Incident comorbidities after tamoxifen or aromatase inhibitor therapy in a racially and ethnically diverse cohort of women with breast cancer.

PURPOSE: As survival with early-stage, hormone receptor (HR)-positive breast has improved, it is essential to understand the long-term risks of incident comorbidities with different adjuvant endocrine therapy (ET) options. METHODS: Women treated with tamoxifen and/or an aromatase inhibitor (AI) for stages 1-3, HR-positive/HER2-negative breast cancer from 2000 to 2016 in either of two healthcare systems in the San Francisco Bay Area were included. We considered the following comorbidities: cerebrovascular accidents, congestive heart failure, dementia, depression/anxiety, diabetes mellitus, hyperlipidemia, myocardial infarction, non-alcoholic steatohepatitis, osteoporosis/fracture, peripheral vascular disease, and venous thromboembolism. Cause-specific Cox proportional hazards models were fit to time-to-new-diagnosis for each comorbidity, accounting for death as a competing risk. Hazard ratios (HR) and 95% confidence intervals (CI) for tamoxifen versus AI were reported. RESULTS: Among 2,902 analyzed patients, the median age at diagnosis was 58.3 years; 67.6% were non-Hispanic white, 22.3% Asian, 7.5% Hispanic, and 1.7% non-Hispanic Black. Half (54.7%) used AIs only, 27.6% used tamoxifen only and 17.7% used both tamoxifen and AIs sequentially. Tamoxifen was associated with a lower risk of osteoporosis than AI (multivariable HR 0.45, 95% CI 0.32-0.62). No other incident comorbidity risk varied between users of tamoxifen versus AIs. CONCLUSION: In a diverse, multi-institutional, contemporary breast cancer cohort, the only incident comorbidity that differed between ET options was osteoporosis, a known side effect of AIs. These results may inform clinical decision-making about ET, and reassure patients who have bothersome symptoms on AIs that they are unlikely to develop worse comorbidities if they switch to tamoxifen.

A Comprehensive Review on Current Perspectives of Flavonoids as Antimicrobial Agent.

Flavonoids are the secondary plant metabolites with diversities of pharmacological activities like antioxidant, anticancer, anti-inflammatory, hepatoprotective, free radical scavenging activity and antiviral activities. Flavonoids have also been proved as a major contributor to an antimicrobial phytochemical. Being the major substituent of antibiotics, today flavonoids have attained great attention as there is an increase in the persistence of untreatable microbial infections due to microbial resistance. This review demonstrates the screening, isolation of extracts and derivatization of various flavonoids and their evaluation for antimicrobial potency. Recent advancements of various derivatives of flavonoids having antimicrobial activity have also been discussed in this review. This review helps researchers to get vast knowledge about flavonoids and also gives an idea for the current scenario of flavonoids and their applications as an antimicrobial agent.

Evaluation of bioactive compounds and antioxidant potential of hydroethanolic extract of Moringa oleifera Lam. from Rajasthan, India.

Moringa oleifera Lam., the miracle tree, is widely used as a traditional medicine. The analyses of phytochemicals and antioxidant potential of hydroethanolic extract of various plant parts of M. oleifera revealed that leaves possessed the highest content of total phenolics (9.58 mg/g), ß-carotene (14.10 mg/g) and lycopene (2.60 mg/g). Flowers and bark showed the highest content of total flavonoids (3.5 mg/g) and anthocyanin (52.80 mg/g), respectively. Leaves also showed maximum antioxidant potential using nitric oxide scavenging assay (IC50 - 120 µg/ml) and deoxyribose degradation assay (IC50-178 µg/ml). Highest DPPH radical scavenging activity was observed in flowers (IC50-405 µg/ml). The GC-MS study revealed the presence of 29, 36 and 24 compounds in bark, leaf and flower, respectively. The major constituent identified were epiglobulol (41.68% in bark), phytol (23.54% in leaf) and ß-sitosterol (15.35% in flower).The phytochemicals identified possess several therapeutic activity, including antioxidant potential, which was confirmed through earlier reports. Moreover, the presence of 1,1,3-triethoxubutane in all the plant parts analyzed, projects it as an important source of waste water treatment as hydrophobic modifiers.