Self-limited travelers' diarrhea by Isospora belli in a patient with dengue infection

Isospora belli diarrhea is usually associated with immunosuppression. This parasite has rarely been reported as a cause of travelers' diarrhea in immunocompetent patients. We present a clinical case of travelers' diarrhea due to I belli in a patient with transient lymphopenia secondary to dengue infection.     

The anti-diabetic drug metformin suppresses the metastasis-associated protein CD24 in MDA-MB-468 triple-negative breast cancer cells

CD24, a mucin-like adhesion molecule that enhances the metastatic potential of malignant cells, has been suggested to be a marker of poor prognosis in breast carcinomas. The tumor-initiating potential of CD44posCD24pos cell populations has been recently recognized and, accordingly, distant metastases are largely composed of CD24-positive cells in breast cancer patients refractory to treatment. Therefore, new therapeutic strategies aimed at down-regulating CD24 may negatively regulate the dissemination of tumor cells and formation of metastasis. Here, we reveal that suppression of CD24 protein expression is a crucial event in the molecular mechanisms underlying the growth-inhibitory effects of the anti-diabetic drug metformin in MDA-MB-468 triple-negative (basal-like) breast cancer cells. First, we confirmed that, among the different molecular classes of breast cancer, basal-like breast cancer cells were significantly more sensitive to the growth-inhibitory effects of metformin. Second, we observed a positive correlation between the growth inhibitory activity of metformin and the relative enrichment in cells bearing the CD44posCD24pos immunophenotype. Third, high-content indirect immunofluorescence imaging assays revealed that CD24 protein levels were drastically decreased in the presence of growth-inhibitory concentrations of metformin. Fourth, to preliminary assess the clinical relevance of metformin's anti-CD24 effects we took advantage of the recently developed ROCK online interface (http://rock.icr.ac.uk/), a publicly accessible portal that allows rapid integration of breast cancer functional and molecular profiling datasets. When we evaluated the impact of CD24 expression on distant metastasis-free survival (DMFS) in microarray gene expression breast cancer datasets, Kaplan-Meier survival analyses and log-rank tests comparing DMSF for CD24-high and CD24-low breast carcinomas revealed that patients with CD24-high tumors tended to have a shorter DMFS. These findings, altogether, suggest that the ability of metformin to suppress the oncogene, metastasis promoter and breast cancer stem cell marker CD24 may open a novel molecular avenue in the therapeutic management of highly-metastastic subgroups of triple-negative (basal-like) breast cancers naturally enriched with CD44posCD24pos tumor-initiating cell populations.     

The Asn19Lys Substitution in the Osteoclast Inhibitory Lectin (OCIL) Gene is Associated with a Reduction of Bone Mineral Density in Postmenopausal Women

Osteoclast inhibitory lectin (OCIL) is a newly recognized inhibitor of mouse and human osteoclast differentiation whose cellular expression is similar to that of receptor activator of nuclear factor kappaB (RANKL). The main objective of the present work was to elucidate whether naturally occurring single-nucleotide polymorphisms (SNPs) in this gene could be associated with bone mass in postmenopausal women. To that end, we studied the association of bone mineral density (BMD) measured by dual-energy X-ray absorptiometry with two nonsynonymous SNPs in the OCIL gene resulting in Asn19Lys and Leu23Val substitutions in a population of 500 postmenopausal Spanish women. A weak association was detected for Asn19Lys SNP with femoral neck (FN) BMD and lumbar spine (LS) BMD in the whole population. When the population was stratified by age, however, the association was strong in older women (> or =53 years). Thus, in this group of participants, women with CG/GG genotype displayed reductions of 5.6% and 6.7% in FN BMD and LS BMD adjusted by age and body mass index (BMI), respectively, compared to women with CC genotype. The Asn19Lys SNP alleles explained about 7% of BMD variance in older women but only 1.7-3.9% in the whole population in regression models including age and BMI. In conclusion, women with a lysine (GG genotype) at position 19 of the OCIL protein displayed lower BMD at femoral neck and at lumbar spine sites than women having an asparagine residue. Since the OCIL protein inhibits osteoclast differentiation, this amino acid substitution could have consequences for OCIL functionality.     

Molecular lymph node staging in bladder urothelial carcinoma: impact on survival

Background

Routine histologic analysis of lymph nodes (LN) for detecting disseminated bladder urothelial carcinoma (BUC) lacks sensitivity.

Objective

To identify and test potential mRNA markers of BUC dissemination in LN that has been missed by histological analysis, and to compare the performance of selected markers with patients’ clinical outcome.

Design, setting, and participants

Microarray data and a literature search were used to identify potential markers expressed in BUC but absent in LN. Five genes were finally selected to be studied by quantitative real-time RT-PCR (qRT-PCR) in 181 and 29 LN from 102 BUC patients and 29 controls, respectively, collected from 2002 to 2004 (median follow-up of 35 mo).

Measurements

The three most expressed genes plus two additional markers selected from the literature were finally evaluated by qRT-PCR. Gene expression values were statistically compared with histologic results and clinical outcome.

Results and limitations

A discriminant analysis showed that the combination of FXYD3 and KRT20 genes yielded a 100% sensitivity and specificity differentiating LN with BUC dissemination from controls. Combined, the expression of both genes allowed the identification of urothelial cells in LN in 20.5% of patients with previous histologically negative LN. These patients did not have a significantly worse survival than those who were negative by qRT-PCR.

Conclusions

Using molecular markers it was possible to improve the sensitivity of LN histologic analysis. However, since 20.5% of patients that reclassified as positive by qRT-PCR did not have a significantly worse survival, we assume lymphadenectomy was important to remove residual disease.     

Ward mortality after ICU discharge: a multicenter validation of the Sabadell score

Background  

Tools for predicting post-ICU patients’ outcomes are scarce. A single-center study showed that the Sabadell score classified patients into four groups with clear-cut differences in ward mortality.     

Understanding Quality of Working Life of Workers with Intellectual Disabilities

Background This paper examines the perceived quality of working life of workers with intellectual disabilities. Specifically, this paper looks at participants’ perceptions in relation to perceived job demands and resources and their impact on experienced job satisfaction. Methods In this cross‐sectional survey, 507 workers with intellectual disabilities, employed in either sheltered workshops or supported employment, completed questionnaires on the quality of working life through semi‐structured interviews. Results Regression analyses showed that perceived low job demands and elevated social support from coworkers and supervisors predicted higher quality of working life. Conclusions Common organizational psychology measures can be successfully used with this population to assess quality of working life. This study confirms the multidimensional nature of quality of working life, and the impact of job demands and available resources on perceived satisfaction with job for workers with intellectual disabilities.     

Developmental changes in nerve growth factor (NGF) binding and NGF receptor proteins trkA and p75 in the facial nerve

This study characterizes the temporal-spatial distribution of nerve growth factor (NGF) low (p75) and high-affinity (trkA) receptors in the facial nerve and geniculate ganglion (GG) of developing quail embryos (E-3 to E-14). We used ¹²⁵I-labeled NGF (¹²⁵I-NGF) to study binding dynamics in a temporal series of isolated primordia and an autoradiographic series of staged specimens to characterize the occurrence and distribution of NGF receptors in this cranial nerve and its ganglion. In addition, expression of trkA and p75 protein-like immunoreactivity in the facial nerve and GG was studied by Western blot, in order to distinguish between high- and low-affinity NGF receptors respectively. The quantitative study of binding show that isolated facial primordia ranging from E-3 to E-14 exhibit different levels of specific binding. High initial binding levels were observed on E-3 specimens, then an initial decrease on day 4 (E-4) followed by a steady increase from days E-4 to E-7. Maximum ¹²⁵I-NGF binding was achieved on E-7, followed by a steady decline in binding on days 8 (E-8) and 9 (E-9), reaching near background levels on day 10 (E-10) of development and until the oldest stage assayed (E-14). Most of the cells bearing NGF receptors appeared to be nonneuronal crest-derived cells, but some placode-derived neurons and motor fibers of the VIIth cranial nerve transiently expressed the ability to bind ¹²⁵I-NGF. The temporal pattern of p75 expression matches the pattern of quantitative binding of NGF, while the trkA expression is restricted to a few stages mainly E7 and E9, implying that most of the binding detected is via low-affinity receptors, except for a proportion of high-affinity receptors present at stages of maximum binding. This temporal pattern of NGF binding sites suggests that cells within the VIIth cranial nerve are responsive to and/or dependent upon NGF in vivo, so NGF may play a biological role during normal development of the facial nerve. In view of the developmental events that parallel the occurrence and type of NGF binding sites, we suggest that this role may be to modulate from earlier chemotaxis and cell proliferation to much later events, such as neuronal differentiation and neuron-glia interactions. The significance of these findings in regeneration during adult life remain to be investigated.     

Altered Peptidase Activities in Thyroid Neoplasia and Hyperplasia

Background. Papillary thyroid carcinoma (PTC), follicular thyroid adenoma (FTA), and thyroid nodular hyperplasia (TNH) are the most frequent diseases of the thyroid gland. Previous studies described the involvement of dipeptidyl-peptidase IV (DPPIV/CD26) in the development of thyroid neoplasia and proposed it as an additional tool in the diagnosis/prognosis of these diseases. However, very little is known about the involvement of other peptidases in neoplastic and hyperplastic processes of this gland. Methods. The catalytic activity of 10 peptidases in a series of 30 PTC, 10 FTA, and 14 TNH was measured fluorimetrically in tumour and nontumour adjacent tissues. Results. The activity of DPPIV/CD26 was markedly higher in PTC than in FTA, TNH, and nontumour tissues. Aspartyl aminopeptidase (AspAP), alanyl aminopeptidase (AlaAP), prolyl endopeptidase, pyroglutamyl peptidase I, and aminopeptidase B activities were significantly increased in thyroid neoplasms when compared to nontumour tissues. AspAP and AlaAP activities were also significantly higher in PTC than in FTA and TNH. Conclusions. These data suggest the involvement of DPPIV/CD26 and some cytosolic peptidases in the neoplastic development of PTC and FTA. Further studies will help to define the possible clinical usefulness of AlaAP and AspAP in the diagnosis/prognosis of thyroid neoplasms.