Age-specific risk factor profiles of adenocarcinomas of the esophagus: a pooled analysis from the international BEACON consortium

Esophageal (EA) and esophagogastric junction (EGJA) adenocarcinoma have been steadily increasing in frequency in younger people, however the etiology of these cancers is poorly understood. We therefore investigated associations of body- mass index (BMI), cigarette smoking, alcohol consumption, gastroesophageal reflux, and use of non-steroidal anti-inflammatory drugs (NSAIDs) in relation to age-specific risks of EA and EGJA. We pooled individual participant data from eight population-based, case-control studies within the international Barrett’s and Esophageal Adenocarcinoma Consortium (BEACON). The analysis included 1,363 EA patients, 1,472 EGJA patients, and 5,728 control participants. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for age-specific (<50, 50–59, 60–69, ≥70 years) cancer outcomes, as well as interactions by age. BMI, smoking status and pack-years, recurrent gastroesophageal reflux, and frequency of gastroesophageal reflux were positively associated with EA and EGJA in each age group. Early-onset EA (<50 years) had stronger associations with recurrent gastroesophageal reflux (OR=8.06, 95%CI: 4.52, 14.37; Peffect modification=0.01) and BMI (ORBMI ≥30 vs. <25=4.19, 95%CI: 2.23, 7.87; Peffect modification=0.04), relative to older age groups. In contrast, inverse associations of NSAID use were strongest in the oldest age group (≥70 years), although this apparent difference was not statistically significant. Age-specific associations with EGJA showed similar, but slightly weaker patterns and no statistically significant differences by age were observed. Our study provides evidence that associations between obesity and gastroesophageal reflux are stronger among earlier onset EA cancers.

Polymorphism and physiology of arsenate tolerance in Holcus lanatus L. from an uncontaminated site

The polymorphism of arsenate tolerance in a Holcus lanatus L. population from an uncontaminated soil was investigated and a high percentage of tolerant individuals (65%) was found in the population studied. Influx of arsenate was highly correlated to arsenate tolerance within the population, with the most tolerant individuals having the lowest rates of arsenate influx. Isotherms for the high affinity arsenate uptake systems were determined in six tolerant and six non-tolerant genotypes. Tolerant plants had the lowest rates of arsenate influx. This was achieved by adaptation of the V_max of arsenate influx with the V_max of the high affinity uptake system saturating at lower substrate concentrations in the tolerant plants. The polymorphism is discussed with relation to adaptation to the extreme environments to which the plants are subjected on mine-spoil soils. © 1992 Kluwer Academic Publishers.

Nonsteroidal Anti-Inflammatory Drug Use is Not Associated With Reduced Risk of Barrett’s Esophagus

OBJECTIVES: Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with a reduced risk of esophageal adenocarcinoma. Epidemiological studies examining the association between NSAID use and the risk of the precursor lesion, Barrett’s esophagus, have been inconclusive.

METHODS: We analyzed pooled individual-level participant data from six case-control studies of Barrett’s esophagus in the Barrett’s and Esophageal Adenocarcinoma Consortium (BEACON). We compared medication use from 1474 patients with Barrett’s esophagus separately with two control groups: 2256 population-based controls and 2018 gastroesophageal reflux disease (GERD) controls. Study-specific odds ratios (OR) and 95% confidence intervals (CI) were estimated using multivariable logistic regression models and were combined using a random effects meta-analytic model.

RESULTS: Regular (at least once weekly) use of any NSAIDs was not associated with the risk of Barrett’s esophagus (vs. population-based controls, adjusted OR = 1.00, 95% CI = 0.76–1.32; I2=61%; vs. GERD controls, adjusted OR = 0.99, 95% CI = 0.82–1.19; I2=19%). Similar null findings were observed among individuals who took aspirin or non-aspirin NSAIDs. We also found no association with highest levels of frequency (at least daily use) and duration (≥5 years) of NSAID use. There was evidence of moderate between-study heterogeneity; however, associations with NSAID use remained non-significant in “leave-one-out” sensitivity analyses.

CONCLUSIONS: Use of NSAIDs was not associated with the risk of Barrett’s esophagus. The previously reported inverse association between NSAID use and esophageal adenocarcinoma may be through reducing the risk of neoplastic progression in patients with Barrett’s esophagus.

Effect of water chemistry on the physiology and toxicity assessment in Daphnia

Todos os sistemas aquáticos estão potencialmente expostos a alterações nos parâmetros da água em consequência de fenómenos ambientais tais como deposição ácida, lixiviação de iões dos solos e alterações climáticas. Dado que os parâmetros químicos da água estão geralmente correlacionados, é pertinente estudar os seus efeitos combinados para o biota aquático. Assim, o principal objetivo desta tese é avaliar a importância ecológica da variação simultânea dos principais parâmetros fisico-químicos da água nos parâmetros de história de vida dos crustáceos tanto na ausência como na presença de metais. Foram estudados os seguintes parâmetros: dureza (0.5 - 3.5 mM), alcalinidade (0.3 - 2.3 mM), pH (5.7 - 9.0) e temperatura (13 - 30ºC). A Daphnia magna foi usada como espécie modelo representando os crustáceos aquáticos. A variação simultânea da dureza e alcalinidade afetou significativamente o crescimento, reprodução e crescimento populacional de Daphnia; no entanto, os efeitos da dureza excederam os efeitos da alcalinidade. Pareceu haver interação entre a dureza e alcalinidade na reprodução dos dafnídeos, o que sugere que os efeitos da variação da dureza para Daphnia e provavelmente outros crustáceos poderão depender do nível de alcalinidade. O pH e dureza da água exerceram efeitos combinados para Daphnia, sendo os efeitos do pH mais pronunciados do que os efeitos da dureza. A diminuição do pH reduziu a sobrevivência, crescimento, reprodução, taxa de ingestão e crescimento populacional dos dafnídeos. No entanto, os efeitos do pH baixo foram mais adversos a baixa dureza, o que sugere uma interação entre estes parâmetros. Assim, a diminuição do pH em lagos de água mole pode ser um estressor determinante para os crustáceos sensíveis à acidez, ameaçando a sua sobrevivência e, consequentemente, afetando a estrutura das cadeias alimentares aquáticas. A temperatura e a química da água (dureza e alcalinidade) interagiram entre si nos parâmetros de história de vida de Daphnia; no entanto, os efeitos da temperatura excederam os efeitos da química da água. De um modo geral, temperaturas extremas reduziram o crescimento, reprodução e, consequentemente, o crescimento populacional de Daphnia. Os efeitos do aumento da temperatura foram mais adversos a baixa dureza e alcalinidade, aumentando a preocupação com os efeitos ecológicos do aquecimento global em águas moles. A dureza e alcalinidade da água também desempenharam um papel importante na toxicidade aguda e subletal (inibição da ingestão) dos metais para Daphnia. A diminuição da dureza aumentou a toxicidade aguda do zinco. Por outro lado, a diminuição da alcalinidade aumentou a toxicidade aguda e subletal do cobre, mas reduziu a toxicidade subletal do zinco, tornando evidente o importante papel da alcalinidade na toxicidade subletal dos metais para Daphnia. Globalmente, os parâmetros fisico-químicos da água parecem interagir entre si, afetando os parâmetros de história de vida e o crescimento populacional de Daphnia e também afetam a toxicidade dos metais. Em particular, a baixa dureza agrava os efeitos adversos da diminuição do pH, aumento da temperatura e toxicidade dos metais, o que aumenta a preocupação com os efeitos ecológicos da sua variação simultânea sobre os crustáceos e, portanto, sobre as cadeias alimentares aquáticas.

Physiology and metabolic profile of Moringa olifera and Eucalyptus globulus plants subjected to climate changes

As alterações climáticas emergentes têm um grande impacto no crescimento e desenvolvimento de espécies florestais, nomeadamente em espécies de valor industrial e medicinal, como é o caso do eucalipto (Eucalyptus globulus) e da moringa (Moringa oleifera). Assim, é urgente conhecer as respostas fisiológicas e entender as variações que ocorrem nos perfis metabólicos de espécies vegetais. Neste trabalho, plantas jovens de Eucalyptus globulus foram expostas a radiação UVB (12kJ/m2) e foram avaliadas as respostas fisiológicas e o perfil metabólico, um e onze dias após a aplicação da radiação. A dose de UVB usada não afetou as reações fotoquímicas nem as trocas gasosas, contudo ao nível do metabolismo do carbono (AST e amido) e do conteúdo de pigmentos verificaram-se pequenas alterações (AST e pigmentos). Através da análise do perfil metabólico de E. globulus foram encontrados compostos voláteis e semi-voláteis pertencentes às famílias dos terpenos, sesquiterpenos e aldeídos. Em geral, os sesquiterpenos e os álcoois monoterpénicos apresentaram uma tendência para manter e, em alguns casos, diminuir com o stress, enquanto que o grupos dos aldeídos aumentou e os monoterpenos apresentaram um comportamento mais heterogéneo. O E. globulus mostrou ser uma espécie tolerante à aplicação da dose de UVB usada neste trabalho. Por outro lado, plantas jovens de M. oleifera foram expostas a défice hídrico (DH). Um grupo de plantas foi recolhido um dia após o final da exposição e o outro grupo após onze dias do final da exposição. Foi avaliado o perfil metabólico desta espécie através de GC/MS. Os dados cromatográficos indicaram que em condições de stress (DH(1) e DH(11)), as quantidades de compostos associados a vias primárias e secundárias de defesa (como os alcanos, álcoois, ácidos carboxílicos, esteróis, aminoácidos e açucares) sofreram algumas alterações. As plantas analisadas 11 dias após a remoção do stress mostraram maiores variações do perfil de metabolitos. No entanto, tanto um como onze dias após a remoção do stress, as plantas apresentaram a formação de novos rebentos. Apesar do perfil de metabolitos ter sofrido algumas alterações, por não se registarem casos de morte, conclui-se que as plantas de moringa mostraram ser tolerantes aos tratamentos aplicados.

Impact of multi-metals (Cd, Pb and Zn) exposure on the physiology of the yeast Pichia kudriavzevii

Metal contamination of the environment is frequently associated to the presence of two or more metals. This work aimed to study the impact of a mixture of metals (Cd, Pb and Zn) on the physiology of the non-conventional yeast Pichia kudriavzevii. The incubation of yeast cells with 5 mg/l Cd, 10 mg/l Pb and 5 mg/l Zn, for 6 h, induced a loss of metabolic activity (assessed by FUN-1 staining) and proliferation capacity (evaluated by a clonogenic assay), with a small loss of membrane integrity (measured by trypan blue exclusion assay). The staining of yeast cells with calcofluor white revealed that no modification of chitin deposition pattern occurred during the exposure to metal mixture. Extending for 24 h, the exposure of yeast cells to metal mixture provoked a loss of membrane integrity, which was accompanied by the leakage of intracellular components. A marked loss of the metabolic activity and the loss of proliferation capacity were also observed. The analysis of the impact of a single metal has shown that, under the conditions studied, Pb was the metal responsible for the toxic effect observed in the metal mixture. Intracellular accumulation of Pb seems to be correlated with the metals' toxic effects observed.

Modulation of electrical stimulation applied to human physiology and clinical diagnostic

The use, manipulation and application of electrical currents, as a controlled interference mechanism in the human body system, is currently a strong source of motivation to researchers in areas such as clinical, sports, neuroscience, amongst others. In electrical stimulation (ES), the current applied to tissue is traditionally controlled concerning stimulation amplitude, frequency and pulse-width. The main drawbacks of the transcutaneous ES are the rapid fatigue induction and the high discomfort induced by the non-selective activation of nervous fibers. There are, however, electrophysiological parameters whose response, like the response to different stimulation waveforms, polarity or a personalized charge control, is still unknown. The study of the following questions is of great importance: What is the physiological effect of the electric pulse parametrization concerning charge, waveform and polarity? Does the effect change with the clinical condition of the subjects? The parametrization influence on muscle recruitment can retard fatigue onset? Can parametrization enable fiber selectivity, optimizing the motor fibers recruitment rather than the nervous fibers, reducing contraction discomfort? Current hardware solutions lack flexibility at the level of stimulation control and physiological response assessment. To answer these questions, a miniaturized, portable and wireless controlled device with ES functions and full integration with a generic biosignals acquisition platform has been created. Hardware was also developed to provide complete freedom for controlling the applied current with respect to the waveform, polarity, frequency, amplitude, pulse-width and duration. The impact of the methodologies developed is successfully applied and evaluated in the contexts of fundamental electrophysiology, psycho-motor rehabilitation and neuromuscular disorders diagnosis. This PhD project was carried out in the Physics Department of Faculty of Sciences and Technology (FCT-UNL), in straight collaboration with PLUX - Wireless Biosignals S.A. company and co-funded by the Foundation for Science and Technology.

Endoscopic mucosal resection in the esophagus with a new rigide device : an animal study

Résumé: Introduction : L'utilisation de méthodes endoscopiques peu invasives est en constante augmentation pour le traitement des lésions tumorales précoces de l'oesophage. Le but du traitement comprend l'éradication complète de tous les foyers de dysplasie ou de carcinome in situ, notamment dans les métaplasies intestinales de l'oesophage de Barrett, qui peuvent dégénérer en adénocarcinome. Plusieurs techniques d'ablation de la muqueuse oesophagienne (laser, argon plasma, electrocoagulation, photothérapie dynamique, résection endoscopique) ont été utilisées jusqu'à présent, mais aucune n'a vraiment donné entière satisfaction. Les techniques actuelles de résections endoscopiques par fibroscopie sont entre autres limitées par le grand nombre de séances nécessaires à l'éradication complète de la lésion et par la petite taille des fragments de muqueuse obtenus, ce qui rend l'analyse histologique difficile. Dans notre étude animale, nous avons évalué la faisabilité, l'efficacité et la sécurité d'une méthode de résection endoscopique à l'aide d'un nouvel oesophagoscope rigide. Matériel et méthode : Le résectoscope est formé d'un oesophagoscope rigide avec une fenêtre distale transparente à travers laquelle la muqueuse et une partie de la sous-muqueuse sont aspirées et ensuite réséquées avec une anse thermique. Les diverses fenêtres utilisées ont une taille comprise entre 2.2 et 4.4 cm. Le mouton a été choisi en raison de la ressemblance de son oesophage avec celui de l'humain en ce qui concerne l'épaisseur de son oesophage et sa structure histologique. Nous avons effectué 55 résections hémi-circonférentielles sur 21 animaux et 11 résections circonférentielles sur 11 autres. La Mitomycine-C, une substance qui inhibe la prolifération fibroblastique, a été utilisée dans 8 résections circonférentielles à différents intervalles de temps afin d'empêcher la survenue de sténoses oesophagiennes. Résultats : Toutes les résections hémi-circonférentielles ont permis d'obtenir des fragments compacts de tissu avec des bords nets, ce qui permet une excellente étude histologique. La surface du tissu prélevé était en corrélation avec la taille de la fenêtre du resectoscope. Nous avons ainsi pu obtenir des fragments avec des dimensions comprises entre 6 et 12 cm2. Pour les résections circonférentielles, les tissus étaient obtenus en 2 parties, en inversant de 180° la position de l'appareil. La profondeur de la résection a été optimale dans 58 cas sur 65 avec une découpe précise au niveau de la sous-muqueuse sans lésion de la couche musculaire sous- jacente. Il n'y a pas eu de complications après les résections hémi-circonférentielles. Les complications engendrées par les résections circonférentielles (sténose, perforation) n'ont plus été rencontrées après application locale de Mitomycine-C administrée à des intervalles de temps bien précis. Conclusion : Notre méthode de résection endoscopique de la muqueuse oesophagienne offre une nouvelle approche très prometteuse par rapport aux options déjà disponibles. Elle apparaît supérieure en ce qui concerne la taille de tissu prélevé, la précision et régularité de la profondeur de résection, ainsi que la facilité et sûreté du diagnostic histologique et des marges de sécurité. Les résections hémi-circonférentielles se sont révélées sûres chez le modèle animal. Cette nouvelle technique mérite de plus amples investigations pour les résections circonférentielles avant son utilisation chez l'humain. Abstract: Background and Study Aims: We undertook this retrospective study to evaluate the frequency and prognosis of endoscopic treatment of laterally spreading tumors (LSTs) in the rectum. The recurrence rate for lesions of the lower rectum was compared with that of the upper rectum. Patients and Methods: During the period from July 1989 to June 2002, a total of 1237 rectal tumors were detected. LSTs accounted for 6.9% (85/1237) of all rectal tumors. A total of 224 tumors of the lower rectum were detected among the 1237 rectal tumors. LSTs accounted for 16.1 % (36/224) of all the lower rectal tumors. From 85 LST lesions, 67 were evaluated for their prognosis after endoscopic mucosal resection (EMR). Patients whose LSTs had been resected were followed up by endoscopy at the following frequencies: once 15 (22.4%); twice (more than 1 year), 20 (29.9%); three times (more than 3 years), 21(31.3%); and four times or more (more than 5 years), 11 (16.4%). Results: A total of 67 patients with endoscopically treated LSTs were followed up by endoscopy. We observed recurrences in two lesions of the upper rectum (2/38, 5.3%) and five lesions of the lower rectum (5/29, 17.2%) (P = 0.2364); all seven lesions were resected piecemeal. LSTs whose horizontal margin reached the pectinate line frequently recurred in the lower rectum, at a rate of 80% (4/5). However, all patients were completely cured by additional endoscopic resections, the greatest number of treatments being four. Conclusion: For early detection of recurrence and successful endoscopic cure, further colonoscopic examination within a few months after the first treatment is necessary.

The physiology of inscription : Foucault's genealogy as curative science

In ''Nietzsche, Genealogy, History," Foucault suggests that genealogy is a sort of "curative science." The genealogist must be a physiologist and a pathologist as well as an historian, for his task is to decipher the marks that power relations and historical events leave on the subjugated body; "he must be able to diagnose the illnesses of the body, its conditions of weakness and strength, its breakdowns and resistances, to be in a position to judge philosophical discourse." But this claim seems to be incongruent with another major task of genealogy. After all, genealogy is supposed to show us that the things we take to be absolute are in fact discontinuous and historically situated: "Nothing in man-not even his body-is sufficiently stable to serve as the basis for self-recognition or for understanding other men." If this is true, then the subjugated body can never be restored to a healthy state because it has no essential or original nature. There are no universal standards by which we can even distinguish between healthy and unhealthy bodies. So in what sense is genealogy to be a "curative science"? In my thesis, I try to elucidate the complex relationship between genealogy and the body. I argue that genealogy can be a curative science even while it "multiplies our body and sets it against itself." Ifwe place a special emphasis on the role that transgression plays in Foucault's genealogical works, then the healthy body is precisely the body that resists universal standards and classifications. If genealogy is to be a curative science, then it must restore to the subjugated body an "identity" that transgresses its own limits and that constitutes itself, paradoxically, in the very effacement of identity. In the first chapter of my thesis, I examine the body's role as "surface of the inscription of events." Power relations inscribe on and around the body an identity or subjectivity that appears to be unified and universal, but which is in fact disparate and historically situated. The "subjected" body is the sick and pathologically weak body. In Chapters 2 and 3, I describe how it is possible for the unhealthy body to become healthy by resisting the subjectivity that has been inscribed upon it. Chapter 4 explains how Foucault's later works fit into this characterization of genealogy