ABSTRACT
ABSTRACT Objective: To identify condom use and drug consumption in migrants, as well as the association between these variables. Method: A systematic search was carried out for articles published in Spanish and English (2017-2022), in PubMed, EBSCO, WEB of SCIENCE, Elsevier, Scielo, Redalyc, with eligible studies reporting on condom use and drug consumption, and their association. Results: The search strategy found 147 articles with the combination of terms and other sources. After excluding articles by title, abstract, and finding that they had the study variables, eight articles were included for qualitative analysis and only three met the criteria for quantitative analysis. Conclusion: Drug consumption favors inconsistent condom use, increasing the risk of acquiring an STI, and can lead to other mental health issues derived from the use of these substances.
RESUMO Objetivo: Identificar o uso de preservativo e o consumo de drogas em migrantes, bem como a associação entre essas variáveis. Método: Foi realizada uma busca sistemática de artigos publicados em espanhol e inglês (2017-2022), em PubMed, EBSCO, WEB of SCIENCE, Elsevier, Scielo, Redalyc, com estudos elegíveis relatando o uso de preservativos e consumo de drogas, e sua associação. Resultados: Com a estratégia de busca foram identificados 147 artigos com a combinação de termos e outras fontes. Após eliminar os artigos por título, resumo e identificar que continham as variáveis do estudo, oito artigos foram incluídos para análise qualitativa e apenas três atenderam aos critérios para análise quantitativa. Conclusão: O consumo de drogas estimula o uso inconsistente do preservativo, o que aumenta o risco de aquisição de uma IST, além de outros problemas de saúde mental decorrentes do consumo dessas substâncias.
RESUMEN Objetivo: Identificar el uso del condón y el consumo de drogas en migrantes, así como la asociación entre estas variables. Método: Se realizó una búsqueda sistemática de artículos publicados en español e inglés (2017-2022), en PubMed, EBSCO, WEB of SCIENCE, Elsevier, Scielo, Redalyc, siendo que los estudios elegibles informaron sobre el uso del condón y el consumo de drogas, y su asociación Resultados: Con la estrategia de búsqueda se identificaron 147 artículos con la combinación de términos y de otras fuentes. Después de la eliminación de artículos por título, resumen, identificar que cuenten con las variables de estudio, se incluyeron ocho artículos para el análisis cualitativo y únicamente tres cumplieron con los criterios para el análisis cuantitativo. Conclusión: El consumo de drogas favorece el uso inconstante del condón, y esto incrementa el riesgo de adquirir alguna ITS, además de otras cuestiones de salud mental derivadas del consumo de estas sustancias.
Subject(s)
Humans , Substance-Related Disorders , Emigrants and Immigrants , Illicit Drugs , CondomsABSTRACT
Background The treatment of choice of newly diagnosed multiple myeloma (NDMM) is an induction with proteasome inhibitors followed autologous stem cell transplantation (HSCT). Since 2013, the treatment of these patients in the public system is based on CTD (cyclophosphamide, thalidomide, and dexamethasone). Aim To evaluate the response rates achieved with CTD, and the results of HSCT in patients with NDMM in the public setting. Material and Methods Data from patients considered as candidates for HSCT from different centers of the National Adult Antineoplastic Drug Program (PANDA, for its acronym in Spanish), diagnosed between 2013 and 2017, was analyzed. The response to treatment of first and second lines of treatment was evaluated, in addition to the results of HSCT. An optimal Response was defined as the sum of strict complete remission, complete remission and very good partial response (sCR, CR and VGPR). Results One hundred and seventy-seven patients were analyzed, 54% women, and 53% with IgG multiple myeloma. Information about the international staging system was retrieved in 127 patients (71%). Seventeen percent were ISS I, 22% in ISS II and 32% ISS III. CTD was used as first treatment in 106 patients (60%), and cyclophosphamide, bortezomib and dexamethasone (CyBorD) in 13 (7%). As first line, CTD had an overall response of 50.9%, and CyBorD of 76.9%. Thirty patients were treated with bortezomib as second line treatment. Forty patients (22%) underwent HSCT. The 5-year Overall Survival (OS) in transplanted patients and non-transplanted patients was 100 and 62% respectively (p < 0.01). Conclusions The response rate achieved by CTD in these patients is suboptimal. The response to CyBorD was better.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Hematopoietic Stem Cell Transplantation/methods , Multiple Myeloma/therapy , Time Factors , Transplantation, Autologous , Dexamethasone/administration & dosage , Antineoplastic Combined Chemotherapy Protocols , Retrospective Studies , Combined Modality Therapy , Disease-Free Survival , Cyclophosphamide/administration & dosage , Kaplan-Meier Estimate , Bortezomib/administration & dosage , Multiple Myeloma/mortalityABSTRACT
ABSTRACT Background: Immunoglobulin light chain (AL) amyloidosis is a rare and underdiagnosed entity. Aim: To characterize patients with AL amyloidosis in Chilean public health centers. Material and Methods: We conducted a retrospective, multicenter study. Public centers of the Chilean Monoclonal Gammopathies Cooperative Group were asked to search for patients with AL amyloidosis in their databases. Epidemiological, clinical and laboratory characteristics were evaluated. Results: Forty-two patients aged 22 to 84 years were found. Twenty four percent had localized AL amyloidosis; 64% had a lambda light chain clone; 47% were associated with multiple myeloma and 9% with non-Hodgkin lymphoma. The most commonly involved organ was the kidney (76%). Serum free light chains were measured in 31% and an echocardiogram was performed in 74% of patients. Seventeen percent of patients received only palliative care, 17% were treated with bortezomib, 21% with thalidomide, and 40% with melphalan. No patient was transplanted. The mean overall survival (OS) of the group was 19 months. The 5-year OS was 28%. Conclusions: It is important to obtain these realistic, national data to initiate strategies to improve early diagnosis and proper management of this disease.
La amiloidosis AL es una entidad poco frecuente y subdiagnosticada. Mientras todo el mundo discute sobre las nuevas herramientas diagnósticas y terapéuticas, en Chile y en América Latina en general, estamos lejos de esa realidad. El objetivo del presente estudio fue caracterizar a los pacientes con amiloidosis AL en centros del sistema público de nuestro país. Se realizó un estudio retrospectivo, multicéntrico, descriptivo. Los centros públicos del grupo cooperativo hematológico chileno buscaron en sus bases de datos pacientes diagnosticados con amiloidosis AL. Se evaluaron las características epidemiológicas, clínicas y de laboratorio. La edad media fue de 65 años. A 24% de los pacientes se les diagnosticó amiloidosis AL localizada; 64% tuvo paraproteína con cadena ligera lambda; 47% se asoció con mieloma múltiple y 9% con linfoma no Hodgkin. El órgano afectado con mayor frecuencia fue el riñón (76%). Las cadenas ligeras libres de suero se realizaron en 31% y ecocardiograma en 74%. El 17% recibió solo cuidados paliativos, 17% recibió tratamiento con bortezomib, 21% con talidomida y 40% con melfalán. Ningún paciente fue trasplantado. La media de sobrevida global (SG) del grupo fue de 19 meses. La SG a 5 años fue de 28%. Es importante reportar estos resultados nacionales para iniciar estrategias que mejoren tanto el diagnóstico temprano como el tratamiento de esta patología. Por lo tanto, mejorar la sospecha diagnóstica es crucial.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Public Sector/statistics & numerical data , Immunoglobulin Light-chain Amyloidosis/epidemiology , Health Services/statistics & numerical data , Time Factors , Blood Protein Electrophoresis , Chile/epidemiology , Retrospective Studies , Immunoglobulin lambda-Chains , Kaplan-Meier Estimate , Immunoglobulin Light-chain Amyloidosis/physiopathologyABSTRACT
El proceso de cuidar es un entendimiento propio de cada situación, la práctica en Enfermería es contextualizar un sinfín de tareas que el profesional debe llevar a cabo, lo cual se denomina como Práctica Avanzada. El cuidado humano se ha definido desde varias perspectivas filosóficas, para Heidegger el cuidado es la conciencia del desvelo por sí mismo, significando inquietud, preocupación y alarma por otros, implicando el quehacer expresado en la praxis mediante una clara manifestación del cuidado existencial. Las enfermeras de Práctica Avanzada son capaces de realizar cuidados a un elevado nivel de pericia, con un alto grado de complejidad basada en evidencia científica. Es claro que la filosofía del cuidado no es un mundo alejado de las competencias de la Enfermería, ya que descifrar esta, es comprender la esencia de la profesión y de la humanidad, llevarla a la Práctica Avanzada es fundamental para mantener la calidad integral del cuidado.
The process of caring is an understanding of each situation, the practice in nursing is to contextualize a myriad of tasks that the professional must carry out, which is called Advanced Practice. Human care has been defined from various philosophical perspectives, for Heidegger the care is the conscience of sleeplessness by itself, meaning restlessness, concern and alarm for others, implying the task expressed in praxis through a clear manifestation of existential care. The Advanced Practice Nurses are capable of performing care at an expert level, with a high degree of complexity based on scientific evidence. It is clear that the philosophy of care is not a world away from the competencies of nursing, because to decipher this, is to understand the essence of the profession and humanity, take it to Advanced Practice is essential to maintain comprehensive quality of care.
Subject(s)
Humans , Health Knowledge, Attitudes, Practice , Nursing , Advanced Practice Nursing , Institutional Practice , Nursing Care , MexicoABSTRACT
Background: Patients with Glioblastoma multiforme (GBM) have a five years survival of less than 5%, but the response to chemotherapy with alkylating agents can vary depending on the methylation status of O6-methylguanine-DNA-methyltransferase (MGMT). Genetic testing has limitations for routine use, while immunohistochemistry (IHC) offers a fast and affordable technique but with heterogeneous results in the literature. Aim: To evaluate MGMT expression by IHC in tumor tissue of Chilean patients with GBM. Material and Methods: Tumor samples of 29 patients with a pathological diagnosis of GBM were studied. We performed IHC staining and manual analysis of positive and negative cells for MGMT expression. A cut-off of at least 10% of cells expressing MGMT was used. Demographic and clinical features of patients were obtained from clinical records. Results: The median number of cells counted per case was 692 (interquartile range [IQR] 492-928). Fifteen cases (52%) were positive for MGMT expression. Median overall survival was 5.3 months (IQR 3.4-12-8). The effect of MGMT expression on the therapeutic response was not studied since only 3 patients received chemotherapy. Conclusions: Our results are similar to international reports, but we were not able to determine the association between MGMT expression and therapeutic response.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Brain Neoplasms/enzymology , Biomarkers, Tumor/metabolism , Glioblastoma/enzymology , O(6)-Methylguanine-DNA Methyltransferase/metabolism , Prognosis , Brain Neoplasms/genetics , Immunohistochemistry , Biomarkers, Tumor , Gene Expression Regulation, Neoplastic , Chile , Survival Rate , Retrospective Studies , Glioblastoma/genetics , O(6)-Methylguanine-DNA Methyltransferase/geneticsABSTRACT
Background: Intensified treatment of Philadelphia chromosome negative acute lymphoblastic leukemia (Ph(-)ALL) in adolescents by pediatric teams, with fve years disease free survival (DFS) rate of 65%, encouraged the use of intensified protocols in patients between 15 and 30 years, improving the DFS from 45% to 60-80%. The protocol LLA 15-30 for patients between 15 and 30 years with Ph(-)ALL, based on the Children’s Oncology Group (COG) protocol AALL0232 resulting in a five years DFS of 78%, was started in 2007 by the PANDA national program. Aim: To report the results of the prospective cohort study evaluating the results of this protocol four years after its implementation. Patients and Methods: Between January 2007 and December 2010, 68 Ph(-) ALL patients, aged between 15-30 years (75% males) were incorporated. Survival was evaluated using Kaplan-Meier and log-rank tests. Results: Fifty percent of patients were of high risk. A complete response was achieved in 91%, early death occurred in 6% and induction failure in 3%. Median follow-up was 23 months. Overall survival, disease free survival and relapse rates at 35 months were 61.8, 67.5% and 31% respectively. Conclusions: LLA 15-30 protocol significantly improved three-year overall survival from 31 to 62%. The 20% difference observed with AALL0232 protocol is explained by the high rate of relapse. Improving provider and patient compliance with protocols may eliminate this gap.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Philadelphia Chromosome , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics , Asparaginase/administration & dosage , Cohort Studies , Dexamethasone/administration & dosage , Methotrexate/administration & dosage , Prognosis , Prospective Studies , Treatment Outcome , Vincristine/administration & dosageABSTRACT
Background: The current recommendations for treatment of patients with newly diagnosed acute promyelocytic leukemia (APL) include all-trans-retinoic acid (ATRA) and anthracycline based chemotherapy. Aim: To evaluate the results of the Chilean protocol following the LPA99 regimen of the Spanish PETHEMA group, except for the replacement of Idarubicin by Daunorubicin. Patients and Methods: Induction consisted of Daunorubicin 45 mg/m² on days 2, 4, 6 and 8 plus ATRA 45 mg/m² daily until complete remission. Patients in complete remission (CR) received three monthly chemotherapy courses: Daunorubicin 45 mg/m²/d/4days i.v. and ATRA 45 mg/m²/d/15 days p.o. (course no. 1); Mitoxantrone 10 mg/m²/d/5 days i.v. and ATRA 45 mg/m²/d/15 days p.o. (course no. 2); Daunorubicin 60 mg/m²/d/ day 1 i.v. in the low risk group, and 1 and 2 in the intermediate-high risk groups and ATRA 45 mg/m²/d/15 days p.o. (course no. 3). Maintenance therapy consisted of mercaptopurine 90 mg/m²/d p.o., methotrexate 15 mg/m²/wk p.o. and, ATRA intermittently, 45 mg/m²/d p.o. for 15 days every three months. Results: Between January 2000 and December 2005, 56 patients with newly diagnosed APL from 10 centers were enrolled. A total of 46 patients achieved CR (85%), 8 (15%) died of early complications, seven patients relapsed, with a 16% relapse risk at three years. The 5-year Kaplan-Meier estimates of overall survival and relapse-free survival were 64% and 84% respectively. Conclusions: These data indicate that this protocol has a good antileukemic effect but further reduction of early death and relapse, especially in the high risk group is needed.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Daunorubicin/administration & dosage , Leukemia, Promyelocytic, Acute/drug therapy , Tretinoin/administration & dosage , Chile , Induction Chemotherapy , Kaplan-Meier Estimate , Leukemia, Promyelocytic, Acute/diagnosis , Leukemia, Promyelocytic, Acute/mortalityABSTRACT
El avance sostenido que ha experimentado en los últimos años el cuidado intensivo neonatal, ha dado como resultdo el aumento de la sobrevida de niños de alto riesgo. Terapias como el uso de surfactante, ventilación de alta frecuencia, oxido nítrico inhalatorio permiten la sobrevida, tanto de niños prematuros extremos, así como de niños de término que han estado gravemente enfermos y que en otras circunstancias habrían fallecido. Esta disminución de la mortalidad, no ha sido acompañada de una disminución sostenida en la incidencia de secuelas neurológicas o del desarrollo; así, el número absoluto tanto de niños sanos como de secuelados ha aumentado. Por lo anterior, se hace necesaria la existencia de programas de seguimiento para los RN de alto riesgo. Esto permite dar continuidad al trabajo de la unidad de recién nacidos, vigilar el estado de salud de los niños que ellas egresan y además permite entregar información de retroalimentación al equipo de neonatólogos para optimizar las acciones médicas futuras
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Infant, Very Low Birth Weight/growth & development , Child Development , Follow-Up Studies , Food and Nutritional Surveillance , Risk Groups , Surveillance in Disasters , Vaccines/administration & dosageABSTRACT
Se determina la actividad de acetilcolinoesterasa (AchE) en 2 cerebros de pacientes que cumplen los criterios de demencia por infartos múltiples. Se demuestra una disminución de la actividad de AchE en el córtex prefrontal, parietal, hipocampo y núcleo basal de Meynert, la que afecta de manera particular a las fibras, con conservación de la actividad en los somas neuronales. Se postula que la inhibición de los sistemas colinérgicos del telencéfalo basal, tendrían algún rol en la génesis de la demencia por múltiples infartos
Subject(s)
Aged , Humans , Female , Acetylcholinesterase/biosynthesis , Dementia/enzymology , Substantia Innominata/physiopathology , Cerebral InfarctionABSTRACT
Realizamos un dobel estudio del estado nutricional de 1027 niños, valorandolos mediante el método Edad-Peso-Talla y comparándolo con la valoración obtenida por el Método del Brazalete de la Salud que se introduce a través de UNICEF. Encontramos un grado de acierto en 67.5% y un error de 31.5% y debemos destacar en su totalidad a los niños como Desnutridos cuando según la valoración por edad-Peso-Talla son normales. En ningún caso se da el error de considerar Normal a un niño Desnutrido