Visceral leishmaniasis and hemophagocytic syndrome

A 11 months old female infant from Portugal, free of family history, consults for apathy, weight loss, tachycardia, tachypnea, petechiae, pallor without icterus and hepatoslenomegaly. Seven months earlier, while being in Portugal, she presented a persistent bluish pimple on her buttock. Laboratory results showed anemia (35 g/l), leucopenia (3.3 G/l), thrombocytopenia (13 G/l), impaired coagulation (INR 1.4, PTT 41 sec.), hyponatremia (124 mmol/l), elevated CRP (139 mg/l), high ferritin (34.775 μg/l) and high triglycerides (5.22 mmol/l). After correction of vital parameters, a bone marrow aspiration and biopsy (BMB) revealed both the etiological diagnosis, namely a visceral leishmaniasis (VL) as well as one of its potential complications, the hemophagocytic syndrome (HS). Transfusions of whole blood, platelets and fresh frozen plasma were immediately started. Dexamethasone (10 mg/m2) and amphotericin B (3 mg/kg/day) have also been administrated. Visceral leishmaniasis is caused by a protozoan (Leishmania donovani) transmitted by the female sandfly. It is endemic in the Mediterranean basin (including France, Italy, Spain and Portugal), South America, sub-Saharan Africa as well as in India and Bangladesh. The parasite infects macrophages and, after several weeks of incubation, the disease occurs by affection of bloodlines (anemia, leucopenia, thrombocytopenia), hepatosplenomegaly, cachexia, gastrointestinal damage. The complications of the disease may lead to death. Liposomal amphotericin B is the currently recommended treatment. HS is caused by the proliferation and activation of macrophages in the marrow in response to a cytokine storm. It may be of primary cause. When it is secondary, it may be related to infections such as leishmaniasis. Patients present with fever and laboratory diagnostic criteria include cytopenia, hypertriglyceridemia, high ferritin and hemophagocytosis in the BMB. The treatment consists among other in the administration of high doses corticosteroids and, in secondary cases, in the treatment of the underlying cause. In conclusion, the clinical and biological features of VL may mimic haematological disorders as leukemia, but an enlargement of the liver and especially of the spleen should remind in this parasitic infection and its potential fatal complication, the HS.

The scarf osteotomy for the treatment of hallux valgus deformity: a review of 84 cases.

This study reviewed the subjective, clinical and radiological outcome of 71 patients (84 feet) treated by scarf osteotomy for hallux valgus deformity at our institution from 1995 to 1998 with an average follow-up time of 22 months (range, 17 to 48 months). At the time of follow-up, 39% of the patients were very satisfied, 50% were satisfied and 11% were not satisfied. The mean AOFAS score raised significantly from 43 points (14-68) preoperatively to 82 points (39 to 100) at follow-up (p < 0.001). The radiological angles including M1-M2, M1-P1, M1-M5 and DMAA improved significantly (p < 0.001). Among the 16 complications recorded, seven (8%) were minor and nine (11%) required an additional procedure. The scarf osteotomy of the first metatarsal coupled with a lateral soft-tissue release and, in three-quarters of our cases, with a basal closing wedge varisation osteotomy of the first phalanx, resulted in overall high satisfaction rate as well as significant clinical and radiological improvements in our series. Nevertheless, the range of motion of the first MP joint remained low: 30 degrees to 74 degrees in 52 patients (62%) and <30 degrees in four patients (5%). Furthermore, the mobility of the first ray as well as the consequences of the procedure in the sagittal plane need to be assessed more accurately, and this may be achieved by incorporating measurement of the plantar pressures in the forefoot area into the global rating system.

Liberação de nitrato de hidróxidos duplos lamelares como potenciais fertilizantes de liberação lenta

Hidróxidos duplos lamelares (HDL) são intercaladores potenciais aniônicos. Com o objetivo de obter fertilizantes de liberação lenta de nitrato, foram sintetizados HDL com a fórmula geral [M2+1-xM3+x(OH)2]x-(NO3)x.yH2O, em que M2+ = Mg2+ e M3+ = Al3+ e, ou, Fe3+, utilizando-se o método de coprecipitação a pH alcalino constante. Medidas de difração de raios-X evidenciaram que a cristalinidade aumenta com o acréscimo do valor de pH e da razão molar M2+/M3+. As medidas de FTIR apresentaram bandas características de nitrato livre no espaço interlamelar, além de pequena contaminação de íons carbonato. Medidas de TGA/DTA possibilitaram a confirmação das composições e dos teores de íons de nitrato intercalados. As curvas de liberação de nitrato demonstraram dois comportamentos de liberação complementar, um inicial rápido (A) e um lento gradativo (D), sendo, este último, relacionado à orientação planar do íon nitrato intercalado. Os materiais sintetizados e investigados neste trabalho apontaram grande potencial para serem utilizados como matrizes para fertilizantes de liberação lenta de nitrato.

Volatilização de Amônia Proveniente de Ureia Compactada com Enxofre e Bentonita, em Ambiente Controlado

Nos últimos anos, novas tecnologias têm sido desenvolvidas para reduzir as perdas de N quando se utiliza ureia como fonte desse macronutriente. A utilização de fertilizantes de características ácidas pode reduzir as perdas de amônia por volatilização, quando combinados com a ureia. O objetivo deste trabalho foi avaliar as perdas de amônia provenientes de fontes de N revestidas e, ou, incorporadas com ou sem enxofre e bentonita. Esses foram aplicados na superfície de um Planossolo Háplico contido em bandejas (0,1 m2 de área e 10 cm de profundidade), em dose equivalente a 200 kg ha-1 de N. Foram avaliadas as perdas de N-NH3 por volatilização durante 21 dias, com auxílio de um coletor semiaberto. A adição de diferentes fontes de enxofre e de bentonita no processo de compactação da ureia reduziu as perdas de amônia em até 29 %, quando comparadas com a ureia granulada comercial, comprovando serem alternativas promissoras para aumentar a eficiência da adubação nitrogenada.

VARIABILIDADE DE ATRIBUTOS FÍSICOS E QUÍMICOS DO SOLO E PRODUÇÃO DE FEIJOEIRO CULTIVADO EM SISTEMA DE CULTIVO MINIMO COM IRRIGAÇÃO

A compreensão do potencial agrícola de um solo muitas vezes é com base apenas na interpretação por meio de análises univariadas, podendo elevar a dimensão dos problemas no momento de escolher o manejo adequado ao solo. Dessa forma, a análise multivariada surge como alternativa, pois ela é um conjunto de procedimentos que visa agrupar e discriminar grupos de indivíduos. Também, serve como instrumento de seleção de variáveis, na medida em que aquelas com maior peso na construção dos primeiros componentes principais são as possíveis que melhor representam o conjunto de dados estudados. O objetivo deste trabalho foi identificar, por meio de análises multivariadas, os atributos do solo que melhor explicam a variabilidade espacial na produção da cultura do feijão. No ano agrícola de 2006/2007, no município de Selvíria, MS, foi analisada a produtividade do feijão em razão de alguns atributos físicos e químicos de um Latossolo Vermelho distroférrico, cultivado nas condições de elevado nível tecnológico de manejo pelo sistema de cultivo mínimo irrigado com pivô central. Foi demarcada a malha geoestatística para a coleta de dados do solo e da planta, com 117 pontos amostrais, numa área de 2.025 m2 e declive homogêneo de 0,055 m m-1. A classificação em grupos foi feita por três métodos: método de agrupamentos hierárquico, método não hierárquico k-means e análise de componentes principais. Essa última análise permitiu identificar três grupos que explicam 86,3 % da variabilidade total dos dados, os quais são constituídos pelos atributos físicos: densidade do solo, porosidade total, umidade gravimétrica e umidade volumétrica, que se evidenciaram com maior poder de explicação da variação da produtividade. Pode-se concluir que a análise multivariada aliada à geoestatística é importante ferramenta no auxílio ao manejo localizado.

ESTRUTURA DO SOLO SOB FEIJÃO IRRIGADO E DIFERENTES MANEJO DO SOLO

O manejo agrícola influencia a estrutura do solo, modificando os atributos físicos e o comportamento hídrico do solo. O objetivo deste trabalho foi avaliar os efeitos da semeadura direta (SD) e do preparo convencional (PC) sobre a estrutura do solo, por meio de atributos físicos e da distribuição dos poros, utilizando imagens digitais 2-D. O estudo foi realizado em um Latossolo Vermelho distroférrico com delineamento de blocos casualizados. A densidade do solo, macroporosidade, diâmetro médio ponderado (DMP), condutividade hidráulica do solo saturado (Kfs) e análise de imagens digitais 2-D (resolução de 156,25 μm2) foram avaliadas nas profundidades de 0-0,20 e 0,20-0,40 m. Os manejos não diferiram para a densidade e macroporosidade do solo. A SD revelou maior DMP e Kfs em relação ao PC. O PC apresentou maior área total de poros na profundidade de 0-0,20 m em relação ao SD, ocorrendo o inverso na profundidade de 0,20-0,40 m. A SD apresentou maior quantidade de poros complexos de tamanho grande (>0,156 mm2) na camada de 0,20-0,40 m em relação ao PC, que evidenciou predomínio de poros arredondados. A SD demonstrou melhorias na estrutura do solo em relação ao PC, com maior estabilidade dos agregados, condutividade hidráulica e área total de poros, contribuindo para a conservação do solo e da água em sistemas produtivos.

Relationship Between Edaphic Factors and Vegetation in Savannas of the Brazilian Midwest Region

The Brazilian savanna is a mosaic of phytophysiognomies influenced by edaphic and topographic factors that range from the occurrence of fires to anthropic disturbance. The goal of this study was a comparative analysis between two cerrado areas in southeastern Goiás, relating the floristic composition and structure of the vegetation to soil properties to better understand the physiognomic characteristics of the region. Twenty-five 20 × 20 m plots were used. All plants with circumference at breast height of more than 15 cm were measured. Soil samples collected at a depth of 0-20 cm were subjected to physical and chemical analyses. Canonical correspondence analysis (CCA) was used to detect possible correlations between the soil properties and species abundance and distribution. The density and total basal area were 1,647 ind/ha and 15.57 m2/ha, respectively, in Ouroana. At this site, 107 species were sampled. In Montes Claros de Goiás, the density and total basal area were 781 ind/ha and 17.62 m2/ha, and 120 species were sampled. The soil texture of Ouroana was sandy and significantly different from the medium to clayey texture of Montes Claros. The soils of both areas are dystrophic, however, more fertile in Montes Claros and aluminum-toxic in Ouroana. The species of vegetation were distributed according to soil fertility levels. The CCAs grouped species according to soil properties that defined location and abundance as well as the phytophysiognomies of the studied areas.

Body composition using bio-impedance analysis in pediatric patients with inflammatory bowel disease. Corcordance with dual energy X-ray absorptiometry and comparison with healthy controls

Introduction: Growth is a central process in paediatrics. Weight and height evaluation are therefore routine exams for every child but in some situation, particularly inflammatory bowel disease (IBD), a wider evaluation of nutritional status needs to be performed. Objectives: To assess the accuracy of bio-impedance analysis (BIA) compared to the gold standard dual energy X-ray absorptiometry (DEXA) in estimating percentage body fat (fat mass; FM) and lean body mass (fat free mass; FFM) in children with inflammatory bowel disease (IBD). To compare FM and FFM levels between patients with IBD and healthy controls. Methods: Twenty-nine healthy controls (12 females; mean age: 12.7 ± 1.9 years) and 21 patients (11 females; 14.3 ± 1.3 years) were recruited from August 2011 to October 2012 at our institution. BIA was performed in all children and DEXA in patients only. Concordance between BIA and DEXA was assessed using Lin's concordance correlation and the Bland-Altman method. Between-group comparisons were made using analysis of variance adjusting for age. Results: BIA-derived FM% showed a good concordance with DEXA-derived values, while BIA-derived FFM% tended to be slightly higher than DEXA-derived values (table). No differences were found between patients and controls regarding body mass index (mean ± SD: 19.3 ± 3.3 vs. 20.1 ± 2.8 kg/m2, respectively; age-adjusted P = 0.08) and FM% (boys: 25.3 ± 10.2 vs. 22.6 ± 7.1%, for patients and controls, respectively; P = 0.20; girls: 28.2 ± 5.7 vs. 26.4 ± 7.7%; P = 0.91). Also, no differences were found regarding FFM% in boys (74.9 ± 10.2 vs. 77.4 ± 7.1%; P = 0.22) and girls (71.8 ± 5.6 vs. 73.5 ± 7.7%; P = 0.85). Conclusion: BIA adequately assesses body composition (FM%) in children with IBD and could advantageously replace DEXA, which is more expensive and less available. No differences in body composition were found between children with IBD and healthy controls.

Water Balance Components in Covered and Uncovered Soil Growing Irrigated Muskmelon

ABSTRACT Knowledge of the terms (or processes) of the soil water balance equation or simply the components of the soil water balance over the cycle of an agricultural crop is essential for soil and water management. Thus, the aim of this study was to analyze these components in a Cambissolo Háplico (Haplocambids) growing muskmelon (Cucumis melo L.) under drip irrigation, with covered and uncovered soil, in the municipality of Baraúna, State of Rio Grande do Norte, Brazil (05º 04’ 48” S, 37º 37’ 00” W). Muskmelon, variety AF-646, was cultivated in a flat experimental area (20 × 50 m). The crop was spaced at 2.00 m between rows and 0.35 m between plants, in a total of ten 50-m-long plant rows. At points corresponding to ⅓ and ⅔ of each plant row, four tensiometers (at a distance of 0.1 m from each other) were set up at the depths of 0.1, 0.2, 0.3, and 0.4 m, adjacent to the irrigation line (0.1 m from the plant row), between two selected plants. Five random plant rows were mulched using dry leaves of banana (Musa sp.) along the drip line, forming a 0.5-m-wide strip, which covered an area of 25 m2 per of plant row with covered soil. In the other five rows, there was no covering. Thus, the experiment consisted of two treatments, with 10 replicates, in four phenological stages: initial (7-22 DAS - days after sowing), growing (22-40 DAS), fruiting (40-58 DAS) and maturation (58-70 DAS). Rainfall was measured with a rain gauge and water storage was estimated by the trapezoidal method, based on tensiometer readings and soil water retention curves. For soil water flux densities at 0.3 m, the tensiometers at the depths of 0.2, 0.3, and 0.4 m were considered; the tensiometer at 0.3 m was used to estimate soil water content from the soil water retention curve at this depth, and the other two to calculate the total potential gradient. Flux densities were calculated through use of the Darcy-Buckingham equation, with hydraulic conductivity determined by the instantaneous profile method. Crop actual evapotranspiration was calculated as the unknown of the soil water balance equation. The soil water balance method is effective in estimating the actual evapotranspiration of irrigated muskmelon; there was no significant effect of soil coverage on capillary rise, internal drainage, crop actual evapotranspiration, and muskmelon yield compared with the uncovered soil; the transport of water caused by evaporation in the uncovered soil was controlled by the break in capillarity at the soil-atmosphere interface, which caused similar water dynamics for both management practices applied.

Prevalence of overweight and obesity in the Swiss population

Introduction: The latest data on prevalence of overweight (OW) and obesity (OB) in the general Swiss resident population rely on the Swiss Health Survey (SHS), a telephonic interview performed in 2007. However, body mass index (BMI) is underestimated when self-reported, leading to a misclassification of up to 60% of obese subjects. The last survey with measured BMI performed in the 3 linguistic regions of Switzerland dates back to 1977. We explored the regional prevalences of OW and OB by measured BMI in the general Swiss resident population. Methods: Cross-sectional population-based survey in the 3 linguistic regions of Switzerland in 2010-2011. Data on 1471 participants aged 15-95 years (712 men, 759 women) were available for the analysis. BMI was calculated from measured height and weight and categorized into 3 groups according to WHO classification: lean (<25 kg/m2), overweight (25-30 kg/m2) and obese (>= 30 kg/m2). Data on medication, smoking, education, physical activity and dietary habitudes were collected using a questionnaire. Results: The overall prevalence of OW and OB was 32.1% and 13.9%, respectively. OB prevalence was similar across the 3 linguistic regions (13.5% in German-, 15.6% in French- and 12.0% in Italian-speaking Switzerland, p = 0.40), unlike OW prevalence, which significantly differed in unadjusted analyses (35.4%, 29.1% and 25.4%, respectively, p = 0.005). In analyses including age, sex, smoking, physical activity and education as covariates, living in the Italian-speaking region was associated neither with BMI (linear regression) nor with OW or OB (logistic regressions) . Age (beta coefficient [SE]: 0.064[0.006] kg/m2 per year, p <0.001) and sex (-1.76 [0.23] kg/m2 in women, p <0.001) were significantly associated with BMI. Conclusions: Overweight and obesity affect nearly half of the Swiss population aged >15 years. We observed no significant differences across regions once we accounted for age, sex, education and lifestyle. Public health interventions addressing modifiable behavioral factors to reduce overweight and obesity in Switzerland can be expected to have substantial benefits.

Hydro-Physical Properties of a Typic Hapludult under the Effect of Rice Husk Ash

ABSTRACT The combustion of rice husk generates a partially burnt mixture called rice husk ash (RHA) that can be used as a source of nutrients to crops and as a conditioner of soil physical properties. The objective of this study was to evaluate the effect of RHA levels on the hydro-physical properties of a Typic Hapludult. The experimental design was composed of random blocks with four replications, which comprised plots of 24 m2 and treatments with increasing RHA rates: 0, 40, 80 and 120 Mg ha-1. Undisturbed soil samples were collected in the soil layers of 0.00-0.10 and 0.10-0.20 m after nine months of RHA application, using steel cylinders (0.03 m of height and 0.047 m of diameter). These samples were used to determine soil bulk density (Bd), total soil porosity (TP), soil macroporosity (Ma), soil microporosity (Mi) and the available water capacity (AWC). Disturbed soil samples were collected to determine the stability of soil aggregates in water, mean weight diameter of water stable aggregates (MWD), and soil particle size distribution. The results show that, as the RHA rate increased in the soil, Bd values decreased and TP, Ma and MWD values increased. No effect of RHA was found on Mi and AWC values. The effects of RHA on the S parameter (Dexter, 2004), precompression stress and compression index (Dias Junior and Pierce, 1995) values are consistent those shown for density and total porosity. Rice husk ash was shown to be an efficient residue to improve soil physical properties, mainly at rates between 40 and 80 Mg ha-1. Rice husk ash reduces bulk density and increases total porosity, macroporosity and soil aggregation, but does not affect microporosity, field capacity, permanent wilting point, and available water capacity of the soil. The effect of rice husk ash on the S parameter, precompression stress and index compressibility coefficient values are consistent with those observed for the bulk density and total porosity.

Effect of a governmentally-led physical activity program on motor skills in young children attending child care centers: a cluster randomized controlled trial.

OBJECTIVE: To assess the effect of a governmentally-led center based child care physical activity program (Youp'la Bouge) on child motor skills.Patients and methods: We conducted a single blinded cluster randomized controlled trial in 58 Swiss child care centers. Centers were randomly selected and 1:1 assigned to a control or intervention group. The intervention lasted from September 2009 to June 2010 and included training of the educators, adaptation of the child care built environment, parental involvement and daily physical activity. Motor skill was the primary outcome and body mass index (BMI), physical activity and quality of life secondary outcomes. The intervention implementation was also assessed. RESULTS: At baseline, 648 children present on the motor test day were included (age 3.3 +/- 0.6, BMI 16.3 +/- 1.3 kg/m2, 13.2% overweight, 49% girls) and 313 received the intervention. Relative to children in the control group (n = 201), children in the intervention group (n = 187) showed no significant increase in motor skills (delta of mean change (95% confidence interval: -0.2 (-0.8 to 0.3), p = 0.43) or in any of the secondary outcomes. Not all child care centers implemented all the intervention components. Within the intervention group, several predictors were positively associated with trial outcomes: 1) free-access to a movement space and parental information session for motor skills 2) highly motivated and trained educators for BMI 3) free-access to a movement space and purchase of mobile equipment for physical activity (all p < 0.05). CONCLUSION: This "real-life" physical activity program in child care centers confirms the complexity of implementing an intervention outside a study setting and identified potentially relevant predictors that could improve future programs.Trial registration: Trial registration number: clinical trials.gov NCT00967460 http://clinicaltrials.gov/ct2/show/NCT00967460.

Relationship between cigarette smoking and abdominal obesity

BACKGROUND: Although smokers tend to have a lower body-mass index (BMI) than non-smokers, smoking may affect body fat (BF) distribution. Some studies have assessed the association between smoking, BMI and waist circumference (WC), but, to our knowledge, no population-based studies assessed the relation between smoking and BF composition. We assessed the association between amount of cigarette smoking, BMI, WC and BF composition. METHODS: Data was analysed from a cross-sectional population-based study including 6187 Caucasians aged 32-76 and living in Switzerland. Height, weight and WC were measured. BF, expressed in percent of total body weight, was measured by electrical bioimpedance. Obesity was defined as a BMI>=30 kg/m2 and normal weight as a BMI<25 kg/m2. Abdominal obesity was defined as a WC>=102 cm for men and >=88 cm for women and normal WC as <94 cm for men and <80 cm for women. In men, excess BF was defined as %BF >=28.1, 28.7, 30.6 and 32.6 for age groups 32-44, 45-54, 55-64 and 65-76, respectively; the corresponding values for women were 35.9, 36.5, 40.5 and 44.4. Cigarette smoking was assessed using a self-reported questionnaire. RESULTS: 29.3% of men and 25.0% of women were smokers. Prevalence of obesity, abdominal obesity, and excess of BF was 16.9% and 26.6% and 14.2% in men and 15.0%, 33.0% and 27.5% in women, respectively. Smokers had lower age-adjusted mean BMI, WC and percent of BF compared to non-smokers. However, among smokers,mean age-adjusted BMI,WC and BF increased with the number of cigarettes smoked per day: among light (1-10 cig/day), moderate (11-20) and heavy smokers (>20), mean +/-SE %BF was 22.4 +/−0.3, 23.1+/−0.3 and 23.5+/−0.4 for men, and 31.9+/−0.3, 32.6+/−0.3 and 32.9+/−0.4 for women, respectively. Mean WC was 92.9+/−0.6, 94.0+/−0.5 and 96.0+/−0.6 cm for men, and 80.2+/−0.5, 81.3+/−0.5 and 83.3+/−0.7 for women, respectively. Mean BMI was 25.7+/−0.2, 26.0+/−0.2, and 26.1+/−0.2 kg/m2 for men; and 23.6+/−0.2, 24.0+/−0.2 and 24.1+/−0.3 for women, respectively. Compared with light smokers, the age-adjusted odds ratio (95% Confidence Interval) for excess of BF was 1.04 (0.58 to 1.85) formoderatesmokers and 1.06 (0.57 to 1.99) for heavy smokers in men (p-trend = 0.9), and 1.35 (0.92 to 1.99) and 2.26 (1.38 to 3.72), respectively, in women (p-trend = 0.04). Odds ratio for abdominal obesity vs. normal WC was 1.32 (0.81 to 2.15) for moderate smokers and 1.95 (1.16 to 3.27) for heavy smokers in men (p-trend < 0.01), and 1.15 (0.79 to 1.69) and 2.36 (1.41 to 3.93) in women (p-trend = 0.03). Odds ratio for obesity vs. normal weight was 1.35 (0.76 to 2.41) for moderate smokers and 1.33 (0.71 to 2.49) for heavy smokers in men (p-trend = 0.9) and 0.78 (0.45 to 1.35) and 1.44 (0.73 to 2.85), in women (p-trend = 0.08). CONCLUSIONS: WC and BF were positively and dose-dependently associated with the number of cigarettes smoked per day in women, whereas onlyWC was dose dependently and significantly associated with the amount of cigarettes smoked per day in men. This suggests that heavy smokers, especially women, are more likely to have an excess of BF and to accumulate BF in the abdomen compared to lighter smokers.

Time-related improvement of survival in resectable gastric cancer: the role of Japanese-style gastrectomy with D2 lymphadenectomy and adjuvant chemotherapy

Background: We investigated the change of prognosis in resected gastric cancer (RGC) patients and the role of radical surgery and adjuvant chemotherapy. Methods: We retrospectively analyze the outcome of 426 consecutive patients from 1975 to 2002, divided into 2 time-periods (TP) cohort: Before 1990 (TP1, n = 207) and 1990 or after (TP2; n= 219). Partial gastrectomy and D1-lymphadenetomy was predominant in TP1 and total gastrectomy with D2-lymphadenectomy it was in TP2. Adjuvant chemotherapy consisted of mitomycin C (MMC), 10¿20 mg/m2 iv 4 courses or MMC plus Tegafur 500 mg/m2 for 6 months. Results: Positive nodes were similar in TP2/TP1 patients with 56%/59% respectively. Total gastrectomy was done in 56%/45% of TP2/TP1 respectively. Two-drug adjuvant chemotherapy was administered in 65%/18% of TP2/TP1 respectively. Survival at 5 years was 66% for TP2 versus 42%for TP1 patients (p < 0.0001). Survival by stages II, IIIA y IIIB for TP2 versus TP1 patients was 70 vs. 51% (p = 0.0132); 57 vs. 22% (p = 0.0008) y 30 vs. 15% (p = 0.2315) respectively. Multivariate analysis showed that age, stage of disease and period of treatment were independent variables. Conclusion: The global prognosis and that of some stages have improved in recent years with case RGC patients treated with surgery and adjuvant chemotherapy.

Genetic evidence for a role of adiponutrin in the metabolism of apolipoprotein B-containing lipoproteins.

Adiponutrin (PNPLA3) is a predominantly liver-expressed transmembrane protein with phospholipase activity that is regulated by fasting and feeding. Recent genome-wide association studies identified PNPLA3 to be associated with hepatic fat content and liver function, thus pointing to a possible involvement in the hepatic lipoprotein metabolism. The aim of this study was to examine the association between two common variants in the adiponutrin gene and parameters of lipoprotein metabolism in 23,274 participants from eight independent West-Eurasian study populations including six population-based studies [Bruneck (n = 800), KORA S3/F3 (n = 1644), KORA S4/F4 (n = 1814), CoLaus (n = 5435), SHIP (n = 4012), Rotterdam (n = 5967)], the SAPHIR Study as a healthy working population (n = 1738) and the Utah Obesity Case-Control Study including a group of 1037 severely obese individuals (average BMI 46 kg/m2) and 827 controls from the same geographical region of Utah. We observed a strong additive association of a common non-synonymous variant within adiponutrin (rs738409) with age-, gender-, and alanine-aminotransferase-adjusted lipoprotein concentrations: each copy of the minor allele decreased levels of total cholesterol on average by 2.43 mg/dl (P = 8.87 x 10(-7)), non-HDL cholesterol levels by 2.35 mg/dl (P = 2.27 x 10(-6)) and LDL cholesterol levels by 1.48 mg/dl (P = 7.99 x 10(-4)). These associations remained significant after correction for multiple testing. We did not observe clear evidence for associations with HDL cholesterol or triglyceride concentrations. In conclusion, our study suggests that adiponutrin is involved in the metabolism of apoB-containing lipoproteins.