RESUMEN
BACKGROUND: Intakes of specific fatty acids have been postulated to impact breast cancer risk but epidemiological data based on dietary questionnaires remain conflicting. MATERIALS AND METHODS: We assessed the association between plasma phospholipid fatty acids and breast cancer risk in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition study. Sixty fatty acids were measured by gas chromatography in pre-diagnostic plasma phospholipids from 2982 incident breast cancer cases matched to 2982 controls. Conditional logistic regression models were used to estimate relative risk of breast cancer by fatty acid level. The false discovery rate (q values) was computed to control for multiple comparisons. Subgroup analyses were carried out by estrogen receptor (ER) and progesterone receptor expression in the tumours. RESULTS: A high level of palmitoleic acid [odds ratio (OR) for the highest quartile compared with the lowest OR (Q4-Q1) 1.37; 95% confidence interval (CI), 1.14-1.64; P for trend = 0.0001, q value = 0.004] as well as a high desaturation index (DI16) (16:1n-7/16:0) [OR (Q4-Q1), 1.28; 95% C, 1.07-1.54; P for trend = 0.002, q value = 0.037], as biomarkers of de novo lipogenesis, were significantly associated with increased risk of breast cancer. Levels of industrial trans-fatty acids were positively associated with ER-negative tumours [OR for the highest tertile compared with the lowest (T3-T1)=2.01; 95% CI, 1.03-3.90; P for trend = 0.047], whereas no association was found for ER-positive tumours (P-heterogeneity =0.01). No significant association was found between n-3 polyunsaturated fatty acids and breast cancer risk, overall or by hormonal receptor. CONCLUSION: These findings suggest that increased de novo lipogenesis, acting through increased synthesis of palmitoleic acid, could be a relevant metabolic pathway for breast tumourigenesis. Dietary trans-fatty acids derived from industrial processes may specifically increase ER-negative breast cancer risk.
Asunto(s)
Biomarcadores de Tumor/sangre , Neoplasias de la Mama/diagnóstico , Dieta , Ácidos Grasos/sangre , Fosfolípidos/sangre , Neoplasias de la Mama/sangre , Neoplasias de la Mama/epidemiología , Estudios de Casos y Controles , Europa (Continente) , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Receptores de Estrógenos/metabolismo , Receptores de Progesterona/metabolismo , Factores de RiesgoRESUMEN
From January 1993 to January 1994, we realized at Risk Hospital 11 percutaneous mitral commissurotomies (PMC). This first Lebanese series comprised 9 women and 2 men. The mean age was 36 y (18-73 y). Ten patients were en class III of the NYHA and one in class IV (pregnant woman on the end of the 7th month). The predilatation evaluation was done by transthoracic echocardiography for the just 2 patients and by transthoracic with transesophageal multiplane echocardiography for the 9 others. The mean gradient was at 20 mmHg (10-24 mmHg) and the mean mitral area at 1 cm2 (0.65-1.5 cm2). We used the Inoue balloon for all these procedures with a stepwise technique and a color echo-doppler control between inflations. We obtain bicommissural opening in 8 patients and unicommissural opening in 3 patients. The mean gradient post dilatation was at 4 mmHg (3-8 mmHg) and the mean mitral area at 2.3 cm2 (1.5-2.8 cm2). No mitral regurgitation > 2/4 was noted. After a general review, we concluded the PMC is at present the treatment of choice of non or discrete calcified mitral stenosis and this procedure has to be taken on charge by the Ministry of Health in Lebanon.
Asunto(s)
Cateterismo/métodos , Estenosis de la Válvula Mitral/cirugía , Adolescente , Adulto , Anciano , Ecocardiografía Transesofágica , Femenino , Humanos , Líbano , Masculino , Persona de Mediana Edad , Estenosis de la Válvula Mitral/clasificación , Estenosis de la Válvula Mitral/diagnóstico por imagen , Embarazo , Complicaciones Cardiovasculares del Embarazo/cirugía , Índice de Severidad de la Enfermedad , Resultado del TratamientoAsunto(s)
Arritmias Cardíacas/diagnóstico , Electrocardiografía , Prolapso de la Válvula Mitral/complicaciones , Adolescente , Adulto , Anciano , Antiarrítmicos/uso terapéutico , Arritmias Cardíacas/etiología , Arritmias Cardíacas/terapia , Estimulación Cardíaca Artificial , Prueba de Esfuerzo , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
A frequencia das arritmias, no prolapso de valva mitral, em 51 pacientes (41 do sexo feminino e 10 do sexo masculino, com idade media de 35 anos), foi avaliada por meio de eletrocardiografia dinamica (sistema Holter) por 12 horas. Disturbios de ritmo foram evidenciado em 30 (58,8%) dos casos: arritmias ventriculares em 70,0%; taquicardia sinusal em 10%; bradicardia sinusal em 6,7%; fibrilacao atrial em 3,3%. Nao se observou correlacao significativa entre os sintomas referidos durante o exame e a presenca de arritmias. Formulam-se comentarios sobre a genese das arritmias na sindrome e sobre a indicacao terapeutica
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Arritmias Cardíacas , Prolapso de la Válvula Mitral , ElectrocardiografíaAsunto(s)
Adolescente , Adulto , Persona de Mediana Edad , Humanos , Masculino , Femenino , Prueba de Esfuerzo , Prolapso de la Válvula MitralAsunto(s)
Prolapso de la Válvula Mitral , Anestesia , Antiarrítmicos/uso terapéutico , Arritmias Cardíacas/etiología , Muerte Súbita/etiología , Femenino , Humanos , Prolapso de la Válvula Mitral/complicaciones , Prolapso de la Válvula Mitral/tratamiento farmacológico , Embarazo , Complicaciones Cardiovasculares del Embarazo , Simpaticolíticos/uso terapéuticoAsunto(s)
Niño , Adolescente , Adulto , Persona de Mediana Edad , Humanos , Masculino , Femenino , Enfermedad Cardiopulmonar , EsquistosomiasisRESUMEN
Foram submetidos a teste cicloergometrico continuo (protocolo habitual) 30 pacientes (22 do sexo masculino) portadores da sindrome de Wolff-Parkinson_white (WPW). A idade variou de 13 a 70 anos. Nao havia evidencia de outras doencas nem estavam em tratamento com antiarritmicos. Durante o teste, nao foram observados sinais de comprometimento da funcao cardiaca nem arritmias significativas (4 pacientes haviam apresentado previamente taquiarritmias paroxisticas comprovadas). A onda delta permaneceu inalterada em 19 pacientes e nos 3 casos de WPW intermitente, o esforco nao determinou o seu aparecimento. Em 8 pacientes, submetidos a teste maximo, desapareceu a onda delta durante o esforco (mantendo-se o segmento PR curto), com frequencia cardiaca superior a 150 bpm. Neste subgrupo, a onda delta reapareceu apos o esforco (1 a 4 min), ainda com frequencia cardiaca superior a 100 bpm. Foi encontrada em 9 pacientes (30%) resposta isquemica indiscutivel, 1 deles evidenciou desaparecimento da onda delta durante o esforco. Os autores comentam a fisiopatologia das alteracoes eletrocardiograficas encontradas durante o exercicio e o mecanismo determinante de arritmias, concluindo que o teste ergometrico nao parece ser um metodo eficiente para inducao de arritmias e para analise de drogas antiarritmicas em portadores de WPW
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Electrocardiografía , Síndrome de Wolff-Parkinson-White , Prueba de EsfuerzoRESUMEN
E relatado o caso de um paciente de 27 anos, sem fatores de risco e antecedentes de coronariopatia na familia, acometido de infarto do miocardio transmural apos eletrocussao acidental. A cinecoronariografia realizada 30 dias apos, mostrou arterias coronarias normais e acinesia antero-apical. Os autores discutem a etiopatogenia, dando enfase a possibilidade de vasoespasmo coronario ou trombose coronaria com recanalizacao
Asunto(s)
Humanos , Masculino , Adulto , Traumatismos por Electricidad , Infarto del MiocardioRESUMEN
Os autores apresentam um caso de estenose aortica supravalvar associada a anomalia facial e a retardo mental, caracterizando a sindrome de Williams-Beuren. Sao abordados os aspectos etiologicos, o quadro clinico, os metodos de exames complementares de diagnostico e o tratamento cirurgico