An Open-label Study to Investigate the Efficacy and Tolerability of Dapsone Gel, 7.5% in the Treatment of Acne Vulgaris in Men and Women With Skin of Color

INTRODUCTION: Acne vulgaris is a common skin disease prevalent in skin of color patients. Studies have demonstrated that dapsone gel, 7.5% (Aczone) used once daily is effective, safe, and well-tolerated for the treatment of acne in both men and women. However, minimal data are available in skin of color populations. This single-center, open-label clinical study investigated the efficacy and safety of dapsone gel, 7.5% in the treatment of moderate to severe acne vulgaris in patients with Fitzpatrick skin types IV-VI. METHODS: Twenty (20) adult subjects with moderate to severe acne and Fitzpatrick skin types IV-VI were enrolled in this study and treated with dapsone gel, 7.5% once daily for 24 weeks. RESULTS: Dapsone gel, 7.5% applied daily for 24 weeks reduced acne severity, post-inflammatory hyperpigmentation, and decreased new inflammatory and noninflammatory acne lesions in skin of color patients with moderate to severe acne vulgaris. Treatment resulted in improved acne health-related quality of life and patient symptoms related to acne, including patient-reported post-inflammatory hyperpigmentation, especially with a treatment duration of 18 weeks or longer.  Limitations: The sample size was small and underpowered to detect statistically significant changes in some endpoints. CONCLUSION: Dapsone gel 7.5% was safe, well-tolerated, and efficacious in treating acne vulgaris and post-inflammatory hyperpigmentation in skin-of-color patients. Larger studies involving skin-of-color populations with acne vulgaris are warranted. J Drugs Dermatol. 2024;23(6):410-417. doi:10.36849/JDD.7897.

Synthesis of Novel Heterocyclic Ferrocenyl Chalcones and Their Biological Evaluation.

Breast cancer is currently the most commonly diagnosed cancer, with 287,850 new cases estimated for 2022 as reported by the American Cancer Society. Therefore, finding an effective treatment for this disease is imperative. Chalcones are α,ß-unsaturated systems found in nature. These compounds have shown a wide array of biological activities, making them popular synthetic targets. Chalcones consist of two aromatic substituents connected by an enone bridge; this arrangement allows for a large number of derivatives. Given the biological relevance of these compounds, novel ferrocene-heterocycle-containing chalcones were synthesized and characterized based on a hybrid drug design approach. These heterocycles included thiophene, pyrimidine, thiazolyl, and indole groups. Fourteen novel heterocyclic ferrocenyl chalcones were synthesized and characterized. Herein, we also report their cytotoxicity against triple-negative breast cancer cell lines MDA-MB-231 and 4T1 and the noncancer lung cell line MRC-5. System 3 ferrocenyl chalcones displayed superior anticancer properties compared to their system 1 analogues. System 3 chalcones bearing five-membered heterocyclic substituents (thiophene, pyrazole, pyrrole, and pyrimidine) were the most active toward the MDA-MB-231 cancer cell line with IC50 values from 6.59 to 12.51 µM. Cytotoxicity of the evaluated compounds in the 4T1 cell line exhibited IC50 values from 13.23 to 213.7 µM. System 3 pyrazole chalcone had consistent toxicity toward both cell lines (IC50 ∼ 13 µM) as well as promising selectivity relative to the noncancer MRC-5 control. Antioxidant activity was also evaluated, where, contrary to anticancer capabilities, system 1 ferrocenyl chalcones were superior to their system 3 analogues. Antioxidant activity comparable to that of ascorbic acid was observed for thiophene-bearing ferrocenyl chalcone with EC50 = 31 µM.

No evidence of accelerated epigenetic aging among black heroin users: A case vs control analysis.

This study sought to assess the association between illicit opioid use and accelerated epigenetic aging (A.K.A. DNAm Age) among people of African ancestry who use heroin. DNA was obtained from participants with opioid use disorder (OUD) who confirmed heroin as their primary drug of choice. Clinical inventories of drug use included: the Addiction Severity Index (ASI) Drug-Composite Score (range: 0-1), and Drug Abuse Screening Test (DAST-10; range: 0-10). A control group of participants of African ancestry who did not use heroin was recruited and matched to heroin users on sex, age, socioeconomic level, and smoking status. Methylation data were assessed in an epigenetic clock to determined and compare Epigenetic Age to Chronological Age (i.e., age acceleration or deceleration). Data were obtained from 32 controls [mean age 36.3 (±7.5) years] and 64 heroin users [mean age 48.1 (±6.6) years]. The experimental group used heroin for an average of 18.1 (±10.6) years, reported use of 6.4 (±6.1) bags of heroin/day, with a mean DAST-10 score of 7.0 (±2.6) and ASI Score of 0.33 (±0.19). Mean age acceleration for heroin users [+0.56 (± 9.5) years] was significantly (p< 0.05) lower than controls [+5.19 (± 9.1) years]. This study did not find evidence that heroin use causes epigenetic age acceleration.

An exploratory follow-up study of cannabis use and decision-making under various risk conditions within adolescence.

OBJECTIVE: Studies examining the associations between decision-making (DM) and cannabis use (CU) often use cross-sectional, adult samples, and composite scores or single tasks to assess DM. The present study explored differential associations between tasks assessing DM under various risk conditions (i.e., ambiguous vs. explicit; gain vs. loss) and CU frequency, CU-related problems, and CU disorder (CUD) onset across a 2-year period within adolescence. METHOD: Adolescents (n = 401, 90% Hispanic) aged 14-17 at baseline participated in five biannual assessments. CU frequency, CU-related problems, and CUD were assessed using the Drug Use History Questionnaire, Marijuana Problems Scale, and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition, respectively. DM was assessed using the Iowa gambling task (IGT), Game of Dice Task (GDT), and Cups Task. We used latent growth curve modeling to examine bidirectional associations between DM and escalation in CU frequency and CU-related problems, and discrete time survival analyses to determine whether baseline performance across DM tasks predicted CUD onset. RESULTS: Baseline performance on the GDT predicted greater escalation in CU (ß = .200, p = .008) and CU-related problems (ß = .388, p = .035). No other significant associations were found. CONCLUSIONS: DM under explicit risk may be a more salient risk factor for escalating CU and CU-related problems than DM under ambiguous risk. Deficits in executive functioning could partially explain the results. Findings suggest that neurocognitive development should inform prevention and intervention efforts focused on reducing CU. Given the exploratory nature of the present study, replication of findings is needed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Study on the New Role of Civil and Military Air Rescue Nurses in the Italian Context.

Context: An emergency medical nurse is a health professional who operates at a very high level in the field of emergencies. The nurses of the critical area departments of the Territorial Emergency Department currently operate in the Sardinian helicopter rescue service. The effectiveness of the treatment that these nurses administer can be attributed to the quality of the previous and recurrent training that this unit must undergo. Objective: This study's aim was to investigate the role of civil and military helicopter nurses in the context of Italian medical aid. Methods: A qualitative study, with a phenomenological approach, was conducted by interviewing 15 emergency medical nurses, using detailed recordings and transcripts. These findings were then compared to understand how nurses work outside their department of origin, how their training has influenced their ability to establish themselves outside it, and thus their ability to become part of a context considered to be of the highest level. Participants and research context: The personnel interviewed in this study were those who were working in the helibases of Cagliari, Olbia, and Alghero. The limitations of this study are linked to the impossibility of obtaining an internship at a company, because, at the time of the study, an agreement between the university and the Areus company was not active. Ethical considerations: Participation in this research was completely voluntary. In fact, the participants could cease participating at any time. Results: This study revealed issues related to training, preparation, motivation to carry out the role held, nursing autonomy, the willingness to collaborate between the various rescue organizations, the use of the helicopter rescue service, and possible improvements for this service. Conclusions: civil air rescue nurses can deepen their knowledge by examining the work of military air rescue nurses, because, although the operational contexts are different, some techniques used in a hostile environment are also applicable to civilian environments. By doing so, nurses could become independent team leaders for all intents and purposes, managing their own training, preparation, and technical skills.

Efficacy and Safety of Calcipotriene/Betamethasone Dipropionate Foam in the Treatment of Psoriasis in Skin of Color.

BACKGROUND: There is a paucity of data on usage of topical medications in patients with darker phototypes. This single-center, randomized, double-blinded, vehicle-controlled clinical study investigated the efficacy of a combination calcipotriene/betamethasone dipropionate (Cal/BD) aerosol foam 0.005%/0.064% in the treatment of psoriasis vulgaris in Fitzpatrick skin types IV to VI. METHODS: 25 adult subjects were randomized 4:1 to Cal/BD foam or foam vehicle once daily for 4 weeks followed by 4 weeks of open label treatment. From week 4 to week 8, subjects randomized to Cal/BD foam once daily switched to Cal/BD foam twice weekly for 4 weeks, while those randomized to vehicle applied Cal/BD foam once daily. RESULTS: At week 4, 4/19 (21%) of Cal/BD foam patients achieved clear/almost clear Investigator Global Assessment (IGA) status with ≥2 grade improvement compared with 0/5 (0%) of vehicle patients (P=0.54). 12/19 (63%) of Cal/BD foam patients achieved a 50% reduction in Psoriasis Area and Severity Index (PASI 50) at week 4, compared with 0/5 (0%) of vehicle patients (P=0.04). Mean changes in melanin index at week 4 indicate a trend toward increased pigmentation in Cal/BD foam patients and decreased pigmentation in foam vehicle patients (P=0.30). All adverse events were mild and deemed unrelated to treatment by the investigators. LIMITATIONS: The sample size was small and underpowered to detect statistically significant changes in most endpoints. CONCLUSION: Cal/BD foam was safe and well tolerated in plaque psoriasis patients with skin of color. Larger studies involving skin of color populations with psoriasis are warranted. Pigmentary changes (hyper- and hypopigmentation) in lesional skin were observed. J Drugs Dermatol. 2023;22(2): 165-173.doi:10.36849/JDD.6910.

The effect of changing the military's sexual assault laws on law enforcement investigative findings in the U.S. Army.

OBJECTIVE: In 2007, Congress changed the military's sexual assault laws as part of an effort to improve sexual assault case processing. This study looked at the U.S. Army law enforcement investigative finding for every sexual assault reported to the Army from 2004 through June 2012, along with every nonsexual assault. Our objective was to measure whether the legal intervention affected the investigative findings made by Army law enforcement officers in sexual assault cases (penetrative, nonpenetrative, and combined) as compared to assault cases (aggravated, simple, and combined). HYPOTHESES: We hypothesized that we would not find evidence that the legal intervention affected the rate of sexual assault cases labeled as "founded" by Army law enforcement, such that for the best-fitting time-series models, any difference in the residuals of the means before and after the intervention would not be statistically significant. METHOD: We received data from the U.S. Army on all sexual assaults and nonsexual assaults from 2004 through June 2012. The data comprised 47,058 observations. We used time-series analysis with autoregressive integrated moving average modeling. The variable tracked over time was the ratio of the proportion of founded sexual assault cases to the proportion of founded nonsexual assault cases. We then conducted t tests of the means of the residuals before and after the legal intervention. RESULTS: The difference in the means of the residuals before and after the intervention was not statistically significant for combined sexual assaults versus combined assaults, penetrative sexual assaults versus aggravated assaults, or nonpenetrative sexual assaults versus simple assaults. CONCLUSIONS: This reform to sexual assault laws does not appear to have affected sexual assault case processing by U.S. Army law enforcement. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Risky decision-making as an antecedent or consequence of adolescent cannabis use: findings from a 2-year longitudinal study.

BACKGROUND AND AIMS: Although poor decision-making (DM) has been correlated with problematic cannabis use (CU), cross-sectional designs make it difficult to determine whether poor DM represents an antecedent and/or consequence of CU. The current study measured bidirectional associations between CU and DM among adolescents over 2 years and compared these findings to those observed with episodic memory, which is consistently reported as a consequence of CU. We also measured the role of DM as a risk factor for cannabis use disorder (CUD) onset. DESIGN: Two-year longitudinal study with five bi-annual assessments. PARTICIPANTS: Participants were 401 adolescents aged 14-17 years at baseline. SETTING: Miami, Florida, USA. MEASUREMENTS: CU frequency and CUDs were assessed at each time-point through the Drug Use History Questionnaire and Structured Clinical Interview for DSM-IV, respectively. Neurocognition was assessed at odd time-points throughout the Iowa Gambling Task, Game of Dice Task and Cups Task [decision-making (DM)] and the Wechsler Memory Scale IV and California Verbal Learning Test II (episodic memory). We used latent growth curve modeling to examine bidirectional influences between CU and neurocognition over time. We applied discrete time survival analyses to determine whether baseline DM predicted CUD onset. FINDINGS: Greater lifetime CU frequency was associated with poorer episodic memory at baseline (bs = -14.84, -16.44, Ps = 0.038, 0.021). Greater CU escalation predicted lesser gains in immediate episodic memory (b = -0.05, P = 0.020). Baseline DM did not predict CU escalation (b = 0.07, P = 0.421), nor did escalation in CU predict changes in DM (b = 0.02, P = 0.352). Baseline DM also did not predict CUD onset (adjusted OR = 1.01, 95% confidence interval = 0.98-1.06). CONCLUSIONS: This study replicates findings that poorer episodic memory in adolescents appears to be a consequence of cannabis use, even among adolescents at earlier stages of use. Poor decision-making does not appear to be either a consequence of or a risk factor for escalating cannabis use or onset of cannabis use disorder among adolescents.

Description of four Millepora spp. transcriptomes and their potential to delimit the Caribbean fire coral species.

Millepora is a relatively species-rich genus of hydrocorals, with 16 species distributed around the globe. It is considered an important reef building cnidarian. The current diversity of Caribbean Millepora species consists of Millepora complanata, M. alcicornis, M. squarrosa and M. striata. Here, we report the de novo transcriptome assembly and phylotranscriptomic analysis of M. alcicornis, M. complanata, M. squarrosa and a undescribed morphotype (Millepora sp.) found in exposed Thalassia beds and mangrove areas in southwest Puerto Rico. Over 345 million sequence reads were obtained for the analysis of the Millepora transcriptomes (Illumina HiSeq4000; 2x150bp). The analysis pipeline consisted of assembly with Trinity, BUSCO, RSEM and ORFs calling for each transcriptome, followed by ontology (Blast2GO) and phylogenetic analysis. The phylogenetic analysis was performed after selecting homologous genes among the transcriptomes, resulting in 10,596 sequences. Concatenation analysis (Maximum Likelihood and Bayesian inference) and a coalescence-based analysis were performed to the dataset too. Concatenation analysis yielded a topology supporting a clade of M. complanata and M. alcicornis, with Millepora sp. outside this clade and M. squarrosa as an outgroup. The coalescence-based tree estimation analysis (ASTRAL-II), presented a different topology placing M. alcicornis and Millepora sp. as sister taxa, rather than grouping with M. alcicornis with M. complanata. Our coalescence analysis indicated that there is a high degree of incomplete lineage sorting, suggesting a very recent time of species emergence among three out of the four Caribbean Millepora species. Calculations of ABBA-BABA statistics derived from transcriptome-wide SNP data indicate the possible presence of introgression between Millepora complanata and M. alcicornis.

Crystal structure of 1-ferrocenyl-2-(4-nitro-phen-yl)ethyne.

The title ferrocene derivative, [Fe(C5H5)2(C8NO2)], including an alkyne bonded to a para-nitro-phenyl substituent, which was synthesized from a copper-free Sonogashira cross-coupling reaction between ethynylferrocene and 4-bromo-1-nitro-benzene, crystallizes in the P21/n space group. In the ferrocene unit, the penta-dienyl (Cps) rings are in an eclipsed conformation. The angle of rotation between the substituted cyclo-penta-dienyl ring and the p-nitro-phenyl group is 6.19 (10)°, yielding a quasi-linear extension of the ferrocenyl substitution. Important inter-molecular inter-actions arise from π-π stacking between the Cp rings and the p-nitro-phenyl, from corners of the Cp rings that are perpendicularly aligned, and between the O atoms from the nitro substituent and carbons at the corners of the Cp rings, propagating along all three crystallographic axes.

Applying an Innovative Model of Disaster Resilience at the Neighborhood Level : The COPEWELL New York City Experience.

Community resilience is a community's ability to maintain functioning (ie, delivery of services) during and after a disaster event. The Composite of Post-Event Well-Being (COPEWELL) is a system dynamics model of community resilience that predicts a community's disaster-specific functioning over time. We explored COPEWELL's usefulness as a practice-based tool for understanding community resilience and to engage partners in identifying resilience-strengthening strategies. In 2014, along with academic partners, the New York City Department of Health and Mental Hygiene organized an interdisciplinary work group that used COPEWELL to advance cross-sector engagement, design approaches to understand and strengthen community resilience, and identify local data to explore COPEWELL implementation at neighborhood levels. The authors conducted participant interviews and collected shared experiences to capture information on lessons learned. The COPEWELL model led to an improved understanding of community resilience among agency members and community partners. Integration and enhanced alignment of efforts among preparedness, disaster resilience, and community development emerged. The work group identified strategies to strengthen resilience. Searches of neighborhood-level data sets and mapping helped prioritize communities that are vulnerable to disasters (eg, medically vulnerable, socially isolated, low income). These actions increased understanding of available data, identified data gaps, and generated ideas for future data collection. The COPEWELL model can be used to drive an understanding of resilience, identify key geographic areas at risk during and after a disaster, spur efforts to build on local metrics, and result in innovative interventions that integrate and align efforts among emergency preparedness, community development, and broader public health initiatives.

The Role and Function of the Liaison Officer: Lessons Learned and Applied after Superstorm Sandy.

In October 2012, Superstorm Sandy had a wide impact on the public across New York City (NYC). The NYC Department of Health and Mental Hygiene (DOHMH) activated its incident command system (ICS) and deployed a liaison officer (LNO) to the NYC Emergency Operations Center (EOC) at NYC Emergency Management (NYCEM) 24 hours a day for 6 weeks. This prolonged response period, coupled with environmental effects on NYC's coastal communities, increased public awareness of Sandy's health impacts, requiring a broad scope of interagency coordination and operational input from the liaison officer. Liaison officers involved in this response later conducted a content analysis of issues handled throughout Sandy, to better understand the skill set required to serve in this role, identify greater staff depth, integrate liaison officers into DOHMH exercises, and update just-in-time training provided before liaison officers deploy. This analysis revealed defined training topics for liaison officers to improve staff performance and effectiveness in leading interagency coordination during emergency responses. Topics include resources, staffing, data management, public messaging, and vulnerable populations, and these topics have since been used to revamp liaison officer training and guide policy changes in the liaison officer job charter. Targeted use of liaison officers to support development and implementation and to coordinate response objectives with local, state, and federal partners has only become more important. This analysis continues to influence how DOHMH defines its citywide agency response role, to inform how best to staff and train liaison officers to respond, and to pose lessons for other jurisdictions seeking to maximize the effectiveness of liaison officers deployed in emergencies.

Public Housing on the Periphery: Vulnerable Residents and Depleted Resilience Reserves post-Hurricane Sandy.

Hurricane Sandy was the greatest natural disaster to ever impact public housing residents in New York City. It affected approximately 80,000 residents in 400 buildings in 33 developments throughout the city. The storm left residents without power, heat, or running water, yet many chose not to evacuate. This qualitative study was conducted to understand the impact of Sandy among this socially, physically, and geographically vulnerable population. It is the first known study to examine the impact of disasters in high-rise, high-density public housing as a unique risk environment. Findings demonstrate (1) broad impacts to homes, health and access to resources, (2) complex evacuation decision-making, (3) varied sources of support in the response and recovery phases, and (4) lessons learned in preparedness. Results are contextualized within an original conceptual framework-"resilience reserve"-that explains the phenomenon of delayed recovery stemming from enactments of resilience to manage chronic hardship leaving vulnerable populations without the requisite capacity to take protective action when facing acute adversity. We discuss recommendations to establish and replenish the resilience reserve that include personal, institutional, and structural facets.

Use of Autologous Serum Tears for the Treatment of Ocular Surface Disease From Patients With Systemic Autoimmune Diseases.

PURPOSE: To describe the safety and efficacy of autologous serum tears (AST) in managing ocular surface disease resistant to conventional therapy in patients with systemic autoimmune disease(s). DESIGN: Retrospective, interventional case series. METHODS: Records of patients from 2009 to 2015 with systemic autoimmune disease treated with AST (20%-50%) for chronic surface disease were analyzed. Standardized measures of subjective dry eye symptoms, objective dry eye staining of the cornea, and slit-lamp findings including punctate epithelial erosion (PEE), filamentary keratopathy (FK), and corneal epithelial defects (KED) were compared during first and last visit. We attempted to standardize outcomes by creating a scale from 1 to 4 for subjective and objective components: worsening (1), no improvement (2), partial improvement (3), and complete resolution (4). RESULTS: Fifty-one patients (101 eyes) were included. The mean age was 59.8 ± 13.2 years (72.5% female). Average use of AST was 14.3 ± 11.7 months. Complete objective improvement of initial slit-lamp findings was achieved in 30% and partial improvement in 55% of eyes. Presence of PEE, FK, and KED decreased from 92.1% to 52.5% (P < .001), from 22.8% to 9.9% (P = .02), and from 5% to 2% (P = .44) of the eyes, respectively. Full subjective improvement of symptoms was achieved in 34.6%, partial in 50.5%, and none in 14.9% of patients. No adverse side effects were noted during follow-up. CONCLUSIONS: AST are a safe and effective adjunct therapy in improving both objective signs and subjective symptoms of ocular surface disorders associated with systemic autoimmune disease(s).

How Community and Public Health Partnerships Contribute to Disaster Recovery and Resilience.

OBJECTIVE: To summarize ways that networks of community-based organizations (CBO), in partnership with public health departments, contribute to community recovery from disaster. METHODS: The study was conducted using an online survey administered one and 2 years after Hurricane Sandy to the partnership networks of 369 CBO and the New York Department of Health and Mental Hygiene. The survey assessed the structure and durability of networks, how they were influenced by storm damage, and whether more connected networks were associated with better recovery outcomes. RESULTS: During response and recovery, CBOs provide an array of critical public health services often outside their usual scope. New CBO partnerships were formed to support recovery, particularly in severely impacted areas. CBOs that were more connected to other CBOs and were part of a long-term recovery committee reported greater impacts on the community; however, a partnership with the local health department was not associated with recovery impacts. CONCLUSION: CBO partners are flexible in their scope of services, and CBO partnerships often emerge in areas with the greatest storm damage, and subsequently the greatest community needs. National policies will advance if they account for the dynamic and emergent nature of these partnerships and their contributions, and clarify the role of government partners. (Disaster Med Public Health Preparedness. 2018;12:635-643).

Synthesis and characterization of novel ferrocenyl chalcone ammonium and pyridinium salt derivatives.

A novel series of ferrocenyl chalcone ammonium and pyridinium salt derivatives were synthesized in order to improve their solubility in aqueous media. Substituted ferrocenyl chalcones with amines and pyridines were synthesized using the base-catalyzed Claisen-Schmidt reaction, and their corresponding salts were prepared by a nucleophilic quaternization reaction at the nitrogen atom. Most of the synthesized ferrocenyl chalcone salts were soluble in water at room temperature. They were fully characterized by IR, NMR spectroscopy and HRMS spectrometry, and their electrochemistry was studied. The salt derivatives presented chemical reversibility, electrochemical quasi reversibility, and the slope of a plot of Log Ipc (or Ipa) versus Log v were almost 0.5 suggesting that their redox process was controlled by diffusion.

Perfil socioeconómico de familias de niños diagnosticados con cáncer / Socioeconomic profiles of families of children diagnosed with cancer

INTRODUCCIÓN: El cáncer es una enfermedad que demanda grandes recursos en el área médica y psicosocial. En Chile, cada año, se diagnostica cáncer a 500 niños; la sobrevida a 5 años es similar a países de altos ingresos (75%). El ingreso económico de los países es un factor relevante dado que se correlaciona con la sobrevida de los enfermos de cáncer de forma directamente proporcional. En el caso de Chile los costos de la enfermedad están cubiertos por el Sistema de Salud. Fundación Nuestros Hijos, institución privada sin fines de lucro, asiste integralmente a los niños con cáncer atendidos en el Hospital Exequiel González Cortés, entre otros. OBJETIVO: Describir la situación socioeconómica de las familias de niños diagnosticados de cáncer en el Hospital Exequiel González Cortés, durante el año 2011. MÉTODO: Estudio observacional descriptivo. Del total de 69 niños diagnosticados ese año se incluyeron 57 niños, 12 fueron excluidos: 6 por ser recaída de enfermedad oncológica y 6 por no contar con todos los datos. RESULTADOS: el 54% [n=31) fue diagnosticado de Leucemia; la edad promedio fue de 6 años; 35% (n=20) provenía de la Región de O'Higgins, Chile; 32% (n= 18) de las madres y 95% (n=40) de los padres tenía algún tipo de trabajo remunerado; el ingreso familiar promedio mensual era equivalente a 579 dólares (por debajo del promedio nacional 1.621 dólares), per cápita de 116 dólares. El 35% de las familias compartía casa con otras familias. CONCLUSIONES: Las condiciones económicas y sociales de estas familias, podrían poner en riesgo la sobrevida de sus hijos enfermos de cáncer, si no cuentan con soporte suficiente que permitan acceder de forma apropiada al tratamiento.

INTRODUCTION: Cancer is a disease that requires a great number of medical and psychosocial resources. Each year in Chile, 500 children are diagnosed with cancer, and the 5-year survival rates are similar to those of high-income countries (75%). National income is a crucial factor, given that it is directly related to cancer survival rates. In Chile, the Health System covers the medical costs of the disease. Fundación Nuestros Hijos (Our Children Foundation), a nonprofit organization, gives comprehensive assistance to children with cancer that are treated in Hospital Exequiel Gonzáles Cortés, among other centers. PURPOSE: To describe the socioeconomic situation of families who have children diagnosed with cancer, who were treated in Hosptial Exequiel González Cortés in 2011. METHODOLOGY: For this descriptive and observational study, of the 69 children who were diagnosed with cancer in Hospital Exequiel Gonzáles Cortés during 2011, 57 were included in the study, and 12 were excluded: 6 because they were suffering relapse of a previously treated oncologica disease, and the other 6 because all of their necessary data were not available. RESULTS: Of the 57 children included in the study, 54% (n=31) were diagnosed with leukemia; the average age of the children was 6 years; and 35% (n=20) of patients came from the O'Higgins Region of Chile. Additionally, 32% (n=18) of the children's mothers and 95% (n=40) of their fathers had paid employment; the average monthly family income was equivalent to USD$579 (lower than the national average USD$1,621), and USD$116 per capita. It was found that 35% of the children's families shared their home with other families. CONCLUSIONS: These families' economic and social conditions could be a risk factor for the survival of their children with cancer, if they do not have sufficient support to access appropriate treatment.

Lesiones intraepiteliales en pacientes atendidas en el Hospital General Docente "Márti-res del 9 de Abril", 2010 / Intraepithelial lesions in patients treated at the General Hospital "Mártires del 9 de Abril", 2010

Las lesiones neoplásicas del cérvix pueden evolucionar en un período de meses o años hasta desarrollar cáncer. Mediante un estudio cuantitativo de tipo prospectivo descriptivo se alcan-zó el propósito de caracterizar el estado de las patologías de cuello uterino en las pacientes con diagnóstico definitivo de citología anormal, que fueron remitidas a la consulta especiali-zada en el Hospital "Mártires del 9 de Abril" durante el año 2010; cuya población de estudio estuvo conformada por 259 pacientes, de las cuales fueron seleccionadas 248 a través de un muestreo no probabilístico en base a criterios. Prevalecieron aquellas con edades comprendi-das entre 25 y 54 años, así como las secundíparas y las que tuvieron su primera relación sexual antes de cumplir los 20 años. Las lesiones intraepiteliales de bajo grado predomina-ron. Se observó independencia entre las variables resultados citológicos y antecedentes personales de infección vaginal, en contraposición de la dependencia significativa entre los resultados de tres métodos diagnósticos empleados; así como, entre resultados histológicos y conducta terapéutica. Las reintervenciones que se requirieron fueron debido a la presencia de bordes de sección quirúrgica positivos y la detección de carcinoma microinfiltrante.

The neoplastic lesions of the cervix can evolve over a period of months or years until cancer develops. Characterizing the condition of cervical pathologies in patients with a definitive diagnosis of abnormal cytology was reached through a quantitative study of a descriptive prospective type. The patients of this research were referred to the specialized consultation at the General Hospital "Mártires del 9 de Abril" during the year 2010. The study population consisted of 259 patients, of which 248 ones were selected through a non-probabilistic sampling based on criteria. Patients between 25 and 54 years of age, those ones who had their first sexual relationship before reaching the age of 20 prevailed in the study. Low-grade intraepithelial lesions predominated. Independence was observed between cytological results and personal history of vaginal infection variables, as opposed to the significant dependence between the results of three diagnostic methods used including histological results and therapeutic behavior. The reoperations were required due to the presence of positive surgical section borders and the detection of micro-infiltrating carcino-ma.

Low Rates of Malignancy and Mortality in Asymptomatic Patients With Suspected Neoplastic Pancreatic Cysts Beyond 5 Years of Surveillance.

BACKGROUND & AIMS: The 2015 American Gastroenterological Association guidelines recommend discontinuation of surveillance of pancreatic cysts after 5 years, although there are limited data to support this recommendation. We aimed to determine the rate of pancreatic cancer development from neoplastic pancreatic cysts after 5 years of surveillance. METHODS: We performed a retrospective multicenter study, collecting data from 310 patients with asymptomatic suspected neoplastic pancreatic cysts, identified by endoscopic ultrasound from January 2002 to June 2010 at 4 medical centers in California. All patients were followed up for 5 years or more (median, 87 mo; range, 60-189 mo). Data were used to calculate the risk for pancreatic cancer and all-cause mortality. RESULTS: Three patients (1%) developed invasive pancreatic adenocarcinoma. Based on American Gastroenterological Association high-risk features (cyst size > 3 cm, dilated pancreatic duct, mural nodule), risks for cancer were 0%, 1%, and 15% for patients with 0, 1, or 2 high-risk features, respectively. Mortality from nonpancreatic causes was 8-fold higher than mortality from pancreatic cancer after more than 5 years of surveillance. CONCLUSIONS: There is a very low risk of malignant transformation of asymptomatic neoplastic pancreatic cysts after 5 years. Patients with pancreatic lesions and 0 or 1 high-risk feature have a less than 1% risk of developing pancreatic cancer, therefore discontinuation of surveillance can be considered for select patients. Patients with neoplastic pancreatic cysts with 2 high-risk features have a 15% risk of subsequent pancreatic cancer, therefore surgery or continued surveillance should be considered.

A propósito de una nueva clasificación del embarazo a término. Resultados neonatales en una clínica de tercer nivel de atención en Cali, Colombia. Un estudio de corte transversal / In view of a new classification of term pregnancy. Neonatal outcomes in a level III clinic in Cali, Colombia. A cross-sectional study

Objetivo: Aplicar la clasificación del parto a término del American College of Obstetricians and Gynaecologists (ACOG); describir la frecuencia de las diferentes categorías y hacer un análisis exploratorio de los resultados neonatales entre los grupos. Materiales y métodos: Estudio de corte transversal. Se incluyeron gestantes consideradas inicialmente sanas, con embarazo a término definido según última menstruación confiable y ecografía en la primera mitad de la gestación, de una clínica privada de tercer nivel, de Cali (Colombia), año 2013. Los partos se clasificaron como parto a término temprano, a término y a término tardío. Se describen las características sociodemográficas maternas y los resultados perinatales, así como la frecuencia de cada categoría; la comparación de grupos se estableció a través de análisis de varianza (ANOVA), Kruskal-Wallis o chi cuadrado. Resultados: De 502 nacimientos, fueron clasificados como embarazos a término temprano 200 (39,8 %), completo 254 (50,6 %) y tardío 48 (9,6 %). Hubo mayor frecuencia de aseguramiento contributivo de la madre y embarazos de alto riesgo en el grupo a término temprano. Se observaron diferencias estadísticamente significativas en bajo peso al nacer y peso promedio del neonato en el grupo a término temprano, y mayor asfixia neonatal en el grupo a término tardío. No hubo diferencias en cuanto a síndrome de dificultad respiratoria y tiempo de hospitalización. Conclusión: La nueva clasificación de embarazo a término de la ACOG es factible de aplicar. La frecuencia de parto a término temprano es alta en Colombia. No se evidenciaron diferencias significativas en los resultados neonatales entre los tres grupos excepto en la asfixia neonatal, que fue mayor en el grupo a término tardío.

Objective: To apply the classification of term delivery of the American College of Obstetricians and Gynaecologists, describe the frequency of the various categories, and explore neonatal outcomes among groups. Materials and methods: A cross-sectional study including pregnant women considered initially healthy with a term pregnancy defined on the basis of the last reliable menstruation and ultrasound performed in the first half of the gestation period in a private, Level III clinic, in Cali, Colombia, in 2013. Deliveries were classified as early term, term and late term. Social and demographic characteristics of the mothers and perinatal outcomes are described. The frequency of each category is described and group comparisons are performed using the variance analysis (ANOVA),and the Kruskal-Wallis or Chi-square test. Results: Of 502 births, 200 (39.8 %) were classified as early term, 354 (50.6 %) as full term, and 48 (9.6 %) as late term. There was a higher frequency of contributive insurance coverage and high risk pregnancies in the early term group. Statistically significant differences were observed in terms of low birth weight and average neonatal weight in the early term group, whereas neonatal asphyxia was higher in the late term group. There were no differences in terms of respiratory distress syndrome or length of stay. Conclusion: It is feasible to apply the new ACOG term pregnancy classification. The frequency of early term delivery is high in Colombia. There was no evidence of significant differences in neonatal outcomes between the three groups except for higher neonatal asphyxia in the late term group.