Phase Angle in Head and Neck Cancer: A Sex-Differential Analysis from Biological and Clinical Behavior to Health-Related Quality of Life.

Head and neck cancer (H&NC) is a diverse category of tumors related to malignancies in the common aerodigestive pathway, with high metabolic rate, poor nutritional and treatment outcomes, and elevated mortality despite the best standard treatment. Herein, we focus on determining how the phase angle (PA) differs across sex as a predictor of poor prognosis, low quality-of-life (QoL) scores, and mortality in patients with head and neck cancer. This follow-up study presents a sex-differential analysis in a prospective cohort of 139 head and neck cancer patients categorized by sex as male (n = 107) and female (n = 32). Patients were compared in terms of nutritional, biochemical, and quality-of-life indicators between low and normal PA in women (<3.9° (n = 14, 43.75%) and ≥3.9°) and men (<4.5° (n = 62, 57.9%) and ≥4.5°). Our results show that most patients were in locally advanced clinical stages (women: n = 21 (65.7%); men: n = 67 (62.6%)) and that patients with low PA had a lower punctuation in parameters such as handgrip strength, four-meter walking speed, albumin, C-reactive protein (CRP), and CRP/albumin ratio (CAR), as well as the worst QoL scores in functional and symptomatic scales in both the male and female groups. A comparison between sexes revealed significant disparities; malnourishment and tumor cachexia related to an inflammatory state was more evident in the women's group.

Phase Angle and Nutritional Status: The Impact on Survival and Health-Related Quality of Life in Locally Advanced Uterine Cervical Cancer.

The phase angle, an indicator of muscle mass status and membrane cell integrity, has been associated with low survival, poorer clinical outcomes, and worse quality of life among cancer patients, but information on women with uterine cervical cancer (UCCa) is scarce. In this prospective study, we used a bioelectrical impedance analyzer to obtain the PA of 65 women with UCCa. We compared the health-related quality of life and inflammatory and nutritional indicators between low PA and normal PA. The mean age was 52 ± 13. The low PA and normal PA groups differed in terms of the C-reactive protein (15.8 ± 19.6 versus 6.82 ± 5.02, p = 0.022), glucose (125.39 ± 88.19 versus 88.78 ± 23.08, p = 0.021), albumin (3.9 ± 0.39 versus 4.37 ± 0.30, p = 0.000), EORTC QLQ-C30 loss of appetite symptom scale score (33.33 (0.0-100.00) versus 0.0 (0.0-0.0), p = 0.005), and EORTC QLQ-CX24 menopausal symptoms scale score (0.0 (0.0-33.33) versus 0.0 (0.0-100.0), p = 0.03). The main finding of the present study is the interaction between PA and obesity as critical cofactors in the UCCa adeno and adenosquamous histologic variants, to a greater extent than cervical squamous cell carcinoma.

Phase Angle, a Cornerstone of Outcome in Head and Neck Cancer.

In patients with head and neck cancer, malnutrition is common. Most cases are treated by chemo-radiotherapy and surgery, with adverse effects on the aerodigestive area. Clinical and biochemical characteristics, health-related quality of life, survival, and risk of death were studied. The selected subjects were divided into normal- and low-phase-angle (PA) groups and followed up for at least two years. Mean ages were 67.2 and 59.3 years for low and normal PA, respectively. Patients with PA < 4.42° had significant differences in age, anthropometric and biochemical indicators of malnutrition, and inflammatory status compared to patients with PA > 4.42°. Statistical differences were found in the functional and symptom scales, with lower functional scores and higher symptom scores in patients with low PA. Median survival was 19.8 months for those with PA < 4.42° versus 34.4 months for those with PA > 4.42° (p < 0.001).The relative risk of death was related to low PA (2.6; p < 0.001). The percentage of living patients (41.7%) is almost the same as the percentage of deceased subjects (43.1%; p = 0.002), with high death rates in patients with PA < 4.42°. Phase angle was the most crucial predictor of survival and a risk factor for death in the studied cases.

Adipocytokines and Insulin Resistance: Their Role as Benign Breast Disease and Breast Cancer Risk Factors in a High-Prevalence Overweight-Obesity Group of Women over 40 Years Old.

Insulin levels, adipocytokines, and inflammatory mediators trigger benign breast disease (BBD) and breast cancer (BC). The relationship between serum adipocytokines levels, overweight-obesity, metabolic disturbs, and BC is unclear. Methods: To analyze the serum levels of the adipocytokines, insulin, and the HOMA IR in women without breast disease, with BBD or BC, and the role of these as risk factors for benign breast disease or breast cancer. Results: Adipsin values > 0.91 and visfatin levels > 1.18 ng/mL represent a risk factor to develop BBD in NBD lean women (OR = 18; and OR = 12). Data in overweight-obese women groups confirm the observation due to insulin levels > 2.6 mU/mL and HOMA IR > 0.78, with OR = 60.2 and 18, respectively; adipsin OR = 26.4, visfatin OR = 12. Breast cancer risk showed a similar behavior: Adipsin risk, adjusted by insulin and visfatin OR = 56 or HOMA IR and visfatin OR = 22.7. Conclusion: Adipose tissue is crucial for premalignant and malignant tissue transformation in women with overweight-obesity. The adipocyte−breast epithelium interaction could trigger a malignant transformation in a continuum, starting with BBD as premalignant disease, especially in overweight-obese women.

Cementerios y cadáveres durante las crisis epidémicas en Guadalajara, Jalisco. México / Cemeteries and bodies in epidemic crisis in Guadalajara, Jalisco. México

Resumen Objetivo: Describir las características de los cementerios y el tratamiento higiénico de cadáveres durante las pandemias a través de la historia. Materiales y método: Es un estudio histórico que parte de la heurística y se combina con el criticismo para evaluar las fuentes utilizadas y responder al objetivo. El universo de trabajo se construyó con documentos del Archivo Histórico Municipal de Guadalajara sobre los panteones de esta ciudad y la revisión bibliográfica en bibliotecas y medios electrónicos relacionados con el tema. Resultados: Las inhumaciones estuvieron a cargo de la iglesia al principio, por razones médico-sanitarias, se trasladaron a orillas de las ciudades en el siglo XIX, y durante el siglo XX se construyeron otros más, quedando algunos dentro de la zona urbana. En 1785-1786, dejaban los cadáveres desnudos y amontonados a las puertas de las iglesias. Se pedía dejarlos en puntos específicos debido a su riesgo para la salud pública. Los cadáveres eran trasladados en cajas de madera cerradas para evitar más contagios. Actualmente, durante la pandemia en México, cada estado ha tomado estrategias para el control de contagios. El gobierno de Jalisco ha conformado la Comisión Interinstitucional de Manejo de Cadáveres por COVID-19, y la aplicación de normas de bioseguridad tanto en hospitales como fuera de ellos. Conclusiones: La evolución de los panteones de Guadalajara, ha dependido de asuntos sociales y de salud, vinculado a intereses económicos, políticos y religiosos. A pesar de las normas establecidas, los panteones han quedado dentro de la zona urbana en consecuencia al crecimiento poblacional, su ubicación geográfica representa una situación crítica, de ahí la importancia del control sanitario y normas de bioseguridad en el manejo de cadáveres.

Abstract Objective. To describe the characteristics of cemeteries and the hygienic treatment of corpses during pandemics throughout history. Materials and method. It is a historical study that starts from Heuristics and it is combined with Criticism to evaluate the sources used and respond to the objective. The universe of work was done with documents from the Guadalajara Municipal Historical Archive on the pantheons of this city and the bibliographic review in libraries and electronic media related to the subject. Results The burials were in charge of the church at first, for medical-sanitary reasons, they moved to the cities' borders in the 19th century, and during the 20th century others were built, some remained within the urban area.1785-1786 The bodies were left naked and piled up at the churches doors. They were asked to leave them at specific points due to their risk to public health. The bodies were transported in closed wooden boxes to avoid further contagion. Currently, during the pandemic in Mexico, each state has adopted strategies for contagion control. Jalisco's government has formed the Inter- institutional Commission for the Management of Dead Bodies by COVID-19, and the application of biosafety regulations both in and outside hospitals. Conclusions. The evolution of the pantheons of Guadalajara has depended on social and health issues, linked to economic, political and religious interests. Despite the established norms, the pantheons have remained within the urban area due to population growth, their geographical location represents a critical situation, hence the importance of sanitary control and biosafety standards in the management of corpses.