Perinatal and childhood factors and risk of breast cancer subtypes in adulthood

BACKGROUND: Accumulated exposure to hormones and growth factors during early life may influence the future risk of breast cancer (BC). This study examines the influence of childhood-related, socio-demographic and anthropometric variables on BC risk, overall and by specific pathologic subtypes. METHODS: This is a case-control study where 1539 histologically-confirmed BC cases (23-85 years) and 1621 population controls, frequency matched by age, were recruited in 10 Spanish provinces. Perinatal and childhood-related characteristics were directly surveyed by trained staff. The association with BC risk, globally and according to menopausal status and pathologic subtypes, was evaluated using logistic and multinomial regression models, adjusting for tumor specific risk factors. RESULTS: Birth characteristics were not related with BC risk. However, women with high socioeconomic level at birth presented a decreased BC risk (OR=0.45; 95% CI=0.29-0.70), while those whose mothers were aged over 39 years at their birth showed an almost significant excess risk of hormone receptor positive tumors (HR+) (OR=1.35; 95% CI=0.99-1.84). Women who were taller than their girl mates before puberty showed increased postmenopausal BC risk (OR=1.26; 95% CI=1.03-1.54) and increased HR+ BC risk (OR=1.26; 95% CI=1.04-1.52). Regarding prepubertal weight, while those women who were thinner than average showed higher postmenopausal BC risk (OR=1.46; 95% CI=1.20-1.78), associated with HR+ tumors (OR=1.34; 95% CI=1.12-1.61) and with triple negative tumors (OR=1.56; 95% CI=1.03-2.35), those who were heavier than average presented lower premenopausal BC risk (OR=0.64; 95% CI=0.46-0.90) and lower risk of epidermal growth factor receptor positive tumors (OR=0.61; 95% CI=0.40-0.93). CONCLUSION: These data reflect the importance of hormones and growth factors in the early stages of life, when the mammary gland is in development and therefore more vulnerable to proliferative stimuli

Toenail zinc as a biomarker: Relationship with sources of environmental exposure and with genetic variability in MCC-Spain study

Background: Toenails are commonly used as biomarkers of exposure to zinc (Zn), but there is scarce information about their relationship with sources of exposure to Zn. Objectives: To investigate the main determinants of toenail Zn, including selected sources of environmental exposure to Zn and individual genetic variability in Zn metabolism. Methods: We determined toenail Zn by inductively coupled plasma mass spectrometry in 3,448 general popu-lation controls from the MultiCase-Control study MCC-Spain. We assessed dietary and supplement Zn intake using food frequency questionnaires, residential proximity to Zn-emitting industries and residential topsoil Zn levels through interpolation methods. We constructed a polygenic score of genetic variability based on 81 single nucleotide polymorphisms in genes involved in Zn metabolism. Geometric mean ratios of toenail Zn across categories of each determinant were estimated from multivariate linear regression models on log-transformed toenail Zn. Results: Geometric mean toenail Zn was 104.1 mu g/g in men and 100.3 mu g/g in women. Geometric mean toenail Zn levels were 7 % lower (95 % confidence interval 1-13 %) in men older than 69 years and those in the upper tertile of fibre intake, and 9 % higher (3-16 %) in smoking men. Women residing within 3 km from Zn-emitting industries had 4 % higher geometric mean toenail Zn levels (0-9 %). Dietary Zn intake and polygenic score were unrelated to toenail Zn. Overall, the available determinants only explained 9.3 % of toenail Zn variability in men and 4.8 % in women. Discussion: Sociodemographic factors, lifestyle, diet, and environmental exposure explained little of the indi-vidual variability of toenail Zn in the study population. The available genetic variants related to Zn metabolism were not associated with toenail Zn

Diagnóstico de la hipoacusia infantil en Navarra : detección precoz, procesos de derivación y tratamiento

La hipoacusia es un trastorno de la integración propioceptiva que viene dado por un trastorno en el aspecto sensorial periférico. Ante la necesidad de conseguir una mejora en la detección de las sorderas el Gobierno de Navarra mediante la Orden Foral 170-1998, de 16 de noviembre, ordenó la implantación del programa de detección precoz de la sordera en el que se definen los siguientes aspectos: 1.Bases para el establecimiento de un programa de detección precoz de la sordera congénita de carácter universal; 2. Características que debe reunir un programa universal de screening de la sordera; 3. Proceso del screening de la sordera; 4. Protocolo de diagnóstico y tratamiento; 5. Datos del screening neonatal en Navarra hasta agosto del 2002.NavarraBiblioteca General de Navarra; Calle Plaza San Francisco, s. n.; 31001 Pamplona;ES

Desarrollando las inteligencias múltiples a través del aprendizaje cooperativo

Seleccionado en la convocatoria: Proyecto de innovación e investigación educativa de centros docentes no universitarios, Gobierno de Aragón 2012-2013Proyecto cuyo objetivo es desarrollar unidades didácticas en las que cada alumno trabaje actividades acordes a su nivel de competencia curricular y desarrolle las competencias básicas prestando atención a las distintas inteligencias y basándose en el aprendizaje cooperativo. Inicialmente se evalúa el nivel del que parten los alumnos, para después crear grupos heterogéneos y establecer los objetivos para cada unidad didáctica. Ya en el aula se ponen en marcha estrategias y actividades adaptadas a cada grupo, tomando como base el libro de texto de cada asignaturaGobierno de Aragón. Departamento de Educación, Universidad, Cultura y DeporteAragónDirección General de Política Educativa y Educación Permanente; Avenida Gómez Laguna, 25, planta 2ª; 50009 Zaragoza; Tel. +34976715416; Fax +34976715496ES

Modulación en la expresión de biomarcadores (RE, RP y C-erbB2) en cáncer de mama tras tratamiento neoadyuvante

Introducción. El tratamiento oncológico pre y postoperatorio en pacientes con carcinoma de mama está condicionado entre otros factores, por el resultado del estudio inmunohistoquímico de los receptores hormonales y por la expresión de c-erbB2. El objetivo del estudio es determinar la influencia del tratamiento neoadyuvante en la expresión de receptores de estrógeno (RE), progesterona (PR) y c-erbB2. Material y métodos. Estudiamos 53 pacientes con cáncer de mama diagnosticadas mediante biopsia ¿trucut¿. Las pacientes con carcinoma localmente avanzado (20) se someten a quimioterapia preoperatoria. Se realiza extirpación quirúrgica en todos los casos. Comparamos la expresión de receptores de estrógeno (RE), receptores de progesterona (PR) y c-erbB2, en la biopsia¿trucut¿ y en la pieza quirúrgica. Resultados. Encontramos diferencias significativas en la expresión de RE, RP entre biopsia/pieza quirúrgica, comparando el grupo de pacientes sometidas a tratamiento neoadyuvante frente al grupo de pacientes sin tratamiento oncológico prequirúrgico. Encontramos diferencias de signo (positivización y negativización) entre un 10 y un 40% de casos en la expresión inmunohistoquímica para RE, RP y c-erbB2 entre la biopsia¿trucut¿ y la resección quirúrgica en las pacientes tratadas con neoadyuvancia. Estas diferencias de signo no tienen significación estadística

El trabajo cooperativo en el aula como método para desarrollar las competencias

Seleccionado en la convocatoria: Ayudas a la innovación e investigación educativa en centros docentes de niveles no universitarios, Gobierno de Aragón 2009-10El IES Cinco Villas de Ejea de los Caballeros en Zaragoza consolida el aprendizaje cooperativo en primero y segundo de la ESO. El objetivo es orientar los contenidos curriculares de las diferentes materias, secuenciados por niveles, a la adquisición de destrezas en el aprendizaje cooperativo consiguiendo así que los alumnos aprendan, además de contenidos, a trabajar juntos, aprovechando las potencialidades e intereses de cada uno, y desarrollando las competencias comunicativas, de autoaprendizaje, de cooperación y de habilidades sociales. La novedad en este curso es ampliar la implicación del profesorado de otras áreas y adaptar los materiales para el trabajo con las tecnologías de la información y comunicación: pizarra digital, ordenadores personales, tablets pc, etc. El alumnado ha trabajado en equipos cooperativos para optimizar su aprendizaje y el de sus compañeros, asumiendo roles y responsabilidades que les ha permitido tomar una mayor responsabilidad de su propio aprendizaje y en donde aplican, en proyectos reales, las habilidades y conocimientos adquiridos.Gobierno de Aragón. Departamento de Educación, Cultura y DeporteAragónDirección General de Política Educativa; Avda. Gómez Laguna, 25, planta 2; 50009 Zaragoza; Tel. +34976715416; Fax +34976715496ES

Validating a breast cancer score in Spanish women. The MCC-Spain study

A breast-risk score, published in 2016, was developed in white-American women using 92 genetic variants (GRS92), modifiable and non-modifiable risk factors. With the aim of validating the score in the Spanish population, 1,732 breast cancer cases and 1,910 controls were studied. The GRS92, modifiable and non-modifiable risk factor scores were estimated via logistic regression. SNPs without available genotyping were simulated as in the aforementioned 2016 study. The full model score was obtained by combining GRS92, modifiable and non-modifiable risk factor scores. Score performances were tested via the area under the ROC curve (AUROC), net reclassification index (NRI) and integrated discrimination improvement (IDI). Compared with non-modifiable and modifiable factor scores, GRS92 had higher discrimination power (AUROC: 0.6195, 0.5885 and 0.5214, respectively). Adding the non-modifiable factor score to GRS92 improved patient classification by 23.6% (NRI = 0.236), while the modifiable factor score only improved it by 7.2%. The full model AUROC reached 0.6244. A simulation study showed the ability of the full model for identifying women at high risk for breast cancer. In conclusion, a model combining genetic and risk factors can be used for stratifying women by their breast cancer risk, which can be applied to individualizing genetic counseling and screening recommendations

Validating a breast cancer score in Spanish women. The MCC-Spain study

A breast-risk score, published in 2016, was developed in white-American women using 92 genetic variants (GRS92), modifiable and non-modifiable risk factors. With the aim of validating the score in the Spanish population, 1,732 breast cancer cases and 1,910 controls were studied. The GRS92, modifiable and non-modifiable risk factor scores were estimated via logistic regression. SNPs without available genotyping were simulated as in the aforementioned 2016 study. The full model score was obtained by combining GRS92, modifiable and non-modifiable risk factor scores. Score performances were tested via the area under the ROC curve (AUROC), net reclassification index (NRI) and integrated discrimination improvement (IDI). Compared with non-modifiable and modifiable factor scores, GRS92 had higher discrimination power (AUROC: 0.6195, 0.5885 and 0.5214, respectively). Adding the non-modifiable factor score to GRS92 improved patient classification by 23.6% (NRI = 0.236), while the modifiable factor score only improved it by 7.2%. The full model AUROC reached 0.6244. A simulation study showed the ability of the full model for identifying women at high risk for breast cancer. In conclusion, a model combining genetic and risk factors can be used for stratifying women by their breast cancer risk, which can be applied to individualizing genetic counseling and screening recommendations