Estudio epidemiológico de la incidencia de la sobreexposición de HER2 en pacientes portadoras de cáncer de mama de reciente diagnóstico en estados iniciales / An epidemiological study of the incidente of HER2 overexpression in recently diagnosed inicial-stage breast cancer patients

Introducción: la posibilidad de identificar pacientes HER2 positivo y poder ofrecerles una terapia específica ha cambiado el pronóstico y la evolución de las mismas, es por ello que la determinación de sobreexpresión de HER2 es una factor clave para la toma de decisiones en el tratamiento del cáncer de mama. Objetivo: recolectar datos locales de la incidencia de la sobreexpresión de HER2 en la población con cáncer de mama de reciente diagnóstico y datos de anatomía patológica y la relación de los mismos con la sobreexpresión de HER2. Materiales y método: estudio epidemiológico que recolecta datos de las fichas de anatomía patológica y de las historias clínicas de pacientes con cáncer de mama operadas entre agosto de 2006 y agosto de 2007. De las biopsias previamente realizadas de rutina en pacientes operadas, se tomó un extendido para la determinación de HER2 por inmunohistoquímica (IHQ) con un anticuerpo policlonal anti HER2 (Dako), recuperación antigénica en microondas, sistema de detección En Vision (Dako) y revelado con diaminobenzidina. Para interpretar los resultados se usó el score de ASCO/CAP. Resultados: ingresaron 342 pacientes, HER negativo, 285 pacientes (83%); dudoso, 19 pacientes (6%); y HER2 positivo, 38 pacientes (11%). La edad promedio fue de 63,7 años. Se compararon las características clínicas y anatomopatológicas de ambas poblaciones (Tabla I). Conclusiones: la incidencia de HER2 positivo fue inferior (11%) a las reportadas en otras series, probablemente influida por el tamaño de la muestra o por el estadio inicial de las pacientes.

Estudio epidemiológico de la incidencia de la sobreexposición de HER2 en pacientes portadoras de cáncer de mama de reciente diagnóstico en estados iniciales / An epidemiological study of the incidente of HER2 overexpression in recently diagnosed inicial-stage breast cancer patients

Introducción: la posibilidad de identificar pacientes HER2 positivo y poder ofrecerles una terapia específica ha cambiado el pronóstico y la evolución de las mismas, es por ello que la determinación de sobreexpresión de HER2 es una factor clave para la toma de decisiones en el tratamiento del cáncer de mama. Objetivo: recolectar datos locales de la incidencia de la sobreexpresión de HER2 en la población con cáncer de mama de reciente diagnóstico y datos de anatomía patológica y la relación de los mismos con la sobreexpresión de HER2. Materiales y método: estudio epidemiológico que recolecta datos de las fichas de anatomía patológica y de las historias clínicas de pacientes con cáncer de mama operadas entre agosto de 2006 y agosto de 2007. De las biopsias previamente realizadas de rutina en pacientes operadas, se tomó un extendido para la determinación de HER2 por inmunohistoquímica (IHQ) con un anticuerpo policlonal anti HER2 (Dako), recuperación antigénica en microondas, sistema de detección En Vision (Dako) y revelado con diaminobenzidina. Para interpretar los resultados se usó el score de ASCO/CAP. Resultados: ingresaron 342 pacientes, HER negativo, 285 pacientes (83%); dudoso, 19 pacientes (6%); y HER2 positivo, 38 pacientes (11%). La edad promedio fue de 63,7 años. Se compararon las características clínicas y anatomopatológicas de ambas poblaciones (Tabla I). Conclusiones: la incidencia de HER2 positivo fue inferior (11%) a las reportadas en otras series, probablemente influida por el tamaño de la muestra o por el estadio inicial de las pacientes.

[Alcohol consumption among 7th grade students of EGB]. / Consumo de alcohol entre escolares de séptimo de EGB.

OBJECTIVES: To identify habits of alcohol consumption among school-children and analyse their ways of thinking about the question. DESIGN: A descriptive study of observation, using a crossover method, and carried out by means of a self-administered questionnaire. SETTING: Those EGB schools within the Molina de Segura (Murcia) Health Area which accepted the questionnaire. PARTICIPANTS: The 534 7th-year EGB students who attended class on the day of the field work. MEASUREMENTS AND RESULTS: We used the questionnaire elaborated by Torres Hernández to collect the data and that by Eysenck and Eysenck (EPI type A) to evaluate the replies' reliability. We analysed 478 of the 534 questionnaires which exceeded level 4 of the sincerity scale. We found that 83.3% had tried alcohol on some occasion, 2.5% drank it daily, 14.2% had consumed alcohol before the age of 10 and 19.5% had got drunk on some occasion. Cider and beer were the drinks preferred. We found no significant differences for gender. 91.6% thought that alcohol damaged health, 83.7% that it affected studies and 94.1% sport. 10.7% thought that it did not create dependence. CONCLUSIONS: We underline the high percentage of alcohol consumption in young people and their early starting-age, as well as the change in the patterns of traditional female behaviour in relation to alcohol consumption. We emphasise the need for Health Education among schoolchildren.

A comparison of patient charges associated with percutaneous transluminal coronary angioplasty and coronary artery bypass grafting.

Appropriate interventional treatment for coronary artery disease is an important component in controlling health care expenditures. We conducted a retrospective study to compare the patient charges associated with percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass grafting (CABG). All patients underwent treatment for left anterior descending coronary artery stenosis over a 3 year 9 month time period from March 1987 to December 1990 and were followed for 7-58 months (median 43 months) after treatment. The two groups were constructed in such a way that they were balanced for common vessels diseased, number of vessels diseased, sex, age, and ejection fraction (EF). The study included 26 PTCA patients between the ages of 33 and 86 years, 18 males and eight females, with a mean EF of 58 per cent, and 26 CABG patients from 39 to 80 years of age, 18 males and 8 females, with a mean EF of 61 per cent. Charges were categorized as to hospital, professional, cardiac medication, follow-up, and total costs. While CABG was initially more expensive, nine of the PTCA patients (38%) required further interventional treatment (3 PTCA, 5 CABG, 1 PTCA and CABG), whereas none of the CABG patients required further intervention (P < .001). This short-term follow-up demonstrated, that although initially less expensive, repeat interventional charges are significantly higher in PTCA patients. With the escalating costs of health care, the appropriate initial interventional therapy for coronary artery disease must be carefully selected to reduce long-term health care expenses.

Methanol intoxication. Case report.

A 46-year-old male presented to the emergency room seven hours after consuming a large container of sterno. He could not see and complained of abdominal and back pain. He was tachypneic, tachycardic, hypertensive and hypothermic. Laboratory results were significant for a severe metabolic acidosis, a serum osmolality of 465 and serum methanol level of 493 mg/dl. Aggressive treatment included ethanol drip, bicarbonate and hemodialysis. He survived and regained his eyesight in spite of this degree of elevation of the serum methanol level. The literature does not reveal a similar report.

Methanol intoxication. How to help patients who have been exposed to toxic solvents.

Methanol intoxication can be a challenge, in part because it is relatively uncommon but also because of the pharmacokinetics involved. A patient may not experience symptoms and thus may not present for treatment for several hours, or even a day or two, after exposure to the toxic substance. Yet, the interval between ingestion and treatment is one of the most important factors in determining patient outcome. Typical symptoms of methanol intoxication include lethargy, vertigo, vomiting, blurred vision, and decreased visual acuity. Treatment focuses on prevention of methanol conversion to its toxic metabolites, correction of metabolic acidosis, and elimination of the toxic substances from the system. Ethanol and bicarbonate administration and hemodialysis have been effective.

[The revision of the organization of consultation for long-term treatment]. / Revisión de la organización de la consulta de largo tratamiento.

The growing drug dependency of developed societies has meant the uncontrolled use of drugs with the consequent medical risks and important economic repercussions. Primary health care in our country is characterized by high demand bureaucratization of clinics. Because of this, we consider it useful to rely on a prescription system for long term treatment, this being understood as a mechanism which allows the obtaining of prescriptions easily both for the patient and the doctor, control and monitoring of established chronic treatments, periodical therapy evaluations, which rely on the participation of other members of the primary health care team. In this report the model of the repeat prescription system in our health area is shown, from which the prescription can be obtained in a maximum time limit of 8 hours, the medication taken for chronic illness can be easily recognized and to make note of the date of the prescription.

Dietary obesity and weight cycling in rats: a model of stress-induced hypertension?

The present study was designed to reproduce the mild hypertension seen in dietary obese weight-cycled rats [P. Ernsberger and D. O. Nelson. Am. J. Physiol. 254 (Regulatory Integrative Comp. Physiol. 23): R47-R55, 1988] and determine whether this mild hypertension was associated with changes in sodium excretion and pressor responsiveness to angiotensin II (ANG II). Male Sprague-Dawley rats were fed pelleted chow (Pellet group) or chow plus sweetened condensed milk (Milk group) or were exposed to four cycles of a 4-day fast alternated with 2 wk of refeeding of pelleted chow and sweetened condensed milk (Cycled group). Blood pressure and heart rate were measured by tail cuff at the onset and last day of each fast and after 3 days of refeeding. During fasting, urine sodium excretion was measured. Mean arterial pressure and heart rate responses to intravenous administration of ANG II (40, 80, and 120 ng/kg), metoprolol (1 mg/kg), and methyl scopolamine (2 mg/kg) were obtained from the femoral artery in awake unrestrained rats. Weight cycling did not lead to mild hypertension or increased bradycardic response to sympathetic blockade with metoprolol. ANG II-elicited pressor responses were similar for Pellet, Milk, and Cycled groups. Sodium excretion did not change with fasting. Mild hypertension developed when obese weight-cycled rats were housed together in groups and not when housed individually. Our preliminary data are consistent with the notion that stress associated with group housing may be a factor in the mild hypertension of obese weight-cycled rats.

Di- and tri-methoxystyryl derivatives of heterocyclic nitrogen compounds.

A series of mono-, di-, and trimethoxystyryl derivatives of heterocyclic nitrogen compounds were prepared to test the N-O-O triangulation hypothesis of Zee-Cheng and Cheng. Of 29 free bases submitted for KB cell culture test, only 2-(3,4-methylenedioxystyryl)benzoxazole and 4-(2,5-dimethoxystyryl)cinnoline were active (ED50 of 4 microgram/ml or less). Methiodide salts were more potent: 8 of 14 were active. 2-(2,4,6-Trimethoxystyryl)quinoline methiodide and 4-(2,4,5-trimethoxystyryl)quinoline methiodide had ED50 of 0.4 and 0.9 microgram/ml, respectively. The methiodides of 2-(2,3,4-, 4-(2,4,5-, 4-(2,4,6-, and 2,4-bis-(2,4,6-trimethoxystyryl)quinoline and 1-(2,4,6-trimethoxystyryl) isoquinoline and the propiodide of 4-(2,4,6-trimethoxystyryl)quinoline were active against P388 leukemia. Several of the active compounds do not conform to the dimensions of the Zee-Cheng and Cheng triangle.

Platinum and palladium derivatives for chemotherapy studies.

Analogues of cis-dichlorodiammineplatinum(II) were prepared in which substituted pyridines (A), 1-(4-aminobenzylidene)indene (B), or DL-3,5,3'5'-tetraoxo-1,2-dipiperazinopropane (ICRF-159) was used in place of ammonia, and in some cases platinum(IV) or palladium(II) was used in place of the platinum(II). Both platinum complexes with ICRF-159 were active against leukemia 1210, but none of the others produced significant life extension following a single ip dose of 400 mg/kg. Attempts to prepare complexes of ICRF-159 with Zn(II), Mn(II), and Cr(III) were unsuccessful, but there were indications of complex formation with CuCl2 and with NiCl2.