High-dose neoadjuvant chemoradiotherapy versus chemotherapy alone followed by surgery in potentially-resectable stage IIIA-N2 NSCLC. A multi-institutional retrospective study by the Oncologic Group for the Study of Lung Cancer (Spanish Radiation Oncology Society).

BACKGROUND: The optimal induction treatment in potentially-resectable stage IIIA-N2 NSCLC remains undefined. AIM: To compare neoadjuvant high-dose chemoradiotherapy (CRT) to neoadjuvant chemotherapy (CHT) in patients with resectable, stage IIIA-N2 non-small-cell lung cancer (NSCLC). METHODS: Retrospective, multicentre study of 99 patients diagnosed with stage cT1-T3N2M0 NSCLC who underwent neoadjuvant treatment (high-dose CRT or CHT) followed by surgery between January 2005 and December 2014. RESULTS: 47 patients (47.5%) underwent CRT and 52 (52.5%) CHT, with a median follow-up of 41 months. Surgery consisted of lobectomy (87.2% and 82.7%, in the CRT and CHT groups, respectively) or pneumonectomy (12.8% vs. 17.3%). Nodal downstaging (to N1/N0) and Pathologic complete response (pCR; pT0pN0) rates were significantly higher in the CRT group (89.4% vs. 57.7% and 46.8% vs. 7.7%, respectively; p < 0.001)). Locoregional recurrence was significantly lower in the CRT group (8.5% vs. 13.5%; p = 0.047) but distant recurrence rates were similar in the two groups. Median PFS was 45 months (CHT) vs. "not reached" (CRT). Median OS was similar: 61 vs. 56 months (p = 0.803). No differences in grade ≥3 toxicity were observed. On the Cox regression analysis, advanced pT stage was associated with worse OS and PFS (p < 0.001) and persistent N2 disease (p = 0.002) was associated with worse PFS. CONCLUSIONS: Compared to neoadjuvant chemotherapy alone, a higher proportion of patients treated with preoperative CRT achieved nodal downstaging and pCR with better locoregional control. However, there were no differences in survival. More studies are needed to know the optimal treatment of these patients.

Human intestinal protozoa in fresh asparagus from different types of markets in northwest Mexico.

Caborca is one of the most productive asparagus-growing regions in the state of Sonora in northwest Mexico, an area where some fresh fruits and vegetables are sold at unregulated open-air street markets. This is a cross-sectional study in which fifty bundles of asparagus for exportation, 50 bundles of sub-standard asparagus, and 50 bundles of asparagus from open-air markets were selected randomly and then subjected to Faust, Kinyoun and ELISA testing to detect intestinal parasites. Pearson's chi-square (χ2) and Student-NewmanKeuls tests were used to estimate differences among the sampling site groups (P < 0.05). The pathogens Cryptosporidium spp. (29%) G. intestinalis (5%) and Cyclospora spp. (3%) were found in the asparagus sold in the region. The prevalence of Cryptosporidium spp. was higher in both the sub-standard asparagus and the product sampled from the open-air markets than in the samples for exportation (P < 0.05). This is the first study to demonstrate contamination by intestinal parasites in asparagus sold in different markets in northwest Mexico.

Prognostic factors in neoadjuvant treatment followed by surgery in stage IIIA-N2 non-small cell lung cancer: a multi-institutional study by the Oncologic Group for the Study of Lung Cancer (Spanish Radiation Oncology Society).

PURPOSE: To evaluate the prognostic factors associated with survival in patients treated with neoadjuvant treatment [chemoradiotherapy (CRT) or chemotherapy] followed by surgery (CRTS) in patients with stage IIIA-N2 non-small cell lung cancer (NSCLC). METHODS: A retrospective study was conducted of 118 patients diagnosed with stage T1-T3N2M0 NSCLC and treated with CRTS at 14 hospitals in Spain between January 2005 and December 2014. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method and compared using the log-rank test. Cox regression analysis was performed. RESULTS: Surgery consisted of lobectomy (74.5% of cases), pneumectomy (17.8%), or bilobectomy (7.6%). Neoadjuvant treatment was CRT in 62 patients (52.5%) and chemotherapy alone in 56 patients (47.5%). Median follow-up was 42.5 months (5-128 months). 5-year OS and PFS were 51.1% and 49.4%, respectively. The following variables were independently associated with worse OS and PFS: pneumonectomy (vs. lobectomy); advanced pathologic T stage (pT3 vs. pT0-pT2); and presence of persistent N2 disease (vs. ypN0-1) in the surgical specimen. CONCLUSIONS: In this sample of patients with stage IIIA-N2 NSCLC treated with CRTS, 5-year survival (both OS and PFS) was approximately 50%. After CRTS, the patients with the best prognosis were those whose primary tumour and/or mediastinal nodal metastases were downstaged after induction therapy and those who underwent lobectomy. These findings provide further support for neoadjuvant therapy followed by surgery in selected patients.

Neoadjuvant treatment followed by surgery versus definitive chemoradiation in stage IIIA-N2 non-small-cell lung cancer: A multi-institutional study by the oncologic group for the study of lung cancer (Spanish Radiation Oncology Society).

OBJECTIVES: The role of surgery in stage IIIA-N2 non-small cell lung cancer (NSCLC) is an actively debated in oncology. To evaluate the value of surgery in this patient population, we conducted a multi-institutional retrospective study comparing neoadjuvant chemoradiotherapy or chemotherapy plus surgery (CRTS) to definitive chemoradiotherapy (dCRT). MATERIAL AND METHODS: A total of 247 patients with potentially resectable stage T1-T3N2M0 NSCLC treated with either CRTS or dCRT between January 2005 and December 2014 at 15 hospitals in Spain were identified. A centralized review was performed to ensure resectability. A propensity score matched analysis was carried out to balance patient and tumor characteristics (n = 78 per group). RESULTS: Of the 247 patients, 118 were treated with CRTS and 129 with dCRT. In the CRTS group, 62 patients (52.5%) received neoadjuvant CRT and 56 (47.4%) neoadjuvant chemotherapy. Surgery consisted of either lobectomy (97 patients; 82.2%) or pneumonectomy (21 patients; 17.8%). In the matched samples, median overall survival (OS; 56 vs 29 months, log-rank p = .002) and progression-free survival (PFS; 46 vs 15 months, log-rank p < 0.001) were significantly higher in the CRTS group. This survival advantage for CRTS was maintained in the subset comparison between the lobectomy subgroup versus dCRT (OS: 57 vs 29 months, p < 0.001; PFS: 46 vs 15 months, p < 0.001), but not in the comparison between the pneumonectomy subgroup and dCRT. CONCLUSION: The findings reported here indicate that neoadjuvant chemotherapy or chemoradiotherapy followed by surgery (preferably lobectomy) yields better OS and PFS than definitive chemoradiotherapy in patients with resectable stage IIIA-N2 NSCLC.

Membrana de Quitosano con Aceites Esenciales de Romero y Árbol de Té: Potencial como Biomaterial / Membrane of chitosan with essential oils of Romero and Tree of Tea: Potential as biomaterial

RESUMEN: El quitosano (CH) tiene propiedades hemostáticas, cicatrizantes y estimulantes del sistema inmune del hospedero contra infecciones virales y bacterianas. Además es biodegradable, no tóxico, antimicrobiano, biocompatible y filmogénico. Estas propiedades han sido utilizadas para acarrear y liberar compuestos bioactivos para sus posibles usos en la salud humana. Por otro lado, los compuestos bioactivos como los aceites esenciales de gran volatilidad como romero (RMO) [Rosmarinus officinalis] y árbol de té (TTO) [Melaleuca alternifolia], pueden ser alternativa importante de uso como antioxidantes y antimicrobianos que podrían inducir cambios favorables en la membrana de CH. Por lo tanto, se incorporaron aceites esenciales de TTO y RMO (0.25, 0.50 y 1.00% v/v) en membranas de CH por el método de casting y se evaluaron su solubilidad, PVA, transparencia y capacidad de bloqueo de la luz ultravioleta, capacidad antioxidante y de protección del eritrocito humano. RMO y TTO redujeron la solubilidad (28-58%) y PVA (entre 28-58%) de las membranas de CH. Todas las membranas fueron amarillas, ligeramente opacas y con capacidad de bloquear la luz ultravioleta. También, las membranas mostraron relativa baja capacidad antioxidante por el radical ABTS (≈ 6 at 9 %), pero con excelente efecto protector sobre el eritrocito humano (> 63 %).

ABSTRACT: Chitosan (CH) has hemostatic properties and accelerated healing ability to stimulate the host immune system against viral and bacterial infections. It is also biodegradable, nontoxic, antimicrobial, biocompatible, and capable of forming membranes and to carry and to release bioactive compounds. These properties of CH can be useful to carry some volatile essential oils having bioactive compounds (antioxidants and antimicrobials) with potential application in human health as those as rosemary (RMO) [Rosmarinus officinalis] and tea tree (TTO) [Melaleuca alternifolia]. These essential oils were incorporated into the chitosan by the casting method in this study. The physical properties (solubility, PVA, transparency and blocking ultraviolet light) of these membranes with TTO and RMO (0.25, 0.50 and 1.00% v/v), antioxidant capacity and protection human erythrocyte were evaluated. TTO and RMO reduced solubility (28-58%) and PVA (between 28-58%) of CH membranes. All membranes were yellow, slightly opaque and they were able to block the ultraviolet light. Membranes also showed relatively low antioxidant capacity by the radical ABTS (≈ 6 at 9%), but it was accompanied by an excellent protective effect on the human erythrocyte (> 63%).

Efecto de Microemulsiones de Aceites Esenciales Sobre el Eritrocito Humano y Bacterias Patógenas / Effect of Microemulsions of Essential Oils on Human Erythrocyte and Pathogens Bacteria

RESUMEN: El objetivo del presente trabajo fue evaluar el efecto de las microemulsiones de aceite esencial de romero (AER) y árbol de té (AET) sobre el eritrocito humano y microorganismos patógenos. Para ello, se elaboraron microemulsiones de AER y AET al 8.0% (v/v), 5.0% (v/v) y 2.5% (v/v). Las microemulsiones fueron probadas sobre el eritrocito humano para determinar el porcentaje de hemólisis, el porcentaje de inhibición de hemólisis y su actividad antibacterial contra E. coli O157:H7 y S. aureus. Las microemulsiones con AER no presentaron actividad hemolítica significativa, caso contrario con las microemulsiones de AET al 8.0% (≈70%) y 5.0% (33%) que presentaron mayor actividad hemolítica. Las microemulsiones de AER protegieron significativamente al eritrocito contra la presencia de radicales libres, en comparación con aquellas de AET (p< 0.05). Además, las emulsiones de AET al 8.0% mostraron efectos antibacterianos contra E. coli O157:H7 y S. aureus mientras que AER al 8.0% solo mostraron efecto contra E. coli O157:H7. La limitante del estudio fue que no utilizamos células nucleadas para establecer si los aceites esenciales dañan el material nuclear. Sin embargo, observamos que el tipo y la cantidad de aceite utilizado pueden tener implicaciones serias sobre la membrana eritrocitaria. Se concluye que las microemulsiones de AER presentaron mejor efecto protector eritrocitario, mientras que las microemulsiones de AET presentaron mejor actividad antibacterial contra las bacterias estudiadas, pero con mayor efecto tóxico sobre el eritrocito.

ABSTRACT: The aim of the study was to evaluate the effect of microemulsions of rosemary (AER) and tea tree (AET) essential oils on human erythrocyte and pathogen bacteria. Microemulsions of each oil were prepared at 8.0% (v/v), 5.0% (v/v) and 2.5% (v/v), and they were tested on human erythrocyte to determine the hemolysis percentage, hemolysis inhibition percentage and the antibacterial capacity against E. coli O157:H7 and S. aureus. All AER microemulsions showed no significant hemolytic activity. On the contrary, AET microemulsions showed hemolytic effect but those in concentrations of 8.0% (≈70 %) and 5.0% (33%) showed the highest effect. In addition, AER microemulsions showed protective effect against free radicals in comparison with the AET microemulsions (p< 0.05). On the other hand, the AET microemulsion at 8.0% showed antibacterial effect against E. coli O157:H7 and S. aureus, and the AER at 8.0% showed antibacterial effect against E. coli O157:H7. The limitation of this study was that nucleated cells were not used to observe the damage of the essential oils on nuclear material. However, the observed damage of erythrocyte's membrane is depending on type and amount of used oil. Therefore, it can be concluded that the AER microemulsions showed better protective effect of erythrocytes, while AET microemulsions showed better antibacterial effect against the tested bacteria, although with toxic effect on the erythrocytes.

Impact of Giardia intestinalis on vitamin a status in schoolchildren from northwest Mexico.

We conducted a cross-sectional study in northwest Mexico in order to investigate the association between giardiasis and serum vitamin A in 40 Giardia-infected and 70 Giardia-free schoolchildren who were covered by a regional school breakfast program. There were no significant differences in age, Z-scores for nutritional indices of height for age, weight for age, or weight for height, socioeconomic conditions (employment and education of the parents, household conditions, sanitation facilities, type of drinking water, and family income), and mean daily intakes of vitamin A in the Giardia-free (899 +/- 887 microg) and the Giardia-infected (711 +/- 433 microg) groups. A higher concentration of serum retinol was found in the Giardia-free group than in the Giardia-infected group (0.75 micromol/L versus 0.61 micromol/L, respectively; p < 0.0001). Giardia-infected children were more likely to be vitamin A-deficient than the Giardia-free children (OR = 3.2; 95% CI = 1.2-8.5). Although 95% of the children met the daily-recommended intakes of vitamin A, half of them showed subclinical vitamin A deficiency. It is recognized that vitamin A deficiency is multifactorial and giardiasis was a factor significantly associated with this deficiency in this study. Mexican program developers and policymakers should be aware about the distinction between dietary deficiencies and deficiency diseases when current national program strategies for parasitic control and vitamin A supplementation are redesigned.

Comparación de la Tomografía Axial Computarizada con el estudio anatomopatológico en el estadiaje ganglionar del cáncer de pulmón / Comparison between computerized axial tomography and anatomicopathologic study of node staging of lung cancer

• Propósito: Evaluar la Sensibilidad, Especificidad, Valor predictivo positivo y Valor Predictivo Negativode la Tomografia Axial Computarizada (TAC) en el estadiaje ganglionar del cáncer de pulmón.• Material y métodos: Se han analizado 30 pacientes diagnosticados de carcinoma pulmonar entre Mayode 2003 y Mayo de 2004. A todos los pacientes se les realizó una TAC torácica, valorando la afectaciónganglionar mediastínica. A su vez, se les realizó o una mediastinoscopia o una resección pulmonar más linfadenectomíamediastínica, obteniendo así material para el estudio anatomo-patológico para confirmar o no laafectación ganglionar mediastínica y correlacionarla con los hallazgos de la TAC.• Resultados: Hemos obtenido una Sensibilidad del 72,2%, una Especificidad del 100%, un valor predictivopositivo del 100% y un valor predictivo negativo del 70,6% para la TAC, utilizando como “gold standar”el estudio anatomopatológico.• Conclusiones: La TAC torácica se considera una prueba de imagen de rutina en el diagnóstico del cáncerde pulmón; pero en muchos casos no es capaz de estadiar correctamente la afectación ganglionar mediastínica.Es en estos casos, donde es necesario realizar pruebas invasivas como la mediastinoscopia. Actualmente,la aparición de la PET permite estadiar mejor el tumor, ofreciendo mejor tratamiento a cada paciente, y en determinadoscasos evitar técnicas diagnósticas invasivas

• Purpose: To analise the sensitivity, specificity, and positive and negative predictive values of the computerized axial tomography (CT) in nodal stages of lung carcinoma. • Material and methods: Thirty patients suffering from lung carcinoma were analysed between May 2003 and May 2004. CT screening of the thorax was made to all the patients. Mediastinoscopy or lung resection samples plus systematic node dissection were performed, and the efficiency of CT analysed by comparing the obtained data with the histopathology results of nodal affection shown by mediastinoscopy and lymph node dissection. • Results: The sensitivity, specificity, and positive and negative predictive value of the computerized axial tomography (CT) for nodal staging involved in lung carcinoma were 72.2%, 100%, 100% and 70,6% respectively. • Conclusions: CT of the thorax is considered a usual imaging technique in lung carcinoma diagnosis; but in some cases it does not focalise correctly the nodal staging involved in lung carcinoma. In theses cases, it is necessarry to perform invasive techniques such as mediastinoscopy. At present, positron emission tomography (PET) is the technique that better permits to focalise the tumor offering the best data for the therapy of each patient, and avoiding invasive diagnosis techniques

Toxicidad de piel. Prevencion y tratamiento / No disponible

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Radioterapia postoperatoria exclusiva en carcinoma de recto / Single postoperative radiotherapy in rectal carcinoma

- Propósito: analizar los resultados del tratamiento radioterápico sin quimioterapia tras cirugía radical en cáncer rectal.- Material y métodos: se analizaron los resultados de 20 pacientes tratados entre enero 94 y enero 97, por un cáncer rectal estadio B2-C. Se administró radioterapia postoperatoria exclusiva por no cumplir los requisitos para la administración de quimioterapia (edad >75 años, mala función hepática, renal o hematológica). Edad mediana: 71 años. Todos recibieron 50 Gy sobre volumen pélvico, con fraccionamiento estándar y técnica de cuatro campos, con fotones de 23 MV (42,1 por ciento) o cobaltoterapia (57,9 por ciento) y tras planificación bidimensional. Se analizaron las cifras de supervivencia, control de la enfermedad y toxicidad.- Resultados: tras un seguimiento mediano de 76,64 meses, la supervivencia cáncer-específica y libre de enfermedad a 5 años fueron del 60,5 por ciento y del 58,1 por ciento, respectivamente. La probabilidad de control local fue del 66,6 por ciento a 5 años y de control a distancia del 80,1 por ciento. La incidencia de toxicidad aguda fue del 73,7 por ciento, pero con ningún grado 3-4 de la RTOG, ni interrupciones de la radioterapia u hospitalización por toxicidad. La incidencia de toxicidad tardía grado 3 fue de un 5,3 por ciento.- Conclusiones: en aquellos pacientes con cáncer rectal en estadios B2-C en los que no se pueda administrar quimioterapia, debería ofrecerse la posibilidad de administrar radioterapia adyuvante exclusiva, dada su baja morbilidad y sus buenos resultados (AU)