Gastric cancer surveillance in a high-risk population in tuscany (Central Italy): preliminary results.

BACKGROUND/AIMS: The surveillance of subjects at high risk for developing gastric cancer (GC) may represent an effective strategy for reducing specific morbidity and mortality. The aim of this study was to identify GC at its initial phase and to identify precancerous lesions in a group of GC high-risk subjects. METHODS: We enrolled first-degree relatives of patients affected by GC who resided in a GC high-risk area (Tuscany, Central Italy). The study's protocol included the collection of several individual measurements, including a blood sample for the determination of specific biomarkers, an upper digestive tract endoscopy with detailed gastric biopsies and Helicobacter pylori (Hp) treatment followed by a specific check. RESULTS: We enrolled 167 subjects who were members of 128 different familial groups with GC history. We identified 1 case of initial-phase GC, 1 gastric dysplasia type II, 32 intestinal metaplasia, 10 gastric atrophy, and 21 atrophic chronic gastritis. 81 subjects were Hp-positive and underwent eradication therapy. CONCLUSION: This study of a GC high-risk Italian population reveals positive results in terms of population compliance, the identification of specific gastric lesions requiring close follow-up and successful therapy for Hp infection. To define future surveillance strategies, a longer follow-up of these patients is necessary.

Low-fat and fat-free pleomorphic lipomas: a diagnostic challenge.

Pleomorphic lipomas are benign tumors that most commonly present as subcutaneous masses in the head and neck, shoulder, or back region of middle-aged to elderly men. They are related to spindle cell lipomas based on shared cytogenetic aberrations and histologic features. When little or no fat is present, the diagnosis can be challenging. A review of 38 pleomorphic lipomas seen in consultation revealed 7 cases in which fat was present in reduced (<5%) amounts (n = 5) or absent (n = 2). Six of 7 cases were from men with a mean age of 59 years. Excluding 1 case where the site was not specified, they all presented as solitary well-circumscribed subcutaneous masses in the head and neck (n = 3) or shoulder (n = 2) region. The seventh case was an intradermal tumor from the nose of a 48-year-old woman. All displayed pleomorphic and multinucleated floret cells interspersed among bland spindle cells and ropey collagen. They were diffusely immunoreactive for CD34. Referring diagnoses, when provided, included myxofibrosarcoma, giant cell fibroblastoma, and granulomatous rosacea for the tumor from the nose; none considered pleomorphic lipomas. When fat is absent or present in reduced amounts, clinical context and identification of classic nonlipogenic components are essential for the diagnosis of pleomorphic lipomas.

The application of a monoclonal antibody to CD62L on paraffin-embedded tissue samples in the assessment of the cutaneous T-cell infiltrates.

BACKGROUND: A reduction in the expression of the pan T-cell markers CD7 and CD62L supports an endogenous T-cell dyscrasia. Previously, clone availability for CD62L restricted its application to frozen tissue sections. MATERIALS AND METHODS: A nonavidin/biotin technique to examine CD3, CD62L, and CD7 in paraffin formalin-fixed tissue in non-neoplastic and neoplastic T-cell infiltrates. RESULTS: In the reactive group, CD62L manifested a 15 and 22% reduction in epidermal and dermal staining, respectively; there was a 42 and 31% reduction in epidermal and dermal CD7 staining. In lymphomatoid hypersensitivity, CD62L showed a 24 and 9% reduction in epidermal and dermal staining, respectively; CD7 staining demonstrated reduced staining by 70 and 66% in the epidermis and dermis. In the non-lymphomatous endogenous T-cell dyscrasia and lymphoma categories, an 80% diminution in CD62L and CD7 expression was seen. CONCLUSIONS: CD62L can be successfully applied in formalin-fixed tissue and exhibits enhanced specificity compared to CD7 in the evaluation of cutaneous T-cell infiltrates. Both CD62L and CD7 in paraffin-embedded, formalin-fixed tissue are useful diagnostic adjuncts, especially in regard to the discrimination of lymphomatoid hypersensitivity reactions from true endogenous T-cell dyscrasia.

The influence of the hypertensive patient's education in compliance with their medication.

The purpose of this study was to examine the relationships between patient's education in compliance with their medical regimen and the external variables: (1) "years of schooling," (2) duration of treatment, and (3) compliance with the medical regimen. The hypothesis tested in this study was as follows: "Hypertensive individuals who are educated about the importance of their medication and about the consequences of not taking the prescribed dosage will show better compliance with their prescribed drug regimen than those who are not thus educated." The sample of the study consisted of 40 hypertensive patients. A "posttest-only" control group design was used in this study. The hypothesis of the study was tested by using the Mann-Whitney U test. For the relationship between the external variables (years of schooling, duration of treatment, and compliance with the medical regimen), the Spearman test was used. The findings of the study revealed a statistically significant difference between compliance levels in the experimental group and in the control group (U = 130, p < 0.05), a positive correlation between "years of schooling" and compliance (rs = 0.33, p = 0.04), and a negative correlation between duration of treatment and compliance (rs = -0.45, p = 0.005). The findings support the hypothesis of the study.

The brain-drain: a sub-system of centre-periphery relationship.

PIP: A general review of the brain drain, which involves the international migration of skilled professionals, is presented. Data on skilled migration from developing countries to the United States, Canada, and the United Kingdom are provided by occupation and country of origin for the period 1961-1976. The causes of this migration are considered, and some proposals to reduce the flow and to compensate developing countries for their losses are reviewed.^ieng