ABSTRACT
Burn injury as a form of hetero or auto-aggression accounts for a significant amount of admissions to a Burn Care Unit, with epidemiologic and clinical specificities. To investigate the differences in risk factors, psychiatric comorbidities, injury severity and mortality among adult patients with accidental or intentional burns, we analyzed routinely collected data from a Central Hospital Burn Unit over a period of 6 years (January 1st, 2010 to December 31st, 2015). We identified 22 intentional burn patients (5%) among all the admissions to our Burn Unit. When compared to the accidental burns, the intentional burn patients are significantly younger (45.7±14.7 vs. 54.9±19.9), have a bigger percentage of body surface area burned (35% vs. 14%), have a higher incidence of inhalation burn (50% vs. 22.8%) and higher mortality (18.2% vs. 6.1%). Fifty-five percent of cases of intentional burns were self-inflicted. Self-inflicted burns have a worse prognosis than hetero-aggressions (inhospital mortality 25% vs. 10%). Psychiatric comorbidities were largely more prevalent in the intentional burn patients (59% vs. 6.6%), namely mood disorders. Compared to patients with accidental burns, intentional burn patients have worse clinical condition and prognosis. A multidisciplinary preventive approach, looking at the specificities of the violent nature of the lesions and identifying risk groups may reduce the incidence and severity of this type of burns.
Les brûlures par suicide ou consécutives à une agression représentent une entité à part, non négligeable dans la patientèle d'un CTB. Nous avons cherché à en caractériser les facteurs de risque, les pathologies psychiatriques associées, la gravité et la mortalité, par une revue des dossiers des patients hospitalisés dans notre CTB entre 2010 et 2015. Vingt deux (5%) patients ont été victimes de brûlures non accidentelles. Elles touchent des patients plus jeunes (45,7+/-17,7 VS 54,9+/-19,9 ans, sont plus étendues (35 VS 14%), l'incidence de l'inhalation de fumées y est plus élevée (50 VS 22,8%) et leur mortalité est supérieure (18,2 VS 6,1%). Les tentatives de suicide représentent 55% des brûlures non accidentelles et sont grevées d'une mortalité supérieures (25%) aux agressions (10%). Des troubles de l'humeur étaient présents dans 59% des brûlures non accidentelles (6,6% ailleurs). Les brûlures non accidentelles sont donc plus graves que les autres. Une politique préventive ciblant les groupes à risque pourrait réduire l'incidence et la gravité des brûlures non accidentelles.
ABSTRACT
Introduction: Surgical treatment of basal cell carcinomas is often performed by physicians with different surgical backgrounds. Collecting data from different surgical departments would better reflect their real-life surgical management.Objectives: To identify the rate, recurrence risk, and predictive factors accordingly to their relative contribution for an incomplete basal cell carcinoma excision in a large multidisciplinary real-life settingMethods: Retrospective cohort study of 2305 surgically treated lesions in different departments of a tertiary center.Results: There was a rate of incomplete excisions (15%) and a recurrence rate (35.5% vs. 6.8% in incomplete vs. complete excisions (p < .001)). A third of incompletely excised basal cell carcinoma (BCC) will recur over time. Stratified by relevancy, high-risk histological subtypes (micronodular (OR 5.10 - p < .001) and morpheaform (OR 5.42 - p < .001), smaller specimen sizes ( <0.5 cm or 0.5-1 cm, OR 3.99 and 2.49, respectively, p < .001) high-risk locations (OR 3.06 on the nose, OR 2.77 on the eyelids, p < .001), and recurrent BCCs (OR 1.72, p < .001). are the best predictors of an incomplete excision.Conclusions: Acknowledging the rate, recurrence risk and predictive factors for incomplete excisions may be beneficial for optimal preoperative planning and to prevent unwarranted re-interventions, morbidity, and healthcare costs.
Subject(s)
Carcinoma, Basal Cell/surgery , Skin Neoplasms/surgery , Aged , Carcinoma, Basal Cell/mortality , Carcinoma, Basal Cell/pathology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasm Recurrence, Local , Odds Ratio , Retrospective Studies , Risk Factors , Skin Neoplasms/mortality , Skin Neoplasms/pathology , Survival Rate , Tertiary Care CentersABSTRACT
The expression of transfer RNAs (tRNAs) is deregulated in cancer cells but the mechanisms and functional meaning of such deregulation are poorly understood. The proteome of cancer cells is not fully encoded by their transcriptome, however, the contribution of mRNA translation to such diversity remains to be elucidated. We review data supporting the hypothesis that tRNA expression deregulation and translational error rate is an important contributor to proteome diversity and cell population heterogeneity, genome instability, and drug resistance in tumors. This hypothesis is aligned with recent data in various model organisms, showing unanticipated adaptive roles of translational errors (adaptive mistranslation), expression control of specific gene subsets by tRNAs, and proteome diversification by elevation of translational error rates in tumors.
Subject(s)
Neoplasms/metabolism , RNA, Transfer/metabolism , Animals , Humans , Neoplasms/genetics , Protein Biosynthesis , Proteome/genetics , Proteome/metabolism , RNA Stability , RNA, Transfer/chemistry , RNA, Transfer/geneticsABSTRACT
Deregulation of tRNAs, aminoacyl-tRNA synthetases and tRNA modifying enzymes are common in cancer, raising the hypothesis that protein synthesis efficiency and accuracy (mistranslation) are compromised in tumors. We show here that human colon tumors and xenograft tumors produced in mice by two epithelial cancer cell lines mistranslate 2- to 4-fold more frequently than normal tissue. To clarify if protein mistranslation plays a role in tumor biology, we expressed mutant Ser-tRNAs that misincorporate Ser-at-Ala (frequent error) and Ser-at-Leu (infrequent error) in NIH3T3 cells and investigated how they responded to the proteome instability generated by the amino acid misincorporations. There was high tolerance to both misreading tRNAs, but the Ser-to-Ala misreading tRNA was a more potent inducer of cell transformation, stimulated angiogenesis and produced faster growing tumors in mice than the Ser-to-Leu misincorporating tRNA. Upregulation of the Akt pathway and the UPR were also observed. Most surprisingly, the relative expression of both misreading tRNAs increased during tumor growth, suggesting that protein mistranslation is advantageous in cancer contexts. These data highlight new features of protein synthesis deregulation in tumor biology.
