Predictors for recombinant HIV infection in a Thai cohort

Recombinant human immunodeficiency virus (HIV) infection was associated with exchange of sex for money, ≥1 sex partner within the prior 6 months, and decline in CD4 cell count in this Thai cohort study. These findings suggest that recombinant HIV infection may have implications for HIV disease progression, safer sex practices, and vaccine development.     

Breast Cancer in Young Women in Latin America: An Unmet,Growing Burden

Background.

Breast cancer (BC) is the leading cause of malignancy-related deaths among women aged ≤45 years. There are unexplored and uncertain issues for BC in this particular group in Latin America. The aim of this study is to evaluate BC incidence and mortality among young women and related clinicopathological and survivorship aspects in this region.

Materials and Methods.

Data were obtained from Globocan 2008 and the International Agency for Research on Cancer''s Cancer Incidence in Five Continents series plus databases. We requested collaboration from the 12 different national cancer institutes in Latin America through SLACOM, the Latin American and Caribbean Society of Medical Oncology, and conducted a systematic literature review to obtain local data regarding the prevalence of BC among young women and their characteristics, outcomes, and survivorship-related issues.

Results.

BC incidence and mortality proportions for Latin American women aged <44 years were higher when compared with those of developed countries (20% vs. 12% and 14% vs. 7%, respectively). We found only a few Latin American series addressing this topic, and prevalence varied between 8% and 14%. Stage II and III disease, high histological grade, and triple-negative and HER2 BC were features frequently observed among young Latin American BC patients.

Conclusion.

The rising incidence and mortality of BC in young Latin American women is a call to action in the region. It is necessary to monitor the epidemiological and clinical data through reliable cancer registries and to consider the implementation of protocols for education of patients and health professionals. This unmet, growing burden must be considered as a top priority of the national programs in the fight against BC, and models of specialized units should be implemented for this particular group of patients to provide better care for this emergent challenge.     

Targeted agents for HER2-positive breast cancer in older adults: current and future perspectives

ABSTRACT

Introduction: One-third of breast cancer (BC) cases worldwide occur in women aged 65 years and older, with 10 to 15% overexpressing the human epidermal growth factor receptor 2 (HER2). Although several HER2-targeted therapies have been developed, the lack of data regarding their use in older patients hampers evidence-based decision-making for this population.

Areas Covered: We review current evidence on the efficacy and safety of HER2-targeted therapies in older adults with BC, focusing on approved therapies such as trastuzumab, lapatinib, pertuzumab, ado-trastuzumab-emtansine, and neratinib. Additionally, we discuss drugs under development to target the HER2-receptor, and to overcome resistance to existing therapies. Finally, we highlight the cardiotoxicity of HER2-targeted drugs among older adults.

Expert Opinion: Older adults are underrepresented in trials of HER2-targeted therapies in BC. We propose strategies to increase recruitment of older adults in clinical trials in order to increase the evidence base to treat this growing population.     

Psychological contributors to the frail phenotype: The association between resilience and frailty in patients with cirrhosis

We examined whether a key psychological trait—resilience, defined as one's ability to recover quickly from difficulties—contributes to the frail phenotype in patients with cirrhosis. Included were 300 adult patients with cirrhosis who underwent outpatient physical frailty testing using the Liver Frailty Index and resilience testing using the Connor-Davidson Resilience Scale (CD-RISC). The Liver Frailty Index was categorized as robust, prefrail-robust, prefrail-frail, and frail; CD-RISC was categorized using population norms as: least, less, more, and most resilient. Linear regression was used to assess factors associated with frailty (by the Liver Frailty Index per 0.1 unit change). Among the most resilient, only 10% were frail; among the least resilient, 29% were frail. In univariable analysis, resilience was strongly associated with the Liver Frailty Index (coef = −0.13 per point increase; 95% confidence interval [CI], −0.20 to −0.60; P < .001) and remained significantly associated with frailty in multivariable adjustment (coef = −0.13, 95% CI −0.19 to −0.07; P < .001). Low resilience is strongly associated with the frail phenotype in patients with cirrhosis. Given that resilience is modifiable, our data suggest that effective interventions to mitigate frailty should include strategies to build resilience in patients with low baseline resilience.     

Peroxiredoxin VI in human respiratory system

Peroxiredoxins (Prxs) constitute a novel family of antioxidant proteins, which specifically prevent enzymes from metal-catalyzed oxidation. The localization of a member of the mono-cystein subfamily of Prxs, Prx VI in human respiratory system and its antioxidant properties were investigated. By immunoblotting, the Prx VI was found to be present in human respiratory epithelium. Immunostaining with rabbit polyclonal antibody raised against the Prx VI revealed that the said protein was present in apical areas and mucus of all respiratory airways from trachea to bronchioles. Immunodepletion of the Prx VI profoundly decreased the antioxidant activity of the respiratory epithelium extract.     

Embryonic morphogenesis of the human pituitary

Light microscopy methods were used to study the main stages in the organogenesis of the pituitary in human embryos at Carnegie stages (CS) 12–23. Rathke’s pouch (RP) was shown to form as a traction fold over whole width of the roof of the stomodeum in embryos at CS 12 due to a flexure of the neural tube with which the epithelium had a tight anatomical relationship (the attached part of the anterior wall of the RP) in the median plane of the embryo. The rudiment of the hypothalamic infundibulum and neurohypophysis formed at CS 15, as a thickening of the posterior wall of the diencephalon. Transorientation of the positions of brain components, including the rudiment of the hypophysis, occurred at CS 20–23. The attached part of the anterior wall of the RP then formed the pars intermedia and pars tuberalis of the anterior lobe, while the epithelium of the orifice of the RP and its posterior wall formed the pars distalis. From CS 20 to 23, the RP epithelium formed the structural-functional units of the adenohypophysis, i.e., the epithelial cords, by invagination. __________ Translated from Morfologiya, Vol. 132, No. 4, pp. 52–56. July–August, 2007.