S-31B8-3 Background/Aims: Experimental data suggest that disinfection byproducts (DBPs) are colorectal carcinogens but epidemiological evidence is contradictory. To evaluate colorectal cancer risk associated with long-term DBP exposure. Methods: A case-control study was conducted in Italy and Spain. Cases were newly diagnosed and histologically confirmed, aged 20–85 years, and living in the study areas. Controls were matched to cases by age, gender, and area of residence. Study area comprised Barcelona (Spain) and Milan, Pordenone and Udine (Italy). Study subjects were interviewed on potential risk factors of colorectal cancer, residential history and water uses including ingestion, showering, bathing, dishwashing, and swimming in pools. Blood samples were collected to obtain DNA sample. Retrospective data on trihalomethane levels in the study areas have been collected through water companies, and water samples have been collected to measure a range of DBPs. Results: Based on 500 cases and 436 controls in Spain and 400 cases and 363 controls in Italy, the longest residence lasted 35 years on average in Spain and 37 years in Italy. Drinking water at the longest residence was from public water supply among 56% subjects in Spain and 46% in Italy. The rest consumed bottled water or from other sources. Those drinking water from public supplies compared to bottled water had an odds ratio and 95% confidence interval of 1.17 (0.87–1.58) in Spain and 1.18 (0.79, 1.77) in Italy, adjusting for potential confounders. Taking long compared to short showers (above vs. below median) yield an odds ratio of 1.04 (0.80–1.40) in Spain and 1.16 (0.83–1.63) in Italy. Mean trihalomethane levels in Italy were <10 μg/L and ranged from 17.6 to 134 μg/L in Spain. Residential trihalomethane level was associated with an increased colorectal cancer risk for some exposure categories without a clear dose-response. Conclusion: These initial results suggest a weak association between colorectal cancer and DBP exposure.
Falls are a major public health concern in the older population, and certain medication classes are a significant risk factor for falls. However, knowledge is lacking among both physicians and older people, including caregivers, concerning the role of medication as a risk factor. In the present statement, the European Geriatric Medicine Society (EuGMS) Task and Finish group on fall-risk-increasing drugs (FRIDs), in collaboration with the EuGMS Special Interest group on Pharmacology and the European Union of Medical Specialists (UEMS) Geriatric Medicine Section, outlines its position regarding knowledge dissemination on medication-related falls in older people across Europe. The EuGMS Task and Finish group is developing educational materials to facilitate knowledge dissemination for healthcare professionals and older people. In addition, steps in primary prevention through judicious prescribing, deprescribing of FRIDs (withdrawal and dose reduction), and gaps in current research are outlined in this position paper.
Malignant metastases to the thyroid are rare and are even rarer from a colorectal primary. As these metastases are often asymptomatic, they are usually discovered incidentally on imaging performed as follow-up for the primary tumour. In this report, we present a case of metastatic sigmoid adenocarcinoma to the thyroid diagnosed and treated at our institution.
Abstract No gold standard treatment exists for metastatic breast cancer (MBC). Clinical decision making is based on knowledge of prognostic and predictive factors that are extrapolated from clinical trials and, sometimes, are not reliably transferable to a real-world scenario. Moreover, misalignment between endpoints used in drug development and measures of outcome in clinical practice has been noted. The roles of overall survival (OS) and progression-free survival (PFS) as primary endpoints in the context of clinical trials are the subjects of lively debate. Information about these parameters in routine clinical practice is potentially useful to design new studies and/or to interpret the results of clinical research. This study analyzed the impact of patient and tumor characteristics on the major measures of outcome across different lines of treatment in a cohort of 472 patients treated for MBC. OS, PFS, and postprogression survival (PPS) were analyzed. The study showed how biological and clinical characteristics may have different prognostic value across different lines of therapy for MBC. After first-line treatment, the median PPS of luminal A, luminal B, and human epidermal growth factor receptor 2 (HER2)-positive groups was longer than 12 months. The choice of OS as a primary endpoint for clinical trials could not be appropriate with these subtypes. In contrast, OS could be an appropriate endpoint when PPS is expected to be low (e.g., triple-negative subtype after the first line; other subtypes after the third line). The potential implications of these findings are clinical and methodological.
About 10% of pre-school children has recurrent respiratory infections (RRI), which could be related to environmental and/or immunological factors. The aim of the present study has been to evaluate the impact of phagocytosis (FAG) and reactive oxygen intermediates (ROI) production deficiencies on pediatric RRI by the measurement of FAG and ROI activity of the polymorphonuclear neutrophils.Serum immunoglobulins, IgG subclasses, lymphocytic subpopulations, FAG and ROI tests were measured in 90 children with RRI, in a moment of well-being and off all medications for at least 4 weeks. FAG and ROI tests were also measured in 19 healthy children.FAG (91.4 +/- 11.5%) and ROI (81.8 +/- 17.5%) of patients resulted in significantly decreased measurements compared to the control values (95.2 +/- 1.8% and 89.7 +/- 4.8%, respectively). No significant difference was manifest between the mean values of FAG and ROI tests among the patients when they were divided for age (above and below 6 years). A significant decreased likelihood of abnormal ROI (odds ratio, 0.3; 95% confidence interval, 0.07-0.97) was found in the patients with low IgA.The authors' results permit only to suppose an etiological role of FAG and ROI deficiencies of polymorphonuclear neutrophils in the genesis of pediatric RRI, irrespective of the age of the patients, and further studies are necessary for confirmation.
Background and purpose Bilateral globus pallidus deep brain stimulation ( GP i‐ DBS ) represents an effective and relatively safe therapy for different forms of refractory dystonia. The aim of this study was to assess, retrospectively, the effect of two different stimulation settings during GP i‐ DBS in 22 patients affected by primary generalized or multi‐segmental dystonia. Methods Thirteen patients were stimulated using a voltage‐controlled setting whilst in the other nine patients a current‐controlled setting was used. Clinical features were evaluated for each patient at baseline, 6 months and 12 months after surgery by means of the Burke−Fahn−Marsden Dystonia Rating Scale. Results Globus pallidus deep brain stimulation was effective in all patients. However, comparing constant‐current and constant‐voltage stimulation, a better outcome was found in the current‐controlled group during the last 6 months of follow‐up. Conclusions Current‐controlled stimulation is effective during GP i‐ DBS for primary dystonia and it could be a better choice than voltage‐controlled stimulation over long‐term follow‐up.