Methane (CH4) is a greenhouse gas generated during the feed fermentation processes in the rumen. However, numerous studies have been conducted to determine the capacity of plant secondary metabolites to enhance ruminal fermentation and decrease CH4 production, especially those plants rich in tannins. This review conducted a descriptive analysis and meta-analysis of the use of tannin-rich plants in tropical regions to mitigate CH4 production from livestock. The aim of this study was to analyse the effect of tannins supplementation in tropical plants on CH4 production in ruminants using a meta-analytic approach and the effect on microbial population. Sources of heterogeneity were explored using a meta-regression analysis. Final database was integrated by a total of 14 trials. The 'meta' package in R statistical software was used to conduct the meta-analyses. The covariates defined a priori in the current meta-regression were inclusion level, species (sheep, beef cattle, dairy cattle, and cross-bred heifers) and plant. Results showed that supplementation with tropical plants with tannin contents have the greatest effects on CH4 mitigation . A negative relationship was observed between the level of inclusion and CH4 emission (-0.09), which means that the effect of CH4 mitigation is increasing as the level of tannin inclusion is higher. Therefore, less CH4 production will be obtained when supplementing tropical plants in the diet with a high dose of tannins.
Background & objectives: The Covid-19 pandemic has revolutionised how we receive services, with a huge shift to online delivery. Online health promotion tools could be a cost-effective and safe way to improve population health. We used mixed methods to explore user responses to an online cognitive health tool.Methods1528 months after completing an online tool, comprising a cognitive test, lifestyle questionnaire; and dietary and lifestyle behaviour feedback, 4826 participants completed an online survey about their perceptions of it; and questions about their capability, opportunity and motivation for behavioural change developed using the COM-B behaviour change model. We reported how responses to the behaviour change questionnaire predicted decisions to make lifestyle and dietary changes. 24 participants attended focus groups to further explore their responses.ResultsMost users reported that the tool was useful (88%), with 37% reporting they made lifestyle or dietary changes after using it. More positive responses to questions regarding capability and motivation predicted making changes. Over a third (36%) felt more fearful after completing the tool. In qualitative findings, we identified barriers to engagement across the three COM-B domains: a sense that information was nothing new (so did not enhance capability); that experts dont agree and that the tool may not be credible (influencing motivation), and a lack of support from peers and lower availability of healthy food (reducing opportunities for change).ConclusionsFuture e-health tools will be most effective if they have high credibility, demonstrate advice is evidence-based and provide opportunities for support and follow up. (AU)
Humans , Severe acute respiratory syndrome-related coronavirus , Coronavirus Infections/epidemiology , Health Promotion , Life Style
Creation of the "auroral" green line, a fascinating occurrence commonly observed in the upper atmosphere, has long been a difficult endeavor, especially at atmospheric pressure. Here we report strong emission of the "auroral" green line for the first time in a kHz frequency, linear field atmospheric pressure plasma jet system. The device used 99.999% pure argon as a working gas for the plasma generation. Optical emission spectroscopy measurements of the after discharge region show the existence of 557.7 nm emission which corresponds to the transition O([Formula: see text]S)-O([Formula: see text]D). The intensity of the produced green line is strong enough that the entire plasma plume in the ambient air is visible as a green plasma. We provide the chemical reactions of O([Formula: see text]S) production in the plasma and the estimation of the density of the O([Formula: see text]S) metastable state using the kinetic reactions. Further, the O([Formula: see text]S) emission is characterized by changing the flow rate of argon, applied voltage and electrode gap. The adequate plasma length ([Formula: see text]) along with the production of a variety of reactive components viz; OH, [Formula: see text] and oxygen (777 nm) make this configuration useful for applications such as: blood coagulation, cancer treatment, sterilization, and waste treatment. Moreover, this setup can be potentially used as a test bed for the in-depth understanding of plasma chemistry relevant to the aurora and comet tails using a laboratory setting.
Mutations in BRCA1 and BRCA2 high penetrance genes account for most hereditary breast and ovarian cancer, although other new high-moderate penetrance genes included in multigene panels have increased the genetic diagnosis of hereditary breast and ovarian cancer families by 50%. Multigene cancer panels provide new challenges related to increased frequency of variants of uncertain significance, new gene-specific cancer risk assessments, and clinical recommendations for carriers of mutations of new genes. Although clinical criteria for genetic testing continue to be largely based on personal and family history with around a 10% detection rate, broader criteria are being applied with a lower threshold for detecting mutations when there are therapeutic implications for patients with breast or ovarian cancer. In this regard, new models of genetic counselling and testing are being implemented following the registration of PARP inhibitors for individuals who display BRCA mutations. Massive sequencing techniques in tumor tissue is also driving a paradigm shift in genetic testing and potential identification of germline mutations. In this paper, we review the current clinical criteria for genetic testing, as well as surveillance recommendations in healthy carriers, risk reduction surgical options, and new treatment strategies in breast cancer gene-mutated carriers.
Breast Neoplasms/prevention & control , Clinical Trials as Topic/standards , Genetic Predisposition to Disease , Mutation , Neoplasm Proteins/genetics , Ovarian Neoplasms/prevention & control , Practice Guidelines as Topic/standards , Breast Neoplasms/genetics , Female , Humans , Medical Oncology , Ovarian Neoplasms/genetics , Societies, Medical
PURPOSE: To evaluate the efficacy and safety of lapatinib (L) and trastuzumab (T) combination in HER2-positive metastatic breast cancer (MBC) patients previously treated with T and/or L. MATERIALS AND METHODS: We conducted a retrospective, post-authorized, multicenter study including patients with HER2-positive MBC or locally advanced breast cancer (ABC) treated with the combination of L-T. Concomitant endocrine therapy, as well as brain metastasis and/or prior exposure to L, were allowed. RESULTS: One hundred and fifteen patients from 14 institutions were included. The median age was 59.8 years. The median number of prior T regimens in the advanced setting was 3 and 73 patients had received a prior L regimen. The clinical benefit rate (CBR) was 34.8% (95% CI 26.1-43.5). Among other efficacy endpoints, the overall response rate was 21.7%, and median progression-free survival (PFS) and overall survival were 3.9 and 21.6 months, respectively. Heavily pretreated and ≥ 3 metastatic organ patients showed lower CBR and PFS than patients with a low number of previous regimens and < 3 metastatic organs. Moreover, CBR did not significantly change in L-pretreated compared with L-naïve patients (31.5% versus 40.5% for L-pretreated versus L-naïve). Grade 3/4 adverse events were reported in 19 patients (16.5%). CONCLUSION: The combination of L-T is an effective and well-tolerated regimen in heavily pretreated patients and remains active among patients progressing on prior L-based therapy. Our study suggests that the L-T regimen is a safe and active chemotherapy-free option for MBC patients previously treated with T and/or L.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Lapatinib/therapeutic use , Receptor, ErbB-2/metabolism , Trastuzumab/therapeutic use , Adult , Aged , Aged, 80 and over , Breast Neoplasms/pathology , Female , Humans , Middle Aged , Neoplasm Metastasis , Protein Kinase Inhibitors/therapeutic use , Receptor, ErbB-2/antagonists & inhibitors , Retrospective Studies , Spain , Treatment Outcome
RESUMEN Los efectos nocivos de la radiación solar han sido reportados, pero casi no se ha estudiado la población laboral de Latinoamérica. Este es un estudio transversal analítico realizado en ocho países. Las preguntas sobre protección solar se tomaron de trabajos previos; además, se preguntó por las características laborales; ambos datos se cruzaron para obtener datos estadísticos de asociación. De los 3.222 trabajadores encuestados, el 71% (2270) tenía piel mestiza. Hubo asociación del enrojecimiento de la piel según la cantidad de horas de exposición solar directa (p<0,001) e indirecta (p<0,001). El 47% (995) usaban protector/bloqueador solar, el 54% (1150) usaban ropa adecuada y el 50% (1056) usaban alguna gorra o sombrero; siendo estadísticamente diferente el medio de adquisición de dichos equipos. El 21% (446) no usaba ninguno de los equipos de protección personal ante los efectos del sol. Concluimos que es alarmante el bajo porcentaje de trabajadores que reciben adecuada protección contra los efectos de la radiación solar. Esto podría generar problemas a corto, mediano y largo plazo entre los empleados, lo que podría aumentar la morbi-mortalidad y el riesgo de cáncer de piel.
ABSTRACT The harmful effects of solar radiation have been reported, but the work population in Latin America has hardly been studied. The objective is describe the type of sun protection they use and find associations according to their characteristics in Latin American workers. The methodology isCross-sectional analytical study carried out in 8 countries, the questions of sun protection were taken from previous work, in addition, asked about the labor characteristics; Both were crossed to obtain association statistics. Our results: Of the 3.222 workers surveyed, 71% (2270) had mestizo skin. There was association of skin redness according to the number of hours of direct (p <0.001) and indirect sun exposure (p <0.001). 47% (995) wore the sunscreen / protector, 54% (1150) wore appropriate clothing and 50% (1056) wore a cap or hat; statistically different according to the means of acquisition of such equipment (p value <0.001 for all three cases). 21% (446) did not wear any personal protective equipment to the effects of the sun. It is alarming that the low percentage of workers who receive adequate protection against the effects of solar radiation can cause problems in the short, medium and long term among employees. This could increase morbidity and mortality and the risk of skin cancer. It is important to do more research in this regard, as this issue is of utmost importance because of the changes that have occurred in radiation levels, which could generate a public health problem in this work group.
PURPOSE: To evaluate the efficacy and safety of oral weekly vinorelbine 60 mg/m2 for metastatic breast cancer (MBC) in patients previously treated with anthracyclines or taxanes in routine clinical practice. MATERIALS AND METHODS: Fifty-five patients were enrolled in a prospective multicentre study conducted in Spain. Women ≥ 18 years of age with locally advanced breast cancer who were not candidates for surgical treatment with a radical intention or patients with stage IV disease, and who had received a prior taxane or anthracycline regimen were eligible for participation. RESULTS: Median age was 67 years. Median progression-free survival was 3.7 months (95% CI 2.5-4.9), median overall survival 10 months (95% CI 6.6-13.5), and overall response rate and clinical benefit rate were 29.1% and 49.1%, respectively. Main grade 3 and 4 toxicities were neutropenia 9.1%, febrile neutropenia 3.6% and constipation 3.6%. In total, 86% of the patients received complete treatment without delays or dose reduction. Moreover, HER2-positive patients who received oral vinorelbine concomitantly with trastuzumab showed better response (complete response: HER2-positive 14.3% vs. HER2-negative 0%; partial response: HER2-positive 42.9% vs. HER2-negative 25.6%; p = 0.008), better disease control rate (HER2-positive 100% vs. HER2-negative 46.2%; p = 0.011), and better values for the remaining analysed variables than HER2-negative patients. CONCLUSION: Our study provides real-world data on the use of oral weekly vinorelbine, which proves an effective and well-tolerated regimen for MBC patients previously treated with taxanes or anthracyclines. Patients with HER2-positive disease could also benefit from this treatment in combination with trastuzumab.
Antineoplastic Agents, Phytogenic/administration & dosage , Breast Neoplasms/drug therapy , Breast Neoplasms/pathology , Vinorelbine/administration & dosage , Adult , Aged , Aged, 80 and over , Anthracyclines/administration & dosage , Anthracyclines/pharmacology , Antineoplastic Agents, Phytogenic/adverse effects , Breast Neoplasms/metabolism , Drug Administration Schedule , Drug Resistance, Neoplasm , Female , Humans , Middle Aged , Neoplasm Metastasis , Prospective Studies , Receptor, ErbB-2/metabolism , Spain , Survival Analysis , Taxoids/administration & dosage , Taxoids/pharmacology , Trastuzumab/administration & dosage , Treatment Outcome , Vinorelbine/adverse effects
INTRODUCTION: Our aim is to find features that define prognosis in surgically resected ductal pancreatic adenocarcinoma readily accessible in everyday practice. MATERIALS AND METHODS: Longitudinal retrospective case series of pancreatic adenocarcinoma operated with a curative intent in a large tertiary hospital in Madrid between 2009 and 2015. RESULTS: 162 were enrolled. 40.8% survived less than 1 year. Multivariate Cox's regression model revealed that gender, presence of symptoms, T and N stage independently influenced progression-free survival, while overall survival was determined by gender, smoking, presence of symptoms and N stage. Logistic regression analysis revealed that only symptoms at diagnosis could predict death, while gender, symptoms, histopathological type, vessel invasion, T stage and necrosis could independently predict recurrence. DISCUSSION: Our series show that patients with symptomatic disease at the time of diagnosis and females showed a shorter progression-free and overall survival. We herein propose a regression model to predict outcome.
Adenocarcinoma/pathology , Carcinoma, Pancreatic Ductal/pathology , Molecular Medicine , Neoplasm Recurrence, Local/pathology , Pancreatic Neoplasms/pathology , Pancreaticoduodenectomy/methods , Adenocarcinoma/surgery , Aged , Carcinoma, Pancreatic Ductal/surgery , Disease Progression , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , Neoplasm Recurrence, Local/surgery , Pancreatic Neoplasms/surgery , Prognosis , Retrospective Studies
Resumen Plecoptera es un grupo basal de insectos acuáticos, también conocidos como "moscas de piedra". Con el objetivo de contribuir al conocimiento taxonómico y ecológico del género Anacroneuria, se realizaron recolectas de ninfas en la parte alta y media del río Caldera, en la provincia de Chiriquí. Para esto se hicieron giras de campo una vez al mes de enero a diciembre de 2015. En siete estaciones de muestreo, se recolectaron ninfas en rocas y hojarasca sumergida, de forma manual con pinzas entomológicas y con red triangular, para su posterior cría en sistemas de acuarios en el laboratorio. Se recolectaron 485 ninfas, con la emergencia de 138 adultos. Cinco especies de Anacroneuria: Anacroneuria annulipalpis, A. benedettoi, A. planicollis, A. quetzali, A. marca y dos especies no identificadas fueron determinadas a través de la crianza de ninfas en laboratorio. El rango de distribución de A. benedettoi fue extendido a la provincia de Chiriquí. El primer registro de A. quetzalipara Panamá es comentado. Se aporta datos de distribución altitudinal, variabilidad estacional y requerimientos ambientales. Se recomienda ampliar los estudios sobre las asociaciones de ninfas con las formas adultas en otras áreas de Panamá y del Neotrópico, así como incrementar el conocimiento sobre la biología y ecología de este grupo.
Abstract Plecoptera order is a basal group of aquatic insects, also known as stonefly. In order to contribute to the taxonomic and ecological knowledge of the genus Anacroneuria, nymphs were collected in the upper and low parts of the Caldera River, in the Chiriquí province. For this, field trips were carried out once a month, from January to December of 2015. A total of seven stations were sampled, and nymphs were collected on rocks and submerged leaf litter, manually with entomological tweezers, and with a triangular net; nymphs were later transported and reared in aquarium systems in the laboratory, and their growth was followed. A total of 485 nymphs were collected, with the emergence of 138 adults. Five species of Anacroneuria: Anacroneuriaannulipalpis, A. benedettoi, A. planicollis, A. quetzali, A. marca and two unknown species were obtained after nymphs rearing. The distribution range of A. benedettoi was extended to the Chiriqui province. The first record for A. quetzaliin Panamá is commented. In addition, data of altitudinal distribution, seasonal variability and environment requirements were mentioned. We recommend to expand studies on Plecoptera nymph associations with adult forms in other areas of Panama and the Neotropics, as well as to increase the knowledge about their biology and ecology. Rev. Biol. Trop. 66(1): 164-177. Epub 2018 March 01.
Biodiversity studies are more efficient when large numbers of breeds belonging to several countries are involved, as they allow for an in-depth analysis of the within- and between-breed components of genetic diversity. A set of 21 microsatellites was used to investigate the genetic composition of 24 Creole goat breeds (910 animals) from 10 countries to estimate levels of genetic variability, infer population structure and understand genetic relationships among populations across the American continent. Three commercial transboundary breeds were included in the analyses to investigate admixture with Creole goats. Overall, the genetic diversity of Creole populations (mean number of alleles = 5.82 ± 1.14, observed heterozygosity = 0.585 ± 0.074) was moderate and slightly lower than what was detected in other studies with breeds from other regions. The Bayesian clustering analysis without prior information on source populations identified 22 breed clusters. Three groups comprised more than one population, namely from Brazil (Azul and Graúna; Moxotó and Repartida) and Argentina (Long and shorthair Chilluda, Pampeana Colorada and Angora-type goat). Substructure was found in Criolla Paraguaya. When prior information on sample origin was considered, 92% of the individuals were assigned to the source population (threshold q ≥ 0.700). Creole breeds are well-differentiated entities (mean coefficient of genetic differentiation = 0.111 ± 0.048, with the exception of isolated island populations). Dilution from admixture with commercial transboundary breeds appears to be negligible. Significant levels of inbreeding were detected (inbreeding coefficient > 0 in most Creole goat populations, P < 0.05). Our results provide a broad perspective on the extant genetic diversity of Creole goats, however further studies are needed to understand whether the observed geographical patterns of population structure may reflect the mode of goat colonization in the Americas.
Genetic Variation , Genetics, Population , Goats/genetics , Alleles , Americas , Animals , Bayes Theorem , Breeding , Gene Frequency , Genetic Markers , Genotype , Geography , Heterozygote , Microsatellite Repeats , Sequence Analysis, DNA
Studying genetic parameters and genetic changes in Santa Ines sheep is important, because it is the commonest breed in Brazil. This study obtained genetic data from 37,735 pedigree records of lambs over 12 years (2003-2014) from 33 flocks in 10 Brazilian States; 11,851 records of performance were available. (Co)variance components, genetic parameters and breeding values estimates were obtained by derivative-free restricted maximum likelihood in a univariate analysis that included maternal additive genetic and maternal permanent environmental effects. Birth weight, weaning weight, weight at 180 days of age, weight at 270 days of age, average daily weight gain in the following states: from birth to weaning, from weaning to 6 months, from 6 months to 9 months, and from weaning to 9 months; presence of hair in fur and leg muscularity were assessed. (Co)variance component values increased in the weight traits with age. A significant maternal effect was found in the pre-weaned stage that decreased in the post-weaned stage. High values were estimated for the maternal permanent environmental effect, possibly because of the extensive grassland that was available. High total heritability values were estimated for all of the traits evaluated. Significant, positive correlations were found between direct and maternal additive genetic traits with a gradual decrease as the lambs gained independence from their mothers. The genetic trends observed were irregular and incremental. Significant genetic variance suggests that direct selection for pre-weaning traits results in indirect selection of maternal abilities, and individual selection of any post-weaning trait results in rapid genetic improvement.
Sheep, Domestic/genetics , Animals , Birth Weight/genetics , Breeding , Female , Genetic Variation , Male , Pedigree , Sheep, Domestic/growth & development , Weight Gain/genetics
BACKGROUND: Self-management may be an option to monitor oral anticoagulant therapy in health systems, but before recommending it, we need to assess patients' ability to take on this task. The purpose of the study was to describe patients' ability to self-manage and associated factors. METHODS: This was a 3-year prospective quasi-experimental study with a control group. Overall, 333 patients on anticoagulant therapy from seven primary care health centres of the Basque Health Service were included in the intervention group and followed up for 6 months after the intervention, assessing their ability to self-test and self-manage. The intervention consisted of a patient training programme, providing detailed information on their condition and its treatment, and practical training in how to use a portable blood coagulation monitor and adjust their anticoagulant dose. Comparisons were made with a control group (333 patients receiving OAT under usual care from the same seven health centres). Outcome variables were ability to self-manage, quality of the outcome (in terms of time in therapeutic range), and quality of life in the intervention group, and general patient characteristics (age and sex), clinical variables (reason for OAT, INR range), and quality of the outcome (in terms of percentage of INR measurements in range and complications) in both groups. RESULTS: Overall, 26.13 % of patients invited to participate in the intervention agreed. Of these, 99 % successfully learned to self-manage their OAT. Just 4.2 % did not complete the follow-up, in all cases for reasons unrelated to self-management, and 4.5 % required additional learning support. Outcomes were better than under usual care in terms of percentage of INR measurements in range (12 %), rate of complications (4 %) and quality of life (9.2 %). LIMITATIONS: Patients were only followed-up period for 6 months and the study was conducted in a single health organization. Though patients eligible to participate were selected randomly, they were not randomly allocated to the groups. This is a potential source of selection bias. Data needed to calculate in-range time were not collected from controls; rather the results for the self-management group were compared with external data from other studies. CONCLUSIONS: Almost all participants achieved competency in self-management, with no differences by age, sex, concurrent illnesses, polypharmacy or educational level. The greatest barrier to self-management was the attitude of patients themselves and those around them. Self-management in primary care is a good alternative to usual care, patients having longer times in therapeutic range and fewer complications, and improving their quality of life. Remote management is a good support tool. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01878539.
Anticoagulants/administration & dosage , Primary Health Care/methods , Quality of Life , Self Care/methods , Thromboembolism/prevention & control , Vitamin K/antagonists & inhibitors , Administration, Oral , Aged , Blood Coagulation , Dose-Response Relationship, Drug , Female , Follow-Up Studies , Humans , Male , Patient Satisfaction , Prospective Studies , Thromboembolism/blood , Time Factors , Treatment Outcome
This work studies the impact of systematic uncertainties associated to interaction cross sections on depth dose curves determined by Monte Carlo simulations. The corresponding sensitivity factors are quantified by changing cross sections by a given amount and determining the variation in the dose. The influence of total and partial photon cross sections is addressed. Partial cross sections for Compton and Rayleigh scattering, photo-electric effect, and pair production have been accounted for. The PENELOPE code was used in all simulations. It was found that photon cross section sensitivity factors depend on depth. In addition, they are positive and negative for depths below and above an equilibrium depth, respectively. At this depth, sensitivity factors are null. The equilibrium depths found in this work agree very well with the mean free path of the corresponding incident photon energy. Using the sensitivity factors reported here, it is possible to estimate the impact of photon cross section uncertainties on the uncertainty of Monte Carlo-determined depth dose curves.
Radiometry/methods , Radiotherapy Planning, Computer-Assisted/methods , Algorithms , Brachytherapy/methods , Cobalt Radioisotopes/chemistry , Computer Simulation , Models, Statistical , Monte Carlo Method , Photons , Probability , Radiotherapy Dosage , Reproducibility of Results , Software , Uncertainty
Global awareness of material sustainability has increased the demand for bio-based polymers like poly(lactic acid) (PLA), which are seen as a desirable alternative to fossil-based polymers because they have less environmental impact. PLA is an aliphatic polyester, primarily produced by industrial polycondensation of lactic acid and/or ring-opening polymerization of lactide. Melt processing is the main technique used for mass production of PLA products for the medical, textile, plasticulture, and packaging industries. To fulfill additional desirable product properties and extend product use, PLA has been blended with other resins or compounded with different fillers such as fibers, and micro- and nanoparticles. This paper presents a review of the current status of PLA mass production, processing techniques and current applications, and also covers the methods to tailor PLA properties, the main PLA degradation reactions, PLA products' end-of-life scenarios and the environmental footprint of this unique polymer.
Polyesters/chemistry , Polyesters/chemical synthesis , Humans , Lactic Acid/chemistry , Nanoparticles/chemistry
Breast cancer is a burden for western societies, and an increasing one in emerging economies, because of its high incidence and enormous psychological, social, sanitary and economic costs. However, breast cancer is a preventable disease in a significant proportion. Recent developments in the armamentarium of effective drugs for breast cancer prevention (namely exemestane and anastrozole), the new recommendation from the National Institute for Health and Care Excellence to use preventative drugs in women at high risk as well as updated Guidelines from the US Preventive Services Task Force and the American Society of Clinical Oncology should give renewed momentum to the pharmacological prevention of breast cancer. In this article we review recent major developments in the field and examine their ongoing repercussion for breast cancer prevention. As a practical example, the potential impact of preventive measures in Spain is evaluated and a course of practical actions is delineated (AU)
No disponible
Humans , Female , Breast Neoplasms/prevention & control , Antineoplastic Agents/therapeutic use , Aromatase Inhibitors/therapeutic use , Genetic Markers , Genetic Predisposition to Disease , Risk Factors , Genes, Neoplasm , Genes, BRCA1 , Genes, BRCA2
Breast cancer is a burden for western societies, and an increasing one in emerging economies, because of its high incidence and enormous psychological, social, sanitary and economic costs. However, breast cancer is a preventable disease in a significant proportion. Recent developments in the armamentarium of effective drugs for breast cancer prevention (namely exemestane and anastrozole), the new recommendation from the National Institute for Health and Care Excellence to use preventative drugs in women at high risk as well as updated Guidelines from the US Preventive Services Task Force and the American Society of Clinical Oncology should give renewed momentum to the pharmacological prevention of breast cancer. In this article we review recent major developments in the field and examine their ongoing repercussion for breast cancer prevention. As a practical example, the potential impact of preventive measures in Spain is evaluated and a course of practical actions is delineated.
Breast Neoplasms/prevention & control , Antineoplastic Agents, Hormonal/therapeutic use , BRCA1 Protein/genetics , Breast Neoplasms/genetics , Female , Humans , Tamoxifen/therapeutic use
BACKGROUND: BRCA1-associated breast cancers have been associated to a triple-negative phenotype. The prevalence of BRCA1 germline mutations in young onset TNBC based on informativeness of family history has not been reported. PATIENTS AND METHODS: From January 2008 to May 2009 were collected blood and tumor samples from patients with TNBC younger than 50 years and without a family history of breast and ovarian cancer in first- and second-degree relatives. Analysis of BRCA1 germline mutations was made. Age at diagnosis and informativeness of family history (presence of female in first- and second-degree relatives alive until age 45) was collected in all cases. Immunohistochemistry of basal-like features was performed centrally in all available tumors. RESULTS: Seven pathogenic mutations were detected in 92 patients (7.6 %), two of them in patients younger than 35 years (28.6 %) (Fisher's exact test, p = 0.631). Three non-classified variants were detected (3.2 %). Family history was informative in two patients with a pathogenic mutation (28.6 %) and not informative in five (71.4 %) (Fisher's exact test, p = 0.121). Of the seven patients with a pathogenic mutation, four had a basal-like phenotype. CONCLUSION: Patients with apparently sporadic TNBC younger than 50 years and a non-informative family history are candidates for germline genetic testing of BRCA1 (AU)
No disponible
Humans , Female , Middle Aged , Aged , Genes, BRCA1 , Germ-Line Mutation , Chromatography, High Pressure Liquid , DNA Mutational Analysis , Genetic Predisposition to Disease , Immunohistochemistry , Retrospective Studies
Introducción: El leiomiosarcoma renal es un tumor raro que constituye el 0,12 por ciento de todas las neoplasias renales malignas; su presentación clínica es muy variable. Caso clínico: Se reporta el caso de un hombre de 68 años de edad con lumbalgia derecha, en una tomografía contrastada de abdomen y pelvis se detecta una gran masa tumoral dependiente del polo superior renal derecho. Se realizó una nefrectomía radical y la resección incidental de una lesión pulmonar basal derecha, el diagnóstico histopatológico y de inmuno-histoquímica fue de un leiomiosarcoma renal maligno de alto grado metastásico a pulmón.
Introduction: Renal leiomyosarcoma is a rare tumor constituting 0.12% of all malignant renal neoplasms; the clinical presentation is highly variable. Clinical case: We report the case of a 68 year old man who presented with right back pain; CT scan (computed tomography) showed a large mass located at upper pole of the right kidney. We performed a radical nephrectomy and resection of a right basal lung node incidentally found, the histopathological and immunohistochemical diagnosis was a renal high-grade leiomyosarcoma with metastases to the lung.
Humans , Male , Aged , Leiomyosarcoma/surgery , Leiomyosarcoma/diagnosis , Kidney Neoplasms/surgery , Kidney Neoplasms/diagnosis , Low Back Pain/etiology , Leiomyosarcoma/pathology , Nephrectomy/methods , Lung Neoplasms/secondary , Kidney Neoplasms/pathology , Tomography, X-Ray Computed
BACKGROUND: BRCA1-associated breast cancers have been associated to a triple-negative phenotype. The prevalence of BRCA1 germline mutations in young onset TNBC based on informativeness of family history has not been reported. PATIENTS AND METHODS: From January 2008 to May 2009 were collected blood and tumor samples from patients with TNBC younger than 50 years and without a family history of breast and ovarian cancer in first- and second-degree relatives. Analysis of BRCA1 germline mutations was made. Age at diagnosis and informativeness of family history (presence of female in first- and second-degree relatives alive until age 45) was collected in all cases. Immunohistochemistry of basal-like features was performed centrally in all available tumors. RESULTS: Seven pathogenic mutations were detected in 92 patients (7.6 %), two of them in patients younger than 35 years (28.6 %) (Fisher's exact test, p = 0.631). Three non-classified variants were detected (3.2 %). Family history was informative in two patients with a pathogenic mutation (28.6 %) and not informative in five (71.4 %) (Fisher's exact test, p = 0.121). Of the seven patients with a pathogenic mutation, four had a basal-like phenotype. CONCLUSION: Patients with apparently sporadic TNBC younger than 50 years and a non-informative family history are candidates for germline genetic testing of BRCA1.
Genes, BRCA1 , Germ-Line Mutation , Triple Negative Breast Neoplasms/genetics , Adult , Age of Onset , Chromatography, High Pressure Liquid , DNA Mutational Analysis , Female , Genetic Predisposition to Disease , Humans , Immunohistochemistry , Middle Aged , Retrospective Studies , Triple Negative Breast Neoplasms/metabolism
