[Available resources for the treatment of breast cancer in Mexico]. / Recursos disponibles para el tratamiento del cáncer de mama en México.

OBJECTIVE: Describe the resources for the treatment of breast cancer in Mexico. METHODS: Information was obtained from 23 Centros Estatales de Cáncer (State Cancer Centers, CEC), two federal hospitals and Cancerología. This study was performed in Mexico City in August/September of 2008. RESULTS: These 23 centers provide medical care for breast cancer including surgery, chemotherapy and radiotherapy; all of them validated by the Seguro Popular. The costs were defined according to clinical stage and ranged from $27,500.00 pesos for clinical stage 0 to $480,00.00 in the advanced stage. A total of 2 689 women with breast cancer have been treated; only 1% was reported with in situ carcinoma. CONCLUSIONS: An adequate medical infrastructure is in place to treat breast cancer in Mexico. The costs are high due to late diagnosis of the disease. Early detection of breast cancer is a high priority for optimal control of this disease in Mexico.

Incidental pulmonary embolism. Incidence, clinical-radiological features and survival / Tromboembolismo pulmonar incidental. Incidencia, manifestaciones clínico-radiológicas y supervivencia

Objetive: To describe the incidence and features of incidental pulmonary embolism (IPE) and survival of all patients with IPE from January 2012 to December 2014. Rationale: The prevalence of IPE accounts for 1–10% of all pulmonary embolisms (PE). Methods: All radiological reports of computed tomography with intravenous contrast in which the IPE was not suspected were evaluated. The numerical data are expressed by mean and standard deviation (SD); Survival by the Kaplan–Meier analysis and the Log Rank test. Results: We reviewed 7508 reports, detecting 44 patients with IPE (0.6%). Men 64%, age 68 years, pack-year 25, oncological disease 73%, chemotherapy last month before IPE 82%. The predominant histological strain was adenocarcinoma (60%) and epidermoid (20%). The origin of the most common tumor was bronchogenic (27%) and colorectal (14%). The distribution according to the PESI index was mainly I (71%) and II (21%). They received anticoagulation 54%. The location of thrombi was bilateral in 32%. Around 70% were located in main and lobar arteries. Overall survival at one year was more than 70%, being higher in anticoagulated patients (log rank <0.05). Conclusions: The incidence of IPE is low, predominantly in oncological patients. Adenocarcinoma is the predominant strain. Most of them have a low severity index. Survival is higher in anticoagulated patients and higher than in the case of published non-incidental PE.(AU)

Objetivo: Describir la incidencia, características y supervivencia de todos los pacientes con TEPI desde Enero de 2012 hasta Diciembre de 2014. Justificación: La prevalencia de tromboembolismo pulmonar incidental (TEPI) ocurre en el 1–10% de todos los tromboembolismos pulmonares (TEP). Método: Todos los informes radiológicos de tomografía computerizada con contraste intravenoso en los cuales el TEP no era sospechado fueron evaluados. Los resultados numéricos fueron expresados mediante media y desviación estándar; Supervivencia por KaplanMeier y test de LogRank. Resultado: Revisamos 7508 informes detectando 44 pacientes con TEPI (0.6%). Hombres 64%, edad 68 años, índice paquetes-año 25, enfermedad oncológica 73%, quimioterapia el mes previo al TEPI 82%. La estirpe histológica predominante fue adenocarcinoma (60%) y epidermoide (20%). El origen del tumor más frecuente fue broncogénico (27%) y colorrectal (14%). La distribución teniendo en cuenta la escala PESI fue predominantemente I (71%) y II (21%). Recibieron anticoagulación el 54%. La localización del trombo fue bilateral en el 32%. En torno al 70% fueron localizados en arterias principales y lobares. La supervivencia global al año fue mayor del 70%, siendo mayor en pacientes anticoagulados (log rank <0.05). Conclusiones: La incidencia de TEPI es baja, predominantemente en pacientes oncológicos. La mayoría presentaron bajo índice de severidad. La supervivencia es mayor en pacientes anticoagulados y mayor que la publicada para embolismos pulmonares no incidentales.(AU)

Tetrahydropyrrolo[3,2-c]azepin-4-ones as a new class of cytotoxic compounds.

Pyrroloazepinones 8a-j and 9a-j were designed by structural modification of lead compound 3. These compounds were tested on five tumor cell lines to determine the role of the azeto ring and the 2-methyl substituent in the cytotoxicity of compound 3. Our results show that compounds 8a-j (R1=CH3) have dramatically reduced cytotoxicity, resulting from the loss of the azeto moiety of lead compound 3. By contrast, azepinones 9a-j (R1=4-nitrophenyl) inhibited the proliferation of almost all cancer cell lines tested even though they lack the azeto ring. Preliminary SAR studies with these compounds revealed the importance of halogens at the para- or meta-position of the 1-phenyl moiety. Additionally, derivatives 9a (R2=H), 9e (R2=4-F), and 9g (R2=4-OMe) were selectively cytotoxic to U-251 cells. However, none of the pyrroloazepinones inhibited the enzymatic activity of CDK1/cyclin B, CDK5/p25, and GSK-3.

Recursos disponibles para el tratamiento del cáncer de mama en México / Available resources for the treatment of breast cancer in Mexico

OBJECTIVE: Describe the resources for the treatment of breast cancer in Mexico. METHODS: Information was obtained from 23 Centros Estatales de Cáncer (State Cancer Centers, CEC), two federal hospitals and Cancerología. This study was performed in Mexico City in August/September of 2008. RESULTS: These 23 centers provide medical care for breast cancer including surgery, chemotherapy and radiotherapy; all of them validated by the Seguro Popular. The costs were defined according to clinical stage and ranged from $27,500.00 pesos for clinical stage 0 to $480,00.00 in the advanced stage. A total of 2 689 women with breast cancer have been treated; only 1 percent was reported with in situ carcinoma. CONCLUSIONS: An adequate medical infrastructure is in place to treat breast cancer in Mexico. The costs are high due to late diagnosis of the disease. Early detection of breast cancer is a high priority for optimal control of this disease in Mexico.

OBJETIVO: Describir los recursos existentes para el tratamiento del cáncer de mama en México. MATERIAL Y MÉTODOS: Se recolectó información de 23 Centros Estatales de Cáncer (CEC), dos hospitales federales y el Instituto Nacional de Cancerología. Este estudio se realizo en México, DF, en agosto y septiembre del año 2008. RESULTADOS: Los 23 CEC ofrecen atención médica para el cáncer de mama, incluidos cirugía, quimioterapia y radioterapia, todos ellos acreditados por el Seguro Popular. Las cuotas de recuperación se definieron por etapa clínica, desde 27 500 pesos para la etapa clínica cero hasta 480 000 pesos en pacientes con enfermedad avanzada. Se ha atendido a 2 689 pacientes con cáncer de mama; sólo 1 por ciento se presentó con carcinoma in situ CONCLUSIONES: Se tiene la infraestructura y los recursos médicos para el óptimo tratamiento, pero los costos son altos debido al diagnóstico tardío. La detección oportuna del cáncer de mama es una prioridad para el óptimo control de esta enfermedad en México.