Estudio prospectivo orientado al diagnóstico y evaluación clínico-terapéutica en hepatitis B

Teniendo en cuenta la alta incidencia mundial de carcinoma hepatocelular y hepatitis crónica, es de primordial importancia, el conocimiento del comportamiento de estas patologías en nuestro país, por lo tanto hemos programado un estudio internacional y multicéntrico, entre investigadores cubanos y colombianos, el cual daremos a conocer a continuación en este número de Biomédica dedicado a hepatitis viral tipo B

Inmunogenicidad de la vacuna cubana recombitante contra HVB, en niños de 1 a 10 años

We evaluated the immunogenecity of the recombinant HBV Cuban vaccine, utilising the 012 months scheme in children between 1 to 10 years of age. Whith the second dose, 98% of after the vaccinated children developed seroprotection (values 210 IU/l) and after the third dose (75 days), 100% had antibody levels > 100 IU/l.Evaluamos la inmunogenicidad de la vacuna cubana recombinane contra la HBV aplicando el esquema 012 meses, en niños de 1 a 10 años, encontrándose que con la segunda dosis el 98% tienen seroprotección (valores 10 Ul/l) y después de la tercera dosis (75 días) el 100% de los vacunados tienen niveles de anticuerpos 100 Ul/l

Resultados al primer año de aplicada la vacuna recombinante cubana antiHVB en esquemas 012 y 016 meses

An immunoassay analysis of the seroprotection achieved one year after vaccination with the Cuban recombinant vaccine anti-VHB, revealed immunogenicity in 100% ofthose vaccinated with the schemes 012 and 016 months and reached values 100 lU/l in 97% for both schemes. The geometrical media showed a significan reductiion with the 016 scheme but not with the 012 scheme. Consequently, we propose the use of the levels 012 scheme because of its short latency, simmety and stability of the levels anti-HBs stability antibody.Los resultados obtenidos por el método inmunoenzimático cuantitativo de Abbott al primer año de completados los esquemas 012 y 016 meses, con la vacuna recombinante cubana contra la hepatitis viral B, muestran la inmunogenicidad en los vacunados con los dos esquemas, viéndose que el 100% tienen seroprotección y el 97% de estos tienen valores 100 Ul/l para ambos esquemas. En cuanto a los valores de las medias geométricas, observamos que no se evidencian disminuciones significativas con el esquema 012, pero sí con el esquema 016, por lo cual sugerimos el uso del esquema 012, debido a su corta latencia, simetría y estabilidad de los valores de anticuerpos anti-HBs

Estudio de inmunogenicidad para dos vacunas recombinantes contra hepatitis B

This study compares the immunogenicity (seroconversion, seroprotection and hiperesponse) produced by two hepatitis B recombinant vaccines (Engerix- B Belge and Cuban). For this purpose two sketches were used (012 and 016 months). The anti-HBs quantification was performed by using Abbott and Organon methods in order to compare its results. In the study 257 volunteers were distributed in four groups to the hapazard (two vaccines and two sketches). Results: the Abbott and Organon methods did not show any statistically significant difference. The Cuban vaccine shows greater immunogenous response for two doses and 012 sketch. There are no differences between sketch 012 and 016 with the Cuban vaccine. The scheme 016 did not show statistically significant difference for the Engerix-B Belge vaccine. The last mentioned vaccine showed to be better with the 016 scheme.Este estudio compara la inmunogenicidad (seroconversión, seroprotección e Hiperrespuesta), producida por dos vacunas recombinantes contra la hepatitis B (Engerix-B de Bélgica y Cubana), en dos esquemas (012 y 016 meses), empleando los métodos de cuantificación para Anti-HBsAg (Abbott y Organón), los cuales fueron también comparados. En el estudio participaron 257 voluntarios,  divididos al azar en 4 grupos (dos vacunas, dos esquemas). Resultados: los dos métodos de Abbon y Organon, no presentan diferencias estadísticas significativas. La vacuna cubana muestra una mayor respuesta inmunogénica para dos dosis de vacuna y para el esquema 012. No hay diferencia entre los esquemas 012 y 016 y en el esquema 016 no se ven diferencias estadísticamente significativas con la vacuna Engerix-B. En esta Última el esquema 016 muestra mejores resultados que el 012

First Colombian Multicentric Newborn Screening for Congenital Toxoplasmosis

Congenital toxoplasmosis can result in permanent sequel as blindness or neurological damage in children and it seems to be more severe in South America than in other continents. There is a lack of information about this frequency in Colombia, where no control program is established, although it is a recognized cause of potentially preventable congenital blindness. We propose the first Colombian multicentric study to determine the frequency and impact of congenital toxoplasmosis. More than 15,000 newborns in seven cities were studied. Newborns were tested at birth by doing a cord blood test for toxoplasmosis. Additionally, children from mothers with history of toxoplasmosis acquired during pregnancy were recalled for a follow-up. The program identified fifteen children otherwise undiagnosed; three of these children died as consequence of congenital toxoplasmosis. The frequency of the congenital infection varied significantly between cities, being higher in Armenia and Florencia, intermediate in Bogota, Bucaramanga and Barranquilla and very low in western cities such as Cucuta and Riohacha. For the first time a significant correlation was found between mean rainfall at the city and the incidence of this congenital infection

Update of the PANCCO clinical practice guidelines for the treatment of ulcerative colitis in the adult population

Ulcerative colitis (US) is a chronic disease of unknown etiology. It is incurable and its clinical course is intermittent, characterized by periods of remission and relapse. The prevalence and incidence of the disease has been increasing worldwide. The update presented herein includes the participation of healthcare professionals, decision-makers, and a representative of the patients, all of whom declared their conflicts of interest. Answerable clinical questions were formulated, and the outcomes were graded. The information search was conducted on the Medline/PubMed, Embase, Epistemonikos, and LILACS databases, and covered grey literature sources, as well. The search was updated on November 30, 2020, with no restrictions regarding date or language. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification system was implemented to establish the strength of the recommendation and quality of evidence. A formal consensus was developed, based on the RAND/UCLA methodology and the document was peer reviewed. The short version of the Clinical Practice Guidelines for the Treatment of Ulcerative Colitis in the Adult Population is presented herein, together with the supporting evidence and respective recommendations. In mild-to-moderate UC, budesonide MMX is an option when treatment with 5-ASA fails, and before using systemic steroids. In moderate-to-severe UC, infliximab, adalimumab, vedolizumab, ustekinumab, and tofacitinib can be used as first-line therapy. If there is anti-TNF therapy failure, ustekinumab and tofacitinib provide the best results. In patients with antibiotic-refractory pouchitis, anti-TNFs are the treatment of choice

Nonoperative Approaches to Rectal Cancer: A Critical Evaluation

A neoadjuvant multimodality approach with chemoradiation therapy (CRT) is the preferred treatment strategy for most distal rectal cancers. Significant downstaging and complete pathologic response may develop after this strategy, and there is still controversy regarding the management of these patients. In this setting, a nonoperative approach has been suggested in select patients with complete clinical response after thorough clinical, endoscopic, and radiologic assessment. However, the assessment of these patients is not straightforward and remains complex. Available data regarding this approach are limited to a single institution`s experience from retrospective analyses. Standardization of the assessment of tumor response and the development of radiological/molecular tools may clarify the role of no immediate surgery in patients with complete clinical response after neoadjuvant CRT. Advances in radiation and medical oncology could potentially lead to significant improvements in complete tumor regression rates, leading to an increase in importance of a minimally invasive approach in patients with rectal cancer. Semin Radiat Oncol 21:234-239 (C) 2011 Elsevier Inc. All rights reserved

The need for effective radiosentitizing agents: experience in patients with complete pathological response

Chemoradiation therapy is now considered the preferred initial treatment strategy for distal rectal cancer because of the observation of better local disease control and significant tumor downstaging. Downstaging has become an important clinical outcome as patients with complete pathological response are associated with improved survival. Even though radiation alone may result in low local recurrence rates, the use of additional radiosensitizing agents may provide an increase in local disease control in addition to improved tumor regression rates. Several compounds have been investigated in the setting of neoadjuvant multimodality treatment of rectal cancer with variable rates of treatment-related toxicity and complete pathological response. The balance between complete pathological response and toxicity should aid in the management decision for the use of radiosensitizing agents in the neoadjuvant setting for the treatment of rectal cancer. Anti-Cancer Drugs 22: 308-310 (C) 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

A prospective evaluation of Dignity Therapy in advanced cancer patients admitted to palliative care

Background: Dignity Therapy is a brief, psychosocial intervention for patients with incurable disease. Aim: To investigate participation in and evaluation of Dignity Therapy and longitudinal changes in patient-rated outcomes. Design: A prospective (pre/post) evaluation design was employed. Evaluation questionnaires were completed when patients received the generativity document (T1) and 2 weeks later (T2). Changes from baseline (T0) were measured in sense of dignity, Structured Interview for Symptoms and Concerns items, Patient Dignity Inventory, Hospital Anxiety and Depression Scale and European Organisation for Research and Treatment of Cancer QLQ-C15-PAL (ClinicalTrials.gov number: NCT01507571). Setting/participants: Consecutive patients with incurable cancer, =18 years, informed of prognosis and not having cognitive impairment/physical limitations precluding participation were included at a hospice and a hospital palliative medicine unit. Results: Over 2 years, 80 of 341 eligible patients completed Dignity Therapy. At T1, 55 patients completed evaluations, of whom 73%-89% found Dignity Therapy helpful, satisfactory and of help to relatives; 47%-56% reported that it heightened their sense of purpose, dignity and will to live. Quality of life decreased (mean = -9 (95% confidence interval: -14.54; -2.49)) and depression increased (mean = 0.31 (0.06; 0.57)) on one of several depression measures. At T2 (n = 31), sense of dignity (mean = -0.52 (-1.01; -0.02)) and sense of being a burden to others (mean = -0.26 (-0.49; -0.02)) improved. Patients with children and lower performance status, emotional functioning and quality of life were more likely to report benefit. Conclusions: This study adds to the growing body of evidence supporting Dignity Therapy as a valuable intervention in palliative care; a substantial subset of patients facing end of life found it manageable, relevant and beneficial