EBV-positive diffuse large B-cell lymphoma of the elderly: a case series from Peru.

EBV-positive diffuse large B-cell lymphoma (DLBCL) of the elderly is an entity recently included in the WHO classification of lymphoid tumors. We have reviewed our experience and clinical outcomes of this distinct subtype of DLBCL. Between 2002 and 2009, cases of DLBCL were identified from medical records of the Hospital Nacional Edgardo Rebagliati Martins in Lima, Peru, and underwent pathological evaluation including immunohistochemistry for CD20, CD10, bcl-6, MUM1/IRF4, and EBV-encoded RNA in situ hybridization. Clinical data were gathered, tabulated, and reported descriptively. Survival analyses were performed using Kaplan-Meier estimates. Out of 199 cases of DLBCL, 28 cases of EBV-positive DLBCL of the elderly were identified. The median age was 75 years with male predominance (1.5:1). B-symptoms were present in 43%, advanced stage in 50% and International Prognostic Index (IPI) score > 2 in 57% of patients; 68% of patients had a nongerminal center (NGC) phenotype. The complete response rates to R-CHOP and CHOP were 63% and 33%, respectively. The median overall survival (OS) for the group was 5 months. In the univariate analysis, age ≥70 years, lymphocyte count <1.0 × 10(9) /L, and advanced clinical stage were associated with worse OS in patients treated with chemotherapy with and without rituximab. EBV-positive DLBCL of the elderly is a clinically aggressive entity with a short OS and typically presents with advanced stage, high IPI score, and a NGC phenotype. Further studies are needed to investigate if rituximab-containing regimens are associated with better response and OS rates in EBV-positive DLBCL of the elderly.

Nutrición de precisión en los tiempos de la medicina del estilo de vida / Precision nutrition in the life style medicine times

El origen etimológico del término dieta, deriva del griego δίαιτα, entendido como "estilo de vida"; actualmente la ciencia demuestra que la prevención y la tutela del bienestar empiezan en la alimentación y continúan en nuestro estilo de vida. La dieta es un factor clave para el estado de salud del individuo ya que la interacción entre dieta, factores ambientales y genes determina el bienestar de las personas.Los impactos negativos en la salud, originados por una inadecuada alimentación, son cada día mayores. La obesidad, principal consecuencia de esta alteración nutricional, es una de las principales causas de morbilidad y mortalidad en la mayoría de los países para las enfermedades asociadas con ella, las NTCDs ( Non Transmissible Chronic Disease) : dislipidemias, enfermedades cardiovasculares, diabetes mellitus de tipo 2, hígado graso no alcohólico e inclusive Cáncer.

The etymological origin of the term Diet, derives from the Greek δίαιτα, understood as "lifestyle"; currently the Science shows that prevention and protection of well-being begin in the diet and continue in our Lifestyle. Diet is a key factor for the health status of the individual since the interaction between diet, environmental factors and genes, determines the well-being of people. The negative impacts on health, caused by an inadequate diet, are increasing every day. The obesity, the main consequence of this nutritional alteration, is one of the main causes of morbidity and mortality in most countries for the diseases associated with it, NTCDs (Non Transmissible Chronic Disease): dyslipidemias, cardiovascular diseases, diabetes mellitus type 2, fatty liver not alcoholic and even Cancer.

Genotyping non-small cell lung cancer (NSCLC) in Latin America.

INTRODUCTION: Frequency of mutations in EGFR and KRAS in non-small cell lung cancer (NSCLC) is different between ethnic groups; however, there is no information in Latin-American population. METHODS: A total of 1150 biopsies of NSCLC patients from Latin America (Argentina, Colombia, Peru, and Mexico) were used extracting genomic DNA to perform direct sequencing of EGFR gene (exons 18 and 21) and KRAS gene in 650 samples. In Mexico, Scorpions ARMS was also used to obtain a genetic profile. RESULTS: We report the frequency of mutations in EGFR and KRAS genes in four Latin-American countries (n = 1150). Frequency of EGFR mutations in NSCLC was 33.2% (95% confidence interval [CI] 30.5-35.9) (Argentina 19.3%, Colombia 24.8%, Mexico 31.2%, and Peru 67%). The frequency of KRAS mutations was 16.6% (95% CI 13.8-19.4). EGFR mutations were independently associated with adenocarcinoma histology, older age, nonsmokers, and absence of KRAS mutations. Overall response rate to tyrosine kinase inhibitors in EGFR-mutated patients (n = 56) was 62.5% (95% CI 50-75) with a median overall survival of 16.5 months (95% CI 12.4-20.6). CONCLUSIONS: Our findings suggest that the frequency of EGFR mutations in Latin America lies between that of Asian and Caucasian populations and therefore support the genetic heterogeneity of NSCLC around the world.