Nivel de control del asma en pacientes que acuden al Departamento de Neumología del Hospital Infantil doctor Robert Reid Cabral, agosto 2015 a febrero 2016. Santo Domingo, República Dominicana / Level of control of asthma in patients who come to the Department of Pulmonology of the Children's Hospital Doctor Robert Reid Cabral, August 2015 to February 2016. Santo Domingo, Dominican Republic

Antecedentes: el asma es la enfermedad crónica más frecuente en la infancia, aun con medicamentos eficaces y seguros, muchos permanecen sin control. Objetivo: determinar el nivel de control del asma que tienen los pacientes que acuden al Departamento de Neumología del Hospital Infantil Doctor Robert Reid Cabral, durante el periodo de agosto 2015 a febrero 2016. Material y Métodos: estudio descriptivo con recolección prospectiva de datos. Se incluyeron pacientes con edad de 6 años o más y diagnóstico de asma, se excluyeron menores de 6 años de edad, con comorbilidades agregadas y que rechazaron participar; se siguieron por 3 meses, el nivel de control y tratamiento se estableció de acuerdo a las recomendaciones de la Iniciativa Global de Asma (GINA). Resultados: se siguieron 36 pacientes, 56 % masculino, con edad media de 9,2 ± 2,8 años. En el 92 % se identificó algún factor de riesgo para asma. El 75 % no tenía controlada la enfermedad; al tercer mes de iniciar tratamiento, 22.2 % ya tenían controlada el asma y aquellos sin control de la enfermedad disminuyó a 16.6 %. 12 pacientes suspendieron el tratamiento, 75 % de estos por limitación económica para comprar el medicamento

Background: Asthma is the most frequent chronic disease in childhood, even with effective and safe medications, many remain uncontrolled. Objective: To determine the level of asthma control of patients who come to the Department of Pulmonology of the Children's Hospital Doctor Robert Reid Cabral, during the period from August 2015 to February 2016 Material and Methods: Descriptive study, prospective collection of data, patients with age 6 years or older and diagnosis of asthma were included; children under 6 years of age were excluded, with added comorbidities and who refused to participate; were followed for 3 months, the level of control and treatment was established according to the recommendations of the Global Asthma Initiative (GINA) Results: 36 patients were followed, 56% male, with a mean age of 9.2 + 2.8 years. In 92%, some risk factor for asthma was identified. 75% did not control the disease; at the third month after starting treatment, 22.2% had asthma controlled and those without control of the disease decreased to 16.6%. 12 patients suspended the treatment, 75% of these due to financial limitation to buy the medication

Decreased Anti-Tumor Cytotoxic Immunity among Microsatellite-Stable Colon Cancers from African Americans.

Colorectal cancer is a leading cause of cancer related deaths in the U.S., with African-Americans having higher incidence and mortality rates than Caucasian-Americans. Recent studies have demonstrated that anti-tumor cytotoxic T lymphocytes provide protection to patients with colon cancer while patients deficient in these responses have significantly worse prognosis. To determine if differences in cytotoxic immunity might play a role in racial disparities in colorectal cancer 258 microsatellite-stable colon tumors were examined for infiltrating immune biomarkers via immunohistochemistry. Descriptive summary statistics were calculated using two-sample Wilcoxon rank sum tests, while linear regression models with log-transformed data were used to assess differences in race and Pearson and Spearman correlations were used to correlate different biomarkers. The association between different biomarkers was also assessed using linear regression after adjusting for covariates. No significant differences were observed in CD8+ (p = 0.83), CD57+ (p = 0.55), and IL-17-expressing (p = 0.63) cell numbers within the tumor samples tested. When infiltration of granzyme B+ cells was analyzed, however, a significant difference was observed, with African Americans having lower infiltration of cells expressing this cytotoxic marker than Caucasians (p<0.01). Analysis of infiltrating granzyme B+ cells at the invasive borders of the tumor revealed an even greater difference by race (p<0.001). Taken together, the data presented suggest differences in anti-tumor immune cytotoxicity may be a contributing factor in the racial disparities observed in colorectal cancer.

Influence of race on microsatellite instability and CD8+ T cell infiltration in colon cancer.

African American patients with colorectal cancer show higher mortality than their Caucasian counterparts. Biology might play a partial role, and prior studies suggest a higher prevalence for microsatellite instability (MSI) among cancers from African Americans, albeit patients with MSI cancers have improved survival over patients with non-MSI cancers, counter to the outcome observed for African American patients. CD8+ T cell infiltration of colon cancer is postively correlated with MSI tumors, and is also related to improved outcome. Here, we utilized a 503-person, population-based colon cancer cohort comprising 45% African Americans to determine, under blinded conditions from all epidemiological data, the prevalence of MSI and associated CD8+ T cell infiltration within the cancers. Among Caucasian cancers, 14% were MSI, whereas African American cancers demonstrated 7% MSI (P = 0.009). Clinically, MSI cancers between races were similar; among microsatellite stable cancers, African American patients were younger, female, and with proximal cancers. CD8+ T cells were higher in MSI cancers (88.0 vs 30.4/hpf, P<0.0001), but was not different between races. Utilizing this population-based cohort, African American cancers show half the MSI prevalence of Caucasians without change in CD8+ T cell infiltration which may contribute towards their higher mortality from colon cancer.