Abstract P4-10-05: Changes in metabolic syndrome components in breast cancer patients receiving neoadjuvant or adjuvant chemotherapy

Purpose. We sought to determine the impact of (neo)adjuvant chemotherapy on metabolic syndrome (MetS) components and related anthropometric and metabolic biomarkers among premenopausal and postmenopausal early stage breast cancer patients.

Methods. Eighty-six women with early stage (I-III) breast cancer who were free from clinically diagnosed MetS (defined as 3 out of 5 components of MetS) and were planning to undergo chemotherapy, enrolled in the study. Participants were tested for MetS (blood pressure; BP, waist circumference; WC, fasting blood glucose; FBG, high-density lipoprotein cholesterol; HDL-C, and triglycerides; TG), anthropometrics (body weight; BW, percent body fat; BF, fat mass; FM), lipid profile (total cholesterol; TC, low-density lipoprotein cholesterol; LDL-C), glucose metabolism (insulin, homeostatic model- insulin resistance; HOMA-IR, glycosylated hemoglobin; HbA1c), and inflammation (C-reactive protein; CRP) within one week before and following the completion of chemotherapy. Fasting (12-hour) venous blood samples of the antecubital vein were drawn to measure glucose, insulin, lipid profile (TC, HDL-C, LDL-C, and TRI), HbA1c, and CRP. Blood samples were analyzed at the City of Hope Clinical Pathology Laboratory. Insulin resistance was calculated using the HOMA index: [(fasting glucose (mg/dL) x fasting insulin (mg/dL)/405]. Height, BW, and BP measurements were obtained by the nursing staff during pre-chemotherapy physical exams. Body composition (BF and FM) was measured using a portable hand-held bioelectrical impedance device (Omron®; Hoffman Estates, IL). WC was measured, using a fabric measuring tape, as the distance around the waist using the umbilicus as the reference point.

One-way analysis of covariance (ANCOVA) using SPSS version 18.0 was used to compare means adjusting for covariates such as age, race, type of chemotherapy, duration of chemotherapy, BMI at baseline, and menopausal status.

Results. The majority of the 86 women enrolled were Caucasian (44%) or Hispanic (30%), nonsmoking (96%), employed (84%), and well-educated (90%), with a mean age of 48.2 years. Women were most commonly undergoing Cytoxan/Adriamycin + Taxol (42%) or Taxotere/Cytoxan (36%) chemotherapy regimens, lasting on average 15.3 (±2.7) weeks. Overall the population was sedentary, averaging 7.2 (±5.8) minutes of physical activity/week.

Following chemotherapy, all MetS components and overall MetS score (out of 5) significantly increased (p<0.01). Additionally, BW, BF, FM, lipids (TC, LDL), glucose metabolism (HOMA-IR, insulin, HbA1c), and inflammation (CRP) significantly increased (p<0.01).

Conclusion. In women without MetS, (neo)adjuvant chemotherapy negatively altered MetS components, related anthropometrics, and biomarkers of glucose metabolism and inflammation, within 12 -18 weeks. Studies that test the impact of lifestyle interventions, such as diet and exercise, should be explored in this population of breast cancer patients to reduce the onset of MetS.

Citation Format: Dieli-Conwright CM, Wong L, Waliany S, Bernstein L, Salehian B, Mortimer JE. Changes in metabolic syndrome components in breast cancer patients receiving neoadjuvant or adjuvant chemotherapy. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-10-05.

Abstract P1-10-23: Bladder symptoms in women with newly diagnosed breast cancer

Background: Changes in bladder function are recognized effects of aging and menopause but have not generally been reported in women treated for breast cancer. We initiated a prospective trial to assess the impact of (neo) adjuvant therapy on women with early stage breast cancer.

Methods: Women with newly diagnosed invasive breast cancer who were to initiate (neo) adjuvant chemotherapy or endocrine therapy were approached for study participation. At baseline a urinalysis, urine culture, and self assessment quality of life questionnaires were completed. The Urogenital Distress Inventory (UDI-6) assesses bladder symptoms and the Incontinence Impact Questionnaire (IIQ-7) assesses the impact of bladder symptoms on quality of life. Three months after initiation of (neo)adjuvant therapy, the quality of life questionnaires were repeated. We report the results of the pretreatment questionnaires.

Results: Between February and June, 2015, forty-nine women with newly diagnosed breast cancer were enrolled on study. The median age was 54 (Range 25-78); 21 were premenopausal and 28 postmenopausal. Twenty nine (59%) were treated in the adjuvant setting; 12 with chemotherapy and 17 with endocrine therapy. Twenty patients, (41%) were treated in the neoadjuvant setting with chemotherapy. Prior to initiation of therapy, " Frequent urination" was reported in 38 (65%), " Leakage related to urgency" in 5 ( 10%), " Leakage with physical activity" in 32 (55%) and "Small amounts of leakage" in 32 (55%). Bladder symptoms impacted the ability to perform household chores in 8 (16%), Physical recreation in 10 (20%), social activities in 9 (18%), and Emotional health in 5 (10%).

Conclusions: Symptoms of bladder dysfunction are common in women with newly diagnosed breast cancer even before therapy is initiated.

Citation Format: Wong L, Chung C, Flores S, Mortimer J. Bladder symptoms in women with newly diagnosed breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-10-23.

Three-dimensional imaging of the uterus: The value of the coronal plane

Advent in three-dimensional (3D) imaging technology has seen 3D ultrasound establish itself as a useful adjunct complementary to traditional two-dimensional imaging of the female pelvis. This advantage largely arises from its ability to reconstruct the coronal plane of the uterus, which allows further delineation of many gynecological disorders. 3D imaging of the uterus is now the preferred imaging modality for assessing congenital uterine anomalies and intrauterine device localization. Newer indications include the diagnosis of adenomyosis. It can also add invaluable information to delineate other endometrial and myometrial pathology such as fibroids and endometrial polyps.

Mitigation of organic laser damage precursors from chemical processing of fused silica

Increases in the laser damage threshold of fused silica have been driven by the successive elimination of near-surface damage precursors such as polishing residue, fractures, and inorganic salts. In this work, we show that trace impurities in ultrapure water used to process fused silica optics may be responsible for the formation of carbonaceous deposits. We use surrogate materials to show that organic compounds precipitated onto fused silica surfaces form discrete damage precursors. Following a standard etching process, solvent-free oxidative decomposition using oxygen plasma or high-temperature thermal treatments in air reduced the total density of damage precursors to as low as <50 cm(-2). Finally, we show that inorganic compounds are more likely to cause damage when they are tightly adhered to a surface, which may explain why high-temperature thermal treatments have been historically unsuccessful at removing extrinsic damage precursors from fused silica.

Unusual cause of iatrogenic anterior open bite after bilateral sagittal split mandibular advancement osteotomy

We describe a case of anterior open bite after bilateral sagittal split mandibular advancement osteotomy. The discrepancy in height between the proximal and distal segments at the osteotomy sites damaged the soft tissue and caused bony interferences. Removal of the maxillary third molars and bilateral removal of bony interferences of the distal segments using a bur led to full resolution and a good orthognathic outcome on follow-up.

PCR-based identification of adriatic specimen of three scorpionfish species (Scorpaenidae, Teleostei)

The identification of three scorpionfish species, the black scorpionfish (Scorpaena porcus Linnaeus, 1758), the large-scaled scorpionfish (S. scrofa Linnaeus, 1758) and the small red scorpionfish (S. notata Rafinesque, 1810) is possible in adults by morphometry, but often problematic in juveniles due to their similar phenotypes. To develop a molecular species identification tool, first, we have analyzed the genetic similarity of the three species by a PCR-based 'blind method' that amplified bands from various locations of the genome. We found high levels of nucleotide similarity between S. porcus and S. scrofa, whereas S. notata showed a higher level of divergence from the other two species. Then, we have searched these patterns for differences between the genomes of Adriatic specimen of these three species and identified several species-specific products in two of them. For the third one a species-specific primer pair amplifying from the 16S ribosomal DNA was designed. One marker for each species was cloned, sequenced and converted into Sequence Characterized Amplified Region (SCAR) markers amplified by specific primer pairs. The SCAR markers amplified robust bands of limited variability from the target species, while no or only occasional weak products were obtained from the other two, proving that they can be used for molecular identification of these three species. These markers can help the conservation and future analysis of these three species as well as their possible selection programs for aquaculture purposes.

Comparative gastrointestinal safety of bisphosphonates in primary osteoporosis: a network meta-analysis

We completed a network meta-analysis of published papers to compare bisphosphonate gastrointestinal safety. We found that zoledronic acid had the highest chance of causing gastrointestinal adverse events. Etidronate had the highest chance of discontinuation due to an adverse event. No difference was found for serious adverse events.

INTRODUCTION

Bisphosphonates are first-line treatment for osteoporosis. Gastrointestinal (GI) adverse events (AE) are the primary reason for non-adherence. Little is known about the comparative GI safety of bisphosphonates.

PURPOSE

Leverage published clinical trial data to examine the comparative GI safety of bisphosphonates.

METHODS

We completed a systematic review of all English-language clinical trials that assessed bisphosphonate safety and/or efficacy in primary osteoporosis through to 2012. Randomized, blinded, and controlled studies were eligible. The primary outcome was any GI-related AE. Subanalyses were completed for upper GI symptoms, serious GI, nausea, esophageal-related events, and discontinuation due to AE. A Bayesian-based network meta-analysis was completed to allow for indirect comparisons. Results were reported as the probability that a specific drug had the highest number of events.

RESULTS

We identified 50 studies: 32 alendronate, 12 risedronate, 5 etidronate, and 7 zoledronic acid. Zoledronic acid had the highest probability of having the highest number of any GI AE (91%) and nausea (70%). Etidronate (70%) and zoledronic acid (28%) had the highest probability of having the greatest attrition due to AE. Etidronate had the highest probability (56%) of having the greatest number of upper GI symptoms among oral bisphosphonates.

CONCLUSION

Zoledronic acid had the highest probability of causing the greatest number of GI AE, possibly related to nausea. These results question the assumption that annual zoledronic acid will translate into better adherence. Little difference was found between alendronate and risedronate for serious AE. More research into real-world implications of the comparative safety of bisphosphonates is needed.

High fluence laser damage precursors and their mitigation in fused silica

The use of any optical material is limited at high fluences by laser-induced damage to optical surfaces. In many optical materials, the damage results from a series of sources which initiate at a large range of fluences and intensities. Much progress has been made recently eliminating silica surface damage due to fracture-related precursors at relatively low fluences (i.e., less than 10 J/cm(2), when damaged by 355 nm, 5 ns pulses). At higher fluence, most materials are limited by other classes of damage precursors which exhibit a strong threshold behavior and high areal density (>10(5) cm(-2)); we refer to these collectively as high fluence precursors. Here, we show that a variety of nominally transparent materials in trace quantities can act as surface damage precursors. We show that by minimizing the presence of precipitates during chemical processing, we can reduce damage density in silica at high fluence by more than 100 times while shifting the fluence onset of observable damage by about 7 J/cm(2). A better understanding of the complex chemistry and physics of cleaning, rinsing, and drying will likely lead to even further improvements in the damage performance of silica and potentially other optical materials.

Myomectomy: technique and current indications

Uterine fibroids are the commonest benign tumor of the female genital tract. They affect a significant proportion of reproductive aged women and while some women are asymptomatic, fibroids can cause excessive menstrual bleeding, pelvic pressure, and adversely affect reproductive outcomes. Myomectomy is the most suitable surgical option for women who desire preservation of their fertility potential. However, only a selected group of women of childbearing age will benefit from a myomectomy. Furthermore, the consequences of myomectomy on reproductive function have remained controversial. The purpose of this paper is to review the main surgical approaches for myomectomy - hysteroscopic resection, laparoscopic myomectomy and open myomectomy (by laparotomy) - and discuss evidence-based indications for myomectomy in women with fibroids, especially with regards to its impact on reproductive outcomes. A critical review of the literature pertaining to the surgical approaches of myomectomy and the indications for myomectomy was performed, focusing on their impact on fertility and reproductive outcomes. Myomectomy is useful for the treatment of symptomatic fibroids and in selected women with infertility. Symptomatic submucosal fibroids are classically treated by hysteroscopic resection. Symptomatic intramural and subserosal fibroids may be treated by myomectomy, either by laparotomy or laparoscopy depending on their number and size. Prophylactic myomectomy is not recommended for preventing obstetrical complications or the risk of leiomyosarcoma. Although fibroids can have a negative effect on fertility, only the removal of submucosal fibroids has been consistently shown to improve spontaneous fertility or outcomes of assisted reproduction technology.

Assessment of online visibility of the British Association of Oral and Maxillofacial Surgeons (BAOMS): a strategic study

The Internet is a powerful method of acquiring and sharing information. In marketing and business, online visibility is vital for publicity and the reputation of an organisation. To our knowledge, the importance of such visibility in medicine in general, and in Oral and Maxillofacial Surgery (OMFS) services in the UK, has not previously been investigated. We aimed to provide a better understanding of the way that patients use the Internet by asking 450 patients to complete a questionnaire when they attended outpatient OMFS departments at 2 centres. We also assessed the online visibility of the British Association of Oral and Maxillofacial Surgeons (BAOMS) and investigated the correlation between the strength of online visibility and professional reputation. Results from the self-administered, anonymous, validated questionnaires showed that 82% of patients agreed that the Internet was a powerful source of information, and two-thirds associated online visibility with a good reputation. However, the perceived online visibility of the BAOMS was poor (2%). This study mirrors findings in business publications, and confirms the link between online visibility and professional reputation. It also shows that there is a gap between patients' perceptions and the level of uptake of professional resources. We propose various strategies to bridge this gap and to promote the online visibility and professional reputation of the BAOMS and of OMFS services in the UK.

High temperature luminescence of Dy3+ in crystalline silicon in the optical communication and eye-safe spectral regions

We report on photoluminescence in the 1.3 and 1.7 μm spectral ranges in silicon doped with dysprosium. This is attributed to the Dy3+ internal transitions between the second Dy3+ excited state and the ground state, and between the third Dy3+ excited state and the ground state. Luminescence is achieved by Dy implantation into Si substrates codoped with boron, to form dislocation loops, and show a strong dependence on fabrication process. The spectra consist of several sharp lines with the strongest emission at 1736 nm, observed up to 200 K. No Dy3+ luminescence is observed in samples without B codoping, showing the paramount importance of dislocation loops to enable the Dy emission.

Displasia renal em cão da raça Rotweiller

Descreveram-se os achados clínicos e patológicos de um caso de displasia renal em um cão da raça Rotweiller com oito meses de idade. O animal apresentou vômitos, emagrecimento, polidpsia e poliúria. Houve elevação sanguínea de creatinina, cálcio e da fosfatase alcalina. À necropsia, notaram-se os rins diminuídos de tamanho, com estruturas císticas proeminentes sobre a superfície natural do órgão e, ao corte, firmes e com estruturas císticas distribuídas pelo parênquima. Na avaliação histológica, havia glomérulos imaturos, fibroplasia intersticial e dilatação cística tubular.