[Food consumption patterns and risk of gallstone disease (GD): Case and Control Study in Rosario Argentina.] / Patrones de consumo alimentario y riesgo de enfermedad colelitiásica (EC): Estudio de Casos y Controles en Rosario Argentina.

Introduction: Nutritional exposure is considered the main environmental influence that contributes to gallstone disease (GD). Aim: The aim of this study was to determine food intakes patters and estimate risk of GD. Methods: A nested case-control study was carried out within the framework of a previous screening study conducted on a representative sample in Rosario, Argentina. Participants underwent a personal interview. Average amount of each food intake and quantity nutrients were estimated applying a food-frequency questionnaire. Food consumption patterns were identified by principal component analysis, and logistic regression analysis was used to estimate risks. Results: The sample was conformed by 51 cases and 69 controls. Two dietary patterns were identified. Cases were characterised by the unhealthy intake pattern (high intakes of animal fats, sugar, cereals, grains, cold cuts, processed meats, chicken with skin, fat beef and low intake of red vegetables and yellows, cabbages, fruits and fish). Conclusion: Controls were characterised by the healthy intake pattern (high intake of skinless chicken, nuts, lean beef, vitamin A and C rich fruits, and low consumption of chicken with skin, green leaves vegetables and sprouts). The unhealthy pattern showed an increased risk of developing GD while healthy patter behaved as a protective factor.

Introducción: La exposición nutricional se considera la principal exposición ambiental que contribuye a la formación de cálculos biliares. Objetivo: El objetivo de este trabajo fue determinar el patrón de consumo alimentario de casos y controles de EC y estimar el riesgo de desarrollar la enfermedad según los distintos patrones constituidos. Métodos: Se llevó a cabo un estudio analítico retrospectivo transversal de casos y controles, anidado a un estudio de prevalencia realizado en Rosario. Todos los participantes fueron entrevistados personalmente. El consumo de alimentos se consignó a través de un cuestionario semi-cuantitativo de frecuencia de consumo. Para determinar patrones de consumo alimentario se realizó un análisis de componentes principales, y análisis de regresión logística múltiple para evaluar riesgos. Resultados: La muestra quedó conformada por 51 casos y 69 controles. Se determinaron dos componentes que permitían diferenciar los casos de los controles, a través de las cuales se establecieron 2 patrones de consumo. Los casos se caracterizaron por un consumo determinado por el Patrón Poco saludable (altas ingestas de grasas animales, azúcar, cereales, granos, fiambres y embutidos) y los controles por el consumo del patrón Saludable (altas ingestas de pollo sin piel, frutas secas, carne vacuna magra, frutas, lácteos enteros). El patrón Poco saludable, aumentó el riesgo de desarrollar EC mientras que el patrón Saludable, se comportó como protector. Conclusión principal: Los patrones constituidos diferencian los casos de los controles, y la ingesta propia de los casos se correlaciona con un perfil de consumo que caracteriza a las culturas occidentales modernas y urbanas.

Factors associated with mortality among hospitalized patients with COVID-19 disease treated with convalescent plasma.

The use of convalescent plasma (CP) for hospitalized patients with SARS-CoV-2 infection might be a useful option in certain settings. Soon after the outbreak of COVID-19, the National Ministry of Health of Argentina recommended the use of CP transfusion for hospitalized patients with COVID-19 disease. Between 1 June and 3 October 2020, 480 patients, excluding those on invasive mechanical ventilation (IMV), received at least one CP infusion in the province of Santa Fe. We aimed to find factors associated with mortality among this cohort of patients. The median age was 60 years (interquartile range: 49-69 years) and 320 (66.7%) were males. Most of these patients (93.75%) received a single CP infusion, 82.1% and 95.6% before day 4 and day 7 of hospitalization, respectively. Anti-SARS-CoV-2 titers were determined in the CP units administered using Elecsys Anti-SARS-CoV-2 S assay. At 28 days of follow-up, 250 patients were discharged (52.1%), 131 (27.3%) remained hospitalized without and 16 (3.3%) with oxygen requirement, 27 (5.6%) were on IMV, and 56 (11.7%) had died. In the multivariate logistic regression analysis, the factors significantly associated with 28-day mortality were (i) requirement of IMV, (ii) the administration of CP after the third day of hospitalization, (iii) age, and (iv) number of comorbidities. The qualitative and quantitative analyses of antibodies against SARS-CoV-2 in the infused CP were not associated with mortality. Our findings may imply a seemingly favorable effect of CP administration among patients with severe COVID-19 disease when infused sooner after hospitalization.IMPORTANCEThe use of convalescent plasma (CP) could be an option for patients with severe COVID-19, especially in poor-resource countries where direct antiviral drugs are not commercially available. Currently, the U.S. Food and Drug Administration limits the CP administration for outpatients and inpatients with COVID-19 who are immunocompromised and only if high levels of anti-SARS-CoV-2 antibodies are confirmed in the CP unit. Although most of the randomized clinical trials failed to show a clear-cut benefit of CP in hospitalized patients with severe COVID-19, other studies have shown that if given early in the course of the disease, it might be a useful therapeutic option. In this retrospective study, we demonstrated that early treatment (within 3 days of hospitalization) was significantly associated with reduced 28-day mortality compared with those patients treated beyond day 3. The results from our study add up to the scientific evidence on the use of CP as a relatively safe, cheap, and possibly effective therapy in certain patients suffering from severe SARS-CoV-2 infection.

The long-term antibody response after SARS-CoV-2 prime-boost vaccination in healthy individuals. The positive influence of extended between-dose intervals and heterologous schedule.

Introduction: Anti-COVID vaccination in Argentina was carried out using different protocols and variations in periods between administrations, as well as combinations of different vaccine platforms. Considering the relevance of the antibody response in viral infections, we analyzed anti-S antibodies in healthy people at different points of time following the Sputnik immunization procedure. Methods: We attended the vaccination centers in the city of Rosario, which had shorter versus longer intervals between both doses. A total of (1021) adults with no COVID-compatible symptoms (throughout the study period) were grouped according to the gap between both vaccine doses: 21 (Group A, n=528), 30 (Group B, n=147), and 70 days (Group C, n=82), as well as an additional group of individuals with heterologous vaccination (Sputnik/Moderna, separated by a 107-day interval, group D, n=264). Results and conclusions: While there were no between-group differences in baseline levels of specific antibodies, data collected several weeks after administering the second dose showed that group D had the highest amounts of specific antibodies, followed by values recorded in Groups C, B, and A. The same pattern of group differences was seen when measuring anti-S antibodies at 21 or 180 days after the first and second doses, respectively. Delayed between-dose intervals coexisted with higher antibody titers. This happened even more when using a prime-boost heterologous schedule.

Correlación electro-ecocardiográfica en deportistas de alto rendimiento / Electrocardiographic and echocardiographic association in high performance athletes

Introducción: El entrenamiento físico sostenido genera adaptaciones cardíacas estructurales y funcionales. El objetivo de nuestro trabajo fue evaluar la correlación entre los hallazgos electro-ecocardiográficos en una población de deportistas de alto rendimiento. Material y método: Se evaluaron 30 deportistas varones (10 waterpolistas, 10 triatletas y 10 nadadores), entre 18 y 40 años, con 20 a 30 horas semanales de entrenamiento por al menos un año. Se efectuó evaluación clínica, electrocardiográfica y ecocardiográfica a cada uno de ellos en el Instituto Vozzi. Resultados: En la evaluación ecocardiográfica, se observó que la media del espesor septal, el índice de masa del ventrículo izquierdo (VI), el diámetro anteroposterior y el área de la aurícula izquierda (AI), el área de la aurícula derecha (AD) y la base del ventrículo derecho (VD) se hallaron por encima de los valores normales para la población general. En los ECG, ninguno de los deportistas presentó crecimiemto de AI, AD o VD. Nueve de los 30 (30%) presentaron signos de hipertrofia del VI. Luego de ajustar por edad, peso, talla, superficie corporal y deporte realizado, el diámetro diastólico del VI (DdVI) indexado a la superficie corporal (SC) fue mayor en los deportistas con hipertrofia del VI en el electrocardiograma (ECG) (media ajustada 28,94±0,56 mm; IC95%= 27,78-30,10) vs sin hipertrofia (27,67±0,36 mm; IC95%= 26,93-28,41). Los triatletas presentaron con mayor frecuencia hipertrofia del VI en el ECG respecto de los otros grupos. Conclusiones: Ciertos parámetros ecocardiográficos en nuestra población de deportistas se hallan por encima de los valores normales para la población general. No se halló relación entre los signos electrocardiográficos y ecocardiográficos de crecimiento de la AI, la AD e hipertrofia del VD. Se halló relación entre hipertrofia del VI en el ECG y aumento del diámetro diastólico del VI indexado en el ecocardiograma.(AU)

Background: Functional and structural cardiac adaptations are generated by sustained physical training. The objective of our investigation was to evaluate the association in electrocardiographic and echocardiographic findings in a population of high-performance athletes. Material and method: 30 male athletes (10 water polo players, 10 triathlonists and 10 swimmers), ages 18 to 40 years old, training 20 to 30 hours per week for at least one year, were evaluated. Clinical, electrocardiographic (ECG) and echocardiographic examination was performed on each of them at Instituto Vozzi. Results: Echocardiographic results showed that the mean septal thickness, the mass index of the left ventricle (LV), the anteroposterior diameter and the area of the left atrium (LA), the area of the right atrium (RA) and the base of the right ventricle (RV) were found above normal values for the general population. None of the athletes ECGs presented LA, RA or RV enlargement. Nine of 30 (30%) presented signs of LV enlargement. After adjusting for age, weight, height, body surface area, and sport performed, LV diastolic diameter (LVDD) indexed to body surface area (BSA) was higher in athletes with LV enlargement on ECG (adjusted mean 28.94 ± 0.56 mm; 95% CI = 27.78-30.10) vs without (27.67 ± 0.36 mm; 95% CI = 26.93-28.41). More triathlonists presented LV enlargement signs on the ECG compared to the other groups. Conclusions: Certain echocardiographic parameters in our population of athletes are above normal values for the general population. There was no relationship comparing electrocardiographic and echocardiographic signs of LA, RA and RV enlargement. An association was found between ECGs LV enlargement and increased LVDD indexed to BSA on the echocardiograms. LV enlargement on the ECGs was more frequent in the triathlon group.(AU)

Knowledge, adherence and perceptions about colorectal cancer screening in primary and secondary school teachers in Carcarañá / [Conocimiento, adherencia y percepciones acerca del tamizaje del cáncer colorrectal en docentes de escuelas primarias y secundarias de Carcarañá]

Introduction: This study describes the knowledge and perceptions regarding colorectal cancer screening (CRC) in a population of teachers from primary and secondary schools in Carcarañá, Santa Fe. The proportion of participants who underwent the screening is described, as well as the facilitating factors and barriers that could affect test adherence. Methods: An observational, descriptive and cross-sectional study was carried out through a self-administered survey of the population of teachers aged 50 or over from all primary and secondary schools in the city. Results: 96 teachers, 87 women (90.6%) and 9 men (9.4%) were surveyed. Average age: 53.2 ± 2.5 years. 66.7% knew about CRC screening. However, only 13.5% knew the recommended time to start performing these tests. 28.1% had adhered to some of the screening tests. 94.8% agreed that CRC has a greater chance of cure if it is discovered early, and 92.7% reported that screening is part of good health care. . Conclusion: The positive perception regarding screening is not consistent with adherence to screening. Lack of knowledge, lack of information and medical indication are the most important barriers to adherence. The main facilitating factor was the existence of a family history of CRC. New research that addresses this issue would be necessary in order to develop strategies aimed at modifying these barriers and reducing mortality from this neoplasm

Introducción: Este estudio describe los conocimientos y percepciones respecto del tamizaje del cáncer colorrectal (CCR) en una población de  docentes de escuelas primarias y secundarias de Carcarañá, Santa Fe. Se describe la proporción de participantes que se sometió a la realización del mismo, así como los factores facilitadores y las barreras que podrían afectar la adherencia a las pruebas. Métodos: Se realizó una estudio observacional, descriptivo y transversal mediante una encuesta autoadministrada a la población de docentes de 50 años o más de todas las escuelas primarias y secundarias de la ciudad. Resultados: Se encuestaron 96 docentes, 87 mujeres (90,6%) y  9 hombres (9,4%). Edad promedio: 53,2 ± 2,5 años. El 66,7% tenía conocimiento acerca de la existencia del tamizaje de CCR. Sin embargo, sólo el 13,5% conocía cuál era el momento recomendado para iniciar la realización dichas pruebas. El 28,1% había adherido a alguna de las pruebas de tamizaje. El 94,8% acordó que el CCR tiene mayor posibilidad de curación si se descubre de manera temprana y el 92,7% refirió que el tamizaje es parte del buen cuidado de salud. Conclusión: La percepción positiva respecto del tamizaje no se condice con la adherencia al mismo. El desconocimiento, la falta de información y de indicación médica constituyen las barreras más importantes a la adherencia. El principal factor facilitador fue la existencia de antecedentes familiares de CCR. Serían necesarias nuevas investigaciones que aborden esta temática con el fin de elaborar estrategias dirigidas a modificar dichas barreras y disminuir la mortalidad por esta neoplasia.

La alimentación en estudiantes del primer ciclo de la carrera de medicina de la Universidad Nacional de Rosario, Argentina / Eating habits of medical students of the National University of Rosario, Argentina

Con el objetivo de indagar sobre los hábitos alimentarios de los estudiantes de la carrera de Medicina de la Facultad de Ciencias Médicas de la Universidad Nacional de Rosario (UNR), y compararlos con las Guías Alimentarias para la Población Argentina se llevó a cabo un estudio cuali-cuantitativo, descriptivo, observacional y transversal. Se aplicó una encuesta y un recordatorio de 24 horas. La muestra quedó conformada por 140 alumnos. El consumo de alimentos declarado mostró que el 70% había consumido leche o yogur, el 56,4% frutas, el 79,3% verduras, el 75,7% carnes, el 62,1% cereales, el 20% huevos y el 25% fiambres. El 46,4% declaró haber utilizado azúcar y el 20% edulcorante. El 81,4% expresó haber consumido panificados blancos y sólo el 15,7% integrales. Los vegetales y el edulcorante fueron más consumidos por las mujeres y las carnes y los panificados blancos por los hombres. Respecto del hábito de desayunar fue importante el número de estudiantes que cumplió la recomendación de las Guías. El número de ingestas diarias recomendado (mínimo 4) lo cumplió el 77%. Sólo el 12,8% declaró consumir frutas y verduras tal como es recomendado (5 porciones al día). Respecto de los panificados, esta muestra no cumple la recomendación de seleccionar granos integrales.

The aim of this study was to investigate the dietary habits of the students at the School of Medicine, Faculty of Medical Sciences of the National University of Rosario (UNR), and to compare them with the Dietary Guidelines for the Argentinian population. We carried out a quantitative, descriptive, observational cross-sectional study using a 24- hour dietary recall questionnaire. The sample was made up of 140 students. The declared food consumption showed that 70% consumed milk or yogurt, 56.4% fruits, 79.3% vegetables, 75.7% meats, 62.1% cereals, 20% eggs and 25% cold cuts. Sugar consumption was reported by 46.4% of the students, and use of artificial sweeteners by 20% of them. Most students (81.4%) consumed white bread and only 15.7% whole wheat. While vegetables and sweeteners were more consumed by women, meat and white bread were more consumed by men. Many students met the recommendation for breakfast consumption. The recommended number of daily meals (minimum 4) was met by 77%. Only 12.8% reported eating fruits and vegetables as recommended (5 servings a day). Regarding breads, this sample does not meet the recommendation of selecting whole grains.

Sentinel Lymph Node Biopsy in Patients With Thick Primary Cutaneous Melanoma.

BACKGROUND: The clinical value of sentinel lymph node biopsy (SLNB) in patients with thick melanoma is uncertain. The purpose of this study was to investigate the correlations between survival and lymph node status in thick melanomas. METHODS: Of a total of 736 melanoma patients registered between 2000 and 2016, 50 presented with thick melanomas (≥ 4.0 mm) without distant metastatic disease. All patients were examined with a whole-body magnetic resonance imaging, or computed tomography, and positron emission tomography-computed tomography depending on the incorporation of the new technology in our medical institutions. They were studied according to the following procedure: 1) preoperative determination of regional lymph node along with the estimation and localization of sentinel lymph node (SLN) (dynamic isotope lymphography); 2) intraoperative localization and SLNB (lymphatic mapping); and 3) histopathology. Patient and tumor features were collected. RESULTS: Mean follow-up was 40 months, and 37% had a follow-up ≥ 5 years. A positive SLN was identified in 28 patients (56%). No significant difference in melanoma-specific overall survival was observed in terms of the primary tumor site. Hazard ratios (HRs) were statistically significant for SLNB-positive group and mitotic rate (MR) > 3 mm2, but not for presence of ulceration. Mortality risk in the SLN-positive group was almost fourfold greater than that in the SLN-negative group at any time of follow-up. CONCLUSIONS: SLN status, along with MR, can provide valuable prognostic information in patients with thick primary cutaneous melanoma.

[Study about skin cancer screening in comparison with breast and cervix cancer screening in a female sample from Concordia, Argentina.] / Estudio acerca del conocimiento, actitudes y prácticas del cribado de cáncer de piel, mama y cérvix en una muestra de mujeres en Concordia, Argentina.

Introduction: The aim of this study was to describe the knowledge, practices and attitudes regarding the screening of skin cancer, compared to the breast and cervix cancer. Methods. An observational, cross-sectional study using structured questionnaires was carried out among women in the city of Concordia, Entre Ríos. The sample consisted of 90 mothers or tutors from low (G1, n=32), middle (G2, n=29) and high (G3, n=29) socioeconomic status elementary schools students. Results. Mean age were 37,9±6,6, 38,0±6,9 and 43,1±5,6 years, respectively. The annual skin exam has been performed by dermatologist in 30.0% (G1), 30.8% (G2) and 51.7% (G3) of these women. The annual gynecological exam has been done by 46.4% (G1), 60.7% (G2) and 86.2% (G3). The existence of the skin cancer prevention campaign was known in 35,7%, 16% and 10,7% in G1, G2 and G3 respectively, but only 3,7% of G2, 3,7% of G3 and no women in G1 had ever participated in a campaign. Major conclusion. These data indicate the need to achieve effective strategies that allow improving the adherence of women to prevention campaigns, especially those for skin cancer prevention, where there is less participation when compared with breast and cervical cancer screening. Methods: An observational, cross-sectional study using structured questionnaires was carried out among women in the city of Concordia, Entre Ríos. The sample consisted of 90 mothers or tutors from low (G1, n=32), middle (G2, n=29) and high (G3, n=29) socioeconomic status elementary schools students. Results. Mean age were 37,9±6,6, 38,0±6,9 and 43,1±5,6 years, respectively. The annual skin exam has been performed by dermatologist in 30.0% (G1), 30.8% (G2) and 51.7% (G3) of these women. The annual gynecological exam has been done by 46.4% (G1), 60.7% (G2) and 86.2% (G3). The existence of the skin cancer prevention campaign was known in 35,7%, 16% and 10,7% in G1, G2 and G3 respectively, but only 3,7% of G2, 3,7% of G3 and no women in G1 had ever participated in a campaign. Major conclusion. These data indicate the need to achieve effective strategies that allow improving the adherence of women to prevention campaigns, especially those for skin cancer prevention, where there is less participation when compared with breast and cervical cancer screening. Results: Mean age were 37,9±6,6, 38,0±6,9 and 43,1±5,6 years, respectively. The annual skin exam has been performed by dermatologist in 30.0% (G1), 30.8% (G2) and 51.7% (G3) of these women. The annual gynecological exam has been done by 46.4% (G1), 60.7% (G2) and 86.2% (G3). The existence of the skin cancer prevention campaign was known in 35,7%, 16% and 10,7% in G1, G2 and G3 respectively, but only 3,7% of G2, 3,7% of G3 and no women in G1 had ever participated in a campaign. Major conclusion. These data indicate the need to achieve effective strategies that allow improving the adherence of women to prevention campaigns, especially those for skin cancer prevention, where there is less participation when compared with breast and cervical cancer screening. Major conclusion: These data indicate the need to achieve effective strategies that allow improving the adherence of women to prevention campaigns, especially those for skin cancer prevention, where there is less participation when compared with breast and cervical cancer screening.

Introducción: En este estudio se describen los conocimientos, prácticas y actitudes en relación al cribado de cáncer de mama, cérvix y piel en una muestra de madres o tutoras de alumnos de sexto grado de establecimientos de educación primaria de la ciudad de Concordia, Entre Ríos. Métodos. Durante el año 2016 se realizó un estudio observacional, descriptivo, transversal, mediante entrevistas y encuestas estructuradas a 90 mujeres mayores de 18 años, madres o tutoras de alumnos de tres escuelas de la ciudad de Concordia correspondientes a diferentes niveles socioeconómicos (bajo: G1, n=32), medio (G2, n=29) y alto (G3, n=29). Resultados. La edad promedio fue 37,9±6,6; 38±6,9 y 43,1±5,6 años, respectivamente. Las proporciones de mujeres que se realizaron controles periódicos de mama, cérvix y piel por médicos especialistas fueron mayores en el grupo de madres pertenecientes al nivel socioeconómico alto. El 35,7%, 16% y 10,7% de las mujeres del G1, G2 y G3 respectivamente, conocían las campañas de prevención de cáncer cutáneo; pero sólo participó en alguna de ellas el 3,7% del G2, 3,7% del G3 y ninguna del G1. Conclusión principal. Estos datos nos indican la necesidad de lograr estrategias que permitan mejorar la adhesión de las mujeres a las campañas de prevención. Métodos: Durante el año 2016 se realizó un estudio observacional, descriptivo, transversal, mediante entrevistas y encuestas estructuradas a 90 mujeres mayores de 18 años, madres o tutoras de alumnos de tres escuelas de la ciudad de Concordia correspondientes a diferentes niveles socioeconómicos (bajo: G1, n=32), medio (G2, n=29) y alto (G3, n=29). Resultados. La edad promedio fue 37,9±6,6; 38±6,9 y 43,1±5,6 años, respectivamente. Las proporciones de mujeres que se realizaron controles periódicos de mama, cérvix y piel por médicos especialistas fueron mayores en el grupo de madres pertenecientes al nivel socioeconómico alto. El 35,7%, 16% y 10,7% de las mujeres del G1, G2 y G3 respectivamente, conocían las campañas de prevención de cáncer cutáneo; pero sólo participó en alguna de ellas el 3,7% del G2, 3,7% del G3 y ninguna del G1. Conclusión principal. Estos datos nos indican la necesidad de lograr estrategias que permitan mejorar la adhesión de las mujeres a las campañas de prevención. Resultados: La edad promedio fue 37,9±6,6; 38±6,9 y 43,1±5,6 años, respectivamente. Las proporciones de mujeres que se realizaron controles periódicos de mama, cérvix y piel por médicos especialistas fueron mayores en el grupo de madres pertenecientes al nivel socioeconómico alto. El 35,7%, 16% y 10,7% de las mujeres del G1, G2 y G3 respectivamente, conocían las campañas de prevención de cáncer cutáneo; pero sólo participó en alguna de ellas el 3,7% del G2, 3,7% del G3 y ninguna del G1. Conclusión principal: Estos datos nos indican la necesidad de lograr estrategias que permitan mejorar la adhesión de las mujeres a las campañas de prevención.

Frecuencia de fracturas en una población cerrada de Atención Primaria de la Salud (APS) del Distrito Centro de la ciudad de Rosario / Frequency of fractures in a closed Primary Health Care population in the Downtown District of Rosario, Argentina

Con el propósito de determinar la prevalencia de fracturas osteoporóticas en una población cerrada de Atención Primaria de la Salud (APS) correspondiente al Distrito Centro de la ciudad de Rosario, se realizó este estudio observacional transversal. Los datos se obtuvieron de las fichas clínicas de los pacientes correspondientes a los registrosdel consultorio de APS. Se determinó la prevalencia de las fracturas del esqueleto periférico y axial estratificadas poredad y sexo, y se exploró la asociación entre índice de masa corporal y fracturas en esta población y según sexo. Seobtuvo información de 898 pacientes; 662 mujeres (73,7%) y 236 varones (26,3%); la relación mujer/varón fuede 2,8/1. La edad promedio fue de 75 años, y similar en ambos sexos. Los varones habían perdido 4,3±2,9 cm detalla con respecto a su talla histórica (rango: 0-17 cm), y las mujeres 5,7±3,7 cm (rango: 0-19 cm)...

In order to determine the prevalence of osteoporotic fractures in a closed population of Primary Health Care (PHC)corresponding to the Downtown District of the city of Rosario, this cross-sectional observational study was performed. Data were obtained from patients’ clinical records corresponding to PHC office records. The prevalence of axial andperipheral skeletal fractures was determined and the association between fractures and age, sex and body mass index (BMI)was explored. Information was obtained from 898 patients; 662 women (73.7%) and 236 men (26.3%); The male/female ratio was 2.8/1. Mean age was 75 years, and similar in both sexes. Males had lost 4.3±2.9 cm in height withrespect to their historical height (range: 0-17 cm), and females 5.7±3.7 cm (range: 0-19 cm)...

Putative Biomarkers of Response to Treatment in Breast Cancer Patients: A Pilot Assay.

Identifying tumor biomarkers associated with clinical behavior in breast cancer patients may allow higher accuracy in the selection of treatment. Different types of cells were determined in the primary tumors of stage I, II, and III of breast cancer patients, who were assigned to one of the two groups: (1) disease-free or (2) relapsed/progressed, at 5 years after primary treatment. We studied 32 tumor samples. CD4+ lymphocytes and CD44+CD24-/low cells (cancer stem cells) showed a significant association with clinical outcome at 5 years of primary treatment, while CD8+, Foxp3+, CD34+, and myeloid-derived suppressor cells did not show any association. Coincident with the results of individual analysis, we identified CD4+ cells and CD44+CD24-/low cells as good predictors of long-term clinical outcome in a logistic regression.

Ingesta alimentaria y estado nutricional de pacientes con enfermedad de chagas / Dietary intake and nutritional status of patients with Chagas disease

La enfermedad de Chagas es una infección parasitaria que afecta a 17 millones de personas en Latinoamérica. Es aún desconocida la real influencia del efecto del estado nutricional y la ingesta alimentaria sobre la evolución de la enfermedad hacia la miocardiopatía chagásica crónica, así como los factores de riesgo cardiovascular que pueden influir en la evolución de la patología. Con el objetivo de caracterizar la ingesta alimentaria y determinar el estado nutricional de las personas con enfermedad de Chagas, se llevó a cabo un estudio descriptivo transversal de una muestra de pacientes atendidos en el servicio de cardiología del Hospital Centenario de Rosario. Se recolectaron datos sobre las características generales de la muestra, se realizaron mediciones antropométricas y se entrevistó sobre el consumo de alimentos a través de un cuestionario de frecuencia de consumo y un atlas fotográfico. Se reclutaron 113 paciente, de los cuales el 70% de los hombres y el 90 % de las mujeres presentaban sobrepeso u obesidad. Además el 78.9% de las mujeres y el 27% de los hombres, presento un Índice cintura/cadera de riesgo cardiovascular. En el análisis de la ingesta de macronutrientes se observa que se superan las recomendaciones del aporte de lípidos. Al analizar la ingesta de alimentos por grupos se encontró que los hombres consumen más carne vacuna magra, fiambres y embutidos, carne de cerdo y bebidas alcohólicas, en cambio las mujeres ingieren más lácteos enteros y bebidas azucaradas. Esta muestra urbana de pacientes con enfermedad de Chagas, presenta un perfil nutricional similar al de la población general, y el consumo alimentario se encuentra influenciado por la vida en las grandes ciudades(AU)

Chagas disease is a parasitic infection that affects 17 million people in Latin America. The real influence of nutritional status and food intake effect over the course of the disease to chronic Chagas Cardiomyopathy is still unknown. Furthermore, some cardiovascular risk factors might influence the evolution of the disease. A cross-sectional study of a sample of patients with Chagas disease attending the Cardiology Section of the Hospital Centenario of Rosario was carried out in order to characterize their food intake and nutritional status. Data on the general characteristics of the sample was collected; anthropometric measurements were performed and food consumption was investigated using a food frequency questionnaire and a n photographic atlas. One hundred and thirteen patients were enrolled; 70% of men and 90% of women were overweight or obese. In addition 78.9% of women and 27% of men presented a waist-hip ratio according to cardiovascular risk. When analyzing macronutrient intake, it was observed that lipid intake recommendations were exceeded. When the food intake groups were analyzed separately, it was found that men consume more lean beef, cold cuts, pork and alcoholic drinks, while women eat more whole dairy products and sugary drinks. This patients´ urban sample with Chagas disease, he presents a nutritional profile similar to that of the general population, and the food consumption is influenced by life in big cities(AU)

Quality of life in patients with metastatic breast cancer treated with metronomic chemotherapy.

AIM: The objective of the study was to detect changes in quality of life (QoL) in metastatic breast cancer patients treated with metronomic chemotherapy with daily low doses of cyclophosphamide and celecoxib. MATERIAL & METHODS: Patients included in a Phase II trial, treated with metronomic cyclophosphamide and celecoxib were included in the QoL study. Assessment of QoL was carried out every 2 months by the Functional Assessment of Cancer Therapy Breast (FACT-B) questionnaire, Brief Pain Inventory and Eastern Cooperative Oncologic Group scale. Data were analyzed at three time points: baseline (BL); middle of treatment (MT); and end of treatment (ET). RESULTS: A total of 20 patients were included. All patients were heavily pretreated. Treatment showed a good and safe therapeutic profile. With FACT-B questionnaire, no significant differences were observed during the response period (BL-MT). However, a significant increase was observed in the Emotional well-being and Additional concerns axes, when the last time point was included in the analysis (BL-MT-ET). A significant decrease in the proportion of patients with pain was found when comparing BL with ET (p = 0.046). The assessment with Eastern Cooperative Oncologic Group scale showed that 26.7% (4/15) of the patients improved their functional status and 40% (6/15) showed no changes, while 33.3% (5/10) worsened it. CONCLUSION: Patients treated metronomically for several months did not worsen their QoL. A high proportion of patients showed improvement or no changes and there were less patients with pain at the end of the treatment.

Metastatic breast cancer patients treated with low-dose metronomic chemotherapy with cyclophosphamide and celecoxib: clinical outcomes and biomarkers of response.

BACKGROUND: Preclinical results showing therapeutic effect and low toxicity of metronomic chemotherapy with cyclophosphamide (Cy) + celecoxib (Cel) for mammary tumors encouraged its translation to the clinic for treating advanced breast cancer patients (ABCP). PATIENTS AND METHODS: A single-arm, mono-institutional, non-randomized, phase II, two-step clinical trial (approved by Bioethics Committee and Argentine Regulatory Authority) was designed. Patients received Cy (50 mg po.d) + Cel (200 mg p.o.bid). Patient eligibility criteria included: ABCP who progressed to anthracyclines, taxanes and capecitabine, ≤4 chemotherapy schemes, with good performance status. Several pro- and anti-angiogenic molecules and cells were determined as biomarkers. Informed consent was signed by all patients. Primary endpoint was clinical benefit (CB). RESULTS: Twenty patients were enrolled. Main clinical outcomes were prolonged disease stabilization and partial remission in 10/20 and 1/20 patients, respectively. CB was 55 %, and time to progression (TTP) was 21.1 weeks. Median TTP in patients who achieved CB was 35.6 weeks, and mean overall survival was 44.20 weeks. There were no grade 3/4 toxicities associated with treatment. Circulating endothelial cells (CECs) increased at the time of progression in patients who showed CB (P = 0.014). Baseline CECs and circulating endothelial progenitor cells showed marginal associations with TTP. Serum VEGF decreased (P = 0.050), sVEGFR-2 increased (P = 0.005) and VEGF/sVEGFR-2 ratio decreased during treatment (P = 0.041); baseline VEGF and VEGF/sVEGFR-2 were associated with TTP (P = 0.035 and P = 0.030, respectively), while sVEGFR-2 did not. CONCLUSIONS: Treatment was effective, showing low toxicity profile and excellent tolerability. The combination had anti-angiogenic effect. Increased levels of CEC could be useful for detecting progression. Baseline VEGF and VEGF/sVEGFR-2 values could be useful as early predictors of response. TRIAL REGISTRATION: ANMAT#4596/09.

Dietary intake and nutritional status of patients with Chagas disease.

Chagas disease is a parasitic infection that affects 17 million people in Latin America. The real influence of nutritional status and food intake effect over the course of the disease to chronic Chagas Cardiomyopathy is still unknown. Furthermore, some cardiovascular risk factors might influence the evolution of the disease. A cross-sectional study of a sample of patients with Chagas disease attending the Cardiology Section of the Hospital Centenario of Rosario was carried out in order to characterize their food intake and nutritional status. Data on the general characteristics of the sample was collected; anthropometric measurements were performed and food consumption was investigated using a food frequency questionnaire and a n photographic atlas. One hundred and thirteen patients were enrolled; 70% of men and 90% of women were overweight or obese. In addition 78.9% of women and 27% of men presented a waist-hip ratio according to cardiovascular risk. When analyzing macronutrient intake, it was observed that lipid intake recommendations were exceeded. When the food intake groups were analyzed separately, it was found that men consume more lean beef, cold cuts, pork and alcoholic drinks, while women eat more whole dairy products and sugary drinks. This patients´ urban sample with Chagas disease, he presents a nutritional profile similar to that of the general population, and the food consumption is influenced by life in big cities.

Incidencia de fracturas de cadera en los seis distritos de Rosario / Incidence of hip fracture in the six districts of Rosario city, Argentina

Las tasas de incidencia de fracturas de cadera varían entre países vecinos de un mismo continente, entre distintas regiones de un mismo país, y aún entre distintos barrios de una misma ciudad. El objetivo de este trabajo fue determinar si existían diferencias en las tasas de incidencia de fractura de cadera en los 6 distritos en que se divide la ciudad de Rosario (provincia de Santa Fe, Argentina), con una población de alrededor de un millón de habitantes, y establecer si hay factores ambientales (indicadores sanitarios) o socioeconómicos que pudieran explicar las diferencias. Se realizó un estudio de diseño ecológico. Se calcularon las tasas de incidencia globales, específicas por sexo y grupos etarios, así como las tasas truncadas y ajustadas en cada distrito municipal de Rosario. Los indicadores sociosanitarios estudiados fueron: tasas de mortalidad, necesidades básicas insatisfechas (NBI), habitantes/vivienda, habitantes/hectárea, madres menores de 20 años, nacidos de bajo peso, asentamientos precarios, espacios libres. Se aplicó un análisis multivariado considerando las tasas como variable dependiente y los indicadores sociosanitarios, sexo y grupos de edad como variables independientes, utilizando la regresión de Poisson y calculando el riesgo relativo (razón de tasas). Como resultados de este estudio, concluimos que la incidencia de fractura de cadera no difiere entre los distritos poblacionales de Rosario, y no se individualizaron grupos poblacionales que (de acuerdo a su lugar de residencia, con condiciones sanitarias y socioeconómicas características) presenten un riesgo especial para este tipo de complicación de la osteoporosis.

The incidence rates of hip fractures vary between neighboring countries in the same continent, between different regions of the same country, and even among different neighborhoods in the same city. The aim of this study was to determine whether there were differences in the incidence rates of hip fracture in the 6 districts in which the city of Rosario (province of Santa Fe, Argentina: population 1 million) is divided. We also tried to ascertain whether there are environmental (health indicators) or socioeconomic factors that could explain the differences. The study had an ecological design. Globalincidence rates specific for sex and age groups, and the truncated rates were calculated and adjusted in each municipal district of Rosario. The social health indicators studied were mortality, unmet basic needs, housing, inhabitants/hectare, mothers under age 20, low birth weight, settlements, open spaces. Multivariate analysis considering rates as the dependent variable and social and health indicators, gender and age as independent variables, using Poisson regression and calculating the relative risk (rate ratio) was applied. As results of this study, we conclude that the incidence of hip fracture does not differ between population districts of Rosario, and that no population groups were identified presenting an increased risk for this complication of osteoporosis, based on their place of residence, health conditions or socioeconomic characteristics.

Incidencia de fracturas de cadera en los seis distritos de Rosario / Incidence of hip fracture in the six districts of Rosario city, Argentina

Las tasas de incidencia de fracturas de cadera varían entre países vecinos de un mismo continente, entre distintas regiones de un mismo país, y aún entre distintos barrios de una misma ciudad. El objetivo de este trabajo fue determinar si existían diferencias en las tasas de incidencia de fractura de cadera en los 6 distritos en que se divide la ciudad de Rosario (provincia de Santa Fe, Argentina), con una población de alrededor de un millón de habitantes, y establecer si hay factores ambientales (indicadores sanitarios) o socioeconómicos que pudieran explicar las diferencias. Se realizó un estudio de diseño ecológico. Se calcularon las tasas de incidencia globales, específicas por sexo y grupos etarios, así como las tasas truncadas y ajustadas en cada distrito municipal de Rosario. Los indicadores sociosanitarios estudiados fueron: tasas de mortalidad, necesidades básicas insatisfechas (NBI), habitantes/vivienda, habitantes/hectárea, madres menores de 20 años, nacidos de bajo peso, asentamientos precarios, espacios libres. Se aplicó un análisis multivariado considerando las tasas como variable dependiente y los indicadores sociosanitarios, sexo y grupos de edad como variables independientes, utilizando la regresión de Poisson y calculando el riesgo relativo (razón de tasas). Como resultados de este estudio, concluimos que la incidencia de fractura de cadera no difiere entre los distritos poblacionales de Rosario, y no se individualizaron grupos poblacionales que (de acuerdo a su lugar de residencia, con condiciones sanitarias y socioeconómicas características) presenten un riesgo especial para este tipo de complicación de la osteoporosis. (AU)

The incidence rates of hip fractures vary between neighboring countries in the same continent, between different regions of the same country, and even among different neighborhoods in the same city. The aim of this study was to determine whether there were differences in the incidence rates of hip fracture in the 6 districts in which the city of Rosario (province of Santa Fe, Argentina: population 1 million) is divided. We also tried to ascertain whether there are environmental (health indicators) or socioeconomic factors that could explain the differences. The study had an ecological design. Globalincidence rates specific for sex and age groups, and the truncated rates were calculated and adjusted in each municipal district of Rosario. The social health indicators studied were mortality, unmet basic needs, housing, inhabitants/hectare, mothers under age 20, low birth weight, settlements, open spaces. Multivariate analysis considering rates as the dependent variable and social and health indicators, gender and age as independent variables, using Poisson regression and calculating the relative risk (rate ratio) was applied. As results of this study, we conclude that the incidence of hip fracture does not differ between population districts of Rosario, and that no population groups were identified presenting an increased risk for this complication of osteoporosis, based on their place of residence, health conditions or socioeconomic characteristics. (AU)

Raíces dentales humanas normales y con perlas de cemento: comparación histológica de estructuras / Normal human dental roots and withcementum pearls: structural histological comparison

Durante la vida del diente en boca se deposita cemento celular en el ápice a fin de compensar el desgaste oclusal considerado normal. Al extraer un diente, en raras ocasiones es posible visualizar excesos de cemento con forma de perlas bien delimitados y duros al tacto, ubicados en otro sector radicular diferente al ápice. Nuestro objetivo fue comparar estructuras en ambos tipos de cemento a fin de hallar diferencias histológicas. Se utilizaron 20 dientes permanentes con perlas (G1) y 20 con raíces normales (G2). Las raíces de G1 se cortaron con disco metálico de grano fino a baja velocidad en sentido transversal, a la altura de la parte más prominente de la protuberancia, las raíces de G2 se marcaron en tercios y se cortaron en sentido transversal aproximadamente a la altura de la mitad del tercio apical y de ambos grupos se obtuvieron un segmento que fue reservado y otro que fue preparado con técnica por desgaste para visualización con MO a menor y mayor aumentos. Los resultados se compararon con prueba t de student, las variables categóricas se compararon con pruebas de Fisher significación 5 por ciento. Se obtuvieron 40 dientes de pacientes adultos, 42,5 por ciento masculinos y 57,5 por ciento femeninos, edad promedio 61+/-16 en G1 y 55+/-18 en G2 (p=0,289). El contorno exterior de las perlas fue liso, conservando su perímetro, la zona granular de Tomes fue visible al igual que las lagunas, que fueron menos abundantes, de mayor tamaño y con distribución desordenada llegando en menor proporción al borde del tejido comparado con cemento normal.

During tooth life in mouth cellular cement settles in the apex in order to compensate the occlusal wear considered normal. After a tooth extraction, on rare occasions it is possible to visualize cement excesses with pearls form well delimited and hard to tact, located in another radicular sector different of the apex. Our aim was to compare structures in both types of cement in order to find histological differences. Consequently, 20 permanent teeth with pearls (G1) and 20 with normal roots (G2) were used. G1 roots were cut by a thin grain metallic disc at low speed in transverse sense, at the height of the protuberance most prominent part; G2 roots were marked in thirds and cut in transverse sense at the half of the third apical. From both groups a segment was obtained to be reserved and other one that was prepared by erosion technology to be visualized by MO at minor and major increases. Results were compared with student t test, categorical variables with Fisher's tests significance 5 percent. Forty adult patients teeth were obtained, male 42.5 percent and female 57.5 percent, age average in G1 61+/-16 and 55+/-18 in G2 (p=0.289). Pearls exterior face was smooth, with a preserved perimeter, Tomes granular zone was visible as were lagoons, which were less abundant, greater in size and with uneven distribution arriving at tissue border in a lesser proportion compared with normal cement.

Safety and therapeutic effect of metronomic chemotherapy with cyclophosphamide and celecoxib in advanced breast cancer patients.

Metronomic chemotherapy (MCT), the chronic administration, at regular intervals, of low doses of chemotherapeutic drugs without extended rest periods, allows chronic treatment with therapeutic efficacy and low toxicity. Our preclinical results suggested that combined MCT with cyclophosphamide and celecoxib could inhibit breast cancer growth. The aim of this study was to determine the toxicity, safety and efficacy of oral MCT with cyclophosphamide 50 mg per orem daily and celecoxib 400 mg (200 mg per orem two-times a day) in advanced breast cancer patients. During the first stage of the study, the therapeutic response consisted of prolonged stable disease for ≥24 weeks in six out of 15 (40%) patients with a median duration of 37.5 weeks and a partial response in one out of 15 (response rate: 6.7%) patients lasting 6 weeks. The overall clinical benefit rate was 46.7%. The median time to progression was 14 weeks. Progression-free survival at 24 weeks was 40% and the 1-year overall survival rate was 46.7%. The adverse events were mild (gastric, grade 1; and hematologic, grade 1 or 2). No grade 3 or 4 toxicities were associated with the treatment. Evaluation of patients' quality of life showed no changes during the response period. MCT with cyclophosphamide plus celecoxib is safe and shows a therapeutic effect in advanced breast cancer patients.

Patrón de consumo alimentario en una muestra de adultos con Enfermedad Colelitiasica (EC)

En un estudio realizado en una muestra aleatoria de adultos de Rosario se encontró una tasa de prevalencia de Enfermedad Colelitiásica (EC) del 20,5%. Con el objetivo de determinar el patrón de consumo alimentario de estas personas y compararlo con las Raciones Dietéticas Recomendadas (RDA) se entrevistaron 44 de dichas personas con EC. Se les realizó una encuesta sobre hábitos alimentarios 5 años previos al diagnóstico, empleando un cuestionario semi-cuantitativo de frecuencia de consumo (FFQ) y un Atlas fotográfico de porciones estandarizadas. Se calcularon los promedios (± desvío estándar) de la edad, del Índice de Masa Corporal (IMC), del consumo de cada nutriente y de la energía total consumida (Kilocalorías). La significación estadística de las diferencias entre sexos se evaluó aplicando pruebas t de student. La edad de las personas estudiadas (18 varones y 26 mujeres) fue 63,8±13,8 años y el IMC fue 28,2±5,8. Consumos promedio diarios: Kcalorias 2941±791,1 ; Carbohidratos 295,3±96,9 g; Proteínas 131,6±36,8 g; Grasa 128,9± 43 g; Ácidos grasos saturados 41,9±18,6 g; Ácidos grasos poliinsaturados 13,8±8,7 g; Colesterol 455,4±186,8 mg; Sodio 2730±1552,1 mg; Potasio 2912,8±1001,4 mg; Calcio 719,3±403,3 mg; Hierro 16±4,6 mg; Fósforo 801,6±320,3 mg; Vitamina A 3121,7±1811,9 mcg; Vitamina B1 0,80±0,30 mg; Vitamina B2 1,9±0,8 mg; Vitamina C 157,6±114,1 mg; Niacina 6,9±2,7 mg; Fibra total 12± 5,3 g; Café 70,7±104,3 cc. Se concluye que el patrón alimentario de las personas con EC se caracterizó por un alto consumo de Grasas, Ácidos grasos saturados y Colesterol, no alcanzando las recomendaciones para Carbohidratos, Calcio, Niacina y Fibra.

Food intake pattern in a sample of adults with Gallbladder Disease (GD). In Rosario, Argentina, a 20,5% prevalence rate of Gallbladder Disease (GD) was found in a random sample of adults. The aim of this study was to determine the food consumption pattern of subjects with GD nested in that sample for further comparison with the Recommended Dietary Allowances (RDA). Forty-four subjects were interviewed about the food consumption during the five years before their diagnosis, by applying a semi-quantitative food frequency questionnaire (FFQ) and a photographic atlas of standardized portions. Age, body mass index (BMI), all consumed nutrients, and total energy intake (kilocalories) were reported as Mean ± standard deviation. Comparisons according to sex (18 males and 26 females) revealed no significant differences in the variables under analysis. Age and BMI in the overall sample were as follows 63.8±13.8 years and 28.2±5.8, respectively. Mean daily consumption of nutrients was as follows: Carbohydrates 295.3±96.9 g , Protein 131.6±36.8 g , Fat 128.9±43 g , Saturated fatty acids 41.9±18,6 g, Polyunsaturated fatty acids 13.8±8.7 g, Cholesterol 455.4±186.8 mg, Sodium 2730±1552.1 mg, Potassium 2912.8±1001.4 mg, Calcium 719.3±403.3 mg, Iron 16±4.6 mg, Phosphorus 801.6±320.3 mg, Vitamin A 3121.7±1811.9 mcg, Vitamin B1 0.80±0.30 mg, Vitamin B2 1.9±0.8 mg, Vitamin C 157.6±114.1 mg, Niacin 6.9±2.7 mg, Fiber 5.3±12 g, Coffee 70.7±104.3 cc (total energy intake 2941±791.1 Kcal). Subjects with GD have a history of higher intake of fat, saturated fatty acids and cholesterol with consumption of carbohydrates, calcium, niacin and fiber below the recommended quantities.

[Food intake pattern in a sample of adults with gallbladder disease (GD)]. / Patrón de consumo alimentario en una muestra de adultos con Enfermedad Colelitiasica (EC).

In Rosario, Argentina, a 20,5% prevalence rate of Gallbladder Disease (GD) was found in a random sample of adults. The aim of this study was to determine the food consumption pattern of subjects with GD nested in that sample for further comparison with the Recommended Dietary Allowances (RDA). Forty-four subjects were interviewed about the food consumption during the five years before their diagnosis, by applying a semi-quantitative food frequency questionnaire (FFQ) and a photographic atlas of standardized portions. Age, body mass index (BMI), all consumed nutrients, and total energy intake (kilocalories) were reported as Mean +/- standard deviation. Comparisons according to sex (18 males and 26 females) revealed no significant differences in the variables under analysis. Age and BMI in the overall sample were as follows 63.8 +/- 13.8 years and 28.2 +/- 5.8, respectively. Mean daily consumption of nutrients was as follows: Carbohydrates 295.3 +/- 96.9 g, Protein 131.6 +/- 36.8 g, Fat 128.9 +/- 43 g, Saturated fatty acids 41.9 +/- 18,6 g, Polyunsaturated fatty acids 13.8 +/- 8.7 g, Cholesterol 455.4 +/- 186.8 mg, Sodium 2730 +/- 1552.1 mg, Potassium 2912.8 +/- 1001.4 mg, Calcium 719.3 +/- 403.3 mg, Iron 16 +/- 4.6 mg, Phosphorus 801.6 +/- 320.3 mg, Vitamin A 3121.7 +/- 1811.9 mcg, Vitamin B1 0.80 +/- 0.30 mg, Vitamin B2 1.9 +/- 0.8 mg, Vitamin C 157.6 +/- 114.1 mg, Niacin 6.9 +/- 2.7 mg, Fiber 5.3 +/- 12 g, Coffee 70.7 +/- 104.3 cc (total energy intake 2941 +/- 791.1 Kcal). Subjects with GD have a history of higher intake of fat, saturated fatty acids and cholesterol with consumption of carbohydrates, calcium, niacin and fiber below the recommended quantities.