Ductal carcinoma in situ in African American versus Caucasian American women

BACKGROUND:

Invasive breast carcinoma has a more aggressive phenotype and a higher mortality rate in African American (AA) than in Caucasian American (CA) women. The characteristics of ductal carcinoma in situ (DCIS) in the AA population have not been extensively studied.

METHODS:

The authors reviewed cases of DCIS diagnosed in AA and CA patients between 1996 and 2000 at their institution. Treatment and outcome were obtained from the clinical charts and the Surveillance, Epidemiology, and End Results database. They identified 217 AA (61%) and 141 CA (39%) patients.

RESULTS:

AA women were significantly older at diagnosis (61 years vs 56 years, P = .001), and the size of the tumor was larger in AA patients (P = .001). The other pathological features examined were not statistically different between the 2 groups. Treatments with surgery and radiation were also similar. However, the CA patients were more likely to receive hormone therapy. Recurrence rate as DCIS or invasive carcinoma was similar in both patient groups, as was death due to disease. Time to recurrence with invasive carcinoma, however, was shorter for AA patients (32.8 ± 13 vs 58 ± 9; P = .02). Only overall survival (OS) rate was higher for CA patients (92% vs 71% at 10 years; P = .003).

CONCLUSIONS:

Unlike invasive carcinoma, DCIS is diagnosed at a later age in AA patients. Except for larger size, DCIS does not have a more aggressive histology in AA patients. Treatment and recurrence rate were similar in both groups, as was death due to breast cancer. OS, however, was worse in AA women. Cancer 2009; 115:3181–8. © 2009 American Cancer Society.     

The role of central autonomic nervous system dysfunction in Takotsubo syndrome: a systematic review

Clinical Autonomic Research - Takotsubo syndrome (TTS), also known as stress cardiomyopathy or “broken heart” syndrome, is a mysterious condition that often mimics an acute myocardial...     

Programmed cell death ligand 1 expression in aggressive pediatric non-Hodgkin lymphomas: frequency,genetic mechanisms,and clinical significance

Programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) are immunomodulatory molecules over-expressed in lymphomas and are promising immunotherapy targets for hematologic malignancies. However, studies of PD-1/PD-L1 overexpression and their clinical significance in aggressive pediatric non-Hodgkin lymphomas (NHL) are limited. We assessed PD-1/PD-L1 overexpression using immunohistochemistry in 68 aggressive pediatric NHL: ALK-positive anaplastic large cell lymphoma (ALK+ ALCL, n=8), Burkitt lymphoma (BL, n=27), and large B-cell lymphoma (LBCL) de novo LBCL, n=22 and diffuse LBCL arising as monomorphic post-transplant lymphoproliferative disorder [PTLD-DLBCL], n=11. In LBCL, correlations between PD-L1 overexpression and Epstein-Barr virus (EBV) status, cell of origin, stage, nodal status, overall survival (OS), and event-free survival (EFS) were examined. The genetic mechanisms of PD-L1 overexpression were investigated using targeted next-generation sequencing (NGS) and cytogenetic data. All ALK+ ALCL samples, 50.0% of de novo LBCL (11/22), 72.7% of PTLD-DLBCL (8/11), and no BL overexpressed PD-L1. Overexpressed PD-L1 correlated with EBV positivity (P=0.033) in LBCL and lower EFS in de novo LBCL (P=0.017). NGS of select LBCL revealed distinct somatic mutations and an ultra-hypermutated PTLD-DLBCL. Most cases with 9p24.1 copy gains overexpressed PD-L1 although some cases had no discernible genetic drivers of PD-L1 overexpression. Overexpressed PD-L1 is common in pediatric LBCL, associated with EBV positivity and 9p24.1 gains, and may have prognostic significance in de novo LBCL. Furthermore, diverse molecular mechanisms for PD-L1 overexpression in aggressive pediatric NHL can occur. Thus, additional studies exploring the therapeutic and prognostic significance and molecular mechanisms of PD-L1 overexpression in aggressive pediatric NHL are warranted.     

Application of polyethylene glycol (PEG) to the control of permeability of poly(meth)acrylate coatings

Pellets with pholedrine sulphate are coated by means of a fluid-bed process with poly(meth)acrylate materials (Eudragit RS, Eudragit E 30 D, Scopacryl D 340) and varying portions of PEG 6000. In addition to influencing drug release by change of the thickness it was studied the admixture of PEG to the films. Figure logarithm permeability coefficient vs. the portion of PEG can be used to select a coating composition with wished permeability. By application of aqueous latex dispersions (Eudragit E 30 D, Scopacryl D 340) PEG dissolves completely very fast from the coatings. On the other hand if organic lac solution (Eudragit RS) is used a stagnation of the dissolution process after some min is observed. By leaching out the PEG the structure of the resulting films is loosened and therefore its permeability is increased.     

Respiratory distress syndrome treated with human surfactant: radiographic findings

Chest radiographs of 18 newborns treated with endotracheal instillation of human surfactant for respiratory distress syndrome (RDS) were compared with those of 18 similar but untreated infants. In the treated infants, severity of RDS significantly improved after surfactant administration. Most treated infants (16/18) exhibited a left-to-right shunt, presumably through a patent ductus arteriosus; similar findings were noted in untreated infants (17/18). Complications of respiratory assistance in the treated infants included transient pulmonary interstitial emphysema (n = 1), pneumothorax (n = 1), and mild (n = 4) to moderate (n = 2) bronchopulmonary dysplasia; the incidences of these complications did not exceed those in untreated infants. In three treated infants, a transient interstitial lung disease developed 3-4 days after surfactant administration.     

Preparation of preoral sustained-release preparations with a base of biodegradable polymers. 3. Preparation of matrix tablets with a base of poly-3-hydroxybutyric acid

Poly-3-hydroxybutyric acid belongs to the biological polymers, which are produced by bacterials. The determination of the grain size, moisture content, flowability and the parameters for the direct compression was performed in regard of their use as auxillary substance for the preparation of solid sustained release dosage forms. The production of the matrix tablets was performed on the basis of a factorial design. The content of substance, an addition of Heweten 12 and the compression power served as factors. Caffeine was used as model drug. The in vitro release values show, that all three factors have an influence of the drug release. Optimized matrix tablets were produced on the basis of this result.