COL1A1 Sp1-binding site polymorphism as a risk factor for genital prolapse

The objective of this study was to verify the possible association between the Sp1-binding site polymorphism and genital prolapse. A case–control study was conducted in 107 patients with stages III and IV genital prolapse. The control group included 209 women with stages 0 and I. The polymorphism of type I collagen Sp1-binding site was identified by amplification of the first intron of the COL1A1 gene. We did not find differences in the prevalence of the GT and TT genotypes between the groups (p = 0.34), even when we grouped patients with at least one polymorphic allele (GT and TT) and compared them with patients without the polymorphic allele (GG; p = 0.17) The presence of at least one vaginal delivery, family history for prolapse, and macrosomatic fetus were independent risk factors for prolapse. In conclusion, the COL1A1 Sp1-binding site was not significantly associated with genital prolapse among our study subjects.     

School dropout and conduct disorder in Brazilian elementary school students.

OBJECTIVES: To evaluate the association between DSM-IV conduct disorder (CD) and school dropout in a sample of students from the third and fourth elementary grades at state schools in the capital of the southernmost state of Brazil. METHODS: In this case-control study, students that dropped out of schools (n = 44) and a control group who continued attending schools (n = 44) were assessed for CD and other prevalent mental disorders, using the Schedule for Affective Disorders and Schizophrenia for School Age Children, Epidemiological Version (K-SADS-E). RESULTS: The prevalence of DSM-IV CD was significantly higher in the school-dropout group than in control subjects (P < 0.001), both in the entire sample and in a subsample including only subjects under age 12 years (P = 0.001). Also, the odds ratio (OR) for school dropout was significantly higher in the presence of DSM-IV CD, even after controlling for potential confounding factors (age, estimated IQ, school repetition, family structure, and income) (P < 0.01). CONCLUSION: Our results extend to children and young adolescents previous findings from studies of older adolescents, suggesting an association between school dropout and CD.     

Complete genotyping of mucosal human papillomavirus using a restriction fragment length polymorphism analysis and an original typing algorithm.

BACKGROUND: Due to the differences in the oncogenic activity of human papillomaviruses (HPV), it is clinically important to accurately identify HPV types in a simple and time effective manner. OBJECTIVES: We aimed at developing a straightforward and cost-effective assay to individually identify all mucosal HPVs, based on the amplification of L1 gene using MY09/11 primers, and subsequent restriction fragment length polymorphism (RFLP) analysis. STUDY DESIGN: We made use of bioinformatic tools to analyze all published DNA sequences of 49 mucosal HPV types for PstI, HaeIII, DdeI and RsaI restriction sites. Based on the RFLP patterns, we have designed an original genotyping algorithm. RESULTS: Each HPV type presented a distinct RFLP pattern, which was visually distinguishable on polyacrylamide gels. A set of 27 pre-selected patient samples of known HPV types was confirmed positive for the same HPV type using this RFLP assay. Furthermore, in a random and blind HPV typing experiment performed in 30 untyped clinical samples, RFLP data consistently matched DNA sequencing results. CONCLUSIONS: Our polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method, using 4 restriction enzymes (PstI, HaeIII, DdeI, RsaI) and an original genotyping algorithm, allows discrimination of all individual mucosal HPV types in single infections, and even detection of multiple infections. This assay gives complementary information to commercially available methods, and may also be financially advantageous, particularly when financial resources are scarce.     

Ethinyl estradiol and medroxyprogesterone acetate in patients with epithelial ovarian carcinoma: a phase II study

Patients with ovarian carcinoma refractory to chemotherapy received a sequential combination of ethinyl estradiol and medroxyprogesterone acetate in two dose regimens. There was no difference in therapeutic activity of the two dose regimens. Of 65 patients, nine (14%) responded to treatment and 13 (20%) had stable disease. Vascular complications occurred in three patients; hemiplegia developed in one of those. Nine patients had significant nausea and vomiting, and one experienced severe depression that required treatment withdrawal. The sequential and combined use of ethinyl estradiol and medroxyprogesterone acetate may provide an alternative treatment for certain patients with ovarian carcinoma that does not respond to optimum chemotherapy. Additional studies are required to determine if synergism exists between this treatment and other modalities of therapy. Further investigation is required into the vascular disorders that complicate therapy to determine whether appropriate preventive measures are possible.     

Imatinib plus low‐dose doxorubicin in patients with advanced gastrointestinal stromal tumors refractory to high‐dose imatinib

BACKGROUND:

In KIT‐expressing Ewing sarcoma cell lines, the addition of doxorubicin to imatinib increases apoptosis, compared with imatinib or doxorubicin alone. On the basis of these in vitro data, the authors conducted a phase 1‐2 trial of doxorubicin with imatinib in patients with gastrointestinal sarcoma tumors refractory to high‐dose imatinib therapy.

METHODS:

Patients with metastatic gastrointestinal sarcoma tumor resistant to imatinib at 400 mg by mouth (p.o.) twice a day were eligible for this multicenter study, and received imatinib (400 mg p.o. every day [q.d.]) concomitantly with doxorubicin 15‐20 mg/m²/weekly for 4 cycles (monthly cycles), followed by imatinib (400 mg p.o. q.d.) maintenance in nonprogressive patients. Spiral computed tomography and positron emission tomography with F18‐fluorodeoxyglucose were done basally and after 2 months of therapy to evaluate response. An in vitro study assessed the effect of combining imatinib and doxorubicin.

RESULTS:

Twenty‐six patients with progressive gastrointestinal sarcoma tumor were entered in the study. Treatment was well tolerated. Three (14%) of 22 evaluable patients had partial responses per Response Evaluation Criteria in Solid Tumors, and 8 (36%) had clinical benefit (partial response or stable disease for ≥6 months). Median progression‐free survival (PFS) was 100 days (95% confidence interval [CI], 62‐138), and median survival was 390 days (95% CI, 264‐516). Interestingly, PFS was 211 days (95% CI, 52‐370) in patients with wild type (WT) KIT and 82 days (95% CI, 53‐111) in non‐WT patients (10 mutant, 6 not assessed). A synergistic effect on cell line proliferation and apoptosis was found with imatinib and doxorubicin combination.

CONCLUSIONS:

Low‐dose chemobiotherapy combination showed promising activity in heavily pretreated gastrointestinal sarcoma tumor patients, especially in those with WT‐KIT genotype. Cancer 2010. © 2010 American Cancer Society.     

A radiographic comparison of apical root resorption after orthodontic treatment with 3 different fixed appliance techniques.

Apical root resorption is an undesirable, but frequent side effect of orthodontic treatment, and therefore improvements in orthodontic techniques and materials are in constant development to decrease it. One of the most recently developed orthodontic techniques is the Bioefficient Therapy that uses contemporary orthodontic materials. Therefore, the primary objective of this study was to compare the amount of root resorption after orthodontic treatment between the simplified standard edgewise technique (group 1), the edgewise straight wire system (group 2), and the Bioefficient Therapy (group 3). It was also the purpose of this investigation to evaluate the amount of root resorption in the whole sample studied and the prevalence of root resorption in the upper and lower incisors. Thus, periapical radiographs were obtained with the long cone paralleling technique for the upper and lower incisors from 30 patients for each group. Root resorption was ranked by scores by 2 examiners who had an excellent intra and interexaminer calibration by Kendall concordance coefficient. Results of the Kruskal-Wallis test demonstrated that group 3 (Bioefficient Therapy) presented less root resorption than the others. It was speculated that the factors responsible for the lesser resorption in this technique were the use of heat-activated and superelastic wires with the bracket design in this technique as well as the use of a smaller rectangular stainless steel wire (0.018 x 0.025 inch) in a 0.022 x 0.028 inch slot during incisor retraction and the finishing stages, as compared to the other techniques. Considering the whole sample, there was no root resorption in 2.25% of the analyzed teeth. There was only a slight resorption in 42.56%, a moderate resorption in 53.37%, an accentuated resorption in 1.40% and an extreme root resorption in only 0.42% of the teeth. The prevalence of resorption for each incisor indicated, in decreasing order, a greater resorption for the upper centrals, followed by the upper laterals, lower centrals, and lastly the lower lateral incisors.     

How does the prevalence of specific morbidities compare with measures of socio-economic status at small area level?

BACKGROUND: Evidence from other studies has show large, systematic differences between the health of social groups. It is not clear whether this relationship applies equally to all areas of health need. We assess whether a variety of areas of ill health show positive correlations with increasing socioeconomic disadvantage, and whether there are indicators of socio-economic disadvantage that are better than others at predicting the prevalence of specific morbidities at a population level. METHODS: The prevalence of a range of common morbidities was determined by a postal questionnaire sent to 16,750 subjects (response rate 79 per cent), and compared with socio-economic information obtained from the 1991 Census. RESULTS: There was substantial variation in the degree to which the various morbidities were related to the socioeconomic variables. When compared with socio-economic variables, long-term limiting illness, respiratory conditions and depression had high correlations of +0.8 or more. Cardiovascular conditions were less related (r = +0.60 to +0.79). None of the disorders of the gastrointestinal system showed a high correlation with socio-economic variables. There was also substantial variation in the degree of correlation of the socio-economic measures with each area of morbidity. The measures that showed the highest correlations were in respect of household characteristics such as car ownership and single parent households. Variables describing household amenities such as lacking a bath or central heating were least related to the morbidity measures. CONCLUSIONS: Some areas of morbidity show strong associations with socio-economic disadvantage, but others show only modest or no relationship. The optimum choice of socio-economic variable as a proxy for health need depends on the area of illness being considered.