Comparison of methodologies for KRAS mutation detection in metastatic colorectal cancer

Cetuximab and panitumumab are two monoclonal antibodies targeting the epidermal growth factor receptor that have been approved for treatment of metastatic colorectal cancer. Recent clinical trials found an association between KRAS mutation status and resistance to anti-epidermal growth factor receptor therapy, leading to the recommendation to perform KRAS mutation analysis before cetuximab or panitumumab treatment. This study was designed to compare and evaluate the efficacy of four different methodologies--high resolution melting, Sanger sequencing, DxS kit, and SNaPshot--for KRAS mutation detection in a clinical setting. In total, 372 samples from patients with metastatic colorectal cancer were analyzed by high resolution melting and SNaPshot, with 184 of those being further analyzed by Sanger sequencing and 188 with the DxS kit. Sensitivities were compared after consensus findings were determined by the presence of the same result in two of the three methodologies used in each case. The frequency of KRAS codon 12 and 13 mutations in our population was 43.5%, and a discordant finding was observed in 22 samples. Comparing to Sanger sequencing, significantly more consensus mutations were detected by the DxS kit (P=0.0139), high resolution melting (P=0.0004), and SNaPshot (P=0.00001), but no statistically significant differences were found among the three methodologies with higher sensitivity.     

Psychometric properties of the Reminiscence Functions Scale for the Portuguese population: a preliminary report

The aim of the present study was to assess the psychometric properties of a version in Portuguese of the Reminiscence Functions Scale. Total sample was composed of 628 participants aged between 18 and 92 years, divided into three groups according to their age (18-24 years, n = 249; 26-54 years, n = 174; 55 and older, n = 205). Results indicated a five-factor solution for the Portuguese version of the Reminiscence Functions Scale, which accounted for 54% of the variance with good internal consistency (mean alpha = 0.86). Age and gender differences emerged regarding reminiscence functions. These results demonstrate that, while significant cultural differences exist, the psychometric properties of the Reminiscence Functions Scale are adequate for the Portuguese population.     

Gastroprotective effect of lupeol on ethanol-induced gastric damage and the underlying mechanism

The effect of lupeol, a natural pentacyclic triterpene on ethanol-induced gastric damage in mice was evaluated. The gastroprotection was assessed by determination of changes in mean gastric lesion area, quantification of mucosal non-protein sulfhydryls (NP-SH), and characterized using drugs that influence the endogenous prostaglandins, α₂-adrenoceptors, nitric oxide, K_ATP-channels, and intracellular calcium. Orally administered lupeol (3, 10, and 30 mg/kg) significantly and dose-dependently attenuated the ethanol-induced gastric damage by 39–69%, whereas the positive control N-acetylcysteine (NAC, 300 mg/kg, i.p.) afforded 32% protection. Both lupeol and NAC restored the NP-SH depleted by ethanol but the lupeol effect was only marginal. Lupeol gastroprotection was attenuated by indomethacin and L-NAME, the respective COX and NO-synthase inhibitors and was weakly sensitive to α₂-adrenergic antagonist yohimbine and K_ATP-channel blocker glibenclamide, but more profoundly to calcium blocker verapamil. These pharmacological effects of lupeol may synergistically contribute to alleviating the ethanol-associated gastric damage, which is multifactorial.     

阿司匹林与结直肠癌存活率的关系

背景及目的：随机对照临床试验已经表明阿司匹林可降低结直肠癌的发生风险,动物实验还发现其可抑制肿瘤生长与转移,但阿司匹林与已确诊结直肠癌患者存活率的关系仍不可知.本研究探讨了在已确诊的结直肠癌患者中,阿司匹林与结直肠癌总体存活率的关系.     

聚乙二醇干扰素α（-2b或α-2a与利巴韦林联合治疗丙型肝炎疗效比较

背景及目的：随机对照临床试验已经表明阿司匹林可降低结直肠癌的发生风险,动物实验还发现其可抑制肿瘤生长与转移,但阿司匹林与已确诊结直肠癌患者存活率的关系仍不可知.本研究探讨了在已确诊的结直肠癌患者中,阿司匹林与结直肠癌总体存活率的关系.     

Non-steroidal anti-inflammatory drugs-associated acute interstitial nephritis with granular tubular basement membrane deposits

Acute tubulo-interstitial nephritis (ATIN) is an important cause of acute renal failure resulting from a variety of insults, including immune complex-mediated tubulo-interstitial injury, but drugs such as non-steroidal anti-inflammatory drugs (NSAIDs) are a far more frequent cause. Overall, as an entity, ATIN remains under-diagnosed, as symptoms resolve spontaneously if the medication is stopped. We report on a 14-year-old boy who developed acute renal failure 2 weeks after aortic valve surgery. He was put on aspirin following surgery and took ibuprofen for fever for nearly a week prior to presentation. He then presented to the emergency department feeling quite ill and was found to have a blood urea nitrogen (BUN) concentration of of 147 mg/dl, creatinine of 15.3 mg/dl and serum potassium of 8.7 mEq/l. Dialysis was immediately initiated. A kidney biopsy showed inflammatory infiltrate consistent with ATIN. However, in the tubular basement membrane (TBM), very intense granular deposits of polyclonal IgG and C3 were noted. He needed dialysis for 2 weeks and was treated successfully with steroids for 6 months. His renal recovery and disappearance of proteinuria took a year. In conclusion, this is a first report of NSAIDs-associated ATIN, showing deposits of granular immune complex present only in the TBM and not in the glomeruli.     

Thighplasty After Bariatric Surgery: Evaluation of Lymphatic Drainage in Lower Extremities

BACKGROUND: Bariatric surgery for morbid obesity achieves an accentuated weight loss, with skin and soft tissue redundancy in some corporal segments, including the thighs. The thigh lift is a plastic surgery that improves this redundant tissue in the medial thigh area, but this surgical procedure may have complications, such as inferior migration of the scar, delayed wound healing, vulvar distortion, and lymphatic system alterations. METHODS: To evaluate the effect of the thighplasty on the lymphatic system, 14 patients were prospectively included in this study. Lymphoscintigraphy was performed before thighplasty, and this result was compared to the new examination performed 6 months after thighplasty. The exclusion standards include patients with clinical alterations and abnormal lymphoscintigraphy in previous surgery. RESULTS: The statistical analysis was performed on 26 inferior members, according to exclusion standards. All the members had normal lymphoscintigraphy in the preoperative period. After thighplasty, eight members (30.8%) demonstrated abnormal lymphoscintigraphy (p = 0.008) resulting in significant functional and anatomic alterations in the lymphatic system. CONCLUSION: The thigh lift changes lymphatic drainage in lower extremities according to lymphoscintigraphy analyses.     

Signification biologique de 410 microcytoses de découverte fortuite chez des adultes jeunes

We have detected 410 microcytosis among biological tests of military people. These microcytosis are principally coumpounded by haemoglobin's abnormalities (minor thalassemia, sickle cell diseases, E haemoglobin cases and cases of C haemoglobin) and cases of iron deficiency, usually among women.