RESUMEN
OBJECTIVE: To evaluate the relation between serum total testosterone (TT) and prostate cancer (PCa) grade and the effect of race and demographic characteristics on such association. METHOD: We analyzed 695 patients undergoing radical prostatectomy (RP), of whom 423 had serum TT collected. Patients were classified as having hypogonadism or eugonadism based on two thresholds of testosterone: threshold 1 (300 ng/dL) and threshold 2 (250 ng/dL). We evaluated the relation between TT levels and a Gleason score (GS) ≥ 7 in RP specimens. Outcomes were evaluated using univariate and multivariate analyses, accounting for race and other demographic predictors. RESULTS: Out of 423 patients, 37.8% had hypogonadism based on the threshold 1 and 23.9% based on the threshold 2. Patients with hypogonadism, in both thresholds, had a higher chance of GS ≥ 7 (OR 1.79, p=0.02 and OR 2.08, p=0.012, respectively). In the multivariate analysis, adjusted for age, TT, body mass index (BMI) and race, low TT (p=0.023) and age (p=0.002) were found to be independent risk factors for GS ≥ 7. Among Black individuals, low serum TT was a stronger predictor of high-grade disease compared to White men (p=0.02). CONCLUSION: Hypogonadism is independently associated to higher GS in localized PCa. The effect of this association is significantly more pronounced among Black men and could partly explain aggressive characteristics of PCa found in this race.
Asunto(s)
Hipogonadismo/sangre , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/sangre , Testosterona/sangre , Testosterona/deficiencia , Humanos , Hipogonadismo/complicaciones , Hipogonadismo/etnología , Masculino , Clasificación del Tumor , Pronóstico , Neoplasias de la Próstata/complicaciones , Neoplasias de la Próstata/etnología , Neoplasias de la Próstata/patología , Estudios Retrospectivos , Factores de RiesgoRESUMEN
Summary Objective: To evaluate the relation between serum total testosterone (TT) and prostate cancer (PCa) grade and the effect of race and demographic characteristics on such association. Method: We analyzed 695 patients undergoing radical prostatectomy (RP), of whom 423 had serum TT collected. Patients were classified as having hypogonadism or eugonadism based on two thresholds of testosterone: threshold 1 (300 ng/dL) and threshold 2 (250 ng/dL). We evaluated the relation between TT levels and a Gleason score (GS) ≥ 7 in RP specimens. Outcomes were evaluated using univariate and multivariate analyses, accounting for race and other demographic predictors. Results: Out of 423 patients, 37.8% had hypogonadism based on the threshold 1 and 23.9% based on the threshold 2. Patients with hypogonadism, in both thresholds, had a higher chance of GS ≥ 7 (OR 1.79, p=0.02 and OR 2.08, p=0.012, respectively). In the multivariate analysis, adjusted for age, TT, body mass index (BMI) and race, low TT (p=0.023) and age (p=0.002) were found to be independent risk factors for GS ≥ 7. Among Black individuals, low serum TT was a stronger predictor of high-grade disease compared to White men (p=0.02). Conclusion: Hypogonadism is independently associated to higher GS in localized PCa. The effect of this association is significantly more pronounced among Black men and could partly explain aggressive characteristics of PCa found in this race.
Resumo Objetivo: Avaliar a relação entre testosterona sérica total (TT) e grau do câncer de próstata (CP) e o efeito da raça e de características demográficas sobre essa associação. Método: Foram analisados 695 pacientes submetidos a prostatectomia radical (PR), dos quais 423 tinham medidas dos níveis séricos de TT. Os pacientes foram classificados como portadores de hipogonadismo ou eugonadismo com base em dois limites de testosterona: limite 1 (300 ng/dL) e limite 2 (250 ng/dL). Avaliou-se a relação entre nível de TT e escore Gleason (GS) ≥ 7 em amostras de PR. Os resultados foram avaliados por análises univariada e multivariada, com ajuste para raça e outros fatores prognósticos demográficos. Resultados: Do total de 423 pacientes, 37,8% apresentavam hipogonadismo com base no limite 1, e 23,9% com base no limite 2. Os pacientes com hipogonadismo, independentemente do limite de referência, tiveram uma chance maior de GS ≥ 7 (OR 1,79, p=0,02 e OR 2,08, p=0,012, respectivamente). Na análise multivariada, após ajuste para idade, TT, índice de massa corporal (IMC) e raça, baixo TT (p=0,023) e idade (p=0,002) foram considerados fatores de risco independentes para GS ≥ 7. Entre os indivíduos negros, baixo TT sérico foi mais preditivo de doença de alto grau em comparação com os brancos (p=0,02). Conclusão: O hipogonadismo é independentemente associado a escores mais altos de GS no CP localizado. O efeito dessa associação é significativamente mais pronunciado entre homens negros, o que poderia explicar, em parte, as características agressivas do CP observadas nessa população.
Asunto(s)
Humanos , Masculino , Neoplasias de la Próstata/sangre , Testosterona/deficiencia , Testosterona/sangre , Antígeno Prostático Específico/sangre , Hipogonadismo/sangre , Pronóstico , Neoplasias de la Próstata/complicaciones , Neoplasias de la Próstata/etnología , Neoplasias de la Próstata/patología , Estudios Retrospectivos , Factores de Riesgo , Clasificación del Tumor , Hipogonadismo/complicaciones , Hipogonadismo/etnologíaRESUMEN
Chromosome microarray analysis of patients with developmental delay has provided evidence of small deletions or duplications associated with this clinical phenotype. In this context, a 7.1- to 8.7-Mb interstitial deletion of chromosome 16 is well documented, but within this interval a rare 200-kb deletion has recently been defined that appears to be associated with obesity, or developmental delay together with overgrowth. We report a patient carrying this rare deletion, who falls into the latter clinical category, but who also carries a second very rare deletion in 13q31.3. It remains unclear if this maternally inherited deletion acts as a second copy number variation leading to pathogenic variation, or is non-causal and the true modifiers are yet to be determined.
Asunto(s)
Deleción Cromosómica , Cromosomas Humanos Par 13/genética , Cromosomas Humanos Par 16/genética , Discapacidades del Desarrollo/complicaciones , Discapacidades del Desarrollo/genética , Trastornos del Crecimiento/complicaciones , Trastornos del Crecimiento/genética , Preescolar , Predisposición Genética a la Enfermedad , Humanos , MasculinoRESUMEN
The infective behavior of a mutant Trypanosoma cruzi clone, carrying a targeted deletion of the gp72 gene, was studied in the insect vector Triatoma infestans and in mice. After feeding T. infestans with complement-resistant forms (CRF) of Ynull and wild-type clones, it was observed that the number of parasites released in the bug's feces was reduced to less than 1% in the mutant clone. Both gp72-null and wild-type clones had a low infectivity for mice in comparison with other T. cruzi isolates, probably as a consequence of prolonged in vitro culture. Therefore, the behavior of both clones was tested in highly susceptible BALB suckling mice and immunodeficient athymic mice. After infecting the animals with 10(5) CRF, wild-type parasites could be detected in fresh blood mounts of most mice, but mutants were never found by this method. However, in 4 of 22 hemocultures from 11 athymic mice, gp72-null epimastigotes carrying the mutant phenotype were reisolated by day 29 of infection. Serological and polymerase chain reaction determinations performed on the blood of animals inoculated with the mutants indicated the possibility of temporary infections, which were extinguished after 90 days. The intact GP72 gene seems essential for sustaining latent infections in immunocompetent animals.
Asunto(s)
Insectos Vectores/parasitología , Fosfoproteínas/genética , Proteínas Protozoarias/genética , Trypanosoma cruzi/genética , Trypanosoma cruzi/patogenicidad , Animales , Animales Lactantes , Anticuerpos Antiprotozoarios/sangre , ADN Protozoario/química , ADN Protozoario/genética , Eliminación de Gen , Corazón/parasitología , Histocitoquímica , Ratones , Ratones Endogámicos BALB C , Ratones Desnudos , Músculo Esquelético/parasitología , Mutación , Parasitemia , Fosfoproteínas/inmunología , Reacción en Cadena de la Polimerasa , Proteínas Protozoarias/inmunología , Triatoma/parasitología , Trypanosoma cruzi/inmunología , Vejiga Urinaria/parasitologíaRESUMEN
BACKGROUND: Dengue, a mosquito-transmitted viral disease, is a risk for visitors in tropical and subtropical areas. Several participants in a community-assistance program in Tortola, British Virgin Islands, in August, 1995, reported dengue-like symptoms either before or soon after leaving the island. METHODS: We conducted a retrospective cohort study to determine the extent of the outbreak, risk factors for illness, and the proportion of inapparent infections. Program participants were interviewed by telephone or mail, and asked to submit a serum sample for dengue diagnosis. A clinically-diagnosed case of dengue was defined as a person with fever and two or more of the following: headache, retro-orbital pain, myalgia, arthralgia, rash, or hemorrhagic manifestations. Serum specimens were tested for virus isolation, polymerase chain reaction (PCR), plaque-reduction neutralization (PRNT) or anti-dengue IgM and IgG antibody. RESULTS: Thirty-two (97%) of the 33 program participants responded; 21 of the 32 (66%) provided at least one serum sample for study. The median age was 17 years; 20 (62%) were women. Of 32 respondents, 22 (69%) met the clinical case definition for dengue: 15 of them (68%) had a positive IgM antibody response and 7 did not submit a serum sample. Dengue 1 virus (DEN-1) was identified by PCR in one case and all 11 positive PRNT results. No asymptomatic infections were identified. No respondent used effective mosquito repellent, and only 2 (6%) used bednets. CONCLUSIONS: A DEN-1 outbreak with a high attack rate (69%) occurred in a group of young short-term community aid workers. There were no asymptomatic infections documented. Participants' rare use of bednets or effective mosquito repellent highlights the importance of providing travelers to tropical areas with information about dengue fever and the recommended precautions to protect against infection.
Asunto(s)
Dengue/epidemiología , Brotes de Enfermedades , Viaje , Adolescente , Anticuerpos Antivirales/sangre , Dengue/diagnóstico , Virus del Dengue/aislamiento & purificación , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Masculino , Reacción en Cadena de la Polimerasa , Sistemas de Socorro , Estudios Retrospectivos , Factores de Riesgo , Indias Occidentales/epidemiologíaRESUMEN
Analisaram-se retrospectivamente 94 paciente submetidos à toracotomia de urgência por trauma que apresentavam sinais vitais ao chegar ao centro cirúrgico do Hospital da RetauraçÝo- Recife. O quadro clínico predominante à admissÝo e o principal critério de indicaçÝocirúrgica foi o choque hipovolêmico. Haviam lesSes extra-torácicas associadas em 43 pacientes (45,7por cento). Os órgÝos mais acometidos foram pulmÝo esquerdo (34,0por cento), pulmÝo direito(24,5por cento) e coraçÝo (22,3por cento). Trinta e quatro pacientes (36,2por cento) apresentaram complicaçSes, predomínio de caáter infeccioso. NÝo houve correlaçÝo estatisticamente significativa entre o regime antibioótico usado e a presença de complicaçSes pós-operatórias. Onze pacientes (11,7por cento) foram à óbito, sendo cinco (45,6por cento) destes devido à complicaçSes infecciosas. Todos estes a partir do terceiro dia pós-operatório. Os demais óbitos foram relacionados à gravidade do trauma. A presença de lesSes extra-torácicas associou-se de forma estatisticamente significativa com o desenvolvimento de complicaçSes pós-operatórias e com a mortalidade(p<0,05). As complicaçSes pós-operatórias que exigiram reoperaçÝo e a presença de peritonite estiveram de forma estatisticamente significativa relacionados com a mortalidade (p<0,05). Pacientes com trauma cardíaco nas condiçSes estidadas apresentaram baixa mortalidade