Metabolic-associated fatty liver disease and hepatocellular carcinoma: a prospective study of characteristics and response to therapy

BACKGROUND AND AIM

The rising incidence of hepatocellular carcinoma (HCC) in Australia is related to increasing rates of metabolic-associated fatty liver disease (MAFLD). This study aimed to prospectively characterize the metabolic profile, lifestyle, biometric features, and response to treatment of HCC patients in an Australian population.

METHOD

Multicenter prospective cohort analysis of newly diagnosed HCC patients at six multidisciplinary team meetings over a 2-year period.

RESULTS

Three hundred and thirteen (313) newly diagnosed HCC patients with MAFLD (n = 77), MAFLD plus other liver disease (n = 57) (the "mixed" group), and non-MAFLD (n = 179) were included in the study. Alcohol-associated liver disease (ALD) (43%) and MAFLD (43%) were the most common underlying liver diseases. MAFLD-HCC patients were older (73 years vs 67 years vs 63 years), more likely to be female (40% vs 14% vs 20%), less likely to have cirrhosis (69% vs 88% vs 85%), showed higher ECOG, and were less likely to be identified by screening (29% vs 53% vs 45%). Metabolic syndrome was more prevalent in the MAFLD and mixed groups. The severity of underlying liver disease and HCC characteristics were the same across groups. While the MAFLD population self-reported more sedentary lifestyles, reported dietary patterns were no different across the groups. Dyslipidemia was associated with tumor size, and those taking statins had a lower recurrence rate.

CONCLUSION

Equal to ALD, MAFLD is now the most common underlying liver disease seen in HCC patients in Australia. Future HCC prevention screening and treatment strategies need to take this important group of patients into consideration.

Rapid culture-based LNZ test for detection of linezolid susceptibility/resistance in staphylococci and enterococci

A rapid, easy-to-handle, cost-effective and universal culture-based test was developed for the identification of linezolid resistance among the most clinically relevant enterococcal and staphylococcal species. Our technique was tested using linezolid-resistant (n = 50) and linezolid-susceptible (n = 67) Gram-positive isolates: 34 Enterococcus faecium, 20 Enterococcus faecalis, 20 Staphylococcus aureus, 38 Staphylococcus epidermidis, and 5 Staphylococcus capitis. The susceptibility/resistance phenotype of E. faecium, E. faecalis, S. aureus, and S. epidermidis to linezolid was detected within 4.5 hours, while an extended timeframe was actually required for S. capitis (6.5 hours). The Rapid LNZ test showed a full agreement with the standard broth microdilution method, independently of the molecular resistance mechanism and MIC values, with sensitivities and specificities of 100% for all species.

ESBL- and Carbapenemase-Producing Escherichia coli and Klebsiella pneumoniae among Bivalves from Portuguese Shellfish Production Areas

Bivalves are filter-feeding organisms and biomarkers of bacterial pollution. Our study aimed to analyze the occurrence and characteristics of extended-spectrum β-lactamase (ESBL)- and carbapenemase-producing Escherichia coli among bivalves. A total of 522 bivalve samples were collected along Portuguese shellfish production areas. Homogenized samples were screened for E. coli contamination on corresponding selective plates, allowing for concomitant growth of Klebsiella pneumoniae. E. coli growth was observed in 39% of the samples. Subsequent selective screening identified nine samples (4.4%) contaminated with ESBL producers, corresponding to E. coli (n = 7) and K. pneumoniae (n = 2), while a single carbapenemase-producing K. pneumoniae (0.5%) was identified. ESBLs were all CTX-M-types commonly identified in human isolates, i.e., CTX-M-32 (n = 4), CTX-M-15 (n = 4), and CTX-M-14 (n = 1). The carbapenemase producer harbored the bla_GES-5 gene located on a ColE plasmid. Clonality was evaluated by multilocus sequence typing, identifying E. coli backgrounds as ST10, ST23, ST540, ST617, ST746, SLV206, and SLV2325, commonly identified among environmental and human strains. The K. pneumoniae isolates belonged to ST834, ST15, and DLV644. The occurrence of ESBL- and carbapenemase-producing Enterobacteriaceae in bivalves reveals how the marine environment constitutes a reservoir of critical bacterial pathogens, thus potentially representing a risk to human health.

Assessing oral reading fluency within and across grade levels: Development of equated test forms

Deficits in oral reading fluency (ORF) impair reading comprehension and tend to persevere throughout schooling. Therefore, the assessment and monitoring of the students' performance in ORF across time should be routinely performed to guide the instruction and intervention. The goal of this work was to develop and validate a test of ORF for Portuguese students from grades 1 to 6 (TAF - Teste de Avaliação da Fluência) that includes specific test forms for each grade level with equated scores that allow comparison across multiple assessment points. In study 1 (N = 1166), the chained equipercentile equating method was performed to equate the test forms' scores horizontally and vertically. The tests of differences performed using the equated scores indicated that they were similar within the same grade level but increased significantly across grade levels. In study 2 (N = 549), reliability and validity evidence for the test forms was collected. Test-retest correlations were higher than .90, suggesting a high stability of the scores. Significant correlations between the TAF scores and the ones obtained in other reading tests, teachers' judgments, and school outcomes, were obtained, thus providing evidence of validity for the developed test forms. This instrument allows not only interindividual comparisons but also the assessment of intra-individual changes in ORF across time or as a result of intervention programs, while avoiding learning effects that arise when the same measure is administered multiple times.

Reading, linguistic, and metacognitive skills: are they reciprocally related past the first school years?

Empirical research has systematically demonstrated the predictive role of reading, linguistic and metacognitive skills on reading comprehension performance. The study of the directionality of these relations and their relative contribution in the more advanced grades of primary school is an important aim for reading research, with practical implications for educational contexts. These issues are of particular relevance in semitransparent orthographies such as European Portuguese, as there is empirical evidence that these relations change over time. The goal of this study was to examine the longitudinal relations between oral reading fluency, listening comprehension, vocabulary, reading strategy use and reading comprehension in Portuguese students across grades 4 to 6. For this purpose, reciprocal-causation models with cross-lagged paths were tested using Mplus. The sample included 110 students who completed at least two assessment time points. The results indicated that there is a reciprocal relation between listening comprehension and reading comprehension, as well as between vocabulary and reading comprehension, in every grade. Oral reading fluency was a significant predictor of reading comprehension across grades 4-6, but the opposite relation was not verified. Reading strategy use in grade 5 was predicted by reading comprehension in grade 4. The results are discussed considering previous studies and their potential impact on psychoeducational practice and research. Limitations of the study and guidelines for future research are pointed out.

Epidemiology and impact of frailty in patients with atrial fibrillation in Europe

BACKGROUND

Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent.

OBJECTIVES

We aim to perform a comprehensive evaluation of frailty in a large European cohort of AF patients.

METHODS

A 40-item frailty index (FI) was built according to the accumulation of deficits model in the AF patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Association of baseline characteristics, clinical management, quality of life, healthcare resources use and risk of outcomes with frailty was examined.

RESULTS

Among 10,177 patients [mean age (standard deviation) 69.0 (11.4) years, 4,103 (40.3%) females], 6,066 (59.6%) were pre-frail and 2,172 (21.3%) were frail, whereas only 1,939 (19.1%) were considered robust. Baseline thromboembolic and bleeding risks were independently associated with increasing FI. Frail patients with AF were less likely to be treated with oral anticoagulants (OACs) (odds ratio 0.70, 95% confidence interval 0.55-0.89), especially with non-vitamin K antagonist OACs and managed with a rhythm control strategy, compared with robust patients. Increasing frailty was associated with a higher risk for all outcomes examined, with a non-linear exponential relationship. The use of OAC was associated with a lower risk of outcomes, except in patients with very/extremely high frailty.

CONCLUSIONS

In this large cohort of AF patients, there was a high burden of frailty, influencing clinical management and risk of adverse outcomes. The clinical benefit of OAC is maintained in patients with high frailty, but not in very high/extremely frail ones.

Profilaxia Pré-Exposição para o Vírus da Imunodeficiência Humana e os Cuidados de Saúde Primários

N/a.

Efeito das competências de literacia emergente na aprendizagem inicial da leitura

Vários estudos têm sugerido que os conceitos acerca do impresso, os conhecimentos acerca da escrita, o reconhecimento de letras e a consciência fonológica são preditores da aprendizagem inicial da leitura. No entanto, são mais escassos os estudos que visam determinar em que medida estas variáveis permitem identificar com precisão os alunos em risco na aprendizagem inicial da leitura, sendo esta a questão visada neste estudo. A amostra foi constituída por 60 alunos do 1º ano de escolaridade, com idades compreendidas entre os 6 e os 8 anos. Os alunos foram avaliados no início do 1.º ano com provas que avaliavam os conceitos acerca do impresso, os conhecimentos acerca da escrita, o reconhecimento de letras e a consciência fonológica. No final do ano foi-lhes administrada uma prova de leitura de palavras. Os resultados da análise de regressão logística indicaram que as variáveis em estudo não predizem o risco de dificuldades na leitura no final do 1.º ano de escolaridade. Todavia, a análise de curvas ROC sugeriu uma precisão razoável na identificação de alunos em risco na aprendizagem da leitura, tendo por base o desempenho em consciência fonológica.

Premature rupture of membranes - A cause of foetal complications among lupus: A cohort study, systematic review and meta-analysis

OBJECTIVE

The present study aimed to analyse the frequency of premature rupture of membranes (PROMs) among 190 women with systemic lupus erythematosus (SLE) followed up at the Hospital Universitário Pedro Ernesto from 2011 to 2018 and to review the literature on PROM in patients with SLE.

METHODS

A cohort study of SLE patients was conducted by analysing the following variables: sociodemographic characteristics, clinical manifestations of lupus, modified disease activity index for pregnancy, drugs used during pregnancy, intercurrent maternal infections and obstetric outcomes. Additionally, seven electronic databases (PubMed, Embase, Cochrane, Scielo, Scielo Brazil, Virtual Health Library Regional Portal and Google Scholar) were systematically searched. The search was updated on 3 February 2020.

RESULTS

Infections (relative risk (RR): 3.26, 95% confidence interval (CI): 1.5-6.7, p = .001), history of serositis (RR: 2.59, 95% CI: 1.31-5.11, p = .006) and anti-RNP positivity (RR: 3.08, 95% CI: 1.39-6.78, p = .005) were associated risk factors for PROM, while anti-RNP positivity (RR: 3.37, 95% CI: 1.35-8.40; p = .009) were associated with premature PROM (PPROM). The prevalence of PROM and PPROM was 28.7% and 12.9%, respectively. In the systematic review, the prevalence of PROM and PPROM was 2.7%-35% (I² = 87.62%) and 2.8%-20% (I² = 79.56%), respectively.

CONCLUSIONS

PROM, both at term and preterm, occurs more frequently in women with lupus than in the general population. A history of serositis, anti-RN, infections and immunosuppression during pregnancy may increase the susceptibility to PROM. The systematic review did not find any study with the main objective of evaluating PROM/PPROM in women with lupus.

Early Cerebrovascular Ultrasonography as a Predictor of Hemorrhagic Transformation After Thrombectomy

OBJECTIVES

To determine the predictive value of early transcranial color-coded sonography (TCCS) for intracranial hemorrhage (ICH) in patients with large artery occlusion (LAO) stroke of carotid circulation, who were submitted to endovascular therapy (EVT) with successful reperfusion.

MATERIALS AND METHODS

Retrospective study evaluating a cohort of consecutive stroke patients with LAO of the carotid circulation that were recanalyzed with EVT. We measured angle-corrected peak systolic velocities, end-diastolic velocities and mean flow velocities (PSV, EDV and MFV) of the symptomatic and asymptomatic middle cerebral artery (MCA). The ratio between MFV of the symptomatic MCA and MFV of the asymptomatic MCA (MCA-Ra) was calculated. Parenchymal hematoma in the 24 hours control CT was considered as ICH. Univariate associations and multivariate analyses were used to identify early independent predictors for ICH among TCCS findings.

RESULTS

We included 234 patients, mean age 72.5 (SD 12.6) years, 52.1% male. The mean time between recanalization and TCCS was 12.3 hours (range 3-22). Patients who developed postinterventional ICH showed a higher MCA-Ra (1.02 ± 0.26 vs 1.16 ± 0,21, p = 0.036). In multivariate analysis, only higher MCA-Ra remained independently associated with postinterventional ICH (OR: 6.778, 95%CI: 1.152-39.892, p = 0.034). A value of MCA-Ra ≥ 1,05 was associated with ICH, showing a sensitivity of 81.3% and a specificity of 65.9%; the AUC based of the ROC analysis was 0.688 (95% CI 0.570-0.806).

CONCLUSION

TCCS performed within the first 24 hours after stroke onset can help to predict hemorrhagic transformation in patients with LAO.

Developing and Validating Tests of Reading and Listening Comprehension for Fifth and Sixth Grade Students in Portugal

An efficient assessment of reading and linguistic abilities in school children requires reliable and valid measures. Moreover, measures which include specific test forms for different academic grade levels, that are vertically equated, allow the direct comparison of results across multiple time points and avoid floor and ceiling effects. Two studies were conducted to achieve these goals. The purpose of the first study was to develop tests of reading and listening comprehension in European Portuguese, with vertically scaled test forms for students in the fifth and sixth grades, using Rasch model analyses. The purpose of the second study was to collect evidence for the validity of these tests based on the relationships of test scores with other variables. The samples included 454 and 179 students for the first and second study, respectively. The data from both studies provided evidence for good psychometric characteristics for the test forms: unidimensionality and local independence, as well as adequate reliability and evidence of validity. The developed test forms are an important contribution in the Portuguese educational context as they allow for the assessment of students’ performance in these skills across multiple time points and can be used both in research and practice.

Device therapy guided by implantable loop recorders: predictors of bradyarrhythmic events

Background

Implantable loop recorders (ILR) improved diagnostic yield in unexplained syncope patients (pts). Data on possible predictive factors for bradycardia requiring device implantation in these pts is limited. We aim to identify clinical predictors for device implantation due to a significant bradyarrhythmia in patients who underwent ILR insertion for the study of syncopal/presyncopal (S/pS) events.

Methods

Single-center retrospective study of patients who implanted an ILR for the study of unexplained S/pS episodes between 2013 and 2018. The primary endpoint was a documented bradyarrhythmia requiring device implantation during the follow-up.

Results

A total of 251 pts were included. Mean age was 68±15 years and 53% were female. The majority of pts (220; 88%) had normal ejection fraction. Fifty-two (21%) pts had atrial fibrillation (AF). Regarding basal electrocardiographic characteristics, 34 (14%) pts had 1st degree auriculo-ventricular block (AVB), 31 (12%) pts had left bundle branch block (L-BBB), 22 (9%) pts had R-BBB and 13 (5%) pts had bifascicular block.

During a median follow-up of 20 (IQR 9–34) months, 74 (29%) pts required device implantation because of a significant bradyarrhythmia (92% pacemaker, 4% CRT, 4% ICD). Median duration from ILR until device implantation was 5 (IQR 1–10) months. The indications were sick-sinus-syndrome in 47 (64%) pts, advanced AV block in 23 (31%) pts and symptomatic slow AF in 4 (5%) pts.

Patients who required device implantation were older (73±12 vs 66±15 years, p <0.001), had more hypertension (73% vs 59% p=0.048), a higher prevalence of AF (34% vs 15% p=0.001) and a lower glomerular filtration rate (GFR<60 ml/min: 32% vs 21%, p=0.047). They also had more 1st AVB (22% vs 11%, p=0.026) and intraventricular conduction disturbances (38% vs 25%, p=0.025). There was a trend for a higher device implantation in pts with concomitant 1st AVB and left anterior fascicular block (7% vs 2%, p=0.063)

In a logistic regression model, age >75 years (HR: 1.7; 95% CI: 1.1–2.8) and the presence of AF (HR: 1.8; 95% CI: 1.1–3.0) were independent predictors for device implantation.

Conclusion

An older age and the presence of AF were independent predictors for device therapy in pts who implanted an ILR for the study of S/pS. These factors may identify a higher risk group and should be considered in the initial workup of these pts.

Funding Acknowledgement

Type of funding source: None

Pulmonary sequestration and endovascular treatment: a case report

Pulmonary sequestration is a congenital anomaly defined as a nonfunctioning mass of lung parenchyma. Presence of an independent pleural envelope classifies it as intralobar, accounting for approximately 75% of the cases, while absence classifies cases as extralobar, accounting for the remaining 25%. Diagnosis is made through radiography and confirmed by computed tomography, magnetic resonance, or angiography. The traditional treatment is open surgical repair, but endovascular techniques have been used, with good results. We report the case of a 29-year-old-woman presenting with recurrent pneumonia for 5 years. A CT scan of the chest revealed poor vascular formation in the lower region of the right lung. The pulmonary sequestration was treated by embolization of the anomalous branch.

Effect of pequi (Caryocar brasiliense) and juçara (Euterpe edulis) waste extract on oxidation process stability in broiler meat treated by UV-C

The aim of this study was to determine the potential for waste extracts from the pequi (Caryocar brasiliense) and juçara (Euterpe edulis) to reduce oxidatiove processes in antibiotic-free broiler meat. The use of natural antioxidants extracted from fruit-processing wastes has been neglected. Although these residues contain high amounts of these bioactive compounds, they are often discarded by industry. Meat samples were exposed previously submitted to UV-C radiation at 1.161 mW / cm2 for 10 minutes to accelerate the rancidity process. Pequi and juçara waste extracts were obtained by microwave-assisted extraction (MAE). A total of four conditions were tested using antibiotic-free broiler thighs and drumstick meat: BN-with no antioxidant (negative control), BP-with BHT (Butylated hydroxytoluene) (positive control), BE-with juçara extract, BC-with pequi extract. The color, pH, lipid and protein oxidation (days 0, 2, 4, 6, 8 and 10), antioxidant contents and activity (days 0 and 10), and proximal composition and fatty acid profile (day 0) were tested, followed by principal component analysis (PCA). Pequi waste extract presented the highest antioxidant content and activity. BE and BC treatments presented the highest total phenolic (TPC) and flavonoid (TFC) content, and BE presented the highest total monomeric anthocyanin content (TAC). TFC increased during storage in all treatments. The waste extracts of C. brasiliense presented the highest antioxidant activity against lipid oxidation in the antibiotic-free broiler meat. Moreover, both extracts presented high antioxidant activity against protein oxidation. Although the pequi peel extract had a better effect in terms of suppressing both types of oxidation, either this extract or the jussara waste extract could be used as a technological strategy to reduce the oxidative processes in antibiotic-free broiler meat for the poultry industry. Thus, waste extracts can be a potential technology to reduce the oxidative processes in antibiotic-free broiler meat.

Impact of the African Organisation for Research and Training in Cancer on Improving Cancer Care on the Continent: 15-Year History

Background and context: African Organisation for Research and Training in Cancer (AORTIC) seeks to become the continent's preeminent nonprofit organization working for cancer control. Established in 1982, and gaining exponential momentum since 2003. Milestones achieved include placing cancer control on the continent's health agenda. Main activities have been to foster collaboration for research and training, advocacy, palliative and psychosocial care, survivor groups, educative meetings for local and international cancer care professionals. Strategy/Tactics: To demonstrate impact of AORTIC on the continent over the past one and a half decades as a successful nonprofit organization aimed at reducing impact of cancer in Africa. Position our organization to lead the continent with home grown innovation to sensitize the cancer workforce to needs of our patients and countries by developing strategies that impact on improving cancer care across the continuum, research priorities and capabilities, professional development, including advocacy, survivorship, acting as a consultative mouth piece and authority on cancer control needs of Africa. Program/Policy process: 11 successful international biennial cancer conferences in Africa, with a steady increase in attendance from 300 to +900 delegates, 12 to 95 sessions, +3000 abstracts presented over 15 years. Last meeting labeled as; “This meeting is high-value; at the level of the best oncology meetings as ASCO and ESMO”. Regional training in pathology, oncology, psycho-oncology, palliative care, advocacy, prevention and early diagnosis. Regional meetings: Senegal, Tanzania, Nigeria, Angola, Mozambique and Cape Verde. Special interest groups: radiation, pathology, nursing, pediatrics and advocacy promoting professional and research development activities. African cancer leadership mentoring academies for young investigators - +40 participants to date. Grants for qualifying members to participate in external training workshops. 39 newsletters - translated into French and Portuguese. Memberships - span across the African continent, Europe, North America and Australia and organizations - 500 individual and close to 20 organizational members. Hosted Africa regional meetings at UICC WCC since 2014. Active on social media - +1300 followers. Publications: Cancer Plan for the African Continent 2013-2017 Handbook for Cancer Research in Africa Cancer Advocacy Training Toolkit for Africa AORTIC Cancer Network Directory, plus an online map Journal articles and position papers - 12 Declarations - 2 Projects - cancer registry mapping Grants - Beginning investigator catalytic grants (BIG Cat), partner NCI (USA) +20 beneficiaries. What was learned: Through coordinated and concerted efforts, relevant stakeholders who can influence and improve cancer care on the continent through collaboration, research and training, AORTIC is a continental networking hub spanning the African continent of more than 13,000 contacts and is a major instrument of change in effective control of cancer in Africa.

Informativeness of patient initial reports of adverse drug reactions. Can it be improved by a pharmacovigilance centre?

PURPOSE

Little is known about the informativeness of initial patient reports before they are reviewed by a pharmacovigilance centre (PVC). We aim to describe the patterns of patient adverse drug reaction (ADR) reporting in France and estimate the contribution of a review by a PVC assessor on the informativeness of these reports.

METHODS

A retrospective study was conducted on patient reports between July 2011 and July 2015. Informativeness of 16 key elements of information (including drug start and end date, duration of treatment, time to onset and duration of the ADR, outcome, medical history and concomitant medication) was assessed in initial reports before and after review by a pharmacovigilance assessor.

RESULTS

Overall, 240 reports concerning 522 ADR and involving 278 drugs were reported over this 4-year period. Mean number of available key elements of information in initial reports was increased from 11/16 to 15/16 after review of reports by the PVC. Time to onset and duration of the ADR were respectively available in only 51 and 58% of the reports before review compared to 83 and 90% after review. Medical history and concomitant medication were missing in 75% of the initial reports compared to less than 30% of the reports after review. Contacting the reporter enabled an increase of informativeness of most elements of information for more than 90% of the reports.

CONCLUSION

Patient reports often need to be completed on key elements of information that are required to assess reports. Both upstream education of patients and downstream intervention of a pharmacovigilance assessor to complete missing information could help to enhance the informativeness of such reports.

Impact of High-intensity Intermittent and Moderate-intensity Continuous Exercise on Autonomic Modulation in Young Men

The aim of this study was to compare heart rate variability (HRV) recovery after two iso-volume (5 km) exercises performed at different intensities. 14 subjects volunteered (25.17±5.08 years; 74.7±6.28 kg; 175±0.05 cm; 59.56±5.15 mL·kg(-1)·min(-1)) and after determination of peak oxygen uptake (VO2Peak) and the speed associated with VO2Peak (sVO2Peak), the subjects completed 2 random experimental trials: high-intensity exercise (HIE - 1:1 at 100% sVO2Peak), and moderate-intensity continuous exercise (MIE - 70% sVO2Peak). HRV and RR intervals were monitored before, during and after the exercise sessions together with, the HRV analysis in the frequency domains (high-frequency - HF: 0.15 to 0.4 Hz and low-frequency - LF: 0.04 to 0.15 Hz components) and the ratio between them (LF/HF). Statistical analysis comparisons between moments and between HIE and MIE were performed using a mixed model. Both exercise sessions modified LFlog, HFlog, and LF/HF (F=16.54, F=19.32 and F=5.17, p<0.05, respectively). A group effect was also found for LFlog (F=23.91, p<0.05), and HFlog (F=57.55, p< 0.05). LF/HF returned to resting value 15 min after MIE exercise and 20 min after HIE exercise. This means that the heavy domain (aerobic and anaerobic threshold) induces dissimilar autonomic modification in physically active subjects. Both HIE and MIE modify HRV, and generally HIE delays parasympathetic autonomic modulation recovery after iso-volume exercise.

Cardioprotective Properties of Aerobic and Resistance Training Against Myocardial Infarction

We evaluated the effects of aerobic and resistance exercise training on ventricular morphometry and function, physical capacity, autonomic function, as well as on ventricular inflammatory status in trained rats prior to myocardial infarction. Male Wistar rats were divided into the following groups: sedentary+Sham, sedentary+myocardial infarction, aerobic trained+myocardial infarction, and resistance trained+myocardial infarction. Sham and myocardial infarction were performed after training periods. In the days following the surgeries, evaluations were performed. Aerobic training prevents aerobic (to a greater extent) and resistance capacity impairments, ventricular dysfunction, baroreflex sensitivity and autonomic disorders (vagal tonus decrease and sympathetic tonus increase) triggered by myocardial infarction. Resistance training was able to prevent negative changes to aerobic and resistance capacity (to a greater extent) but not to ventricular dysfunction, and it prevented cardiovascular sympathetic increments. Additionally, both types of training reduced left ventricle inflammatory cytokine concentration. Our results suggest that aerobic and, for the first time, dynamic resistance training were able to reduce sympathetic tonus to the heart and vessels, as well as preventing the increase in pro-inflammatory cytokine concentrations in the left ventricle of trained groups. These data emphasizes the positive effects of aerobic and dynamic resistance training on the prevention of the negative changes triggered by myocardial infarction.

Correlations between traits in soybean (Glycine max L.) naturally infected with Asian rust (Phakopsora pachyrhizi)

Soybean (Glycine max L.)-breeding programs aim to develop cultivars with high grain yields and high tolerance to Asian soybean rust (Phakopsora pachyrhizi). Considering that the traits targeted for breeding are mainly quantitative in nature, knowledge of associations between traits allows the breeder to formulate indirect selection strategies. In this study, we investigated phenotypic, genotypic, and environmental correlations between the agronomic traits of soybean plants naturally infected with P. pachyrhizi, and identified agronomic traits that would be useful in indirectly selecting soybean genotypes for high yields. The study was conducted on the Capim Branco Farm, Uberlândia, Brazil, with 15 soybean genotypes, which were cultivated in a completely randomized block design with four replications. Fourteen phenotypic traits were evaluated using the GENES software. The phenotypic and genotypic correlations were positive and of a high magnitude between the total number of pods and the number of pods with two or three grains, indicating that the total number of pods is a useful trait for the indirect selection of soybean genotypes for high grain yields. Strong environmental correlations were found between plant height at blooming and maturity and grain yield and yield components.

Abstract 2662: A dual PI3K/mTOR inhibitor as potential therapeutic option for vulvar cancer

Introduction: Epithelial to mesenchymal transition (EMT) is an important process during cancer progression by which epithelial cells acquire mesenchymal phenotype and show reduced intercellular adhesion as well as increased motility. Interfering PI3K/AKT pathway has been considered an anti-EMT target therapy, due to its effect in restoration of E-cadherin function and inhibition of transcription factors that repress the E-cadherin promoter, such as Snail, Slug, and Twist. Aim: Investigate the antitumor effects of treatment with PI3K/mTOR dual inhibitor, NVP-BEZ235, in biological behavior of lymph node metastatic vulva cancer cell line (SW962), as a potential anti-EMT agent in vulvar tumor. Methods: we performed in vitro assays and evaluated the expression of proteins related to PI3K/Akt/mTOR pathway as well as Vimentin and E-cadherin, relevant EMT biomarkers. All results were presented as mean standard deviation and were compared using the unpaired t test or ANOVA followed by the Bonferroni post test using Graph Pad InStat v3.02 software. P values &lt; 0.05 were considered statistically significant. Results: Treatment with NVP-BEZ235 resulted in a significant decrease in cell migration (p&lt; 0.001), proliferation (p&lt; 0.01) and invasion (p&lt;0.05). The phosphorylation of AKT, S6K, 4E-BP1 and p70S6 was markedly reduced by NVP-BEZ235 treatment. In contrast, the levels of p-GSK3β (Ser9) were increased. Our qualitative results demonstrated that the localization pattern of E-cadherin and Vimentin protein was similar between control and treatment groups. We observed Vimentin protein only in isolated cells and, E-cadherin protein was found exclusively in cell clusters, demonstrating EMT-like events in SW962 cells. The expression of E-cadherin in SW962 cells treated was slightly increased and the levels of Vimentin was reduced in these cells. Conclusion: The present study suggests that NVP-BEZ235 is an effective inhibitor of PI3K/mTOR pathway, resulting in the decrease of Vimentin expression, an important EMT marker, as well as of other essential tumor events, such as proliferation, migration and invasion of vulva cancer. Taken together, these findings not only provide a novel insight into the actions of NVP-BEZ235 as inhibitor of EMT process in cancer progression, but also highlight a novel potential therapeutic option for the treatment of aggressive tumors such as vulvar carcinoma.

Citation Format: Iara Rodrigues, Bruna Rodrigues, Fernanda Giudice, Glauco Baiocchi, Fernando Augusto Soares, Vilma Martins, Rafael Malagoli Rocha. A dual PI3K/mTOR inhibitor as potential therapeutic option for vulvar cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 2662. doi:10.1158/1538-7445.AM2015-2662

Exercise training prevents increased intraocular pressure and sympathetic vascular modulation in an experimental model of metabolic syndrome

The present study aimed to study the effects of exercise training (ET) performed by rats on a 10-week high-fructose diet on metabolic, hemodynamic, and autonomic changes, as well as intraocular pressure (IOP). Male Wistar rats receiving fructose overload in drinking water (100 g/L) were concomitantly trained on a treadmill for 10 weeks (FT group) or kept sedentary (F group), and a control group (C) was kept in normal laboratory conditions. The metabolic evaluation comprised the Lee index, glycemia, and insulin tolerance test (KITT). Arterial pressure (AP) was measured directly, and systolic AP variability was performed to determine peripheral autonomic modulation. ET attenuated impaired metabolic parameters, AP, IOP, and ocular perfusion pressure (OPP) induced by fructose overload (FT vs F). The increase in peripheral sympathetic modulation in F rats, demonstrated by systolic AP variance and low frequency (LF) band (F: 37±2, 6.6±0.3 vs C: 26±3, 3.6±0.5 mmHg²), was prevented by ET (FT: 29±3, 3.4±0.7 mmHg²). Positive correlations were found between the LF band and right IOP (r=0.57, P=0.01) and left IOP (r=0.64, P=0.003). Negative correlations were noted between KITT values and right IOP (r=-0.55, P=0.01) and left IOP (r=-0.62, P=0.005). ET in rats effectively prevented metabolic abnormalities and AP and IOP increases promoted by a high-fructose diet. In addition, ocular benefits triggered by exercise training were associated with peripheral autonomic improvement.

Abstract 3942: Cell death resistance promoted by radiotherapy in a colorectal cell line

Colorectal adenocarcinoma is the fourth more frequent cause of death by cancer in the world. Despite some similarities, the rectal cancer has characteristics that differentiate it from the colon cancer, resulting in different treatments and outcomes. The rectal cancer in stages II and III is treated with neoadjuvant chemoradiation followed by surgery, and the response to neoadjuvant treatment in patients is variable and unpredictable. Up to now, surgery intervention is required to assess the pathologic response to therapy. The identification of predictive biomarkers for response to therapy is of great importance, in order to identify the patients that will benefit from such treatment. To better understand the molecular alterations in cells that resist to the radiotherapy, we started our research using WiDr, a colon tumor cell line. Cell cycle synchronized WiDr cells were submitted to two cycles of irradiation (4Gy in each cycle and 2 week of interval between the cycles) and resistant cells were isolated. Irradiated WiDr cells (RxTWiDr) shown a better capacity to form colonies, in colony growth assays, when compared to parental WiDr cells. This characteristic was maintained when they were submitted to a new round of irradiation. In addition, WiDrRxT cells treated with Staurosporine presented a higher viability in MTT assays than WiDr cells. We also collected the conditioned medium (CM) from RxTWiDr and WiDr cells, and treated the parental WiDr cells. The parental cells treated with CM from RxTWiDr cells for 15 minutes shown an increase in the ERK1/2 activation when compared to cells treated CM from WiDr cells. These results demonstrated that radio resistant cells are more resilient than parental cells and that their secreted factors activated specific signaling pathways via ERK1/2 phosphorylation. The nature of these factors is under investigation using proteomics.

Supported by São Paulo State Foundation (FAPESP)

Citation Format: Antuani R. Baptistella, Bruna Rodrigues, Marcos Dias, Fernanda Giudice, Tonielli Lacerda, Tiago Santos, Felipe Silva, Petrus Paulo Silva, Samuel Aguiar, Vilma Martins. Cell death resistance promoted by radiotherapy in a colorectal cell line. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3942. doi:10.1158/1538-7445.AM2014-3942

Investigation of a spatiotemporal cluster of verotoxin-producing Escherichia coli O157 infections in eastern England in 2007

An outbreak of verotoxin-producing Escherichia coli O157 (VTEC O157) infections linked to an open farm occurred in eastern England in April and May 2007. This paper describes the investigation and highlights the importance of multidisciplinary collaboration for successful control of such outbreaks. There was a temporal cluster of 12 confirmed symptomatic cases of VTEC O157 and one asymptomatic carrier, from five families. The investigation revealed that four of these cases formed part of an outbreak involving two families who visited an open farm. The phenotypic and genotypic characteristics of the isolates from the two families and the putative farm animal contacts were indistinguishable, indicating that the animals were the source of the primary infections. No epidemiological link could be established between the remaining three families affected and the open farm or people having visited the farm. Control measures included improved hand washing facilities on the farm, information for visitors and staff, restricted access and suspended petting and feeding of animals, and thorough cleaning and disinfection of affected areas.

Investigation of a spatiotemporal cluster of verotoxin-producing Escherichia coli O157 infections in eastern England in 2007

An outbreak of verotoxin-producing Escherichia coli O157 (VTEC O157) infections linked to an open farm occurred in eastern England in April and May 2007. This paper describes the investigation and highlights the importance of multidisciplinary collaboration for successful control of such outbreaks. There was a temporal cluster of 12 confirmed symptomatic cases of VTEC O157 and one asymptomatic carrier, from five families. The investigation revealed that four of these cases formed part of an outbreak involving two families who visited an open farm. The phenotypic and genotypic characteristics of the isolates from the two families and the putative farm animal contacts were indistinguishable, indicating that the animals were the source of the primary infections. No epidemiological link could be established between the remaining three families affected and the open farm or people having visited the farm. Control measures included improved hand washing facilities on the farm, information for visitors and staff, restricted access and suspended petting and feeding of animals, and thorough cleaning and disinfection of affected areas.

Schistosoma mansoni: a rare cause of tubal infection

S. haematobium is an important cause of urinary schistosomiasis, and symptomatic female genital infection is a common gynecological finding in areas where S. haematobium is prevalent. On the other hand, genital manifestations of intestinal schistosomas as S. mansoni are not frequent or are misdiagnosed. A case of a 40-year-old woman with abnormal uterine bleeding and asymptomatic tubal infection by S. mansoni identified in histological examination is presented.

Is intravenous urography necessary in the assessment of renal duplex system in children?

OBJECTIVE

Partial or complete duplication of the renal tract may be an incidental finding or may be associated with significant pathology. Accurate assessment is not always easy. This retrospective review was undertaken to determine whether intravenous urography (IVU) in combination with a DMSA renal scan provides significant additional information.

PATIENTS AND METHODS

Eighteen patients referred to our imaging department with a provisional diagnosis on ultrasound of renal tract duplication during a three year period were identified by searching the radiological computer files. The presenting features were urinary infection (13), abdominal pain (3) and abnormal antenatal sonography (2).

RESULTS

Four patients were found not to have renal duplication. There was concordance between the IVU and DMSA scan in seven. Additional clinically relevant information was obtained in three cases. A false negative result from the DMSA scan was found in four children and a false positive result in three.

CONCLUSION

In a significant number of cases of possible renal tract duplication, additional relevant information can be obtained from an IVU. Patient distress is minimised by combining the IVU and DMSA in one single episode of venous access. Review of the radiological images during the investigation allows minimisation of radiation dosage.