El propósito de este informe especial es describir cronológicamente los eventos que contribuyeron al desarrollo y aprobación de la legislación e implementación del requisito escolar de vacunación en ...Puerto Rico (PR), con el fin de prevenir el VPH y los cánceres asociados a este. A partir del 2010, PR inició las aprobaciones de políticas públicas con el objetivo de mejorar el registro de casos de los cánceres y la cobertura de la vacuna contra el VPH a través de los planes médicos en adolescentes de 11 a 18 años. En el 2014, los esfuerzos científicos y comunitarios lograron documentar la magnitud de las enfermedades causadas por el VPH, y desarrollar en conjunto, estrategias de prevención y promoción de la vacuna contra el VPH. En agosto de 2018, PR logró ser uno de los primeros cuatro territorios de los Estados Unidos de América en implementar la vacuna contra el VPH como requisito escolar con el fin de disminuir la incidencia de cánceres asociados al VPH en la isla. En el 2019 se garantizó por ley que todo proveedor de vacunación debe reportar al Registro de Inmunización. El caso de PR demuestra que el desarrollo de políticas públicas junto con colaboraciones entre coaliciones académicas, científicas y comunitarias, logran cambios poblacionales y resultados medibles dirigidos a la prevención de VPH. Países con una problemática de salud pública similar podrían adoptar esfuerzos similares a los presentados, y alinearlos al objetivo de la Organización Mundial de la Salud: erradicación del cáncer cervical para 2030.
Abstract
In recent years, the use of steel fibers has increased in Colombia, optimizing structure designs, quality specifications and mechanical behavior. However, the concrete durability and ...resistance to aggressive environments such as sulfates and chlorides are not commonly evaluated. This paper includes results of durability analysis for 21 MPa compressive strength concretes reinforces with steel and synthetic fibers. Performance parameters measured during tests include sulfate resistance, chlorides penetration, and carbonation according to technical standards. The Variables of experimental program were fiber type and fiber dosage. Dosages for synthetic fibers were 1.5 kg/m
3
, 3.0 kg/m
3
and 5.0 kg/m
3
, and for steel fibers were 5.0 kg/m
3
, 9.0 kg/m
3
and 18 kg/m
3
. Results of the study were used to propose recommendations for reducing concrete deterioration when exposed to these aggressive environments and for extending the durability service life.
Abstract
Background
In August 2018, Puerto Rico (PR) became the 4th state or territory in the United States to adopt a human papillomavirus (HPV) vaccine school-entry requirement, for students 11–12 ...years old. Evidence suggests that the content of media coverage may impact people’s perception of HPV vaccine and their willingness to vaccinate. This study aimed to analyze the content of digital news coverage related to the implementation of the policy in PR.
Methods
A content review was conducted of digital media published from January 2017 through December 2018. The content reviewed was carried out in two steps: 1) creating a matrix to summarize each article’s content about the policy and 2) qualitative analysis using a grounded theory approach.
Results
The search resulted in 34 articles obtained from 17 online local and international news outlets that reported the policy's implementation. Analyses showed that 61% of the news articles did not mention the number of required doses, and 79% discussed the new policy concerning cancer prevention. In 2017, news coverage focused mostly on describing the policy, while 2018 coverage focused on controversies surrounding the implementation. Neutral emergent codes included: 1) Description of the policy; 2) Information about HPV related cancers; and 3) General information about HPV vaccine. Negative emergent codes included: 1) infringement to patient and parental autonomy; 2) Hesitancy from the political sector, and 3) Hesitancy from groups and coalitions. Positive content included: 1) knowledge and acceptance of HPV vaccine for cancer prevention; 2) importance of education and protective sexual behaviors; and 3) new vaccination law proposal.
Conclusions
Most of the media coverage in PR was neutral and included limited information related to the vaccine, HPV, and HPV-related cancers. Neutral and negative themes could influence public concerns regarding the new policy, as well as HPV vaccination rates in PR.
Background
Sexually transmitted infections (STIs) are a serious public health problem worldwide, especially among reproductive-age women. The early sexual onset of sexual intercourse (EOSI) has been ...suggested as a risk factor, although there is no data at the national level.
Objective
To evaluate the association between EOSI and STIs in Peruvian women of childbearing age.
Methods
Analytical cross-sectional study with secondary data analyzes of the Peruvian Demographic and Family Health Survey 2018. The outcome was the presence of STIs in the last 12 months and the exposure variable was EOSI (age < 15 years at the time of their first sexual experience). To evaluate the association of interest, crude and adjusted prevalence ratios (aPRs) were calculated using generalized linear models with Poisson family and logarithmic link function.
Results
We analyzed data from 31,028 women of childbearing age. The 11.3% reported having STIs in the last 12 months and 20.2% of the participants had an EOSI. After adjusting for potential confounders, we found that EOSI was associated with STIs (aPR: 1.27; 95% CI: 1.08–1.50;
p
= 0.005). When conducting stratified analysis by area of residence and number of sexual partners, this association was maintained in women living in urban areas (aPR: 1.36; 95% CI: 1.11–1.66;
p
= 0.003) those who did not report having a history of multiple sexual partners (aPR: 1.27; 95% CI: 1.08–1.51;
p
= 0.005), and those in the middle (aPR: 1.42; 95% CI: 1.03–1.97;
p
= 0.034) and highest (aPR: 2.12; 95% CI: 1.33–3.39;
p
= 0.002) wealth quintiles.
Conclusion
Among reproductive-age women from Peru, EOSI was associated with STIs, especially in women living in urban areas, with no history of multiple sexual partners, and belonging to the middle to higher wealth index. The implementation of measures to prevent EOSI and fostering appropriate sexual health counseling for women with EOSI is advised.
Previous reports have documented the antiproliferative properties of I(2) and the arachidonic acid (AA) derivative 6-iodolactone (6-IL) in both thyroid and mammary glands. In this study, we ...characterized the cellular pathways activated by these molecules and their effects on cell cycle arrest and apoptosis in normal (MCF-12F) and cancerous (MCF-7) breast cells. Low-to-moderate concentrations of I(2) (10-20 microM) cause G1 and G2/M phase arrest in MCF-12F and caspase-dependent apoptosis in MCF-7 cells. In normal cells, only high doses of I(2) (40 microM) induced apoptosis, and this effect was mediated by poly (ADP-ribose) polymerase-1 (PARP1) and the apoptosis-induced factor, suggesting an oxidative influence of iodine at high concentrations. Our data indicate that both I(2) and 6-IL trigger the same intracellular pathways and suggest that the antineoplasic effect of I(2) in mammary cancer involves the intracellular formation of 6-IL. Mammary cancer cells are known to contain high concentrations of AA, which might explain why I(2) exerts apoptotic effects at lower concentrations only in tumoral cells.
In this work we characterized the occurrence of killer activity in 64 Candida glabrata clinical isolates under different conditions. We found that only 6.25 % of the clinical isolates tested were ...positive for killer activity against a Saccharomyces cerevisiae W303 sensitive strain. Sensitivity of killer activity to different values of pH and temperatures was analyzed. We found that the killer activity presented by all isolates was resistant to every pH and temperature tested, although optimal activity was found at a range of pH values from 4 to 7 and at 37°C. We did not observe extrachromosomal genetic elements associated with killer activity in any of the positive C. glabrata isolates. The killer effect was due to a decrease in viability and DNA fragmentation in sensitive yeast.
Antecedentes y Objetivo: Los linfomas cutáneos de células T (LCCT) como la micosis fungoide (MF) y el síndrome de Sézary (SS) son linfomas poco comunes con pronósticos variables. El objetivo del ...estudio fue describir la supervivencia de una cohorte de pacientes con MF/SS y evaluar aquellos factores pronósticos con impacto en la supervivencia de la enfermedad.
Material y Métodos: Se analizaron retrospectivamente todos los casos diagnosticados de MF/SS entre 2008 y 2022. Se evaluaron variables demográficas, parámetros histológicos, y datos analíticos. Se calcularon la supervivencia libre de progresión (PFS) y la supervivencia específica de la enfermedad (DSS).
Resultados: Se incluyeron un total de 148 casos. Ciento veintiún casos (82%) fueron diagnosticados de MF y 27 casos de SS. Treinta y siete pacientes (25%) progresaron en algún momento de la evolución. La mediana de PFS fue de 127 meses y la mediana de DSS de 135 meses. La edad >60 años, el diagnóstico de SS, la presencia de transformación a célula grande (TCG) al diagnóstico, el foliculotropismo en estadios iniciales, la elevación de Ki-67, la presencia de TCR clonal en sangre, niveles elevados de LDH y B2M, y estadios avanzados (IIB, IVA, T3, T4, N3/Nx) se asociaron con un peor pronóstico en la cohorte.
Conclusiones: El estadio IVA y la presencia de TCG al diagnóstico destacaron como factores independientes de pronóstico desfavorable. La TCG fue la variable que produjo una disminución más acentuada de la supervivencia de los pacientes estando estrechamente relacionada con la afectación cutánea tumoral y el estadio IIB.
Background and Objective: Cutaneous T-cell lymphomas (CTCL) such as mycosis fungoides (MF) and Sézary syndrome (SS) are rare lymphomas with varying prognoses. The aim of the study was to describe the survival of a cohort of patients with MF/SS and evaluate the prognostic factors impacting disease survival.
Materials and Methods: All cases of MF/SS diagnosed from 2008 through 2022 were retrospectively analyzed. The demographic variables, histological parameters, and analytical data were analyzed too. Progression-free survival (PFS) and disease-specific survival (DSS) were calculated.
Results: A total of 148 cases were included. A total of 121 (82%) and 27 cases were diagnosed with MF, and SS, respectively. A total of 37 patients (25%) experienced progression at some point disease progression. The median PFS and median DSS were 127 and 135 months, respectively. Age > 60 years, diagnosis of SS, the presence of large cell transformation (LCT) at diagnosis, folliculotropism in early stages, high Ki-67 expression, the presence of the clonal T-cell receptor (TCR) in blood, elevated LDH and B2M levels, and advanced stages (IIB, IVA, T3, T4, N3/Nx) were associated with worse prognosis across the entire cohort.
Conclusions: Stage IVA and the presence of LCT at diagnosis stood out as independent factors of unfavorable prognosis. LCT was the variable that most significantly impacted the patients’ survival and was closely associated with tumor skin involvement and stage IIB.
Los linfomas cutáneos de células T (LCCT) como la micosis fungoide (MF) y el síndrome de Sézary (SS) son linfomas poco comunes con pronósticos variables. El objetivo del estudio fue describir la ...supervivencia de una cohorte de pacientes con MF/SS y evaluar aquellos factores pronósticos con impacto en la supervivencia de la enfermedad.
Se analizaron retrospectivamente todos los casos diagnosticados de MF/SS entre 2008 y 2022. Se evaluaron variables demográficas, parámetros histológicos, y datos analíticos. Se calcularon la supervivencia libre de progresión (PFS) y la supervivencia específica de la enfermedad (DSS).
Se incluyeron un total de 148 casos. Ciento veintiún casos (82%) fueron diagnosticados de MF y 27 casos de SS. Treinta y siete pacientes (25%) progresaron en algún momento de la evolución. La mediana de PFS fue de 127 meses y la mediana de DSS de 135 meses. La edad >60 años, el diagnóstico de SS, la presencia de transformación a célula grande (TCG) al diagnóstico, el foliculotropismo en estadios iniciales, la elevación de Ki-67, la presencia de TCR clonal en sangre, niveles elevados de LDH y B2M, y estadios avanzados (IIB, IVA, T3, T4, N3/Nx) se asociaron con un peor pronóstico en la cohorte.
El estadio IVA y la presencia de TCG al diagnóstico destacaron como factores independientes de pronóstico desfavorable. La TCG fue la variable que produjo una disminución más acentuada de la supervivencia de los pacientes estando estrechamente relacionada con la afectación cutánea tumoral y el estadio IIB.
Cutaneous T-cell lymphomas (CTCL) such as mycosis fungoides (MF) and Sézary syndrome (SS) are rare lymphomas with varying prognoses. The aim of the study was to describe the survival of a cohort of patients with MF/SS and evaluate the prognostic factors impacting disease survival.
All cases of MF/SS diagnosed from 2008 through 2022 were retrospectively analyzed. The demographic variables, histological parameters, and analytical data were analyzed too. Progression-free survival (PFS) and disease-specific survival (DSS) were calculated.
A total of 148 cases were included. A total of 121 (82%) and 27 cases were diagnosed with MF, and SS, respectively. A total of 37 patients (25%) experienced progression at some point disease progression. The median PFS and median DSS were 127 and 135 months, respectively. Age >60 years, diagnosis of SS, the presence of large cell transformation (LCT) at diagnosis, folliculotropism in early stages, high Ki-67 expression, the presence of the clonal T-cell receptor (TCR) in blood, elevated LDH and B2M levels, and advanced stages (IIB, IVA, T3, T4, N3/Nx) were associated with worse prognosis across the entire cohort.
Stage IVA and the presence of LCT at diagnosis stood out as independent factors of unfavorable prognosis. LCT was the variable that most significantly impacted the patients’ survival and was closely associated with tumor skin involvement and stage IIB.
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