Timing of breast cancer surgery in relation to menstrual cycle phase: No effect on three-year prognosis: The ITS Study

Background: The effect of breast cancer surgery timing during the menstrual cycle on prognosis remains controversial. We conducted a multi-centre prospective study to establish whether timing of interventions influences prognosis. We report three-year overall and disease-free survival (OS/DFS) results for ‘primary analysis’ patients (regular cycles, no oral contraceptives within previous six months). Methods: Data were collected regarding timing of interventions in relation to patients’ last menstrual period (LMP) and first menstrual period after surgery (FMP). Hormone profiles were also measured. Cox’s Proportional Hazards model incorporated LMP in continuous form. Exploratory analyses used menstrual cycle categorisations of Senie, Badwe and Hrushesky. Hormone profiles with LMP and FMP data were also used to define menstrual cycle phase. Results: 412 ‘primary analysis’ patients were recruited. Three-year OS from first surgery was 90.7%, 95% confidence interval (CI) [87.9%, 93.6%]. Menstrual cycle according to LMP was not statistically significant (OS hazard ratio (HR)=1.02, 95%CI [0.995,1.042], p=0.14; DFS HR=1.00, 95%CI [0.980,1.022], p=0.92). Conclusion: Timing of surgery in relation to menstrual cycle phase had no significant impact on three-year survival. This may be due to 97% of patients receiving some form of adjuvant therapy. Survival curves to 10 years indicate results may remain true for longer-term survival

Importance of Nutrition Intervention in Autistic Patients

Along with the issues of inflated social and financial burden associated with autism spectrum disorder (ASD), specific treatment for this disorder has also not been developed. Having a thorough look at previous trials done to treat autism, we find that nutrition intervention had been used frequently as a complementary form of therapy. Indeed, an early diagnosis of nutrition deficiency and metabolic disorders done concomitantly with accurate therapeutic interventions can be a cornerstone for improving cognitive and behavioral aptitudes of people with autism. Several studies have showed that increasing the intake of specific nutrients can reduce the symptoms and comorbidities associated with autism. Consequently, nutrition intervention and appropriate supplementation can be crucial in managing and treating autism. This paper will discuss recent literature on the significance of metabolic aspects in autistic disorder and highlight the influence of nutrition intervention on the symptoms of autism