Prognostic factors are clinical and pathological features that give information in estimating the likely clinical outcome of an individual suffering from cancer. The author gives a short review of the most important prognostic factors in breast cancer. 376 breast cancer cases of a ten year interval in a county hospital are summarized. Traditional clinico-pathological parameters i.e. TNM and steroid receptor status are discussed. The more common karyotipic, oncogene and tumor suppressor gene alterations are outlined in the study. Methods for their detection are presented and their value in prognostication is reviewed. Emphasis was laid on steroid receptors, c-erpB-2, p53 and bcl-2 alterations. Genes responsible for heritable forms of increased breast cancer risk are briefly reviewed.

Prognostic factors in breast cancer

Phthalates (diesters of phthalic acid) are widely used as plasticizers and additives in many consumer products. Laboratory animal studies have reported the endocrine-disrupting and reproductive effects of phthalates, and human exposure to this class of chemicals is a concern. Several phthalates have been recognized as substances of high concern. Human exposure to phthalates occurs mainly via dietary sources, dermal absorption, and air inhalation. Phthalates are excreted as conjugated monoesters in urine, and some phthalates, such as di-2-ethylhexyl phthalate (DEHP), undergo secondary metabolism, including oxidative transformation, prior to urinary excretion. The occurrence of phthalates and their metabolites in urine, serum, breast milk, and semen has been widely reported. Urine has been the preferred matrix in human biomonitoring studies, and concentrations on the order of several tens to hundreds of nanograms per milliliter have been reported for several phthalate metabolites. Metabolites of diethyl phthalate (DEP), dibutyl- (DBP) and diisobutyl- (DiBP) phthalates, and DEHP were the most abundant compounds measured in urine. Temporal trends in phthalate exposures varied among countries. In the United States (US), DEHP exposure has declined since 2005, whereas DiNP exposure has increased. In China, DEHP exposure has increased since 2000. For many phthalates, exposures in children are higher than those in adults. Human epidemiological studies have shown a significant association between phthalate exposures and adverse reproductive outcomes in women and men, type II diabetes and insulin resistance, overweight/obesity, allergy, and asthma. This review compiles biomonitoring studies of phthalates and exposure doses to assess health risks from phthalate exposures in populations across the globe.

https://www.mdpi.com/2305-6304/7/2/21/pdf

A Review of Biomonitoring of Phthalate Exposures

Phthalate diesters, widely used in flexible plastics and consumer products, have become prevalent contaminants in the environment. Human exposure is ubiquitous and higher phthalate metabolite concentrations documented in patients using medications with phthalate-containing slow release capsules raises concerns for potential health effects. Furthermore, animal studies suggest that phthalate exposure can modulate circulating hormone concentrations and thus may be able to adversely affect reproductive physiology and the development of estrogen sensitive target tissues. Therefore, we conducted a systematic review of the epidemiological and experimental animal literature examining the relationship between phthalate exposure and adverse female reproductive health outcomes. The epidemiological literature is sparse for most outcomes studied and plagued by small sample size, methodological weaknesses, and thus fails to support a conclusion of an adverse effect of phthalate exposure. Despite a paucity of experimental animal studies for several phthalates, we conclude that there is sufficient evidence to suggest that phthalates are reproductive toxicants. However, we note that the concentrations needed to induce adverse health effects are high compared to the concentrations measured in contemporary human biomonitoring studies. We propose that the current patchwork of studies, potential for additive effects and evidence of adverse effects of phthalate exposure in subsequent generations and at lower concentrations than in the parental generation support the need for further study.

/pdf/reproductive-and-developmental-effects-of-phthalate-diesters-390sd5mtmg.pdf

Reproductive and developmental effects of phthalate diesters in females.

BACKGROUND
Herein, we describe the consensus guideline methodology, summarize the evidence-based recommendations we provided to the World Health Organization (WHO) for their consideration in the development of global guidance and present a narrative review of the diagnosis of male infertility as related to the eight prioritized (problem or population (P), intervention (I), comparison (C) and outcome(s) (O) (PICO)) questions. Additionally, we discuss the challenges and research gaps identified during the synthesis of this evidence.

/pdf/the-diagnosis-of-male-infertility-an-analysis-of-the-27wchg7ij9.pdf

The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance—challenges and future research opportunities

Depression is a disabling illness which increases the risk of suicide. The Corona Virus Disease 2019 (COVID-19) pandemic has led to a rise in fear, anxiety, stress, and depression among the population: of these, university undergraduates from countries severely affected by COVID-19 are some of the most vulnerable of all, as they face strict lockdown measures and have fewer resources to cope with it. The aim of this study was to analyze the levels of fear of COVID-19, stress, anxiety, and depression during lockdown among undergraduates from Ecuador, and to test these possible predictors of depression using a model taken from our study of the scientific literature. A total of 640 undergraduates (72% women) between 18 and 47 years old (M = 21.69; S.D = 4.093) were surveyed. The resulting mean levels found for stress, anxiety, and depression were above levels considered non-pathological. Women showed higher levels of fear of COVID-19 than men. The statistical prediction for depression showed a good fit. This depression could be related: both directly and positively by fear of COVID-19 and stress, and indirectly, as a result of these two factors, positively mediated by anxiety. Our study concludes by highlighting the important role that the complex relationships between fear, stress, and anxiety can play in the development of depression symptoms and how they can be taken into account in programs aimed at preventing and alleviating this disorder. We propose some general measures for reducing fear of COVID-19 and stress and suggest that specific programs be designed to control and overcome anxiety among undergraduates.

/pdf/fear-of-covid-19-stress-and-anxiety-in-university-1vefm8bhel.pdf

Lei Sun

Papers

Semen damage contributed over 50 % to air-pollutant-induced infertility: A prospective cohort study of 3940 men in China.

Lei Sun

Papers

Semen damage contributed over 50 % to air-pollutant-induced infertility: A prospective cohort study of 3940 men in China.

Semen damage contributed over 50 % to air-pollutant-induced infertility: A prospective cohort study of 3940 men in China.