Long-term effect of chemotherapy after ovarian decortication on the ovarian function in women surviving cancer.

PURPOSE: Ovarian decortication may affect ovarian function. We investigated the status of ovarian reserve after ovarian decortication plus chemotherapy at a stage of presumed stabilized recovery in women surviving cancer. METHODS: We searched our database for cancer survivors subjected to ovarian decortication and chemotherapy at least 3 years previously. Ovarian function was explored for levels of anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and estradiol (E2), and menstrual pattern. RESULTS: Forty women (mean age 29.6 (SD, 6.1) years) were assessed at a mean of 4.7 (1.5) years after surgery. The predecortication levels of AMH and FSH changed at post-treatment from 2.2 (1.4) to 0.5 (1.3) ng/mL for AMH (p < 0.001) and from 4.7 (2.1) to 16.7 (21. 6) IU/L for FSH (p < 0.001). Amenorrhea consistent with primary ovarian insufficiency (POI) was diagnosed in 11 women, and normal ovarian reserve (AMH ≥ 1.0 ng/mL) was found in 4 of the 21 women who recovered regular cycles. Logistic regression confirmed AMH as an independent predictor of diminished ovarian reserve (OR = 0.24, 95% CI: 0.04-0.63, p = 0.025) and POI (OR = 0.11, 95% CI: 0.01-0.52, p = 0.027), and age was predictive of POI (OR = 1.36, 95% CI: 1.08-1.96, p = 0.035) and of irregular menstrual cycle (OR = 1.20, 95% CI: 1.03-1.46, p = 0.034). CONCLUSION: Ovarian decortication plus chemotherapy had a deleterious effect when assessed at a stage of stabilized ovarian recovery, but whether ovarian decortication had a specific impact cannot be revealed from our data.

Comparison of IOTA three-step strategy and logistic regression model LR2 for discriminating between benign and malignant adnexal masses.

AIMS: To compare the diagnostic performance of two ultrasound-based diagnostic systems for the classification of benign or malignant adnexal masses, the three-step strategy and the predictive logistic regression model LR2, both proposed by the International Ovarian Tumour Analysis (IOTA) Group. MATERIAL AND METHODS: Prospective observational study at a single centre that included patients diagnosed with a persistent adnexal mass by transvaginal ultrasound over a period of two years. They were evaluated by a non-expert sonographer by applying the three-step diagnostic strategy and the LR2 predictive model to classify the masses as benign or malignant. Patients were treated surgically or followed up for at least one year, taking as the standard reference for benignity or malignancy the histological diagnosis of the lesion or ultrasound changes suggestive of malignancy during the follow-up period. Sensitivity, specificity, positive and negative likelihood ratios and overall accuracy of both systems was calculated and compared. RESULTS: One hundred patients were included, with a mean age of 50.6 years (range 18-87). Surgery was performed on 62 (62%) patients and 38 (38%) were managed expectantly. Eighty-three (83%) lesions were benign and 17 (17%) were malignant. The IOTA three-step strategy presented sensitivity of 94.1% (95%CI, 86.7-98.3%) and specificity 97.6% (95%CI, 94.8-99%). The LR2 logistic regression model showed sensitivity 94.1% (95%CI, 73-98.9%) and specificity 81.9% (95%CI 72.3-88.7%). Comparison of the two systems showed a statistically significant dif-ference in specificity in favour of the three-step strategy. CONCLUSIONS: The IOTA three-step strategy, in addition to being sim-ple to use in clinical practice, has a high diagnostic accuracy for the classification of benignity and malignancy of the adnexal masses, overtaking that of other predictive models such as the LR2 logistic regression model.

Postoperative Intestinal Fistula in Primary Advanced Ovarian Cancer Surgery.

BACKGROUND: Advanced ovarian cancer (AOC) requires an aggressive surgery with large visceral resections in order to achieve an optimal or complete cytoreduction and increase the patient's survival. However, the surgical aggressiveness in the treatment of AOC is not exempt from major complications, such as the gastrointestinal fistula (GIF), which stands out among others due to its high morbidity and mortality. METHODS: We evaluated the clinicopathological features in patients with AOC and their association with GI. Data for 107 patients with AOC who underwent primary debulking surgery were analyzed retrospectively. Clinicopathological features, including demographic, surgical procedures and follow-up data, were analyzed in relation to GIF. RESULTS: GIF was present in 11% of patients in the study, 5 (4.5%) and 7 (6.4%) of colorectal and small bowel origin, respectively. GIF was significantly associated with peritoneal cancer index (PCI) >20, more than 2 visceral resections, and multiple digestive resections. Overall and disease-free survival were also associated with GIF. Multivariate analysis identified partial bowel obstruction and operative bleeding as independent prognostic factors for survival. The presence of GIF is positively associated with poor prognosis in patients with AOC. CONCLUSION: Given the importance of successful cytoreductive surgery in AOC, the assessment of the amount of tumor and the aggressiveness of the surgery to avoid the occurrence of GIF become a priority in patients with AOC.

Operando Reactor-Cell with Simultaneous Transmission FTIR and Raman Characterization (IRRaman) for the Study of Gas-Phase Reactions with Solid Catalysts.

Raman and transmission FTIR spectroscopic techniques have been coupled in a new homemade reactor-cell designed in a joint CSIC-LCS collaboration. The setup is easily adapted to any FTIR and fiber-coupled Raman spectrometers and gas analysis techniques. It allows for simultaneous operando FTIR and Raman spectroscopic measurement, which provide complementary characterization of adsorbed species, reaction intermediates, and structural properties of the catalyst. This system was validated with the study of vanadium-based catalysts during propane oxydehydrogenation (ODH). The combined use of both spectroscopies with gas analysis techniques to measure the activity contributes to the understanding of propane ODH and the identification of the role of different oxygen species bound to vanadium sites. For example, the simultaneous characterization of the catalyst under the same conditions by IR and Raman confirms that the V═O mode has the same frequency in both spectroscopies and that bridging oxygen sites (V-O-V, V-O-Zr) present higher activity than terminal V═O bonds. These results demonstrate the high potential of the new simultaneous transmission IR-Raman operando rig to correlate the activity and the structure of catalysts, thus assisting the rational design of catalytic processes.

Preservación de la fertilidad de emergencia en paciente con diagnóstico de cáncer de mama durante embarazo: caso clínico / Emergency fertility preservation after cesarean delivery in a woman with breast cancer diagnosed during pregnancy

El cáncer de mama es la neoplasia más frecuente en la mujer; sin embargo, el cáncer de mama asociado al embarazo es una entidad poco común que incluye aquellos casos diagnosticados durante el embarazo y los doce meses postparto. En los últimos años su incidencia se ha incrementado, al igual que su tasa de supervivencia media que se encuentra en el 78 %, por ello, unido al retraso en la maternidad en las sociedades actuales, resulta cada vez más usual que estas pacientes no presenten sus deseos genésicos cumplidos, requiriendo un manejo multidisciplinar que englobe la preservación de la fertilidad como procedimiento previo a la pauta de quimioterápicos. La técnica de elección es la vitrificación de ovocitos, ya que se trata de una opción consolidada que evita la generación de embriones con un futuro incierto. Se presenta el caso de una paciente en el que se realiza preservación de ovocitos en el puerperio inmediato. La derivación temprana a las unidades de reproducción asistida, así como un diseño protocolizado e individualizado en la medida de lo posible del tratamiento, resultan vitales para disponer de unas mínimas garantías de éxito, de igual manera es indispensable tener presente que el embarazo después de un cáncer de mama es posible y que puede conseguirse en condiciones de seguridad para todas las partes

Breast cancer is the most frequent neoplasm in women; however, breast cancer associated with pregnancy is a rare entity that includes those cases diagnosed during pregnancy and twelve months postpartum. In recent years, its incidence has increased, as has its average survival rate of 78%, which is why, together with the delay in maternity in current societies, it is increasingly common for these patients to not present their genetic wishes fulfilled, requiring a multidisciplinary management that includes the preservation of fertility as a previous procedure to the chemotherapy regimen. The technique of choice is the vitrification of oocytes, since it is a consolidated option that avoids the generation of embryos with an uncertain future. We present the case of a patient in whom preservation of oocytes is performed in the immediate puerperium. The early referral to assisted reproduction units as well as a protocolized and individualized design as far as possible of the treatment, are vital to have a minimum guarantee of success, in the same way it is essential to bear in mind that pregnancy after cancer of breast is possible and that it can be achieved in conditions of safety for all parties

Fixing PAN Nanofiber Mats during Stabilization for Carbonization and Creating Novel Metal/Carbon Composites.

Polyacrylonitrile (PAN) is one of the materials most often used for carbonization. PAN nanofiber mats, created by electrospinning, are an especially interesting source to gain carbon nanofibers. A well-known problem in this process is fixing the PAN nanofiber mats during the stabilization process which is necessary to avoid contraction of the fibers, correlated with an undesired increase in the diameter and undesired bending. Fixing this issue typically results in breaks in the nanofiber mats if the tension is too high, or it is not strong enough to keep the fibers as straight as in the original state. This article suggests a novel method to overcome this problem by electrospinning on an aluminum substrate on which the nanofiber mat adheres rigidly, stabilizing the composite and carbonizing afterwards either with or without the aluminum substrate to gain either a pure carbon nanofiber mat or a metal/carbon composite.

Influencia del clima en el infarto de miocardio en Galicia / Influence of weather in the incidence of acute myocardial infarction in Galicia (Spain)

Objetivo: Analizar la influencia del clima y el impacto de cada parámetro meteorológico sobre la incidencia del infarto agudo de miocardio (IAM) en Galicia. Métodos: Estudio retrospectivo analizando el número de IAM diagnosticados y trasladados a hospitales por la Fundación Pública de Urgencias Sanitarias de Galicia-061 entre 2002 y 2009. Incluimos pacientes con criterios clínicos y electrocardiográficos de IAM, y analizamos su correlación con variables meteorológicas diezminutales (temperatura, humedad, presión, precipitaciones acumuladas y velocidad del viento) registradas por MeteoGalicia. Resultados: Se incluyeron 4.717 infartos diagnosticados (72,8% varones y 27,2% mujeres), sin detectar variación estacional. La temperatura media diaria (p = 0,683) y la velocidad media del viento (p = 0,895) no mostraron relación significativa con la incidencia de IAM. La presión atmosférica presenta una asociación estadísticamente significativa con la incidencia de IAM (p < 0,005), así como la humedad relativa, asociada a una mayor incidencia en el cuarto cuartil (p = 0,005). Conclusiones: Nuestro estudio muestra una asociación estadísticamente significativa entre la presión atmosférica y la humedad relativa media diaria con la incidencia de IAM en Galicia. Dado que las condiciones locales en las diferentes estaciones son muy variables, los futuros trabajos deberían dirigirse a establecer la relación entre patrones climáticos (definidos por combinaciones de parámetros meteorológicos individuales), en lugar de variaciones estacionales, y la incidencia de IAM (AU)

Objective: To assess the interactions between weather and the impact of each individual meteorological parameters in the incidence of acute myocardial infarctions (AMI) in Galicia. Methods: Retrospective study analyzing the number of AMI diagnosed and transferred to the hospital by the Emergencies Sanitary System of Galicia between 2002 and 2009. We included patients with clinical and ECG findings of AMI. The correlation between 10-minute meteorological variables (temperature, humidity, pressure, accumulated rainfall and wind speed) recorded by MeteoGalicia and the incidence of AMI was assessed. Results: A total of 4,717 AMI were registered (72.8% men, 27.2% women). No seasonal variations were found. No significant correlations were detected with regard to average daily temperature (P = .683) or wind speed (P = .895). Correlation between atmospheric pressure and incidence of AMI was significant (P < .005), as well as with the daily relative humidity average (P = .005). Conclusions: Our study showed a statistical significant association with atmospheric pressure and with the daily relative humidity average. Since the local conditions of weather are widely variable, future studies should establish the relationship between weather patterns (including combinations of meteorological parameters), rather than seasonal variations, and the incidence of AMI (AU)

[Influence of weather in the incidence of acute myocardial infarction in Galicia (Spain)]. / Influencia del clima en el infarto de miocardio en Galicia.

OBJECTIVE: To assess the interactions between weather and the impact of each individual meteorological parameters in the incidence of acute myocardial infarctions (AMI) in Galicia. METHODS: Retrospective study analyzing the number of AMI diagnosed and transferred to the hospital by the Emergencies Sanitary System of Galicia between 2002 and 2009. We included patients with clinical and ECG findings of AMI. The correlation between 10-minute meteorological variables (temperature, humidity, pressure, accumulated rainfall and wind speed) recorded by MeteoGalicia and the incidence of AMI was assessed. RESULTS: A total of 4,717 AMI were registered (72.8% men, 27.2% women). No seasonal variations were found. No significant correlations were detected with regard to average daily temperature (P=.683) or wind speed (P=.895). Correlation between atmospheric pressure and incidence of AMI was significant (P<.005), as well as with the daily relative humidity average (P=.005). CONCLUSIONS: Our study showed a statistical significant association with atmospheric pressure and with the daily relative humidity average. Since the local conditions of weather are widely variable, future studies should establish the relationship between weather patterns (including combinations of meteorological parameters), rather than seasonal variations, and the incidence of AMI.

Overcoming challenges of ovarian cancer stem cells: novel therapeutic approaches.

Understanding the genetic and molecular mechanisms of ovarian cancer has been the focus of research efforts working toward the greater goal of improving cancer therapy for patients with residual disease after initial treatment with conventional surgery and neoadjuvant chemotherapy. The focus of this review will be centered on new therapeutic strategies based on Cancer Stem Cells studies of chemoresistant subpopulations, the prevention of metastasis, and individualized therapy in order to find the most successful combination of treatments to effectively treat human ovarian cancer. We reviewed recent literature (1993-2011) of novel treatment approaches to ovarian cancer stem cells. As the focus of ovarian cancer investigation has centered on the cancer stem cell model and the complexities that it presents in the development of effective treatments, the future of treating ovarian cancer lies in utilizing individualized treatment systems that include enhancing existing treatments, aiming for novel therapy targets, managing the plasticity of stem cells to induce cellular differentiation, and regulating oncogenic signaling pathways.

Evaluación de metaconocimientos sobre la comprensión de textos: análisis de un instrumento de medida en un estudio descriptivo / Metaknowlegde assessment about the understanding of texts: analysis of a measure instrument in a descriptive study

Queremos con este articulo dar a conocer un instrumento de evaluación de metaconocimientos sobre la comprensión de textos. Se trata de un cuestionario de selección múltiple que consta de 26 preguntas, que se encuentran agrupadas en siete bloques de procesos: metaconocimiento sobre el significado y sentido de la lectura, metaconocimiento sobre estrategias de planificación, de supervisión, autoevaluación, transferencia y generalización, integración textual e integración texto-conocimientos previos. Se expone un breve análisis cualitativo sobre el contenido de la prueba, así como un análisis cuantitativo sobre aspectos relativos a los ítems, la validez y la fiabilidad. Se recogen igualmente algunos resultados de una investigación reciente, con una muestra de 1006 sujetos, en la que se aplicó el instrumento (AU)

Ductal carcinoma in situ of the breast: a comparative analysis of histology, nuclear area, ploidy, and neovascularization provides differentiation between low- and high-grade tumors.

Ductal carcinoma in situ (DCIS) is a heterogeneous group of lesions that has been subdivided into three types: well differentiated (grade I), moderately differentiated (grade II), and poorly differentiated (grade III). Forty-five cases of DCIS were analyzed for image analysis: nuclear area, DNA ploidy, and vascularization in order to establish a more precise correlation between the histologic grade and these morphometric parameters. Our results confirm that the mean nuclear area, DNA ploidy, and microvessel density (MVD) progressively increased from DCIS grade I to DCIS grade III. The analysis of the nuclear area in relationship to DCIS grading demonstrated a progressive increase of values between grades I/II to grade III, but these data have no statistical significance. An analysis of DNA ploidy demonstrated significant differences between grades I/III (p < 0.05), but there was no statistical significance between grades I/II, grades II/III, or both (p > 0.005). The analysis of MVD was extremely significant between grades I/III (p < 0.001) and grades II/III (p < 0.001), but between grades I/II, these values showed no significant differences (p > 0.05). Based on this study, it can be concluded that image analysis techniques confirm how DCIS presents morphometric values that increase from DCIS grade I to DCIS grade III and that within this spectrum, DCIS grade III can be identified as a group of tumors presenting a large nuclear area, aneuploid DNA, and abundant vascular neogenesis, confirming that this neoplasm displays more aggressive patterns than the other two types. These criteria should justify a higher rate of tumor progression to DCIS grade III.