Pregnancy and lung cancer: a case report and review of the literature

Lung cancer is a frequent pathology among women, as a result of tobacco increase. Lung cancer among pregnant women is especially rare when revealed by Pancoast-Tobias syndrome. Foetal injury is possible. The approach is multidisciplinary. Prognosis is bad.     

Giant cervical polyp: a case report and review of a rare entity

BACKGROUND: If cervical polyps are a common pathology in the female adult population, giant cervical polyps with a size greater than 4 cm are rare and until now only several cases have been described in literature. The size and the clinical presentation can mimic a cervical neoplasia. The management is surgical and can be conservative regarding to the benign pathological feature of this entity. CASE REPORT: We report the case of a giant cervical polyp of 5.5 cm occurring in a multiparous 47-year-old woman who clinically presented vaginal bleeding. The lesion was resected by electrosurgery with no recurrence 7 months after surgery. CONCLUSION: The diagnosis, management and outcome of this rare entity had been reviewed according to the literature.     

Neonatal and 5-year outcomes after birth at 30-34 weeks of gestation

OBJECTIVE: To evaluate the rates of in-hospital death, neonatal complications, and 5-year outcomes of infants born at 30-34 weeks of gestation. METHODS: In nine regions of France, all 2,020 stillbirths and live births at 30, 31, and 32 weeks in 1997 and all 457 births at 33 and 34 weeks in April and October 1997 were recorded. Survivors were evaluated at 5 years of age. RESULTS: Increasing gestational age from 30 to 34 weeks was associated with progressive decreases in in-hospital mortality (from 8.1% to 0.4%) and neonatal complications (respiratory distress syndrome, 43.8% to 2.6%; maternofetal infections, 7.2% to 2.6%; and severe white matter injury, 5.5% to 1.3%). Although infants at 33 and 34 weeks of gestation rarely experienced necrotizing enterocolitis, bronchopulmonary dysplasia, or nosocomial infections, they still required endotracheal ventilation, antibiotics, or parenteral nutrition. At 5 years of age, older gestational age was associated with significant decreases in rates of cerebral palsy (6.3% at 30 weeks and 0.7% at 34 weeks) and mild to severe cognitive impairments (35.3% at 30 weeks and 23.9% at 34 weeks). In singletons, preterm rupture of membranes or preterm labor carried an increased risk of cerebral palsy but not of cognitive impairment. CONCLUSION: Neonates born at 30-34 weeks experienced substantial morbidity and often required admission to neonatal intensive care units. These outcomes suggest that prolonging pregnancies beyond 34 weeks may be desirable whenever possible. Infants born at 30-34 weeks should be carefully monitored to ensure prompt detection and management of neurodevelopmental impairment.     

Stimulation of brain lipase activity by polyamines. Comparison with the effect of ACTH

Polyamines, as well as ACTH, strongly stimulate at pH 5.75 triacylglycerol lipase (TAGL) activity from rat brain. Whether the activating potency is expressed in terms of molar concentration or amount of positive charges, polyarginine, polylysine, spermine and spermidine exhibit, in this order, decreasing potencies. By contrast to other lipases, heparin (25 micrograms/ml) inhibits brain TAGL. Polyarginine, polylysine and spermine reverse the heparin-dependent inhibition and further stimulate TAGL activity above basal values; spermidine is much less potent. In the presence of heparin, ACTH has the greatest stimulating effect, being 1.6-fold and 3.3-fold more potent than polyarginine and polylysine, respectively. Taken together, the data suggest that polybasic effectors modify the interaction of TAGL with its substrate, resulting in increased levels of TAGL activity. In the presence of heparin, the enzyme charge density is mandatory for determining the stimulation process. Such cationic interactions appear to be specific of brain TAGL and should be considered in assessing any direct neuro-hormonal role to ACTH or physiological polyamines in brain.     

The Fate of Global Precedence With Age

The literature is virtually devoid of studies examining the effect of aging on the ''global precedence'' effect (Navon, D. [1977]. Cognitive Psychology, 9, 353-383). In this paradigm, global letters formed with local letters are shown, and the subject has to recognize either the local or the global letters. The relation between the global and the local letters is either congruent, neutral, or conflicting. Five experiments are reported, with five sets of 16 young and five sets of 16 elderly, healthy, adult subjects. The global precedence effect was observed in both age groups in the basic perceptual experiment as designed by Navon (Experiment 1). In addition, young and elderly subjects were able to process separately the global and the local shapes when attention was not directed towards a specific level (Experiment 1a). However, subpopulations emerged, especially in the elderly, depending on their ability to ''resist'' to the interference of the global shape upon the processing of the local form. This could support the few indirect published data suggesting that global precedence tends to diminish or to disappear with age. In experiments 2 and 2a, subjects were retained only if they did process the local level better than at random. Global precedence was confirmed in both young and elderly subjects. Again, elderly subjects manifested an increased sensitivity to interference. Moreover, a general effect of age remained, even in the control (neutral) conditions, suggesting difficulties of encoding in elderly. Therefore, in Experiment 3, encoding conditions of both age groups were equated by increasing exposure durationof the material for elderly. Subjects of Experiment 3 were also submitted to a Strooptest, to verify whether the increased sensitivity to interference in the elderly was specific to the ''Navon task'' or the expression of a general effect of aging on inhibition mechanisms. The global precedence phenomen on was observed in young andelderly subjects, with no sign of an effect of age under these conditions; in elderly, furthermore, the interference effect did not appear to result froma general aspecific deficit of inhibition mechanisms. It thus appears that the global precedence phenomenon resists well the effects of aging, but that subpopulations of elderly subjects should be considered in future studies.     

Thrombin generation and procoagulant phospholipids in patients with essential thrombocythemia and reactive thrombocytosis

Thrombocytosis is a commonly encountered clinical scenario and can be either a secondary process (reactive thrombocytosis), or due to clonal disorder (i.e., essential thrombocythemia). This distinction is important as it carries implications for evaluation, prognosis and treatment. In this study we compared procoagulant potential in essential thrombocythemia and reactive thrombocytosis by measuring the thrombin generation and the level of circulating procoagulant phospholipids with functional tests. Twenty nine patients with essential thrombocythemia and 24 with reactive thrombocytosis were studied. Thrombin generation was determined by calibrated automated thrombography. Procoagulant phospholipids were detected by a chronometric standardised method (STA‐Procoag‐PPL). Patients with reactive thrombocytosis had a longer lag time, higher endogenous thrombin potential, peak of thrombin generation and velocity index than patients with essential thrombocythemia. The level of circulating procoagulant phospholipids was increased in patients with essential thrombocythemia as observed with the procoagulant phospholipids assay. Each parameter was analysed using ROC curves. Highest areas under the curve (AUC) were found for lag time and procoagulant phospholipids ratio (0.817 and 0.853, respectively), associated with high negative predictive value for ET (92.3% and 80%, respectively). In conclusion, patients with essential thrombocythemia and reactive thrombocytosis displayed significant differences in terms of thrombin generation and levels of procoagulant phospholipids. Among these parameters, lag time and procoagulant phospholipids ratio could help to differentiate between reactive thrombocytosis and essential thrombocythemia patients. Am. J. Hematol. 88:1007–1011, 2013. © 2013 Wiley Periodicals, Inc.     

Unweaving the Web: An Exploratory Study of Low-Literate Adults' Navigation Skills on the World Wide Web

For traditionally underserved populations, the Web can potentially unlock resources that could fundamentally improve health and wellbeing. However, there are many barriers to using Web-based content. While physical access issues are well documented, there is little understanding of how nonmainstream populations use or will use the Web. Based on an ethnographic study of a group of low-literate adults, we have identified specific navigational and content issues that present barriers to this population. We discuss preliminary assumptions that can be used to inform the development of Web tools for this target audience, and directions for future applied research.     

Genetic control of myeloproliferation in BXH-2 mice

While studying the unique Nramp1 (Slc11a1)-independent susceptibility to Mycobacterium bovis (BCG) infection of BXH-2 mice, we noted that these mice develop important splenomegaly and enlargement of lymph nodes. Segregation analyses in several F2 crosses showed that splenomegaly segregates as a single recessive trait caused by a novel mutation in BXH-2, independent of the infection. Histologic and fluorescence-activated cell sorter (FACS) analyses indicated that splenomegaly is associated with a large increase in Mac1+/GR1+ (macrophage antigen-1+/granulocyte differentiation antigen 1+) granulocyte precursors in spleen, lymph nodes, and bone marrow, resembling a myeloproliferative syndrome. This is concomitant to extramedullary erythropoiesis in the spleen, as measured by proportion of Ter119+ erythroid cells. The locus controlling this myeloproliferative syndrome and splenomegaly was designated Myls and maps to an 18 centimorgan (cM) region of chromosome 8, which also contains an integrated copy of an N-ecotropic murine leukemia virus (MuLV) provirus (Emv2). The relationship between Myls, expansion of Mac1+/GR1+ cells, and Emv2 was investigated. Homozygosity at Myls is necessary but not sufficient for B-ecotropic virus replication in splenocytes, the extent of which appears to be under separate genetic control. Our results suggest a model in which Myls-dependent myeloproliferation in BXH-2 acts as a predisposing factor for the subsequent development of virally induced myeloid leukemia characteristic of this strain.