A hint for the obesity paradox and the link between obesity, perirenal adipose tissue and Renal Cell Carcinoma progression

Increasing evidence supports a role for local fat depots in cancer outcomes. Despite the robust positive association of obesity with renal cell carcinoma (RCCa) diagnosis, increased adiposity is inversely related to RCCa oncological outcomes. Here, we sought to ascertain whether imagiologically assessed local fat depots associate with RCCa progression and survival and account for this apparent paradox. A retrospective cohort of renal carcinoma patients elective for nephrectomy (n = 137) were included. Beyond baseline clinicopathological characteristics, computed tomography (CT)-scans at the level of renal hilum evaluated areas and densities of different adipose tissue depots (perirenal, subcutaneous, visceral) and skeletal muscle (erector spinae, psoas and quadratus lumborum muscles) were analyzed. Univariate and multivariable Cox proportional hazards models were estimated following empirical analysis using stepwise Cox regression. Age, visceral adipose tissue (VAT) area and body mass index (BMI) predicted tumour-sided perirenal fat area (R-2 = 0.584), which presented upregulated UCP1 expression by 27-fold (P = 0.026) and smaller adipocyte areas, compared with subcutaneous depot. Multivariate analyses revealed that increased area of perirenal adipose tissue (PRAT) on the contralateral and tumour side associate with improved progression-free survival (HR = 0.3, 95CI = 0.1-0.8, P = 0.019) and overall survival (HR = 0.3, 95CI = 0.1-0.7, P = 0.009). PRAT measurements using CT, might become a possible tool, well correlated with other measures of obesity such as VAT and BMI, that will improve determination of obesity and contribute to assess the risk for disease progression and mortality in renal cancer patients. Present data supports the obesity paradox in RCCa, assumed that larger PRAT areas seem to protect from disease progression and death

Cervical, Anal and Oral HPV in an Adolescent Inner-City Health Clinic Providing Free Vaccinations

Published human papillomavirus (HPV) vaccine trials indicate efficacy is strongest for those naive to the vaccine-types. However, few high-risk young women have been followed and cervical HPV has been the predominant outcome measure.We collected cervical and anal swabs, as well as oral rinse specimens from 645 sexually active inner-city young females attending a large adolescent health-clinic in New York City that offers free care and HPV vaccination. Specimens were tested for HPV-DNA using a MY09/MY11-PCR system. Type-specific prevalence of HPV at each anatomic site was compared for individuals by vaccination dose using generalized estimating equation logistic regression models.The majority of subjects reported being of non-Caucasian (92%) and/or Hispanic ethnicity (61%). Median age was 18 years (range:14-20). All had practiced vaginal sex, a third (33%) practiced anal sex, and most (77%) had also engaged in oral sex. At enrollment, 21% had not received the vaccine and 51% had received three doses. Prevalent HPV infection at enrollment was detected in 54% of cervical, 42% of anal and 20% of oral specimens, with vaccine types present in 7%, 6% and 1% of specimens, respectively. Comparing prevalence for vaccine types, the detection of HPV in the cervix of vaccinated compared to unvaccinated adolescents was significantly reduced: HPV6/11 (odds ratio [OR] = 0.19, 95%CI:0.06-0.75), HPV16 (OR = 0.31, 95%CI:0.11-0.88) and HPV18 (OR = 0.14, 95%CI:0.03-0.75). For anal HPV, the risk of detecting vaccine types HPV6/11 (OR = 0.27, 95%CI:0.10-0.72) and HPV18(OR = 0.12, 95%CI:0.01-1.16) were significantly reduced for vaccinated adolescents however, the risk for HPV16 was not significantly decreased (OR = 0.63, 95%CI:0.18-2.20).HPV Prevalence is extremely high in inner-city female adolescents. Administration of the HPV vaccine reduced the risk for cervical HPV; however continued follow-up is required to assess the protection for HPV at all sites in young women with high exposure

INTERPRETANDO O LÍQUOR – COMO DADOS EPIDEMIOLÓGICOS PODEM AJUDAR NO RACIOCÍNIO CLÍNICO

Introdução: A meningite bacteriana sofreu grandes mudanças epidemiológicas após a introdução dos antibióticos e vacinas, passando de uma condição letal para tratável e prevenível. Compreender essas mudanças no perfil epidemiológico em nível local permitem planejar estratégias de terapia empírica. As alterações de líquor possuem papel fundamental nessa avaliação. Metodologia: Foi realizado um estudo transversal dos casos notificados de meningite entre janeiro de 2010 e junho de 2015 no Complexo Hospital de Clínicas – Universidade Federal do Paraná. Foram analisados a celularidade e citologia do líquor e os agentes etiológicos. Para as etiologias bacterianas, foi avaliado dados epidemiológicos. Resultados: Foram notificados 504 casos de meningite no período avaliado. A meningite asséptica foi a classificação epidemiológica mais comum. As meningites bacterianas com confirmação etiológica causadas por Neisseria meningitidis, Streptococcus pneumoniae ou Haemophilus influenzae ocorreram em 8,7% dos casos notificados, sendo que 30% delas ocorreram em menores de 1 ano. A N. meningitidis correspondeu a 61% desses casos, enquanto que S. pneumoniae a 34%. As meningites neutrofílicas com mais de 75% de neutrófilos são causadas por tais bactérias em mais da metade (53%). A meningite asséptica é a segunda principal etiologia (20%) seguida de perto pela meningite tuberculosa (17%). Os casos de meningite meningocócica se concentram em crianças até 1 ano (56% dos casos), a meningite pneumocócica se concentra nos adultos entre 18 e 50 anos (46%) e idosos (27%). Conclusões: O conhecimento da epidemiologia local através da interpretação do líquor, somada à avaliação da faixa etária são importantes aliados da avaliação clínica para determinação do agente etiológico mais provável e podem ajudar na decisão terapêutica

Integrated sensory motor system in prematurely born children

Objetivo: Investigar a existência de sistema sensório motor integrado em recém-nascidos (RNs) prematuros submetidos à estimulação gustativa. Métodos: Estudo experimental analítico e duplo-cego. Participaram 90 RNs prematuros, divididos em dois grupos (água e sacarose para análise (PA) 12%), filmados durante 15 minutos (primeiro e último momentos, sem estimulação; e segundo momento com estimulação gustativa). Três juízes independentes analisaram os comportamentos mão na boca direita e esquerda e sucção da mão direita e esquerda durante os diversos estados comportamentais, inseridos no banco de dados do Statistical Package for Social Science, sendo considerados em concordância os eventos observados por pelo menos dois deles. Empregou-se teste de correlação de Spearman com nível de significância valor de p<0,05. Resultados: Tanto ao serem considerados os grupos separadamente quanto juntos, mão na boca direita e esquerda tiveram inicialmente correlação moderada, sendo que mão na boca direita manteve-se forte no final e mão na boca esquerda finalizou com correlação moderada e forte, de acordo com cada estado comportamental. Sucção de mão direita na totalidade e em sacarose apresentou-se inicialmente com correlação forte no estado sonolento, passando para moderada ao final. No estado alerta houve inicialmente correlação fraca em ambos os estímulos, finalizando com correlação moderada em sacarose e forte em água. Sucção de mão esquerda apresentou-se inicialmente correlação moderada em alerta, finalizando com correlação fraca no grupo sacarose, o que não ocorreu na água, que iniciou e finalizou forte. Conclusão: A estimulação oral influenciou na coordenação mão-boca, independente do estímulo, evidenciando integração sensório motora precoce, mas não inferindo sobre capacidade de discriminação gustativa nos prematuros. _________________________________________________________________________________________ ABSTRACT: Purpose: To investigate about an integrated sensory motor system existence in premature newborns, submitted to gustatory stimulation. Methods: Analytical and experimental study of contents, double-blind. Being participants 90 premature newborns, divided into two groups (water or sucrose analysis 12%). Recorded by 15 minutes (first and last moments, without stimulation; and second time with gustatory stimulation). Three independent judges analyzed the behaviors in the right hand and left hand in the mouth and suction in the left and right and hand during the various behavioral states, those being inserted in the database of Statistical Package for Social Science, being then considered that the events observed by at least two of them. It was made use of Spearman’s rank correlation test on a significance level by p<0.05. Results: Considering the groups both separately and together, right and left had initially moderate correlation, being right hand in the mouth remained strong at the end and left hand in the mouth finished on moderate and strong correlation, according to each behavioral state. Right hand suction in its total and sucrose showed a strong correlation initially in drowsy state, becoming moderate at the end. In alertness state there was initially a weak correlation in both stimuli ending in moderate correlation in sucrose and strong in water. Left hand suction presented initially moderate correlation on the alert state, ending in weak correlation in sucrose stimuli, which did not occur in the water that started and finished strong. Conclusion: The oral stimulation influenced the hand-mouth coordination, showing early motor sensory integration. However, there was no discrimination about the gustatory capacity on the newborns

Peripheral Immune Cell Gene Expression Predicts Survival of Patients with Non-Small Cell Lung Cancer

Prediction of cancer recurrence in patients with non-small cell lung cancer (NSCLC) currently relies on the assessment of clinical characteristics including age, tumor stage, and smoking history. A better prediction of early stage cancer patients with poorer survival and late stage patients with better survival is needed to design patient-tailored treatment protocols. We analyzed gene expression in RNA from peripheral blood mononuclear cells (PBMC) of NSCLC patients to identify signatures predictive of overall patient survival. We find that PBMC gene expression patterns from NSCLC patients, like patterns from tumors, have information predictive of patient outcomes. We identify and validate a 26 gene prognostic panel that is independent of clinical stage. Many additional prognostic genes are specific to myeloid cells and are more highly expressed in patients with shorter survival. We also observe that significant numbers of prognostic genes change expression levels in PBMC collected after tumor resection. These post-surgery gene expression profiles may provide a means to re-evaluate prognosis over time. These studies further suggest that patient outcomes are not solely determined by tumor gene expression profiles but can also be influenced by the immune response as reflected in peripheral immune cells

Designation processes and semantic substitutions used by european portuguese children in a vocabulary test

This research study focus on the designation processes and semantic substitutions of each word on the vocabulary sub-task from the language test for children – ABFW, standardized in Brazil and adapted to European Portuguese, as well as the comparison of the results obtained in the two countries, to analyze the relevance of their extensibility to the Portuguese population. Methods: The test was applied to 150 children from 5 to 6 years old, of typical development. The test consists of 9 conceptual categories. Each category consists of different words, which were always assessed in the same sequential order. Results: The sample of this study showed a lower performance only in clothes, places and food semantic categories. All the other categories have outperformed the standard. The categories of vocabulary with higher percentage in the right designation of the words were colors and shapes, animals and toys and music instruments. The categories with a higher percentage of substitution processes, from the reference results, were: food and locations. The most recurrent substitution processes were the co-hyponym, words that designate semantic attributes, valorization of the visual stimulus, hypernym and parasynonyms Conclusion: Given the homogeneity of the results of this study with the results obtained with other studies in Brazil, this test reveal potentiality as an instrument for vocabulary assessment in Portugal.Objetivo: Este estudo teve por objetivo a análise e quantificação dos processos de designação e substituição semântica apresentados na prova do vocabulário do Teste de Linguagem Infantil ABFW, padronizado no Brasil e adaptado para Português Europeu (PE), assim como a comparação dos resultados obtidos nos dois países, de forma a analisar a pertinência da sua extensibilidade à população portuguesa. Métodos: A prova foi aplicada a 150 crianças de 5 e 6 anos de idade, de desenvolvimento típico, na Região Norte de Portugal. A prova é constituída por nove categorias conceituais e cada categoria formada por diferentes vocábulos, que foram avaliados sempre pela mesma ordem sequencial. Resultados: A amostra mostrou desempenho inferior, em relação à norma, apenas nas categorias semânticas vestuário, locais e alimentos. Todas as outras categorias revelaram desempenho superior. As categorias do vocabulário que apresentaram maior percentagem de respostas corretas foram: animais, formas e cores e brinquedos e instrumentos musicais. As categorias que apresentaram percentagem superior de processos de substituição, em relação à norma, foram alimentos e locais. Os processos de substituição mais utilizados foram: substituição por co-hipônimo, vocábulos que designam atributos semânticos, valorização do estímulo visual, hiperônimos e parassinônimos. Conclusão: Dada a homogeneidade dos resultados deste estudo com os resultados obtidos em outros estudos no Brasil, esta prova revela potencialidades como instrumento de avaliação do vocabulário em Portugal.This work is funded by CIEd – Research Centre on Education, projects UID/CED/1661/2013 and UID/CED/1661/2016, Institute of Education, University of Minho, through national funds of FCT/MCTESPT.info:eu-repo/semantics/publishedVersio

Reaction rates and transport in neutron stars

Understanding signals from neutron stars requires knowledge about the transport inside the star. We review the transport properties and the underlying reaction rates of dense hadronic and quark matter in the crust and the core of neutron stars and point out open problems and future directions.Comment: 74 pages; commissioned for the book "Physics and Astrophysics of Neutron Stars", NewCompStar COST Action MP1304; version 3: minor changes, references updated, overview graphic added in the introduction, improvements in Sec IV.A.