Sociodemographic characteristics and HIV risk behaviors of native-born and displaced Syrian men and transgender women who have sex with men in Lebanon.

HIV rates among men and transgender women who have sex with men (MTWSM) in Lebanon are consistent with a concentrated epidemic. Geopolitical and social circumstances leave these communities vulnerable to HIV spread. To document this risk encountered by Lebanese native and displaced Syrian MTWSM, participants, recruited by respondent driven sampling beginning with Syrian seeds, completed a survey with questions covering sociodemographic, behavioral, medical, and stigma, followed by opt-out HIV testing. Analyses included descriptive statistics and linear regression to differentiate between native Lebanese and Syrians who migrated after the onset of the civil war to identify correlations among sociodemographic factors, stigma, and risk behavior as a function of country of birth. Experienced and internalized stigmas were higher in the Syrian born MTWSM and correlated with elements of HIV risk. Combatting the intersectional stigmas of Syrian MTWSM in Lebanon would be most beneficial in mitigating HIV risk for these individuals.

RESUMEN: Las tasas de VIH entre hombres y mujeres transgénero que tienen sexo con hombres (HMTSH) en el Líbano son consistentes con una epidemia concentrada. Las circunstancias geopolíticas y sociales dejan a estas comunidades vulnerables a la propagación del VIH. Para documentar este riesgo al que se enfrentan los HMTSH nativos libaneses y HMTSH sirios desplazados, los participantes, reclutados mediante un muestreo impulsado por los encuestados que comenzó con semillas sirias, completaron una encuesta con preguntas que cubrían aspectos sociodemográficos, conductuales, médicos y de estigma, seguidas de una prueba de VIH de exclusión voluntaria. Los análisis incluyeron estadísticas descriptivas y regresión lineal para diferenciar entre libaneses nativos y sirios que emigraron después del inicio de la guerra civil para identificar correlaciones entre factores sociodemográficos, estigma y comportamiento de riesgo como función del país de nacimiento. Los estigmas experimentados e internalizados fueron más altos en los HMTSH nacidos en Siria y se correlacionaron con elementos de riesgo de VIH. Combatir los estigmas interseccionales de los HMTSH sirios en el Líbano sería lo más beneficioso para mitigar el riesgo de VIH para estos individuos.

Comparison of Predictive Immunohistochemical Marker Expression of Primary Breast Cancer and Paired Distant Metastasis using Surgical Material: A Practice-Based Study.

Parallel studies of primary breast carcinomas and corresponding distant metastases samples reveal considerable differences. Our aim was to highlight this issue from another perspective and provide further data based on 98 patient samples: 69 primary breast carcinoma and 85 distant metastases from bone, central nervous system (CNS) and lung (56 paired). Two independent series of immunohistochemical reactions with different antibodies for estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor 2 (Her2), along with HER2 fluroscence in situ hybridization (FISH) were performed on tissue microarrays to classify breast carcinoma and distant metastases samples into Luminal A, Luminal B-proliferating, Luminal B-HER2+, HER2+ and triple negative (TNBC) surrogate breast cancer groups. Correlation and agreement between the two assessments of ER and PgR were fair-to-moderate, and almost perfect for HER2 and Ki67. There was 40% discordance concerning immunophenotype between breast carcinomas and distant metastases. Most common metastatic site of ER+ breast carcinoma was the skeletal system (59.2%), whereas that of TNBCs was the CNS (58.8%) and lungs (23.5%). Distant metastases in bones were mostly luminal (54.3%), in the CNS, Luminal B (53.2%), and in the lung, TNBC (37.5%). The change of drugable properties of primary breast cancers in the respective bone and CNS metastases suggests that characterization of the metastasis is necessary for appropriate treatment planning.

Expression of proliferation markers Ki67, cyclin A, geminin and aurora-kinase A in primary breast carcinomas and corresponding distant metastases.

AIMS: To assess the expression of the following cell cycle regulatory proteins in primary metastatic breast carcinomas (MBCs) and on availability in matched distant metastases (DMs): Ki67, cyclin A, geminin and aurora-kinase A (aurkA); and to compare the expression of these markers in early MBC (EMBC) and late MBC separated into groups according to median time point on metastatic event occurred (28 months). METHODS: The expression of the above mentioned markers was analysed in a total of 47 primary MBCs and 59 DMs (out of which 37 were pairs) by immunohistochemistry. Fourteen breast carcinomas with no relapse over a 10-year follow-up period were utilised as control cases (CBC). RESULTS: Among the MBCs, 22 metastasised to the bone, 4 to the lung and 21 to the central nervous system (CNS). Geminin (p<0.001) and Ki67 (p=0.001) were increased in the MBCs while aurkA and cyclin A showed no difference when compared with CBCs. There were no differences between aurkA, cyclin A and geminin expression in MBCs and DMs in general. Expression of Ki67 was, however, elevated (p=0.027) in DMs. In CNS metastases all markers showed elevated expression as compared to MBCs. In bone metastases, geminin was lower (p<0.001) compared with primary MBCs. In the metastases of the lung, the evaluated markers did not show different expression. According to the median follow-up until the metastatic event, Ki67 was found to be significantly elevated in EMBC (p=0.018). CONCLUSIONS: Ki67 index and geminin distinguish a fraction of MBC with worse prognosis, showing increased levels in the latter in comparison to CBC being tumour-free over a 10-year follow-up period. Ki67 could possibly identify a group of MBCs that develop early DMs.

Trafficking of non-regulated secretory proteins in insulin secreting (INS-1) cells.

AIMS/HYPOTHESIS: Sorting of proinsulin to the regulated secretory pathway of pancreatic beta cells and retention of insulin in dense-core granules of this pathway is remarkably efficient. To monitor the specificity of these events, the secretion of two exogenous secretory proteins not known to carry information for sorting or retention in the regulated pathway was investigated in INS-1 cells. METHODS: SEGFP, a fusion protein consisting of a signal peptide N-terminal to EGFP (mutant green fluorescent protein with enhanced fluorescence) and secreted alkaline phosphatase (SEAP) were expressed in INS-1 cells by transfection and by infection with recombinant adenovirus, respectively. Secretion of SEGFP was monitored by quantitative western blotting and that of SEAP by its activity. RESULTS: Secreted alkaline phosphatase showed high basal secretion (6.6% total) but only modest (3.6-fold) stimulation of secretion by secretagogues, in keeping with secretion largely through the constitutive pathway. By contrast SEGFP had a secretory pattern similar to insulin, with low basal secretion (0.8% total) and 16-fold stimulation by secretagogues. Granular localization of SEGFP was confirmed by high resolution electron microscopy immunocytochemistry. Pulse-chase experiments indicated retention of SEGFP in granules at least 24 h after synthesis. The secretory SEGFP, but not cytosolic EGFP, formed disulphide-linked oligomers. This could be implicated in its regulated secretion. CONCLUSION/INTERPRETATION: These data indicate that in INS-1 cells SEGFP, but not SEAP, is unexpectedly handled as a regulated secretory protein and stored along with insulin in granules. This raises questions about the specificity and mechanism of the sorting of proteins to granules in INS-1 cells or their retention therein or both.

Frequency and photographs of HGM11 chromosome anomalies in bone marrow samples from 3,996 patients with malignant hematologic neoplasms.

This study establishes the prevalence of Human Gene Mapping 11 (HGM11) chromosome abnormalities in bone marrow (BM) samples from 3,996 patients with malignant hematologic disorders. Examination of the karyotype of the stemline in these patients showed that 71.6% had one abnormality and 26.4% had two or more; the remaining 2.1% had two different abnormal clones. We observed 9,431 chromosome abnormalities, of which 56% were structural and 44% numeric, but these figures varied slightly with karyotype complexity. Because the HGM11 committee studied published cases with a single chromosome abnormality to identify potential "primary anomalies," we examined the karyotype from our 2,860 patients with a single abnormality in their stemline. We observed all but 12 of the 34 HGM11 numeric abnormalities. Except for 21 patients with a +Y, we did not observe two or more patients with any non-HGM11 numeric abnormality. We observed 91 of the 124 HGM11 structural abnormalities and noted 6 that were not listed by HGM11, and each of these occurred in two or more patients. Among patients with two abnormal clones, 34% had a t(9;22)(q34;q11), del(20)(q11q13), or +8. In 50% of the males with two abnormal clones, one of the clones was -Y. We attempted to create a reference table that lists HGM11 abnormalities in hematologic disorders and their frequency in our series, the reported associated disorders, and photographs of representative chromosome abnormalities.