Managing menopausal symptoms and associated clinical issues in breast cancer survivors

Objective: Review evidence to guide management of menopausal signs and symptoms in women after breast cancer and make recommendations accordingly. Evidence: Randomized controlled clinical trials, observational studies, evidence-based guidelines, and expert opinion from professional societies. Background: Symptoms and clinical problems associated with estrogen depletion—sleep disorders, vulvovaginal atrophy (VVA), vasomotor symptoms (VMS), mood changes, depressive symptoms, cardiovascular disease, osteopenia, and osteoporosis—confront the estimated 9.3 million breast cancer survivors globally. Recommendations: Following breast cancer, women should not generally be treated with menopausal hormone therapy or tibolone but should optimize lifestyle. Women with moderate to severe symptoms may benefit from mind–brain behavior or nonhormone, pharmacologic therapy. The selective serotonin/noradrenaline reuptake inhibitors and gabapentenoid agents improve VMS and quality of life. For osteoporosis, nonhormonal agents are available. Treatment of VVA remains an area of unmet need. Low-dose vaginal estrogen is absorbed in small amounts with blood levels remaining within the normal postmenopausal range but could potentially stimulate occult breast cancer cells, and although poorly studied, is not generally advised, particularly for those on aromatase inhibitors. Intravaginal dehydroepiandrosterone and oral ospemiphene have been approved to treat dyspareunia, but safety after breast cancer has not been established. Vaginal laser therapy is being used for VVA but efficacy from sham-controlled studies is lacking. Therapies undergoing development include lasofoxifene, neurokinin B inhibitors, stellate ganglion blockade, vaginal testosterone, and estetrol. Conclusions: Nonhormone options and therapies are available for treatment of estrogen depletion symptoms and clinical problems after a diagnosis of breast cancer. Individualization of treatment is essential

Treatment of symptoms of the menopause: an endocrine society clinical practice guideline

Objective: The objective of this document is to generate a practice guideline for the management and treatment of symptoms of the menopause. Participants: The Treatment of Symptoms of the Menopause Task Force included six experts, a methodologist, and a medical writer, all appointed by The Endocrine Society. Evidence: The Task Force developed this evidenced-based guideline using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and the quality of evidence. The Task Force commissioned three systematic reviews of published data and considered several other existing meta-analyses and trials. Consensus Process: Multiple e-mail communications, conference calls, and one face-to-face meeting determined consensus. Committees of The Endocrine Society, representatives from endorsing societies, and members of The Endocrine Society reviewed and commented on the drafts of the guidelines. The Australasian Menopause Society, the British Menopause Society, European Menopause and Andropause Society, the European Society of Endocrinology, and the International Menopause Society (co-sponsors of the guideline) reviewed and commented on the draft. Conclusions: Menopausal hormone therapy (MHT) is the most effective treatment for vasomotor symptoms and other symptoms of the climacteric. Benefits may exceed risks for the majority of symptomatic postmenopausal women who are under age 60 or under 10 years since the onset of menopause. Health care professionals should individualize therapy based on clinical factors and patient preference. They should screen women before initiating MHT for cardiovascular and breast cancer risk and recommend the most appropriate therapy depending on risk/benefit considerations. Current evidence does not justify the use of MHT to prevent coronary heart disease, breast cancer, or dementia. Other options are available for those with vasomotor symptoms who prefer not to use MHT or who have contraindications because these patients should not use MHT. Low-dose vaginal estrogen and ospemifene provide effective therapy for the genitourinary syndrome of menopause, and vaginal moisturizers and lubricants are available for those not choosing hormonal therapy. All postmenopausal women should embrace appropriate lifestyle measures

Biomass burning and pollution aerosol over North America: Organic components and their influence on spectral optical properties and humidification response

Thermal analysis of aerosol size distributions provided size resolved volatility up to temperatures of 400°C during extensive flights over North America (NA) for the INTEX/ICARTT experiment in summer 2004. Biomass burning and pollution plumes identified from trace gas measurements were evaluated for their aerosol physiochemical and optical signatures. Measurements of soluble ionic mass and refractory black carbon (BC) mass, inferred from light absorption, were combined with volatility to identify organic carbon at 400°C (VolatileOC) and the residual or refractory organic carbon, RefractoryOC. This approach characterized distinct constituent mass fractions present in biomass burning and pollution plumes every 5–10 min. Biomass burning, pollution and dust aerosol could be stratified by their combined spectral scattering and absorption properties. The “nonplume” regional aerosol exhibited properties dominated by pollution characteristics near the surface and biomass burning aloft. VolatileOC included most water-soluble organic carbon. RefractoryOC dominated enhanced shortwave absorption in plumes from Alaskan and Canadian forest fires. The mass absorption efficiency of this RefractoryOC was about 0.63 m2 g−1 at 470 nm and 0.09 m2 g−1 at 530 nm. Concurrent measurements of the humidity dependence of scattering, γ, revealed the OC component to be only weakly hygroscopic resulting in a general decrease in γ with increasing OC mass fractions. Under ambient humidity conditions, the systematic relations between physiochemical properties and γ lead to a well-constrained dependency on the absorption per unit dry mass for these plume types that may be used to challenge remotely sensed and modeled optical properties

Phishing as a new information threat: a crime or mischief?

Bailov A. Phishing as a new information threat: a crime or mischief? / Bailov Anton, Pinkerton Ron, Wihelm Schwebel // Теоретичні та практичні проблеми реалізації норм права : матеріали ІІ Всеукр. наук.-практ. конф. (з міжнар. участю) (м. Кременчук, 4–5 груд. 2015 р.). – Кременчук : Видавець ПП Щербатих О. В., 2015. – C. 20-22.У доповіді розглядається кіберзлочинність - одне з найскладніших негативних явищ, яке вимагає більш глибокого, всебічного та комплексного вивчення для забезпечення ефективної боротьби зі шахрайством у мережі Інтернет. Відзначено, необхідність серйозного опрацюваня законодавчої бази, яка не відповідає темпам кіберзлочинності, необхідність синхронізації міжнародного права, важливість підготовки професіоналів - слідчих та суддів до особливостей кіберзлочинів.The report deals with the cybercrime – one of the most complex negative phenomena, which requires deeper, more integrated, comprehensive study for ensuring effective combating Internet fraud. It is noted that the necessity of serious elaboration of the legislative framework, which does not correspond to the pace of cybercrime, the need for synchronization of international law, the importance of training of professionals - investigators and judges to the peculiarities of cybercrime.В докладе рассматривается киберпреступность - одно из самых сложных негативных явлений, которое требует более глубокого и комплексного всестороннего изучения для обеспечения эффективной борьбы с интернет-мошенничеством. Отмечается необходимость серьезной разработки законодательной базы, которая не соответствует темпам киберпреступности, необходимости синхронизации международного права, важности подготовки специалистов - следователей и судей к особенностям киберпреступности

5′ Fluorogenic PCR Assay for the iap Gene of Listeria species

We developed a fluorogenic 5′ nuclease polymerase chain reaction (PCR) assay targeting the iap gene, which is highly conserved in all Listeria species. We used this assay to screen tissues obtained during a survey of cull sows. To date, we have detected Listeria species in in caecal contents (66%, 23 of 35 samples), tonsil homogenates (67%, 4 of 6 samples), and ileocaecal lymph nodes (75%, 6 of 8 samples), but infrequently in feces collected before slaughter (4.4%,1 of 23 samples). Taken together, these data indicate that second-generation 5′ nuclease PCR (TaqMan) assays accelerates detection and quantitation of Listeria during pork production. This may reduce product recalls as well as reduce human illness and deaths. The development of portable instruments for 5′ nuclease assays will expedite field surveys

Distribution of particulate matter and tissue remodeling in the human lung.

We examined the relationship between intrapulmonary particle distribution of carbonaceous and mineral dusts and remodeling of the airways along anatomically distinct airway paths in the lungs of Hispanic males from the central valley of California. Lung autopsy specimens from the Fresno County Coroner's Office were prepared by intratracheal instillation of 2% glutaraldehyde at 30 cm H(2)O pressure. Two distinct airway paths into the apico-posterior and apico-anterior portions of the left upper lung lobe were followed. Tissue samples for histologic analysis were generally taken from the intrapulmonary second, fourth, sixth, and ninth airway generations. Parenchymal tissues beyond the 12th airway generation of each airway path were also analyzed. There was little evidence of visible particle accumulation in the larger conducting airways (generations 2-6), except in bronchial-associated lymphoid tissues and within peribronchial connective tissue. In contrast, terminal and respiratory bronchioles arising from each pathway revealed varying degrees of wall thickening and remodeling. Walls with marked thickening contained moderate to heavy amounts of carbonaceous and mineral dusts. Wall thickening was associated with increases in collagen and interstitial inflammatory cells, including dust-laden macrophages. These changes were significantly greater in first-generation respiratory bronchioles compared to second- and third-generation respiratory bronchioles. These findings suggest that accumulation of carbonaceous and mineral dust in the lungs is significantly affected by lung anatomy with the greatest retention in centers of lung acini. Furthermore, there is significant remodeling of this transitional zone in humans exposed to ambient particulate matter

The Prevalence of L. monocytogenes in Cull Sows

The goal of this study was to determine the distribution of Listeria monocytogenes in cull sows and their pork. Two trials were conducted at a single packing plant in 2001 (n=179 cull sows) and in 2002 (n= 160 cull sows). Fecal samples collected antemortem (trial 1) as well as animal tissues, carcass, and environmental swabs, and meat block samples collected at the abattoir (trials 1 and 2) were analyzed. When results from both trials were combined, overall L. monocytogenes was detected in five or 0.17% of the total samples (n=2,858). Specifically, L. monocytogenes was confirmed in a tonsil sample (0.55% of tonsils positive) and in a carcass swab sample (0.56% of carcasses) before the organic acid rinse. L. monocytogenes was recovered in three (1.21%) meat block samples (n=213). These data indicate that L. monocytogenes is present in the cull sow and their pork