Patritumab deruxtecan in untreated hormone receptor-positive/HER2-negative early breast cancer: final results from part A of the window-of-opportunity SOLTI TOT-HER3 pre-operative study.

BACKGROUND: Patritumab deruxtecan (HER3-DXd) is a human epidermal growth factor receptor 3 (HER3)-directed antibody-drug conjugate composed of a fully human anti-HER3 monoclonal antibody (patritumab) covalently linked to a topoisomerase I inhibitor payload via a stable, tumor-selective, tetrapeptide-based cleavable linker. TOT-HER3 is a window-of-opportunity study designed to assess the biological activity, measured by CelTIL score [= -0.8 × tumor cellularity (in %)  + 1.3  × tumor-infiltrating lymphocytes (TILs) (in %)], and clinical activity of HER3-DXd during short-term (21 days) pre-operative treatment in patients with primary operable HER2-negative early breast cancer. PATIENTS AND METHODS: Patients with previously untreated hormone receptor-positive/HER2-negative tumors were allocated to one of four cohorts according to baseline ERBB3 messenger RNA expression. All patients received one dose of HER3-DXd 6.4 mg/kg. The primary objective was to evaluate change from baseline in CelTIL score. RESULTS: Seventy-seven patients were evaluated for efficacy. A significant change in CelTIL score was observed, with a median increase from baseline of 3.5 (interquartile range, -3.8 to 12.7; P = 0.003). Among patients assessable for clinical response (n = 62), an overall response rate of 45% was observed (tumor measurement by caliper), with a trend toward an increase in CelTIL score among responders compared with non-responders (mean difference, +11.9 versus +1.9). Change in CelTIL score was independent of baseline ERBB3 messenger RNA and HER3 protein levels. Genomic changes occurred, including switching toward a less proliferative tumor phenotype based on PAM50 subtypes, suppression of cell proliferation genes, and induction of genes associated with immunity. Treatment-emergent adverse events were observed in 96% of patients (14% grade ≥3); most common were nausea, fatigue, alopecia, diarrhea, vomiting, abdominal pain, and neutrophil count decrease. CONCLUSIONS: A single dose of HER3-DXd was associated with clinical response, increased immune infiltration, suppression of proliferation in hormone receptor-positive/HER2-negative early breast cancer, and a tolerable safety profile consistent with previously reported results. These findings support further study of HER3-DXd in early breast cancer.

Vaginal birth after caesarean section before and during COVID-19 pandemic. Factors associated with successful vaginal birth.

BACKGROUND: The ratio of caesarean has been increasing considerably in many countries. Planning a vaginal birth after a previous caesarean is considered an important option for women in a subsequent pregnancy. AIMS: To analyse obstetric and neonatal outcomes in women in labour after caesarean section before and during the COVID-19 pandemic, and to determine factors associated with successful vaginal birth after caesarean (VBAC). METHODS: Observational cohort study of women in labour with history of caesarean section who gave birth between March 2019 and December 2020 in a tertiary hospital in southern Spain. Consecutive sampling was performed using the maternal birth database and a descriptive and inferential analysis of the study variables was carried out. Socio-demographic, obstetric and neonatal variables were compared between the pre-pandemic and pandemic periods. Multiple logistic regression analysis was performed to determine variables associated with VBAC success. FINDINGS: The VBAC success rate was 67.4%. The caesarean section rate was significantly higher during the COVID-19 pandemic period. Factors associated with VBAC success were: birth before the pandemic (OR 0.32) and at night (OR 0.45), use of epidural analgesia (OR 2.14), and having had a previous vaginal birth (OR 1.98). CONCLUSIONS: The success rate of VBAC was lower during the pandemic. Knowledge of the factors related to VBAC success is critical for practitioners when supporting women in decision-making about mode of birth after a previous caesarean section.

Nutrient database improvement project: Separable components and proximate composition of raw and cooked retail cuts from the beef loin and round.

Beef nutrition research has become increasingly important domestically and internationally for the beef industry and its consumers. The objective of this study was to analyze the nutrient composition of ten beef loin and round cuts to update the nutrient data in the USDA National Nutrient Database for Standard Reference. Seventy-two carcasses representing a national composite of Yield Grade, Quality Grade, sex classification, and genetic type were identified from six regions across the U.S. Beef short loins, strip loins, tenderloins, inside rounds, and eye of rounds (NAMP # 173, 175, 190A, 169A, and 171C) were collected from the selected carcasses and shipped to three university meat laboratories for storage, retail fabrication, and raw/cooked analysis of nutrients. Sample homogenates from each animal were analyzed for proximate composition. These data provide updated information regarding the nutrient status of beef, in addition, to determining the influence of Quality Grade, Yield Grade, and sex classification on nutrient composition.

Nutrient database improvement project: the influence of USDA quality and yield grade on the separable components and proximate composition of raw and cooked retail cuts from the beef chuck.

This study was designed to provide updated information on the separable components, cooking yields, and proximate composition of retail cuts from the beef chuck. Additionally, the impact the United States Department of Agriculture (USDA) Quality and Yield Grade may have on such factors was investigated. Ultimately, these data will be used in the USDA - Nutrient Data Laboratory's (NDL) National Nutrient Database for Standard Reference (SR). To represent the current United States beef supply, seventy-two carcasses were selected from six regions of the country based on USDA Yield Grade, USDA Quality Grade, gender, and genetic type. Whole beef chuck primals from selected carcasses were shipped to three university laboratories for subsequent retail cut fabrication, raw and cooked cut dissection, and proximate analyses. The incorporation of these data into the SR will improve dietary education, product labeling, and other applications both domestically and abroad, thus emphasizing the importance of accurate and relevant beef nutrient data.

Nutrient database improvement project: the influence of U.S.D.A. Quality and Yield Grade on the separable components and proximate composition of raw and cooked retail cuts from the beef rib and plate.

Beef nutrition is important to the worldwide beef industry. The objective of this study was to analyze proximate composition of eight beef rib and plate cuts to update the USDA National Nutrient Database for Standard Reference (SR). Furthermore, this study aimed to determine the influence of USDA Quality Grade on the separable components and proximate composition of the examined retail cuts. Carcasses (n=72) representing a composite of Yield Grade, Quality Grade, gender and genetic type were identified from six regions across the U.S. Beef plates and ribs (IMPS #109 and 121C and D) were collected from the selected carcasses and shipped to three university meat laboratories for storage, retail fabrication, cooking, and dissection and analysis of proximate composition. These data provide updated information regarding the nutrient content of beef and emphasize the influence of common classification systems (Yield Grade and Quality Grade) on the separable components, cooking yield, and proximate composition of retail beef cuts.

Leishmaniasis mucocutánea con afectación laríngea / Mucocutaneous leishmaniasis with laryngeal involvement

La leishmaniasis es la infección producida por protozoos del género Leishmania. Presenta diferentes formas clínicas, dentro de las cuales, la leishmaniasis mucocutánea es una de las que conlleva mayor gravedad debido al compromiso de la vía aérea superior, que puede producir secuelas incapacitantes e incluso la muerte. Presentamos el caso de un paciente con diagnóstico de leishmaniasis mucocutánea con importante compromiso laríngeo, el cual tuvo excelente respuesta al tratamiento con antimoniales pentavalentes (AU)

Leishmaniasis is an infection caused by protozoa of the genus Leishmania. Mucocutaneous leishmaniasis is one of the clinical forms that presents more severity, due to the involvement of the upper airway, which can lead to incapacitating consequences or even death. We report the case of a patient with diagnosis of mucocutaneous leishmaniasis with significant laryngeal involvement which had excellent response to treatment with pentavalent antimonials (AU)

Comparison of quality attributes of shell eggs subjected to directional microwave technology.

Microwaves have been shown to cause thermal as well as nonthermal destruction of pathogens such as Salmonella, which can be found in shell eggs. The objective of this study was to determine if using microwave technology would cause detrimental quality effects in shell eggs. Treatments included control (no treatment) and microwave-treated (20 s) shell eggs. There were no differences in mineral content, fatty acid profile, Haugh units, broken-out score, yolk index, emulsion stability, pH of whole egg, and foaming capacity between 2 treatments (P >or= 0.05). At 0 and 30 d, there were no noticeable differences in H(2)O activity between 2 treatments. The foaming stability and albumen thermocoagulation of microwave-treated eggs were significantly higher than control eggs (P or= 0.05). Therefore, microwave technology can be applied to shell eggs without causing detrimental effects to quality.

Preparation and characterization of composite polyaniline materials for catalytic purposes.

Composite film electrodes were prepared by open-circuit Pt deposition on polymeric PANI films that were electrosynthesized from aniline acid solutions with suspended carbon particles (CPs). Gold, nickel, and a Ni-based alloy, Nichrome, were used as substrates, and carbon particles, carbon nanotubes (CNT), and Vulcan XC-72R carbon black, suspended in the monomer acid solution, were incorporated into the film. Pt particles were dispersed on films grown on Ni-based substrates by deposition from a Pt(IV) acid solution at open circuit (OC). CNT trapped into the PANI films have a favorable influence on Pt dispersion. The novel composite electrodes showed significant catalytic activity for methanol oxidation.

CO adsorption on copper in alkaline electrolytes: an electrochemical and ellipsometric study.

The influence of CO on the passive behavior of copper was analyzed in the potential region near the rest potential in borax solutions (pH 9.2) by cyclic voltammetry, ellipsometry, and surface charge determination techniques. The oxide formation is explained as a sequence of Cu(2)O growth, cation adsorption, Cu(II), and dissolution steps, similarly to previously reported investigations for the metal in free CO solutions. The CO adsorption hinders the cationic defect in the outer oxide layer and accelerates the Cu(2)O growth both at open circuit and in controlled potential experiments. The isoelectric point, iep, obtained at pH 10.8 for both the metal Cu and CuO particles in KCl solutions shifts to pH 10.1 for copper particles in the presence of CO. The iep indicates a CuO coating on Cu metallic particles in the absence of CO.

Symptomatic gastrointestinal amyloidosis in an HIV-infected patient.

We report a rare case of symptomatic GI amyloidosis in an HIV-infected patient who ultimately developed uncontrollable upper GI bleeding. Gastric and jejunal biopsies revealed amyloidosis. Although the patient's history suggested the possibility of secondary amyloidosis, immunohistochemical staining together with serum electrophoresis and immunofixation revealed the presence of lambda light chains indicating primary amyloidosis.

Epithelioid leiomyoma of the vulva.

Smooth muscle tumors are uncommon lesions of the vulva and represent a variety of histologic types. When encountered, surgical treatment is guided by the malignant potential of the tumors. This article presents the case of a 45-year-old woman who underwent conservative excision of a 10-cm vulvar lesion consistent with benign epithelioid leiomyoma. This unusual case provides an opportunity to review the clinical and pathologic features of this uncommon variant of leiomyoma and to describe the recently suggested pathologic criteria for determining the malignant potential of smooth muscle tumors arising in the vulva. Knowledge of these criteria can guide the clinician in selecting the appropriate management.

[Hysteroscopy in infertility]. / Histeroscopia en infertilidad.

An evaluation of hysteroscopy as complementary study of the sterile couple, was carried out; the hysteroscopic findings were compared with laparoscopic findings, and with Hysterosalpingography (HSG); it was a longitudinal, retrospective study of 20 patients. In the obstetrical antecedents there were 58 gestations, 50 of which ended in abortion. From de five normal cavities by HSG four were for hysteroscopy. As compared with hysteroscopy, HSG detected only 75% of submucous myomas, 85% of walls, 100% of IUD's fragments and of cervical incompetences. In the case of sinechias it was confirmed by hysteroscopy 80% of the diagnosed by HSG. The only case of endometrial polyp was detected by hysteroscopy. Surgical procedures were carried out in 40%, with complications in 16.6%. It was conclude that hysteroscopy is a complementary method, but necessary, in the study of the sterile couple with the possibility at the same time of being a therapeutic method.

[Hemodynamic repercussion of epidural bupivacaine in thoracic injuries]. / Repercusión hemodinámica de la bupivacaína epidural en los traumatismos torácicos.

Systemic and pulmonary hemodynamic effects of 8 to 10 ml of 0.25% bupivacaine containing 1:200,000 adrenaline administered at the midthoracic level were prospectively assessed in 20 patients (aged 45 +/- 16 years) with thoracic trauma presenting 6 +/- 2 rib fractures and pulmonary contusion of different extent and radiologic density. The study was carried out at comparable evolving times, 24 h after trauma, during the second or third day of treatment, and when the hemodynamic stability of the patient was achieved. Hemodynamic measurements were performed before and 30 min after administration of the analgesic agent using a Swan-Ganz catheter. The results indicate that administration of moderate doses of epidural bupivacaine at the middle thoracic level in patients with normovolemic thoracic traumatism were not followed by alterations in the hemodynamic function except for a slight decrease in systemic arterial and pulmonary pressure. The mean arterial pressure decreased by 8% (p less than 0.05), the cardiac index showed a 4% reduction (p = 0.05), and the mean pulmonary pressure experienced a 14% decrease (p less than 0.05).

Somatomedins in adolescence: a cross-sectional study of the effect of puberty on plasma insulin-like growth factor I and II levels.

To explore the effect of puberty on the somatomedins (SMs), a group of insulin-like peptides which mediate the action of GH on skeletal tissue, we measured SM-C/insulin-like growth factor-I (SM-C/IGF-I) and IGF-II by specific RIAs in 110 adolescents between the ages of 10 and 18 yr. All subjects were in good health and between the 5th and 95th percentiles for height. In both females and males, SM-C/IGF-I levels rose during puberty to a peak approximately 3-fold higher than the average adult level. The rise in SM-C/IGF-I levels corresponded better with the Tanner stage of the adolescents than with their chronological age. IGF-II levels did not rise during puberty and were slightly below adult levels. The dramatic rise in SM-C/IGF-I levels during puberty suggests a role for this SM peptide in the adolescent growth spurt. Furthermore, these data indicate that proper interpretation of SM-C/IGF-I levels during adolescence must include a knowledge of the patient's pubertal development.

Laparoscopia abierta. Analisis de 60 casos. / Open laparoscopy. Analysis of 60 cases

Sesenta pacientes las cuales presentaban alguna contraindicacion relativa para efectuar una laparoscopia, como cirugia abdominal previa y obesidad, fueron manejadas con laparoscopia abierta, mediante una tecnica simple, la cual no requiere intrumental especial. La tecnica se efectuo para comprobar la facilidad de ejecucion de la misma en pacientes con cirugia previa y obesidad. Importantes adherencias subincisionales fueron encontradas en el 15.6 por ciento de las pacientes con incisiones abdominales previas. No se apreciaron efectos colaterales de importancia. El tiempo quirurgico para la colocacion de la camisa del laparoscopio asi como la ejecucion del neumoperitoneo y cirugia fue entre 10 y 20 minutos. Las complicaciones observadas despues del procedimiento fueron de tipo infeccioso leve y a nivel de piel en tres pacientes. No hubo ninguna laparoscopia fallida con esta tecnica. La laparoscopia abierta es una tecnica confiable en particular para pacientes obesas y en aquellas con antecedentes de cirugias abdominales previas

Salpingoclasia por minilaparotomia postaborto espontaneo. / Salpingochlasia by minilaparotomy after spontaneous abortion

Se presenta la revision de 200 casos de oclusion tubaria bilateral por minilaparotomia, postaborto espontaneo no infectado, con un seguimiento a un ano. El 45 por ciento de las pacientes tenian la experiencia de un aborto previo. Se encontro util realizar la salpingoclasia aprovechando el mismo tiempo anestesico-quirurgico de el legrado uterino y emplear la tecnica de Pomeroy. Se encontro que pueden ser causa de complicaciones el aborto con DIU in situ, la falta de empleo de un movilizador uterino en uteros intrapelvicos, la obesidad de la paciente y la falta de experiencia del cirujano. Hubo un caso de embarazo lo que implica una falla del 0,5 por ciento.La esterilizacion postaborto debe formar parte importante de los programas de planificacion familiar