"Percentage of excess body mass index loss and cardiometabolic risk reduction in Peruvian adults undergoing sleeve gastrectomy"

"Objective: To assess the association between the percentage of excess body mass index loss (%EBMIL) and cardiometabolic risk reduction in Peruvian adults undergoing laparoscopic sleeve gastrectomy (LSG). Methods: Retrospective cohort study conducted with adult patients who underwent LSG in a bariatric clinic during 2016–2020. The outcome variable was cardiometabolic risk change (expressed in Δ) 1 year after LSG. To that effect, the variables total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein (LDL) cholesterol, very LDL (VLDL) cholesterol, triglycerides, glucose, insulin, and HOMA-IR at baseline and after 12 months were considered. The exposure variable was %EBMIL. Crude and adjusted β coefficients were estimated with linear regression models. Results: Of the 110 patients analyzed, 68.2% were women, and the median patient age was 34.5 years. In the model adjusted for sex, age, and baseline BMI, we noted that each 25% increase in %EBMIL resulted in a decrease in the values for total cholesterol, LDL, triglycerides, and insulin by 10.36 mg/dL (p < 0.001), 7.98 mg/dL (p = 0.001), 13.35 mg/dL (p = 0.033), and 3.63 uU/mL (p = 0.040), respectively. Conclusion: %EBMIL was associated with a decrease in total cholesterol, LDL, triglycerides, and insulin levels, which could suggest a favorable cardiometabolic evolution during the first 12 months following LSG.

CITOMEGALOVIRUS Y PANUVETIS SIFILITICA OCULAR EN PACIENTE CON SIDA

La retinitis por citomegalovírus es una de las infecciones oculares oportunistas más frecuente en los pacientes con SIDA con  cd4 bajo; sin tratamiento es inevitable la ceguera, la cual se manifiesta  en semanas o meses, debida a la afectación retiniana extensa, desprendimiento de retina o atrofia óptica.La sífilis es otra patología que se asocia a infección por VIH, se reporta sífilis  secundaria en mayor porcentaje de los casos; siendo la uveítis por sífilis  pleomórfica, se presenta en la etapa secundaria. Las manifestaciones oculares más frecuentes ocurren en el segmento posterior, se presentan en un 80 % de los casos en pacientes con SIDA.Se presenta el reporte de caso por encontrarse coinfeccion de sífilis y citomegalovírus en un paciente en estadio SIDA.Palabras clave: SIDA, Panuveitis sifilítica, Citomegalovirus Ocular

Resistencia extrema al cobre por un consorcio bacteriano conformado por Sulfobacillus spp. y Acidithiobacillus ferrooxidans

RESUMENLa sensibilidad al cobre por parte de microorganismos biolixiviadores es uno de los principales problemas que enfrenta la minería para mejorar los procesos de biolixiviación. En tal sentido, nosotros evaluamos la resistencia al cobre de un consorcio microbiano conformado por Sulfobacillus spp., y Acidithiobacillus ferrooxidans, el cual se propagó, en bioreactores de tanque aireado y agitado de 1 L, los cuales contenían medio 9K suplementado con hierro y concentraciones crecientes de cobre (200 mM, 400 mM, 600 mM, 800 mM y 1,000 mM) a 30°C con un pH de 1.6 durante 96 horas. Se colectó una muestra de cada biorreactor cada 8 horas, para realizar análisis, microscópicos y moleculares, además el cultivo del consorcio en placa mostró una resistencia al cobre hasta 1,000 mM. Se observó que el consorcio microbiano puede crecer en presencia de cobre tanto en medio líquidos (biorreactores-9K+Cu: 200 mM-800mM) como en medios sólidos (agarosa-9K + Cu: 1,000mM). Nuestros resultados proponen que el consorcio conformado por Sulfobacillus spp., y Acidithiobacillus ferrooxidans, presenta resistencia extrema al cobre y podría ser aplicado bajo condiciones de mayor escalamiento en procesos de biolixiviación de minerales sulfuros donde el cobre se encuentra en concentraciones de hasta 1,000 mM. Palabras clave: Acidithiobacillus ferrooxidans; consorcio microbiano; microorganismos biolixiviadores; Sulfobacillus spp, resistencia al cobreABSTRACTThe sensitivity to copper by bioleaching microorganism is one of the main problems faced by mining to improve bioleaching processes. In this sense, we evaluated the resistance to copper of a microbial consortium formed by Sulfobacillus spp., and Acidithiobacillus ferroxidans which was propagated, in aerated and agitated tank bioreactors of 1 L, which contained 9 K medium supplemented with iron and concentrations copper (200 mM, 400 mM, 600 mM, 800 mM and 1,000 mM) at 30 °C with a pH of 1.6 for 96 hours. A samples of each bioreactor was colleted every 8 hours, to perform cytometric microscope and molecular analysis, and plate count test showed a resistance to copper at 1,000 mM. It was observed that the microbial consortium can grow in the presence of copper both in liquid medium (bioreactors -9K + Cu: 200 mM – 800 mM) and in solid media (agarose – 9K + Cu: 1,000 mM). Our results propose that the consortium formed Sulfobacillus spp., and Acidithiobacillus ferrooxidans presents wxtreme resistance to copper and could be applied under higher scaling conditions in bioleaching processes of sulfide minerals where copper is found in concentrations up to 1 000 mM. Keywords: Acidithiobacillus ferrooxidas; bioleaching microorganisms; microbial consortium; Sulfobacillus spp; resistance to copper

Combination of everolimus with trastuzumab plus paclitaxel as first-line treatment for patients with HER2-positive advanced breast cancer (BOLERO-1) : a phase 3, randomised, double-blind, multicentre trial

BACKGROUND : mTOR inhibition has been shown to reverse trastuzumab resistance from hyperactivated the PIK/AKT/mTOR pathway due to PTEN loss, by sensitizing PTEN-deficient tumors towards trastuzumab. The BOLERO-1 study evaluated the efficacy and safety of adding everolimus to trastuzumab and paclitaxel as first-line therapy for HER2+ advanced breast cancer (ABC). METHODS : In this phase III, randomized, double-blind trial, patients were enrolled across 141 sites in 28 countries. Eligible patients were ≥18 years of age, with locally assessed HER2+ advanced breast cancer (ABC), with Eastern Cooperative Oncology Group performance status of 0-1, who had not received prior trastuzumab or chemotherapy for ABC, had measurable disease as per Response Evaluation Criteria in Solid Tumors or bone lesions in the absence of measurable disease, without prior systemic therapy for advanced disease except endocrine therapy. The patients were randomized 2:1 (with an interactive voice and web response system) to receive either daily everolimus (10 mg/day) orally or placebo plus weekly trastuzumab intravenously at 4 mg/kg loading dose on Day-1 with subsequent weekly doses of 2 mg/kg of each 4-week cycle plus paclitaxel intravenously at a dose of 80 mg/m2 on days 1, 8, and 15 of each 4- week cycle. Randomization was stratified according to prior use of trastuzumab and visceral metastasis. Patients and investigators were blinded to the assigned treatments. Identity of experimental treatments was concealed by use of everolimus and placebo that were identical in packaging, labelling, appearance, and administration schedule. The two primary objectives were investigator-assessed progression-free survival (PFS) in the full study population and in the subset of patients with hormone receptor-negative (HR) breast cancer at baseline; the latter was added during the course of the study, prior to unblinding based on new clinical and biological findings from other studies. All efficacy analyses were based on the intention-to-treat population. Enrolment for this trial is closed and results of the final PFS analyses are presented here. Clinicaltrials.gov identifier: NCT00876395. FINDINGS : Between 10-Sep-2009 and 16-Dec-2012, 719 patients were randomized to receive everolimus (n=480) or placebo (n=239). Median follow-up was 41.3 months (IQR: 35.4 – 46.6 months). INTERPRETATION : The primary objective in the full population was not met; median PFS was 15.0 months with everolimus vs 14.5 months with placebo (hazard ratio, 0.89; 95% CI, 0.73-1.08; p=0.1166). In the HR subpopulation (n=311), median PFS with everolimus was 20.3 months vs 13.1 months with placebo (hazard ratio, 0.66; 95% CI, 0.48-0.91; p=0.0049), however, the protocol-specified statistical significance threshold (p=0.0044) was not crossed. The most common adverse events (AEs) with everolimus vs placebo were stomatitis (314 [66.5%] vs 77 [32.4%] patients), diarrhea (267 [56.6%] vs 111 [46.6%] patients), and alopecia (221 [46.8%] vs 125 [52.5%]). The most frequently reported grade 3/4 AEs in the EVE arm vs PBO arm were neutropenia (117 [24.8%] of 472 patients vs 35 [14.7%] of 238 patients), stomatitis (59 [12.5%] of 472 patients vs 3 [1.3%] of 238 patients), anemia (46 [9.7%] of 472 patients vs 6 [2.5%] of 238 patients) and diarrhea (43 [9.1%] of 472 patients vs 10 [4.2%] of 238 patients) On-treatment AE-related deaths were reported in 17 [3.6%] vs 0% of patients respectively.Interpretation: The primary objective of PFS was not met. However, consistent with the preliminary observations from BOLERO-3, everolimus prolonged median PFS by 7.2 months in patients with HR, HER2+ ABC, which warrants further investigation. The safety profile was generally consistent with what was previously reported in BOLERO-3. Proactive monitoring and early management of AEs in patients treated with everolimus and chemotherapy is critical..Novartis Pharmaceuticals Corporation.http://www.journals.elsevier.com/the-lancet-oncology2016-07-31hb201

5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5)

The ESO-ESMO 5th international consensus recommendations for advanced breast cancer (ABC 5) provide the latest updates on the management of patients with all breast cancer subtypes, locally advanced breast cancer, follow-up, palliative and supportive care and integrative medicine. Updated diagnostic and treatment algorithms are also provided, as well as several new therapies/indications in advanced breast cancer now approved by the European Medicines Agency