A "bug-in-the-eye" can be better than a "bug-in-the-ear". A teleprompter technique for on-line therapy skills training

The only existing method of therapy supervision that provides on-line feedback to trainees is the "bug-in-the-ear," an auditory communication system. Although this system has several advantages over supervision strategies that use retrospective accounts, audio- and videotapes, and direct observation on sessions, it is disruptive to the trainee and must be limited to strategically timed three- or four-word communications. We describe and discuss advantages of the "bug-in-the-eye," an alternative to the bug-in-the-ear, which provides visual on-line feedback for therapist skill training.     

Combined targeting of epidermal growth factor receptor and MDM2 by gefitinib and antisense MDM2 cooperatively inhibit hormone-independent prostate cancer.

PURPOSE: The epidermal growth factor receptor (EGFR) may play a relevant role in the progression, hormone therapy resistance, and prognosis of prostate cancer patients. Also MDM2, a negative p53 regulator that interacts with retinoblastoma (Rb), E2F, p19(arf) and the ras-mitogen-activated protein kinase(MAPK) cascade plays an important role in prostate cancer progression and prognosis. On the basis of the EGFR and MDM2 role in integrating signaling pathways critical for prostate cancer progression, we investigated whether their selective combined blockade may have a cooperative antitumor effect in prostate cancer. For this purpose, we have used the EGFR tyrosine kinase inhibitor gefitinib (ZD1839, Iressa) and a second generation hybrid oligonucleotide antisense MDM2 (AS-MDM2), respectively. EXPERIMENTAL DESIGN: Gefitinib and AS-MDM2 were administered to hormone-refractory and hormone-dependent human prostate cancer cells in vitro and to mice bearing tumor xenografts, evaluating the effects on growth, apoptosis, and protein expression, in vitro and in vivo. RESULTS: We demonstrated that the combination of gefitinib and AS-MDM2 synergistically inhibits the growth of hormone-independent prostate cancer cells in vitro. This effect is accompanied by the inhibition of MDM2, phosphorylated Akt (pAkt), phosphorylated MAPK (pMAPK), and vascular endothelial growth factor (VEGF) expression and by Rb hypophosphorylation. The combination of the two agents in nude mice bearing the same hormone-independent tumors caused a potent cooperative antitumor effect. Tumor samples analysis confirmed the inhibition of MDM2, pAkt, pMAPK, VEGF, and basic fibroblast growth factor expression. CONCLUSIONS: This study shows that EGFR and MDM2 play a critical role in the growth of prostate cancer, especially hormone-dependent, and that their combined blockade by gefitinib and AS-MDM2 causes a cooperative antitumor effect, supporting the clinical development of this therapeutic strategy.     

Helicobacter pylori VacA toxin up-regulates vascular endothelial growth factor expression in MKN 28 gastric cells through an epidermal growth factor receptor-, cyclooxygenase-2-dependent mechanism.

PURPOSE: Helicobacter pylori causes gastric damage and is involved in gastric carcinogenesis. Vascular endothelial growth factor (VEGF) plays a major role in gastric mucosa repair and is overexpressed in gastric cancer. We investigated: (a) whether H. pylori, and in particular H. pylori VacA toxin, affected VEGF expression in gastric epithelial cells in culture; and (b) the signal transduction pathway involved in any effect exerted by H. pylori. EXPERIMENTAL DESIGN: MKN-28 cells were incubated with uninoculated BCF (control) or with BCF obtained from VacA-producing wild-type H. pylori 60190 strain or from its isogenic mutant 60190:v1, specifically lacking vacA gene in the presence or absence of ZD 1839, a selective inhibitor of the epidermal growth factor receptor (EGFR) tyrosine kinase, PD098059, a selective inhibitor of mitogen-activated protein (MAP)/extracellular signal-regulated kinase (ERK) kinase, the kinase responsible for ERK phosphorylation, or SC-236, a selective inhibitor of cyclooxygenase (COX)-2 for 24-48 h. RESULTS: (a) Toxigenic H. pylori up-regulated VEGF mRNA and protein expression and caused a 2.5-fold increase in VEGF release compared with control, whereas nontoxigenic H. pylori did not; (b) H. pylori VacA toxin-induced up-regulation of VEGF was counteracted by selective inhibition of EGFR tyrosine kinase; (c) toxigenic H. pylori activated the ERK/MAP kinase cascade, and inhibition of MAP kinase activation counteracted H. pylori-induced VEGF up-regulation; (d) toxigenic H. pylori up-regulated COX-2 expression, and this effect was counteracted by blockade of EGFR tyrosine kinase; and (e) COX-2 selective inhibition counteracted H. pylori-induced up-regulation of VEGF. CONCLUSION: (a) H. pylori up-regulates VEGF expression in gastric epithelial cells; and (b) this effect is specifically related to VacA toxin and seems to depend on the activation of an EGFR-, MAP kinase-, and COX-2-mediated pathway.     

Integrated imaging of systemic Langerhans cell histiocytosis in an infant

Langerhans cell histiocytosis (LCH) is a myeloid neoplasm characterized by a clonal proliferation of CD1a+/CD207+ dendritic cells. Although individuals of any age can be affected, the disease is most common in infants younger than 5 years of age, especially males. A wide range of manifestations, from asymptomatic to aggressive, have been described, along with multiorgan involvement. Even though the majority of bone lesions are observed, skin, lymph nodes, brain and lungs can also be involved. The involvement of hematopoietic system, including bone marrow, liver and spleen, is less frequent yet associated with worse prognosis, due to a worse treatment response. Diagnosis of LCH is based on the integration of clinical, laboratory, and radiological data; however, only histopathological examination might confirm it. As far as the spleen involvement is concerned, according to literature, it has been reported in about 15% patients with multisystem involvement, nonetheless only a few cases show parenchymal lesions. The present study reports the case of an infant with LCH with multisystem involvement, including bone, skin, liver, and spleen, with evidence of parenchymal lesions.     

Accuracy of planned tooth movement with lingual straight wire technique

ObjectivesTo analyze the accuracy of planned tooth movements of torque, tip, rotations, and transverse width values with lingual straight-wire technique.Materials and Methods40 Caucasian subjects with mean age of 23.9 years, consecutively treated in private practice with a lingual straight-wire appliance (STb, Ormco, Glendora, Calif) were evaluated. Maxillary and mandibular dental casts were taken before treatment (T0), in the setup (T1), and at the end of treatment (T2) and scanned with an intraoral 3D scanner Carestream CS 3600 (Carestream Dental, Atlanta, GA). Virtual models at the three time points were superimposed on T1 using 3D software, and the coordinates were exported as a set of x, y, and z values. Angular and linear measurements were analyzed to measure torque, tip, rotation movements, and transverse intra-arch widths. Changes among the three time points were analyzed with Friedman''s nonparametric test.ResultsA general increase in torque was recorded in the setup and in the final result, except for the maxillary molars. Torque, tip, and rotation movement mean accuracy was ≥84% for incisors, canines, and premolars. A general increase in transverse width was measured in the setup and in the final models, except for the upper second molars, which showed reduced transverse width during treatment.ConclusionsThe movements planned in the setup to obtain the ideal torque, tip, and rotations actually occurred, except for second molars, which showed less accuracy. Planned expansion of the arches occurred only partially.     

Reactive vaccination as control strategy for an outbreak of invasive meningococcal disease caused by Neisseria meningitidis C:P1.5-1,10-8:F3-6:ST-11(cc11), Bergamo province,Italy, December 2019 to January 2020

In Italy, serogroup C meningococci of the clonal complex cc11 (MenC/cc11) have caused several outbreaks of invasive meningococcal disease (IMD) during the past 20 years. Between December 2019 and January 2020, an outbreak of six cases of IMD infected with MenC/cc11 was identified in a limited area in the northern part of Italy. All cases presented a severe clinical picture, and two of them were fatal. This report is focused on the microbiological and molecular analysis of meningococcal isolates with the aim to reconstruct the chain of transmission. It further presents the vaccination strategy adopted to control the outbreak. The phylogenetic evaluation demonstrated the close genetic proximity between the strain involved in this outbreak and a strain responsible for a larger epidemic that had occurred in 2015 and 2016 in the Tuscany Region. The rapid identification and characterisation of IMD cases and an extensive vaccination campaign contributed to the successful control of this outbreak caused by a hyperinvasive meningococcal strain.     

Effects of cigarette smoking on phobic anxiety

Smokers report that smoking reduces anxiety. However, experimental research on the anxiety-reducing effects of smoking is limited to two self-report studies, both of which have methodological problems. We tested the effects of smoking on self-reported anxiety and avoidance behavior in a behavioral avoidance test (BAT) using a large white rat. In a counterbalanced within subjects design, 20 rat phobic female smokers smoked or were smoking deprived in two separate administrations of the BAT. A second group of 20 rat phobic nonsmokers also received two BATs. Subjects manifested substantial anxiety during BATs. However, neither smoking condition nor smoker versus nonsmoker status affected self-reported or motoric anxiety. Although smoking did not reduce anxiety in this study, smoking may affect anxiety in other situations, such as social settings, where the stimulus is more diffuse or less intense. It may also affect anxiety in individuals who are heavier smokers than our subjects, who smoked only 10-20 cigarettes per day.