BackgroundDifferences in the incidence and outcome of breast cancer among Hispanic women compared with white women are well documented and are likely explained by ethnic differences in genetic composition, lifestyle, or environmental exposures.Methodolgy/Principal FindingsA population-based study was conducted in Galicia, Spain. A total of 510 women diagnosed with operable invasive breast cancer between 1997 and 2010 participated in the study. Data on demographics, breast cancer risk factors, and clinico-pathological characteristics were collected. The different breast cancer tumor subtypes were compared on their clinico-pathological characteristics and risk factor profiles, particularly reproductive variables and breastfeeding. Among the 501 breast cancer patients (with known ER and PR receptors), 85% were ER+/PR+ and 15% were ER-&PR-. Among the 405 breast cancer with known ER, PR and HER2 status, 71% were ER+/PR+/HER2- (luminal A), 14% were ER+/PR+/HER2+ (luminal B), 10% were ER−/PR−/HER2- (triple negative breast cancer, TNBC), and 5% were ER−/PR−/HER2+ (non-luminal). A lifetime breastfeeding period equal to or longer than 7 months was less frequent in case patients with TNBC (OR = 0.25, 95% CI = 0.08–0.68) compared to luminal A breast cancers. Both a low (2 or fewer pregnancies) and a high (3–4 pregnancies) number of pregnancies combined with a long breastfeeding period were associated with reduced odds of TNBC compared with luminal A breast cancer, although the association seemed to be slightly more pronounced among women with a low number of pregnancies (OR = 0.09, 95% CI = 0.005–0.54).Conclusions/SignificanceIn case-case analyses with the luminal A cases as the reference group, we observed a lower proportion of TNBC among women who breastfed 7 or more months. The combination of longer breastfeeding duration and lower parity seemed to further reduce the odds of having a TNBC compared to a luminal A breast cancer.

Remote sensing has been used from the 1980s to study inland water quality. However, it was not until the beginning of the twenty-first century that CHRIS (an experimental multi-angle sensor with good spectral and spatial resolutions) and MERIS (with good temporal and spectral resolutions) started to acquire imagery with very good resolutions, which allowed to develop a reliable imagery acquisition system so as to consider remote sensing as an inland water management tool. This paper presents the methodology developed, from the field data acquisition with which to build a freshwater spectral library and the study of different atmospheric correction systems for CHRIS mode 2 and MERIS images, to the development of algorithms to determine chlorophyll-a and phycocyanin concentrations and bloom sites. All these algorithms allow determining water eutrophic and ecological states, apart from generating surveillance maps of toxic cyanobacteria with the main objective of Assessment of the Water Quality as it was used for Monitoring Ecological Water Quality in smallest Mediterranean Reservoirs integrated in the Intercalibration Exercise of European Union Water Framework Directive (WFD). We keep on using it to monitor the Ecological Quality Ratio (EQR) in Spain inland water.

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Funding Acknowledgements Type of funding sources: None. Introduction and objectives   Cardiac rehabilitation programmes (CRP) are a fundamental pillar in the education, optimization of treatment and assessment of the functional class in cardiovascular pathology. The aim of this study is to analyse the levels of LDL cholesterol at discharge and after 6 months of follow-up after the CRP carried out in our centre. Material and methods   Analysis of a prospective cohort of 268 patients, included in the CRP between November 2015 and October 2018 after an acute coronary event and with a minimum follow-up of 6 months. The CRP consists of a medical and nursing consultation both for inclusion and prior to discharge. It lasts 1 month and includes 3 weekly sessions of individualised and monitored exercise which are carried out together with talks on cardiovascular risk factors, diet, treatments... In the pre-discharge consultation, an analysis is carried out to adjust the treatment, and a new control is performed after 6 months.  Results   Average age 56.2 years (SD: 8.9), 90% men, 46% hypertense, 24% diabetics, 68% dyslipemics, 70% smokers/ex-smokers and 57% sedentary. 60% of the patients had presented a STEMI, with 80% being revascularized percutaneously. 48% had 1-vessel disease. LVEF was conserved in 74% of the patients.  The mean LDL cholesterol after the event is 105.3 mg/dl (SD: 37.7) and at the discharge of the program, 61 mg/dl (SD: 21.3) being the difference statistically significant (p < 0.005). The mean LDL at 6 months was 62 mg/dl (SD: 19.9) with no statistically significant difference with respect to the previous one (p = 0.53) (table 1). At the beginning of the CRP 91% of the patients presented an LDL >55 mg/dl, after the same 55 % and at 6 months 57% (graph 1). After 6 months, 4% maintained levels >100 mg/dl. 98% of patients were receiving high-potency statins and 12% ezetimibe. At discharge, treatment with ezetimibe was started in 28 patients (13%). No treatment with iPCSK9 was initiated. This study was carried out while the 2016 European guidelines were still in effect, with an LDL target in secondary prevention of less than 70 mg/dl. Conclusions   CRPs are effective in improving control of LDL cholesterol, due to a closer monitoring and a better health education that allows greater therapeutic adherence.  However, after the programme it is necessary to continue with regular monitoring to maintain and, in some cases, reach the target figures. In our case there is a small percentage of patients who could still benefit from starting treatment with iPSCK9. Abstract Figure. Graph 1

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