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INTRODUCTION: The Biopsychosocial Prognosis Scale for Coronary Artery Bypass Grafting (BIPROSCAB) assesses biophysical symptoms and psychosocial experiences following coronary artery bypass grafting (CABG), thereby enabling the targeting of interventions to improve post-procedure biopsychosocial prognosis. The aim of this study was to adapt the BIPROSCAB for use in Brazil and assess the content validity of the adapted version.METHODS: For the cross-cultural adaptation, English-Portuguese translations, synthesis of translations, back-translations, assessment of back-translations for conceptual consistency by the authors of the original instrument, and evaluation of semantic, idiomatic, cultural, and conceptual equivalences by 11 expert judges were performed. Modifications were made based on suggestions until consensus > 80% was achieved. For the content validity assessment, experts assessed the clarity, theoretical relevance, and practical pertinence of the items, which were considered adequate when the content validity ratio (CVR) > 0.635. Post-CABG patients completed the questionnaire and evaluated understandability of the items.RESULTS: Three rounds were required to achieve the desired agreement in the cross-cultural adaptation process. In the content evaluation by experts, only one round was needed, with CVR > 0.635. Following content evaluation by patients, it was decided to reverse the order of the response scale to an ascending order.CONCLUSION: The Brazilian version, BIPROSCAB-Br, is equivalent to the original instrument and has satisfactory evidence of content validity. Additional psychometric assessments are needed for use in Brazil

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INTRODUCTION: The Biopsychosocial Prognosis Scale for Coronary Artery Bypass Grafting (BIPROSCAB) assesses biophysical symptoms and psychosocial experiences following coronary artery bypass grafting (CABG), thereby enabling the targeting of interventions to improve post-procedure biopsychosocial prognosis. The aim of this study was to adapt the BIPROSCAB for use in Brazil and assess the content validity of the adapted version. METHODS: For the cross-cultural adaptation, English-Portuguese translations, synthesis of translations, back-translations, assessment of back-translations for conceptual consistency by the authors of the original instrument, and evaluation of semantic, idiomatic, cultural, and conceptual equivalences by 11 expert judges were performed. Modifications were made based on suggestions until consensus > 80% was achieved. For the content validity assessment, experts assessed the clarity, theoretical relevance, and practical pertinence of the items, which were considered adequate when the content validity ratio (CVR) > 0.635. Post-CABG patients completed the questionnaire and evaluated understandability of the items. RESULTS: Three rounds were required to achieve the desired agreement in the cross-cultural adaptation process. In the content evaluation by experts, only one round was needed, with CVR > 0.635. Following content evaluation by patients, it was decided to reverse the order of the response scale to an ascending order. CONCLUSION: The Brazilian version, BIPROSCAB-Br, is equivalent to the original instrument and has satisfactory evidence of content validity. Additional psychometric assessments are needed for use in Brazil.

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PURPOSE: To identify the prognostic variables related to the survival of patients operated on for adenocarcinoma of the rectum who underwent preoperative radiochemotherapy (RCT). METHODS: We studied 70 patients from the Discipline of Surgical Gastroenterology at Escola Paulista de Medicina from 2000 to 2019, with rectal cancer located up to 10 cm from the anal verge and with stages II or III, submitted to preoperative RCT and curative surgery (R0) and with follow-up of at least 12 months. Clinical restaging was performed four to six weeks after the end of neoadjuvant treatment to characterize the degree of clinical tumor regression. Surgery by laparotomy or videolaparoscopy was performed six to 12 weeks after RCT. Primary endpoint were: overall survival (OS), disease-free survival (DFS), metastasis-free survival (MSS), and neoplasm-specific survival (SEN). These were compared with gender, age, carcinoembryonic antigen (CEA) dosage, distance from the tumor to the anal verge, radiation dose, radiotherapy-surgery interval, clinical regression, type of surgery, pT and pN TNM stage tumor, number of nodes, circumferential resection margin, and complete pathological response. Survival was assessed by Kaplan-Meier curves. Univariate and multivariate Cox analyses were calculated to identify factors associated with survival outcomes. RESULTS: The mean follow-up time was 62 months. The pathological complete response rate was 18.6%. Univariate cox regression showed a significant relationship of CEA equal to or greater than 4 ng/mL with DFS and MFS, pT3/pT4 staging with DFS, MFS and SEN, pN1/N2 with DFS, MFS and SEN and stages II and III with DFS and MFS. Multivariate regression found that CEA, pT, and pN staging are independent prognostic factors for DFS, MFS, and SEN. CONCLUSION: Carcinoembryonic antigen level prior to radiotherapy, pT staging and pN staging were independent prognostic factors for survival in patients with rectal adenocarcinoma who are treated with preoperative radiochemotherapy.

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It has been confirmed that the expression of miR-501-3p is closely related to the behavior of several cancers. This study aimed to elucidate the effects of miR-501-3p/SPC24 axis on the behavior of renal cancer cells and to identify its prognostic value in renal cancer. First, the expression of miR-501-3p in the renal cell carcinoma (RCC) cell line was detected using real-time quantitative polymerase chain reaction (RT-qPCR). Second, cell function identification experiments were performed, including CCK-8, scratch, transwell invasion, and flow cytometry assays. Several databases were applied to explore the possible mechanism of miR-501-3p tumor suppressor effect in RCC. To explore the value of miR-501-3p/SPC24 axis in predicting renal cancer patient overall survival (OS), GEPIA (http://gepia.cancer-pku.cn/index.html) was used. Finally, western blot was performed to detect the expression level of SPC24 in renal cancer cells predicted by bioinformatics analysis. Dual-Luciferase Reporter Assay was used to verify if SPC24 is a target of mir-501-3p. MiR-501-3p was found to be down-regulated in cancer cells and tissues and to play a role in suppressing tumor cell proliferation, cell viability, cell migration, and cell invasion, while promoting apoptosis. We also found that high expression levels of SPC24 were associated with shorter OS time in patients diagnosed with renal cell carcinoma. In addition, the results of TCGA data analysis and western blot showed that the tumor suppressor effect of miR-501-3p may be achieved by targeting SPC24. The MiR-501-3p/SPC24 axis affects cell proliferation, migration, invasion, apoptosis, and prognosis in renal cell carcinoma.

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Frailty is a significant risk factor for adverse outcomes in elderly surgical patients. Gait speed assessment is a new tool recently used to stratify risk for these pre-operative adverse outcomes. In this prospective study of 392 frail elderly patients undergoing abdominal surgery, we investigated the predictive value of preoperative gait speed for postoperative outcomes. Patients were divided into two groups based on their 6-meter gait speed: normal (≥0.8 m/s, n=184) and slow (<0.8 m/s, n=208). The slow group was older, had more comorbidities, and higher American Society of Anesthesiologists (ASA) grades (P<0.05). They also had significantly higher rates of 30-day overall complications (38.9 vs 18.5%, P<0.01), severe complications (12.0 vs 4.3%, P<0.01), and 1-year mortality (15.4 vs 6.5%, P=0.008) compared to the normal group. Pulmonary infection, wound infection, and delirium were the most common complications. Multivariate logistic regression confirmed slow gait speed as an independent risk factor for 30-day complications (OR=2.38, 95%CI: 1.41-4.01) and 1-year mortality (OR=2.19, 95%CI: 1.07-4.48). Our findings demonstrated that preoperative 6-meter gait speed effectively predicted short-term complications and mid-term mortality in frail elderly patients undergoing abdominal surgery. This suggests the need for individualized perioperative management strategies for high-risk patients with slow gait speed to potentially improve their prognosis.

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Head and neck squamous cell carcinoma (HNSCC) is a common malignant tumor that poses a major hazard to people's health. ZC3H12D, which belongs to the family of CCCH-type zinc finger-containing proteins, is a negative regulator with a key function in immune modulation. However, it is still unclear how ZC3H12D affects the immune infiltration and prognosis of HNSCC. In this study, the data obtained from various databases were used to assess ZC3H12D expression in HNSCC and in various tumors under the HNSCC classification. The association between clinical features and ZC3H12D expression in HNSCC was evaluated using the UALCAN database. Additionally, a ROC curve was employed to analyze the diagnostic value of ZC3H12D. The effect of ZC3H12D on prognosis was assessed using Kaplan-Meier curves, Cox analysis, and the nomogram model. Gene Set Enrichment Analysis, Gene Ontology, and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were employed to investigate the underlying role of ZC3H12D in HNSCC. The association between ZC3H12D expression and the tumor microenvironment and immune checkpoints were investigated by TIMER2 and Tumor Immune Single Cell Hub 2 databases and various packages in R. The findings demonstrated a significant up-regulation of ZC3H12D expression in HNSCC, while ZC3H12D expression was found to be associated with clinical parameters. Our study also demonstrated that ZC3H12D could act as a potential prognostic biomarker for HNSCC, especially oral squamous cell carcinoma. Additional analyses have shown that ZC3H12D was associated with common immune checkpoint genes and may be related to immune infiltration in HNSCC.

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This systematic review of inception prospective cohort studies aimed to investigate whether autoantibodies are potential prognostic factors for short- and long-term clinical outcomes of COVID-19. Searches were conducted in MEDLINE, EMBASE, AMED, GLOBAL HEALTH, and COCHRANE databases from 2019 to 2022. When possible, meta-analysis was conducted, otherwise findings from individual studies were reported using odds ratios (OR) with 95% confidence intervals (CI). Quality of evidence was summarized using the GRADE criteria. We identified 2292 references, 18 inception prospective cohort studies (3178 patients) were included in the systematic review, and 12 studies reached criteria for meta-analysis. Studies achieved, in general, low to moderate risk of bias. Moderate quality of evidence showed that anti-interferon (IFN) was associated with increased risk of severity (OR=7.75; CI=1.79-33.61) and mechanical ventilation (OR=4.19; CI=2.06-8.53), but not with COVID-19 mortality (OR=1.68; CI=0.63-4.44). Antiphospholipids were not associated with COVID-19 mortality (OR=1.42; CI=0.85-2.37; P=0.18; I2=3.21) nor with thrombosis risk (OR=1.41; CI: 0.71-2.8; P=0.33). Antinuclear antibody level was not associated with risk of mortality or severity (risk for mortality: OR=3.8; CI=0.78-18.6; P=0.1; I2: 32.3; severity: OR=1.74; CI=0.96-3.16; P=0.07). Evidence currently available is insufficient for a quantitative analysis of autoantibodies association with long COVID-19. Anti-IFN measurement should be considered in COVID-19 follow-up. In a population-based rational, optimized vaccination strategies should be considered for individuals with anti-IFN antibodies since it could represent a risk for a worse prognosis. High-quality prospective studies for short- and long-term disease effects and autoantibody evaluation are still needed.

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Oral squamous cell carcinoma (OSCC) is the main form of head and neck cancer. Gap junctions (GJs) are communication channels involved in cell proliferation control; they consist of hemichannels formed by connexin (Cx) proteins. The abnormal expression/function of Cx43 has been associated with tumor progression. Also, some human papillomaviruses (HPVs) have been linked to squamous cell cancer. Therefore, this study aimed at assessing Cx43 as a potential OSCC biomarker and exploring its association with histopathological differentiation and HPV infection. OSCC samples were inspected using hematoxylin and eosin staining, and Cx43 expression and HPV 16/18 were tested by immunofluorescence. Pearson correlation tests, ANOVA, and Kaplan-Meier curves were used in the analysis. Samples from 39 patients with OSCC were studied. Most had well-differentiated histology and 61.5% were HPV+. Cx43 expression was significantly associated with HPV infection (p = 0.047), differentiation (p < 0.001), and survival (p = 0.009), and HPV positivity was also associated with the degree of differentiation (p = 0.012). Cx43 shows potential as a prognostic biomarker for OSCC. Lower Cx43 expression, correlated with poorer differentiation, is associated with an unfavorable prognosis. Further studies are needed to confirm its clinical utility.

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BACKGROUND: Rapid progression of symptoms and development of Acute Respiratory Distress Syndrome (ARDS) frequently occurred during COVID-19 pandemic, while CT-Scan was useful to assess severity of lung damage, with classic patterns like early Ground Glass Opacity and/or late consolidation. Likewise, lung injury has been related to activation of the coagulation-fibrinolysis systems and pro-inflammatory mediators; where D-Dimer acquires prognostic relevance. The present study aimed to evaluate whether the extent of lung involvement and pattern of lung injury, as determined by chest CT-scan, are related with D-Dimer; and further impact clinical prognosis in patients with ARDS due to COVID-19. METHODS: Longitudinal, prospective, observational, multi-center study. Patients diagnosed with ARDS due to COVID-19, without previous lung damage, clotting disorder and/or anticoagulants use, who were attended at the Intensive Care Unit and Internal Medicine Department from March to June 2020. Tomographic extent of lung involvement was analyzed by image software, as well as damage patterns, assessed by experienced radiologists. Endpoints included relation of lung injury with coagulopathy markers like D-Dimer, and prognostic outcome including mortality, mechanical ventilation and hospitalization time. RESULTS: One-hundred and four patients mean aged 55 years old, 66% males, main comorbidities obesity, hypertension and diabetes mellitus. Larger lung damage was associated with older age, male gender and higher pro-inflammatory mediators like leukocytes and ferritin; whilst consolidation pattern was related to higher Body Mass Index. Higher values of D-Dimer were related either to a larger extent of lung involvement or late consolidation pattern. In addition, the extent of lung involvement was related with longer hospital stay, higher requirement of mechanical ventilation (HR 0.12, p < 0.01) and mortality rate (HR 0.13, p < 0.01); whereas late consolidation was mainly associated with requirement of mechanical ventilation (HR 0.23, p < 0.01). CONCLUSION: Tomographic extent of lung involvement and the pattern of lung injury are related with coagulopathy severity markers like D-Dimer, and own prognostic clinical ability in ARDS.

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INTRODUCTION: The main objective of this study was to evaluate the association between the baseline level of Histoplasma capsulatum urinary antigen (AgU) and the severity of histoplasmosis in the context of HIV, as well as its utility for treatment monitoring. Secondary objectives included determining the appropriate cutoff point for AgU detection for the diagnosis of proven histoplasmosis. MATERIALS AND METHODS: The study was an analytical, retrospective cohort study in adults diagnosed with HIV, with at least one determination of AgU using ELISA. Sociodemographic, clinical, and laboratory variables were collected. Statistical analysis was performed using R-project® software. RESULTS: A total of 452 individuals with AgU were included from March 2018 to July 2022, with 42 (9.3%) positive results (25 proven histoplasmosis and 17 probable cases). An statistically significant correlation was found between the baseline concentration of AgU and positive cultures. However, the utility of AgU as a followup tool could not be evaluated. The optimal cutoff point for detecting proven histoplasmosis was an AgU value ≥2.2 ng/mL (specificity: 96.3% and sensitivity: 100%). DISCUSSION: Further studies are needed to evaluate the utility of AgU as a tool for monitoring antifungal treatment. A value of AgU ≥2.2 ng/mL could potentially correspond to a diagnosis of proven histoplasmosis.

Introducción: El objetivo principal del estudio fue evaluar la asociación entre el valor basal del antígeno urinario de Histoplasma capsulatum (AgU) y la gravedad del cuadro de histoplasmosis en contexto de HIV, así como su utilidad para seguimiento de tratamiento antifúngico. En los objetivos secundarios se incluyódeterminar el punto de corte adecuado en la detección del AgU para el diagnóstico de histoplasmosis probada. Materiales y métodos: Estudio de cohorte analítico, retrospectivo en adultos con diagnóstico de HIV con una determinación del AgU, mediante ELISA. Se recolectaron variables sociodemográficas, clínicas y de laboratorio. Se realizóel análisis estadístico mediante software Rproject®. Resultados: Se incluyeron 452 individuos con determinación de AgU desde marzo 2018 a julio 2022, con 42 (9.3%) resultados positivos (25 histoplasmosis probadas y 17 probables). Se hallóuna correlación estadísticamente significativa entre la concentración basal del AgU y los cultivos positivos. No pudo evaluarse la utilidad del AgU como herramienta de seguimiento. El mejor punto de corte para detectar histoplasmosis probada fue un valor de AgU ≥2.2 ng/mL (especificidad: 96.3% y sensibilidad: 100%). Discusión: Se requieren mayores estudios para evaluar la utilidad del AgU como herramienta para seguimiento del tratamiento antifúngico. Un valor de AgU ≥2.2 ng/mL, podría equivaler a un diagnóstico de histoplasmosis probada.

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OBJECTIVES: Anti-MDA5 autoantibodies are strongly associated with interstitial lung disease (ILD) and rapidly progressive ILD (RP-ILD) in Asian patients with dermatomyositis (DM) or amyopathic DM (ADM). However, this association has not yet been established in Brazilian patients with anti-MDA5(+) DM/ADM. This study aimed to investigate the phenotypic differences between Brazilian and Japanese patients with anti-MDA5(+) DM/ADM, with a particular focus on ILD. METHODS: This was an international, tricentric, retrospective cohort study conducted in one Brazilian and two Japanese tertiary centres. Patients diagnosed with anti-MDA5(+) DM/ADM at the three centres were enrolled. Clinical characteristics and outcomes were collected using a pre-standardised protocol and compared between Brazilian and Japanese patients. RESULTS: Thirty-four Brazilian and 65 Japanese patients were analysed. Brazilian patients were younger at the time of diagnosis than Japanese patients. The prevalence of muscle weakness, myalgia, dysphagia, heliotrope rash, V-sign, calcinosis, Raynaud's phenomenon, and digital ulcers was higher in Brazilian patients, whereas mechanic's hands were more prevalent in Japanese patients. The prevalence of ILD was significantly lower in Brazilian patients than in Japanese patients (50.0% vs. 98.5%, p<0.001). RP-ILD was observed in 34 (52.3%) Japanese patients and in only one (3.3%) Brazilian patient (p<0.001). Outcomes including overall survival and the frequency of relapses and complications, such as severe infection and malignancy, were comparable between the two populations. CONCLUSIONS: Brazilian patients with anti-MDA5(+) DM/ADM had a higher prevalence of skin and muscle involvement, whereas the prevalence of ILD and RP-ILD was significantly lower than in Japanese patients.

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BACKGROUND: Delays in diagnosing pediatric brain tumors are often associated with limited awareness of the signs and symptoms by parents and healthcare professionals, as well as the absence of routine childcare follow-ups and delays in healthcare system referrals. AIMS: To explore opportunities for reducing diagnostic delays, the study assessed the knowledge of pediatric brain tumor signs and symptoms, routine follow-up care for children, use of the Child Health Book (CHB), and referral intervals of a suspected case to a specialized center. PROCEDURE: This cross-sectional study collected data through interviews and virtual questionnaires. RESULTS: Between August and November 2023, 200 parents (pediatric and oncology departments) and 147 healthcare professionals (primary and tertiary care) participated. Except for headaches and seizures, the rates of parental recognition of warning signs were below 70%. Physicians in tertiary care demonstrated greater recognition of these warning signs than those in primary care (p = 0.011). Recognition rates among nurses were below 75%. Primary and tertiary care professionals reported referral intervals >1 month in 10%-15% cases. Children routine follow-up care was reported in both levels. Over 75% of all participants reported that the CHB could be a useful tool for educating about childhood cancer. CONCLUSIONS: Our study provides essential insights to improve the early diagnosis of pediatric brain tumors. The findings emphasize the need to strengthen pediatric care follow-ups and use of CHB by parents and healthcare professionals to raise awareness of warning signs and symptoms, along with a flowchart for timely and accurate referrals to specialized centers.

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Homeobox A9 promoter methylation (HOXA9) has been reported as a biomarker for early lung adenocarcinoma patients' prognosis. We aim to evaluate its prognostic value, regardless of disease stage. Using droplet digital PCR, we measured HOXA9 methylation in a cohort comprising 161 Brazilian patients. Low HOXA9 methylation was associated with higher cancer-specific survival but showed no significance after adjustment for clinical covariates. While low HOXA9 methylation was associated with earlier stages, no survival association was observed in this subset of patients. Overall, HOXA9 promoter methylation is not an independent prognostic biomarker of cancer-specific survival in Brazilian lung adenocarcinomas patients.

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INTRODUCTION: Early neurological deterioration (END) is an adverse outcome of acute ischemic stroke that affects up to one-third of patients and is linked to poorer functional outcomes. Tirofiban, a nonpeptide glycoprotein IIb/IIIa receptor blocker, is widely used in the treatment of atherosclerotic heart disease and percutaneous coronary intervention. Herein, we sought to assess whether Tirofiban reduces the severity of outcomes and improves stroke patient recovery through a systematic review and meta-analysis. METHODS: We systematically searched Pubmed, Cochrane, Web of Science and Scopus for randomized clinical trials and observational studies. The studies compared the effects on the administration of Tirofiban or control on END in individuals with acute ischemic stroke. Risk ratio (RR) was used for binary outcomes and mean difference (MD) for continuous endpoints with 95% confidence intervals (CIs). Heterogeneity was evaluated with I2 statistics and p value < 0,05 were considered statistically significant. Statistical analysis was performed using R statistical software 4.4.1 version. RESULTS: Seven studies and 2163 patients were included. Among them, 1132 (52,34%) were allocated to receive Tirofiban and 1031 (47,66%) received a placebo. The number of male patients was higher than females, with 1401 (64,80%), while 762 (35,20%) were women. The outcomes of END (RR 0.43; 95% CI 0.21 to 0.87; P=0.018715; I2=50%), 7th day National Institutes of Health Stroke Scale (NIHSS Score) (MD -1,03; 95% CI -2.03 to -0.02; P=0.045408; I2=72%) and score of 0 to 2 on the Modified Rankin Scale (mRS) for functional independence (MD -1.05; 95% CI -1.71 to -0.39; P=0.001916; I2=95%) presented statistical significance favoring the Tirofiban group. The following outcomes showed no statistical significance: mortality (RR 0.94; 95% CI 0.57 to 1.55; P=0.810315; I2=39%) and symptomatic intracerebral hemorrhage (RR 1.27; 95% CI 0.32 to 5.04; P=0.738112; I2=47%). CONCLUSION: Even though there was no significant difference between the groups in all outcomes, such as mortality and symptomatic intracerebral hemorrhage, Tirofiban induced a favorable impact on functional outcome and improved the prognosis in patients with acute ischemic stroke. This systematic review and meta-analysis suggest that Tirofiban is efficient in preventing early neurological deterioration and improving the mRS and NIHSS scores, however, new RCTs are needed to clarify our results.

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OBJECTIVE: This study aimed to investigate the influence of p16 immunohistochemical expression on the biochemical recurrence rate of pT2-pT3 prostate cancer. MATERIALS AND METHODS: A total of 488 pT2-pT3 stage prostate adenocarcinomas undergoing radical prostatectomy were included in this study. Following a review of Gleason classification and retrieval of sociodemographic and clinicopathological data, as well as the date of last consultation and biochemical recurrence, immunohistochemistry for p16 was performed. Data were associated using the chi-square test, Fisher's exact test, and multinomial logistic regression model. RESULTS: A total of 432(94.5%) cases showed positivity for p16 with an average of 37.38±27.32% positive cells and a mean histoscore of 2.70±2.24. A total of 117 (18.4%) patients experienced biochemical recurrence within three years, which was directly associated with high preoperative PSA (p=0.007), positive surgical margins (p<0.001), pT3 staging (p<0.001), nodal involvement (p<0.001), Gleason score > 3+4 (p<0.001), <50% positivity for p16 (p=0.035), and histoscore p16 =<3 (p=0.004). In multivariate analysis, Gleason score > 3+4 (HR = 3.08 (95% CI = 1.69-5.62), positive surgical margins (HR = 2.93 (95% CI = 1.70-5.04), and histoscore p16 =<3 (HR = 2.49 (95% CI = 1.17-5.32) were predictors of biochemical recurrence within three years. CONCLUSION: p16 immunostaining, along with classical features such as Gleason Score and surgical margin involvement, are significant predictors of biochemical recurrence in pT2-pT3 prostate tumors.

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OBJECTIVE: To apply the Toronto Childhood Cancer Staging Guidelines (TG) and Estimate the Observed Survival Probabilities for Pediatric Patients with Leukemia and Lymphoma. METHODS: Staging at diagnosis was conducted according to tier 2 of the TG. The study cohort included patients aged 0 -19 years from the Population-Based Cancer Registry (PBCR) of Mato Grosso, diagnosed with leukemia and lymphoma between 2008 and 2017, with follow-up until December 31, 2022. Observed 60-month survivals were calculated using the Kaplan-Meier method. RESULTS: Staging was assigned in 67.3% of cases (n=239), while in 32.7% (n=116), staging could not be applied due to incomplete data. Among the cases of acute lymphoblastic leukemia (ALL), 70.7% (n=133) were staged as CNS1, with an observed survival probability of 75.0%. For acute myeloid leukemia (AML), 42.2% (n=21) were staged as CNS-, with an estimated survival of 60.0%. Most Hodgkin lymphoma (HL) cases were staged as IIA/B (37.7%, n=23) and IIIA/B (21.3%, n=13), with survival probabilities of 91.3% and 91.7%, respectively. Among non-Hodgkin lymphoma (NHL) cases, 32.1% (n=18) were staged as stage III, with a survival probability of 70.6%. CONCLUSION: The application of TG in the PBCR in Mato Grosso proved feasible, allowing for comparability of survival estimates across different stages. However, collecting tier 2 staging information will be a challenge for the PBCR due to incomplete information in medical records.

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OBJECTIVE: We aimed to assess the coverage of a Human Papillomavirus (HPV) screening program for each of the 32 federal states of Mexico, as well as the spatial patterns for HPV infections from 2013 to 2019. METHODS: We conducted an exploratory, ecological study on data from a national health program in Mexico during 2013-2019. Adjusted rates per 100,000 females aged 25-64 years were estimated and georeferenced at the national and state level to assess the coverage of the screening program and positive detections of HPV infections. Cluster analysis was used to identify the location, magnitude, and trends of spatial patterns (p <0.05) by year and state. RESULTS: 2,529,819 screening tests for HPV detection were analyzed (2013-2019). A prevalence of HPV positivity of 11.1% (n= 228,582) was estimated. The number of HPV screening tests decreased from 2,835.4 (2013) to 0.8 (2019) per 100,000 females aged 25 to 64. HPV detection also showed a downward trend. A cluster (p <0.05) associated with a higher probability of detecting HPV infections was identified, comprised of territorially close states. CONCLUSION: A decreased coverage of the HPV screening program and geographic differences were identified, suggesting that the existing strategies to prevent and detect HPV infections to accelerate cervical cancer elimination in Mexico need to be further reconsidered.

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Acute lymphoblastic leukemia (ALL) is a malignant neoplasm with the highest incidence in the pediatric population. Although the 5-year overall survival is greater than 85%, in emerging countries such as Mexico, the mortality rate is high. In Mexico, B-ALL is the most common type of childhood cancer; different characteristics suggest the presence of the disease; however, the prognosis is dependent on clinical and laboratory features, and no adverse prognostic molecular marker for B-ALL has yet been identified. The present research aimed to identify the prognostic value of HMMR expression in pediatric patients with B-ALL. The differential expression profile of B-ALL cells was determined via in silico analysis, and HMMR expression was subsequently measured via qRT-PCR and immunocytochemistry. The results were statistically analyzed via the ROUT test, Kolmogorov-Smirnov Z test, and Mann-Whitney U test. ROC curves and the Youden index were constructed, and Kaplan-Meier curves were plotted. We found that HMMR expression was increased in B-ALL patients (p < 0.0001). We observed that high expression was related to poor prognosis (p < 0.05). We observed that high expression was related to poor prognosis (p < 0.05). The increase in HMMR expression could be a potential early molecular prognostic marker and/or a new target in childhood B-ALL patients.

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Introduction: Lung cancer is the leading cause of death by cancer worldwide and has a high lethality. The best treatment for patients with localized disease is anatomical surgical resection, granting good average survival in the long term. We did not find Chilean studies focusing on complications, long term survival or potential association with pathological or clinical factors. The aim of this work is to describe clinical characteristics, surgical complications and 5-to-10-year survival of a cohort of lung cancer patients operated in the Clinical Hospital of University of Chile and explore possible prognostic factors influencing in it. Methods: A 107 patient's cohort of operated lung cancer patients in a single center from 2004 to 2015 was analyzed. We included patients with curative intent surgery performed in our hospital and excluded non- primary lung cancer histology or biopsies analyzed in other center. Clinical, perioperative and histopathologic data were collected. 5-10 year overall survival was determined and an exploratory analysis of prognostic factors on survival was performed. Results: We found 107 surgeries fulfilling criteria, with 27% morbidity and 5.6% and 6.5% mortality at 30 and 90 days, respectively. 5- and 10-year overall survival was 44.7% and 32.3%, respectively. Univariate analysis found that gender, age, histology, disease stage, loco-regional dissemination and postoperative complications were factors associated with survival. Multivariate analysis confirmed that gender, age, loco-regional dissemination and postoperative complications were independent factors associated with survival. Conclusions: Surgical results of a cohort of patients operated in a Chilean center show that 30 and 90-days mortality aligned with data reported worldwide. Overall survival in these selected patients is far better than reported in lung cancer patients. Risk factors that may be screened in preoperative analysis were found, which could change prognosis. Those findings suggest that improving preoperative evaluation could optimize patient selection to obtain better performance in surgical results and overall long-term survival.

Introducción: El cáncer pulmonar es la primera causa de muerte por cáncer a nivel mundial, con una alta letalidad. El mejor tratamiento para pacientes con enfermedad localizada es la resección anatómica, que logra buenas sobrevidas promedio a largo plazo. En Chile no encontramos estudios enfocados en esta cirugía en términos de complicaciones, sobrevida a largo plazo, ni su potencial asociación con factores clínicos o patológicos. El objetivo de este trabajo es describir las características clínicas, complicaciones perioperatorias y sobrevida a 5 y 10 años de una cohorte de pacientes con cáncer pulmonar, operados en el Hospital Clínico de la Universidad de Chile, así como explorar posibles factores pronósticos que inciden en ella. Metodología: Se analizó una cohorte de 107 pacientes con cáncer pulmonar operados desde el año 2004 hasta 2015 en un solo centro. El criterio de inclusión fue cirugía de intención curativa realizada en nuestro hospital. Los criterios de exclusión fueron cirugías con otra intención, biopsia no concordante con cáncer primario pulmonar o analizada en otro centro. Se registraron datos clínicos, perioperatorios e histopatológicos. Se estimó la sobrevida global a 5 y 10 años, y se realizó un análisis exploratorio de posibles factores pronósticos que pudieran incidir en la sobrevida. Resultados: Se realizaron 107 cirugías que cumplieron el criterio. Se registró 27% de complicaciones con mortalidad de 5,6% a 30 días y 6,5% a 90 días. La sobrevida global fue de 44,7% a cinco años y 32,3% a 10 años. El análisis univariado mostró que factores con efecto en la sobrevida son sexo, edad, histología del tumor, estadio de la enfermedad, nivel de diseminación regional y la presencia de complicaciones postoperatorias. El análisis multivariado confirma que sexo, edad, nivel de diseminación regional y complicaciones postoperatorias se asocian de manera independiente a sobrevida. Conclusiones: Los resultados quirúrgicos de una cohorte de pacientes operados en un centro chileno muestran una mortalidad a 30 y 90 días similar a otras reportadas en la literatura internacional. La sobrevida global en estos pacientes seleccionados es mucho mayor a la reportada para pacientes con cáncer pulmonar en general. Se encontraron factores de riesgo eventualmente pesquisables en el estudio preoperatorio, que podrían cambiar el pronóstico. Estos hallazgos sugieren que mejorar la evaluación preoperatoria, permitiría optimizar la selección de pacientes para obtener mejores resultados quirúrgicos y de sobrevida a largo plazo.

ABSTRACT

FGF21 regulates local and systemic metabolic homeostasis. High serum FGF21 was found in obesity, metabolic syndrome, type 2 diabetes mellitus, and coronary heart disease. The pathways linking obesity and breast cancer remain elusive. We aimed to analyze the serum FGF21 in breast cancer patients at diagnosis. Circulating FGF21 levels in 45 breast cancer women (median age 59, range 32-88 years) and 51 age-matched healthy controls were evaluated using a quantitative ELISA assay. Patients' samples were obtained before surgery ahead of any previous therapy. Breast cancer patients showed significantly elevated serum FGF21 (median 267.13, range 28.41-780.45) respect to healthy controls (76.86, 0.00-425.60) (p < 0.0001). A ROC curve determined a cut-off value of 130.64 pg/ml to define positive or high FGF21 levels. Based on this cut-off point, 30/45 (66.7%) breast cancer patients showed positive serum FGF21 levels as compared to 18/51 (35.3%) healthy controls. Circulating FGF21 levels could be useful as a highly sensitive diagnosis biomarker for early breast cancer detection. We did not find any significant association between the serum FGF21 levels, and many clinical-pathological or metabolic parameters determined at the diagnosis of the primary disease. Interestingly, a statistically significant correlation was determined between serum FGF21 and the body mass index (BMI). Furthermore, patients with positive FGF21 serum levels had a worst overall survival (Log Rank Test [Mantle Cox] p = 0.017). We propose serum FGF21 levels determined at the diagnosis of primary breast cancer as a promising diagnostic and prognosis biomarker in this oncological disease.