Molecular identification of an ETV6-RET fusion in a secretory carcinoma associated with a pleomorphic adenoma.

Pleomorphic adenoma (PA) is the most common neoplasm of the salivary glands. Although several carcinomas have been reported to arise from PA, only 1 case of salivary gland secretory carcinoma (SC) ex pleomorphic adenoma has been previously reported. SC is a newly described salivary gland tumor harboring an ETV6-NTRK3 translocation, which is classically observed in secretory carcinoma of the breast, although other translocations have recently been observed. We report the first case of the molecular identification of a rare ETV6-RET translocation in an SC arising from a PA in the submandibular salivary gland (SC ex PA). Our results add to the diversity of tumors that are associated with PA and contribute to the molecular characterization of SC, which will have implications on its diagnosis, prognosis, and treatment.

PD-L1 Positivity Associated With Presence of Tertiary Lymphoid Structures and High-Stage Disease in Upper Tract Urothelial Carcinoma.

OBJECTIVES: Persistent antigen exposure leads to the accumulation of lymphocytes and subsequent tertiary lymphoid structures (TLS). We investigated the relationship of tumor microenvironment (TME) with respect to programmed death ligand 1 (PD-L1), its receptor programmed death 1 (PD-1), and TLS in upper tract urothelial carcinoma (UTUC) cases and compared them with UTUC associated with urothelial bladder carcinoma (UTUC-BCa). METHODS: We retrospectively identified 72 patients with UTUC. Representative slides were reviewed, and TLS were counted. Immunohistochemical stains for PD-1 and PD-L1 were performed. PD-1-positive lymphocytes were counted and H-score for PD-L1-positive membranous staining was determined. RESULTS: PD-L1 expression in the tumor was present in 55.1% of the UTUC cases. Higher stage was associated with increased PD-L1 expression (P = .035). TLS were present in 33.3% and their presence was significantly associated with PD-L1 positivity (P = .024). This association remained significant after adjustment for UTUC-BCa. TLS were also associated with a greater number of infiltrating PD-1-positive lymphocytes (P = .013). CONCLUSIONS: This study is one of the first comparative studies of the TME in UTUC and UTUC-BCa. PD-L1 is expressed in a subset of UTUC and is associated with TLS. The presence of TLS is an inherent characteristic of UTUC and not secondary to the presence of BCa.

Increased risk of disordered eating in polycystic ovary syndrome.

OBJECTIVE: To determine the prevalence of eating disorders (EDs) in women with polycystic ovary syndrome (PCOS) and the effects of EDs on health-related quality of life. DESIGN: Cross-sectional study. SETTING: University practice. PATIENT(S): Women with PCOS (Rotterdam criteria; n = 148) and controls seen for routine gynecologic care (n = 106) from 2015 to 2016. INTERVENTION(S): Eating Disorder Examination-Questionnaire (EDE-Q), Night Eating Questionnaire (NEQ), Hospital Anxiety and Depression Scale, and Health-Related Quality of Life Questionnaire (PCOSQ). MAIN OUTCOME MEASURE(S): EDE-Q and NEQ scores, prevalence of bulimia nervosa (BN), binge eating disorder (BED), and night eating syndrome (NES). RESULT(S): Women with PCOS were at an increased risk for overall abnormal EDE-Q scores compared with controls (12.16% vs. 2.83%; odds ratio [OR], 4.75; 95% confidence interval [CI], 1.36, 16.58). Clinically significant elevated scores were noted for shape and weight concern. In unadjusted analysis, body mass index (OR, 1.06; 95% CI, 1.01, 1.11), elevated depression score (OR, 5.43; 95% CI, 1.85, 15.88), and elevated anxiety score (OR, 6.60; 95% CI, 2.45, 17.76) were associated with an abnormal EDE-Q global score. In the multivariable model, PCOS was associated with abnormal EDE-Q global score (adjusted OR, 4.67; 95% CI, 1.16, 18.80). Elevated EDE-Q scores inversely correlated with PCOSQ scores (r = -0.57). The prevalence of BN was 6.1%, of BED was 17.6%, and of NES was 12.9% in women with PCOS, with no differences compared with controls. CONCLUSION(S): Women with PCOS, especially those with concurrent anxiety symptoms but independent of obesity, have a significantly increased risk of abnormal EDE-Q scores. Our findings suggest the need for routine screening for ED in this population.

Characterization of the ATG8-conjugation system in 2 Plasmodium species with special focus on the liver stage: possible linkage between the apicoplastic and autophagic systems?

Plasmodium parasites successfully colonize different habitats within mammals and mosquitoes, and adaptation to various environments is accompanied by changes in their organelle composition and size. Previously, we observed that during hepatocyte infection, Plasmodium discards organelles involved in invasion and expands those implicated in biosynthetic pathways. We hypothesized that this process is regulated by autophagy. Plasmodium spp. possess a rudimentary set of known autophagy-related proteins that includes the ortholog of yeast Atg8. In this study, we analyzed the activity of the ATG8-conjugation pathway over the course of the lifecycle of Plasmodium falciparum and during the liver stage of Plasmodium berghei. We engineered a transgenic P. falciparum strain expressing mCherry-PfATG8. These transgenic parasites expressed mCherry-PfATG8 in human hepatocytes and erythrocytes, and in the midgut and salivary glands of Anopheles mosquitoes. In all observed stages, mCherry-PfATG8 was localized to tubular structures. Our EM and colocalization studies done in P. berghei showed the association of PbATG8 on the limiting membranes of the endosymbiont-derived plastid-like organelle known as the apicoplast. Interestingly, during parasite replication in hepatocytes, the association of PbATG8 with the apicoplast increases as this organelle expands in size. PbATG3, PbATG7 and PbATG8 are cotranscribed in all parasitic stages. Molecular analysis of PbATG8 and PbATG3 revealed a novel mechanism of interaction compared with that observed for other orthologs. This is further supported by the inability of Plasmodium ATG8 to functionally complement atg8Δ yeast or localize to autophagosomes in starved mammalian cells. Altogether, these data suggests a unique role for the ATG8-conjugation system in Plasmodium parasites.

Influence of climatic factors on the medical attentions of dermatologic diseases in a hospital of Lima, Peru.

BACKGROUND: Significant associations have been described between climatic factors and human health, which can occur in dermatologic diseases too. OBJECTIVE: To determine the influence of the climatic factors on the medical attentions of dermatologic diseases in a general hospital in Lima (Peru). PATIENTS AND METHODS: Observational study which was carried out in a national hospital between January 2004 and December 2007. The diagnoses were classified according to the ICD-10 system. The climate information was provided by the National Oceanographic and Atmospheric Administration from USA(NOAA). RESULTS: 3 294 patients were included in the study, the average age was 35.4 ± 20.7 years old, and 53.2% were females. The "El Niño" phenomenon was associated with an increase in the prevalence of actinic keratosis (p=0.002), viral warts (p=0.001) and rosacea (p=0.014). The "La Niña" phenomenon was associated with a reduction in viral warts (p=0.026). Spring was associated with an increase of dermatitis (p=0.003), and summer was associated with an increase of benign neoplasms (p=0.049). CONCLUSION: The climatic variations influenced the occurrence of certain dermatologic diseases. The present study may represent an orientation guide to specialists and general practitioners identifying the most common dermatologic diagnoses and thus enabling better preparation to treat these cases in determined seasons of the year.

Influence of climatic factors on the medical attentions of dermatologic diseases in a hospital of Lima, Peru / Influência de fatores climáticos no tratamento médico de doenças dermatológicas em um hospital em Lima, Peru

BACKGROUND: Significant associations have been described between climatic factors and human health, which can occur in dermatologic diseases too. OBJECTIVE: To determine the influence of the climatic factors on the medical attentions of dermatologic diseases in a general hospital in Lima (Peru). PATIENTS AND METHODS: Observational study which was carried out in a national hospital between January 2004 and December 2007. The diagnoses were classified according to the ICD-10 system. The climate information was provided by the National Oceanographic and Atmospheric Administration from USA(NOAA). RESULTS: 3 294 patients were included in the study, the average age was 35.4 ± 20.7 years old, and 53.2 percent were females. The "El Niño" phenomenon was associated with an increase in the prevalence of actinic keratosis (p=0.002), viral warts (p=0.001) and rosacea (p=0.014). The "La Niña" phenomenon was associated with a reduction in viral warts (p=0.026). Spring was associated with an increase of dermatitis (p=0.003), and summer was associated with an increase of benign neoplasms (p=0.049). CONCLUSION: The climatic variations influenced the occurrence of certain dermatologic diseases. The present study may represent an orientation guide to specialists and general practitioners identifying the most common dermatologic diagnoses and thus enabling better preparation to treat these cases in determined seasons of the year.

FUNDAMENTO: Associações significativas entre fatores climáticos e saúde humana têm sido descritas, inclusive na área de Dermatologia. OBJETIVO: Determinar a influência de fatores climáticos no tratamento de doenças dermatológicas em um hospital em Lima (Peru). PACIENTES E MÉTODOS: Estudo observacional realizado em um hospital em Lima entre janeiro de 2004 e dezembro de 2007. Os diagnósticos foram classificados de acordo com o sistema ICD-10. Informações climáticas foram fornecidas pela "National Oceanographic and Atmospheric Administration" (NOAA - USA). RESULTADOS: 3.294 pacientes participaram do estudo. A idade media foi 35.4 ± 20.7 anos e 53,2 por cento eram mulheres. O fenômeno "El Niño" foi associado a um aumento da prevalência de queratose actínica (p=0,002), verrugas virais (p=0,001) e rosácea (p=0,014). O fenômeno "La Niña" foi associado a diminuição das verrugas virais (p=0,026). A primavera foi associada a um aumento de dermatite (p=0,003) e o verão, a um aumento de tumores benignos (p=0,049). CONCLUSÃO: Variações climáticas influenciam o aparecimento de algumas doenças dermatológicas. O presente trabalho pode orientar especialistas e clínicos gerais por meio da identificação dos diagnósticos dermatológicos mais comuns e, consequentemente, prepará-los para tratar doenças sazonais.