Glucocorticoid receptor gene polymorphisms associated with progression of lung disease in young patients with cystic fibrosis

<p>Abstract</p> <p>Background</p> <p>The variability in the inflammatory burden of the lung in cystic fibrosis (CF) patients together with the variable effect of glucocorticoid treatment led us to hypothesize that <it>glucocorticoid receptor </it>(<it>GR</it>) gene polymorphisms may affect glucocorticoid sensitivity in CF and, consequently, may contribute to variations in the inflammatory response.</p> <p>Methods</p> <p>We evaluated the association between four <it>GR </it>gene polymorphisms, <it>TthIII</it>, <it>ER22/23EK</it>, <it>N363S </it>and <it>BclI</it>, and disease progression in a cohort of 255 young patients with CF. Genotypes were tested for association with changes in lung function tests, infection with <it>Pseudomonas aeruginosa </it>and nutritional status by multivariable analysis.</p> <p>Results</p> <p>A significant non-corrected for multiple tests association was found between <it>BclI </it>genotypes and decline in lung function measured as the forced expiratory volume in one second (FEV₁) and the forced vital capacity (FVC). Deterioration in FEV₁and FVC was more pronounced in patients with the <it>BclI </it>GG genotype compared to the group of patients with <it>BclI </it>CG and CC genotypes (p = 0.02 and p = 0.04 respectively for the entire cohort and p = 0.01 and p = 0.02 respectively for F508del homozygous patients).</p> <p>Conclusion</p> <p>The <it>BclI </it>polymorphism may modulate the inflammatory burden in the CF lung and in this way influence progression of lung function.</p

Cervical lymph node metastasis in high-grade transformation of head and neck adenoid cystic carcinoma: a collective international review

Adenoid cystic carcinoma (AdCC) is among the most common malignant tumors of the salivary glands. It is characterized by a prolonged clinical course, with frequent local recurrences, late onset of metastases and fatal outcome. High-grade transformation (HGT) is an uncommon phenomenon among salivary carcinomas and is associated with increased tumor aggressiveness. In AdCC with high-grade transformation (AdCC-HGT), the clinical course deviates from the natural history of AdCC. It tends to be accelerated, with a high propensity for lymph node metastasis. In order to shed light on this rare event and, in particular, on treatment implications, we undertook this review: searching for all published cases of AdCC-HGT. We conclude that it is mandatory to perform elective neck dissection in patients with AdCC-HGT, due to the high risk of lymph node metastases associated with transformation

Zooplankton fluctuations in Jurumirim Reservoir (São Paulo, Brazil): a three-year study

During three consecutive years, monthly samples of zooplankton were taken in the lacustrine (dam) zone of Jurumirim (São Paulo, Brazil). The seasonal effect on basic limnological features (thermal regime, oxygen distribution, phytoplankton biomass, etc.) was also examined. The influence of the seasonality on the fluctuation of the zooplankton composition and abundance was not clearly detected (low degree of recurrent patterns). Rotifers (32 taxa) were the most abundant organisms during almost the entire study period with some seasonal alternations in the maximum abundance peaks of the main taxa (Conochilus unicornis, Keratella americana, K. cochlearis and Hexarthra spp.), except for Polyarthra (mainly P. vulgaris). Only occasionally copepods were numerically dominant. Higher copepod abundance was positively associated to periods of increase in the water retention time. Among the Copepoda (10 taxa) the calanoids (mainly Notodiaptomus iheringi) were more abundant, especially in warmer periods. Conversely, cyclopoids had higher abundance in autumn and winter. The species Thermocyclops minutus and T. decipiens co-occurred, but the first attained higher abundance. Some evidence of co-existence strategies between both species are considered. Cladocera (17 taxa) was never numerically dominant and the main taxa (Bosmina spp., Ceriodaphnia spp. and Diaphanosoma spp.) occurred almost the whole study period and did not present a seasonal pattern of fluctuation. Diaphanosoma (mainly D. birgei) attained the highest abundance among cladocerans. Most organisms were always found at the surface, but they also occupy the whole water column, even in periods of stratified conditions and low oxygen concentration in the bottom layers. Among the main zooplanktonic taxa, only Hexarthra avoids deep layers. An exceptionally high concentration of Copepoda nauplii on the surface was influenced by low transparency, high concentration of phytoplankton at this layer and low oxygen concentration at the bottom. In periods of higher retention timevariability there was a more heterogeneous distribution of the zooplankton in the water column. The increase in the retention time seems also to favor the copepod development. Finally, some inter-decade changes are considered on the basis of zooplankton assemblage structure observations

Analysis of long-term outcomes for combined pars plana vitrectomy (PPV) and glaucoma tube shunt surgery in eyes with advanced glaucoma

PURPOSE: To analyze 12- and 24-month visual acuity, intraocular pressure, and complications associated with combined pars plana vitrectomy (PPV) and glaucoma tube shunt placement in eyes with glaucoma. PATIENTS AND METHODS: A retrospective chart review was performed of patients with advanced glaucoma who underwent combined PPV and tube shunt surgery from 2006 to 2010. A minimum of 12 months of follow-up was required for their inclusion in the study. Visual acuity, intraocular pressure, complications, and number of glaucoma medications at 1 and 2 years postoperatively were analyzed. RESULTS: Twenty-eight eyes met the inclusion and exclusion criteria. Baseline visual acuity was 20/200 or worse in 14/28 eyes (50.0%) and 20/40 or better in 2/28 eyes (7.1%). Visual acuity remained 20/200 or worse in 50.0% (P=0.921) and 44.4% (P=0.973) of eyes after 1 and 2 years postoperatively, respectively. At baseline, the mean intraocular pressure was 30.4 mm Hg. There was significant improvement in mean IOP at 1 year (14.7 mm Hg, P=0.001) and at 2 years (15.2 mm Hg, P=0.001) postoperatively. Baseline number of glaucoma medications averaged 3.0±1.09 (SD), and improved to 1.8±1.28 (SD) at 1 year (P=0.0002) and to 1.4±1.33 at 2 years (P<0.0001) postoperatively. CONCLUSION: In this retrospective interventional case series, surgical management of advanced glaucoma with a combination of PPV and glaucoma tube shunt resulted in significantly reduced IOP and glaucoma medications at 1 and 2 years postoperatively

Boston Keratoprosthesis Type II: Indications, Techniques, Outcomes, and Management

Implantation of a keratoprosthesis device is indicated for the visual rehabilitation of patients with corneal blindness in whom a standard corneal allograft would likely fail. The Boston keratoprosthesis type I device is a collar button-shaped device, composed of polymethyl methacrylate and titanium, whereas the type II device has an additional anterior extension that allows for implantation through surgically closed eyelids. The type I device is used in patients with intact eyelids, normal blink, and adequate tear film. The type II device is reserved for patients with abnormal lid function and tear secretion, forniceal foreshortening, and ocular surface keratinization. Herein, we focus on the indications, preoperative assessment, surgical technique, and postoperative care for the Boston keratoprosthesis type II and provide advice on management of complications