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Objectives Mammography screening is generally accepted in women aged 50–69, but the balance between benefits and harms remains controversial in other age groups. This study systematically reviews these effects to inform the European Breast Cancer Guidelines. Methods We searched PubMed, EMBASE and Cochrane Library for randomised clinical trials (RCTs) or systematic reviews of observational studies in the absence of RCTs comparing invitation to mammography screening to no invitation in women at average breast cancer (BC) risk. We extracted data for mortality, BC stage, mastectomy rate, chemotherapy provision, overdiagnosis and false-positive-related adverse effects. We performed a pooled analysis of relative risks, applying an inverse-variance random-effects model for three age groups (Results We identified 10 RCTs including 616,641 women aged 38–75. Mammography reduced BC mortality in women aged 50–69 (relative risk (RR) 0.77, 95%CI (confidence interval) 0.66–0.90, high certainty) and 70–74 (RR 0.77, 95%CI 0.54–1.09, high certainty), with smaller reductions in under 50s (RR 0.88, 95%CI 0.76–1.02, moderate certainty). Mammography reduced stage IIA+ in women 50–69 (RR 0.80, 95%CI 0.64–1.00, very low certainty) but resulted in an overdiagnosis probability of 23% (95%CI 18–27%) and 17% (95%CI 15–20%) in under 50s and 50–69, respectively ( moderate certainty). Mammography was associated with 2.9% increased risk of invasive procedures with benign outcomes ( low certainty). Conclusions For women 50–69, high certainty evidence that mammography screening reduces BC mortality risk would support policymakers formulating strong recommendations. In other age groups, where the net balance of effects is less clear, conditional recommendations will be more likely, together with shared decision-making.

The European Union Council Recommendation of 2 December 2003 on cancer screening suggests the implementation of organised, population- based breast cancer screening programmes based on mammography every other year for women aged 50 to 69 years, ensuring equal access to screening, taking into account potential needs for targeting particular socioeconomic groups. A European survey on coverage and participation, and key organisational and policy characteristics of the programmes, targeting years 2010 and 2014, was undertaken in 2014. Overall, 27 countries contributed to this survey, 26 of the 28 European Union member states (92.9%) plus Norway. In 2014, 25 countries reported an ongoing population- based programme, one country reported a pilot programme and another was planning a pilot. In eight countries, the target age range was broader than that proposed by the Council Recommendation, and in three countries the full range was not covered. Fifteen countries reported not reaching some vulnerable populations, such as immigrants, prisoners and people without health insurance, while 22 reported that participation was periodically monitored by socioeconomic variables (e.g. age and territory). Organised, population- based breast cancer screening programmes based on routine mammograms are in place in most EU member states. However, there are still differences in the way screening programmes are implemented, and participation by vulnerable populations should be encouraged. (C) 2016 The Authors. Published by Elsevier Inc.

RESUMEN Introducción: el síndrome metabólico (SM) es una entidad clínica con alteraciones vasculares y metabólicas que predisponen a la enfermedad cardiovascular (ECV). El estado nutricional es un factor predominante en la evolución del SM y el riesgo de ECV. Objetivo: analizar el estado nutricional a través de indicadores antropométricos y alimentarios en pacientes con SM. Métodos: estudio observacional, de corte transversal. Participaron 41 personas de ambos sexos (20 hombres y 21 mujeres), entre 30 y 60 años, que asistieron a consulta ambulatoria del Servicio de Cardiología y Clínica Médica de la Clínica Universitaria Reina Fabiola (CURF) y del Servicio de Cardiología No Invasiva del Hospital Nacional de Clínicas (HNC), durante el periodo 2015-2016. Se realizó toma de indicadores antropométricos para determinar el estado nutricional (índice de masa corporal o IMC), circunferencia de cintura (CC), presión arterial sistólica (PAS) y diastólica (PAD). Las variables alimentarias incluidas fueron valor calórico total (VET), consumo de colesterol (CCol) y consumo de sodio (CS). El estudio cuenta con la aprobación del Comité de Ética del CURF y HNC. Para estimar el VET, el consumo de colesterol y de sodio se utilizó el programa informático Interfood v.1.3. El análisis de los datos se llevó a cabo con el programa InfoStat. Para analizar si existían diferencias por sexo, se utilizó el test de Wilcoxon para variables continuas y Kruskal Wallis para las categóricas. Resultados: el 93% de los pacientes presentaron exceso de peso (el 61% con IMC superior a 30kg/mts2). En relación a CC, el 75% de las mujeres y 86% de hombres presentaron riesgo cardiovascular muy aumentado. La media de PAS fue 131,18±18,96 mmHg y la de PAD fue 79,88±12,29 mmHg. El VET fue 2828,45±1255,42 Kcal, el consumo promedio de colesterol fue 380,09±191mg y el de sodio fue 2072,26±1195,44 mg, siendo estas ingestas superiores a las recomendadas. Al analizar las comparaciones por sexo, no se encontraron diferencias estadísticamente significativas para las variables en estudio. Conclusión: estos resultados preliminares resaltan el perfil de riesgo para el desarrollo de ECV de los pacientes con SM. Se necesita continuar profundizando el estudio de estas poblaciones, para aportar evidencia que contribuya a la promoción de hábitos saludables y la prevención de patologías crónicas vinculadas a la alimentación y nutrición.

Background: There is still lack of consensus on the benefit-harm balance of breast cancer screening. In this scenario, women's values and preferences are crucial for developing health-related recommendations. In the context of the European Commission Initiative on Breast Cancer, we conducted a systematic review to inform the European Breast Guidelines. Methods: We searched Medline and included primary studies assessing women's values and preferences regarding breast cancer screening and diagnosis decision making. We used a thematic approach to synthesise relevant data. The quality of evidence was determined with GRADE, including GRADE CERQual for qualitative research. Results: We included 22 individual studies. Women were willing to accept the psychological and physical burden of breast cancer screening and a significant risk of overdiagnosis and false-positive mammography findings, in return for the benefit of earlier diagnosis. The anxiety engendered by the delay in getting results of diagnostic tests was highlighted as a significant burden, emphasising the need for rapid and efficient screening services, and clear and efficient communication. The confidence in the findings was low to moderate for screening and moderate for diagnosis, predominantly because of methodological limitations, lack of adequate understanding of the outcomes by participants, and indirectness. Conclusions: Women value more the possibility of an earlier diagnosis over the risks of a false-positive result or overdiagnosis. Concerns remain that women may not understand the concept of overdiagnosis. Women highly value time efficient screening processes and rapid result delivery and will accept some discomfort for the peace of mind screening may provide.

Psycho-oncology addresses the psychological, social, behavioural, and ethical aspects of cancer. Identification and proper management of the patients' psychosocial needs, as well as the needs of their caregivers and family are essential for a person-centred concept of breast cancer care. The aim of this overview is to describe how psychosocial support in breast cancer is incorporated in cancer-related policy documents, such as national cancer plans and breast cancer care certification schemes. post-print 163 KB

International guidelines recommend assessing women's satisfaction with breast cancer screening programmes; however, validated tools are needed. A systematic review to identify and evaluate the quality of validated instruments for screening satisfaction, from 01/1965 until 11/2017 was performed. From 3283 individual citations, six instruments were identified. Evaluation of the MammoGraphy Questionnaire using the COSMIN checklist resulted in 'good' to 'excellent' scores in most assessed domains, while the other tools were mostly 'poor'/'fair' quality or did not provide enough information for assessment. Nevertheless, substantial changes in screening processes and programmes have been implemented in recent years. Thus, further development work is needed.

Fumonisins B1 ,B 2 y B3 (FB1 ,F B 2 y FB3), are a group of toxins produced by different mold species, Fusarium moniliforme and Fusarium proliferatum being the most important ones. Its compounds were tested in chromosome aberrations (CA), sister chromatid exchange (SCE), and micronucleus (MN) in human lymphocytes, and, in Allium cepa (onion), the chromosomal aberrations (CA) assay was used. Moreover, the presence of fumonisins and their producer moulds was determined in different food substrata in Cordoba city, Argentina. Cytogenetic studies using FB1 ,F B 2 and FB3 levels gave positive results for the higher concentrations (5 and 10 lg/g) with FB1. As regards the cytogenetic aspect of FB1, we found an increase in the incidence of genetic damage measured by chromosomal aberrations, sister chromatid exchange, micronuclei and chromosomal aberrations in Allium cepa. These results indicate that human lymphocytes cells and plants cells (Allium cepa) have a very sensitive cellular response to the mycotoxin fumonisin B1 as observed at the highest concentrations. � 2005 Elsevier Ltd. All rights reserved.

Several problems concerning air quality in urban areas with special regard to benzene pollution from motor vehicle traffic are described. Some medical and regulatory aspects relative to the exposure of population and specific classes of workers are given particular stress. Benzene concentrations measured in the metropolitan area of Milan in an extensive monitoring campaign are presented together with historical carbon monoxide (CO) measurements realized by the Milan air pollution network. Starting from these two series of values a typical ratio between CO and benzene has been calculated and it has been found to be consistent with literature data. A risk assessment hypothesis has been performed using a simple model based on both kinds of data mentioned above.

Subjects which had been consuming drinking water with a high vanadium content, namely, 0.34 mg/l (0.34 ppm), for at least 10 years were investigated. Research was aimed at correlating the frequency of sister chromatid exchange (SCE) and chromosomal aberrations (CA) in human lymphocytes with vanadium values in water and urine. A questionnaire was administered to each subject to find any other vanadium-related symptom. Data collected on both SCE and CA suggest that vanadium at concentrations affecting population under study (i.e. 0.34 mg/l) does not induce a significantly higher response., Fil: Lerda, Daniel Enrique. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; Argentina