An extremely rare association of multiple familial trichoepitheliomas and hereditary multiple osteochondromas

info:eu-repo/semantics/publishedVersio

Predictor variables and screening protocol for depressive and anxiety disorders in cancer outpatients

Background Cancer patients are at increased risk of persistent depressive and anxiety symptoms and disorders compared to the general population. However, these issues are not always identified, which may worsen the prognosis and increase morbidity and mortality. Therefore, the objectives of this study are to identify predictor variables (demographic and clinical) for the development of mood and anxiety disorders in cancer outpatients and to propose a probabilistic screening protocol considering these variables and certain standardized screening instruments. Methods A total of 1,385 adults, of both genders, receiving outpatient cancer care were evaluated using a questionnaire and screening instruments. Thereafter, 400 of these subjects responded to the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-IV) by telephone to confirm or rule out the presence of a Current Major Depressive Episode (CMDE) or Anxiety Disorder (AD). Results Of the patients surveyed, 64% met the criteria for CMDE and 41% for AD. Female gender was found to be a risk factor for both disorders, and the presence of previous psychiatric history and marital status (divorced and widowed) were risk factors for anxiety disorders. When scoring above the recommended cutoff score, the screening instruments also indicated a risk of the studied disorders. Based on these findings, a screening protocol and nomograms were created for the quantification, combination and probabilistic estimate of risk, with accuracy indicators >0.68. Conclusion The prevalence rates for the disorders under study are extremely high in cancer patients. The use of the proposed protocol and nomogram can facilitate rapid and wide screening, thus refining triage and supporting the establishment of criteria for referral to mental health professionals, so that patients can be properly diagnosed and treated.info:eu-repo/semantics/publishedVersio

Equatorial Non-muscle Myosin II and Plastin Cooperate to Align and Compact F-actin Bundles in the Cytokinetic Ring

Cytokinesis is the last step of cell division that physically partitions the mother cell into two daughter cells. Cytokinesis requires the assembly and constriction of a contractile ring, a circumferential array of filamentous actin (F-actin), non-muscle myosin II motors (myosin), and actin-binding proteins that forms at the cell equator. Cytokinesis is accompanied by long-range cortical flows from regions of relaxation toward regions of compression. In the C. elegans one-cell embryo, it has been suggested that anterior-directed cortical flows are the main driver of contractile ring assembly. Here, we use embryos co-expressing motor-dead and wild-type myosin to show that cortical flows can be severely reduced without major effects on contractile ring assembly and timely completion of cytokinesis. Fluorescence recovery after photobleaching in the ingressing furrow reveals that myosin recruitment kinetics are also unaffected by the absence of cortical flows. We find that myosin cooperates with the F-actin crosslinker plastin to align and compact F-actin bundles at the cell equator, and that this cross-talk is essential for cytokinesis. Our results thus argue against the idea that cortical flows are a major determinant of contractile ring assembly. Instead, we propose that contractile ring assembly requires localized concerted action of motor-competent myosin and plastin at the cell equator.The research leading to these results was funded by the European Research Council under the European Union’s Horizon 2020 Research and Innovation Programme (grant agreement 640553 – ACTOMYO). AXC and RG hold Principal Investigator positions from the Portuguese Foundation for Science and Technology (FCT) (CEECIND/01967/2017 and CEECIND/00333/2017, respectively). F-YC and AMS hold FCT junior researcher positions (DL 57/2016/CP1355/CT0013 and DL 57/2016/CP1355/CT0017, respectively). AFS holds an FCT Ph.D. scholarship (SFRH/BD/121874/2016). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Validação e reprodutibilidade de sinais clínicos no diagnóstico de anemia em crianças Validity and reproductibility of the clinical signs for the diagnosis of anemia in children

Este trabalho teve como objetivo avaliar a validade e reprodutibilidade dos sinais clínicos (palidez palmar e conjuntival) no diagnóstico de anemia em crianças de 6-23 meses, no Nordeste do Brasil, por meio de estudo transversal com amostra de 421 crianças, realizado nos ambulatórios de pediatria e puericultura do Instituto Materno Infantil de Pernambuco. Os sinais clínicos foram avaliados por dois examinadores. A reprodutibilidade foi avaliada pelo coeficiente de kappa e a validação (sensibilidade e especificidade) foi realizada utilizando-se a hemoglobina como padrão. Os sinais clínicos demonstraram baixa reprodutibilidade (kappa de 0,24-0,25). A maior sensibilidade para diagnosticar anemia (Hb < 11g/dl) e anemia moderada/ grave (Hb < 9g/dl), respectivamente, foi apresentada pela combinação de palidez palmar ou conjuntival (39,7% e 53,5%), seguida pela palidez palmar isoladamente (29,9% e 40,0%). A maior especificidade foi para a palidez palmar comparada à palma da mão da mãe (95,5% e 90,1% para Hb < 11g/dl e Hb < 9g/dl, respectivamente). A sensibilidade dos sinais clínicos foi melhor para diagnosticar a anemia moderada/grave, especialmente quando a palidez palmar e conjuntival são combinadas, sugerindo que a utilização dos mesmos não se constitui em um bom instrumento para diagnosticar anemia leve.<br>This study aimed to assess the validity and reproducibility of clinical signs (palmar and conjunctival pallor) in the diagnosis of anemia in children 6-23 months of age in Northeast Brazil. This was a cross-sectional study with a sample of 421 children in the child care and pediatric outpatient wards at the Mother and Child Care Institute of Pernambuco. Two examiners evaluated clinical signs using the Kappa coefficient, and validation (sensitivity and specificity) was performed using hemoglobin as the standard. Clinical signs demonstrated low reproducibility (kappa 0.24-0.25). The highest sensitivity for diagnosing anemia (Hb < 11g/dl) and moderate/ severe anemia (Hb < 9g/dl), respectively, was provided by combining palmar and conjuntival pallor (39.7% and 53.5%), followed by palmar pallor alone (29.9% and 40.0%). The highest specificity was provided by palmar pallor in the child as compared to the mother (95.5% and 90.1%, Hb < 11g/dl and Hb < 9g/dl, respectively). Sensitivity of clinical signs was better in diagnosing moderate/severe anemia, especially when combining palmar and conjunctival pallor, suggesting that their utilization does not provide a good instrument for diagnosing mild anemia