Diagnostic accuracy of fine needle aspiration cytology versus concurrent core needle biopsy in evaluation of intrathoracic lesions: A retrospective comparative study

Background: Transthoracic fine needle aspiration (FNA) cytology and core needle biopsy (CNB) are two commonly used approaches for the diagnosis of suspected neoplastic intrathoracic lesions. This study compared the diagnostic accuracy of FNA cytology and concurrent CNB in the evaluation of intrathoracic lesions. Materials and Methods: We studied FNA cytology and concurrent CNB specimens of 127 patients retrospectively, using hematoxylin and eosin (H&E), immunohistochemistry, and, on certain occasions cytochemistry. Information regarding additional tissue tests was derived from the electronic archives of the Department of Pathology and Laboratory Medicine as well as patient records. Diagnostic accuracy was calculated for each test. Results: Of 127 cases, 22 were inconclusive and excluded from the study. The remaining 105 were categorized into 73 (69.5) malignant lesions and 32 (30.5) benign lesions. FNA and CNB findings were in complete agreement in 63 cases (60). The accuracy and confidence intervals (CIs) of FNA and CNB for malignant tumors were 86.3 (CI: 79.3-90.7) and 93.2 (CI: 87.3-96.0) respectively. For epithelial malignant neoplasms, a definitive diagnosis was made in 44.8 of cases by FNA and 80.6 by CNB. The diagnostic accuracy of CNB for nonepithelial malignant neoplasms was 83.3 compared with 50 for FNA. Of the 32 benign cases, we made specific diagnoses in 16 with diagnostic accuracy of 81.3 and 6.3 for CNB and FNA, respectively. Conclusions: Our findings suggest that FNA is comparable to CNB in the diagnosis of malignant epithelial lesions whereas diagnostic accuracy of CNB for nonepithlial malignant neoplasms is superior to that for FNA. Further, for histological typing of tumors and examining tumor origin, immunohistochemical work up plays an important role

Insulin adherence in patients with diabetes: Risk factors for injection omission

Aims The purpose of this study was to evaluate adherence to insulin therapy in patients with diabetes. The underlying factors affecting insulin injection omission among patients with type 1 or 2 diabetes were also investigated. Methods This cross-sectional study has been conducted on 507 patients with diabetes. Adherence to insulin therapy was measured by the 8-Item Moriskey Medication Adherence Scale (MMS) and the autocompliance method. Furthermore, socio-demographic, disease and injection-related barriers to insulin injection were assessed. Results Based on the Morisky Green test, 14.3 and 28.8 of patients with type 1 and 2 diabetes respectively had low adherence to insulin therapy. However, almost all patients were adherent according to the autocompliance method. Different factors showed a significant association with insulin compliance in both groups. Conclusions The current study suggests acceptable adherence to insulin therapy among patients with type 1, and poor adherence in patients with type 2, diabetes. Our findings regarding barriers with significant effect on insulin adherence may be useful to identify patients at risk for low compliance, and to guide the design of proper strategies to improve adherence and the consequential clinical outcomes. © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved

¿Procesamiento de proteínas en Plasmodium falciparum?

human and animal malaria, are characterized by an extreme high A+T content and an associated abundant low complexity inserts within their proteins. The enzyme glucose-6-phosphate dehydrogenase-6-phosphogluconolactonase (G6PD- 6PGL) found in Plasmodium species has unique structural and bifunctional characteristics. Here, we report the expression analysis of P. faciparum G6PD- 6PGL along the intraerythrocytic cycle by immunological analysis with antibodies raised against its N- and C- terminal domains. The pattern modification of band sizes at the different stages of parasite development suggest intracellular protein processing involving the cleavage of the native bifunctional form to produce two main fragments. In vitro RNA-mediated PfG6PD-6PGL gene silencing, studied along short-term parasite development also revealed the apparent intracellular protein modification dependent on the parasite stage. Fragment sizes were consistent with separating both catalytic functions of the enzyme. The proteolytic machinery underlying this specific PfG6PD-6PGL proccesing is still unknown in P. falciparum but suggests the existence of distinctive mechanisms in the parasite to deal with unique protein structures of essential function resulting from its genome evolution.Los genomas de los organismos del género Plasmodium, agente causante de la malaria humana y animal, se caracterizan por un alto contenido en A+T e inserciones de baja complejidad en sus proteínas. La enzima glucosa-6-fosfato deshidrogenasa- 6-fosfogluconolactonasa (G6PD-6PGL) de las especies de Plasmodium posee unas características estructurales y bifuncionales únicas. En el presente trabajo analizamos la expresión de la G6PD-6PGL de P. faciparum a lo largo del ciclo intraeritrocítico mediante análisis inmunológico con anticuerpos frente a sus dominios N- y C- terminal. La modificación del tamaño del patrón de bandas en los diferentes estadios del desarrollo del parásito sugiere un procesamiento intracelular de la proteína que implicaría que la forma nativa bifuncional genera dos fragmentos principales. El silenciamiento in vitro del gen PfG6PD-6PGL, mediante ARN de interferencia, durante el desarrollo a corto plazo del parásito, también reveló la aparente modificación intracelular de la proteína dependiente del estadio de su ciclo vital. El tamaño de los fragmentos fue consistente con la separación de las dos funciones catalíticas de la enzima. Aunque en P. falciparum no se ha identificado la maquinaria proteolítica de este procesamiento específico de PfG6PD- 6PGL, nuestros resultados sugieren la existencia de mecanismos especializados para el procesamiento intracelular de este tipo de proteínas de estructura única y de función esencial, y que han podido aparecer como consecuencia de la particular evolución de su genoma

Evaluation of antibacterial and antifungal activity of root and root callus extracts of Trianthema decandra L.

Trianthema decandra L. root and root callus extracts of different solvents viz.,petroleum ether, chloroform, ethyl acetate and ethanol were tested against both Gram positive and Gram negative bacteria and also against Fusarium spp. Root callus extract of chloroform and ethanol showed significant activity against Bacillus subtilis, B. cereus. Staphylococcus aureus, Staph. epidermis and also against the other spp. of Gram negative bacteria viz., Pseudomonas aeruginosa, Klebseilla pneumonia, Alcaligens faecalis, Proteus vulgaris Enterobacter aerogenes,Salmonella typhi, Salmonella tyhimurium, Salmonella paratyphi A and Salmonella enterica subsp. enterica with a MIC of 3.12 to 12.50 μg/ml when compared to root extract of chloroform, ethyl acetate and ethanol of Trianthema decandra. Root callus extract of chloroform, ethyl acetate and ethanol showed activity against Fusarium verticilliodes, F. anthophilum, F. oxysporum and F. proliferatum with a lowest MIC of 3.12 μg/ml when compared to root extract of Trianthema decandra. The result showsthat antibacterial and antifungal activity was more in root callus extract than root extract