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Identification of new biomarkers for breast cancer remains critical in order to enhance early detection of the disease and improve its prognosis. Towards this end, we performed an untargeted metabolomic analysis of breast ductal fluid using an ultra-performance liquid chromatography coupled with a quadrupole time-of-light (UPLC-QTOF) mass spectrometer. We investigated the metabolomic profiles of breast tumors using ductal fluid samples collected by ductal lavage (DL). We studied fluid from both the affected breasts and the unaffected contralateral breasts (as controls) from 43 women with confirmed unilateral breast cancer. Using this approach, we identified 1560 ions in the positive mode and 538 ions in the negative mode after preprocessing of the UPLC‑QTOF data. Paired t-tests applied on these data matrices identified 209 ions (positive and negative modes combined) with significant change in intensity level between affected and unaffected control breasts (adjusted p-values <0.05). Among these, 83 ions (39.7%) showed a fold change (FC) >1.2 and 66 ions (31.6%) were identified with putative compound names. The metabolites that we identified included endogenous metabolites such as amino acid derivatives (N-Acetyl-DL-tryptophan) or products of lipid metabolism such as N-linoleoyl taurine, trans-2-dodecenoylcarnitine, lysophosphatidylcholine LysoPC(18:2(9Z,12Z)), glycerophospholipids PG(18:0/0:0), and phosphatidylserine PS(20:4(5Z,8Z,11Z,14Z). Generalized LASSO regression further selected 21 metabolites when race, menopausal status, smoking, grade and TNM stage were adjusted for. A predictive conditional logistic regression model, using the LASSO selected 21 ions, provided diagnostic accuracy with the area under the curve of 0.956 (sensitivity/specificity of 0.907/0.884). This is the first study that shows the feasibility of conducting a comprehensive metabolomic profiling of breast tumors using breast ductal fluid to detect changes in the cellular microenvironment of the tumors and shows the potential for this approach to be used to improve detection of breast cancer.

Introduction: several studies indicate a consistency between the physical inactivity and low levels of mobility in hip and knee joint., Objective: to determine the differences in the motion range of the hip and knee joint between the different classifications of somatotype in students of Pedagogy in Physical Education of the Universidad Autónoma de Chile, campus Temuco., Methods: the sample included 102 physical education students (31.3% female), somatotype was obtained through the protocol of the International Society for the Advancement of Kinanthropometry (ISAK) and the motion range of the hip and knee joint (ROM) using a universal goniometer., Results: the mean somatotype was endo-mesomorphic (4.8 - 3.4 - 2) for the women and meso-endomorphic (3.5 - 5.7 - 2) for the males, while the ROM evaluation indicated that the 50% of the students presented mobility values of joint lower than the normal ones. Furthermore, the endo-mesomorphic women showed lower ROM values of medial rotation of the right hip (45.5 ° ± 10.2 °; P = 0.0125, t = 2.732) and left hip side rotation (41.7 ° ± 10.3 °; P = 0.0256; p = 2.402) than the women meso-endomorphic., Conclusion: the results shows a relationship between the somatotype and hip ROM in the women, showing that in the women the most favorable results of joint mobility are related with a greater muscle mass. In contrasts, no significant differences were observed in men. It is important to encourage the development of joint mobility exercises according to the specific needs of each sex., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

The syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis or pseudomigraine with temporary neurological symptoms and lymphocytic pleocytosis (HaNDL) is a syndrome consisting of recurrent headaches, reversible neurological deficit, lymphocytic pleocytosis in cerebrospinal fluid (CSF), variable duration over time and spontaneous resolution. Although several etiopathogenic mechanisms have been suggested (vascular, infectous, immunological and calcium channelopthy), its etiology remains unknown. We describe a 28 year old female, with recurrent migraine with pleocytosis, confusional syndrome and transient neurological deficit. The clinical remission was achieved within two months. Although its etiology remains unknown the differential diagnosis is discussed in order to keep in mind this syndrome.

Case Report: A 41-year-old man presented a clinical picture characterized by lymphocytic meningoencephalitis, visual loss in both eyes and transverse sinus thrombosis. This picture was treated with prednisone and anticoagulation. Fundus examination showed complete occlusive arteritis, periphlebitis, peripheral ischemia and perfusion macular defects affecting both eyes. The picture was suggestive of Behçet's disease. Azathioprine was added to the treatment without improvement in visual acuity. Four months later oral aphthous ulcers developed, confirming the suspected diagnosis., Discussion: Behçet's disease may appear with the sudden onset of visual loss secondary to massive occlusive retinal vasculitis. The critical state of neuro-Behçet disease may delay the diagnosis. This combination of visual and neurological symptoms is associated with a poor visual prognosis (Arch Soc Esp Oftalmol 2002; 77: 275-278).

We studied the presence of apolipoprotein B (apo B) by immunoelectrophoresis in subretinal fluid (SRF) and serum from 15 rhegmatogenous retinal detachments and 5 retinal detachments with proliferative vitreoretinopathy (PVR). Apo B concentration +/- standard deviation was 1.49 +/- 1.06 mg/dl in SRF and 108.41 +/- 40.22 mg/dl in serum. Only in four cases was apo B not detected in SRF. We found no significant correlation between apo B concentrations in SRF and apo B levels in serum. We did not find a positive correlation between apo B concentrations in SRF and the duration and size of the detachments. There was no statistical relationship between the presence of PVR and apo B levels. This phenomenon suggests the preservation of the outer blood retinal barrier during rhegmatogenous retinal detachment.

Reasons why nurses left a general Hospital were analyzed through a questionnaire sent to all nurses who abandoned their position over the last 5 years (218). 50.6% of these nurses do not live in Lombardy region. 127 (57.7%) answered the questionnaire. 35% of whom answered the questionnaire would get back to work in the hospital. The main reason for hospital leave is related to family reasons (children and parents) for registered nurses and to shift work state enrolled nurses. Low salary is the main problem for 21-30 years old nurses. According to nurses who answered the questionnaire, more efficient recruitment and retention strategies should include higher salaries, riqualification of the profession in general and improvement of working conditions and organization.