Beneficios de la implementación de un programa de seguimiento fármaco-terapéutico a pacientes VIH positivo atendidos en el Instituto Nacional Cardiopulmonar

Objective: To evaluate the clinical implications of the pharmaceutical intervention,product of a pharmacotherapeutic follow-up program, in the improvement of the adherence,in the virological and immunological parameters and in the management of the negative results associated to the medication in HIV + patients that attend the HIV/AIDS Treatment Center at the Instituto Nacional Cardiopulmonary. Methods: A study with a quantitative approach, a correlational scope and quasi-experimental, prospective and randomized design was proposed. At the moment of recruiting volunteers, the pharmacotherapeutic follow-up basis was explained to the patients and the participation in the study was proposed. Thirty-one adult patients accepted. They all had HIV infection and were treated in the INCP's. To evaluate the clinical implications of this strategy, adherence levels, immunological and virologic parameters and the management of negative results associated with medication were compared with those patients in a control group, who did not receive the pharmacotherapeutic follow-up program. Results: When comparing the means of adherence scores between the intervention group and the control group, statistically significant differences were observed (p <0.05, 95% CI), which showed the influence of the pharmacotherapeutic follow-up program on adherence to therapy. In addition, the pharmacotherapeutic follow-up program identified negative results associated with the medication; 81% of these negative results were due to effectiveness, 17% of safety and 2% of necessity. The most frequent pharmaceutical intervention was patient education to increase adherence to treatment (80%). Conclusion: The results show that pharmacist intervention, through pharmacotherapeutic follow-up, improves adherence to antiretroviral treatment. The pharmacists were able to improve the adherence issue through their interventions.Objetivo: Evaluar las implicaciones clínicas de la intervención farmacéutica, producto de un programa de seguimiento farmacoterapéutico, en la mejora de la adherencia, en los parámetros virológicos einmunológicos y en el manejo de los resultados negativos asociados a la medicación en pacientes VIH+ que atienden el Servicio de Atención Integral del Instituto Nacional Cardiopulmonar. Métodos: Se planteó un estudio con enfoque cuantitativo, un alcance correlacional y diseño cuasi experimental, prospectivo y aleatorizado. Al momento de reclutar voluntarios, se explicó en que consiste el seguimiento farmacoterapéutico y se ofertó la participación en dicho programa. Aceptaron 31 pacientes adultos, con infección por VIH y en tratamiento ARV atendidos en el SAI del INCP. Se evaluaron las implicaciones clínicas de esta estrategia, comparando los niveles de adherencia, parámetros inmunológicos y virológicos y el manejo de los resultados negativos asociados a la medicación en los de pacientes del grupo de intervención y del grupo control, estos últimos no recibieron el programa de seguimiento farmacoterapéutico. Resultados: Al comparar las medias de las puntuaciones en adherencia entre el grupo de intervención y el grupo de control se observaron diferencias estadísticamente significativas (p<0.05, IC95%), lo que mostró la influencia del programa de seguimiento farmacoterapéutico sobre la adherencia a la terapia. Además el programa de seguimiento farmacoterapéutico permitió identificar resultados negativos que el 81% de los resultados negativos de la medicación fueron de efectividad, el 17 % de seguridad y 2% de necesidad. La intervención farmacéutica más frecuente fue la educación al paciente para incrementar la adherencia al tratamiento (80%). Conclusiones: Los resultados demuestran que la intervención del farmacéutico, mediante el seguimiento farmacoterapéutico mejora la adherencia al tratamiento antirretroviral. El farmacéutico fue capaz de mejorar el aspecto de cumplimiento y de mediante su intervención

Mutational Landscape of Bladder Cancer in Mexican Patients: <i>KMT2D</i> Mutations and chr11q15.5 Amplifications Are Associated with Muscle Invasion

Bladder cancer (BC) is the most common neoplasm of the urinary tract, which originates in the epithelium that covers the inner surface of the bladder. The molecular BC profile has led to the development of different classifications of non-muscle invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). However, the genomic BC landscape profile of the Mexican population, including NMIBC and MIBC, is unknown. In this study, we aimed to identify somatic single nucleotide variants (SNVs) and copy number variations (CNVs) in Mexican patients with BC and their associations with clinical and pathological characteristics. We retrospectively evaluated 37 patients treated between 2012 and 2021 at the National Cancer Institute—Mexico (INCan). DNA samples were obtained from paraffin-embedded tumor tissues and exome sequenced. Strelka2 and Lancet packages were used to identify SNVs and insertions or deletions. FACETS was used to determine CNVs. We found a high frequency of mutations in TP53 and KMT2D, gains in 11q15.5 and 19p13.11-q12, and losses in 7q11.23. STAG2 mutations and 1q11.23 deletions were also associated with NMIBC and low histologic grade

Somatic Mutational Landscape in Mexican Patients: <i>CDH1</i> Mutations and chr20q13.33 Amplifications Are Associated with Diffuse-Type Gastric Adenocarcinoma

The Hispanic population, compared with other ethnic groups, presents a more aggressive gastric cancer phenotype with higher frequency of diffuse-type gastric adenocarcinoma (GA); this could be related to the mutational landscape of GA in these patients. Using whole-exome sequencing, we sought to present the mutational landscape of GA from 50 Mexican patients who were treated at The Instituto Nacional de Cancerología from 2019 to 2020. We performed a comprehensive statistical analysis to explore the relationship of the genomic variants and clinical data such as tumor histology and presence of signet-ring cell, H. pylori, and EBV. We describe a potentially different mutational landscape between diffuse and intestinal GA in Mexican patients. Patients with intestinal-type GA tended to present a higher frequency of NOTCH1 mutations, copy number gains in cytobands 13.14, 10q23.33, and 12q25.1, and copy number losses in cytobands 7p12, 14q24.2, and 11q13.1; whereas patients with diffuse-type GA tended to present a high frequency of CDH1 mutations and CNV gains in cytobands 20q13.33 and 22q11.21. This is the first description of a mutational landscape of GA in Mexican patients to better understand tumorigenesis in Hispanic patients and lay the groundwork for discovering potential biomarkers and therapeutic targets