Aplicación de tres modelos pronósticos en cáncer de mama precoz / Application of three prognostic models in T1N0M0 breast cancer

Resumen Objetivo Aplicar tres modelos pronósticos "online" (índice pronóstico de Nothingham (NPI), Adjuvantonline! (AO) y PREDICT utilizados en la práctica oncológica para estratificar a pacientes y definir el uso de terapias adyuvantes en pacientes con cáncer de mama (CM) precoz, para evaluar su correlación y predicción de sobrevida en nuestra población. Métodos Obtuvimos datos clínicos de pacientes con CM invasor T1N0M0, tratados en el Centro de Cáncer de la Pontificia Universidad Católica de Chile, Santiago, Chile, desde enero de 1997 hasta diciembre de 2003. Resultados Analizamos datos de 125 pacientes. Edad mediana fue 55 años (35-80). La mayoría de los tumores fueron carcinomas ductales infiltrantes (72,8%), receptor de estrógeno (RE) positivos (88,8%), 80% recibieron terapia endocrina (TE). El beneficio estimado de la TE y la quimioterapia (QT) en la sobrevida global (SG), determinadas según AO y PREDICT, no fueron significativamente diferentes (1,3% y 1% para QT, p = 0,13; 0,9% y 1% para TE, p = 0,8; respectivamente). El modelo NPI estimó una mediana de SG superior (96%) a la calculada por AO (90,9%) y PREDICT (92,5%). La mortalidad específica por CM fue de 3%, similar a lo observado (3,2%). La mediana de SG estimada por todos los modelos en el grupo de pacientes fallecidos no fue estadísticamente diferente al grupo de sobrevivientes (p = 0,85). Conclusión Los modelos pronósticos predicen apropiadamente la SG en pacientes con CM precoz; sin embargo, en esta serie, no discriminaron pacientes de mal pronóstico.

Objective Apply three prognostic models "online" (Nothingham index (NPI), Adjuvantonline! (AO) and PREDICT used in routine oncology practice in order to stratify patients and define the use of adjuvant therapies in patients with stage I breast cancer (BC) to evaluate its correlation and overall survival (OS) in our population. Methods We obtained patients' medical records data with invasive BC T1N0M0, treated at the Cancer Center of the Pontificia Universidad Católica de Chile, Santiago, Chile, from January 1997 to December 2003. Results We analyzed data from 125 patients. Median age was 55 years (35 80). Most tumors were infiltrating ductal carcinoma (72.8%), estrogen receptor positive (88.8%), 80% received endocrine therapy (ET). The estimated ET and chemotherapy benefit was not significantly different according to the AO and PREDICT models (1.3% and 1% for CT, p = 0.13, 0.9% and 1% for ET p = 0.8, respectively). The estimated median OS on NPI (96%) was higher than calculated by AO (90.9%) and PREDICT (92.5%). Interestingly disease specific mortality estimated was 3%, similar to that observed (3.2%). While the estimated median OS by all models in the group of deceased patients was lower than in surviving, this difference did not reach statistical significance (p = 0.85). Conclusion The prognostic models applied effectively predict OS in Chilean patients with T1N0M0 BC, but in this series, they do not sufficiently discriminate patients with poor prognosis. The addition of co -morbidities to AO does not alter the results.

Cross-amplification tests of ungulate primers in the endangered Neotropical pampas deer (Ozotoceros bezoarticus)

In cross-species amplification tests of 15 ungulate primers in pampas deer, five were retained to form a small panel of highly polymorphic loci that could be used to efficiently screen populations of this endangered species. The polymerase chain reactions were performed incorporating the universal fluorescent labeled M13 (-21) primer. In 69 pampas deer, average allelic diversity was 15, expected heterozygosity was 0.869 and the mean polymorphic information content value was 0.847. Paternity exclusion probabilities over loci were NE-1P = 0.01336 and NE-2P = 0.00135, and combined non-exclusion probability of identity was P(ID) = 3 × 10-8.

Infliximab in Hispanics: characterization of response to infliximab in an ethnic minority with Crohn's disease

PURPOSE: The incidence and prevalence of Crohn's disease (CD) varies geographically and with racial/ ethnic background. The highest frequency of occurrence is in North America and Northern Europe. Incidence is highest among Caucasians, lower in blacks and Hispanics, and lowest in Asians. However in the mid-1980s and 1990s, the incidence and prevalence increased in continental Europe, the Middle East, the Pacific Rim, Africa, and Latin America. An increase in the incidence of CD has been noted in Puerto Rico, although our population differs genetically from other described CD populations. A study in our population showed lower prevalence of ASCA and no NOD2 in our CD patients. Infliximab, a TNFa antibody, is effective in refractory inflammatory CD and in fistulizing disease. Since limited data exists regarding CD in Hispanics, the fastest growing minority group in the United States, we designed this retrospective study with patients treated with infliximab at our institution. We wanted to determine if the response to infliximab in genetically admixed Hispanics differed from that previously reported. METHODS: Baseline characteristics, infusion related information and clinical response was abstracted from medical records. Clinical response was classified as complete response, partial response, and nonresponse. RESULTS: The study included 15 patients treated for refractory inflammatory disease, 9 for fistulizing disease, and 11 for both. The positive response rate was 83%(29/35) and the non response rate was 17%(6/35). Overall the patients with complete, partial, and no response were 13/35(37%), 16/35(46%), and 6/ 35(17%), respectively. No statistically significant association was found between response and disease location. Significant association was found between response and fistula type (p = 0.02). Steroid withdrawal was possible in 21/31 patients (68%). In terms of safety, 9/35 patients (26 %) suffered an adverse reaction, 4 patients required therapy discontinuation. CONCLUSION: This study suggests that infliximab has similar global response, allowance of steroid withdrawal and safety in Hispanics as in other populations. Ethnicity does not seem to influence response rate to infliximab.

Obstruction of the ventricular catheter of a CSF shunt system due to the own cyst of Taenia solium

Se estudiaron cinco pacientes con el disgnóstico de hidrocefalia secundaria a neurocisticercosis, que presentaron disfunción valvular por obstrucción del catéter ventricular debido a quistes de cisticercos. En cuatro casos se utilizaron sistemas Biomed (Mex) y en un caso sistema tipo Hakim. Los pacientes presentaron la disfunción valvular entre 18 y 24 meses posterior a la derivación, ellos tenían historia de múltiples disfunciones valvulares. El diagnóstico se realizó al momento de la extracción del catéter en que se encontró el quiste adherido al cepillo ventricular. La evolución clínica posterior ha sido poco satisfactoria. Las causas de esta complicación parecen relacionarse con factores relacionados a la hidrodinámica (a pesar de haberse cambiado el sistema derivativo), al tratamiento farmacológico y al crecimiento propio del quiste. Esta complicación por su rareza, es poco sospechosa por lo que recomendamos que en casos de pacientes cisticercosos con disfunción valvular con hidrocefalia asimétrica se realicen estudios (yodotomografía o resonancia magnética nuclear) para descartar esta posibilidad

Manejo con nimodipina del vasoespasmo cerebral secundario a hemorragia subaracnoidea por ruptura de aneurisma intracraneano / Management with nimodipine of the cerebral vasoespasm secondary to subarachnoid hemorrhage due to the rupture of an intracraneal aneurysm

El vasoespasmo cerebral secundario a hemorragia subaracnoidea por ruptura de aneurisma intracraneano es causa de alta morbimortalidad. Su fisiopatogenia es aún desconocida por lo que en el tratamiento y prevención se obtienen resultados controversiales. Estudiamos dos grupos de 29 pacientes cada uno, donde el primero se manejo con nimodipina sistémica y el segundo sirvió de grupo control. No observamos una correlación sistemática entre el vasoespasmo clínico o sintomático y el angiográfico. No hubo diferencia en los resultados finales de ambos grupos. No se presentaron efectos colaterales en otros órganos con el uso de este fármaco

Infeccoes conjuntas de bovinos por Balanorchis anastrophus Fischoeder, 1901 e Paramphistomum sp. (Trematoda, Paramphistomidae) no Rio Grande do Sul, Brasil. / Cattle associated infections by Balanorchis anastrophus Fischoeder, 1901 and Paramphistomum sp. (Trematoda, Paramphistomidae) in Rio Grande do Sul, Brazil

Duzentos e noventa e seis bovinos (Bostaurus. L.) provenientes dos municipios de Santa Vitoria do Palmar (255), Pedro Osorio (27), e Camaqua (14), no Estado do Rio Grande do Sul, Brasil, foram examinados com o objetivo de encontrar termatodeos de rumen, A prevalencia dos trematodeos foi de aproximadamente 68, 70 e 100%, respectivamente. Balanorchis anastrophus foi encontrado em infeccoes conjuntas com Paramphistomum sp., em tres bovinos, entre os dez primeiros animais positivos para trematodeos, um de cada municipio. As infrapopulacoes de B. anastrophus foram encontradas com baixas densidades: 15 (3,56%), 4 (1,48%) e 27 (5,55%), enquanto aquelas de Paramphistomum sp. ocorreram em densidades maiores: 421, 270 e 486, respectivamente. Um metodo simples foi descrito, para a separacao de helmintos nao comprimidos e nao corados, dos generos Paramphistomum e Balanorchis. Os autores sugeriram que o mesmo podera ser util ao veterinario de campo e aos pesquisadores interessados em levantamentos de trematodeos de rumen em matadouros