Evaluation of factors leading to poor outcomes for pediatric acute lymphoblastic leukemia in Mexico: a multi-institutional report of 2,116 patients

Background and aimsPediatric acute lymphoblastic leukemia (ALL) survival rates in low- and middle-income countries are lower due to deficiencies in multilevel factors, including access to timely diagnosis, risk-stratified therapy, and comprehensive supportive care. This retrospective study aimed to analyze outcomes for pediatric ALL at 16 centers in Mexico.MethodsPatients <18 years of age with newly diagnosed B- and T-cell ALL treated between January 2011 and December 2019 were included. Clinical and biological characteristics and their association with outcomes were examined.ResultsOverall, 2,116 patients with a median age of 6.3 years were included. B-cell immunophenotype was identified in 1,889 (89.3%) patients. The median white blood cells at diagnosis were 11.2.5 × 103/mm3. CNS-1 status was reported in 1,810 (85.5%), CNS-2 in 67 (3.2%), and CNS-3 in 61 (2.9%). A total of 1,488 patients (70.4%) were classified as high-risk at diagnosis. However, in 52.5% (991/1,889) of patients with B-cell ALL, the reported risk group did not match the calculated risk group allocation based on National Cancer Institute (NCI) criteria. Fluorescence in situ hybridization (FISH) and PCR tests were performed for 407 (19.2%) and 736 (34.8%) patients, respectively. Minimal residual disease (MRD) during induction was performed in 1,158 patients (54.7%). The median follow-up was 3.7 years. During induction, 191 patients died (9.1%), and 45 patients (2.1%) experienced induction failure. A total of 365 deaths (17.3%) occurred, including 174 deaths after remission. Six percent (176) of patients abandoned treatment. The 5-year event-free survival (EFS) was 58.9% ± 1.7% for B-cell ALL and 47.4% ± 5.9% for T-cell ALL, while the 5-year overall survival (OS) was 67.5% ± 1.6% for B-cell ALL and 54.3% ± 0.6% for T-cell ALL. The 5-year cumulative incidence of central nervous system (CNS) relapse was 5.5% ± 0.6%. For the whole cohort, significantly higher outcomes were seen for patients aged 1–10 years, with DNA index >0.9, with hyperdiploid ALL, and without substantial treatment modifications. In multivariable analyses, age and Day 15 MRD continued to have a significant effect on EFS.ConclusionOutcomes in this multi-institutional cohort describe poor outcomes, influenced by incomplete and inconsistent risk stratification, early toxic death, high on-treatment mortality, and high CNS relapse rate. Adopting comprehensive risk-stratification strategies, evidence-informed de-intensification for favorable-risk patients and optimized supportive care could improve outcomes

Phenotypic characteristics of isolates of Aspergillus section Fumigati from different geographic origins and their relationships with genotypic characteristics

BACKGROUND: Epidemiological studies worldwide have shown that A. fumigatus exhibits important phenotypic and genotypic diversity, and these findings have been of great importance in improving the diagnosis and treatment of diseases caused by this fungus. However, few studies have been carried out related to the epidemiology of this fungus in Latin America. This study's aim is to report on the epidemiology of the fungus by analyzing the phenotypic variability of Aspergillus section Fumigati isolates from different Latin American countries and the relationship between this variability, the geographical origin and genotypic characteristics. METHODS: We analyzed the phenotypic characteristics (macro- and micromorphology, conidial size, vesicles size, antifungal susceptibility and thermotolerance at 28, 37 and 48°C) of A. section Fumigati isolates from Mexico (MX), Argentina (AR), Peru (PE) and France (FR). The results were analyzed using analysis of variance (ANOVA) and Tukey's multiple comparison test to detect significant differences. Two dendrograms among isolates were obtained with UPGMA using the Euclidean distance index. One was drawn for phenotypic data, and the other for phenotypic and genotypic data. A PCoA was done for shown isolates in a space of reduced dimensionality. In order to determine the degree of association between the phenotypic and genotypic characteristics AFLP, we calculated the correlation between parwise Euclidean distance matrices of both data sets with the nonparametric Mantel test. RESULTS: No variability was found in the macromorphology of the studied isolates; however, the micromorphology and growth rate showed that the PE isolates grew at a faster rate and exhibited the widest vesicles in comparison to the isolates from MX, AR and FR. The dendrogram constructed with phenotypic data showed three distinct groups. The group I and II were formed with isolates from PE and FR, respectively, while group III was formed with isolates from MX and AR. The dendrogram with phenotypic and genotypic data showed the same cluster, except for an isolate from FR that formed a separate cluster. This cluster was confirmed using PCoA. The correlation between the phenotypic and genotypic data of the isolates revealed a statistically significant association between these characteristics. CONCLUSIONS: The PE isolates showed specific phenotypic characteristics that clearly differentiate them from the rest of the isolates, which matches the genotypic data. The correlation between the phenotypic and genotypic characteristics showed a statistically significant association. In conclusion, phenotypic and genotypic methods together increase the power of correlation between isolates.The data presented here are part of the doctoral thesis of MGFDL (Programa de Posgrado en Ciencias Biológicas, Facultad de Ciencias, UNAM) who has a fellowship from CONACyT (Grant 172552). This research was supported by Instituto de Ciencia y Tecnología del Distrito Federal (ICyTDF). PIFUTP08-122 and Dirección General de Asuntos del Personal Académico (DGAPA) DGAPA-UNAM-IN224706-3.S

La prohexadiona-ca aumenta rendimiento y contenido de antioxidantes en vid cultivar shiraz

Abstract: In recent years the grapevine planting surface has grown worldwide. In Mexico, the improvement in production systems on this crop is of a significant interest; in particular, when increment on yield is followed by higher antioxidant content in berries. Prohexadione-Ca (P-Ca) is a growth retardant which increases yield and fruit quality. P-Ca was applied in 2014 to a vineyard plot growing the cultivar Shiraz. The hormone was sprayed in two occasions with the following treatments: 0 (water-control), 100, 200 and 300 mg L-1. The first application was conducted at full bloom; whereas the second took place two weeks later. At harvest; size, weight and fruit quality; yield; weight and number of raquis were evaluated. Yield per plant increased in most P-Ca treatments; where, the dosage at 300 mg L-1 increased 53 %. The fruit quality analysis showed that P-Ca sprayed twice at 300 mg L-1 increased 42 % the content of total polifenols. P-Ca at 200 mg L-1 in two applications caused an increment of 68% in total anthocyanins; whereas the content of procyanidins substantially increased with the growth retardant; in particular at 300 mg L-1 which caused an increment of 98 % in comparison to fruit controls.Resumen: El cultivo de vid se ha expandido a nivel mundial en años recientes. En México, el interés por mejorar los sistemas de producción en esta especie es significativo. En particular, cuando además de aumentar el rendimiento se mejora la calidad del fruto al incrementar su contenido de antioxidantes. El retardante de crecimiento prohexadiona Ca (P-Ca) mejora la producción y calidad de frutos. Se aplicó P- Ca a un viñedo del cultivar Shiraz durante el ciclo 2014. Se aplicaron los siguientes tratamientos: 0 (agua-testigo), 100, 200 y 300 mg L-1 de la hormona P-Ca, por medio de la asperción en dos ocasiones. La primera se realizó en oración y la segunda, dos semanas después. Durante la cosecha, se evaluaron peso, tamaño y calidad de fruto; rendimiento; así como número y peso de racimos. El rendimiento por planta fue superior en la mayoría de los tratamientos con P-Ca; en donde, la dosis con 300 mg L-1 aumentó en un 53%. Los análisis químicos del fruto mostraron que la P-Ca a 300 mg L-1 aplicado en dos ocasiones aumentó un 42% el contenido de polifenoles totales. El contenido de antocianinas se incrementó en un 68% con P-Ca a 200 mg L-1; en tanto que los niveles de procianidinas totales reflejaron incrementos substanciales con P-Ca destacando el tratamiento con 300 mg L-1 que aumentó un 98% el contenido de procianidinas en comparación con el testigo

Multidrug-Resistant Bacteria Isolated from Surface Water in Bassaseachic Falls National Park, Mexico

Bacterial pathogens are a leading cause of waterborne disease, and may result in gastrointestinal outbreaks worldwide. Inhabitants of the Bassaseachic Falls National Park in Chihuahua, Mexico show seasonal gastroenteritis problems. This aim of this study was to detect enteropathogenic microorganisms responsible for diarrheal outbreaks in this area. In 2013, 49 surface water samples from 13 selected sampling sites along the Basaseachi waterfall and its main rivers, were collected during the spring, summer, autumn, and winter seasons. Fecal and total coliform counts were determined using standard methods; the AutoScan-4 system was used for identification of isolates and the antibiotic resistance profile by challenging each organism using 21 antibiotics. Significant differences among seasons were detected, where autumn samples resulted in the highest total (p < 0.05) and fecal (p < 0.001) coliform counts, whereas the lowest total coliform counts were recorded in spring. Significant differences between sampling sites were observed, where samples from sites 6, 8, and 11 had the highest total coliform counts (p < 0.009), whereas samples from site 9 exhibited the lowest one. From the microbiological analysis, 33 bacterial isolates from 13 different sites and four sampling seasons were selected; 53% of isolates were resistant to at least one antibiotic, and 15% exhibited a multidrug resistance (MDB) phenotype. MDB were identified as Klebsiella oxytoca (two out of four identified isolates), Escherichia coli (2/7), and Enterobacter cloacae (1/3). In addition, some water-borne microorganisms exhibited resistance to cefazoline, cefuroxime, ampicillin, and ampicillin-sulbactam. The presence of these microorganisms near rural settlements suggests that wastewater is the contamination source, providing one possible transmission mechanism for diarrheal outbreaks

Effect of an educational intervention to promote intradialysis aerobic exercises on the functional state of hemodialysis patients from Mexico

Introduction: Health education search to influence on persons’ attitude for to improve your health by mean of healthy habits promotion. In patients with hemodialysis your functional capacity usually is diminished for physical inactivity. Objective: To evaluate the effect of a health education intervention for aerobic exercise’s promotion on the functional capacity in hemodialysis patients from Mexico. Methods: Quasi-experimental study beforeafter with control group in Hospital Medical Care Units of the Mexican Institute of Social Security, Jalisco’s Delegation, with a universe of 26 patients with hemodialysis purposively sampled, 14 in Group “A” (experimental) and 12 in Group “B” (control). It included variables: age, gender and functional capacity. The intervention consisted of directed dialogue on biopsychosocial factors of renal disease, functional capacity and nutrition, with accompaniment in aerobic exercises of 30 minutes/week for 20 weeks. It evaluated functional capacity with Delta Test and it compared means before and after with Student’s T (p ≤ 0,05). Results: There were no statistically significant differences between age and gender of patients in the “A” and “B” Groups. Mean functional capacity before and after: Group “A” 14 ± 5 vs 8 ± 4 (p < 0,001), Group “B” 16 ± 4 vs 17 ± 5 (p = 0,405). Conclusions: The health education influenced favorably on the physical activity of patients with hemodialysis and improved your functional capacity. To implement aerobic exercise programs during hemodialysis sessions it advisable

Phase Angle and Nutritional Status: The Impact on Survival and Health-Related Quality of Life in Locally Advanced Uterine Cervical Cancer

The phase angle, an indicator of muscle mass status and membrane cell integrity, has been associated with low survival, poorer clinical outcomes, and worse quality of life among cancer patients, but information on women with uterine cervical cancer (UCCa) is scarce. In this prospective study, we used a bioelectrical impedance analyzer to obtain the PA of 65 women with UCCa. We compared the health-related quality of life and inflammatory and nutritional indicators between low PA and normal PA. The mean age was 52 ± 13. The low PA and normal PA groups differed in terms of the C-reactive protein (15.8 ± 19.6 versus 6.82 ± 5.02, p = 0.022), glucose (125.39 ± 88.19 versus 88.78 ± 23.08, p = 0.021), albumin (3.9 ± 0.39 versus 4.37 ± 0.30, p = 0.000), EORTC QLQ-C30 loss of appetite symptom scale score (33.33 (0.0–100.00) versus 0.0 (0.0–0.0), p = 0.005), and EORTC QLQ-CX24 menopausal symptoms scale score (0.0 (0.0–33.33) versus 0.0 (0.0–100.0), p = 0.03). The main finding of the present study is the interaction between PA and obesity as critical cofactors in the UCCa adeno and adenosquamous histologic variants, to a greater extent than cervical squamous cell carcinoma