Macrophage polarization as a novel weapon in conditioning tumor microenvironment for bladder cancer: can we turn demons into gods?

Macrophages are major components of the immune infiltration in cancer where they can affect tumor behavior. In the bladder, they play important roles during the resolution of infectious processes and they have been associated with a worse clinical prognosis in bladder cancer. The present review focused on the characteristics of these important immune cells, not only eliciting an innate immune surveillance, but also on their importance during the cancer immunoediting process. We further discuss the potential of targeting macrophages for anticancer therapy, the current strategies and the state of the art as well as the foreseen role on combined therapies on the near future. This review shows how a comprehensive understanding of macrophages within the tumor should translate to better clinical outcome and new therapeutic strategies focusing especially on bladder cancer.

Probable hereditary familial overlap syndrome with multiple synchronous lung tumors

Here we report a case of a young, never-smoker Hispanic woman with a hereditary familial overlap syndrome (Li-Fraumeni plus CDH1). The patient developed multiple synchronous primary lung adenocarcinomas related to Intra-Alveolar Tumor Spread (STAS) several years after the diagnosis of a locally advanced lower limb osteosarcoma. Comprehensive genomic profiling by next generation sequencing (NGS) was performed on 90 cancer-related genes over each lung lesion (including two nodules of acinar adenocarcinoma, one lepidic spread tumor and in the STAS area). Likewise, the broad genomic analysis was performed on archival tissue from the previous bone tumor. Lung tumors were found to harbor PIK3CA (invasive lesions) and a rare in-frame insertion of nucleotides in exon 19 of EGFR (lepidic tumor). STAS area showed KRAS and BRAF mutations in two different segments, and osteosarcoma tested positive for well known PIK3CA, KRAS and CDH1 alterations. This unique case raises practical questions as to the challenges of molecular testing and highlights the potential association of germline TP53 and CDH1 mutations with concurrent somatic alterations that elucidate the basis of tumor heterogeneity.

Multiple Hereditary Exostoses: Report of an EXT2 Gene Mutation in a Colombian Family

Multiple hereditary exostoses (MHE) is a rare disease with autosomal dominant inheritance, caused by heterozygous germline mutations in the EXT1 or EXT2 genes. This disorder is characterized by the growth of prominences surrounded by cartilage in the growth plates and the long bones. Here, we report a family affected by MHE. In this family, a pathogenic variant c.544C > T (p. Arg182Ter) was identified in the EXT2 gene. This variant has been previously described in the literature, and here we are reporting the relationship with clinical findings. MHE is suspected according to the clinical manifestations; molecular research should be performed to establish the most frequent mutations. A support, diagnosis, and follow-up group should be created, and genetic counseling should be available for patients and families.

Metal Concentrations in Wild-Harvested Phaeophyta Seaweed from the Atlantic Ocean (Canary Islands, Spain)

Seaweeds are being consumed more often worldwide and are a source of essential minerals, fiber, vitamins, amino acids, and various bioactive compounds that have many beneficial effects on human health. However, marine pollution and the high capacity of seaweed to absorb metals may mean this food can also be dangerous to human health. The concentrations of some trace elements (B, Ba, Fe, Ni, Li, and V) and toxic metals (Al, Cd, and Pb) were determined in various species of wild seaweeds in the Phaeophyta group of brown algae from the Atlantic Ocean. Inductively coupled plasma atomic emission spectrometry revealed high concentrations of Al (256 mg/kg dry weight), Pb (3.92 mg/kg dry weight), and Cd (0.20 mg/kg dry weight) in Padina pavonica. Pb contributed the most to the tolerable daily intake (TDI) of toxic metals in these samples; 57.2 and 45.3% of the TDI for Pb was found in 5 g of dehydrated P. pavonica and Halopteris scoparia, respectively. This percent contribution is half of the recommended TDI for this metal, which is 34.24 μg/day; therefore, high consumption of these species is discouraged. The maximum TDIs established by various institutions for the other metals were not exceeded from the daily consumption of 5 g of the other dehydrated seaweeds evaluated in this study.

Metal Concentrations in Samples of Frozen Cephalopods (Cuttlefish, Octopus, Squid, and Shortfin Squid): An Evaluation of Dietary Intake

Cephalopods are an important source of nutrients and some of the most widely consumed marine foods. However, because of contamination of the oceans and the bioaccumulative nature of toxic metals, these foods may pose a health risk. For this reason, the concentrations of some trace elements (chromium [Cr], lithium, strontium [Sr], copper [Cu], and nickel) and toxic metals (aluminum [Al], cadmium, and lead) were determined in 65 frozen samples of cuttlefish, octopus, common squid, and shortfin squid by inductively coupled plasma optical emission spectrometry to evaluate dietary intake and toxic risk. Sr was the major trace element (3.03 mg/kg) in cuttlefish; however, Cu (1.57 mg/kg) was found in the highest concentration in common squid. Among the toxic metals, Al had the highest concentration (3.09 mg/kg) in common squid. Al can pose an important health risk to individuals with kidney problems and to children because these groups are most vulnerable to the toxic effects. Significant differences among the four cephalopod types were found in the concentrations of most of the metals examined. Taking into account the average consumption of cephalopods, the contribution of toxic metals does not pose a risk to the health of adults.

Study of insulin vascular sensitivity in aortic rings and endothelial cells from aged rats subjected to caloric restriction: Role of perivascular adipose tissue

The prevalence of metabolic syndrome is dramatically increasing among elderly population. Metabolic syndrome in aged individuals is associated with hyperinsulinemia and insulin resistance both in metabolic tissues and in the cardiovascular system, with this fact being associated with the cardiometabolic alterations associated to this condition. Caloric restriction (CR) improves insulin sensitivity and is one of the dietetic strategies most commonly used to enlarge life and to prevent aging induced cardiovascular alterations. The aim of this study was to analyze the possible beneficial effects of CR in aging-induced vascular insulin resistance both in aortic rings and in primary culture of endothelial cells. In addition, the inflammatory profile of perivascular adipose tissue (PVAT) and its possible role in the impairment of vascular insulin sensitivity associated with aging was also assessed. Three experimental groups of male Wistar rats were used: 3 (3m), 24 (24m) fed ad libitum and 24months old rats subjected to 20% CR during their three last months of life (24m-CR). Aorta rings surrounded or not by PVAT were mounted in an organ bath and precontracted with phenylephrine (10^-7.5M). Changes in isometric tension were recorded in response to cumulative insulin concentrations (10^-8-10^-5.5M) in the presence or absence of L-NAME (10^-4M). Aortic rings and primary aortic endothelial cells were incubated in presence/absence of insulin (10^-7M) and the activation of the PI3K/Akt and MAPK pathways as well as nitrite and nitrates concentrations and the mRNA levels of eNOS, insulin receptor, and GLUT-4 were assessed. CR prevented the aging-induced decrease in the vasodilator response to insulin and the aging-induced increase in the vasoconstrictor response to high insulin concentrations. Changes between 24m and 24m-CR aorta rings were abolished in the presence of L-NAME. CR induced-improvement in insulin vascular sensitivity was related with activation of the PI3K/Akt both in aortic rings and in aortic endothelial cells in response to insulin. CR attenuated the overexpression of iNOS, TNF-α and IL-1β in the PVAT of aged rats although aortic rings surrounded by PVAT from 24m rats showed and increased vasorelaxation in response to insulin compared to aortic rings from 3m and 24m-CR rats. In conclusion, a moderate protocol of CR improves insulin vascular sensitivity and prevents the aging induced overexpression of pro-inflammatory cytokines in PVAT.

Metals in edible seaweed

The concentration levels of 20 metals were analyzed by ICP-OES in edible seaweed (Chondrus, Eisenia, Gelidium, Himanthalia, Laminaria, Palmaria, Porphyra, Undaria), from two origins (Asia vs EU) according to their cultivation practices (conventional vs organic). Red seaweed showed higher concentrations of trace and toxic elements. Porphyra may be used as a potential bioindicator for metals. Significant differences were found between the Asian vs European mean contents. The mean Cd level from the conventional cultivation (0.28 mg/kg) was two points higher than the organic cultivation (0.13 mg/kg). A daily consumption of seaweed (4 g/day) contributes to the dietary intake of metals, mainly Mg and Cr. The average intakes of Al, Cd and Pb were 0.064, 0.001 and 0.0003 mg/day, respectively. Based on obtained results, this study suggests that exposure to the toxic metals analyzed (Al, Cd and Pb) through seaweed consumption does not raise serious health concerns, but other toxic metals should be monitored.

Door in - door out assessment of patients admitted with acute ST-segment elevation myocardial infarction in hospitals without catheterization facilities

BACKGROUND

Many patients with acute ST-segment elevation myocardial infarction (STEMI) are admitted to emergency departments (EDs) of centres without percutaneous coronary intervention (PCI) facilities. The 2012 European Society of Cardiology guidelines recommend transfer to a PCI centre with a "door in - door out" (DI-DO) time≤30min.

PURPOSE

To report DI-DO times in a registry of patients with acute STEMI.

METHODS

The RESeau des Urgences CORonarienne (RESUCOR) is a permanent registry of patients admitted with acute STEMI in 16 hospitals in the north French Alps since 2002. In patients admitted to a non-PCI centre, the DI-DO times were split into "diagnostic time" (from admission to transfer decision) and "logistical time" (from transfer decision to discharge).

RESULTS

Of 2081 patients included in the registry from 2012 to 2014, 493 were admitted directly into an ED (254 PCI centre and 239 non-PCI centre). Of those admitted into an ED of a non-PCI centre, 228 were immediately transferred to a PCI centre (76 treated with thrombolysis and 132 with primary PCI). The proportions of patients with DI-DO≤30min and median (interquartile range [IQR]) DI-DO times are reported in the Table 1. Median (IQR) DIDO times were 90.5 (69-118) min for patients treated with thrombolysis and 88 (62-147) min for primary PCI.

CONCLUSIONS

DI-DO times were longer than recommended. Efforts to decrease these delays are required. Transfer with a non-PCI centre ambulance is preferable.

Clinical effectiveness of grip strength in predicting ambulation of elderly inpatients

Background

Assessing the clinical effectiveness of measuring grip strength as a prognostic tool in recovering ambulation in bed-confined frail elderly patients.

Methods

A prospective study was carried out with 50 elderly inpatients (mean age: 81.6 years old). Manual muscle test was used for checking strength of hip flexor muscles, hip abductor muscles and knee extensor muscles. Grip strength was assessed by hydraulic dynamometer. Walking ability was assessed by functional ambulation categories and Functional Classification of Sagunto Hospital Ambulation. Existence of cognitive impairment (Short Portable Mental Status of Pfeiffer) and comorbidity (abbreviated Charlson index) were considered to be confounding variables.

Statistical analysis

Simple comparisons and mixed models of multiple ordinal regression.

Results

The sample presented generalized weakness in scapular (mean 4.22) and pelvic (mean 3.82) muscle. Mean hand grip values were similar: 11.98 kg right hand; 11.70 kg left hand. The patients had lost walking ability. After treatment, there was a statistically significant for scapular waist strength (P=0.001), pelvic waist strength (P=0.005) and walking ability (P=0.001). A statistically significant relationship in the regression analysis was found between the grip (right and left hands) and walking ability post-treatment (P=0.009; odds ratio 1.14 and P=0.0014 odds ratio 1.113 for each walking scale). The confounding variables showed no statistical significance in the results.

Conclusion

Grip strength is associated with walking ability in hospitalized frail elderly. Grip strength assessment by hydraulic dynamometry is useful in patients with poor collaboration. Walking ability training in frail elderly inpatients is useful.

Evaluation of content and estimation of daily intake of cadmium and lead in several varieties of potatoes (Solanum tuberosum L.) cultivated in the Canary Islands (Spain)

Monitoring the metal content in foods such as potatoes is an important aspect of food safety and regulation. Samples of nine varieties of potatoes (73 samples of local potatoes and 77 samples of imported potatoes) were randomly obtained from supermarkets, farmers markets, and farmer plots in Tenerife (Canary Islands, Spain). The edible portion (pulp) was the only part considered for analysis because Spaniards traditionally eat only peeled potatoes. Cadmium (Cd) and lead (Pb) were determined using graphite furnace atomic absorption spectrometry. Cd concentrations ranged from 0.006 mg/kg in the Cara and Negra varieties to 0.019 mg/kg in the Bonita variety, and Pb concentrations ranged from 0.007 mg/kg in the Up-to-date variety to 0.023 mg/kg in the Recara variety. The mean concentrations of Cd (0.01 mg/kg) and Pb (0.014 mg/kg) were below the limits established by European regulations for potatoes (0.1 mg/kg of wet weight for each metal). Based on a mean consumption of 143.2 g of potato per person per day for the Canary Islands population, the mean daily intakes of Cd (0.015 mg/day) and Pb (0.023 mg/day) were below the legislated respective tolerable weekly intakes. Thus, the samples analyzed were considered safe to eat with regard to the metal concentrations found.

[Mineral composition of different types of Canarian gofio; factors affecting the presence of Na, K, Mg, Ca, Mn, Fe, Cn and Zn]

The contents of Na, K, Mg, Ca, Mn, Fe, Cu and Zn were analyzed and evaluated in 181 samples of various types of gofio produced from different roasted cereal grains. Samples were analyzed by ICP-OES. Based on a daily gofio intake of 30 g/day for adults and 15 g/day for children, the daily intake of each metal, and its percentage contribution to the RDAs established for the Spanish population, were estimated. The metal with the highest concentration was K (2189 ± 766 mg/kg). The lowest concentration was observed for Cu in corn gofio samples (2.05 ± 0.36 mg/kg). With respect to daily intake, it is noteworthy that gofio contributes significantly to the recommended allowance of copper (53.77%-71.45% of the RDI), depending on the population group considered and on the type of gofio.

Trace elements and toxic metals in intensively produced tomatoes (lycopersicon esculentum)

INTRODUCTION

Tomato is considered a healthy food due to its high content in lycopene and other health-promoting natural compounds. Tomatoes have, undoubtedly, assumed the status of a food with functional properties, considering the epidemiological evidence of reducing the risk of certain types of cancers.

OBJECTIVE

Samples of tomatoes from Morocco were analyzed for the mineral composition.

METHODS

94 tomato samples from Morocco were analyzed. Flame Atomic Absorption Spectrophotometry (FAAS) was used to determine essential elements (Copper (Cu), iron (Fe), manganese (Mn) and zinc (Zn)) and Atomic Absorption Spectrophotometry with Graphite Furnace (GAAS) was used to analyzed cadmium (Cd) and lead (Pb).

RESULTS

The mean concentrations were 0.17 mg/kg, 0.73 mg/kg, 0.20 mg/kg, 0.44 mg/kg, 7.58 μg/kg and 15.8 μg/kg for Cu, Fe, Mn, Zn, Cd and Pb, respectively. The highest contribution to the intakes was observed for Cu (0.67% for adults) while that Zn showed the lowest contribution (0.14% for adult males and 0.20% for adult females).

CONCLUSIONS

Tomatoes are a good source of essential elements for the diet, mainly iron and zinc. Tomatoes consumption does not significantly affect the intake of heavy metals.