Rhabdomyosarcoma with TFCP2 Rearrangement or Typical Co-expression of AE1/AE3 and ALK: Report of Three New Cases in the Head and Neck Region and Literature Review.

BACKGROUND: Rhabdomyosarcoma (RMS) harboring EWSR1/FUS-TFCP2 fusions has been recently described as a distinct form of RMS with an aggressive course and predilection for the craniofacial bones, especially the jaws. METHODS: We report three new cases of this rare entity, two from Brazil and one from Guatemala, with detailed clinicopathologic, immunohistochemical, and molecular descriptions. Additionally, we explored the English-language literature searching RMS with TFCP2 rearrangement or typical immunophenotype with co-expression of AE1/AE3 and ALK in the head and neck region. RESULTS: Case 1 is a 58-year-old male with a 3-month history of painful swelling in the anterior maxilla. Case 2 is a 22-year-old male presenting with right facial swelling and proptosis. Case 3 is a 43-year-old female with a rapidly growing tumor located in the zygomatic region. Imaging examinations revealed highly destructive intraosseous masses in the first two cases, and a soft tissue tumor with bone invasion in case 3. Microscopically, all cases showed a hybrid spindle and epithelioid phenotype of tumor cells which expressed desmin, myogenin and/or Myo-D1, AE1/AE3, and ALK. FISH confirmed molecular alterations related to TFCP2 rearrangement in Cases 1-2. In case 3, there was no available material for molecular analysis. The patients were subsequently referred to oncologic treatment. Additionally, we summarized the clinicopathologic, immunohistochemical, and molecular features of 27 cases of this rare RMS variant in the head and neck region reported in the English-language literature. CONCLUSION: RMS with TFCP2 rearrangement is a rare and aggressive tumor with a particular predilection for craniofacial bones, especially the jaws. Knowing its clinicopathologic and immunohistochemical profile can avoid misdiagnosis.

Migratory phenomenon and expressive sandwork in vulnerable populations.

In these times the migratory phenomenon is a crisis with alarming dimensions worldwide. Wars, human rights violations and violence within borders have pushed many people to seek asylum or have forced internal displacement. We approach this phenomenon taking into account the cultural complexes, understanding it as a process with multiple psychological, social and existential effects for those who suffer it. We find these effects symbolized in many of the processes of the children participating in Expressive Sandwork projects. Expressive Sandwork is a transcultural, non-verbal method of therapeutic care that offers psychological support to children from vulnerable populations where psychotherapy is deficient or non-existent. The aim is to allow the emergence of images that favour reconnection with the child's creative potential, activating the process of self-regulation of the psyche. Its basis in symbolic processes and empathetic accompaniment makes it a Jungian psychosocial intervention for these times of transition. In Latin America, Expressive Sandwork projects have been implemented in Colombia and Argentina. Two examples of the participating children are presented.

A notre époque le phénomène migratoire est une crise qui a des dimensions alarmantes au niveau mondial. Les guerres, les violations des droits humains et la violence au sein même des frontières ont poussé de nombreuses personnes à chercher asile à l'étranger, ou les ont forcées à un déplacement à l'intérieur des frontières. Nous abordons ce phénomène en prenant en compte les complexes culturels. Nous le comprenons comme un processus ayant de multiples effets psychologiques, sociaux et existentiels pour les personnes qui en souffrent. Nous observons ces effets symbolisés dans de nombreux processus des enfants qui participent aux projets de travail expressif à l'aide du jeu de sable (Expressive Sandwork). L'Expressive Sandwork est une méthode de soin thérapeutique transculturelle et non-verbale qui offre du soutien psychologique à des enfants de populations vulnérables quand la psychothérapie est déficiente ou non-existante. Le but en est de permettre l'émergence d'images qui favorisent le rétablissement du potentiel créatif de l'enfant, activant ainsi le processus d'autorégulation de la psyché. Son enracinement dans les processus symboliques et l'accompagnement empathique en font une intervention Jungienne psychosociale pour notre époque de transition. En Amérique Latine, les projets de travail expressif à l'aide du jeu de sable ont été implantés en Colombie et en Argentine. Deux exemples d'enfants qui y ont participé sont présentés.

En estos tiempos el fenómeno migratorio es una crisis con dimensiones alarmantes a nivel mundial. Las guerras, la violación de los derechos humanos y la violencia al interior de las fronteras han empujado a muchas personas a buscar asilo o al desplazamiento forzado interno. Nos aproximamos a este fenómeno teniendo en cuenta los complejos culturales y comprendiéndolo como un proceso con múltiples efectos psicológicos, sociales y existenciales para quienes lo sufren. Estos efectos los encontramos simbolizados en muchos de los procesos de los niños/as participantes en los proyectos de Trabajo Expresivo con Arena. El Trabajo Expresivo con Arena es un método de cuidado terapéutico no verbal y transcultural que ofrece apoyo psicológico a niños/as de poblaciones vulnerables, donde la psicoterapia es deficiente o inexistente. El objetivo es permitir el surgimiento de imágenes que favorezcan la reconexión con el potencial creativo del niño/a, activando el proceso de autorregulación de su psique. Su base en procesos simbólicos y en el acompañamiento empático, lo constituyen en una intervención psicosocial de la psicología junguiana para estos tiempos de transición. En Latinoamérica se han implementado proyectos de Trabajo Expresivo con Arena en Colombia y Argentina. En este artículo se presentarán dos ejemplos de niños que formaron parte de estos proyectos.

Nestes tempos, o fenômeno migratório é uma crise com dimensões alarmantes em todo o mundo. Guerras, violações dos direitos humanos e violência dentro das fronteiras levaram muitas pessoas a buscar asilo ou deslocamento interno forçado. Abordamos esse fenômeno levando em consideração os complexos culturais, entendendo-o como um processo com múltiplos efeitos psicológicos, sociais e existenciais para aqueles que o sofrem. Encontramos esses efeitos simbolizados em muitos dos processos das crianças que participam de projetos Expressive Sandwork. O Expressive Sandwork é um método transcultural e não verbal de cuidados terapêuticos que oferece apoio psicológico a crianças de populações vulneráveis onde a psicoterapia é deficiente ou inexistente. O objetivo é permitir o surgimento de imagens que favoreçam a reconexão com o potencial criativo da criança, ativando o processo de autorregulação do psiquismo. Sua base em processos simbólicos e acompanhamento empático o torna uma intervenção psicossocial junguiana para esses tempos de transição. Na América Latina, projetos Expressive Sandwork foram implementados na Colômbia e na Argentina. Dois exemplos das crianças participantes são.

Evaluation of pay-for-release conservation incentives for unintentionally caught threatened species.

In the developing world, the exploitation of threatened species jeopardizes their permanence in the wild. Because not all captures are intentional, for instance when capture methods have low selectivity, pressure on these species may be lessened by releasing living incidentally caught animals. However, it is often unrealistic to expect people to voluntarily do so because it means foregoing the benefits of resource extraction. Financial incentives for such animal release may foster conservation objectives. Reducing human-animal conflicts, protecting natural habitat, and conserving nests of threatened species are examples of conservation benefits that can be built on financial reward systems. However, incentives aiming to protect unintentionally captured threatened species are scarce. We considered pay for release, a type of ecosystem-service payment designed to foster the release of incidentally captured threatened species. We aimed to determine the best conditions to implement this scheme, its potential benefits (e.g., incentivizing the release of threatened species), and pitfalls and priority research needs (e.g., required conditions for pay for release to work) to show that its global applicability is possible. Given that approaches solely based on education and law enforcement may be ineffective under some circumstances, we argue that pay for release can protect incidentally captured endangered species if used under conditions conducive for its success. When local participants' intrinsic motivation for conservation is weak, but the release of incidentally live-caught animals into their habitats is readily achievable, pay-for-release schemes could jump start urgently needed conservation efforts against indiscriminate animal harvesting.

Evaluación de los Incentivos de Pago por Liberación para las Especies Amenazadas Capturadas Involuntariamente Resumen En este mundo en desarrollo, la explotación de las especies amenazadas pone en peligro su permanencia en la naturaleza. Ya que no todas las capturas son voluntarias, por ejemplo cuando los métodos de captura tienen una selectividad baja, la presión que se ejerce sobre estas especies puede aminorarse con la liberación de animales capturados vivos accidentalmente. Sin embargo, a menudo es poco realista esperar que las personas hagan esto voluntariamente, pues representa una renuncia a los beneficios de la extracción de recursos. Los incentivos financieros para dichas liberaciones de animales pueden promover los objetivos de conservación. La reducción de los conflictos humano-animal, la protección del hábitat natural y la conservación de los nidos de las especies amenazadas son ejemplos de los beneficios de conservación que pueden construirse con los sistemas de recompensas financieras. Sin embargo, los incentivos que buscan proteger a las especies amenazadas que son capturadas involuntariamente son escasos. Consideramos el pago por liberación, un tipo de pago por servicio ambiental diseñado para fomentar la liberación de las especies amenazadas capturadas accidentalmente. Buscamos determinar las mejores condiciones para implementar este programa, sus beneficios potenciales (p. ej.: la incentivación de la liberación de especies amenazadas) y los inconvenientes y las necesidades de la prioridad de investigación (p. ej.: las condiciones requeridas para que funcione el pago por liberación) para mostrar que su aplicación global es posible. Ya que las estrategias basadas solamente en la educación y la aplicación de la ley pueden no ser efectivas bajo ciertas circunstancias, argumentamos que el pago por la liberación puede proteger a las especies amenazadas capturadas accidentalmente si se usa bajo condiciones propicias para su éxito. Cuando los participantes locales tienen una motivación intrínseca débil pero la liberación de animales capturados vivos accidentalmente a sus hábitats es inmediatamente alcanzable, los programas de pago por liberación podrían arrancar los esfuerzos de conservación tan necesarios para combatir la extracción indiscriminada de animales.

Ambiguous Loss Experienced by Transnational Mexican Immigrant Families.

In this study, an ambiguous loss framework as described by Boss (1999, Ambiguous loss: Learning to live with unresolved grief, First Harvard University Press, Cambridge, MA) was used to examine and understand the family experiences of Mexican immigrant agricultural workers in Minnesota. Transcripts from interviews with 17 workers in Minnesota and 17 family members in Mexico were analyzed using qualitative methodology to identify experiences of ambiguous loss in the participants' narratives. Key dimensions of ambiguous loss identified in the transcripts include: psychological family, feelings of chronic/recurring loss, finding support, and meaning making. In the category of psychological family, participants in both Mexico and the United States mourned the physical absence of their family members and experienced ambiguity regarding family responsibilities, but worked to maintain their psychological roles within the family. In the category of chronic/recurring loss, participants in both countries experienced chronic worry from not knowing if family members were safe, ambiguity regarding when the immigrant would return, and chronic stressors that compounded these feelings of loss. Participants in both countries coped with both real and ambiguous losses by accessing family support and by using ambiguous communication to minimize worry. Participants in Mexico also accessed work and community-based support. Participants in both countries made meaning of the ambiguous loss by identifying ways their lives were improved and goals were met as a result of the immigration for agricultural work in Minnesota.

Avaliação do comprometimento linfonodal através de análise Imuno-histoquímica e sua importância como fator prognóstico em pacientes com câncer invasivo de bexiga / Evaluation of lymph node involvement by immunohistochemical analysis and its importance as a prognostic factor in patients with invasive bladder cancer

Introdução: A progressão sistêmica é a principal forma de recorrência do câncer invasivo de bexiga (CB) após a cistectomia radical (CR). O diagnóstico de células tumorais ocultas em linfonodos (LN) normais histologicamente pode ter valor prognóstico. Os autores avaliaram a possibilidade do marcador AE1AE3, através de exame imuno-histoquímico, diagnosticar a presença de células tumorais ocultas em 832 LN de 61 pacientes com CB submetidos à CR e os impactos prognósticos na sobrevida câncer específica (SCE) em 5 anos. Casuísticas e métodos: Estudaram-se 61 pacientes admitidos no Departamento de Cirurgia Pélvica do Hospital do Câncer A.C. Camargo com CB, sem tratamento prévio e que foram submetidos à CR. A coleta de dados foi realizada nos prontuários, sendo registrados dados sociodemográficos, clínicos, histopatológicos e terapêuticos. Os cortes histológicos dos LN foram revistos e analisados por imuno-histoquímica (IHQ) com anticorpos AE1AE3 em corte histológico único.Resultados: Após avaliação imuno-histoquímica com o marcador AE1AE3 2/61 pacientes (3,27%) apresentaram micrometástase linfonodal. Não foi possível a avaliação de sobrevida câncer específica nos 2 pacientes diagnosticados com micrometástases uma vez que os dois morreram por complicacações da CR. Conclusão: Os autores concluíram que o uso do anticorpo monoclonal anticitoqueratina AE1AE3 em pacientes com câncer de bexiga estádios pN0 submetidos a CR evidenciou a presença de micrometáses em 3,27% da amostra analisada. Não foi possível avaliar o impacto da presença de micrometástase como fator prognóstico devido à sua baixa positividade na população estudada.

Introduction: Systemic progression is the main form of recurrence of muscle invasive bladder cancer (BC) after radical cystectomy (RC). The diagnosis of occult tumor cells in lymph nodes (LN) histologically normal may have prognostic value. The authors evaluated the ability of the marker AE1AE3 through immunohistochemical examination, diagnose the presence of occult tumor cells in 61LN of 832 patients with BC who underwent CR and its impacts prognosis in cancer specific survival (SCE) in 5 years. Material and Methods: We studied 61 patients with BC admitted to the Department of Pelvic Surgery of the Cancer Hospital AC Camargo, without prior treatment and who underwent RC. Data collection was performed on records, and recorded demographic data, clinical, histopathological and therapeutic. Histological sections of LN were reviewed and analyzed by immunohistochemistry (IHC) with AE1AE3 antibody single histological sections. Results: After immunohistochemical analysis with the marker AE1AE3 2/61 patients (3.27%) had lymph node micrometastases. Conclusions: The authors concluded that the use of monoclonal cytokeratin AE1AE3 in patients with bladder cancer stage pN0 undergoing radical cystectomy revealed the presence of micrometastasis in 3,27% of the sample analised. It was not possible to assess the impact of the presence of micrometastases as a prognostic factor because of its low positivity in this population.