Plasma metabolomics of oral squamous cell carcinomas based on NMR and MS approaches provides biomarker identification and survival prediction.

Metabolomics has proven to be an important omics approach to understand the molecular pathways underlying the tumour phenotype and to identify new clinically useful markers. The literature on cancer has illustrated the potential of this approach as a diagnostic and prognostic tool. The present study aimed to analyse the plasma metabolic profile of patients with oral squamous cell carcinoma (OSCC) and controls and to compare patients with metastatic and primary tumours at different stages and subsites using nuclear magnetic resonance and mass spectrometry. To our knowledge, this is the only report that compared patients at different stages and subsites and replicates collected in diverse institutions at different times using these methodologies. Our results showed a plasma metabolic OSCC profile suggestive of abnormal ketogenesis, lipogenesis and energy metabolism, which is already present in early phases but is more evident in advanced stages of the disease. Reduced levels of several metabolites were also associated with an unfavorable prognosis. The observed metabolomic alterations may contribute to inflammation, immune response inhibition and tumour growth, and may be explained by four nonexclusive views-differential synthesis, uptake, release, and degradation of metabolites. The interpretation that assimilates these views is the cross talk between neoplastic and normal cells in the tumour microenvironment or in more distant anatomical sites, connected by biofluids, signalling molecules and vesicles. Additional population samples to evaluate the details of these molecular processes may lead to the discovery of new biomarkers and novel strategies for OSCC prevention and treatment.

Active middle ear implants. / Implantes activos de oído medio.

Active middle ear implants are surgically implanted prosthesis, which intend to stimulate the ossicular chain or the inner ear fluids through the oval or round windows. These implants may be useful for the treatment of certain patients with sensorineural hearing loss as well as for conductive or mixed hearing loss. This clinical guide attempts to summarize the current knowledge concerning the basic characteristics and indications of the most commonly used middle ear implants, including Vibrant Soundbrige (Med-el, Innsbruck), Carina (Cochlear, Australia), and CodacsTM. (Cochlear, Australia).

Application of the extraction induced by emulsion breaking for the determination of Cu, Fe and Mn in used lubricating oils by flame atomic absorption spectrometry.

A novel approach is proposed for the sample preparation of used lubricating oils to determine Cu, Fe and Mn by FAAS. The method is based on the extraction induced by emulsion breaking, in which the elements of interest are transferred to an aqueous phase before the measurement by FAAS. In the method, each sample of used lubricating oil was diluted with toluene (20% v/v) and the resulting solution was emulsified with a Triton X-114 solution containing HNO3. Further, the water-in-oil emulsion was broken by centrifugation for 30 min at 3500 rpm, originating a system with two well-separated phases: (i) the upper phase, containing the used lubricating oil diluted in toluene and (ii) the lower aqueous phase, containing the analytes that were extracted from oil. The lower phase was collected, diluted with water and the analytes were determined by FAAS. The optimization of the methodology was performed by studying the influence of different parameters that could affect the extraction efficiency such as the nature and concentration of the solvent used for sample dilution, the concentrations of HNO3 and Triton X-114 in the solution employed for emulsification and the operational conditions for extraction (extraction, centrifugation and sampling times). The limits of quantification for Cu, Fe and Mn were 2.9, 77 and 8.2 ng g(-1), respectively. The accuracy of the method was evaluated by comparison with the reference method based on the total digestion of the samples in a closed-vessel microwave oven. There were no statistical differences between the results obtained with the proposed method and the reference one, except for Fe in the cases where its concentration was higher than 80 µg g(-1).

Direct determination of sitagliptin in pharmaceutical formulations and its determination in urine after solid-phase extraction by spectrofluorimetry.

The fluorescence characteristics of sitagliptin phosphate were used to develop a methodology that allowed its determination in pharmaceutical formulations and urine samples; under the studied conditions, limits of determination and quantification of 0.25 and, respectively, 0.85 mg/L were achieved. Linear correlation between fluorescence analytical signal and sitagliptin concentration was achieved up to 10.0 mg/L. The method was considered selective for sitagliptin determination in pharmaceutical formulations because no interferences due to excipients present in considered matrix were observed (as demonstrated by recovery tests comparing analytical and addition curves). When the method was applied to urine samples, Interferences related to the matrix were observed, which made a solid-phase extraction system necessary. The use of calibration was possible only by applying the standard addition method.

Development of a focused ultrasound-assisted extraction method for the determination of trace concentrations of Cr and Mn in pharmaceutical formulations by ETAAS.

This paper reports the development of a new method for the focused ultrasound extraction of Cr and Mn from pharmaceutical formulations and their determination by electrothermal atomic absorption spectrometry (ETAAS). The method was optimized by evaluating the influence of several variables such as the sonication power and time, concentration of HCl in the extractant solution and mass of sample employed in the extraction procedure. The curves of pyrolysis and atomization were constructed for both analytes in order to evaluate the effect of the matrix on the measurement of Cr and Mn. Quantitative extraction of both Cr and Mn was achieved when 25-150 mg of the sample were sonicated for 30 min at 50% power with 5 ml of a 1 moll(-1) HCl solution. The developed method was successfully applied in the determination of Cr and Mn in samples of pharmaceutical formulations containing different active principles such as ciprofloxacin, cephalexin, azithromycin, amlodipine and methionine. There was no statistical (95% confidence level, paired t-test) difference between the results obtained by the proposed method and the results obtained after total digestion of the samples.

Development of an ultrasonic slurry sampling method for the determination of Cu and Mn in antibiotic tablets by electrothermal atomic absorption spectrometry.

A new method is described for simple, efficient and rapid determination of Cu and Mn in tablets of antibiotics (ciprofloxacin and cephalexin) by electrothermal atomic absorption spectrometry (ETAAS) using slurry sampling. In order to optimize the procedure, several variables that could affect the performance of the method were investigated. In the best conditions, the tablets could be analyzed by introducing into the graphite tube 20 µl of a slurry prepared with approximately 90-100mg of the sample and 2 ml of a solution containing 5% m/v of Triton X-114 and 2.8 M of HNO(3). Before the introduction, the slurries were sonicated for 15 min at 40% of amplitude (130 W maximum power) with an ultrasonic probe. The developed method was applied in the determination of Cu and Mn in four samples, and the results were compared with those obtained by focused microwave acid digestion with aqua regia (1:3 mixture of HNO(3):HCl). There was no statistical difference between the obtained values at 95% confidence level when a paired Student t-test was applied.

Multivariate optimization of the determination of zinc in diesel oil employing a novel extraction strategy based on emulsion breaking.

This paper describes the extraction/pre-concentration of Zn from diesel oil and its determination by Flame Atomic Absorption Spectrometry (FAAS), proposed as a novel approach for these kinds of analyses and the multivariate optimization of the proposed procedure. The extraction of Zn is based on the emulsification of an aqueous solution containing Triton X-114 and HNO(3) with diesel oil samples followed by breaking of the emulsion by heating. The aqueous phase obtained after the emulsion breaking was collected and used for Zn quantification by FAAS. The methodology was optimized using a Doehlert design and the system variables were the concentrations of surfactant and HNO(3) in the solution employed in the emulsification and the temperature used in the emulsion breaking. The ratio between absorbance and the time required to break the emulsions was taken as response. Two sets of experiments, using different emulsifier agents, were run: the first one using Triton X-100 and the second one using Triton X-114. At optimized conditions, the emulsions were prepared by mixing 10 mL of diesel oil with 2 mL of a solution containing 5% w/v of Triton X-114 and 15% v/v of HNO(3) and broken by heating at 80 °C. The proposed analytical procedure was applied in the analysis of six real samples of diesel oil and a recovery test was carried out by spiking the samples with known amounts of Zn (25 and 50 µg L(-1)), added as organometallic oiled standard. Recovery percentages achieved in this test were between 92 and 109%.

[Treatment of acute mastoiditis in children with cochlear implants]. / Tratamiento de la mastoiditis aguda en niños con implante coclear.

INTRODUCTION: Acute mastoiditis (AM) is a paediatric infectious complication that raises a specific problem in case of implanted patients. OBJECTIVE: To review the cases of AM in a paediatric cochlear implant (CI) programme to study its incidence and associated problems. MATERIALS AND METHODS: A retrospective study was conducted on 248 children aged between 8 months and 14 years who underwent CI from 1994 to 2009. The demographics, clinical data and their treatment were analyzed. RESULTS: Five patients developed acute mastoiditis (2.01%), three of them with subperiosteal abscess (1.21%). The mean age of implantation was 2 years and 4 months, and the complication presented between 1 and 33 months post-implantation (mean, 11.6 months). Four patients had episodes of serous otitis preimplantation. The mean age of AM patients was of 3 years and 4 months. The CI type was nucleus in all cases. CONCLUSIONS: Conservative management is suggested for AM and subperiosteal abscess in children with cochlear implants. Surgical treatment should be avoided to prevent CI contamination. The first option is intravenous antibiotics and simple puncture of the abscess. If surgical drainage is needed, radiological study should be performed to locate the CI electrodes.

Adenomioepitelioma maligno: relato de caso / Malignant adenomyoepithelioma: case report

O adenomioepitelioma é uma neoplasia caracterizada por uma proliferação de células epiteliais e mioepiteliais. Essa lesão pode ser encontrada em glândulas salivares, anexos de pele e, muito raramente, na glândula mamária. O adenomioepitelioma foi descrito pela primeira vez em 1970 e muito poucos casos foram publicados desde então. Nós apresentamos o caso de uma mulher de 32 anos com um tumor de 5 cm localizado no quadrante inferior externo que se estendia para o quadrante central e inferior interno da mama esquerda. A paciente apresentava ainda uma lesão satélite de 2 cm no quadrante superior interno da referida mama. Um linfonodo suspeito foi palpado na axila ipsilateral. A paciente foi classificada como no estádio IIIb do sistema TNM. A mamografia mostrou uma lesão infiltrativa categorizada como BI-RADS 4C. Foi realizada uma core-biopsy e uma biópsia incisional. Os exames histopatológico e imunoistoquímico mostraram tratar-se de um carcinoma adenomioepitelial. A paciente foi, então, submetida à mastectomia radical modificada, e o exame histopatológico confirmou o diagnóstico de carcinoma adenomioepitelial; 38 linfonodos axilares dissecados se apresentavam livres de metástases. Foram realizadas radioterapia e quimioterapia como tratamentos complementares. Como a paciente apresentava receptores hormonais negativos, nenhuma forma de tratamento hormonal complementar foi realizada. A paciente se encontrava viva e sem evidência de doença após 27 meses do diagnóstico.

The adenomioepitelioma is a neoplasm characterized by a proliferation of epithelial and myoepithelial cells. This injury can be found in the salivary glands, skin attachments and very rarely in the mammary gland. The adenomioepitelioma was first described in 1970 and very few cases have been published since then. We present the case of a woman of 32 years with a 5 cm tumor located in the lower outer quadrant extending into the central and lower inner quadrant of left breast. The patient still had a satellite lesion 2 cm in the upper inner quadrant of that breast. One suspect was palpable lymph nodes in the ipsilateral axilla. The patient was classified as stage IIIb in the TNM system. Mammography showed an infiltrative lesion classified as BI-RADS 4C. We performed a biopsy and a core-biopsy. Histopathologic and immunohistochemistry showed that it was a adenomioepitelial carcinoma. The patient then underwent modified radical mastectomy, and histopathology confirmed the diagnosis of carcinoma adenomioepitelial, 38 axillary lymph nodes dissected was presented free of metastases. Radiotherapy and chemotherapy were performed as complementary treatments. As the patient had hormone receptor-negative, no further form of hormonal treatment was performed. The patient was alive and without evidence of disease after 27 months of diagnosis.