Breast Cancer Mortality in Older and Younger Patients in California

BACKGROUND: Breast cancer in younger patients is reported to be more aggressive and associated with lower survival; however, factors associated with age-specific mortality differences have not been adequately assessed. METHODS: We used data from the population-based California Cancer Registry for 38,509 younger (18-49 years) and 121,573 older (50 years and older) women diagnosed with stage I to III breast cancer, 2005-2014. Multivariable Cox regression models were used to estimate breast cancer-specific mortality rate ratios (MRR) and 95% confidence intervals (CI), stratified by tumor subtype, guideline treatment, and care at an NCI-designated cancer center (NCICC). RESULTS: Older breast cancer patients at diagnosis experienced 17% higher disease-specific mortality than younger patients, after multivariable adjustment (MRR = 1.17; 95% CI, 1.11-1.23). Higher MRRs (95% CI) were observed for older versus younger patients with hormone receptor (HR)(+)/HER2(-) (1.24; 1.14-1.35) and HR(+)/HER2(+) (1.38; 1.17-1.62), but not for HR(-)/HER2(+) (HR = 0.94; 0.79-1.12) nor triple-negative breast cancers (1.01; 0.92-1.11). The higher mortality in older versus younger patients was diminished among patients who received guideline-concordant treatment (MRR = 1.06; 95% CI, 0.99-1.14) and reversed among those seen at an NCICC (MRR = 0.86; 95% CI, 0.73-1.01). CONCLUSIONS: Although younger women tend to be diagnosed with more aggressive breast cancers, adjusting for these aggressive features results in older patients having higher mortality than younger patients, with variations by age, tumor subtype, receipt of guideline treatment, and being cared for at an NCICC. IMPACT: Higher breast cancer mortality in older compared with younger women could partly be addressed by ensuring optimal treatment and comprehensive patient-centered care

A Sensitive Branched DNA HIV-1 Signal Amplification Viral Load Assay with Single Day Turnaround

Branched DNA (bDNA) is a signal amplification technology used in clinical and research laboratories to quantitatively detect nucleic acids. An overnight incubation is a significant drawback of highly sensitive bDNA assays. The VERSANT® HIV-1 RNA 3.0 Assay (bDNA) (“Versant Assay”) currently used in clinical laboratories was modified to allow shorter target incubation, enabling the viral load assay to be run in a single day. To dramatically reduce the target incubation from 16–18 h to 2.5 h, composition of only the “Lysis Diluent” solution was modified. Nucleic acid probes in the assay were unchanged. Performance of the modified assay (assay in development; not commercially available) was evaluated and compared to the Versant Assay. Dilution series replicates (>950 results) were used to demonstrate that analytical sensitivity, linearity, accuracy, and precision for the shorter modified assay are comparable to the Versant Assay. HIV RNA-positive clinical specimens (n = 135) showed no significant difference in quantification between the modified assay and the Versant Assay. Equivalent relative quantification of samples of eight genotypes was demonstrated for the two assays. Elevated levels of several potentially interfering endogenous substances had no effect on quantification or specificity of the modified assay. The modified assay with drastically improved turnaround time demonstrates the viability of signal-amplifying technology, such as bDNA, as an alternative to the PCR-based assays dominating viral load monitoring in clinical laboratories. Highly sensitive bDNA assays with a single day turnaround may be ideal for laboratories with especially stringent cost, contamination, or reliability requirements

Anthropometric measures at different ages and endometrial cancer risk

BACKGROUND: Endometrial cancer is strongly associated with body mass index (BMI), but the influence of BMI history and of different types of obesity is uncertain. METHODS: A case\u2013control study was carried out in Italy including 454 cases and 908 controls admitted to hospital for acute non-hormone-related conditions. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using multivariate logistic and spline regression models. RESULTS: The OR for BMI 430 at diagnosis compared with 20 to o25 kgm 2 was 4.08 (95% CI: 2.90\u20135.74). The association for BMI was monotonic with a possible steeper increase for BMI above 28. Conversely, waist-to-hip ratio (WHR) showed a bell shaped curve with increased OR (2.10; 95% CI: 1.43\u20133.09) in the intermediate tertile only. After stratification by BMI at diagnosis, history of weight loss and BMI at age 30 did not influence endometrial cancer risk. History of obesity in middle age had a weak and not significant adverse effect among obese women (OR\ubc1.60; 95% CI: 0.52\u20134.96). CONCLUSION: The predominant importance of recent weight compared to lifetime history, justifies encouraging weight reduction in women at any age

Associations of Cumulative Sun Exposure and Phenotypic Characteristics with Histologic Solar Elastosis

Solar elastosis adjacent to melanomas in histologic sections is regarded as an indicator of sun exposure although the associations of ultraviolet (UV) exposure and phenotype with solar elastosis are yet to be fully explored

Tracto retinohipotalamico en el conejo

Circadian rhythms are fluctuations with a period around 24 hrs and the most remarkable in humans is the awake-sleep cycle. In mammals these rhythms are under control of a master clock in the suprachiasmatic nucleus (SCN), in the brain. However these rhythms are endogenous, need to be synchronized to the external light-dark cycles in order to have an adaptive value for the individuals. Photic external information is transmitted through retinohypothalamic tract, a bundle of fibers from retina to SCN. In the present contribution we analyzed the anatomy and ontogenetic development of this tract in rabbits in two conditions, when their main synchronizer is food (postnatal days 1 and 9) and in adults when their main synchronizer is light, with aid of the tracer cholera toxin ß. Retinohypothalamic tract is present at postnatal days 1 and 9 when eyelids are closed and presents a gradual development; scarce fibers on postnatal day 1, but on day 9 it has a dense innervation, similar to adult subjects. It remains to determine whether the tract is functional at postnatal day 1 and 9, i.e., if responds to photic stimulation when the main synchronizer at these age is food, not light.Los ritmos circádicos son variaciones que ocurren en un período de aproximadamente 24 horas y el más notable en nuestra especie es el ciclo sueño-vigilia. En los mamíferos dichos ritmos están controlados por un reloj maestro que se localiza en el núcleo supraquiasmático (NSQ), ubicado en el cerebro. Estos ritmos son endógenos pero necesitan sincronizarse a los ciclos externos de luz-oscuridad para que tengan una función adaptativa a los organismos. La información fótica externa es transmitida a través del tracto retinohipotalámico, una haz de fibras que va de la retina hasta el núcleo NSQ. En el presente trabajo se estudió la anatomía y el desarrollo ontogenético de dicho tracto en el conejo en dos condiciones, cuando su sincronizador principal es el alimento (día postnatal 1 y 9) y en adultos cuando su principal sincronizador es la luz, con el trazador ß toxina de cólera. El tracto está presente desde los días 1 y 9 postnatal cuando los individuos aún no abren los ojos y presenta un desarrollo gradual de inervación en el NSQ. Esto es en el día 1 se observan escasas fibras en el núcleo, pero en el día 9 ya se observa una intensa inervación, la cual es similar a la del adulto. Sin embargo se debe determinar si tanto en el día 1 y 9 dicha inervación ya es funcional, esto es, si responde a la estimulación fótica ya que el principal sincronizador de estos sujetos es el alimento y no la luz