Lipid Changes During Endocrine Therapy in Breast Cancer Patients: The Results of a 5-Year Real-World Retrospective Analysis

BackgroundThe aim of this study was to investigate the status of serum lipids during endocrine therapy.MethodsWe retrospectively analysed lipid profiles during the 5-year treatment of 1487 consecutive postoperative BC patients. Lipid parameters included triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL-C) and high-density lipoprotein (HDL-C). Those biomarkers were measured at baseline and 1, 2, 3, 4 and 5 years following the initiation of endocrine therapy.ResultsFor premenopausal BC patients, LDL levels rapidly decreased at 1 year in the tamoxifen (TAM) group compared with baseline levels (p<0.05), and this decline remained for the following 4 years. Additionally, LDL levels were significantly lower in the TAM group than in the nonendocrine group at all assessment time points (p<0.05). Similarly, TC levels also decreased in the TAM group compared with baseline levels at all assessment time points (p<0.05), and compared with the levels in the nonendocrine group, TC levels were also lower for the first 4 years. For postmenopausal BC patients, there was no significant difference in the lipid profiles (TG, TC, LDL and HDL) in the letrozole (LET), anastrozole (ANA) or exemestane (EXE) groups compared with the nonendocrine group. For patients who received TAM, compared with the nonendocrine group, TC levels decreased at 1 year, and LDL levels decreased at 1 and 2 years.ConclusionsTAM may improve LDL and TC levels in premenopausal BC patients. In postmenopausal BC patients, aromatase inhibitors (AIs) may have no adverse effects on lipid profiles, and TAM may have limited beneficial effects on serum lipids.

Factor Structure and Internal Consistency on a Reduced Version of the Revised Test of Need for Cognitive Closure

The need for cognitive closure is a construct postulated by Kruglanski that explains the motivational aspects which influence decision-making and its impact on the social environment. Initially, it was assessed through a unidimensional scale, later criticized for its poor satisfactory reliability and validity. Regarding these criticisms, Pierro and Kruglanski developed a new 14-item scale to measure two dimensions, which were not previously evaluated: urgency tendency and permanence tendency. Although the Revised Test of Need for Cognitive Closure is more economical in terms of assessment time, it would be optimal to develop a reduced test that can assess faster while maintaining validity and reliability. The present research aims to reduce the Revised Test of Need for Cognitive Closure scale to the Argentinian context. To this end, we worked on a non-experimental design, assessing this scale within a sample of 690 Argentinian university students (Women = 81.16%, Men = 18.84%), and proceeded to perform reliability, as well as confirmatory factor analysis, convergent validity, and factorial invariance analysis. The results indicate a bi-factorial structure of a Need for Cognitive Closure instrument with eight items and two dimensions: urgency tendency (α = 0.76) and permanence tendency (α = 0.64), suggesting good reliability in both of them. In addition, well convergent validity was checked with other validated instruments, and finally, the factor loadings were shown to be invariant. In conclusion, it was demonstrated the reliability and validity of reducing the Revised Test of Need for Cognitive Closure in our social environment.

The Optimism–Pessimism Short Scale–2 (SOP2): a comprehensive validation of the English-language adaptation

The Optimism–Pessimism Short Scale–2 (SOP2) described in this article measures the psychological disposition of optimism with two items. SOP2 is the English-language adaptation of an originally for the German language developed scale. Because an empirical validation of this English-language SOP2 was hitherto lacking, the aim of the present study was to assess the psychometric properties (objectivity, reliability, validity) of the English-language adaptation and to investigate measurement invariance across both language versions using heterogeneous quota samples from the UK and Germany. Our results show that the English-language adaptation has satisfactory reliability coefficients and is correlated with 10 external variables in the study (e.g., self-esteem, Emotional Stability, life satisfaction). Moreover, scalar measurement invariance of the scale holds when comparing the UK and Germany, implying the comparability of latent (co)variances and latent means across the two nations. As an ultra-short scale with a completion time of < 20 s, SOP2 lends itself particularly to the assessment of dispositional optimism in survey contexts in which assessment time or questionnaire space are limited. It can be applied in a variety of research disciplines, such as psychology, sociology, or economics.

Peri-Implantitis: Application of a Protocol for the Regeneration of Deep Osseous Defects. A Retrospective Case Series

Background and aims: Peri-implantitis is a complex pathology, both in its diagnosis and in the identification of etiological causes. Although we have been studying more and more over the years to try to answer the many questions that remain regarding everything that circulates around this disease which affects implants, nothing has yet been taken as an official consensus regarding its surgical treatment. There are still many proposed protocols, each of which has been shown to have comforting results and promising prospects, but no total predictability. The aim of this case series is to assess the clinical outcomes of a mixed protocol for the regeneration of deep osseous defects. Materials and methods: The data and clinical records of 23 patients, with 29 implants affected by peri-implantitis treated surgically in private practice, were analyzed retrospectively. The method used for the surgical treatment was a mixed protocol of mechanical–chemical decontamination and bone regeneration with bovine xenograft. Results: All patients were followed for at least 2 years, averaging 28.9 months (a range of 24–38 months) with a reduction in the probing depth (PD) at one year from the initial 8.14 ± 1.156 mm to 3.72 ± 0.649 mm, and to 4.14 ± 1.093 mm at the final assessment. The differences between assessment time points were always statistically significant. The data regarding bleeding on probing (BoP) and suppuration also showed a statistically significant reduction at the final time point compared to the baseline. Only one patient, at 24 months, still showed BoP, suppuration, and a PD deeper than 5 mm, indicating a recurrence of the disease compared to the initial improvement of the PD (5 mm) at one year. Conclusions: In conclusion, within the limits of this retrospective analysis, it can be affirmed that this combined mechanical–chemical and regenerative decontamination therapy is effective in the treatment of peri-implantitis.

Suicide risk assessment: time to think again?

This paper considers recent research on suicide risk assessment to support calls for a ‘rethink’ of our assessment of the patients in our care, along with the adoption of a more collaborative approach to care planning with service users who remain at risk of self-harm and in need of a plan for their safety.

Timing Assessment of Response to Fluid Challenge in Patients with Septic Shock

Objectives: Fluid challenge (FC) is most commonly used for fluid responsiveness (FR) evaluation, with a wide divergence in assessment time choices. Therefore, we aimed to explore the optimal assessment time for FC in patients with septic shock. Methods: A prospective cohort study was conducted. Septic shock patients who had experienced initial resuscitation and required an FC with 500 mL 4% gelatin or normal saline (NS) over 5-10 min were included. FR was defined by an increase in cardiac index (CI) >10%. FR and other predefined variables were recorded at baseline (Tb), immediately (T0), and at 10 (T1), 30 (T2), 45 (T3), 60 (T4), 90 (T5), and 120 (T6) min after FC. The incidence of FR and hemodynamic variables at predefined time points were recorded. Data were analyzed by repeated measures of analysis of variance. Results: 63 patients were enrolled, with 43 in the gelatin group and 20 in the NS group. Among the 45/63 (71%) responders, 31 were responded at T0 (ER), while 14 responded at T1 or later (LR). The proportion of NR, ER and LR was comparable between gelatin and NS groups. After FC, the time course of FR status was slightly different between gelatin and NS groups. In the gelatin group, FC induced most responders (69%, 31/45) and frequency of CI maximum (35%, 11/31) at T2 and sustained a positive FR status until T4; while in the NS group, FC induced most responders (55%, 11/20) and frequency of CI maximum (64%, 9/14) at T1, and sustained FR status until T1. Conclusions: Different time courses of FR were found between gelatin and NS group patients undergoing FC. Thus, when NS is used, FR should be performed within 10 min, while it is better to extend the assessment time to 30 min after FC when gelatin is used.

Michigan International Copper Analogue (MICA) project – current status

One of the key requirements for the deep geological disposal of high-level nuclear waste is the assessment of its long-term performance and safety (up to 1 Ma). Regarding engineered barrier system materials, such as copper, much of the data available comes from short-term investigations, such as laboratory experiments at different scales. Copper is an important part of many waste packaging and disposal concepts, e.g. KBS-3 developed in Sweden and Finland and Mark II developed in Canada. Natural analogues provide another important way of obtaining understanding on potential repository system behavior. Observations made from the geological systems can be utilized in the safety case, providing information on the assessment time scale. Copper analogue studies (both natural analogues and archaeological analogues) have been reported in the literature and they have been extensively reviewed by various authors (e.g. Miller et al., 2000) and by safety case projects (e.g. Reijonen et al., 2015) within waste management organizations. So far, only a few studies have focussed on the general stability of native copper within its natural media (e.g. Milodowski et al., 2000; Marcos, 2002). Keweenaw native copper occurrences (Lake Superior, USA) have been mentioned as a qualitative source of information (e.g. in Miller et al., 2000); however, data to be used in process-based safety assessments for geological disposal are lacking. These deposits have been mined for a long time and there is a great deal of knowledge related to them as well as samples collected, but no formal review has been made from the geological disposal point of view. The native copper at the Keweenaw area reflects various geological environments from bedrock to sediment and even anthropogenic mine site remnants and geochemical environments (e.g., anoxic vs. oxic, sulphur-free vs. sulphur-bearing). It thus provides a unique complementary data source that will be useful for estimating processes governing behavior of metallic copper. The MICA project phase I systematically collects and reviews the existing literature and data on the Michigan copper analogue sites and available sampling potential. Here, we present the current status of the project.

BRMP-02. Feasibility and evaluation of a novel language paradigm for intraoperative language testing

INTRODUCTION Mapping language during direct cortical stimulation (DCS) in the stetting of awake craniotomy might be challenging without using more than one language paradigm. Applying several language tasks leads to increasing surgery times and to patient’s exhaustion. Additionally, a single language trial must be performed in less than 4 seconds to avoid DCS-induced seizures. Therefore, we aimed to design a single language paradigm which pictures highly relevant language functions and simultaneously restrains the assessment time of single language trials up to 4 seconds. METHOD The intraoperative language task comprised a combination of picture naming and verb generation. During DCS patients should generate correct sentences according to the language stimulus by not exceeding 4 seconds. To assess the intraoperative feasibility of the language task we included 30 healthy subjects in a pilot study to measure subjects’ speed of performing a single language task trial and to evaluate the language paradigm according to its language sensitivity by using the paradigm as a task for functional MRI. Intraoperatively, 21 patients with brain tumors in language associated brain areas were included. Patients received neuropsychological testing before and after surgery. RESULTS The pilot study showed in healthy subjects that by applying the novel paradigm during fMRI there is activation in a left accentuated network of inferior frontal and parietal regions and the superior and middle temporal gyrus (p&lt;.05, FEW). It was feasible to conduct a single language trial of the novel paradigm in a time frame of 4s (performance speed 2.53 s; SD=.32s). Intraoperatively, tumor patients showed DCS-associated language errors while conducting the language task. Postoperatively, mild language but no other neuropsychological deteriorations compared to presurgical assessment were observed (p&lt;.05). CONCLUSION We present a novel language paradigm which safely pictures and monitors highly relevant language functions and consequently can minimize postoperative language deficits.

Training vs. Competition in Sport: State Anxiety and Response of Stress Hormones in Young Swimmers

This study was aimed to assess the neuroendocrine response to stress induced by different sports environments (a regular training session and a competitive event), to define the contribution of psychological and physical stress, and to check the possible relationship between state-anxiety and stress hormones responses to competitive and non-competitive sports practices. Twelve young national-level male swimmers participated in this investigation. Endorphins, adrenocorticotropin, and prolactin plasma levels were measured at baseline conditions (t0), before a regular swimming training session (t1), and before and after real swimming competition consisting of 100 m freestyle (t2 and t3, respectively). Moreover, state-anxiety was evaluated in all assessment time-points. The results showed no differences in endorphin, adrenocorticotropin, prolactin and state-anxiety between t0 and t1; however, significant increases in endorphins (142%), prolactin (137%) and state-anxiety (13%) were observed in t2. Huge stress response was observed in t3 (increases of 354%, 387%, and 250% for endorphins, adrenocorticotropin, and prolactin, respectively) although state-anxiety decreased slightly. Lastly, a lack of the relationship between stress hormones and state-anxiety was found in all conditions. Mental and especially physical stress associated with sports competition induces a significant release of stress hormones which is not relevant for the regular training session.