A definition for aggressive disease in patients with HER-2 negative metastatic breast cancer: an expert consensus of the Spanish Society of Medical Oncology (SEOM).

PURPOSE: To converge on an expert opinion to define aggressive disease in patients with HER2-negative mBC using a modified Delphi methodology. METHODS: A panel of 21 breast cancer experts from the Spanish Society of Medical Oncology agreed upon a survey which comprised 47 questions that were grouped into three sections: relevance for defining aggressive disease, aggressive disease criteria and therapeutic goals. Answers were rated using a 9-point Likert scale of relevance or agreement. RESULTS: Among the 88 oncologists that were invited to participate, 81 answered the first round (92%), 70 answered the second round (80%), and 67 answered the third round (76%) of the survey. There was strong agreement regarding the fact that identifying patients with aggressive disease needs to be adequately addressed to help practitioners to decide the best treatment options for patients with HER2-negative mBC. The factors that were considered to be strongly relevant to classifying patients with aggressive HER2-negative mBC were a high tumor burden, a disease-free interval of less than 12-24 months after surgery, the presence of progressive disease during adjuvant or neoadjuvant chemotherapy and having a triple-negative phenotype. The main therapeutic goals were controlling symptoms, improving quality of life and increasing the time to progression and overall survival. CONCLUSIONS: High tumor burden, time to recurrence after prior therapy and having a triple-negative phenotype were the prognostic factors for which the greatest consensus was found for identifying patients with aggressive HER2-negative mBC. Identifying patients with aggressive disease leads to different therapeutic approaches.

Antimicrobial Susceptibility of Flavobacterium psychrophilum from Chilean Salmon Farms and Their Epidemiological Cut-Off Values Using Agar Dilution and Disk Diffusion Methods.

Flavobacterium psychrophilum is the most important bacterial pathogen for freshwater farmed salmonids in Chile. The aims of this study were to determine the susceptibility to antimicrobials used in fish farming of Chilean isolates and to calculate their epidemiological cut-off (COWT) values. A number of 125 Chilean isolates of F. psychrophilum were isolated from reared salmonids presenting clinical symptoms indicative of flavobacteriosis and their identities were confirmed by 16S rRNA polymerase chain reaction. Susceptibility to antibacterials was tested on diluted Mueller-Hinton by using an agar dilution MIC method and a disk diffusion method. The COWT values calculated by Normalized Resistance Interpretation (NRI) analysis allow isolates to be categorized either as wild-type fully susceptible (WT) or as manifesting reduced susceptibility (NWT). When MIC data was used, NRI analysis calculated a COWT of ≤0.125, ≤2, and ≤0.5 µg mL-1 for amoxicillin, florfenicol, and oxytetracycline, respectively. For the quinolones, the COWT were ≤1, ≤0.5, and ≤0.125 µg mL-1 for oxolinic acid, flumequine, and enrofloxacin, respectively. The disk diffusion data sets obtained in this work were extremely diverse and were spread over a wide range. For the quinolones there was a close agreement between the frequencies of NWT isolates calculated using MIC and disk data. For oxolinic acid, flumequine, and enrofloxacin the frequencies were 45, 39, and 38% using MIC data, and 42, 41, and 44%, when disk data were used. There was less agreement with the other antimicrobials, because NWT frequencies obtained using MIC and disk data, respectively, were 24 and 10% for amoxicillin, 8 and 2% for florfenicol, and 70 and 64% for oxytetracycline. Considering that the MIC data was more precise than the disk diffusion data, MIC determination would be the preferred method for susceptibility testing for this species and the NWT frequencies derived from the MIC data sets should be considered as the more authoritative. Despite the high frequency of isolates showing full susceptibility to florfenicol, the significant frequencies of isolates exhibiting reduced susceptibility to oxytetracycline and quinolones may result in treatment failures when these agents are used.

Electronic excitations of C60 aggregates.

Excitation properties of the isolated C(60) and (C(60))(N) model clusters (N = 2, 3, 4, 6 and 13) are studied using an a priori parameterized and self-consistent Hamiltonian, the Complete Neglect of Differential Overlap considering the l azimuthal quantum number method. This method properly describes electron excitations of the isolated C(60) after the configuration interaction of singles (CIS) procedure, when those are compared with experimental data in n-hexane solution and in a molecular beam. Geometry models of (C(60))(N) clusters to model the effect of aggregation were obtained from the fullerene fcc crystal. Some peaks in the low energy edge of the absorption spectrum appear corresponding to clustering effects, as well as small increases of bandwidths in the strong bands at the UV region. An analysis of the theoretical absorption spectrum for dimer models has been carried out, taking into account the influence of the distance between fullerene centers. The density of states of CIS for fullerene clusters in the range from 2.0 to 6.5 eV shows the possibility of electron transitions as functions of the size of the clusters.

Communication: Accurate determination of side-chain torsion angle χ1 in proteins: phenylalanine residues.

Quantitative side-chain torsion angle χ(1) determinations of phenylalanine residues in Desulfovibrio vulgaris flavodoxin are carried out using exclusively the correlation between the experimental vicinal coupling constants and theoretically determined Karplus equations. Karplus coefficients for nine vicinal coupling related with the torsion angle χ(1) were calculated using the B3LYP functional and basis sets of different size. Optimized χ(1) angles are in outstanding agreement with those previously reported by employing x ray and NMR measurements.

A theoretical approach to the influence of the macrocycle conformation on the molecular electronic structure in Mg-porphyrins.

Nonplanar saddled (sad) ruffled (ruf) and domed (dom) conformations of the Mg-porphyrin (MgP) macrocycle in several degrees of deformation have been computed. These symmetrical distortion modes were induced in unsubstituted macrocycle using molecular definitions for calculations which permits us to achieve a systematical variation of the nonplanarity varying only a convenient geometrical parameter of the molecule. Series of nonplanar macrocycles like those synthesized in previous works employing peripheral substitutions are obtained. The procedure here used to induce deformations gives the possibility of investigating the modulator role of the out-of-plane distortions on the geometry and electronic properties of the porphyrin avoiding additional influences due to the substituents or the surrounding protein scaffolding.

Disfunción vesical: estudio urodinámico en pacientes con y sin patología orgánica / Bladder dysfunction: Urodynamic studies in patients with and without organic diseas

Se presenta un grupo de 73 pacientes con disfunción vesical (DV) incluyendo 43 sin patología orgánica (SPO) y 30 con patología orgánica(CPO), siendo el reflujo vésico-ureteral la patología predominante. Los pacientes presentaron incontinencia de orina, infección urinaria, hábito de retención, urgencia miccional, posiciones anormales, polaquiuria, micción disfuncional y trastornos defecatorios, en ese orden de frecuencia. La edad promedio de presentación fue de 8,5 años en el grupo SPO y 7 en el grupo CPO. Se efectuaron estudios urodinámicos en todos los pacientes y de acuerdo a los resultados se los clasificó en tres grupos: A) Con vejiga normal y micción normal, B) Con vejiga disfuncional y con micción normal y C) Con vejiga normal o disfuncional y con micción incoordinada.Los tres grupos fueron comparados considerando por separado los pacientes con patología orgánica y aquellos sin patología orgánica. Los 43 pacientes SPO se distribuyeron en Grupo A):6, B): 18 y C): 19.De los pacientes CPO la distribución fue Grupo A): 1, B):17 y C):12. Todos los pacientes del Grupo A tuvieran o no patología orgánica tuvieron evolución favorable. En los pacientes del Grupo B predominó la evolución favorable en los SPO y fue compartida en los CPO. En el Grupo C predominó la evolución en los SPO y fue muy desfavorable en los CPO.Concluimos que los pacientes con disfunciones vesicales sin y con patología orgánica tienen un pronóstico de respuesta favorable al tratamiento, excepto en aquellos pacientes con micción disfuncional los cuales tratados y aún mejorando su dinamia vesical , tienen un pobre pronóstico de mejoría

Disfunción vesical: estudio urodinámico en pacientes con y sin patología orgánica / Bladder dysfunction: Urodynamic studies in patients with and without organic diseas

Se presenta un grupo de 73 pacientes con disfunción vesical (DV) incluyendo 43 sin patología orgánica (SPO) y 30 con patología orgánica(CPO), siendo el reflujo vésico-ureteral la patología predominante. Los pacientes presentaron incontinencia de orina, infección urinaria, hábito de retención, urgencia miccional, posiciones anormales, polaquiuria, micción disfuncional y trastornos defecatorios, en ese orden de frecuencia. La edad promedio de presentación fue de 8,5 años en el grupo SPO y 7 en el grupo CPO. Se efectuaron estudios urodinámicos en todos los pacientes y de acuerdo a los resultados se los clasificó en tres grupos: A) Con vejiga normal y micción normal, B) Con vejiga disfuncional y con micción normal y C) Con vejiga normal o disfuncional y con micción incoordinada.Los tres grupos fueron comparados considerando por separado los pacientes con patología orgánica y aquellos sin patología orgánica. Los 43 pacientes SPO se distribuyeron en Grupo A):6, B): 18 y C): 19.De los pacientes CPO la distribución fue Grupo A): 1, B):17 y C):12. Todos los pacientes del Grupo A tuvieran o no patología orgánica tuvieron evolución favorable. En los pacientes del Grupo B predominó la evolución favorable en los SPO y fue compartida en los CPO. En el Grupo C predominó la evolución en los SPO y fue muy desfavorable en los CPO.Concluimos que los pacientes con disfunciones vesicales sin y con patología orgánica tienen un pronóstico de respuesta favorable al tratamiento, excepto en aquellos pacientes con micción disfuncional los cuales tratados y aún mejorando su dinamia vesical , tienen un pobre pronóstico de mejoría