Abstract
Background: In Puerto Rico (PR), colorectal cancer (CRC) is the 1st cause of cancer death and the 2nd most common cancer among men and women. Familial CRC accounts for 10-15% of all CRCs. ...Several studies suggest that inheritance has a significant impact in the pathogenesis of up to a third of all CRC cases. Little is known about the prevalence of polyposis syndromes among Hispanics and statistics are needed to quantify disease burden.
Aim: To determine the prevalence of oligopolyposis (defined as ≥20 synchronous colorectal adenomas) among Hispanics with incident CRC.
Methods: Pathological reports from patients with biopsies positive for CRC from 2007 to 2011 were retrieved from the PR Central Cancer Registry. A total of 4334 pathological reports were initially obtained. After taking into account the inclusion/exclusion criteria, 1685 reports were included in the final analysis. Reports were analyzed by age, gender, stage at diagnosis and colorectal location (proximal vs. distal). Colorectal polyp burden was calculated using pathology reports and normalization of data based on colon segment size (STATA 10.0).
Results: A total of 1685 colectomy specimens with colonic adenocarcinoma were analyzed (46.5% were female). The mean patient age was 68 years (SD ± 11) with an age distribution of: <50 (6.3%), 50-64 (30.7%), 65-75 (72.3%), >75 (27.8%). Tumors were classified as Stage 0 (2.9%), Stage I (19.5%), Stage II (32.2%), Stage III (40.3%), and Stage IV (4.93%). The mean number of polyps was 11 (SD ± 9.6) after normalization. 10.2% of CRC patients had oligopolyposis. Most patients with oligopolyposis were >50 years (96.5%), had tumors located in the proximal colon (62.3%), and had an earlier stage at diagnosis (35.9%) compared to patients without oligopolyposis (p<0.001).
Conclusion: In our cohort of Hispanics, oligopolyposis was seen in 10% of cases. Our observations suggest that genetic syndromes associated with colorectal polyposis may account for a higher than expected number of CRC cases.
Characteristics<20 adenomas n (%)≥20 adenomas n (%)P-valueAge<50100 (6.6)6 (3.5)0.12350-64467 (30.9)50 (29.0)65-75536 (35.5)57 (33.1)>75408 (27.0)59 (34.3)GenderFemale710 (46.9)75 (43.6)0.408Male803 (53.0)97 (56.4)Stage0/I283 (20.7)56 (35.9)<0.001II442 (32.4)47 (30.1)III/IV640 (46.9)53 (34.0)GradeWell276 (21.4)36 (25.2)0.042Moderate942 (72.9)105 (73.4)Poor75 (5.8)2 (1.4)LocationDistal780 (55.5)62 (37.4)<0.001Proximal625 (44.5)104 (62.3)
Citation Format: Carlos E. Bertran, Juan M. Marques, Vanessa Mendez, Katerina Freyre, Yaritza Diaz-Algorri, Luis R. Pericchi, Marievelisse Soto, Marcia R. Cruz-Correa. Prevalence of synchronous oligopolyposis in Hispanics with incident colorectal cancer: A population-based analysis. abstract. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1283. doi:10.1158/1538-7445.AM2014-1283
Metástasis cerebral de melanoma lentiginoso acral Méndez-Mathey, Vanessa Elizabeth
Revista de la Facultad de Medicina, Universidad Nacional de Colombia,
2019, Letnik:
67, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Introducción. El melanoma lentiginoso acral es un subtipo de melanoma potencialmente agresivo y el tercer tumor primario en producir metástasis cerebral. Debuta con síntomas neurológicos y hemorragia ...intracerebral en el 50% de los casos y afecta las palmas de las manos, las plantas de los pies y las regiones subungueales. Su pronóstico es pobre en comparación con otras variantes clínicas debido a que estos melanomas son diagnosticados de forma tardía. Representan el 4% de todas las neoplasias malignas de la piel y son responsables del 80% de las muertes.Presentación del caso. Paciente masculino de 44 años de edad, foto tipo cutáneo tipo IV, que presenta lesión en planta de pie izquierdo, pigmentada y ulcerada, de crecimiento lento con cerca de 2 años de evolución. El sujeto fue sometido a intervención quirúrgica para resección de melanoma lentiginoso acral 1 año atrás e ingresó a emergencias por presentar cuadro neurológico súbito y compromiso de conciencia. Se realizó tomografía axial computarizada cerebral donde se observó tumoración temporoparietal izquierda hiperdensa de 4.1x5cm con edema perilesional y hemorragia. Previa estabilización, el hombre fue referido a un centro hospitalario de mayor nivel para tratamiento microquirúrgico.Conclusiones. Dado que el melanoma metastásico es una enfermedad incurable, el diagnostico precoz y oportuno de lesiones dérmicas accesibles a la inspección para iniciar tratamiento es prioritario para mejorar el pronóstico de esta enfermedad.
The practice of Taekwondo, in the confinement of the COVID19 pandemic, is related to healthy lifestyle habits and physical self-concept. In this sense, the objective of this research was determined ...to identify the relationships that may occur between the responses to the CAF (Physical Self-Concept Questionnaire) and healthy lifestyle habits of Taekwondo practitioners nationwide. An ex post facto design of a retrospective and correlational nature was implemented, where the independent variables are not susceptible to manipulation, a discretionary non-probabilistic sampling was used, which sample is made up of 423 taekwondo athletes between 12 and 58 years old. The participants completed the Physical Self-Concept Questionnaire (CAF) and the Healthy Life Habits questionnaire. The results prove the importance of Taekwondo confinement training as a contribution to a healthy life, in relation to their own perception of the participants' physical self-concept. It was concluded that the practice of taekwondo during the pandemic contributed significantly to the care and development of healthy lifestyle habits.
A prática do Taekwondo, no confinamento da pandemia da COVID-19, está relacionada a hábitos de vida saudáveis e ao autoconceito físico. Nesse sentido, o objetivo desta pesquisa foi identificar as relações que podem ocorrer entre as respostas ao CAF (Questionário de Autoconceito Físico) e os hábitos de vida saudável dos praticantes de Taekwondo em nível nacional. Foi implementado um projeto retrospectivo e correlacional ex post facto, em que as variáveis independentes não são suscetíveis de manipulação. Foi utilizada uma amostragem não probabilística discreta, com uma amostra de 423 atletas de taekwondo entre 12 e 58 anos de idade. Os participantes preencheram o Questionário de Autoconceito Físico (CAF) e o Questionário de Hábitos de Estilo de Vida Saudável. Os resultados comprovam a importância do treinamento de confinamento do taekwondo como contribuição para um estilo de vida saudável, em relação à percepção dos próprios participantes sobre seu autoconceito físico. Concluiu-se que a prática do taekwondo em tempos de pandemia contribuiu significativamente para o cuidado e o desenvolvimento de hábitos de vida saudáveis.
La práctica de taekwondo, en el confinamiento de la pandemia del COVID19, guarda relación con los hábitos de vida saludables y autoconcepto físico. En tal sentido, se determinó como el objetivo de esta investigación el identificar las relaciones que puedan producirse entre las respuestas al CAF (Cuestionario de autoconcepto físico) y hábitos de vida saludables de los practicantes de taekwondo a nivel nacional. Se implementó un diseño ex post facto de carácter retrospectivo y correlacional, donde las variables independientes no son susceptibles de manipulación, se utilizó un muestreo no probabilístico discrecional, cuya muestra la componen 423 deportistas de taekwondo entre 12 y 58 años. Los participantes cumplimentaron el Cuestionario de autoconcepto físico (CAF) y el Cuestionario de hábitos de vida saludables. Los resultados, comprueban la importancia de los entrenamientos en confinamiento de taekwondo como aporte de una vida saludable, en relación con su propia percepción del autoconcepto físico de los participantes. Se concluyó que la práctica del taekwondo en época de pandemia aportó significativamente en el cuidado y desarrollo de los hábitos de vida saludables.
Se estima que la mortalidad infantil global podría aumentar por primera vez en más de 60 años debido a los efectos indirectos en el estado nutricional infantil y a la falta de acceso a servicios ...básicos de salud. Existe además evidencia alarmante en varios países sobre el incumplimiento de los calendarios de vacunación. Objetivo: Conocer el acceso a los servicios de salud para el control del crecimiento, desarrollo y vacunación en tiempo de pandemia y de huracanes en los niños menores de 5 años del Centro de Salud “José TrinidadMoreno” la Lima, en el segundo semestre del 2021. Pacientes y métodos: Estudio cuantitativo, exploratorio-descriptivo, transversal. Muestra: no probabilístico por conveniencia de 90 niños. Instrumento tipo cuestionario. Resultados: 41% (37) de los niños tenían 1-6 meses, 29% (26) de 6-12 meses, 11% (10) 12-18 meses, 2% (2) de 18 a 24 meses, 17% (15) de 2 a 4 años 11meses 29 días. 89% (80) tenían su esquema de vacunación completo y un 11% (10) incompleto. 59% (66) tenían acceso al centro de salud, 18% (20) hospitales privados, 13% (14) otros, 7% (8) al IHSS, 4% (4) al HMCR. 64% (58) tenían acceso a programas de desarrollo y crecimiento Conclusión: Debido a la pandemia y huracanes se vieron afectados los servicios de salud, sin embargo, la mayoria tenían acceso a una unidad de salud, un poco más de la mitad tenian acceso a programas de crecimento y desarrollo un alto porcentaje tenían su esquema de vacunación completo.
Several genetically defined hereditary colorectal cancer (CRC) syndromes are associated with colonic polyposis including familial adenomatous polyposis (FAP) and MUTYH adenomatous polyposis (MAP). ...Limited data exists on the clinical characterization and genotypic spectrum of polyposis syndromes among Hispanics. To describe the phenotype and genotype of Puerto Rican Hispanic patients with FAP and MUTYH and compare with other ethnic and racial groups. Probands were identified from the Puerto Rico Familial Colorectal Cancer Registry (PURIFICAR). Recruited individuals completed risk factors, medical, and family history questionnaires and underwent genetic testing for genotype analysis. Frequency analysis, Chi square, Fisher’s exact and Wilcoxon rank-sum tests were used for statistical analysis methods. A total of 31 FAP (from 19 families) and 13 MAP (from 13 families) Hispanic patients recruited from the PURIFICAR were evaluated. Among the FAP cases, mean age at diagnosis was 27.6 (range 9–71 years); 67.7 % cases had more than 100 polyps and 41.9 % had upper gastrointestinal polyps. Among the 19 FAP families, there were 77 affected FAP individuals and 26 colorectal cancer cases. Genetic mutations were available for 42.2 % of FAP families; all mutations identified were unique. Surgeries were reported in 31 cases; 14 (45.2 %) prophylactic surgeries and 6 (19.4 %) therapeutic surgeries for management of CRC. Among MAP cases, mean age at diagnosis was 53 (range 34–76 years). Genetic analysis revealed homozygous biallelic mutations (G382D) in 53.8 %, compound heterozygous mutations (G382/Y165C) in 23 %, and non-G382/Y165C monoallelic mutations in 23 %. Familial cancer registries should be promoted as vehicles for detection, education and follow up of families at-risk of acquiring familial cancers. PURIFICAR is the first and only familial cancer registry in Puerto Rico providing these services to families affected with familial cancer syndromes promoting education, testing and surveillance of at-risk family members, and focusing on cancer prevention efforts. The fact that only 40 % of FAP patients had access to genetic testing stresses the need to promote the establishment of policies supporting genetic testing coverage by medical insurance companies in order to provide patients with the highest standard of care to prevent cancer. Furthermore, our results suggest that Hispanics may have uncommon mutations in adenomatous polyposis related genes, which emphasize the need for full gene sequencing to establish genetic diagnosis.
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