Significant Decrease in Annual Cancer Diagnoses in Spain during the COVID-19 Pandemic: A Real-Data Study.

The COVID-19 pandemic has caused a profound change in health organizations at both the primary and hospital care levels. This cross-sectional study aims to investigate the impact of the COVID-19 pandemic in the annual rate of new cancer diagnosis in two university-affiliated hospitals. This study includes all the patients with a pathological diagnosis of cancer attended in two hospitals in Málaga (Spain) during the first year of pandemic. This study population was compared with the patients diagnosed during the previous year 2019. To analyze whether the possible differences in the annual rate of diagnoses were due to the pandemic or to other causes, the patients diagnosed during 2018 and 2017 were also compared. There were 2340 new cancer diagnosis compared to 2825 patients in 2019 which represented a decrease of -17.2% (p = 0.0001). Differences in the number of cancer patients diagnosed between 2018 and 2019 (2840 new cases; 0.5% increase) or 2017 and 2019 (2909 new cases; 3% increase) were not statistically significant. The highest number of patients lost from diagnosis in 2020 was in breast cancer (-26.1%), colorectal neoplasms (-16.9%), and head and neck tumors (-19.8%). The study of incidence rates throughout the first year of the COVID-19 pandemic shows that the diagnosis of new cancer patients has been significantly impaired. Health systems must take the necessary measures to restore pre-pandemic diagnostic procedures and to recover lost patients who have not been diagnosed.

Randomized crossover pharmacokinetic evaluation of subcutaneous versus intravenous granisetron in cancer patients treated with platinum-based chemotherapy.

BACKGROUND: 5-HT3-receptor antagonists are one of the mainstays of antiemetic treatment, and they are administered either i.v. or orally. Nevertheless, sometimes neither administration route is feasible, such as in patients unable to admit oral intake managed in an outpatient setting. Our objective was to evaluate the bioavailability of s.c. granisetron. PATIENTS AND METHODS: Patients receiving platinum-based chemotherapy were randomized to receive 3 mg of granisetron either s.c. or i.v. in a crossover manner during two cycles. Blood and urine samples were collected after each cycle. Pharmacokinetic parameters observed with each administration route were compared by analysis of variance. RESULTS: From May to November 2005, 31 patients were included and 25 were evaluable. Subcutaneous granisetron resulted in a 27% higher area under the concentration-time curve for 0-12 hours (AUC(0-12h)) and higher levels at 12 hours, with similar values for AUC(0-24h). The maximum concentration was lower with the s.c. than with the i.v. route and was observed 30 minutes following s.c. administration. CONCLUSION: Granisetron administered s.c. achieves complete bioavailability. This is the first study that shows that s.c. granisetron might be a valid alternative to i.v. delivery. Further trials to confirm clinical equivalence are warranted. This new route of administration might be especially relevant for outpatient management of emesis in cancer patients.

Evaluación del paradigma diagnóstico en diabetes gestacional / Assessment of diagnosis paradigm of gestational diabetes

En junio de 1992 se diseñó e inició el programa de tamizaje de diabetes mellitus gestacional (DMG) en el Servicio de Gineco-Obstetrica del Hospital Nacional "Almanzor Aguinaga" IPSS en Chiclayo. Hasta junio de 1997 se estudió a 3,076 mujeres entre las semanas 28ñ4 de gestación, siendo el 18 por ciento de los tamizajes positivos o anormales. Paralelamente se estableció un grupo control de 85 gestantes, con prueba oral de tolerancia a la glucos (POTG) normal, cuyos resultados sirvieron de punto de corte y parámetros de normalidad locales. Se consideró que si dos o más valores de glucemia eran hallados mayores de 90 mg/dl en ayunas, 140 mg en 1 h. 120 mg a las 2 h. y 110 mg a las 3 h., se diagnosticaba DMG. Se clasificó también a las gestantes, de conformidad con los criterios clásicos de NDDG-O'Sullivan y de Carpenter-Cousteau. Usando los parámetros locales los resultados dieron una incidencia de 161 gestantes con DMG o sea el 5 por ciento, en tanto que con los clásicos fue de 6, o sea el 0.17 por ciento. Se establece que la POTG es el medio más eficaz para el diagnóstico y seguimiento de DM, las cifras de POTG locales son mucho más sensibles para detectar DMG que las clásicas, comúnmente usadas