MicroRNAs in HPV associated cancers: small players with big consequences

Introduction: MicroRNAs (miRs) are short (~20 nucleotides) non-coding ribonuecleic acids (ncRNAs) known to be involved in cellular processes such as proliferation, differentiation, immune response, pathogenicity and tumourigenesis, among many others. The regulatory mechanisms exerted by miRs have been implicated in many cancers, including Human Papillomavirus (HPV)-associated cancers.

Areas covered: In this review, the authors discuss the involvement of miRs (?143, ?375, ?21, ?200, ?296 etc.) that have been shown to be dysregulated in HPV-associated cancers. This review also encompasses both intracellular and exosomal miRs, and their potential as diagnostic biomarkers in saliva and blood. The authors have also attempted to dissect the functional impact of miRs on cellular processes such as changes in cellular polarity, loss of apoptosis and tumour suppression, and unchecked and uncontrolled cell cycle regulation, all of which ultimately lead to aberrant cellular proliferation.

Expert commentary: Identification of dysregulated miRs in HPV-associated cancers opens up new opportunities to develop diagnostic, therapeutic and prognostic biomarkers. Studies on global expression patterns of miRs dysregulated in HPV-associated cancers can be instrumental in developing broader therapeutic strategies. Therapies like anti-miR, miR-replacement and those based on alternative natural products targeting miRs, need to be improved and better synchronized to be cost-effective and have better treatment outcomes.     

Glucose, insulin, and acute myocardial infarction: reply

Dr Das comments that the association between the failure ofglucose levels to drop during hospitalization and higher mortalityfollowing acute myocardial     

Use of potentially inappropriate drugs in nursing homes.

STUDY OBJECTIVES: To examine patterns and determine predictors of inappropriate drug use in nursing homes. DESIGN: Retrospective study. SETTING: One thousand four hundred ninety-two nursing homes in five states. PATIENTS: A total of 44,562 residents admitted to nursing homes over 1 year. METHODS: Frequency of discontinuation and initiation of potentially inappropriate drugs over the first 90 days after admission to a nursing home was calculated. Data were collected using the minimum data set. RESULTS: On admission, 33% of residents were receiving at least one potentially inappropriate drug. After 90 days, the drug was discontinued in 16% of these residents. Of those not receiving a potentially inappropriate drug on admission, one was begun in 18%. Demographic factors and number of drugs taken by patients were associated with the use of potentially inappropriate drugs. CONCLUSIONS; Use of potentially inappropriate drugs was prevalent on admission and at 90 days after admission. Discontinuation was highest among patients with conditions for which potentially safer therapeutic alternatives existed.     

Piroxicam gel, compared to EMLA cream is associated with less pain after venous cannulation in volunteers

PURPOSE: To evaluate and compare the analgesic efficacy and anti-inflammatory effects of topical piroxicam gel vs eutectic mixture of local anesthetic (EMLA) cream applied to the peripheral venous cannulation site in adult volunteers. METHODS: Piroxicam gel and EMLA cream were randomly applied on the dorsum of the right and left hand of ten volunteers who acted as their own control. A venous cannula was inserted (no iv infusion) and removed after one hour. Pain scores and signs of inflammation were noted at the cannulation site up to 48 hr. RESULTS: Pain scores with piroxicam gel were higher on cannulation and on advancement of the cannula (P < 0.05). Thereafter, pain scores were significantly higher with EMLA (P < 0.05). Blanching was present at all the peripheral venous sites treated with EMLA cream. Signs of inflammation (erythema, edema) were not more frequent with EMLA than with piroxicam (P > 0.05). Induration was more frequent with EMLA at six hours. CONCLUSION: In volunteers EMLA cream is associated with less pain on cannulation and cannula advancement compared to piroxicam gel. Topical application of piroxicam gel before peripheral venous cannulation alleviates pain and, possibly, inflammation in the period subsequent to cannulation itself.     

Electrolyte disturbances in acute diarrhoea

Summary A clinical and biochemical study of 100 cases of acute diarrhoea in infancy was done. 75 cases each showed low serum values of sodium and potassium, and chloride was low in 59% and bicarbonate in 66%. Blood urea was raised in 53 cases. From the Department of Pediatrics. Guntur Medical College, Guntur, A.P.