Evolution of pancreatic ductal adenocarcinoma diagnosis during the last decade

Background: Pancreatic Ductal Adenocarcinoma (PDAC) has historically been an important diagnostic and therapeutic challenge. The multidisciplinary approach and new diagnostic techniques' implementation have modified this process. Method(s): We conducted a retrospective analysis based on clinical data of patients with PDAC between the years 2010 to 2021, analyzing the diagnosis and initial treatment evolution. Result(s): 673 patients between 2010-2021 with a suspected diagnosis of pancreatic adenocarcinoma were reviewed. Most of them were metastatic (n=362;53.8%), followed by locally advanced unresectable (n=166;24.7%) and resectable or borderline resectable (n=145;21.5%). Regarding the pathological diagnosis, it was not possible in 62 patients (9.2%), varying over time from 21.2%in 2010-2012 to 1% in 2019-2021 (p<0,0001). Moreover, the number of biopsies has decreased with a mean number of biopsies to obtain a pathological diagnosis of 1.55 (2010-2012) vs 1.31 (2019-2021). During this last period, most of the diagnoses were made by cytological analysis (61.4%;n=121). Specifically in the 2019-2021 patients subgroup, we found that 18 NGS (9,1%) were performed in this period (solid tumor), with 4 patients having actionable mutations (22.2%;3 KRAS G12C). Germline (g) mutational panels were carried out in 89 patients, finding only 9 positive cases (10.1%), being 3 of them gBRCA1/2 mutated (3,4%). In our study, a decrease in palliative management was evidenced over time. In 2010-2012, 28,8% of patients received exclusively palliative care against 9,6% in 2019-21 (p, 0.0001). An increase in PDAC diagnosis was observed since 2010, 44 patients/year in 2010-12 vs. 66 patients/year in 2019-21 (including COVID-19 pandemic period). All previous results are summarized. Conclusion(s): The diagnosis of PDAC has changed throughout the last decade, increasing the percentage of patients with a pathological diagnosis without increasing the number of invasive procedures. The number of patients suitable for anti-cancer therapy has also increased among time. In our cohort, the implementation of molecular testing would change the therapeutic approach in more than 20% of patients.

[Mental health consequences of isolation of patients with COVID-19.]

OBJECTIVE: The COVID-19 pandemic has had a negative effect on the mental health on the population. It is unknown if the different types of patient isolation affect them equally. The objective of the study was to determine if the effect on the psychological discomfort caused by the isolation of the population with COVID-19 in a hotel supervised by health professionals was different compared with those who were isolated at home. METHODS: Patients diagnosed with COVID-19 during the first pandemic wave in Barcelona, consecutively selected from the Primary Care lists. A telephone survey was carried out to collect information about mental health in patients who were isolated in a hotel compared to those isolated at their homes. Descriptive statistics were performed and the study variables were analyzed using mean and standard deviation, count (percentage), Chi-square test, and Student's t-test. Logistic regression models were carried out selecting frustration and anger/irritability as response variables. RESULTS: Of the 89 patients included, 45 (50.6%) were isolated at their homes and 44 (49.4%) at the hotel. Frustration was identified in 48.3% and irritability in 29.2% of the most patients. Most of those who presented frustration were between 45 and 65 years old, while 50% of those who felt irritability were younger. Multivariate models confirmed that patients isolated at home showed a higher risk of frustration (Odds ratio 4,12;95% Confidence interval 1,60-11,49) and irritability (Odds ratio 3,81;95% Confidence interval 1,32-12,10), respectively. CONCLUSIONS: Patients isolated at home show a higher risk of presenting feelings of frustration and irritability than isolated patients in supervised hotels.

THE CHALLENGE OF THE PANDEMIC FOR TRADE FACILITATION IN CHILE AND PERU

This work seeks to describe the reaction of the customs authorities in Chile and Peru in the context of the health crisis, distinguishing the trade facilitation measures that they implemented during 2020. An exploratory investigation is carried out. This describes the reaction of both customs authorities by reviewing the resolutions issued by the SNA, in Chile, and by SUNAT, in Peru. The revised period covers the arrival of the disease in each country until the last day of 2020. In Peru, most of the trade facilitation measures implemented are structural and were designed before the appearance of the disease. In Chile, the measures are not structural, but were originated during the pandemic. In both cases, the intensive implementation of information technologies is central. This opens the possibility of consolidating its use when the health emergency is over.

TWO CITIES IN ONE. WORK, WOMEN, AND ECONOMICS IN THE LATIN AMERICA CITY

Neoliberalism and financialization of the economy have produced a transformation in labour markets, having an impact on the dualization of cities. The pandemic caused by COVID-19 deepened these processes, leaving women to pay the main costs. In this context, the right to the city was placed under discussion. This article will illustrate a specific case, the controversy that emerged in Mar del Plata and Batán (Party of General Pueyrredón, Argentina) due to the pandemic’s socio-economic consequences, how these should be resolved, what status do the parties in the litigation have, and what was the role of women in this process. Central aspects will be discussed, such as the way in which the city reconfigures the process of ex-pulsion from labour markets and the distribution of health, and how the CBEs (neighbourhood emergency committees) emerge as a setting for social antagonism. Finally, occupation and use of public space, the demand and transformation of institutions at the local level, and the political dimensions of resignification of cities will be analysed. © 2022 CSIC.

Children's opera as a means of learning and unity in times of Covid-19: an interdisciplinary proposal for distance education

Music education emerges as a teaching-learning process which contributes to students comprehensive development. The main objective of this work was to analyze the adaptation of the distance educational process in Musical Education, Spanish Language and Literature, Physical Education and Art Education areas in sixth grade of Primary Education, through an interdisciplinary proposal based on the The magic flute opera by WA Mozart. It is based on a mixed approach in which the results obtained through a case study are complemented with descriptive procedures of a quantitative cut. The data analysis showed positive results regarding the participation and satisfaction of the families, students and teachers. Similarly, students obtained optimal levels of content acquisition and key competences. The results of this work corroborate the importance of proposing interdisciplinary projects, as well as the possibilities provided by online teaching in Primary Education in isolation situations, such as those caused by Covid-19

Quick test performance verification “AMP Rapid Test SARS-CoV-2 IgG/IgM- Cassettes”

Objective: We aimed to realize a verification of the performance of the rapid serological tests used in Risaralda department. Methods: Analytical, cross-sectional study. Serum samples from health workers in Pereira city, who had a clinical and epidemiological suspicion for SARS-CoV-2 were included. The processing and validation of the tests was carried out at Universidad Tecnológica de Pereira. Sensitivity and specificity of rapid IgM / IgG serological tests were calculated using RT-PCR as the gold standard test. Results: 144 samples of health professionals were included. Rapid serological tests useful to identify or rule out the presence of IgM and IgG antibodies, especially in symptomatic patients, in whom the onset of symptoms is longer than 11 days. Discussion: The use of rapid tests is increasing, not only due to the speed of their results, but also due to the low associated costs and the need to identify non-susceptible patients, who must prioritize their return to work activities in the community as part of the economic reactivation of Colombia. It is necessary to confirm the adequate performance of the test to increase the probability of an adequate classification before proceeding with the routine use of this test. © 2021 Asociacion Colombiana de Infectologia. All rights reserved.