Hypoxia-inducible proteins HIF1α and lactate dehydrogenase LDH5, key markers of anaerobic metabolism, relate with stem cell markers and poor post-radiotherapy outcome in bladder cancer.

PURPOSE: To assess whether anaerobic metabolism, proliferation activity and stem cell content are linked with radioresistance in bladder cancer. MATERIALS AND METHODS: Tissue sections from 66 patients with invasive transitional cell bladder cancer treated with hypofractionated accelerated radiotherapy, was immunohistochemically analyzed for the Hypoxia-Inducible Factor 1α (HIF1α) and the anaerobic glycolysis enzyme lactate dehydrogenase 5 (LDH5). Proliferation index (Ki-67) and stem-cell marker (cluster of differentiation CD44, aldehyde dehydrogenase ALDH1) expression was also examined. RESULTS: Both HIF1α and LDH5 expression were linked with high CD44 stem cell population (p = 0.001 and 0.05, respectively), while high Ki-67 proliferation index was linked with nuclear LDH5 expression (p = 0.03) and high histological grade (p = 0.02). A strong significant association of HIF1α (p = 0.0009) and of LDH5 (p < 0.0001) with poor local relapse free survival (LRFS) was noted, which was also confirmed in multivariate analysis. A significant association with overall survival was also noted. Silencing of lactate dehydrogenase LDHA gene in the human RT112 bladder cancer cell line, or exposure to oxamate (LDH activity inhibitor), resulted in strong radio-sensitization. CONCLUSIONS: HIF1α and LDH5 are markers of poor outcome in patients with bladder cancer treated with radiotherapy. Blockage of anaerobic metabolism may prove of importance in clinical radiotherapy.

Knowledge of autism and attitudes of children towards their partially integrated peers with autism spectrum disorders.

This study aimed to measure the effects of contact with integrated students with autism spectrum disorders (ASD) on the knowledge, attitudes and empathy of children (n = 224) from grades 4-6. A comparison group of children (n = 251) who had no contact with classmates with ASD was also included. All participants completed self-report instruments. The implementation of multilevel modeling and moderation analysis indicated significant effects on all dependent variables as well as differences across gender and grades. Implications are discussed regarding the role of contact on peers' conceptions of autism and their attitudes towards children with ASD within inclusionary settings.

Treatment of low-risk prostate cancer with radical hypofractionated accelerated radiotherapy with cytoprotection (HypoARC): an interim analysis of toxicity and efficacy.

AIM: Radiobiological analysis of clinical data suggests that prostate cancer has a low α/ß ratio, implying that large radiotherapy fractions may better control the disease. Acceleration of radiotherapy may be also of importance in a subset of tumors. In this study we assessed the feasibility and efficacy of a highly accelerated and hypofractionated scheme of radiotherapy (HypoARC), for the treatment of localized low risk prostate cancer. PATIENTS AND METHODS: Fifty-five patients with prostate cancer (T1-2 stage, Gleason score <7 and prostate specific antigen (PSA) <10 ng/ml) were treated with localized conformal 4-field radiotherapy to the prostate and seminal vesicles: 51 Gy were delivered (3.4 Gy/fraction, within 19 days). The biological dose to the prostate ranged from 67.9-91.7 Gy. Amifostine (0-1000 mg depending upon tolerance) was delivered daily for cytoprotection. The median follow-up of patients is 30 (6-69) months. RESULTS: Early toxicity was overall low, proctitis being the most frequent side-effect (23.6% grade II). High dose amifostine significantly protected against proctitis (p=0.005). Grade 2 frequency and dysurea occurred in 1.8% and 3.7% of cases, respectively. There was no late toxicity ≥grade 2. Amifostine significantly protected against chronic frequency (p=0.02). Within a median follow-up of 30 months, one patient (1.8%) experienced a biochemical relapse. CONCLUSION: HypoARC is feasible and safe for patients with low-risk prostate cancer and, considering also the high efficacy noted, a strong rationale is provided for the further evaluation of HypoARC in randomized trials.

Effects of task organization on the independent play of students with autism spectrum disorders.

The purpose of the study was to examine the impact of task organization, a component of Structured Teaching developed by Division TEACCH, on the independent play of children with autism spectrum disorders (ASD). On-task behavior, task accuracy, task performance and teacher prompting were measured across independent play sessions in the classroom. An ABAB design was implemented to evaluate the effects of task organization on the independent play skills of two young children with ASD. Results regarding on-task behavior, task accuracy and independence were variable and are discussed. The implications of findings on the use of task organization for increasing independence in children with ASD are discussed.

Developing Pilot Befriending Schemes for People with Autism Spectrum Disorders in a Region of Greece: Lessons from Practice.

Befriending represents an expanding resource for the social support of vulnerable people in the community. This article discusses the development of two pilot befriending schemes for individuals with Autism Spectrum Disorders (ASDs) in the central region of Greece. In the first part, the context, the aims and participants of the schemes are described and in the next part, the positive aspects and obstacles encountered in both schemes are discussed.