Hormones and breast and endometrial cancers: preventive strategies and future research.

A number of hormonal approaches for prevention of endometrial and breast cancers have been proposed. Because of the hormonal responsiveness of both tumors, much attention has focused on effects of exogenous hormone use. Although estrogens in hormone replacement therapy increase the risk of endometrial cancer, the disease is substantially reduced by long-term use of oral contraceptives. The issues with breast cancer are more complex, mainly because of a variety of unresolved effects. Long-term estrogen use is associated with some increase in breast cancer risk, and certain patterns of oral contraceptives appear to predispose to early-onset disease. With respect to estrogens, preventive approaches for both tumors would include use for as limited periods of time as possible. Addition of a progestin appears to lower estrogen-associated endometrial disease, but its effect on breast cancer risk remains less clear. Additional studies on effects of detailed usage parameters should provide useful insights into etiologic mechanisms. Other preventive approaches for endometrial cancer that may work through hormonal mechanisms include staying thin, being physically active, and maintaining a vegetarian diet. Breast cancer risk may possibly be reduced by extended periods of breastfeeding, restriction of intake of alcoholic beverages, remaining thin later in life, and being physically active. Additional research is needed to clarify the biologic mechanisms of these associations. The bridging of epidemiology with the biologic sciences should clarify many unresolved issues and lead to better preventive approaches

An illustrated key to the Malacostraca (Crustacea) of the northern Arabian Sea. Part 3: Euphausiacea

The key includes twenty-one species of euphausiids belonging to two families and six genera. The key was prepared following Brinton (1975). Since several authors attributed a fundamental importance to thelycum in systematics of euphausiids therefore the available figures of thelycum are also included

Micro-class mobility: social reproduction in four countries

In the sociological literature on social mobility, the long-standing convention has been to assume that intergenerational reproduction takes one of two forms, either a categorical form that has parents passing on a big-class position to their children, or a gradational form that has parents passing on their socioeconomic standing to their children. These conventional approaches ignore in their own ways the important role that occupations play in transferring advantage and disadvantage from one generation to the next. In log-linear analyses of nationally representative data from the United States, Sweden, Germany, and Japan, we show that (a) occupations are an important conduit for reproduction, (b) the most extreme rigidities in the mobility regime are only revealed when analyses are carried out at the detailed occupational level, and (c) much of what shows up as big-class reproduction in conventional mobility analyses is in fact occupational reproduction in disguise. Although the four countries studied here differ in the extent to which the occupational form has been institutionalized, we show that it is too prominent to ignore in any of these countries. Even in Japan, which has long been regarded as distinctively 'deoccupationalized,' we find evidence of extreme occupational rigidities. These results suggest that an occupational mechanism for reproduction may be a fundamental feature of all contemporary mobility regimes. [author's abstract

Male breast cancer

Male breast cancer (MBC) is a rare disease representing less than 1% of all breast cancers (BC) and less than 1% of cancers in men. Age at presentation is mostly in the late 60s. MBC is recognized as an estrogen-driven disease, specifically related to hyperestrogenism. About 20% of MBC patients have family history for BC. Mutations in BRCA1 and, predominantly, BRCA2, account for approximately 10% of MBC cases. Because of its rarity, MBC is often compared with female BC (FBC). Based on age-frequency distribution, age-specific incidence rate patterns and prognostic factors profiles, MBC is considered similar to late-onset, postmenopausal estrogen/progesterone receptor positive (ER+/PR+) FBC. However, clinical and pathological characteristics of MBC do not exactly overlap FBC. Compared with FBC, MBC has been reported to occur later in life, present at a higher stage, and display lower histologic grade, with a higher proportion of ER+ and PR+ tumors. Although rare, MBC remains a substantial cause for morbidity and mortality in men, probably because of its occurrence in advanced age and delayed diagnosis. Diagnosis and treatment of MBC generally is similar to that of FBC. Men tend to be treated with mastectomy rather than breast-conserving surgery. The backbone of adjuvant therapy or palliative treatment for advanced disease is endocrine, mostly tamoxifen. Use of FBC-based therapy led to the observation that treatment outcomes for MBC are worse and that survival rates for MBC do not improve like FBC. These different outcomes may suggest a non-appropriate utilization of treatments and that different underlying pathogenetic mechanisms may exist between male and female BC

Vulnerability to bullying in children with a history of specific speech and language difficulties

This is an electronic version of an article published in Lindsay, Geoff and Dockrell, Julie and Mackie, Clare (2008) Vulnerability to bullying in children with a history of specific speech and language difficulties. European Journal of Special Needs Education, 23 (1). pp. 1-16. European Journal of Special Needs Education is available online at: http://www.informaworld.com/10.1080/0885625070179120

REDUCE-IT USA: Results From the 3146 Patients Randomized in the United States.

BackgroundSome trials have found that patients from the United States derive less benefit than patients enrolled outside the United States. This prespecified REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl - Intervention Trial) subgroup analysis was conducted to determine the degree of benefit of icosapent ethyl in the United States.MethodsREDUCE-IT randomized 8179 statin-treated patients with qualifying triglycerides ≥135 and <500 mg/dL and low-density lipoprotein cholesterol >40 and ≤100 mg/dL and a history of atherosclerosis or diabetes mellitus to icosapent ethyl 4 g/d or placebo. The primary composite end point was cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, or hospitalization for unstable angina. The key secondary composite end point was cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. A hierarchy was prespecified for examination of individual and composite end points.ResultsA total of 3146 US patients (38.5% of the trial) were randomized and followed for a median of 4.9 years; 32.3% were women and 9.7% were Hispanic. The primary composite end point occurred in 24.7% of placebo-treated patients versus 18.2% of icosapent ethyl-treated patients (hazard ratio [HR], 0.69 [95% CI, 0.59-0.80]; P=0.000001); the key secondary composite end point occurred in 16.6% versus 12.1% (HR, 0.69 [95% CI, 0.57-0.83]; P=0.00008). All prespecified hierarchical end points were meaningfully and significantly reduced, including cardiovascular death (6.7% to 4.7%; HR, 0.66 [95% CI, 0.49-0.90]; P=0.007), myocardial infarction (8.8% to 6.7%; HR, 0.72 [95% CI, 0.56-0.93]; P=0.01), stroke (4.1% to 2.6%; HR, 0.63 [95% CI, 0.43-0.93]; P=0.02), and all-cause mortality (9.8% to 7.2%; HR, 0.70 [95% CI, 0.55-0.90]; P=0.004); for all-cause mortality in the US versus non-US patients, Pinteraction=0.02. Safety and tolerability findings were consistent with the full study cohort.ConclusionsWhereas the non-US subgroup showed significant reductions in the primary and key secondary end points, the US subgroup demonstrated particularly robust risk reductions across a variety of individual and composite end points, including all-cause mortality.Clinical trial registrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT01492361

Families' social backgrounds matter : socio-economic factors, home learning and young children's language, literacy and social outcomes

Parental support with children's learning is considered to be one pathway through which socio-economic factors influence child competencies. Utilising a national longitudinal sample from the Millennium Cohort Study, this study examined the relationship between home learning and parents' socio-economic status and their impact on young children's language/literacy and socio-emotional competence. The findings consistently showed that, irrespective of socio-economic status, parents engaged with various learning activities (except reading) roughly equally. The socio-economic factors examined in this study, i.e., family income and maternal educational qualifications, were found to have a stronger effect on children's language/literacy than on social-emotional competence. Socio-economic disadvantage, lack of maternal educational qualifications in particular, remained powerful in influencing competencies in children aged three and at the start of primary school. For children in the first decade of this century in England, these findings have equity implications, especially as the socio-economic gap in our society widens

Hormonal content and potency of oral contraceptives and breast cancer risk among young women

A small study of women with early-onset breast cancer published in 1983 initially sparked the debate about combination oral contraceptives and breast cancer by suggesting that a woman's risk of breast cancer increased if she used oral contraceptives early in life, particularly pills with high progestin potency (Pike et al, 1983). Evidence from a multitude of case–control and cohort studies conducted in the 1980s and early 1990s subsequently found a modest (approximately 20–40%) but consistent excess in breast cancer risk associated with recent oral contraceptive use among women younger than 45 years of age (Collaborative Group on Hormonal Factors in Breast Cancer, 1996a). Whether this excess risk is ubiquitous for all pill types or attributable to specific oral contraceptive preparations is considerably less well studied