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Objective We aimed to determine outcome predictors of papillary thyroid cancer ( PTC) persistence and recurrence, separately. Context The factors contributing to either persistence or recurrence of PTC are poorly defined, as both outcomes are usually evaluated together. Design and patients In this 10-year follow-up cohort study, 190 PTC patients were evaluated (18-85 years old; registered from 1 January 1990 to31 December 1999 at a Brazilian Cancer Care referral Hospital). After initial surgery, we examined persistence (disease detected up to 1 year), recurrence (disease detected after 1 year) and PTC-free status (disease absence during follow-up). Measurements Outcome predictors were modelled using multinomial logit regression analysis. Results The univariate analysis showed that persistence and recurrence were significantly associated with lymph node metastasis ( OR = 12·33; OR = 2·84, respectively), local aggressiveness ( OR = 5·22; OR = 3·35) and extrathyroidal extension ( OR = 5·07; OR = 7·11). Persistence was associated with male sex ( OR = 3·49), age above 45 years old at diagnosis ( OR = 1·03), macroscopic lymph node metastasis ( OR = 5·85), local aggressiveness ( OR = 5·22), each 1-cm tumour size increase ( OR = 1·34), a cancer care referral hospital as the place of initial surgery ( OR = 2·3), thyroidectomy or near total thyroidectomy( OR = 3·03) and neck dissection ( OR = 3·19). Recurrence was associated with the time of radioactive iodine (131I) therapy ( OR = 3·71). After data modelling, persistence was associated with macroscopic lymph node metastasis ( OR = 6·17), 1-cm increases in tumour size ( OR = 1·30) and thyroidectomy or near total thyroidectomy ( OR = 3·82), while recurrence was associated with surgery at referral hospital ( OR = 3·79). Conclusions The best predictors of persistence were tumour size and macroscopic lymph node metastasis; when the initial surgery is of quality, the recurrence depends more on tumour's biology aspects. [ABSTRACT FROM AUTHOR]

Apolipoproteins have a unique role in lipoprotein metabolism regulation, aiding lipid transport and acting as a cofactor of the enzymes involved in metabolism. There are three co-dominant alleles, APOE*2, APOE*3 and APOE*4, which encode three protein isoforms, apoE2, apoE3 and apoE4. APOE*3 is the most frequent in all populations thus far investigated, ranging from 50 to 90%. Some studies have tried to resolve a genetic 'dilemma' by evaluating the cause of the frequency and survival of the three alleles. Genetic drift, migration or natural selection could explain the current distribution of APOE gene frequencies worldwide. If APOE*4 is the ancestral allele, APOE*3 must have offered a considerable selective advantage, perhaps consisting of a positive effect during the reproductive period. Given this, there is a need to understand if APOE gene polymorphism might affect reproductive capacity. Few studies have been conducted in this area, and they generally correlate APOE polymorphism with reproductive efficiency in terms of number of children. The aim of our study was to look for correlations between APOE polymorphism in humans and semen quality, to establish if APOE genotypes have any demonstrable effect on spermatogenesis. In conclusion, our data show that APOE polymorphism is not associated with semen quality, as it is present to a similar extent in both normal and impaired or absent spermatogenesis. This demonstrates once again that the use of number of children as an index of fertility is not indicative of real male reproductive capacity. [ABSTRACT FROM AUTHOR]

Angiotensin I-converting enzyme (ACE), in addition to its role in the renin angiotensin system, has a physiological function in the fibrinolysis pathway, the accurate control of which is critical for the normal development of pregnancy. Recently, the ACE I/D polymorphism was found to be associated with recurrent spontaneous miscarriages (RM). The present study analysed the relationship between ACE I/D polymorphism and the number of spontaneous miscarriages, the number of pregnancies and the number of children in a sample of 88 Italian women born before 1930, with a pre-modern reproductive behaviour. The ACE DD genotype was more prevalent among women with RM (p = 0.02). However, the women carrying the DD genotype not only had the highest number of miscarriages (p = 0.03), but also the highest number of pregnancies with an eventual complete fertility (children no = 4.4), similar to that of women carrying the other ACE genotypes. In contrast, published data on contemporary women with RM seem to indicate that the DD genotype could now be associated with a reduced reproductive success compared to the other ACE genotypes. It is suggested that this phenomenon may be the effect of the interaction between ACE genotypes and contemporary reproductive behaviours (delay in childbearing, below-replacement fertility). [ABSTRACT FROM AUTHOR]

The manipulation of a wide variety of unsealed sources in Nuclear Medicine results in a significant risk of internal exposure of the workers. 131I should be highlighted among the most frequently used radionuclides because of its large application for diagnosis and therapy of thyroid diseases. The increasing use of radionuclides for medical purposes creates a demand for feasible methodologies to perform occupational control of internal contamination. Currently in Brazil, there are ~300 nuclear medicine centres in operation but individual monitoring is still restricted to the control of external exposure. This work presents the development of in vivo and in vitro bioassay techniques aimed to quantify incorporation of radionuclides used in Nuclear Medicine. It is also presented the results of a preliminary survey of internal exposure of a group of workers involved in the preparation of therapeutic doses of 131I. Workers were monitored with a gamma camera available in the Nuclear Medicine Service of the University Hospital of Rio de Janeiro and at the Institute of Radiation Protection and Dosimetry Whole-Body Counter (IRD-WBC). The in viva detection systems were calibrated with a neck-thyroid phantom developed in IRD. Urine samples from radio-pharmacy workers were collected after preparation and administration of therapeutic doses (10-250 mCi) of 131I and measured with a HPCe detection system available in the Bioassay Laboratory of IRD. The results show that the bioassay methods developed in this work present enough sensitivity for routine monitoring of nuclear medicine workers. All workers monitored in this survey presented positive results for 131I in urine samples and two workers presented detectable activities in thyroid when measured at the IRD-WBC. The highest committed effective dose per preparation was estimated to be 17 µSv. [ABSTRACT FROM AUTHOR]

The human apoE gene ( APOE, GenBank accession AF261279) shows a common polymorphism, with the three ℇ2, ℇ3 and ℇ4 alleles resulting from the haplotypes of two C→T SNPs. However, whereas the three common T-T, T-C and C-C haplotypes corresponding to the ℇ2, ℇ3 and ℇ4 alleles are well known, the last C-T haplotype (GenBank accession AY077451), encoding a fourth apoE allele, has rarely been reported. We detected this fourth allele in a Caucasian patient with motor neuron disease (MND). According to the literature we refer to this allele as ℇ3r. Although several explanations may be proposed for its formation, the existence of this fourth allele is consistent with the evolutionary hypothesis generally accepted for the apoE alleles. The rarity and physiological role of ℇ3r remains to be explained, and requires further investigation. [ABSTRACT FROM AUTHOR]

Phosphoglucomutase phenotypes 8-1 and 8-2 have been found in 2 members of an Italian family. The PGMallele stemmed from the father of the propositus. [ABSTRACT FROM AUTHOR]