Immunohistochemical Predictors for Intestinal and Pancreatobiliary Types of Adenocarcinoma of The Ampulla of Vater

Objectives

To investigate immunohistochemical predictors for intestinal and pancreatobiliary types of adenocarcinoma of ampulla of Vater and identify clinicopathological characteristics associated with the histological types and patient survival.

Methods

Immunohistochemical markers included MUC1, MUC2, MUC5AC, CDX2, CK7, and CK20. The data were analyzed by univariate and multivariate methods. The two-step cluster method was used to determine the best immunohistochemical markers to discriminate the intestinal from the pancreatobiliary type.

Results

This study identified 9 (33.3%) intestinal and 21 (66.7%) pancreatobiliary tumors. CK7 and CDX2 achieved the highest value (=?1) as predictor markers, while CK20, MUC1, and MUC2 showed degrees of importance equal to 0.77, 0.71, and 0.68, respectively. MUC5AC did not reach 0.50 of importance. In the univariate analysis, lymph node involvement, staging (TNM), and angiolymphatic and perineural invasions were associated with histological types. The independent clinicopathological variable in the multivariate model to predict the histological type was angiolymphatic invasion (p?=?0.005), OR?=?17 (95% CI 2.33 to 123.83). The final model showed positive nodes (N1) associated with shorter survival (HR?=?9.5; p?=?0.006). Overall survival at 12, 36, and 60 months was 88.5, 67.0, and 47.6%, respectively.

Conclusions

CDX2 and CK7 were the immunohistochemical markers that best discriminated the intestinal from the pancreatobiliary type. Lymph node involvement had a high impact on survival and proved to be more frequent in the pancreatobiliary type.

     

Brazilian Intragastric Balloon Consensus Statement (BIBC): practical guidelines based on experience of over 40,000 cases

Background

Intragastric balloons (IGBs) are a minimally invasive option for obesity treatment, acting as a space-occupying device and leading to weight loss through increased satiety. This device has been growing in popularity owing to its safety profile and good weight loss results. However, there are no published guidelines that standardize the technical aspects of the procedure.

Decreased blood pressure is related to changes in NF-kB promoter methylation levels after bariatric surgery

Background

Obesity is characterized by a chronic, low-grade inflammation, and bariatric surgery is proposed as an effective treatment for reducing the obesity-related co-morbidities. Epigenetic modifications could be involved in the metabolic improvement after surgery.

Atrazine contaminated sites and bullfrog tadpoles: evasive trends and biochemical consequences

Atrazine (ATZ) is one of the most used active principles in agricultural systems. This pesticide has the ability to easily accumulate in terrestrial and aquatic environments, causing impacts with chronic adverse effects. Avoidance tests are tests that seek to assess the concentration from which a given organism escapes, that is, migrates to another habitat. They are being used as a modality of innovative and minimally invasive ecotoxicological tests. Our objective was to evaluate the sensitivity and possible toxic effects of ATZ in bullfrog tadpoles (Lithobates catesbeianus), through avoidance tests and oxidative stress analyses. We performed the behavioral avoidance test lasting 12 h, with observations every 60 min in a linear multi-compartment system with seven compartments. Each compartment corresponded to a concentration: negative control, 1, 2, 20, 200, 2000, 20,000 µg L⁻¹. After the selection of habitat, organisms were forcedly maintained in the chosen concentrations for 48 h and then, metabolic effects were measured assessing the blood plasma amino acid profile and liver protein degradation. We also determined the effective concentrations of ATZ tested at 0 h and 48 h. The results showed that there was an effect of the treatment on the distribution of tadpoles, but not on the hours or on the combined effect (interaction). The biochemical analyses also showed a concentration-dependent relationship which caused significant toxic effects even in a short period of time. In conclusion, these frogs were able to avoid places with high concentrations of ATZ in the first hours of exposure, which suggests that in the natural environment these animals can migrate or avoid areas contaminated by this herbicide; however, depending on the selected concentration, serious biochemical consequences can occur.

     

Creatine supplementation impairs airway inflammation in an experimental model of asthma involving P2 × 7 receptor

Creatine (Cr) is a substrate for adenosine triphosphate synthesis, and it is the most used dietary supplement among professional and recreative athletes and sportsmen. Creatine supplementation may increase allergic airway response, but the cellular and molecular mechanisms are unknown. We used murine model of OVA‐induced chronic asthma and showed that Cr supplementation increased total proteins, ATP level, lymphocytes, macrophages, and IL‐5 levels in BALF, as well as IL‐5 in the supernatant of re‐stimulated mediastinal lymph nodes. IL‐5 and IL‐13 expression by epithelial cells and by peribronchial leukocytes were increased by Cr. Cr augmented the expression of P2 × 7 receptor by peribronchial leukocytes and by epithelial cells, and increased the accumulation of eosinophils in peribronchial space and of collagen fibers in airway wall. In human cells, while Cr induced a release of ATP, IL‐6, and IL‐8 from BEAS‐2B cells, whole blood cells, such as eosinophils, and CD4⁺ T cells, P2 × 7 receptor inhibitor (A740003) reduced such effects, as denoted by reduced levels of ATP, IL‐6, and IL‐8. Therefore, Cr supplementation worsened asthma pathology due to activation of airway epithelial cells and peribronchial leukocytes, involving purinergic signaling.