Sex and gender disparities in patients with advanced gastroesophageal adenocarcinoma: data from the AGAMENON-SEOM registry.

BACKGROUND: Recommendations for research articles include the use of the term sex when reporting biological factors and gender for identities or psychosocial or cultural factors. There is an increasing awareness of incorporating the effect of sex and gender on cancer outcomes. Thus, these types of analyses for advanced gastroesophageal adenocarcinoma are relevant. PATIENTS AND METHODS: Patients with advanced gastroesophageal adenocarcinoma from the Spanish AGAMENON-SEOM registry treated with first-line combination chemotherapy were selected. Epidemiology, characteristics of the disease, treatment selection, and results were examined according to sex. RESULTS: This analysis included 3274 advanced gastroesophageal adenocarcinoma patients treated with combination chemotherapy between 2008 and 2021: 2313 (70.7%) men and 961 (29.3%) women. Tumors in females were more frequently HER2-negative (67.8% versus 60.8%; P < 0.0001), grade 3 (45.4% versus 36.8%; P < 0.001), diffuse (43.3% versus 26.5%; P < 0.0001), and signet ring cell histology (40.5 versus 23.9%; P < 0.0001). Peritoneal spread was more common in women (58.6% versus 38.9%; P < 0.0001), while liver burden was lower (58.9% versus 71.1%; P < 0.0001). There were no significant differences in treatment recommendation. Treatment doses, density, and duration were comparable between sexes. Women experienced more diarrhea (46% versus 37%; P < 0.0001), neutropenia (51% versus 43%; P < 0.0001), and anemia (62% versus 57%; P < 0.0001). After a median 59.6-month follow-up [95% confidence interval (CI) 54.5-70.8], there were no statistically significant differences between the sexes in progression-free survival [6.21 months (95% CI 5.8-6.5 months) versus 6.08 months (95% CI 5.8-6.3 months); log-rank test, χ2 = 0.1, 1 df, P = 0.8] or in overall survival [10.6 months (95% CI 9.8-11.1 months) versus 10.9 months (95% CI 10.4-11.4 months); log-rank test: χ2 = 0.6, 1 df, P = 0.5]. CONCLUSION: This sex analysis of patients with advanced gastroesophageal adenocarcinoma from the AGAMENON-SEOM registry receiving first-line polychemotherapy found no differences in survival. Although women had worse prognostic histopathology, metastatic disease pattern, and greater toxicity, treatment allocation and compliance were equivalent.

Grynfelt-Lesshaft hernia a case report and review of the literature.

INTRODUCTION: Lumbar hernia account for less than 2% of al abdominal hernias, been the Grynfelt-Lesshaft's hernia (GLH) more frequent than the others. With approximately 300 cases published in the literature, the general surgeon may have the chance of treat it ones in their professional life. CASE REPORT: A 42-years old male with human immunodeficiency virus and Diabetes Mellitus presented to the outpatient clinic with a GLH. Preoperative classified as a type "A" lumbar hernia an open approach was scheduled. We performed a Sandwich technique with a sublay and onlay ULTRAPRO(®) mesh fixed with PDS(®) II suture without complications and discharged the patient 24-h after. After six months, the patient denied any complication. DISCUSSION: Primary (spontaneous) lumbar hernias represent 50-60% of all GLH. The preoperative classification of a lumbar hernia is mandatory to propose the best surgical approach. According to the classification of Moreno-Egea A et al., the best technique for our patient was an open approach. The Sandwich technique has demonstrated good outcomes in the management of the GLH. CONCLUSION: The surgical approach should be according to the classification proposed and to the experience of the surgeon. The Sandwich technique has good outcomes.

Interleukin-1ß enhances cartilage-to-cartilage integration.

The failure of cartilages to fuse, particularly in the case of articular cartilage under conditions of repair is due to morphological and structural constraints of the tissue. Factors that impede integration include, non-vascularisation, low cellularity, and proteoglycan in the surrounding extracellular matrix acting as a natural barrier to cellular migration. We hypothesised that brief activation of a catabolic cascade by cytokines followed by culture under anabolic conditions would promote tissue fusion in a ring-disk model of cartilage integration. Our results show that transient exposure to 10 ng mL(-1) interleukin-1ß, followed by two weeks post-culture under anabolic conditions, enhanced cartilage-cartilage integration compared to untreated explants. Quantitative PCR analysis of catabolism-related genes ADAMTS4 and MMP13 showed both were transiently upregulated and these findings correlated with evidence of extracellular matrix remodelling. At the level of histology, we observed chondrocytes readily populated the interfacial matrix between fused explants in interleukin-1ß treated explants, whereas in control explants this region was relatively acellular in comparison. Catabolic cytokine treated explants exhibited 29-fold greater adhesive strength (0.859 MPa versus 0.028 MPa, P 〈 0.05) than untreated counterparts. Collectively, our results demonstrate that a single short catabolic pulse followed by an anabolic response is sufficient to generate mechanically robust, integrative cartilage repair.

Changes in [(3)H]glibenclamide binding to mouse forebrain membranes during morphine tolerance.

The characteristics of specific binding of the ATP-sensitive K(+) (K(ATP)) channel blocker [3H]glibenclamide to forebrain membranes (P(2) fraction, 4 degrees C) obtained from morphine-naive and -tolerant mice were evaluated. Morphine tolerance was induced by osmotic minipumps that released 45 mg/kg/day of morphine subcutaneously for 6 days. This treatment enhanced the antinociceptive ED(50) of morphine without changing its E(max). In morphine-naive animals, (1) both the association and the dissociation of [3H]glibenclamide were biphasic; (2) [3H]glibenclamide was displaced by other sulfonylureas (order of potency: glibenclamide>glipizide&z.Gt;tolbutamide) with pseudo-Hill coefficients lower than unity and biphasic Hofstee plots; and (3) Scatchard plots of saturation experiments were curvilinear, showed a Hill coefficient of 0.81+/-0.04 and suggested the presence of two binding sites with a K(D) of 0.13 and 3.17 nM and a B(max) of 12.30 and 84.47 fmol/mg protein, respectively. By contrast, in membranes obtained from morphine-tolerant animals, (1) the Scatchard plots showed only one population of binding sites with a K(D) of 0.87 nM and a B(max) of 77.99 fmol/mg protein, and the Hill coefficient was very close to unity (0.96+/-0.1); (2) competition experiments (using glibenclamide as displacer) showed a pseudo-Hill coefficient of 0.99+/-0.04; and (3) dissociation experiments showed only one phase of dissociation. These results suggest that [3H]glibenclamide binds to two different sites in membranes obtained from morphine-naive animals, but to only one site in morphine-tolerant animals. Consequently, it seems that morphine tolerance in mice involves adaptive changes in K(ATP) channels.

Utilidad diagnóstica de la toracoscopia en heridas toracoabdominales izquierdas por arma cortopunzante: estudio prospectivo / Usefulness of thoracoscopy in the management of stab wounds

De manera relativamente frecuente y originado por un traumatismo toracoabdominal ya sea penetrante y/o cerrado, se presentan lesiones del diafragma que favorecen la aparicion de hernias diafragmaticas, que de no ser detectadas y manejadas de manera oportuna conllevan una importante morbimortalidad. Con el fin de establecer la sensibilidad y especificidad de la toracoscopia en el diagnostico de heridas diafragmaticas por arma cortopunzante especificamente del lado izquierdo, se realizó el presente trabajo. Es un estudio prospectivo de cohorte dinámica desarrollado entre mayo de 1995 y abril de 1997 en el hospital San Juan de Dios de Santa Fe de Bogota. Se incluyeron pacientes entre 15 y 50 años ingresados por urgencias que presentaran herida por arma cortopunzante toracoabdominal izquierda, normales hemodinámicamente y sin indicacion de cirugía inmediata. Previa firma de autorizacion se llevaron a toracoscopia y posterior laparotomia para verificacion de los hallazgos. El universo del estudio lo conformaron 28 pacientes, 26 hombres y 2 mujeres con un promedio de edad de 26 años y con una frecuencia modal de TRTS: 12, ISS: 9, ATI: 2, PT-TI: 5. La mitad de los pacientes presento herida diafragmática y en el 25 por ciento lesiones intraabdominales asociadas; el tiempo promedio de toracoscopia fue de 33 minutos y de laparotomia de 37 minutos. En el análisis estadistico se encontro una sensibilidad de la prueba del 100 por ciento con una tasa de falsos negativos de 0 por ciento y un valor predictivo negativo del 100 por ciento. En conclusion estamos frente a una prueba de alto rendimiento que nos garantiza el diagnostico de una lesion que de ser omitida tiene una alta morbimortalidad.

Prevalencia de los anticuerpos contra el virus A de la hepatitis (VAH) en donantes de sangre de 13 países y territorios del hemisferio occidental / Prevalence of antibodies to hepatitis A virus (HAV) in blood donors of 13 Western Hemisphere countries and territories

Los resultados de una encuesta con 7.342 muestras de sangre de 13 países y territorios de las Américas indican una elevada prevalencia de los anticuerpos contra el virus A de la hepatitis en esa Región. Los resultados señalan también una correlación significativa entre la ausencia de dichos anticuerpos y la ausencia de marcadores indicativos de infección por el virus B de la hepatitis (AU)

Prevalencia de los anticuerpos contra el virus A de la hepatitis (VAH) en donantes de sangre de 13 países y territorios del hemisferio occidental / Prevalence of antibodies to hepatitis A virus (HAV) in blood donors of 13 Western Hemisphere countries and territories

Los resultados de una encuesta con 7.342 muestras de sangre de 13 países y territorios de las Américas indican una elevada prevalencia de los anticuerpos contra el virus A de la hepatitis en esa Región. Los resultados señalan también una correlación significativa entre la ausencia de dichos anticuerpos y la ausencia de marcadores indicativos de infección por el virus B de la hepatitis (AU)