Combination of phenotype and polygenic risk score in breast cancer risk evaluation in the Spanish population: a case -control study.

BACKGROUND: In recent years, the identification of genetic and phenotypic biomarkers of cancer for prevention, early diagnosis and patient stratification has been a main objective of research in the field. Different multivariable models that use biomarkers have been proposed for the evaluation of individual risk of developing breast cancer. METHODS: This is a case control study based on a population-based cohort. We describe and evaluate a multivariable model that incorporates 92 Single-nucleotide polymorphisms (SNPs) (Supplementary Table S1) and five different phenotypic variables and which was employed in a Spanish population of 642 healthy women and 455 breast cancer patients. RESULTS: Our model allowed us to stratify two groups: high and low risk of developing breast cancer. The 9th decile included 1% of controls vs 9% of cases, with an odds ratio (OR) of 12.9 and a p-value of 3.43E-07. The first decile presented an inverse proportion: 1% of cases and 9% of controls, with an OR of 0.097 and a p-value of 1.86E-08. CONCLUSIONS: These results indicate the capacity of our multivariable model to stratify women according to their risk of developing breast cancer. The major limitation of our analysis is the small cohort size. However, despite the limitations, the results of our analysis provide proof of concept in a poorly studied population, and opens up the possibility of using this method in the routine screening of the Spanish population.

Vesicular nanostructures composed of oleic acid and phosphatidylcholine: Effect of pH and molar ratio.

Phospholipids and fatty acids are the main building blocks of biological membranes. Oleic acid is a monounsaturated omega-9 fatty acid commonly found in many natural sources. Its characteristic kinked structure grants this molecule with a great number of biological properties. To better understand the role that this kind of fatty acids play into phospholipid membranes, nanostructured systems formed with hydrogenated soy phosphatidylcholine and oleic acid were studied in this work by means of cryo-electron microscopy, dynamic light scattering and differential scanning calorimetry. Differences concerning size, morphology and phase behavior were found when those systems were prepared at different conditions of pH and molar ratio between both compounds. Broadly, it was seen how alkaline mediums and high proportions of oleic acid reduced the size of the structures and increased the fluidity of the membranes. The ease of preparation of these lipid systems, and the response to pH suggests a future use of these systems as model membranes or delivery systems.

[A current overview of the teaching of Tropical Medicine, International Health and Global Health in the Spanish university]. / Panorama actual de la enseñanza de la Medicina Tropical, Salud Internacional y Salud Global en la universidad española.

OBJECTIVE: The teaching of tropical medicine, international health or global health in the Spanish Schools of Medicine and Pharmacy is unknown. The objective of this study is to show a current overview of teaching in degree and post-graduate. METHODS: The curricula are reviewed, identifying those subjects and postgraduate courses with the denomination "Tropical Medicine", "International Health", "Global Health" or "Imported Diseases". RESULTS: In 15 of the 40 (37.5%) schools of Medicine the subject of Tropical Medicine, International Health or Global Health is taught during the degree. In 14 of them (93.3%) with an optional character and in one (6.7%) with obligatory character. In 4 out of 22 (18.1%) Pharmacy schools are taught in the degree of Tropical Medicine, International Health or Global Health. CONCLUSIONS: The teaching in Tropical Medicine, International Health and Global Health in the Schools of Medicine and Pharmacy in Spain has, currently, a limited presence.

Dark Matter Search Results from the PICO-60 C_{3}F_{8} Bubble Chamber.

New results are reported from the operation of the PICO-60 dark matter detector, a bubble chamber filled with 52 kg of C_{3}F_{8} located in the SNOLAB underground laboratory. As in previous PICO bubble chambers, PICO-60 C_{3}F_{8} exhibits excellent electron recoil and alpha decay rejection, and the observed multiple-scattering neutron rate indicates a single-scatter neutron background of less than one event per month. A blind analysis of an efficiency-corrected 1167-kg day exposure at a 3.3-keV thermodynamic threshold reveals no single-scattering nuclear recoil candidates, consistent with the predicted background. These results set the most stringent direct-detection constraint to date on the weakly interacting massive particle (WIMP)-proton spin-dependent cross section at 3.4×10^{-41} cm^{2} for a 30-GeV c^{-2} WIMP, more than 1 order of magnitude improvement from previous PICO results.

Quantitative image analysis to characterize the dynamics of Listeria monocytogenes biofilms.

This work shows that the combination of two-dimensional (2D) and three-dimensional (3D) analyses of images acquired by confocal laser scanning microscopy facilitates the quantitative spatiotemporal characterization of architectures formed by Listeria monocytogenes biofilms. In particular, the analysis of structural features such as maximum thickness, biovolume, areal porosity and maximum diffusion distance allowed elucidating differences in biofilm formation of three L. monocytogenes strains (L1A1, CECT5873 and CECT4032). The analysis showed a common sequence for all strains. In the first phase, independent clusters evolve to interconnected clusters and honeycomb-like structures. Flat biofilms characterized the second phase. The structures disappear in the third phase. Nevertheless, the duration of the phases differed from strain to strain. L1A1 strain exhibited the slowest dynamics and the thickest biofilms while the strain CECT4032 presented the faster dynamics and the thinnest biofilms. Also, the number of dead cells varies significantly from strain to strain. From the results of the analysis, it can be concluded that 2D parameters are critical to differentiating morphological features while 3D parameters ease the interpretation and comparative study of the different phases during the life cycle of biofilms.

Dark Matter Search Results from the PICO-2L C3F8 Bubble Chamber.

New data are reported from the operation of a 2 liter C3F8 bubble chamber in the SNOLAB underground laboratory, with a total exposure of 211.5 kg days at four different energy thresholds below 10 keV. These data show that C3F8 provides excellent electron-recoil and alpha rejection capabilities at very low thresholds. The chamber exhibits an electron-recoil sensitivity of <3.5×10(-10) and an alpha rejection factor of >98.2%. These data also include the first observation of a dependence of acoustic signal on alpha energy. Twelve single nuclear recoil event candidates were observed during the run. The candidate events exhibit timing characteristics that are not consistent with the hypothesis of a uniform time distribution, and no evidence for a dark matter signal is claimed. These data provide the most sensitive direct detection constraints on WIMP-proton spin-dependent scattering to date, with significant sensitivity at low WIMP masses for spin-independent WIMP-nucleon scattering.

Numerical spatio-temporal characterization of Listeria monocytogenes biofilms.

As the structure of biofilms plays a key role in their resistance and persistence, this work presents for the first time the numerical characterization of the temporal evolution of biofilm structures formed by three Listeria monocytogenes strains on two types of stainless-steel supports, AISI 304 SS No. 2B and AISI 316 SS No. 2R. Counting methods, motility tests, fluorescence microscopy and image analysis were combined to study the dynamic evolution of biofilm formation and structure. Image analysis was performed with several well-known parameters as well as a newly defined parameter to quantify spatio-temporal distribution. The results confirm the interstrain variability of L. monocytogenes species regarding biofilm structure and structure evolution. Two types of biofilm were observed: homogeneous or flat and heterogeneous or clustered. Differences in clusters and in attachment and detachment processes were due mainly to the topography and composition of the two surfaces although an effect due to motility was also found.

Tratamiento del cáncer de próstata y cáncer renal con fármacos orales (abiraterona y antiangiogénicos): posicionamiento de la Asociación Española de Urología / Treatment of prostate and renal cancer with oral drugs (abiratarone and antiangiogenic agents): Positioning statement from the Spanish Association of Urology

No disponible

Mesenteric vein thrombosis after laparoscopic sleeve gastrectomy.

Mesenteric vein thrombosis is a rare complication of bariatric laparoscopic surgery. We report a case of a 47-year-old man with obesity who had mesenteric vein thrombosis 14 days after laparoscopic sleeve gastrectomy. He was treated with heparin anticoagulation with a good therapeutic response. This case and literature review illustrate that mesenteric vein thrombosis has to be included in the differential diagnosis of abdominal pain after a bariatric procedure and listed formally as a complication of bariatric surgery.

Comparison between the resistance of benzalkonium chloride-adapted and -nonadapted biofilms of Listeria monocyogenes to modified atmosphere packaging and nisin once transferred to mussels.

Benzalkonium chloride-adapted and -nonadapted Listeria monocytogenes biofilm cells were transferred by contact to cooked or live mussels and packed in rich CO(2) and O(2), respectively. The viabilities of transferred cells during storage of these packed samples at 2.5 °C were compared. In addition, in cooked mussels the combined effect of CO(2) and nisin against the survival of L. monocytogenes was also studied by using a first-order factorial design. The results obtained demonstrated that biofilms formed by benzalkonium chloride-adapted L. monocytogenes cells could be more resistant to the application of modified atmospheres rich in CO(2) and nisin once they have been transferred to cooked mussels by contact (simulating cross-contamination). This implies an increase in the risk associated with the presence of these cells in food processing plants. Significant empirical equations obtained after 7, 11, and 20 days showed an inhibitory effect of CO(2) and nisin against L. monocytogenes. However, a significant positive interaction between both variables highlights an incompatibility between CO(2) and nisin at high concentrations. Results also demonstrated that L. monocytogenes could persist after cross-contamination during the processing of live mussels, so L. monocytogenes is of concern as a contaminant in live mussels packaged in high-O(2) atmospheres.

Resistance to benzalkonium chloride, peracetic acid and nisin during formation of mature biofilms by Listeria monocytogenes.

Increase of resistance to the application of benzalkonium chloride (BAC), peracetic acid (PA) and nisin during biofilm formation at 25 °C by three strains of Listeria monocytogenes (CECT 911, CECT 4032, CECT 5873 and BAC-adapted CECT 5873) in different scenarios was compared. For this purpose, resistance after 4 and 11-days of biofilm formation was quantified in terms of lethal dose 90% values (LD(90)), determined according with a dose-response logistic mathematical model. Microscopic analyses after 4 and 11-days of L. monocytogenes biofilm formation were also carried out. Results demonstrated a relation between the microscopic structure and the resistance to the assayed biocides in matured biofilms. The worst cases being biofilms formed by the strain 4032 (in both stainless steel and polypropylene), which showed a complex "cloud-type" structure that correlates with the highest resistance of this strain against the three biocides during biofilm maturation. However, that increase in resistance and complexity appeared not to be dependent on initial bacterial adherence, thus indicating mature biofilms rather than planctonic cells or early-stage biofilms must be considered when disinfection protocols have to be optimized. PA seemed to be the most effective of the three disinfectants used for biofilms. We hypothesized both its high oxidizing capacity and low molecular size could suppose an advantage for its penetration inside the biofilm. We also demonstrated that organic material counteract with the biocides, thus indicating the importance of improving cleaning protocols. Finally, by comparing strains 5873 and 5873 adapted to BAC, several adaptative cross-responses between BAC and nisin or peracetic acid were identified.

Multidisciplinary approach and multimodal therapy in resected pancreatic cancer. Observational study.

OBJECTIVE: Analysis and evaluation of a multidisciplinary approach, postoperative results and survival of a group of patients with resected pancreatic cancer after a multimodal therapy. DESIGN: DESCRIPTIVE, prospective and observational study. PATIENTS: Between January 2004 and December 2004, 124 patients with pancreatic cancer were evaluated. In 30 patients pancreatic resection was performed, and they are the object of this study. Results of preoperative evaluation, postoperative morbidity and mortality, and long term survival were studied. RESULTS: Diagnostic evaluation was completed in ambulatory basis in 20% of the patients. In 63% of cases, admission was done in the same day of surgery. In 3 patients (9%), tumor resection was not achieved, therefore, concordance between radiological and surgical resectability rate was 91%. Resectability rate was 24.1%. Surgical Mortality was 3.3%, with a global morbidity rate of 56.6%. Survival at one, two, three and, four years was 76.2%, 56.3%, 43%, y 27.3% respectively. CONCLUSIONS: Technological development and coordination of efforts in multidisciplinary teams offer an accurate evaluation of tumor involvement, and may reduce the number of laparotomies without tumor resection. The application of a systematic and generalized multimodal treatment in pancreatic cancer is progressively showing a tendency of progressive increase in resectability and survival rates in pancreatic cancer.

Evaluación multidisciplinaria y tratamiento multimodal del cáncer de páncreas resecado. Estudio observacional / No disponible

Objetivo: analizar la evaluación del abordaje multidisciplinario de un grupo de pacientes con cáncer de páncreas resecado, los resultados postoperatorios y la supervivencia tras la aplicación de un tratamiento multimodal. Diseño: estudio descriptivo prospectivo observacional. Pacientes: entre enero de 2004 y diciembre 2009 se evaluaron 124 pacientes con cáncer de páncreas. De ellos, se realizó la resección pancreática con intención curativa en 30 casos que constituyen el objeto del estudio. Se analizaron los resultados del estudio preoperatorio de extensión tumoral, la morbi-mortalidad postoperatoria, y la supervivencia. Resultados: la evaluación diagnóstica se hizo en régimen ambulatorio en el 20% de los pacientes. En el 63% de los casos, el ingreso fue el mismo día de la intervención. En 3 pacientes intervenidos no se consiguió realizar la resección del tumor (9%), por lo que la tasa de concordancia entre la resecabilidad radiológica y la quirúrgica fue del 91%. La tasa de resecabilidad quirúrgica fue del 24,1%. La mortalidad quirúrgica de la serie fue de un 3,3%, con una morbilidad global del 56,6%. La supervivencia al año, dos, tres y cuatro años fue del 76,2%, 56,3%, 43%, y 27,3% respectivamente. Conclusiones: el desarrollo tecnológico y la evaluación multidisciplinar coordinada, permite realizar una evaluación precisa de la extensión tumoral, y puede reducir el número de laparotomías sin resección del tumor. Con la aplicación de una terapia multimodal sistemática combinada, la resecabilidad quirúrgica y la supervivencia a medio y largo plazo parece que están aumentando de forma progresiva(AU)

Objective: analysis and evaluation of a multidisciplinary approach, postoperative results and survival of a group of patients with resected pancreatic cancer after a multimodal therapy. Design: descriptive, prospective and observational study. Patients: between January 2004 and December 2004, 124 patients with pancreatic cancer were evaluated. In 30 patients pancreatic resection was performed, and they are the object of this study. Results of preoperative evaluation, postoperative morbidity and mortality, and long term survival were studied. Results: diagnostic evaluation was completed in ambulatory basis in 20% of the patients. In 63% of cases, admission was done in the same day of surgery. In 3 patients (9%), tumor resection was not achieved, therefore, concordance between radiological and surgical resectability rate was 91%. Resectability rate was 24.1%. Surgical Mortality was 3.3%, with a global morbidity rate of 56.6%. Survival at one, two, three and, four years was 76.2%, 56.3%, 43%, y 27.3% respectively. Conclusions: technological development and coordination of efforts in multidisciplinary teams offer an accurate evaluation of tumor involvement, and may reduce the number of laparotomies without tumor resection. The application of a systematic and generalized multimodal treatment in pancreatic cancer is progressively showing a tendency of progressive increase in resectability and survival rates in pancreatic cancer(AU)

A proteomic approach to cold acclimation of Staphylococcus aureus CECT 976 grown at room and human body temperatures.

Staphylococcus aureus is an important pathogenic microorganism that has been associated with serious infection problems in different fields, from food to clinic. In the present study, we have taken into account that the main reservoirs of this microorganism are the human body and some parts of food processing plants, which have normal temperatures of around 37 and 25°C, respectively. It can be expected that S. aureus must acclimate its metabolism to colder temperatures before growing in food matrices. Since temperature abuse for foods occurs at approximately 12°C, it is expected that S. aureus must acclimate its metabolism to colder temperatures before growing in food. For this reason, we have performed a proteomic comparison between exponential- and stationary-phase cultures of S. aureus CECT 976 acclimated to 12°C after growing at 25°C or 37°C. The analysis led to the identification of two different protein patterns associated with cold acclimation, denominated pattern A and pattern B. The first was characteristic of cultures at stationary phase of growth, grown at 25°C and acclimated to 12°C. The second appeared in the rest of experimental cases. Pattern A was distinguished by the presence of glycolytic proteins, whereas pattern B was differentiated by the presence of general stress and regulatory proteins. Pattern A was related through physiological experiments with a cross-resistance to acid pH, whereas pattern B conferred resistance to nisin. This prompted us to conclude that both molecular strategies could be valid, in vivo, for the process of acclimation of S. aureus to cold temperatures.

Effects of mussel processing soils on the adherence of Listeria monocytogenes to polypropylene and stainless steel.

A comparative study of adhesion kinetics of L. monocytogenes (strains CECT 5873, CECT 936, CECT 911, and CECT 4032, representing serotypes 1/2a, 1/2b, 1/2c, and 4b, respectively) to polypropylene (PP) and stainless steel (SS) under two surface contamination conditions in plants processing cooked mussel was carried out. The conditions were either (i) contamination of clean surfaces with mussel cooking juice carrying L. monocytogenes or (ii) contamination with L. monocytogenes after soiling with mussel cooking juice, i.e., conditioning film (CF). The kinetics of adhesion were successfully described by a modified logistic model. Adhesion to PP was higher than to SS in all strains, except CECT 5873. Adhesion was initially higher in the presence of CF, but numbers of adherent cells decreased sharply in the late phase of study in three of eight cases as a result of cell detachment. Combinations of strain, surface material, and surface conditioning where adhesion was most enhanced were defined as the worst-case scenarios (CECT 911-PP, 4032-PP-CF, 5873-SS, and 4032-SS-CF). Subsequently, adhesion in worst-case scenarios was compared with a similar contamination event taking place in plants processing live mussels, using intervalvar water of mussel as a food residue matrix. Adhesion levels were higher in intervalvar water than in cooking juice, especially in both cases with no CF; this was attributed to more space available for adhesion or to physicochemical conditions enhancing cells to adhere.

Application of nisin and pediocin against resistance and germination of Bacillus spores in sous vide products.

Sous vide and other mild preservation techniques are increasingly demanded by consumers. However, spores often will survive in minimally processed foods, causing both spoilage and safety problems. The main objective of the present work was to solve an industrial spoilage problem associated with two sous vide products: mushrooms and shellfish salad. Bacillus subtilis and Bacillus licheniformis predominated as the most heat-resistant organisms isolated from mushrooms and shellfish salad, respectively. The combined effects of nisin and pediocin against resistance and germination of both Bacillus species were described by empirical equations. Whereas nisin was more effective for decreasing thermal resistance of B. subtilis spores, pediocin was more effective against B. licheniformis. However, a significant positive interaction between both biopeptides for decreasing the proportion of vegetative cells resulting from thermoresistant spores was demonstrated in later experiments, thus indicating the increased efficacy of applying high concentrations of both bacteriocins. This efficacy was further demonstrated in additional challenge studies carried out at 15 degrees C in the two sous vide products: mushrooms and shellfish salad. Whereas no vegetative cells were detected after 90 days in the presence of bacteriocins, almost 100% of the population in nontreated samples of mushrooms and shellfish salad was in the vegetative state after 17 and 43 days of storage at 15 degrees C, respectively.

Actividad acuática adaptada en el tratamiento rehabilitador interdisciplinario de la esclerosis múltiple / Adapted aquatic activity in interdisciplinary rehabilitation treatment

Objetivos. Valorar el impacto físico y psicológico yla autonomía de las personas con esclerosis múltiple(EM) por medio de un programa de actividad acuáticaadaptada (AAA).Diseño. Un total de 25 pacientes ambulatorios(24 personas afectadas de EM y un afectado deesclerosis lateral amiotrófica) del Hospital de Día deEsclerosis Múltiple fueron incluidos en el programade AAA. El programa consistió en 12 sesiones de1 h por semana y consecutivas. Los datos clínicos concluían que el 54,2 % de los pacientes tenían una EM remitente-recurrente, el 33,3 % una EM secundariamente progresiva y el 12,5 % una EM primariamente progresiva. El 68% eran mujeres y el 32 %, hombres; la edad media:45 años; la media de la Escala Ampliada deDiscapacidad de Kurtzke (EDSS): 4,5. El rangode puntuaciones para el 12,5 % de los participantesfue de 1,0 a 3,5, y de 4,0 a 6,5 para el resto.Las escalas utilizadas al inicio y final del período detratamiento fueron el EDSS, la escala modificada de Ashworth, el test de Oxford, el test de Tinetti parala marcha, el Modified Rivermead Mobility Index, elMotor Assessment Scale y una encuesta de satisfaccióndel usuario.Resultados. Mejora estadísticamente significativa en lacalidad del patrón de marcha (Wilcoxon; z = –2,754;p = 0,006) y en la fuerza de las extremidades inferiores(Kolmogorov-Smirnov; z = 1,874; p = 0,002). Lamejora en el test Tinetti y del grado subjetivo de fatigase correlacionaron significativamente (U deMann-Whitney; p = 0,005).Conclusión. Estos resultados sugieren que nuestroprograma es beneficioso tanto a nivel objetivo comosubjetivo. A pesar de ello, la mayoría de losparticipantes refirieron no continuar con el programade AAA como hábito de salud por problemas deaccesibilidad. Se deberían conseguir soluciones paraeliminar estas barreras y promover la autonomía enpersonas discapacitadas con EM

Objective. To assess the impact of physical,psychological and autonomy conditions of personswith multiple sclerosis (PwMS) through an AdaptedAquatics Actitvity Program (AAAP).Methods. Twenty-five outpatients (twenty-four withMS and one with an amyothrophic lateral sclerosis)from the MS Day Hospital were included in theAAAP. The program consisted of 12 one-hour weeklyconsecutive sessions. Clinical data were: 54.2% of patients had a relapsing-remitting MS, 33.3 % had a secondary progressive MS and 12.5% had a primaryprogressive MS. 68% were female and 32% weremale; mean age: 45; mean Kurtzke ExpandedDisability Status Scale (EDSS): 4.5 The range ofscores for 12.5% of the patients was 1.0 to 3.5 and4.0 to 6.5 for the rest.Measurements assessed at the beginning and at theend of the period of treatment were EDSS, themodified Ashworth Scale, the Oxford test, the TinettiTest on walking, the modified Rivermead Mobility Index, the Motor Assessment Scale and a self satisfactionquestionnaire.Results. A statistically significant improvement wasobserved in the gait pattern (Wilcoxon; z = –2.754,p = 0.006) and in the strength of the lower limbs(Kolmogorov-Smirnov; z = 1.874, p = 0.002).The Tinetti score with the subjective fatigue degree score correlated significantly (U de Mann-Whitney;p = 0.005).Conclusions. The results suggested that our program isbeneficial using both objective and subjective scores. Inspite of the results, most participants did not continuewith the AAAP as a health activity because ofarquitectural barriers. More resources should be providedto eliminate such barriers in order to promote autonomyin handicapped PwMS

Adhesion and detachment kinetics of several strains of Staphylococcus aureus subsp. aureus under three different experimental conditions.

The kinetics of adhesion of five Staphylococcus aureus subsp. aureus strains (CECT 976, 4459, 4465, 4466 and 5191) to polypropylene at 25 degrees C in the absence of nutrients (PBS medium) were initially compared. Those strains with the highest (CECT 4459) and the lowest (CECT 976) adhesion levels were selected for further studying the effects of a nutrient-rich adhesion-promoting medium (TSB plus 1% glucose-TSBG) as well as of a conditioning film consisting of dried mussel cooking juices (MCJ) on adhesion to and detachment from polypropylene surfaces. Adhesion kinetics were properly described by an empirical model in the absence of conditioning film. The maximum adhesion level was much higher in the presence of TSBG than in PBS, decreasing sharply in both cases after 10-15 h. In contrast, adhesion increased exponentially during 25 h in the presence of dried MCJ. Clear differences were thus found in different media, and it suggests that cleaning strategies should vary under different conditions. The comparison of the adhesion strengths under the different experimental conditions showed that the persistence was highest when biofilms were formed on MCJ, which indicates that cells would remain longer as a source of cross-contamination. Some biofilms were examined by electronic microscopy, and different structures were observed under the different experimental conditions. It is concluded that the study of biofilm formation by S. aureus is necessary to establish efficient control systems in the food industry.

Action of different monoterpenic compounds against Anisakis simplex s.l. L3 larvae.

Different natural monoterpenes (geraniol, citronellol, citral, carvacrol, cuminaldehyde and eugenol) are studied in vitro against Anisakis simplex s.l. L3 larvae, employing perillaldehyde as a reference substance. Final concentrations used were: 12.50, 6.25 and 3.12 microg/ml for each of the tested products. The parameters average survival, survival 50 and maximum survival were determined at 4, 8, 24 and 48 hours after the start of the experiment. All tested products, except eugenol, were active at the highest concentration (12.50 microg/ml). The damage caused to A. simplex s.l. L3 was by examining histological sections. The antioxidant activity of the tested products by DPPH free radical scavenging does not appear to be associated with their larvicide activity against A. simplex s.l. L3.