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BackgroundHereditary breast and ovary cancer syndrome affects both genders but little is known about the uptake of genetic services by men. The objective of this study is to characterise the male population counselled through a multidisciplinary breast/ovarian program.MethodsDescriptive analysis of male patients counselled from January 2000 to December 2015. Data in this analysis include new cancer diagnoses during prospective follow up.ResultsFrom 4,320 families registered, 362 male patients were identified: 236 (65.2%) from hereditary cancer families (HCF) and 126 (34.8%) from non-HCF. In HCF, 121 patients (51.3%) were mutation carriers (MC): BRCA2 – 102 (84.3%), BRCA1 – 16 (13.2%), CHEK2 – 1 (0.8%) and TP53 – 2 (1.7%). Non-HCF included 126 patients: 85 (67.5%) belonged to families without pathogenic mutations or with variants of unknown clinical significance; 22 (17.5%) refused testing after counselling and 19 (15.0%) did not meet criteria for testing. Both HCF and non-HCF included patients with previous cancer diagnoses: HCF- Breast Cancer (BC) - 18; prostate cancer (PC) - 13; melanoma - 1; others - 7) and non-HCF (BC - 77; PC - 20; gastric cancer (GC) - 1; melanoma - 8; bladder cancer - 1; others - 22). From the 121 MC identified (including the TP53 and CHEK2 carriers), 97 patients (80.2%) adhered to prospective surveillance. With a median follow-up of 36.9 months, 17 cancers were diagnosed in 14 patients, PC being the most frequently diagnosed neoplasia (5 cases). Eleven patients (78.6%) are alive and three patients died of advanced cancer (2 with GC, 1 with disseminated adenocarcinoma).ConclusionWe observed a high adherence to counselling, genetic testing and active surveillance by men belonging to hereditary BC families. Male carriers of pathogenic DNA variants are at risk for several cancers and should be included in prospective follow-up studies.

Merkel cell carcinoma is a rare and aggressive cutaneous tumor, and the use of checkpoint inhibitors immunotherapy is a recent indication in its metastatic setting, both first and second line. However, the widespread use of immunotherapy is associated with an increase of acute and late immune-mediated adverse events. We present a case of an elderly fit patient with metastatic Merkel cell carcinoma treated with pembrolizumab who developed diabetic ketoacidosis, a severe immune-mediated adverse event. A multidisciplinary approach was crucial to overcome the life-threatening event. Even with early treatment stop, the patient had a significant and durable response to the treatment for 15 months. Meanwhile, a progressive pancerebellar syndrome emerged, possible due to a paraneoplastic syndrome with a negative onco-neuronal antibody panel, although an autoimmune etiology associated with immunotherapy could not be excluded. Unfortunately, the situation was irreversible and refractory to immunomodulatory treatment. Despite the unpredictable toxicity, it is important to note the efficacy profile, with a progression-free survival of 15 months, which is higher than the one reported in reference clinical trials in this setting.

Axenic mice and rats fed different diets were associated only with two strains of Clostridium. The first one identified as Clostridium perenne was isolated from the fecal dominant flora of an adult rat. The second one belonging to the group I of Clostridium was isolated from the dominant flora of the feces from a piglet. Both strains were capable of becoming established in the digestive tract of animals fed dietary regimens called "permissive", while they did not become established in animals fed "nonpermissive" diets. However, when these bacterial strains had become established in animals fed a permissive diet, they persisted in the dominant flora even if the permissive diet was replaced by the nonpermissive one. This phenomenon was called remanent effect of the diet. It disappeared after 103 days for C. perenne, but not for the other Clostridium strain. This effect was not due to a selection of a genetic variant from the original strain or to a durable change in some characteristics of the host-animal associated with the bacterial strain.

Introduction: intestinal-type sinonasal adenocarcinoma (ITAC) is a rare epithelium tumor of the nasal cavities and paranasal sinuses. Exposure to wood and leather dusts is a strong etiological factor related to its development. Prolonged cork exposure has rarely been associated. Materials and Methods: thirty-seven-year (1981-2018) retrospective cohort analysis of all consecutive patients with sinonasal cancer (SNC) followed at our institution. Medical records were reviewed to determine patient demographics, occupational/environmental exposure, location and extent of the tumor, stage, histopathology findings, treatment strategies, and oncologic outcomes. Survival analysis was done using Kaplan-Meier method. Results: we evaluated 379 patients with SNC, including 39 (10.3%) ITAC. Patient median age was 73 years (range 49-87), 56% male and 69% with identified professional occupational exposure (54% for cork; 69.2% considering only those for which an agent has been identified). Seventy-two percent had locally advanced disease (stage III or IVA-B). The initial treatment was surgery in 77%, and 54% received adjuvant radiotherapy. The median time to progression, progression-free survival, and overall-survival was 2.36 years (95% CI 1.54-8.70), 1.96 years (95% CI 1.43-3.74), and 3.51 years (95% CI 2.33-10.02), respectively. Conclusion: ITAC is an uncommon malignancy that grows silently, which contributes to delayed diagnosis, advanced stage and low survival rates. In our cohort, we observed a high prevalence of cork occupational exposure. This finding may lead to the implementation of protection measures and suggest a potential link to be further studied.

The scorpion mud turtle (Kinosternon scorpioides) is a small freshwater turtle broadly distributed in South America and commonly consumed in some Brazilian regions. This study aimed to identify the species of helminths that parasitize the digestive tract of K. scorpioides and report infection parameters such as parasite prevalence, mean intensity of the infection, abundance, and the relationship between these nematodes and host body size in this species. We captured 20 adult male K. scorpioides, and 6 animals had nematodes in their gastrointestinal tract. These animals had Serpinema magathi (prevalence = 0.3) and Spiroxys figueiredoi (prevalence = 0.25). There were no correlations between the number of total parasites and carapace length (rs = 0.17, n = 6, P = 0.74) or the length of the gastrointestinal tract (rs = 0.18, n = 6, P = 0.73).

The presence of soybean meal in the diet of gnotobiotic mice was shown to prevent the establishment of a clostridial strain in the gastrointestinal tract. Soybean meal did not inhibit the growth of Clostridium in vitro, suggesting that the host plays a role in the observed inhibition of bacterial growth. The inhibitory factor in the soybean meal contains at least two components.

► This report concerns a long survival of a BRCA2 patient with a relapsing uterine carcinosarcoma. ► Rarity of long survivorship in relapsing carcinosarcoma is confirmed by literature review. ► BRCA2 status plus platinum-hypersensitivity as contributors for the favorable outcome, even if carcinosarcoma doesn't belong to the BRCA1/2 phenotype.