Recurrence factors in patients with cutaneous melanoma and positive sentinel lymph node treated in a single reference unit in Buenos Aires / Factores de recurrencia en pacientes con melanoma cu táneo y ganglio centinela positivo

Abstract Introduction : Although therapeutic advances have improved results of cutaneous melanoma (CM), senti nel node-positive patients still have substantial risk to develop recurrent disease. We aim to investigate prog nostic indicators associated with disease recurrence in positive-sentinel lymph node biopsy (SLNB) patients in a Latin-American population. Methods : Retrospective analysis of CM patients and positive-SLNB (2010-2020). Patients were divided into two groups: Group A (completion lymph node dissection, CLND), Group B (active surveillance, AS). Association of demographics, tumor data and SLN features with recurrence-free (RFS), distant metastases-free (DMFS) and melanoma specific (MSS) survival was analyzed. Results : Of 205 patients, 45 had a positive SLNB; 27(60%) belonged to Group A and 18(40%) to Group B. With a median follow-up of 36 months, 16 patients (12 in Group A and 4 in Group B) developed recurrent dis ease and estimated 5-yr RFS at any site was 60% (CI95%, 0.39 - 0.77) (44.5% in CLND group vs. 22% in AS group; P = 0.20). Estimated 5-yr DMFS and MSS: 65% (CI 95%, 0.44 - 0.81) and 73% (CI 95%, 0.59 - 0.89) with no differ ences between groups (p = 0.41 and 0.37, respectively). Independent predictors of poorer MSS were extranodal extension (ENE) and MaxSize > 2 mm of melanoma deposit in SLN. Factors independently associated with DMFS: Breslow depth > 2 mm, ENE, number (≥ 2) of posi tive SN and CLND status. Conclusion : Primary tumor and SN features in mela noma provide important prognostic information that help optimize prognosis and clinical management. AS is now the preferred approach for most positive-SLNB CM patients.

Resumen Introducción : Si bien los avances terapéuticos han permitido mejorar los resultados del melanoma cutáneo (MC), los pacientes con ganglio centinela positivo (BGCP) aún tienen riesgo elevado de desarrollar recurrencia de la enfermedad. Nuestro objetivo fue investigar in dicadores pronósticos asociados a dicho evento en una población latinoamericana. Métodos : Análisis retrospectivo de pacientes con MC y BGCP entre 2010-2020. Los pacientes se dividieron en 2 grupos: Grupo A (linfadenectomía terapéutica) y Grupo B (Vigilancia activa, VA). Se analizaron datos demográficos, tumorales y características del GC junto con sobrevida-libre de recurrencia (SLR), libre de metástasis a distancia (SLMD) y específica de melanoma (SEM). Resultados : De 205 pacientes, 45 presentaron BGCP; 27 (60%) perteneció al Grupo A y 18 (40%) al Grupo B. Con una mediana de seguimiento de 36 meses, 16 pa cientes (12 en Grupo A y 4 en Grupo B) desarrollaron enfermedad recurrente con una SLR a 5 años de 60% (IC95%: 0.39-0.77) (44.5% en Grupo B vs. 22% en Grupo A; P = 0.20). Las SLMD y SEM estimadas a 5 años fueron de 65% (CI 95%, 0.44 - 0.81) y 73% (CI 95%, 0.59 - 0.89) sin diferencias entre ambos grupos (p = 0.41 y 0.37, respec tivamente). Los predictores independientes de peor SEM fueron: extensión extranodal (ENE) y MaxSize > 2mm de depósito tumoral en GC. Los factores asociados de forma independiente con SLMD fueron Breslow >2mm, ENE, número (≥ 2) de GC positivos y el status (positividad) de la linfadenectomía. Conclusión : Características del tumor primario y del GC brindan información importante que ayuda a optimi zar el pronóstico y manejo clínico de los pacientes con MC. La VA es actualmente el abordaje de elección para la mayoría de los pacientes con BGCP.

Análisis de los dos primeros años de pandemia COVID-19 en un hospital de enfermedades infecciosas, en Buenos Aires / Analysis of the first two years of the COVID-19 pandemic in an infectious diseases hospital in Buenos Aires

Resumen Introducción: En el Hospital Muñiz se instauró la Unidad Febril (UF), un dispositivo que opera durante la pandemia por COVID-19. Su implementación ha demos trado la importancia de políticas públicas en el sistema sanitario, además del posible desarrollo de estrategias en vigilancia y seguimiento epidemiológico que den apor tes en salud. Se realizó un análisis de los dos primeros años en pandemia en la UF-Muñiz. El objetivo de esta unidad es determinar qué pacientes tienen criterios de mal pronóstico y definir la internación. Una de las características más importantes de esta UF es la atención de una población con enfermedades infectocontagiosas por ser este un Hospital dedicado a este tipo de patologías. Métodos: Se realizó un estudio observacional trans versal, retrospectivo, con el objetivo de evaluar las inter naciones realizadas en la UF-Muñiz durante el periodo comprendido entre enero 2020 y diciembre 2021. Resultados: Se recibieron 153 546 consultas, se in ternaron 2872 pacientes. En 2020 se internaron 1001 pacientes COVID-19 positivos (76%), 87 con tuberculosis (TBC) (6.6%) y 102 con HIV (7.7%). En 2021 se internaron 991 pacientes COVID-19 positivos (66%), 151 con TBC (10%) y 157 con HIV (10.5%) Conclusiones: Solo el 1.9% de las consultas deriva ron en internación y correspondieron en su mayoría a pacientes COVID-19 positivos, le siguieron casos de HIV y TBC en una menor proporción. La enfermedad pulmo nar obstructiva crónica (EPOC) y la obesidad fueron las comorbilidades que con mayor frecuencia requirieron internación en pacientes COVID-19.

Abstract Introduction: At the Muñiz Hospital, the Febrile Unit (UF) was established, a device that operates during the COVID-19 pandemic. Its implementation has demon strated the importance of public policies in the health system, in addition to the possible development of epi demiological surveillance and monitoring strategies that provide health contributions. An analysis of the first two years of the pandemic at UF-Muñiz was carried out. The objective of this unit is to determine which patients have poor prognostic criteria and define hospitalization. One of the most important characteristics of this UF is the care of a population with infectious diseases because this is a Hospital dedicated to this type of pathology. Methods: A retrospective, cross-sectional observa tional study was carried out with the objective of evalu ating the hospitalizations made at UF-Muñiz during the period between January 2020 and December 2021. Results: 153 546 consultations were received, 2872 patients were admitted. In 2020, 1001 COVID-19 positive patients (76%) were admitted, 87 with tuberculosis (TB) (6.6%) and 102 with HIV (7.7%). In 2021, 991 positive CO VID-19 patients (66%) were admitted, 151 with TB (10%) and 157 with HIV (10.5%) Conclusions: Only 1.9% of the consultations led to hospitalization, and the majority corresponded to CO VID-19 positives, followed by HIV and TB cases in a smaller proportion. Chronic obstructive pulmonary dis ease (COPD) and obesity were the comorbidities that most frequently required hospitalization in COVID-19 patients.

An Analysis of The Trend of Incidences and Fatality of Pulmonary Tuberculosis in East Java from 2015-2020: A Lesson From COVID-19

Background: Pulmonary tuberculosis is still a public health problem, and surveillance data analysis has not been done much. Recently a global pandemic of COVID-19 has the potential in disturbing TB elimination pro-grams and treatment. This study aims to comprehensively analyse the incidence rate (IR) and Case Fatality Rate (CFR) of pulmonary tuberculosis in East Java from 2015–2020 and during COVID-19 and the strategies for optimizing tuberculosis disease control. Methodology: The study analyzed annual surveillance data using an analytical descriptive design. The Varia-bles were analyzed with Spearman correlation with a level of evidence of 95% (p<0.05). Results: The prevalence of pulmonary tuberculosis in East Java fluctuated from 2015–2020. In 2020 and dur-ing the COVID-19 pandemic, the number of cases and morbidity rates increased. Statistic results confirm the presence of a significant correlation between the values of Incidence rate (IR) and Case Fatality rate (CFR) (p = 0.032), IR and Treatment Success Rate (TSR) (p = 0.020), and CFR and TSR (p = 0.002). Population density is not correlated with the number of new cases (p = 0.667). Treatment rates have increased to 51%; cure and treatment rates have decreased to 76% and 89%, respectively, and there was a 4% increase in mortality dur-ing COVID-19. Conclusions: COVID-19 has tremendously affected the treatment of pulmonary TB cases in East Java, Indone-sia by increasing the incidence rate and decreasing the fatality rate. The pandemic promotes fear in the com-munity to check their medical status and improve the quality of their health in East Java.

Mechanism of inflammatory reaction to vaccination and its effects on immunogenicity / 中华微生物学和免疫学杂志

Vaccination, one of the greatest inventions of mankind, prevents millions of people from infectious diseases and death each year. With the continuous improvement in immunization coverage, the safety of vaccines has attracted widespread attention. Common adverse reactions to vaccinations are mainly caused by inflammation, but the immune responses and biological damages following immunization are so complicated that the possible mechanisms have not been completely unveiled. Exploring the relationship be-tween inflammation and immunogenicity after vaccination is of great significance for the monitoring and man-agement of vaccines after marketing. This article reviewed the mechanism of inflammatory responses after vaccination and its potential impact on immunogenicity.

Analysis of the safety surveillance data of adverse events following immunization with varicella atten-uated live vaccine in Hebei province, 2012-2014 / 中华微生物学和免疫学杂志

Objective To analyze the characteristics of adverse events following immunization ( AEFI) with varicella attenuated live vaccine ( VarV) in Hebei province during 2012—2014, to evaluate the safety of VarV and to provide supportive evidences for planning chicken pox prevention and control strate-gies in Hebei province.Methods The AEFI data associated with VarV in Hebei province during 2012 to 2014 were collected from the national AEFI information management system and were analyzed by using the method of descriptive epidemiology.Results A total of 239 cases reported during 2012 to 2014 were col-lected from the national AEFI information management system, with a male to female ratio of 1.44 ∶1.The estimated incidence rate was 25.51 per 100 000 doses.One case was serious AEFI with an incidence rate of 0.11 per 100 000 doses.Most of the AEFI cases were children under 3 years old and identified in scattered inhibiting children and kindergarten kids.The main symptoms of common vaccine reactions were fever, local swelling and induration .The rare vaccine reactions were presented as anaphylactic rashes .Conclusion The reported incidence rate of VarV associated AEFI in Hebei province was less than expected.However, the estimated incidence rate of common vaccine reactions in Hebei province was higher than that showed on the Analysis on Surveillance Data of Post-marketing Immunization Safety for Varicella Attenuated Live Vac-cine in China, 2010—2012.Attentions to the AEFI after immunization with VarV should also be paid in fu-ture.