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PASH syndrome: a novel surgical approach

Sat, 01 Jan 2022 00:00:00 GMT

Título: PASH syndrome: a novel surgical approach Autor: Cawe, Irina; Navarrete, Jorge; Agorio, Carolina Resumen: PASH syndrome is a rare autoinflammatory syndrome (AIS), which consists of pyoderma gangrenosum (PG), acne conglobata and hidradenitis suppurativa (HS).1 No standard treatment has been determined, although case reports have focused on systemic antibiotics, immunosuppressants and biologics.

Real‑world evaluation of molecular testing and treatment patterns for EGFR mutations in non‑small cell lung cancer in Latin America

Sat, 01 Jan 2022 00:00:00 GMT

Título: Real‑world evaluation of molecular testing and treatment patterns for EGFR mutations in non‑small cell lung cancer in Latin America Autor: Martín, Claudio; Cuello, Mauricio; Barajas, Olga; Recondo, Gonzalo; Aruachan, Sandra; Perroud, Herman; Sena, Susana; Bonilla, Carlos; Orlandi, Francisco; Berrutti, Susana; Garcia Cocco, Virginia; Gómez, Álvaro; Korbenfeld, Ernesto; Zapata, Maycos; Cundom, Juan; Orellana, Eric; Goncalves, Susana; Reinhold, Florencia Resumen: Lung cancer is a leading cause of cancer-related deaths in Latin America, with non-small cell lung cancer (NSCLC) being the most prevalent. The current study aimed to report real-world data on epidermal growth factor receptor (EGFR) mutational testing and treatment regimens at diagnosis and progression in patients with metastatic NSCLC across four Latin American countries (Argentina, Chile, Colombia and Uruguay). A retrospective, multicenter, observational study was conducted in patients with NSCLC using medical records from participating countries. The study population was categorized into two cohorts: Cohort 1 comprised of newly diagnosed, treatment-naïve patients with stage IV NSCLC; and cohort 2 comprised of stage IV NSCLC EGFR mutation (EGFRm)-positive patients who had progressed after first- or second-generation EGFR-tyrosine kinase inhibitor (TKI) treatment. Measures included demographic variables, health characteristics, treatment regimen, molecular testing rate and turnaround time at diagnosis and at progression for cohorts 1 and 2, respectively. Descriptive statistics were used to summarize all study measures. Of the 462 patients enrolled, 431 were newly diagnosed or treatment naïve with metastatic NSCLC. In cohort 1, the majority of patients with private health insurance (57.31%) underwent molecular diagnosis while only 41.3% of patients within the public sector had access to testing. The average molecular testing rate in cohort 1 varied across countries, with Argentina having the highest testing rate (79%) and Uruguay the lowest (27.63%). EGFRm was observed in 22% of patients. Cohort 2 comprised 31 patients who had progressed after first- or second-generation EGFR-TKI treatment and of these, only 22 (70.97%) underwent testing after progression. Access to molecular testing is still a challenge impacting the choice of first-line treatment in Latin American patients with NSCLC. These findings underline the unmet needs of ensuring early diagnosis, molecular profiling and use of correct treatment to alleviate NSCLC burden in the region.

HOLA COVID-19 Study: Evaluating the Impact of Caring for Patients With COVID-19 on Cancer Care Delivery in Latin America

Sat, 01 Jan 2022 00:00:00 GMT

Título: HOLA COVID-19 Study: Evaluating the Impact of Caring for Patients With COVID-19 on Cancer Care Delivery in Latin America Autor: Bernabe-Ramirez, Carolina; Velázquez, Ana I.; Olazagasti, Coral; Decat Bergerot, Cristiane; Gustavo Bergerot, Paulo; Ubillos, Luis Resumen: PURPOSE The HOLA COVID-19 study sought to evaluate the impact of COVID-19 on oncology practices across Latin America (LATAM), challenges faced by physicians, and how practices and physicians adapted while delivering care to patients with cancer. METHODS This international cross-sectional study of oncology physicians in LATAM included a 43-item anonymous online survey to evaluate changes and adaptations to clinical practice. Multivariable logistic regression analyses were used to evaluate the association of caring for patients with COVID-19 and changes to clinical practice. RESULTS A total of 704 oncology physicians from 19 countries completed the survey. Among respondents, the most common specialty was general oncology (34%) and 56% of physicians had cared for patients with COVID-19. The majority of physicians (70%) noted a decrease in the number of new patients evaluated during the COVID-19 pandemic when compared with prepandemic, and 73% reported adopting the use of telemedicine in their practice. More than half (58%) of physicians reported making changes to the treatments that they offered to patients with cancer. In adjusted models, physicians who had cared for patients with COVID-19 had higher odds of changing the type of chemotherapy or treatments that they offered (adjusted odds ratio 1.81; 95% CI, 1.30 to 2.53) and of delaying chemotherapy start (adjusted odds ratio 2.05; 95% CI, 1.49 to 2.81). Physicians identified significant delays in access to radiation and surgical services, diagnostic tests, and supportive care. CONCLUSION The COVID-19 pandemic has significantly disrupted global cancer care. Although changes to health care delivery are a necessary response to this global crisis, our study highlights the significant disruption and changes to the treatment plans of patients with cancer in LATAM resulting from the COVID-19 health care crisis. Descripción: Carolina Bernabe-Ramirez, MD 1 ; Ana I. Velazquez, MD, MSc 2,3 ; Coral Olazagasti, MD 4 ; Cristiane Decat Bergerot, PhD5 ; Paulo Gustavo Bergerot, MD5 ; Jose Corona Cruz, MD6 ; Ivy Riano, MD 7 ; Christina Adaniel, MD 8 ; Francisca Ramirez, MD9 ; Jesus Anampa, MD 10 ; Carmen Cajina, MD11 ; Evelin Mena, MD12 ; Elias Gracia, MD13 ; Alvaro Menendez, MD14 ; Henry Idrovo, MD 15 ; Raimundo Bezares, MD16 ; Omar Orlando Castillo Fernandez, MD 17 ; Liseth Duque, MD 18 ; Luis Corrales-Rodr´ıguez, MD19 ; Glenda Ramos, MD9 ; Alba J. Kihn-Alarc ´on, MD MSc 20 ; Ilana Schlam, MD21 ; Ximena Bruno, MD22 ; Gerardo Umanzor, MD23 ; Jenny Lissette Castro, MD 24 ; Federico Losco, MD 25 ; Luis Ubillos, MD26 ; Eduardo Richardet, MD27 ; Enrique Soto-Perez-de-Celis, MD, PhD28 ; Narjust Duma, MD 29 ; and HOLA COVID-19 Study Group; AFFILIATIONS 1 Essen Health Care, Bronx, NY 2 Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA 3 National Clinician Scholars Program, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA 4 Sylvester Comprehensive Cancer Center at the University of Miami, Miami, ML 5 Centro de C ˆancer de Bras´ılia (CETTRO), Bras´ılia, DF, Brazil 6 Instituto Nacional de Cancerologia (INCan), Mexico City, Mexico 7 Hematology and Oncology Section, Dartmouth-Hitchcock Medical Center, Lebanon, NH 8 Clinica Alemana, Santiago, Chile 9 SOLCA, Instituto Oncologico Nacional, Guayaquil, Ecuador 10 Montefiore Medical Center/Albert Einstein College of Medicine/Albert Einstein Cancer Center, Bronx, NY 11 Universidad Nacional Autonoma de Nicaragua, Managua, Nicaragua 12 Instituto Nacional Del Cancer Rosa Emilia Sanchez Perez de Tavares (INCART), Santo Domingo, Dominican Republic 13 National Institute of Oncology and Radiobiology, Havana City, Cuba 14 Hartford Healthcare, Hartford, CT 15 Universidad del Valle, Cali, Colombia 16 Hospital Teodoro Alvarez Caba, Buenos Aires, Argentina 17 Instituto Oncologico Nacional, Panama City, Panama 18 Hospital Universitario Dr Jose Maria Vargas, Caracas, Venezuela 19 Clinical Oncology Department, Hospital San Juan de Dios, San Jose, Costa Rica 20 Research Department, Liga Nacional Contra el C ´ancer & Instituto de Cancerolog´ıa, Guatemala City, Guatemala 21 Tufts Medical Center, Boston, MA 22 Hematology Oncology Division, Department of Medicine, University of Pennsylvania, Philadelphia, PA 23 Centro Oncologico Integral in San Pedro Sula, Honduras 24 Department of Medical Oncology, Oncology Hospital, Salvadoran Institute of Social Security, Rosales National Hospital, San Salvador, El Salvador 25 Instituto Alexander Fleming, Ciudad Aut ´onoma de Buenos Aires, Argentina 26 Hospital de Cl´ınicas, Montevideo, Uruguay 27 Instituto Oncol ´ogico De C ´ordoba, C ´ordoba, Argentina 28 Department of Geriatrics, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico 29 Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA

Características de los pacientes con lumbalgia atendidos en un centro de atención primaria en Ecuador

Sat, 01 Jan 2022 00:00:00 GMT

Título: Características de los pacientes con lumbalgia atendidos en un centro de atención primaria en Ecuador Autor: Fuseau, Michelle; Garrido, David; Toapanta, Edgar Resumen: La lumbalgia constituye un problema de salud pública por su alta prevalencia y carga de la enfermedad. Este estudio tuvo como objetivo determinar las características de los pacientes con lumbalgia atendidos en el centro de salud N1 de Ibarra, entre enero 2017 y noviembre 2020. Se incluyeron 2055 consultas por lumbalgia, observándose un incremento durante el período de estudio, a excepción del año 2020 (53,78% menos consultas que en 2019). La consulta por lumbalgia fue significativamente más frecuente en mujeres que hombres (64,18% vs. 35,82%; z-score 12,87, p<0,05). La edad en hombres (mediana 49 años, rango intercuartílico 30,75 años) fue significativamente mayor (p=0,003) que en mujeres (mediana 46 años, rango intercuartílico 25 años). La frecuencia acumulada de consultas fue mayor entre los 28-60 años, en su mayoría (67,98%) por lumbalgia no especificada. El 4,79% de las consultas fueron referidas al segundo nivel de atención, donde la mayoría (69,77%) tuvo una codificación diagnóstica de lumbalgia específica. Sobre las consultas subsecuentes (220 pacientes), la mayoría tuvieron 2 (9,05%) y menos frecuente ≥3 (1,65%) consultas por año. En conclusión, se observó un incremento en la frecuencia de consultas por lumbalgia, predominante en los grupos en edad laboral, con un bajo porcentaje referido al segundo nivel de atención.; Low back pain is a public health problem due to its high prevalence and burden of the disease. This study aimed to determine the characteristics of patients with low back pain treated at the Centro de Salud N1 from Ibarra, between January 2017 and November 2020. Two-thousand fifty-five consultations for low back pain were included, observing an increase during the study period, except for 2020 (53.78% fewer consultations than 2019). Consultation for low back pain was more frequent in women than men (64.18% vs 35.82%; z-score 12.87, p <0.05). The age in men (median 49 years, interquartile range 30.75 years) was significantly higher (p=0.003) than in women (median 46 years, interquartile range 25 years). The cumulative frequency of consultations was higher between 28-60 years, mostly (67.98%) due to unspecified low back pain. Four-point seventy-nine percent of the consultations were referred to secondary care, where most (69.77%) had a specific diagnostic coding for low back pain. Regarding subsequent consultations (220 patients), most had 2 (9.05%) and less frequent ≥3 (1.65%) yearly consultations. In conclusion, there was an increase in the frequency of consultations for low back pain, predominant in the working-age groups, with a low percentage referred to secondary care.