font Groga population (Barcelona, Spain) were sampled in autumn during 5 consecutive years (2011-2015) to obtain their inversion chromosomal polymorphism, and climatic data of several meteorological variables were also collected. The aim was to analyze the adaptive potential of inversions with regard to climatic variables, being the most relevant: mean temperature (T_mean), maximum temperature (T_max), minimum temperature (T_min), humidity (Hm) and rainfall (Rf). As expected, no significant variation in inversion frequencies were detected over this short period of time. However, from a climatic point of view it was possible to differentiate 'warm' and 'dry' from 'cold' and 'humid' samples. The joint study of maximum (T_max) and minimum (T_min) temperatures was a key element to understand the effect on adaptation of many inversions. It was also observed that temperature had to be considered in conjunction with humidity and rainfall. All these factors would condition the biota of D. subobscura habitat, and chromosomal inversions could provide an adaptive response to it.

Integrated side-stream reactor for biological nutrient removal and minimization of sludge production

Integrated processes to reduce in situ the sludge production in wastewater treatment plants are gaining attention in order to facilitate excess sludge management. In contrast to post-treatments, such as anaerobic digestion which is placed between the activated sludge system and dewatering processes, integrated technologies are placed in the sludge return line. This study evaluates the application of an anoxic side-stream reactor (SSR) which creates a physiological shock and uncouples the biomass metabolism and diverts the activity from assimilation for biosynthesis to non-growth activities. The effect of this system in biological nutrient removal for both nitrogen and phosphorus was evaluated for the anaerobic, anoxic and aerobic reactors. The RedOx potential within the SSR was maintained at -150 mV while the sludge loading rate was modified by increasing the percentage of recycled activated sludge feed to the SSR (0 and 40% at laboratory scale and 0, 10, 50 and 100% at pilot scale). The use of the SSR presented a slight reduction of phosphorus removal but maintained the effluent quality to the required discharge values. Nitrogen removal efficiency increased from 75 to 86% while reducing the sludge production rate by 18.3%.

Global leadership development, strategic alignment and CEOs commitment

Purpose

– Global corporate strategy has moved faster than global leadership development in many companies. This outcome has created some leadership problems: global companies may not have enough leaders in their growth markets or leaders with the required global competencies in their headquarters. The purpose of this paper is to offer some concepts that may help companies tackle those problems.

Design/methodology/approach

– This paper has a conceptual basis. It draws on previous theoretical knowledge on global leadership development and the experience of some leadership programs in global companies.

Findings

– The first is that global leadership competencies should be based on the functions that global leaders need to perform and their specific context, not on some theoretical notions isolated from the business context. The second is the need for alignment of global leadership development with the firm's purpose and strategy. The third is that CEOs’ commitment is a key factor in making global leadership initiatives successful.

Research limitations/implications

– This is a conceptual paper based on business experience. It needs to be complemented with additional empirical work.

Practical implications

– Global leadership development should be based on real global business functions. Global leadership development should be aligned with the firm's purpose and strategy and its success depends on CEOs’ commitment.

Originality/value

– The study of global capabilities needs to observe what happens in companies that have global leadership programs. Global leadership development takes place in specific organizations. This paper gets theory closer to the practice of global leadership development.

Minimization of sludge production by a side-stream reactor under anoxic conditions in a pilot plant

This study evaluates the application of an anoxic side-stream reactor in the sludge return line of a conventional activated sludge system for the reduction of biomass production. The oxidation-reduction potential was maintained at -150 mV while the applied sludge loading rate was modified by changing the percentage of return sludge treated in this reactor. The observed yield from the conventional system (0.513 kg VSS kg(-1) COD) was continuously reduced when the portion of return sludge treated was increased. A maximum reduction of 18.3% of the observed yield was obtained treating the whole sludge return line. The sludge age maintained through the experiment. The organic matter removal was not deteriorated, even improved, by the proposed plant modification. Thus, simply applying an anoxic side-stream reactor would decrease the final volume of waste sludge while maintaining the sludge retention time and would, in fact, decrease the economic costs in terms of sludge handling.

A two-phase population study: relationships between overweight, body composition and risk of eating disorders

BACKGROUND

Overweight and eating disorder (ED) are major public health problems in adolescents.

AIMS

To assess the association of overweight, body composition and anthropometric characteristics with the probability being at risk of ED.

METHODS

A two-phase study was used. 329 girls and 96 boys (aged 12-18 years) from an initial sample of 2967 adolescents were studied. The BMI, percentage of fat mass estimated by bioimpedance (FM(BIA)), waist circumference, waist-to-height ratio, and waist-to-hip ratio (WHipr) were calculated. The Eating Attitudes Test, Youth's Inventory-4 and a questionnaire to evaluate social influences were administered.

RESULTS

A total of 34.7% of girls and 53.6% of boys at risk of ED were overweight (including obesity). For girls, overweight frequency was significantly higher in risk ED group than in control group. Increases of one point in the BMI or FM(BIA) increased the probability of being at risk of ED by 12% (3.0-19.0) and 4% (0.0-8.0), respectively. An increase in WHipr was negatively associated with ED risk. Smoking and symptoms of dysthymia and the genralized anxiety disorder also increase the probability of being at risk of ED in adolescent girls. In adolescent boys, these relations were not observed.

CONCLUSIONS

The higher BMI and the percentage of FM(BIA) are associated with greater risk of ED in adolescent girls, when psychological factors are present. Increases in the WHipr, characteristic of childhood body is negatively associated with that risk.

Influence of parent's eating attitudes on eating disorders in school adolescents

OBJECTIVE

To investigate the relationship between parents' cognitive and behavioural dimensions and the risk of eating disorders (ED) in non-clinical adolescents.

METHODS

From an initial sample of 1,336 boys and girls with a mean age of 11.37, a total of 258 subjects were selected either as being at risk of ED or as controls. These subjects and their parents comprised the sample at T1 and were followed-up 2 years later (T2). We examined disordered eating attitudes, body dissatisfaction (BD), body mass index (BMI) and ED diagnoses in the adolescents at two points in time. We also used the Eating Disorder Inventory-2 to examine the disordered eating attitudes of their parents at T1.

RESULTS

The mother's BD, drive for thinness (DT), ineffectiveness and interoceptive awareness, and the father's DT and perfectionism were related to long-term ED. Logistic regression showed that predictors of ED were being female, mother's DT and social insecurity, and adolescent's BD. The BMI was not a predictor in this model. Father's perfectionism was a risk factor of ED.

CONCLUSION

Specific cognitive and behavioural dimensions of ED in both parents can influence the development of an ED in early adolescents. This should be taken into account in the prevention and family oriented treatment of ED.

Prevalence and determinants of high-risk human papillomavirus (HPV) infection and cervical cytological abnormalities in imprisoned women

The aim of the study was to estimate the prevalence and risk factors associated with infection by high-risk human papillomavirus (HR-HPV) in cervix and squamous intra-epithelial lesions (SIL) in imprisoned women. This was done by a cross-sectional study of imprisoned women attending the gynaecological clinic in Foncalent prison in Alicante, Spain. The study period was from May 2003 to December 2005. HR-HPV infection was determined through Digene HPV Test, Hybrid Capture II (HC-II). HPV typing was determined by multiplex nested PCR assay combining degenerate E6/E7 consensus primers. Multiple logistic regression modelling was used for the analysis of associations between variables where some were considered possible confounders after checking for interactions. A total of 219 women were studied. HR-HPV prevalence was 27.4% and prevalence of SIL was 13.3%. HIV prevalence was 18%, higher in Spaniards than in migrant women (24.6% vs. 14.3%, P<0.05). In multivariate analyses, risk factors for HPV infection were younger age (P for trend=0.001) and tobacco use (OR 2.62, 95% CI 1.01-6.73). HPV infection (OR 4.8, 95% CI 1.7-13.8) and HIV infection were associated with SIL (OR 4.8, 95% CI 1.6-14.1). The commonest HPV types were HPV16 (29.4%), HPV18 (17.6%), HPV39 (17.6%) and HPV68 (17.6%). The prevalence of both HR-HPV infection and SIL in imprisoned women found in this study is high. Determinants for each of the outcomes studied were different. HPV infection is the most important determinant for SIL. A strong effect of HIV co-infection on the prevalence of SIL has been detected. Our findings reinforce the need to support gynaecological clinics in the prison setting.

Non-clinical adolescent girls at risk of eating disorder: under-reporters or restrained eaters?

BACKGROUND

To evaluate the plausibility of self-reported energy intake, Goldberg et al proposed a technique to identify the miss-reporters.

SUBJECTS

After screening 2,967 adolescents by EAT-40 test, 132 at risk of ED and 151 as a control group were studied.

AIM

To determine whether subjects at risk of eating disorders that are identified as under reporters can be considered as UR or in turn as restrained eaters.

METHODS

We determined dietary energy intake, body mass index, body satisfaction, physical activity, psychopathology, dietary restraint factor, weight loss and diagnoses of eating disorders. We applied Goldberg's equations to identify under reporters.

RESULTS

40.9% of girls at risk of eating disorders were identified as under reporters and only 7.3% were in the control group. A total of 64.4% of the Eating Disorders Not Otherwise Specified were under reporters. The body mass index of under reporters was significantly higher than in the other of subjects regardless of whether they were at risk of eating disorders. Girls at risk of eating disorders and under reporter had significantly lower body satisfaction than other groups. Multiple logistic regressions in all subjects showed that the risk of being UR was associated with an increase in the body mass index, increase in dietary restraint scores and weight loss; whereas, that only the body mass index was associated with the control group.

CONCLUSION

The prevalence of under reporter increases with the severity of the eating disorders several adolescent girls at risk of eating disorder and identified by Goldberg cut-off technique as under reporter may to be restricting their intake and therefore they would not be under reporter.

Epidemiology of eating disorders: a two year follow up in an early adolescent school population

OBJECTIVE

The aims of this study were to determine the prevalence of eating disorders (ED) in a representative school population of early adolescents of both sexes and to evaluate persistence and incidence after two years.

METHOD

An initial sample of 1336 (mean age = 11.37) was assessed in a two-phase design. The Children Eating Attitudes Test was used to select 258 participants (T1) from the initial sample who were followed-up two years later (T2; n = 200). Diagnoses of ED were obtained using the Diagnostic Interview for Children and Adolescents- Children and Parent Version (DICA-C and DICA-P) at T1, and Adolescent Version (DICA-A) at T2. At T2, participants were also assessed with the Eating Attitudes Test, the Bulimic Investigatory Test, and the Eating Disorders Inventory. The Body mass index (BMI) was obtained for all participants.

RESULTS

The estimated prevalence of any ED according to DICA-C (T1) and DICA-A was 3.44% and 3.81%, respectively. The most frequent diagnoses were syndromes that were not full-blown. Biannual incidence of any ED was 2.02%. Amongst those with an ED, 52.17% persisted. Females showed a higher incidence and persistence of any ED than males. Participants who had the highest BMI were those who had a persistent diagnosis of ED.

CONCLUSION

ED that began at early ages in less severe forms and in females often persisted with increasing severity.

Oncogenic human papillomavirus (HPV) type distribution and HPV type 16 E6 variants in two Spanish population groups with different levels of HPV infection risk

The aim of this study is to determine oncogenic human papillomavirus (HPV) types and HPV type 16 (HPV16) variant distribution in two Spanish population groups, commercial sex workers and imprisoned women (CSW/IPW) and the general population. A multicenter cross-sectional study of 1,889 women from five clinical settings in two Spanish cities was conducted from May to November 2004. Oncogenic HPV infection was tested by an Hybrid Capture II (HC2) test, and positive samples were genotyped by direct sequencing using three different primer sets in L1 (MY09/11 and GP5+/GP6+) and E6/E7. HPV16 variants were identified by sequencing the E6, E2, and L1 regions. Four hundred twenty-five samples were positive for the HC2 test, 31.5% from CSW/IPW and 10.7% from the general population. HPV16 was the most frequent type. Distinct profiles of oncogenic HPV type prevalence were observed across the two populations. In order of decreasing frequency, HPV types 16, 31, 58, 66, 56, and 18 were most frequent in CSW/IPW women, and types 16, 31, 52, 68, 51, and 53 were most frequent in the general population. We analyzed HPV16 intratype variants, and a large majority (78.7%) belonged to the European lineage. AA variants were detected in 16.0% of cases. African variants belonging to classes Af1 (4.0%) and Af2 (1.3%) were detected. Different HPV types and HPV16 intratype variants are involved in oncogenic HPV infections in our population. These results suggest that HPV type distribution differs in CSW/IPW women and in the general population, although further analysis is necessary.

Higher prevalence of human papillomavirus infection in migrant women from Latin America in Spain

OBJECTIVES

To estimate prevalence and determinants of high risk (HR) human papillomavirus (HPV) by country of origin in women attending a family planning centre (FPC) in Alicante, Spain.

METHODS

Cross sectional study of all women attending a FPC from May 2003 to January 2004. An ad hoc questionnaire was designed and data were collected prospectively. HR HPV infection was determined through the Digene HPV test, Hybrid Capture II, and positive samples for PCR were directly sequenced. Data were analysed through multiple logistic regression.

RESULTS

HR HPV prevalence in 1011 women was 10% (95% CI: 8.2 to 12). Compared to Spaniards (prevalence 8.2%) HR HPV prevalence in Colombians was 27.5% (OR: 4.24 95% CI: 2.03 to 8.86), 23.1% in Ecuadoreans (OR: 3.35 95% CI: 1.30 to 8.63), and 22.73% in women from other Latin American countries (OR: 3.29 95% CI: 1.17 to 9.19). Women with more than three lifetime sexual partners had an increased risk of HR HPV infection (OR 3.21 95% CI: 2.02 to 5.10). The higher risk of HR HPV infection was maintained in Latin American women in multivariate analyses that adjusted for age, number of lifetime sexual partners, and reason for consultation. The commonest HPV types in women with normal cervical smears were HPV-18 (20%), HPV-16 (14%) and HPV-33 (11%).

CONCLUSIONS

Prevalence of HR HPV is more than three times higher in Latin Americans than in Spaniards. Latin American women's HPV prevalence resembles more that of their countries of origin. It is essential that health service providers identify these women as a priority group in current cervical screening programmes.

Feeding problems in nursery children: prevalence and psychosocial factors

AIM

In this study we analyze the prevalence of feeding problems in a sample of nursery children and examine the environmental and psychopathological factors related to such problems.

METHODS

We used the Early Childhood Inventory-Parents Checklist to assess 851 Spanish children aged between 3 and 6 years from both urban and rural samples. This screens emotional and behavioural problems and is based on the Diagnostic and Statistical Manual of Mental Disorders-IV. We collected sociodemographic data and information about life events and the psychopathology of the children's parents (General Health Questionnaire-28).

RESULTS

Our results showed that the prevalence of feeding problems was 4.8% and that there were no differences between gender. Sample subtype, socioeconomic level and family characteristics were not linked to feeding problems. Children with feeding problems had significantly more symptoms of psychological problems and somatic complaints and had experienced more life events in the previous 12 months. The psychopathology of the mother, especially in terms of anxiety problems, increased the risk of feeding problems in children.

CONCLUSION

When there are complaints of feeding problems in preschools, the psychological problems of children and their mothers should be taken into consideration during paediatric consultation, irrespective of gender or socioeconomic status.

The Beck Depression Inventory: Psychometric Characteristics and Usefulness in Nonclinical Adolescents

Summary: Epidemiological utility and characteristics of the Beck Depression Inventory (BDI) were examined in a sample of 304 nonclinical adolescents. Psychopathological diagnoses according ICD-10 criteria were assessed by the Schedules for Clinical Assessment in Neuropsychiatry. The female BDI scores were significantly higher than the male scores. The depressed adolescent scores were significantly higher than for nondepressed adolescents. Different scores as discriminators of depression subtypes were reported. The BDI pessimism item was the most important predictor of the total BDI score. Gender differences were found in depressive symptomatology. According to the rates of sensitivity and specificity, the best cutoff scores found were 16 and 10 for major depression and dysthymia, respectively. In conclusion, the BDI proved to be a reliable and valid instrument that could be used as a depression screening in nonclinical adolescents.

Prevalence of DSM-III-R and ICD-10 psychiatric disorders in a Spanish population of 18-year-olds

The aim of this study was to estimate the current prevalence of DSM-III-R and ICD-10 psychiatric disorders in Spanish 18-year-old members of the general population. Subjects were assessed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Nearly 30% of the study subjects reported at least one current disorder according to ICD-10 criteria, and almost 21% reported at least one current disorder according to DSM-III-R criteria. Women had a significantly higher probability of suffering from any psychiatric disorder than men. The most common disorders were insomnia, dysthymia, major depression and simple phobia. Nearly 40% of the diagnosed subjects had one or more comorbid disorders. Comorbidity was found to be higher among female subjects. Consistent with previous risk factor research, it was found that women had higher rates of mood, anxiety and sleep disorders than men. Good communication between parents and their offspring was found to be a protecting factor for all disorders.

Stressful events and salivary cortisol

No relationship of stressful events with salivary cortisol was found for 29 stressed women. An increased cortisol tendency in women suggests different responses by sex.

Smoking and trait anxiety

Smoking behavior was not associated with trait anxiety scores for a sample of 290 Spanish youth of 18 years.

A longitudinal study of depression in an urban Spanish pubertal population

Depression characteristics were investigated in 507 adolescents using a two-stage longitudinal study design. The three-year longitudinal study started when the girls and boys were 11 and 12 years, respectively. In the initial (screening) phase the Children's Depression Inventory (CDI) was used to select subjects for phase-II of the study in which the Children's Depression Rating Scale-Revised (CDRS-R) interview was used. The caseness definition of Major Depression (MD) and Dysthymia (D) was based on the DSM-III-R criteria. Pubertal development was assessed by Tanner's staging. Estimated prevalence of Major Depression in the female sample for each increasing year of age was 2.2%, 2.7% and 4.1%. In the male sample the prevalence for the three years was 0.9%, 0.3% and 0.6%. There was no relation to age. The estimated mean prevalence of Dysthymia was 1.4% in girls and 0.8% in boys. No association between pubertal development and depression was found. Longitudinal data support the notion of chronic depression in early adolescence.

Host Range of a Population of Pratylenchus vulnus in Commercial Fruit, Nut, Citrus, and Grape Rootstocks in Spain

In a host-range study carried out under greenhouse conditions, a total of 37 commercial fruit tree, grape, and citrus rootstocks were tested for their reaction to a population of the lesion nematode, Pratylenchus vulnus, in Spain. Twenty-five rootstocks had a Pf/Pi > 1.5. These included almond (Desmayo Rojo, 1143), apple (EM-9, EM-106), avocado (Hass), cherry (Santa Lucia 64, Camil, M x M 14, Masto de Montafiana), grape (41-B, Fercal, Ritcher 110), hazelnut (Pauetet), loquat (Nadal), peach (Montclar, GF-305), pear (OHF-333), pistachio (P. atlantica, P. vera, P. terebinthus), plum (San Julian 655-2, Montizo, Pixy, Myrobalan 605), and walnut (Serf). The peach rootstock Nemaguard and the grape 161-49 had Pf/Pi between 1.0 and 1.5 (slightly higher than inoculation level). All the tested citrus (Alemow, rough lemon, Carrizo citrange, sour orange, Troyer citrange, Citrumelo), plus three grape (SO4, Vitis rupestris, 1103-P), and the olive rootstock Arbequina had a Pf/Pi < 1.0.

Scores on the State-Trait Anxiety Inventory for children in a longitudinal study of pubertal Spanish youth

Changes in scores on the State-Trait Anxiety Inventory for Children for a sample of 534 pubertal adolescents were longitudinally studied over a period of 4 years. Biological development and other variables were investigated. For the 310 boys, A-trait scores decreased significantly with age. The 224 girls showed significantly higher scores than boys in all years of the study. No significant relationship was found between anxiety and pubertal maturity. The year-to-year persistence in symptomatology of anxiety ranged between 55.6% and 66.1% for girls and between 48.5% and 53.1% for boys. Girls showed bi- and tri-annual persistence between 31% and 50%, and boys between 13% and 27%. Neuroticism scores formed the best predictor of A-trait scores. Symptomatology of anxiety is not transient during early adolescence, so personality may provide a risk indicator in the development of anxiety.

[Abdominal trauma at a third-level pediatric hospital: study of 150 patients]

All paediatric patients with abdominal trauma admitted in our hospital from 1975 to 1989 were retrospectively studied. We present 150 children with ages ranging from 1 to 14 years, mean age 6 +/- 2.6 years. Sixty-five percent of them were male. Trauma was classified as severe (37%) and mild (63%) and relationated with associated extra-abdominal injuries. The 42% of patients could be attended in other less specialized centres. Since 1982, severe abdominal trauma patient with parenchymal lesions of liver, kidney and spleen were treated according to a non-surgical protocol without secondary complications.