An integrative multi-omics approach to characterize interactions between tuberculosis and diabetes mellitus.

Tuberculosis-diabetes mellitus (TB-DM) is linked to a distinct inflammatory profile, which can be assessed using multi-omics analyses. Here, a machine learning algorithm was applied to multi-platform data, including cytokines and gene expression in peripheral blood and eicosanoids in urine, in a Brazilian multi-center TB cohort. There were four clinical groups: TB-DM(n = 24), TB only(n = 28), DM(HbA1c ≥ 6.5%) only(n = 11), and a control group of close TB contacts who did not have TB or DM(n = 13). After cross-validation, baseline expression or abundance of MMP-28, LTE-4, 11-dTxB2, PGDM, FBXO6, SECTM1, and LINCO2009 differentiated the four patient groups. A distinct multi-omic-derived, dimensionally reduced, signature was associated with TB, regardless of glycemic status. SECTM1 and FBXO6 mRNA levels were positively correlated with sputum acid-fast bacilli grade in TB-DM. Values of the biomarkers decreased during the course of anti-TB therapy. Our study identified several markers associated with the pathophysiology of TB-DM that could be evaluated in future mechanistic investigations.

Prognostic Factors and Markers in Non-Small Cell Lung Cancer: Recent Progress and Future Challenges.

Lung cancer is a highly aggressive neoplasm and, despite the development of recent therapies, tumor progression and recurrence following the initial response remains unsolved. Several questions remain unanswered about non-small cell lung cancer (NSCLC): (1) Which patients will actually benefit from therapy? (2) What are the predictive factors of response to MAbs and TKIs? (3) What are the best combination strategies with conventional treatments or new antineoplastic drugs? To answer these questions, an integrative literature review was carried out, searching articles in PUBMED, NCBI-PMC, Google Academic, and others. Here, we will examine the molecular genetics of lung cancer, emphasizing NSCLC, and delineate the primary categories of inhibitors based on their molecular targets, alongside the main treatment alternatives depending on the type of acquired resistance. We highlighted new therapies based on epigenetic information and a single-cell approach as a potential source of new biomarkers. The current and future of NSCLC management hinges upon genotyping correct prognostic markers, as well as on the evolution of precision medicine, which guarantees a tailored drug combination with precise targeting.

Biomarkers in Breast Cancer: An Old Story with a New End.

Breast cancer is the second most frequent cancer in the world. It is a heterogeneous disease and the leading cause of cancer mortality in women. Advances in molecular technologies allowed for the identification of new and more specifics biomarkers for breast cancer diagnosis, prognosis, and risk prediction, enabling personalized treatments, improving therapy, and preventing overtreatment, undertreatment, and incorrect treatment. Several breast cancer biomarkers have been identified and, along with traditional biomarkers, they can assist physicians throughout treatment plan and increase therapy success. Despite the need of more data to improve specificity and determine the real clinical utility of some biomarkers, others are already established and can be used as a guide to make treatment decisions. In this review, we summarize the available traditional, novel, and potential biomarkers while also including gene expression profiles, breast cancer single-cell and polyploid giant cancer cells. We hope to help physicians understand tumor specific characteristics and support decision-making in patient-personalized clinical management, consequently improving treatment outcome.

Computational Biology Helps Understand How Polyploid Giant Cancer Cells Drive Tumor Success.

Precision and organization govern the cell cycle, ensuring normal proliferation. However, some cells may undergo abnormal cell divisions (neosis) or variations of mitotic cycles (endopolyploidy). Consequently, the formation of polyploid giant cancer cells (PGCCs), critical for tumor survival, resistance, and immortalization, can occur. Newly formed cells end up accessing numerous multicellular and unicellular programs that enable metastasis, drug resistance, tumor recurrence, and self-renewal or diverse clone formation. An integrative literature review was carried out, searching articles in several sites, including: PUBMED, NCBI-PMC, and Google Academic, published in English, indexed in referenced databases and without a publication time filter, but prioritizing articles from the last 3 years, to answer the following questions: (i) "What is the current knowledge about polyploidy in tumors?"; (ii) "What are the applications of computational studies for the understanding of cancer polyploidy?"; and (iii) "How do PGCCs contribute to tumorigenesis?"

Translational Bioinformatics Applied to the Study of Complex Diseases.

Translational Bioinformatics (TBI) is defined as the union of translational medicine and bioinformatics. It emerges as a major advance in science and technology by covering everything, from the most basic database discoveries, to the development of algorithms for molecular and cellular analysis, as well as their clinical applications. This technology makes it possible to access the knowledge of scientific evidence and apply it to clinical practice. This manuscript aims to highlight the role of TBI in the study of complex diseases, as well as its application to the understanding and treatment of cancer. An integrative literature review was carried out, obtaining articles through several websites, among them: PUBMED, Science Direct, NCBI-PMC, Scientific Electronic Library Online (SciELO), and Google Academic, published in English, Spanish, and Portuguese, indexed in the referred databases and answering the following guiding question: "How does TBI provide a scientific understanding of complex diseases?" An additional effort is aimed at the dissemination, inclusion, and perpetuation of TBI knowledge from the academic environment to society, helping the study, understanding, and elucidating of complex disease mechanics and their treatment.

Phototherapies for the management of a large painful facial cutaneous lesion from human monkeypox infection.

BACKGROUND: The management of patients with Monkeypox (MPX) infection is generally symptomatic as there has been no approved antiviral drug so far. Despite being generally a self-limited disease, some complications may be encountered such as severe pain and the formation of permanent skin scarring. AIM: To present a case report in which a combination of antimicrobial photodynamic therapy (aPDT) and photobiomodulation therapy (PBMT) was used for a large facial cutaneous lesion in an MPX patient. CASE REPORT: A 20-year-old Caucasian man presenting with a large, painful, grayish, rubbery, well-circumscribed, deep-seated, and umbilicated ulcer on his face was treated with four daily sessions of PBMT and two sessions of aPDT every other day. Within a day, the patient's pain complaint was no longer present and a crust central area was visible. On the 4th day of laser treatment, the wound almost completely disappeared, leaving a small reddish area free of inflammation or infection signs and without unaesthetic skin scarring. CONCLUSION: Given the lack of specific strategies for the management of severe MPX-related skin lesions, the current case report suggests that the concomitant use of PMBT and aPDT seems to be a promising therapeutic approach. The most appropriate laser parameters, however, should be further investigated in future studies in order to establish an effective and reliable clinical protocol.

Biometric assessment of early stem growth at a commercial stand of African mahogany (Khaya grandifoliola)

African mahogany species (Khaya spp.) have proven to be promising in the Brazilian forestry scenario, replacing native mahogany owing to their medium-fast growth and relevant timber value. This study aimed to carry out forest inventory and assessments of a Khaya grandifoliola plantation in the first years after planting, test hypsometric models to describe tree growth, and identify the maximum commercial stem yield (i.e., greater than 6 m in height). The stand was located in the municipality of Piracanjuba (GO), where seedlings of seed origin were used. Twenty random plots with a 15 m radius were allocated, and the total height (HT), stem height (HS), diameter at breast height (DBH), crown area, and forest canopy were measured. Four hypsometric models were employed in this study. The best equation was selected based on determination coefficients and standard errors. Further, the models were cross-validated to evaluate predictability and bias. At four years of planting, the largest class of HS was found to range from 3.1 to 4.1 m, and most trees had a DBH ranging from 0.084 to 0.126 m. The percentage of trees with stems > 6 m was 8.35%. The linear model ensured more consistent results for estimating HT, while the quadratic and Weibull models led to more consistent results for HS. By using models, stem measurements can be measured based on DBH, ultimately aiding the selection of stem management strategies for the growth of forests with greater commercial value.

Phototherapies for erythema multiforme secondary to viral infections: A case report of a child.

INTRODUCTION: Erythema multiforme (EM) is a reactive mucocutaneous disorder typically initiated by viral infections. Although the management of EM differs according to the clinical course and trigger factor, it is not clear whether antiviral suppressive therapies may be useful in cases related to such infections. Moreover, the treatment is most often based on supportive care directed towards only the symptoms. AIM: To present a clinical case of a child in which antimicrobial photodynamic therapy (aPDT) and photobiomodulation therapy (PBMT) were used for orofacial manifestations of EM secondary to viral infections. CASE REPORT: A Brazilian 1-year-old boy was admitted to an ICU due to a severe Influenza A H3N2 infection, pneumonia with pleural effusion, and sepsis. About 10 days later, it was noted bleeding lip lesions covered by crusts and bleeding tongue lesions, diagnosed as EM secondary to both H3N2 and herpes simplex virus infections, confirmed by serology tests. A combination of an aPDT session and six PBMT sessions was proposed and resulted in almost complete resolution of the lesion on the 7th day. CONCLUSION: Given the complexity of the present case, the combination of phototherapies seems to be a promising tool for treating acute orofacial mucosal lesions of viruses-induced EM. More studies, however, are needed to reach a definite conclusion.

Extemporaneous Compounding: A Possible Trigger Tool to Detect Potential Health Incidents.

BACKGROUND: Extemporaneous compounding (EC) involves the preparation of a therapeutic product for specific patient need. However, there is a potential relationship between this procedure and the occurrence of health incidents (HI). The use of trigger tools increases HI identification. OBJECTIVE: This study assessed the performance of EC as a trigger to detect potential health incidents arising from this procedure. METHODS: A one-month observational and cross-sectional study was performed in internal medicine ward and intensive care unit of medium-sized hospital. Data collection was carried out in 5 stages: all triggered patients with dysphagia or enteral feeding tube with prescription of EC were included; EC executed in prescribed standardized drugs was observed; the procedure was compared with the hospital guide and scientific literature; HI monitoring and their evaluation using WHO and NCC MERP algorithms; a search for pharmaceutical alternatives (PA) that would avoid the observed EC. RESULTS: 197 patients were recruited. Almost half of them were triggered by EC from 84 standardized drugs. 48 patients met the inclusion criteria. 28 adverse drug reactions, 01 therapeutic ineffectiveness, and 29 medication errors were identified. EC as a trigger tool showed a PPV value of 0.38. Only 24 drugs have PA available in the market, which could avoid one third of all observed EC. CONCLUSION: It was possible to detect potentially HI in one of two patients with enteral feeding tubes using EC as a trigger tool. The use of EC as a trigger tool contributes to identifying potential HI arising from drugs, which have not gotten pharmaceutical alternatives to be administered via enteral feeding tube.

Carcinoma basocelular originado de uma tatuagem: relato de dois casos / Basal cell carcinoma originating in a tattoo: report of two cases

Carcinoma basocelular sobre a região da tatuagem foi pouco descrito na literatura, com um total de 13 casos. Todos descrevem o aspecto clínico da lesão e sua patogênese, porém não caracterizam a dermatoscopia. Descrevemos dois casos de carcinoma basocelular na tatuagem, com características clínicas e dermatoscópicas, tratados com a cirurgia micrográfica de Mohs. Houve dificuldade em estabelecer as margens clínicas e dermatoscópicas do tumor em decorrência do pigmento exógeno da tatuagem

Basal cell carcinoma over the tattoo region has been poorly reported in the literature, with a total of 13 cases. All cases describe the clinical aspect of the lesion and its pathogenesis but do not characterize the dermoscopy. We report two cases of basal cell carcinoma on tattoos with clinical and dermoscopy features, treated with Mohs micrographic surgery. It was challenging to establish the tumor's clinical and dermoscopic margins due to the tattoo's exogenous pigment

Emprego do isolamento absoluto em Endodontia: uma análise da percepção do paciente e do cirurgião-dentista do noroeste do Paraná / Use of absolute isolation in Endodontics: an analysis of the perception of the patient and the dentist of northwestern Paraná/Brazil

O isolamento absoluto é um procedimento indispensável no tratamento odontológico, principalmente em Endodontia. Contudo, certos profissionais ainda relutam em usá-lo. Objetivo: O presente estudo teve como objetivo entrevistar profissionais, acadêmicos de Odontologia e pacientes, visando avaliar a percepção de cada grupo com relação à eficácia e segurança do lençol de borracha, por meio do percentual de respostas dadas às perguntas. Métodos: Foram elaborados questionários a serem respondidos por 50 acadêmicos do último ano do curso de Odontologia da UNIPAR, 50 cirurgiões-dentistas e 100 pacientes de clínicas particulares e da clínica odondológica da UNIPAR da cidade de Umuarama, no Paraná. Após a coleta de todos os questionários distribuídos, as respostas apresentadas foram tabuladas e analisadas. Resultados: 66% dos odontólogos e 74% dos estudantes de Odontologia entrevistados relataram que sempre fazem o uso do isolamento absoluto, citando como pontos negativos da sua utilização o tempo para aplicação, a intolerância a ele por parte do paciente, e a falta de treinamento. Ainda, 52% dos pacientes de clínicas particulares e 54% dos pacientes da clínica odontológica da UNI- PAR consideraram o isolamento absoluto desconfortável; porém, apenas 6% e 10%, respectivamente, assinalaram que não gostariam que o isolamento absoluto fosse utilizado na próxima consulta. Conclusões: O isolamento absoluto tem uma grande aprovação pelos profissionais, acadêmicos e pacientes. Uma maioria significativa de cirurgiões-dentistas e acadêmicos de Odontologia tem em- pregado o isolamento absoluto rotineiramente na prática endodôntica. Os pacientes consideram o isolamento absoluto desconfortável; apesar disso, preferem que se faça uso dele durante o tratamento odontológico (AU).

Introduction: Rubber dam isolation is a mandatory procedure in dental treatment, especially in Endodontics. However, some professionals still refuse to employ it. Aim: This study interviewed dental professionals, dental students and patients, evaluating the perception of each group concerning the efficacy and safety of rubber dam by the percentage of responses to the questions. Methods: The questionnaires were responded by 50 students of the last year of Dentistry course at Unipar, 50 dental professionals and 100 patients from private clinics and the dental clinic of Unipar, at the city of Umuarama in Paraná. After collection of all submitted questionnaires, the responses were tabulated and analyzed. Results: 66% of dental professionals and 74% of dental students interviewed reported that they always use rubber dam isolation, mentioning as negative aspects for not using it the time required for placement, patient refusal and lack of training. Among the patients, 52% from private clinics and 54% from the dental clinic of Unipar considered the rubber dam uncomfortable, yet only 6% and 10%, respectively, indicated they would not like to use the rubber dam on the following session. Conclusions: Rubber dam isolation has great acceptance by professionals, students and patients. A significant part of dental professionals and students have been using the rubber dam routinely in the endodontic practice. The patients consider the rubber dam uncomfortable, notwithstanding they prefer to use it during dental treatment (AU).