Molecular Classification of Ependymal Tumors across All CNS Compartments, Histopathological Grades, and Age Groups.

Ependymal tumors across age groups are currently classified and graded solely by histopathology. It is, however, commonly accepted that this classification scheme has limited clinical utility based on its lack of reproducibility in predicting patients' outcome. We aimed at establishing a uniform molecular classification using DNA methylation profiling. Nine molecular subgroups were identified in a large cohort of 500 tumors, 3 in each anatomical compartment of the CNS, spine, posterior fossa, supratentorial. Two supratentorial subgroups are characterized by prototypic fusion genes involving RELA and YAP1, respectively. Regarding clinical associations, the molecular classification proposed herein outperforms the current histopathological classification and thus might serve as a basis for the next World Health Organization classification of CNS tumors.

Tuberculosis, incarceration, and HIV at a crossroads in Guyana.

OBJECTIVES: The objective of this study was to describe the sociodemographic and clinical characteristics of patients dually infected with HIV and tuberculosis (TB) in Guyana. METHODS: The data for this study were obtained as part of a related project conducted to determine the prevalence of diabetes mellitus among TB patients in Guyana. From April to June 2006, a convenience sample of 100 patients was selected from those attending three TB clinics in Guyana and a structured questionnaire was used to collect relevant sociodemographic and risk factor data. The sociodemographic and clinical data of HIV-negative and HIV-positive patients with pulmonary TB were compared. Logistic regression was conducted to determine independent relationships between sociodemographic and clinical features. RESULTS: One hundred TB patients were considered for enrolment in the study, but since the HIV status was known for only 77 persons, these were included in the analysis. Thirty-one of the 77 (40.3%) were HIV-positive. Seventy-two of the 77 (93.5%) patients had pulmonary TB, 28 of whom were HIV-positive; the other five had extrapulmonary TB, three of whom were dually infected. Several social factors and clinical manifestations including incarceration at the time of TB diagnosis (p=0.01), cigarette smoking (p=0.05), homelessness (p=0.07), chest pain (p=0.001), hemoptysis (p=0.02), cough (p=0.08), and being acid-fast bacillus (AFB) sputum smear-positive (p=0.06) were associated with HIV-negative pulmonary TB. In the logistic regression model, HIV-negative TB patients demonstrated higher frequencies of complaints of chest pain (odds ratio (OR) 34.48, 95% confidence interval (CI) 4.35-250) and were more likely to be AFB sputum smear-positive (OR 11.97, 95% CI 1.91-74.76) than HIV-positive TB patients. CONCLUSIONS: Guyana is faced with a particularly high burden of HIV infection among TB patients. Given the impact of HIV on the clinical presentation of TB, physicians managing HIV patients should demonstrate a high level of suspicion for TB among these patients. Incarceration is a strong correlate of TB, overall.

Tuberculosis and diabetes in Guyana.

OBJECTIVES: This study was conducted to determine the prevalence of diabetes mellitus among tuberculosis (TB) patients attending three TB clinics in Guyana. METHODS: A cross-sectional study was conducted among TB patients attending TB clinics in three regions in Guyana. A structured questionnaire was used to collect demographic, clinical, and risk factor data. Random blood sugar testing was done using the OneTouch UltraSmart glucometer (LifeScan, Inc., 2002). RESULTS: One hundred TB patients were recruited; 90 had pulmonary TB and 10 had extrapulmonary disease. Fourteen patients were classified as diabetic: 12 had been previously diagnosed as diabetic by a physician and two had abnormally high random blood sugar at the time of enrolment. Of the 12 known diabetics, seven had been diagnosed before TB was discovered, three were identified at the time TB was diagnosed, and two after TB was diagnosed. All 14 diabetic patients presented with pulmonary TB. Thirty-one patients were HIV-positive and 28 of these had pulmonary TB, whereas three had extrapulmonary TB. None of the diabetics were infected with HIV. TB-diabetic patients tended to be older than non-diabetics (median age 44 vs. 36.5 years), were more likely to have been incarcerated at the time of TB diagnosis than non-diabetics (p=0.06), and were more likely to have an elevated (random) blood sugar level (p=0.02). Clinically, diabetes did not influence the presentation of TB. CONCLUSIONS: This study clearly highlights that diabetes and HIV are frequent in Guyanese TB patients. Routine screening of TB patients for diabetes and diabetic patients for TB should be speedily implemented. The National TB Programme should work closely with the diabetes clinics so that TB patients who are diabetics are optimally managed.

Occurrence of IRGAROL 1051 in coastal waters from Biscayne Bay, Florida, USA.

Surface water samples from marinas, commercial ports and open bay areas collected from Biscayne Bay and the Miami River, Florida, USA, were analyzed for the occurrence of IRGAROL 1051 by GC/MS. The anifouling boosting herbicide was found in 80% (46/57) of the samples collected between March 1999 and September 2000. Concentrations within the bay range between non-detected (<1 ppt) and 61 ppt (ng/L) and were generally low compared with levels reported in European or Japanese waters. Aside from the elevated concentrations observed along the Miami River South Fork (61 ppt), the highest concentrations observed in the bay corresponded to marinas with high density of pleasure craft and restricted water circulation. In contrast, occurrence of IRGAROL 1051 along the commercial port or the cruise line terminal was generally lower (<1-2.2 ppt). Concentrations around Coconut Grove Marina were consistently higher (5-12 ppt) than the rest of the bay waters during the whole period of time surveyed.