Epidemiological Profile of Patients of Aged 65 Years and Over in a University Private Hospital

Objectives: An increase in life expectancy is predicted for the general population and, by 2050, about one billion people will be older than 65 years. The Global Cancer Incidence, Mortality and Prevalence database estimates that 1.2 million people of this age will have cancer; this number represents 58% of new cases in the American population. This represents a challenge for diagnosis and treatment, given that some older people have multiple comorbidities and disabilities. Materials and Methods: This was a retrospective descriptive study of 204 patients aged 65 years and over. All had a solid tumor that was diagnosed in a private hospital from January 2015 to December 2017. Results: The median age was 72.2 years; the most frequent age group (48.5% of patients) was 65–75 years, and only a small percentage (4.4%) were aged > 85 years. The most common type of cancer was lung cancer (22.5%), followed by colorectal and urinary cancer. Most patients received cancer treatment after the disease diagnosis. Conclusion: There are no epidemiological studies of the older oncology population in Mexico. We believe it is necessary to perform larger studies to understand this population and to undertake actions to facilitate greater attention to patient diagnosis, treatment, and alleviation

Searching for the Culprit: Metastases from a Cancer of Unknown Primary

We report a case of metastases from a cancer of unknown primary whose primary site could not be identified during the appropriate pretreatment evaluation. The patient was a 58-year-old woman with a history of passive smoking and with no history of cancer in the family. Her current condition started with asthenia, adynamia, and pallor, followed by palpitations. An abdominopelvic computed tomography (CT) scan was performed, showing multiple osteolytic lesions distributed in all bone structures and axillary adenopathy on the left side. As part of the approach and given the high suspicion of multiple myeloma, tests were performed. The results were negative for multiple myeloma. A PET-CT scan was performed and showed left axillary adenopathy. The breasts and other organs were not affected. Left axillary lymph node resection revealed breast primary metastatic pleomorphic lobular carcinoma. Due to the metastatic disease (caused by the primary breast cancer), it was decided to start chemotherapy

Relaciones entre los hongos filamentosos y solubilizadores de fosfatos con algunas variables edáficas y el manejo de cafetales Filamentous and phosphate solubilizing fungi relationships with some edaphic parameters and coffee plantations management

El suelo y sus propiedades tienen múltiples relaciones con las comunidades fúngicas. El efecto conjunto de la intensidad de manejo y las variables edáficas, incluida la estabilidad de agregados sobre las comunidades de hongos microscópicos filamentosos (HMF), solubilizadores de fosfato de hierro (HSP-Fe) y solubilizadores tanto de fosfato de hierro como de calcio (HSP-(Fe+Ca)) no han sido evaluadas en campo. A partir de 40 muestras edáficas de ocho plantaciones de café de Colombia y México, con diferentes intensidades de manejo (IMPC) y con diferencias en sus variables edáficas, se aislaron y evaluaron las comunidades de HMF, HSP-Fe y HSP-(Fe+Ca) durante 2008-2009. Empleando modelos basados en ecuaciones estructurales se encontró que el carbono orgánico se relacionó positivamente con la riqueza y abundancia de HMF (&#955;>0.58) y fue variable en su relación con HSP-Fe y HSP-(Fe+Ca). Las relaciones del fósforo disponible, pH y las fracciones de macro-agregados fueron altamente variables. El IMPC se relacionó negativamente con HSP-Fe (&#955;&#8804;-0.21) en cafetales colombianos. Se discuten las interacciones para cada conjunto de variables (químicas, estabilidad de macro-agregados y de manejo de plantación) y se explican las relaciones resultantes. Las relaciones de cada variable son inseparables del contexto edáfico y geográfico, los cuales imprimen marcadas diferencias.<br>Soil properties and the environment have multiple outcomes on fungal communities. Although, the interaction effects between management intensity, pH, available phosphorus, organic carbon, soil texture and different fractions of water stable macro-aggregates on the communities of microscopic filamentous fungi (MFF), iron phosphate solubilizing fungi (PSF-Fe), and iron and calcium phosphate solubilizing fungi (PSF-(Fe+Ca)), have been previously evaluated in field conditions, this has never been performed in terms of their combined effects, neither with phosphate solubilizing fungi. To assess this, we collected 40 composite soil samples from eight Mexican and Colombian coffee plantations, with different management intensities and physico-chemical edaphic parameters, during 2008-2009. We isolated different communities of MFF, PSFFe and PSF-(Fe+Ca), by wet sieving and soil particles culture in Potato-Dextrose-Agar from soil samples, and we classified isolates in terms of their phosphate solubilizing ability. Following the principal component analysis results, we decided to analyze fungal communities and abiotic factors interactions for each country separately. Structural Equation Models revealed that organic carbon was positively associated to MFF richness and number of isolates (&#955;>0.58), but its relationship with PSF-Fe and PSF-(Fe+Ca) were variable; while the available phosphorus, pH and water stable macro-aggregate fractions did not show a clear pattern. Management intensity was negatively related to PSF-Fe (&#955;&#8804;-0.21) morphotype richness and the number of isolates in Colombian coffee plantations. We found that the relationships of clay and organic carbon content, and available phosphorus and soil pH, with the species richness and number of isolates of MFF, PSF-Fe and PSF-(Fe+Ca) were highly variable; this made impossible to generalize the responses between saprotrophic fungal groups and geographic zones. The management intensity was not related to species richness and number of isolates of MFF in any coffee areas, while for PSF the relationship could not be defined. The different water stable macro-aggregates fractions did not show a defined pattern in relation to the species richness and the number of isolates of saprophytic and phosphate solubilizing fungi (PSF). This study highlights the need to take into account edaphic and geographic context in order to reach a better understanding of the intensity management effects on MFF and PSF function in agroecosystems

Relaciones entre los hongos filamentosos y solubilizadores de fosfatos con algunas variables edáficas y el manejo de cafetales

Filamentous and phosphate solubilizing fungi relationships with some edaphic parameters and coffee plantations management. Soil properties and the environment have multiple outcomes on fungal communities. Although, the interaction effects between management intensity, pH, available phosphorus, organic carbon, soil texture and different fractions of water stable macro-aggregates on the communities of microscopic filamentous fungi (MFF), iron phosphate solubilizing fungi (PSF-Fe), and iron and calcium phosphate solubilizing fungi (PSF-(Fe+Ca)), have been previously evaluated in field conditions, this has never been performed in terms of their combined effects, neither with phosphate solubilizing fungi. To assess this, we collected 40 composite soil samples from eight Mexican and Colombian coffee plantations, with different management intensities and physico-chemical edaphic parameters, during 2008-2009. We isolated different communities of MFF, PSFFe and PSF-(Fe+Ca), by wet sieving and soil particles culture in Potato-Dextrose-Agar from soil samples, and we classified isolates in terms of their phosphate solubilizing ability. Following the principal component analysis results, we decided to analyze fungal communities and abiotic factors interactions for each country separately. Structural Equation Models revealed that organic carbon was positively associated to MFF richness and number of isolates (λ&gt;0.58), but its relationship with PSF-Fe and PSF-(Fe+Ca) were variable; while the available phosphorus, pH and water stable macro-aggregate fractions did not show a clear pattern. Management intensity was negatively related to PSF-Fe (λ≤-0.21) morphotype richness and the number of isolates in Colombian coffee plantations. We found that the relationships of clay and organic carbon content, and available phosphorus and soil pH, with the species richness and number of isolates of MFF, PSF-Fe and PSF-(Fe+Ca) were highly variable; this made impossible to generalize the responses between saprotrophic fungal groups and geographic zones. The management intensity was not related to species richness and number of isolates of MFF in any coffee areas, while for PSF the relationship could not be defined. The different water stable macro-aggregates fractions did not show a defined pattern in relation to the species richness and the number of isolates of saprophytic and phosphate solubilizing fungi (PSF). This study highlights the need to take into account edaphic and geographic context in order to reach a better understanding of the intensity management effects on MFF and PSF function in agroecosystems.El suelo y sus propiedades tienen múltiples relaciones con las comunidades fúngicas. El efecto conjunto de la intensidad de manejo y las variables edáficas, incluida laestabilidad de agregados sobre las comunidades de hongos microscópicos filamentosos (HMF), solubilizadores de fosfato de hierro (HSP-Fe) y solubilizadores tanto de fosfato de hierro como de calcio (HSP-(Fe+Ca)) no han sido evaluadas en campo. A partir de 40 muestras edáficas de ocho plantaciones de café de Colombia y México, con diferentes intensidades de manejo (IMPC) y con diferencias en sus variables edáficas, se aislaron y evaluaron las comunidades de HMF, HSP-Fe y HSP-(Fe+Ca) durante 2008-2009. Empleando modelos basados en ecuaciones estructurales se encontró que el carbono orgánico se relacionó positivamente con la riqueza y abundancia de HMF (λ&gt;0.58) y fue variable en su relación con HSP-Fe y HSP- (Fe+Ca). Las relaciones del fósforo disponible, pH y las fracciones de macro-agregados fueron altamente variables. El IMPC se relacionó negativamente con HSP-Fe (λ≤-0.21) en cafetales colombianos. Se discuten las interacciones para cada conjunto de variables (químicas, estabilidad de macro-agregados y de manejo de plantación) y se explican las relaciones resultantes. Las relaciones de cada variable son inseparables del contexto edáfico y geográfico, los cuales imprimen marcadas diferencias

Bone metastases as the initial presentation of hepatocellular carcinoma. Two case reports and a literature review

Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver and is the fifth most common cancer in the world; its incidence has been increasing in recent years. Extrahepatic spread is present at the time of diagnosis in only about 5 to 15% of patients. Skeletal metastasis of HCC occurs less frequently compared with other cancers and is considered a rare primary form of presentation. We report two cases of unsuspected HCC presenting with multiple bone lesions as the initial presentation. The first patient was a 76-year-old man with symptoms of fatigue and back pain. The PET-CT revealed the hypercaptant bone lesions and a liver lesion. The pathology report showed that the metastases were positive for the hepatic marker HEPAR-1, indicating that they had originated from the HCC. The second patient was a 56-year-old man. He presented to the emergency department for right shoulder pain and weakness of the entire right arm with no history of trauma. During hospitalization, the patient became quadriplegic. MRI revealed osseous blastic lesions in the cervical vertebrae and right shoulder. A CT-guided biopsy was performed in the cervical lesion and showed poorly differentiated carcinoma. Immunohistochemistry staining was positive for HEPAR-1. In conclusion, this cases show an unusual presentation of HCC with skeletal metastasis