Evidence on non-steroidal anti-inflammatory drugs (NSAID) use and breast cancer risk shows a slightly protective effect of these drugs, but previous studies lack randomized clinical trial results and present high heterogeneity in exposure measurement. This systematic review and meta-analysis widens the knowledge about NSAID use and breast cancer risk, updating the information from the last meta-analysis, focusing on evidence on specific effects of COX-2 inhibitors and differential expression patterns of hormonal receptors. A PubMed-database search was conducted to include all entries published with the keywords "BREAST CANCER NSAID ANTI-INFLAMMATORY" until 10/24/2013 providing original results from cohort studies, case-control studies, or randomized clinical trials with at least one reported relative risk (RR) or odds ratio (OR) on the association between any NSAID use and incidence of invasive breast cancer. This resulted in 49 publications, from which the information was retrieved about type of study, exposure characteristics, breast cancer characteristics, and breast cancer-NSAID association. Meta-analyses were performed separately for case-control and cohort studies and for different hormone-receptor status. NSAID use reduced invasive breast cancer risk by about 20 %. A similar effect was found for aspirin, acetaminophen, COX-2 inhibitors and, to a lesser extent, ibuprofen. The effect of aspirin was similar in preventing hormone-receptor-positive breast cancer. This meta-analysis suggests a slightly protective effect of NSAIDs-especially aspirin and COX-2 inhibitors- against breast cancer, which seems to be restricted to ER/PR+tumors.
Breast cancer is the most common malignancy in women, and its incidence increases with age, with the majority of patients diagnosed after menopause. However, in 15–25% of cases, patients are premenopausal at the time of diagnosis, and about 7% of them are below the age of 40. Therefore, a considerable amount of young women are diagnosed with breast cancer during their reproductive life. Within this group, most cancer cases require cytotoxic chemotherapy and/or hormone therapy, which are responsible for a decrease in the patients’ reproductive function, along with their age. The efficacy of such treatments, among other factors, has led to a high five-year-survival rate, which results in an increasing number of young women who survive breast cancer before having fulfilled their reproductive wishes, especially considering the current trend to delay pregnancy until the late 30s or early 40s in developed countries. The combination of these factors justifies the importance of fertility preservation and reproductive counselling at the time of breast cancer diagnosis in young women.A wide range of fertility preservation techniques has been developed, such as ovarian suppression, oocyte and embryo cryopreservation, immature oocyte retrieval and in vitro maturation, and ovarian tissue cryopreservation.Early counselling and referral of these patients to fertility specialists are fundamental factors in order to maximise their chances of pregnancy. This review aims to update the knowledge about the influence of breast cancer in fertility, the influence of pregnancy and fertility preservation techniques in breast cancer patients and assessment of ovarian reserve for a better treatment choice. A special section dedicated to BRCA-mutation carriers has been included because of their specific features.A comprehensive literature search has been conducted, including publications from the last five years.
Waelz slag is an industrial by-product from the recovery of electric arc furnace (EAF) dust which is mainly sent to landfills. Despite the different chemical and mineralogical compositions of Waelz slag compared to traditional clays, previous experiments have demonstrated its potential use as a clay substitute in ceramic processes. Indeed, clayey products containing Waelz slag could improve mechanical and environmental performance, fixing most of the metallic species and moreover decreasing the release of some potential pollutants during firing. However, a deeper understanding of the complex phase transformations during its thermal treatment and the connection of this behaviour with the end properties is desirable in order to explain the role that is played by the Waelz slag and its potential contribution to the ceramic process. For this purpose, in the present study, the chemical, mineralogical, thermal and environmental behaviour of both (i) unfired powdered samples, and (ii) pressed specimen of Waelz slag fired up to different temperatures within the typical range of clay based ceramic production, has been studied. The effect of the heating temperature on the end properties of the fired samples has been assessed. In general, an increase of the firing temperature promotes sintering and densification of the products and decreases the open porosity and water absorption which also contributes to the fixation of heavy metals. On the contrary, an increase in the leaching of Pb, Cr and Mo from the fired specimens is observed. This can be attributed to the creation of Fe and Ca molybdates and chromates that are weakly retained in the alkali matrix. On the other side, at temperature above 950 °C a weight gain related to the emission of evolved gases is observed. In conclusion, the firing temperature of the ceramic process is a key parameter that affects not only the technical properties but also strongly affects the leaching behaviour and the process emissions.
BackgroundNon-steroidal anti-inflammatory drugs (NSAIDs) are widely used despite their risk of gastrointestinal bleeding or cardiovascular events. We report the profile of people taking NSAIDs in Spain, and we include demographic factors, health-related behaviours and cardiovascular disease history.MethodsFour thousand sixtyparticipants were selected using a pseudorandom number list from Family Practice lists in 12 Spanish provinces. They completed a face-to-face computerized interview on their NSAID consumption, demographic characteristics, body mass index, alcohol and tobacco consumption and medical history. In addition, participants completed a self-administered food-frequency and alcohol consumption questionnaire. Factors associated with ever and current NSAID consumption were identified by logistic regression.ResultsWomen consumed more non-aspirin NSAIDs (38.8% [36.7–41.0]) than men (22.3 [20.5–24.2]), but men consumed more aspirin (11.7% [10.3–13.2]) than women (5.2% [4.3–6.3]). Consumption of non-aspirin NSAIDs decrease with age from 44.2% (39.4–49.1) in younger than 45 to 21.1% (18.3–24.2) in older than 75, but the age-pattern for aspirin usage was the opposite. Aspirin was reported by about 11% patients, as being twice as used in men (11.7%) than in women (5.2%); its consumption increased with age from 1.7% (< 45 years old) to 12.4% (≥75 years old). Aspirin was strongly associated with the presence of cardiovascular risk factors or established cardiovascular disease, reaching odds ratios of 15.2 (7.4–31.2) in women with acute coronary syndrome, 13.3 (6.2–28.3) in women with strokes and 11.1 (7.8–15.9) in men with acute coronary syndrome. Participants with cardiovascular risk factors or diseases consumed as much non-aspirin NSAID as participants without such conditions.ConclusionsNon-aspirin NSAIDs were more consumed by women and aspirin by men. The age patterns of aspirin and non-aspirin NSAIDs were opposite: the higher the age, the lower the non-aspirin NSAIDs usage and the higher the aspirin consumption. People with cardiovascular risk factors or diseases consumed more aspirin, but they did not decrease their non-aspirin NSAIDs usage.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6019-z) contains supplementary material, which is available to authorized users.
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