Dietary Intake of (Poly)phenols and Risk of All-Cause and Cause-Specific Mortality in the Mexican Teachers' Cohort Study.

BACKGROUND: Observational studies have reported that total (poly)phenol intake is associated with a reduction in all-cause and cardiovascular mortality, but mainly from high-income countries, where (poly)phenol intake may differ from that of low- and middle-income countries. OBJECTIVES: Our objective was to evaluate the association between the intake of total, all classes, and subclasses of (poly)phenols and risk of all-cause and cause-specific mortality in a Mexican cohort. METHODS: We used data from the Mexican Teachers' Cohort, which included 95,313 adult females. After a median follow-up of 11.2 y, 1725 deaths were reported, including 674 from cancer and 282 from cardiovascular diseases. (Poly)phenol intake was estimated using a validated food frequency questionnaire and the Phenol-Explorer database. Multivariable Cox models were applied to estimate the association between (poly)phenol intake and all-cause mortality and competitive risk models for cause-specific mortality. RESULTS: Comparing extreme quartiles, total (poly)phenol intake was associated with lower risk of all-cause [hazard ratio (HR)Q4vs.Q1: 0.88; 95% CI: 0.76, 0.99; P-trend = 0.01] and cancer mortality (HRQ4vs.Q1: 0.81; 95% CI: 0.64, 0.99; P-trend = 0.02). Among (poly)phenol classes, phenolic acids, particularly hydroxycinnamic acids from coffee, showed an inverse association with all-cause (HRQ4vs.Q1: 0.79; 95% CI: 0.69, 0.91; P-trend = 0.002) and cancer mortality (HRQ4vs.Q1: 0.75; 95% CI: 0.61, 0.94; P-trend = 0.03). No associations were observed with flavonoids or with cardiovascular mortality. CONCLUSION: Our study suggests that high (poly)phenol intake, primarily consisting of phenolic acids such as hydroxycinnamic acids, may have a protective effect on overall and cancer mortality. Null associations for flavonoid intake might be due to the potential underestimation of their intake in this population.

Tumor germinal mixto maligno de testículo de inicio súbito: presentación de un caso / Testicle´s malignant mixed germ tumor of sudden onset: a case presenting

Los tumores germinales mixtos representan el 40-60% de las neoplasias testiculares, pueden presentarse en testículos descendidos o no, y en sitios extratesticulares. Están asociados a condiciones como criptorquidia, atrofia testicular y hernia inguinal. Pueden debutar con síntomas que incluyen aumento unilateral del volumen escrotal, con o sin dolor. Microscópicamente se observan varias combinaciones de componentes histológicos germinales, es indispensable la determinación del porcentaje de cada uno de ellos, y la medición de marcadores tumorales, por sus implicaciones pronósticas. El tratamiento principal está basado en la orquiectomía radical y dependiendo del estadio la quimioterapia y o radioterapia complementaria. En los pacientes adecuadamente tratados, la sobrevida es muy buena, aun en estadios avanzados de la enfermedad. Se presenta masculino de 20 años con dolor de inicio súbito y sensación de masa en testículo derecho. Ecografía revela lesión sólida que compromete parénquima testicular. Se realiza orquiectomía radical. Estudio anatomopatológico muestra tumor maligno con áreas sólidas y quísticas, tipo tumor germinal mixto con componente de carcinoma embrionario, teratoma maduro, y tumor de seno endodérmico, sin componente seminomatoso.

Mixed germ cell tumors represent 40-60% of testicular tumors, they can occur in undescended testicles or not, and Extratesticular sites. They are associated with conditions such as cryptorchidism, testicular atrophy and inguinal hernia. They may present with symptoms including unilateral scrotal volume increase, with or without pain. Microscopically various combinations of components observed histological germ is indispensable determining the percentage of each, and measurement of tumor markers for prognostic implications. Treatment is based on surgical resection plus chemotherapy and / or adjuvant radiotherapy. In treated patients, survival is good, even in advanced stages of the disease. Male 20 years presents with sudden onset of pain and sensation of mass in the right testicle. Ultrasound reveals solid lesion that compromises testicular parenchyma. Radical orchiectomy is done. Pathological study shows malignant tumor with solid and cystic areas, with mixed germ cell tumor type component of embryonic carcinoma, teratoma, endodermal sinus tumor and without seminoma component.