Risk factors and timing of subsequent cutaneous squamous cell carcinoma in patients with cutaneous squamous cell carcinoma: A retrospective cohort study.

BACKGROUND: Information about the frequency and timing of subsequent cutaneous squamous cell carcinoma (cSCC), along with associated risk factors, is limited. However, this information is crucial to guide follow-up care for these patients. OBJECTIVE: To evaluate the risk and timing of subsequent cSCC in patients who presented with an initial diagnosis of cSCC. METHODS: Retrospective review of an institutional review board-approved, single-institution registry of invasive cSCC. All patients had at least 2 primary cSCCs diagnosed on 2 separate dates 2 months apart. RESULTS: A total of 299 primary cSCCs were included. At 6 months from initial cSCC diagnosis, 18.06% (n = 54) of patients developed subsequent cSCC; at 1 year, 31.77% (n = 94); at 3 years, 67.56% (n = 202); and at 5 years, 87.96% (n = 263) developed subsequent cSCC. Risk factors associated with subsequent cSCC include age at initial diagnosis (hazard ratio [HR], 1.02; 95% confidence interval, 1.004-1.027; P = .008), T2 stage (HR, 1.66; 95% CI, 1.07-2.57; P = .025), and poor tumor grade. Tumor grades well, moderate, and unknown have HRs of 0.21 (P < .001), 0.16 (P .001), and 0.25 (P = .001), respectively. CONCLUSIONS: Of patients who develop subsequent cSCC, 18.06% do so within 6 months, and 31.77% do so within 1 year of initial cSCC diagnosis. Patients with advanced age, poor histologic differentiation, and American Joint Committee on Cancer T2 stage are at highest risk. Close clinical follow-up after the initial diagnosis is recommended.

Outcomes in intermediate-risk squamous cell carcinomas treated with Mohs micrographic surgery compared with wide local excision.

BACKGROUND: Brigham and Women's Hospital stage T2a squamous cell carcinomas, demonstrating a single high-risk feature, have a low risk of metastasis and death but an increased risk of local recurrence. Little evidence exists for the best treatment modality and associated outcomes in T2a squamous cell carcinoma. OBJECTIVE: We aimed to compare outcomes for T2a squamous cell carcinoma treated by Mohs micrographic surgery compared with wide local excision with permanent sections. METHODS: Retrospective review of an institutional review board-approved single-institution registry of T2a squamous cell carcinoma. RESULTS: Three hundred sixty-six primary T2a tumors were identified, including 240 squamous cell carcinomas (65.6%) treated with Mohs micrographic surgery and 126 (34.4%) treated with wide local excision. A total of 32.5% of patients were immunosuppressed and mean oncologic follow-up was 2.8 years. Local recurrence was significantly more likely after wide local excision (4.0%) than after Mohs micrographic surgery (1.2%) (P = .03). Multiple logistic regression demonstrated immunocompromised state (odds ratio [OR] 5.1; 95% confidence interval [CI] 1.1-23.3; P = .03) and wide local excision (OR 4.8; 95% CI 1.1-21.6; P = .04) associated with local recurrence; and wide local excision (OR 7.8; 95% CI 2.4-25.4; P < .001), high-risk head and neck location (OR 8.3; 95% CI 1.8-38.7; P = .004), and poor histologic differentiation (OR 4.7; 95% CI 1.4-15.4; P = .03) associated with poor outcomes (overall recurrence or disease-specific death). CONCLUSION: Mohs micrographic surgery provides improved outcomes in Brigham and Women's Hospital T2a squamous cell carcinoma.

Fatherhood among adolescents in conflict with the law: A family systemic approach / Paternidad en adolescente en conflicto con la ley: una perspectiva desde la terapia familiar sistémica / Paternidade em adolescentes em conflito com a lei: uma perspectiva da terapia familiar sistêmica

Resumen (analítico) The objective of this paper was to analyze the construction of father-hood in adolescents who are in conflict with the law through an exploratory and qualitative study. Life stories were developed using the in-depth interview technique. The sample consisted of four adolescents in conflict with the law. Through interpretative content analysis, we obtained seven categories, including: emotional context of family origin, family functioning, witnessing family violence and the expression of masculinity by transgressing the law and using drugs. Paternity allows these young fathers to reflect on their own experiences during childhood and develop a paternal role during their transition process out of detention. The main role they assume in their paternity is that of provider, but they also make space to satisfy the affective needs of their children.

Abstract (analytical) El objetivo fue analizar la construcción de la paternidad en adolescentes en conflicto con la ley. Se llevó a cabo un estudio exploratorio y cualitativo, se construyeron historias de vida a través de la técnica de entrevista a profundidad. La muestra se conformó por cuatro adolescentes en conflicto con la ley. Se hizo un análisis de contenido interpretativo y se obtuvieron siete categorías: contexto emocional de la familia de origen, el funcionamiento familiar, ser testigo de violencia familiar y la expresión de masculinidad al transgredir la ley y usar drogas. La paternidad permite reflexionar acerca de sus experiencias en la infancia, desarrollar un rol paternal en transición, en el que asumen como principal función el proveer, pero dando espacio a satisfacer las necesidades afectivas de sus hijos.

Resumo (analítico) O objetivo foi analisar a construção da paternidade em adolescentes em conflito com a lei. Realizou-se um estudo exploratório e qualitativo, as histórias de vida foram construídas por meio da técnica de entrevista em profundidade. A mostra foi composta por quatro adolescentes em conflito com a lei. Por meio da análise de conteúdo interpretativa, obtivemos sete categorias: contexto emocional de origem familiar, funcionamento familiar, testemunho de violência familiar, expressão da masculinidade pela transgressão da lei e uso de drogas. A paternidade permite que reflitam sobre suas vivências na infância, desenvolvam um papel paternal em transição, em que assumem a função principal de prover, mas dando espaço para a satisfação das necessidades afetivas de seus filhos.

Testing a coping scale in Mexican families in the face of the COVID-19 pandemic: Exploring the psychometric properties / Escala de afrontamiento en familias mexicanas ante la pandemia por COVID-19: Propiedadespsicométricas

Abstract Introduction The rapid spread of the pandemic due to the SARS-CoV-2 virus, more commonly known as COVID-19, required sanitary measures, such as social distancing and quarantining, which represented non-normative stressors for Mexican families. Objective Obtaining evidence of the validity and reliability of a family coping scale in the face of the COVID-19 pandemic. Method A questionnaire was developed containing 48 items, and responses were collected using Google forms with a total of 558 participants. Exploratory and confirmatory factor analyses were conducted to obtain the reliability and validity of the scale. Results The instrument is made up of six factors that explain 67.27% of the variance. The scale had a McDonald's omega coefficient of .82, and the model had a good fit with most values equal to or higher than .90. Discussion and conclusions The final items showed proper theoretical congruence and good indicators of fit. These results allow for the assertion that factors 1, 2, 5, and 6 allude to a good family adaptation in the face of the pandemic. Meanwhile, factors 3 and 4 indicate a poor family adaptation. Among the main contributions of this study is that this is one of the first scales to address the subject in Mexico, followed by statistical data that suggests the scale possesses appropriate psychometric properties to be used in the Mexican population.

Resumen Introducción La rápida propagación de la pandemia por el virus SARS-CoV-2, más conocido como COVID-19, requirió medidas sanitarias, como el distanciamiento social y la cuarentena, que representan estresores no normativos para las familias mexicanas. Objetivo Obtención de evidencia de la validez y confiabilidad de una escala de afrontamiento familiar ante la pandemia por COVID-19. Método Se desarrolló un cuestionario que contenía 48 ítems y las respuestas se recopilaron mediante un formulario de Google con un total de 558 participantes. Se realizó un análisis factorial exploratorio y confirmatorio para obtener la confiabilidad y validez de la escala. Resultados El instrumento está compuesto por seis factores que explican el 67.27% de la varianza. La escala tuvo un coeficiente Omega de McDonald's de .82, y el modelo tuvo un buen ajuste con la mayoría de los valores iguales o superiores a .90. Discusión y conclusiones Los ítems finales mostraron adecuada congruencia teórica y buenos indicadores de ajuste. Estos resultados permiten afirmar que los factores 1, 2, 5 y 6 aluden a una buena adaptación familiar ante la pandemia. Por su parte, los factores 3 y 4 indican mala adaptación familiar. Entre los principales aportes de este estudio se encuentra que esta es una de las primeras escalas que aborda el tema en México, seguido de datos estadísticos que sugieren que la escala posee propiedades psicométricas adecuadas para ser utilizada en población mexicana.

Evolución de la resistencia a insecticidas en Culex quinquefasciatus (Díptera: Culicidae) en un área de La Habana / Course of insecticide resistance in Culex quinquefasciatus (Diptera: Culicidae) in a region of La Habana

The use of malathion to control mosquitoes in Cuba during 7 years until 1986 selected 2 resistance mechanisms: that of elevated activity of nonspecific esterases and that of altered acetylcholinesterase (Ache) in Culex quinquefasciatus (Say). In Havana, specifically in the area under study (Quibú River), malathion was replaced by cypermethrin in 1987 and cycles of treatment with cypermethrin have been intensively used since 1987 up to now when the populations of Aedes or Culex increase. In Culex quinquefasciatus (Say) from the Quibú River the resistance levels, mainly to malathion, declined significantly from 1986 to 1997. An increase of resistance to pyrethroid was observed during that period of 11 years. The mechanism of elevated esterases rose to a frequency of 1 and there was also an increase in the frequency of the mechanism of Ache. The esterase B1, responsible for the resistance to malathion, but not to pyrethroid, was selected in this population until 1986. Starting from the use of pyrethroid for the control in this area, 2 new phenotypes of esterases named A6 and B6, apparently related to pyrethroid resistance, were selected.