Patrones de recaída y respuesta patológica según tipo subrogado en pacientes con cáncer de mama y axila negativa al inicio tratadas con quimioterapia neoadyuvante / Patterns of relapse and pathological response according to surrogate type in breast cancer patients treated with neoadjuvant chemotherapy and negative axillary involvement

Objetivos: Determinar los patrones de recaída y la respuesta patológica en relación con los diferentes tipos subrogados de cáncer de mama tras tratamiento neoadyuvante para analizar supervivencia y optimizar la vigilancia. Material y métodos: Análisis retrospectivo de 112 pacientes con 116 tumores, con axila clínicamente negativa, tratados con quimioterapia neoadyuvante en nuestro Centro entre 2008 y 2014, y operadas posteriormente con cirugía conservadora o radical. Analizamos respuesta patológica en función de los tipos subrogados, tasas de recurrencia y sus patrones, supervivencia libre de enfermedad (SLE) y supervivencia global (SG). Resultados: Se logró una respuesta patológica completa (RPC) en el 52,6%, constatando que estas pacientes tenían mejor supervivencia (p<0,05). En cuanto a los tipos subrogados, observamos RPC en el 85% de los tumores Her-2/neu positivos puros, el 65,6% de los triple negativos, el 43,8% de Luminal B Her-2 positivo, el 40% de Luminal B Her-2 negativo y en el 25% de Luminal A (p<0,05). Con un tiempo medio de seguimiento de 53 meses encontramos una tasa de recaídas del 9%. Los tipos menos agresivos tenían un tiempo a recaída loco-regional de 38,5 meses y a recurrencia sistémica de 74 meses. Los tipos más agresivos mostraron un tiempo medio a recaída loco- regional de 36,2 meses y a recurrencia sistémica de 8 meses. Conclusiones: La quimioterapia neoadyuvante adaptada al tipo subrogado es una estrategia válida para intentar alcanzar una RPC. Las diferencias observadas en el patrón de recurrencia permiten optimizar el seguimiento.(AU)

Purpose: To determine relapse patterns and pathological response in relation to surrogate types of breast cancer after neoadjuvant treatment to analyse survival and optimize surveillance. Material and methods: Retrospective analysis of 112 patients with 116 tumours, with negative axillary involvement, treated with neoadjuvant chemotherapy at our hospital, between 2008 and 2014, who systematically underwent surgery. We analysed pathological response according to surrogate subtypes, rates and patterns of recurrence, disease free survival (DFS) and overall survival (OS). Results: Pathological complete response (pCR) was achieved in 52.6%, finding that these patients had better survival (p<.05). Looking at surrogate subtypes, we observed a pCR in 85% of pure Her-2/neu positive tumours, 65.6% of triple negatives, 43.8% of Her -2 positive Luminal B, 40% of Luminal B and 25% of Luminal A (p<.05). With a median follow-up of 53 months, we found a 9% rate of relapses. The less aggressive types had a median loco-regional relapse time of 38.5 months and a systemic recurrence time of 74 months. The more aggressive types showed a loco-regional relapse time of 36.2 months and systemic recurrence time of 8 months. Conclusions: Neoadjuvant chemotherapy according to surrogate type is a useful strategy to attempt pCR. Loco-regional relapse and systemic recurrence patterns allow surveillance adjustments.(AU)

MRI guided ROLL/SNOLL in breast cancer patients treated with neoadjuvant chemotherapy. / ROLL/SNOLL guiado por resonancia magnética en pacientes con cáncer de mama tratadas con quimioterapia neoadyuvante.

PURPOSE: To describe the results of MRI (magnetic resonance image) guided ROLL (radioguided occult lesion localization) and SNOLL (sentinel node occult lesion localization) in the localization of residual disease after neoadjuvant chemotherapy for breast cancer, as well as assessing the surgical results obtained and disease free survival. METHODS: Prospective observational analysis of 132 patients with 136 tumors, treated with neoadjuvant chemotherapy at our hospital between 2011-2017. Residual disease was located presurgically with MRI guided ROLL/SNOLL technique. We analyzed technical aspects of localization, and variables corresponding to surgical procedures and events occurred during follow-up. RESULTS: The median tumor size was of 20.5mm (interquartilic range [IQR]: 14-28). The majority (96.3%) were invasive ductal carcinomas. Sentinel lymph node detection rate was 98.9%. Complete pathological response (CPR) in the breast was achieved in 58.1% of cases. The rate of affected margins in 89 cases operated by conservative surgery was 2.2%. With a median follow-up of 50 months (IQR: 37-61) we found a 7.4% rate of relapses. Of these, seven were loco-regional and three at distant sites. The estimated mean of disease-free survival time was 83.2 months (Confidence Interval [CI] 95%: 79.6-86.6). CONCLUSIONS: MRI guided ROLL/SNOLL is a great tool for breast cancer residual disease localization following neoadjuvant chemotherapy. In addition, this technique attains good loco-regional control of the diseases and has excellent surgical results.

Ecology of duckweed ponds used for nutrient recovery from wastewater.

The microorganism community that grows under duckweed shelter can play an important role on treatment processes. Therefore, the present study aimed to assess the zooplankton dynamic and microbial community in duckweed ponds (DPs) applied for domestic wastewater treatment under open field conditions. A pilot system comprised of two DPs in series (DP1 and DP2), with 10 m2 each, received domestic wastewater through a flow rate of 200 L·day-1. Thus, the system was monitored during 314 days through samples collected and analysed weekly. Also, the zooplankton organisms were identified and quantified. DNA sequencing was performed in order to identify the bacterial populations. The findings showed a high efficiency of nutrient removal with 93% and 91% of total phosphorus and total nitrogen, respectively. A high density of microcrustaceans was observed in DP1 reaching 4,700 org.100 mL-1 and rotifers (over than 32,000 org.100 mL-1) in DP2, that could be related to the low suspended solids concentration (<30 mg·L-1) and turbidity (<10 NTU). The bacterial community showed a strong heterogeneity between samples collected along the seasons. Through these findings, it is possible to realise that the understanding of ecology could help to enhance the operation and designs of DPs.

Compact étendue-preserving light-mixing optics.

We present a compact freeform optic, called "Freeform Shell-Mixer", which, when placed on top of a multicolor light source (particularly, a multi-chip LED), turns it into a virtual source in which colors are uniformly mixed. The optic, compatible with injection molding, makes use of étendue-conserving Köhler integration to provide homogeneous mixing of light. Its minimal size (just 2x larger than the source) makes the concept compatible with many luminaries, as ray tracing models show. Simulations indicate that the Freeform Shell-Mixer can reach efficiencies above 95% and both the size of the virtual source and its emission pattern are very similar to the ones of the original source, so the correct performance of the luminaire is secured.

Using full-scale duckweed ponds as the finish stage for swine waste treatment with a focus on organic matter degradation.

The rapid increase in the number of swine has caused pronounced environmental impacts worldwide, especially on water resources. As an aggregate, smallholdings have an important role in South American pork production, contributing to the net diffusion of pollution. Thus, duckweed ponds have been successfully used for swine waste polishing, mainly for nutrient removal. Few studies have been carried out to assess organic matter degradation in duckweed ponds. Hence, the present study evaluated the efficiency of two full-scale duckweed ponds for organic matter reduction of swine waste on small pig farms. Duckweed ponds, in series, received the effluent after an anaerobic biodigester and storage pond, with a flow rate of 1 m(3) day(-1). After 1 year of monitoring, an improvement in effluent quality was observed, with a reduction in biochemical oxygen demand (BOD) and total chemical oxygen demand (tCOD), respectively, of 94.8 and 96.7%, operating at a loading rate of approximately 27 kgBOD ha(-1) day(-1) and 131 kgCOD ha(-1) day(-1). Algae inhibition due to duckweed coverage was strongly observed in the pond effluent, where chlorophyll a and turbidity remained below 25 µg L(-1) and 10 NTU. Using the study conditions described herein, duckweed ponds were shown to be a suitable technology for swine waste treatment, contributing to the environmental sustainability of rural areas.

[Contents, positioning and quality analysis in Spanish websites related to nutrition and eating behavior disorders]. / Análisis del contenido, posicionamiento y calidad de páginas web en español relacionadas con la nutrición y los trastornos de la conducta alimentaria.

INTRODUCTION: Eating disorders are serious psychological disorders with an increased incidence in last years. One of the factors that determine the high prevalence of eating disorders in our society is the lack of knowledge about nutrition. One of the reasons of this lack of knowledge could be the presence of online resources without scientific validity. OBJECTIVE AND SCOPE: The aim of this study was to analyze the scientific quality and positioning of websites in Spanish that have information on nutrition, eating disorders and obesity. MATERIALS AND METHODS: For this purpose, a web search was conducted in the Google Chrome browser using the key words: diet, anorexia, bulimia, obesity and nutrition, and selecting the first 20 results of each search at the rates offered by SeoQuake positioning (Page Rank, Alexa Rank y SEMrush Rank). The variables used for the analysis were: information related to eating habits and diets, information on healthy eating, information about eating disorders and their diagnostics, and formative information about general health topics with professional criteria. RESULTS: Only the 50% of the webpages accomplished the inclusion criteria for this study. Most of them did not follow the guidelines established by e- Europe assessment for quality. The median of the Webpage's PageRank was 2, except those associated with health institutions. CONCLUSIONS: Given the scarcity of healthcare websites with scientific rigor is essential to review the existing one and to create new online spaces whose supervision must be carried out by specialists in health and nutrition.

Introducción: Los trastornos del comportamiento alimentario (TCA) son las patologías psicológicas que más se han incrementado en los últimos años. Uno de los factores que determina la elevada prevalencia de TCA en nuestra sociedad es el gran desconocimiento sobre alimentación. Este desconocimiento puede deberse a la consulta de recursos online sin validez científica. Objetivo y ámbito: El objetivo de este trabajo ha sido analizar la calidad científica y el posicionamiento de los sitios web en español con información sobre nutrición, TCA y obesidad. Material y métodos: Se realizó una búsqueda de páginas web en el navegador Google Chrome con las palabras clave: dieta, anorexia, bulimia, nutrición y obesidad, seleccionándose los 20 primeros resultados de cada búsqueda según los índices de posicionamiento ofrecidos por SEOquake (Page Rank, Alexa Rank y SEMrush Rank). Las variables de análisis fueron: información relacionada con dietas y hábitos alimentarios, información sobre alimentación saludable, información sobre TCA y sus criterios diagnósticos e información de carácter formativo acerca de temas profesionales de salud general. Resultados: Sólo el 50% de las web encontradas cumplían los criterios de inclusión en el estudio. La mayoría no seguían las pautas establecidas por e-Europa sobre calidad. La mediana de Page Rank fue de 2, excepto en aquellas asociadas a instituciones sanitarias de prestigio. Conclusiones: Dada la escasez de webs sanitarias con rigor científico, es imprescindible la revisión de las existentes y la creación de nuevos espacios on-line cuya supervisión sea realizada por profesionales especialistas en salud y nutrición.

Nutrient recovery from swine waste and protein biomass production using duckweed ponds (Landoltia punctata): southern Brazil.

Brazil is one of the most important countries in pork production worldwide, ranking third. This activity has an important role in the national economic scenario. However, the fast growth of this activity has caused major environmental impacts, especially in developing countries. The large amount of nitrogen and phosphorus compounds found in pig manure has caused ecological imbalances, with eutrophication of major river basins in the producing regions. Moreover, much of the pig production in developing countries occurs on small farms, and therefore causes diffuse pollution. Therefore, duckweed pond have been successfully used in the swine waste polishing, generating further a biomass with high protein content. The present study evaluated the efficiency of two full scale duckweed ponds for the polishing of a small pig farm effluent, biomass yield and crude protein (CP) content. Duckweed pond series received the effluent from a biodigester-storage pond, with a flow rate of 1 m(3)/day (chemical oxygen demand rate = 186 kg/ha day) produced by 300 animals. After 1 year a great improvement of effluent quality was observed, with removal of 96% of total Kjeldahl nitrogen (TKN) and 89% of total phosphorus (TP), on average. Nitrogen removal rate is one of the highest ever found (4.4 g TKN/m(2) day). Also, the dissolved oxygen rose from 0.0 to 3.0 mg/L. The two ponds produced together over 13 tons of fresh biomass (90.5% moisture), with 35% of CP content, which represents a productivity of 24 tonsCP/ha year. Due to the high rate of nutrient removal, and also the high protein biomass production, duckweed ponds revealed, under the presented conditions, a great potential for the polishing and valorization of swine waste. Nevertheless, this technology should be better exploited to improve the sustainability of small pig farms in order to minimize the impacts of this activity on the environment.