PI3K-AKT, JAK2-STAT3 pathways and cell-cell contact regulate maspin subcellular localization.

BACKGROUND: Maspin (SERPINB5) is a potential tumor suppressor gene with pleiotropic biological activities, including regulation of cell proliferation, death, adhesion, migration and gene expression. Several studies indicate that nuclear localization is essential for maspin tumor suppression activity. We have previously shown that the EGFR activation leads to maspin nuclear localization in MCF-10A cells. The present study investigated which EGFR downstream signaling molecules are involved in maspin nuclear localization and explored a possible role of cell-cell contact in this process. METHODS: MCF-10A cells were treated with pharmacological inhibitors against EGFR downstream pathways followed by EGF treatment. Maspin subcellular localization was determined by immunofluorescence. Proteomic and interactome analyses were conducted to identify maspin-binding proteins in EGF-treated cells only. To investigate the role of cell-cell contact these cells were either treated with chelating agents or plated on different cell densities. Maspin and E-cadherin subcellular localization was determined by immunofluorescence. RESULTS: We found that PI3K-Akt and JAK2-STAT3, but not MAP kinase pathway, regulate EGF-induced maspin nuclear accumulation in MCF-10A cells. We observed that maspin is predominantly nuclear in sparse cell culture, but it is redistributed to the cytoplasm in confluent cells even in the presence of EGF. Proteomic and interactome results suggest a role of maspin on post-transcriptional and translation regulation, protein folding and cell-cell adhesion. CONCLUSIONS: Maspin nuclear accumulation is determined by an interplay between EGFR (via PI3K-Akt and JAK2-STAT3 pathways) and cell-cell contact. Video Abstract.

SEOM clinical guideline for the diagnosis and treatment of gastric cancer (GC) and gastroesophageal junction adenocarcinoma (GEJA) (2019).

Gastric cancer (GC) is the fifth most common cancer worldwide with a varied geographic distribution and an aggressive behavior. In Spain, it represents the sixth cause of cancer death. In Western countries, the incidence is decreasing slightly, with an increase in gastroesophageal junction adenocarcinoma (GEJA), a different entity that we separate specifically in the guideline. Molecular biology advances have been done recently, but do not yet lead to the choice in treatment approach except in advanced disease with overexpression of HER2. Endoscopic resection in very early stage, perioperative chemotherapy in locally advanced tumors and preliminary immune therapy resulting in advanced disease are the main treatment innovations in the GC/GEJA treatment. We describe the different evidences and recommendations following the statements of the American College of Physicians.

Pancreatic ductal adenocarcinoma: metastatic disease.

The treatment of choice of metastatic PADC is systemic chemotherapy. In the last decade, there have been significant advances in this area. New combination poli-chemotherapy schemes have shown a significant increase in overall survival and progression-free survival without impairing quality of life. In addition, the value of second-line chemotherapy treatment has consolidated and a new concept called "therapeutic sequencing" has also emerged. The aim of this article is to review the different therapeutic options in metastatic PDAC based on patient's characteristics.

Consensus guidelines for diagnosis, treatment and follow-up of patients with pancreatic cancer in Spain.

The management of patients with pancreatic cancer has advanced over the last few years. We convey a multidisciplinary group of experts in an attempt to stablish practical guidelines for the diagnoses, staging and management of these patients. This paper summarizes the main conclusions of the working group. Patients with suspected pancreatic ductal adenocarcinoma should be rapidly evaluated and referred to high-volume centers. Multidisciplinary supervision is critical for proper diagnoses, staging and to frame a treatment plan. Surgical resection together with chemotherapy offers the highest chance for cure in early stage disease. Patients with advanced disease should be classified in treatment groups to guide systemic treatment. New chemotherapeutic regimens have resulted in improved survival. Symptomatic management is critical in this disease. Enrollment in a clinical trial is, in general, recommended.

Second primary malignancies in patients with neuroendocrine tumors.

PURPOSE: An association between neuroendocrine tumors (NETs) and second primary malignancies (SPMs) has been reported. We have examined the incidence and etiology of SPMs in patients with NETs included in the Neuroendocrine Tumor Association of Andalusia (ATNEA) Registry. METHODS: Data on 111 patients were collected. Sex, age, NET site, chromogranin A levels, neuropeptide secretion and disease stage were compared between NETs with and without SPMs. RESULTS: SPMs were present in 21 patients (18.9 %): five colorectal tumors, four non-small-cell lung cancers, three gastric cancers, two tumors in the small intestine, one hepatocarcinoma, two ovarian tumors, one breast adenocarcinoma, one hypernephroma, one bladder cancer, and one neuroblastoma. SPMs were present in 18 % of patients with a gastrointestinal NET and 22 % of those with a non-gastrointestinal NET. SPMs were found in 23 % of patients with elevated levels of serum chromogranin A, compared to 17 % of patients with normal levels, and in 22 % of patients with functional tumors, compared to 11 % of those with non-functional tumors. Finally, SPMs were observed in 24 % of patients with a local or locoregional tumor but in only 13 % of those with a metastatic tumor. No other differences between patients with and without SPMs were observed. CONCLUSIONS: The percentage of patients with SPMs in the ATNEA Registry is similar to those reported in other series. In our registry, patients with functional NETs and local/locoregional tumors have higher probability of SPMs. The low number of patients, selection bias and other etiologic factors of SPMs may have influenced our results.

[Acetabular anteversion angle of the hip in the Mexican adult population measured with computed tomography]. / Angulo de anteversión acetabular de la cadera en población adulta mexicana medida por tomografía computada.

BACKGROUND: Knowledge of the radiogrametric characteristics of a specific skeletal segment in a healthy population is of the utmost clinical importance. The main justification for this study is that there is no published description of the radiogrametric parameter of acetabular anteversion in a healthy Mexican adult population. MATERIAL AND METHODS: A prospective, descriptive and cross-sectional study was conducted. Individuals of both genders older than 18 years and orthopedically healthy were included. They underwent a two-dimensional axial tomographic study of both hips to measure the acetabular anteversion angles. The statistical analysis consisted of obtaining central trend and scatter measurements. A multivariate analysis of variance (ANOVA) and statistical significance were performed. RESULTS: 118 individuals were studied, 60 males and 58 females, with a mean age of 47.7 +/- 16.7, and a range of 18-85 years. The anteversion of the entire group was 18.6 degrees + 4.1 degrees. Anteversion in males was 17.3 degrees +/- 3.5 degrees (10 degrees - 25 degrees) and in females 19.8 degrees +/- 4.7 degrees (10 degrees - 31 degrees). There were no statistically significant differences (p < or = 0.05) in right and left anteversion in the entire group. However, there were statistically significant differences (p > or = 0.005) both in the right and left sides when males and females were compared. CONCLUSIONS: Our study showed that there are great variations in the anteversion ranges of a healthy population. When our results are compared with those published by other authors the mean of most measurements exceeds 15 degrees. This should be useful to make therapeutic decisions that involve acetabular anteversion.

Physical activity of poor urban women in Cali, Colombia: a comparison of working and not working women.

We have previously presented evidence that the physical activity level (PAL) and total energy expenditure (per kg body weight) of poor urban women who "work" (engage in income-earning activities) is similar to those who do not "work" (but do tend to household and childcare responsibilities) (Spurr et al. [1996] Am J Clin Nutr 63:870-878; [1997] Med Sci Sports Exerc 29:1255-1262). These findings were unexpected and raised questions regarding the actual types of activities engaged in by the two groups. In this article we address those questions by comparing the time allocation of the two groups. Time allocation during waking hours (14.2 +/- 1.1 hours/day) was recorded in minute-by-minute diaries by trained observers for two consecutive days for 52 working women and 28 not-working women. The working women were engaged in predominately informal sector economic activities, such as street vending, childcare, and domestic service, in addition to their own household and childcare responsibilities. The activities of the not-working women were largely restricted to household and childcare responsibilities. The working women tended to spend less time in resting activities and TV-watching and more time in travel and miscellaneous work activities, but other between-group differences were not significant. We conclude that the time allocation of working women is similar to that of not-working women because 1) many of the activities engaged in are the same or similar, and 2) some working women are only engaged in income-earning activities for limited time periods.

Energy intake and expenditure of free-living, lactating Colombian women in an urban setting.

OBJECTIVES: To examine the components of energy balance during lactation in a population of economically disadvantaged women in an urban developing country setting in order to better understand the metabolic response to lactation. DESIGN: Cross-sectional comparison of lactating (LACT) and non-pregnant non-lactating (NPNL) women. Body size and composition were assessed via anthropometry, energy intake was measured using estimated diet records and energy expenditure using indirect calorimetry and the Flex-Heart Rate method. SETTING: Low-income neighborhoods of Cali, Colombia. SUBJECTS: Lactating women (n=15) studied at 2.4+/-0.8, 5.5+/-0.8 and 8.9+/-1.2 months postpartum, and NPNL women (n=48) studied in three measurement rounds at 0, 3.5+/-0.6 and 7.1+/-1.0 months. RESULTS: There were no significant differences between LACT and NPNL women in anthropometric dimensions, but LACT women showed decreases in waist-hip ratio, lean body mass and increases in mid-arm circumference and percentage body fat with time. Energy intake was higher in LACT women (P=0.04), but there were no significant between-group differences in energy expenditure variables. CONCLUSION: This group of women met the cost of lactation principally via increased energy intake.

Energy intake and expenditure of free-living, pregnant Colombian women in an urban setting.

BACKGROUND: This study examined the components of energy balance in poor, free-living pregnant women living in an urban setting of a developing country. OBJECTIVES: We tested the following hypotheses: 1) energy intake increases in pregnancy and is greater than when nonpregnant and nonlactating (NPNL), 2) basal metabolic rate (BMR) increases in pregnancy and the increase is positively correlated with prepregnancy fatness, and 3) energy expenditure in activity decreases in pregnancy and is lower than in NPNL women. DESIGN: Pregnant women were studied at 14.8 +/- 3.4 (n = 40), 25.0 +/- 3.2 (n = 54), and 34.9 +/- 2.4 (n = 43) wk gestation, and NPNL women at baseline (n = 114) and at 3 (n = 103) and 6 (n = 93) mo. Energy intake was measured by using estimated diet records and energy expenditure by using the flex heart rate method. Time allocation in physical activity was assessed by observation. RESULTS: In pregnant women, body weight, BMR, and energy intake increased but total daily energy expenditure (TDEE) did not change significantly. There were no significant changes in time allocation to selected activities except for lying down. In comparison with NPNL control subjects, women in late pregnancy had higher energy intakes and BMRs. Values for TDEE were not significantly different, but pregnant women expended less energy in activity and allocated more time to 2 energy-saving activities and less time to 2 energy-demanding activities. CONCLUSION: A decrease in energy expenditure in activity and changes in time allocation are important ways in which pregnant women meet the energy demands of pregnancy.

Estimating energy intake of urban women in Colombia: comparison of diet records and recalls.

As part of a larger study of energy-nutrition, we compared the performance of 24 h diet recalls with estimated diet records kept by trained observers. The subjects were economically disadvantaged women (n = 85) in the city of Cali, Colombia. A 24 h recall and an estimated diet record were collected for each woman at 0 and approximately 3 and 6 months. Energy intake obtained from the estimated dietary records was validated against energy expenditure and used as the reference method. Energy and macronutrient intake were calculated from published food composition tables and proximate analyses of common foods. The number of food items consumed per woman per day, total and in each of 16 food groups, was tabulated. Energy and macronutrient intakes were 11-13% lower in the 24 h recalls. The discrepancy energy could be largely accounted for by the lower number of food items in the recalls. The number of food items in eight of 16 food groups was significantly lower in the recalls compared to the records. Underreporting on the recalls was a general tendency in these subjects and not clearly related to average energy intake. We conclude that 24 h diet recalls underestimate energy and nutrient intake in this population and are not suitable for studies of human energetics.

Gastrointestinal parasitic infection, anthropometrics, nutritional status, and physical work capacity in Colombian boys.

This article tests the hypothesis that the presence of gastrointestinal parasites in Colombian boys is negatively associated with anthropometric characteristics, physical work capacity, blood hemoglobin (Hb) levels, and nutritional status. Anthropometric, Hb, &Vdot;O(2) max, and parasite load data were collected on 1,016 boys in Cali, Colombia. The boys were classified as lower socioeconomic class (SEC) from either urban or rural environments, and upper SEC from an urban environment. Sixty-three percent of the boys were infected with gastrointestinal parasites and, of the infected boys, 80-95% had light parasite loads. Parasites found included Necator americanus, Ascaris lumbricoides, Entamoeba histolytica, Trichuris trichiura, Giardia spp., and Enterobius vermicularis. Infected boys had significantly lower weight, stature, weight-for-height (among 6-9-year-old boys), Hb levels, and &Vdot;O(2) max (ANCOVA, controlling for age and SEC). In terms of nutritional status, infected boys were 1.47 times more likely to be classified as iron deficient than noninfected boys (chi-square, P < 0.001), and 1.61 times more likely to be classified as stunted (P < 0.001). Infection was not associated with wasting in any SEC group. In conclusion, light to moderate gastrointestinal parasite loads were associated with significantly lower weight, stature, weight-for-height (in 6-9-year-old boys), Hb levels, and &Vdot;O(2) max, and a significantly higher frequency of IDA and stunting. These data suggest that comprehensive analyses of the nutritional status of populations in regions endemic for parasitic infection should include testing for the presence of infection. Am. J. Hum. Biol. 11:763-771, 1999. Copyright 1999 Wiley-Liss, Inc.

Increased muscular efficiency during lactation in Colombian women.

OBJECTIVE: To determine the muscular efficiency of lactating women and compare it to that of nonpregnant, nonlactating (NPNL) women. DESIGN: The study was retrospective. The subjects were selected randomly in the two groups and studied on three occasions (rounds) separated by approximately three months. SUBJECTS: There were 109, 101, and 80 NPNL women and 45, 31 and 16 lactating women in rounds 1, 2 and 3 respectively, 19-43 y of age, living under economically deprived conditions in Cali, Colombia, who participated in the study. METHODS: Muscular efficiency was measured as delta efficiency on a cycle ergometer. RESULTS: Muscular efficiency was significantly higher in lactating women in all three rounds compared to NPNL women. In six women it was possible to measure efficiency at variable times prior to their pregnancies, and again during lactation about three months post partum. There was a statistically significant (P = 0.03) increase in muscular efficiency during lactation. CONCLUSION: Lactation results in about a 5% increase in muscular efficiency which may contribute to the adaptation of the mother to the increased energy demands associated with lactation.

PIP: The muscular efficiency of low-income lactating women living in Cali, Colombia, was compared to that of nonpregnant, nonlactating women from the same neighborhoods in a retrospective study that involved 3 rounds separated by about 3 months. Rounds 1, 2, and 3 (occurring at an average of 2.4, 5.3, and 8.6 months postpartum) included 109, 101, and 80 nonpregnant, nonlactating women, respectively, and 45, 31, and 16 lactating women, respectively. Muscular efficiency, measured as delta efficiency on a cycle ergometer, was significantly higher among lactating than nonlactating, nonpregnant women in all 3 rounds. In the 6 women in whom it was possible to measure muscular efficiency at variable times prior to their pregnancy as well as at 3 months postpartum, there was a statistically significant increase in muscular efficiency during lactation. Overall, lactation resulted in about a 5% increase in muscular efficiency. This phenomenon may contribute to the adaptation of the mother to the increased energy demands associated with breast feeding.

Understanding the nutrition of poor urban women: ethnographic and biological approaches.

To better understand how women respond to conditions of urban poverty in a developing country a sample of 85 women living in Cali, Colombia was studied. Anthropometric indicators of nutritional status were normal for the group. However, many women indicated that they did not always have sufficient money to purchase food, and described the strategies they used when financial resources were inadequate. These strategies included changes in meal composition, reductions in food portion size, and reductions in the number of meals eaten. Evidence of the use of these strategies was identified in 17.1% of all diet records (n = 509). The adequate nutritional status of this group of women suggests that their strategies were usually successful in maintaining adequate energy intake, but the frequent use of these strategies suggests that the women are potentially at risk for undernutrition.

Living on the edge: dietary strategies of economically impoverished women in Cali, Colombia.

Economically impoverished women in Cali, Colombia, have restricted access to food in a city where food is abundant. Ethnographic observations, interviews and 2 day food records were used to better understand the coping strategies used by a group of these women (n = 85) to maintain adequate levels of energy intake. Anthropometric indicators of nutritional status were normal for the group. Interview data revealed that the ability to purchase food was a concern for 58% of the women. When faced with a restricted ability to purchase food, the women indicated they made compromises in meal composition, reduced portion sizes, and/or reduced the number of meals. They also relied on relatives, friends, neighbors, store credit, or local government programs for access to food. Changes in meal composition were identified in 17.1% of all diet records (n = 509). Low energy intake (defined as energy intake < or = 1.27 x BMR) was identified in 17.1% of all diet records. Carbohydrate consumption was significantly greater on low-energy intake days. The adequate nutritional status of this group of women suggests that their coping strategies are usually adequate to maintain energy intake, but the presence of uncertainty, the frequency of compromises in diet composition, and the frequency of low-energy intake days suggest that these women are at risk for undernutrition.

Energy expenditure of urban Colombian women: a comparison of patterns and total daily expenditure by the heart rate and factorial methods.

The heart rate and factorial methods of measuring both total daily energy expenditure (TDEE) and the daily pattern of energy expenditure (EE) were compared in nonpregnant, nonlactating women aged 19-43 y living in urban conditions of economic deprivation. The methods were applied on each of 2 successive days. There were no significant differences between the 2 d by either method. Women who worked at their household chores at home (n = 29) and those who also worked for remuneration (at work) in various kinds of employment (n = 23) were compared. The factorial method gave values for TDEE and for the pattern of EE that were significantly lower than those obtained by the heart rate method. This was related to lower values for EE for certain activities obtained from the literature than for values measured in these subjects. Women at work had significantly higher values for both TDEE and for the pattern of EE than did those at home. The TDEE at home by the heart rate method was 8.83 +/- 1.94 MJ/d and at work was 9.99 +/- 1.91 MJ/d (P = 0.036); this difference disappeared when adjusted for body weight or fat-free mass. Physical activity levels were 1.83 +/- 0.43 for women at home and 1.90 +/- 0.46 for women at work, which indicate moderate to heavy work. The factorial method should be used with measured EE values in the present subject population. The heart rate method can detect differences in TDEE and in the pattern of EE between women engaged in different activities and may offer an experimental approach to the study of the effects of daily variations in EE on nutritional energy intake.

[Traumatic rupture of the aorta. A report of a case operated on with success]. / Sección traumática de la aorta. Presentación de un caso operado con éxito.

The purpose of this paper is to present the case of a patient with traumatic rupture of the aorta, that was diagnosed and treated successfully. We describe the clinical data and diagnostic procedures of this case and we analyze the diagnostic and treatment aspects in accordance to the review of the literature. If, as in this case, the lesion does not extend through the adventitia and the entity is suspected based on the mechanism of the traumatism, a successful surgical treatment is feasible. This can be done by only clamping the aorta and doing the repair without an atrium to aorta by-pass, as was done in this case with no complications, or with the use of such a by-pass with a centrifugal pump with which it might be possible to prevent, in some cases, the paraplegia that can be associated with the clamping of the aorta. We conclude that a high degree of suspicion and a precise surgical technique are mandatory for a successful treatment of a traumatic rupture of the aorta.

Body composition of Colombian women.

Measurements of anthropometry and total body water (TBW) were made in 99 women 19-44 y of age living in socioeconomically deprived circumstances in Cali, Colombia. TBW was measured by dilution of deuterium oxide. An empirical equation for estimating lean body mass (LBM) was derived and applied satisfactorily to an independent study group. Comparisons were also made with body-composition values obtained by the Durnin and Womersley equations and an equation derived from rural women living in Guatemala. Neither set of equations was suitable for use with the Colombian subjects because both significantly overestimated LBM and therefore underestimated body fat. Lower values of standing height in older women suggest that they may have been subjected to more severe undernutrition during their growth than the younger subjects. When compared with a group of US women, Colombian subjects were less physically fit and had greater subcutaneous-fat deposits, which were distributed over the trunk and limbs, whereas body mass indexes and waist-hip ratios were not significantly different.

Variation of the basal metabolic rate and dietary energy intake of Colombian women during 1 y.

Anthropometry, basal and resting metabolic rates (BMR and RMR), and dietary energy intake were measured on five occasions approximately 3 mo apart for 1 y in 21 nonpregnant, non-lactating women 20-42 y of age living under deprived economic conditions in Cali, Colombia. There was a significant increase in body weight (1-1.5 kg) because of increased body fat during the last two rounds of measurement. BMR was elevated in the first round but fell to stable values that did not vary significantly from 3 to 12 mo. The intraindividual CV of BMR was 8.3% whereas the intraindividual CV of dietary energy intake was 17%. Measured BMR was closely related to the BMR estimates provided by the empirical equations of Schofield, but significantly higher than estimates from the equations of Henry and Rees. RMR-BMR ratios were very close to those published by FAO/WHO/UNU. Autocorrelation analysis of BMR showed weak ability to predict subsequent variation of BMR over time and is consistent with random variation of the data.

Anthropometry and secular changes in stature of urban Colombian women of differing socioeconomic status.

Anthropometric dimensions were taken on 1,572 women, 18-44 years of age, from Cali, Colombia, from three different socioeconomic (SEC) groups: low (LEC), mid-low (MLEC), and upper (UEC). LEC and MLEC women were significantly shorter and had higher body mass indices (BMIs) than UEC women, and a significantly larger number had BMIs over 27.3 kg/m2 . There were no significant differences between SEC groups for skinfolds on the arm, but skinfolds on the trunk, the subscapular-triceps ratio, and the waist-hip ratio followed an inverse SEC gradient, indicating a greater tendency for upper body fat distribution in the lower SEC groups. SEC differences in body fatness and fat distribution diminished with age, suggesting that health risks associated with obesity and an upper body fat distribution may be similar in all three groups by ages 40-44 years. Secular changes in stature were similar, 0.12 cm/year for LEC/MLEC women and 0.15 cm/year for UEC women, and there was no indication that the statural differences between the groups is diminishing. The results indicate that women from Cali exhibit anthropometric characteristics seen in both developing countries (stature positively associated with SEC) and developed countries (fatness and centralized fat distribution inversely related to SEC). These findings may reflect the relative economic prosperity of Colombia as a "developing country". © 1994 Wiley-Liss, Inc.

V̇ O 2 max and nutritional status in Urban Colombian girls and women.

Maximal oxygen consumption (V̇ O 2 max, liters min-1 ) was measured in 60 nutritionally normal and 74 marginally undernourished girls 6-16 years of age and 27 upper socioeconomic (UEC) women and 22 women living in economically deprived conditions (LEC) in Cali, Colombia. All girls were recruited from the LEC neighborhoods. Lower values for V̇ O 2 max (liters min-1 ) in undernourished girls were replaced by a nutritionally normal status in adulthood in which V̇ O 2 max was not significantly different from that measured in UEC women. Physical condition varied from average to fair in the younger to older subjects compared to women from industrialized countries. When V̇ O 2 max is expressed as ml min-1 kg-1 of lean body mass (LBM), all age and group effects disappear, confirming regression analysis which demonstrated a close relationship (r2 = 0.81) between V̇ O 2 max (liters min-1 ) and LBM in which there were no significant differences between nutritional or socioeconomic groups. © 1994 Wiley-Liss, Inc.