ΔNp73 status in peritoneal and ovarian dissemination of appendicular adenocarcinoids (goblet cells).

INTRODUCTION: Goblet cell carcinoma (GCC) is an appendicular neoplasia representing less than 5% of all appendicular tumors, found in 0.3-0.9% of the appendectomies, 35-58% of all appendicular neoplasms, and less than 14% of malign appendix tumors. The most frequent clinical presentation is abdominal pain associated with a picture of acute appendicitis. MATERIALS AND METHODS: We present 3 clinical cases of appendix GCC, 2 subjected to cytoreductory surgery plus intraperitoneal hyperthermic chemotherapy and a third, who is currently receiving neoadjuvant treatment with a good response to chemotherapy and who will be offered the same treatment as the first two patients. Given the unpredictable behavior of these tumors, the use of molecular markers could help us to predict their behavior and prognosis. In this context, the TP73 gene would make an interesting putative marker. ∆Np73 has been described as overexpressed in a great variety of tumor types including colon cancer and this up-regulation is associated with a poor prognosis. To evidence its role in this malignancy, we evaluate here the status of ∆Np73 in the primary tumor and normal counterpart tissues, in the metastatic implants and in healthy areas of the peritoneum from the appendicular GCC patients. In addition, we checked the expression levels of this p73 variant in the tumor and normal tissue of 26 patients with colon cancer. RESULTS: Remarkably, 2 patients showed significant ∆Np73 down-regulation in both the primary tumor and the implants. Case 1 presented a fourfold decrease of levels in the primary tumor and 20-fold decrease in the implants. Case 2 showed a seven- and fourfold down-regulation in the primary tumor and implants, respectively. However, Case 3 showed an up-regulation of 53- and threefold in the primary tumor and implants, respectively. CONCLUSION: Goblet cell carcinoma of the appendix is very rate. It tends to seed throughout the peritoneum, making aggressive surgical cytoreduction and chemotherapy viable treatment options. Investigation into the molecular basis of these tumors may improve the diagnosis, prognosis and therapeutic decisions regarding these patients. ∆Np73 seems a good candidate for further analysis in longer series.

Características del hábito tabáquico en una muestra de enfermos psicóticos / Characteristics of the smoking habit in a sample of psychotic patients

Pacientes y Métodos: Estudio multicéntrico transversal descriptivo, con una muestra de 298 sujetos fumadores procedentes de diferentes centros de la red pública de Salud Mental de Cataluña, diagnosticados y tratados de forma ambulatoria por enfermedades de la esfera psicótica. La recogida de datos se realizó entre febrero y junio del 2004, mediante entrevista estructurada, realizada por el personal sanitario que trata habitualmente al paciente. Se analiza mediante técnicas de estadística descriptiva: la existencia de posibles diferencias entre el grupo de pacientes tratados con antipsicóticos típicos y atípicos, controlando las variables nivel de actividad y diagnostico. Resultados: Los resultados muestran con diferencias significativas que los pacientes esquizofrénicos presentan mayor severidad del hábito tabáquico; no se observan diferencias significativas respecto a la media de cigarrillos fumados en función del tratamiento antipsicótico. Se ha observado que las personas que realizan actividades presentan menor consumo sin que las diferencias sean significativas. Conclusiones: A pesar de que hay evidencia científica sobre la relación existente entre factores neuroquímicos, efectos farmacológicos y tabaquismo en el paciente psicótico, éstos no ejercen una influencia tan relevante en la forma de fumar de estos pacientes puesto que se hallan moduladas por las características intrínsecas del hábito tabáquico por sí mismo, los factores sociales y del entorno (AU)

Objectives: From 70% to 805 of the patients with diseases within the psychotic sphere in the Spanish State smoke (general population 35%-40%). The reasons are both biological as well as psychosocial. It is believed that the neurobiological effects of nicotine on some of the neurotransmitters involved in schizophrenia play an important role, but the life style of these patients also affects the amount of tobacco smoked. It is proposed to study if there are differences in the amount of tobacco smoked among psychotic patients based on diagnosis, type of antipsychotic drug they are treated with and the activity level. Patients and Methods: Multicenter, cross-sectional descriptive study with a sample of 298 subjects who smoked from different centers of the public Mental Health network, who were diagnosed and treated as outpatients for diseases within the psychotic sphere. Data collection was done between February and June 2004 using a structured interview and conducted by health-care personnel who generally treated the patient. Descriptive statistical techniques were used for the analysis: the existence of possible differences between the group of patients treated with typical and atypical antipsychotic drugs, controlling the variables of activity level and diagnoses. Results: The results show that schizophrenic patients have significantly greater severity of the smoking habit; no significant differences being observed regarding the mean number of cigarettes smoked based on the antipsychotic treatment. It has been observed that the persons who perform activities have less consumption although the differences are not significant. Conclusions: Although there is scientific evidence and the relationship existing between neurochemical factors, pharmacological effects on smoking in the psychotic patient, these do not have such a relevant influence on the way these patients smoke since they are modulated by the intrinsic characteristics of the smoking habit itself, social factors and the setting (AU)