The Off-Label Use of Antineoplastics in Oncology Is Limited But Has Notable Scientific Support in a University Hospital Setting.

Purpose: The off-label (OL) use of antineoplastic drugs for the treatment of various types of tumors in patients of different disease stages is becoming a common occurrence. The objective of this study was to analyze these patterns by quantification and characterization of the OL use of antineoplastic drugs and their level of scientific evidence in a medium/high-complexity Spanish general university hospital. Method: All oncology patients who underwent OL treatment with one or several antineoplastics during the 10 years from 2002 to 2012 were retrospectively selected. The use of these drugs was considered OL if they were used for indications, stages, lines of treatment, or chemotherapy schemes not reflected in the summary of product characteristics published by the European Medicines Agency at the time of prescription. To calculate the prevalence of patients who received one or more OL treatments during the study period, all patients whose primary or secondary diagnosis had been coded with the diagnoses included in the study were selected through the minimum basic data set (MBDS). This database was cross-referenced with that of the Farmatools® program (Dominion®), which collects information on all patients receiving chemotherapy to obtain the total number of patients who received chemotherapy in the hospital during this period. Results: In total, 684 patients and 866 OL treatments were included. The prevalence of patients undergoing OL treatment with antineoplastics was 6%. OL treatments were used mainly for breast, gynecological, lung, and gastric tumors. The most often-used antineoplastic was paclitaxel, followed by gemcitabine, carboplatin, vinorelbine, and capecitabine, which were used mainly in monotherapy and with palliative intent. A total of 56.1% of the OL schemes used had a level of evidence of 2A according to the National Comprehensive Cancer Network, and 55.3% had a level of evidence of 2B according to Micromedex®. Conclusion: The OL use of antineoplastics in oncology patients is limited; their use is mainly focused in a small group of tumors and at advanced stages of disease. OL use of antineoplastics occurs under palliative therapeutic strategies with a limited number of drugs, preferably off-patent drugs. In addition, these OL treatments have high levels of clinical evidence.

Sarcoma de Kaposi en paciente con síndrome antisintetasa en tratamiento corticoideo / Kaposi's sarcoma in a steroid-treated antisynthetase antibody syndrome patient

El sarcoma de Kaposi (SK) es un tumor vascular maligno conocido fundamentalmente por ser una complicación del síndrome de inmunodeficiencia adquirida (sida), pero también asociado a inmunosupresión en trasplantados renales y, menos frecuentemente, en otras enfermedades. Se presenta un caso de SK en un paciente diagnosticado de síndrome antisintetasa en tratamiento con corticoides (AU)

Kaposi's sarcoma (KS) is a malignant vascular tumor widely known as a complication of acquired immunodeficiency syndrome (AIDS) but also related to immunosuppression in renal transplants, and less frequently, to other diseases. We describe a case of KS in a patient affected by antisynthetase syndrome treated with steroids (AU)

Factores psicosociales y síndrome de burnout en trabajadores de la industria de la transformación de la masa, Tepic, México / Psychosocial Factors and Burnout Syndrome Found in Workers in the Dough Processing Industry, Tepic, Mexico

Introducción: Los trabajadores de la industria de la masa son una población expuesta a factores de riesgo de tipo psicosocial debido a las condiciones propias del lugar de trabajo, en el que, por ende, son proclives a padecer una de las consecuencias derivadas del estrés crónico al que el trabajador está expuesto día a día, el síndrome de burnout. Objetivo: El objetivo del trabajo es analizar la relación entre los factores psicosociales y el síndrome de burnout en los trabajadores de la industria transformadora de la masa en la ciudad de Tepic, México. Material y métodos: Se llevó a cabo un estudio descriptivo y transversal en cinco empresas de la industria de la masa. Conformaron la población total 122 trabajadores, a los que se aplicó la escala de identificación de factores psicosociales del Instituto Mexicano del Seguro Social y la escala de Maslach Burnout Inventory para recabar la información. Resultados: Se identificaron factores psicosociales negativos en el 18,3 % y factores del síndrome en el 79,8 %. Diversas fueron las variables que se comportaron como factor de riesgo; en específico, la del área del sistema de trabajo con el agotamiento emocional.

Introduction: The workers in the dough processing industry are a population exposed to psychosocial risk factors due to the conditions in the workplace; therefore, they are likely to suffer from one of the consequences of chronic stress to which a worker is exposed daily: burnout syndrome. Objetive: The aim of this study was to analyze the relationship between psychosocial factors and the burnout syndrome in workers in the dough processing industry in the city of Tepic, Mexico. Material and methods: A cross-sectional and descriptive study was conducted in five companies from the dough processing industry. The total population consisted of 122 workers who were administered the scale of Psychosocial Factors Identification of the Mexican Social Security Institute and the Maslach Burnout Inventory scale, in order to gather information. Results: The presence of adverse psychosocial factors was reported in 18.3 %, and 79.8 % with the syndrome. There were several variables that behaved as risk factors, specifically, the system of working with the emotional exhaustion.

Kaposi's sarcoma in a steroid-treated antisynthethase antibody syndrome patient.

Kaposi's sarcoma (KS) is a malignant vascular tumor widely known as a complication of acquired immunodeficiency syndrome (AIDS) but also related to immunosupression in renal transplants, and less frequently, to other diseases. We describe a case of KS in a patient affected by anti-synthetase syndrome treated with steroids.