Identification of bacterial pathogens and antimicrobial resistance directly from clinical urines by nanopore-based metagenomic sequencing.

OBJECTIVES: The introduction of metagenomic sequencing to diagnostic microbiology has been hampered by slowness, cost and complexity. We explored whether MinION nanopore sequencing could accelerate diagnosis and resistance profiling, using complicated urinary tract infections as an exemplar. METHODS: Bacterial DNA was enriched from clinical urines (n = 10) and from healthy urines 'spiked' with multiresistant Escherichia coli (n = 5), then sequenced by MinION. Sequences were analysed using external databases and bioinformatic pipelines or, ultimately, using integrated real-time analysis applications. Results were compared with Illumina data and resistance phenotypes. RESULTS: MinION correctly identified pathogens without culture and, among 55 acquired resistance genes detected in the cultivated bacteria by Illumina sequencing, 51 were found by MinION sequencing directly from the urines; with three of the four failures in an early run with low genome coverage. Resistance-conferring mutations and allelic variants were not reliably identified. CONCLUSIONS: MinION sequencing comprehensively identified pathogens and acquired resistance genes from urine in a timeframe similar to PCR (4 h from sample to result). Bioinformatic pipeline optimization is needed to better detect resistances conferred by point mutations. Metagenomic-sequencing-based diagnosis will enable clinicians to adjust antimicrobial therapy before the second dose of a typical (i.e. every 8 h) antibiotic.

What are the needs of adolescents and young adults after a cancer treatment? A Delphi study.

Advances in the early detection of cancer and the development of more effective treatments have resulted in a larger number of adolescents and young adults (AYAs), becoming cancer survivors. However, knowledge regarding their needs and if those needs are adequately addressed remains limited. The aims of this study were to: (1) better understand the needs of AYAs after cancer treatment; (2) analyse the importance of those needs; (3) determine which needs are not adequately addressed; and (4) test the hypothesis that AYA cancer survivors have different needs than adult survivors. Twenty-nine health oncology professionals, 17 AYA survivors and 12 relatives of AYA survivors participated in the Delphi study. The needs identified could be classified into six categories, and all were rated as highly important by all participants. The category perceived as least adequately addressed across the three groups was 'Counselling and psychological support.' The findings provide important new information regarding the needs of AYA cancer survivors that can inform the development of interventions to improve the quality of life of these individuals.

MicroRNA signatures characterizing caste-independent ovarian activity in queen and worker honeybees (Apis mellifera L.).

Queen and worker honeybees differ profoundly in reproductive capacity. The queen of this complex society, with 200 highly active ovarioles in each ovary, is the fertile caste, whereas the workers have approximately 20 ovarioles as a result of receiving a different diet during larval development. In a regular queenright colony, the workers have inactive ovaries and do not reproduce. However, if the queen is sensed to be absent, some of the workers activate their ovaries, producing viable haploid eggs that develop into males. Here, a deep-sequenced ovary transcriptome library of reproductive workers was used as supporting data to assess the dynamic expression of the regulatory molecules and microRNAs (miRNAs) of reproductive and nonreproductive honeybee females. In this library, most of the differentially expressed miRNAs are related to ovary physiology or oogenesis. When we quantified the dynamic expression of 19 miRNAs in the active and inactive worker ovaries and compared their expression in the ovaries of virgin and mated queens, we noted that some miRNAs (miR-1, miR-31a, miR-13b, miR-125, let-7 RNA, miR-100, miR-276, miR-12, miR-263a, miR-306, miR-317, miR-92a and miR-9a) could be used to identify reproductive and nonreproductive statuses independent of caste. Furthermore, integrative gene networks suggested that some candidate miRNAs function in the process of ovary activation in worker bees.

Neighbourhood Determinants of Caries Experience in Preschool Children: A Multilevel Study.

OBJECTIVES: To investigate the association between neighbourhood factors and decayed, missing, and filled teeth (dmft) index among preschool children. METHODS: The sample of this cross-sectional study comprised 1,110 children (0-5 years old) clustered in 16 official neighbourhoods of Canoas city, southern Brazil. Multilevel binomial models were used to estimate the association of contextual variables at neighbourhood level (Human Development Index, average income, and public primary health care units) with two oral health outcomes: decayed teeth (dt) and missing or filled teeth (mft), after adjusting for individual variables (gender, age, maternal education, equivalent household income logarithm, household, and point of care). RESULTS: Overall, 24.9% of the sample had dental caries experience (dmft >0), and 92.3% of the dmft was untreated caries. There was no statistical significant association (p > 0.05) of contextual characteristics with the decay component. The teeth of children living in richer areas had 2.87 (95% CI: 1.05-7.86) times more chances of being treated (mft component). Variance attributed to neighbourhood level was estimated as 5.9% (p < 0.01) and 4.1% (p = 0.17) for dt and mft, respectively, in adjusted models. CONCLUSIONS: Intra-urban areas seem homogeneous, with small variability between neighbourhoods, having no contextual effect on untreated dental caries (dt). Contextual variables may influence treatment access (mft) through the use of dental services in preschool children.

Toxicity of irrigating solutions and pharmacological associations used in pulpectomy of primary teeth.

AIM: To evaluate the in vitro toxicity of irrigating solutions and pharmacological associations used in the pulpectomy of primary teeth. METHODOLOGY: The cell viability (MTT), lipid peroxidation (TBARS), alkaline comet assay and GEMO tests were performed to evaluate the cytotoxicity and genotoxicity of solutions: sodium hypochlorite (1% and 2.5%), 2% chlorhexidine, 6% citric acid and 17% EDTA, which were tested, individually and in association, exposing human peripheral blood mononuclear cells (MTT, TBARS and alkaline comet assay), at 24 and 72 h, and dsDNA (GEMO). After performing the Kolmogorov-Smirnov test, data were analysed by anova followed by Dunnett's post hoc test, and Kruskal-Wallis followed by Dunn post hoc test. A significance level was established at P < 0.05. RESULTS: All irrigating solutions and pharmacological associations reduced cell viability at 24 h (P < 0.05). These reductions were maintained after 72 h, except for EDTA and associations of sodium hypochlorite (1% and 2.5%) with EDTA and of chlorhexidine with EDTA. Lipid peroxidation at 24 h was caused by EDTA and by 2.5% sodium hypochlorite with EDTA; it was also caused at 72 h by sodium hypochlorite (1% and 2.5%) and the three associations with citric acid (P < 0.05). All groups caused DNA damage when assessed by the alkaline comet assay, at 24 h and 72 h (P < 0.05). In the GEMO assay, all groups caused dsDNA damage (P < 0.05), except for chlorhexidine with EDTA. CONCLUSION: All groups showed some level of toxicity. Amongst the main solutions, chlorhexidine presented less cytotoxic potential. EDTA was the least cytotoxic of the auxiliary irrigant solutions, and the association of these two solutions showed the lowest toxicity potential amongst all groups.

Induction of cytotoxicity, oxidative stress and genotoxicity by root filling pastes used in primary teeth.

AIM: To evaluate the cytotoxicity, oxidative stress and genotoxicity in vitro of four iodoform pastes and three calcium hydroxide pastes. METHODOLOGY: Peripheral blood mononuclear cells (PBMCs) and pure calf thymus DNA (dsDNA) were exposed to extracts of the pastes. Cytotoxicity was assessed with the MTT assay. Generation of reactive oxygen species (ROS) was evaluated using a DCFH-DA assay, and lipid peroxidation was evaluated using a TBARS assay. Genotoxicity was evaluated using the alkaline comet assay and Genomodifier capacity assay (GEMO). All tests were performed after 24 h and 72 h of cell exposure, except GEMO. After performing the Kolmogorov-Smirnov test, data were analysed by Kruskal-Wallis and Dunn's post-tests, and anova with Dunnett's post-test, with a significance level established at P < 0.05. RESULTS: The MTT assay revealed that chlorhexidine, Maxitrol and neomycin sulphate + bacitracin pastes decreased cell viability after 24 h (P < 0.05). No group was associated with a significant decreased cell viability or lipid peroxidation after 72 h. Calcium hydroxide pastes increased the cell viability levels at both experimental times (P < 0.05). Lipid peroxidation was observed with the exposure of cells to calcium hydroxide pastes after 24 h (P < 0.05). Exposure to chlorhexidine, Guedes-Pinto and calcium hydroxide pastes resulted in a significant increase in ROS after 24 h (P < 0.05), whereas iodoform pastes and Calen thickened with zinc oxide significantly increased the ROS after 72 h (P < 0.05). The comet assay revealed that exposure of the PBMCs to iodoform pastes did not damage DNA at either period of time (P > 0.05). However, chlorhexidine paste caused DNA damage in dsDNA (P < 0.05). Calcium hydroxide pastes caused DNA damage in both tests (P < 0.05). CONCLUSION: The pastes varied in their ability to induce cytotoxicity, genotoxicity and oxidative stress. In general, Guedes-Pinto, Maxitrol and neomycin sulphate + bacitracin pastes exhibited better biocompatibility in vitro.

Mitochondrial DNA Intraspecific Variability in Sergentomyia minuta (Diptera: Psychodidae).

Recently, there has been growing interest in analysis of the geographical variation between populations of different Phlebotomus spp. and American sand flies by comparing the sequences of various genes. However, little is known about the genetic structure of the genus Sergentomyia França & Parrot. No study has been carried out on Sergentomyia minuta Rondani. Most authors recognize this as a species with a high degree of morphological polymorphism, and some suspect that there are two subspecies: Se. minuta minuta Rondani in Europe, having about 40 horizontal cibarial teeth (sticks aligned along a straight line in the cibarial cavity), and Se. minuta parroti Adler & Theodor in North Africa, having about 70 cibarial teeth. Here we analyzed phylogeographic patterns using cytochrome b (Cytb) and cytochrome C oxidase I mtDNA for 29 populations from 10 countries: Algeria, Cyprus, France (continental and Corsica), Greece (continental and Crete), Malta, Montenegro, Morocco, Portugal (continental and Atlantic Savage Islands), Spain, and Tunisia. We analyzed intra- and interpopulation patterns of genetic diversity. Our results from Bayesian inference showed a complex genetic structure of Se. minuta with four haplogroups including many different haplotypes. One haplogroup includes all the specimens from North Africa. A second haplogroup includes a few specimens from the south of France, Spain, and one from Portugal. The third includes many specimens from southern France, all the specimens from Corsica, one from Spain, and all specimen from Portugal except one. A fourth branch includes specimens from the Balkans, Malta, Crete, Cyprus, and curiously some from the Atlantic Savage Islands; settlement of the latter population remains unexplained. However, our results suggest that the settlement of the Mediterranean basin could have occurred at the same time for Se. minuta and both Phlebotomus perniciosus Newstead and Phlebotomus ariasi Tonnoir. The spatial distribution of haplotypes was congruent with phylogenetic findings.

[Open versus laparoscopic radical prostatectomy: a French center experience]. / Prostatectomie radicale ouverte versus laparoscopique: expérience d'un centre français.

OBJECTIVE: To compare peri-operative outcomes of open radical prostatectomy (ORP) to laparoscopic radical prostatectomy (LRP) in a single French institution. METHODS: Between 1998 and 2003, 72 patients underwent ORP followed by 279 LRP between 2003 and 2010 for a clinically localized prostate cancer. Demographic, peri-operative and pathological data in the ORP and LRP groups were analyzed and compared. RESULTS: In the ORP group, compared to the LRP group, the following significant differences were found: patients were older (63.1 years versus 65.6), initial PSA was higher (10.2 ng/mL versus 6.7) and the proportion of T1c was higher (62.8 % versus 80.6 %). Operative blood loss (1500 mL versus 500) and length of hospitalization (9.0 days versus 6.3) were higher in the ORP group (P<0.001). Operative time was longer in the LRP group (250 min versus 160; P<0 .001). There was no significant difference regarding length of catheterization (average of 8.5 days). Anastomotic strictures were more frequent following ORP (P<0.001). Positive margins proportion in the ORP group (7.1 %) was lower than that observed in the LRP group (28.7 %) (P=0.001). Patients in the ORP group achieved early continence more frequently (P<0.01) but at 12 months postoperatively there was no significant difference. CONCLUSION: Patients in the LRP group had lower operative blood losses and a shorter length of hospitalization. However, in the ORP group, operative time was shorter and positive margins rate was lower.

Influence of the addition of nanohydroxyapatite to scaffolds on proliferation and differentiation of human mesenchymal stem cells: a systematic review of in vitro studies.

One of the main challenges of tissue engineering in dentistry is to replace bone and dental tissues with strategies or techniques that simulate physiological tissue repair conditions. This systematic review of in vitro studies aimed to evaluate the influence of the addition of nanohydroxyapatite (NHap) to scaffolds on cell proliferation and osteogenic and odontogenic differentiation of human mesenchymal stem cells. In vitro studies on human stem cells that proliferated and differentiated into odontogenic and osteogenic cells in scaffolds containing NHap were included in this study. Searches in PubMed/MEDLINE, Scopus, Web of Science, OpenGrey, ProQuest, and Cochrane Library electronic databases were performed. The total of 333 articles was found across all databases. After reading and analyzing titles and abstracts, 8 articles were selected for full reading and extraction of qualitative data. Results showed that despite the large variability in scaffold composition, NHap-containing scaffolds promoted high rates of cell proliferation, increased alkaline phosphatase (ALP) activity during short culture periods, and induced differentiation, as evidenced by the high expression of genes involved in osteogenesis and odontogenesis. However, further studies with greater standardization regarding NHap concentration, type of scaffolds, and evaluation period are needed to observe possible interference of these criteria in the action of NHap on the proliferation and differentiation of human stem cells.

Time course of NT-proBNP levels after acute ischemic stroke.

BACKGROUND: Studies suggest that N-terminal-pro-brain natriuretic peptide (NT-proBNP) can be a biomarker of cardioembolic stroke. However, the best time to measure it after stroke is unknown. We studied the time course of NT-proBNP in patients with ischemic stroke. METHODS: Consecutive acute ischemic stroke patients were admitted over 10 months to a Stroke Unit. Stroke type was classified according to TOAST. Blood samples were drawn within 24, 48, and 72 hours after stroke. Friedman test was used to compare NT-proBNP values across the 3 times in all, cardioembolic and non-cardioembolic stroke patients. Post hoc analysis with Wilcoxon signed-rank tests was conducted with a Bonferroni correction. Mann-Whitney test was used to compare median values of NT-proBNP between cardioembolic and non-cardioembolic stroke patients. ROC curves were drawn to determine NT-proBNP accuracy to diagnose cardioembolic stroke at 24, 48, and 72 hours after stroke onset. RESULTS: One hundred and one patients were included (29 cardioembolic) with a mean age of 64.5±12.3 years. NT-proBNP values for cardioembolic stroke were significantly higher (P < 0.001) than for non-cardioembolic stroke in the 3 time points. NT-proBNP was highest in the first 24-48 h after ischemic stroke and decreased significantly 72 h after stroke onset. The area under the curve for the three time points was similar. CONCLUSION: NT-proBNP levels were highest in the first 2 days after ischemic stroke and declined significantly thereafter. However, the area under the curve for the three time points was similar. The first 72 hours after ischemic stroke have a similar diagnostic accuracy to diagnose cardioembolic stroke.

Reproductive dormancy in boll-weevil from populations of the midwest of Brazil.

The boll weevil (Anthonomus grandis Boheman) (Coleoptera: Curculionidae) is an introduced pest in Brazil, which in 30 yr has successfully expanded to various eco-regions and became the most important pest of cotton (Gossypium hirsutum, Malvaceae). Given the limited knowledge about the adaptive mechanisms that allowed successful establishment of the pest population in a tropical region, in this work we studied the potential of the Midwest population of boll weevils to enter a reproductive dormancy and identified the importance of the feeding source for induction of dormancy. We investigated morphological and physiological characters as indicators of the dormancy. We also investigated the occurrence of reproductive dormancy in boll weevils populations from cotton farms of the Midwestern region of Brazil during the cotton and noncotton seasons of 2009 and 2010. The studies revealed that boll weevils entered facultative reproductive dormancy; however, unlike what has been observed for boll weevils from temperate and subtropical regions, the hypertrophy of fat body and hexamerin levels did not straightly correlated to reproductive dormancy. The food source and field conditions during early adult development were decisive factor for the induction of reproductive dormancy. The incidence of reproductive dormancy increased progressively as the phenology of cotton plant advanced, reaching approximately 90% at the end of the crop season. During the noncotton season, the boll weevil was predominantly found in reproductive dormancy, especially females; however, there is evidence of use of multiple adaptive strategies to colonize the next harvest.

Red and brown seaweeds extracts: A source of biologically active compounds.

The biological activities of Porphyra sp., Gracilaria gracilis, Alaria esculenta and Saccharina latissima extracts prepared by enzymatic and ball milling-assisted methods and hot water were evaluated. Enzyme-assisted methods allowed the highest extraction yields. Alcalase-assisted extraction (EAA) was the most effective in the recovery of polyphenolic compounds and Porphyra sp. had the highest content. The efficiency of flavonoids extraction was highly dependent on the used method. Globally, Porphyra sp. and EAA extracts exhibited the highest antioxidant and chelating activities. The highest α-amylase inhibitory activity was determined in HW Porphyra sp. extract while EAA A. esculenta extract had the highest α-glucosidase inhibitory activity. The highest ACE inhibitory activity was obtained in EAA from S. latissima. None of the extracts showed antimicrobial activity against the tested bacteria. The results showed that Porphyra sp. and S. latissima are potentially useful as ingredient in functional foods and nutraceuticals.

Early ADC changes in motor structures predict outcome of acute stroke better than lesion volume.

OBJECTIVES: The lesion volume assessed from diffusion-weighted imaging (DWI) within the first six hours to first week following stroke onset has been proposed as a predictor of functional outcome in clinical studies. However, the prediction accuracy decreases when the DWI lesion volume is measured during the earliest stages of patient evaluation. In this study, our hypothesis was that the combination of lesion location (motor-related regions) and diffusivity measures (such as Apparent Diffusion Coefficient [ADC]) at the acute stage of stroke predict clinical outcome. PATIENTS AND METHODS: Seventy-nine consecutive acute carotid territory stroke patients (median age: 62 years) were included in the study and outcome at three months was assessed using the modified Rankin scale (good outcome: mRS 0-2; poor outcome: mRS 3-5). DWI was acquired within the first six hours of stroke onset (H2) and the following day (D1). Apparent Diffusion Coefficient (ADC) values were measured in the corticospinal tract (CST), the primary motor cortex (M1), the supplementary motor area (SMA), the putamen in the affected hemisphere, and in the contralateral cerebellum to predict stroke outcome. RESULTS: Prediction of poor vs. good outcome at the individual level at H2 (D1, respectively) was achieved with 74% accuracy, 95%CI: 53-89% (75%, 95% CI: 61-89%, respectively) when patients were classified from ADC values measured in the putamen and CST. Prediction accuracy from DWI volumes reached only 62% (95%CI: 42-79%) at H2 and 69% (95%CI: 50-85%) at D1. CONCLUSION: We therefore show that measures of ADC at the acute stage in deeper motor structures (putamen and CST) are better predictors of stroke outcome than DWI lesion volume.

[Open partial nephrectomy: standard of minimal invasive surgery]. / Néphrectomie partielle par chirurgie conventionnelle : définir les critères de la chirurgie mini-invasive.

OBJECTIVE: Partial nephrectomy is now recognized as the standard treatment for tumors less than 7cm. The oncological results are comparable to those obtained by total nephrectomy, while preserving kidney function. Our objective was to describe our experience and research factors associated with complications, recurrence and death. PATIENTS AND METHODS: Partial nephrectomy performed in our center by June 1996 to December 2008 were reviewed retrospectively. Demographic and tumors characteristics, postoperative complications and patient outcomes were identified. Factors associated with complications and survival were investigated by regression tests. RESULTS: Of the 96 patients enrolled (mean age 61.4 years±12.8), 13 had renal insufficiency (serum creatinine 120 to 212µmol/L). The mean tumor size was 32mm (±13.9) and 57 (79.2%) corresponded to clear cell carcinoma. The overall rate of postoperative complications was 26%, including 8.3% of hemorrhagic complications and 3.1% of urinary complications. None of the analyzed variables were associated with the occurrence of complications. With a mean of 2 years and 9 months follow-up (±28months), eight patients (11.1%) had tumor recurrence. Multifocal tumors as well as postoperative complications were associated with risk of recurrence. Three patients with positive tumor margins were monitored with no evidence of progression (with 71, 42 and 12 months of follow-up). CONCLUSION: Our single-center retrospective study of partial nephrectomy for renal tumor showed medium-term oncological results similar to those reported in the total nephrectomy with the advantage of nephron preservation. The results of studies by conventional surgery such as that we report should be a benchmark for laparoscopic surgery.

[Efficiency and tolerance of intermittent self-dilatation after internal urethrotomy for urethral strictures]. / Efficacité et tolérance des dilatations par autosondages après urétrotomie interne pour sténoses urétrales.

OBJECTIVE: To retrospectively evaluate efficiency and tolerance of intermittent self-dilatation (ISD) after unicenter internal urethrotomy (IU) on urethral strictures (US). PATIENTS AND METHODS: From January 2000 to November 2008, ISD have been performed after IU on 54 patients; 44.4% were iatrogenic. ISD median frequency was once a week (0.25-14). ISD was carried out for a median period of 8.4 months (0-97). RESULTS: IPSS was 21 at diagnosis vs 7 during ISD (P=0.018). QoL score of IPSS was 5 at diagnosis vs 2 during ISD (P=0.03). Maximum flow rate was 4.6mL/s at diagnosis vs 16.6mL/s during ISD (P=0.003). Ten patients had recurrence during ISD period. The follow-up from the beginning of ISD was 35 months (range, 0-164). Urologists' evaluation of ISD tolerance was excellent or good for 47 patients (87%). Tolerance self-evaluation was excellent or good for seven patients out of 15. CONCLUSION: ISD was a well-tolerated and useful option after IU. It had a 81.5% efficiency in our cohort.

[Survival is associated with time to reach PSA nadir (DAN) and the ratio DAN/nadir value after androgen deprivation for prostate cancer]. / La survie est associée au délai d'atteinte du PSA nadir (DAN) et au ratio DAN/valeur nadir après suppression androgénique pour cancer de prostate.

OBJECTIVE: The objective of this study was to assess the prognostic decrease rate of PSA in patients treated with androgen suppression (AS) for prostate cancer (PCa). METHODS: We identified in our database CaP patients with histologically documented, treated with SA alone and for whom vital status with a minimum follow-up of 6 months (except death beforehand) was established. Patient characteristics and CaP and PSA at baseline, PSA nadir, time of reaching the nadir PSA (DAN) and the ratio of the DAN/nadir value (ratio DAN/Nadir) were analyzed in relation to progression-free survival, specific and overall survival. RESULTS: One hundred ninety eight patients met the inclusion criteria and the median was 61.5 months (range 4.8 to 233). The median PSA at the start of the SA were 37.1 ng/mL and the median nadir PSA was 0.48 ng/mL. The median time to progression was 23.6 months. The median specific and overall survivals were 94 and 78 months, respectively. In univariate analysis, predictors of progression-free survival were PSA before SA, PSA nadir, DAN, DAN ratio/nadir, Gleason score, the percentage of core positive prostate biopsy and the status of bone scintigraphy. Except for PSA before SA which was no longer significant, predictors of specific and overall survival were similar and added the biochemical response (decrease of more than 50% of PSA) to a second hormonal manipulation during the biological progression. In multivariate analysis, the nadir PSA and the ratio DAN/Nadir remained significant predictors. CONCLUSION: These results have confirmed in one hand the predictive value of survival in patients DAN SA for CaP: achieving faster nadir PSA was associated with shorter survival. They have introduced in the other hand the new concept of DAN/Nadir PSA which provides independent prognostic information.

[Variation of urinary PCA3 following transrectal ultrasound-guided prostate biopsy]. / Variation du PCA3 urinaire après biopsie de prostate transrectale échoguidée.

INTRODUCTION: Serum PSA is known to rise slightly following an attentive digital rectal examination (DRE) and dramatically following prostatic biopsy. The aim of this study was to evaluate the PCA3 response in these situations. PATIENTS AND METHODS: In 15 consecutive men undergoing transrectal ultrasound-guided needle biopsy of the prostate and who gave their informed consent, urinary PCA3 was determined twice: at a first consultation, urine being sampled immediately after an attentive DRE and second within 2 hours after the biopsy. The mean interval between the two samplings was 14 days (median 15). PCA3 measurements were centralized and performed by the same biologist. At least twelve cores were taken using a biopsy gun with an 18-gauge needle. Changes in PCA3 levels were studied. RESULTS: Mean age of the 15 men was 67.3 years (range 50.9-79.1). Mean (median) pre-biopsy total and %free PSA were respectively 6.6 ng/ml (5.7) and 15.8% (15.5). Mean prostate volume was 43.6 cm(3). Seven patients complained of mild LUTS. DRE was suspicious in eight patients. Of the 15 men, 6 (40%) had adenocarcinoma on biopsy (all clinically confined to the prostate). Median (range) Gleason score was 6 (6-7). Median PCA3 score (range) before and after prostatic biopsy were respectively 36 (9-287) and 27 (5-287) with no significant difference between the two groups (sign test for matched series p > 0.05). The median variation between pre- and post-biopsy PCA3 was -18%. When considering a PCA3 cut-off of 35, two patients changed group: one patient had 51 before and 31 after (PSA 4.6; no cancer on prostate biopsy) and the second had 36 before and 27 after (PSA 5.6; low-risk PCa). The figure represents the PCA3 values for each case (squares for the pre-biopsy and diamonds for the post-biopsy). When considering only the six patients with PCA, median (mean) PCA3 score before and after prostatic biopsy were respectively 51.5 (60.8) and 44.5 (54.8) with no significant difference between the two groups (sign test for matched series p > 0.5) and a median variation between pre- and post-biopsy PCA3 of 1.5%. CONCLUSIONS: Prostate biopsy did not alter significantly urinary PCA3 value. This confirms what was theoretically expected.

E-cadherin expression in estrogen receptor-positive and negative breast carcinomas of postmenopausal women.

BACKGROUND: Preservation of E-cadherin expression is usually related to non-invasive and well differentiated breast carcinomas. PURPOSE: The aim of this study was to evaluate E-cadherin immunohistochemical expression in estrogen receptor (ER) positive and negative infiltrating ductal breast carcinomas. METHODS: Twenty-three postmenopausal patients with Stage II, operable, infiltrating ductal breast carcinomas were divided into groups A (ER+; n = 13) and B (ER-; n = 10). E-cadherin immunohistochemical expression was assessed semiquantitatively according to membrane staining intensity and classified as negative (< 10% of cells with stained membranes), positive + (10-50% of cells stained) or positive ++ (> 50% of cells stained). Fisher's exact test was used to compare the distribution of staining intensity in the two groups (p < 0.05). RESULTS: In group A (ER+), E-cadherin staining was positive in all cases: + (n = 3; 23%) and ++ (n = 10; 77%) compared to three cases (30%) in group B (ER-), + (n = 2; 20%) and ++ (n = 1; 10%). This difference was statistically significant (p < 0.0005). CONCLUSIONS: The present results indicate that E-cadherin expression loss is significantly associated with ER-negative tumors and therefore with a more aggressive phenotype of invasive ductal breast carcinoma.

Chewing patterns and digestion in sheep submitted to feed restriction.

Two experiments were conducted to evaluate the relationship among the level of feed intake, chewing pattern, and diet digestibility in sheep fed a moderate-concentrate diet. The first experiment was conducted using six male lambs at a replicated 3 × 3 Latin square design to evaluate diet digestibility and microbial N synthesis according to the level of intake: ad libitum, or restricted to either 70 or 55% of the ad libitum intake. In the second experiment, fifteen male lambs were housed in individual stalls, in a completely randomized design, and fed one of the three levels of dry matter intake (DMI). Chewing patterns were then evaluated for 24 h using a regular 5-min interval observation technique, two times during the experimental period. Decreasing level of feed intake resulted in increased apparent digestibility of dry matter, organic matter, crude protein, and neutral detergent fibre, as well as of the true digestibility of organic matter. Total time spent eating and ruminating decreased with feed restriction. However, lambs fed at restricted levels of intake presented a higher rate of eating (g DMI/min) than those fed ad libitum, and spent more time ruminating each gram of DM (min/g DMI). In conclusion, our results suggest that a more effective chewing during rumination activity can have an important role on feed digestion in animals submitted to feed restriction.

[Pelvic lymph nodes dissection for prostate cancer: Minilap with speculum vs laparoscopy]. / Curage ilio-obturateur pour cancer de prostate : minilaparotomie au spéculum vs coelioscopie.

INTRODUCTION: The pelvic lymph nodes dissection (PLND) is indicated in case of prostate cancer with high risk of ganglionic metastasis. Criteria admitted for indication of PLND are PSA>or=10ng/ml and/or Gleason score >or=7. Two techniques are available for PLND: minilap and laparoscopy. The purpose of this study was to compare retrospectively minilap and the 2 ways of laparoscopy: intra- and extraperitoneum, in terms of efficiency and complications. MATERIAL AND METHOD: We reviewed 147 cases of men who's had a PLND in our department between 1992 and 2006. The distribution for every technique was: 34 cases of minilap (23%), 39 cases of intraperitoneum laparoscopy (27%) and 74 cases of extraperitoneum laparoscopy (50%). The mean age was of 67.9 years (52-79). The mean PSA was 19.01ng/ml (0.3-93) and the average Body Mass Index (BMI) was 26.75kgm(-2) (17.6-41). RESULTS: Twenty-eight patients (19%) presented a postoperating complication. There was no statistically significant difference according to technique. We did not either find statistical difference concerning the number of analyzed nodes between three groups and the duration of hospitalization. Only the mean operating time and the number of drain of Redon were statistically different. CONCLUSION: This study did not show any difference in terms of result and complications between the laparoscopy and minilap for the PLND in case of prostate cancer. We think each technique could be proposed.