Appended Lewis Acids Enable Dioxygen Reactivity and Catalytic Oxidations with Ni(II)

We disclose a suite of Ni(II) complexes featuring secondary sphere Lewis acids of varied Lewis acidity and tether lengths. Several of these complexes feature atypical behavior of Ni(II): reactivity with O2 that occurs only in the presence of a tethered Lewis acid. In situ UV-vis spectroscopy revealed that, although adducts are stable at -40 °C, complexes containing 9-borabicyclo[3.3.1]nonane (9-BBN) Lewis acids underwent irreversible oxidative deborylation when warmed to room temperature. We computationally and experimentally identified that oxidative instability of appended 9-BBN moieties can be mitigated using weaker Lewis acids such as pinacolborane (BPin). These insights enabled the realization of catalytic reactions: hydrogen atom abstraction from phenols and room temperature oxygen atom transfer to PPh3.

Multimodal deep learning methods enhance genomic prediction of wheat breeding

While several statistical machine learning methods have been developed and studied for assessing the genomic prediction (GP) accuracy of unobserved phenotypes in plant breeding research, few methods have linked genomics and phenomics (imaging). Deep learning (DL) neural networks have been developed to increase the GP accuracy of unobserved phenotypes while simultaneously accounting for the complexity of genotype-environment interaction (GE); however, unlike conventional GP models, DL has not been investigated for when genomics is linked with phenomics. In this study we used 2 wheat data sets (DS1 and DS2) to compare a novel DL method with conventional GP models. Models fitted for DS1 were GBLUP, gradient boosting machine (GBM), support vector regression (SVR) and the DL method. Results indicated that for 1 year, DL provided better GP accuracy than results obtained by the other models. However, GP accuracy obtained for other years indicated that the GBLUP model was slightly superior to the DL. DS2 is comprised only of genomic data from wheat lines tested for 3 years, 2 environments (drought and irrigated) and 2-4 traits. DS2 results showed that when predicting the irrigated environment with the drought environment, DL had higher accuracy than the GBLUP model in all analyzed traits and years. When predicting drought environment with information on the irrigated environment, the DL model and GBLUP model had similar accuracy. The DL method used in this study is novel and presents a strong degree of generalization as several modules can potentially be incorporated and concatenated to produce an output for a multi-input data structure.

[Monitoring of anticoagulant treatment with Unfractionated Heparin in pediatrics]

Unfractionated heparin (UFH) is the most widely used anticoagulant in hospitalized patients. The therapeutic range (TR) was defined in adults according to the prolongation of the activated Partial Thromboplastin Time (aPTT). However, the recommendation is to maintain a therapeutic range with anti-factor Xa assay (antiFXa). As this technique is more complex to perform and less available, it is recommended to make local correlation curves of aPTT with antiFXa.

OBJECTIVE

to determine the correlation between the values of aPTT and antiFXa in patients treated with UFH.

PATIENTS AND METHOD

52 patients between 2 days to 14 years of age hospitalized in the Pediatric Critical Patient Unit were recruited. They received treatment with UFH in continuous infusion for at least 24 hours. aPTT and antiFXa tests were performed according to the moment of anticoagulation. To evaluate the concordance of the levels of aPTT with those of antiFXa, the Kappa statistical coefficient of Landis and Koch was used.

RESULTS

105 samples were collected from 52 patients. The overall concordance was 0.452 (moderate correlation). In patients aged < 1 month (n = 40), a considerable correlation was evident (r = 0.617); in those from 1 month to < 6 months (n = 18) and 6 months - < 12 months with aPTT < 120 seconds (n = 11), also showed a considerable correlation (r = 0.636 and 0.615, respec tively), while in those aged > 12 months (n = 37) with aPTT < 120 seconds, a moderate correlation was evident (r = 0.454).

CONCLUSION

In our population, there is a moderate correlation between the values of aPTT and antiFXa.

Orofacial manifestations of chorea-acanthocytosis: case presentation and literature review

Chorea-acanthocytosis is a rare neurological disorder that produces involuntary body movements, along with a condition of misshapen red blood cells that is characterized by appearing in early adulthood. There are numerous orofacial manifestations linked to chorea-acanthocytosis that the dental practitioner must consider in early and late stages of the disease, such as chronic oral ulcerations, chronic mouth grinding, difficulty swallowing, and biting the lip and tongue, among others. This case, the first to the authors' knowledge to address the area of orofacial pain, provides general signs and symptoms of the disorder and management following a multidisciplinary approach. The life span of patients with this disorder is generally shortened, and correct management is essential to improve the quality of life.

Cis and trans platinum(II) N-heterocyclic carbene isomers: synthesis, characterization and biological activity

The synthesis of cis and trans geometrical isomers of platinum(II) complexes with a symmetric N-heterocyclic carbene ligand (MeNHC) is reported. These complexes were obtained from 1,3-dimethylimidazolium-2-carboxylate, a masked NHC precursor....

Abstract MP257: Dual Actions Of β 2 Ar-agonism Confer Protection Against Heart Failure And Renal Dysfunction Via Inotropic And Lusitropic Effects And Normalized Cholesterol Homeostasis In A Mouse Model Of Alport Syndrome

Background: Col4a3 -/- Alport mice present a model of heart failure with preserved ejection fraction (HFpEF) secondary to chronic kidney disease (CKD) wherein etiological relationships have been established between hypertension, pulmonary edema, inflammation, cardiac hypertrophy and fibrosis, diastolic dysfunction and underlying abnormalities of elevated low-density lipoprotein receptor (LDLR) expression, excess LDL-cholesterol (LDL-C) accumulation, and mitochondrial dysfunction in renal tubules. HFpEF is characteristically unresponsive to pharmacological intervention. Here, we tested the hypothesis that selective β 2 -Adrenoceptor (β 2 AR) modulation with salbutamol, a short-acting β 2 AR agonist, could alleviate symptoms of CKD and simultaneously augment cardiac function. Secondarily, we investigated the mechanism of actions of such β 2 AR-mediated therapeutics on cardiac and renal functions.

Methods: Alport mice were injected intraperitoneally with salbutamol or DMSO vehicle as a single bolus of 200μg/dose in short-term studies or daily with 100 μg/dose for 2 weeks long-term. Cardiac and renal functions, cAMP levels, in vivo renal tubular LDL-C uptake and renal histology were evaluated post-injection. In vitro mechanistic studies were performed in HK-2, Alport dog smooth muscle and tubular epithelial cells differentiated from Alport patient-derived iPSCs. Protein-protein interactions were studied using co-immunoprecipitation experiments and LDL-C uptake was measured by live-cell imaging.

Results: Short-term, salbutamol improved renal function in parallel with decreased LDLR levels and reduced uptake of LDL-C into renal tubules. Long-term, cardiac diastolic function assessed by isovolumetric relaxation time (IVRT), filling pressures (E/E’), and myocardial performance index, and systolic function reflected by ejection fraction, stroke volume and cardiac output improved significantly in parallel with increased cardiac cAMP. Mechanistically, in the kidney, salbutamol activated IDOL and hence lysosomal ubiquitination and degradation of LDLR via a novel β 2 AR-mediated, cAMP-independent pathway involving the Rac1/Cdc42 β 1 PixGEF. β 1 Pix reversibly sequesters IDOL into a complex with LDLR, thereby blocking the degradation pathway. β 2 AR stimulation dissipates the complex reactivating IDOL-mediated LDLR degradation thereby re-establishing LDL-C homeostasis and renal function. Using flow cytometry in HEK293T cells, ectopic expression of bPix stabilized membrane LDLR, sensitive to IDOL- but not PCSK-mediated degradation.

Conclusions: β 2 AR agonism represents a potential treatment strategy to alleviate progression of CKD and heart failure associated with HFpEF phenogroup 3.

Ancestral patterns of recessive dystrophic epidermolysis bullosa mutations in Hispanic populations suggest sephardic ancestry

Recessive dystrophic epidermolysis bullosa (RDEB) is a rare genodermatosis caused by mutations in the gene coding for type VII collagen (COL7A1). More than 800 different pathogenic mutations in COL7A1 have been described to date; however, the ancestral origins of many of these mutations have not been precisely identified. In this study, 32 RDEB patient samples from the Southwestern United States, Mexico, Chile, and Colombia carrying common mutations in the COL7A1 gene were investigated to determine the origins of these mutations and the extent to which shared ancestry contributes to disease prevalence. The results demonstrate both shared European and American origins of RDEB mutations in distinct populations in the Americas and suggest the influence of Sephardic ancestry in at least some RDEB mutations of European origins. Knowledge of ancestry and relatedness among RDEB patient populations will be crucial for the development of future clinical trials and the advancement of novel therapeutics.

[Psychometric properties of the Post-COVID 19 Functional Status scale for adult COVID 19 survivors]

Introducción

Para evaluar el estado funcional es fundamental contar con instrumentos simples que permitan hacer un seguimiento del curso de los síntomas y del compromiso que pueden presentar las personas adultas sobrevivientes de COVID-19. Este estudio tiene como objetivo evaluar las propiedades psicométricas de la escala de estado funcional post-COVID-19 (Post COVID-19 Functional Status [PCFS]).

Material y método

Corresponde a un estudio transversal de validación de escala. En la validación de contenido participaron 22 profesionales sanitarios, quienes mediante juicio de expertos evaluaron la escala en las categorías de suficiencia, claridad, coherencia y relevancia. Así también, dos profesionales realizaron la prueba de test-retest con 20 personas que habían cursado con infección por COVID-19. Adicionalmente, expusieron sus observaciones y comentarios. El grado de acuerdo entre los expertos fue determinado con el coeficiente de Kendall. Para el test-retest se utilizó el coeficiente de Spearman. En todos los análisis fue considerado significativo un valor de p < 0,05.

Resultados

En relación con la validez de contenido, hubo acuerdo entre evaluadores solo para la categoría relevancia (p = 0,032). Se obtuvo buena fuerza de concordancia entre dos evaluadores (Rho de Spearman = 0,929 para la puntuación). Se ajustaron algunos términos del contenido sin afectar la estructura general de la escala. De los 16 ítems originales que componen la escala PCFS, no se eliminó ninguno.

Conclusiones

La versión en español para Chile de la PCFS, adaptada al contexto cultural del país, muestra buenas características psicométricas en términos de confiabilidad.

Bioengineering potato plants to produce benzylglucosinolate for improved broad-spectrum pest and disease resistance

In traditional, small-scale agriculture in the Andes, potatoes are frequently co-cultivated with the Andean edible tuber Tropaeolum tuberosum, commonly known as mashua, which is believed to exert a pest and disease protective role due to its content of the phenylalanine-derived benzylglucosinolate (BGLS). We bioengineered the production of BGLS in potato by consecutive generation of stable transgenic events with two polycistronic constructs encoding for expression of six BGLS biosynthetic genes from Arabidopsis thaliana. First, we integrated a polycistronic construct coding for the last three genes of the pathway (SUR1, UGT74B1 and SOT16) into potato driven by the cauliflower mosaic virus 35S promoter. After identifying the single-insertion transgenic event with the highest transgene expression, we stacked a second polycistronic construct coding for the first three genes in the pathway (CYP79A2, CYP83B1 and GGP1) driven by the leaf-specific promoter of the rubisco small subunit from chrysanthemum. We obtained transgenic events producing as high as 5.18 pmol BGLS/mg fresh weight compared to the non-transgenic potato plant producing undetectable levels of BGLS. Preliminary bioassays suggest a possible activity against Phytophthora infestans, causing the late blight disease and Premnotrypes suturicallus, referred to as the Andean potato weevil. However, we observed altered leaf morphology, abnormally thick and curlier leaves, reduced growth and tuber production in five out of ten selected transgenic events, which indicates that the expression of BGLS biosynthetic genes has an undesirable impact on the potato. Optimization of the expression of the BGLS biosynthetic pathway in potato is required to avoid alterations of plant development.

Maturity-onset diabetes of the young type 5 a MULTISYSTEMIC disease: a CASE report of a novel mutation in the HNF1B gene and literature review

Background

Diabetes mellitus with autosomal dominant inheritance, such as maturity-onset diabetes of the young (MODY), is a genetic form of diabetes mellitus. MODY is a type of monogenic diabetes mellitus in which multiple genetic variants may cause an alteration to the functioning of beta cells. The three most known forms of MODY are caused by modifications to the hnf4a, gck, and hnf1a genes. However, other MODY variants can cause multiple alterations in the embryonic development of the endoderm. This is the case in patients presenting with MODY5, who have a mutation of the hepatic nuclear factor 1B (hnf1b) gene.

Case presentation

We present the clinical case of a 15 year-old patient with a family history of diabetes mellitus and a classical MODY type 5 (MODY5) phenotype involving the pancreas and kidney, with a novel, unreported mutation in the hnf1b gene.

Conclusions

MODY5 is characterised by a mutation in the hnf1b gene, which plays an important role in the development and function of multiple organs. It should be suspected in patients with unusual diabetes and multisystem involvement unrelated to diabetes.

Graphical abstract

Different methods of cell quantification can lead to different results: a comparison of digital methods using a pilot study of dendritic cells in HIV-positive patients

BACKGROUND

Although new digital pathology tools have improved the positive cell quantification, there is a heterogeneity of the quantification methods in the literature. The aim of this study was to evaluate and propose a novel dendritic cells quantification method in squamous cell carcinoma comparing it with a conventional quantification method.

MATERIAL AND METHODS

Twenty-six squamous cell carcinomas HIV-positive cases affecting the oropharynx, lips and oral cavity were selected. Immunohistochemistry for CD1a, CD83, and CD207 was performed. The immunohistochemical stains were evaluated by automated examination using a positive pixel count algorithm. A conventional quantification method (unspecific area method; UA) and a novel method (specific area method; SA) were performed obtaining the corresponding density of positive dendritic cells for the intratumoral and peritumoral regions. The Mann-Whitney U test was used to verify the influence of the quantification methods on the positive cell counting according to the evaluated regions. Data were subjected to the ANOVA and Student's t-test to verify the influence of the tumour location, stage, histological grade, and amount of inflammation on the dendritic cells density counting.

RESULTS

The cell quantification method affected the dendritic cells counting independently of the evaluated region (P-value <0.05). Significant differences between methods were also observed according to the tumour features evaluations.

CONCLUSIONS

The positive cell quantification method influences the dendritic cells density results. Unlike the conventional method (UA method), the novel SA method avoids non-target areas included in the hotspots improving the reliability and reproducibility of the density cell quantification.

172 Effect of period of insertion of a progesterone-releasing device and pro-oestrus length on follicular and luteal characteristics and pregnancy rates to fixed-time AI in Bos indicus heifers

An experiment was designed to evaluate the effect of the length of insertion of a progesterone (P4)-releasing device and the length of pro-oestrus on follicular and luteal characteristics and pregnancy rates to AI (P/AI) in Bos indicus heifers treated with oestradiol/P4-based treatments. Bos indicus beef heifers (n=374), 22-26 months of age, with a corpus luteum (CL) or at least one follicle ≥8mm in diameter and with a body condition score between 2.5 and 3.5 (1-to-5 scale) were synchronised using three treatments for fixed-time AI (FTAI). On Day 0, all heifers received 2mg of oestradiol benzoate (Sincrodiol, Ourofino) and an intravaginal device with 1g of P4 (Sincrogest, Ourofino). The P4 device was removed on Day 6 in heifers in the J-Synch 6 group (n=120) and on Day 7 in heifers in the J-Synch 7 group (n=105) and conventional group (n=165). All heifers received 500μg of cloprostenol (Sincrocio, Ourofino) and 300IU of equine chorionic gonadotrophin (SincroeCG 6000UI, Ourofino) at the time of P4 device removal. Furthermore, heifers in the conventional treatment group received 0.5mg of oestradiol cypionate (SincroCP, Ourofino) at the same time. In addition, all heifers were tail-painted for oestrus detection (CeloTest, Biotay). Heifers that had lost ≥50% of the tail paint by 70-74h (J-Synch groups) or 48-52h (conventional group) after device removal were FTAI at that time. Heifers not showing oestrus by 70-74h (J-Synch groups) or 48-52h (conventional group) received 10μg of gonadotrophin-releasing hormone (Sincroforte, Ourofino) at the same time and were FTAI 8h later. All heifers were also examined using ultrasonography (Mindray DP50 Vet) every 12h from the time of device removal to determine the time of ovulation, 6 days after ovulation to determine the diameter of the CL, and 28 days after FTAI for P/AI determination. Data were analysed using the MLGM procedure (InfoStat) for normal data families (follicular dynamics) and binary data family (P/AI). The results are shown in Table 1. The diameter of the dominant preovulatory follicle and the CL did not differ among groups (P&gt;0.12). However, the interval from device removal to ovulation was longer in heifers in the J-Synch groups than in heifers in the conventional group (P&lt;0.05). Furthermore, P/AI was not different among groups. In conclusion, although the J-Synch protocols delayed the interval from P4 device removal to ovulation, the three protocols evaluated in the present study were equally effective in Bos indicus heifers. Table 1.Mean (±s.e.m.) diameter of the preovulatory follicle (P/Foll) and corpus luteum (CL), interval from progesterone (P4) device removal to ovulation, and pregnancy rates to AI (P/AI) in Bos indicus heifers Treatment P/Foll, mm Interval to ovulation, h CL diameter, mm P/AI,% (n) J-Synch 6 10.5±0.7 101.4±2.3a 18.6±1.0 52.0 (62/120) J-Synch 7 10.6±0.7 96.0±2.2a 16.5±0.9 39.0 (41/105) Conventional 9.4±0.7 73.0±1.9b 16.8±0.9 45.0 (74/165) a,bDifferent superscripts denote differences between groups in the interval from P4 device removal to ovulation.

Determination of Arsenic, Cadmium, Cobalt, Chromium, Lead, Molybdenum, Nickel, and Selenium in Fertilizers by Microwave Digestion and Inductively Coupled Plasma-Optical Emission Spectrometry Detection: Collaborative Study

There is increasing regulatory interest in the non-nutritive metals content of fertilizer materials, but at present there is no consensus analytical method for acid digestion and instrument detection of those elements in fertilizer matrixes. This lack of method standardization has resulted in unacceptable variability of results between fertilizer laboratories performing metals analysis. A method has been developed using microwave digestion with nitric acid at 200C, followed by inductively coupled plasma-optical emission spectrometry instrument detection, for the elements arsenic, cadmium, cobalt, chromium, molybdenum, nickel, lead, and selenium. The method has been collaboratively studied, and statistical results are here reported. Fourteen collaborators were sent 62 sample materials in a blind duplicate design. Materials represented a broad cross section of fertilizer types, including phosphateore, manufactured phosphate products, N-P-K blends, organic fertilizers, and micro-nutrient materials. As much as possible within the limit of the number of samples, materials were selected from different regions of the United States and the world. Limit of detection (LOD) was determined using synthetic fertilizers consisting of reagent grade chemicals with near zero levels of the non-nutritive elements, analyzed blindly. Samples with high iron content caused the most variability between laboratories. Most samples reasonably above LOD gave HorRat values within the range 0.5 to 2.0, indicating acceptable method performance according to AOAC guidelines for analyses in the mg/kg range. The method is recommended for AOAC Official First Action status.

Uromodulin regulates renal magnesium homeostasis through the ion channel transient receptor potential melastatin 6 (TRPM6)

Up to 15% of the population have mild to moderate chronic hypomagnesemia, which is associated with type 2 diabetes mellitus, hypertension, metabolic syndrome, and chronic kidney disease. The kidney is the key organ for magnesium homeostasis, but our understanding of renal magnesium regulation is very limited. Uromodulin (UMOD) is the most abundant urinary protein in humans, and here we report that UMOD has a role in renal magnesium homeostasis. Umod-knockout (Umod ^-/-) mice excreted more urinary magnesium than WT mice and displayed up-regulation of genes promoting magnesium absorption. The majority of magnesium is absorbed in the thick ascending limb. However, both mouse strains responded similarly to the diuretic agent furosemide, indicating appropriate function of the thick ascending limb in the Umod ^-/- mice. Magnesium absorption is fine-tuned in the distal convoluted tubule (DCT) via the apical magnesium channel transient receptor potential melastatin 6 (TRPM6). We observed decreased apical Trpm6 staining in the DCT of Umod ^-/- mice. Applying biotinylation assays and whole-cell patch-clamp recordings, we found that UMOD enhances TRPM6 cell-surface abundance and current density from the extracellular space. UMOD physically interacted with TRPM6 and thereby impaired dynamin-dependent TRPM6 endocytosis. WT mice fed a low-magnesium diet had an increased urinary UMOD secretion compared with the same mice on a regular diet. Our results suggest that increased urinary UMOD secretion in low-magnesium states reduces TRPM6 endocytosis and thereby up-regulates TRPM6 cell-surface abundance to defend against further urinary magnesium losses.

Oral diseases: a 14-year experience of a Chilean institution with a systematic review from eight countries

Background

Retrospective studies to assess the distribution of oral diseases (ODs) are helpful in estimating the prevalence of oral diagnoses in the population, and thus help in preventive and curative services. Prevalence and frequency data for ODs are available from many countries, but information from Chile is scarce.

Material and Methods

This study investigated the frequency of ODs in a Chilean population. For this, we included all patients treated at the University of Talca (UTALCA, Chile) between 2001 and 2014. Patient characteristics were retrieved from medical files. To contextualize our results, we conducted a systematic review (SystRev) using Publish or Perish software (PoP), Google Scholar and MEDLINE/PubMed.

Results

One hundred sixty-six ODs were diagnosed, and the most prevalent groups were soft tissue tumours, epithelial pathology and salivary gland pathology. Individually, irritation fibroma, oral lichen planus (OLP) and mucocele were the most common diagnoses. ODs frequently affected unspecified parts of the mouth (including cheek, vestibule and retromolar area), gum, lips, tongue and palate. In the SystRev, the more studied diagnoses were leukoplakia, OLP and recurrent aphthous stomatitis; prevalent lesions included Fordyce’s spots, recurrent aphthous stomatitis and fissured tongue. Chilean patients and SistRev shared almost all ODs.

Conclusions

The results reflect ODs diagnosed in a specialized service of oral pathology and medicine in Chile and will allow the establishment of preventive/curative policies, adequate health services and dentistry curriculum.

Key words:Stomatognathic diseases, mouth diseases, oral mucosal lesions, epidemiology, Chilean population, retrospective cohort study.

Scolecobasidium granulomatous pneumonia and abscess - an emerging opportunistic fungal pathogen: a case report

Scolecobasidium sp. are commensal soil and water thermophilic dematiaceous fungi. They are commonly isolated as contaminants from respiratory secretions due to their abundant presence in water supplies, but they are also rare yet emerging culprits producing severe opportunistic infections in immunocompromised individuals. The most consistent presentations reported in literature are life-threatening pulmonary and cerebral granulomatous lesions.

[Lung cancer measuring 1cm or less: A miniature subset requiring surgery]

INTRODUCTION

Lung cancer measuring 1cm or less has an apparently very good outcome. However, the characteristics permitting their oncological management are unappreciated.

PATIENT AND METHOD

We reviewed 187 patients with such a cancer (145 men and 42 women, mean age 60.2years) and studied the type of surgery performed, the pTNM, and the histological features.

RESULTS

Surgery (19 wedge-resections, 12 segmentectomies, 136 lobectomies, 20 pneumonectomies) was complete (R0) in 97.3%. The tumors, each precisely defined among 98 adenocarcinomas (52.4%), 83 squamous cell carcinomas (44.4%), and 6 others, measured 1mm to 10mm:<5mm (n=41), 6 to 9mm (n=43), and 10mm (n=103). There were 161 pT1 (86.1%), 22 pT2 (11.8%) and 4 pT3; 148 pN0 (79.6%), 18 pN1 (9.7%) and 20 pN2 (10.7%). pN1 and pN2 were present in tumors<5mm (12/41, 29.3%) as well as in the others (26/146, 17.8% P=0.11). Histological examination frequently discovered visceral pleura involvement (tumors:<5mm 12.2% (5/41), 6 to 9mm 7% (3/43), 10mm 13.6% (14/103), P=0.53) and lympho-vascular invasion (12.9%). Five-year survival rate (66.4%) was adversely influenced by age, type of resection, pN and histological features. The survival rate was not better in tumor<5mm.

CONCLUSION

Surgical resection allows the local control of lung cancers<1cm and their complete histological study, a key issue in the therapy of the future, which renders surgery an absolute must even in very small tumors.

[Consequences of tobacco smoking on lung cancer treatments]

In France, in 2010, tobacco induced 81% of deaths by lung cancer corresponding to about 28,000 deaths. Continued smoking after diagnosis has a significant impact on treatment. In patients with lung cancer, the benefits of smoking cessation are present at any stage of disease. For early stages, smoking cessation decreases postoperative morbidity, reduces the risk of second cancer and improves survival. Previous to surgery, smoking cessation of at least six to eight weeks or as soon as possible is recommended in order to reduce the risk of infectious complications. Tobacco could alter the metabolism of certain chemotherapies and targeted therapies, such as tyrosine kinase inhibitors of the EGF receptor, through an interaction with P450 cytochrome. Toxicity of radiations could be lower in patients with lung cancer who did not quit smoking before treatment. For patients treated by radio-chemotherapy, overall survival seems to be better in former smokers but no difference is observed in terms of recurrence-free survival. For advanced stages, smoking cessation enhances patients' quality of life. Smoking cessation should be considered as full part of lung cancer treatment whatever the stage of disease.

Mucin-1 Increases Renal TRPV5 Activity In Vitro, and Urinary Level Associates with Calcium Nephrolithiasis in Patients

Hypercalciuria is a major risk factor for nephrolithiasis. We previously reported that Uromodulin (UMOD) protects against nephrolithiasis by upregulating the renal calcium channel TRPV5. This channel is crucial for calcium reabsorption in the distal convoluted tubule (DCT). Recently, mutations in the gene encoding Mucin-1 (MUC1) were found to cause autosomal dominant tubulointerstitial kidney disease, the same disease caused by UMOD mutations. Because of the similarities between UMOD and MUC1 regarding associated disease phenotype, protein structure, and function as a cellular barrier, we examined whether urinary MUC1 also enhances TRPV5 channel activity and protects against nephrolithiasis. We established a semiquantitative assay for detecting MUC1 in human urine and found that, compared with controls (n=12), patients (n=12) with hypercalciuric nephrolithiasis had significantly decreased levels of urinary MUC1. Immunofluorescence showed MUC1 in the thick ascending limb, DCT, and collecting duct. Applying whole-cell patch-clamp recording of HEK cells, we found that wild-type but not disease mutant MUC1 increased TRPV5 activity by impairing dynamin-2- and caveolin-1-mediated endocytosis of TRPV5. Coimmunoprecipitation confirmed a physical interaction between TRPV5 and MUC1. However, MUC1 did not increase the activity of N-glycan-deficient TRPV5. MUC1 is characterized by variable number tandem repeats (VNTRs) that bind the lectin galectin-3; galectin-3 siRNA but not galectin-1 siRNA prevented MUC1-induced upregulation of TRPV5 activity. Additionally, MUC1 lacking VNTRs did not increase TRPV5 activity. Our results suggest that MUC1 forms a lattice with the N-glycan of TRPV5 via galectin-3, which impairs TRPV5 endocytosis and increases urinary calcium reabsorption.

[Clinical and paraclinical prognostic factors in non-small cell lung cancer surgery]

INTRODUCTION

Lung cancer prognosis is mainly based on the TNM, histology and molecular biology. Our aim was to analyze the prognostic value of certain clinical and paraclinical variables.

PATIENTS AND METHODS

We studied among 6105 patients operated on, divided during 3 time-periods (1979 to 2010), the following prognostic factors: type of surgery, pTNM, histology, age, sex, smoking history, clinical presentation, and paraclinical variables.

RESULTS

Postoperative mortality was 4% (243/6105), rate of complications was 23.3% (1424/6105). The 5-year overall survival was 43.2% and 10-year was 27%. Best survival was observed after complete resection (R0) (P<10(-6)), lobectomy (P<10(-6)), lymph node dissection (P=0.0006), early pTNM stages (P<10(-6)), absence of a solid component in adenocarcinoma. Other pejorative factors were: male gender (P=10(-5)), age (P=0.0000002), comorbidity (P=0.016), history of cancer (P<10(-5)), postoperative complications (P=0.0018), FEV lower than 80% (P=0.0000025), time-periods (P<10(-6)). All these factors were confirmed by multivariate analysis, except gender. Smoking was not poor prognostic factor in univariate analysis (P=0.09) but became significant in the multivariate one (P=0.013).

CONCLUSION

Medical and human factors, and the general physiological state, play an important role in prognosis after surgery. We do not know their exact meaning and, like studies on chemotherapy, they justify special research.

Using the whole cohort in the analysis of countermatched samples

We present a technique for using calibrated weights to incorporate whole-cohort information in the analysis of a countermatched sample. Following Samuelsen's approach for matched case-control sampling, we derive expressions for the marginal sampling probabilities, so that the data can be treated as an unequally-sampled case-cohort design. Pseudolikelihood estimating equations are used to find the estimates. The sampling weights can be calibrated, allowing all whole-cohort variables to be used in estimation; in contrast, the partial likelihood analysis makes use only of a single discrete surrogate for exposure. Using a survey-sampling approach rather than a martingale approach simplifies the theory; in particular, the sampling weights need not be a predictable process. Our simulation results show that pseudolikelihood estimation gives lower efficiency than partial likelihood estimation, but that the gain from calibration of weights can more than compensate for this loss. If there is a good surrogate for exposure, countermatched sampling still outperforms case-cohort and two-phase case-control sampling even when calibrated weights are used. Findings are illustrated with data from the National Wilms' Tumour Study and the Welsh nickel refinery workers study.

Health-related quality of life in children with and without chronic conditions: A multicenter study

INTRODUCTION

Chronic conditions (CCs) in the early stages of life may have an impact on various dimensions of health-related quality of life (HRQoL) in children.

OBJECTIVE

To compare HRQoL in children with confirmed CCs, reported CCs, and without CC.

POPULATION AND METHOD

Cross-sectional study conducted in 2012 in the context of a larger research study carried out at schools in Córdoba and Bahía Blanca, and at Hospital Italiano of Buenos Aires and Hospital Prof. Dr. Juan P. Garrahan at Buenos Aires. The presence of a chronic condition was established by medical diagnosis at the hospital or as reported by schoolchildren's caregivers. Eight-to-twelve year-old children completed the KIDSCREEN-52 questionnaire on HRQoL, a pubertal development scale, and a family financial resource scale. The association between CCs and HRQoL adjusted by sex, age, pubertal development, maternal education level, and socioeconomic level was estimated.

RESULTS

Six hundred and seventy children/ caregiver dyads participated; 13.3% (n= 89) had confirmed CCs, 14.5% (n= 97) were schoolchildren with reported CCs, and the rest corresponded to healthy schoolchildren. Their average age was 10.2 years old (standard deviation= 1.01); 54.8% were girls. Having a confirmed CC was associated with a higher frequency of low physical wellbeing (odds ratio |-OR-|: 2.61; 95% confidence interval |-95% CI-|:1.43-4.76), while the presence of a reported CC was associated with a low score in psychological well-being (OR: 1.96; 95% CI: 1.06-3.63), self-perception (OR: 2.22; 95% CI: 1.28-3.87), and parent relations (OR: 2.04; 95% CI: 1.21-3.44).

CONCLUSIONS

Children with confirmed CCs showed a higher frequency of physical discomfort, and those with reported CCs showed discomfort in psychosocial areas compared to children without CCs.

[Place of limited resections and prognostic factors in non-small lung cancer]

INTRODUCTION

Results of surgery for non-small-cell lung cancer (NSCLC) are poorer after limited resection, wedge and segmentectomy, than after lobectomy. Guidelines recommend avoiding wedge-resection, which new techniques (radiofrequency ablation and cyberknife) tend to replace. This work aimed to study the wedge-resection carcinological value.

PATIENTS AND METHODS

NSCLC without previous other cancer history and neoadjuvant therapy measuring less than 31 millimetres and operated from 1980 to 2009 were reviewed. Analyzed variables were: location, gender, age, FEVS, type of resection, histology, pT and pN.

RESULTS

There were 66 wedge-resections (10.9%), 32 segmentectomies (5.3%), 507 lobectomies (83.8%), nine postoperative deaths (1.5%), 136 complications (22.5%), 557 complete resections (R0=92%); 72.2% of NSCLC upper lobe location (437/605). Age was more advanced in wedge-resection and segmentectomy, FEVS lower and NSCLC most often a squamous cell pN0 and pStage I carcinoma than in lobectomy. Lymphadenectomy was not performed in half the wedge-resections. Five-year survival rates were poorer after wedge-resection: 50% versus segmentectomy 59.8% (P=0.09), and lobectomy 66% (P=0.0035), but the number of recurrences was similar. Multivariate analysis demonstrated that age, FEVS, type of surgery and lymphadenectomy, pN in pTNM were the only prognosis factors.

CONCLUSION

Wedge-resection is less carcinological than segmentectomy when the patient-status and NSCLC location allow performing the latter, but more than the new techniques, because of its pathological yield, when the patient-status and nodule peripheral location allow wedging.

[Total femoral replacement. Three case reports and literature review]

INTRODUCTION

Currently hip and knee joint replacement were performed frequently at orthopedic centers. However, these surgeries do not last forever and thus revision procedures are required. The latter usually involve complications like bone loss that may compromise implant stability.

METHODS

Three hip and knee arthroplasty revisions were performed from 2006 to 2011, which warranted the total replacement of the femur and the joints involved. The purpose of this paper is to describe our experience with these implants used in arthroplasty revision surgery.

RESULTS

A standardized postoperative management protocol was used in all patients. They required debridement and specific antibiotic therapy. They had a significant improvement in the pain visual analog scale (VAS) (the score went from 8 to 2.3, p ‹ 0.05) and in function, measured with the WOMAC score (from a preoperative score of 21.6 to 55, p ‹ 0.05).

CONCLUSIONS

Total femoral replacement is an infrequent, demanding and complex salvage surgery that represents an alternative to the disarticulation of the pelvic limb at the end stage of prosthetic disease. This is a feasible option used to improve patient functionality and decrease residual capacity for performing activities independently.

Plantas hospederas de los virus más importantes que infectan el melón, <i>Cucumis melo</i> (Cucurbitaceae) en Costa Rica

Las especies hospederas naturales de los virus (PRSV, WMV-2. CMV y ZYMV) que infectan el cultivo de melón (Cucumis me/o L.) para la exportación en Costa Rica se identificaron en plantaciones comerciales de dos fincas ubicadas, una en la provincia de Guanacaste, y la otra en la provincia de Puntarenas. En ambas fincas se cultiva el melon con irrigación durante la época seca, pero su manejo cultural es diferente. La finca A con una larga trayectoria en el cultivo de melón en rotación con maíz. sorgo y arroz, y con poco control de malezas; mientras que la finca B con una corta trayectoria en la producción del melón y un mayor control de malezas. La diversidad de especies vegetales fue estudiada en cuadrantes de 100 m' en cinco diferentes comunidades de plantas previamente seleccionada, en la finca A (cultivo, canal de drenaje, charral, potrero mejorado, y semi-bosque) y tres en la finca B (cultivo, charral, pastizal natural, semibosque). El número de cuadrantes estudiados dependió del área total cultivada en cada una de las fincas. Toda, las especies de plantas representadas en cada cuadrante se recolectaron e identificaron pero solo aquella, especies que presentaron síntomas virales en el campo fueron analizadas por EUSA para determinar la presencia de los cuatro virus estudiados. La diversidad de especies, porcentaje de cobertura y épocade aparición de las especies hospederas fue monitoreada durante un año calendario en cinco fechas diferentes. Un total de 86 y 72 especies de plantas fueron identificadas en las tlncas A y B respectivamente. Catorce encontradas positivas por lo menos para uno de los cuatro virus. Los cuatro virus fueron encontrados en cada finca en cada fecha de muestreo indicando que la permanencia y abundancia de alguna, especies hospederas garantiza la permanencia de los cuatro virus en el campo como fuente de inóculo primario para la próx.ima siembra. Varia, especies de plantas hospederas silvestres previamente no informadas en la literatura fueron encontradas para PRSV, WMV-2 y ZYMV.

[Obesity and lung cancer: incidence and repercussions on epidemiology, pathology and treatments]

INTRODUCTION

Obesity and lung cancer are major public health problems. The purpose of this work is to review the data concerning this association.

METHOD

We report clinical and epidemiological data on obesity and discuss the impact on the incidence of lung cancer, as well as the safety and efficiency of anti-tumor treatments.

RESULTS

Obesity does not contribute to the occurrence of lung cancer, unlike other malignancies. Patients may be more likely to undergo treatment at lower risk. Regarding surgery, obesity makes anaesthesia more difficult, increases the operative duration but does not increase postoperative morbidity and mortality. Chemotherapy and radiotherapy seem to be administered according to the same criteria as patients with normal weight. Paradoxically, survival rates of lung cancer are better in obese patients as well after surgery than after non-surgical treatment.

CONCLUSION

Obesity is related to many neoplasms but not to lung cancer. Regarding long-term survival all treatments combined, it has a favorable effect: this is the "obesity paradox".

[Lung cancer surgery and cirrhosis]

INTRODUCTION

Lung cancer is the leading cause of death by cancer and cirrhosis is the fourteenth, all causes included. Surgery increases postoperative risks in cirrhotic patients. Our purpose was to analyze this point in lung cancer surgery.

METHODS

We collected, among 7162 patients, the data concerning those operated for lung cancer (n=6105) and compared patients with hepatic disease (n=448) to those presenting other medical disorder (n=2587). We analyzed cirrhotic patients' characteristics (n=49).

RESULTS

Five-year survival of patients with hepatic disease was lower (n=5657/6105): 35.3% versus 43.8% for patients with no hepatic disease, P=0.0021. Survival of cirrhotic patients was not statistically different from the one of patients with other hepatic disorder, but none survived beyond 10 years (0% versus 26.4%). Surgery in cirrhotic patients consisted in one explorative thoracotomy, three wedges resections, two segmentectomies, 33 lobectomies and 10 pneumonectomies. Postoperative mortality (8.2%; 4/49) was not different for patients without hepatic disease (4.2%; 239/5657) (P=0.32), as well as the rate of complications (40.8%; 20/49 and 24.8%; 1404/5657, P=0.11). Only one postoperative death was associated to a hepatic failure. Multivariate analysis pointed age, histological subtype of the tumour and stage of disease as independent prognosis factors.

CONCLUSION

When cirrhosis is well compensated, surgical resection of lung cancer can be performed with acceptable postoperative morbidity and satisfactory rates of survival. Progressive potential of this disease is worse after five years.

[Pneumonectomy for benign disease: indication and factors affecting the postoperative course]

Pneumonectomy for benign disease is rare but may generate more postoperative morbimortality than when performed for lung cancer. We questioned this assessment and retrospectively reviewed 1436 pneumonectomies and 54 completions of which 82 and 10 performed for benign disease (5.7% and 18.5%, respectively): left n=65 and right n=27. Indications were: post-tuberculosis destroyed lung (n=37), aspergilloma (n=18), bronchiectasis (n=19), infection (n=5), congenital malformations (n=5), inflammatory pseudotumor (n=3), trauma (n=2), post-radiation (n=2) and mucormycosis (n=1). Pneumonectomy consisted of 48 standard and 44 pleuro-pneumonectomies. Stump coverage by flaps was performed in 66.3% (61/92). Complications occurred in 21.7% (20/92) and postoperative deaths in 7.6% (7/92, of which 5 with fungal infections), which was not different than what was observed in lung cancer. There was no difference in fistula formation and mortality regarding the side, the type of resection and the protective role of stump coverage. Considering patients with fungal infections versus others, mortality was 26.3% (n=5/19) and 2.7% (n=2/74), respectively (P=0.0028). Pneumonectomy for benign disease achieves cure with acceptable mortality and morbidity. However, presence of fungal infection should raise the attention for possibility of increased postoperative risks.

[Mucoepidermoid tracheo-bronchial tumors in adulthood. A series of 22 cases]

INTRODUCTION

Mucoepidermoid tumours (TME) are rare tumours arising from the submucosal glands of the tracheobronchial tree. The majority of these tumours develop in a benign fashion but some of them are malignant. The latter can be easily mistaken for adenosquamous carcinomas.

PATIENTS AND METHOD

We have reviewed 22 patients suffering from TME observed over a period of 25 years. Two arose from the trachea and 20 from the cartilaginous bronchi; 12 of these tumours had macroscopic and histological criteria of low-grade malignancy, 4 had macroscopic and 6 macroscopic and microscopic criteria of high grade malignancy.

RESULTS

Prognosis of the latter was very poor and no survival observed after 6 years follow-up, a behavior similar to that observed in non-small cell lung carcinomas and adenosquamous carcinomas.

CONCLUSION

The best treatment of these orphan tumours remains surgery.

[Lung cancer surgery in a single-lung]

INTRODUCTION

The diagnosis of a second lung cancer in a patient with a previous medical history of lung cancer is no longer a rarity. Also, it is possible to observe a new location in a patient who underwent pneumonectomy in the past. Surgery remains the best treatment. Our objective was to overview this subject.

PATIENTS AND METHODS

Among 5611 patients operated in our institution, 186 (3.3%) had metachronous cancer and 17 had previous pneumonectomy (0.7% of pneumonectomies and 0.2% of NSCLC treated in our department). The procedure was diagnostic and therapeutic in 88% of cases (n=15).

RESULTS

There were 16 males and 1 female, mean age was 62.5-years. All were smokers (11 were former smokers) and 6 had other medical history. Mean FEV was 52% (range 35-95%). Types of resection were 2 lobectomies, 4 segmentectomies, and 11 wedge resections. There were no postoperative deaths, but two complications. Histological subtype of the first and second cancer was the same in 11 patients. All patients were pN0 after second surgery. The long-term survival (median 33 months) was 35.3% at 5-years and 14.1% at 10-years. Two patients treated with pneumonectomy for their first cancer were pN2. Patients who underwent upper right lobectomy for treatment of their second cancer survived longer than 5-years.

CONCLUSION

Surgical resection for lung cancer on single-lung is associated with acceptable morbidity and mortality. Prolonged survival can be achieved in selected patients.

[Lung cancer surgery in solid organ transplanted patients]

BACKGROUND

The incidence of lung cancer is reputed to be higher and prognosis worse in solid organ transplant recipients than in the general population. Our purpose was to review the results of surgery in this group of patients.

METHODS

We retrospectively reviewed 49 male and 6 female patients; mean aged 60.6 years (38-85). Transplanted organ was heart (n = 37), kidney (n=12), liver (n = 5) and both-lungs (n = 1); 48 patients had smoking habits and 42 heavy comorbidities (76.4%). Lung cancer was diagnosed during surveillance (78.2%, n = 43) or because of symptoms (21.8%, n = 12). We reviewed TNM and other main characteristics, among them histology (squamous-cell-carcinoma n = 23, adenocarcinomas n = 24, others n = 8).

RESULTS

Surgery consisted of: exploratory thoracotomy (n = 2), wedge resections (n = 6), segmentectomy (n = 1), lobectomy (n = 42), pneumonectomy (n = 4). Postoperative mortality was 7.4% (n = 4) and complication rate 34.5% (n = 19). Five-year survival rate was 46.4% (65.4% for stage I patients, n = 25). Among the 35 dead patients during follow-up, 14 died of their lung cancer (40%). Two had been re-operated from another lung cancer: one after 3 and 8 years who survived 16 years, and the other after 2 years who survived 70 months.

CONCLUSIONS

Surgery results are good and postoperative events acceptable despite theoretically increased risks. This also supports performing a close follow-up of transplanted patients and particularly those with smoking history in view of detecting lung cancer appearing at an early stage.

[Place and role of the pleura in non-small cell lung cancer dissemination]

INTRODUCTION

The pleural involvement (PLI) in non-small cell lung cancer (NSCLC) has a poor prognosis, even though it might be very heterogeneous.

PATIENTS AND METHODS

A multicentric retrospective descriptive study was performed over 2329 patients who were operated for NSCLC between 1979 and 2010. The patients with PLI were classified in P(Parietal)PLI and V(visceral)PLI and then each subdivided : VPLI to peripheric (VPLI-P) and fissural (VPLI-F) and PPLI to mediastinal (PPLI-M) and costal (PPLI-C). Characteristics and survival were compared between the subgroups as well as with patients without PLI (WPLI, n=1439).

RESULTS

The sex-ratio was 2.8 (males: n=1713). The PLI patients were significantly younger, with a less sex-ratio, less R0 resections (96% versus 98.7%, P=0.000076), and less N0 (60% vs 70%, P<10(-6)) as their 5-year survival (45.7% vs 55.5%, P<10(-6)). The PLI was related to the size of NSCLC (P<10(-6)) and N2 involvement (P=0.0020). It was less frequent after neoadjuvant treatment (36.2% vs 39.1% P=0.03). In the VPLI-F or PPLI-M, pneumonectomies were more frequent (P<10(-6)). In VPLI-P (n=196/561), there were more pN1 and pN2 (P=0.0065) with a 5-year survival of 42.9% vs 54.4%, P=0.013. In multivariate analysis, the PLI was not an independent prognostic factor contrary to age, sex, type of resection, pT and pN.

CONCLUSION

The pleura play a major role in NSCLC dissemination. Its involvement affects pN, the type of surgical resection and justifies the use of neoadjuvant treatment.