Biological role of the bidirectional interaction between epithelial-mesenchymal transition and PD-L1 expression in head and neck squamous cell carcinomas: A systematic review.

BACKGROUND: Squamous cell carcinoma (SCC) is the most common head and neck malignant neoplasm. Despite progress in antineoplastic treatment for SCC, there are still high morbidity and mortality rates. Over the years, several tumor biomarkers have been suggested to predict the prognosis of patients with oral SCC. Studies point to a bidirectional association between the epithelial-mesenchymal transition (EMT) and the expression of PD-L1 with the aggressive biological behavior of the neoplastic cell. Thus, this systematic review aimed to explore the biological roles and mechanisms underlying the interaction between EMT and PD-L1 expression in head and neck SCC-derived cell lines. MATERIAL AND METHODS: An electronic search was performed in the PubMed/Medline, Web of Science, Science Direct, Scopus, Embase, and Cochrane Collaboration Library databases. Articles evaluating the in vitro relationship between EMT/PD-L1 interaction and the biological behavior of head and neck SCC cell lines were selected for this systematic review. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. RESULTS: After applying the previously established inclusion/exclusion criteria, 9 articles were included in the qualitative synthesis. The present systematic review suggests the existence of a bidirectional interaction between EMT and PD-L1 expression, which is related to alterations in the cell cycle, proliferation, apoptosis, and cell survival, affecting the migration and invasion ability of tumor cells. CONCLUSIONS: Combined targeting of the two pathways may be potentially effective for immunotherapy in head and neck SCC.

Ultra-processed food consumption and its effects on anthropometric and glucose profile: A longitudinal study during childhood.

BACKGROUND AND AIMS: Obesity and insulin resistance development are related to known risk factors (such as diet) that begin in childhood. Among dietary factors, the consumption of ultra-processed foods has received attention. The present study investigated the association between ultra-processed foods consumption at preschool age and changes in anthropometric measurements from preschool to school age and glucose profile at school age. METHODS AND RESULTS: The present study was a follow-up of a randomized controlled trial, conducted with 307 children of low socioeconomic status from São Leopoldo, Brazil. At ages 4 and 8 years, children's anthropometric assessments were collected from preschool to school age including body-mass index (BMI) for-age, waist circumference (WC), waist-to-height ratio (WHtR) and skinfold. At the age 8 years, blood tests were performed to measure glucose profile. Dietary data were collected through 24-h recalls and the children's ultra-processed food intake was assessed. Linear regression analysis was used to assess the relationship between ultra-processed food consumption and the outcomes. The percentage of daily energy provided by ultra-processed foods was 41.8 ± 8.7 (753.8 ± 191.0 kcal) at preschool age and 47.8 ± 8.9 (753.8 ± 191.0 kcal) at school age, on average. The adjusted linear regression analyses showed that ultra-processed food consumption at preschool age was a predictor of an increase in delta WC from preschool to school age (ß = 0.07; 95%CI 0.01-0.14; P = 0.030), but not for glucose metabolism. CONCLUSION: Our data suggest that early ultra-processed food consumption played a role in increasing abdominal obesity in children. These results reinforce the importance of effective strategies to prevent the excessive consumption of ultra-processed foods, especially in early ages.

Circulating concentrations, cerebral output of the CINC-1 and blood­brain barrier disruption in Wistar rats after pneumococcal meningitis induction.

Pneumococcal meningitis is a severe infectious illness of the central nervous system (CNS), with high rates of lethality and morbidity, being that the microorganism and the host's inflammatory response are responsible for cerebral complications. Moreover, the blood­brain barrier (BBB) itself secretes cytokines and, because of the bipolar nature of the BBB, these substances can be secreted into either the CNS compartment or in the blood, so patients with acute bacterial meningitis frequently develop sepsis. Therefore, the aim of this study was to evaluate the cytokine/chemokine levels in different vessels and the BBB integrity after pneumococcal meningitis induction. Wistar rats were infected with Streptococcus pneumoniae, and the BBB integrity was investigated using Evan's blue dye. Also, blood from the carotid artery and jugular vein was collected in order to perform tumour necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1ß), interleukin-6 (IL-60 and cytokine-induced neutrophil chemoattractant-1 (CINC-1) analyses by enzyme-linked immunosorbent assay (ELISA). CINC-1 levels were increased at 6 h in the arterial plasma and at 3 and 6 h in the jugular plasma. We observed BBB breakdown between 12 and 24 h in the hippocampus and at 12 and 18 h in the cortex after pneumococcal meningitis induction. The increase of CINC-1 occurred prior to the BBB breakdown. CINC-1 is a neutrophil chemoattractant and it may be related to early events in the pneumococcal meningitis pathophysiology.

The life impact of burns: the perspective from burn persons in Brazil during their rehabilitation phase.

PURPOSE: By using a combination of qualitative and quantitative methods, the focus of this study was to describe the changes associated with burns on the lives of Brazilian burn victims during the rehabilitation phase, and to investigate possible associations between the changes in work reported by the participants and the percentage of total body surface area burnt, and the body areas affected by the injury. METHOD: Participants were 18 years of age or older, who had been discharged from hospitalisation between 6 months and 1 year before the interview, or who underwent reconstructive surgery during the previous year, or who were under outpatient follow-up awaiting reconstructive surgery. Data were collected by means of semi-structured interviews. RESULTS: Thirty-eight of the 44 participants (86.4%) reported some type of changes associated with the burn injury, the treatment, or both, regarding the following aspects: work, leisure, relationships, religious ties, educational activities and habits (smoking, using alcohol and drugs and dressing style). The data showed a statistically significant association between burns on at least one of the upper limbs (with or without hands) and changes in work. CONCLUSIONS: Some of the aspects mentioned by the participants, such as work and leisure activities, need to be further researched in order to improve our understanding of the impact that these changes causes in the person's life.

Gallstone ileus caused by a gallstone impacted at a cecum neoplasm - A case report.

BACKGROUND: Gallstone ileus is an infrequent complication of biliary disease that produces a mechanical intestinal obstruction. It is caused by a gallstone passing through a bilio-digestive communication, usually a cholecystoduodenal fistula. The presence of neoplasms can decrease the bowel lumen size and may cause the gallstone to impact at the narrowing site. CASE SUMMARY: In this report, we present a unique case of gallstone ileus due to a gallstone impacted in a cecum tumor, causing obstruction at the level of the ileocecal valve. The patient needed an urgent right hemicolectomy to solve both his problems. The gallbladder and the enterobiliary fistula remained in situ. DISCUSSION: The clinical presentation is not always straightforward and sometimes the diagnosis is only made by imaging, mostly resorting to an abdominal CT. The mainstay of management is surgical relief of the gastrointestinal obstruction, with the surgical method being based on what is found intra-operatively and according to the patient general condition. CONCLUSION: Although a rare disease, gallstone ileus should be suspected in elderly patients with intestinal obstruction and a previous history of biliary problems, keeping in mind that other conditions may be present and can alter the surgical treatment of choice.

Massive gastric dilation caused by gastric outlet obstruction in the setting of peptic ulcer disease-A case report.

BACKGROUND: The prevalence of Peptic Ulcer Disease has decreased as did its elective surgical treatment, however its complications continue to occur. Gastric Outlet Obstruction is the least frequent complication of Peptic Ulcer disease. CASE SUMMARY: In this report, we present a case of massive gastric dilation due to gastric outlet obstruction, that needed emergency surgery due to perforation. A subtotal gastrectomy with a Billroth II reconstruction was performed. DISCUSSION: Usually non-operative management is tried first, with medical therapy and endoscopic dilation. Emergent surgery is rarely needed, but in this patient, despite trying to optimize his condition first, the ulcer perforation precipitated surgical management. CONCLUSION: Although Gastric Outlet Obstruction is the least frequent complication of Peptic Ulcer Disease and usually non-operative treatment is tried first, surgery may be necessary.

Effect of ultrasound-assisted cold plasma pretreatment to obtain sea asparagus extract and its application in Italian salami.

The effect of the glow discharge cold plasma pretreatment (CPT) was investigated on the ultrasound-assisted extraction (UAE) of phenolic compounds from sea asparagus Salicornia neei. The extract was applied in dry fermented sausage (Italian salami). Thermal extraction methods demand a long processing time, are highly energy-consuming and cause irreversible nutrient losses. It was found that CPT (discharge power of 14 W for 5 min) prior to UAE increased the antioxidant activity by 22% and 19% measured by the DPPH and ABTS assays, respectively. The S. neei extract showed high antioxidant activity, low antimicrobial activity, and was added to salami formulations with reduced-sodium nitrite content and no addition of sodium erythorbate. Despite a slight color change, lipid oxidation and texture parameters were similar to the control at the end of ripening. Furthermore, higher antioxidant activity was observed in S. neei extract supplemented salami with no impact on its sensory overall acceptability, indicating its potential as a natural alternative to synthetic additives.

Exploring physical and chemical properties in new multifunctional indium-, bismuth-, and zinc-based 1D and 2D coordination polymers.

Main group element coordination polymers (MGE-CPs) are important compounds for the development of multifunctional materials. However, there has been a shortage of studies regarding their structural, optical, catalytic, mechanical, and antibacterial properties. This work presents an exhaustive study of a set of crystalline MGE-CPs obtained from bismuth and indium metals and iminodiacetate, 1,2,4,5-benzenetetracarboxylate, and 2,2'-bipyridine as building blocks. An in-depth topological analysis of the networks was carried out. Additionally, nanoindentation studies were performed on two representative low-dimensional compounds in order to find the relationships between their structural features and their intrinsic mechanical properties (hardness and elasticity). The solid-state photoluminescence (SSPL) properties were also studied in terms of excitation, emission, lifetimes values, and CIE chromaticites. Moreover, the heterogeneous catalytic activities of the compounds were evaluated with the cyanosilylation reaction using a set of carbonylic substrates under solvent-free conditions. Finally, the inhibitory effect of the Bi-CPs on the growth of microorganisms such as Escherichia coli, Salmonella enterica serovar Typhimurium, and Pseudomonas aeruginosa, which are associated with relevant infectious diseases, is reported.

Octreotide for esophageal variceal bleeding treated with endoscopic sclerotherapy: a randomized, placebo-controlled trial.

BACKGROUND/AIMS: Endoscopic sclerotherapy is considered a first line therapy to stop bleeding from esophageal varices, but acute variceal bleeding is still associated with high risk of rebleeding and death. We compared the use of octreotide with endoscopic sclerotherapy versus sclerotherapy alone to control acute variceal bleeding and prevent rebleeding in patients with cirrhosis. METHODOLOGY: In a prospective controlled trial, 68 patients with cirrhosis and acute variceal bleeding who underwent emergency sclerotherapy were randomly assigned to receive a continuous infusion of octreotide or placebo for two days. The primary outcome measure was 7-day mortality. RESULTS: After seven days the overall mortality was 19.1%, and the proportion of patients who died in octreotide group (8 of 40, or 20%) was similar to the placebo group (5 of 28, or 17.85%; p = 0.74). Rebleeding occurred in 20.6% (14 of 68 patients), being 20% (8 of 40) in the octreotide group vs. 21.4% (6 of 28) in the placebo group (p = 0.88). The mean number of units of blood transfused after sclerotherapy was 2.05 units in the octreotide group vs. 2.08 units in the placebo group (p = 0.96). Thirty patients needed intensive care support (20 of 40 in the octreotide group vs. 10 of 28 in the placebo group; p = 0.24). The differences remained without statistical significance even after adjustment for hepatic function and endoscopic bleeding stigmata by a linear regression model analysis test. CONCLUSIONS: In patients with cirrhosis, octreotide intravenous per 48h associated with sclerotherapy is not superior to sclerotherapy alone in terms of 7-day mortality, frequency of rebleeding, number of units of packet red blood cell transfusion and length of stay in intensive care setting.

Effect of ultraviolet-B radiation on salt marsh vegetation: Trends of the genus Salicornia along the Americas.

The effects of natural UV-B radiation on growth, photosynthetic and photoprotective pigment composition of different Salicornia species were analyzed in salt marshes at three different sites along the Americas (Puerto Rico, southern Brazil and Patagonia, Argentina). Plants were exposed to different levels of UV-B radiation for 1-2 years in situ as well as in outdoor garden UV-B exclusion experiments. Different UV-B levels were obtained by covering plants with UV-B opaque (blocked 93-100% of ambient UV-B) and UV-B attenuating (near-ambient) filters (reduced 20-25% of UV-B). Unfiltered plants were exposed to natural irradiance. UV-B filters had significant effects on temperature and photosynthetic pigments (due to changes in PAR; 400-700 nm). The growth of Salicornia species was inhibited after 35 to 88 days of exposure to mean UV-B radiation dosages between 3.6 and 4.1 kJ m(-2) day(-1). The highest number of branches on the main shoot (S. bigelovii and S. gaudichaudiana) and longest total length of the branches (S. gaudichaudiana) were observed in the UV-B opaque treatment. Salicornia species responded to increasing levels of UV-B radiation by increasing the amount of UV-B absorbing pigments up to 330%. Chromatographic analyses of seedlings and adult S. bigelovii plants found seven different UV-B absorbing flavonoids that are likely to serve as UV-B filtering pigments. No evidence of differential sensitivity or resilience to UV-B radiation was found between Salicornia species from low-mid latitudes and a previously published study of a high-latitude population.

Role of the ftsA1p promoter in the resistance of mucoid mutants of Salmonella enterica to mecillinam: characterization of a new type of mucoid mutant.

Mucoid mutants of Salmonella enterica serovar Typhimurium isolated by resistance to mecillinam include lon (27%) and rcsC (8%) mutants but the most frequent class (65%) is affected in a new gene (mucM) located at centisome 76. mucM cells are shorter than mucM+ cells and rcsB mutations normalize size and response to mecillinam. Expression of ftsA1p, the ftsA-ftsZ promoter submitted to RcsB stimulation, is greatly increased in mucM mutants, and this expression is dependent on RcsB and ftsA1p. It is proposed that the mucM product interferes with RcsB activation. Mucoidy results from the activation of cps genes and mecillinam resistance from ftsA-ftsZ overexpression, both traits caused by the increased activity of the RcsB effector. The same mechanism seems to be responsible for the resistance of mucoid rcsC mutants to mecillinam but the resistance of lon mutants is not dependent on RcsB and so responds to a different cause.

[Palliative surgery in carcinoma of the stomach. Retrospective study of 112 consecutive cases]. / Cirurgia paliativa por carcinoma do estômago. Estudo retrospectivo de 112 casos consecutivos.

From January 1980 until October 1991 we operated 112 patients with Gastric cancer in which Surgery was considered palliative by intra-operative criteria or by pathological analysis of the resected specimen. Locally irresectable tumour was found in 24.1% of the cases, peritoneal metastases (mets.) in 21.4%, liver mets. in 17%, lymphatic mets. in 16.1%, and other mets. in 21.4%. Resections were possible in 57 patients (50.8%), with a mortality rate of 10.5%, which was similar to the mortality in the non-resection group (7%) p = 0.2. Median survival for the entire group was 7 months, the non-resection group had a median survival of 4 months, and the resection group of 18 months (p = 6.480 e-0.7). Locally advanced tumors had a better outcome than the metastatic group (p = 0.05), but no difference was observed between patients with liver or peritoneal mets. Patients in stage 3 and 4 of the disease had a different prognosis (p = 0.03), and the resection group within each stage fared better.

[The curative surgery of periampullary tumors. The results of 48 resections]. / Cirurgia de intenção curativa nos tumores peri-ampulares. Resultados de 48 ressecções consecutivas.

Periampullary tumors form a clinical entity with common symptoms, similar therapeutic options, unsatisfactory resectability rates and unfavorable prognosis. From April 1970 until March 1994, one hundred and twenty-seven patients with periampullary carcinoma were operated by our surgical team. In 48 of these patients, a resection for cure was performed (38%). Resectability rates varied according to the origin of these tumors, i.e., pancreas-20%, ampulla-76%; distal bile duct-71%, periampullary duodenum-88%. Pancreatic tumors showed a different resectability rate from the other periampullary carcinomas (p = 0.04). Forty-two of these patients had a pancreatoduodenectomy and in the remaining 6 cases a total pancreatectomy was performed. Fifteen patients had major post-operative morbidity (31%) and 8 of these cases died in-hospital (17%). Follow-up data was available in 81% of the patients, survival estimates were calculated according to the Kaplan-Meier method and survival comparisons were made with the Log-rank test. Median survival for resected pancreatic carcinoma was 6 months and for resected tumors of the ampulla 37 months. In this group of patients, pancreatic tumors showed a different survival rate from the remaining periampullary tumors (Log-rank-p = 0.002). This work evidences the need to improve management of periampullary tumors, particularly in-hospital mortality and long-term survival. To achieve these goals, patients with periampullary tumors should be treated in specialized centers and research to improve local and systemic control of this disease should be pursued.

Review of Solier's Mecorhopalus species (Coleoptera: Staphylinidae: Aleocharinae).

Antoine Joseph Jean Solier, a French naturalist, described 53 species of Staphylinidae of the Chilean fauna, among them three species in a new genus Mecorhopalus (M. ater, M. bipustulatus and M. elongatus). Today these species are regarded as Aleochara atra, A. solieri and A. mutare , respectively. The objective of this study is to provide an updated description and nomenclatural status of these species. Mecorhopalus remains as junior synonym of Aleochara with one species in the subgenus Aleochara and another in Coprochara. Through study of the type material, A. mutare is synonymized with A. solieri as junior subjective synonym. 

Conditional lethality of cell shape mutations of Salmonella typhimurium: rodA and mre mutants are lethal on solid but not in liquid medium.

Round-cell (rodA, mre, divD) derivatives of a conditional alaS mutant of Salmonella typhimurium were studied under conditions allowing expression of tolerance to lethal cell shape mutations (41 degrees C), and under nontolerant conditions (30 degrees C). The rodA22::Tn10d(Kan) derivative grew normally (OD650 nm) in LB-broth at 30 degrees C; however, doubling of total cell count took much longer (130 min) than at 41 degrees C (57 min). Although the cells were able to divide in LB-broth at 30 degrees C, viable count on LB-agar at 30 degrees C was 10(3)-fold lower than on LB-agar at 41 degrees C. Phase-contrast microscopy of rodA cells incubated under different conditions showed that their size increased on LB-soft agar at 30 degrees C, but they failed to divide and finally lysed. In contrast, division occurred in LB-broth at 30 degrees C and also in LB-broth and LB-soft agar at 41 degrees C. The mre-17::Tn10d(Kan) derivative acted like the rodA strain whereas the divD135::Tn10d(Kan) mutant behaved normally both at 30 degrees C and 41 degrees C. It is concluded that rodA and mre mutations delay cell division, but are lethal only on solid medium. Mutations conferring tolerance to "lethal" rodA and mre mutations improve division performance both in liquid and solid media.

Round-cell mutants of Salmonella typhimurium produced by transposition mutagenesis: lethality of rodA and mre mutations.

Thirty-three insertions of transposon Tn10 delta 16 delta 17 into genes involved in the control of rod cell shape were isolated in Salmonella typhimurium by the characteristic glossy appearance of colonies composed of spherical cells. Genetic tests demonstrated that 25 (76%) were insertions in the rodA gene, 7 (21%) were mre mutants, and 1 (3%) was a divD mutant. No insertion in the pbpA gene were found. Insertions in cell shape genes only appeared when strains displaying resistance to mecillinam (not caused by beta-lactamase production) were employed. Neither rodA nor mre insertions could be transduced to wild-type strains but they were normally accepted by mecillinam-resistant derivatives and by cya and crp mutants, which, unlike the corresponding Escherichia coli strains, did not display resistance to mecillinam. On the other hand, the divD insertion could be efficiently transduced to any strain. It is concluded that the rodA, mre, and divD genes are involved in the control of rod cell shape but, in addition, the RodA and Mre products perform some function(s) that is essential for wild-type cells but dispensable for some mecillinam-resistant strains, and for cya and crp mutants.

Curative surgery for gastric cancer: study of 166 consecutive patients.

From January 1980 to December 1991 we operated on 295 patients with a gastric carcinoma. In 166 cases (56.3%) surgery was performed with curative intent. In 93 patients (56%) a subtotal gastrectomy was performed, and in 73 cases (44%) a total gastrectomy. In all the cases a D-2 type lymphadenectomy was used. The global morbidity rate was 23%, and in-hospital mortality was 3.6%. The morbidity and mortality rates of these two operations were statistically different. Global 5-year survival estimate for the whole series is 61.3%. Univariate and multivariate analysis according to T and N (TNM classification), the number of positive nodes resected, and the relation of positive per resected nodes, revealed statistically different outcomes. This kind of quantitative classification allowed identification of high risk groups irrespective of site of nodal involvement. Tumors classified as intestinal or diffuse type by the Lauren classification had similar survival curves and 5-year survival estimates (p = 0.834). By univariate and multivariate analysis this classification did not reveal a prognostic value in this group of patients. In our opinion, tumor penetration and lymph node involvement are at present the most reliable prognostic factors available.

Surgical treatment of lung metastases: prognostic factors for long-term survival.

BACKGROUND AND OBJECTIVES: Surgical resection of lung metastases is an established therapy for a large number of primary tumors, but there is some controversy about prognostic factors for long-term survival. METHODS: From 1968 to 1996, we performed a retrospective review of a series of 85 patients (100 operations) that have been operated for resection of lung metastases. The Kaplan-Meier method was used to estimate the probabilities of survival, the log-rank test for the univariate analysis of prognostic factors for survival, and the Cox model in the subsequent multivariate analysis. RESULTS: The operative mortality was 4% and the morbidity 18%. The mean follow-up after lung resection was 22.13 months (1-146). The actuarial 5-year survival rate was 29.2%. By univariate analysis, the following factors were associated with survival after resection: location and histology of the primary tumor, greatest dimension of the largest metastasis, radicality of the resection, involvement of the resection margins, and use of adjuvant therapy (P < 0.05). After multivariate analysis, only the dimension of the metastases and involvement of surgical margins have been found to be independently associated with survival. CONCLUSIONS: Surgical excision is a safe and effective therapy for lung metastases from a large number of primary tumors, provided a complete resection is feasible.

[Development of the physiologic response to stress in the neonatal period]. / Evolution de la réponse physiologique au stress pendant la période néonatale.

An attempt was made to assess the course of physiological response to stress - an autonomic regulation process - in 60 newborn infants during the 1st month of life. Data used in this study were based on results of the B.N.B.A.S. (Brazelton Neonatal Behavioral Assessment Scale) applied on the 1st, 3rd and 28th days of life. An improvement of scores was demonstrated in all items throughout the 1st month of life.