Should all CAR-T therapy for acute lymphoblastic leukemia Be consolidated with allogeneic stem cell transplant?

Autologous T cells genetically modified with a CD19 chimeric antigen receptor are an effective therapy for children and adults with relapsed or refractory acute lymphoblastic leukemia with initial response rates ranging from 70 to 85%. Unfortunately, about half of these responding patients will subsequently relapse raising the question of whether allogeneic hemopoietic stem cell transplant should be considered as a consolidative therapy. Currently efforts are focused on defining risk factors for relapse to try and develop algorithms predicting which patients may benefit from allogenic transplant.

Highlights from the 7th Oncological Pathology Conference 'Pathological Anatomy in the context of the National Cancer Law: An overview of the Latin American experience', 15, 22 and 23 July 2022, Trujillo, Peru.

The seventh session of the Oncological Pathology Conference (JoPaO) entitled 'Pathological Anatomy in the context of the National Cancer Law: An overview of the Latin American experience', was held virtually on July 15, 22 and 23. Peru was the headquarters for this event, where 17 national and international professors of high academic standing participated. They interacted in a multidisciplinary context through talks with national panellists and the general public. The recent promulgation of the 'National Cancer Law' fosters the development of discussion forums to analyse the national realities and uphold continuous learning about experiences in other Latin American countries with successful cancer programmes, in which pathology holds a principal role. The topics addressed during this JoPaO included the exchange of Latin American cancer management experiences, an emphasis on investments in and the development of strategic plans to improve care, the use of new technologies, laboratory quality control, and the need to advance scientific research.

An unusual aetiology of back pain.

We present the case of a healthy young man who developed pyogenic myositis, an infection that is rare in the USA. He had no prior medical conditions except for an obsessive-compulsive disorder and skin picking disorder resulting in multiple superficial skin infections. He presented to our hospital with acute back pain. He was found to be septic with fever, tachycardia and elevated white cell counts. Imaging revealed evidence of myositis in the gluteal region. He was treated with antibiotics and fully recovered. It is likely that the skin picking disorder and the recurrent superficial skin infections are responsible for the development of this infection.

Coexistencia de síndrome de Burnout y síntomas depresivos en médicos residentes: estudio descriptivo transversal en un hospital nacional de Lima / Coexistence of Burnout syndrome and depressive symptoms in medical residents: cross-sectional descriptive study at a general hospital in Lima, Peru

Objetivo: Determinar la frecuencia de coexistencia de síndrome de Burnout (SBO) y síntomas depresivos en médicos residentes en un hospital general. Material y métodos: Estudio descriptivo transversal realizado en médicos residentes de todas las especialidades del Hospital Nacional Cayetano Heredia (HNCH) durante febrero del 2011, utilizando la versión en español del inventario de Maslach para SBO (MBI) y de la Escala de depresión del Centro de Estudios Epidemiológicos (CES-D 20). Resultados: Se analizó la información de 84 médicos residentes, 60 de los cuales fueron varones. La edad promedio de los participantes fue de 31 ± 4,4 años. La frecuencia de SBO fue 54,9% y desintomatología depresiva 38,6%. El 32,9% presentó síntomas depresivos y SBO. No se encontró asociación entre el número de horas trabajadas a la semana con la presencia de síntomas depresivos o SBO. Conclusiones: La coexistencia entre SBO y síntomas depresivos fue 32,9% y debe tenerse en cuenta para desarrollar investigaciones e intervenciones en esta población médica para reducir su presentación y las derivadas complicaciones.

Objective: To determinate the frequency between Burnout Syndrome (SBO) and depressive symptoms among residents at a general hospital. Material and methods: Cross-sectional descriptive study in residents from Hospital Nacional Cayetano Heredia (HNCH) during February 2011. SBO presence was measured with the Spanish version of Maslach Burnout Inventory (MBI) and depressive symptoms with the Spanish version of Center for Epidemiological Studies (CESD-D20). Results: We included 84 residents, 60 of them were males and the mean age was 31 ± 4.4 years. Burnout syndrome was reported in 54.9% of residents and depressive symptoms in 38.6% of them. 32.9% of our population presented both Burnout syndrome and depressive symptoms. No statistically association was found between the presence of SBO or depressive symptoms and the number of hours worked per week. Conclusions: The coexistence of Burnout Syndrome and depressive symptoms is clinically important (32.9%) and must be considered for research and interventions to be planned to avoid future complications.

Trastornos del sueño y dolor: Estudio transversal descriptivo en un instituto de medicina de sueño de Lima / Sleep disorders and pain: Cross-sectional descriptive study in a sleep institute of Lima

Objetivo: Determinar la existencia y fuerza de asociación entre síntomas relacionados con trastornos del sueño (ronquidos, pausas respiratorias durante el sueño, somnolencia e insomnio) con presentar dolor expresado como cefalea matutina, tensión muscular y dolor muscular matutino. Material y Métodos: Estudio transversal descriptivo. Se evaluó cuestionarios de pacientes ambulatorios de Hypnos Instituto del Sueño entre los años 1995 y 2008. Se empleó regresión logística para el análisis multivariado ajustando para edad e índice de masa corporal (IMC). Resultados: Se analizó en total 2140 cuestionarios. El 46% de sujetos fueron varones, la edad promedio fue de 51 años y la media del IMC fue de 25,3. Se encontró una asociación significativa entre somnolencia con cefalea matutina (OR=1,5, IC95%:1,2-1,9), tensión muscular (OR=1,4, IC95%:1,1-1,8) y con dolores musculares matutinos (OR=1,5, IC95%:1,2-2,0). Del mismo modo, se encontró una asociación significativa entre insomnio con cefalea matutina (OR=1,9, IC95%:1,6-2,4), tensión muscular (OR=2,1, IC95%:1,7-2,6) y con dolores musculares matutinos (OR=1,8, IC95%:1,5-2,3). Conclusiones: Existe en nuestra población de estudio una relación de gran intensidad estadística entre síntomas relacionados a trastornos de sueño con cuadros de dolor.

Objectives: The aim of this study was to determine the presence and strength of association between sleep related complaints (snoring, respiratory pauses during sleep, somnolence and insomnia) with pain, assessed as morning headaches, muscle tension and morning muscular pain. Materials and methods: Descriptive cross-sectional study. The questionnaires from outpatients treated at Hypnos Sleep Institute, between 1995 and 2008 were reviewed. Logistic regression was performed adjusting for age and body mass index (BMI) in the multivariate analysis. Results: In total 2140 questionnaires were assessed, 46% were males, the mean age was 51 years and the mean BMI was 25.3. A significant association was found between somnolence with morning headache (OR=1.5, IC95%:1.2-1.9), muscular tension (OR=1.4, IC95%:1.1-1.8) and with morning muscular pain (OR=1.5, IC95%:1.2-2.0). Also, a significant association was found between insomnia with morning headache (OR=1.9, IC95%:1.6-2.4), muscular tension (OR=2.1, IC95%:1.7-2.6) and with morning muscular pain (OR=1.8, IC95%:1.5-2.3). Conclusions: A strong statistical association between sleep disorders related symptoms and pain was found in the studied population.