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Jover R.,Hospital General Universitario Of Alicante | Nguyen T.,Baylor University | Prezcarbonell L.,Hospital General Universitario Of Alicante | Zapater P.,Hospital General Universitario Of Alicante | And 18 more authors.
Gastroenterology | Year: 2011

Background & Aims: 5-Fluorouracil (5-FU)based adjuvant chemotherapy does not increase survival times of patients with colorectal tumors with microsatellite instability. We determined the response of patients with colorectal tumors with the CpG island methylator phenotype (CIMP) to 5-FUbased therapy. Methods: We analyzed a population-based cohort of 302 patients with colorectal cancer (CRC) for a median follow-up time of 50.7 months. CIMP status was determined by analysis of the CACNAG1, SOCS1, RUNX3, NEUROG1, and MLH1 promoters; tumors were considered to be CIMP positive if at least 3 promoters were methylated. Results: Tumors from 29.5% of patients (89/302) were CIMP positive; CIMP status did not influence disease-free survival (DFS; log-rank = 0.3). Of tumors of TNM stages IIIII (n = 196), 32.7% were CIMP positive. Among patients with stages IIIII CRC who did not receive adjuvant 5-FU chemotherapy, those with CIMP-positive tumors had longest times of DFS (log-rank = 0.04); In patients who received chemotherapy, those with CIMP-positive tumors had shorter times of DFS (log-rank = 0.02). In patients with CIMP-negative tumors, adjuvant 5-FU chemotherapy significantly increased time of DFS (log-rank = 0.00001). However, in patients with CIMP-positive tumors, adjuvant 5-FU chemotherapy did not affect time of DFS (log-rank = 0.7). Multivariate analysis showed a significant, independent interaction between 5-FU treatment and CIMP status (hazard ratio [HR], 0.6; 95% confidence interval [CI], 0.50.8). Among patients with CIMP-positive tumors, adjuvant chemotherapy was not an independent predictor of outcome (HR, 0.8; 95% CI, 0.32.0). In patients who did not receive adjuvant 5-FU chemotherapy, CIMP status was the only independent predictor of survival (HR, 2.0; 95% CI, 1.13.8). Conclusions: Patients with CIMP-positive colorectal tumors do not benefit from 5-FUbased adjuvant chemotherapy. © 2011 AGA Institute. Source


Fernandez Y.,Hospital Universitario Central Of Asturias | Cueva J.,Complexo Hospitalario Universitario Of Santiago | Palomo A.G.,Hospital de Leon | Ramos M.,Centro Oncologico Regional | And 6 more authors.
Cancer Treatment Reviews | Year: 2010

Metastatic breast cancer is ultimately an incurable disease, although recent data have shown that its incidence is decreasing and that patients with metastatic breast cancer live longer. This improvement in survival seems to be linked with the introduction of new therapeutic agents, novel combinations of existing therapies and targeted therapies. Our increasing understanding of the molecular biology of metastatic disease has allowed the development of therapies aimed at specific molecular targets. Some of these have already been approved for the treatment of metastatic breast cancer in combination with cytotoxics, and others have shown promising results regarding disease-free survival, overall response rates and time to disease progression. Given the enormous amount of information about drug discovery in cancer, it is important to be familiar with the present state of the treatment of metastatic breast cancer. The purpose of this review is to provide an update on the development of some of the most promising novel agents and treatment strategies in metastatic breast cancer. © 2009 Elsevier Ltd. All rights reserved. Source


Cameselle-Teijeiro J.,University of Santiago de Compostela | Ferreira R.,University of Porto | Carames N.,Complexo Hospitalario de Ourense | Abdulkader I.,University of Santiago de Compostela | And 3 more authors.
American Journal of Clinical Pathology | Year: 2012

We report the first case of oncocytic solid cell nests (SCNs), found in the right lobe of the thyroid of a 70-year-old man. Conventional SCNs and 1 papillary microcarcinoma (mPTC) were also found in the left lobe. In the oncocytic SCNs, 80% of the main cells showed oncocytic cytoplasm immunoreactive for porin and proteins of the SDHB and SDHA genes. Positivity for cytokeratin 19, p63, galectin-3, and HBME-1 and negativity for thyroglobulin, thyroperoxidase, vimentin, Oct-4, and α-fetoprotein were found in oncocytic and conventional SCNs. An inverse correlation was found between oncocytic metaplasia and p63. Association with C cells was confirmed at protein and messenger RNA levels in both types of SCNs. No germinal mutation of GRIM-19 was detected. No somatic BRAF mutation was found in any of the SCNs nor in the mPTC. We conclude that SCNs may acquire mitochondrial alterations similar to those seen in follicular and C cells, as well as in their respective tumors. Copyright© by the American Society for Clinical Pathology. Source


Perez-Pereira M.,University of Santiago de Compostela | Fernandez P.,University of Santiago de Compostela | Gomez-Taibo M.,University of La Coruna | Gonzalez L.,Complexo Hospitalario Universitario Of Vigo | And 3 more authors.
Early Human Development | Year: 2013

Background: Previous studies indicate that VLBW preterm children obtain significantly lower scores than full-term children in all the NBAS clusters. However the samples studied usually presented additional medical complications. Aims: The present study aims to compare the results obtained by low-risk preterm and full term children in the NBAS, and relate possible differences to biological and contextual factors. Method: Early neurobehavioral development of 150 preterm (PR) children is compared to that of 49 full term children (FT). The children were assessed at the age of 15. days (corrected age for preterm children) with the NBAS. Biological and environmental variables were collected through an extended interview with the mothers as well as medical data. Results: Significant differences were found between preterm and full term children in the following areas: motor, range of state, and regulation of state. Differences were also found in relation to birth weight in these same three areas, following a parallel pattern. These differences between the two groups were not, however, necessarily more favorable for the FT group; the PR group had higher results in the motor and range of state areas, and lower results in the regulation of state area. The mothers' smoking habit had a negative effect on infants' regulation and orientation. Conclusions: No general maturation delay in this particular sample of preterm children was found. © 2012 Elsevier Ltd. Source


Fernandez J.C.,Complexo Hospitalario de Ourense | Calvo L.N.,Complexo Hospitalario de Ourense | Vazquez E.G.,Fundacion Publica Hospitalaria de Verin | Garcia M.J.G.,Research Support Unit | And 3 more authors.
World Journal of Gastroenterology | Year: 2010

AIM: To ascertain the role of cardiovascular risk factors, cardiovascular diseases, standard treatments and other diseases in the development of ischemic colitis (IC). METHODS: A retrospective, case-control study was designed, using matched data and covering 161 incident cases of IC who required admission to our hospital from 1998 through 2003. IC was diagnosed on the basis of endoscopic findings and diagnostic or compatible histology. Controls were randomly chosen from a cohort of patients who were admitted in the same period and required a colonoscopy, excluding those with diagnosis of colitis. Cases were matched with controls (ratio 1:2), by age and sex. A conditional logistic regression was performed. RESULTS: A total of 483 patients (161 cases, 322 controls) were included; mean age 75.67 ± 10.03 years, 55.9% women. The principal indications for colonoscopy in the control group were lower gastrointestinal hemorrhage (35.4%), anemia (33.9%), abdominal pain(19.9%) and diarrhea (9.6%). The endoscopic findings in this group were hemorrhoids (25.5%), diverticular disease (30.4%), polyps (19.9%) and colorectal cancer(10.2%). The following variables were associated with IC in the univariate analysis: arterial hypertension (P = 0.033); dyslipidemia (P < 0.001); diabetes mellitus (P= 0.025); peripheral arterial disease (P = 0.004); heart failure (P = 0.026); treatment with hypotensive drugs (P = 0.023); angiotensin-converting enzyme inhibitors; (P = 0.018); calcium channel antagonists (P = 0.028);and acetylsalicylic acid (ASA) (P < 0.001). Finally, the following variables were independently associated with the development of IC: diabetes mellitus [odds ratio(OR) 1.76, 95% confidence interval (CI): 1.001-3.077, P = 0.046]; dyslipidemia (OR 2.12, 95% CI: 1.26-3.57, P = 0.004); heart failure (OR 3.17, 95% CI: 1.31-7.68, P = 0.01); peripheral arterial disease (OR 4.1, 95% CI: 1.32-12.72, P = 0.015); treatment with digoxin (digitalis) (OR 0.27, 95% CI: 0.084-0.857, P = 0.026); and ASA (OR 1.97, 95% CI: 1.16-3.36, P = 0.012). CONCLUSION: The development of an episode of IC was independently associated with diabetes, dyslipidemia, presence of heart failure, peripheral arterial disease and treatment with digoxin or ASA. © 2010 Baishideng. Source

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