Prevalence and risk factors of intestinal parasites in Cuban children

The definitive version is available at www3.interscience.wiley.comOBJECTIVES: To determine the prevalence of intestinal parasite infections and their risk factors in children in urban and rural settings in two Cuban municipalities. METHODS: A total of 1320 Cuban schoolchildren aged 4-14 were tested by stool examination for intestinal parasite infections and evaluated by parental questionnaire for a number of common environmental, sanitary, socioeconomic and behavioural risk factors. Multivariate regression was applied to examine the relationship between the respective parasite infections and the risk factors. RESULTS: Prevalences of intestinal parasite infections were 58% in Fomento and 45% in San Juan y Martínez; for helminth infections, these were 18% and 24% and for protozoa infections, 50% and 29%, respectively. Helminth infections were associated with high parental education (maternal: OR 0.68, CI 0.50-0.93; paternal: OR 0.71, CI 0.52-0.96), absence of toilet (OR 1.57, CI 1.12-2.19), consumption of water from a well or river (OR 0.56, CI 0.41-0.77) and eating unpeeled/unwashed fruit (OR 1.37, CI 1.01-1.87); protozoa infections were only associated with high maternal education (OR 0.72, CI 0.57-0.91). CONCLUSIONS: Paediatric intestinal parasite infections are still prevalent in certain areas in Cuba and associated with a number of common environmental, socioeconomic and sanitary risk factors

Association of atopy, allergic rhinoconjunctivitis, atopic dermatitis and intestinal helminth infections in Cuban children

The definitive version is available at www3.interscience.wiley.comOBJECTIVE: To examine the relationship of past and current intestinal helminth infections with asthma, allergic rhinoconjunctivitis, atopic dermatitis and atopy. METHODS: Cross-sectional study of 1320 children aged 4-14 years from two Cuban municipalities. Helminth infections were determined by stool examination and parental questionnaire. Asthma, rhinoconjunctivitis and atopic dermatitis were diagnosed by International Study of Asthma and Allergies in Childhood questionnaire, asthma additionally by spirometry, atopy by skin prick testing. RESULTS: Questionnaire-based frequencies were 21% for asthma, 14% for allergic rhinoconjunctivitis and 8% for atopic dermatitis. According to spirometry, 4% had asthma; 20% had a positive skin prick test. A history of infection for Enterobius vermicularis was associated with increased risk of atopic dermatitis (OR 1.88, P = 0.001) and allergic rhinoconjunctivitis (OR 1.34, P = 0.046), and hookworm with increased risk of allergic rhinoconjunctivitis (OR 2.77, P = 0.021). A positive stool examination for Ascaris lumbricoides infection was negatively associated with atopic dermatitis (OR 0.22, P = 0.007). Asthma and atopy were unrelated to helminth infections. CONCLUSION: Current A. lumbricoides infection protects against atopic dermatitis in Cuban children, while past infection with E. vermicularis and hookworm are risk factors for allergic rhinoconjunctivitis and/or atopic dermatitis. Apparently, interactions differ depending on the type of helminth and atopic disease and on the time of helminth infestation

707PSAFETY AND EFFICACY OF NEOADJUVANT FOLFIRINOX IN PATIENTS (PTS) WITH LOCALLY ADVANCED PANCREATIC ADENOCARCINOMA (LAPC)

Abstract Aim: In a retrospective study of 18 pts with unresectable (UR) or borderline resectable (BR) LAPC, neoadjuvant therapy with FOLFIRINOX with or without subsequent chemoradiation (CCRT) resulted in an R0 resection rate (RR) of 44% (Hosein et al, BMC Cancer 2012). The reported 1-year progression-free survival (PFS) was 83 % and the 1-year overall survival (OS) was 100 %. Toxicity profile was tolerable. In order to confirm these preliminary results, we analyzed a large cohort of pts treated in a similar fashion with mature follow-up. Methods: Between 2008 and 2013, 51 treatment-naïve pts with LAPC were treated with first-line FOLFIRINOX with neoadjuvant intent. Pts were categorized as BR or UR using the NCCN criteria. Pts received FOLFIRINOX chemotherapy (at the full dose as described in the ACCORD-11 trial) until maximum response or tolerability, and then underwent surgery if their imaging suggested resectability. Pts then received CCRT if they were still UR or BR after FOLFIRINOX. The end points of this retrospective analysis were OS, PFS, R0 RR and toxicity profile. Results: A total of 429 cycles were given with a median of 8 (range 2-29); 27 (53%) went on to receive CCRT. After a median follow-up of 17 mo (range 2-56), the Kaplan-Meier median OS was 35 mo (95% CI 26-45), the 3-yr OS rate was 42% and the median PFS was 14 mo (95% CI 11 – 16). By imaging criteria, 13 (26%) were converted to resectability and 10 (4 BR and 6 UR) of these had successful R0 resections. Pts who had R0 resections had a significantly longer survival than pts who did not (3-yr OS rate 67% vs 21%, log rank p = 0.042). Grade 1&2/3&4 chemotherapy-related toxicities were neutropenia (39%/20%), neutropenic fever (0%/12%), thrombocytopenia (53%/16%), anemia (63%/10%), fatigue (76%/6%), nausea (57%/4%) vomiting (22%/4%), neuropathy (53%/4%) and diarrhea (37%/10%). Conclusions: FOLFIRINOX followed by chemoradiotherapy is feasible as neoadjuvant therapy in patients with unresectable LAPC. Although the resection rate was only 20%, the median OS of almost 3 years is appreciably longer than historical survival rates for this population. Prospective controlled trials testing this algorithm in LAPC are ongoing. Disclosure: All authors have declared no conflicts of interest