CRISPR-Cas and its wide-ranging applications: from human genome editing to environmental implications, technical limitations, hazards and bioethical issues

The CRISPR-Cas system is a powerful tool for in vivo editing the genome of most organisms, including man. During the years this technique has been applied in several fields, such as agriculture for crop upgrade and breeding including the creation of allergy-free foods, for eradicating pests, for the improvement of animal breeds, in the industry of bio-fuels and it can even be used as a basis for a cell-based recording apparatus. Possible applications in human health include the making of new medicines through the creation of genetically modified organisms, the treatment of viral infections, the control of pathogens, applications in clinical diagnostics and the cure of human genetic diseases, either caused by somatic (e.g., cancer) or inherited (mendelian disorders) mutations. One of the most divisive, possible uses of this system is the modification of human embryos, for the purpose of preventing or curing a human being before birth. However, the technology in this field is evolving faster than regulations and several concerns are raised by its enormous yet controversial potential. In this scenario, appropriate laws need to be issued and ethical guidelines must be developed, in order to properly assess advantages as well as risks of this approach. In this review, we summarize the potential of these genome editing techniques and their applications in human embryo treatment. We will analyze CRISPR-Cas limitations and the possible genome damage caused in the treated embryo. Finally, we will discuss how all this impacts the law, ethics and common sense

Incidental ameloblastoma diagnosed after treatment for childhood tumor

Abstract Ameloblastoma is a rare odontogenic neoplasm accounting for 1% of all tumors of the jaws. It is rarely diagnosed in pediatric and adolescent age. Cancer treatment is a well-known risk factor for the onset of secondary malignancies among childhood cancer survivors, but any link between ameloblastoma and prior cancer treatments has yet to be explored. Here we report on two cases of ameloblastoma diagnosed in patients previously treated for tumors in pediatric age

High resolution simulations of freely decaying shallow water turbulence on a rotating sphere

Results of high-resolution, long-time numerical integrations of the unforced shallow-water equations on a rotating sphere are presented. A new accurate and efficient grid point method is used for these simulations, that allows to easily reach very high spatial resolutions (up to an equivalent T680 spectral truncation). It is found that, for small values of the Rossby deformation radius LD, the final quasi-steady states of the free evolution are characterized by the formation of robust westward (retrograde) equatorial jets, whose strengths and widths depend on LD and on the rotation speed. It is also shown that the presence of a westward equatorial jet is related to the global prevalence of anticyclonic vorticity

Is Stereotactic Body Radiotherapy (SBRT) in lymph node oligometastatic patients feasible and effective?

ObjectivesTo review the available data about stereotactic body-radiotherapy (SBRT) for oligometastatic lymph node cancer recurrence.MethodsThe inclusion criteria for this study were as follows: Medline search for the (1) English language (2) full paper (abstracts were excluded) on (3) adult oligometastatic solid cancer recurrence limited to lymph node that underwent SBRT (4) outcome data available and (5) published up to the 30th April 2014.Results38 papers fulfilling the inclusion criteria have been found: 7 review articles and 31 patient series (20 and 11 retrospective and prospective studies, respectively) including between 1 and 69 patients (636 lymph nodes). Twelve articles reported only lymph node SBRT while in 19 – all types of SBRT including lymph node SBRT were presented. Two-year local control, 4-year progression free survival and overall survival was of up to 100%, 30% and 50%, respectively. The progression was mainly out-field (10–30% of patients had a recurrence in another lymph node/nodes). The toxicity was low with mainly mild acute events and single grade 3–4 late events. When compared to SBRT for any oligometastatic cancer, SBRT for lymph node recurrence carried better prognosis and showed lower toxicity.ConclusionsSBRT is a feasible approach for oligometastatic lymph node recurrence, offering excellent in-field tumor control with low toxicity profile. The potential abscopal effect has been hypothesized as a basis of these findings. Future studies are warranted to identify the patients that benefit most from this treatment. The optimal combination with systemic treatment should also be defined

Resultados de la investigación evaluativa de un curso a distancia de genética humana para profesionales de las Ciencias de la Salud usando como material un CD-ROM

Introduction: Genetics discipline has had a fast development during last years. Recently, it has been included in undergraduate health sciences curriculum. This study looks to evaluate a distance post graduated course in human genetics comparatively using CD-ROM or printed materials. Method: the postgraduate course has been developed in two modes: one using CD-ROM and the other using printed materials. Both modes included autoevaluation, heteroevaluation, tutorials, course evaluation (administration and materials) and a final exam. Litoral University Biochemistry School granted certifications. Results: final exams average scores have been 83,9% en CD-ROM mode and 82,2% for the other group. Conclusion: no significant differences have been identified. Both modes have shown to be effective. Postgraduate students have learnt with good scores in both systems an shown satisfied with distance system in both modes.Introducción: La Genética ha sido la disciplina de evolución más rápida en los últimos años. En forma relativamente reciente se ha incorporado a la curricula de grado de las profesiones del área de la salud. La presente investigación busca evaluar el dictado de un curso de actualización y perfeccionamiento a distancia sobre Genética Humana usando como material didáctico el CD-ROM. Material y método: el curso fue dictado, en forma paralela a dos grupos de graduados; para uno de los grupos el material utilizado fue un CDROM y para el otro módulos impresos. Ambas modalidades incluían autoevaluaciones, heteroevaluaciones, tutorías y consultas, encuestas el curso en general (administración y materiales) y un examen final cuyo certificado fue otorgado por la Facultad de Bioquímica y Cs. Biológicas de la UNL. Resultados: los puntajes promedio obtenidos en el examen final fueron de 83,9 % en los alumnos que utilizaron CD-ROM y para el otro grupo alcanza el 82,2 %. Conclusiones: Se verifica que el sistema es idóneo para la enseñanza sin notarse ventaja a favor de una de las modalidades. En cualquiera de las formas han aprendido, lo han hecho con rendimientos muy favorables y se muestran conformes con el sistema a distancia en ambas modalidades

Comportamento de estridulação em Heilipus odoratus Vanin & Gaiger (Coleoptera, Curculionidae, Molytinae)

Heilipus odoratus Vanin & Gaiger, 2005 (Coleoptera, Curculionidae, Molytinae) is considered the main plague of rosewood fruit. Being recently described, the biological aspects of this species are not very well known. This study aimed at contributing for the knowledge of this species' behavior and providing a method for sexing adults based on stridulation. Individuals were divided into two groups: stridulating and non-stridulating. After dissection, stridulation was associated with the sex of each individual. Most males (92.2 %, N= 115) emitted sound by stridulation due to the presence of stridulatory organs on the posterior internal surface of their elytra and penultimate tergite, while none of the females (N=92) have such organs. This result is the first report of stridulatory activity in H. odoratus

Prevalence of frailty in surgical older patients and its impact on assisted discharge

Background & aim. An increasing number of older persons is today undergoing emergency and elective surgical procedures. Frailty is a highly prevalent condition and a predictor of postoperative adverse outcomes. This study is aimed at measuring the prevalence of frailty among older persons awaiting for surgical procedures, and the activation of services supporting protected discharge from the hospital in individuals with high vulnerability to stressors. Methods. A prospective observational study was conducted in patients aged 65 years and older waiting for surgery. Frailty was measured using the criteria proposed by Robinson and colleagues. Length of stay and care services activated at the discharge recorded. Results. A total of 1,144 patients were recruited. Two-hundred and seventeen (19%) patients were defined as frail, and 395 (34.5%) were pre-frail. The average length of post-operative stay was 5 days. Only 39 (3.4%) patients received care plan assuring a protected discharge. Among these, 35 (89.7%) were frail, 4 (10.3%) pre-frail. The variable most strongly correlated with the activation of services supporting an assisted discharge was the dependence in activities of daily living (ρ = 0.27, p < 0.001). Conclusions. Frailty is a highly prevalent condition among persons undergoing emergency and elected surgery procedures. Nevertheless, services supporting assisted discharge on the territory are quite infrequently activated. An improved integration of care services bridging hospital and community is necessary and therefore a lack of continuity of health and social care. Further research should focus on the postoperative management of the frail elderly patient

Perfil e fatores associados ao câncer de próstata em Criciúma – Santa Catarina, Brasil

Background: Prostate cancer is the second most incident of the male population in Brazil. The aim of this study is to analyze the frequency of risk factors associated to the evolution of the prostate cancer and the impact of conducting examinations in the age range (55-69 years old), in assisting health professionals to manage and prevent the disease. Methods: A case-control study was performed on patients from 2011 to 2016 in Criciúma – SC, Brazil. The sample was divided into two groups, one with biopsy for prostate adenocarcinoma (case; n = 124) and the other with a negative biopsy (control; n = 251). The following variables were compared between the two groups: age, family history of prostate cancer, prostate specific antigen, and altered digital rectal examination. Results: In the case group, ranging between 55-69 years old, there was a significant higher of altered digital rectal examination (p &lt; 0.001, odds ratio 15.5 and positive predictive value 91.3%), prostate-specific antigen ≥ 4 ng/mL (p &lt; 0.001, odds ratio 7.02 and positive predictive value 56.2%) and when both exams were altered (p &lt; 0.001, odds ratio was 19.63 and the positive predictive value was 90.5%). Conclusion: This findings show that, mainly between 55-69 years old, there is a significant correlation between positive biopsy, altered digital rectal examination, and PSA ≥ 4 ng/mL.Objetivo: O câncer de próstata é o segundo mais incidente na população masculina no Brasil. O objetivo do estudo é analisar a frequência dos fatores de risco associados ao desenvolvimento do câncer de próstata e o impacto da realização de exames na faixa etária de rastreamento (55-69 anos), auxiliando os profissionais de saúde no manejo e prevenção da doença. Método: Foi realizado um estudo caso-controle no período de 2011 a 2016 em Criciúma – SC, Brasil. A amostra foi dividida em dois grupos, um com biópsia de adenocarcinoma de próstata (casos; n = 124) e outro com biópsia negativa (controles; n = 251). Entre ambos os grupos, foram comparadas as variáveis: idade, história familiar de câncer de próstata, antígeno prostático específico e toque retal alterado. Resultados: No grupo dos casos, na faixa etária entre 55-69 anos, ocorreu maior significância de toque retal alterado (p &lt; 0,001; odds ratio 15.5 e valor preditivo positivo 91,3%), antígeno prostático específico ≥ 4 ng/mL (p &lt; 0,001; odds ratio 7.02 e valor preditivo positivo 56,2%) e quando os dois exames estavam alterados (p &lt; 0,001; odds ratio 19.63 e valor preditivo positivo 90,5%). Conclusão: Há evidências, principalmente entre 55-69 anos, de maior correlação de biópsia positiva, toque retal alterado e PSA ≥ 4 ng/mL

Implementation of a routine outcome monitoring and feedback system for psychotherapy in Argentina: A pilot study.

INTRODUCTION Routine Outcome Monitoring (ROM) has emerged as a strong candidate to improve psychotherapy processes and outcome. However, its use and implementation are greatly understudied in Latin-America. Therefore, the aim of the present pilot study conducted in Argentina was to implement a ROM and feedback system grounded on a psychometrically sound instrument to measure session by session outcome in psychotherapy. METHODS The sample consisted of 40 patients and 13 therapists. At baseline, the patients completed the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7, and they also completed the Hopkins Symptom Checklist-11 before each of the first five sessions. To estimate patient change during the first sessions, we conducted a quantitative analysis using Hierarchical Linear Models. Furthermore, we conducted a qualitative analysis using Consensual Qualitative Research to analyze therapist perception regarding the ROM and feedback system. RESULTS Results showed a significant reduction in patients' symptomatic severity during the first five sessions. Additionally, baseline depression significantly predicted the estimated severity at the end of the fifth session. Feedback was given to the therapists after the first four sessions based on these analyses. With regard to the perception of the feedback system, clinicians underlined its usefulness and user-friendly nature. They also mentioned that there was a match between the information provided and their clinical judgment. Furthermore, they provided suggestions to enhance the system that was incorporated in a new and improved version. DISCUSSION Limitations and clinical implications are discussed