Increased homocysteine plasma levels in breast cancer patients of a Mexican population.

AIM: Hyperhomocysteinemia has been associated with different pathologies, including cardiovascular diseases, hypertension, diabetes, and breast cancer (BC). To examine the differences in total homocysteine (tHcy) plasma levels, we compared healthy women to BC patients from a Mexican population. MATERIALS AND METHODS: The tHcy plasma levels were measured using high-performance liquid chromatography with a fluorescence detector in 89 female controls and 261 BC patients. RESULTS: The observed plasma tHcy levels were significantly higher among the BC patients (11.1019 ± 5.9161 µmol/l) compared to the controls (9.1046 ± 1.3213 µmol/l) (p = 0.002), and these differences were evident when stratified by age (≥ 50 years old), menopause status, overweight and obesity, miscarriages, node metastases, progression, subtype classification (luminal, Her2 and triple negative) and nonresponse to chemotherapy. CONCLUSIONS: The tHcy plasma levels could be a good marker for the progression and chemosensitivity of BC in the analyzed sample from a Mexican population.

[EORTC QLQ-C30 questionnaire role as predictor for malnutrition risk in head and neck cancer Mexican patients]. / Papel del cuestionario EORTC QLQ-C30 en la predicción de riesgo de desnutrición en pacientes mexicanos con cáncer de cabeza y cuello.

INTRODUCTION: Head and neck cancer treatment restricts oral intake and conditioning malnutrition. Adequate nutritional support during treatment can limit the impact of side effects. OBJECTIVE: To describe EORTC QLQ-C30 role for malnutrition risk screening in head and neck cancer patients. METHODS: Analytical and cross-sectional, diagnostic test study in head and neck cancer patients. We correlated malnutrition diagnosis with subjective global assessment (SGA) and score for the EORTC QLQ-C30 scales with Pearson and Spearman correlation. We realized COR (Receiver Operating Characteristic) curves to calculate cut point in the score for the EORTC QLQ-C30 scales; we calculated sensitivity, specificity, positive predictive value, negative predictive value and Odds Ratio through logistic regression. RESULTS: Functional scales (role, physic, global health status/QoL) showed limited utility to malnutrition risk estimation in people with head and neck cancer. Symptoms' scales with strong association were: pain (sensitivity 76.47%, specificity 69.23%), insomnia (sensitivity 88.24%, specificity 53.85%), fatigue (sensitivity 70.59%, specificity 76.92%). CONCLUSIONS: EORTC QLQ-C30 questionnaire is a useful tool to early malnutrition diagnosis in head and neck cancer patients with short term results in nutritional condition, treatment response and a better QoL in this kind of patients.

Papel del cuestionario EORTC QLQ-C30 en la predicción de riesgo de desnutrición en pacientes mexicanos con cáncer de cabeza y cuello / EORTC QLQ-C30 questionnaire role as predictor for malnutrition risk in head and neck cancer Mexican patients

Introducción: El tratamiento del cáncer de cabeza y cuello puede limitar la ingesta oral y condicionar desnutrición. Un soporte nutricional adecuado durante el tratamiento puede limitar el impacto de los efectos secundarios. Objetivo: Describir la utilidad de la encuesta EORTC QLQ-C30 en el tamizaje de riesgo de desnutrición en pacientes con cáncer de cabeza y cuello. Métodos: Estudio transversal analítico, validación de prueba diagnóstica en pacientes con cáncer de cabeza y cuello en diferentes etapas clínicas. Se correlacionó el diagnóstico de desnutrición (Valoración Global Subjetiva) con las escalas del cuestionario EORTC QLQ-C30.v3 a través de las correlaciones de Pearson y de Spearman; se realizó una curva ROC para determinar el punto de corte en los puntajes de las escalas del cuestionario QLQ-C30.v3 y el cálculo de sensibilidad, especificidad, valores predictivos positivo y negativo, y el cálculo de Odds Ratio por regresión logística. Resultados: Las escalas funcionales (función de rol, función física y estado global de salud) presentaron valores limitados para estimar riesgo de desnutrición en las personas, con cáncer de cabeza y cuello. Las escalas de síntomas que mostraron mayor grado de asociación fueron: dolor con sensibilidad de 76,47% y especificidad de 69,23%, insomnio con sensibilidad de 88,24% y especificidad de 53,85%, fatiga con sensibilidad de 70,59% y especificidad de 76,92%. Conclusiones: El cuestionario EORTC QLQ-C30, es una herramienta útil para detectar tempranamente desnutrición en pacientes con cáncer de cabeza y cuello, impactar el estadio nutricio, la respuesta al tratamiento y elevar la calidad de vida de estos pacientes (AU)

Introduction: Head and neck cancer treatment restricts oral intake and conditioning malnutrition. Adequate nutritional support during treatment can limit the impact of side effects. Objective: To describe EORTC QLQ-C30 role for malnutrition risk screening in head and neck cancer patients. Methods: Analytical and cross-sectional, diagnostic test study in head and neck cancer patients. We correlated malnutrition diagnosis with subjective global assessment (SGA) and score for the EORTC QLQ-C30 scales with Pearson and Spearman correlation. We realized COR (Receiver Operating Characteristic) curves to calculate cut point in the score for the EORTC QLQ-C30 scales; we calculated sensitivity, specificity, positive predictive value, negative predictive value and Odds Ratio through logistic regression. Results: Functional scales (role, physic, global health status/QoL) showed limited utility to malnutrition risk estimation in people with head and neck cancer. Symptoms' scales with strong association were: pain (sensitivity 76.47%, specificity 69.23%), insomnia (sensitivity 88.24%, specificity 53.85%), fatigue (sensitivity 70.59%, specificity 76.92%). Conclusions: EORTC QLQ-C30 questionnaire is a useful tool to early malnutrition diagnosis in head and neck cancer patients with short term results in nutritional condition, treatment response and a better QoL in this kind of patients (AU)

Elevated CA125 level associated with Meigs' syndrome: case report and review of the literature.

Meigs' syndrome is the association of ovarian fibroma, pleural effusion, and ascites. Meigs' syndrome with marked elevation of CA125 is an unusual clinical condition reported in 27 cases in the literature. The patient was a 46-year-old woman with right pleural effusion, ascites, ovarian tumor, and CA125 level of 1808 U/mL. Tomography revealed ascites and bilobate pelvic tumor of approximately 25 cm. The diagnosis of advanced epithelial ovarian cancer was considered, and the patient was treated with chemotherapy. Three chemotherapy schemes were applied due to the total lack of response in tumor volume; however, CA125 decreased to 90 U/mL. Thus, surgery was performed with resection of 25 cm of the left ovarian tumor, with intact capsule and without implants; the result of histopathologic analysis was fibroma. Postoperative CA125 was 11 U/mL. Patients with elevated CA125 and ascites cytology positive for malignancy must be cautiously treated due to the possibility of false positives, even if the probability is low. Therefore, minimally invasive surgery for biopsy collection must be considered. Although the association between ovarian tumor, pleural effusion, ascites, and marked elevation of CA125 is highly indicative of epithelial ovarian cancer, Meigs' syndrome must be considered in the differential diagnosis.

[The domestic inhalation of the smoke from firewood and of other biological materials. A risk for the development of respiratory diseases]. / La inhalación doméstica del humo de leña y otros materiales biológicos. Un riesgo para el desarrollo de enfermedades respiratorias.

A high proportion of the world population, especially in developing countries, is exposed to indoor pollutants produced by inefficient biomass stoves. The levels of pollutants, including toxins and carcinogens in the kitchen are usually very high. This potential pathogenic exposure has been scarcely studied. The exposure to biomass smoke has been associated to chronic bronchitis and chronic airflow obstruction in adults and to acute respiratory infections in children. At the National Institute of Pulmonary Diseases in Mexico, we have observed the entire spectrum of diseases associated with tobacco in people who never smoked and who were exposed to wood smoke. Women exposed to wood smoke had a five-fold risk of chronic bronchitis and chronic airflow obstruction, as compared to the non-exposed, according to a recent case-control study done at our Institute. The indoor levels of suspended particles smaller than 10 microns were frequently above 1,000 micrograms/m3 in a rural community in the state of Mexico. This information supports a causal role for biomass smoke for the genesis of several respiratory diseases, representing a potentially public health problem.