Family History of Breast and Colorectal Cancer in a Population-Based Cohort in two cities of Argentina

INTRODUCCIÓN: Los cánceres de mama (CM) y colorrectal (CCR) presentan una elevada carga de enfermedad en Argentina, por lo que el estudio de la epidemiología de estos tumores constituye una prioridad en salud pública. El objetivo del presente trabajo fue describir la prevalencia de antecedentes familiares de CM y CCR, y estimar la incidencia de los tumores en adultos de 35 a 74 años de dos ciudades de Argentina: Bariloche y Marcos Paz. MÉTODOS: En el marco de la cohorte prospectiva de población general CESCAS I (Estudio de detección y seguimiento de enfermedad cardiovascular y factores de riesgo en el Cono Sur de Latinoamérica), se recolectó información individual sobre antecedentes familiares de CM y CCR en una muestra representativa de las ciudades de Bariloche y Marcos Paz. Los casos de cáncer fueron investigados mediante documentación médica respaldatoria. RESULTADOS: Durante 2016-2017 se obtuvo información de 3245 participantes. El 8,4% de la población reportó antecedente familiar de CCR, y el 15,2% de las mujeres, de CM. La incidencia anual para el período 2011-2017 fue de 55,2/100 000 mujeres de 35 a 74 años (IC95%: 22,8-133,7) para CM y 38,5/100 000 adultos de 35 a 74 años (IC95%: 15,3-96,8) para CCR. CONCLUSIONES: Además de garantizar el acceso universal a los programas de tamizaje, se debe tener en cuenta la importancia de indagar sobre los antecedentes familiares de cáncer para identificar pacientes con riesgo aumentado, que requieren algoritmos particulares de detección temprana y vigilancia.INTRODUCTION: Breast cancer (BC) and colorectal cancer (CRC) both present a high burden of disease in Argentina. Hence, studying the epidemiology of these tumors constitutes a public health priority. The objective of this study was to describe the prevalence of family history of BC and CRC and to estimate the incidence of these tumors in adults aged between 35 and 74 years from two cities in Argentina: Bariloche and Marcos Paz. METHODS: As part of the prospective population-based cohort CESCAS I (Study of detection and monitoring of cardiovascular disease and risk factors in the Southern Cone of Latin America), individual information on family history of BC and CRC was collected from a representative sample of the cities of Bariloche and Marcos Paz. Cancer cases were investigated using supporting medical documentation. RESULTS: During 2016- 2017, information from 3245 participants was obtained. Family history of CRC was reported by 8.4% of the population, and 15.2% of women reported a family history of BC. The annual incidence for the 2011-2017 period was 55.2/100 000 women aged 35 to 74 years (95%CI: 22.8-133.7) for BC and 38.5/100 000 adults aged 35 to 74 years (95%CI: 15.3-96.8) for CRC.CONCLUSIONS: Besides guaranteeing universal access to screening programs, it is important to evaluate family history of cancer to identify patients with increased risk, who require specific early detection and surveillance algorithmsFil: Melendi, Santiago Ezequiel. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Chaparro, Raul Martin. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: González, Lucas Ángel Damián. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Gutiérrez, Laura. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Calandrelli, Matías Enrique. Sanatorio San Carlos, Bariloche; ArgentinaFil: Mores, Nora Cecilia. Municipalidad de Marcos Paz (buenos Aires).; ArgentinaFil: Elorriaga, Natalia. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Poggio, Rosana. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Irazola, Vilma. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Childhood acute leukemias are frequent in Mexico City: descriptive epidemiology

<p>Abstract</p> <p>Background</p> <p>Worldwide, acute leukemia is the most common type of childhood cancer. It is particularly common in the Hispanic populations residing in the United States, Costa Rica, and Mexico City. The objective of this study was to determine the incidence of acute leukemia in children who were diagnosed and treated in public hospitals in Mexico City.</p> <p>Methods</p> <p>Included in this study were those children, under 15 years of age and residents of Mexico City, who were diagnosed in 2006 and 2007 with leukemia, as determined by using the International Classification of Childhood Cancer. The average annual incidence rates (AAIR), and the standardized average annual incidence rates (SAAIR) per million children were calculated. We calculated crude, age- and sex-specific incidence rates and adjusted for age by the direct method with the world population as standard. We determined if there were a correlation between the incidence of acute leukemias in the various boroughs of Mexico City and either the number of agricultural hectares, the average number of persons per household, or the municipal human development index for Mexico (used as a reference of socio-economic level).</p> <p>Results</p> <p>Although a total of 610 new cases of leukemia were registered during 2006-2007, only 228 fit the criteria for inclusion in this study. The overall SAAIR was 57.6 per million children (95% CI, 46.9-68.3); acute lymphoblastic leukemia (ALL) was the most frequent type of leukemia, constituting 85.1% of the cases (SAAIR: 49.5 per million), followed by acute myeloblastic leukemia at 12.3% (SAAIR: 6.9 per million), and chronic myeloid leukemia at 1.7% (SAAIR: 0.9 per million). The 1-4 years age group had the highest SAAIR for ALL (77.7 per million). For cases of ALL, 73.2% had precursor B-cell immunophenotype (SAAIR: 35.8 per million) and 12.4% had T-cell immunophenotype (SAAIR 6.3 per million). The peak ages for ALL were 2-6 years and 8-10 years. More than half the children (58.8%) were classified as high risk. There was a positive correlation between the average number of persons per household and the incidence of the pre-B immunophenotype (Pearson's r, 0.789; P = 0.02).</p> <p>Conclusions</p> <p>The frequency of ALL in Mexico City is among the highest in the world, similar to those found for Hispanics in the United States and in Costa Rica.</p

The Lipopolysaccharide Core of Brucella abortus Acts as a Shield Against Innate Immunity Recognition

Innate immunity recognizes bacterial molecules bearing pathogen-associated molecular patterns to launch inflammatory responses leading to the activation of adaptive immunity. However, the lipopolysaccharide (LPS) of the gram-negative bacterium Brucella lacks a marked pathogen-associated molecular pattern, and it has been postulated that this delays the development of immunity, creating a gap that is critical for the bacterium to reach the intracellular replicative niche. We found that a B. abortus mutant in the wadC gene displayed a disrupted LPS core while keeping both the LPS O-polysaccharide and lipid A. In mice, the wadC mutant induced proinflammatory responses and was attenuated. In addition, it was sensitive to killing by non-immune serum and bactericidal peptides and did not multiply in dendritic cells being targeted to lysosomal compartments. In contrast to wild type B. abortus, the wadC mutant induced dendritic cell maturation and secretion of pro-inflammatory cytokines. All these properties were reproduced by the wadC mutant purified LPS in a TLR4-dependent manner. Moreover, the core-mutated LPS displayed an increased binding to MD-2, the TLR4 co-receptor leading to subsequent increase in intracellular signaling. Here we show that Brucella escapes recognition in early stages of infection by expressing a shield against recognition by innate immunity in its LPS core and identify a novel virulence mechanism in intracellular pathogenic gram-negative bacteria. These results also encourage for an improvement in the generation of novel bacterial vaccines

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Impact of the scientific production of the Top 15 universities in Colombia

Colombia ranks fifth in Latin America in scientific production, with a contribution of 0.24% of its GDP to research and development in 2019, much lower than the 0.71% of the Latin American average. Even so, this country has stood out in the last decade for the increase in its scientific production and improvements in its international positioning. The universities corresponding to the Top15 of the SIR2020 ranking are analyzed, using four scientometric indicators compiled from the SirIber 2020 report. There is a high correlation between International Collaboration (IC), Normalized Impact (NI), and High-quality publication (Q1). The Universidad Nacional de Colombia, Universidad de Antioquia, Universidad de Los Andes, and Pontificia Universidad Javeriana together account for 63% of the country's scientific production

Manejo de la cadena aséptica del instrumental utilizado en los tratamientos de endodoncia, evaluado por medio del indicador de proceso en las Clínicas Multidisciplinarias de la Facultad de Odontología de la UNAN-León en el período comprendido ...

Tesis (Dr. Cirujano Dentista)-Universidad Nacional Autónoma de Nicaragua, LeónUNAN-Leó

Competencia para cuidar en el hogar de personas con enfermedad crónica y sus cuidadores en Colombia

Antecedentes. La competencia para el cuidado en el hogar es parte de las características fundamentales requeridas en la atención de personas con enfermedad crónica y se describe como la capacidad, habilidad y preparación que tiene el usuario o su cuidador familiar para ejercer la labor de cuidar.  Objetivo. Describir y comparar la competencia para cuidar en el hogar de personas con enfermedad crónica, así como la competencia de sus cuidadores familiares para atenderlas en el hogar. Materiales y métodos. Estudio cuantitativo, descriptivo, comparativo y de corte transversal desarrollado entre 2012 y 2014 en las cinco regiones geográficas de Colombia. La muestra está compuesta de 2231 personas con enfermedad crónica y cuidadores familiares. Se emplearon los instrumentos Encuesta de caracterización para el cuidado de una diada persona con enfermedad crónica-cuidador familiar y Competencia para cuidar en el hogar GCPC-UN-CPC, versión paciente y cuidador familiar.  Del mismo modo, se utilizó estadística descriptiva para analizar la competencia para cuidar en el hogar y sus dimensiones a partir de los niveles de estratificación alto, medio y bajo; para la comparación se utilizaron pruebas no paramétricas en muestras independientes.  Resultados. Tanto las personas con enfermedad crónica como los cuidadores familiares tienen niveles heterogéneos de competencia para cuidar en el hogar en las diferentes regiones del país. En ambos casos los niveles superiores se encuentran en la Región Amazónica y los más bajos en la Pacífica. Estos niveles de competencia para cuidar en el hogar distan de ser adecuados para garantizar la calidad y seguridad que se requiere.  Conclusión. Los indicadores de cuidado continuo deben tener en cuenta la diada receptor-cuidador familiar y abordar el talento humano, las instituciones y al mismo sistema general de seguridad social en salud para modificar una realidad que, de no ser atendida, resultará agobiante para el país

Competence for Home Health Care in Colombian People with Chronic Ilness and their Caregivers

Antecedentes. La competencia para el cuidado en el hogar es parte de las características fundamentales requeridas en la atención de personas con enfermedad crónica y se describe como la capacidad, habilidad y preparación que tiene el usuario o su cuidador familiar para ejercer la labor de cuidar. Objetivo. Describir y comparar la competencia para cuidar en el hogar de personas con enfermedad crónica, así como la competencia de sus cuidadores familiares para atenderlas en el hogar. Materiales y métodos. Estudio cuantitativo, descriptivo, comparativo y de corte transversal desarrollado entre 2012 y 2014 en las cinco regiones geográficas de Colombia. La muestra está compuesta de 2231 personas con enfermedad crónica y cuidadores familiares. Se emplearon los instrumentos Encuesta de caracterización para el cuidado de una diada persona con enfermedad crónica-cuidador familiar y Competencia para cuidar en el hogar GCPC-UN-CPC, versión paciente y cuidador familiar. Del mismo modo, se utilizó estadística descriptiva para analizar la competencia para cuidar en el hogar y sus dimensiones a partir de los niveles de estratificación alto, medio y bajo; para la comparación se utilizaron pruebas no paramétricas en muestras independientes. Resultados. Tanto las personas con enfermedad crónica como los cuidadores familiares tienen niveles heterogéneos de competencia para cuidar en el hogar en las diferentes regiones del país. En ambos casos los niveles superiores se encuentran en la Región Amazónica y los más bajos en la Pacífica. Estos niveles de competencia para cuidar en el hogar distan de ser adecuados para garantizar la calidad y seguridad que se requiere. Conclusión. Los indicadores de cuidado continuo deben tener en cuenta la diada receptor-cuidador familiar y abordar el talento humano, las instituciones y al mismo sistema general de seguridad social en salud para modificar una realidad que, de no ser atendida, resultará agobiante para el país.Background. The competence for home health care is part of the fundamental features required when taking care of people with chronic disease. It is described as the ability, the skill and the preparation the user or their family caregiver possesses in order to perform the work of caring. Objective. To describe and compare the competence for home health care in Colombian people with chronic illness and their family caregivers in the different regions of Colombia. Materials and Methods. Quantitative, descriptive, comparative and cross-sectional study conducted between 2012 and 2014 in the five geographical regions of Colombia. The sample consists of 2231 participants including people with chronic illness and family caregivers. The measurement instruments used were the Survey for the characterization of the caring Dyad patient - family caregiver GCPC-UN-D, and the Home health care competence instrument “GCPCUN-CPC”, both in its patient and family caregiver versions. Descriptive statistics were used to analyze the home health care competence. For comparison of the groups nonparametric tests for independent samples were used. Results. People with chronic illness and their family caregivers have heterogeneous levels of home health caring competence in the different regions of Colombia. In both cases the higher levels are found in the Amazon region, while the lowest are found in the Pacific region. These levels of home health care competence are far away from the required ones to ensure quality and safety in the care of these patients. Conclusion. The indicators for the evaluation of home health care competence must address patients and their family caregiver as well as the health human talent, health institutions and the Social Security System in order to understand in a better way and change the current vulnerability in home health care practices in the country