Chagasic Megacolon and Proximal Jejunum Microbiota

Background: Among other factors, control of jejunal microflora depends on intestinal emptiness, and it can be impaired by Chagas disease. This study was developed to identify the microecology of the proximal jejunum in chagasic megacolon. Our objective was to characterize both the jejunal microbial stasis before surgery and the microflora after surgical treatment in patients with chagasic megacolon. Methods: The intestinal fluids were collected, and the proximal jejunum microflora was analyzed. Results: Preoperative microflora had shown an increase in bacteria compatible with bacterial overgrowth syndrome, mainly facultative and strict anaerobes microorganisms and fungi. The microflora had changed in the postoperative period in 83% of these patients, with significant decrease in the number of transient microorganisms. Conclusions: Chagasic megacolon was related to an increase in jejunal microflora. By removing the impairment of the colon there was a transient decrease in the proximal jejunum microflora.     

Insulin-Like Growth Factor Pathway–Targeted Therapy in Breast Cancer

The insulin-like growth factor (IGF) pathway plays an important role in cancer development, survival, metastasis, and resistance to antineoplastic therapies in various malignancies. Components of the IGF pathway are potential targets for novel anticancer therapy. In breast cancer, preclinical and clinical data suggest that IGF signaling is critical for tumor growth and resistance to therapy, leading to poor prognosis. There is also evidence of cross-talk between IGF, estrogen, erbB, and mTOR pathways; a potential mechanism of cancer resistance to hormonal or HER2-targeted therapy. This review discusses the rationale and strategies being evaluated in the clinical development of targeting the IGF pathway. It highlights the potential interactions between the IGF pathway and other therapies in breast cancer, and also focuses on the completed and ongoing clinical trials of different IGF pathway–targeted therapies in breast cancer.