Survival Analysis of Male Patients with Brain Metastases at Initial Breast Cancer Diagnosis over the Last Decade.

Breast cancer in men represents approximately 1% of all breast cancer diagnoses. Among all patients with breast cancer, approximately 30% will develop brain metastases. Over the past decade, there have been multiple advances in the treatment of metastatic breast cancer; however, long-term outcomes of this presentation in male patients are lacking. We evaluated male patients with de novo stage IV breast cancer using the Surveillance, Epidemiology and End Results (SEER) database from 2010 to 2019. Overall survival (OS) was estimated using the Kaplan-Meier method and differences between groups were compared using log rank tests. In total, 22 male patients with brain metastases at initial breast cancer diagnosis were included. Patients with HR-positive/HER2-negative tumors had the longest OS (median 13 months). Factors associated with shorter overall survival were advanced age, unmarried marital status, lower household income, and grade III disease, among others. Brain metastases remains an unmet medical need for patients with breast cancer; the development of new drugs may provide an improvement in overall survival for male patients in the future.

Survival analysis of patients with brain metastases at initial breast cancer diagnosis over the last decade.

PURPOSE: There have been significant advances in the treatment of metastatic breast cancer (BC) over the past years, and long-term outcomes after a diagnosis of brain metastases are lacking. We aimed to identify predictors of brain metastases at initial breast cancer diagnosis, describe overall survival (OS) in the past decade, and identify factors associated with OS after brain metastases diagnosis. METHODS: We evaluated patients with de novo stage IV BC using the Surveillance, Epidemiology and End Results database from 2010 to 2019. Multivariate logistic regression was conducted to assess predictors of brain metastases at initial breast cancer diagnosis. OS was estimated using the Kaplan-Meier method and log rank test was used to compare differences between groups. Cox regression was used to assess associations between several variables and OS. RESULTS: 1,939 patients with brain metastases at initial breast cancer diagnosis were included. Factors associated with this presentation were grade III/IV tumors, ductal histology, hormone receptor (HR)-negative/human epidermal growth factor receptor 2 (HER2)-positive subtype, and extracranial metastases. Patients with HR-positive/HER2-positive disease had the longest OS (median 18 months) and 12.2% were alive at 8 years. Factors associated with shorter OS included older age, lower income, triple-negative subtype, higher grade, and visceral metastases. CONCLUSION: Over the last decade, the median OS of patients with brain metastases at initial breast cancer diagnosis remained poor; however, a substantial minority survive 5 or more years, with rates higher in patients with HER2-positive tumors. In addition to tumor subtype, OS varied according to age, extracranial metastases, and sociodemographic factors.

Treatments for breast cancer in men: late effects and impact on quality of life.

PURPOSE: Male breast cancer accounts for approximately 1% of all breast cancer diagnoses. Unfortunately, a lack of information exists regarding late effects of breast cancer treatment in men. METHODS: An online survey directed towards male breast cancer patients was distributed via social medial and emails from June to July 2022. Participants were asked about their disease characteristics, treatments and side effects from the disease or treatment. Patients and treatment variables were reported via descriptive statistics. Univariate logistic regression was performed to evaluate associations between different treatment variables and outcomes expressed by odds ratio. RESULTS: A total of 127 responses were analyzed. Median age of the participants was 64 years (range 56-71 years). A total of 91 participants (71.7%) revealed they experienced late effects secondary to their cancer or cancer treatment. The most concerning physical and psychological symptoms reported were fatigue and fear of recurrence respectively. Axillary lymph node dissection was associated with swollen arm and with difficulty in arm or shoulder movement. Systemic chemotherapy was related to bothersome hair loss and changes on interest in sex; and endocrine therapy was associated with feeling less masculine. CONCLUSION: Our study showed that men suffer several late effects from treatments for breast cancer. Lymphedema, difficulty with arm and shoulder movement, sexual dysfunction and hair loss should be discussed with males as it can be distressing for some patients and decrease their quality of life.

Militarismo y militarización en Venezuela: ¿juego de veridicción? / Militarism and militarization in Venezuela: veridiction game?

En el marco de los conceptos desarrollados por Michel Foucault sobre el estatuto histórico de la verdad, juegos de verdad o veridicción, y sobre la condición del discurso del saber, figuras epistemológicas, se analiza en este ensayo el discurso académico de los últimos veinte años en torno a la situación de la institución militar en Venezuela. En particular, se intenta desentrañar el régimen de veridicción de ese campo discursivo que se sostiene sobre la multiplicidad de nociones que se construyen a partir de las de militarismo y militarización.

Advances in the Management of Central Nervous System Metastases from Breast Cancer.

Central nervous system (CNS) metastases are common in breast cancer (BC) patients and are particularly relevant as new treatments for BC are prolonging survival. Here, we review advances in the treatment of CNS metastases from BC, including radiotherapy, systemic therapies, and the evolving role of immunotherapy. The use of radiotherapy and chemotherapy is the cornerstone of treatment for CNS metastases. However, new targeted therapies have recently been developed, including anti-HER2 agents and antibody-drug conjugates that have presented promising results for the treatment of these patients.

Identification of two potential aetiological agents of chronic diarrhoea in an immunocompromised patient in Cuba using conventional and molecular diagnostic techniques.

The aetiology of diarrhoea in a patient in Cuba with HIV was investigated. Although molecular diagnostics are still not used in many under-resourced settings, here traditional methods were supported by use of PCR. This approach enabled detection of a dual infection (Cystoisospora belli and Enterocytozoon bieneusi), the latter of which was not identified by microscopy with Didier's trichromic staining.

Impact of preoperative pectoralis plane nerve blocks for mastectomy on perioperative opioid consumption: a retrospective study.

Aim: To compare perioperative opioid consumption for patients undergoing mastectomy surgery with or without pectoralis nerve (PECS) plane blocks. Patients & methods: Retrospective study evaluating 152 adult females with mastectomies. Demographics, postanesthesia care unit stay duration and opioid consumption data at three time points were collected and analyzed for statistical significance. Results: 98 patients were included in the PECS block group, 54 patients were in the general anesthesia only group. Age and BMI were comparable. Total perioperative intravenous opioid consumption was less in the PECS block group (50.88 mg) compared with the general anesthesia only group (67.83 mg), p < 0.001. Conclusion: Acute pain after mastectomy is often severe. PECS plane block may decrease perioperative opioid consumption after mastectomy surgery compared with general anesthesia alone.

PACAP27 mitigates an age-dependent hippocampal vulnerability to PGJ2-induced spatial learning deficits and neuroinflammation in mice.

BACKGROUND: Inflammation in the brain is mediated by the cyclooxygenase pathway, which leads to the production of prostaglandins. Prostaglandin (PG) D2, the most abundant PG in the brain, increases under pathological conditions and is spontaneously metabolized to PGJ2. PGJ2 is highly neurotoxic, with the potential to transition neuroinflammation into a chronic state and contribute to neurodegeneration as seen in many neurological diseases. Conversely, PACAP27 is a lipophilic peptide that raises intracellular cAMP and is an anti-inflammatory agent. The aim of our study was to investigate the therapeutic potential of PACAP27 to counter the behavioral and neurotoxic effects of PGJ2 observed in aged subjects. METHODS: PGJ2 was injected bilaterally into the hippocampal CA1 region of 53-week-old and 12-week-old C57BL/6N male mice, once per week over 3 weeks (three total infusions) and included co-infusions of PACAP27 within respective treatment groups. Our behavioral assessments looked at spatial learning and memory performance on the 8-arm radial maze, followed by histological analyses of fixed hippocampal tissue using Fluoro-Jade C and fluorescent immunohistochemistry focused on IBA-1 microglia. RESULTS: Aged mice treated with PGJ2 exhibited spatial learning and long-term memory deficits, as well as neurodegeneration in CA3 pyramidal neurons. Aged mice that received co-infusions of PACAP27 exhibited remediated learning and memory performance and decreased neurodegeneration in CA3 pyramidal neurons. Moreover, microglial activation in the CA3 region was also reduced in aged mice cotreated with PACAP27. CONCLUSIONS: Our data show that PGJ2 can produce a retrograde spread of damage not observed in PGJ2-treated young mice, leading to age-dependent neurodegeneration of hippocampal neurons producing learning and memory deficits. PACAP27 can remediate the behavioral and neurodegenerative effects that PGJ2 produces in aged subjects. Targeting specific neurotoxic prostaglandins, such as PGJ2, offers great promise as a new therapeutic strategy downstream of cyclooxygenases, to combat the neuronal deficits induced by chronic inflammation.

Lupus eritematosos sistémico en la epidemia VIH/SIDA. Reporte inicial de casos en Cuba / Systemic lupus erythematous in the HIV / AIDS epidemic. Initial report of cases in Cuba

El lupus eritematoso sistémico clasifica como una compleja, multisistémica enfermedad autoinmune que evoluciona por brotes de actividad, con diferentes grados de severidad, determinante de daño crónico irreversible. Las infecciones constituyen un capitulo particular en pacientes con lupus eritematoso sistémico, y estos pacientes pueden asociar sus manifestaciones autoinmune-reumáticas a la infección por VIH/SIDA, aunque no existen muchos reportes a nivel mundial sobre esta asociación. Existen diferencias en cuanto a los mecanismos patogénicos que obran en ambas entidades, no obstante presentan homologías en el orden clínico las cuales en ocasiones hacen difícil establecer el diagnóstico diferencial entre estas entidades. Nuestro objetivo estuvo dirigido a reportar dos casos de féminas de 47 y 36 años de edad, con esta asociación en el marco de la epidemia cubana VIH-SIDA. Una de ellas desarrolló la infección varios años después del diagnóstico de lupus, y ha presentado luego del VIH brotes aislados de actividad; desarrollado daño renal y severas lesiones discoideas en cuero cabelludo todo ello aunado a infecciones urinarias. La segunda paciente desarrolló la infección VIH, y luego de varios años en tratamiento antirretroviral, tórpidamente presentó criterios clínicos e inmunológicos para lupus: debutó con un síndrome febril, toma del estado general, lesiones importantes vasculíticas de miembros inferiores complicadas con ulceraciones infectadas que remedaban pioderma gangrenosa así como serositis lúpica e infección respiratoria grave. Ambos casos contaban con tratamiento antirretroviral, y un buen conteo de células T CD4+, con carga viral indetectable. Se logró en ambos casos yugular los brotes de actividad e infecciones intercurrentes. Metodológicamente desarrollamos una amplia revisión por Medline, PubMed-Lilacs entre otros motores de búsqueda. No conocemos de otros estudios que establezcan una descripción clínica y analítica de este tipo de pacientes en Cuba(AU)

Systemic lupus erythematous classifies as a complex, multisystemic autoimmune disease that evolves through outbreaks of activity, with different degrees of severity, determining irreversible chronic damage. Infections are a particular chapter in patients with systemic lupus erythematous, and these patients can associate their autoimmune-rheumatic manifestations with HIV / AIDS infection, although there are not many worldwide reports on this association. There are differences in the pathogenic mechanisms that work in both entities, however they present homologies in the clinical order which sometimes make it difficult to establish the differential diagnosis between these entities. Our objective was to report two cases of females aged 47 and 36 years old, with the association within the framework of the Cuban HIV-AIDS epidemic. One of them developed the infection several years after the diagnosis of lupus, has presented isolated HIV activity outbreaks and developed kidney damage and severe discoid lesions on the scalp and urinary tract infections. The second patient developed HIV infection, and after several years on antiretroviral treatment, she presented clinical and immunological criteria for lupus: She debuted with a febrile syndrome, taking the general condition, important vasculitic lesions of the lower limbs complicated by infected ulcerations mimicking pioderma, gangrenous as well as lupus serositis and severe respiratory infection. Both cases had ARV treatment, and a good CD4 + T cell count, with undetectable viral load. In both cases, the outbreaks of activity and intercurrent infections were achieved. Methodologically, we developed an extensive review by Med-Line, Pubmed-Lilacs among other search engines using the keywords lupus and VIH infections: We do not know of other studies that establish a clinical and analytical description of this type of patients in Cuba.We conclude with the presentation of two patients differents form of presentation, both with systemic lupus in asociation with VIH-aids infection, and hgih level of disease activity . The were safe with a good control of the diseases and the treatment wih antirretroviral drugs, antibiotics, an especific drugs like antimalarials, corticosteroids and others with satisfactory clinical evolutions(AU)

Supervivencia en pacientes con metástasis cerebrales tratados con radioterapia holocraneal / Survival in patients with brain metastases treated with whole-brain radiotherapy

Resumen: Objetivo: Describir la supervivencia global en los pacientes con metástasis cerebrales tratados con radioterapia holocraneal en el período 2015-2016 en el Hospital Dr. Teodoro Maldonado Carbo de la ciudad de Guayaquil. Métodos: Esta investigación siguió un modelo observacional descriptivo longitudinal. La muestra fue de 48 pacientes; se utilizó la curva de Kaplan-Meier y se corroboró los resultados con tests no paramétricos. Resultados: La mediana global de supervivencia fue 5,8 meses, y los factores que indicaban un mayor tiempo de supervivencia fueron: edad menor de 65 años, índice Karnofsky mayor o igual a 70, tumor primario controlado, metástasis provenientes de mama, clase 1 del análisis de particionamiento recursivo (RPA) y calificación 3,5- 4 en el graded prognostic assessment (GPA). Así mismo, se describió la mediana de supervivencia dependiendo del tumor primario; la mayor fue de 10,3 meses y la menor de 0,5 meses en aquellas provenientes de mama y cérvix respectivamente. Conclusión: La mediana de supervivencia de los pacientes de este estudio según la escala RPA fue mayor que la expuesta en la literatura para todos los pacientes. La mediana de supervivencia según la calificación GPA fue menor en los pacientes con calificación 0-1, y mayor en el resto.

Abstract Objective: To describe the overall survival in patients with cerebral metastases treated with holocraneal radiotherapy in the period 2015-2016 in the Dr. Teodoro Maldonado Carbo hospital in the city of Guayaquil. Methods: An observational longitudinal study was conducted on a sample of 48 patients. The Kaplan-Meier curve was used and the results were corroborated with non-parametric tests. Results: The overall median survival was 5.8 months, and the factors that indicated a longer survival time were: age less than 65 years, Karnofsky index greater or equal to 70, primary tumor control, metastases from the breast, class 1 of the recursive partitioning analysis (RPA), and a score of 3.5-4 in the graded prognostic assessment (GPA). The median survival of the primary tumor is also described, with the highest being 10.3 months and the lowest 0.5 months in those of the breast and cervix, respectively. Conclusion: The median survival of patients in this study, according to the RPA scale, was higher than that reported in the literature for all patients. The median survival, according to the GPA score, was lower in patients with a 0-1 score, and higher in the remainder.

Patients with Non-invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features are Unlikely to have Malignant Preoperative Cytology.

BACKGROUND: The newly termed tumor 'noninvasive follicular thyroid neoplasm with papillary-like nuclear features' (NIFTP) acts in an indolent manner and can likely be safely managed with a thyroid lobectomy. Preoperative fine-needle aspiration (FNA) is the cornerstone of surgical planning, but the ability of FNA to distinguish NIFTP from other variants of papillary thyroid carcinoma (PTC) has not been well-evaluated. METHODS: A 9-year retrospective review of the preoperative cytology and surgical pathology of PTC patients who underwent a thyroidectomy at our tertiary referral center. RESULTS: Overall, 174 patients with 177 PTCs had a preoperative FNA followed by a thyroidectomy, and met our inclusion criteria. Of the 21 patients with NIFTP, the preoperative cytology was read as malignant in three (14%), suspicious for malignancy in three (14%), follicular neoplasm in ten (48%), atypia of undetermined significance in four (19%), and benign in one (5%) nodule. When comparing patients with NIFTP with other variants of PTC, patients with NIFTP were younger (p = 0.023) and less likely to have malignant cytology (p < 0.001). On multivariable regression modeling, malignant cytology was independently associated with a decreased risk of a final diagnosis of NIFTP (odds ratio 0.064, 95% confidence interval 0.018-0.233, p < 0.001). CONCLUSIONS: Patients with a final diagnosis of NIFTP are less likely to have preoperative FNA diagnosis of malignancy than those with final pathology of classical or other variants of PTC. Surgeons should take this into consideration when considering between a lobectomy and total thyroidectomy for patients with suspected PTC.

Novel large-particle FACS purification of adult ventricular myocytes reveals accumulation of myosin and actin disproportionate to cell size and proteome in normal post-weaning development.

RATIONALE: Quantifying cellular proteins in ventricular myocytes (MCs) is challenging due to tissue heterogeneity and the variety of cell sizes in the heart. In post-weaning cardiac ontogeny, rod-shaped MCs make up the majority of the cardiac mass while remaining a minority of cardiac cells in number. Current biochemical analyses of cardiac proteins do not correlate well the content of MC-specific proteins to cell type or size in normally developing tissue. OBJECTIVE: To develop a new large-particle fluorescent-activated cell sorting (LP-FACS) strategy for the purification of adult rod-shaped MCs. This approach is developed to enable growth-scaled measurements per-cell of the MC proteome and sarcomeric proteins (i.e. myosin heavy chain (MyHC) and alpha-actin (α-actin)) content. METHODS AND RESULTS: Individual cardiac cells were isolated from 21 to 94days old mice. An LP-FACS jet-in-air system with a 200-µm nozzle was defined for the first time to purify adult MCs. Cell-type specific immunophenotyping and sorting yielded ≥95% purity of adult MCs independently of cell morphology and size. This approach excluded other cell types and tissue contaminants from further analysis. MC proteome, MyHC and α-actin proteins were measured in linear biochemical assays normalized to cell numbers. Using the allometric coefficient α, we scaled the MC-specific rate of protein accumulation to growth post-weaning. MC-specific volumes (α=1.02) and global protein accumulation (α=0.94) were proportional (i.e. isometric) to body mass. In contrast, MyHC and α-actin accumulated at a much greater rate (i.e. hyperallometric) than body mass (α=1.79 and 2.19 respectively) and MC volumes (α=1.76 and 1.45 respectively). CONCLUSION: Changes in MC proteome and cell volumes measured in LP-FACS purified MCs are proportional to body mass post-weaning. Oppositely, MyHC and α-actin are concentrated more rapidly than what would be expected from MC proteome accumulation, cell enlargement, or animal growth alone. LP-FACS provides a new standard for adult MC purification and an approach to scale the biochemical content of specific proteins or group of proteins per cell in enlarging MCs.

Estradiol rapidly increases GluA2-mushroom spines and decreases GluA2-filopodia spines in hippocampus CA1.

Hippocampal dendritic spine density rapidly increases following estradiol (E2 ) treatment, but the types of spines and trafficking of synaptic markers have received little investigation. We assessed rapid effects of E2 over time on the density of four spine types (stubby, filopodial, long thin, and mushroom) and trafficking of AMPA receptor subunit GluA2 and PSD95 on tertiary, apical dendrites in CA1. Castrated male rats received 20 µg kg-1 of E2 or vehicle and were sacrificed 30 or 120 min later. Images of Golgi-Cox impregnated and PSD95/GluA2 stained dendrites were captured under the confocal microscope and quantified with IMARIS-XT. Stubby and filopodial spine densities did not change following treatment. Long-thin spines significantly decreased at 30 min while mushroom spines significantly increased at 120 min. GluA2, PSD95, and GluA2/PSD95 colocalization levels in stubby or long thin spines did not change, but filopodial spines had significantly reduced GluA2 levels at 30 min. Mushroom spines showed significantly increased levels for GluA2, PSD95 and GluA2/PSD95 colocalization at 120 min. Because GluA2 is important for memory consolidation, current results present novel data suggesting that trafficking of GluA2 to mushroom spines provides one mechanism contributing to estradiol's ability to enhance learning and memory by the PI3 signaling pathway.

Dinámica de adquisición de VIH: definiciones desde seropositivos cubanos / Dynamics of HIV acquisition: definitions by Cuban seropositives

Introducción: la exposición a la infección por el VIH, con participación consciente del individuo vulnerable, es un problema complejo que se ha extendido rápidamente, especialmente entre los hombres que tienen sexo con otros hombres. Objetivo: definir cómo se produce la infección teniendo en cuenta la contribución individual a la exposición y los elementos que caracterizan dicha contribución. Métodos: un estudio cualitativo con grupos de discusión se llevó a cabo para explorar los criterios y percepciones de las personas con VIH /sida sobre los modos de exposición a la infección. Se seleccionó una muestra intencional de grupos homogéneos. Las respuestas y comentarios de los grupos de discusión fueron ponderados para darles un orden jerárquico. Resultados: se realizaron 6 grupos de discusión. Los principales conceptos construidos fueron: infección no evitada e infección intencionada, esta última referida a la exposición consciente o participativa del individuo. Además, el riesgo general de contraer la infección para toda la población cubana, independientemente de su grado de participación (en base a la tasa de prevalencia del VIH en Cuba) se definió como infección accidental. Para cada concepto se generaron diferentes categorías que describen la manera y el propósito de la exposición a la infección por VIH. Conclusiones: los diferentes perfiles de comportamiento individuales están condicionados por factores complejos que conducen a no evitar exponerse y en muchos casos incluso intencionalmente buscar la infección con el VIH. Estrategias de intervención adecuadas podrían contribuir a identificar a tiempo y controlar estos patrones en la población con mayor riesgo(AU)

Introduction: Exposure to HIV infection, with conscious participation of the vulnerable individual, is a complex problem that has spread rapidly, especially among men who have sex with men. Objective: To define how the infection occurs taking into account the individual's contribution to the exposure and the elements that characterize such contribution. Methods: A qualitative study with discussion groups was conducted to explore the criteria and perceptions of people with HIV/AIDS about the ways of exposure to infection. An intentional sample of homogeneous groups was selected. The answers and comments of the discussion groups were weighted to give them a hierarchical order. Results: Six discussion groups were held. The main concepts were unavoided infection and intentional infection, the latter referred to the conscious or participatory exposure of the individual. In addition, the overall risk of infection for the entire Cuban population, regardless of their degree of participation (based on the HIV prevalence rate in Cuba) was defined as accidental infection. Different categories were generated for each concept describing the manner and purpose of exposure to HIV infection. Conclusions: Different individual behavioral profiles are conditioned by complex factors that lead not to avoid exposure and, in many cases, even intentionally seek HIV infection. Appropriate intervention strategies could help timely identify and control these patterns in the population at greater risk(AU)

Enfermedades oportunistas en pacientes VIH/sida con debut de sida que reciben tratamiento antirretroviral / Opportunistic diseases observed in HIV/aids patients with onset of aids and antiretroviral treatment

INTRODUCCIÓN: el debut del sida es una forma de presentación de la enfermedad caracterizada por alteración del estado general, síndrome de desgaste, graves infecciones oportunistas, neoplasias y alteraciones neurológicas. El tratamiento con antirretrovirales ha aumentado la esperanza de vida de estos pacientes. OBJETIVOS: identificar las enfermedades oportunistas, asociadas a la condición clínica de los pacientes bajo estudio, y su relación con el conteo de linfocitos T CD4+ y la carga viral así como, evaluar la mortalidad en el grupo de pacientes estudiados y su relación con las enfermedades oportunistas. MÉTODOS: se realizó un estudio observacional prospectivo de corte transversal. El tamaño de la muestra estuvo condicionado al universo total de pacientes VIH/sida del servicio de Medicina del Instituto de Medicina Tropical "Pedro Kourí". La muestra (55 pacientes) se seleccionó, se tuvo en cuenta los sujetos que fueron diagnosticados con debut de sida y presentaron enfermedades oportunistas durante un año. RESULTADOS: las enfermedades oportunistas infecciosas como neurotoxoplasmosis 21,8 % y neumonía por Pneumocystis jirovecii 12,7 % fueron los eventos definitorios de sida predominantes. No hubo asociación estadística significativa, con el conteo bajo de linfocitos T CD4+ bajos y carga viral elevada. En los pacientes mayores de 50 años con más de una enfermedad oportunista el riesgo de morir fue 4,72 veces mayor que para el resto. CONCLUSIONES: las enfermedades oportunistas infecciosas como neurotoxoplasmosis y Pneumocystis jirovecii,fueron los eventos definitorios de sida predominantes. La mortalidad asociada a sida en los pacientes mayores de 50 años aumentó en los individuos que presentaron más de una enfermedad oportunista. Estos resultados son útiles para el diseño de estrategias de tratamiento que disminuyan la aparición de las enfermedades oportunistas y mejoren aun más, la supervivencia de los pacientes VIH/sida.

INTRODUCTION: onset of aids is a form of presentation of the disease that is characterized by altered general condition, wornout syndrome, serious opportunistic infections, neoplasias and neurological alterations. The antiretroviral treatment has increased the life expectancy of these patients. OBJECTIVES: to identify the opportunistic diseases associated to the clinical condition under study and their linking to the CD4+ T lymphocyte count and the viral load as well as to evaluate the mortality in the studied group and its relationship with opportunistic diseases. METHODS: prospective, observational and cross-sectional study of a sample of 55 patients. The size of the sample depended on the total universe of HIV/aids patients in the medicine service of "Pedro Kouri" Tropical Medicine Institute. The study took into account those subjects who were diagnosed with onset of aids and presented with opportunistic diseases during one year. RESULTS: infectious opportunistic diseases such as neurotoxoplasmosis (21.8 %) and pneumonia caused by Pneumocystis jirovecii (12.7 %) were the predominant defining events of aids. There was no statistically significant association with low CD4+ T lymphocyte count and high viral load. In patients over 50 years of age with more than one opportunistic disease, the risk of dying was 4.72 times higher than in the rest of the group. CONCLUSIONS: infectious opportunistic diseases as neurotoxoplasmosis and Pneumocystis jirovecii were the prevailing defining events of aids. Aids-associated mortality in patients aged over 50 years increased in individuals who presented more than one opportunistic disease. These results are useful for the design of treatment strategies that reduce the occurrence of opportunistic diseases and improve even more the survival of HIV/aids patients.