Clinical role of trastuzumab in metastatic breast cancer: experience of a center

Objective: To study the efficacy of different regimens of treatment based on trastuzumab in patients with Her2+ metastatic breast cancer (MBC).

Plan de marketing para el Dive Center Palamós específico para el mercado francés

Realització d’un pla de màrqueting i comercial de l’empresa Dive Center Palamós orientat específicament al mercat francès. L'autora tria aquest segment de clients per la seva proximitat a la Costa Brava i per la seva tradició de submarinisme

Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC).

BACKGROUND Earlier analyses within the EPIC study showed that dietary fibre intake was inversely associated with colorectal cancer risk, but results from some large cohort studies do not support this finding. We explored whether the association remained after longer follow-up with a near threefold increase in colorectal cancer cases, and if the association varied by gender and tumour location. METHODOLOGY/PRINCIPAL FINDINGS After a mean follow-up of 11.0 years, 4,517 incident cases of colorectal cancer were documented. Total, cereal, fruit, and vegetable fibre intakes were estimated from dietary questionnaires at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models stratified by age, sex, and centre, and adjusted for total energy intake, body mass index, physical activity, smoking, education, menopausal status, hormone replacement therapy, oral contraceptive use, and intakes of alcohol, folate, red and processed meats, and calcium. After multivariable adjustments, total dietary fibre was inversely associated with colorectal cancer (HR per 10 g/day increase in fibre 0.87, 95% CI: 0.79-0.96). Similar linear associations were observed for colon and rectal cancers. The association between total dietary fibre and risk of colorectal cancer risk did not differ by age, sex, or anthropometric, lifestyle, and dietary variables. Fibre from cereals and fibre from fruit and vegetables were similarly associated with colon cancer; but for rectal cancer, the inverse association was only evident for fibre from cereals. CONCLUSIONS/SIGNIFICANCE Our results strengthen the evidence for the role of high dietary fibre intake in colorectal cancer prevention.

Clinical manifestations of mucous membrane pemphigoid in a tertiary center.

Mucous membrane pemphigoid (MMP) is a progressive inflammatory disease of autoimmune etiology. We performed a retrospective analysis of clinical signs and treatment on 16 patients. Conjunctival biopsies were performed in all patients and showed typical immuno-deposits at the basement membrane zone. The mean age at presentation was 69 years, 60 % were female.12 patients demonstrated ocular involvement (11 bilaterally). At the time of referral to our hospital, 92 % had reached an advanced stage III or IV. All patients presented conjunctival fibrosis with resultant fornix foreshortening. Trichiasis and symblepharon were found in 11 patients. Keratitis was found in 11 patients resulting in ulceration in 5 cases. Complications required surgical interventions included: entropion surgery (n = 2), tarsorrhaphy (n = 1), amniotic membrane transplantation (n = 2), keratoplasty (n = 1). Systemic immunomodulatory therapy is the treatment of choice. Dapsone (n = 8), steroids (n = 8), azathioprine (n = 5), cyclophosphamide (n = 2), mycophenolate mofetil (n = 4) and methotrexate (n = 1) were used concomitantly or consecutively. Early diagnosis can prevent ocular complications. Immunomodulatory therapy has provided an avenue for preserving vision. The management of MMP requires a multidisciplinary approach.

Agriculture, technological change and environmental sustainability: Looking for a win-win water policy strategy

This paper analyses the effects that technological changes in agriculture would have on environmental, social and economic indicators. Specifically, our study is focused on two alternative technological improvements: the modernization of water transportation systems versus the increase in the total factor productivity of agriculture. Using a computable general equilibrium model for the Catalan economy, our results suggest that a water policy that leads to greater economic efficiency is not necessarily optimal if we consider social or environmental criteria. Moreover, improving environmental sustainability depends less on the type of technological change than on the institutional framework in which technological change occurs. Keywords: agricultural technological changes, computable general equilibrium model, economic impact, water policy

Nutrient patterns and their food sources in an International Study Setting: report from the EPIC study.

BACKGROUND Compared to food patterns, nutrient patterns have been rarely used particularly at international level. We studied, in the context of a multi-center study with heterogeneous data, the methodological challenges regarding pattern analyses. METHODOLOGY/PRINCIPAL FINDINGS We identified nutrient patterns from food frequency questionnaires (FFQ) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study and used 24-hour dietary recall (24-HDR) data to validate and describe the nutrient patterns and their related food sources. Associations between lifestyle factors and the nutrient patterns were also examined. Principal component analysis (PCA) was applied on 23 nutrients derived from country-specific FFQ combining data from all EPIC centers (N = 477,312). Harmonized 24-HDRs available for a representative sample of the EPIC populations (N = 34,436) provided accurate mean group estimates of nutrients and foods by quintiles of pattern scores, presented graphically. An overall PCA combining all data captured a good proportion of the variance explained in each EPIC center. Four nutrient patterns were identified explaining 67% of the total variance: Principle component (PC) 1 was characterized by a high contribution of nutrients from plant food sources and a low contribution of nutrients from animal food sources; PC2 by a high contribution of micro-nutrients and proteins; PC3 was characterized by polyunsaturated fatty acids and vitamin D; PC4 was characterized by calcium, proteins, riboflavin, and phosphorus. The nutrients with high loadings on a particular pattern as derived from country-specific FFQ also showed high deviations in their mean EPIC intakes by quintiles of pattern scores when estimated from 24-HDR. Center and energy intake explained most of the variability in pattern scores. CONCLUSION/SIGNIFICANCE The use of 24-HDR enabled internal validation and facilitated the interpretation of the nutrient patterns derived from FFQs in term of food sources. These outcomes open research opportunities and perspectives of using nutrient patterns in future studies particularly at international level.

Ideas, Possibilities and Limitations of Sustainable Economic Policy – the Example of Ecological Economics

A mesura que el suport del creixement econòmic constitueix un objectiu fonamental de la formulació de polítiques econòmiques, cal assenyalar que aquest tipus de creixement està limitat naturalment per un planeta finit. Aquest article argumenta que, des del punt de vista de la justícia intergeneracional, la realització d'un concepte de desmaterialització i, com a efecte, d'una economia que no creix (en el sentit de dissociació absoluta del creixement econòmic i consum d'energia i materials) es pot justificar. Per tant, el creixement pot ser també entesa com la millora de la qualitat de vida sobretot en comptes d'ampliar quantitats escarpats de sortida. Per tant, una dràstica reducció del cabal de material es necessita, sobretot en els països d'alts ingressos. Després de presentar alguns crítica de les propostes, en el focus d'aquest article es dibuixen en els arguments de per què la política econòmica en el futur han de ser etiquetats com "ecològic" i, a continuació, les opcions de posar en acció les idees del teòric presentat marc en tasques manejables polítiques seran discutides. En aquest cas, s'argumentarà que l'enfocament clàssic de internalització d'efectes externs sovint seguides de decisions de política econòmica ortodoxa no és completament capaç de reflectir canvis ecològics en les estructures de preus dels mercats. Per tant, formal (industrial i l'establiment de la política de consum) i institucions informals (llars) representen punts clau de la política econòmica sostenible, assenyalant l'individu com així com la responsabilitat col · lectiva per omplir aquest buit substancial.

A Sustainable Development Strategy for the Pyrenees-Mediterranean Euroregion: Basic Guidelines

L'estudi presenta té per objecte formular els requisits necessaris per posar en marxa una estratègia per al desenvolupament sostenible de l'Euroregió Pirineus-Mediterrània. Aquest és un projecte de cooperació transfronterera regional promogut per l'expresident de la Generalitat, Honorable Sr Pasqual Maragall, que, a més de Catalunya, inclou Aragó, Illes Balears, Llenguadoc-Rosselló i Migdia-Pirineus. A la Unió Europea hi ha més de 70 euroregions, que han estat en funcionant per diferents periodes de temps, després d'haver estat creat per regions o entitats locals, o ambdós

Institutional regimes for sustainable collective housing stocks

The influence of public policy, property rights and contracts on the sustainability of residential buildings remains largely unknown. This research will use the analytical framework of the housing institutional regime to study the sustainability over time of the housing stock. We aim to produce an inventory of the housing institutional regime in Switzerland, a comparison with the German and Catalan regimes, and policy suggestions to achieve a better sustainability of the housing stock.

Are sustainable companies less risky and more profitable?

The purpose of this study was to determine whether there were significant differences in accounting indicators when comparing sustainable enterprises to other similar companies that are not considered as sustainable. The Corporate Sustainability Index of BM (São Paulo Stock, Commodities and Futures Exchange) was the criterion selected to break down the samples into sustainable and non-sustainable enterprises. The accounting indicators were separated into two kinds: risk (dividend payout, percentage growth of assets, financial leverage, current liquidity, asset size, variability of earnings, and accounting beta) and return (ROA, ROE, asset turnover, and net margin). We individually analyzed the companies in the energy sector, followed by those in the banking sector, as well as the entire ISE portfolio as of 2008/2009, including all the sectors. Mann-Whitney tests were performed in order to verify the difference of the means between the groups (ISE and non-ISE). The results, considering the method chosen and the time span covered by the study, indicate that there are no differences between sustainable companies and the others, when they are assessed by the accounting indicators used here.

Networks in Argentine agriculture: a multiple-case study approach

Argentina is among the four largest producers of soybeans, sunflower, corn, and wheat, among other agricultural products. Institutional and policy changes during the 1990s fostered the development of Argentine agriculture and the introduction of innovative process and product technologies (no-till, agrochemicals, GMO, GPS) and new investments in modern, large-scale sunflower and soybean processing plants. In addition to technological changes, a "quiet revolution" occurred in the way agricultural production was carried out and organized: from self-production or ownership agriculture to a contract-based agriculture. The objective of this paper is to explore and describe the emergence of networks in the Argentine crop production sector. The paper presents and describes four cases that currently represent about 50% of total grain and oilseed production in Argentina: "informal hybrid form", "agricultural trust fund", "investor-oriented corporate structure", and "network of networks". In all cases, hybrid forms involve a group of actors linked by common objectives, mainly to gain scale, share resources, and improve the profitability of the business. Informal contracts seem to be the most common way of organizing the agriculture process, but using short-term contracts and sequential interfirm collaboration. Networks of networks involve long-term relationships and social development, and reciprocal interfirm collaboration. Agricultural trust fund and investor-oriented corporate structures have combined interfirm collaboration and medium-term relationships. These organizational forms are highly flexible and show a great capacity to adapt to challenges; they are competitive because they enjoy aligned incentives, flexibility, and adaptability.