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RESUMEN El objetivo es proponer un esquema conceptual que sea útil para interpretar las implicaciones económicas y ambientales que tienen las organizaciones sociales basadas en un paradigma individualista o altruista. Tras una revisión de literatura y breve recuento histórico de estos paradigmas, se concluye que son las organizaciones complejas y equilibradas las que tienen mayor propensión a desarrollar intercambios de cooperación altruistas. La implicación para las políticas ambientales contemporáneas es que, además de los mecanismos de mercado, es posible complementarlas con otros esquemas basados en mecanismos comunitarios, siempre y cuando exista un contexto propicio para implementarlo.

ABSTRACT The objective is to propose a practical conceptual scheme to interpret social organizations' economic and ecological implications based on an individualistic or altruistic paradigm. After a literature review and a brief historical analysis of these paradigms, we conclude that complex and balanced organizations have the most remarkable propensity to develop altruistic cooperation exchanges. The implication for contemporary environmental policies is the possibility of complementing market mechanisms with community-based schemes in a favorable context.

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Background: To comprehend the complex interplay of multiple risk factors impacting survival at a localized level is imperative. This study aimed to explore survival patterns and identify the underlying causal factors linked to mortality risk in the region. Methodology: Data from 200 patients with esophageal cancer treated at three prominent hospitals over the course of one year is collected for the study purpose. The Kaplan?Meier curve and Cox proportional hazard regression model were employed. Results: This study identified smokeless tobacco consumption habits showing a 6-fold elevated mortality risk (HR 6.22, p<0.001). Subsequently, cultivator (HR 4.85, p=0.001) and male gender (HR 4.24, p=0.001) showed higher mortality risk. Additionally, a significantly higher prevalence of death among smokers with comorbidity (66.0%) is found compared to smokers without comorbidity (44.1%), p=0.043. The survival probability shows a declining trend, i.e. 84.50% in the first year to 13% in the 6th year. With an 82% change, this variation was greatest between the 3rd and 4th years. Conclusions: To better understand mortality risk, certain risk factors, such as salted fish, fertilizer and pesticide exposure, and length of marriage, need to be thoroughly investigated in future studies due to limited knowledge about this exposure at a localized level.

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INTRODUCTION. There is an important number of reports in Latin America, but there is a lack of data on acute promyelocytic leukemia (APL) in Ecuador., this is the main reason to carry out this study in the country, a disease that in recent decades has shown a significant improvement in survival. OBJECTIVES. To evaluate the overall survival (OS) and event-free survival (EFS), and also the demography, and the most relevant clinical and laboratorial findings. METHODS. We retrospectively reviewed the medical records of 48 patients with APL, diagnosed between January 2012 and December 2019. We collected the most relevant demographic, clinical and laboratorial characteristics, as well as data related to 30-day mortality, and 5 year­OS (overall survival) and EFS (event-free survival). RESULTS. Among the forty-eight (48) patients with acute promyelocytic leukemia, 44 patients received treatment, the mean number of days for the start of all trans retinoic acid (ATRA) and/or arsenic trioxide (ATO) was of 2.5 days from the moment of the diagnosis. 60.4% of patients were classified as low risk and 39.5% as high risk, according to the national comprehensive cancer network (NCCN). The early death rate was 31.2%, the main cause of which was sepsis, multidrug resistant (MDR) bacterias were isolated in 83% of the patients who took blood cultures and died of early sepsis. after a median follow-up of 35 months only one patient relapsed. the five-year OS and EFS was 51.2%; In the multivariate analysis, only age was identified as an adverse prognostic factor. DISCUSSION. Compared to prospective trials with ATRA-based regimens, we found an inferior OS, mainly because of a high-rate early death. if we compare our findings with other real-world reports, we will also show inferior results probably explained by the high rate of early death due to infection by MDR batteries, in addition to the early deaths caused by hemorrhages. CONCLUSION. The low rate of OS shown in this study, could be improved based on changes to optimize the ac-cess of the patients to an early diagnosis and treatment and the reduction of the unacceptably high rates of multidrug resistance bacterial infections in our setting.

INTRODUCCION. Existe un número importante de reportes en Latinoamérica, pero se carece de datos sobre la leucemia promielocítica aguda (LPA) en Ecuador, ésta es la principal razón para realizar este estudio en el país, enfermedad que en las últimas décadas ha mostrado una importante mejoría en la sobrevida. OBJETIVOS. Evaluar la sobrevida global (SG) y la sobrevida libre de eventos (SLE), así como la demografía y los hallazgos clínicos y laboratoriales más relevantes. MÉTODOS. Se revisaron retrospectivamente las historias clínicas de 48 pacientes con LPA, diagnosticados entre enero de 2012 y diciembre de 2019. Se recogieron las características demográficas, clínicas y datos de laboratorio más relevantes, así como datos relacionados con la mortalidad a 30 días, y a 5 años-OS (supervivencia global) y EFS (supervivencia libre de eventos). RESULTADOS. De los cuarenta y ocho (48) pacientes con leucemia promielocítica aguda, 44 pacientes recibieron tratamiento, la media de días para el inicio de ácido transretinoico total (ATRA) y/o trióxido de arsénico (ATO) fue de 2,5 días desde el momento del diagnóstico. El 60,4% de los pacientes fueron clasificados como de bajo riesgo y el 39,5% de alto riesgo, según la red nacional integral del cáncer (NCCN). La tasa de mortalidad precoz fue del 31,2%, cuya causa principal fue la sepsis, aislándose bacterias multirresistentes (MDR) en el 83% de los pacientes que se sometieron a hemocultivos y fallecieron por sepsis precoz. Tras una mediana de seguimiento de 35 meses, sólo un paciente sufrió una recaída, la SG y la SSC a cinco años fue del 51,2%; en el análisis multivariante, sólo la edad se identificó como factor pronóstico adverso. DISCUSIÓN. En comparación con los ensayos prospectivos con regímenes basados en ATRA, encontramos una SG inferior, principalmente debido a una alta tasa de muerte temprana. Si comparamos nuestros hallazgos con otros informes del mundo real, también mostraremos resultados inferiores probablemente explicados por la alta tasa de muerte temprana debida a infección por baterías MDR, además de las muertes tempranas causadas por hemorragias. CONCLUSIONES. La baja tasa de SG mostrada en este estudio, podría mejorarse en base a cambios para optimizar el acceso de los pacientes a un diagnóstico y tratamiento precoz y la reducción de las inaceptablemente altas tasas de infecciones bacterianas multirresistentes en nuestro medio.

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INTRODUCCION: El rechazo se define como un aumento en el nivel de creatinina sérica des-pués de la exclusión de otras causas de disfunción del injerto, asociado a cambios patológicos específicos en el injerto y puede ocurrir en cualquier momento después del trasplante.OBJETIVO: Determinar el tiempo de sobrevida del injerto renal en pacientes trasplantados renales con Rechazo Activo.MATERIALES Y MÉTODOS: Estudio observacional, descriptivo, transversal, se realizó en el Hospital de Especialidades Carlos Andrade Marín en el periodo 2013-2022, el universo se con-formó por una base de datos anonimizada de 460 pacientes trasplantados, de los cuales 92 pacientes (20 %) presentaron diagnóstico de rechazo activo. Se utilizó el programa estadístico SPSS v26®.RESULTADOS: El 60,8% fueron pacientes de sexo masculino, con una edad media de 43,7 años, la supervivencia del aloinjerto en pacientes con rechazo fue del 85% a los 5 años de seguimiento, y de los que no tuvieron rechazo fue del 97,1 % a los 5 años con una (p =0,001). El rechazo mediado por células T presentó una mayor sobrevida del injerto renal del 97% y la menor tasa de sobrevida se evidenció en el rechazo mediado por anticuerpos.DISCUSIÓN. La incidencia del rechazo del injerto renal a nivel global se estima del 5% al 10%, aunque puede ser mayor hasta el 35%, en el grupo de alto riesgo inmunológico. La sobrevida del aloinjerto empeora con cada episodio de rechazo comparado con pacientes que no experi-mentan rechazo del injerto.CONCLUSIÓN: La tasa más alta de sobrevida se evidenció en pacientes sin rechazo durante 5 años de seguimiento, corroborando lo hallado en el estado del arte. En este estudio la super-vivencia del rechazo mediado por células T fue superior en relación con el rechazo mediado por anticuerpos.

Rejection is defined as an increase in serum creatinine level after exclusion of other causes of injectable dysfunction, associated with specific pathological changes in the injectable and may occur at any time after transplantation.OBJECTIVE: Determine the survival time of the kidney graft in kidney transplant patients with Active Rejection.MATERIALS AND METHODS: Observational, descriptive, cross-sectional study was carried out at the Carlos Andrade Marín Specialty Hospital in the period 2013-2022, the universe was made up of an anonymized database of 460 transplant patients, of which 92 patients (20 %) presented a diagnosis of active rejection. The SPSS v26® statistical program was used. RESULTS: 60.8% were male patients, with a mean age of 43.7 years, allograft survival in pa-tients with rejection was 85% at 5 years of follow-up, and of those who did not have rejection it was 97.1% at 5 years with one (p =0.001). Rejection mediated by T cells presented a greater survival rate of the kidney graft of 97% and the lowest survival rate was evident in rejection mediated by antibodies.DISCUSSION. The incidence of kidney graft rejection globally is estimated at 5% to 10%, al-though it can be higher, up to 35%, in the high immunological risk group, with increasing preva-lence. Allograft survival worsens with each episode of rejection compared to patients who do not experience graft rejection.CONCLUSION: The highest survival rate was evident in patients without rejection during 5 years of follow-up, corroborating what was found in the state of the art in this study, the survival of rejection mediated by T cells was superior in relation to rejection mediated by antibodies.

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Introduction: The present study aimed to calculate the burden of oral cavity cancer (OCC) including incidence, mortality rate, survival rate, and influence of predictive factors such as clinicopathological, demographic findings, and treatment modalities. Materials and Methods: Data in this retrospective study were collected from India’s population-based cancer registry (PBCR) from 2010 to 2016. A total of 1051 cases of OCC were noted. Incidence and mortality rates were calculated. The cumulative survival outcome was calculated using Kaplan–Meier (KM) method. Prognostic factors were estimated using the Cox proportional hazard regression model. Results: The age-standardized incidence rates (ASR), and mortality rate (ASMR), of overall OCC cases were 10.1 and 8.4 per 100 thousand population, respectively. Five-year overall survival (OS) was 32.3%. Survival outcome was significantly associated with the given treatment (Chi-square value = 58.17, P = 0.0001) and anatomical site (Chi-square value = 26.70, P = 0.0001). 17.6% of cases in males were <39-year age group. The hazard ratio (HR) in the age group of >50 years was 2.065 (95% CI 1.34-3.18, P = 0.001). Combination therapy had an HR of 2.630 (95% CI 1.91-3.63, P value 0.000). Tonsillar carcinoma (C09) (95% CI 1.04-3.12) had 1.8 times more chances of death than lip carcinoma (C00). Conclusion: OCC cases are increasing in the younger population, and overall, cases show higher mortality rates with reduced survival outcomes. Prognostic factors such as age >50 years, single modality treatment, and alveolar and tonsillar malignancy are associated with poor survival. OCC robust screening by a trained health professional can improve early detection and increases awareness and lower mortality of the disease.

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We wanted to present a rare case of metastatic grade 2 spinal ependymoma with an atypical course at the time of diagnosis. Temozolomide plus capecitabine chemotherapy was started in May 2018 on a 30?year?old female patient with sacral ependymoma who had extensive lung metastases at the time of diagnosis. The patient remained in remission for approximately 29 months, and the current chemotherapy was continued until it progressed in November 2020. According to this case report, a combination of temozolomide and capecitabine may be the best treatment option for ependymoma patients.

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Aims/Objectives: In resource?limited settings, data regarding the impact of molecular/receptor subtypes on breast cancer (BC) are sparse. In this single?center retrospective study from north India, we analyze the outcomes of various molecular subtypes of BC. Materials and Methods: Females with biopsy?proven BC who were treated at our State Cancer Institute from 2014?2018 were included. Data regarding clinicopathological parameters and follow?up details were evaluated. For data analysis, cancers were categorized into 4 subtypes: HR+HER2–, HR+HER2+, HR–HER2+, and HR–HER2–. Results: Among 944 patients included, HR+HER2– (49.1%) and HR+HER2+ (13.1%) were the most and least common subtypes, respectively. The receptor subtype significantly impacted overall survival (OS). HR+HER2– cancers had the best outcomes while HR–HER2– cancers fared worst (3?yr OS of 94.3% and 69.1%, respectively). On subgroup analysis, the molecular subtype continued to significantly impact OS in patients with tumor grades II and III, disease stages II and III, and age groups of <40 and 40?60 years, respectively (HR–HER2– cancers had the lowest cumulative survival in each subgroup). In patients with metastatic BC, all molecular subtypes except HR+HER2– had a dismal prognosis. Conclusions: Overall and across various subgroups, patients with triple?negative BC had the poorest outcomes. Ensuring optimal treatment utilization including affordable access to personalized tailored therapy is the need of the hour to improve long?term outcomes in these patients.

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Introdução: A taxa de mortalidade em pacientes queimados diminuiu significativamente, tornando importante avaliar outros desfechos, como o tempo de internação, que aumenta a morbidade física e psicológica, o risco de infecção hospitalar e os custos financeiros. O objetivo deste estudo é analisar a relevância de vários fatores no tempo de internação na Unidade de Queimados. Método: Foram incluídos neste estudo 711 pacientes admitidos entre 2011 e 2020 na Unidade de Queimados do Hospital de São José, Centro Hospitalar Lisboa Central, Lisboa, Portugal. Os dados coletados foram analisados utilizando o PSPP para Windows. Resultados: Os pacientes eram predominantemente do sexo masculino, com idade média de 54 anos. O tempo médio de permanência hospitalar foi de 29 dias. Os fatores que prolongaram a estadia hospitalar foram relacionados à gravidade da queimadura, ao número de cirurgias e ao tempo decorrido até a primeira cirurgia, valores laboratoriais alterados tanto no perfil hematológico quanto químico durante a hospitalização, e a presença e o número de infecções documentadas. Conclusão: Existem fatores potencialmente modificáveis que infiuenciam o tempo de permanência hospitalar. Nosso estudo nos permite concluir que o tempo decorrido até a primeira intervenção cirúrgica e a presença e o número de infecções documentadas prolongam significativamente esse desfecho, e ênfase deve ser dada à implementação de medidas que favoreçam a intervenção cirúrgica precoce e o controle rigoroso de infecções.

Introduction: Burn patients' mortality rate has decreased significantly, making it important to evaluate other outcomes, such as length-of-stay, which increases physical and psychological morbidity, risk of nosocomial infection, and financial costs. The objective of this study is to analyze the relevance of several factors in the Burn Unit length-of-stay. Material and Methods: 711 patients were included in this study, admitted between 2011 and 2020 to the Burn Unit at São José Hospital, Centro Hospitalar Lisboa Central, Lisbon, Portugal. Collected data was analyzed using PSPP for Windows. Results: Patients included in the study were predominantly males, with a mean age of 54 years. The mean length of stay was 29 days. The factors that prolonged in-hospital stay were those related to the severity of the burn, the number of surgeries and the time elapsed until the first one, altered laboratory values in both hematologic and chemistry profile during the hospitalization, and the presence and number of documented infections. Conclusion: There are potentially modifiable factors that influence length-of-stay. Our study allows us to conclude that the time elapsed until the first surgical intervention and the presence and number of documented infections significantly prolong this outcome, and emphasis should be given to the implementation of measures that favor early surgical intervention and strict infection control.

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RESUMEN El propósito del estudio fue describir las características clínicas, anatomopatológicas, tratamiento y supervivencia de los pacientes con cáncer de tiroides diferenciado. Se realizó un estudio de cohorte retrospectiva con datos de 150 pacientes de un hospital peruano entre los años 2010 al 2020. Se describieron las características y supervivencia (método de Kaplan-Meier). La media de edad fue 48,3 años, 130 (86,7%) fueron mujeres y el tipo histológico más frecuente fue el papilar 94,6%. El 74,2% tenían estadio TNM I, 70,7% tiroidectomía total y 68,7% recibió yodo radiactivo. La supervivencia global a los 5 años fue 89,3%, siendo menor en aquellos con estadio TNM IV y mayor en los que usaron yodo radiactivo. En conclusión, en un hospital de Cusco, el cáncer diferenciado de tiroides fue más frecuente en mujeres y la supervivencia fue menor en comparación con reportes de otros países.

ABSTRACT This study aimed at studying the clinical and anatomopathological characteristics, treatment and survival of patients with differentiated thyroid cancer. A retrospective cohort study was conducted with data from 150 patients from a Peruvian hospital between the years 2010 to 2020. Characteristics and survival (Kaplan-Meier method) were described. The mean age was 48.3 years, 130 participants (86.7%) were women and the most frequent histologic type was papillary 94.6%. Of the participants, 74.2% had TNM stage I, 70.7% had total thyroidectomy and 68.7% received radioactive iodine. Overall survival at 5 years was 89.3%, being lower in those with TNM stage IV and higher in those who used radioactive iodine. In conclusion, in a hospital in Cusco, differentiated thyroid cancer was more frequent in women and survival was lower compared to reports from other countries.

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Introducción Fulvestrant demostró beneficio en sobrevida global y sobrevida libre de progresión en pacientes con cáncer de mama avanzado, con receptores hormonales positivos y receptor de factor de crecimiento epidérmico humano 2 negativo. Se evaluaron las características, la evolución y la sobrevida de pacientes con cáncer de mama receptor hormonal positivo, HER2 negativo, tratadas con fulvestrant, de acuerdo con los protocolos nacionales de cobertura de tratamiento del Fondo Nacional de Recursos. Su objetivo fue conocer la eficacia de fulvestrant en pacientes tratados en la práctica clínica habitual. Se compararon los resultados obtenidos en el presente trabajo con los resultados de los estudios pivotales. Métodos Se utilizó la base de datos del Fondo Nacional de Recursos, que abarca el período de 2009 a 2022. La evaluación de las curvas de sobrevida se realizó mediante el método Kaplan-Meier y las diferencias se analizaron utilizando el test de Log-Rank. Resultados Se incluyeron 1085 pacientes con una edad media de 63,66 años. Tras un seguimiento de 14 meses, la mediana de la sobrevida global fue de 16 meses y la de la sobrevida libre de progresión de 6 meses. La presencia de metástasis hepáticas y óseas se asoció con una menor sobrevida global. Los pacientes del sector público y aquellos con una mejor escala de estado funcional experimentaron una mayor sobrevida global. Conclusiones Los resultados obtenidos ofrecen una perspectiva valiosa para la gestión de tratamientos en un contexto de recursos limitados. La sobrevida global y la sobrevida libre de progresión fueron algo inferiores a los reportados en los ensayos clínicos pivotales. La presencia de metástasis hepáticas y óseas se asoció a un peor pronóstico y una peor sobrevida. Además, los pacientes con peor escala de estado funcional tuvieron una menor sobrevida global. Estos hallazgos subrayan la necesidad de terapias personalizadas, abriendo nuevas líneas de investigación futura.

Introduction Fulvestrant demonstrated benefits in overall survival and progression-free survival in patients with advanced breast cancer, who are hormone receptor-positive and human epidermal growth factor receptor 2 negative. The characteristics, evolution, and survival of patients with hormone receptor-positive, HER2-negative breast cancer treated with fulvestrant were evaluated according to the national treatment coverage protocols of the National Resources Fund, with the aim of understanding the efficacy of fulvestrant in patients treated in usual clinical practice and comparing our results with those from pivotal studies. Methods A database from the National Resources Fund covering the period from 2009 to 2022 was used. Survival curves were assessed using the Kaplan-Meier method, and differences were analyzed using the Log-Rank test. Results A total of 1085 patients with an average age of 63,66 years were included. Following a follow-up of 14 months, the median overall survival was 16 months, and the median progression-free survival was 6 months. The presence of liver and bone metastases was associated with a shorter overall survival. Patients from the public sector and those with a better performance status experienced longer overall survival. Conclusions Our findings provide a valuable perspective for treatment management in a context of limited resources. Overall survival and progression-free survival were somewhat lower than those reported in pivotal clinical trials. The presence of liver and bone metastases was associated with worse prognosis and survival; additionally, patients with worse performance status had shorter overall survival. These findings underscore the need for personalized therapies, opening new lines of future research.

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Objective: There is a lack of evidence to support a consensus on whether surgery or radiotherapy is optimal for elderly or very elderly patients with early?stage non?small cell lung cancer (NSCLC). We aimed to assess the impact of surgery or radiotherapy on survival in elderly (?70 years) and very elderly (?80 years) patients with early?stage NSCLC. Methods: Patients aged ?70 years diagnosed with early?stage NSCLC between January 1, 1975, and December 31, 2018, were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Overall survival (OS) and cancer?specific survival (CSS) were assessed based on surgery, radiotherapy, and no?treatment groups. Results: Data for 15,224 NSCLC patients aged ?70 years were collected, which consisted of 6949 (45.6%) patients who underwent surgery alone, 5014 (32.9%) who underwent radiotherapy alone, and 3261 (21.5%) who received no treatment. Surgery significantly improved patient survival compared with no treatment (MST: 74 months vs. 7 months, HR: 0.201, 95% CI: 0.186–0.217, P < 0.001), as did radiotherapy (MST: 28 months vs. 7 months, HR: 0.440; 95% CI: 0.413–0.469, P < 0.001). Surgery also resulted in improved survival compared with radiotherapy (74 months vs. 28 months, HR: 0.455; 95% CI: 0.430–0.482, P < 0.001). A similar conclusion was made from the analysis of CSS. A subgroup analysis further confirmed the survival benefits. Conclusions: The results of this large?scale retrospective study indicate that both surgery and radiotherapy significantly enhance survival outcomes in patients aged ?70 or ?80 years with early?stage NSCLC. The survival benefits of surgery were particularly notable.

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Objective: We aimed to assess the efficacy and safety of the three?dimensional visualization ablation planning system (3DVAPS) in ultrasound?guided percutaneous microwave ablation (US?PMWA) for malignant adrenal tumors (MATs). Methods: A retrospective analysis was conducted on a cohort of 62 unilateral MAT cases from March 2011 to November 2022. There were a total of 62 lesions, with a mean maximum diameter of 5.4 ± 2.7 cm (range, 1.4–15.7 cm). The patients were categorized into the following, based on the pre?operative planning method: 3D planning (n = 32) and 2D planning (n = 30) groups. A comparative analysis was performed on various parameters, including ablation techniques, tumor?related prognosis, and incidence of complications. This analysis encompassed indicators, such as overall survival (OS) rate and local tumor progression (LTP), among others. Results: The median follow?up period was 30 months (range, 3–84 months). Notably, compared with the 2D planning group, the 3D planning group exhibited significant disparities in the number of punctures (P = 0.035) and incidence of complications (P = 0.029) and had no significant difference in the OS (P > 0.05) but had a significantly lower LTP rate (6.2% vs. 23.3%, P = 0.033). In the 3D planning group, the sub?group with a tumor diameter of < 5 cm exhibited a significantly less number of punctures (P = 0.039), lower input energy (P = 0.002), and a shorter ablation time (P = 0.001), compared with the sub?group with a tumor diameter of ? 5 cm, but there was no significant difference in the LTP and OS rates between the two sub?groups (P > 0.05). Conclusions: The use of 3DVAPS in US?PMWA of MATs was advantageous, especially in lesions with a diameter of ? 5 cm. It can help in developing more rational surgical plans, reducing the incidence of complications, and extending the local recurrence?free survival time of patients and can add a certain value for precise treatment and expand the indications for ablation.

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Introduction: Loss of skeletal muscle volume is an important aspect of sarcopenia in hepatocellular carcinoma (HCC) patients treated by surgical resection, transcatheter arterial chemoembolization (TACE), or sorafenib. Purpose: This study determined the influence of sarcopenia and other laboratory results on survival in patients with HCC treated with TACE plus sorafenib. Methods: The patients were divided into two groups based on the presence of sarcopenia. The skeletal muscle index was calculated by normalizing the cross?sectional muscle area at the L3 level on an abdominal computed tomography scan before embolization according to the patient’s height. The clinical characteristics of the two groups were then compared. The progression?free survival (PFS) and overall survival (OS) rates after treatment were determined. Results: Sarcopenia was present in 75 of the 102 (74%) patients with HCC included in this study. The albumin, prealbumin, and cholinesterase levels were lower in those with sarcopenia. The OS (P = 0.001) and PFS (P = 0.008) were significantly prolonged in the nonsarcopenia group compared to the sarcopenia group. Sarcopenia, ECOG (?2), and prealbumin (<180 mg/L) were significantly associated with PFS. Sarcopenia, ECOG (?2), Child–Pugh B, BCLC stage C, prealbumin (<180 mg/L), and cholinesterase (<5,320 U/L) were significantly associated with OS. The prognostic factors for OS included sarcopenia, ECOG (?2), and cholinesterase (<5,320 U/L), whereas only ECOG (?2) was identified as a prognostic factor for PFS. Conclusion: Sarcopenia may be an indicator of poor clinical outcome in patients with HCC receiving TACE plus sorafenib.

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Proper feeding is crucial for promoting fast and healthy growth in fish, contributing to increased overall production. However, access to high-nutritional feed is not always feasible. Utilizing locally available ingredients presents a potential solution to this challenge. Consequently, this research aims to assess the impact of locally available feed ingredients on the growth and production of tilapia (O. niloticus) in Liberia. Three types of fish feed were prepared, namely Africa Rice fish feed (diet 1), soybeans fish feed (diet 2), and Gbarnga fish feed (control), each with distinct compositions. These feeds were evaluated to determine their effects on the growth and production performance of tilapia fish for the duration of 31 weeks. Fifty fish with an initial body weight of 12 g each were stocked in each hapa net. Data on survival rate (%), feed conversion ratio (FCR), and growth (g) were collected and compared. The growth results revealed a statistically significant difference (P < 0.001) among the three selected fish feed types. Diet 1 exhibited a higher average mean weight of 1521.67 g per 92 fish followed by the control with an average mean weight of 1315.56 g per 88 fish, while diet 2 demonstrated comparatively lower growth, 1164.44 g per 96 fish. Survival rate and FCR, however, exhibited no significant differences. Notably, the cost of food supplies, particularly proteins, may constrain farmers' access to feed processing and formulation technology. Consequently, the findings of this study are expected to address challenges related to feed formulation and processing, providing valuable insights for the enhancement of fish farming practices.

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Introduction: Elevated plasma D?dimer levels are an unfavorable prognostic indicator for various tumors. However, its predictive value for prognosis in pediatric patients with Wilms tumor (WT) remains unknown. We aimed to investigate the clinical and prognostic value of preoperative plasma D?dimer levels and other clinicopathological characteristics in patients with favorable histology WT (FHWT). Materials and Methods: The clinical data of 74 children with FHWT from January 2010 to January 2022 were retrospectively analyzed. The clinicopathologic characteristics, preoperative laboratory parameter results, including D?dimer level, and follow?up data were collected. Based on the postoperative recovery status, the patients were divided into tumor?free survival and disease progression groups. The risk factors affecting disease progression in pediatric patients with WT and the impact of plasma D?dimer levels on overall survival (OS) were evaluated. Results: Over a median follow?up of 33 months (range: 2–145 months), 56 patients survived without progression. Relapses and metastases occurred in 18 patients, of which four survived and 14 died. Higher preoperative plasma D?dimer levels (>0.865) (Odds ratio [OR] = 7.240, 95% confidence interval (CI) = 1.276–33.272, P = 0.011) and tumor rupture (OR = 19.984, 95% CI = 1.182–338.013, P = 0.038) were independent prognostic factors for disease progression. Additionally, patients with elevated D?dimer levels demonstrated a worse 5?year OS than those with low D?dimer levels (Hazard ratio (HR) =4.278, 95% CI = 1.074–17.035, P = 0.039). Conclusions: Elevated D?dimer levels are a prognostic factor for a poorer outcome in pediatric patients with WT and are expected to become a clinical biomarker for predicting the prognosis of WT.

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ABSTRACT Purpose The clinical outcomes of kidney transplantation from deceased donors have seen significant improvements with the use of machine perfusion (MP), now a standard practice in transplant centers. However, the use of perfusate biomarkers for assessing organ quality remains a subject of debate. Despite this, some centers incorporate them into their decision-making process for donor kidney acceptance. Recent studies have indicated that lactate dehydrogenase (LDH), glutathione S-transferase, interleukin-18, and neutrophil gelatinase-associated lipocalin (NGAL) could predict post-transplant outcomes. Materials and Methods Between August 2016 and June 2017, 31 deceased-donor after brain death were included and stroke was the main cause of death. Pediatric patients, hypersensitized recipients were excluded. 43 kidneys were subjected to machine perfusion. Perfusate samples were collected just before the transplantation and stored at -80ºC. Kidney transplant recipients have an average age of 52 years, 34,9% female, with a BMI 24,6±3,7. We employed receiver operating characteristic analysis to investigate associations between these perfusate biomarkers and two key clinical outcomes: delayed graft function and primary non-function. Results The incidence of delayed graft function was 23.3% and primary non-function was 14%. A strong association was found between NGAL concentration and DGF (AUC=0.766, 95% CI, P=0.012), and between LDH concentration and PNF (AUC=0.84, 95% CI, P=0.027). Other perfusate biomarkers did not show significant correlations with these clinical outcomes. Conclusion The concentrations of NGAL and LDH during machine perfusion could assist transplant physicians in improving the allocation of donated organs and making challenging decisions regarding organ discarding. Further, larger-scale studies are required.

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Introdução:O transplante autólogo dentário é uma técnica cirúrgica na qual há a transposição de um dente para uma nova área receptora, no mesmo paciente. É viável para o tratamento de ausências e impactações dentárias. O método apresenta benefícios como manutenção de periodonto vital, volume ósseo alveolar e papila dentária, possibilidade de movimentação dentária por forças ortodônticas ou fisiológicas e estética favorável.Objetivo:Promover uma revisão de literatura sobre o transplante dentário autólogo, visando relatar as principais indicações, benefícios e contraindicações da técnica, além de descrever o protocolo cirúrgico e os fatores que influenciam no sucesso, de modo a orientar o manejo clínico.Metodologia:Para esse fim, as bases de dados analisadas foram PUBMED, LILACS e SCIELO, sendo obtidos artigos de Revisão Sistemática e Metanálises dos anos de 2018 a 2023.Resultados:O autotransplante apresenta taxas de sobrevida entre 93% e 100% e taxas de sucesso entre 89,4% e 96,6%, o que depende dos fatores relacionados ao paciente, ao dente doador, à área receptora e à técnica cirúrgica.Dentes anteriores e com ápice aberto apresentam melhores taxas de sobrevivência e sucesso em relação aos dentes posteriores e de ápice fechado, todavia não há comprovação que os demais pontos realmente influenciam diretamente no método. Conclusões:Com isso, podemos compreender que o estabelecimento de protocolos pré,trans e pós-operatório, além de esclarecimento de todos os fatores que influenciam na técnica, devem ser foco de estudos dos Cirurgiões-Dentistas, trazendo benefícios consideráveisparao manejo cirúrgico e saúde desses pacientes (AU).

Introduction:Autologous dental transplantation is a surgical technique in which there is the transposition of a tooth to a new recipient area within the same patient. It is a viable option for treating dental absenteeism and impactions. The method offers benefits such as the maintenance of vital periodontium, alveolar bone volume, and dental papilla, the possibility of dental movement through orthodontic or physiological forces, and favorable aesthetics.Objective:To promote a literature review on autologous dental transplantation, aiming to report the main indications, benefits, and contraindications of the technique, in addition to describe the surgical protocol and factors influencing success, providing guidance for clinical management.Methodology:For this purpose, the analyzed databases included PUBMED, LILACS, and SCIELO, obtaining Systematic Review and Meta-Analysesarticles from the years 2018 to 2023.Results:Autotransplantation presents survival rates between 93% and 100% and success rates between 89.4% and 96.6%, depending on factors related to the patient, the donor tooth, the recipient area, and the surgical technique. Anterior teeth with open apices present better survival and success rates compared to posterior teeth with closed apices, however, there is no conclusive evidence that other factors directly influence the method.Conclusions:Therefore, we can understand that the establishment of preoperative, intraoperative, and postoperative protocols, along with clarification of all factors influencing the technique, should be the focus of studies for Dental Surgeons, bringing significant benefits to these individuals' health (AU).

Introducción: : El trasplante autólogo dental es una técnica quirúrgica en la que se transpone un diente a una nueva área receptora, en el mismo paciente. Es viable para el tratamiento de ausencias e impactos dentales. El método presenta beneficios como mantenimiento de periodonto vital, volumen óseo alveolar y papila dental, posibilidad de movimiento dental por parte de fuerzas ortodoncias o fisiológicas y estética favorable.Objetivo: Promover una revisión de la literatura sobre el trasplante dentario autólogo, con el objetivo de reportar las principales indicaciones, beneficios y contra indicaciones de la técnica, además de describir el protocolo quirúrgico ylos factores que influyen en el éxito, con el fin de orientar el manejo clínico.Metodología: Para este fin, las bases de datos analizadas fueron PUBMED, LILACS y SCIELO, siendo obtenidos artículos de Revisión Sistemática y Metanálisis de los años 2018 a2023.Resultados: El autotrasplante presenta tasas de sobrevida entre 93% y 100% y tasa de éxito entre 89,4% y 96,6%, lo que depende de los factores relacionados con el paciente, el donante, el área receptora y la técnica quirúrgica. Los dientes anteriores y ápice abiertos presentan mejores tasas de supervivencia y éxito con respecto a los dientes posteriores y de ápice cerrado, pero no hay prueba de que los demás puntos realmente influyen directamente en el método.Conclusiones: Con eso, podemos comprender que el establecimiento de protocolos pre, intra y postoperatorio, además de esclarecimiento de todos los factores que influyen en la técnica, deben ser foco de estudios de los CirujanosDentistas, trayendo beneficios considerables para la salud de estos individuos (AU).

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Malignant spindle cell melanoma is a rare cancer with a questionable prognosis because of limited published case reports. This article discusses a male patient with a history of Spindle cell melanoma tumor, Rt heel, Grade 3 (Gr 3) Stage 2 (St 2) seen in our OPD treated with supporting herbo-mineral combination of Ayurvedic medicine. Such types of cancers are of concern and can be more troublesome to the patient. The initial chief complaint of the patient was a palpable corn-like growth in the right heel, which was surgically removed at that time. When it recurred after one year, it was investigated thoroughly and it was found malignant, and then operated again. The patient came to us after his second operation. After appropriate analysis based on Ayurvedic and modern parameters, the patient was treated with Ayurved treatment. As there was no other treatment suggested by oncologists, he was on supportive Ayurvedic treatment only. Ayurvedic treatment continued for 2 years after- wards. The treatment module showed complete relief in the symptoms (100%), by the end of treatment. Follow- up PET scans showed further improvement and a complete reversal of residual disease was observed. The last PET scan did not show any evidence of abnormality. To date, there has been no recurrence and the patient has been living completely normally for the last almost 5 years (karnofsky score 90/100). It can be concluded that the addition of Ayurvedic treatment might have helped this patient of malignant spindle cell melanoma for regression of residual disease, prevention of metastasis to date, and a good quality of life. We have observed 5+ years of disease-free survival and near-normal quality of life for this patient, and still ongoing.

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Background: B-cell prolymphocytic leukemia (B-PLL) is a rare disease, consisting <1% of mature B-cell malignancies. B-PLL is often refractory to chemotherapy, with a median survival of 3 years. Due to its rarity, no large cohort studies exist elucidating outcomes. Methods: All B-PLL patients >15 years were identified in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database between 2000-2020. Statistical analysis explored demographic variables like age; categorized as adolescent or young adult (AYA) and adults. In adults, differences in survival due to factors such as sex, race/ethnicity, household income, rurality, and age categorized in 10-15 year buckets was analyzed. Results: B-PLL patients were predominantly white (78%), over 40 years (96%) and mostly residing in metropolitan areas (90%). Interestingly, the AYA cohort were mostly female (70%). 35% of the AYA patients were Hispanic, while being only 9% in adults. Among adults, the rate of Asian/Pacific-Islander patients that were alive at the time of the data query was 53% compared to 34% in Hispanic, 31% in black, and 24% in white patients (p=0.025). Younger age was also associated with greater chances of survival (p<0.001). Conclusions: In line with known poor prognosis of the disease, 23% patients were alive at the time of data query. Female and Hispanic patients were overrepresented in the AYA age group. In the adult group Asian/Pacific-Islander patients had better survival outcomes, as did younger patients. Further research is necessary to explore why B-PLL incidence in AYA patients is higher among Hispanic and females.

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RESUMEN Introducción: El melanoma lentiginoso acral (MLA) es el cuarto tipo de melanoma cutáneo y es el subtipo más común en algunos países de América Latina y Asia. El índice neutrófilo-linfocito (NLR) es un marcador inflamatorio que ha demostrado tener utilidad como herramienta pronóstica en varias neoplasias malignas. Objetivo: El objetivo del estudio fue evaluar si el NLR tiene valor pronóstico en la MLA. Se realizó un estudio retrospectivo que incluyó pacientes con MLA entre 2010 y 2015. Métodos: Se empleó un diseño observacional, analítico, y de tipo cohorte retrospectiva. Se trabajó con una población total de 69 pacientes con el diagnóstico de melanoma acral lentiginoso. Para el análisis estadístico se empleó el paquete estadístico SPSS versión 26. Se realizaron modelos de regresión proporcional de Cox univariados y multivariados. Resultados: Se incluyeron un total de 69 pacientes con MLA. La mediana de edad fue 68 años, con predominio del sexo femenino (55%). La mayoría de los pacientes tenían T4 (34%), compromiso ganglionar (57,1%) y Clark III (34,4%). En el análisis univariado, el nivel de Clark III/IV, la anaplasia, la infiltración linfocitaria, el estadio III-IV y el NLR se asociaron con el pronóstico. En el análisis multivariado, el NLR >3,5 (HR 3,9, IC 95% 1,5-10,3, p=0,005) y el nivel de Clark III-IV (HR 3,5, IC 95% 1,6-7,8, p= 0,002) se asociaron con mala supervivencia general (SG). Conclusiones: El NLR es un factor pronóstico independiente de supervivencia en la MLA.

ABSTRACT Introduction: Acral lentiginous melanoma (ALM) is the fourth type of cutaneous melanoma and is the most common subtype in some countries in Latin America and Asia. The neutrophil-lymphocyte ratio (NLR) is an inflammatory marker that has been shown to be useful as a prognostic tool in several malignant neoplasms. Objective: The objective of the study was to evaluate whether NLR has prognostic value in ALM. A retrospective study was conducted that included patients with ALM between 2010 and 2015. Methods: An observational, analytical and retrospective cohort design was used. We worked with a total population of 69 patients with the diagnosis of acral lentiginous melanoma. For the statistical analysis, the SPSS statistical package version 26 was used. Univariate and multivariate Cox proportional regression models were performed. Results: A total of 69 patients with ALM were included. The median age was 68 years, with a predominance of females (55%). Most patients had T4 (34%), lymph node involvement (57.1%), and Clark III (34.4%). In univariate analysis, Clark level III/IV, anaplasia, lymphocytic infiltration, stage III-IV, and NLR were associated with prognoses. In the multivariate analysis, NLR >3.5 (HR 3.9, 95% CI 1.5-10.3, p=0.005) and Clark level III-IV (HR 3.5, 95% CI 1.6-7.8, p= 0.002) were associated with poor overall survival (OS). Conclusions: NLR is an independent prognostic factor for survival in ALM.