Genetic and epigenetic alterations of the EGFR and mutually independent association with BRCA1, MGMT,and RASSF1A methylations in Vietnamese lung adenocarcinomas

Genetic and epigenetic alterations importantly contribute to the pathogenesis of lung cancer. In the study, we measured the frequency and distribution of molecular abnormalities of EGFR as well as the aberrant promoter methylations of BRCA1, MGMT, MLH1, and RASSF1A in Vietnamese lung adenocarcinomas. We investigated the association between genetic and epigenetic alteration, and between each abnormality with clinicopathologic parameters. Somatic EGFR mutation that was found in 49/139 (35.3%) lung adenocarcinomas showed a significant association with young age, female gender, and non-smokers. EGFR overexpression was identified in 82 tumors (59.0%) and statistical relationships with EGFR or BRCA1 methylation but not EGFR mutation. In addition, EGFR, BRCA1, MGMT, MLH1, and RASSF1A methylations were found in 33 (23.7%), 41 (29.5%), 46 (33.1%), 28 (20.1%), and 41 (29.5%) cases of a total of 139 lung adenocarcinomas, respectively. The RASSF1A methylation was found to be linked to the smoking habit. Methylations in MGMT and RASSF1A were also found to correlate with metastasis status. Furthermore, the distribution of EGFR mutation and that of BRCA1, MGMT or RASSF1A methylation were significantly exclusive in lung adenocarcinomas. The main finding of our study demonstrate that epigenetic abnormalities might play a critical role for the lung tumorigenesis in patients with smoking history and metastasis, and partly affect the predictive value of EGFR mutations through blocking expression due to promoter EGFR hypermethylation. Mutually exclusive distribution of genetic and epigenetic alterations reflects differently biological characteristics in the etiology of lung adenocarcinomas.     

Health Behavior Correlates of Depression in a Sample of High School Students

Frequency of symptoms of depression and selected health-related practices and events were measured in a sample of 219 high school students. Students reported numerous symptoms of depression. Relative proportions of boys and girls reporting symptoms of depression were not significantly different. However, girls reported experiencing more severe depression than their male counterparts. Depression correlated significantly with several of the 22 health practices and states of affect examined. Both the determinants and manifestations of depression in adolescent cohorts require in-depth investigation. Possible implications for school health personnel are discussed.     

Trial of a new method of natural family planning in Liberia

This paper describes the evaluation of a new method of natural family planning (NFP) in Liberia. The Modified Mucus Method (MMM) was developed to address the need for a simple method of charting for poor and illiterate women. The acceptance, use, and cost-effectiveness of the MMM were compared with standard NFP methods, the sympto-thermal and ovulation method (ST/OM), used in the same population.The personal discontinuation rate of MMM users was 27.3 per 100 women per year compared with 3.2 among ST/OM users. Unplanned pregnancy rates were low for both MMM and ST/OM, 6.6 and 1.5 respectively. The cost per couple year protection (CYP) for MMM was $55.80 and for ST/OM $56.10. There were differences in characteristics between MMM and ST/OM clients. The MMM clients were more likely to have attended school and to have used a family planning method previously, and were less likely to be housewives.We conclude that the MMM in Liberia was provided to an inappropriate sample of women, educated and middle-class rather than poor and illiterate. The MMM users were dissatisfied and discontinued at the rate of 44 per 100 women entering per year. This is an unfair evaluation of the MMM because of the unsuitable study population. It is our opinion that the MMM needs more study to become part of the inventory of birth spacing methods.

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Resumen Este trabajo describe la evaluación de un nuevo método de planificación familiar natural (PFN) in Liberia. El Método del Moco Modificado (MMM) se desarrolló a fin de atender a la necesidad de un método sencillo de registro para mujeres pobres y analfabetas. La aceptación, el uso y la eficacia en función de los costos del MMM se comparó con los métodos estándares de PFN, el Método Sintotérmico y de Ovulación (ST/OM), utilizado en la misma población.La tasa de abandono personal de las usuarias del MMM fue 27,3 por cada 100 mujeres por año en comparación con 3,2 entre las usuarios del ST/OM. El costo por protección-año de la pareja en le caso del MMM fue $55,80 y el del ST/OM $56,10. Hubo características diferentes entre las usuarias del MMM y del ST/OM. Había más probabilidades de que las usuarias del MMM hubieran asistido a la escuela y utilizado métodos de planificación familiar anteriormente, y menos probabilidades de que fueran amas de casa. Llegamos a la conclusión de que el MMM en Liberia era proporcionado a una muestra inadecuada de mujeres, más bien educadas y de clase media que pobres y analfabetas. Las usuarias del MMM estaban insatisfechas y lo abandonaron a razón de 44 por cada 100 mujeres que lo adoptaban por año. Esta es una evaluación injusta del MMM debido a lo inadecuado de la población del estudio. Opinamos que el MMM requiere mayores estudios para poder llegar a integrar el inventario de métodos de espaciamiento de nacimientos.

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Resumé Le présent exposé décrit l'évaluation d'une nouvelle méthode de planning familial naturel au Libéria. La méthode de modification des glaires (MMM) a été mise au point pour satisfaire au besoin de disposer d'une méthode simple pouvant être appliquées par les femmes pauvres et analphabètes. L'acceptation, l'utilisation et l'efficacité de cette méthode par rapport à son coût ont été comparées à celles d'autres méthodes de planning familial naturel, à la méthode sympto-thermique et de l'ovulation (ST/O), appliquées dans cette même population.Le taux d'abandon de la MMM pour des raisons personnelles s'est élevé à 27,3 par an, alors qu'il était de 3,2 chez les femmes utilisant la méthode ST/O. Le nombre des grossesses non planifiées était faible pour l'une et l'autre des méthodes, soit 6,6 pour la MMM et 1,5 pour la méthode ST/O. Le coût annuel de la protection par couple se situait à $55,80 pour la première méthode et à $56,10 pour la seconde. Les femmes présentaient des caractéristiques différentes d'un groupe à l'autre. Celles qui utilisaient la MMM étaient plus souvent susceptibles d'avoir été scolarisées et d'avoir auparavant utilisé une méthode de planning familial, et moins susceptibles d'être des ménagères.Nous en avons conclu que la MMM avait été mise à la disposition d'un groupe de femmes éduquées, de classe moyenne, à qui elle ne convenait pas, plutôt qu'à des femmes pauvres et analphabètes. Les utilisatrices n'en étant pas satisfaites, elles avaient abandonné la méthode à un pourcentage de 44 pour cent femmes l'essayant chaque année. Cette évaluation de la MMM n'est pas valable car cette méthode n'était pas adaptée à la population étudiée. Nous estimons qu'il est nécessaire d'étudier plus en profondeur la MMM si l'on veut qu'elle fasse partie de l'ensemble des méthodes visant à espacer les naissances.

     

Nosocomial colonisation and infection in a paediatric respiratory intensive care unit.

A study of the prevalence of nosocomial colonisation and nosocomial infection (NI) was conducted in the paediatric respiratory intensive care unit of a large teaching hospital serving a developing community. Surveillance specimens were collected regularly from 63 consecutive patients admitted over 4 months, and also from professional staff, boarder mothers, cleaners and the unit environment. The incidence among patients of colonisation (40%) and of NI (43%) was high. The risk of dying in children with NI was appreciably increased (relative risk 2,241, confidence interval 0,591-8,503). This did not reach statistical significance, probably because so few children escaped acquiring hospital organisms. The significant risk factor for acquiring colonisation (P = 0.008) and NI (P < 0.0001) was a ward stay of more than 10 days. In addition, for acquiring NI an age of under 6 months was also predictive (P = 0.0298). The nature of the primary illness dictated the time spent in the ward; an important proportion of patients had preventable diseases, such as measles, pneumonia and tetanus, which required prolonged treatment. All children with endotracheal intubation had hospital-acquired organisms in tracheal aspirates. Eighty-two per cent of children developed positive gastric aspirates, 17% a positive urine culture and 11% a positive blood culture. Colonisation occurred rapidly; organisms initially appeared in gastric aspirates (mean 2 days), then in tracheal aspirates (mean 5 days) and urine cultures (mean 10 days). The acquired organisms, many of which were antibiotic-resistant, were almost exclusively enteric Gram-negative bacilli (GNB) and Staphylococcus aureus.(ABSTRACT TRUNCATED AT 250 WORDS)     

Chronic pulmonary manifestations of varicella in adults. Apropos of 2 cases

The pulmonary manifestations of varicella are observed more frequently in adults than in children. They make present according to 3 modes: acute, subacute or chronic. The authors report 2 cases of chronic pulmonary manifestations in the form of diffuse, partially calcified micronodular lesions of both lung fields observed in the course of varicella in adults.     

Designing the workstation for the immediate future

Conclusions Although much attention is being given to the design of the anesthesia workstation of the next century, significant opportunities exist to improve current systems. There have been sufficient technological advances that enable immediate improvement on current techniques and methodologies. As this team realized, much can be done to improve the workstation of the immediate future.