High linoleic acid levels in red blood cells predict a poor response to neoadjuvant chemotherapy in human epidermal growth factor receptor type 2-positive breast cancer patients.

OBJECTIVE: Polyunsaturated fatty acids are categorized as ω-3 or ⍵-6. Previous studies demonstrate that breast cancers display a high expression of fatty acid synthase and high fatty acid levels. Our study sought to determine if changes in plasma or red blood cell membrane fatty acid levels were associated with the response to preoperative (neoadjuvant) chemotherapy in non-metastatic breast cancer patients. METHODS: Our prospective study assessed fatty acid levels in plasma and red blood cell membrane. Response to neoadjuvant chemotherapy was evaluated by the presence or absence of pathologic complete response and/or residual cancer burden. RESULTS: A total of 28 patients were included. First, patients who achieved pathologic complete response had significantly higher neutrophil-to-lymphocyte ratio versus no pathologic complete response (P = 0.003). Second, total red blood cell membrane polyunsaturated fatty acids were higher in the absence of pathologic complete response (P = 0.0028). Third, total red blood cell membrane ⍵-6 polyunsaturated fatty acids were also higher in no pathologic complete response (P < 0.01). Among ⍵-6 polyunsaturated fatty acids, red blood cell membrane linoleic acid was higher in the absence of pathologic complete response (P < 0.01). Notably, plasma polyunsaturated fatty acid, ⍵-6, and linoleic acid levels did not have significant differences. A multivariate analysis confirmed red blood cell membrane linoleic acid was associated with no pathologic complete response; this was further confirmed by receiver operating characteristic analysis (specificity = 92.3%, sensitivity = 76.9%, and area under the curve = 0.855). CONCLUSIONS: Pending further validation, red blood cell membrane linoleic acid might serve as a predictor biomarker of poorer response to neoadjuvant chemotherapy in non-metastatic human epidermal growth factor receptor type 2-positive breast cancer. Measuring fatty acids in red blood cell membrane could offer a convenient, minimally invasive strategy to identifying patients more likely to respond or those with chemoresistance.

Trastornos respiratorios del sueño en niños escolares chilenos: prevalencia y factores de riesgo / Prevalence and risk factors for sleep-disordered breathing in chilean schoolchildren

Resumen: Objetivos: Describir la prevalencia de trastornos respiratorios del sueño (TRS) en escolares chilenos y estudiar factores de riesgo asociados. Pacientes y Método: Estudio transversal y descriptivo. Se enviaron cuestionarios a los padres de niños de 1° año básico de colegios de la Región Metropolitana (Santiago), Región del Biobío (Concepción, Chillán, Yumbel) y Región de Magallanes (Porvenir y Puerto Natales). Se consignaron datos antropométricos, desempeño escolar, características del hogar, contaminantes intradomiciliarios, antecedentes médicos y síntomas actuales de asma, rinitis alérgica y dermatitis atópica. Se determinó estado nutricional según zIMC. Se aplicó un cuestionario de sue ño pediátrico validado en español (pediatric sleep questionnaire, PSQ). Resultados: 564 encuestas fueron analizadas, la edad mediana fue 6 años (rango 5 a 9), 44,9% sexo masculino. La prevalencia de TRS fue 17,7% (n = 100): 6% en Vitacura (Metropolitana), 28,7% en Chillán (Biobío) y 36,4% en Puerto Natales (Magallanes) (p = 0,001). El grupo con TRS tuvo mayor proporción de hombres (54,5 vs 42,8%, p = 0,033), menor rendimiento académico (promedio general 6,36 ± 0,48 vs 6,56 ± 0,34, p = 0,001), menor educación superior materna (44,4 vs 69,9%, p = 0,001) y mayor exposición a contaminantes intradomiciliarios que aquellos sin TRS. Posterior al análisis multivariado se mantu vieron como predictor de TRS el haber presentado síntomas de rinitis en últimos 12 meses (OR 4,79; IC 95% 2,20-10,43) y el nivel educacional básico o medio de la madre (OR 3,51; IC 95% 1,53-8,02). Conclusiones: Los escolares chilenos presentan una alta prevalencia de TRS, con diferencias demo gráficas. Se asoció a factores de riesgo social, a factores más específicos de daño pulmonar y a peor cantidad y calidad del sueño.

Abstract: Objectives: To describe the prevalence of sleep-disordered breathing (SDB) in Chilean schoolchil dren and study associated risk factors. Patients and Method: We carried out a transversal and des criptive study. Questionnaires were sent to the parents of children attending first year of elementary school in the Metropolitan Region (Santiago), the Biobío Region (Concepción, Chillán, Yumbel) and the Magallanes Region (Porvenir and Puerto Natales). Anthropometric data, school performan ce, household characteristics, indoor pollutants, medical history, and current symptoms of asthma, allergic rhinitis, and atopic dermatitis were recorded. The nutritional status was determined accor ding to z-BMI. A pediatric sleep questionnaire validated in Spanish (PSQ) was applied. Results: 564 questionnaires were analyzed, the median age was six years (range 5 to 9), 44.9% male. The SDB prevalence was 17.7% (n = 100): 6% in Vitacura (Metropolitan Region), 28.7% in Chillán (Biobío Region), and 36.4% in Puerto Natales (Magallanes Region) (p = 0.001). The group with SDB had a higher proportion of men (54.5 vs 42.8%, p = 0.033), lower academic performance (overall grade point average 6.36 ± 0.48 vs 6.56 ± 0.34, p = 0.001), lower maternal higher education (44.4% vs 69.9%, p = 0.001), and higher exposure to indoor pollutants than those without SDB. After the multivariate analysis, symptoms of rhinitis in the last 12 months (OR 4.79, 95% CI 2.20-10.43) and lower maternal educational level (OR 3.51; 95% CI 1.53-8.02) remained as predictors of SDB. Con clusions: Chilean schoolchildren have a high prevalence of SDB with demographic differences. It was associated with social risk factors, more specific factors of lung damage, and worse sleep quality and quantity.