Observational analysis of clinical and pathological characteristics and their prognostic impact in Mexican patients with breast cancer: A multi-center study.

Breast cancer is the most incidental and deadly neoplasm worldwide; in Mexico, very few epidemiologic reports have analyzed the pathological features and its impact on their clinical outcome. Here, we studied the relation between pathological features and the clinical presentation at diagnosis and their impact on the overall and progression-free survival of patients with breast cancer. For this purpose, we collected 199 clinical records of female patients, aged at least 18 years old (y/o), with breast cancer diagnosis confirmed by biopsy. We excluded patients with incomplete or conflicting clinical records. Afterward, we performed an analysis of overall and progression-free survival and associated risks. Our results showed an average age at diagnosis of 52 y/o (24-85), the most common features were: upper outer quadrant tumor (32%), invasive ductal carcinoma (76.8%), moderately differentiated (44.3%), early clinical stages (40.8%), asymptomatic patients (47.8%), luminal A subtype (47.8%). Median overall survival was not reached, but median progression-free survival was 32.2 months (29.75-34.64, CI 95%) associated risk were: clinical stage (p < 0.0001) symptomatic presentation (p = 0.009) and histologic grade (p = 0.02). Therefore, we concluded that symptom presence at diagnosis impacts progression-free survival, and palpable symptoms are related to an increased risk for mortality.

Establishment of a multidisciplinary fetal center streamlines approach for congenital lung malformations.

PURPOSE: Fetuses with a diagnosis of congenital lung malformations (CLM) on prenatal imaging are commonly referred to a multi-disciplinary specialty team for prenatal assessment and postnatal management. The net effect of such services is broadly stated to improve the outcomes of affected newborns. However, these claims are relatively unsubstantiated. METHODS: After IRB approval, a retrospective review of children diagnosed with CLM from 2008 to 2018 and referred to a large urban children's hospital was performed. A comparison was performed between prenatally diagnosed patients having a multi-disciplinary fetal center evaluation (FC) and prenatally diagnosed patients who did not receive a referral or were seen prior to the establishment of the center (NON-FC). RESULTS: Eighty-eight live-born patients with a prenatal diagnosis of CLM were identified, with 49 in the FC group and 39 NON-FC. Thirty-four (63%) and 23 (59%) patients underwent operative resection of CLM, respectively. FC patients presented earlier at first postnatal follow-up (42 vs. 145 days, p = .03), had fewer preoperative office visits (2.1 vs. 3.4, p = .0003), received fewer preoperative chest radiographs (0.5 vs. 1.3; p = .002) and chest computed tomography (0.9 vs. 1.4; p = .001), and had fewer preoperative pneumonias (0 vs. 17.4%; p = .02) compared to their NON-FC counterparts. FC patients were also more likely to undergo resection at an earlier age (217 vs. 481 days, p = .003) and were more likely to undergo a minimally invasive resection (75% vs. 39.1%, p = .015). There were no differences in post-operative outcomes between the two groups. CONCLUSION: Children with a prenatal diagnosis of CLM appear to benefit from an organized multi-specialty team approach in several impactful parameters. Hospital systems and providers that invest in similar strategies are likely to achieve improved outcomes in the care of newborns prenatally diagnosed with a CLM.

Impact of Additional Anomalies on Postnatal Outcomes in Congenital Lung Malformations.

BACKGROUND: Approximately 20% of fetuses diagnosed with congenital lung malformations (CLMs) are found to have additional anomalies. We aim to determine if additional anomalies have an impact on postnatal outcomes for patients with CLMs. METHODS: After institutional review board approval, we performed a retrospective review of live-born patients with CLMs from 2008 to 2018. All patients were prenatally diagnosed with CLMs. Clinical information pertaining to additional congenital anomalies and outcomes was collected from the electronic health record and analyzed. RESULTS: Of the 88 patients who had a prenatal diagnosis of CLMs, 20.5% had additional anomalies. Ten of the 18 patients (56%) were considered to have a major anomaly in addition to CLMs. Outcomes for patients electing nonoperative management of CLMs were similar between those with and without an additional anomaly. Although patients with an additional anomaly were more likely to have perinatal respiratory complications (44% versus 17%, P = 0.03), the number of preoperative clinic and emergency department visits, age at surgery, minimally invasive approach to surgical resection of CLM, estimated blood loss, length of hospital stay, intubation, duration of intubation, 30-day postoperative complications, and long term sequelae were not statistically different. This held true when stratified for major versus minor anomalies. CONCLUSIONS: Twenty percent of fetuses diagnosed with CLM in our population have additional anomalies. Newborns with additional anomalies have a higher risk of pre-excision pulmonary complications. However, the overall outcomes of all patients with CLMs are similar.

Lipoma con patrón infiltrativo muscular / Lipoma with infiltrative muscular pattern

Los lipomas pueden crecer hasta alcanzar un gran tamaño y se clasifican en dos tipos: cutáneo o superficial, cuando se localizan encapsulados en los tejidos blandos superficiales; y profundo o subfascial, cuando su origen es poco delimitado o difuso y presentan estructuras profundas intraóseas, intermusculares e intramusculares. Esta última es poco usual, su localización puede pasar por desapercibida y toma un patrón de crecimiento infiltrativo a través de las fibras musculares estriadas, lo que hace necesario diferenciarlo de lesiones malignas del tejido graso. Por tal motivo, se realizó la presentación de un caso con lipoma infiltrativo muscular en el miembro inferior derecho

Mitotic activity of the duodenal crypt enterocytes in mice transplanted with EA21a mammary carcinoma.

The presence of a tumor generally changes the mitotic activity of the normal cell population in mice. In the present work, the mitotic activity of the duodenal crypt enterocytes in EA21a mammary carcinoma-bearing mice was determined. The results show that there is a patent circadian variation in normal mice and, in the presence of the EA21a mammary tumor, cell proliferation is stimulated. Stimulation was evident in enterocytes from the intermediate as well as the superficial regions of the crypt. Some humoral factors produced by the transplanted tumor could interfere with the regulatory mechanism of the mitotic activity of duodenal crypt enterocytes.

Actividad mitotica de los enterocitos de las criptas duodenales en ratones portadores de un hepatocarcinoma / Mitotic activity of duodenal-crypt enterocytes in mice with hepatocarcinoma

La presencia de tumores injertados en el ratón generalmente provoca modificaciones de la proliferación de sus poblaciones celulares normales. En el presente trabajo se analiza la actividad mitótica (AM) de los enterocitos de las criptas duodenales del ratón injertado con el hepatocarcinoma ES12a. Se utilizan ratones C3H/S hembras de 28 días de edad, estandarizados para análisis de periodicidad, distribuidos en dos grupos: testigos y portadores del tumor injertado. Animales de ambos grupos se reparten en seis lotes [n = 6-10] que se sacrifican cada cuatro horas después de recibir una dosis de 2 mug/g de colchicina. Muestras de duodeno se fijan en formol tamponado al 10 por ciento y se procesan para la determinación de la actividad mitótica. Se controlan, por animal, los enterocitos correspondientes a 20 criptas, seccionadas longitudinalmente, registrando las células con metafase y su localización topográfica. A partir de estos valores se determinan los índices mitóticos (metafases colchicínicas x 1000 núcleos) de toda la cripta y de cada zona previamente establecida. Con estas cifras se define la X + SEM de cada lote. Las diferencias a comparar se analizan utilizando la prueba de "t"de Student. Los resultados demuestran que la presencia del tumor ES12a ejerce tanto un efecto inhibitorio sobre la AM de los enterocitos, como un desfasamiento de la curva circadiana de este parámetro de crecimiento.