Adjuvant therapy with GnRH agonists/tamoxifen in breast cancer should be a good council for patients with hormone receptor-positive tumours and wish to preserve fertility

Infertility represents one of the main long-term consequences of combination chemotherapy used for the treatment of breast cancer. Approximately 60%-65% of breast cancers express the nuclear hormone receptor in premenopausal women. Adjuvant endocrine therapy is an integral component of care for patients with hormone receptor-positive (HR+) tumours. The GnRH agonist (GnRHa) alone or in combination with tamoxifen produces results at least similar to those obtained with the different chemotherapy protocols in patients with HR+ tumors with respect to recurrence-free survival and overall survival, Presentation of the hypothesis: It is time to indicate adjuvant therapy with GnRHa associated with tamoxifen for patients with breast cancer (HR+ tumours) if they want to preserve their reproductive function. Testing the hypothesis: Assessment of ovarian reserve tests: follicle stimulating hormone (FSH), anti-Mullerian hormone (AMH), inhibin B, antral follicle count (AFC) and ovarian volume 6 months, and 1 year after the end of therapy with GnRHa/tamoxifen. The recurrence-free survival and overall survival should be analysed. Implications of the hypothesis: The major implication will be to avoid adjuvant chemotherapy for patients with breast cancer (HR+ tumours) that request fertility preservation. It is expected that ovarian function should not be altered in almost all cases. © Todos os direitos reservados a SBRA - Sociedade Brasileira de Reprodução Assistida.

Agendas de competitividad por agrocadenas: la experiencia de los organismos interprofesionales en Francia

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Seminario sobre causas de muerte: aplicación al caso de Francia

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El Estado en países desarrollados: la acción pública en Alemania, Estados Unidos, Francia y Japón: enseñanzas para América Latina

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Descentralización político-financiera en Francia

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La planificación en Francia = Planning in France

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Huérfanos y la mortalidad adulta: el ejemplo de Francia de 1740 a 1829

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Nota de la Secretaría (sobre la solicitud del Ministerio de Asuntos Exteriores de Francia, en nombre del Consejo Regional de Martinica, para su incorporación como miembro asociado a la CEPAL)

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Double effort test for evaluation of aerobic capacity of diet-induced obese rats

Introduction: The literature lacks studies about lactate actions and some limitations in studies involving healthy individuals or patients with some metabolic disorder. Objectives: This study aimed to evaluate the protocol of double effort test for obese-induced rats. Methods: Fourteen male Wistar rats were divided into two groups: Control (Con) and Obese (Obe). The control group was fed with standard chow and water ad libitum. The obese group was fed with standard chow, water ad libitum and hyperlipidic diet. Twelve weeks after the beginning of the hyperlipidic diet, insulin tolerance test, Maximal Lactate Steady State (MLSS) test and the double efforts test were performed. Results: The diet was effective to promote obesity. The obese group decreased insulin sensitivity in approximately 19% (Con = 2.156 ± 0.1187 AU vs Obe = 1.742 ± 0.1551 AU). The lactate concentration and velocity of anaerobic threshold at MLSS test were 3.780 ± 0.09 mmol/L e 18 m.min-1 in both groups. The velocity of anaerobic threshold estimated by double efforts test was 15.59±0.653 m.min-1 in Con group control animals and 16.42±0.672 m.min-1 in Obe group. The double effort test underestimated around 13% and 8.7% the aerobic capacity in control and obese groups respectively, however, presented significant correlation with MLSS (r = 0,88; P < 0,0075 controls / r = 0,92; P < 0,0031 obese). Conclusion: So, the double effort test can be an interesting alternative to evaluate the aerobic capacity for both healthy sedentary and obese animals.