Impact of the ´Alforja Educativa' on Ecuadorian schoolchildren's knowledge of bacteria, antibiotics, and antibiotic resistance, a pretest-posttest study.

BACKGROUND: Widespread use of antibiotics disrupts the balance in the microbial world and promotes development and spread of antibiotic resistant bacteria. Educational initiatives are important as part of strategies to mitigate antibiotic resistance. The Alforja Educativa is an innovative educational program developed in Ecuador with the aim to teach schoolchildren about antibiotic use and antibiotic resistance. The program places antibiotic resistance within a broader frame of health, well-being, and ecological awareness, highlighting the importance to maintain balance in the microbial world. The objective of this study was to evaluate the effect of the Alforja Educativa on knowledge about bacteria, antibiotics and antibiotic resistance amongst fifth and sixth grade Ecuadorian schoolchildren. METHODS: This pretest-posttest intervention study was conducted between April and June 2017 and comprised fifth and sixth grade schoolchildren from 20 schools in Cuenca, Ecuador, recruited by purposeful sampling. The Alforja Educativa was implemented over twelve 80-minute sessions by trained university students. Schoolchildren's knowledge was assessed before and after participation in the educational program using a structured questionnaire. A mean total score, the proportion of correct responses for each individual knowledge-based question, as well as correct responses for each of the multiple-choice options of the knowledge-based questions were calculated for the pretest and posttest. RESULTS: A total of 1,257 schoolchildren participated in the Alforja Educativa program, of which 980 (78%) completed both the pretest and posttest. Overall, the mean total knowledge score increased from pretest to posttest (2.58/7.00 vs. 3.85/7.00; CI = 0.5, p < 0.001). After participation in the program, the proportion of schoolchildren that correctly identified that bacteria can be both good and bad increased from 35.0 to 84.3%. In addition, scores increased for correctly identifying the meaning of antibiotic resistance (37.4-72.0%); how to prevent antibiotic resistance (63.2-74.6%); and for identifying the meaning of self-medication (46.3-54.3%). CONCLUSION: The Alforja Educativa was effective in improving the knowledge of participating schoolchildren about concepts related to bacteria, antibiotics and antibiotic resistance. The holistic perspective taken to explain the complex relationship between humans and bacteria, as well as the effect of antibiotics on the microbial world, may help provide a foundation for more sustainable antibiotic use.

Epitomaptaaumakua sp. nov., a new species of apodous sea cucumber from Hawai`i (Echinodermata, Holothuroidea, Apodida).

Epitomaptaaumakuasp. nov. occurs at a depth of 2.5 m in Kualoa, O`ahu, Hawai`i, living in coarse sand. It is distinctive in having 12 pinnate tentacles, each tentacle with three pairs of digits and 6-8 sensory cups. The body wall bears papillae or oval bumps, and the length of body reaches a maximum length of 18.4 mm after relaxation.

Neurogenesis redirects ß-catenin from adherens junctions to the nucleus to promote axonal growth.

Here, we show that, in the developing spinal cord, after the early Wnt-mediated Tcf transcription activation that confers dorsal identity to neural stem cells, neurogenesis redirects ß-catenin from the adherens junctions to the nucleus to stimulate Tcf-dependent transcription in a Wnt-independent manner. This new ß-catenin activity regulates genes implicated in several aspects of contralateral axon growth, including axon guidance and adhesion. Using live imaging of ex-vivo chick neural tube, we showed that the nuclear accumulation of ß-catenin and the rise in Tcf-dependent transcription both initiate before the dismantling of the adherens junctions and remain during the axon elongation process. Notably, we demonstrated that ß-catenin activity in post-mitotic cells depends on TCF7L2 and is central to spinal commissural axon growth. Together, our results reveal Wnt-independent Tcf/ß-catenin regulation of genes that control the growth and guidance of commissural axons in chick spinal cord.

Dbnl and ß-catenin promote pro-N-cadherin processing to maintain apico-basal polarity.

The neural tube forms when neural stem cells arrange into a pseudostratified, single-cell-layered epithelium, with a marked apico-basal polarity, and in which adherens junctions (AJs) concentrate in the subapical domain. We previously reported that sustained ß-catenin expression promotes the formation of enlarged apical complexes (ACs), enhancing apico-basal polarity, although the mechanism through which this occurs remained unclear. Here, we show that ß-catenin interacts with phosphorylated pro-N-cadherin early in its transit through the Golgi apparatus, promoting propeptide excision and the final maturation of N-cadherin. We describe a new ß-catenin-dependent interaction of N-cadherin with Drebrin-like (Dbnl), an actin-binding protein that is involved in anterograde Golgi trafficking of proteins. Notably, Dbnl knockdown led to pro-N-cadherin accumulation and limited AJ formation. In brief, we demonstrate that Dbnl and Drebrin-like ß-catenin assist in the maturation of pro-N-cadherin, which is critical for AJ formation and for the recruitment AC components like aPKC and, consequently, for the maintenance of apico-basal polarity.

Expansion of the genus Massinium (Holothuroidea: Thyonidae) to the American continent and description of a new species / Expansión del género Massinium (Holothuroidea: Thyonidae) al continente americano y descripción de una nueva especie

Introduction: The genus Massinium includes 11 species, most from the Indo Pacific Ocean, and had not previously being reported from the American continent. Objective: To present the new record of the genus Massinium and describe a new species of this genus. Methods: Material collection was done by SCUBA-diving to depths of a maximum of 9 m. Results: Massinium ocumichoensis sp. nov. is described from seven specimens that extends the range of the genus to the American continent (Guerrero, Michoacan and Jalisco, Mexico). The new species lives in sandy-rocky substrata, from 2 to 16 m deep. It is distinguished from its congeneric species by a combination of morphological characters: mid-dorsal slightly bigger pseudobuttons (40-60 μm), and tables in the body wall. A taxonomic key for distinguishing the species of Massinium is provided. Conclusions: The geographic range of the genus Massinium is extended to the Mexican Pacific with M. ocumichoensis sp. nov.

Introducción : El género Massinium incluye 11 especies, la mayoría del Océano Indo-Pacífico, y no se había reportado previamente en el continente americano. Objetivo: Presentar el nuevo registro del género Massinium y describir una nueva especie de este. Métodos: La recolección de material se realizó mediante buceo a una profundidad máxima de 9 m. Resultados: Massinium ocumichoensis sp. nov. se describe a partir de siete ejemplares que extiende el rango de distribución del género al Continente Americano (Guerrero, Michoacán y Jalisco, México). La nueva especie vive en sustratos arenosos-rocosos, de 2 a 16 m de profundidad. Se distingue de sus especies congenéricas por una combinación de caracteres morfológicos: pseudobotones de la zona dorsal media ligeramente más grandes (40-60 μm) y tablas en la pared del cuerpo. Se proporciona una clave taxonómica para distinguir las especies de Massinium. Conclusiones: El rango geográfico del género Massinium se extiende al Pacífico mexicano con M. ocumichoensis sp. nov.

Morphological variability of recent species of the order Cassiduloida (Echinodermata: Echinoidea) of Mexico

Introduction: In Mexico, there are two recorded living species of Cassiduloida: Cassidulus caribaearum and Rhyncholampas pacifica. Most of the taxonomic studies on cassiduloids have used external morphology, pedicellariae and morphometric characters; however, the intraspecific variation of quantitative and qualitative characters has been poorly evaluated. Objective: To compare the basic morphology of R. pacifica and C. caribaearum. Methods: We examined a total of 2 158 specimens of R. pacifica and C. caribaearum, selecting 50 to evaluate shape and size with linear regression and Principal Component analysis. We selected an additional 62 specimens per species to identify significant character correlations and morphological groups within species. Results: There is a direct relationship between Test length and Test width. Test height/Test width, and Total length (oral view)/Distance from the ambitus to the peristome apex, are the two main ratios to distinguish both species. C. caribaearum is more dorsoventrally compressed and has a round peristome base; versus R. pacifica has a tall and triangular one. There are four morphological groups of C. caribaearum and two groups for R. pacifica. Conclusions: These two species can be distinguished with reliable morphological characters, in which peristome shape suggests that R. pacifica is more adapted to burrowing deeper into certain types of substratum.

Introducción: En México, hay dos especies vivientes registradas de Cassiduloida: Cassidulus caribaearum y Rhyncholampas pacifica. La mayoría de los estudios taxonómicos sobre casiduloides han utilizado morfología externa, pedicelarios y caracteres morfométricos; sin embargo, la variación intraespecífica de caracteres cuantitativos y cualitativos ha sido poco evaluada. Objetivo: Comparar la morfología básica de R. pacifica y C. caribaearum. Métodos: Examinamos un total de 2 158 especímenes de R. pacifica y C. caribaearum, seleccionando 50 para evaluar la forma y el tamaño con regresión lineal y análisis de componentes principales. Seleccionamos 62 especímenes adicionales por especie para identificar correlaciones significativas de caracteres y grupos morfológicos dentro de las especies. Resultados: Existe una relación directa entre la longitud de la testa y el ancho de la testa. La Altura de la testa / Anchura de la testa y la Longitud total (vista oral) / Distancia desde el ambitus hasta el ápice del peristoma, son las dos proporciones principales para distinguir ambas especies. C. caribaearum está más comprimido dorsoventralmente y tiene una base del peristoma redonda; versus R. pacifica que tenía una alta y triangular. Hay cuatro grupos morfológicos de C. caribaearum y dos grupos de R. pacifica. Conclusiones: Estas dos especies se pueden distinguir con caracteres morfológicos confiables, en los que la forma del peristoma sugiere que R. pacifica está más adaptada para excavar más profundamente en ciertos tipos de sustratos.

Primer registro del género Leptopentacta (Cucumariidae: Colochirinae) en el Caribe nicaragüense

Introducción: El género Leptopentacta solo ha sido reportado previamente en Florida, Cuba, Colombia, Costa Rica y Surinam. Objetivo: Presentar el primer registro del género para Nicaragua. Métodos: Los caracteres morfológicos del material nicaragüense del Smithsonian Institution (USNM 1014529), fueron corroborados con la descripción original. Resultados: Los cinco especímenes recolectados en el Caribe nicaragüense coinciden con el género. Conclusiones: Leptopentacta se reporta por primera vez en el Mar Caribe de Nicaragua. Esto aumenta el número de equinodermos nicaragüenses a 194 especies.

Introduction: The genus Leptopentacta has only been previously reported from Florida, Cuba, Colombia, Costa Rica, and Suriname. Objective: To present the first record of the genus for Nicaragua. Methods: The morphological characters of Nicaraguan material at the Smithsonian Institution (USNM 1014529), were corroborated with the original description. Results: The five specimens collected in the Nicaraguan Caribbean match the genus. Conclusions: Leptopentacta is reported for the first time from the Nicaraguan Caribbean Sea. This increases the number of Nicaraguan echinoderms to 194 species.

Morfología y crecimiento relativo en Clypeaster europacificus (Clypeasteroida: Clypeasteridae) del Golfo de California

Introducción: Clypeaster europacificus es una especie de galleta de mar que se distribuye de 0 a 200 m en el Golfo de California. Objetivo: Describir la morfología y el crecimiento relativo en la testa de C. europacificus. Métodos: Medimos 1 846 especímenes de museo de C. europacificus (N = 1 846) y analizamos el patrón de crecimiento en 32 especímenes de Baja California Sur, México (64 m de profundidad). Estudiamos cinco variables: radio mayor (R) (variable independiente), radio menor (r), longitud del pétalo anterior (LP), área total de prueba (A) y peso seco (P). Resultados: El área de cobertura del petaloide y el contorno de la testa son los caracteres taxonómicos importantes para C. europacificus: los especímenes van desde casi redondos en especímenes pequeños (≤ 3 cm de radio) a ondulados, enfatizando un contorno pentagonal, en organismos más grandes (≥ 3,1 cm de radio). Conclusiones: Existe un crecimiento alométrico negativo en las relaciones R vs. r, R vs. A y R vs. P; mientras que la relación R vs. LP tiene un crecimiento alométrico positivo.

Introduction: Clypeaster europacificus is a species of sand dollar found from 0 to 200 m in the Gulf of California. Objective: Describe the morphology and relative growth in the test of C. europacificus. Methods: We measured 1 846 museum specimens of C. europacificus (N = 1 846) and analyzed growth pattern in 32 specimens from Baja California Sur, Mexico (64 m depth). We studied five variables: major radius (R) (independent variable), minor radius (r), length of anterior petal (LP), total test area (A) and dry weight (P). Results: The petaloid cover area and the outline of the test are the important taxonomic characters for C. europacificus: they range from almost round in small specimens (≤ 3 cm in radius) to wavy, emphasizing a pentagonal outline, in larger organisms (≥ 3.1 cm in radius). Conclusions: There is negative allometric growth in the relationships R vs. r, R vs. A, and R vs. P; while the relationship R vs. LP has positive allometric growth.

Pentamera fonsecae n. sp. a new species of sea cucumber from the Pacific coast of Costa Rica (Holothuroidea: Dendrochirotida: Thyonidae).

Pentamera fonsecae n. sp. is described from seven specimens as a new species of Thyonidae from the Pacific coast of Costa Rica. It is distinguished from its congeners by having tables with ladder-shaped spires in the body wall, and tube feet with curved support tables of variable height and tables as those found in the body wall slightly smaller than those from the body wall. This species is distributed in Guanacaste, Costa Rica, from 28.5 to 40 m on muddy bottoms.

Trastorno del espectro de la neuromielitis óptica / Neuromyelitis Optica Spectrum Disorder: case report / Distúrbio do spectro da neuromilite óptica

El síndrome de Devic, también conocido como trastorno del espectro de la neuromielitis óptica (NMOSD, por sus sigla en inglés), es considerado una enfermedad inflamatoria, desmielinizante y autoinmune del sistema nervioso central que afecta en su mayoría los nervios ópticos, el quiasma óptico y la médula espinal. Si bien en algunos casos se puede simular un cuadro clínico similar a esclerosis múltiple, hoy en día se conocen aspectos imagenológicos, inmunológicos y patológicos que permiten establecer las diferencias entre estas dos entidades. Se presenta el caso de una mujer adulta mayor con antecedente de síndrome de Sjögren en manejo ambulatorio con corticoide y azatioprina, quien ingresa por cuadro clínico de mes y medio de evolución consistente en disestesias de predominio en miembros inferiores, alteración de la marcha y compromiso visual. Ante el compromiso neurológico, se decide realizar imágenes diagnósticas y perfil inmunológico, con reportes de resonancia magnética nuclear cervical y torácica con contraste que evidencian mielitis multifocal por compromiso cervical y torácico a nivel de C4 en T7-T8 con hiperdensidad centromedular sin realce, además de autoanticuerpos séricos dirigidos contra el canal acuaporínico (AQP4) positivos, dando así el diagnóstico de NMOSD.Se inició manejo con pulsos de metilprednisolona concomitantemente con plasmaféresis completando cinco sesiones. Sin embargo, ante la persistencia del cuadro clínico se inició manejo con un agente biológico selectivo que bloquea la actividad de los linfocitos B tipo rituximab con resolución parcial de los síntomas. Se discute, además, la evolución clínica e imagenológica de este caso ejemplar, así como los avances más notables en el diagnóstico y manejo

Devic's Syndrome, known as Optic Neuromyelitis Spectrum Disorder (NMOSD), is considered an inflammatory, demyelinating and autoimmune disease of the central nervous system (CNS) that mainly affects the optic nerves, the optic chiasm and the spinal cord. Although the said syndrome can sometimes simulate multiple sclerosis (MS), nowadays there are imagining, immunological and pathological aspects that allow to establish the differences between these two entities. In the present paper, the case an older adult woman with a history of Sjögren's syndrome in ambulatory care with corticosteroid and azathioprine, who is admitted for a month and a half of evolution consisting of dysesthesias of predominance in the lower limbs, ambulation impairment and visual compromise is presented . In view of the neurological compromise, it was decided to perform diagnostic imaging and immunological profile. The imaging suggested a report of cervical and thoracic MRI with contrast with evidence of multifocal myelitis due to cervical and thoracic involvement at the level of C4 and T7-T8, with a report of serum autoantibodies directed against the positive aquaporic channel (AQP4). All of the above is consistent with the diagnosis of Devic Syndrome or NMOSD. Treatment was implemented through methylprednisolone pulses alternated with plasmapheresis. Five sessions of the said treatment were completed. Given the persistence of the clinical picture, treatment with rituximab was initiated resulting in partial improvement of the symptoms. The clinical and imaging evolution of this case is also discussed, as well as breakingthrough advan-ces in its diagnosis and management

O síndrome de Devic, convencido cómo Transtorno do espectro da neuromielite ótica ou NMOSD pelo Nome em ingles é considerado uma doença inflamatória, desmielinizante e autoimune do sistema nervioso central (SNC) que afeta principalmente os nervos óticos, o quiasma ótico e a mêdula espinhal; embora em alguns casos pode se apresentar como sendo un caso clínico de esclerosis múltipla, hoje existem aspectos imagemológicos, inmunológicos e patológicos para diferenciar entre as duas condições. Apresentam-se o caso de una mulher idosa com antecedente de Síndrome de Sjögren com tratamento ambulatorio de corticoides, ingresada por quadro clínico de un mês e meio de evoluçao más disestêsias nos miembros inferiores com alteraçao para caminhada e comprometimento visual. Perante essa alteraçao neurológica, decide-se realizar imagens diagnósticas e perfil inmunológico com reporte de RMN cervical e torácica com contaste evidencia de mielitis multifocal por compromiso cervical e torácico a nivel de C4 e T7- T8 com hiperdensidade centromedular sem realce, reporte de autoanticuerpos séricos dirigidos contra o canal acuaporínico positivos, o diagnóstico foi Síndrome de Devic ou NMOSD. Perante esse scenário inicoou-se tratamento com pulsos de metlprednisolona junto con plasmaférese, por cinco sessões. No entanto, perante persistência do quadro clínico, inicoouse tratamento com agente biológico selectivo que bloqueia a atividade dos linfositos B tipo rituximab com resoluçao parcial dos síntomas. Discute-se a evoluçao clínica deste caso exemplar, mesmo cómo os avanços mais notáveis no diagnóstico e tratamento.IntroducciónEl síndrome de Devic, ahora conocido como trastor-no del espectro de la neuromielitis óptica (NMOSD, por su sigla en inglés), es una enfermedad inflamato-ria, desmielinizante y autoinmune del sistema nervioso central (SNC) que en su mayoría y de forma simultá-nea afecta los nervios ópticos, el quiasma óptico y la médula espinal (1). En los hallazgos imagenológicos en resonancia magnética nuclear (RMN) cerebral se evi-dencian lesiones mielínicas trasversas extensas longi-tudinales en tres o más segmentos vertebrales (2).El NMOSD fue reportado por primera vez en el siglo XIX, hacia 1894, luego de un reporte de caso; en esa ocasión se nombró síndrome de Devic y se describió como una variante de esclerosis múltiple (EM) (3,4). Keywords: Devic syndrome. Optic neuromyelitis, multiple sclerosis, antiacuaporin 4 antibodies, methylprednisolone, corticoid, plasmapheresis, rituximab Palavras Chave: sindrome de Devic, neuromielite óptica, esclerosis múltipla, anticorpos antiacuaporina 4, metlprednisolona, corticoides, plasmaférese, rituximab.

Genetic Alterations in the Molecular Subtypes of Bladder Cancer: Illustration in the Cancer Genome Atlas Dataset.

CONTEXT: Recent whole genome mRNA expression profiling studies revealed that bladder cancers can be grouped into molecular subtypes, some of which share clinical properties and gene expression patterns with the intrinsic subtypes of breast cancer and the molecular subtypes found in other solid tumors. The molecular subtypes in other solid tumors are enriched with specific mutations and copy number aberrations that are thought to underlie their distinct progression patterns, and biological and clinical properties. OBJECTIVE: The availability of comprehensive genomic data from The Cancer Genome Atlas (TCGA) and other large projects made it possible to correlate the presence of DNA alterations with tumor molecular subtype membership. Our overall goal was to determine whether specific DNA mutations and/or copy number variations are enriched in specific molecular subtypes. EVIDENCE: We used the complete TCGA RNA-seq dataset and three different published classifiers developed by our groups to assign TCGA's bladder cancers to molecular subtypes, and examined the prevalence of the most common DNA alterations within them. We interpreted the results against the background of what was known from the published literature about the prevalence of these alterations in nonmuscle-invasive and muscle-invasive bladder cancers. EVIDENCE SYNTHESIS: The results confirmed that alterations involving RB1 and NFE2L2 were enriched in basal cancers, whereas alterations involving FGFR3 and KDM6A were enriched in luminal tumors. CONCLUSIONS: The results further reinforce the conclusion that the molecular subtypes of bladder cancer are distinct disease entities with specific genetic alterations. PATIENT SUMMARY: Our observation showed that some of subtype-enriched mutations and copy number aberrations are clinically actionable, which has direct implications for the clinical management of patients with bladder cancer.

Oligofructose as an adjunct in treatment of diabetes in NOD mice.

In type 1 diabetes, restoration of normoglycemia can be achieved if the autoimmune attack on beta cells ceases and insulin requirement is met by the residual beta cells. We hypothesize that an adjunctive therapy that reduces insulin demand by increasing insulin sensitivity will improve the efficacy of an immunotherapy in reversing diabetes. We tested the gut microbiota-modulating prebiotic, oligofructose (OFS), as the adjunctive therapy. We treated non-obese diabetic mice with an immunotherapy, monoclonal anti-CD3 antibody (aCD3), with or without concurrent dietary supplement of OFS. After 8 weeks of OFS supplement, the group that received both aCD3 and OFS (aCD3 + OFS) had a higher diabetes remission rate than the group that received aCD3 alone. The aCD3 + OFS group had higher insulin sensitivity accompanied by reduced lymphocytic infiltrate into the pancreatic islets, higher beta-cell proliferation rate, higher pancreatic insulin content, and secreted more insulin in response to glucose. The addition of OFS also caused a change in gut microbiota, with a higher level of Bifidobacterium and lower Clostridium leptum. Hence, our results suggest that OFS can potentially be an effective therapeutic adjunct in the treatment of type 1 diabetes by improving insulin sensitivity and beta-cell function, leading to improved glycemic control.

Specific micro-RNA expression patterns distinguish the basal and luminal subtypes of muscle-invasive bladder cancer.

The roles of non-coding RNAs in controlling clinical and biological heterogeneity in bladder cancer remain unclear. We used TCGA's published dataset (n = 405 tumors) as a discovery cohort and created a new validation cohort to define the miRNA expression patterns in the basal and luminal molecular subtypes of muscle-invasive bladder cancer (MIBC). We identified 63 miRNAs by PAM, which optimally identified basal and luminal tumors. The targets of the top luminal miRNAs were activators of EMT (ZEB1, ZEB2) and basal subtype transcription (IL-6, EGFR, STAT3), whereas the targets of the top basal miRNAs were involved in adipogenesis pathways and luminal breast cancer (ERBB2, ERBB3). We also identified a 15-miRNA signature that identified stromally infiltrated basal and luminal MIBCs corresponding to the "cluster IV/immune undifferentiated/claudin-low" and "cluster II/luminal immune" subtypes identified previously, which likely contain samples with higher infiltration rates. Using the 63-miRNA signature, we accurately assigned MIBCs to the basal and luminal subtypes and confirmed that patients with basal tumors had shorter overall survival. The results strongly suggest that miRNAs contribute to the control of the gene expression patterns observed in basal and luminal MIBCs and that they can be used as biomarkers and candidate therapeutic targets.

Intrinsic subtypes and bladder cancer metastasis.

Recent studies demonstrated that bladder cancers can be grouped into basal and luminal molecular subtypes that possess distinct biological and clinical characteristics. Basal bladder cancers express biomarkers characteristic of cancer stem cells and epithelial-to-mesenchymal transition (EMT). Patients with basal cancers tend have more advanced stage and metastatic disease at presentation. In preclinical models basal human orthotopic xenografts are also more metastatic than luminal xenografts are, and they metastasize via an EMT-dependent mechanism. However, preclinical and clinical data suggest that basal cancers are also more sensitive to neoadjuvant chemotherapy (NAC), such that most patients with basal cancers who are aggressively managed with NAC have excellent outcomes. Importantly, luminal bladder cancers can also progress to become invasive and metastatic, but they appear to do so via mechanisms that are much less dependent on EMT and may involve help from stromal cells, particularly cancer-associated fibroblasts (CAFs). Although patients with luminal cancers do not appear to derive much clinical benefit from NAC, the luminal tumors that are infiltrated with stromal cells appear to be sensitive to anti-PDL1 antibodies and possibly other immune checkpoint inhibitors. Therefore, neoadjuvant and/or adjuvant immunotherapy may be the most effective approach in treating patients with advanced or metastatic infiltrated luminal bladder cancers.

Therapeutic opportunities in the intrinsic subtypes of muscle-invasive bladder cancer.

Recent studies revealed that muscle-invasive bladder cancers segregate into intrinsic basal and luminal subtypes that are similar to those described for breast cancer. Each subtype is enriched with potentially clinically actionable genomic alterations and epigenetic signatures; there are associations between tumor subtype and sensitivity to conventional cisplatin-based chemotherapy. The authors review biological and clinical characteristics of the intrinsic subtypes and describe their implications for the development of conventional and targeted agents. The role that tumor plasticity seems to play in basal and luminal bladder cancer biology and its potential effects on the development of therapeutic resistance is also discussed.

Intrinsic basal and luminal subtypes of muscle-invasive bladder cancer.

Whole-genome analyses have revealed that muscle-invasive bladder cancers (MIBCs) are heterogeneous and can be grouped into basal and luminal subtypes that are highly reminiscent of those found in breast cancer. Basal MIBCs are enriched with squamous and sarcomatoid features and are associated with advanced stage and metastatic disease at presentation. Like basal breast cancers, basal bladder tumours contain a claudin-low subtype that is enriched with biomarkers characteristic of epithelial-to-mesenchymal transition. The stem cell transcription factor ΔNp63α controls basal MIBC gene expression, just as it does in basal breast cancers. Luminal MIBCs are enriched with activating FGFR3 and ERBB3 mutations and ERBB2 amplifications, and their gene expression profiles are controlled by peroxisome proliferator activator receptor γ (PPARγ) and possibly also by oestrogen receptor activation. Luminal bladder cancers can be further subdivided into two subtypes, p53-like and luminal, which can be distinguished from one another by different levels of biomarkers that are characteristic of stromal infiltration, cell cycle progression, and proliferation. Importantly, basal bladder cancers are intrinsically aggressive, but are highly sensitive to cisplatin-based combination chemotherapy. Although the luminal subtypes are not as intrinsically aggressive as basal cancers, p53-like tumours are resistant to chemotherapy and might, therefore, represent a problem for treated patients.

Primer registro de Heterocucumis godeffroyi (Semper, 1868) (Echinodermata: Holothuroidea) en el mar peruano

Se registra por primera vez para el Perú la especie de pepino de mar Heterocucumis godeffroyi (Semper, 1868) (Echinodermata: Holothuroidea). La especie fue recolectada a 19 m de profundidad en Pucusana, departamento de Lima. Este registro representa el límite más norteño de distribución de la especie reconocido hasta el momento. Material de referencia se encuentra depositado en la Colección de Zoología Acuática, del Laboratorio de Biología Marina, Departamento de Ciencias Biológicas y Fisiológicas, Universidad Peruana Cayetano Heredia, Lima, Perú.

This is the first record of Heterocucumis godeffroyi (Semper, 1868) (Echinodermata: Holothuroidea) for Peruvian waters. The species was collected at19 m deep, in Pucusana, off Lima Departamento. This record represents the northern most distribution limit knowing to the present. Reference material has been deposited at the Colección de Zoología Acuática, Laboratorio de Biología Marina, Departamento de Ciencias Biológicas y Fisiológicas, at Universidad Peruana Cayetano Heredia, Lima, Perú.

Análisis de la ira en pacientes con cardiopatía isquémica de la ciudad de Medellín (Colombia) / Analysis of anger in patients with ischemie heart disease

Este estudio tuvo como objetivo comparar los niveles de ira, y sus componentes, entre un grupo de personas con Cardiopatía Isquémica y un grupo control sin esta enfermedad. Participaron 90 pacientes con cardiopatía isquémica de la Clínica Cardiovascular en Medellín y 78 controles sin la enfermedad. A cada uno de los participantes de les administró la prueba del STAXI- 2. Los resultados muestran que, comparado con los controles, los pacientes con cardiopatía isquémica tuvieron niveles significativamente más altos de ira como rasgo (p < 0.01), específicamente en la subescala reacción de ira (p < 0.05), y expresión interna de ira (p < 0.05). Los pacientes con cardiopatía isquémica experimentan más frecuentemente sentimientos de ira (ira rasgo), aparentemente debido a que son más sensibles a las críticas de los demás (reacción de ira), pero tienden a suprimir la expresión de esta emoción (expresión de ira interna). Estos datos confirman la necesidad de implementar programas dirigidos al manejo adecuado de la ira en estos pacientes y entender mejor las implicaciones que pueda tener la ira en la progresión de su enfermedad.

Objective: To compare levels of anger, and its components, between a group of Colombians individuals with coronary heart disease and a healthy control group. Measures: Each participant was administered the STAXI-2. Results: Compared to controls, patients with coronary artery disease had significantly higher Trait Anger (p < 0.01), specifically the Angry Reaction sub-scale (p < 0.05), and Anger Expression-In (p < 0.05). Conclusion: Patients with coronary artery disease experience more frequent feelings of anger (trait anger), apparently because they are more sensitive to criticism (angry reaction), but they tend to suppress the expression of their anger (anger expression -in). These results confirm the need for implementing anger management programs with these patients and gain a better understanding of how anger/hostility might influence the progression of their disease.