CEA as a prognostic index in colorectal cancer

INTRODUCTION: The carcinoembryonic antigen, CEA, is the tumor marker most used in colorectal patients, principally during follow up after radical surgery. High serum CEA level before surgery is often associated with worse prognosis, in some studies. OBJECTIVE: The purpose of this study was to evaluate the preoperative carcinoembryonic antigen levels (CEA) and the frequency of recurrence. MATERIAL AND METHODS: Eighty-three patients with colorectal cancer at Dukes stages A, B or C were evaluated retrospectively. The patients' follow up was at least two years or to death. CEA was detemined in serum by enzyme immunoassay (Sorin Biomedica), normal value 0-5ng/mI. RESULTS: Disease recurrence was observed in 32 patients (38.5%), 13 Dukes B and 19 Dukes C. Seventy five per cent of the patients with CEA higher than 10ng/ml relapsed and 80% of the patients without recurrence had normal CEA. Disease recurrence in patients with preoperative elevated CEA occurred during the first year of follow up in 56% of the patients. CONCLUSION: Although the tumor stage is today the most valuable prognostic variable in colorectal cancer, the preoperative CEA value can provide some additional information in the prognosis of the patient.INTRODUÇÃO: O antígeno carcinoembrionário, CEA é o marcador tumoral mais usado em pacientes com câncer colorretal, principalmente no acompanhamento clinico após ressecção cirúrgica do tumor. Níveis séricos elevados de CEA no pré-operatório são frequentemente associados, em alguns estudos, a pior prognóstico. OBJETIVO: Comparar os níveis séricos de CEA no pré-operatório e a frequência da recorrência no acompanhamento clinico. MATERIAL E MÉTODOS: Oitenta e três pacientes com câncer colorretal estadiados em Dukes A, B, e C foram avaliados retrospectivamente. Os pacientes foram acompanhados, por no mínimo dois anos ou até o óbito. O CEA sérico foi determinado por Elisa (Sorine Biomédicas, valor normal 0-5 ng/ml). RESULTADOS: A recorrência foi observada em 32 pacientes (38.5%), sendo 13 pacientes Dukes B e 19 Dukes C. Setenta e cinco por cento dos pacientes com CEA maior que 10ng/ml apresentaram recorrência e oitenta por cento dos pacientes sem recorrência tinham níveis séricos de CEA dentro do valor de normalidade. Nos pacientes com CEA elevado no pré-operatório e que desenvolveram recorrência, esta ocorreu no primeiro ano de acompanhamento em 56% dos pacientes. Dezesseis pacientes foram a óbito durante o acompanhamento, 11 destes tinham CEA sérico aumentado no pré-operatório. CONCLUSÃO: Embora, o estadiamento clinico seja a variável mais usada na avaliação do prognóstico, os valores de CEA no pré-operatório podem fornecer algumas informações adicionais sobre o prognóstico do doente.UNIFESP-EPM Department of OncologyUNIFESP, EPM, Department of OncologySciEL

Oscillation dynamics underlie functional switching of NF-κB for B-cell activation.

Transcription factor nuclear factor kappa B (NF-κB) shows cooperative switch-like activation followed by prolonged oscillatory nuclear translocation in response to extracellular stimuli. These dynamics are important for activation of the NF-κB transcriptional machinery, however, NF-κB activity regulated by coordinated actions of these dynamics has not been elucidated at the system level. Using a variety of B cells with artificially rewired NF-κB signaling networks, we show that oscillations and switch-like activation of NF-κB can be dissected and that, under some conditions, these two behaviors are separated upon antigen receptor activation. Comprehensive quantitative experiments and mathematical analysis showed that the functional role of switch activation in the NF-κB system is to overcome transient IKK (IκB kinase) activity to amplify nuclear translocation of NF-κB, thereby inducing the prolonged NF-κB oscillatory behavior necessary for target gene expression and B-cell activation

Prostaglandin E2-EP1 and EP2 receptor signaling promotes apical junctional complex disassembly of Caco-2 human colorectal cancer cells

<p>Abstract</p> <p>Background</p> <p>The apical junctional complex (AJC) is a dynamic structure responsible to maintain epithelial cell-cell adhesions and it plays important functions such as, polarity, mechanical integrity, and cell signaling. Alteration of this complex during pathological events leads to an impaired epithelial barrier by perturbation of the cell-cell adhesion system. Although clinical and experimental data indicate that prostaglandin E₂(PGE₂) plays a critical function in promoting cell motility and cancer progression, little is known concerning its role in AJC disassembly, an event that takes place at the beginning of colorectal tumorigenesis. Using Caco-2 cells, a cell line derived from human colorectal cancer, we investigated the effects of prostaglandin E₂(PGE₂) treatment on AJC assembly and function.</p> <p>Results</p> <p>Exposition of Caco-2 cells to PGE₂promoted differential alteration of AJC protein distribution, as evidenced by immunofluorescence and immunoblotting analysis and impairs the barrier function, as seen by a decrease in the transepithelial electric resistance and an increase in the permeability to ruthenium red marker. We demonstrated the involvement of EP1 and EP2 prostaglandin E₂receptor subtypes in the modulation of the AJC disassembly caused by prostanoid. Furthermore, pharmacological inhibition of protein kinase-C, but not PKA and p38MAPK significantly prevented the PGE₂effects on the AJC disassembly.</p> <p>Conclusion</p> <p>Our findings strongly suggest a central role of Prostaglandin E2-EP1 and EP2 receptor signaling to mediate AJC disassembly through a mechanism that involves PKC and claudin-1 as important target for the TJ-related effects in human colorectal cancer cells (Caco-2).</p

Effects of the COVID-19 pandemic on the prevalence of obsessive-compulsive symptoms among young adults in Peru

The COVID-19 pandemic has exposed the general population to constant stressful and traumatic situations. This, added to the necessary and constant dissemination of preventive measures for COVID-19 infection, can generate an increase in the prevalence of Obsessive-Compulsive (OC) symptoms. Thus, this research aimed to evaluate the prevalence of OC symptoms and explore associated factors in young adults in Peru, the country with the highest COVID-19 death rate in the world. In this analytical cross-sectional study, an online survey distributed through social networks was used. OC symptomatology during the last week was measured by the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Possible Generalized Anxiety Disorder (GAD) and Major Depressive Disorder (MDD) were evaluated with the General Anxiety Disorder 7-items (GAD-7) and Patient Health Questionnaire-9 (PHQ-9), respectively. 1243 young adults were evaluated. Of these, the mean age was 24.1 years, 54.3% were women, and the prevalence of OC symptoms was 50%. Participants who had experienced a traumatic event during COVID-19 pandemic had higher prevalence of OC symptoms (PR 1.54; CI 95% 1.27 – 1.85), when compared to those did not experience such events. In the same way, participants diagnosed with depression (PR 2.37; CI 95% 1.96 – 2.86) and anxiety (PR 1.11; CI 95% 1.02 – 1.21) also had a higher prevalence of OC symptoms, compared with those without depression and anxiety. In conclusion, obsessive-compulsive symptomatology has a high prevalence in young adults, and is associated with the death of a family member or close friend from the COVID-19 disease. The prevalence of possible depression and anxiety are high and are associated with higher prevalence of obsessive-compulsive symptoms. This highlights the importance of including mental health programs during the pandemic for the population who has suffered traumatic events, to be able to give them adequate follow-up and support.Revisión por pare

Cardiovascular risk factors prevalent among elderly performing adapted physical activity

The prevalence of cardiovascular disease risk factors (CVRF) increases linearly with age. Debilitating diseases within the ambit of physical medicine and rehabilitation can promote or aggravate pre-existing comorbidities and CVRFs. A high prevalence of CVRFs was noted in the medical histories of elderly patients receiving regular ambulatory follow up while performing adapted physical activity (APA) as therapy in a rehabilitation center. Objective: To evaluate the presence of CVRFs in the elderly who are practicing APA, in order to map the risk profile of this specific population. Method: Collection and observational analysis of data found in the medical histories of the elderly (&gt; 60 years) practicing APA, and in regular ambulatory follow up, concerning several CVRFs (Systemic Arterial Hypertension - SAH, Diabetes Mellitus - DM, Dyslipidemia - DLP, Smoking; Excess weight/Obesity - EW/Ob, Family history - FH). Results: one hundred and ten (n = 110) elderly patients were found (average age 72.9 ± 7.1 years). Information in medical history about smoking, EW/Ob and FH, were only found in 11.8%, 52.7%, and 0%, respectively, and were thus excluded from posterior analysis. The prevalence of SAH, DLP and DM were 69.0%, 46.3%, and 27.2%, respectively. Only 18.2% of these elderly presented no CVRF (SAH, DLP, DM), 34.5% one associated factor, 33.6% two factors, 13.7% three factors. Of those evaluated, 28.2% already presented established cardiopathy. Conclusion: A high prevalence of SAH, DLP, DM and established cardiopathy among the elderly practicing regular APA in one rehabilitation center was noted, labeling this sample population with high risk profile. Cardiovascular risk factors of crucial importance like smoking, obesity, and a family history of cardiac disease were not appropriately mapped, with little such information found in the evaluated medical histories. Due to the size and specificity of the present study sample, this result could not express the actual national scope of rehabilitation centers, and should be better investigated in future studies. However, the present data are alarming and must be considered with special attention, since no appropriate map of CVRFs was made.A prevalência de fatores de risco para doenças cardiovasculares (FRCV) aumenta em linearidade com o envelhecimento. Doenças debilitadoras do espectro de ação da medicina física e reabilitação podem promover o aparecimento ou agravar comorbidades prévias e FRCV. Em idosos em acompanhamento ambulatorial regular, realizando atividade física adaptada (AFA) como terapia em centro de reabilitação, notou-se alta frequência da presença de fatores de risco cardiovascular constadas em prontuário médico. Objetivo: Avaliar a prevalência de fatores de risco cardiovascular em idosos encaminhados para realização de atividade física adaptada, visando mapeamento do perfil de risco desta população específica. Método: Coleta e análise observacional de dados constados em prontuário médico, de idosos (&gt; 60 anos), em realização de AFA e acompanhamento ambulatorial regular, sobre diversos FRCV (Hipertensão Arterial Sistêmica - HAS; Diabetes Melitus - DM, Dislipidemia - DLP; Tabagismo; Sobrepeso/Obesidade - Sobrep/OB; História familiar - HF). Resultados: Foram encontrados cento e dez (n = 110) pacientes idosos (média de idade 72,9 ± 7,1 anos). Informações constadas em prontuário sobre tabagismo, Sobrep/OB e HF, foram apenas encontradas em 11,8%, 52,7%, e 0%, respectivamente, e assim excluídas de posteriores análises. A prevalência de HAS, DLP e DM foram de 69,0%, 46,3% e 27,2%, respectivamente. Apenas 18,2% dos idosos não apresentavam nenhum FRCV (HAS, DLP, DM), 34,5% um fator associado, 33,6% dois fatores, 13,7% três fatores. Dos idosos avaliados, 28,2% já apresentavam cardiopatia instalada. Conclusão: Foi verificada alta prevalência de HAS, DLP, DM e cardiopatia já instalada em idosos em realização regular de AFA em centro de reabilitação, fazendo desta, população de alto risco. Fatores de risco cardiovascular de suma importância como tabagismo, obesidade e história familiar de DCV não foram adequadamente mapeados, com déficits de informação constada nos prontuários médicos avaliados. Devido ao tamanho e especificidade da amostra do presente estudo, estes resultados podem não representar a realidade atual dos centros de reabilitação em âmbito nacional, devendo ser melhor investigados em estudos futuros. No entanto, os dados apresentados são alarmantes e devem ser considerados com especial atenção, visto que não houve adequado mapeamento de todos os FRCV

Fuzzy Modeling of Electrical Impedance Tomography Images of the Lungs

OBJECTIVES: Aiming to improve the anatomical resolution of electrical impedance tomography images, we developed a fuzzy model based on electrical impedance tomography's high temporal resolution and on the functional pulmonary signals of perfusion and ventilation. INTRODUCTION: Electrical impedance tomography images carry information about both ventilation and perfusion. However, these images are difficult to interpret because of insufficient anatomical resolution, such that it becomes almost impossible to distinguish the heart from the lungs. METHODS: Electrical impedance tomography data from an experimental animal model were collected during normal ventilation and apnea while an injection of hypertonic saline was administered. The fuzzy model was elaborated in three parts: a modeling of the heart, the pulmonary ventilation map and the pulmonary perfusion map. Image segmentation was performed using a threshold method, and a ventilation/perfusion map was generated. RESULTS: Electrical impedance tomography images treated by the fuzzy model were compared with the hypertonic saline injection method and computed tomography scan images, presenting good results. The average accuracy index was 0.80 when comparing the fuzzy modeled lung maps and the computed tomography scan lung mask. The average ROC curve area comparing a saline injection image and a fuzzy modeled pulmonary perfusion image was 0.77. DISCUSSION: The innovative aspects of our work are the use of temporal information for the delineation of the heart structure and the use of two pulmonary functions for lung structure delineation. However, robustness of the method should be tested for the imaging of abnormal lung conditions. CONCLUSIONS: These results showed the adequacy of the fuzzy approach in treating the anatomical resolution uncertainties in electrical impedance tomography images

1,1′:4′,1′′-Terphenyl-2′,5′-dicarb­oxy­lic acid dimethyl sulfoxide-d 6 disolvate

The asymmetric unit of the title solvate, C20H14O4·2C2D6OS, contains half of the substituted terephthalic acid mol­ecule and one solvent mol­ecule. The centroid of the central benzene ring in the acid mol­ecule is coincident with a crystallographic inversion center. Neither the carboxyl nor the phenyl substituents are coplanar with the central aromatic ring, showing dihedral angles of 53.18 (11) and 47.83 (11)°, respectively. The dimethyl sulfoxide solvent mol­ecules are hydrogen bonded to the carb­oxy­lic acid groups

Assessing the Knowledge of Parents and Guardians about Dental Trauma in Children During the COVID-19 Pandemic: A Pilot Study

Objective: To evaluate the knowledge of parents or guardians about dental trauma in children during the COVID-19 pandemic. Material and Methods: After signing the Free and Informed Consent, the children\u27s parents answer the online questionnaires about dental trauma during the COVID-19 pandemic. The data was analyzed using Kruskal-Wallis and Mann-Whitney tests. Results: Of a total of 89 questionnaires, only 84 were answered, and 75.3% experienced dentoalveolar trauma, of which 65.5% exhibited fractures. Most affected teeth (92.2%) were deciduous, and 7.8% were permanent. Furthermore, 53.73% of the trauma involved anterior teeth, only 7.46% affected posterior teeth, and 4.48% included anterior and posterior teeth. Most participants (74.2%) had never received information about dental trauma, and 25.8% had received prior instruction. Many (74%) did not take the affected tooth or fragment to the emergency room. Following the accidents, 38.2% feared brushing their children\u27s teeth, and 28.1% did not. Conclusion: Dentoalveolar trauma in children is common and occurs more often at home or school. Dental trauma affected the deciduous teeth, especially the anterior teeth. Many parents lack knowledge on how to respond to and care for dental trauma in children. Providing informative guidance to parents and guardians is essential for preventing and managing childhood dental injuries, even during the COVID-19 pandemic

Knowledge of Physical Education Students about Tooth Avulsion Before and After Receiving an Informative Leaflet

Objective:&nbsp;To evaluate the knowledge of Physical Education students about&nbsp;tooth avulsion (TA) in both dentitions before and after receiving an informative leaflet (IL).&nbsp;Material and Methods:&nbsp;The questionnaire contained information about TA in dentition and its management and was applied to the Physical Education students before and after reading an IL.&nbsp;Results:&nbsp;A total of 118 students, 96.61%, attended a first aid course, and 17.80% received information about TA. Most students (88.98%) never had an experience with TA, and 90.68% considered its management important. The other questions, before and after reading the IL, respectively, were: would not perform deciduous tooth replantation (42%; 88%); knew how to handle the avulsed permanent tooth (APT) (38%; 92%); knew how to clean the APT (50%; 99%); knew that permanent tooth replantation (PTR) must be immediate (15%; 95%); knew the ideal time to seek for the dentist right after TA without performing PTR (6%; 83%); knew how to store APT (31%; 97%).&nbsp;Conclusion:&nbsp;The knowledge of Physical Education students in this research revealed a limited understanding of dental tooth avulsion. After receiving an informative leaflet, the students showed a significant improvement in knowledge about traumatic avulsion management, including tooth replantation and proper actions