The long-term antibody response after SARS-CoV-2 prime-boost vaccination in healthy individuals. The positive influence of extended between-dose intervals and heterologous schedule.

Introduction: Anti-COVID vaccination in Argentina was carried out using different protocols and variations in periods between administrations, as well as combinations of different vaccine platforms. Considering the relevance of the antibody response in viral infections, we analyzed anti-S antibodies in healthy people at different points of time following the Sputnik immunization procedure. Methods: We attended the vaccination centers in the city of Rosario, which had shorter versus longer intervals between both doses. A total of (1021) adults with no COVID-compatible symptoms (throughout the study period) were grouped according to the gap between both vaccine doses: 21 (Group A, n=528), 30 (Group B, n=147), and 70 days (Group C, n=82), as well as an additional group of individuals with heterologous vaccination (Sputnik/Moderna, separated by a 107-day interval, group D, n=264). Results and conclusions: While there were no between-group differences in baseline levels of specific antibodies, data collected several weeks after administering the second dose showed that group D had the highest amounts of specific antibodies, followed by values recorded in Groups C, B, and A. The same pattern of group differences was seen when measuring anti-S antibodies at 21 or 180 days after the first and second doses, respectively. Delayed between-dose intervals coexisted with higher antibody titers. This happened even more when using a prime-boost heterologous schedule.

Knowledge, adherence and perceptions about colorectal cancer screening in primary and secondary school teachers in Carcarañá / [Conocimiento, adherencia y percepciones acerca del tamizaje del cáncer colorrectal en docentes de escuelas primarias y secundarias de Carcarañá]

Introduction: This study describes the knowledge and perceptions regarding colorectal cancer screening (CRC) in a population of teachers from primary and secondary schools in Carcarañá, Santa Fe. The proportion of participants who underwent the screening is described, as well as the facilitating factors and barriers that could affect test adherence. Methods: An observational, descriptive and cross-sectional study was carried out through a self-administered survey of the population of teachers aged 50 or over from all primary and secondary schools in the city. Results: 96 teachers, 87 women (90.6%) and 9 men (9.4%) were surveyed. Average age: 53.2 ± 2.5 years. 66.7% knew about CRC screening. However, only 13.5% knew the recommended time to start performing these tests. 28.1% had adhered to some of the screening tests. 94.8% agreed that CRC has a greater chance of cure if it is discovered early, and 92.7% reported that screening is part of good health care. . Conclusion: The positive perception regarding screening is not consistent with adherence to screening. Lack of knowledge, lack of information and medical indication are the most important barriers to adherence. The main facilitating factor was the existence of a family history of CRC. New research that addresses this issue would be necessary in order to develop strategies aimed at modifying these barriers and reducing mortality from this neoplasm

Introducción: Este estudio describe los conocimientos y percepciones respecto del tamizaje del cáncer colorrectal (CCR) en una población de  docentes de escuelas primarias y secundarias de Carcarañá, Santa Fe. Se describe la proporción de participantes que se sometió a la realización del mismo, así como los factores facilitadores y las barreras que podrían afectar la adherencia a las pruebas. Métodos: Se realizó una estudio observacional, descriptivo y transversal mediante una encuesta autoadministrada a la población de docentes de 50 años o más de todas las escuelas primarias y secundarias de la ciudad. Resultados: Se encuestaron 96 docentes, 87 mujeres (90,6%) y  9 hombres (9,4%). Edad promedio: 53,2 ± 2,5 años. El 66,7% tenía conocimiento acerca de la existencia del tamizaje de CCR. Sin embargo, sólo el 13,5% conocía cuál era el momento recomendado para iniciar la realización dichas pruebas. El 28,1% había adherido a alguna de las pruebas de tamizaje. El 94,8% acordó que el CCR tiene mayor posibilidad de curación si se descubre de manera temprana y el 92,7% refirió que el tamizaje es parte del buen cuidado de salud. Conclusión: La percepción positiva respecto del tamizaje no se condice con la adherencia al mismo. El desconocimiento, la falta de información y de indicación médica constituyen las barreras más importantes a la adherencia. El principal factor facilitador fue la existencia de antecedentes familiares de CCR. Serían necesarias nuevas investigaciones que aborden esta temática con el fin de elaborar estrategias dirigidas a modificar dichas barreras y disminuir la mortalidad por esta neoplasia.

Sentinel Lymph Node Biopsy in Patients With Thick Primary Cutaneous Melanoma.

BACKGROUND: The clinical value of sentinel lymph node biopsy (SLNB) in patients with thick melanoma is uncertain. The purpose of this study was to investigate the correlations between survival and lymph node status in thick melanomas. METHODS: Of a total of 736 melanoma patients registered between 2000 and 2016, 50 presented with thick melanomas (≥ 4.0 mm) without distant metastatic disease. All patients were examined with a whole-body magnetic resonance imaging, or computed tomography, and positron emission tomography-computed tomography depending on the incorporation of the new technology in our medical institutions. They were studied according to the following procedure: 1) preoperative determination of regional lymph node along with the estimation and localization of sentinel lymph node (SLN) (dynamic isotope lymphography); 2) intraoperative localization and SLNB (lymphatic mapping); and 3) histopathology. Patient and tumor features were collected. RESULTS: Mean follow-up was 40 months, and 37% had a follow-up ≥ 5 years. A positive SLN was identified in 28 patients (56%). No significant difference in melanoma-specific overall survival was observed in terms of the primary tumor site. Hazard ratios (HRs) were statistically significant for SLNB-positive group and mitotic rate (MR) > 3 mm2, but not for presence of ulceration. Mortality risk in the SLN-positive group was almost fourfold greater than that in the SLN-negative group at any time of follow-up. CONCLUSIONS: SLN status, along with MR, can provide valuable prognostic information in patients with thick primary cutaneous melanoma.

Ingesta alimentaria y estado nutricional de pacientes con enfermedad de chagas / Dietary intake and nutritional status of patients with Chagas disease

La enfermedad de Chagas es una infección parasitaria que afecta a 17 millones de personas en Latinoamérica. Es aún desconocida la real influencia del efecto del estado nutricional y la ingesta alimentaria sobre la evolución de la enfermedad hacia la miocardiopatía chagásica crónica, así como los factores de riesgo cardiovascular que pueden influir en la evolución de la patología. Con el objetivo de caracterizar la ingesta alimentaria y determinar el estado nutricional de las personas con enfermedad de Chagas, se llevó a cabo un estudio descriptivo transversal de una muestra de pacientes atendidos en el servicio de cardiología del Hospital Centenario de Rosario. Se recolectaron datos sobre las características generales de la muestra, se realizaron mediciones antropométricas y se entrevistó sobre el consumo de alimentos a través de un cuestionario de frecuencia de consumo y un atlas fotográfico. Se reclutaron 113 paciente, de los cuales el 70% de los hombres y el 90 % de las mujeres presentaban sobrepeso u obesidad. Además el 78.9% de las mujeres y el 27% de los hombres, presento un Índice cintura/cadera de riesgo cardiovascular. En el análisis de la ingesta de macronutrientes se observa que se superan las recomendaciones del aporte de lípidos. Al analizar la ingesta de alimentos por grupos se encontró que los hombres consumen más carne vacuna magra, fiambres y embutidos, carne de cerdo y bebidas alcohólicas, en cambio las mujeres ingieren más lácteos enteros y bebidas azucaradas. Esta muestra urbana de pacientes con enfermedad de Chagas, presenta un perfil nutricional similar al de la población general, y el consumo alimentario se encuentra influenciado por la vida en las grandes ciudades(AU)

Chagas disease is a parasitic infection that affects 17 million people in Latin America. The real influence of nutritional status and food intake effect over the course of the disease to chronic Chagas Cardiomyopathy is still unknown. Furthermore, some cardiovascular risk factors might influence the evolution of the disease. A cross-sectional study of a sample of patients with Chagas disease attending the Cardiology Section of the Hospital Centenario of Rosario was carried out in order to characterize their food intake and nutritional status. Data on the general characteristics of the sample was collected; anthropometric measurements were performed and food consumption was investigated using a food frequency questionnaire and a n photographic atlas. One hundred and thirteen patients were enrolled; 70% of men and 90% of women were overweight or obese. In addition 78.9% of women and 27% of men presented a waist-hip ratio according to cardiovascular risk. When analyzing macronutrient intake, it was observed that lipid intake recommendations were exceeded. When the food intake groups were analyzed separately, it was found that men consume more lean beef, cold cuts, pork and alcoholic drinks, while women eat more whole dairy products and sugary drinks. This patients´ urban sample with Chagas disease, he presents a nutritional profile similar to that of the general population, and the food consumption is influenced by life in big cities(AU)

Metastatic breast cancer patients treated with low-dose metronomic chemotherapy with cyclophosphamide and celecoxib: clinical outcomes and biomarkers of response.

BACKGROUND: Preclinical results showing therapeutic effect and low toxicity of metronomic chemotherapy with cyclophosphamide (Cy) + celecoxib (Cel) for mammary tumors encouraged its translation to the clinic for treating advanced breast cancer patients (ABCP). PATIENTS AND METHODS: A single-arm, mono-institutional, non-randomized, phase II, two-step clinical trial (approved by Bioethics Committee and Argentine Regulatory Authority) was designed. Patients received Cy (50 mg po.d) + Cel (200 mg p.o.bid). Patient eligibility criteria included: ABCP who progressed to anthracyclines, taxanes and capecitabine, ≤4 chemotherapy schemes, with good performance status. Several pro- and anti-angiogenic molecules and cells were determined as biomarkers. Informed consent was signed by all patients. Primary endpoint was clinical benefit (CB). RESULTS: Twenty patients were enrolled. Main clinical outcomes were prolonged disease stabilization and partial remission in 10/20 and 1/20 patients, respectively. CB was 55 %, and time to progression (TTP) was 21.1 weeks. Median TTP in patients who achieved CB was 35.6 weeks, and mean overall survival was 44.20 weeks. There were no grade 3/4 toxicities associated with treatment. Circulating endothelial cells (CECs) increased at the time of progression in patients who showed CB (P = 0.014). Baseline CECs and circulating endothelial progenitor cells showed marginal associations with TTP. Serum VEGF decreased (P = 0.050), sVEGFR-2 increased (P = 0.005) and VEGF/sVEGFR-2 ratio decreased during treatment (P = 0.041); baseline VEGF and VEGF/sVEGFR-2 were associated with TTP (P = 0.035 and P = 0.030, respectively), while sVEGFR-2 did not. CONCLUSIONS: Treatment was effective, showing low toxicity profile and excellent tolerability. The combination had anti-angiogenic effect. Increased levels of CEC could be useful for detecting progression. Baseline VEGF and VEGF/sVEGFR-2 values could be useful as early predictors of response. TRIAL REGISTRATION: ANMAT#4596/09.

Dietary intake and nutritional status of patients with Chagas disease.

Chagas disease is a parasitic infection that affects 17 million people in Latin America. The real influence of nutritional status and food intake effect over the course of the disease to chronic Chagas Cardiomyopathy is still unknown. Furthermore, some cardiovascular risk factors might influence the evolution of the disease. A cross-sectional study of a sample of patients with Chagas disease attending the Cardiology Section of the Hospital Centenario of Rosario was carried out in order to characterize their food intake and nutritional status. Data on the general characteristics of the sample was collected; anthropometric measurements were performed and food consumption was investigated using a food frequency questionnaire and a n photographic atlas. One hundred and thirteen patients were enrolled; 70% of men and 90% of women were overweight or obese. In addition 78.9% of women and 27% of men presented a waist-hip ratio according to cardiovascular risk. When analyzing macronutrient intake, it was observed that lipid intake recommendations were exceeded. When the food intake groups were analyzed separately, it was found that men consume more lean beef, cold cuts, pork and alcoholic drinks, while women eat more whole dairy products and sugary drinks. This patients´ urban sample with Chagas disease, he presents a nutritional profile similar to that of the general population, and the food consumption is influenced by life in big cities.

Medición del espesor miointimal carotídeo como predictor de riesgo de accidente isquémico transitorio / Carotid Intima - Media Thickness measurement as a risk predictor of transient ischemic attack Objectives

Objetivos. Determinar si el riesgo de accidente isquémico transitorio (AIT) es mayor en pacientes con valores anormales de espesor miointimal carotídeo (EMIC). Materiales y Métodos. Evaluación de 168 pacientes con y sin AIT estudiados con ecografías de vasos de cuello, midiendo EMIC. Diseño de casos y controles apareados por distintas variables. Análisis estadístico: variables continuas (media ± DS), comparadas mediante prueba "t de Student" para muestras relacionadas. Variables categóricas (porcentajes) comparadas mediante pruebas de McNemar. Para evaluar EMIC como predictor de AIT, se ajustaron dos modelos de regresión logística condicional, considerando EMIC como variable continua y como variable binaria EMIC normal (<1 mm) vs. patológico (>1 mm). Se construyó una curva ROC para evaluar la capacidad discriminativa de EMIC, calculando la sensibilidad y especificidad para diferentes puntos de corte. Resultados. Valor de EMIC: casos 1,03 ± 0,31 mm (IC 95%: 0,97-1,10); controles 0,77 ± 0,27mm (IC 95%: 0,710,83); p<0,001. El riesgo de AIT fue casi 9 veces mayor en pacientes con EMIC patológico (OR=8,8; p<0,001). Con un 95% de confianza pudo afirmarse que por cada 0,05 mm de incremento en el EMIC, el riesgo de AIT aumentó entre 16 y 44%. Área bajo la curva ROC: 0,75 (IC 95%: 0,67-0,82). Conclusiones. Los valores anormales de EMIC están significativamente asociados a una mayor probabilidad de presentar AIT. En nuestra experiencia, el estudio de las paredes carotídeas con ecografía permitiría predecir enfermedad preclínica cerebrovascular.

To determine if the risk of transient ischemic attack (TIA) is higher in patients with abnormal values of carotid intima-media thickness (CIMT). Materials and Methods. We evaluated 168 patients with and without TIA by ultrasound of the neck vessels, measuring CIMT. Case and controls were matched according to different variables. Statistical analysis: continuous variables (mean ± SD) were compared using the Student's t test for related samples. Categorical variables (percentages) were compared using the McNemar tests. In order to assess CIMT as a predictor of TIA, two models of conditional logistic regression were adjusted, considering CIMT both as a continuous variable and as a binary variable: normal CIMT (<1 mm) vs. pathologic (>1 mm). A ROC curve was performed to determine the discriminative capacity of CIMT, estimating the sensitivity and specificity for different cutoff values. Results. CIMT value: cases 1.03±0.31 mm (95% CI: 0.971.10); controls 0.77±0.27 mm (95% CI: 0.71-0.83); p<0.001. The risk of TIA was about 9 fold higher in patients with abnormal CIMT (OR=8.8; p<0.001). With 95 % confidence interval we were able to affirm that for each 0.05 mm increase in CIMT, the risk of TIA increased between 16 and 44%. Area under ROC curve: 0.75 (95% CI: 0.67-0.82). Conclusions. Abnormal values of CIMT are significantly associated with a higher probability of suffering a TIA. According to our experience, the carotid wall US examination would allow to predict cerebrovascular preclinical disease.

Hábitos alimentarios y riesgo de cancer de piel no melanoma / Diet and risk of non melanoma skin cancer

A case-control study was carried out in order to analyze the association between diet and risk of non melanoma skin cancer -basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), with adjustments for demographic, anthropometric and phenotypic characteristics, sunburns history, skin cancerfamily history, sun-exposure history and skin sensitivity to sun exposure. A full-body skin examination was performed. Dietary data were obtained applying a standardized semi-quantitative questionnaire of consumption frequency. Cases (n=27; age: 65,5+15,1 years) and controls (n=37; age: 63,9+12,3 years) were attended at the same facilities. A decreased risk ofBCC and SCC tumors (Adjusted Odd Ratio=0.10; IC 95 percent= 0.02-0.63; p=0.01) was found for high intakes of green leafy vegetables (more than 40 gr/day). However, results obtained for fruits, cruciferous, vitamin A and carotene-rich vegetables and other vegetables were not statistically significant.

Mediante un diseño de casos y controles se evaluó si la dieta habitual modifica el riesgo de desarrollar cáncer de piel no melanoma: carcinomas basocelulares y carcinomas espinocelulares. En la consulta se consignaron datos demográficos, características fenotípicas y antropométricas, antecedentes de quemadura solar, antecedentes familiares de cáncer de piel y hábitos de exposición solar, y se realizó un exhaustivo examen físico cutáneo. La dieta fue evaluada por cuestionarios semi-cuantitativos de frecuencia de consumo. Se estudiaron 27 casos (edad: 65,5±15,1 años) y 37 controles (63,9±12,3) que asistieron a las mismas instituciones por otras patologías. La ingesta alta de vegetales de hojas verdes (más de 40 g/d) actuaría como factor protector (Odd Ratio ajustado= 0,10; IC 95 por ciento= 0,02-0,63; p=0,01), modificando el efecto negativo de la exposición solar. En cambio, los resultados obtenidos para frutas, crucíferas, vegetales ricos en vitamina A y carotenos y otros vegetales no resultaron estadísticamente significativos.

[Cost-effectiveness analysis of different imaging for the diagnosis of acute pulmonary embolism]. / Análisis coste-efectividad de distintos métodos de diagnóstico por imagen del tromboembolismo pulmonar agudo.

BACKGROUND: The optimal diagnostic test for detecting acute pulmonary embolism (APE) is still under discussion. The ventilation /perfusion scanning has been the preferred examination for several decades, but with the development of new tests the diagnostic possibilities have increased. It is necessary to evaluate them from the cost-effectiveness perspective. The goal of this study was to evaluate several methods of imaging diagnosis so as to determine the most cost-effective for detecting APE. METHODS: Cost-effectiveness (CE) analysis using a decision tree to model various diagnostic test (V/Q lung scan, spiral CT, angiography by MDCT, MRI and conventional arteriography). Sensitivity and specificity values, and positive and negative predictive values of diagnostic tests were calculated. Expected outcome: "new APE case detected." The direct costs were evaluated in eurosos (euros), including the secondary complications of diagnostic methods. To assess the robustness of the findings, a one way sensitivity analysis was performed. RESULTS: The most cost-effective diagnostic test was angiography by MDCT. No diagnostic test were eliminated by extended dominance. The crude rate of CE for MDCT was 486 euros per case of APE detected. The marginal cost between spiral CT and V / Q lung scan was euros 103 for 8 cases of APE detected additionally, while the marginal cost between MDCT and spiral CT was 229 euros to detect an additional case of APE. CONCLUSIONS: The most cost-effective diagnostic test was the MDCT; this finding showed to be robust in relationship to sensitivity, specificity and costs changes. However, the incremental C-E analysis showed that MDCT was capable to detect only one additional case of APE than spiral CT, with an incremental cost of 229 euros. When peripheral branches are affected, high negative predictive value of the MDCT justify its conduct.

Impaired immune responses in tuberculosis patients are related to weight loss that coexists with an immunoendocrine imbalance.

The study's objective was to examine whether factors related to the host status may bear some relation with the profile of the immune response displayed by tuberculosis (TB) patients. The in vitro immune response (antigen-driven lymphoproliferation and cytokine production) and the presence of alcoholism or disease-related factors, like heart and respiratory rates, and weight loss (body mass index, BMI) were investigated in 31 males with active, untreated TB. Compared to 16 age-matched healthy males, TB patients presented depressed lymphoproliferation and increased IL-10 and TGF-beta production. Multivariate analysis indicated that most differences were no longer significant when controlling for the BMI. Immune and endocrine changes coexisting with weight loss, such as circulating levels of TNF-alpha, IFN-gamma, IL-6, cortisol, dehydroepiandrosterone and thyroid hormones, were also analyzed. While pairwise correlations between serum levels of IFN-gamma, T3 or T4 and BMI were not significant, BMI was negatively correlated with IL-6 levels (p < 0.025). In turn, levels of IL-6 correlated positively with cortisol concentrations (p <0.001). Stepwise regression analysis demonstrated that BMI was only associated with IL-6 (r = -0.423, R(2) = 0.18), with the difference remaining significant following adjustment for the other variables. As regards IL-6, BMI, cortisol and IFN-gamma could explain 74% of variability in IL-6 concentrations (R(2) = 0.74). No evidence for effect modification was shown when performing adjusted calculations. To conclude, the relation between weight loss and abnormal immune response of TB patients is partly associated with the immunoendocrine imbalance observed in parallel.

Cardiovascular risk factors in chronic Chagas' disease are associated with a different profile of putative heart-pathogenic antibodies.

Given that cardiovascular risk factors (CRF), such as smoking, alcoholism and hypertension, may contribute to the development of heart lesions, chronically Trypanosoma cruzi-infected individuals were studied to explore the relationship between the presence of such CRF, cardiomyopathy and antibodies that have been proposed to play a pathogenetic role in Chagas' disease. The targets of these antibodies were T. cruzi antigens such as cruzipain (Cz), a P ribosomal antigen (P2), and a component of myelin sheaths also present in T. cruzi (sulphatide). Individuals were classified into four groups on the basis of specific serology and presence of CRF: subjects with T. cruzi infection and CRF; those with positive serology and no CRF; seronegatives with CRF; and seronegatives without CRF, were analysed. Seronegatives or seropositives with CRF showed a greater occurrence of heart involvement (chest X-ray and/or electrocardiogram abnormalities). Seropositives with CRF displayed significantly higher levels of antisulphatide antibodies than the three remaining groups and higher levels of antibodies against Cz and P2 compared to the seropositives without CRF. Increased amounts of anti-P2 and antisulphatide antibodies were also found in seropositives with marked heart involvement. The presence of CRF is associated with a different profile of antibody responses and degree of cardiac effects.

Protective effect of Bacillus Calmette-Guerin (BCG) vaccination in children with extra-pulmonary tuberculosis, but not the pulmonary disease. A case-control study in Rosario, Argentina.

A hospital-based case-control study was carried out at the Vilela Children's Hospital in Rosario, Argentina, to measure the protection conferred by BCG vaccination against tuberculosis (TB). The study included 148 newly diagnosed cases of TB (75 males and 73 females, mean age 3.34+/-2.97 years, S.D.), 134 of them with pulmonary TB and 14 cases with extra-pulmonary disease. Controls (425 males and 357 females, 3.39+/-2.98 years) were selected randomly among children who attended to the Hospital showing, neither respiratory diseases nor any other infectious illnesses. Information on BCG vaccination history was assessed from scars or immunisation records. All participants were negative to human immunodeficiency virus and belonged to the lower and upper-lower socioeconomic status, being similar in place of residence and ethnic characteristics. Rate of vaccinated children was 92.6% of cases and 94.5% of controls (3.4 and 3.9% of them without scars, respectively). Regarding the total cases, the protective association between BCG and TB was statistically insignificant, as was for the pulmonary form. Among cases with extra-pulmonary disease, vaccine effectiveness attained significance [79% (95% CI=26-94)], no matter their age, sex or nutritional status. BCG vaccination exerted a beneficial role in extra-pulmonary TB, even in children not seriously undernourished.

Effect of an infection control program using education and performance feedback on rates of intravascular device-associated bloodstream infections in intensive care units in Argentina.

OBJECTIVE: Our aim was to ascertain the effect of an infection control program, using education and performance feedback on intensive care units, for intravascular device (IVD)-associated bloodstream infection (BSI). METHODS: Within 4 level III, adult, intensive care units in Argentina, all admitted, adult patients with a central vascular catheter in place for at least 24 hours were included. This was a prospective before-and-after trial in which rates of IVD-associated BSI determined during a period of active surveillance without education or performance feedback (phase 1) were compared after sequential implementation of an infection control program using education (phase 2) and performance feedback (phase 3). RESULTS: A total of 1219 IVD days were accumulated in phase 1; 586 during phase 2; and 4140 during phase 3. Compliance with central vascular catheter--site care improved significantly from baseline during the study period. Overall rates of IVD-associated BSI were lowered significantly from baseline after sequential implementation of education and performance feedback (11.10 vs 46.63 BSI/1000 IVD days; relative risk=0.25; 95% confidence interval=0.17-0.36; P<.0001). Rates of IVD-associated BSI decreased significantly after implementation of an educational program (phase 1 to phase 2) (relative risk 0.37; confidence interval 0.19-0.73; P=.0026) and further reductions were seen after implementation of a performance feedback program (phase 2 to phase 3), although the reduction did not reach statistical significance (9.9 vs 17.06 BSI/1000 IVD days; relative risk 0.58; confidence interval 0.29-1.18; P=.11). Additional analysis of the data using chi2 for trends demonstrated that sequential implementation of an education and performance feedback program resulted in a significant trend toward reduced rates of IVD-associated BSI (P<.001). CONCLUSION: Implementation of an infection control program, using education and performance feedback, resulted in significant reductions in rates of IVD-associated BSI.

Evolución de las tasas de mortalidad por cáncer de mama en Rosario, Argentina. Asociación con factores socioeconómicos / Mortality rate trends for breast cancer in Rosario, Argentina. Association with socioeconomic factors

This report is based on data from death certificates of all women whose cause of death was breast cancer, residents in Rosario City, during two 5-year-periods: 1977-81 and 1988-92, in order to know these rates evolution. Deaths, which were allocated to the last residence of the decedents, were aggregated into the 22 census areas of the city. Age-standardized mortality rates (SMR) by area were correlated with socioeconomic variables. The SMR for the whole city was not different in the two studied periods: 38000 and 36000, respectively. However, while small changes were found in the high socioeconomic areas, important increments were found in the poorest ones, mainly in postmenopausal women. Consequently, geographic correlations also changed between the two studied periods. While in the first period negative correlations were found with variables considered as socioenvironmental pointers, such as fertility and infant mortality rates, these associations were positive in the last one.

Prevalencia del habito de fumar en jóvenes y sus padres: asociaciones relevantes con educacion y ocupación / Prevalence of smoking in young people and their parents: important associations with education and occupation

Com o objetivo de conhecer a prevalência de hábito de fumar cigarros entre os jovens, estudaram-se amostras aleatórias de homens de 18 anos e de estudantes universitários de medicina e de economia, que responderam um questionário sobre o hábito, escolaridade e ocupaçäo, próprios e de seus pais. A prevalência do hábito de fumar foi maior nos homens de ambas as geraçöes, nos estudantes de medicina, que nos de economia, e nos pais com educaçäo univiersitária. Achou-se associaçäo entre o hábito dos jovens representativos da populaçäo geral (p<0,001), mas näo entre o dos progenitores e de seus filhos universitários. Visto a participaçäo fundamental que os universitários, em especial os médicos, deveriam ter na comunidade, surge a necessidade de programas educativos, näo só nas escolas mas também nas universidades