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Introduction: Telomere length plays important roles in maintaining genome stability and regulating cell replication and death. Telomerase has functions not only to extend telomere length but also to repair DNA damage. Studies have shown that telomerase may increase cancer cell resistance to DNA-damaging anticancer agents; tamoxifen may suppress telomerase expression in breast cancer cells. This study aimed to investigate the role of telomere length and telomerase activity in breast cancer prognosis. Methods: qPCR and qRT-PCR were used to analyze telomere length and telomerase expression, respectively, in tumor samples of 348 breast cancer patients. Cox regression analysis was performed to examine telomere length and telomerase expression in association with disease-free survival and cause-specific mortality. Results: Telomere length had no relation to tumor features or disease outcomes. Telomerase expression was detected in 53% of tumors. Larger tumors or aggressive disease were more likely to have telomerase expression. Among patients treated with chemotherapy, high telomerase was found to be associated with increased risk of death (hazard ratio (HR) = 3.15; 95% CI: 1.34 to 7.40) and disease recurrence (HR = 2.04; 95% CI: 0.96 to 4.30) regardless of patient age, disease stage, tumor grade, histological type or hormone receptor status. Patients treated with endocrine therapy had different results regarding telomerase: high telomerase appeared to be associated with better survival outcomes. Telomerase expression made no survival difference in patients who received both chemotherapy and endocrine therapy. Conclusions: Overall, telomerase expression was not associated with disease outcome, but this finding may be masked by adjuvant treatment. Patients with high telomerase expression responded poorly to chemotherapy in terms of disease-free and overall survival, but fared better if treated with endocrine therapy. [ABSTRACT FROM AUTHOR]

The long-acting insulin analog glargine (IAG) is largely used as a basal-bolus regimen in type 1 diabetes mellitus (T1DM), but its use is not still recommended during pregnancy. We promoted a national, multicentre, retrospective study to determine the rate of congenital malformation in a large group of offspring of mothers with T1DM who were treated with IAG before and during pregnancy, We collected 98 TIDM pregnancies from 26 Italian centres (age 30.6±4.6 years, diabetes duration 16.1 ± 7.8 years, White's Classes B n=21, C=24, D=36, R=16, RF=1). IAG was started 11.1±10.7 months be fore conception as a basal-bolus regimen with an average dose of 18.7±7.1 IU/die. The pregnancy was unplanned in 92% of cases and the first diabetes assessment occurred at 8.5±4.1 week (HbA1c 7.7±1.3%, range 5.3-13.8%). IAG was continued until the end of pregnancy in 36% of case, while it was stopped during the first trimester of gestation in 64%. Glycemic control was improved during pregnancy with a mean HbA1c at the end of pregnancy of 6.5±0.86%. Spontaneous and elective abortions occurred in 4 and 2 women respectively. 92 babies were delivered at 36.7±2.1 week (preterm deliveries 29.9%, casearean sections 81.1%) with mean birth weight of 3298 ±732 g (LGA 42.1%). Congenital malformations (CM) were reported in 5 newborns (5.4%), involving cardiovascular (n.2), genitourinary system (n.2), and syndactylia (n.1). The rate of CM is not different from that reported in other studies regarding pregnancies of T1DM women treated with other insulins. Our survey, performed in a large cohort of T1DM pregnant women, suggest that insulin glargine does not seem to affect embryo-fetal development. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to evaluate the incidence of endometriosis-associated ovarian cancer (EAOC) and compare clinicopathological characteristics and overall survival (OS) between patients with EAOC and those with ovarian cancer not associated with endometriosis., Patients and Methods: We identified EAOC among 203 patients with invasive epithelial ovarian cancer who underwent complete surgery at our Institution from January 2004 to March 2014., Results: EAOC was present in 45 patients. EAOC was significantly more frequently diagnosed at an earlier stage of disease (p=0.038). At a median follow-up time of 32 months, OS among patients with EAOC was significantly longer (p=0.039). However, stratifying by stage, the OS advantage of EAOC was not significant. At multivariate analysis, only stage was an independent prognostic factor for OS (hazard ratio=5.7; 95% confidence interval=1.8-18.6; p=0.003)., Conclusion: EAOC incidence was 22.2%. EAOC appears to be diagnosed at an earlier stage and confers a better OS. However, stratifying by stage, the advantage in survival of EAOC disappears., (Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.)