Obesidad y riesgo de recaídas en pacientes con Leucemia Linfoblástica Aguda: Estudio retrospectivo

Antecedentes: La obesidad se ha asociado con estado proinflamatorio de bajo grado que se ha relacionado con el desarrollo del cáncer en general incluyendo el hematológico. Objetivos: El presente trabajo tiene el objetivo de identificar la asociación del diagnóstico de obesidad acorde al índice de masa corporal (IMC) con indicadores pronóstico de pacientes adultos con Leucemia Linfoblástica Aguda (LAL). Pacientes y Método: Se trata de un estudio observacional, retrospectivo que incluyó pacientes hospitalizados con diagnóstico de LAL de linaje de células B. Se estimó el IMC con base al peso y talla registrado al ingreso de los pacientes. Se determinó el riesgo de recaídas, recaídas a médula ósea y supervivencia. Se utilizó el método de Kaplan-Meier mediante el test log-Rank en el análisis estadístico. Resultados: Se incluyeron 128 pacientes. El peso y el IMC no mostraron una asociación significativa con el riesgo de recaídas. La frecuencia de recaída a médula ósea fue del 43,8%. La obesidad no impactó con la supervivencia global (p = 0,640) ni en la supervivencia libre de enfermedad (p = 0,527). La presencia de obesidad no se comportó como una variable de riesgo de recaída (p = 0,873). El IMC con punto de corte de 30 kg/m2 no se comportó como un factor de riesgo de recaída (OR 1.078). Conclusión: La obesidad no es un factor de riesgo independiente para el pronóstico de los pacientes adultos portadores de Leucemia Linfoblástica Aguda de linaje B.

Background: Obesity has been associated with a low-grade proinflammatory state, and it has been related to the development of cancer in general, including hematologic cancer. Aim: The present work aimed to identify the association of the diagnosis of obesity according to the body mass index (BMI) with prognostic factors of adult patients with Acute Lymphoblastic Leukemia (ALL). Patients and Method: This observational, retrospective study included hospitalized patients diagnosed with ALL of the B-cell lineages. BMI was estimated based on the weight and height registered on clinical records at the admission of the patients. The relapse risk and bone marrow relapse were determined, and the survival rate was measured. The statistical analysis included the Kaplan-Meier method using the log-Rank test. Results: This study included 128 clinical records of patients. Weight had no significant association with relapse risk. The frequency of bone marrow relapse was 43.8%. Obesity did not impact overall survival (p = 0.640) or disease-free survival (p = 0.527). The presence of obesity does not behave as a relapse risk variable (p = 0.873). BMI with a 30 kg/m2 cut-off point did not influence relapse risk (OR 1.078). Conclusion: Obesity is not an independent risk factor for the prognosis of adult patients with Acute Lymphoblastic Leukemia B-lineage.

Surface Site Density of Synthetic Goethites and Its Relationship to Atomic Surface Roughness and Crystal Size.

The capacity for crystals to adsorb elements and molecules is a function of the structures of their crystal faces and the relative proportions of those faces. More importantly, this study shows that the surface structure of crystal faces is affected by their surface roughness and is the dominant factor controlling the absorption site density. In a continuation of the study of synthetic goethites with varying single crystal size distributions, two more synthetic goethites with intermediate sizes were analyzed by Brunauer-Emmett-Teller (BET) and atomic-resolution scanning transmission electron microscopy (STEM) to determine the effects of crystal size on their shape, atomic-scale surface roughness, and ultimately on their total surface site density. Results show that surface roughness scales directly with the size [or inversely with the specific surface area (SSA)] of synthetic goethites in the SSA range of 40-75 m2/g. This surface roughness, in turn, increases the total site density over ideal atomically smooth crystals. The total site density of synthetic goethite increases from a combination of decreasing crystal length/width ratio and increasing surface roughness.

[Obesity and risk of relapse in patients with Acute Lymphoblastic Leukemia: A retrospective study]. / Obesidad y riesgo de recaídas en pacientes con Leucemia Linfoblástica Aguda: Estudio retrospectivo.

BACKGROUND: Obesity has been associated with a low-grade proinflammatory state, and it has been related to the development of cancer in general, including hematologic cancer. AIM: The present work aimed to identify the association of the diagnosis of obesity according to the body mass index (BMI) with prognostic factors of adult patients with Acute Lymphoblastic Leukemia (ALL). PATIENTS AND METHOD: This observational, retrospective study included hospitalized patients diagnosed with ALL of the B-cell lineages. BMI was estimated based on the weight and height registered on clinical records at the admission of the patients. The relapse risk and bone marrow relapse were determined, and the survival rate was measured. The statistical analysis included the Kaplan-Meier method using the log-Rank test. RESULTS: This study included 128 clinical records of patients. Weight had no significant association with relapse risk. The frequency of bone marrow relapse was 43.8%. Obesity did not impact overall survival (p = 0.640) or disease-free survival (p = 0.527). The presence of obesity does not behave as a relapse risk variable (p = 0.873). BMI with a 30 kg/m2 cut-off point did not influence relapse risk (OR 1.078). CONCLUSION: Obesity is not an independent risk factor for the prognosis of adult patients with Acute Lymphoblastic Leukemia B-lineage.

Tropical tree mortality has increased with rising atmospheric water stress.

Evidence exists that tree mortality is accelerating in some regions of the tropics1,2, with profound consequences for the future of the tropical carbon sink and the global anthropogenic carbon budget left to limit peak global warming below 2 °C. However, the mechanisms that may be driving such mortality changes and whether particular species are especially vulnerable remain unclear3-8. Here we analyse a 49-year record of tree dynamics from 24 old-growth forest plots encompassing a broad climatic gradient across the Australian moist tropics and find that annual tree mortality risk has, on average, doubled across all plots and species over the last 35 years, indicating a potential halving in life expectancy and carbon residence time. Associated losses in biomass were not offset by gains from growth and recruitment. Plots in less moist local climates presented higher average mortality risk, but local mean climate did not predict the pace of temporal increase in mortality risk. Species varied in the trajectories of their mortality risk, with the highest average risk found nearer to the upper end of the atmospheric vapour pressure deficit niches of species. A long-term increase in vapour pressure deficit was evident across the region, suggesting that thresholds involving atmospheric water stress, driven by global warming, may be a primary cause of increasing tree mortality in moist tropical forests.

Tropical tree growth sensitivity to climate is driven by species intrinsic growth rate and leaf traits.

A better understanding of how climate affects growth in tree species is essential for improved predictions of forest dynamics under climate change. Long-term climate averages (mean climate) drive spatial variations in species' baseline growth rates, whereas deviations from these averages over time (anomalies) can create growth variation around the local baseline. However, the rarity of long-term tree census data spanning climatic gradients has so far limited our understanding of their respective role, especially in tropical systems. Furthermore, tree growth sensitivity to climate is likely to vary widely among species, and the ecological strategies underlying these differences remain poorly understood. Here, we utilize an exceptional dataset of 49 years of growth data for 509 tree species across 23 tropical rainforest plots along a climatic gradient to examine how multiannual tree growth responds to both climate means and anomalies, and how species' functional traits mediate these growth responses to climate. We show that anomalous increases in atmospheric evaporative demand and solar radiation consistently reduced tree growth. Drier forests and fast-growing species were more sensitive to water stress anomalies. In addition, species traits related to water use and photosynthesis partly explained differences in growth sensitivity to both climate means and anomalies. Our study demonstrates that both climate means and anomalies shape tree growth in tropical forests and that species traits can provide insights into understanding these demographic responses to climate change, offering a promising way forward to forecast tropical forest dynamics under different climate trajectories.

Group Membership and Social Identities in a Formative Intervention in a Mexican Hospital.

Formative intervention is a participatory methodology that supports organizational change by means of an interactive and systematic dialogue carried out by researchers and participants. In this process, the researchers contribute to expanding the conversational space in the organization by supporting participants in examining and reflecting on their own work practices, as well as in modeling, shaping, and experimenting with innovations. Drawing on transcripts of videotaped sessions, this study analyzes how change is discursively sustained by the researchers who conduct the meetings within a formative intervention in a Mexican hospital. The quantitative and qualitative analysis focuses on the collective pronoun "we" as a membership categorization device deployed by the researchers for rhetorical and pragmatical aims, such as questioning about the state of necessity for the intervention, engaging the participants, or introducing a proposal of innovation with the participants. Results show how group membership and social identity markers are used by researchers to support emerging forms of collaboration, involvement of participants and the creation of common ground during the intervention process. In terms of the practical implications of the study, an informed and strategic use of membership categorization devices used by the researcher can increase the effectiveness of their formative and expansive role.

Pathological Response and Survival in Triple-Negative Breast Cancer Following Neoadjuvant Carboplatin plus Docetaxel.

PURPOSE: Prognostic value of pathologic complete response (pCR) and extent of pathologic response attained with anthracycline-free platinum plus taxane neoadjuvant chemotherapy (NAC) in triple-negative breast cancer (TNBC) is unknown. We report recurrence-free survival (RFS) and overall survival (OS) according to degree of pathologic response in patients treated with carboplatin plus docetaxel NAC. PATIENTS AND METHODS: One-hundred and ninety patients with stage I-III TNBC were treated with neoadjuvant carboplatin (AUC6) plus docetaxel (75 mg/m2) every 21 days × 6 cycles. pCR (no evidence of invasive tumor in breast and axilla) and Residual cancer burden (RCB) were evaluated. Patients were followed for recurrence and survival. Extent of pathologic response was associated with RFS and OS using the Kaplan-Meier method. RESULTS: Median age was 51 years, and 52% were node-positive. pCR and RCB I rates were 55% and 13%, respectively. Five percent of pCR patients, 0% of RCB I patients, and 58% of RCB II/III patients received adjuvant anthracyclines. Three-year RFS and OS were 79% and 87%, respectively. Three-year RFS was 90% in patients with pCR and 66% in those without pCR [HR = 0.30; 95% confidence interval (CI), 0.14-0.62; P = 0.0001]. Three-year OS was 94% in patients with pCR and 79% in those without pCR (HR = 0.25; 95% CI, 0.10-0.63; P = 0.001). Patients with RCB I demonstrated 3-year RFS (93%) and OS (100%) similar to those with pCR. On multivariable analysis, higher tumor stage, node positivity, and RCB II/III were associated with worse RFS. CONCLUSIONS: Neoadjuvant carboplatin plus docetaxel yields encouraging efficacy in TNBC. Patients achieving pCR or RCB I with this regimen demonstrate excellent 3-year RFS and OS without adjuvant anthracycline.

Estructura de la vegetación leñosa en tres áreas con Selva Baja Caducifolia en el Istmo-Costa de Oaxaca, México / Woody vegetation structure in three areas with Tropical Dry Forest in the Isthmus-Coastal of Oaxaca, Mexico

Resumen La Selva Baja Caducifolia (SBC) es de gran importancia por su biodiversidad. En el Istmo-Costa de Oaxaca, México, se encuentran áreas con SBC y distinta categoría de protección (legislación mexicana): (1) Área Natural Protegida (ANP), (2) Área Destinada Voluntariamente para la Conservación (ADVC) y (3) Área de Uso Común (ADUC). En cada una de ellas se analizó la estructura de vegetación leñosa, plantas con DAP ≥ 2.5 cm, muestreando 15 parcelas de 100 m2. La riqueza observada fue de 90 especies incluidas en 36 familias y corresponde al 80 % (Jackknife) y 85 % (ICE) de la esperada. El análisis de agrupamiento identificó dos grupos con 90 % de disimilitud: el primero (G1) incluyó a todas las parcelas muestreadas del ANP; y el segundo (G2) aglomeró las del ADVC y ADUC. Los índices de Shannon, dominancia de Simpson y diversidad verdadera de Jost para el G1 fueron H'= 2.43, D= 0.21 y qD= 11 y para el G2, H'= 2.76, D= 0.28 y qD= 15, sin diferencias entre grupos (P < 0.05). Las especies con Valor de Importancia Relativa más elevado, en ambos grupos, corresponden a vegetación secundaria. La densidad de especies del G1 fue de 1 829 ind/ha y en el G2 de 2 370 ind/ha. Los promedios de altura (6.8 m) y área basal (19.7 m2/ha) del G1 no variaron significativamente (P < 0.05) con los del G2 (7.9 m y 22.1 m2/ha). Las ADVC y ADUC, semejantes en composición y estructura, difieren del ANP. Se sugiere seguir monitoreando la SBC.

Abstract Tropical dry forest (TDF) is important due to its biodiversity. In the Isthmus-Coastal region of the state of Oaxaca, in Southeast Mexico, there are many areas of TDF with varying categories of legal protection (1) Protected Natural Areas (PNA), (2) Voluntarily Designated Conservation Areas (VDCA) and (3) Areas of Common Use (ACU). In each of these, tree vegetation structure was analysed, recording plants with a DBH ≥ 2.5 cm and sampling 15 plots of 100 m2. Observed richness was 90 species, belonging to 36 families and corresponding to 80 % (Jackknife) and 85 % (ICE) of expected richness. A cluster analysis identified two groups with 90 % dissimilitude: the first (G1) included all the sampled plots in the PNA; and the second (G2), grouped together those from the VDCA and the ACU. The Shannon, Simpson dominance and Jost true diversity indices for G1 were H'= 2.43, D= 0.21 and qD= 11 and for G2, H'= 2.76, D= 0.28 and qD= 15 respectively, with no differences between groups (P < 0.05). The species that presented the highest relative importance value (RIV) in both groups, corresponded to secondary vegetation. Species density of G1 was 1 829 ind/ha and 2 370 ind/ha for G2. Mean height (6.8 m) and basal area (19.7 m2/ha) of G1 did not vary significantly (P < 0.05) when compared to G2 (7.9 m y 22.1 m2/ha). The VDCA and ACU presented similar composition and structure, differing from the PNA. Continual monitoring of the TDF is suggested. Rev. Biol. Trop. 66(2): 863-879. Epub 2018 June 01.

Ocular evisceration etiology / Etiología de evisceración ocular

Background: The aim of this paper was to determine the most common etiology of ocular evisceration in a tertiary-level hospital. Methods: Observational and retrospective study in the Ophthalmology Department from January 2013 to December 2016 at the Centro Médico Nacional Siglo XXI. Results: Of the 54 eviscerations, exogenous endophthalmitis was found 25.90%, ocular trauma 22.2%, painful blind eye 14.8%, perforated corneal ulcer and endogenous endophthalmitis both in 13% and perforated infectious corneal ulcers 11.1%; 70.4% were associated with systemic comorbidities and 79.6% were associated with ophthalmologic comorbidities. Conclusions: Exogenous endophthalmitis is the most frequent evisceration; the loss of an eyeball, has important social and labor impact, and economic for the Instituto Mexicano del Seguro Social.

Introducción: El objetivo de este trabajo fue describir la etiología más frecuente de evisceración ocular en un hospital de tercer nivel de atención. Métodos: Estudio observacional y retrospectivo en el servicio de Oftalmología del Hospital de Especialidades del CMN SXXI de enero del 2013 a diciembre del 2016. Resultados: De las 54 evisceraciones, se encontraron como causas principales: la endoftalmitis exógena (25.90%), el traumatismo ocular (22.2%), el ojo ciego doloroso (14.8%), la úlcera corneal perforada y la endoftalmitis endógena, ambas con 13%, así como las úlceras corneales perforadas infecciosas (11.1%); el 70.4% de estas causas estuvieron asociadas a comorbilidades sistémicas y el 79.6% a comorbilidades oftalmológicas. Conclusiones: Las endoftalmitis exógenas son las causas más frecuentes de evisceración; la pérdida de un globo ocular tiene importante repercusión social, laboral, y económico para el Instituto Mexicano del Seguro Social.

Efficacy of Neoadjuvant Carboplatin plus Docetaxel in Triple-Negative Breast Cancer: Combined Analysis of Two Cohorts.

PURPOSE: Recent studies demonstrate that addition of neoadjuvant (NA) carboplatin to anthracycline/taxane chemotherapy improves pathologic complete response (pCR) in triple-negative breast cancer (TNBC). Effectiveness of anthracycline-free platinum combinations in TNBC is not well known. Here, we report efficacy of NA carboplatin + docetaxel (CbD) in TNBC. EXPERIMENTAL DESIGN: The study population includes 190 patients with stage I-III TNBC treated uniformly on two independent prospective cohorts. All patients were prescribed NA chemotherapy regimen of carboplatin (AUC 6) + docetaxel (75 mg/m2) given every 21 days × 6 cycles. pCR (no evidence of invasive tumor in the breast and axilla) and residual cancer burden (RCB) were evaluated. RESULTS: Among 190 patients, median tumor size was 35 mm, 52% were lymph node positive, and 16% had germline BRCA1/2 mutation. The overall pCR and RCB 0 + 1 rates were 55% and 68%, respectively. pCRs in patients with BRCA-associated and wild-type TNBC were 59% and 56%, respectively (P = 0.83). On multivariable analysis, stage III disease was the only factor associated with a lower likelihood of achieving a pCR. Twenty-one percent and 7% of patients, respectively, experienced at least one grade 3 or 4 adverse event. CONCLUSIONS: The CbD regimen was well tolerated and yielded high pCR rates in both BRCA-associated and wild-type TNBC. These results are comparable with pCR achieved with the addition of carboplatin to anthracycline-taxane chemotherapy. Our study adds to the existing data on the efficacy of platinum agents in TNBC and supports further exploration of the CbD regimen in randomized studies. Clin Cancer Res; 23(3); 649-57. ©2016 AACR.

Efecto antibacteriano de tres cementos endodónticos usados en obturación retrógrada sobre tres especies bacterianas estudio in vitro / Antibacterial effect of three endodontics cements used in retrograde root-end filling on three bacterial species in vitro study

Objetivo: Determinar el efecto antibacteriano de tres cementos endodónticos (Super EBA, Ketac Endo y MTA) frente a tres especies bacterianas potencialmente patógenas de la pulpa y periápice radicular (Porphyromonas gingivalis, Streptococcus mutans y Enterococcus faecalis). Material y método: Las especies bacterianas fueron sembradas en 30 placas petri enriquecidas en sus propios medios; donde también se colocaron los respectivos cementos para luego en medios anaeróbicos ser expuestos en la incubadora a 37ºC y anotar el diámetro de los halos de inhibición a las 24, 48 y 168 horas como también las observaciones respectivas en las fichas de registro. Resultados: El efecto antibacteriano de los cementos estudiados se mantiene durante las 24 y 48 horas, mientras que para algunas bacterias se reduce levemente entre las 48 y 168 horas. Conclusiones: Los tres cementos presentaron efecto antibacteriano variable sobre las cepas estudiadas, siendo mayor el del Súper EBA, seguido por el Ketac Endo. El MTA tuvo el menor efecto antibacterial.

Objective: To determinate the antibacterial effect of three endodontics cements (Super EBA, Ketac Endo y MTA) on three potentially pathogenic bacterial species of the pulp and root (Porphyromonas gingivalis, Streptococcus mutans y Enterococcus faecalis). Material and Method: The bacterial species were planted in 30 Petri plates fortified in their own ways, where also were placed the cements; then they were taken to the incubator at 37ºC by anaerobic means; in order to take notes of the different diameters of the halos of inhibition and others observations at 24, 48 and 168 hours on the registration sheets. Results: The antibacterial effect of the study coments is maintained during the 24 and 48 hours, meanwhile to others bacterias it is reduce slawly between the 48 and 168 hours. Conclusions: The three cements presented variable antibacterial effects on the strains studied; being the largest for the Super EBA, followed by Ketac Endo and the lowest for the MTA.