Genomic ancestry and cancer among Latin Americans.

Latin American populations, characterized by intricate admixture patterns resulting from the intermingling of ancestries from European, Native American (NA) Asian, and African ancestries which result in a vast and complex genetic landscape, harboring unique combinations of novel variants. This genetic diversity not only poses challenges in traditional population genetics methods but also opens avenues for a deeper understanding of its implications in health. In cancer, the interplay between genetic ancestry, lifestyle factors, and healthcare disparities adds a layer of complexity to the varying incidence and mortality rates observed across different Latin American subpopulations. This complex interdependence has been unveiled through numerous studies, whether conducted on Latin American patients residing on the continent or abroad, revealing discernible differences in germline composition that influence divergent disease phenotypes such as higher incidence of Luminal B and Her2 breast tumors, EGFR and KRAS mutated lung adenocarcinomas in addition to an enrichment in BRCA1/2 pathogenic variants and a higher than expected prevalence of variants in colorectal cancer associated genes such as APC and MLH1. In prostate cancer novel risk variants have also been solely identified in Latin American populations. Due to the complexity of genetic divergence, inputs from each individual ancestry seem to carry independent contributions that interplay in the development of these complex disease phenotypes. By understanding these unique population characteristics, genomic ancestries hold a promising avenue for tailoring prognostic assessments and optimizing responses to oncological interventions.

Cross-cultural validation into Portuguese of a questionnaire to assess computer vision syndrome in workers exposed to digital devices / Validação intercultural em português de um questionário para avaliar a síndrome visual do computador em trabalhadores expostos a dispositivos digitais

ABSTRACT Purpose: As digital devices are increasingly used at work, valid and reliable tools are needed to assess their effect on visual health. This study aimed to translate, cross-culturally adapt, and validate the Computer Vision Syndrome Questionnaire (CVS-Q©) into Portuguese. Methods: A 5-phase process was followed: direct translation, synthesis of translation, back-translation, consolidation by an expert committee, and pretest. To run the pretest, a cross-sectional pilot study was conducted with 26 participants who completed the prefinal Portuguese version of the CVS-Q© and were asked about difficulties, comprehensibility, and suggestions to improve the questionnaire. To evaluate the reliability and validity of the Portuguese version of the CVS-Q©, a cross-sectional validation study was performed in a different sample (280 workers). Results: In the pretest, 96.2% had no difficulty in completing it, and 84.0% valued it as clear and understandable. CVS-Q© in Portuguese (Questionário da Síndrome Visual do Computador, CVS-Q PT©) was then obtained. Validation revealed the scale's good internal consistency (Cronbach's alpha=0.793), good temporal stability (intraclass correlation coefficient=0.847; 95% CI 0.764-0.902, kappa=0.839), adequate sensitivity and specificity (78.5% and 70.7%, respectively), good discriminant capacity (area under the curve=0.832; 95% CI 0.784-0.879), and adequate convergent validity with the ocular surface disease index (Spearman correlation coefficient=0.728, p<0.001). The factor analysis provided a single factor accounting for 37.7% of the explained common variance. A worker who scored ≥7 points would have computer vision syndrome. Conclusions: CVS-Q PT© can be considered an intuitive and easy-to-understand tool with good psychometric properties to measure computer vision syndrome in Portuguese workers exposed to digital devices. This questionnaire will assist in making decisions on preventive measures, interventions, and treatment and comparing exposed populations in different Portuguese-speaking countries.

RESUMO Objetivos: À medida que a utilização de equipamentos digitais no emprego aumenta, a avaliação do seu efeito na saúde visual necessita de ferramentas válidas e robustas. Este estudo teve como objetivo traduzir, adaptar culturalmente e validar para português o Questionário da Síndrome Visual do Computador (CVS-Q©). Métodos: O procedimento foi realizado em 5 fases: tradução direta, síntese da tradução, tradução inversa, consolidação por um painel de especialistas, e pré-teste. Para fazer o pré-teste foi realizado um estudo piloto transversal aplicado a uma amostra de 26 participantes que completaram a versão pré-final da versão portuguesa do CVS-Q©, questionando por dificuldades, compreensão e sugestões de melhoria do questionário. Para avaliar a confiança e validade da versão portuguesa do CVS-Q© foi realizado um estudo transversal de validação em uma amostra diferente (280 funcionários). Resultados: No préteste, 96.2% dos participantes não apresentaram dificuldades no preenchimento do questionário, enquanto 84.0% indicaram que era claro e compreensível. Obteve-se, então, o CVS-Q© em português (Questionário da Síndrome Visual do Computador, CVS-Q PT©). A sua validação revelou uma boa consistência interna da sua escala (Cronbach's alpha=0.793), boa estabilidade tem poral (coeficiente de correlação interclasse=0.847; 95% CI 0.764-0.902, kappa=0.839), sensibilidades e especificidades adequadas (78.5% e 70.7%, respetivamente), boa capacidade de discriminação (área abaixo da curva=0.832; 95% CI 0.784-0.879), e uma adequada validade da convergência com o índice de doença da superfície ocular (ocular surface disease index - OSDI; coeficiente de correlação de Spearman=0.728, p<0.001). A análise fatorial revelou um único fator responsável por explicar a variância comum em 37.7%. Um funcionário com uma pontuação ≥7 pontos sofria de síndrome visual do computador. Conclusão: O CVS-Q PT© pode ser considerada uma ferramenta intuitiva, de fácil interpretação e com boas pro priedades psicométricas para avaliar a síndrome visual do computador em funcionários portugueses expostos a ecrãs digitais. Este questionário facilitará as decisões sobre medidas preventivas, intervenções e tratamento, e a comparação entre as populações expostas em diferentes países de língua portuguesa.

Cross-cultural validation into Portuguese of a questionnaire to assess computer vision syndrome in workers exposed to digital devices.

PURPOSE: As digital devices are increasingly used at work, valid and reliable tools are needed to assess their effect on visual health. This study aimed to translate, cross-culturally adapt, and validate the Computer Vision Syndrome Questionnaire (CVS-Q©) into Portuguese. METHODS: A 5-phase process was followed: direct translation, synthesis of translation, back-translation, consolidation by an expert committee, and pretest. To run the pretest, a cross-sectional pilot study was conducted with 26 participants who completed the prefinal Portuguese version of the CVS-Q© and were asked about difficulties, comprehensibility, and suggestions to improve the questionnaire. To evaluate the reliability and validity of the Portuguese version of the CVS-Q©, a cross-sectional validation study was performed in a different sample (280 workers). RESULTS: In the pretest, 96.2% had no difficulty in completing it, and 84.0% valued it as clear and understandable. CVS-Q© in Portuguese (Questionário da Síndrome Visual do Computador, CVS-Q PT©) was then obtained. Validation revealed the scale's good internal consistency (Cronbach's alpha=0.793), good temporal stability (intraclass correlation coefficient=0.847; 95% CI 0.764-0.902, kappa=0.839), adequate sensitivity and specificity (78.5% and 70.7%, respectively), good discriminant capacity (area under the curve=0.832; 95% CI 0.784-0.879), and adequate convergent validity with the ocular surface disease index (Spearman correlation coefficient=0.728, p<0.001). The factor analysis provided a single factor accounting for 37.7% of the explained common variance. A worker who scored ≥7 points would have computer vision syndrome. CONCLUSIONS: CVS-Q PT© can be considered an intuitive and easy-to-understand tool with good psychometric properties to measure computer vision syndrome in Portuguese workers exposed to digital devices. This questionnaire will assist in making decisions on preventive measures, interventions, and treatment and comparing exposed populations in different Portuguese-speaking countries.

Expanded Access Study of Palbociclib Plus Letrozole for Postmenopausal Women with HR+/HER2- Advanced Breast Cancer in Latin America for Whom Letrozole Therapy is Deemed Appropriate.

BACKGROUND AND OBJECTIVES: Palbociclib is a cyclin-dependent kinase 4/6 inhibitor that is approved in the United States for the treatment of hormone receptor‒positive (HR+)/human epidermal growth factor receptor‒2 negative (HER2-) advanced breast cancer (ABC). The objectives of this expanded access trial were to provide palbociclib in combination with letrozole to patients with HR+/HER2- ABC in Argentina, Brazil, Colombia, and Mexico who were candidates for letrozole therapy before commercial availability of palbociclib, and to evaluate the safety and tolerability of palbociclib plus letrozole. PATIENTS AND METHODS: Postmenopausal women aged ≥ 18 years with HR+/HER2- ABC were eligible to participate in this study. Patients received palbociclib 125 mg once daily (3/1 schedule) and letrozole 2.5 mg once daily (continuous schedule). Safety, objective response rate (ORR), and duration of treatment were evaluated. RESULTS: A total of 130 patients were treated with palbociclib plus letrozole (Argentina, n = 33; Brazil, n = 35; Colombia, n = 28; Mexico, n = 34). The most common treatment-emergent adverse events (TEAEs) of any grade were neutropenia (70.0%), leukopenia (34.6%), anemia (33.8%), decreased neutrophil count (27.7%), and thrombocytopenia (24.6%); 22.3% of patients required a palbociclib dose reduction due to adverse events (AEs). Serious AEs were reported in 32 patients (24.6%). The ORR was 24.8% (95% confidence interval 17.6‒33.2), and the median duration of treatment was 10.6 months (range 0.1‒29.3). CONCLUSION: Palbociclib in combination with letrozole was generally well tolerated with a clinically manageable safety profile; the observed ORR supported treatment benefit in Latin American women with HR+/HER2- ABC. TRIAL REGISTRY: ClinicalTrials.gov, NCT02600923.

This study was done to learn more about the safety of 2 medicines together for women with advanced breast cancer after menopause. All 130 women in the study had the most common kind of breast cancer and were from Argentina, Brazil, Colombia, and Mexico. Everyone took 2 oral medicines called palbociclib and letrozole during the study. The researchers looked for any side effects experienced by the women while taking these medicines together. Another goal of the study was to see how well the treatment worked. Blood tests showed 70.0% of women had a side effect where they had a lower number of a type of white blood cell called a neutrophil. In total, 34.6% of women had low levels of another white blood cell called a leukocyte. These blood test results can mean a person is more likely to get infections. Serious side effects were experienced by 24.6% of the women, which meant these were life-threatening, caused lasting problems, or they needed hospital care. To cope with their side effects, 22.3% of the women switched to a lower palbociclib dose; 24.8% of the women had an overall response, which meant they either had a decrease in their tumor size or all cancer signs disappeared from their body. The most common length of time in the study was 10.6 months and the longest time was 29.3 months. The results of this study support using palbociclib plus letrozole to treat women who live in Latin America with advanced breast cancer after menopause.

Soft skills in personnel training: Report of publications in scopus, topics explored and future research agenda.

Recent research has documented the interest of organizations in training their staff in soft skills, but few studies have been found. Therefore, the objective of this research was to analyze 753 publications in the Scopus database related to soft skills in staff training during the period 1999-2021. These documents were analyzed to identify the main information, the most explored areas, and a future research agenda; all under a bibliometric and bibliographic approach with the help of RStudio and VOSviewer software. The results showed that the keywords with the most co-occurrence were personnel training (n = 110) and soft skills (n = 79). The year with the most documents was 2021 (n = 121). The country with the most publications was the United Kingdom (n = 199). Medicine is the subject area with the most documents (n = 278) and the Article is the type of document with the most studies (n = 566). Eleven areas of further exploration were identified: "Soft skills in software engineering at the higher education level", "Soft skills and communication", "Soft skills and engineering education", "Soft skills in virtual environments", "Soft skills in machine learning", "Serious games in teaching soft skills", "Soft skills for problem-based learning", "Soft skills for project management", "Soft skills and technical skills", "Project-based learning for the assessment of soft skills" and "Soft leadership skills". Five potential areas for future research were derived: soft skills in collaborative work (CSCL), soft skills in computer-aided collaborative work (CSCW), facial expressions as a mirror of soft skills, soft skills for employability and Professional Development Plan (PDP) to assess soft skills. In conclusion, this Review type document on soft skills in personnel training helped to identify the most studied topics during the evaluated period, as well as to identify the little explored topics for future research.

Reflexiones de las 4 funciones de enfermería e impactos en América Latina / Reflections on the 4 nursing functions and impacts in Latin America / Reflexões sobre as 4 funções e impactos da enfermagem na América Latina

La enfermería reconocida como disciplina profesional cuenta con conocimientos dirigidos al cuidado de la vida humana, su desarrollo la ha diferenciado de otras disciplinas dándole visibilidad particular desde cuatro funciones: gestión, enseñanza, investigación y atención clínica. Para lo cual se generó una reflexión sobre los impactos positivos y negativos del evolucionar de enfermería en América Latina ante estas funciones, desde la gestión se evidencia avances importantes desde el liderazgo gremial y organizacional, pero retrocesos en el escalamiento político, e institucional. Existe brecha de la formación profesional en comparación a otras regiones, aun así, el crecimiento de programas educativos ha dado la posibilidad de la profesionalización, pero debate el reto de la calidad, la disparidad formativa y la oferta centrada en el paradigma clínico. En el campo investigativo se resalta la creación de programas doctorales y post graduales que amplían la generación de conocimiento, pero también se evidencian barreras en la transferencia y visibilidad colectiva del conocimiento. En el área clínica espacio con mayor abordaje de las acciones formativas y laborales del profesional, cuenta con grandes retos en su crecimiento, organización, escalamiento, seguridad y precariedad laboral. En esa perspectiva la comunidad U-Nursing LatAm se ha integrado para aportar a la región en estos retos. Finalmente se concluye que la mayoría de los desafíos son relacionados con las habilidades sociales y blandas que deben potencializarse en el plano personal y colectivo. Todas las situaciones requieren tener una valoración directa de las posibilidades de fortalecer y mejorar la enfermería desde cada país de la región, teniendo en cuenta las cuatro funciones.

Intervención educativa sobre cuidado espiritual para estudiantes de licenciatura en enfermería y obstetricia / Spiritual care educational intervention for undergraduate nursing and midwifery students

Para los estudiantes de enfermería es indispensable la formación en el cuidado espiritual para identificar y satisfacer las propias necesidades espirituales y las de las personas que cuidarán, la dimensión espiritual es inherente al ser humano, para abordarla se requieren conocimientos que lleven a la reflexión e interés en la atención desde una perspectiva integral.

For nursing students, training in spiritual care is essential to identify and satisfy their own spiritual needs and those of the people they will care for; the spiritual dimension is inherent to the human being, and to address it requires knowledge that leads to reflection and interest in care from an integral perspective.

Importancia del control glucémico durante el perioperatorio en pacientes con diabetes mellitus / Importance of glycemic control during the perioperative period in patients with diabetes mellitus

Resumen: La diabetes mellitus se ha convertido en un problema de salud pública en el mundo, ya que su incidencia y prevalencia se ha incrementado de manera exponencial en las últimas décadas, lo que ha traído consigo un aumento en las complicaciones agudas y crónicas asociadas a su diagnóstico tardío y poco apego a su tratamiento. Los pacientes con diabetes mellitus tienen una mayor probabilidad de requerir una cirugía en comparación con la población general, quienes podrían llegar a presentar complicaciones graves asociadas al evento quirúrgico como hipertensión, cardiopatía isquémica, nefropatía y neuropatía autonómica, las cuales se deben a un incremento de la resistencia a la insulina y a la hiperglucemia. Por lo anterior, el control metabólico es pieza clave en la conducta perioperatoria del paciente con diabetes mellitus donde la participación de un equipo multidisciplinario (médico internista, cirujano y anestesiólogo) definan de manera conjunta las mejores estrategias quirúrgicas y anestésicas para un mejor desenlace previo, durante y posterior a la cirugía.

Abstract. Diabetes mellitus has become a public health problem worldwide, its incidence and prevalence have exponentially increased in recent decades, bringing with it an increase in acute and chronic complications associated with late diagnosis and failure of adherence to treatment. Patients with diabetes mellitus are more likely to require surgery compared to the general population, they may have serious complications associated with the surgical event such as hypertension, ischemic heart disease, nephropathy and autonomic neuropathy, due to an increase in insulin resistance and hyperglycemia. Therefore, metabolic control is a key element in the perioperative behavior of patients with diabetes mellitus where the joint collaboration of a multidisciplinary team (internist, surgeon and anesthesiologist) to define the best surgical and anesthetic strategies for a better outcome before, during and after surgery.

Perception about barriers and facilitators of the school-based HPV vaccine program of Manizales, Colombia: A qualitative study in school-enrolled girls and their parents.

In 2012, Colombia implemented a school-based HPV vaccination program of a 3-dose series for nine year old girls. Following a mass psychogenic response after vaccination in a Colombian town, vaccination rates dropped from 80% in 2012-2013 to 5% in 2016. The study aimed to identify barriers and facilitators of HPV vaccine uptake among girls eligible for vaccination in the initial years of vaccine implementation from 2012 to 2014, and their parents. We conducted 19 individual qualitative interviews and 18 focus groups with an average of 5 girls, in Manizales, Colombia between 2016 and 2017. In total, 49 girls from six schools and 58 of their parents participated in the study. Participants had some degree of awareness about cervical cancer, especially among those of middle and upper socioeconomic level. However, the vaccine was known as a prevention measure only after pap-smears and condoms. The main facilitator for vaccine uptake for parents was the desire to prevent diseases in general and for girls, it was facilitated by receiving positive information about the vaccine. The main barriers for vaccine uptake or for three doses completion were the event in Carmen de Bolivar, fear of adverse effects and fear of needles. Girls and parents stated that they received little or no information from schools or health care services about the HPV vaccine prior to vaccination. Our results suggest that improving HPV vaccination rates in Colombia will require a comprehensive education program including mass media information about HPV vaccine.

Aspectos de seguridad en el tratamiento del dolor con analgésicos antiinflamatorios no esteroideos / Security issues in pain management with nonsteroidal anti-inflammatory drugs

Resumen Los antiinflamatorios no esteroideos (AINE) son el grupo farmacológico que más se consume globalmente con o sin prescripción médica, sobre todo para el tratamiento sintomático de diversos padecimientos que cursan con dolor agudo o crónico. La estructura química de los AINE es heterogénea, por lo que comparten efecto antipirético, antiinflamatorio y analgésico a través de su capacidad para inhibir las prostaglandinas proinflamatorias. El conocimiento de que existen múltiples variaciones en cuanto a los perfiles de riesgo que presentan los AINE obliga a individualizar su uso en función de la patología de base, las características particulares del paciente y la experiencia del médico. Los AINE se deben utilizar en ciclos cortos y con las dosis más bajas posibles, tratando de mantenerlos en un rango de eficacia clínica y vigilando en específico las complicaciones gastrointestinales, cardiovasculares, renales, hepáticas y hematológicas derivadas de los mismos. El objetivo de este trabajo es revisar los aspectos de seguridad en el tratamiento analgésico crónico con AINE.

Abstract Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most consumed drugs worldwide, with or without medical prescription, mostly for the symptomatic treatment of a widely range of diseases characterized by acute or chronic pain. NSAIDs have a heterogenous chemical structure that gives them antipyretic, anti-inflammatory and analgesic properties through their ability to inhibit proinflammatory prostaglandins. The variability in risk profiles among NSAIDs forces the medical community to individualize their use based on the personal characteristics of the patients as well as the expertise of the physician. NSAIDs should be used for short cycles of treatment with the lowest doses possible, using them in a range of clinical efficacy, with specific monitoring of gastrointestinal, cardiovascular, renal hepatic and hematologic complications. The objective of this work is to review the safety aspects of the treatment with NSAIDs in chronic analgesic management.

Efficacy and safety of Levetiracetam vs. other antiepileptic drugs in Hispanic patients with glioblastoma.

Epilepsy is a common symptom in patients with glioblastoma (GB). 213 patients with GB from RedLANO follow-up registry were included. All patients underwent surgery, if feasible, followed by chemoradiation based on temozolomide (Stupp platform). Information was recorded regarding demographics, seizure timing, anti-epileptic drugs (AEDs), dosage, time to next seizure, total seizures in 6 months, and main side effects of AEDs. The relationship between epilepsy treatment and overall survival (OS) was evaluated. Mean age was 53 years old and 56.8% were male. Seventy-eight patients (37%) were treated with levetiracetam (LEV), 27% were given another AED and 36% did not require any AED. Choice of AED was not associated with age (p = 0.67), performance status (p = 0.24) or anatomic tumor site (p = 0.34). Seizures and AED requirement were greater in those having primary GB (p = 0.04). After starting an AED, the mean time until next crisis was 9.9 days (SD ± 6.3), which was shorter in those receiving LEV (p = 0.03); mean number of seizures during the first 3 and 6 months were 2.9 and 4, respectively. Most patients treated with LEV (n = 46) required less than two medication adjustments compared to those treated with other AEDs (p = 0.02). Likewise, less patients exposed to LEV required a coadjuvant drug (p = 0.04). Additionally, patients receiving LEV had significantly less adverse effects compared to patients treated with another AED. OS was significantly higher in the group treated with LEV compared to other AEDs (25.5 vs. 17.9 months; p = 0.047). Patients treated with LEV had better seizure control and longer OS compared to other AEDs.

Reading comprehension and self-perceived school performance in elementary school / Compreensão de leitura e desempenho escolar autopercebido no ensino fundamental / Comprensión de la lectura y rendimiento escolar autopercibido en la enseñanza primaria

This research aimed to investigate the reading comprehension and possible associations with self-perception of academic performance in elementary and middle school students. The study included 298 students enrolled from the 2nd to 9th grades in public schools the states of São Paulo and Parana. Two Cloze tests were collectively applied: one specific for elementary school (first stage of basic education) and another for the middle school (second stage). Results indicated that the students presented an instructional reading comprehension. It was also possible to observe statistically significant differences between Cloze score and self-perception of academic performance. In general, it can be stated that the students who presented better levels of reading comprehension are also the ones that better self-assessed. The data are discussed considering the psychoeducational implications concerning the mode of education investigated. (AU)

Esta pesquisa teve por objetivo investigar a compreensão em leitura e possíveis associações com o desempenho escolar autopercebido em alunos do ensino fundamental. Participaram 298 estudantes matriculados do 2º ao 9º anos em escolas públicas dos Estados de São Paulo e Paraná. Foram aplicados, coletivamente, dois testes de Cloze: um específico para a primeira etapa do ensino fundamental e outro para a segunda. Os resultados demonstram que os alunos apresentaram uma compreensão em leitura considerada como instrucional. Foi possível também observar diferenças estatisticamente significantes entre a pontuação no Cloze e a autopercepção do desempenho escolar. No geral, pode-se dizer que os alunos que apresentaram melhor nível de compreensão leitora também são os que melhor se autoavaliaram. Os dados são discutidos considerando as implicações psicoeducacionais concernentes à modalidade de ensino investigada. (AU)

Este artículo tuvo como objetivo investigar la comprensión de la lectura y posibles asociaciones con el rendimiento escolar autopercibido en alumnos de Enseñanza Primaria. Participaron 298 estudiantes matriculados desde 2º al 9º año en escuelas públicas de los Estados de San Pablo y Paraná. Se aplicaron, colectivamente, dos tests de Cloze: uno específico para la primera etapa de Enseñanza Primaria y otro para la segunda. Los resultados demostraron que los alumnos presentaron comprensión en la lectura considerada instructiva. También se observaron diferencias estadísticamente significativas entre puntuación en el Cloze y autopercepción del rendimiento escolar. En general, se puede decir que los estudiantes que presentaron mejor nivel de comprensión de lectura también fueron los que mejor se autoevaluaron. Los datos son discutidos considerando las implicaciones psicoeducativas concernientes a la modalidad de enseñanza investigada. (AU)

BIM deletion polymorphisms in Hispanic patients with non-small cell lung cancer carriers of EGFR mutations.

BACKGROUND: Germline alterations in the proapoptotic protein Bcl-2-like 11 (BIM) can have a crucial role in diverse tumors. To determine the clinical utility of detecting BIM deletion polymorphisms (par4226 bp/ par363 bp) in EGFR positive non-small-cell lung cancer (NSCLC) we examined the outcomes of patients with and without BIM alterations. RESULTS: BIM deletion was present in 14 patients (15.7%). There were no significant differences between patients with and without BIM-del in clinical characteristics or EGFR mutation type; however, those with BIM-del had a worse overall response rate (ORR) to erlotinib (42.9% vs. 73.3% in patients without BIM-del; p=0.024) as well as a significantly shorter progression-free survival (PFS) (10.8 BIM-del+ vs. 21.7 months for patients without BIM-del; p=0.029) and overall survival (OS) (15.5 BIM-del+ vs. 34.0 months for patients without BIM-del; p=0.035). Multivariate Cox regression analysis showed that BIM-del+ was an independent indicator of shorter PFS (HR 3.0; 95%CI 1.2-7.6; p=0.01) and OS (HR 3.4; 95%CI 1.4-8.3; p=0.006). METHODS: We studied 89 NSCLC Hispanic patients with EGFR mutation who were treated with erlotinib between January 2009 and November 2014. BIM deletion polymorphisms (BIM-del) was analyzed by PCR in formalin-fixed paraffin-embedded (FFPE) tissues of tumor biopsies. We retrospectively analyzed clinical characteristics, response rate, toxicity, and outcomes among patients with and without BIM-del. CONCLUSIONS: The incidence of BIM-del found in Hispanic patients is similar to that previously described in Asia. This alteration is associated with a poor clinical response to erlotinib and represents an independent prognostic factor for patients who had NSCLC with an EGFR mutation.

Pemetrexed/Carboplatin/Bevacizumab followed by Maintenance Pemetrexed/Bevacizumab in Hispanic Patients with Non-Squamous Non-Small Cell Lung Cancer: Outcomes according to Thymidylate Synthase Expression.

OBJECTIVE: To evaluate the efficacy and safety of pemetrexed, carboplatin and bevacizumab (PCB) followed by maintenance therapy with pemetrexed and bevacizumab (PB) in chemotherapy-naïve patients with stage IV non-squamous non-small cell lung cancer (NSCLC) through the influence of thymidylate synthase (TS) protein and mRNA expression on several outcomes. The primary endpoints were the overall response rate (ORR), progression-free survival (PFS) and overall survival (OS). METHODS: A cohort of 144 patients were administered pemetrexed (500 mg/m2), carboplatin (AUC, 5.0 mg/ml/min) and bevacizumab (7.5 mg/kg) intravenously every three weeks for up to four cycles. Maintenance PB was administered until disease progression or unacceptable toxicity. RESULTS: One hundred forty-four Colombian patients with a median follow-up of 13.8 months and a median number of 6 maintenance cycles (range, 1-32) were assessed. The ORR among the patients was 66% (95% CI, 47% to 79%). The median PFS and (OS) rates were 7.9 months (95% CI, 5.9-10.0 months) and 21.4 months (95% CI, 18.3 to 24.4 months), respectively. We documented grade 3/4 hematologic toxicities, including anemia (14%), neutropenia (8%), and thrombocytopenia (16%). The identified grade 3/4 non-hematologic toxicities were proteinuria (2%), venous thrombosis (4%), fatigue (11%), infection (6%), nephrotoxicity (2%), and sensory neuropathy (4%). No grade >3 hemorrhagic events or hypertension cases were reported. OS was significantly higher in patients with the lowest TS mRNA levels [median, 29.6 months (95% CI, 26.2-32.9)] compared with those in patients with higher levels [median, 9.3 months (95% CI, 6.6-12.0); p = 0.0001]. TS expression (mRNA levels or protein expression) did not influence the treatment response. CONCLUSION: Overall, PCB followed by maintenance pemetrexed and bevacizumab was effective and tolerable in Hispanic patients with non-squamous NSCLC. This regimen was associated with acceptable toxicity and prolonged OS, particularly in patients with low TS expression. We found a role for Ki67 and TS expression as prognostic factors.

Efficacy and safety of lapatinib as first-line therapy for ErbB2-amplified locally advanced or metastatic breast cancer.

PURPOSE: This study (EGF20009) assessed the efficacy and tolerability of two lapatinib administration schedules as first-line monotherapy in women with ErbB2-amplified locally advanced or metastatic breast cancer. PATIENTS AND METHODS: Patients with ErbB2-amplified, locally advanced or metastatic breast cancer previously untreated in the metastatic setting were randomly assigned to one of two lapatinib dose cohorts and received either 1,500 mg once daily or 500 mg twice daily. Clinical response was assessed at weeks 8 and 12 and every 12 weeks thereafter. RESULTS: A total of 138 patients were treated with lapatinib for a median of 17.6 weeks. The overall response rate (complete response [CR] plus partial response [PR]) was 24% in the intent-to-treat population, and 31% of patients derived clinical benefit (CR, PR, or stable disease for >or= 24 weeks). The median time to response was 7.9 weeks, and the progression-free survival rates at 4 and 6 months were 63% and 43%, respectively. The most common lapatinib-related adverse events (AEs) were diarrhea, rash, pruritus, and nausea, and these events were primarily grade 1 or 2. There were no significant differences in clinical activity or the AE profile between the dosing schedules. CONCLUSION: Lapatinib demonstrated clinical activity and was well tolerated as first-line therapy in ErbB2-amplified locally advanced or metastatic breast cancer. This study supports further evaluation of lapatinib in first-line and early-stage ErbB2-overexpressing breast cancer.

Estudantes de psicologia, eficácia adaptativa e a psicoterapia como medida preventiva em saúde mental / Psychology students, adaptive efficacy and psychotherapy prescription as a mental health preventive measure

O trabalho do profissional da saúde implica tanto a necessidade da habilitação acadêmica como um equilíbrio emocional satisfatório. O objetivo desta pesquisa foi verificar, através da EDAO (Escala Diagnóstica Adaptativa Operacionalizada), o grau de eficácia adaptativa dos alunos de Psicologia da Universidade Metodista de São Paulo (UMESP) e lhes fazer indicação terapêutica, quando necessário. Durante os anos de 1999 e 2000, foram feitas entrevistas diagnósticas individuais com 10 por cento dos alunos de Psicologia, cujos dados nos levaram a resultados que foram analisados individualmente e inter-grupos. Verificou-se que alguns alunos apresentaram dificuldades nos setores Afetivo-Relacional e Produtividade, porém, a grande maioria foi considerada 'normal'(AU)

Estudantes de psicologia, eficácia adaptativa e a psicoterapia como medida preventiva em saúde mental / Psychology students, adaptive efficacy and psychotherapy prescription as a mental health preventive measure

O trabalho do profissional da saúde implica tanto a necessidade da habilitação acadêmica como um equilíbrio emocional satisfatório. O objetivo desta pesquisa foi verificar, através da EDAO (Escala Diagnóstica Adaptativa Operacionalizada), o grau de eficácia adaptativa dos alunos de Psicologia da Universidade Metodista de São Paulo (UMESP) e lhes fazer indicação terapêutica, quando necessário. Durante os anos de 1999 e 2000, foram feitas entrevistas diagnósticas individuais com 10 por cento dos alunos de Psicologia, cujos dados nos levaram a resultados que foram analisados individualmente e inter-grupos. Verificou-se que alguns alunos apresentaram dificuldades nos setores Afetivo-Relacional e Produtividade, porém, a grande maioria foi considerada normal.