Tumor Phyllodes con transformación a osteosarcoma / Breast osteosarcoma originating in a phyllodes tumor: report of one case

Phyllodes tumors account for less than 1% of tumors of the mammary gland, have both epithelial and stromal components and are classified as benign, borderline and malignant. The malignant tumors are highly heterogeneous: they can differentiate to liposarcomas, fibrosarcomas, rhabdomyosarcomas, chondrosarcomas or osteosarcomas. The differentiation to osteosarcoma is extremely rare, constitutes 1.3% of cases and is very aggressive. The standard treatment of these tumors is surgical. The role of radiotherapy and chemotherapy is not clear. However, in patients in whom wide surgical margins are not achieved, adjuvant radiotherapy can be of help. We report a 63 years old female with a right breast osteosarcoma with an osteoclastic component, originating in a phyllodes tumor. The tumor was excised surgically and afterwards she was treated with 10 sessions of 50 Gy of radiotherapy in 25 fractions. She has remained free of disease for the last 10 months.

Asociación de la proteína C-reactiva ultrasensible con la composición de la dieta en niños escolares mexicanos / Association of high sensitivity C-reactive protein with diet composition in Mexican school children

La proteína C-reactiva ultrasensible (PCR-us) es un marcador de riesgo cardiovascular. En niños mexicanos sanos hay escasa evidencia que asocie los niveles séricos de este marcador con la dieta. El objetivo fue asociar los niveles séricos de PCR-us con la composición de la dieta en niños escolares mexicanos. El estudio fue transversal e incluyó 300 niños aparentemente sanos de 10 a12 años de edad. La cuantificación de PCR-us se realizó mediante nefelometría. La dieta se cuantificó con un cuestionario validado de frecuencia de consumo alimentos. Mediante el paquete estadístico SPSS v18, se realizaron pruebas de estadística descriptiva, correlación y modelos de regresión multivariada. El 53,7% fueron niñas y el 46,3% niños. La mediana de la PCR-us fue de 0,3 mg/L (rango: 0,3-6,8 mg/L). Se observó una correlación directa significativa entre la concentración sérica de la PCR-us con la ingesta de proteínas (rho= 0,126, p= 0,029), ácidos grasos totales (rho= 0,128, p= 0,027), ácidos grasos saturados (rho= 0,159, p= 0,006). Mediante el análisis de regresión múltiple se asoció la PCR-us con la ingesta de proteínas (β= 0,203, p=0,037) e inversamente con los granos enteros (β=-0,175, p= 0,002). Con el resto de las variables no se observó asociación significativa. La concentración sérica de la PCR-us se asoció directamente con el consumo de proteínas, ácidos grasos totales y saturados e indirectamente con el consumo de granos enteros.

The high-Sensitivity C-Reactive Protein (hs-CRP) is a cardiovascular risk marker. In healthy Mexican children, there islittle evidence that shows any relationship between serum levels of this marker with diet. The objective of this studywas to associate serum levels of hs-CRP with the diet composition in Mexican school children. The cross-sectional study included 300 seemingly healthy children of 10 to 12 years of age, 53.7% were girls and 46.3% boys.hs-CRP quantification was determined by nephelometry. The diet was quantified with a validated food frequency questionnaire. A descriptive statistical analysis, correlation and multivariate regression models were performed by using the SPSS v18 statistical software. The median of the hs-CRP was 0.3 mg / L (range: 0.3 to 6.8 mg / L). A significant direct correlation was found between serum hs-CRP with protein intake (rho=0.126, p=0.029), total fatty acids (rho = 0.128, p = 0.027) and saturated fatty acids (rho = 0.159, p = 0.006). hs-CRP was associated with the intake of protein (β = 0.203, p = 0.037) by multiple regression analysis, and inversely with whole grains (β = -0.175, p = 0,002). No significant association was found with the rest of the other variables. The serum concentration of hs-CRP was directly associated with the consumption of protein, total and saturated fatty acids and was indirectly proportional with the consumption of whole grains.

Cinética de la inmunoglobulina-A salival (IgAs) en adultos jóvenes con capacidad aeróbica promedio o excelente antes y después de una prueba de esfuerzo máximo / Salivary immunoglobulin A (sIgA) kinetics in young adults with an average or excellent aerobic capacity before and after a cardiopulmonary graded exercise test

Background: Aim: To compare the concentration of secretory immunoglobulin-A (sIgA) in young adults with average or excellent aerobic capacity before and after a cardiopulmonary graded exercise test. Methods: Participants were nine apparently healthy physically active males (Mean age = 21.3 ± 2.1 yr.), randomly allocated in two groups based on their VO2max: a) average aerobic capacity (AEC, n = 5) or b) excellent aerobic capacity (EAC, n = 4). Participants performed the Bruce protocol to determine their aerobic capacity. The sIgA was measured before the test, immediately after the test and 60-, 120-, 240-, and 1440-min after the test. Results: Mixed factorial 2 x 6 ANOVA indicated no significant interactions between groups and measurements (p = 0.956), and main effect groups on sIgA (AEC = 85.4 ± 19.3 μg/mL vs. EAC = 79.2 ± 21.5 μg/mL, p = 0.836). Tukey's post hoc analysis revealed significant differences measurement obtained immediately after the test and between the initial measurement (p = 0.020), 60-min (p = 0.030), 240-min (p = 0.016), and 1440-min (p = 0.028) following the test. Conclusion: There is no change in sIgA kinetics depending on the aerobic capacity of the participants following an aerobic capacity cardiopulmonary graded exercise test.

Introducción. Objetivo: Comparar la cinética en la concentración de inmunoglobulina A salival (IgAs) en adultos jóvenes con capacidad aeróbica promedio (n: 5) o excelente (n: 4) antes y después de una prueba de esfuerzo. Método: 9 adultos jóvenes (edad 21,3 ± 2,1), divididos de acuerdo su VO2máx, realizaron una prueba de esfuerzo mediante el protocolo de Bruce. La concentración de IgAs fue determinada mediante el Salimetrics IgA Kit®, evaluando inicial, inmediatamente finalizada la prueba, +60, +120, +240, +1.440 min. Resultados: La prueba ANOVA 2x6 mixta indicó que no existieron interacciones significativas entre grupos y mediciones (p = 0,956). Tampoco se encontró una diferencia significativa en la media de IgAs en los grupos (Promedio = 85,4 ± 19.3 μg/mL vs Excelente=79,2 ± 21.5 μg/mL, p = 0,836). Independientemente de las mediciones, el análisis post hoc de Tukey indicó que las diferencias se encontraron en la medición obtenida inmediatamente después de la prueba y entre la medición inicial (p: 0,020), la medición obtenida 60 min (p: 0,030), 240 min (p: 0,016) y 1.440 min (p = 0,028) posteriores a la prueba. Conclusión: Los datos encontrados sugieren que no hay un cambio en la concentración de IgAs a través del tiempo en función de la capacidad aeróbica de los participantes.

Efecto de la hidroxicloroquina sobre la sensibilidad a la insulina y el perfil de lípidos en pacientes con artritis reumatoide / Effects of hydroxychloroquine on insulin sensitivity and lipid profile in patients with rheumatoid arthritis

Background: Rheumatoid arthritis (RA) is associated with a decrease in insulin sensitivity (IS), which has been identified as an independent risk factor for the development of early atherosclerosis. Hydroxychloroquine (HCQ) may have beneficial effects on glucose homeostasis and lipid profile. Aim: To assess the effect of HCQ on IS and lipid profile in patients with RA. Material and Methods: An open clinical trial was performed in 15 patients aged between 35 and 56 years. During three months, patients received 400 mg/day of HCQ orally. Before and after the pharmacological intervention, demographic and anthropometric variables, serum glucose, total cholesterol (TC), triglycerides (TG), HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol, insulin and uric acid were measured. IS was estimated as the rate of glucose clearance per minute obtained with the insulin tolerance test (KITT). Results: Baseline and final KITT values were 4.3 ± 1.2 and 4.80 ± 1.1%/min, respectively (p = 0.03). Significant reductions in serum TC (p = 0.04) and TG (p = 0.01) were also observed. No other significant differences were observed. Conclusions: Oral administration of 400 mg/day of HCQ during three months in RA patients is associated with an improvement in IS, TC and TG.