Response to neoadjuvant chemotherapy in breast cancer patients is of prognostic value in determining short- and mid-term outcomes. Inflammatory biomarkers, such as platelet-to-lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR), have been proposed as predictive factors of response to neoadjuvant chemotherapy. Currently, there are no studies in Colombian patients reporting the role of inflammatory biomarkers as response predictors in patients receiving neoadjuvant chemotherapy. Therefore, in this study we performed a cross-sectional study and analyzed the association between inflammatory biomarkers and pCR (pathological complete response) in patients diagnosed with breast cancer–of different molecular subtypes- and treated with neoadjuvant chemotherapy. A total of 288 patients were included in the study, with a median age of 51 years old. Disease was locally advanced in 83% of the participants, and 77.7% had compromised lymph nodes. In our cohort, the most frequent tumor molecular subtype was luminal B/Her2- (27.8%) followed by triple negative [TN] (21.5%), luminal B/Her2+ (19.8%), Her2-enriched (16%) and luminal A (13.5%). PLR was not associated with age, menopausal status, baseline tumor size, histologic grade, axillary lymph node involvement, disease stage, estrogen receptor status, or Ki67; however, complete pathological response was significantly higher in the low PLR group (PLR<150) compared with the high PLR group (35.1% Vs. 22.2%, p = 0.03). In addition, Her2-enriched tumors achieved the highest pCR rates (65%), followed by TN (34%) tumors. Our results suggest that breast cancer patients with low platelet-to-lymphocyte ratio (PLR <150), treated with neoadjuvant chemotherapy achieve higher complete pathological response, independently of primary tumor molecular subtype.

To determine the surgical time, suture time, presence of postoperative dyspareunia, and complications that occur after closing the vaginal cuff with a barbed suture compared with conventional suture. Design: A randomized, controlled clinical trial (Canadian Task Force classification I). Setting: Private gynecologic clinic in Medellin, Colombia. Patients: One hundred fifty women who underwent total laparoscopic hysterectomy for benign pathology. Interventions: The patients underwent total laparoscopic hysterectomy with intracorporeal closure of the vaginal cuff and were randomized to 2 groups, 1 using a barbed suture (V-Loc 90; Medtronic/Covidien, New Haven, CT) and 1 using polyglactin 910 (coated Vicryl suture; Ethicon/Johnson & Johnson, New Brunswick, NJ). Measurements and Main Results: The total operative time, closing time of the vaginal vault, presence of complications in the cuff, and incidence of postoperative dyspareunia were recorded. The patients were evaluated at a postoperative office visit 2 weeks after the procedure and by telephone interview at 24 weeks. Seventy-five patients were included in the barbed suture group and 75 patients in the polyglactin 910 group. The average time to complete the suture of the vaginal cuff was 12.01 minutes (§ 5.37 standard deviation) for the barbed suture group versus 13.49 minutes (§ 6.48) in the polyglactin 910 group (95% confidence interval, −.44 to 3.4; p = .130). Blood loss was 31.56 § 22.93 mL in the barbed suture group versus 30.82 § 21.75 mL in the polyglactin 910 group (95% confidence interval, −7.95 to 6.47; p = .840). The frequency of postoperative events such as hematoma, cellulitis, cuff dehiscence, fever, emergency consultation, and hospitalization was not statistically significant between groups. No statistically significant difference was found regarding deep dyspareunia at 24 postoperative weeks. Conclusion: No differences were found in surgical time or frequency of adverse events when comparing patients after vaginal cuff closure with barbed suture versus polyglactin 910.

BackgroundCardiovascular diseases have become the leading cause of death from chronic diseases in the world. Main risk factors include hypercholesterolemia, which is caused in most cases by a high saturated fat diet. Plant stanol esters partly block cholesterol absorption in the digestive tract and thereby reduce total cholesterol and low-density lipoprotein (LDL) cholesterol serum levels. Based on epidemiological data, a 10 percent reduction of LDL cholesterol leads to a 20 percent decrease in the coronary heart disease risk throughout life. The aim of this study was to evaluate the efficacy of yogurt drink with added plant stanol esters (Benecol® yogurt drink) in higher doses than the typically used (2g/d stanols), in lowering blood lipids in moderately hypercholesterolemic subjects.MethodsA randomized double-blind crossover, placebo-controlled study in moderately hypercholesterolemic subjects (n = 40) aged between 20 and 50 years old.ResultsYogurt drink with added plant stanols (4 g) as esters (Benecol®, Colanta) consumption compared to regular yogurt drink caused a statistically significant decrease in total cholesterol and low density lipoprotein cholesterol by 7.2% and 10.3%. During the two periods and compared to controls, high-density lipoprotein cholesterol and triglycerides were not significantly different.ConclusionsYogurt drink with an active ingredient in Benecol®, plant stanol esters, reduced total cholesterol and LDL cholesterol in moderately hypercholesterolemic subjects.Trial registrationNCT01461798.

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Introduction Obesity is an established risk factor for cancer and cancer-related deaths, including that of the breast. While the prevalence of female obesity has accelerated over the past decade in many developing countries, such as Colombia, the prevalence of overweight and obesity specifically in breast cancer populations has not been fully described. Methods A cross-sectional study including 849 women diagnosed with breast cancer between 2009 and 2014. Based on body mass index, prevalence of overweight (BMI ≥ 25 < 30) and obesity (BMI ≥ 30) and associations of BMI with clinical and tumor histopathological features were analyzed. Results Colombian breast cancer patients had a prevalence of overweight of 34.28% and obesity of 28.15%. Mean BMI was comparable between premenopausal and postmenopausal women (27.2 versus 27.7, resp.). Among premenopausal women, higher BMI was significantly positively associated with hormone receptor negative tumors, as well as with greater lymphovascular invasion. Conclusions Colombian breast cancer patients exhibit a significant prevalence of overweight and obesity. Associations of high BMI and poor prognosis variables in the premenopausal population suggest risk of aggressive disease in this population. Future studies to further validate our observations are warranted in order to implement multidisciplinary clinical guidelines.

BackgroundB lymphocytes are dysregulated in Systemic Lupus Erythematosus (SLE) including the expansion of extrafollicular B cells in patients with SLE of African American ancestry, which is associated with disease activity and nephritis. The population of Colombia has a mixture of European, Native American, and African ancestry. It is not known if Colombian patients have the same B cell distributions described previously and if they are associated with disease activity, clinical manifestations, and environmental exposures.ObjectiveTo characterize B cell phenotype in a group of Colombian Systemic Lupus Erythematosus patients with mixed ancestry and determine possible associations with disease activity, clinical manifestations, the DNA methylation status of the IFI44L gene and environmental exposures.Materials and methodsForty SLE patients and 17 healthy controls were recruited. Cryopreserved peripheral B lymphocytes were analyzed by multiparameter flow cytometry, and the DNA methylation status of the gene IFI44L was evaluated in resting Naive B cells (rNAV).ResultsExtrafollicular active Naive (aNAV) and Double Negative type 2, DN2 (CD27− IgD− CD21− CD11c+) B cells were expanded in severe active patients and were associated with nephritis. Patients had hypomethylation of the IFI44L gene in rNAV cells. Regarding environmental exposure, patients occupationally exposed to organic solvents had increased memory CD27+ cells (SWM).ConclusionaNAV and DN2 extrafollicular cells showed significant clinical associations in Colombian SLE patients, suggesting a relevant role in the disease’s pathophysiology. Hypomethylation of the IFI44L gene in resting Naive B cells suggests that epigenetic changes are established at exceedingly early stages of B cell ontogeny. Also, an alteration in SWM memory cells was observed for the first time in patients exposed to organic solvents. This opens different clinical and basic research possibilities to corroborate these findings and deepen the knowledge of the relationship between environmental exposure and SLE.

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