Analysis of the role of intratecal liposomal cytarabine in the prophylaxis and treatment of central nervous system lymphomatosis: The Balearic Lymphoma Group experience.

Central nervous system (CNS) lymphomatosis is a fatal complication of aggressive non-Hodgkin lymphoma (NHL). In lymphoblastic or Burkitt lymphoma, without specific CNS prophylaxis the risk of CNS relapse is 20-30%. DLBCL has a lower risk of relapse (around 5%) but several factors increase its incidence. There is no consensus or trials to conclude which is the best CNS prophylaxis. Best results seem to be associated with the use of intravenous (iv) high-dose methotrexate (HDMTX) but with a significant toxicity. Other options are the administration of intrathecal (IT) MTX, cytarabine or liposomal cytarabine (ITLC). Our aim is to analyze the experience of the centers of the Balearic Lymphoma Group (BLG) about the toxicity and efficacy of ITLC in the prophylaxis and therapy of CNS lymphomatosis. We retrospectively reviewed cases from 2005 to 2015 (n = 58) treated with ITLC. Our toxicity results were: 33% headache, 20% neurological deficits, 11% nausea, 9% dizziness, 4% vomiting, 4% fever, 2% transient blindness and 2% photophobia. In the prophylactic cohort (n = 26) with a median follow-up of 55 months (17-81) only 3 CNS relapses (11%) were observed (testicular DLBCL, Burkitt and plasmablastic lymphoma, with a cumulative incidence of 8%, 14% and 20% respectively). In the treatment cohort (n = 32), CSF complete clearance was obtained in 77% cases. Median OS was 6 months (0-16). Death causes were lymphoma progression (19 patients, 79%), treatment toxicity (2 patients) and non-related (3 patients, 12%). Toxicity profile was good especially when concomitant dexamethasone was administered. In the prophylactic cohort the incidence of CNS relapse in DLBCL group was similar to previously reported for HDMTX and much better than IT MTX. A high number of ITLC injections was associated with better rates of CSF clearance, clinical responses, PFS and lower relapses. Survival is still poor in CNS lymphomatosis and new therapeutic approaches are still needed.

Revisión documental de experiencias de actividad comunitaria en atención primaria de salud / Documental review of community health promotion experiences in primary health care

ObjetivoDescribir las actividades comunitarias (AC) publicadas o inscritas en redes de promoción de la salud en las que ha participado Atención Primaria (AP).DiseñoEstudio descriptivo, mediante revisión documental de experiencias.Fuentes de datosArtículos, actividades en redes de intercambio de experiencias on-line, comunicaciones y proyectos premiados.Selección de experienciasSe incluyeron AC en las que AP y la comunidad atendida participaban en su inicio, desarrollo y/o evaluación, sin ser acciones puntuales.Extracción de datosSe recogieron las siguiente variables: fuente, año del registro del documento, CCAA, Municipio, número y nombre de los centros de salud implicados, población diana, objetivos, participación de la comunidad, y de sectores sanitarios y no sanitarios, perspectiva teórica, y métodos de evaluación.ResultadosSe identificaron 472 actividades que cumplían criterios, con participación de 300 centros de salud de la mayoría de CCAA. El 71,8% registradas en redes on-line, y el 19,3% en artículos. Las poblaciones diana más frecuentes fueron población general (22,2%), jóvenes (18,2%) y madres y padres (10,2%). El 58,2% tenía como objetivos: capacitar a la comunidad para optar por comportamientos más saludables, transmitir información sanitaria a la población, o fomentar el autocuidado. En el 33,3% no participó ningún agente además de AP. Del resto, participaron sectores no sanitarios en el 53,8%, entidades cívicas 26,9% y administraciones 24,2%.ConclusionesLa mayoría de las AC documentadas se encuentran en redes y su presencia por CCAA es desigual. La participación de otros sectores diferentes de AP en las actividades identificadas es baja(AU)

ObjectiveDescribe the community activities (CA) published or registered in health promotion networks in which Primary Health Care (PHC) has taken part.DesignDescriptive study, by documental review of experiences. Data source: articles, activities in exchange networks, presentations and funded projects.Selected experiencesThe AC included were those where PHC and the local community were involved in its inception, development and/or evaluation, but not solitary actions with no continuity.Data extractionThe following variables were collected: Source and year of the document; region; municipality; name and number of health centres involved; target population; objectives; involvement of the community, the health and the non-health sectors; theoretical perspective and evaluation methods.ResultsA total of 472 activities were found that met criteria, involving 300 health centres in most of the autonomous regions. Of those, 71.8% were registered in networks, and 19.3% were registered in articles. The most frequent target populations were: the general population (22.2%), youth (18.2%) and parents (10.2%). More than half (58.2%) had one or more of the following objectives: to empower the community to choose healthy behaviours; transmit health information to the population, or encourage self-care. In 33.3% of the activities there were no other sectors involved besides Primary Care. Of the remainder, non-health sectors participated in 53.8%, civic bodies in 26.9%, and government administration in 24.2%.ConclusionsMost of the CA are documented in networks and their presence is uneven by region. The involvement of sectors other than PHC in the activities identified is low(AU)

[Documental review of community health promotion experiences in primary health care]. / Revisión documental de experiencias de actividad comunitaria en atención primaria de salud.

OBJECTIVE: Describe the community activities (CA) published or registered in health promotion networks in which Primary Health Care (PHC) has taken part. DESIGN: Descriptive study, by documental review of experiences. DATA SOURCE: articles, activities in exchange networks, presentations and funded projects. SELECTED EXPERIENCES: The AC included were those where PHC and the local community were involved in its inception, development and/or evaluation, but not solitary actions with no continuity. DATA EXTRACTION: The following variables were collected: Source and year of the document; region; municipality; name and number of health centres involved; target population; objectives; involvement of the community, the health and the non-health sectors; theoretical perspective and evaluation methods. RESULTS: A total of 472 activities were found that met criteria, involving 300 health centres in most of the autonomous regions. Of those, 71.8% were registered in networks, and 19.3% were registered in articles. The most frequent target populations were: the general population (22.2%), youth (18.2%) and parents (10.2%). More than half (58.2%) had one or more of the following objectives: to empower the community to choose healthy behaviours; transmit health information to the population, or encourage self-care. In 33.3% of the activities there were no other sectors involved besides Primary Care. Of the remainder, non-health sectors participated in 53.8%, civic bodies in 26.9%, and government administration in 24.2%. CONCLUSIONS: Most of the CA are documented in networks and their presence is uneven by region. The involvement of sectors other than PHC in the activities identified is low.

Detection of Hypoderma actaeon infestation in Cervus elaphus with ELISA and western blotting.

We used enzyme-linked immunosorbent assay (ELISA) and western blotting (WB) to evaluate the reactivity of first-stage larval extracts of Hypoderma lineatum with antibodies in sera from 76 red deer from an endemic area for Hypoderma actaeon. Antibodies in sera from deer infested with H. actaeon recognized hypodermin C from H. lineatum in both ELISA and WB assays. ELISA values were correlated with the epidemiology of the fly infestation in the area where the deer sera were collected. There was no clear relationship between anti-hypodermin C antibody levels and the age of the animals or the number of Hypoderma grubs found at necropsy in the hides of the deer. Our results suggest that first-instar antigens of H. lineatum can be used to diagnose natural infestations by H. actaeon by indicating the presence of first-stage larvae, which can help to accurately describe H. actaeon epidemiology.