Occupational exposure to pesticides and endometrial cancer in the Screenwide case-control study.

BACKGROUND: Endometrial cancer is the most common gynaecological tumour in developed countries and disease burden is expected to increase over the years. Identifying modifiable risk factors may help developing strategies to reduce the expected increasing incidence of these neoplasms. OBJECTIVE: This study evaluates the association between occupational exposure to pesticides and endometrial cancer using data from a recent case-control study in Spain. METHODS: The analyses included data from 174 consecutive incident endometrial cancer cases and 216 hospital controls frequency-matched by age. Data were collected through structured epidemiological questionnaires and exposure to pesticides was assessed using a Spanish job-exposure matrix (MatEmESp). RESULTS: Overall, 12% of controls and 18% of cases were occupationally exposed to pesticides. We observed a positive association between occupational exposure to pesticides and endometrial cancer (OR = 2.08; 95% CI = 1.13-3.88 compared to non-exposed). In general, exposures that occurred farther in the past were significantly associated with endometrial cancer. Exposure to insecticides, fungicides and herbicides were positively associated with endometrial cancer (OR = 2.08; 95% CI = 1.13-3.88, OR = 4.40; 95% CI = 1.65-13.33, and OR = 5.25; 95% CI = 1.84-17.67, respectively). The agricultural, poultry and livestock activities scenario was associated with endometrial cancer (OR = 4.16; 95% CI = 1.59-12.32), while the cleaning exposure scenario was not (OR = 1.22; 95% CI = 0.55-2.67). CONCLUSIONS: Assessment of occupational exposure to pesticides assessed using a Spanish job-exposure matrix revealed a positive association with endometrial cancer. The elucidation of the role of pesticide compounds on endometrial cancer should shed a light on the aetiology of this tumour.

Immune thrombocytopenia and COVID-19: Case report and review of literature.

Immune thrombocytopenia, also known as immune thrombocytopenic purpura (ITP), has been reported as an important complication related to COVID-19.We present a 49-year-old male patient with systemic lupus erythematosus with lupus nephritis, antiphospholipid syndrome and history of ITP who developed an ITP flare in the context of COVID-19. He had no bleeding manifestations and had a good response to prednisone treatment.We review the characteristics of the cases reported to date in the literature, with an analysis of 57 patients. Mean age was 56 years (±19.6 SD), and 50.9% were male. This was the first episode of ITP in most of the patients (86.05%), with SARS-CoV-2 acting as the initial trigger. We found that ITP flares may appear in both mild and severe COVID-19 cases. They also appeared at any time during the course of the disease, 48.2% of patients developed it during hospitalization, while it was diagnosed at admission in the rest of the cases. Platelet counts were significantly lower than other ITP series, with a median nadir platelet count of 8 × 109/L (IQR 2-17.75 × 109/L). These patients show a higher bleeding rate (61.4%) compared with other ITP series. They also show a better response to treatment, with good response to the first line therapies in 76.9% of them. The most common first-line treatment was intravenous immunoglobulin (IVIG), used alone or combined with corticosteroids in 40.4% and 32.7% of cases respectively, while 25% of patients received only corticosteroids.Our review suggests that COVID-19-related ITP can be seen even in previously healthy patients. Clinicians must be aware that ITP may appear both in mild and severe COVID-19, at any time during its course. Given that this kind of ITP seems to be associated with a higher bleeding risk, its diagnosis in a clinical scenario such as COVID-19, where anticoagulant therapy is frequently used, may be critical. Treatment with IVIG and/or corticoids is often effective.

A New Look on Financial Markets Co-Movement through Cooperative Dynamics in Many-Body Physics.

One of the main contributions of the Capital Assets Pricing Model (CAPM) to portfolio theory was to explain the correlation between assets through its relationship with the market index. According to this approach, the market index is expected to explain the co-movement between two different stocks to a great extent. In this paper, we try to verify this hypothesis using a sample of 3.000 stocks of the USA market (attending to liquidity, capitalization, and free float criteria) by using some functions inspired by cooperative dynamics in physical particle systems. We will show that all of the co-movement among the stocks is completely explained by the market, even without considering the market beta of the stocks.

Effect of Several HIV Antigens Simultaneously Loaded with G2-NN16 Carbosilane Dendrimer in the Cell Uptake and Functionality of Human Dendritic Cells.

Dendrimers are highly branched, star-shaped, and nanosized polymers that have been proposed as new carriers for specific HIV-1 peptides. Dendritic cells (DCs) are the most-potent antigen-presenting cells that play a major role in the development of cell-mediated immunotherapy due to the generation and regulation of adaptive immune responses against HIV-1. This article reports on the associated behavior of two or three HIV-derived peptides simultaneously (p24/gp160 or p24/gp160/NEF) with cationic carbosilane dendrimer G2-NN16. We have found that (i) immature DCs (iDCs) and mature (mDCs) did not capture efficiently HIV peptides regarding the uptake level when cells were treated with G2-NN16-peptide complex alone; (ii) the ability of DCs to migrate was not depending on the peptides presence; and (iii) with the use of molecular dynamic simulation, a mixture of peptides decreased the cell uptake of the other peptides (in particular, NEF hinders the binding of more peptides and is especially obstructing of the binding of gp160 to G2-NN16). The results suggest that G2-NN16 cannot be considered as an alternative carrier for delivering two or more HIV-derived peptides to DCs.

Missing data imputation of solar radiation data under different atmospheric conditions.

Global solar broadband irradiance on a planar surface is measured at weather stations by pyranometers. In the case of the present research, solar radiation values from nine meteorological stations of the MeteoGalicia real-time observational network, captured and stored every ten minutes, are considered. In this kind of record, the lack of data and/or the presence of wrong values adversely affects any time series study. Consequently, when this occurs, a data imputation process must be performed in order to replace missing data with estimated values. This paper aims to evaluate the multivariate imputation of ten-minute scale data by means of the chained equations method (MICE). This method allows the network itself to impute the missing or wrong data of a solar radiation sensor, by using either all or just a group of the measurements of the remaining sensors. Very good results have been obtained with the MICE method in comparison with other methods employed in this field such as Inverse Distance Weighting (IDW) and Multiple Linear Regression (MLR). The average RMSE value of the predictions for the MICE algorithm was 13.37% while that for the MLR it was 28.19%, and 31.68% for the IDW.

Deformable mirror model for open-loop adaptive optics using multivariate adaptive regression splines.

Open-loop adaptive optics is a technique in which the turbulent wavefront is measured before it hits the deformable mirror for correction. We present a technique to model a deformable mirror working in open-loop based on multivariate adaptive regression splines (MARS), a non-parametric regression technique. The model's input is the wavefront correction to apply to the mirror and its output is the set of voltages to shape the mirror. We performed experiments with an electrostrictive deformable mirror, achieving positioning errors of the order of 1.2% RMS of the peak-to-peak wavefront excursion. The technique does not depend on the physical parameters of the device; therefore it may be included in the control scheme of any type of deformable mirror.

Modeling a MEMS deformable mirror using non-parametric estimation techniques.

Using non-parametric estimation techniques, we have modeled an area of 126 actuators of a micro-electro-mechanical deformable mirror with 1024 actuators. These techniques produce models applicable to open-loop adaptive optics, where the turbulent wavefront is measured before it hits the deformable mirror. The model's input is the wavefront correction to apply to the mirror and its output is the set of voltages to shape the mirror. Our experiments have achieved positioning errors of 3.1% rms of the peak-to-peak wavefront excursion.

Central Pathology Review in SENTIX, A Prospective Observational International Study on Sentinel Lymph Node Biopsy in Patients with Early-Stage Cervical Cancer (ENGOT-CX2).

The quality of pathological assessment is crucial for the safety of patients with cervical cancer if pelvic lymph node dissection is to be replaced by sentinel lymph node (SLN) biopsy. Central pathology review of SLN pathological ultrastaging was conducted in the prospective SENTIX/European Network of Gynaecological Oncological Trial (ENGOT)-CX2 study. All specimens from at least two patients per site were submitted for the central review. For cases with major or critical deviations, the sites were requested to submit all samples from all additional patients for second-round assessment. From the group of 300 patients, samples from 83 cases from 37 sites were reviewed in the first round. Minor, major, critical, and no deviations were identified in 28%, 19%, 14%, and 39% of cases, respectively. Samples from 26 patients were submitted for the second-round review, with only two major deviations found. In conclusion, a high rate of major or critical deviations was identified in the first round of the central pathology review (28% of samples). This reflects a substantial heterogeneity in current practice, despite trial protocol requirements. The importance of the central review conducted prospectively at the early phase of the trial is demonstrated by a substantial improvement of SLN ultrastaging quality in the second-round review.

A Parametric Model of the LARCODEMS Heavy Media Separator by Means of Multivariate Adaptive Regression Splines.

Modeling of a cylindrical heavy media separator has been conducted in order to predict its optimum operating parameters. As far as it is known by the authors, this is the first application in the literature. The aim of the present research is to predict the separation efficiency based on the adjustment of the device's dimensions and media flow rates. A variety of heavy media separators exist that are extensively used to separate particles by density. There is a growing importance in their application in the recycling sector. The cylindrical variety is reported to be the most suited for processing a large range of particle sizes, but optimizing its operating parameters remains to be documented. The multivariate adaptive regression splines methodology has been applied in order to predict the separation efficiencies using, as inputs, the device dimension and media flow rate variables. The results obtained show that it is possible to predict the device separation efficiency according to laboratory experiments performed and, therefore, forecast results obtainable with different operating conditions.

Niebla en agosto (2016) y la sombra del pasado (2018). Aktion T4: el plan de eutanasia nazi para la eliminación de las personas con discapacidad / Fog in August (2016) and Never look away (2018). Aktion T4: The nazi euthanasia plan for the elimination of persons with disabilities

El ascenso al poder del nacionalsocialismo en Alemania y sus consecuencias ha sido una fuente inagotable para la inspiración de producciones cinematográficas. Sin embargo, el programa Aktion T4 más conocido por plan de eutanasia nazi, no había sido tema principal de una película hasta fechas recientes. Niebla en agosto (2016) y La Sombra del pasado (2018) son dos cintas que abordan los métodos empleados para el control y eliminación de las personas con discapacidad o, mejor dicho, de aquellas personas que no cumplían los cánones de la raza aria y además eran una carga económica para el estado alemán. Las leyes de esterilización, primero, el programa de eliminación de bebés nacidos con alguna clase de discapacidad y, por último, el programa Aktion T4 que seleccionaba y ordenaba el asesinato de las personas ingresadas en instituciones son las tres fases de un calculado plan de exterminio. Psiquiatras, personal de enfermería y otros médicos y sanitarios fueron los diseñadores, colaboradores y ejecutores de ese crimen contra la humanidad que fue, sin duda, un ensayo para el posterior genocidio judío. Todavía hoy se reclama en Alemania verdad, justicia y reparación para las casi 300.000 personas víctimas de esos crímenes olvidados. (AU)

The rise to power of National Socialism in Germany and its consequences has been an inexhaustible source of inspiration for film productions. However, the Aktion T4 program, best known for a Nazi euthanasia plan, had not been the main subject of a movie until recently. Fog in august (2016) and Never look away (2018) are two films that address the methods used for the control and elimination of people with disabilities or, rather, of those who did not comply with the canons of the Aryan race and they were also an economic burden for the German state. The sterilization laws, first, the program for the elimination of babies born with some kind of disability and, finally, the Aktion T4 program that selected and ordered the murder of people admitted to institutions are the three phases of a calculated plan of extermination. Psychiatrists, nursing staff and other doctors and health workers were the designers, collaborators and executors of this crime against humanity that was, without a doubt, a trial for the subsequent Jewish genocide. Truth, justice and reparation for the almost 300,000 people of these forgotten crimes are still claimed in Germany today. (AU)

Marital Satisfaction in Spanish and Dominican Couples / Satisfacción Marital en Parejas Españolas y Dominicanas

Abstract Marriage is an appreciated worldwide institution, although nearly half of first marriages end in divorce. Thus, the relevance of understanding how people choose their partners and what features can predict a satisfactory relationship. More specifically, in search of data supporting similarity or complementarity approaches on marital satisfaction, the current study analyzes the association between different assortative mating options (homogamy, and heterogamy) and marital satisfaction in Spanish and Dominican couples. A stratified quota sampling of 600 participants was selected, corresponding to 300 married couples (50% Spanish and 50% Dominicans). Data were gathered by means of an interview with the 10-item scale on Marital Satisfaction and a 7-item scale on Status. Results suggest that spouses are matched by similarity in their health and education and by the perception of similarity in intelligence and the financial advantages of staying together. Dominican couples experienced higher marital satisfaction than Spanish couples. Findings on hypergamy reveals the persistence of some traditional roles' distribution among Spanish speaking cultures. The association between status and marital satisfaction revealed that heterogamy rather than homogamy is associated to such satisfaction. These results stress the relevance of taking into account social and cultural differences, beyond biological and psychological factors, to fully understand couples' satisfaction.

Resumen El matrimonio es una institución apreciada a nivel mundial, pese a que casi la mitad de los primeros matrimonios terminan en divorcio. De ahí la importancia de comprender cómo las personas eligen a sus parejas y qué factores contribuyen a predecir una relación satisfactoria. Más concretamente, en busca de datos que ofrezcan apoyo a los enfoques de semejanza o de complementariedad en su relación con la satisfacción marital, el presente estudio analiza diferentes alternativas de emparejamiento selectivo (homogamia y heterogamia) y su relación con dicha satisfacción marital en parejas españolas y dominicanas. Para llevar a cabo el estudio se ha empleado un muestreo estratificado por cuotas compuesto por un total de 600 participantes, que se corresponden con 300 parejas casadas (un 50% procedente de España y el otro 50% procedente de República Dominicana). Los datos se recogieron a través de entrevista la escala de 10 ítems de Satisfacción Marital y la escala de 7 ítems de Status. Los resultados sugieren que los emparejamientos se caracterizan por la semejanza en salud, formación, inteligencia, y por la percepción compartida de las ventajas económicas asociadas a su permanencia. Las parejas dominicanas experimentan una mayor satisfacción marital que las españolas. Los resultados obtenidos sobre hipergamia revelan la persistencia de una distribución de roles tradicional en países de habla hispana. La asociación entre estatus y satisfacción marital indicaron que la heterogamia más que la homogamia, se asocia a tal satisfacción. Todos estos resultados subrayan la importancia de tener en cuenta diferencias sociales y culturales, además de factores biológicos y psicológicos, para comprender plenamente la satisfacción en las parejas.

Medicina herbal china ofertada en páginas web en español: calidad de la información y riesgos / Information quality and health risks in Spanish-language retail websites for Chinese herbal medicine

Objetivo: El auge de la venta en Internet propicia el acceso a productos naturales potencialmente tóxicos y la rápida difusión de la información, no necesariamente veraz, que los proveedores ofrecen al consumidor acerca de sus propiedades. El objetivo del presente trabajo ha sido analizar en páginas web en español de venta de medicina herbal china la calidad de la información ofrecida al consumidor y los posibles riesgos derivados de su consumo. Métodos: I) Búsqueda en Google España de sitios web de venta de medicina herbal china y posterior evaluación de la información sobre las propiedades y consumo seguro de los productos ofertados. II) Identificación en los sitios web de plantas III) Cuantificación de las retiradas de productos de medicina herbal china por la Agencia Española de Medicamentos y Productos Sanitarios (AEMPS). Resultados: 1) Sólo un tercio de las 30 páginas web localizadas cumple con la legislación vigente, ya que las demás incluyen indicaciones terapéuticas occidentales como reclamo para la venta de medicina herbal china en España 2) Cinco páginas aportan información sobre consumo seguro 3) Dos páginas ofertan plantas potencialmente tóxicas y 4) Un importante porcentaje de productos retirados por la AEMPS corresponde a medicina herbal china adulterada con sibutramina, sildenafilo o sus derivados. Conclusión: Nuestros resultados indican que existen motivos suficientes que aconsejan la creación por parte de las autoridades españolas de un sitio web que asesore a quienes pretenden utilizar Internet para comprar medicina herbal china y así permitir que los usuarios tomen decisiones estando bien informados (AU)

Objective: The growing use of purchase online via Internet retailers favours the access to potentially toxic natural products. It also contributes to the quick dissemination of the claims made by the retailers on efficacy and safety, these claims being not always based upon reliable information. Here, we have conducted an online search to find Spanish-language retail websites for Chinese herbal medicine and we have analysed them for the quality of product information and the potential health risks. Methods: I) Online search in Google España to find Spanish-language retail websites for Chinese herbal medicine in which we analysed both the claims regarding possible health benefits and adequate safe use indications II) Identification of potentially toxic herbs in the websites III) Quantification of Chinese herbal medicines withdrawn by the Agencia Española de Medicamentos y Productos Sanitarios (AEMPS). Results: 1) Only one third of the 30 Spanish-language retail websites found which sell Chinese herbal medicine observe the law, given that the other websites include illegal Western disease claims as marketing tools, 2) Five websites provide some safety information, 3) Two websites offer potentially toxic herbs and 4) Chinese herbal medicine adulterated with sibutramine, silfenafil or their analogues make a considerable percentage of the total products withdrawn by the AEMPS. Conclusion: Online health seekers should be warned about misinformation on retail websites for Chinese herbal medicine and directed to a Spanish government Web site for guidance in safely navigating the Internet for buying Chinese herbal medicine (AU)

Puntualizaciones al documento de consenso en cardio-onco-hematología y a la revisión sobre técnicas de imagen cardiaca en detección de cardiotoxicidad / Remarks on the position paper on cardio-onco-hematology and remarks on the review of cardiac imaging modalities for the detection of cardiotoxicity

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Diarrea y desnutrición en paciente trasplantado renal: un caso de infección por criptosporidiosis / Diarrhea and malnutrition in kidney transplant recipient: A case of infection by cryptosporidiosis

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Hospital malnutrition screening at admission: malnutrition increases mortality and length of stay / Cribado de la desnutrición hospitalaria en la admisión: la desnutrición aumenta la mortalidad y la duración de la estancia hospitalaria

Introduction: Malnutrition is common in patients admitted to hospital and is associated with morbidity and mortality. We conducted a study to assess the prevalence of nutritional risk, risk factors associated and its consequences in a third-level hospital. Methods: This is a prospective nutritional screening study of hospitalized patients evaluated within the first 72 hours of admission, by Malnutrition Universal Screening Tool (MUST) and Short Nutritional Assessment Questionnaire (SNAQ) screening tests. The variables recorded included demographic, anthropometric, hospitalization and clinical data. Results: Out of 409 patients, 12.7% and 15.3% were nutritionally at risk according to MUST and SNAQ, respectively, with the highest prevalence in critical care units (33.3%; 25.5%), amongst oncologic patients (17.5%; 28.4%) and those with higher Charlson comorbidity indices (CCI). Length of stay (LOS) was longer in patients at severe malnutrition risk (15.4 vs 9.9 days for MUST; 13.3 vs 9.9 days for SNAQ). Mortality was higher in those with high malnutrition risk (66.7% vs 10.9% for MUST; 50.0% vs 14.2% for SNAQ). Multivariate analysis showed that malnutrition was associated with CCI and mortality. Risk factors associated with LOS were admission as emergencies for both MUST and SNAQ tests. Conclusions: The prevalence of malnutrition is high in patients on admission to a third-level hospital, with a higher prevalence in critical care units, amongst oncologic patients and those with a higher CCI. Malnutrition is associated with longer LOS and higher mortality. The systematic clinical use of screening tools enables to detect patients at risk of malnutrition and take appropriate action (AU)

Introducción: la desnutrición es común en los pacientes ingresados en el hospital y se asocia a morbi/mortalidad. El objetivo de este estudio es evaluar la prevalencia de riesgo nutricional, factores de riesgo asociados y sus consecuencias en un hospital de tercer nivel. Métodos: estudio prospectivo de cribado nutricional de pacientes hospitalizados evaluados dentro de las primeras 72 horas de ingreso, mediante las herramientas Malnutrition Universal Screening Tool (MUST) y Short Nutritional Assessment Questionnaire (SNAQ). Las variables registradas incluyen datos demográficos, antropométricos, de hospitalización y clínicos. Resultados: de los 409 pacientes entrevistados, 12,7% y 15,3% presentaban riesgo nutricional según MUST y SNAQ, respectivamente, con una mayor prevalencia en la Unidad de Cuidados Intensivos (UCI) (33,3%; 25,5%), pacientes oncológicos (17,5%; 28,4%) y aquellos con mayor índice de comorbilidad de Charlson (ICC). La estancia hospitalaria fue mayor en pacientes en riesgo de desnutrición severa (15,4 vs. 9,9 días para MUST; 13,3 vs. 9,9 días para SNAQ), así como la mortalidad (66,7% vs. 10,9% para MUST; 50,0% vs. 14,2% para SNAQ). El análisis multivariante mostró una asociación entre desnutrición e ICC y mortalidad. Los factores de riesgo asociados con estancia hospitalaria fueron ingreso por urgencias para ambos tests. Conclusiones: la prevalencia de desnutrición en pacientes al ingreso a un hospital de tercer nivel es alta, siendo mayor en las UCI, entre pacientes oncológicos y con mayor ICC. La desnutrición se asocia con mayor estancia hospitalaria y mayor mortalidad. El uso clínico sistemático de herramientas de detección puede ayudar a identificar pacientes en riesgo de desnutrición y tomar las medidas apropiadas (AU)

Umbilical cord as a mesenchymal stem cell source for treating joint pathologies.

Articular cartilage disorders and injuries often result in life-long chronic pain and compromised quality of life. Regrettably, the regeneration of articular cartilage is a continuing challenge for biomedical research. One of the most promising therapeutic approaches is cell-based tissue engineering, which provides a healthy population of cells to the injured site but requires differentiated chondrocytes from an uninjured site. The use of healthy chondrocytes has been found to have limitations. A promising alternative cell population is mesenchymal stem cells (MSCs), known to possess excellent proliferation potential and proven capability for differentiation into chondrocytes. The "immunosuppressive" property of human MSCs makes them an important candidate for allogeneic cell therapy. The use of allogeneic MSCs to repair large defects may prove to be an alternative to current autologous and allogeneic tissue-grafting procedures. An allogeneic cell-based approach would enable MSCs to be isolated from any donor, expanded and cryopreserved in allogeneic MSC banks, providing a readily available source of progenitors for cell replacement therapy. These possibilities have spawned the current exponential growth in stem cell research in pharmaceutical and biotechnology communities. Our objective in this review is to summarize the knowledge about MSCs from umbilical cord stroma and focus mainly on their applications for joint pathologies.

Evaluación de la respuesta patológica a la quimioterapia neoadyuvante en mama y axila según los fenotipos moleculares del cáncer de mama / Evaluation of pathological response to neoadjuvant chemotherapy in the breast and axilla according to molecular phenotypes of breast cancer

Objetivo. Evaluar la respuesta patológica a la quimioterapia neoadyuvante tanto en la mama como en la axila según los fenotipos moleculares de cáncer de mama. Pacientes y método. Estudio retrospectivo entre enero de 2011 y diciembre de 2014 que incluye a las pacientes con cáncer de mama infiltrante intervenidas tras tratamiento con quimioterapia neoadyuvante. Hemos considerado 5 fenotipos moleculares según los criterios de St. Gallen 2013. La respuesta patológica en mama y en axila se ha evaluado según los criterios de Sataloff. Resultados. Se recogen los datos de un total de 181 pacientes tratadas con quimioterapia neoadyuvante, de las que a 96 se les realizó linfadenectomía axilar. El 34,3% tenían un fenotipo molecular Her-2, 28,7% basal, 25,4% luminal B y 11,6% luminal A. En los luminal A, el 28,5% han tenido una respuesta patológica completa en la mama frente al 21,4% en la axila; en los luminal B, 34,7 frente al 13,7%; en los luminal B Her-2, 65 frente a 41,1%; en los Her-2, 95,4 frente a 70,5%; en los basales, 59,6 frente a 36,8%. Globalmente, la respuesta patológica completa en la mama ha sido del 55,2% frente al 35,4% en axila. Conclusiones. Los fenotipos moleculares Her-2 y basal presentan mayores tasas de respuesta patológica completa tras quimioterapia neoadyuvante. No existe correlación entre la respuesta patológica observada en la mama y en la axila. La respuesta axilar es, en términos generales, menor que en la mama (AU)

Objective. To evaluate pathological response to neoadjuvant chemotherapy in the breast and axilla according to the different molecular phenotypes of breast cancer. Patients and method. A retrospective study was performed between January 2011 and December 2014, including those patients with infiltrating carcinoma who underwent surgery after neoadjuvant chemotherapy. Five molecular phenotypes were considered according to St. Gallen's 2013 criteria. Pathological axillary and breast response were evaluated following the Sataloff system. Results. We analysed data from 181 patients treated with neoadjuvant chemotherapy. Of these, an axillary lymphadenectomy was performed in 96 patients. In total, 34.3% of the patients belonged to the Her-2 group, 28.7% to the basal group, 25.4% to the luminal B group and 11.6% to the luminal A group. In luminal A tumours, pathological complete response was observed in the breast in 28.5% of the patients and in the axilla in 21.4%; in luminal B group, 34.7 versus 13.7%; in luminal B-Her-2, 65 versus 41.1%; in Her-2 positive tumours, pathological complete response was observed in the breast in 95.4% of the patients versus 70.5% in the axilla; in the basal group, pathological complete response was achieved in the breast in 59.6% versus only 36.8% in the axilla. Overall, pathological complete response was observed in the breast in 55.2% compared with 35.4% in the axilla. Conclusions. Her-2 and basal phenotypes of breast cancer show better rates of complete pathological complete response after neoadjuvant chemotherapy. No correlation was found between pathological response in the breast and the axilla. Axillary response was worse than that found in the breast (AU)

Perfil clínico, grado de afectación y manejo terapéutico de pacientes con artrosis en atención primaria: estudio multicéntrico nacional EVALÚA / Clinical profile, level of affection and therapeutic management of patients with osteoarthritis in primary care: the Spanish multicenter study EVALÚA

Objetivo. Determinar el perfil clínico, afectación y tratamiento en pacientes con artrosis de rodilla, cadera y manos. Material y método. Estudio observacional (Centros de Salud de 14 comunidades autónomas, n=363 médicos). Se incluye a pacientes con criterios clínicos/radiológicos de artrosis del American College of Rheumatology, seleccionados consecutivamente (n=1.258). Se analizan variables sociodemográficas, los hallazgos clínico-radiológicos, la comorbilidad y el tratamiento. Resultados. La media ± desviación estándar de edad fue 68,0±9,5 años, 77,8% eran mujeres y 47,6% tenían obesidad. Un 84,3% tenía artrosis de rodilla, un 23,4% de cadera y un 14,7% de manos. Todos los pacientes referían dolor. El grado radiológico de Kellgren-Lawrence más frecuente en rodilla y mano fue el 3 (42,9% y 51,9%, respectivamente), y en cadera grado 3 (37,2%) y 2 (34,5%). El tiempo de evolución de los síntomas de artrosis fue 9,4±7,5 años, con edad de inicio alrededor de 60 años. El 66% de los pacientes tenían antecedentes de artrosis. Las comorbilidades más frecuentes son: hipertensión (55,1%), depresión/ansiedad (24,7%) y patología gastroduodenal (22,9%). Un 97,6% recibía tratamiento farmacológico, los más utilizados son: analgésicos orales (paracetamol) (70,5%) y AINE orales (67,9%). Presentaban afectación bilateral el 76,9% de los pacientes con artrosis de rodilla, el 59,3% en cadera y el 94,7% en manos. El sexo femenino y mayor tiempo de evolución se asocian a afectación bilateral en rodilla y cadera. onclusiones. El perfil del paciente artrósico es de mujer > 65 años, con sobrepeso-obesidad, comorbilidad, clínica frecuente y afectación radiológica moderada. La mayoría presenta afectación bilateral, asociada al sexo femenino y el tiempo de evolución. El paracetamol es el fármaco más utilizado (AU)

Objective. To determine the clinical profile, degree of involvement and management in patients with knee, hip or hand osteoarthritis. Material and method. Observational study (health centers from 14 autonomous regions, n=363 primary care physicians), involving patients with clinical and/or radiological criteria for osteoarthritis from the American College of Rheumatology, consecutively selected (n=1,258). Sociodemographic variables, clinical and radiological findings, comorbidity and therapeutic management were analyzed. Results. Mean age was 68.0±9.5 years old; 77.8% were women and 47.6% obese. Distribution by location was: 84.3% knee, 23.4% hip, 14.7% hands. All patients reported pain. The most frequent radiographic Kellgren-Lawrence grade was stage 3 for knee and hip (42.9% and 51.9%, respectively), and 3 (37.2%) and 2 (34.5%) for hip. Time since onset of osteoarthritis symptoms was 9.4±7.5 years, with a mean age at onset of around 60 years old and a family history of osteoarthritis in 66.0%. The most frequent comorbidities were: hypertension (55.1%), depression/anxiety (24.7%) and gastroduodenal diseases (22.9%). A total of 97.6% of the patients received pharmacological treatment, with oral analgesics (paracetamol) (70.5%) and oral NSAIDs (67.9%) being the most frequent drugs. Bilateral osteoarthritis was present in 76.9% of patients with knee osteoarthritis, 59.3% in hip and 94.7% in hands. Female gender and time since onset were associated with bilateral knee and hip osteoarthritis. onclusions. The profile of the osteoarthritis patient is female, >65 years old, overweight/obese, with comorbidity, frequent symptoms and moderate radiologic involvement. Most of patients had bilateral osteoarthritis, associated with female gender and time since onset of disease. Paracetamol was the most common pharmacological treatment (AU)