Near-Complete Genome Sequence of a SARS-CoV-2 VOC 202012/01 Strain in Peru.

A near-complete genome sequence was obtained for a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant of concern (VOC) 202012/01 strain obtained from an oropharyngeal swab sample from a Peruvian patient with coronavirus syndrome who had contact with an individual who had recently returned from England.

Tomografía de coherencia óptica en lesión palpebral por Molluscum contagiosum / Optical coherence tomography in an eyelid lesion due to Molluscum contagiosum

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Spatiotemporal Oscillatory Patterns During Working Memory Maintenance in Mild Cognitive Impairment and Subjective Cognitive Decline.

Working memory (WM) is a crucial cognitive process and its disruption is among the earliest symptoms of Alzheimer's disease. While alterations of the neuronal processes underlying WM have been evidenced in mild cognitive impairment (MCI), scarce literature is available in subjective cognitive decline (SCD). We used magnetoencephalography during a WM task performed by MCI (n = 45), SCD (n = 49) and healthy elders (n = 49) to examine group differences during the maintenance period (0-4000ms). Data were analyzed using time-frequency analysis and significant oscillatory differences were localized at the source level. Our results indicated significant differences between groups, mainly during the early maintenance (250-1250ms) in the theta, alpha and beta bands and in the late maintenance (2750-3750ms) in the theta band. MCI showed lower local synchronization in fronto-temporal cortical regions in the early theta-alpha window relative to controls (p = 2 × 10-03) and SCD (p = 4 × 10-03), and in the late theta window relative to controls (p = 1 × 1003) and SCD (p = 0.01). Early theta-alpha power was significantly correlated with memory scores (rho = 0.24,p = 0.02) and late theta power was correlated with task performance (rho = 0.24,p = 0.03) and functional activity scores (rho = -0.23,p = 0.02). In the early beta window, MCI showed reduced power in temporo-posterior regions relative to controls (p = 3 × 10-03) and SCD (p = 0.02). Our results may suggest that these alterations would reflect that memory-related networks are damaged.

Identification of gender differences in the factors influencing shoulders, neck and upper limb MSD by means of multivariate adaptive regression splines (MARS).

In the present research, models based on multivariate adaptive regression splines (MARS) are proposed to study the influence of gender in the factors affecting the development of shoulders, neck and upper limb MSD. Two different MARS models, corresponding to men and women, are constructed to identify variables with the strongest effect on the target MSD. Both models are capable to predict successfully the occurrence of the studied disorders. Men seem to be more vulnerable to physical risk factors and some other working conditions, whereas women appear to be more affected by psychosocial risk factors and activities carried out outside their working hours. According to the results, gender needs to be considered to ensure the success and effectiveness of ergonomic interventions on the whole working population.

Somatotipo y dermatoglifia dactilar en futbolistas mexicanos / Somatotype and digital dermatoglyphic in mexican football players

La valoración de la forma corporal y de las capacidades físicas es una necesidad para la selección, clasificación y entrenamiento de los jugadores de futbol. El presente estudio examinó en futbolistas profesionales mexicanos (N = 49) la relación entre clases de somatotipo y clases de capacidades físicas de acuerdo a dermatoglifia dactilar. Las frecuencias de clases de somatotipo y clases de capacidad física fueron comparadas entre subgrupos de futbolistas. Una mayor proporción de futbolistas se caracterizó por somatotipo mesomorfo balanceado con dermatoglifia tipo 2 y 3 correspondiente a fuerza, fuerza explosiva y velocidad. Esto es consistente con hallazgos previos en futbolistas chilenos y brasileños, extendiendo por tanto la evidencia disponible acerca de somatotipo y dermatoglifia en futbolistas latinoamericanos

Evaluating body shape and capacities is needed for selection, classification and training of football players. The present study examined in Mexican male football players (N = 49) the relationship between types of somatotype and types of physical capacities according to digital dermatoglyphics. The frequencies of types of somatotype and of physical capacities were compared between football players subgroups. A higher proportion of football players was characterised by a balanced mesomorph somatotype with dermatoglyphic type 2 and 3 corresponding to strength, explosive strength and velocity. This is consistent with previous findings in Chilenean and Brazilian footballers, Therefore extending the available evidence of somatotype and dermatoglyphics in Latin American football players

Functional Connectivity Changes in Behavioral, Semantic, and Nonfluent Variants of Frontotemporal Dementia.

Frontotemporal dementia (FTD) affects behavior, language, and personality. This study aims to explore functional connectivity changes in three FTD variants: behavioral (bvFTD), semantic (svPPA), and nonfluent variant (nfvPPA). Seventy-six patients diagnosed with FTD by international criteria and thirty-two controls were investigated. Functional connectivity from resting functional magnetic resonance imaging (fMRI) was estimated for the whole brain. Two types of analysis were done: network basic statistic and topological measures by graph theory. Several hubs in the limbic system and basal ganglia were compromised in the behavioral variant apart from frontal networks. Nonfluent variants showed a major disconnection with respect to the behavioral variant in operculum and parietal inferior. The global efficiency had lower coefficients in nonfluent variants than behavioral variants and controls. Our results support an extensive disconnection among frontal, limbic, basal ganglia, and parietal hubs.

Quantifying pruning impacts on olive tree architecture and annual canopy growth by using UAV-based 3D modelling.

BACKGROUND: Tree pruning is a costly practice with important implications for crop harvest and nutrition, pest and disease control, soil protection and irrigation strategies. Investigations on tree pruning usually involve tedious on-ground measurements of the primary tree crown dimensions, which also might generate inconsistent results due to the irregular geometry of the trees. As an alternative to intensive field-work, this study shows a innovative procedure based on combining unmanned aerial vehicle (UAV) technology and advanced object-based image analysis (OBIA) methodology for multi-temporal three-dimensional (3D) monitoring of hundreds of olive trees that were pruned with three different strategies (traditional, adapted and mechanical pruning). The UAV images were collected before pruning, after pruning and a year after pruning, and the impacts of each pruning treatment on the projected canopy area, tree height and crown volume of every tree were quantified and analyzed over time. RESULTS: The full procedure described here automatically identified every olive tree on the orchard and computed their primary 3D dimensions on the three study dates with high accuracy in the most cases. Adapted pruning was generally the most aggressive treatment in terms of the area and volume (the trees decreased by 38.95 and 42.05% on average, respectively), followed by trees under traditional pruning (33.02 and 35.72% on average, respectively). Regarding the tree heights, mechanical pruning produced a greater decrease (12.15%), and these values were minimal for the other two treatments. The tree growth over one year was affected by the pruning severity and by the type of pruning treatment, i.e., the adapted-pruning trees experienced higher growth than the trees from the other two treatments when pruning intensity was low (<10%), similar to the traditionally pruned trees at moderate intensity (10-30%), and lower than the other trees when the pruning intensity was higher than 30% of the crown volume. CONCLUSIONS: Combining UAV-based images and an OBIA procedure allowed measuring tree dimensions and quantifying the impacts of three different pruning treatments on hundreds of trees with minimal field work. Tree foliage losses and annual canopy growth showed different trends as affected by the type and severity of the pruning treatments. Additionally, this technology offers valuable geo-spatial information for designing site-specific crop management strategies in the context of precision agriculture, with the consequent economic and environmental benefits.

Manifestaciones neurológicas del déficit de vitamina B12 en pediatría / Neurological manifestations of vitamin B12 deficiency in pediatrics

Introducción: El déficit de vitamina B12 genera un proceso de desmielinización neuronal, manifestándose con anormalidades cerebrales y degeneración del cordón espinal. En pediatría, las manifestaciones neurológicas son una de las formas de presentación. Usualmente, se observa en niños alimentados con lactancia materna exclusiva cuyas madres tienen escaso consumo de alimentos de origen animal. Objetivo: Describir las manifestaciones neurológicas del déficit vitamínico e identificar factores de riesgo alimentario. Pacientes y método: Se realizó un estudio de serie de casos de 6 pacientes internados en el Hospital Garrahan con deficiencia de vitamina B12 en el periodo comprendido entre julio 1996 y diciembre 2013 cuyo diagnóstico se realizó mediante determinación sérica de vitamina B12. Resultados: La edad media de presentación de los síntomas fue de 3,6 meses. El 83.3% de los pacientes presentaron convulsiones, 60% las manifestaron de forma exclusiva y en el 40% se asociaron a hipotonía y pérdida de pautas madurativas. Un 16.7% presentó hipotonía más pérdida de pautas sin presentar convulsiones. Respecto de la alimentación, la totalidad recibía lactancia materna, el 83.3% de forma exclusiva, el 16.7% asociada a leche maternizada. En cuanto a la dieta de las madres de pacientes alimentados con pecho materno exclusivo, el 40% realizaba dieta vegetariana estricta, en otro 40% no se hallaron datos relacionados con su alimentación, pero se diagnosticó déficit de vitamina B12 por dosaje sérico, y el 20% restante refería recibir dieta general. Conclusión: Ante el aumento de la incidencia de la población vegetariana/vegana, se debería considerar la deficiencia de vitamina B12 ante pacientes con manifestaciones neurológicas de etiología desconocida, dado que es una enfermedad con un tratamiento inocuo y efectivo, y se evidencia mejoría clínica, y de los parámetros de laboratorio en todos los casos (AU)

Introduction: Vitamin B12 deficiency may cause a process of neuronal demyelination associated with brain abnormalities and degeneration of the spinal cord. In pediatrics, neurological manifestations are one of the forms of presentation. It is usually observed in exclusively breast fed children whose mothers do not consume food of animal origin. Aim: To describe neurological manifestations of vitamin B12 deficiency and identify nutritional risk factors. Patients and method: A series of 7 patients admitted to Hospital Garrahan with vitamin B12 deficiency diagnosed by vitamin B12 serum level testing were evaluated between July and December of 1996-2013. Results: Mean age at symptom presentation was 3,6 months. Overall, 83.3% of the patients presented with seizures, in 60% as the only symptom and in 40% associated with hypotonia and developmental delay. Hypotonia and developmental delay without seizures were observed in 16.7%. A single patient presented with pancytopenia only. All infants were breastfed, 83.3% exclusively, 16.7% in combination with formula, and the remaining 14.3% in combination with food. Regarding the diet of the mothers of the exclusively breastfed children, 40% followed a strict vegetarian diet, for another 40% no data on their diet were available but they were diagnosed with vitamin B12 based on serum values, and the remaining 20% followed a general diet. Conclusion: As the incidence of vegetarianism/veganism is increasing in the population, vitamin B12 deficiency should be considered in patients with neurological symptoms of unclear etiology, as treatment of the condition is innocuous and effective and leads to clinical and laboratory parameter improvement in all cases (AU)

Alpha band disruption in the AD-continuum starts in the Subjective Cognitive Decline stage: a MEG study.

The consideration of Subjective Cognitive Decline (SCD) as a preclinical stage of AD remains still a matter of debate. Alpha band alterations represent one of the most significant changes in the electrophysiological profile of AD. In particular, AD patients exhibit reduced alpha relative power and frequency. We used alpha band activity measured with MEG to study whether SCD and MCI elders present these electrophysiological changes characteristic of AD, and to determine the evolution of the observed alterations across AD spectrum. The total sample consisted of 131 participants: 39 elders without SCD, 41 elders with SCD and 51 MCI patients. All of them underwent MEG and MRI scans and neuropsychological assessment. SCD and MCI patients exhibited a similar reduction in alpha band activity compared with the no SCD group. However, only MCI patients showed a slowing in their alpha peak frequency compared with both SCD and no SCD. These changes in alpha band were related to worse cognition. Our results suggest that AD-related alterations may start in the SCD stage, with a reduction in alpha relative power. It is later, in the MCI stage, where the slowing of the spectral profile takes place, giving rise to objective deficits in cognitive functioning.

The Effect of Short Irrigation Frequencies on the Development of Verticillium Wilt in the Susceptible Olive Cultivar 'Picual' under Field Conditions.

The effect of irrigation frequency (daily [T1], biweekly [T2], and dryland [T3]) on Verticillium wilt of olive was studied in two fields that were naturally infested with Verticillium dahliae in southern Spain and planted to 'Picual' olive. Disease onset (average 61 weeks after planting) and disease incidence (average 75.6%) did not differ among irrigation treatments in both fields. Irrigation consistently increased disease development regarding dryland treatment, but this effect varied over time. In experiment I, T1, the relative area under the disease progress curve was greater on all recording dates (ranging from 15.8 to 33.7) in comparison with T3 (average 6.6). Data for experiment II were similar to this on the most favorable dates for disease (March to April). The T2 treatment value varied over time depending on the season and experimental field, being difficult to differentiate from the values of T1 and T3. Significant correlation between disease incidence and severity increments during spring and fall with the soil water content of the same or previous favorable seasons was observed. Through these correlations, we detected soil water contents of 24.3% (experiment I) and 23.6% (experiment II), where the increments of disease parameters remained at zero. Therefore, scheduling irrigation treatments based on rainfall may be a feasible method for maintaining the soil moisture below levels that favor for disease development.

The Influence of Irrigation Frequency on the Onset and Development of Verticillium Wilt of Olive.

The influence of irrigation frequency on the onset and development of Verticillium wilt of olive (VWO) was studied. A split-plot design in microplots with naturally infested soil was established for studying four irrigation frequencies for three olive cultivars with differing levels of disease resistance. Final disease incidence (DI) and mortality in 'Picual' plants subjected to daily irrigation treatment (T1) reached values of 100 and 63%, respectively. For Picual-T1 samples, the area under the disease progress curve values were significantly different between 15 December 2012 and 15 July 2013 (14.8 to 42.8%) compared with the average results of the other treatments, which were weekly (T2), biweekly (T3), and deficit (T4) (0.4 to 11.5%). No significant differences between the irrigation treatments were observed in 'Arbequina', although the DI progressed consistently (60% in all treatments). In 'Frantoio', little disease developed. We conclude that a daily irrigation treatment encourages VWO development in susceptible Picual. Therefore, in susceptible cultivars growing in infested soils under daily irrigation regimes, the extension of irrigation frequency may reduce disease incidence. In the context of an integrated control, the use of resistant cultivars seems to be more relevant than the detrimental effects observed in frequent irrigation schedules.

Field Resistance to Verticillium Wilt in Selected Olive Cultivars Grown in Two Naturally Infested Soils.

The resistance of 11 olive cultivars to Verticillium dahliae was assessed in two experimental field trials. One-year-old rooted olive cuttings from the World Olive Germplasm Bank (IFAPA research center, Córdoba, Spain) were planted in a heavily infested field in Utrera (Sevilla province) and in a moderately infested field in Andújar (Jaén province) of southern Spain. Plants were assessed for Verticillium wilt resistance during 22 months based on disease severity and tree growth. Severe disease symptoms were observed 6 months after planting in both trials. Twenty months after planting in the heavily infested soil, V. dahliae had killed nearly all of the trees of 'Bodoquera', 'Cornicabra', 'Manzanilla de Sevilla', and 'Picual', demonstrating the elevated risk of planting susceptible cultivars in a soil heavily infested with V. dahliae. 'Arbequina', 'Koroneiki', 'Sevillenca', and especially 'Frantoio', 'Empeltre', and 'Changlot Real' showed a high level of disease resistance. However, all of them were affected by the disease. Although the field results confirmed the level of resistance previously obtained for these olive genotypes under controlled conditions, there were some discrepancies. This information will be useful in managing the disease and also in selecting new cultivars for the breeding of Verticillium wilt resistance.

Biopsia del ganglio centinela en pacientes con cáncer de mama operable tratadas con quimioterapia neoadyuvante / Sentinel lymph node biopsy in patients with operable breast cancer treated with neoadjuvant chemotherapy

Objetivo. Validar la biopsia selectiva del ganglio centinela (BGC) en pacientes con cáncer de mama tratadas con quimioterapia neoadyuvante. Materiales y métodos. Estudio prospectivo de enero de 2008 a enero de 2011, 88 pacientes con una edad media de 49,4 años, con cáncer de mama infiltrante T1-3, N0-1, M0, tratadas con epirrubicina/ciclofosfamida, docetaxel y trastuzumab en Her2/neu positivas. El estatus axilar se estableció por exploración física, ecografía axilar y punción ecoguiada de ganglios sospechosos. El día antes de la cirugía se inyectaron periareolarmente 74-111 MBq de 99mTc-nanocoloide de albúmina. En todas se realizó cirugía mamaria, BGC y linfadenectomía axilar. El ganglio centinela (GC) se analizó por cortes de congelación, hematoxilina-eosina, inmunohistoquímica u OSNA. Resultados. El tamaño medio del tumor fue de 3,5 cm. Según el tipo histológico, 69 se clasificaron como ductal infiltrante, 16 como lobulillar infiltrante y 3 como de otro tipo. Treinta y siete pacientes tenían axila clínica/ecográfica positiva al diagnóstico. La respuesta clínica del tumor primario fue: 38 completa, 45 parcial, 5 no respuesta. En todas las pacientes la axila fue clínica/ecográfica negativa después del tratamiento. En 25 casos hubo respuesta patológica completa en el tumor primario. El porcentaje de identificación del GC fue del 92,0%, 6 de las 7 pacientes sin migración eran axila clínica/ecográfica positiva al diagnóstico. En el 96,3% de los casos el GC determinó correctamente el estatus axilar. La tasa de falsos negativos fue del 8,3%. En el 69,4% de los casos el GC era el único afectado de la axila. El número medio de GC identificados fue 1,7 y el de ganglios axilares extirpados fue 13,2. Conclusión. La BGC es una técnica factible en pacientes con cáncer de mama tratadas con quimioterapia neoadyuvante, pudiendo evitar linfadenectomías innecesarias(AU)

Aim. To evaluate the accuracy of sentinel lymph node biopsy (SLNB) in operable breast cancer patients treated with neoadjuvant chemotherapy (NAC). Materials and methods. Between January 2008-2011, 88 women, mean age 49.4 years, with infiltrating breast carcinoma, were studied prospectively. Patients were T1-3, N0-1, M0. Prior to surgery, the patients received chemotherapy (epirubicin/cyclophosphamide, docetaxel), and trastuzumab in Her2/neu-positive patients. Axillary status was established by physical examination, ultrasound-guided core needle biopsy of any suspicious lymph node. The day before surgery, 74-111 MBq of 99mTc-albumin nanocolloid was injected periareolarly. All patients underwent breast surgery, with SLNB, followed by complete axillary lymph node dissection (ALND). Sentinel lymph node (SLN) were examined by frozen sections, hematoxylin-eosin staining and immunohistochemical analysis or One Step Nucleic Acid Amplification (OSNA). Results. Mean tumor size: 3.5 cm. Histologic type: 69 invasive ductal, 16 invasive lobular and 3 others. Thirty seven patients had clinical/ultrasound node-positive at presentation. Clinical response of primary tumor to NAC: complete in 38, partial in 45, and stable disease in 5 patients. A pathological complete response was achieved in 25. All patients were clinically node-negative after NAC. SLN identification rate was 92.0%. Six of 7 patients in whom SLN was not found had clinical/ultrasound positive axilla before NAC. SLN accurately determined the axillary status in 96.5%. False negative rate was 8.3%. In 69.4% of patients, SLN was the only positive node. The mean number of SLN removed was 1.7 and nodes resected from the ALND were 13.2. Conclusion. SLN biopsy after NAC can predict the axillary status with a high accuracy in patients with breast cancer, avoiding unnecessary ALND(AU)

Sentinel lymph node biopsy in patients with operable breast cancer treated with neoadjuvant chemotherapy.

AIM: To evaluate the accuracy of sentinel lymph node biopsy (SLNB) in operable breast cancer patients treated with neoadjuvant chemotherapy (NAC). MATERIALS AND METHODS: Between January 2008-2011, 88 women, mean age 49.4 years, with infiltrating breast carcinoma, were studied prospectively. Patients were T1-3, N0-1, M0. Prior to surgery, the patients received chemotherapy (epirubicin/cyclophosphamide, docetaxel), and trastuzumab in Her2/neu-positive patients. Axillary status was established by physical examination, ultrasound-guided core needle biopsy of any suspicious lymph node. The day before surgery, 74-111 MBq of (99m)Tc-albumin nanocolloid was injected periareolarly. All patients underwent breast surgery, with SLNB, followed by complete axillary lymph node dissection (ALND). Sentinel lymph node (SLN) were examined by frozen sections, hematoxylin-eosin staining and immunohistochemical analysis or One Step Nucleic Acid Amplification (OSNA). RESULTS: Mean tumor size: 3.5 cm. Histologic type: 69 invasive ductal, 16 invasive lobular and 3 others. Thirty seven patients had clinical/ultrasound node-positive at presentation. Clinical response of primary tumor to NAC: complete in 38, partial in 45, and stable disease in 5 patients. A pathological complete response was achieved in 25. All patients were clinically node-negative after NAC. SLN identification rate was 92.0%. Six of 7 patients in whom SLN was not found had clinical/ultrasound positive axilla before NAC. SLN accurately determined the axillary status in 96.5%. False negative rate was 8.3%. In 69.4% of patients, SLN was the only positive node. The mean number of SLN removed was 1.7 and nodes resected from the ALND were 13.2. CONCLUSION: SLN biopsy after NAC can predict the axillary status with a high accuracy in patients with breast cancer, avoiding unnecessary ALND.

Cardiotoxicity associated with trastuzumab in normal clinical practice.

OBJECTIVE: To evaluate the incidence of cardiotoxicity associated with treatment with trastuzumab in clinical practice by describing its characteristics, progress and associated risk factors. METHODS: Retrospective observational study of patients with HER2-positive breast cancer treated with trastuzumab in the fi rst quarter of 2007 in a tertiary hospital. Follow-up was performed from start of treatment until the end of March 2008. The data sources used were the oncological computer program Oncowin® from the pharmacy department and the patient clinical history. We gathered variables related to patient baseline characteristics, treatment and safety. RESULTS: The study included 61 patients. 19 women (32.8%) presented cardiotoxicity, which was the second most common adverse affect of those frequently attributed to the treatment. The average time for toxicity to appear was 7 months, with an average FEVI decrease of 15.6 +/- 9.1 points. In 63.2% of the patients it was symptomatic, and its most frequent manifestation was stress-induced dyspnoea, with a single case of congestive heart failure. Cardiotoxicity led to suspension of treatment in 22.9% of the total patients, which was definitive for 7 out of the 14 patients who interrupted the treatment. No statistically significant differences were found for the possible risk factors. CONCLUSIONS: The incidence of cardiotoxicity in clinical practice is much higher than expected. The important clinical implication of this information and the increasing use of trastuzumab mean that there is a new challenge for the optimal treatment of HER2-positive breast cancer.

Cardiotoxicidad asociada a trastuzumab en la práctica clínica asistencial / Cardiotoxicity associated with trastuzumab in normal clinical practice

Objetivo: Evaluar la incidencia de cardiotoxicidad asociada al tratamiento con trastuzumab en la práctica clínica asistencial, describiendo sus características, su manejo y los factores de riesgo asociados.Método: Estudio observacional retrospectivo que incluyó a pacientes con cáncer de mama HER-2 positivo en tratamiento con trastuzumab durante el primer trimestre de 2007 en un hospital de tercer nivel. Se realizó un seguimiento desde el inicio del tratamiento hasta fi nales de marzo de 2008. Las fuentes de datos utilizadas fueron el programa informático de oncología del servicio de farmacia, Oncowin®, y la historia clínica del paciente. Se recogieron variables relacionadas con las características basales del paciente, con el tratamiento y con la seguridad.Resultados: Se incluyó a 61 pacientes en el estudio; 19 (32,8 %) mujeres presentaron cardiotoxicidad, que supuso el segundo efecto adverso atribuido el tratamiento en frecuencia. La mediana de tiempo de aparición de la toxicidad fue de 7 meses, con un descenso medio de fracción de eyección del ventrículo izquierdo (FEVI) de 15,6 ± 9,1 puntos. En el 63,2 % fue sintomática, la manifestación más frecuente fue la disnea de esfuerzo y hubo un único caso de fallo cardíaco congestivo. La cardiotoxicidad supuso la suspensión del tratamiento en el 22,9 % del total de pacientes, y fue de forma defi nitiva en 7 de las 14 pacientes que interrumpieron el tratamiento. No se hallaron diferencias estadísticamente signifi cativas en cuanto a los posibles factores de riesgo.Conclusiones: La incidencia de cardiotoxicidad en la práctica clínica asistencial se muestra mucho más elevada que la esperada. Su importante implicación clínica y el uso creciente de trastuzumab hacen que suponga un nuevo reto para el tratamiento óptimo del cáncer de mama HER-2 positivo (AU)

Objective: To evaluate the incidence of cardiotoxicity associated with treatment with trastuzumab in clinical practice by describing its characteristics, progress and associated risk factors.Methods: Retrospective observational study of patients with HER2-positive breast cancer treated with trastuzumab in the fi rst quarter of 2007 in a tertiary hospital. Follow-up was performed from start of treatment until the end of March 2008. The data sources used were the oncological computer program Oncowin® from the pharmacy department and the patient clinical history. We gathered variables related to patient baseline characteristics, treatment and safety.Results: The study included 61 patients. 19 women (32.8 %) presented cardiotoxicity, which was the second most common adverse affect of those frequently attributed to the treatment. The average time for toxicity to appear was 7 months, with an average FEVI decrease of 15.6 ± 9.1 points. In 63.2 % of the patients it was symptomatic, and its most frequent manifestation was stress-induced dyspnoea, with a single case of congestive heart failure. Cardiotoxicity led to suspension of treatment in 22.9 % of the total patients, which was defi nitive for 7 out of the 14 patients who interrupted the treatment. No statistically signifi cant differences were found for the possible risk factors.Conclusions: The incidence of cardiotoxicity in clinical practice is much higher than expected. The important clinical implication of this information and the increasing use of trastuzumab mean that there is a new challenge for the optimal treatment of HER2-positive breast cance (AU)

Seguridad farmacológica y ambiental: disrupción endocrina / Drug and environmental safety: hyroid endocrine disruption

La exposición humana a compuestos químicos que interfieren con la homeostasis hormonal es bien conocida, a pesar de que la evidencia sea muy desigual para los distintos sistemas hormonales. Mientras que la disrupción endocrina de los esteroides (estrógenos y andrógenos) ha merecido gran atención, la de la homeostasis de las hormonas tiroideas está mal entendida, si se exceptúa lo que se refiere a la captación de yodo. La lista de disruptores endocrinos que interfieren con la síntesis, la circulación, la unión a receptores específicos, el metabolismo y la degradación de las hormonas tiroideas crece día a día. A los bifenilospoliclorados (PCB), las dioxinas y los furanos, se unen ahora los compuestos bromados retardadores de la llama, los bisfenoles y losftalatos. Cambios sutiles en las concentraciones de las hormonas tiroideas pueden ocasionar efectos adversos en períodos esenciales del desarrollo, de tal manera que se empieza a ver los efectos de tal exposición ahora, una vez que los mecanismos que ligan hormonastiroideas y neurodesarrollo son cada vez más evidentes ( AU)

Human exposure to environmental chemicals that disrupt endocrine homeostasis has been related to several hormone systems. Sex hormones (estrogen sand androgens) have received special attention, but thyroid hormone disruption is not so well known except in the special case of iodine intake deficiency. The list of chemicals that alter synthesis, circulation, binding to specific receptors, metabolism and degradation of thyroid hormones increases daily. Brominated flameretardants, bisphenols and phthalates are now included alongside polychlorinated biphenyls (PCBs), dioxins and furans. Subtle changes in circulating thyroid hormones may have undesirable effects during development. As our understanding of the role of thyroid hormones in neurodevelopment improves, exposure to environmental thyroid disruptors becomes a matter of increasing concern (AU)