Acute promyelocytic leukemia associated with the PLZF-RARA fusion gene: two additional cases with clinical and laboratorial peculiar presentations

Acute promyelocytic leukemia (APL) is characterized by the presence of the t(15;17) and PML-RARa rearrangement, with good response to treatment with retinoids. However, few cases of variant APL involving alternative chromosomal aberrations have been reported, including t(11;17)(q23;q21) (Wells et al. in Nat Genet 17:109-113, 1; Arnould et al. in Hum Mol Genet 8:1741-1749, 2) t(5;17)(q35;q12-21), t(11;17)(q13;q21) (Grimwade et al in Blood 96:1297-1308, 3) and der(17) (Rego et al. in Blood (ASH Annual Meeting Abstracts)114:Abstract 6, 4), whereby RARa is fused to the PLZF, NPM, NuMA, and STAT5b genes, respectively, have been described. These cases are characterized by distinct morphology, clinical presentation, and in respect to PLZF, a lack of differentiation response to retinoids leading to the need of different approaches concerning diagnostic methods and therapeutics. This paper describes two cases of APL associated with the PLZF-RARA fusion gene enrolled in the IC-APL trial that is a non-randomized, multicenter study conducted in Brazil, Mexico, Chile and Uruguay with the aim to improve the treatment outcome of APL patients in developing countries. These cases, although rare, offer a challenge to its early recognition and proper conduction.Universidade Federal de São Paulo, Disciplina Hematol & Hemoterapia, UNIFESP, Escola Paulista Med, BR-04023900 São Paulo, BrazilUniv São Paulo, Fac Med Ribeirao Preto, Dept Hematol, Ribeirao Preto, BrazilUniversidade Federal de São Paulo, Disciplina Hematol & Hemoterapia, UNIFESP, Escola Paulista Med, BR-04023900 São Paulo, BrazilWeb of Scienc

Differences in the mutation of the p53 gene in exons 6 and 7 in cervical samples from HIV- and HPV-infected women

BACKGROUND: Human Papillomavirus (HPV) infection is a serious problem for human immunodeficiency virus (HIV)-infected women, increases their risk of cervical lesions and cancer. In cervical carcinogenesis, mutations in the p53 gene occur most frequently within exons 5–8. To our knowledge, no previous studies have analyzed mutations in exons 5–8 of the p53 gene in HIV- and HPV-infected women. In our study, we verified these mutations in women with and without cervical abnormalities. FINDINGS: The study included 160 women, divided into three groups: (1) 83 HPV- and HIV-infected women (HIV group); (2) 37 HPV-infected/HIV-uninfected (control group); and (3) 40 normal cytology/DNA-HPV negative/HIV-uninfected women (negative control p53 reactions). HPV-DNA was detected using polymerase chain reaction (PCR) and genotyping by PCR-restriction fragment length polymorphism analysis. Using primers for exons 5–8, the mutation of the p53 gene was verified by PCR-single strand conformational polymorphism. The total mutation of the p53 gene in exons 5–8 was not significantly associated with the HIV and control groups. The mutations in exon 7 were the highest in the HIV group (43.8%) and in exon 6 in the control group (57.2%) (p = 0.0793) suggesting a tendency toward differential mutation in exon 7 in the HIV group. CONCLUSIONS: Our study provides preliminary evidence that the mutation in exon 7 might be an important differentiating factor for cervical carcinogenesis in HIV-infected women. This aspect deserves an additional cross-sectional and longitudinal study using a larger sample size with a higher number of High-grade squamous intraephitelial lesion (HSIL) to observe the evolution of cervical lesions

Expectativas dos alunos de enfermagem frente ao primeiro estágio em hospital Nursing students expectations regarding their inicial hospital training

A primeira vivência em estágio hospitalar pode gerar tensões e ansiedades. Esses sentimentos interferem negativamente no processo ensino - aprendizagem. O objetivo deste trabalho foi conhecer as expectativas dos alunos de Fundamentos de Enfermagens II acerca do primeiro estágio hospitalar. Foram sujeitos desta pesquisa alunos do 2º ano do Curso de Enfermagem da Universidade Estadual de Maringá - PR. Os alunos revelaram, atitudes de ansiedade quanto a procedimentos técnicos, relacionamento com o paciente e avaliação. Ao refletir sobre esses aspectos, o docente pode favorecer a eficácia do ensino e a humanização na formação.<br>The first experience in hospital training may create tensions and anxieties. These feelings interfere negatively in the teaching - learning process. The aim of this paper was to investigate the expectations of Nursing Fundamentals II students regarding their initial hospital training. Second-year students of the Nursing Course offered by Universidade Estadual de Maringá (state of Paraná, Brazil,) were chosen as subjects of this investigation. The students revealed a state of anxiety when confronting technical procedures, relationship with patients and evolution. By reflecting on these aspects instructor the may increase the teaching-learning efficiency and humanize the professional training