A Set of miRNAs, Their Gene and Protein Targets and Stromal Genes Distinguish Early from Late Onset ER Positive Breast Cancer.

UNLABELLED: Breast cancer (BC) in young adult patients (YA) has a more aggressive biological behavior and is associated with a worse prognosis than BC arising in middle aged patients (MA). We proposed that differentially expressed miRNAs could regulate genes and proteins underlying aggressive phenotypes of breast tumors in YA patients when compared to those arising in MA patients. OBJECTIVE: Using integrated expression analyses of miRs, their mRNA and protein targets and stromal gene expression, we aimed to identify differentially expressed profiles between tumors from YA-BC and MA-BC. METHODOLOGY AND RESULTS: Samples of ER+ invasive ductal breast carcinomas, divided into two groups: YA-BC (35 years or less) or MA-BC (50-65 years) were evaluated. Screening for BRCA1/2 status according to the BOADICEA program indicated low risk of patients being carriers of these mutations. Aggressive characteristics were more evident in YA-BC versus MA-BC. Performing qPCR, we identified eight miRs differentially expressed (miR-9, 18b, 33b, 106a, 106b, 210, 518a-3p and miR-372) between YA-BC and MA-BC tumors with high confidence statement, which were associated with aggressive clinicopathological characteristics. The expression profiles by microarray identified 602 predicted target genes associated to proliferation, cell cycle and development biological functions. Performing RPPA, 24 target proteins differed between both groups and 21 were interconnected within a network protein-protein interactions associated with proliferation, development and metabolism pathways over represented in YA-BC. Combination of eight mRNA targets or the combination of eight target proteins defined indicators able to classify individual samples into YA-BC or MA-BC groups. Fibroblast-enriched stroma expression profile analysis resulted in 308 stromal genes differentially expressed between YA-BC and MA-BC. CONCLUSION: We defined a set of differentially expressed miRNAs, their mRNAs and protein targets and stromal genes that distinguish early onset from late onset ER positive breast cancers which may be involved with tumor aggressiveness of YA-BC.

[Irritable bowel syndrome: frequency and phylogenetic relationship of Blastocystis sp. from Mexican patients]. / Síndrome de intestino irritable: frecuencia y relación filogenética de Blastocystis sp. de pacientes mexicanos.

INTRODUCTION: Recent studies reported increased presence of Blastocystis in patients with Irritable Bowel Syndrome (IBS) and an etiologic role has been proposed. The pathogenic role of Blastocystis is controversial, because it is frequently found not only in individuals with enteric symptoms but also in healthy and asymptomatic subjects. Furthermore, there are few studies of blastocistosis in Mexico. OBJECTIVE: To assess the frequency of Blastocystis sp. in IBS patients using molecular techniques and to describe its phylogenetic relationship with sequences of other countries. METHODS: IBS patients according to Rome III criteria were enrolled. In all patients evaluations included: colonoscopies, coproparasitoscopic studies, coproculture, fecal virus screening. PCR and sequencing for Blastocystis sp. were also performed. RESULTS: We recruited 11 men and 51 women with a mean age of 45.6 (SD ± 15.7) years. Eighty-six percent of the IBS patients presented a normal colonoscopy, 8% showed polyps and 6% diverticular disease. Blastocystis sp. was identified in 25% patients (all of them with normal colonoscopy), while two patients had Endolimax nana and Entamoeba histolytica/E. dispar, respectively. Phylogenetic analysis showed that major sequences of Mexican carriers clustered together with sequences of parasites from Japan and Denmark; furthermore, two sequences from IBS patients were grouped in a single cluster. CONCLUSIONS: Blastocystis sp. was identified in 25% of the IBS patients. Our data support the hypothesis of clonal lineages in distinct geographical areas in the world.

[Predicting very early rebleeding after acute variceal bleeding based in classification and regression tree analysis (CRTA).]. / Predicción de resangrado precoz en cirróticos con hemorragia variceal aguda. Función del análisis con árboles de clasificación y regresión (CART).

BACKGROUND: Variceal bleeding (VB) is the main cause of death among cirrhotic patients. About 30-50% of early rebleeding is encountered few days after the acute episode of VB. It is necessary to stratify patients with high risk of very early rebleeding (VER) for more aggressive therapies. However, there are few and incompletely understood prognostic models for this purpose. AIMS: To determine the risk factors associated with VER after an acute VB. Assessment and comparison of a novel prognostic model generated by Classification and Regression Tree Analysis (CART) with classic-used models (MELD and Child-Pugh [CP]). PATIENTS AND METHODS: Sixty consecutive cirrhotic patients with acute variceal bleeding. CART analysis, MELD and Child-Pugh scores were performed at admission. Receiver operating characteristic (ROC) curves were constructed to evaluate the predictive performance of the models. RESULTS: Very early rebleeding rate was 13%. Variables associated with VER were: serum albumin (p = 0.027), creatinine (p = 0.021) and transfused blood units in the first 24 hrs (p = 0.05). The area under the ROC for MELD, CHILD-Pugh and CART were 0.46, 0.50 and 0.82, respectively. The value of cut analyzed by CART for the significant variables were: 1) Albumin 2.85 mg/dL, 2) Packed red cells 2 units and 3) Creatinine 1.65 mg/dL the ABC-ROC. CONCLUSION: Serum albumin, creatinine and number of transfused blood units were associated with VER. A simple CART algorithm combining these variables allows an accurate predictive assessment of VER after acute variceal bleeding. Key words: cirrhosis, variceal bleeding, esophageal varices, prognosis, portal hypertension.

[Three prognostic scales; clinical utility and prediction of intrahospital survival in alcoholic hepatitis]. / Utilidad clínica y predicciónde supervivencia intrahospitalaria de 3 escalas pronósticas en hepatitis alcohólica.

BACKGROUND: Alcoholic hepatitis is a serious clinical problem; opportune detection is transcendental for treatment and survival improvement. The aim of this study was to evaluate clinical utility of in-hospital mortality prediction of 3 alcoholic hepatitis scores and to assess survival prediction fitting them to the best cut-off points. MATERIAL AND METHODS: Retrospective, observational study. All patients with diagnosis of alcoholic hepatitis from January 2002 to January 2005 were included.Clinical and laboratory variables were analyzed for the different prognostic scores (MELD, GAHS and the Discriminate Function Maddrey's index) calculation. Evaluation of clinical utility scores was done with ROC curves and expressed by c-statistics. After fitting best cut-off points, survival prediction was assessed by Kaplan-Meier's method. RESULTS: Of 120 patients with alcoholic hepatitis, 48 fulfilled the admission criteria. The c-statistics of MELD was of 0.72, GAHS 0.75 and Maddrey's index 0.64. Survival analysis of the 3 prognostic scales showed statistical significance (log rank < 0.05) with the adjusted cut-off point to our population. CONCLUSION: The prediction of in hospital survival of GAHS, MELD and Maddrey's index after fitting best cut-off points are similar. The clinical utility for in-hospital mortality prediction of GAHS and MELD are superior to Maddrey's index in this Mexican cohort.

[Lesions of the fallopian tube following tube occlusion]. / Lesiones de la trompa de Falopio posteriores a oclusión tubárica.

This is a study using light microscopy and electronic microscopy of Fallopian tube subjected to sterilization; and compare it with a control group. A total of 60 samples from patients with different surgical procedures, whose age was from 20 to 40 years; they were amenorrheic, without antecedents of pelvic inflammatory disease nor endometriosis. Among the control group, there were lesions as isthsmical nodular salpingitis in 30.7%. There was chronic salpingitis in 15.3%; follicular salpingitis in 23%, and polyps in 15%. In the group with OTB antecedents, endosalpingiosis was found in 20%; follicular salpingitis in 30% and chronic salpingitis in the remaining 50%. By means of electronic, ultrastructural microscopy, were seen lesions at myosalpinx level, that is, alterations in myofilaments, formation, much fibrosis and descilliation in the adjacent to OTB. It may be concluded that these findings, never seen before, may condition an alteration of tubal motility in patients subjected to rechannelization procedures, that condition an alteration in gametes transportation, avoiding fecundation or a greater incidence ectopic pregnancy incidence.

[Ultrastructure of human endometrium in vitro in various phases of the menstrual cycle]. / La ultraestructura del endometrio humano in vitro en diferentes fases del ciclo menstrual.

Samples of normal human endometrial tissue from eight young women were initiated in tissue culture. Four biopsies were obtained during the first phase of the cycle and four during the secretory phase. The aim of the work was to characterize ultrastructurally the possible changes of the glandular tissue without being dissociated from the stromal component. At eight hours of incubation there was preservation of all cellular components in the tissue from the first phase of the cycle whereas there were minor degenerative changes in the endometrium from the secretory phase but with outstanding preservation of intranuclear canaliculi typical of this phase. After 16 hours minimal changes were seen in proliferative endometrium while severe changes were present in secretory endometrium. The study suggests that whole endometrium in culture can be used to characterize the short time effect of drugs and substances administered during the first phase of the menstrual cycle.