EBV and MSI Status in Gastric Cancer: Does It Matter?

We investigated the impactof microsatellite instability (MSI) and Epstein-Barr virus (EBV) status in gastric cancer (GC), regarding response to perioperative chemotherapy (POPChT), overall survival (OS), and progression-free survival (PFS). We included 137 cases of operated GC, 51 of which were submitted to POPChT. MSI status was determined by multiplex PCR and EBV status by EBV-encoded RNA in situ hybridization. Thirty-seven (27%) cases presented as MSI-high, and seven (5.1%) were EBV+. Concerning tumor regression after POPChT, no differences were observed between the molecular subtypes, but females were more likely to respond (p = 0.062). No significant differences were found in OS or PFS between different subtypes. In multivariate analysis, age (HR 1.02, IC 95% 1.002-1.056, p = 0.033) and positive lymph nodes (HR 1.82, IC 95% 1.034-3.211, p = 0.038) were the only prognostic factors for OS. However, females with MSI-high tumors treated with POPChT demonstrated a significantly increased OS compared to females with MSS tumors (p = 0.031). In conclusion, we found a high proportion of MSI-high cases. MSI and EBV status did not influence OS or PFS either in patients submitted to POPChT or surgery alone. However, superior survival of females with MSI-high tumors suggests that sex disparities and molecular classification may influence treatment options in GC.

Effectiveness of ovariohysterectomy on feline mammary fibroepithelial hyperplasia treatment.

OBJECTIVES: The aim of this study was to evaluate the effectiveness of ovariohysterectomy (OVH) on feline mammary fibroepithelial hyperplasia (FMFH) treatment, as well as the influence of previous injectable progestin on clinical signs and treatment of FMFH. METHODS: Seventy-nine female cats diagnosed with FMFH between 2014 and 2018 were included. The animals were distributed as follows: (1) treated only with OVH (TA) or OVH plus antiprogestin (TB); and (2) no administration (G1) or previous administration (G2) of injectable progestin before FMFH diagnosis. Data regarding clinical signs of FMFH, occurrence of persistent mammary growth after OVH, and time until complete remission of FMFH post-surgery were recorded and evaluated. RESULTS: Mastectomy was not performed in any cat during the study. TA was adopted in 71/79 (89.9%) cases, with 42/71 (59.2%) from G2 and 29/71 (40.8%) from G1. TB was adopted in 8/79 (10.1%) cats, all from G2. Total remission of FMFH was observed in 73/79 (92.4%) cats, with six animals from G2 having died (n = 6/79 [7.6%]). The time until complete remission of FMFH was higher (P <0.0001) in cats from G2 than from G1. Moreover, animals from G2 had a higher percentage of persistent mammary growth after OVH (P <0.001) and a tendency to higher mortality (P = 0.052) compared with G1. CONCLUSIONS AND RELEVANCE: Previous treatment with injectable progestin may result in a more complex clinical presentation of FMFH. Ovariohysterectomy is a good treatment option for FMFH when there is no interest in breeding the queen. Treatment with antiprogestin is recommended, especially if persistent mammary growth is detected after OVH.

Sensitivity of the invasive bivalve Corbicula fluminea to candidate control chemicals: The role of dissolved oxygen conditions.

The freshwater Corbicula fluminea is a major aquatic nuisance worldwide. Current pest control methods raise cost-effectiveness and environmental concerns, which motivate research into improved mitigation approaches. In this context, the susceptibility of the clams to chemicals under reduced oxygen conditions was examined. Biocides with different mechanisms of toxicity (niclosamide, polyDADMAC, ammonium nitrate, potassium chloride and dimethoate) were tested under normoxic (>7 mg L(-1) dissolved O2) and hypoxic (<2 mg L(-1) dissolved O2) conditions. Hypoxia was observed to potentiate chemical treatment, particularly when combined with non-overwhelming doses that would produce only intermediate responses by themselves. For niclosamide, ammonium nitrate and dimethoate, clam mortality enhancements up to 400% were observed under hypoxia as compared to dosing upon normal dissolved oxygen conditions. For polyDADMAC and potassium chloride, substantially lower mortality enhancements were found. The differences in the clams' sensitivity to the chemicals under hypoxia could be linked to the expected mechanisms of action. This suggests that judicious selection of the biocide is essential if optimized combined control treatments are to be designed and provides an insight into the interference of frequent hypoxia events in the response of natural clam populations to contaminant loads.

Towards curative therapy in gastric cancer: Faraway, so close!

Although recent diagnostic and therapeutic advances have substantially improved the survival of patients with gastric cancer (GC), the overall prognosis is still poor. Surgery is the only curative treatment and should be performed in experienced centers. Due to high relapse following surgery, complementary and systemic treatment aimed at eradicating micrometastasis should be performed in most cases. Cytotoxic treatments are effective in downstaging locally advanced cancer, but different sensitivities and toxicities probably exist in different GC subtypes. Current treatment protocols are based primarily on clinical data and histological features, but molecular biomarkers that would allow for the prediction of treatment responses are urgently needed. Understanding how host factors are responsible for inter-individual variability of drug response or toxicity will also contribute to the development of more effective and less toxic treatments.

Tamponamento cardíaco em lupus eritematoso sistêmico / Cardiac tamponade in systemic lupus erythematosus

O lupus eritematoso sistêmico (LES) é uma doença auto-imune de etiologia desconhecida, multissistêmica com manifestações clínicas diversas. O envolvimento cardíaco no LES foi descrito pela primeira vez no início do século, posteriormente diversos relatos de literatura vieram a comprovar que o sistema cardiovascularé com freqüência, acometido pela doen,ca, ocorrendo em 15 por cento a 50 por cento dos pacientes com LES. O tamponamento cardíaco pode ocorrer em torno de 1 por cento a 5 por cento dos casos como forma de apresentação da doença ou como intercorrência na evolução natural da mesma. Frente à raridade do quadro, apresentamos dois pacientes, um do sexo masculino e outro do sexo feminino, com diagnóstico de LES que apresentaram tamponamento cardíaco, sendo afastadas causas infecciosas, particularmente tuberculose. Em ambos os casos foi realizada drenagem pericárdica associada ao tratamento com altas doses de corticosteróide com resolução do quadro.