GALAD outperforms aMAP and ALBI for predicting HCC in patients with compensated advanced chronic liver disease: A 12-year prospective study

Background and aims: Surveillance programs are strongly recommended in patients with liver cirrhosis for early detection of HCC development. Six-monthly ultrasound sonography is the most reliable and commonly used technique, especially when associated with serum determination of α-fetoprotein, but different score systems have been proposed to overcome the unsatisfactory diagnostic accuracy of α-fetoprotein. The aim of this 12-year prospective study is to compare the gender, age, AFP-L3, AFP, des-gamma-carboxy prothrombin (GALAD) versus age, gender, bilirubin, albumin, and platelets and albumin-bilirubin scores in predicting HCC onset. Approach and results: A cohort of 545 consecutive patients with compensated advanced chronic liver disease without suspected focal lesions was followed up every 6 months by liver imaging and α-fetoprotein to detect HCC occurrence. Harrell's C-index for censored data was employed to evaluate the performance of any parameters or scores helping to predict HCC development. ROC curve analysis showed that the GALAD score was more accurate in evaluating HCC development than albumin-bilirubin and age, gender, bilirubin, albumin, and platelets. The AUC ranged from 0.7268 to 0.6851 at 5 and 10 years, both in the total cohort and in the sub-cohorts (viral hepatitis, NASH, and alcohol). The HCC Risk model was constructed using univariate and multivariate Cox proportional hazard regression analysis, showing a strong association of GALAD with HR > 1, p < 0.05, in the total and sub-cohorts, and a better risk prediction in the alcohol cohort, both alone and standardized with other blood parameters. Conclusions: GALAD is the most reliable and accurate score system to detect HCC risk of development in patients with compensated advanced chronic liver disease

Engineering auxetic cylinders and intestine to improve longitudinal intestinal lengthening and tailoring procedure

Auxetic materials can be exploited for coupling different types of tissues. Herein, we designed a material where the microorganism metabolic activity yields the formation of buckled/collapsed bubbles within gelling silicone cylinders thus providing auxetic properties. The finite element model of such hollow auxetic cylinders demonstrated the tubular structure to promote worm-like peristalsis. In this scenario, the described hybrid auxetic structures may be applied to the longitudinal intestinal lengthening and tailoring procedure to promote enteral autonomy in short bowel syndrome. The presented material and analytical design synergistic approach offer a pioneering step for the clinical translation of hybrid auxetic materials

Ingeniería de tejidos: estudio de hemograma de conejos New Zealand con lesion femoral post-implante de matriz de tercera generaci{on con potencialidad osteoregenerativa

La alta tasa de fracturas a nivel mundial, ha promovido el desarrollo de matrices con la intención de ser aplicados como implantes frente a lesiones óseas, intentado promover la regeneración tisular de novo. En el laboratorio se han comenzado a desarrollar investigaciones tendientes a considerar como potenciales matrices a los recombinámeros de tipo elastina, matrices de tercera generación obtenidas por estrategias de biología molecular (ELRs de las palabras en ingles elastin-like recombinamers, que significan recombinàmeros del tipo elastina).. La propia composición de los ELRs, basada en la repetición de la elastina natural, le dota al material de una serie de propiedades que son difícilmente encontrables en otras familias de polímeros: autoensamblado y adecuadas propiedades mecánicas de sus hidrogeles, asì como la sencilla manipulación frente a su implante, ya que son líquidos en estado refrigerado y gelifican a Ta ambiente o mayor, es decir son de gelificación inversa. Hemos desarrollado previamente un modelo de lesión ósea en fémur de conejo,. Este proyecto pretende frente a este modelo y el implante de ELRs, investigar si se ven afectados o no los hemogramas de los conejos implantados, aportando resultados de lo que ocurre in vivo, contribuyendo a la caracterización de esta estrategia de ingeniería de tejidos. Modelo experimental: Conejos hembras de la línea New Zealand de tres meses de edad, .se dividieron en tres grupos I, II y III ( n= 5 c/u) . Los grupos I y II recibieron bajo anestesia lesión distal-medial del fémur de 6 mm diámetro todo bajo estrictas normas de anestesia y tratamiento del dolor, Sin embargo los animales del grupo I recibieron a su vez a posteriori de este proceso el implante de Elrs, mientras que los animales del grupo II no lo recibieron; III fue grupo control. En tiempos preimplante y a los tres meses, previo al sacrificio de los animales para la realización de otros estudios en paralelo, se extrajeron muestras de sangre en tubos heparinizados para la realización de hemogramas, previa homogenización de las muestras. Se realizaron recuento de Glóbulos rojos (GR), Glóbulos blancos (GB), Hemoglobina (Hb), Hematocrito (Hto), Volumen corpuscular medio(MCV), plaquetas. No se observaron diferencias significativas para las variables mencionadas al realizar los estudios estadísticos mediante programa computadorizado infostat UNC, tanto a nivel intergrupal (test de Kruskall wallis), ni al comparar los estados iniciales y finales del experimento para cada grupo (test de Wicolxon). Dado lo novedoso de este tipo de matrices, consideramos que este tipo de estudios aportan datos imprescindibles para realizar caracterizaciones de los procesos in vivo post-implante, y sumados a otras caracterizaciones bioquímicas, clínicas y anatomopatológicas que estamos realizando, permitirán quizás a futuro considerar potenciales estudios pre-clínicos.Fil: Garbino, Federico. Universidad Nacional de Rosario. Facultad de Ciencias Médicas. Laboratorio de Biología Osteoarticular, Ingeniería Tisular y Terapias Emergentes; ArgentinaFil: Coletta, Dante Jesus. Universidad Nacional de Rosario. Facultad de Ciencias Médicas. Laboratorio de Biología Osteoarticular, Ingeniería Tisular y Terapias Emergentes; Argentina. Universidad Nacional de Rosario. Facultad de Ciencias Médicas. Laboratorio de Biología Osteoarticular, Ingeniería Tisular y Terapias Emergentes; ArgentinaFil: Ibañez Fonseca, Arturo. No especifíca;Fil: Radice, Maria Beatriz. Universidad Nacional de Rosario. Facultad de Ciencias Médicas. Laboratorio de Biología Osteoarticular, Ingeniería Tisular y Terapias Emergentes; ArgentinaFil: Aimone, Maria Angeles. Universidad Nacional de Rosario. Facultad de Ciencias Médicas. Laboratorio de Biología Osteoarticular, Ingeniería Tisular y Terapias Emergentes; ArgentinaFil: Missana, Liliana Raquel. Universidad Nacional de Tucumán. Facultad de Odontología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Planta Piloto de Procesos Industriales Microbiológicos; ArgentinaFil: Alonso, Matilde. Universidad de Valladolid; EspañaFil: Rodriguez Cabello, J. C.. Universidad de Valladolid; EspañaFil: Feldman, Sara. Universidad Nacional de Rosario. Facultad de Ciencias Médicas. Laboratorio de Biología Osteoarticular, Ingeniería Tisular y Terapias Emergentes; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaXVIII Congreso y XXXVI Reunión Anual de la Sociedad de Biología de RosarioRosarioArgentinaSociedad de Biología de RosarioUniversidad Nacional de Rosari

HOXA1 is overexpressed in oral squamous cell carcinomas and its expression is correlated with poor prognosis

<p>Abstract</p> <p>Background</p> <p>HOX genes encode homeodomain-containing transcription factors involved in the regulation of cellular proliferation and differentiation during embryogenesis. However, members of this family demonstrated oncogenic properties in some malignancies. The present study investigated whether genes of the HOXA cluster play a role in oral cancer.</p> <p>Methods</p> <p>In order to identify differentially expressed HOXA genes, duplex RT-PCR in oral samples from healthy mucosa and squamous cell carcinoma was used. The effects of HOXA1 on proliferation, apoptosis, adhesion, invasion, epithelial-mesenchymal transition (EMT) and anchorage-independent growth were assessed in cells with up- and down-regulation of HOXA1. Immunohistochemical analysis using a tissue microarray (TMA) containing 127 oral squamous cell carcinomas (OSCC) was performed to determine the prognostic role of HOXA1 expression.</p> <p>Results</p> <p>We showed that transcripts of HOXA genes are more abundant in OSCC than in healthy oral mucosa. In particular, HOXA1, which has been described as one of the HOX members that plays an important role in tumorigenesis, was significantly more expressed in OSCCs compared to healthy oral mucosas. Further analysis demonstrated that overexpression of HOXA1 in HaCAT human epithelial cells promotes proliferation, whereas downregulation of HOXA1 in human OSCC cells (SCC9 cells) decreases it. Enforced HOXA1 expression in HaCAT cells was not capable of modulating other events related to tumorigenesis, including apoptosis, adhesion, invasion, EMT and anchorage-independent growth. A high number of HOXA1-positive cells was significantly associated with T stage, N stage, tumor differentiation and proliferative potential of the tumors, and was predictive of poor survival. In multivariate analysis, HOXA1 was an independent prognostic factor for OSCC patients (HR: 2.68; 95% CI: 1.59-2.97; p = 0.026).</p> <p>Conclusion</p> <p>Our findings indicate that HOXA1 may contribute to oral carcinogenesis by increasing tumor cell proliferation, and suggest that HOXA1 expression might be helpful as a prognostic marker for patients with OSCC.</p

A Biblioteca Digital de Teses e Dissertações da Universidade de São Paulo

Apresentação dos aspectos principais da Biblioteca Digital de Teses e Dissertações da Universidade de São Paulo (USP): o processo de desenvolvimento adotado para a implementação do site, a tecnologia utilizada, a arquitetura e a funcionalidade. Discussão sobre a Biblioteca Digital no processo de pós-graduação da USP. Relato das várias decisões não-técnicas adotadas ao longo do projeto, que tiveram grande impacto no resultado final

The effect of training in reduced energy density eating and food self-monitoring accuracy on weight loss maintenance

Background: Failure to maintain weight losses in lifestyle change programs continues to be a major problem and warrants investigation of innovative approaches to weight control.Objective: The goal of this study was to compare two novel group interventions, both aimed at improving weight loss maintenance, with a control group.Methods and Procedures: A total of 103 women lost weight on a meal replacement&ndash;supplemented diet and were then randomized to one of three conditions for the 14-week maintenance phase: cognitive-behavioral treatment (CBT); CBT with an enhanced food monitoring accuracy (EFMA) program; or these two interventions plus a reduced energy density eating (REDE) program. Assessments were conducted periodically through an 18-month postintervention. Outcome measures included weight and self-reported dietary intake. Data were analyzed using completers only as well as baseline-carried-forward imputation.Results: Participants lost an average of 7.6 plusminus 2.6 kg during the weight loss phase and 1.8 plusminus 2.3 kg during the maintenance phase. Results do not suggest that the EFMA intervention was successful in improving food monitoring accuracy. The REDE group decreased the energy density (ED) of their diets more so than the other two groups. However, neither the REDE nor the EFMA condition showed any advantage in weight loss maintenance. All groups regained weight between 6- and 18-month follow-ups.Discussion: Although no incremental weight maintenance benefit was observed in the EFMA or EFMA + REDE groups, the improvement in the ED of the REDE group\u27s diet, if shown to be sustainable in future studies, could have weight maintenance benefits.<br /

Pleomorphic adenoma with extensive squamous metaplasia and keratin cyst formations in minor salivary gland: a case report

Pleomorphic adenoma (PA), the most common salivary gland tumor, accounts for 54 to 65% of all salivary gland neoplasias and 80% of the benign salivary gland tumors. It most frequently affects the parotid gland, followed by the submandibular and the minor salivary glands. Microscopically, mucous, sebaceous, oncocytic and squamous metaplasia, sometimes with the formation of keratin pearls, may be present, but the latter rarely results in the formation of extensive keratin-flled cysts lined by squamous epithelium. Extensive squamous metaplasia can be mistaken for malignancy, including mucoepidermoid carcinoma and squamous cell carcinoma. Here, we present an unusual case of PA with extensive squamous metaplasia and keratin cyst formations in a minor salivary gland, and discuss its microscopic features, including the immunohistochemical characteristics, and differential diagnosis of this uncommon presentation

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London