RESUMO
PURPOSE: Elevated markers of host inflammation, a hallmark of cancer, have been associated with worse outcomes in several solid tumors. Here, we explore the prognostic role of the derived neutrophil-to-lymphocyte ratio (dNLR), across different tumor subtypes, in patients with early breast cancer. PATIENTS AND METHODS: This was a retrospective analysis of 1246 patients with lymph node-positive, operable early breast cancer enrolled in the GEICAM/9906 trial, a multicenter randomized phase 3 study evaluating adjuvant chemotherapy. dNLR was calculated as the ratio of neutrophils and the difference between total leukocytes and neutrophils in peripheral blood before chemotherapy. Disease-free survival (DFS) and overall survival were explored using a Cox proportional hazard analysis. RESULTS: The analysis comprised 1243 (99.8%) patients with dNLR data, with a median follow-up of 10 years. Data on intrinsic subtypes were available from 818 (66%) patients (luminal A 34%, luminal B 32%, HER2-enriched 21% and basal-like 9%). Median dNLR was 1.35 [interquartile range (IQR) 1.08-1.71]. In the whole population, dNLR was not prognostic after adjustment for clinico-pathological factors. However, dNLR ≥ 1.35 was independently associated with worse DFS in the hormone receptor-negative/HER2+ population (HR 2.86; p = 0.038) and in patients with one to three lymph node metastases (HR 1.32, p = 0.032). There was a non-significant association with worse DFS in non-luminal and in HER2-enriched tumors (HR 1.40, p = 0.085 and HR 1.53, p = 0.067). No significant interaction was observed between the treatment arm and dNLR. CONCLUSION: Elevated dNLR appears to be an adverse prognostic factor in hormone receptor-negative early breast cancer. TRIAL REGISTRATION: EudraCT: 2005-003108-12 (retrospectively registered 28/06/2005). ClinicalTrials.gov Identifier: NCT00129922 (retrospectively registered 10/08/2005). Results of this study were presented in part at the 2016 ESMO conference October 7-11, 2016, Copenhagen, Denmark (oral presentation).
Assuntos
Biomarcadores Tumorais/imunologia , Neoplasias da Mama/imunologia , Contagem de Linfócitos , Neutrófilos , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/sangue , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/mortalidade , Quimioterapia Adjuvante , Ensaios Clínicos Fase III como Assunto , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Prognóstico , Modelos de Riscos Proporcionais , Estudos RetrospectivosRESUMO
OBJECTIVE: To study prospectively the association of coffee intake with incident diabetes in the Puerto Rico Heart Health Program cohort, comprising 9824 middle-aged men (aged 35-79 years). METHODS: Of 9824 men, 3869 did not provide a fasting blood sample at baseline, 1095 had prevalent diabetes and 131 were not given fasting glucose tests at any subsequent study visit. Thus, the present analysis includes 4685 participants. Diabetes was ascertained at baseline and at two study visits between 1968 and 1975 using fasting glucose tests and self-reports of physician-diagnosed diabetes or use of insulin or hypoglycaemic medication. Logistic regression analysis was used to assess the association of coffee intake with risk of incident diabetes while adjusting for covariates (age, BMI, physical activity, smoking, education, alcohol intake, family history of diabetes, intakes of milk and sugar). RESULTS: Five hundred and nineteen participants met the criteria for incident diabetes. Compared with those reporting intake of 1-2 servings of coffee/d, coffee abstainers were at reduced risk (OR = 0.64; 95 % CI 0.43, 0.94). Among coffee drinkers, there was a significant trend of decreasing risk by intake (P = 0.02); intake of >/=4 servings/d was associated with an odds ratio of 0.75 (95 % CI 0.58, 0.97). CONCLUSIONS: Study findings support a protective effect of coffee intake on diabetes risk, while also suggesting that abstainers may be at reduced risk.
Assuntos
Café , Diabetes Mellitus Tipo 2/epidemiologia , Medição de Risco , Adulto , Idoso , Glicemia/análise , Índice de Massa Corporal , Estudos de Coortes , Diabetes Mellitus Tipo 2/prevenção & controle , Ingestão de Líquidos , Teste de Tolerância a Glucose , Humanos , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estudos Prospectivos , Porto Rico/epidemiologiaRESUMO
OBJECTIVES: This study examined the relationship between acculturation and leisure-time physical inactivity among Mexican American adults. METHODS: Using data from the Third National Health and Nutrition Examination Survey, we estimated the prevalence of physical inactivity according to place of birth and language used at home. RESULTS: Spanish-speaking Mexican Americans had a higher prevalence of physical inactivity during leisure time than those who spoke mostly English, independent of place of birth. CONCLUSIONS: Acculturation seems to be positively associated with participation in leisure-time physical activity.
Assuntos
Aculturação , Atitude Frente a Saúde/etnologia , Exercício Físico/psicologia , Comportamentos Relacionados com a Saúde/etnologia , Atividades de Lazer/psicologia , Americanos Mexicanos/estatística & dados numéricos , Adulto , Idoso , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Americanos Mexicanos/psicologia , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários , Estados Unidos/epidemiologiaRESUMO
The present study analyses the effect of dihydrotestosterone (DHT) and mammalian insulin on the nuclear maturation of Bufo arenarum oocytes under in vitro conditions. The response of fully grown follicle oocytes to DHT, shown by germinal vesicle breakdown (GVBD), occurred in a manner dependent on dose, time and sexual cycle period. The highest oocyte sensitivity to the hormone appeared during the breeding period, a fact evinced by high GVBD percentages after short incubation periods and at a low hormone concentrations. Insulin also proved effective in inducing nuclear maturation, although its action was only visible at high concentrations and after a long incubation period. The combination of insulin and steroid hormones (DHT or progesterone), both at subliminal doses, caused a noticeable potentiating synergism, resulting in a rapid and important increase in GVBD. Another effect of insulin was the acquisition by oocytes of steroid sensitivity during folliculogenesis.
Assuntos
Núcleo Celular/fisiologia , Di-Hidrotestosterona/metabolismo , Hipoglicemiantes/metabolismo , Insulina/metabolismo , Oócitos/fisiologia , Animais , Bufo arenarum , Núcleo Celular/efeitos dos fármacos , Di-Hidrotestosterona/farmacologia , Feminino , Hipoglicemiantes/farmacologia , Insulina/farmacologia , Meiose/fisiologia , Oócitos/citologia , Oócitos/efeitos dos fármacos , Oogênese/efeitos dos fármacos , Oogênese/fisiologia , Progesterona/metabolismoRESUMO
During progesterone-induced nuclear maturation the oocytes of Bufo arenarum undergo a series of nuclear and cytoplasmic changes. The breakdown of heterocellular communications between the follicular cell projections and the oocyte microvilli, and the consequent enlargement of the perivitelline space, were observed at the animal pole. The more evident cytoplasmic feature during nuclear maturation comprised the gathering of glycogen granules in clusters, some phagocytosed by empty vesicles. With respect to the location of these vesicles, some were observed in close proximity to the oolemma and others were freely suspended in the perivitelline space, extruded from the oocyte. Other visible events were the disruption of the annulate lamellae, the formation of an elaborate cortical endoplasmic reticulum and the rearrangement of the cortical granules in a monolayer immediately beneath the oolemma together with aggregates of endoplasmic reticulum cisternae. Our results show that during nuclear maturation the nuclear oocyte changes include a flattening of the spherical oocyte nucleus, its migration towards the surface of the animal pole, the disappearance of the nucleoli and the dissolution of the nuclear envelope.
Assuntos
Bufo arenarum/fisiologia , Oócitos/crescimento & desenvolvimento , Oócitos/ultraestrutura , Animais , Núcleo Celular/metabolismo , Núcleo Celular/ultraestrutura , Feminino , Progesterona/farmacologiaAssuntos
Participação da Comunidade , Emigração e Imigração/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/organização & administração , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Hispânico ou Latino/estatística & dados numéricos , Adulto , Distribuição por Idade , Redes Comunitárias , District of Columbia , El Salvador/etnologia , Feminino , Comportamentos Relacionados com a Saúde , Serviços de Saúde/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
Las personas que hemos estado involucradas en la tarea de capacitar en el tema de género a instituciones de desarrollo social sabemos lo difícil que resulta iniciar el proceso cognocitivo que, como otros temas de desarrollo, afecta directamente a las personas, ya que interpela y cuestiona ideas y conductas culturalmente afectadas. Bajo el supuesto de que no se puede trabajar el enfoque de género a nivel profesional y técnico sin una previa comprensión y compromiso individual de las personas que lo llevarán adelante en las instituciones, organizamos talleres y seminarios para compartir el tema con metodologías que abarcaban dimensiones personales con un público heterogéneo en niveles de formación, en cosmovisiones, en jerarquía y mayoritariamente masculino.
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Sexo , Tutoria , BolíviaRESUMO
DESPITE THEIR HIGHER PREVALENCE of obesity and diabetes, Hispanics have lower or equal rates of hypertension than non-Hispanic whites (1-4). Healthy People 2000 objectives call for increasing the proportion of hypertensive men whose blood pressure is under control to at least 40%. In addition, the objectives recommend reducing the prevalence of overweight to 41% among hypertensive women, and to 35% among hypertensive men (5). The Hispanic Health and Nutrition Examination Survey (HHANES) collected data on Mexican Americans (MA), Cuban Americans (CA), and Puerto Ricans (PR) living in the continental United States. A trained physician measured systolic (SBP) and diastolic (DBP) blood pressure twice in one visit. Our findings provide data to assess baseline estimates for several Healthy People 2000 objectives among Hispanics. Based on criteria from The Fifth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC-V), we found Hispanic women to have higher rates of awareness, treatment, and control of hypertension than men. Only 8% of MA and PR men and 9% of CA men who were hypertensive had their high blood pressure under control. The prevalence of overweight among hypertensive men ranged from 39% to 60%; and among hypertensive women, from 44% to 74%. Hispanic women with six or fewer years of education had higher prevalence of hypertension and other cardiovascular disease (CVD) risk factors. Future research should investigate the socioeconomic factors associated with the presence of these risk factors.
Assuntos
Hispânico ou Latino , Hipertensão/etnologia , Americanos Mexicanos , Obesidade/etnologia , Adulto , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/etiologia , Colesterol/sangue , Cuba/etnologia , Escolaridade , Feminino , Inquéritos Epidemiológicos , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Masculino , México/etnologia , Obesidade/complicações , Prevalência , Porto Rico/etnologia , Fatores de Risco , Fatores Sexuais , Fumar/etnologia , Estados Unidos/epidemiologiaRESUMO
LITTLE IS KNOWN ABOUT BLOOD PRESSURE LEVELS and the extent of high blood pressure in Hispanic children and adolescents, especially in groups other than Mexican Americans. The authors of this study investigated the levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP) and the extent of high blood pressure among Mexican-American, Cuban-American, and mainland Puerto Rican children and adolescents who participated in the Hispanic Health and Nutrition Examination Survey (HHANES). Very few children and adolescents in these three Hispanic groups had high normal or high blood pressure. Puerto Rican children had significantly lower DBP than Mexican-American (2.4 mmHg) and Cuban-American (1.8 mmHg) children. Their SBP was also lower (1.7 mmHg) than that of Cuban-American children. These findings should be interpreted cautiously, however, since a significant observer effect was also found in this study. Correlates of blood pressure in children in all three Hispanic groups were consistent with those found in studies of other ethnic groups. Age, body mass index, and pulse rate were significant predictors of both SBP and DBP (P less than 0.05). Gender was an important predictor of SBP but not DBP. Socioeconomic and cultural factors were not significant predictors of blood pressure in these Hispanic groups.
Assuntos
Pressão Sanguínea , Hispânico ou Latino , Americanos Mexicanos , Adolescente , Índice de Massa Corporal , Criança , Cuba/etnologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , México/etnologia , Porto Rico/etnologia , Fatores SexuaisRESUMO
Se presentan 29 nuevos casos clínicos de adenoma pleomorfo de glándula parótida, estudiados desde una triple vertiente: clínica, radiológica y anatomopatológica, haciendo especial énfasis en los hallazgos obtenidos por medio de la imagen, señalándose los diferentes patrones sialográficos y ecográficos que presenta esta entidad. Consideramos que si bien en algunos casos, la sialografía no es capaz de aclarar todas nuestras dudas diagnósticas, es una exploración que por su sencillez y carencia de complicaciones, no debe omitirse en el algoritmo diagnóstico de ningún caso de tumoración en región parotídea