[There is a role for surgical resection in patients with oligometastatic pancreatic cancer]. / Existe un rol para la resección quirúrgica en los pacientes con cáncer de páncreas oligometastásicos.

OBJECTIVE: The objective of this work is to retrospectively analyze the resection in patients with oligometastatic stage IV pancreatic adenocarcinoma, after first-line chemotherapy for metastatic pancreatic cancer, evaluating the survival of these cases. MATERIALS AND METHODS: Between January 2005 and December 2019, 5 patients diagnosed with oligometastatic pancreatic cancer undergoing first-line chemotherapy were retrospectively evaluated, after which resective surgery was performed. RESULTS: The resective surgery performed in these patients were: three distal pancreatectomies with splenectomy, one duodenopancreatectomy and one total pancreatectomy. All received chemotherapy treatment; three patients received treatment with Folfurinox, one received 5-fluorouracil, and one received gemcitabine plus capecitabine. The patients received an average of 4 months of chemotherapy (3-6 months) and after this, resective surgery was scheduled. The average survival in these patients was 23 months (11 to 39 months), only one patient presented recurrence of the disease and died at 28 months, the remaining 4 are alive. CONCLUSION: Resective surgery in patients with stage IV pancreatic cancer can be done safely. This could be considered in selected patients with a good radiological and biochemical response after an adequate period of chemotherapy in whom there is no obvious distant disease.

Habitat fragmentation threatens wild populations of Carica papaya (Caricaceae) in a lowland rainforest.

• Premise of the study: Wild populations of domesticated species constitute a genetic reservoir and are fundamental to the evolutionary potential of species. Wild papaya (Carica papaya) is a rare, short-lived, gap-colonizing, dioecious tree that persists in the forest by continuous dispersal. Theoretically, these life-history characteristics render wild papaya highly susceptible to habitat fragmentation, with anticipated negative effects on its gene pool. Further, species dioecy may cause founder effects to generate local biases in sex ratio, decreasing effective population size.• Methods: We contrasted the genetic diversity and structure of C. papaya between wild populations from rainforest fragments and continuous forest at Los Tuxtlas, Mexico. We evaluated recent migration rates among populations as well as landscape resistance to gene flow. Finally, we calculated the sex ratio of the populations in both habitats.• Key results: Populations of wild papaya in rainforest fragments showed lower genetic diversity and higher population differentiation than populations in continuous rainforest. Estimates of recent migration rates showed a higher percentage of migrants moving from the continuous forest to the forest fragments than in the opposite direction. Agricultural land and cattle pasture were found to be the most resistant matrices to gene flow. Finally, biased sex ratios were seen to affect the effective population size in both habitats.• Conclusions: The mating system, rarity, and short life cycle of C. papaya are exacerbating the effects of rainforest fragmentation on its genetic diversity, threatening the persistence of its natural populations in the proposed place of origin as well as its genetic reservoir.

Relationship between Thought Style, Emotional Response, Post-Traumatic Growth (PTG), and Biomarkers in Cancer Patients.

(1) Introduction: Cancer diagnosis has been related to depression, anxiety, and distress, as well as to post-traumatic growth (PTG). One of the mediating variables for emotional response is thought style (rumination, cognitive avoidance, and cognitive engagement). (2) Aim: To identify the relationship between thought style and emotional responses to cancer. A secondary aim was to identify the relationship between emotional responses and inflammatory immunological biomarkers. (3) Method: A total of 115 patients with cancer were included in the study. Before initiating cancer treatment, patients were assessed using the Hospital Anxiety and Depression Scale (HADS), distress thermometer, and Post-Traumatic Growth Inventory (PTGI). Patients provided their most recent blood biometry. (4) Results: Rumination correlated with anxiety, depression, and distress. Cognitive avoidance correlated with PTG (-0.240) and distress (-0.209). Cognitive engagement correlated with PTG (0.393). Regarding thought style and biomarkers, a negative correlation was observed for absolute neutrophils with cognitive avoidance (-0.271) and rumination (0.305). Regarding biomarkers and emotional responses, there was a negative correlation between PTG and absolute lymphocytes (-0.291). There was also a correlation between PTG and neutrophils (0.357) and neutrophil-to-lymphocyte ratio (NLR) (0.295). (5) Conclusions: Thought style is related to the emotional response to a cancer diagnosis; rumination is related to depression, distress, and anxiety; and cognitive engagement is related to PTG. PTG is related to inflammation and immunological biomarkers.

Preventable risk factors for type 2 diabetes can be detected using noninvasive spontaneous electroretinogram signals.

Given the ever-increasing prevalence of type 2 diabetes and obesity, the pressure on global healthcare is expected to be colossal, especially in terms of blindness. Electroretinogram (ERG) has long been perceived as a first-use technique for diagnosing eye diseases, and some studies suggested its use for preventable risk factors of type 2 diabetes and thereby diabetic retinopathy (DR). Here, we show that in a non-evoked mode, ERG signals contain spontaneous oscillations that predict disease cases in rodent models of obesity and in people with overweight, obesity, and metabolic syndrome but not yet diabetes, using one single random forest-based model. Classification performance was both internally and externally validated, and correlation analysis showed that the spontaneous oscillations of the non-evoked ERG are altered before oscillatory potentials, which are the current gold-standard for early DR. Principal component and discriminant analysis suggested that the slow frequency (0.4-0.7 Hz) components are the main discriminators for our predictive model. In addition, we established that the optimal conditions to record these informative signals, are 5-minute duration recordings under daylight conditions, using any ERG sensors, including ones working with portative, non-mydriatic devices. Our study provides an early warning system with promising applications for prevention, monitoring and even the development of new therapies against type 2 diabetes.

Does Domestication Affect Structural and Functional Leaf Epidermal Traits? A Comparison between Wild and Cultivated Mexican Chili Peppers (Capsicum annuum).

During domestication, lineages diverge phenotypically and genetically from wild relatives, particularly in preferred traits. In addition to evolutionary divergence in selected traits, other fitness-related traits that are unselected may change in concert. For instance, the selection of chili pepper fruits was not intended to change the structure and function of the leaf epidermis. Leaf stomata and trichome densities play a prominent role in regulating stomatal conductance and resistance to herbivores. Here, we assessed whether domestication affected leaf epidermis structure and function in Capsicum annuum. To do this, we compared leaf stomata and trichome densities in six cultivated varieties of Mexican Capsicum annuum and their wild relative. We measured stomatal conductance and resistance to herbivores. Resistance to (defense against) herbivores was measured as variation in the herbivory rate and larvae mortality of Spodoptera frugiperda fed with leaves of wild and cultivated plants. As expected, the different varieties displayed low divergence in stomatal density and conductance. Leaf trichome density was higher in the wild relative, but variation was not correlated with the herbivory rate. In contrast, a higher mortality rate of S. frugiperda larvae was recorded when fed with the wild relative and two varieties than larvae fed with four other varieties. Overall, although domestication did not aim at resistance to herbivores, this evolutionary process produced concerted changes in defensive traits.

Immediate Effects of Dry Needling on Central Pain Processing and Skin Conductance in Patients with Chronic Nonspecific Neck Pain: A Randomized Controlled Trial.

Although current evidence supports the use of dry needling for improving some clinical outcomes in people with neck pain, no previous research explored the effects of dry needling on the central processing of pain and autonomic nervous system in this population. Therefore, this clinical trial aimed to compare the effects of real and sham dry needling on autonomic nervous system function, pain processing as well as clinical and psychological variables in patients with chronic nonspecific neck pain. A double-blinded randomized clinical trial including 60 patients with neck pain was conducted. Patients were randomized to the real needling (n = 30) or sham needling (n = 30) group. Skin conductance (SC), pressure pain thresholds (PPTs), temporal summation (TS), conditioned pain modulation (CPM) as well as pain intensity, related-disability, catastrophism, and kinesiophobia levels were assessed by an assessor blinded to the allocation intervention. The results did not find significant group * time interactions for most outcomes, except for the global percentage of change of SC values (mean: F = 35.90, p < 0.001, ηp2 = 0.459; minimum: F = 33.99, p = 0.839, ηp2 = 0.371; maximum: F = 24.71, p < 0.001, ηp2 = 0.037) and PPTs at C5-C6 joint in the same side of needling (F = 9.982; p = 0.003; = 0.147), in favor of the dry needling group. Although the proportion of subjects experiencing moderate to large self-perceived improvement after the intervention was significantly higher (X2 = 8.297; p = 0.004) within the dry needling group (n = 18, 60%) than in the sham needling group (n = 7, 23.3%), both groups experienced similar improvements in clinical and psychological variables. Our results suggested that dry needling applied to patients with chronic nonspecific neck pain produced an immediate decrease in mechanical hyperalgesia at local sites and produced an increase in skin conductance as compared with sham needling. No changes in central pain processing were observed. A single session of sham or real dry needling was similarly effective for decreasing related disability, pain intensity, catastrophism, and kinesiophobia levels. Further studies are needed to better understand the clinical implications of autonomic nervous system activation on central sensitization and pain processing in the long-term after the application of dry needling.

Autologous CXCR4+ Hematopoietic Stem Cells Injected into the Scar Tissue of Chronic Myocardial Infarction Patients Normalizes Tissue Contractility and Perfusion.

BACKGROUND: Chronic myocardial infarction (CMI), represents a public health and a financial burden. Since stem cell transplant is used to regenerate cardiac tissue after acute myocardial infarction. AIM OF THE STUDY: To determine if autologous CXCR4 stem cells could restore damaged myocardial tissue in patients with CMI lesions. METHODS: 20 NYHA grade III male patients with CMI defined by clinical, biochemical, ECG and echocardiographic parameters were included. Patients were treated with G-CSF for 6 d before isolating their autologous stem cells from PBMCs. Cell phenotyping was done by cytofluorometry using monoclonal antibodies (anti-CXCR4, -CD34, -48, -117, -133, -Ki67, -SDF1 and CXCR4); CXCR4 cell subpopulations isolated by sorting were adjusted to 1 × 108 cells by subpopulation and injected in a circular pattern into the cicatrix previously defined by echocardiography. RESULTS: Patients were followed for 6 and 12 months. Six months after cell implant improvements in left ventricle ejection fraction (from 33-50%), stress rate values (from -3/-9% to -18/-22%), stress tests (from 4-12 METS), and the quantity of left ventricle affected segments (3-9) disappeared according to the G-SPECT images. 12 months evaluations did not show significant differences. Interestingly, 3 months after cell implant the ECG showed normal electrical activity in 9 patients whereas after 6 months it was normal in all the patients. CONCLUSIONS: These results ratify that locally injected autologous CXCR4+ bone marrow-derived stem cells have a physiological and a clinical impact in patients with CMI.

Single port endoscopic mastectomy: surgical technique and first case in Mexico.

Las innovaciones técnicas han permitido realizar un sinnúmero de cirugías endoscópicas y laparoscópicas, entre ellas la mastectomía preservadora de piel y pezón por puerto único, que ha sido reportada como bien tolerada, con un excelente resultado cosmético y con el mismo pronóstico oncológico que la cirugía tradicional. Esta técnica, común en Asia, presenta diversos retos técnicos y económicos. Presentamos la primera aproximación en nuestro país sobre este abordaje en una paciente con cáncer de mama. Para realizar esta cirugía es preciso el entrenamiento en mínima invasión y en cirugía mamaria, así como una adecuada selección de las pacientes.Technical innovations and scientific advances have allowed to perform countless endoscopic and laparoscopic surgical procedures. Among these, Single port endoscopic Mastectomy has been reported as well tolerated, with great aesthetic results and the same oncologic prognosis as traditional surgery. This popular approach in Asian countries presents many technical and economic challenges. We present the first endoscopic approach in our country: a female patient with infiltrating ductal carcinoma in the left breast. We understand that to carry out this procedure, adequate patient selection, great minimal invasive and breast surgery skills are necessary.

Selection on tropane alkaloids in native and non-native populations of Datura stramonium.

Theories of plant invasion based on enemy release in a new range assume that selection exerted by specialist herbivores on defence traits should be reduced, absent, or even selected against in the new environment. Here, we measured phenotypic selection on atropine and scopolamine concentration of Datura stramonium in eight native (Mexico) and 14 non-native (Spain) populations. Native populations produced between 20 and 40 times more alkaloid than non-native populations (atropine: 2.0171 vs. 0.0458 mg/g; scopolamine: 1.004 vs. 0.0488 mg/g, respectively). Selection on alkaloids was negative for atropine and positive for scopolamine concentration in both ranges. However, the effect sizes of selection gradients were only significant in the native range. Our results support the assumption that the reduction of plant defence in the absence of the plant's natural enemies in invasive ranges is driven by natural selection.

A new method for ocular ultrasound examination.

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An accreting pulsar with extreme properties drives an ultraluminous x-ray source in NGC 5907.

Ultraluminous x-ray sources (ULXs) in nearby galaxies shine brighter than any x-ray source in our Galaxy. ULXs are usually modeled as stellar-mass black holes (BHs) accreting at very high rates or intermediate-mass BHs. We present observations showing that NGC 5907 ULX is instead an x-ray accreting neutron star (NS) with a spin period evolving from 1.43 seconds in 2003 to 1.13 seconds in 2014. It has an isotropic peak luminosity of [Formula: see text]1000 times the Eddington limit for a NS at 17.1 megaparsec. Standard accretion models fail to explain its luminosity, even assuming beamed emission, but a strong multipolar magnetic field can describe its properties. These findings suggest that other extreme ULXs (x-ray luminosity [Formula: see text] 1041 erg second[Formula: see text]) might harbor NSs.

Existe un rol para la resección quirúrgica en los pacientes con cáncer de páncreas oligometastásicos / There is a role for surgical resection in patients with oligometastatic pancreatic cancer

RESUMEN Objetivo: El objetivo de este trabajo es analizar retrospectivamente la resección en pacientes con adenocarcinoma de páncreas en estadio IV oligometastásicos, luego de quimioterapia de primera línea para cáncer de páncreas metastásico evaluando la sobrevida de estos casos. Materiales y métodos: Entre enero del 2005 hasta diciembre del 2019 se evaluó de manera retrospectiva a 5 pacientes con diagnóstico de cáncer de páncreas oligometastásico sometidos a quimioterapia de primera línea luego de la cual se les efectuó cirugía resectiva. Resultados: La cirugía resectiva realizadas en estos pacientes fueron: Tres pancreatectomias distales con esplenectomía, una duodenopancreatectomia y una pancreatectomia total. Todos recibieron tratamiento con quimioterapia; tres pacientes recibieron tratamiento con Folfurinox, uno recibió 5 fluoruracilo y otro recibió gemcitabina más capecitabina. Los pacientes recibieron en promedio 4 meses de quimioterapia (3-6 meses) y luego de estos se programó la cirugía resectiva. La sobrevida media en estos pacientes fue de 23 meses (11 a 39 meses), solamente un paciente presento recidiva de la enfermedad y falleció a los 28 meses, los 4 restantes se encuentran vivos. Conclusión: La cirugía resectiva en pacientes con estadio IV con cáncer de páncreas se puede hacer de forma segura. Esta se podría considerar en pacientes seleccionados con una buena respuesta radiológica y bioquímica luego de un periodo adecuado de quimioterapia en los cuales no exista enfermedad a distancia evidente.

ABSTRACT Objective: The objective of this work is to retrospectively analyze the resection in patients with oligometastatic stage IV pancreatic adenocarcinoma, after first-line chemotherapy for metastatic pancreatic cancer, evaluating the survival of these cases. Materials and methods: Between January 2005 and December 2019, 5 patients diagnosed with oligometastatic pancreatic cancer undergoing first-line chemotherapy were retrospectively evaluated, after which resective surgery was performed. Results: The resective surgery performed in these patients were: three distal pancreatectomies with splenectomy, one duodenopancreatectomy and one total pancreatectomy. All received chemotherapy treatment; three patients received treatment with Folfurinox, one received 5-fluorouracil, and one received gemcitabine plus capecitabine. The patients received an average of 4 months of chemotherapy (3-6 months) and after this, resective surgery was scheduled. The average survival in these patients was 23 months (11 to 39 months), only one patient presented recurrence of the disease and died at 28 months, the remaining 4 are alive. Conclusion: Resective surgery in patients with stage IV pancreatic cancer can be done safely. This could be considered in selected patients with a good radiological and biochemical response after an adequate period of chemotherapy in whom there is no obvious distant disease.

Natural selection drives chemical resistance of Datura stramonium.

Plant resistance to herbivores involves physical and chemical plant traits that prevent or diminish damage by herbivores, and hence may promote coevolutionary arm-races between interacting species. Although Datura stramonium's concentration of tropane alkaloids is under selection by leaf beetles, it is not known whether chemical defense reduces seed predation by the specialist weevil, Trichobaris soror, and if it is evolving by natural selection. We measured infestation by T. soror as well as the concentration of the plants' two main tropane alkaloids in 278 D. stramonium plants belonging to 31 populations in central Mexico. We assessed whether the seed predator exerted preferences on the levels of both alkaloids and whether they affect plant fitness. Results show great variation across populations in the concentration of scopolamine and atropine in both leaves and seeds of plants of D. stramonium, as well as in the intensity of infestation and the proportion of infested fruits by T. soror. The concentration of scopolamine in seeds and leaves are negatively associated across populations. We found that scopolamine concentration increases plant fitness. Our major finding was the detection of a positive relationship between the population average concentrations of scopolamine with the selection differentials of scopolamine. Such spatial variation in the direction and intensity of selection on scopolamine may represent a coevolutionary selective mosaic. Our results support the view that variation in the concentration of scopolamine among-populations of D. stramonium in central Mexico is being driven, in part, by selection exerted by T. soror, pointing an adaptive role of tropane alkaloids in this plant species.

Natural selection on plant resistance to herbivores in the native and introduced range.

When plants are introduced into new regions, the absence of their co-evolved natural enemies can result in lower levels of attack. As a consequence of this reduction in enemy pressure, plant performance may increase and selection for resistance to enemies may decrease. In the present study, we compared leaf damage, plant size and leaf trichome density, as well as the direction and magnitude of selection on resistance and plant size between non-native (Spain) and native (Mexico) populations of Datura stramonium. This species was introduced to Spain about five centuries ago and constitutes an ideal system to test four predictions of the enemy release hypothesis. Compared with native populations, we expected Spanish populations of D. stramonium to have (i) lower levels of foliar damage; (ii) larger plant size; (iii) lower leaf trichome density that is unrelated to foliar damage by herbivores; and (iv) weak or no selection on resistance to herbivores but strong selection on plant size. Our results showed that, on average, plants from non-native populations were significantly less damaged by herbivores, were less pubescent and were larger than those from native populations. We also detected different selection regimes on resistance and plant size between the non-native and native ranges. Positive selection on plant size was detected in both ranges (though it was higher in the non-native area), but consistent positive selection on relative resistance was detected only in the native range. Overall, we suggest that changes in selection pressure on resistance and plant size in D. stramonium in Spain are a consequence of 'release from natural enemies'.

Adaptive divergence in resistance to herbivores in Datura stramonium.

Defensive traits exhibited by plants vary widely across populations. Heritable phenotypic differentiation is likely to be produced by genetic drift and spatially restricted gene flow between populations. However, spatially variable selection exerted by herbivores may also give rise to differences among populations. To explore to what extent these factors promote the among-population differentiation of plant resistance of 13 populations of Datura stramonium, we compared the degree of phenotypic differentiation (P ST) of leaf resistance traits (trichome density, atropine and scopolamine concentration) against neutral genetic differentiation (F ST) at microsatellite loci. Results showed that phenotypic differentiation in defensive traits among-population is not consistent with divergence promoted by genetic drift and restricted gene flow alone. Phenotypic differentiation in scopolamine concentration was significantly higher than F ST across the range of trait heritability values. In contrast, genetic differentiation in trichome density was different from F ST only when heritability was very low. On the other hand, differentiation in atropine concentration differed from the neutral expectation when heritability was less than or equal to 0.3. In addition, we did not find a significant correlation between pair-wise neutral genetic distances and distances of phenotypic resistance traits. Our findings reinforce previous evidence that divergent natural selection exerted by herbivores has promoted the among-population phenotypic differentiation of defensive traits in D. stramonium.

Selection mosaic exerted by specialist and generalist herbivores on chemical and physical defense of Datura stramonium.

Selection exerted by herbivores is a major force driving the evolution of plant defensive characters such as leaf trichomes or secondary metabolites. However, plant defense expression is highly variable among populations and identifying the sources of this variation remains a major challenge. Plant populations are often distributed across broad geographic ranges and are exposed to different herbivore communities, ranging from generalists (that feed on diverse plant species) to specialists (that feed on a restricted group of plants). We studied eight populations of the plant Datura stramonium usually eaten by specialist or generalist herbivores, in order to examine whether the pattern of phenotypic selection on secondary compounds (atropine and scopolamine) and a physical defense (trichome density) can explain geographic variation in these traits. Following co-evolutionary theory, we evaluated whether a more derived alkaloid (scopolamine) confers higher fitness benefits than its precursor (atropine), and whether this effect differs between specialist and generalist herbivores. Our results showed consistent directional selection in almost all populations and herbivores to reduce the concentration of atropine. The most derived alkaloid (scopolamine) was favored in only one of the populations, which is dominated by a generalist herbivore. In general, the patterns of selection support the existence of a selection mosaic and accounts for the positive correlation observed between atropine concentration and plant damage by herbivores recorded in previous studies.

Incidental benign metastasizing leiomyoma in a patient with bone sarcoma: a case report.

Background. The benign metastasizing leiomyoma is an exceptionally rare entity; it presents with ectopic leiomyoma nodules with a benign pattern. Symptoms vary according to the anatomic location. The diagnosis is histopathological, usually in patients with history of hysterectomy. Case Presentation. A 36-year-old female with 2-month history of left knee pain was diagnosed with bone fibrosarcoma. A CT scan showed pulmonary nodules. The patient started neoadjuvant chemotherapy. Conservative surgery of pelvic limb was achieved. A new CT scan reported pulmonary nodules that remained in relation to the previous CT. A nodule resection by thoracotomy and TOB (transoperative biopsy) was performed. The final pathology report described benign proliferative lesions consistent with benign metastatic leiomyoma. Conclusions. Benign metastatic leiomyoma is a rare condition presenting with uterine and extrauterine nodules most commonly in the lung. The diagnosis is histopathological. The surgical procedure must be reserved for selected patients.

Tendencias y comportamientos de los datos disponibles sobre el cáncer de mama / Trends and behaviors in available data on breast cancer

El análisis de datos es útil para descubrir información de interés en diversos campos de aplicación, como en salud, donde se pueden realizar estudios para el pronóstico de tendencias y comportamientos que presentan determinadas enfermedades, como el cáncer. Objetivo: En este trabajo se presenta el análisis y la caracterización de casos de cáncer de mama en mujeres de origen hispano. Método: Para realizar este estudio se empleó un enfoque cualitativo y cuantitativo. La fuente de datos utilizada corresponde a registros clínicos de la base de datos del programa de Vigilancia, Epidemiología y Resultados Finales del Instituto Nacional del Cáncer de los Estados Unidos. El análisis se realizó en dos etapas. La primera consistió en un análisis preliminar del total de variables incluidas en la base de datos con el propósito de establecer las variables relevantes, según el período de sus registros. En la segunda etapa se determinó la calidad de la serie de datos para establecer las variables significativas asociadas con el diagnóstico de cáncer de mama en mujeres de origen hispano. Resultados: Se analizó la variabilidad y distribución de las principales variables oncológicas, previamente identificadas, que registran información puntual sobre el paciente y el cáncer de mama. Conclusión: Se observó que el cáncer de mama es una enfermedad con un comportamiento no uniforme, lo que indica que la posibilidad de recuperación depende de la etapa del cáncer, de si se encuentra exclusivamente en la mama o se ha diseminado a otras partes del cuerpo, así como del tipo, el tratamiento recibido y la salud de la paciente en general.

Data analysis aims to discover information of interest in diverse application fields, such as health, in which studies can be made for the prognosis of trends and behaviors that occur in certain pathologies, such as cancer. Objective: This study aimed to present the analysis and characterization of breast cancer cases diagnosed in Hispanic-origin women. Method: A qualitative and quantitative approach was used to conduct this study. The data source used corresponds to clinical records of the Surveillance, Epidemiology, and End Results program of the National Cancer Institute of the United States. The analysis was performed in two stages. The first consisted of a preliminary analysis of the total variables listed in the database, with the purpose of establishing those relevant variables, according to the period of their registers. In the second stage, the quality of the data series was determined to establish the significant variables associated with the diagnosis of breast cancer in Hispanic-origin women. Results: We analyzed the variability and distribution of the main, previously identified, oncological variables that record specific information about the patient and breast cancer. Conclusion: We observed that breast cancer is a disease with non-uniform behavior, indicating that the possibility of recovery depends on the stage of cancer, whether it is located exactly in the breast or has spread to other parts of the body, type, treatment received, and the health of the patient in general.

[Levels of CD4+ and FOXP3+ lymphocytes in patients with allergic rhinitis]. / Concentraciones de linfocitos T CD4+ y FOXP3+ en pacientes con rinitis alérgica.

BACKGROUND: Allergic rinitis is the more common allergic disease, affecting to 25% of general population. Otitis media, sinusitis and other complications result from not controlled allergic rinitis. It has been reported that a low expression of FOXP3 marker on lymphocytes is associated with allergic diseases, and that allergen immunotherapy increases its synthesis. OBJECTIVE: To compare CD4+ FOXP3+ T cell levels in patients with allergic rhinitis, with and without allergen immunotherapy. METHODS: In this cross-sectional, observational and comparative study were included adult patients with allergic rinitis in two groups: one group with 29 patients under allergen immunotherapy for six months, and other group with 30 patients without immunotherapy. Lymphocyte markers CD3, CD4, CD8 y FOXP3 were determined in both groups, as well as serum immunoglobulins. RESULTS: In the group treated with immunotherapy the mean age was 36.4 years, and 72% of them were women. In the other group the age average was 40.4 years and 63% were women. There were no significant differences in immunoglobulin levels among both groups; IgG4 had higher levels, but not significant, in the immunotherapy group (82.1 vs 72.4 mg/dL, p=0.67). Patients from the group without immunotherapy had higher number of FOXP3+ lymphocytes, but not significant (8.2 vs 7.9, p=0.57). CONCLUSIONS: Patients treated with allergen immunotherapy had lower FOXP3+ lymphocytes number than those not treated. More studies are needed for considering FOXP3+ lymphocyte molecule as a useful marker in the follow-up of patients under immunotherapy.