Male breast cancer

Male breast cancer (MBC) is a rare disease representing less than 1% of all breast cancers (BC) and less than 1% of cancers in men. Age at presentation is mostly in the late 60s. MBC is recognized as an estrogen-driven disease, specifically related to hyperestrogenism. About 20% of MBC patients have family history for BC. Mutations in BRCA1 and, predominantly, BRCA2, account for approximately 10% of MBC cases. Because of its rarity, MBC is often compared with female BC (FBC). Based on age-frequency distribution, age-specific incidence rate patterns and prognostic factors profiles, MBC is considered similar to late-onset, postmenopausal estrogen/progesterone receptor positive (ER+/PR+) FBC. However, clinical and pathological characteristics of MBC do not exactly overlap FBC. Compared with FBC, MBC has been reported to occur later in life, present at a higher stage, and display lower histologic grade, with a higher proportion of ER+ and PR+ tumors. Although rare, MBC remains a substantial cause for morbidity and mortality in men, probably because of its occurrence in advanced age and delayed diagnosis. Diagnosis and treatment of MBC generally is similar to that of FBC. Men tend to be treated with mastectomy rather than breast-conserving surgery. The backbone of adjuvant therapy or palliative treatment for advanced disease is endocrine, mostly tamoxifen. Use of FBC-based therapy led to the observation that treatment outcomes for MBC are worse and that survival rates for MBC do not improve like FBC. These different outcomes may suggest a non-appropriate utilization of treatments and that different underlying pathogenetic mechanisms may exist between male and female BC

Anti-Streptolysin O (ASO) titer in children and adolescents (7-14 years old) of Shahrekord, 1998

Rheumatic fever is a delayed and non-suppurative Streptococcal infection of upper respiratory tracts. Its diagnosis relies on clinical findings and supportive evidence of a recent group A Streptococcal infection. The latter may be provided by elevated or rising ASO titer. Since normal range of ASO titer depends on the test type, age and geographical area, it should be interpreted cautiously. Because a normal range has not been established for this area, we determined the median, mode and upper limit of normal ASO titer in healthy children, and adolescent’s sera in this city. We also investigated the relation of ASO titer with some background variables. This cross-sectional study was performed in the spring of 1998. 400 students (7-14 years old) were selected from 19 primary and guidance schools by a random-stratified method of sampling. The exclusion criteria were 1) History of recent Streptococcal infection, 2) Evidence of Streptococcal infection by physical examination, 3) History of rheumatic fever in the student or a family member. The median, mode and upper limit of normal ASO titer was 166 TU (Todd unit) using a Mann Whitney U-test revealed no significant differences between ASO titers in different age and sex groups. Statistical analysis revealed a significant relation between ASO titers and family size and socioeconomic status. Although the upper limit of normal of titers in our study was different from other studies but the prevalence of high ASO titers in our study was similar to other findings. This confirms that a specific cut-off point level cannot be used as a standard level of normal ASO titer everywhere and it varies from site to site

Effect of biomass fuel combustion on increasing the risk of chronic Bronchitis in women, Shahrekord, 2001

به نظر می رسد که میزان برونشیت در زنان این استان زیاد باشد که احتمالا ناشی از استنشاق هوای آلوده ناشی از سوخت های آلی و چوب است. لذا در یک مطالعه مورد-شاهدی در زنان بالای 40 سال به بررسی احتمال دخالت سوخت مواد آلی و سیگار در ایجاد برونشیت مزمن پرداخته شد. از مراجعه کنندگان به درمانگاه ریه یکصد نفر مبتلا به برونشیت مزمن به عنوان مورد و از بین بیماران بستری 100 نفر به عنوان گروه کنترل انتخاب شدند. افراد این دو گروه به سوالات پرسشنامه در مورد سابقه پخت نان در منزل، نوع سوخت مصرفی برای گرمایش منزل، سوخت آشپزخانه و سوخت تنور پاسخ دادند. عوامل زیر با ایجاد برونشیت مزمن در زنان شهرکرد رابطه آماری معنی داری داشت. سیگار (P=0.009)، قلیان (P=0.014)، پخت نان با تنور در منزل (P=0.002)، وجود بخاری چوب سوز (P=0.009)، مصرف چوب برای آشپزی (P=0.000)، مصرف نفت برای آشپزی (P=0.000) و مصرف چوب برای تنور نان پزی (P=0.000). سوخت چوب برای آشپزی، پخت نان و گرم کردن منزل علل مهم ایجاد برونشیت مزمن در زنان منطقه چهارمحال و بختیاری می باشد و جایگزینی چوب و نفت با سوخت های بهداشتی تر (مثل گاز) باعث کاهش بیماری برونشیت مزمن خواهد شد

Study of the Emitted Dose After Two Separate Inhalations at Different Inhalation Flow Rates and Volumes and an Assessment of Aerodynamic Characteristics of Indacaterol Onbrez Breezhaler® 150 and 300 μg

Onbrez Breezhaler® is a low-resistance capsule-based device that was developed to deliver indacaterol maleate. The study was designed to investigate the effects of both maximum flow rate (MIF) and inhalation volume (Vin) on the dose emission of indacaterol 150 and 300 μg dose strengths after one and two inhalations using dose unit sampling apparatus (DUSA) as well as to study the aerodynamic characteristics of indacaterol Breezhaler® using the Andersen cascade impactor (ACI) at a different set of MIF and Vin. Indacaterol 150 and 300 μg contain equal amounts of lactose per carrier. However, 150 μg has the smallest carrier size. The particle size distribution (PSD) of indacaterol DPI formulations 150 and 300 μg showed that the density of fine particles increased with the increase of the primary pressure. For both strengths (150 μg and 300 μg), ED1 increased and ED2 decreased when the inhalation flow rate and inhaled volume increased. The reduction in ED1 and subsequent increase in ED2 was such that when the Vin is greater than 1 L, then 60 L/min could be regarded as the minimum MIF. The Breezhaler was effective in producing respirable particles with an MMAD ≤5 μm irrespective of the inhalation flow rate, but the mass fraction of particles with an aerodynamic diameter <3 μm is more pronounced between 60 and 90 L/min. The dose emission of indacaterol was comparable for both dose strengths 150 and 300 μg. These in vitro results suggest that a minimum MIF of 60 L/min is required during routine use of Onbrez Breezhaler®, and confirm the good practice to make two separate inhalations from the same dose

CALGB 40603 (Alliance): Long-Term Outcomes and Genomic Correlates of Response and Survival After Neoadjuvant Chemotherapy With or Without Carboplatin and Bevacizumab in Triple-Negative Breast Cancer

PURPOSECALGB 40603 (NCT00861705), a 2 × 2 randomized phase II trial, demonstrated that adding carboplatin or bevacizumab to weekly paclitaxel (wP) followed by doxorubicin and cyclophosphamide significantly increased the pathologic complete response (pCR) rate in stage II-III triple-negative breast cancer. We now report long-term outcomes (LTOs) and correlative science end points.PATIENTS AND METHODSThe Kaplan-Meier method was used to estimate LTOs in 443 patients who initiated study treatment. Log-rank tests and Cox proportional hazards models evaluated the impact of clinical characteristics, pathologic response, calculated residual cancer burden (RCB) in patients with residual disease (RD), treatment assignment, and dose delivery during wP on LTOs, including event-free survival (EFS). Genomic predictors of treatment response and outcomes were assessed on pretreatment tumor samples by mRNA sequencing.RESULTSAmong baseline characteristics, only the clinical stage was associated with LTOs. At a median follow-up of 7.9 years, LTOs were not significantly improved with either carboplatin or bevacizumab, overall or in patients with basal-like subtype cancers by genomic analysis. Patients with pCR (n = 205, 46.3%) had significantly higher 5-year EFS (85.5% v 56.6%, log-rank P <.0001) and overall survival (87.9% v 63.4%, P <.0001) rates compared with patients with RD, even those with RCB class I. Among clinical and genomic features, evidence of immune activation, including tumor-infiltrating lymphocytes and low B-cell receptor evenness, was associated with pCR and improved EFS.CONCLUSIONDespite higher pCR rates, neither carboplatin nor bevacizumab appeared to improve LTOs although the study was not powered to assess these secondary end points. pCR was associated with superior LTOs even when compared with minimal RD. Markers of immune activation in pretreatment tumor biopsies were independently associated with higher pCR rates and improved survival