Insights into incipient oral squamous cell carcinoma: a comprehensive south-american study.

BACKGROUND: To describe demographic and clinicopathological aspects of a South-American cohort of incipient oral squamous cell carcinoma patients. MATERIAL AND METHODS: A cross-sectional, observational study was performed to assess demographic and clinicopathological characteristics of incipient oral squamous cell carcinoma patients from 6 South-American institutions. RESULTS: One hundred and seven patients within the histopathological spectrum of incipient oral squamous cell carcinoma (in-situ and microinvasive) were included. Fifty-eight (54.2%) patients were men with a mean age of 60.69 years. Forty-nine (45.8%) and thirty-nine (36.5%) patients had history of tobacco and alcohol use, respectively. Clinically, most of the lesions were plaques (82.2%), ≥ 2 cm in extension (72%), affecting the lateral border of the tongue (55.1%), and soft palate (12.1%) with a mixed (white and red) appearance. Eighty-two (76.7%) lesions were predominantly white and 25 (23.3%) predominantly red. CONCLUSIONS: To the best of our knowledge, this is the largest cohort of incipient oral squamous cell carcinoma patients, which raises awareness of clinicians' inspection acuteness by demonstrating the most frequent clinical aspects of this disease, potentially improving oral cancer secondary prevention strategies.

Towards developing a Core Outcome Set for malnutrition intervention studies in older adults: a scoping review to identify frequently used research outcomes.

PURPOSE: To conduct a scoping review to provide a systematic overview of outcomes used in nutritional intervention studies focused on the treatment of protein-energy malnutrition in older adults. METHODS: A systematic search of four electronic databases (Medline, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials (CENTRAL) was performed to retrieve randomized controlled trials (RCTs), published until March 9, 2020, that evaluated the effect of nutritional interventions to treat protein-energy malnutrition in older adults and those at risk for malnutrition. Two authors screened titles, abstracts and full texts independently. One author extracted data that were cross-checked by another author. RESULTS: Sixty-three articles reporting 60 RCTs were identified. Most frequently used outcomes included body weight/body mass index (75.0% of RCTs), dietary intake (61.7%), functional limitations (48.3%), handgrip strength (46.7%), and body circumference (40.0%). The frequencies differed by setting (community, hospital and long-term care). For some outcomes there was a preferred assessment method (e.g., Barthel index for functional limitations), while for other outcomes (e.g., functional performance) a much greater variation was observed. CONCLUSION: A large variation in outcomes, not only across but also within settings, was identified in nutritional intervention studies in malnourished older adults and those at risk. Furthermore, for many outcomes there was a large variation in the used assessment method. These results highlight the need for developing a Core Outcome Set for malnutrition intervention studies in older adults to facilitate future meta-analyses that may enhance our understanding on the effectiveness of treatment.

Preclinical and Clinical Development of ABBV-8E12, a Humanized Anti-Tau Antibody, for Treatment of Alzheimer's Disease and Other Tauopathies.

Tau neurofibrillary tangles are found in the brains of patients suffering from Alzheimer's disease and other tauopathies. The progressive spreading of tau pathology from one brain region to the next is believed to be caused by extracellular transsynaptic transmission of misfolded tau between neurons. Preclinical studies have shown that antibodies against tau can prevent this transfer of misfolded tau between cells. Thus, antibodies against tau have the potential to stop or slow the progression of tau pathology observed in human tauopathies. To test this hypothesis, a humanized anti-tau antibody (ABBV-8E12) was developed and a phase 1 clinical trial of this antibody has been completed. The double-blind, placebo-controlled phase 1 study tested single doses of ABBV-8E12 ranging from 2.5 to 50 mg/kg in 30 patients with progressive supranuclear palsy (PSP). ABBV-8E12 was found to have an acceptable safety profile with no clinically concerning trends in the number or severity of adverse events between the placebo and dosed groups. Pharmacokinetic modelling showed that the antibody has a plasma half-life and cerebrospinal fluid:plasma ratio consistent with other humanized antibodies, and there were no signs of immunogenicity against ABBV-8E12. Based on the acceptable safety and tolerability profile of single doses of ABBV-8E12, AbbVie is currently enrolling patients into two phase 2 clinical trials to assess efficacy and safety of multiple doses of ABBV-8E12 in patients with early Alzheimer's disease or PSP.

Characterization of a novel international clonal complex (CC32) of Acinetobacter baumannii with epidemic potential.

Twelve non-replicate Acinetobacter baumannii isolates from five European hospitals, Kuwait, and the US military healthcare system collected between 1980 and 2005 revealed a new clone, CC32. These included representative isolates of outbreaks/cross-infections. Antimicrobial susceptibility and carbapenem-resistant genetic traits varied. The widespread occurrence, the association with an outbreak and the carbapenem resistance indicate that CC32 has epidemic potential.

Long-term exposure of the freshwater shrimp Macrobrachium olfersii to elevated salinity: effects on gill (Na+,K+)-ATPase alpha-subunit expression and K+-phosphatase activity.

The kinetic properties of a microsomal gill (Na+,K+)-ATPase from the freshwater shrimp, Macrobrachium olfersii, acclimated to 21 per thousand salinity for 10 days were investigated using the substrate p-nitrophenylphosphate. The enzyme hydrolyzed this substrate obeying cooperative kinetics at a rate of 123.6+/-4.9 U mg-1 and K0.5=1.31+/-0.05 mmol L-1. Stimulation of K+-phosphatase activity by magnesium (Vmax=125.3+/-7.5 U mg-1; K0.5=2.09+/-0.06 mmol L-1), potassium (Vmax=134.2+/-6.7 U mg-1; K0.5=1.33+/-0.06 mmol L-1) and ammonium ions (Vmax=130.1+/-5.9 U mg-1; K0.5=11.4+/-0.5 mmol L-1) was also cooperative. While orthovanadate abolished p-nitrophenylphosphatase activity, ouabain inhibition reached 80% (KI=304.9+/-18.3 micromol L-1). The kinetic parameters estimated differ significantly from those for freshwater-acclimated shrimps, suggesting expression of different isoenzymes during salinity adaptation. Despite the approximately 2-fold reduction in K+-phosphatase specific activity, Western blotting analysis revealed similar alpha-subunit expression in gill tissue from shrimps acclimated to 21 per thousand salinity or fresh water, although expression of phosphate-hydrolyzing enzymes other than (Na+,K+)-ATPase was stimulated by high salinity acclimation.

Behaviour of a full-scale expanded bed reactor with overlaid anaerobic and aerobic zones for domestic wastewater treatment.

This paper presents the behaviour of a full-scale expanded bed reactor (160 m3) with overlaid anaerobic and aerobic zones used for municipal wastewater treatment. The research was carried out in two experimental steps: anaerobic and anaerobic-aerobic conditions, and the experimental results presented in this paper refer to four months of reactor operation. In the anaerobic condition, after inoculation and 60 days of operation, the reactor treating 3.40 kg CODm(-3)d(-1) for thetaH of 2.69 h, reached mean removal efficiencies of 76% for BOD, 72% for COD, and 80% for TSS, when the effluent presented mean values of 225 mg.L(-1) of COD, 98 mg.L(-1) of BOD and 35 mg.L(-1) of TSS. Under these conditions, for nitrogen loading of 0.27 kgN.m(-3)d(-1), the reactor generated an effluent with mean N-org. of 8 mg.L(-1) and N-ammon. of 37 mg.L(-1), demonstrating high potential of ammonification. For the anaerobic-aerobic condition (118th day) the system was operated with thetaH of 5.38 h presented mean removal efficiencies of 84% for BOD, 79% for COD, 76% for TSS, and 30% for TKN. The reactor's operation time was less than two months, which was not long enough to reach nitrification. Regarding the obtained results, this research confirmed that this reactor is configured as a flexible and adequate alternative for the treatment of sewage, requiring relatively small area and only thetaH of 10 h that can be adjusted to the local circumstances.

Full scale fluidized bed anaerobic reactor for domestic wastewater treatment: performance, sludge production and biofilm.

This paper describes the performance, sludge production and biofilm characteristics of a full scale fluidized bed anaerobic reactor (32 m3) for domestic wastewater treatment. The reactor was operated with 10.5 m x h(-1) upflow velocity, 3.2 h hydraulic retention time, and recirculation ratio of 0.85 and it presented removal efficiencies of 71+/-8% of COD and 77+/-14% of TSS. During the apparent steady-state period, specific sludge production and sludge age in the reactor were (0.116+/-0.033) kgVSS. kgCOD(-1) and (12+/-5)d, respectively. Biofilm formed in the reactor presented two different patterns: one of them at the beginning of the colonization and the other of mature biofilm. These different colonization patterns are due to bed stratification in the reactor, caused by the difference in local-energy dissipation rates along the reactor's height, and density, shape, etc. of the bioparticles. The biofilm population is formed mainly of syntrophic consortia among sulfate reducing bacteria, methanogenic archaea such as Methanobacterium and Methanosaeta-like cells.

Expression of Epstein-Barr virus-gene products in Burkitt's lymphoma in Northeast Brazil.

The Epstein-Barr Virus (EBV) is consistently found in tumor cells of Burkitt's lymphoma (BL) endemic in central Africa and malaria is considered a pathogenic cofactor. In contrast, fewer than 20% of BL cases occurring in Western countries are EBV-associated. We have investigated 54 BL cases from Bahia, a tropical region of Northeast Brazil, for expression of EBV gene products by in situ hybridization and immunohistology and performed typing of the EBV by polymerase chain reaction. Ten pediatric BL cases from Germany served as controls. New cases of malaria were not observed in the period and area of our study. Small nuclear EBV encoded transcripts, EBER, were found in tumor cells of 47 of 54 Brazilian cases (87%) but in only 2 of 10 German cases (20%). Type I latency of the EBV infection with absence of EBV-encoded proteins LMP1 and EBNA2 was found in 45 of 47 of the EBER-positive Brazilian cases. In two cases, occasional LMP1-containing tumor cells were found in the neighborhood of small Schistosoma mansoni granulomas and scars. BHLF1 transcripts associated with lytic EBV infection could be detected in few cells in 3 of the 40 EBER-positive Brazilian cases investigated. EBV type A was found in the majority of Brazilian BL cases (20 of 30 A-type, 7 of 30 B-type, and 3 of 30 not amplifiable). Our results indicate that the association of Bahian BL with EBV, but not the regional prevalence of malaria, is similar to endemic African BL. In two cases, type II latency was found in association with schistosomiasis, suggesting a role of this parasitosis in the induction of an EBV expression pattern that is unusual for BL. Because chronic schistosomiasis is associated with elevated Th2 cytokine expression resulting in reduced cell-mediated cytotoxicity, it seems possible that altered local immunity is responsible for this peculiar phenotype.

Rhabdomyosarcoma mimicking Wilms' tumor.

A case of a 6 year old child, with a pleomorphic rhabdomyosarcoma involving simultaneously the leg muscles and the kidney is reported. The renal tumor distorted the pyelocalycial system and Wilms' tumor was the clinical diagnosis. The authors discuss on the possible primary site of the tumor.

Phase II study of carboplatin as a single drug for relapsed Wilms' tumor: experience of the Brazilian Wilms' Tumor Study Group.

A total of 15 patients with relapsed Wilms' tumor were treated with carboplatin as a single agent. There were six females and nine males, aged between 2 and 9 years (median:5). The treatment consisted of carboplatin given I.V. as a single agent at a dose of 550 mg/m2 over 1 hour every 3 weeks. There were four (26%) complete responses, four (26%) partial responses, one stable disease, and six with progressive disease. In all patients a total of 56 courses were given and the toxicities found were leukopenia and thrombocytopenia. The overall response rate was encouraging and the toxicity was acceptable and reversible.

Phase II study of carboplatin as a single drug for relapsed Wilms tumor: experience of the Brazilian Wilms Tumor Study Group

A total of 15 patients with relapsed Wilms' tumor were treated with carboplatin as a single agent. There were six females and nine males, aged between 2 and 9 years (median:5). The treatment consisted of carboplatin given I.V. as a single agent at a dose of 550 mg/m2 over 1 hour every 3 weeks. There were four (26%) complete responses, four (26%) partial responses, one stable disease, and six with progressive disease. In all patients a total of 56 courses were given and the toxicities found were leukopenia and thrombocytopenia. The overall response rate was encouraging and the toxicity was acceptable and reversible.

Ki-1 large cell lymphoma with regressing lesions in a child.

An 8-year-old boy was seen with a cutaneous Ki-1 anaplastic, large cell lymphoma with multiple lesions. Some of the lesions showed spontaneous regression. During more than seven years of disease no systemic involvement was observed, but recurrent, self-healing lesions did appear. Histopathologic examination of five lesions revealed a variety of findings, from an inflammatory infiltrate to a highly anaplastic pattern. The neoplastic cells expressed Ki-1 and leukocyte common antigens. Ultrastructurally, those cells showed ruffled indentations. The differential diagnosis includes microvillous malignant lymphoma. The patient has had a four-year follow-up without relapses.

Rhabdomyosarcoma in a congenital pigmented nevus.

A 7-month-old boy had a giant pigmented lesion involving the trunk and thighs that exhibited many hyperpigmented hairy and verrucous nevi. One of the nevi ulcerated and on histological examination consisted of pleomorphic rhabdomyosarcoma cells that stained for muscle-specific actin (HHF-35), desmin, and myoglobin. Around the tumor, in the dermis, benign pigmented nevus cells were observed. The occurrence of malignant tumors, other than malignant melanoma, in pigmented nevi is rarely described.

[Wilms tumor. Evaluation of the important prognosis factors in 22 treated cases]. / Tumor de Wilms. Avaliação dos factores de importância prognóstica em 22 casos tratados.

Twenty-two cases of treated Wilms tumor with more than two years of follow-up were classified according to Beckwith (favorable and unfavorable histology) and to Jereb & Sandstedt (histologic types I, II and III). The authors found a good correlation between histologic types I and II and prognosis (72% of the children with type I were free of tumor and of type II only 25%), but in type III no correlation was found between the histologic grading and prognosis, possibly due to the small number of cases observed. The three cases classified as unfavorable histology corresponded to histologic type III. All the children less than two years old at the time of diagnosis were free of tumor, in this group six out of seven cases were of histologic type I. In the older age group only one third of the cases were free of tumor. Otherwise, 70% of the cases with unfavorable prognosis were four or more years old, but only one had unfavorable histology. The present paper shows that the age and the histologic type determined according to the criteria of Jereb & Sandstedt are important data in the prognostic evaluation of Wilm's tumor.

Hiperplasia linfoide pseudotumoral de ileo terminal e ou de valvula ileo-cecal. Associacao com linfoma maligno linfocitico pouco diferenciado. / Pseudotumoral lymphoid hyperplasia of the terminal ileum and or the ileocecalis valve. Association with lymphocytic malignant lymphoma poorly differentiated

Sao apresentados tres casos de hiperplasia linfoide pseudotumoral de ileo terminal e valvula ileocecal causando obstrucao e invaginacao intestinais, todos incidindo em criancas com idade igual ou inferior a tres anos. Em um caso, houve associacao com linfoma linfocitico pouco diferenciado, nodular, da mucosa da valvula ileocecal. Sao feitas consideracoes sobre o diagnostico e o tratamento da hiperplasia linfoide localizada nessa area do intestino

Occurrence of subcutaneous zygomycosis caused by Basidiobolus haptosporus in Brazil.

There were described the first three South American cases of subcutaneous zygomycosis caused by B. haptosporus. The patients were children from nearby towns lying just north of 13 degrees latitude S. The diagnosis was based on histopathological aspects plus cultural isolation of the fungus.