EGFR-Mutationsanalyse beim nichtkleinzelligen Lungenkarzinom: Erfahrungen aus der Routinediagnostik

Zusammenfassung: Hintergrund: Einige Patienten mit einem nichtkleinzelligem Lungenkarzinom (NSCLC) sprechen hervorragend auf Tyrosinkinase-Hemmer (TKI) an. Eine somatische Mutation im epidermalen Wachstumsfaktor-Rezeptor (EGFR) gilt dabei als wichtiger prädikativer Faktor. Patienten und Methode: Wir untersuchten 307 NCSLC auf EGFR-Mutationen (Exone 18-21) und überprüften deren Assoziation mit klinisch-pathologischen Parametern. Ergebnisse: Unter 178 histologischen und 129 zytologischen Tumorproben fanden sich 25 (8,1%) relevante EGFR-Mutationen. Am häufigsten waren Deletionen in Exon19 (50%), gefolgt von der Punktmutation L858R in Exon21 (12,5%). EGFR-Mutationen waren bei Frauen im Vergleich zu Männern (16,8% vs. 2,7%; p<0,001) und in Adenokarzinomen im Vergleich zu den übrigen Karzinomen (11,4% vs. 3,8%; p=0,017) gehäuft. Mutierte NSCLC waren zu 96% TTF-1-positiv. Schlussfolgerung: Therapierelevante EGFR-Mutationen kommen in <10% der mitteleuropäischen NSCLC-Patienten vor und sind gehäuft bei Frauen und TTF-1-positiven Adenokarzinomen. Histologische und zytologische Proben aus der Routinediagnostik sind in gleichem Maße für eine Mutationsanalyse geeigne

Estimation of the Variance Components of the Sow Litter Size Traits Using Reml Method - Repeatability Model

Variance components for sow litter size traits were estimated using the REML method. Number of live born piglets (NBA), number of still born piglets (NSB), number of total born piglets (NTB) and number of weaned piglets (NW) were treated as traits which repeated several times during sow lifetime - repeatability model. Results of the fertility of Swedish Landrace sows realized on three pig farms in the Republic of Serbia were presented in four data sets DS1 (farm 1), DS2 (farm 2), DS3 (farm 3) and DS23 (farms 2 and 3 together). Fixed part of the model for litter size traits at farrowing (NBA, NSB and NTB) included parity, mating season as year-month interaction, litter genotype and weaning to conception interval as class effects. The age at farrowing was modelled as a quadratic regression nested within parity, whereas preceding lactation length was included as linear regression. In case of NW the model included parity, weaning season as year-month interaction, number of piglets in litter subsequent to crossfostering and litter genotype as class effects. The age at farrowing was included into the model in the same way as in case of previous traits. Random part of the model was the same for all analysed traits and represented as effect of common environment in litter where sows had been born, permanent effect of environment in sows’ litters and direct additive genetic effect. Heritability of NBA varied between 0.050 (DS2) and 0.076 (DS3), NSB between 0.004 (DS3) and 0.027 (DS2), NTB between 0.065 (DS2) and 0.073 (DS3) and of NW between 0.010 (DS2) and 0.028 (DS1). Share of permanent environment of sow in phenotypic variance was higher than share of litter effect and mostly lower than share of direct genetic effect

Retrospective case note review of chronic spontaneous urticaria outcomes and adverse effects in patients treated with omalizumab or ciclosporin in UK secondary care.

BACKGROUND: Omalizumab is approved in the UK as add-on treatment for chronic spontaneous urticaria (CSU) in patients with inadequate response to H1-antihistamines. Ciclosporin is an established but unlicensed 3rd line option for CSU. Two parallel retrospective observational studies were conducted to describe outcomes of treatment and adverse events with omalizumab or ciclosporin for CSU treatment. METHODS: Data from UK specialist centres prescribing omalizumab (five centres) or ciclosporin (three centres) in CSU patients were collected from hospital records by clinical staff and pooled for analysis. RESULTS: Forty-six patients prescribed omalizumab and 72 patients prescribed ciclosporin were included. Twenty-two (48%) omalizumab-treated patients had paired Urticaria Activity Scores (UAS7), showing a 25.4 point improvement during treatment (P < 0.0001). Paired Dermatology Life Quality Index (DLQI) was available in 28 (61%) omalizumab-treated and 17 (24%) ciclosporin-treated patients. At least a 75% improvement in DLQI score was observed in 79% of omalizumab-treated and 41% of ciclosporin-treated patients, and 65% of omalizumab-treated patients had complete resolution of their quality-of-life impairment (DLQI 0-1) versus 21% of ciclosporin-treated patients. Clinician comments reported symptom clearance in 15/36 (42%) omalizumab-treated and 10/60 (17%) ciclosporin-treated patients. Proportions of patients with adverse events were similar but those for omalizumab resembled CSU symptoms, making causality assignment difficult, whereas those for ciclosporin were consistent with its known adverse effect profile. CONCLUSIONS: Validated patient-reported measures of disease severity and quality of life should be used routinely in CSU management. Based on clinician comments and DLQI scores, symptoms and quality of life showed a greater improvement in the omalizumab-treated cohort than in the ciclosporin-treated cohort

Developing a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice and subsequently change antibiotic use

Objectives: To develop a behavioural intervention package to support clinicians and patients to amend incorrect penicillin allergy records in general practice. The intervention aimed to: (1) support clinicians to refer patients for penicillin allergy testing (PAT), (2) support patients to attend for PAT and (3) support clinicians and patients to prescribe or consume penicillin, when indicated, following a negative PAT result. Methods: Theory-based, evidence-based and person-based approaches were used in the intervention development. We used evidence from a rapid review, two qualitative studies, and expert consultations with the clinical research team to identify the intervention ‘guiding principles’ and develop an intervention plan. Barriers and facilitators to the target behaviours were mapped to behaviour change theory in order to describe the proposed mechanisms of change. In the final stage, think-aloud interviews were conducted to optimise intervention materials. Results: The collated evidence showed that the key barriers to referral of patients by clinicians were limited experience of referral and limited knowledge of referral criteria and PAT. Barriers for patients attending PAT were lack of knowledge of the benefits of testing and lack of motivation to get tested. The key barriers to the prescription and consumption of first-line penicillin following a negative test result were patient and clinician beliefs about the accuracy of PAT and whether taking penicillin was safe. Intervention materials were designed and developed to address these barriers. Conclusions: We present a novel behavioural intervention package designed to address the multiple barriers to uptake of PAT in general practice by clinicians and patients. The intervention development details how behaviour change techniques have been incorporated to hypothesise how the intervention is likely to work to help amend incorrect penicillin allergy records. The intervention will go on to be tested in a feasibility trial and randomised controlled trial in England

Anisotropy and internal field distribution of MgB2 in the mixed state at low temperatures

Magnetization and muon spin relaxation on MgB2 were measured as a function of field at 2 K. Both indicate an inverse-squared penetration depth strongly decreasing with increasing field H below about 1 T. Magnetization also suggests the anisotropy of the penetration depth to increase with increasing H, interpolating between a low Hc1 and a high Hc2 anisotropy. Torque vs angle measurements are in agreement with this finding, while also ruling out drastic differences between the mixed state anisotropies of the two basic length scales penetration depth and coherence length.Comment: 4 pages, 4 figure

Structural insights into the function of aminoglycoside-resistance A1408 16S rRNA methyltransferases from antibiotic-producing and human pathogenic bacteria

X-ray crystal structures were determined of the broad-spectrum aminoglycoside-resistance A1408 16S rRNA methyltransferases KamB and NpmA, from the aminoglycoside-producer Streptoalloteichus tenebrarius and human pathogenic Escherichia coli, respectively. Consistent with their common function, both are Class I methyltransferases with additional highly conserved structural motifs that embellish the core SAM-binding fold. In overall structure, the A1408 rRNA methyltransferase were found to be most similar to a second family of Class I methyltransferases of distinct substrate specificity (m7G46 tRNA). Critical residues for A1408 rRNA methyltransferase activity were experimentally defined using protein mutagenesis and bacterial growth assays with kanamycin. Essential residues for SAM coenzyme binding and an extended protein surface that likely interacts with the 30S ribosomal subunit were thus revealed. The structures also suggest potential mechanisms of A1408 target nucleotide selection and positioning. We propose that a dynamic extended loop structure that is positioned adjacent to both the bound SAM and a functionally critical structural motif may mediate concerted conformational changes in rRNA and protein that underpin the specificity of target selection and activation of methyltransferase activity. These new structures provide important new insights that may provide a starting point for strategies to inhibit these emerging causes of pathogenic bacterial resistance to aminoglycosides

Muscle transcriptome analysis reveals molecular pathways related to oxidative phosphorylation, antioxidant defense, fatness and growth in Mangalitsa and Moravka pigs

This work was aimed at evaluating loin transcriptome and metabolic pathway differences between the two main Serbian local pig breeds with divergent characteristics regarding muscle growth and fatness, as well as exploring nutrigenomic effects of tannin supplementation in Mangalitsa (MA) pigs. The study comprised 24 Mangalitsa and 10 Moravka (MO) males, which were kept under identical management conditions. Mangalitsa animals were divided in two nutritional groups (n = 12) receiving a standard (control) or tannin–supplemented diet (1.5%; MAT). Moravka pigs were fed the standard mixture. All animals were slaughtered at a similar age; 120 kg of average live weight (LW) and loin tissue was used for RNA‐seq analysis. Results showed 306 differentially expressed genes (DEGs) according to breed, enriched in genes involved in growth, lipid metabolism, protein metabolism and muscle development, such as PDK4, FABP4, MYOD1 and STAT3, as well as a relevant number of genes involved in mitochondrial respiratory activity (MT‐NDs, NDUFAs among others). Oxidative phosphorylation was the most significantly affected pathway, activated in Mangalitsa muscle, revealing the basis of a different muscle metabolism. Also, many other relevant pathways were affected by breed and involved in oxidative stress response, fat accumulation and development of skeletal muscle. Results also allowed the identification of potential regulators and causal networks such as those controlled by FLCN, PPARGC1A or PRKAB1 with relevant regulatory roles on DEGs involved in mitochondrial and lipid metabolism, or IL3 and TRAF2 potentially controlling DEGs involved in muscle development. The Tannin effect on transcriptome was small, with only 23 DEGs, but included interesting ones involved in lipid deposition such as PPARGC1B. The results indicate a significant effect of the breed on muscle tissue gene expression, affecting relevant biological pathways and allowing the identification of strong regulatory candidate genes to underlie the gene expression and phenotypic differences between the compared groups