Expression of Wilms’ tumor gene (WT1) is associated with survival in malignant pleural mesothelioma

INTRODUCTION: Calretinin and Wilms' tumor gene (WT1) are mesothelial markers routinely used to confirm the diagnosis of malignant pleural mesothelioma (MPM). We investigated the prognostic value of calretinin and WT1 expression in predicting survival in a series of patients diagnosed with MPM in our institution. MATERIALS AND METHODS: Fifty-two patients diagnosed of MPM were retrospectively reviewed. Calretinin and WT1 were stained for IHC analysis in formalin-fixed, paraffin-embedded sections and positivity was considered for tumors with >1 % of tumor cells stained. Survival data were calculated by the Kaplan-Meier method and Cox regression was used to evaluate the prognostic value of the variables. RESULTS: Calretinin IHC expression was positive in 83.7 % of patients and WT1 in 78.1 %. A significant association of calretinin and WT1 expression with epithelial histology was detected (p = 0.030 and p = 0.010). We found a significant increase in OS in patients with epithelial subtype, PS1 and neutrophil-lymphocyte ratio (NLR) ≤5 (p < 0.05). In the IHC markers analysis, we found a significant increase in OS for patients with WT1 positive expression (16.4 vs. 2.3 m, p = 0.013), but not differences for calretinin expression (16.6 vs. 5.0 months, p = 0.37). In the multivariate analysis, epithelial histology and WT1 remained as significant prognostic factors for survival (p = 0.004 and p = 0.010, respectively). CONCLUSION: In our series of 52 MPM patients, epithelial histology, PS, NLR and WT1 expression are significant prognostic factors for survival. We concluded that WT1, but not calretinin, is a useful prognostic factor in MPM. The role of WT1 assessment is worth of prospective validation in future studies on MPM (AU)

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Expression of Wilms' tumor gene (WT1) is associated with survival in malignant pleural mesothelioma.

INTRODUCTION: Calretinin and Wilms' tumor gene (WT1) are mesothelial markers routinely used to confirm the diagnosis of malignant pleural mesothelioma (MPM). We investigated the prognostic value of calretinin and WT1 expression in predicting survival in a series of patients diagnosed with MPM in our institution. MATERIALS AND METHODS: Fifty-two patients diagnosed of MPM were retrospectively reviewed. Calretinin and WT1 were stained for IHC analysis in formalin-fixed, paraffin-embedded sections and positivity was considered for tumors with >1 % of tumor cells stained. Survival data were calculated by the Kaplan-Meier method and Cox regression was used to evaluate the prognostic value of the variables. RESULTS: Calretinin IHC expression was positive in 83.7 % of patients and WT1 in 78.1 %. A significant association of calretinin and WT1 expression with epithelial histology was detected (p = 0.030 and p = 0.010). We found a significant increase in OS in patients with epithelial subtype, PS1 and neutrophil-lymphocyte ratio (NLR) ≤5 (p < 0.05). In the IHC markers analysis, we found a significant increase in OS for patients with WT1 positive expression (16.4 vs. 2.3 m, p = 0.013), but not differences for calretinin expression (16.6 vs. 5.0 months, p = 0.37). In the multivariate analysis, epithelial histology and WT1 remained as significant prognostic factors for survival (p = 0.004 and p = 0.010, respectively). CONCLUSION: In our series of 52 MPM patients, epithelial histology, PS, NLR and WT1 expression are significant prognostic factors for survival. We concluded that WT1, but not calretinin, is a useful prognostic factor in MPM. The role of WT1 assessment is worth of prospective validation in future studies on MPM.

Cost containment and totally extraperitoneal laparoscopic herniorrhaphy.

BACKGROUND: Surgeons who favor the laparoscopic repair of groin hernias are under pressure to contain the additional hospital costs associated with this technique, which is not universally acknowledged to be superior to less expensive open repairs. The purpose of this study was to compare costs and quality for TEP (total extraperitoneal) herniorrhaphy performed with and without balloon dissection and disposable cannulas. METHODS: We studied 92 TEP patients. The first 36 patients (group 1) were repaired using balloon dissection and disposable cannulas. The next 37 patients (group 2) were repaired with nondisposable access cannulas, without balloon dissection and with disposable working ports. The final 19 patients (group 3) were repaired just as in group 2 except that all cannulas were nondisposable. RESULTS: The demographic data and complications were comparable for all three groups. The average hospital cost per case for group 1 procedures was $2,099; for group 2, it was $1,920; and for group 3, it was $1,607. Costs for patients decreased comparably but for different reasons. Also reviewed were 20 patients who underwent Lichtenstein repairs during the study period. The average hospital cost for these repairs was $1,556. This group was not randomized with TEP groups, and the selection criteria were different; hence, data comparing the Lichtenstein and TEP procedures were not analyzed statistically. CONCLUSION: Costs can be significantly reduced and quality maintained when performing TEP herniorrhaphy without balloon dissection using nondisposable cannulas.

Vacuum-assisted closure versus saline-moistened gauze in the healing of postoperative diabetic foot wounds.

Diabetic foot wounds present a great challenge to wound care practitioners. The objective of this pilot study was to determine whether vacuum-assisted closure (V.A.C.) therapy would afford quicker wound resolution as compared to saline-moistened gauze in the treatment of postoperative diabetic foot wounds. Ten patients were randomized into either the experimental V.A.C. group or control saline gauze group. Included in the study were diabetic patients 18 to 75 years of age who had a nonhealing foot ulceration. Excluded were those patients with venous disease, coagulopathy, or those who had active infections not resolved by initial surgical debridement. All foot ulcers were surgically debrided prior to initiation of V.A.C. or gauze treatment. In the experimental group, V.A.C. dressings were applied in accordance with manufacturer's protocol for chronic wounds and changed every 48 hours. In the control group, saline gauze dressings were applied at the time of surgical debridement and changed twice a day thereafter. Measurements and photos were obtained to document wound progress. Main outcome measures included: 1) time to satisfactory healing (calculated from date of initial debridement to date of definitive closure, and 2) change in wound surface area (calculated from initial wound tracing to final tracing). Satisfactory healing in the V.A.C. group was achieved in 22.8 (+/- 17.4) days, compared to 42.8 (+/- 32.5) days in the control group. Surface area changes of 28.4% (+/- 24.3) average decrease in wound size in the V.A.C. group, compared to a 9.5% (+/- 16.9) average increase in the control group during measurement period.

[Physicochemical and microbiological evaluation of 3 commercial guava jams (Psidium guajava L.)]. / Evaluación fisicoquimica y microbiológica de tres mermeladas comerciales de guayaba (Psidium guajava L.).

Four different production batches were taken from each brand. Samples were purchased from retail markets in Maracay, Cagua and Turmero. (Venezuela). The average physical and chemical values were: vacuum = 38.81 cm Hg; pH = 3.28; titrable acidity (%citric acid) = 0.59%; degree Brix = 67.24; reducing sugars = 55.28%; total sugars = 62.28, and the color parameters a = +14.44, b = +8.77 and L = 17.09. Molds, yeast and aerobic plate counts were lower than 10 UFC/g; it reveals an excellent microbiological quality of the product. The studied jams degree Brix and acidity fulfil COVENIN (1) requirements for jam products, but not pH range. In agreement with variance analysis, there were highly significance differences between the samples and among the shares of each sample for all physical and chemical properties evaluated.

Identification of Aeromonas strains of clinical origin with atypical phenotypical profiles

A total of 47 strains of Aereomonas isolated from patients with gastroenteritis was analyzed for 40 phenotypical characters and for evaluating the numeric taxonomy based on 27 discriminatory tests. It was proved that the clinical isolates showed a relative phenotypical distance and the groups of strains that had atypical profiles were compared with the type species by the present identification schemes.

Identification of Aeromonas strains of clinical origin with atypical phenotypical profiles.

A total of 47 strains of Aereomonas isolated from patients with gastroenteritis was analyzed for 40 phenotypical characters and for evaluating the numeric taxonomy based on 27 discriminatory tests. It was proved that the clinical isolates showed a relative phenotypical distance and the groups of strains that had atypical profiles were compared with the type species by the present identification schemes.

[Anthropometric characteristics of obese women before and after weight reduction]. / Características antropométricas de mujeres obesas antes y después de un tratamiento reductor.

Anthropometric changes in 53 premenopausal obese women, 25-45 year-old, after an obesity treatment, were analyzed. Before and immediately after treatment, midarm, abdomen, waist, hip, midthigh and midcalf circumferences, as well as tricipital, bicipital, suprailiac, subscapular, abdominal and calf skinfold thickness were measured. The later averaged over percentil 75th. All final measurements, except midcalf circumference, abdomen/waist and hip/midthigh indexes, were significantly lowers as compared with the initial values. Body weight decreased on average 8.9 kg, and skinfold thickness mean fell below the 75th percentile. Percentage body fat decreased 18.3%, and body mass index 11%. Initial principal component analysis results, exhibited three chief characteristics of obesity: general adiposity; trunk vs. extremity fatness, and upper vs. lower fatness. Body fat distribution pattern and body composition were modified as a result of the treatment. Therefore, the morbidity risk associated with them, was substantially reduced.

[The antimicrobial sensitivity and plasmid isolation in Plesiomonas shigelloides]. / Susceptibilidad antimicrobiana y aislamiento de plásmidos en Plesiomonas shigelloides.

30 strains of Plesiomonas shigelloides isolated from patients with acute diarrheal disease at different health centers of the country were studied. The were phenotypically characterized by conventional biochemical tests and the antimicrobial susceptibility to 11 drugs was determined by the Kirby Bauer's method. It was found that the strains of Plesiomonas shigelloides were sensitive to 7 and resistant to 6 of the investigated drugs. The presence of plasmids in 12 of the 29 analyzed strains was determined and the diversity in their plasmidic patterns was proved.

[Aeromonas hydrophila pneumonia associated with a traffic accident. Report of a case]. / Neumonía por aeromonas hydrophila asociada a un accidente de tránsito. Reporte de un caso.

The case of a patient who was driving a car after getting drunk is presented. His car turned over and he fell into an irrigation canal, and, as a result, he suffered from an incomplete drowning syndrome. He was admitted in the Intensive Care Unit with acute inflammatory pneumonia and a strain of Aeromonas hydrophila was isolated in blood. The patient's evolution was favorable. It is the first report on a case like this in our country.

[The application of the hybridization in colonies technic for the identification of toxigenic Vibrio cholerae 01]. / Aplicación de la técnica de hibridación en colonias para la identificación de Vibrio cholerae 01 toxigénico.

By means of the polymerase chain reaction (PCR) it was obtained a probe for the gen that codifies the subunit B of cholerae toxin (CTxB), which carried a Vibrio cholerae 01 reference strain. The checking of the amplified product was performed by using the hybridization techniques in colonies. This product hybridized with the gen that codifies for the subunit B of cholerae toxin isolated from Peru and Ecuador, representing the present epidemics in Latin America, but it did not so with the phylogenetically related strains.

[Phenotype markers in strains of Aeromonas isolated in Cuba from children with an acute diarrheic disease]. / Marcadores fenotípicos en cepas de Aeromonas aisladas en Cuba de niños con enfermedad diarreica aguda.

Twenty-seven cases of Aeromonas isolated from 300 five-years children with acute diarrheal disease (EDA) were studied, with the aim for demonstrating the occurrence of some phenotypical markers associated with enteropathogenicity; among them were lysine decarboxylation, acetil methyl carbinol production, enterotoxigenicity, cytotoxicity and hemolysis. The percentage of analysed strains had two or more of the investigated markers, and 13 (48.1%) lysed the rabbit erythrocytes with titres higher than than 1:16. The presence of markers in Aeromonas hydrophila, Aeromonas sobria, and Aeromonas caviae was demonstrated.

[Septicemia due to Shigella. A case report and review of the literature]. / Septicemia por Shigella. Presentación de un caso y revisión de la literatura.

Knowing that the isolation of Shigella in blood is considered as an unusual medical event, a case of an infant deceased from septicemia by Shigella sonnei is presented here. This is the first case of the kind reported in Pinar del Río province. A review of the literature is included.

[The identification of Aeromonas species isolated in Cuba]. / Identificación en especies de Aeromonas aisladas en Cuba.

100 Aeromonas strains, isolated from children under 5 years with acute diarrheal diseases from various health centers of the country, were studied from January to July, 1990. Using the Janda-modified Popoff's and Veron's model, 63% of the strains were identified in species through primary tests, and 100% of the other 37% were identified in Aeromonas sobria, Aeromonas hydrophila, and Aeromonas caviae, using also supplementary tests.

[Identification of gram negative, facultative anaerobic, oxidase positive bacilli]. / Identificación de bacilos gramnegativos, anaerobios facultativos, oxidasas positivos.

We identified 100 strains of Gram-negative, oxidase-positive bacilli, facultative anaerobes, isolated from different human pathological products by conventional biochemical methods. From the total number of strains studied, 1 corresponded to genus Vibrio, 66 to genus Aeromonas, and 33 to genus Plesiomonas. It is of the utmost importance to conduct surveillance studies of these microorganisms in order to investigate their circulation in Cuba.

[CAMP factor for the differentiation among Aeromonas species]. / Factor CAMP para la diferenciación en especies de Aeromonas.

The CAMP factor technique, described by Natale Figura as a presumptive method for the differentiation of the species hydrophila, sobria and caviae, was applied to 80 Aeromonas strains isolated from children under 5 years with acute diarrheic disease. The typical phenomenon was seen in aerobiosis and anaerobiosis conditions in 10 strains, which were classified as Aeromonas hydrophila. In aerobiosis conditions/alone, it was observed in 20 strains, which were identified as Aeromonas sobria. It was not observed in either of the incubation conditions above mentioned in 50 of the remaining strains, which were identified as Aeromonas caviae. The advantages of applying this new technique is emphasized.

[Identification of species of microorganisms of the genus Vibrio]. / Identificación de especies de microorganismos del género Vibrio.

During 1988, a study was made on 61 microorganisms, genus Vibrio, which were received at the National Reference Laboratory for Acute Diarrheic Diseases. Pedro Kouri Institute of Tropical Medicine. Of them, 46 were from children with acute diarrheic disease and 15 were isolated from the environment. By means of biochemical tests. 61 Vibrio cholerae No. 01. 9 Vibrio parahaemolyticus and 1 Vibrio alginolyticus were identified. Emphasis is placed upon the importance of keeping a systematic surveillance upon these microorganisms in Cuba.

[Isolation and identification of Vibrio genus microorganisms in the Quibu River]. / Aislamiento e identificación de microorganismos del género Vibrio en las aguas del río Quibú.

The Quibú River sewages were studied during 9 weeks, in order to isolate and characterize Vibrio genus microorganisms. Twenty Moore's hyssops were placed 2 or 3 times a week on the banks of the river, where each of them was kept in a passive capture stay for 24 hours. In all the hyssops placed, Vibrio cholerae non-01 were isolated.

[Identification of microorganisms of the Vibrio genus using the method of sample combination]. / Identificacion de microorganismos del genero Vibrio por el metodo de combinacion de muestras.

In order to apply a more rapid, economic and effective method for the isolation of microorganisms of the genus Vibrio. 400 samples of feces from passengers hospitalized at the "Pedro Kouri" Tropical Medicine Institute, Searching Ward, were processed by the combination method. In this study the feces were grouped in combinations of ten; in this way 40 coprocultures were performed. The isolation was carried on enriching the samples in alkaline peptone at pH 8.6 and subcultures in thiosulfate citrate bile salts sucrose agar were performed.