Background
DNA sequencing panels can simultaneously quantify human and viral tumor markers in blood. We explored changes in levels of plasma tumor markers following surgical resection of head and ...neck carcinoma.
Methods
In preresection and postresection plasmas, targeted DNA sequencing quantified variants in 28 human cancer genes and levels of oncogenic pathogens (human papillomavirus HPV, Epstein‐Barr virus EBV, Helicobacter pylori) from 21 patients with head and neck squamous cell carcinoma.
Results
Preresection, 11 of 21 patients (52%) had detectable tumor markers in plasma, most commonly TP53 mutation or HPV genome. Several days postresection, levels fell to undetectable in 8 of 10 evaluable patients, while two high‐stage patients retained circulating tumor markers.
Conclusions
Modern sequencing technology can simultaneously quantify human gene variants and oncogenic viral genomes in plasma. Falling levels of cancer‐specific markers upon resection can help identify viral and human markers to track at subsequent timepoints as a means to evaluate efficacy of interventions.
Background
Racial‐ethnic disparities in acute stroke care can contribute to inequality in stroke outcomes. We examined race‐ethnic disparities in acute stroke performance metrics in a voluntary ...stroke registry among Florida and Puerto Rico Get With the Guidelines‐Stroke hospitals.
Methods and Results
Seventy‐five sites in the Florida Puerto Rico Stroke Registry (66 Florida and 9 Puerto Rico) recorded 58 864 ischemic stroke cases (2010–2014). Logistic regression models examined racial‐ethnic differences in acute stroke performance measures and defect‐free care (intravenous tissue plasminogen activator treatment, in‐hospital antithrombotic therapy, deep vein thrombosis prophylaxis, discharge antithrombotic therapy, appropriate anticoagulation therapy, statin use, smoking cessation counseling) and temporal trends. Among ischemic stroke cases, 63% were non‐Hispanic white (NHW), 18% were non‐Hispanic black (NHB), 14% were Hispanic living in Florida, and 6% were Hispanic living in Puerto Rico. NHW patients were the oldest, followed by Hispanics, and NHBs. Defect‐free care was greatest among NHBs (81%), followed by NHWs (79%) and Florida Hispanics (79%), then Puerto Rico Hispanics (57%) (P<0.0001). Puerto Rico Hispanics were less likely than Florida whites to meet any stroke care performance metric other than anticoagulation. Defect‐free care improved for all groups during 2010–2014, but the disparity in Puerto Rico persisted (2010: NHWs=63%, NHBs=65%, Florida Hispanics=59%, Puerto Rico Hispanics=31%; 2014: NHWs=93%, NHBs=94%, Florida Hispanics=94%, Puerto Rico Hispanics=63%).
Conclusions
Racial‐ethnic/geographic disparities were observed for acute stroke care performance metrics. Adoption of a quality improvement program improved stroke care from 2010 to 2014 in Puerto Rico and all Florida racial‐ethnic groups. However, stroke care quality delivered in Puerto Rico is lower than in Florida. Sustained support of evidence‐based acute stroke quality improvement programs is required to improve stroke care and minimize racial‐ethnic disparities, particularly in resource‐strained Puerto Rico.
Mediante el establecimiento de 40 transectos siguiendo la metodología de Gentry, se realizó un análisis de la diversidad, endemismos, composición florística y complementariamente la estructura de la ...vegetación leñosa de bosques estacionalmente secos (BTES) alterados de cuatro sectores del distrito de Jaén. Las familias más abundantes son Boraginaceae, Leguminosae, Malvaceae y Cactaceae; los géneros más abundantes son Cordia, Tetrasida, Esenbeckia y Browningia. Las especies más importantes son Cordia iguaguana, Tetrasida chachapoyensis y Browningia altissima, las tres son endémicas restringidas a los bosques estacionalmente secos del Marañón. La diversidad vegetal es moderada. Sin embargo, los resultados confirman que la zona presenta valores sorprendentemente altos en endemismo en contraste con BTES interandinos y BTES orientales de nuestro país, además de los BTES del sur occidente del Ecuador. Por lo tanto, su conservación merece especial consideración.
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