Manejo del cáncer cervicouterino en el hospital gineco—obstétrico enrique c. Sotomayor.

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Valores morales y convivencia escolar en estudiantes del sexto grado de primaria de la Institución Educativa San Martín de Porres

El presente trabajo de investigación titulado “Valores morales y convivencia escolar en vii los estudiantes del sexto grado de primaria de la Institución Educativa San Martín de Porres” tuvo como objetivo determinar la relación que existe entre las variables valores morales y convivencia escolar; para tal fin, se trabajó con una muestra de 30 estudiantes matriculados en el año escolar 2019, del sexto grado de primaria. Con respecto a la metodología empleada en la investigación, podemos decir que para establecer la relación entre dichas variables se utilizó el método inductivo – deductivo con el diseño correlacional tipo descriptivo; así como, los instrumentos de investigación denominados: Cuestionario sobre Práctica de Valores Morales y Cuestionario de Convivencia Escolar con un total de 24 ítems cada uno; además, el registro oficial de la sección que conformó la muestra para la recolección de la información. Los resultados del análisis de correlación indicaron que existe una relación estadística significativa entre las variables valores morales y convivencia escolar con un valor de 0,000 y con una correlación de Pearson positivo alto de un valor 0,707

Comorbidities at Diagnosis, Survival, and Cause of Death in Patients with Chronic Lymphocytic Leukemia: A Population-Based Study

Leucèmia limfocítica crònica; Comorbiditat; Causes de mortChronic lymphocytic leukemia; Comorbidity; Cause of deathLeucemia linfocítica crónica; Comorbilidad; Causas de muerteThis study aimed to examine the prevalence of comorbidities in patients diagnosed with chronic lymphocytic leukemia (CLL), and to assess its influence on survival and cause-specific mortality at a population-based level. Incident CLL cases diagnosed in the Girona province (Spain) during 2008-2016 were extracted from the Girona Cancer Registry. Rai stage and presence of comorbidities at diagnosis, further categorized using the Charlson comorbidity index (CCI), were obtained from clinical records. Observed (OS) and relative survival (RS) were estimated and Cox's proportional hazard models were used to explore the impact of comorbidity on mortality. Among the 400 cases included in the study, 380 (99.5%) presented at least one comorbidity at CLL diagnosis, with diabetes without end organ damage (21%) being the most common disease. 5-year OS and RS were 68.8 (95% CI: 64.4-73.6) and 99.5 (95% CI 3.13-106.0), respectively, which decreased markedly with increasing CCI, particularly in patients with CCI ≥ 3. Multivariate analysis identified no statistically significant association between the CCI and overall CLL-related or CLL-unrelated mortality. In conclusion, a high CCI score negatively influenced the OS and RS of CLL patients, yet its effect on mortality was statistically non-significant when also considering age and the Rai stage.We thank CERCA programme/Generalitat de Catalunya for institutional support. Thiswork was supported by Spanish Ministry of Economy and Competitiveness—Carlos III Instituteof Health co-funded by FEDER funds/European Regional Development Fund (ERDF)—A way tobuild Europe (PI11/02213, PI15/00966 and CIBERESP); and with the support of the Secretariat forUniversities and Research of the Ministry of Business and Knowledge of the Government of Catalonia(2017-SGR-733). IDIBGI is a member of the CERCA Programme, Generalitat de Catalunya

Efectos nutritivos del nostoc (cushuro) en los niños desnutridos de 1 a 3 años del distrito de Amarilis-2007

The study aimed to determine the effectiveness of nostoc sp in children 1 to 3 years Amarilis District 2007, province and department of Huanuco. The research was experimental and intervention, longitudinal and prospective, the sample is up to 20 children from 1 to 3 years, divided into two experimental groups and control. To collect information using a structured form, using tables Waterlow It assessed the nutritional status. The results were significant, complementary food based Nostoc improving the nutritional status of children and the value of calculated t statistic = 3.096, and the level of significance for our study was 0.05. Also worth noting that before the children of 1 years of age to 5% had mild and AFTER 5% of children in this age of nutritional status is normal. In children 2 years of age before 25% mild, and then in 15% of normal children of their nutritional status and 5% were overweight. In children 3 years old before the 20% were mild, and then in 15% of their nutritional status is normal.El estudio tuvo como objetivo determinar el grado de eficacia del nostoc sp en los niños de 1 a 3 años del Distrito de Amarilis 2007, provincia y departamento de Huánuco. La investigación fue tipo experimental o de intervención, longitudinal y prospectivo; la muestra lo conformaron 20 niños de 1 a 3 años, distribuidos en dos grupos experimental y control. Para la recolección de información se utilizó un formulario estructurado, tablas de Waterlow mediante ello se evaluó el estado nutricional. Los resultados logrados fueron significativos, la alimentación complementaria a base de nostoc mejora el estado nutricional de los niños, siendo el valor de t = 3,096 estadística calculada, y cuyo nivel de significancia para nuestro estudio fue de 0,05. Así mismo cabe resaltar que antes del estudio los niños de 1 año de edad presentaban el 5% de desnutrición leve y DESPUÉS en 5% de niños de esta edad su estado nutricional es normal. En los niños de 2 años de edad ANTES el 25% con desnutrición leve y DESPUÉS, en 15% de niños su estado nutricional normal y el 5% estaba en sobrepeso. En los niños de 3 años de edad ANTES el 20% presentaba desnutrición leve y DESPUÉS, en 15% su estado nutricional es normal

CD200 genotype is associated with clinical outcome of patients with multiple myeloma

Immune dysfunction in patients with MM affects both the innate and adaptive immune system. Molecules involved in the immune response pathways are essential to determine the ability of cancer cells to escape from the immune system surveillance. However, few data are available concerning the role of immune checkpoint molecules in predicting the myeloma control and immunological scape as mechanism of disease progression. We retrospectively analyzed the clinical impact of the CD200 genotype (rs1131199 and rs2272022) in 291 patients with newly diagnosed MM. Patients with a CD200 rs1131199 GG genotype showed a median overall survival (OS) significantly lower than those with CC+CG genotype (67.8 months versus 94.4 months respectively; p: 0.022) maintaining significance in the multivariate analysis. This effect was specially detected in patients not receiving an autologous stem cell transplant (auto-SCT) (p < 0.001). In these patients the rs1131199 GG genotype negatively influenced in the mortality not related with the progression of MM (p: 0.02) mainly due to infections events

Perfil epidemiológico y molecular de pacientes con cáncer de pulmón en un centro oncológico referencial de Lima, Perú.

Background: According to GLOBOCAN estimates, in 2020, lung cancer was the second most frequent cancer and epidemiological information is needed in Latin American countries. The objective was to describe the epidemiological and molecular characteristics of lung cancer patients from a referral clinic in Lima, Peru. Material and methods: A retrospective cohort study was conducted to characterize the epidemiological and molecular profile of lung cancer patients attended at a referral cancer center in Peru during 2018 to 2021. Variables such as age, sex, histology, staging and mutation were reported. In the descriptive analysis, frequencies and percentages were shown for categorical variables. For numerical variables, the best measure of central tendency and dispersion was reported. Results: A total of 225 patients with a diagnosis of lung cancer were observed. EGFR gene mutation was the most frequently detected (45.3%); and within them exon 19 deletion (55.7%). The most frequent histological type was adenocarcinoma with 180 patients (85.7%). Of the total number of patients with EGFR mutation, 77.8% received treatment with a tyrosine kinase inhibitor (osimertinib, erlotinib, afatinib) and 15.9% received immunotherapy (pembrolizumab, atezolizumab, nivolumab). Conclusions: The predominant mutation was EGFR, the most frequent histologic type was adenocarcinoma and most patients received treatment with a tyrosine kinase inhibitor.Introducción: Según estimaciones del GLOBOCAN, en 2020, el cáncer de pulmón fue el segundo más frecuente y se necesita información epidemiológica en países latinoamericanos. El objetivo fue describir las características epidemiológicas y moleculares de pacientes con cáncer de pulmón de una clínica referencial de Lima, Perú. Material y métodos: Se realizó un estudio cohorte retrospectiva para caracterizar el perfil epidemiológico y molecular de los pacientes con cáncer pulmón atendidos en un centro oncológico referencial del Perú durante 2018 al 2021. Se reportaron variables como edad, sexo, histología, estadiaje y mutación. En el análisis descriptivo, se mostraron frecuencias y porcentajes para las variables categóricas. En el caso de las variables numéricas, se reportó la mejor medida de tendencia central y de dispersión. Resultados: Se observó un total de 225 pacientes con diagnóstico de cáncer de pulmón. La mutación del gen EGFR fue la más frecuentemente detectada (45.3%); y dentro de ellas la deleción del exón 19 (55.7%). El tipo histológico más frecuente fue de Adenocarcinoma con 180 pacientes (85.7%). Del total de paciente con mutación en el EGFR, el 77.8% recibió tratamiento con algún inhibidor de tirosin kinasa (osimertinib, erlotinib, afatinib) y un 15.9% recibieron inmunoterapia (pembrolizumab, atezolizumab, nivolumab). Conclusiones: La mutación predominante fue el EGFR, el tipo histológico más frecuente fue el adenocarcinoma y la mayoría de pacientes recibió tratamiento con un inhibidor de tirosin kinasa

Effectiveness and safety of the bevacizumab and erlotinib combination versus erlotinib alone in EGFR mutant metastatic non-small-cell lung cancer: systematic review and meta-analysis

BackgroundThe EGFR gene encodes a protein that stimulates molecular pathways that allow the growth and development of the tumor microenvironment. The current preferred tyrosine kinase inhibitor (TKI) for the first-line treatment of EGFRm metastatic non-small cell lung cancer (NSCLC) is osimertinib. However, the combination of angiogenesis inhibitors and TKI has produced discordant results. We aimed to assess the effects of the bevacizumab and erlotinib combination in EGFRm metastatic NSCLC.MethodsUsing eligibility criteria focused on patients with EGFRm metastatic NSCLC treated with bevacizumab and erlotinib, we searched databases including clinical trial randomized studies and reviews published until April 15, 2023 in Medline (PubMed), Scopus, and Embase. Eight clinical trials (1,052 patients) were selected from 1,343 articles for quantitative and qualitative assessment. The risk of bias was assessed using the Cochrane Risk of Bias tool. Data were synthesized through random-effects meta-analysis.ResultsThe bevacizumab and erlotinib combination significantly improved the progression-free survival (PFS) (log(HR) = 0.63; 95% CI: 0.54–0.73, p &lt; 0.001) and overall response ratio (ORR) (RR = 0.79; 95% CI, 0.64–0.97, p = 0.03). However, it did not improve the overall survival (log(HR) = 0.93; 95% CI, 0.78–1.10, p = 0.38) and was associated with higher serious adverse events (SAEs) (OR = 3.48; 95% CI, 1.76–6.88, p = 0.005). A subgroup analysis suggested similar benefits in different mutation subtypes and brain metastasis condition. The evidence is limited by a moderate risk of bias across studies and heterogeneity in the reporting of SAEs.ConclusionsThe bevacizumab and erlotinib combination significantly improved PFS and ORR in EGFRm metastatic NSCLC but were also associated with higher-grade (≥3) adverse events. These results suggest that while the combination therapy may enhance progression-free survival and overall response, it does not improve the overall survival and is associated with higher toxicity. Thus, the treatment should be personalized based on individual patient comorbidities. Further prospective trials are needed to validate these results.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/#searchadvanced, identifier CDR 42022364692

Genetic variants of CTLA4 are associated with clinical outcome of patients with multiple myeloma

Immune dysfunction in patients with multiple myeloma (MM) affects both the innate and adaptive immune system. Molecules involved in the immune checkpoint pathways are essential to determine the ability of cancer cells to escape from the immune system surveillance. However, few data are available concerning the role of these molecules in predicting the kinetics of progression of MM. We retrospectively analysed polymorphisms of CTLA4 (rs231775 and rs733618), BTLA (rs9288953), CD28 (rs3116496), PD-1 (rs36084323 and rs11568821) and LAG-3 (rs870849) genes in 239 patients with newly diagnosed MM. Patients with a CTLA4 rs231775 AA/AG genotype showed a median progression-free survival (PFS) significantly lower than those with GG genotype (32.3 months versus 96.8 months respectively; p: 0.008). The 5-year PFS rate was 25% for patients with grouped AA and AG genotype vs 55.4% for patients with GG genotype. Multivariate analysis confirmed the CTLA4 rs231775 genotype as an independent risk factor for PFS (Hazard Ratio (HR): 2.05; 95% CI: 1.0-6.2; p: 0.047). Our results suggest that the CTLA4 genotype may identify patients with earlier progression of MM. This polymorphism could potentially be used as a prognostic biomarker

Rents, knowledge and neo-structuralism: transforming the productive matrix in Ecuador

This paper explores the relationship between ground rent, production and knowledge in Ecuador’s neo-structuralist, state-led project to transform the productive matrix. Based upon insights from the Marxian approach to the critique of political economy, we interrogate how neo-structuralism has conceptualised the relationship between ‘natural resource income’ and ‘knowledge-based’ economic development. The paper argues that a rent-theoretical perspective, which takes seriously the regional unfolding of uneven geographical development in Latin America, can highlight the limits of a national development plan conceived according to the logic of Schumpeterian efficiency. In doing so, the paper identifies the contradictory relationship between natural resource exports, state-led ‘knowledge’-based development and capital accumulation. On this basis the paper offers a historically and empirically informed critical analysis of selective import substitution industrialisation and vanguard science and technology strategies designed to transition Ecuador away from primary resource dependence