International Society of Paediatric Oncology (SIOP) Global Mapping Programme: Latin American Society of Pediatric Oncology (SLAOP) country-level report.

BACKGROUND: Latin American countries are improving childhood cancer care, showing strong commitment to implement the Global Initiative for Childhood Cancer, but there are scant publications of the situation at a continental level. METHODS: As part of the International Society of Paediatric Oncology Global Mapping project, delegates of each country participating in the Latin American Society of Pediatric Oncology (SLAOP) and chairs of national pediatric oncology societies and cooperative groups were invited to provide information regarding availability of national pediatric cancer control programs (NPCCP), pediatric oncology laws, pediatric oncology tumor registries, and training programs and support to diagnosis and treatment. RESULTS: Nineteen of the 20 countries participating in SLAOP responded. National delegates reported nine countries with NPCCP and four of them were launched in the past 5 years. National pediatric tumor registries are available in eight countries, and three provided published survival results. Fellowship programs for training pediatric oncologists are available in 12 countries. National delegates reported that eight countries provide support to most essential diagnosis and treatments and 11 provide partial or minimal support that is supplemented by civil society organizations. Seven countries have a pediatric oncology law. There are three international cooperative groups and four national societies for pediatric oncology. CONCLUSION: Despite many challenges, there were dramatic advances in survivorship, access to treatment, and availability of NPCCP in Latin America. Countries with highest social development scores in general provide more complete support and are more likely to have NPCCP, training programs, and reported survival results.

Delayed Enucleation With Neoadjuvant Chemotherapy in Advanced Intraocular Unilateral Retinoblastoma: AHOPCA II, a Prospective, Multi-Institutional Protocol in Central America.

PURPOSE: Treatment abandonment because of enucleation refusal is a limitation of improving outcomes for children with retinoblastoma in countries with limited resources. Furthermore, many children present with buphthalmos and a high risk of globe rupture during enucleation. To address these unique circumstances, the AHOPCA II protocol introduced neoadjuvant chemotherapy with delayed enucleation. PATIENTS AND METHODS: Patients with advanced unilateral intraocular disease (International Retinoblastoma Staging System [IRSS] stage I) were considered for upfront enucleation. Those with diffuse invasion of the choroid, postlaminar optic nerve, and/or anterior chamber invasion received six cycles of adjuvant chemotherapy (vincristine, carboplatin, and etoposide). Patients with buphthalmos and those with a perceived risk for enucleation refusal and/or abandonment were given two to three cycles of chemotherapy before scheduled enucleation followed by adjuvant chemotherapy to complete six cycles, regardless of pathology. RESULTS: A total of 161 patients had unilateral IRSS stage I disease; 102 underwent upfront enucleation, and 59 had delayed enucleation. The estimated 5-year abandonment-sensitive event-free and overall survival rates for the group were 0.81 ± 0.03 and 0.86 ± 0.03, respectively. The 5-year estimated abandonment-sensitive event-free survival rates for patients undergoing upfront and delayed enucleation were 0.89 ± 0.03 and 0.68 ± 0.06, respectively (P = .001). Compared with AHOPCA I, abandonment for patients with IRSS stage I retinoblastoma decreased from 16% to 4%. CONCLUSION: AHOPCA describes the results of advanced intraocular retinoblastoma treated with neoadjuvant chemotherapy. In eyes with buphthalmos and patients with risk of abandonment, neoadjuvant chemotherapy can be effective when followed by enucleation and adjuvant chemotherapy. Our study suggests that this approach can save patients with buphthalmos from ocular rupture and might reduce refusal of enucleation and abandonment.

Estudio de politicas publicas para el tratamiento de jóvenes adictos a la droga en Ecuador / Study of public policies for the treatment of young people addicted to the drug in Ecuador / Studio delle politiche pubbliche per il trattamento di giovani dedo alla drogas no Equador

Resumen Introducción: El consumo de drogas, es un tema de gran importancia, y un grave problema social, que no sólo aqueja a nuestro país, Ecuador, sino que su afectación es a nivel mundial, tomando en consideración que llega incluso a ocasionar graves daños en la salud, en la convivencia social y la seguridad ciudadana. Objetivo: Proponer y difundir estrategias integrales para la rehabilitación y reinserción de los jóvenes adictos a las drogas. Materiales y métodos: Se implementó una encuesta a 40 jóvenes comprendidos entre los 18 a 25 años de edad, de diferentes clases sociales. Resultados: Se determinó que el consumo de drogas va en aumento, a causa de problemas familiares y la influencia de amistades y redes sociales; así como también, se determina que un alto porcentaje de los encuestados desconoce las normativas que regulan la adicción en el Ecuador y las Políticas de Estado, creadas para la debida rehabilitación y reinserción de los adictos a la sociedad. Conclusión: Se proyecta a través de los resultados obtenidos poner en conocimiento de la sociedad en general y en especial de los adictos, las normativas que regulan el problema de la adicción; así como, hacer conocer el tema de las Políticas Públicas que el Estado, ha creado en función de la prevención integral de esta problémica, con el fin de garantizar una vida digna.

Abstract Introduction: Drug use, is a subject of great importance, and a serious social problem, which not only afflicting our country, Ecuador, but that his involvement is at the global level, taking into consideration that even serious damage in health, social life and the citizen security. Objective: Propose and disseminate comprehensive strategies for the rehabilitation and reintegration of young people addicted to drugs. Materials and methods: A survey was implemented to 40 young people between 18 and 25 years of age, of different social classes. Results: It was determined that drug use is on the rise, because of family problems and the influence of friendships and social networks; as well as, it is determined that a high percentage of respondents unknown regulations governing the addiction in the Ecuador and State policies, created for the appropriate rehabilitation and reintegration of addicts into society. Conclusion: Is projected through the results bring to the attention of society in general and in particular of addicts, the norms that regulate the problem of addiction; as well as, make known the issue of public policy that the State has created based on comprehensive prevention of this problem, in order to ensure a dignified life.

Resumo Introdução: Uso de drogas, é um assunto de grande importância e um grave problema social, que não só que afligem nosso país, o Equador, mas o seu envolvimento é a nível global, levando em consideração que até mesmo sérios danos na saúde, vida social e a segurança dos cidadãos. Objetivo: Propor e divulgar estratégias globais para a reabilitação e a reintegração de jovens viciados em drogas. Materiais e métodos: Um levantamento foi implementado para 40 jovens entre 18 e 25 anos de idade, de diferentes classes sociais. Resultados: Determinou-se que o uso de drogas está em ascensão, por causa de problemas familiares e a influência de amizades e redes sociais; assim como, é determinado que uma elevada percentagem de inquiridos desconhecido regulamentos o vício nas políticas Equador e estado, criado para a adequada reabilitação e reinserção social de toxicodependentes. Conclusão: Projeta-se através dos resultados chamar a atenção da sociedade em geral e em particular dos viciados, as normas que regulam o problema da toxicodependência; bem como, dar a conhecer a questão das políticas públicas que o estado tem criado com base na prevenção abrangente deste problema, a fim de garantir uma vida digna.