Air-Stable Cobalt(III) and Chromium(III) Complexes as Single-Component Catalysts for the Activation of Carbon Dioxide and Epoxides.

Cobalt(III) and chromium(III) salophen chloride complexes were synthesized and tested for the cycloaddition of carbon dioxide (CO2) with epoxides to obtain cyclic carbonates. The cat1, cat2, cat4, and cat5 complexes presented high catalytic activity without cocatalysts and are solvent-free at 100 °C, 8 bar, and 9 h. At these conditions, the terminal epoxides (1a-1k) were successfully converted into the corresponding cyclic carbonates with a maximum conversion of ∼99%. Moreover, cat5 was highlighted due to its capability of opening internal epoxides such as limonene oxide (1l) with a 36% conversion to limonene carbonate (2l), and from cyclohexene oxide (1m), cyclic trans-cyclohexene carbonate (2m) and poly(cyclohexene carbonate) were obtained with 15% and 85% selectivity, respectively. A study of the coupling reaction mechanism was proposed with the aid of electrospray ionization mass spectrometry (ESI-MS) analysis, confirming the single-component behavior of the complexes through their ionization due to epoxide coordination. In addition, crystallographic analysis of cat1 single crystals grown in a saturated solution of pyridine helped to demonstrate that the substitution of chloride ion by pyridine ligands to form an octahedral coordination occurs (Py-cat1), supporting the proposed mechanism. Also, a recyclability study was performed for cat5, and a total turnover number of 952 was obtained with only minor losses in catalytic activity after five cycles.

Biological Activity of Complexes Involving Nitro-Containing Ligands and Crystallographic-Theoretical Description of 3,5-DNB Complexes.

Drug resistance in infectious diseases developed by bacteria and fungi is an important issue since it is necessary to further develop novel compounds with biological activity that counteract this problem. In addition, new pharmaceutical compounds with lower secondary effects to treat cancer are needed. Coordination compounds appear to be accessible and promising alternatives aiming to overcome these problems. In this review, we summarize the recent literature on coordination compounds based on nitrobenzoic acid (NBA) as a ligand, its derivatives, and other nitro-containing ligands, which are widely employed owing to their versatility. Additionally, an analysis of crystallographic data is presented, unraveling the coordination preferences and the most effective crystallization methods to grow crystals of good quality. This underscores the significance of elucidating crystalline structures and utilizing computational calculations to deepen the comprehension of the electronic properties of coordination complexes.

Weak Noncovalent Interactions in Three Closely Related Adamantane-Linked 1,2,4-Triazole N-Mannich Bases: Insights from Energy Frameworks, Hirshfeld Surface Analysis, In Silico 11ß-HSD1 Molecular Docking and ADMET Prediction.

Structural analysis and docking studies of three adamantane-linked 1,2,4-triazole N-Mannich bases (1-3) are presented. Compounds 1, 2 and 3 crystallized in the monoclinic P21/c, P21 and P21/n space groups, respectively. Crystal packing of 1 was stabilized by intermolecular C-H⋯O interactions, whereas compounds 2 and 3 were stabilized through intermolecular C-H⋯N, C-H⋯S and C-H⋯π interactions. The energy frameworks for crystal structures of 1-3 were described. The substituent effect on the intermolecular interactions and their contributions were described on the basis of Hirshfeld surface analyses. The 11ß-hydroxysteroid dehydrogenase type 1 (11ß-HSD1) inhibition potential, pharmacokinetic and toxicity profiles of compounds 1-3 were determined using in silico techniques. Molecular docking of the compounds into the 11ß-HSD1 active site showed comparable binding affinity scores (-7.50 to -8.92 kcal/mol) to the 11ß-HSD1 co-crystallized ligand 4YQ (-8.48 kcal/mol, 11ß-HSD1 IC50 = 9.9 nM). The compounds interacted with key active site residues, namely Ser170 and Tyr183, via strong hydrogen bond interactions. The predicted pharmacokinetic and toxicity profiles of the compounds were assessed, and were found to exhibit excellent ADMET potential.

Novel complexes with ONNO tetradentate coumarin schiff-base donor ligands: x-ray structures, DFT calculations, molecular dynamics and potential anticarcinogenic activity.

The synthesis of eight novel Zn(II), Co(II), Cu(II), Ni(II) and Pt(II) complexes (2-9) derived from the ONNO tetradentate coumarin Schiff-Base donor ligands, L1 and the novel L2, was performed. All compounds were characterized by analytical, spectrometry and spectroscopy techniques. Complexes 2-4 were also characterized by DFT calculations and the structures of 5 and 6 were determined by single-crystal X-ray diffraction analysis. A cytotoxicity study was carried out through an MTT assay in the carcinogenic cell line HeLa and the noncarcinogenic cell lines HFF-1 and HaCaT. The results indicated that among all the evaluated compounds, 2 and 6 presented the best anticarcinogenic potential against HeLa cells with an IC50 of 3.5 and 4.1 µM, respectively. In addition, classical molecular dynamics simulations were performed on the synthesized coordination compounds bound to G4 DNA architectures in the scope of shedding light on their inhibition mode and the most conserved interactions that may lead to the biological activity of the compounds.

Structural Insights and Docking Analysis of Adamantane-Linked 1,2,4-Triazole Derivatives as Potential 11ß-HSD1 Inhibitors.

The solid-state structural analysis and docking studies of three adamantane-linked 1,2,4-triazole derivatives are presented. Crystal structure analyses revealed that compound 2 crystallizes in the triclinic P-1 space group, while compounds 1 and 3 crystallize in the same monoclinic P21/c space group. Since the only difference between them is the para substitution on the aryl group, the electronic nature of these NO2 and halogen groups seems to have no influence over the formation of the solid. However, a probable correlation with the size of the groups is not discarded due to the similar intermolecular disposition between the NO2/Cl substituted molecules. Despite the similarities, CE-B3LYP energy model calculations show that pairwise interaction energies vary between them, and therefore the total packing energy is affected. HOMO-LUMO calculated energies show that the NO2 group influences the reactivity properties characterizing the molecule as soft and with the best disposition to accept electrons. Further, in silico studies predicted that the compounds might be able to inhibit the 11ß-HSD1 enzyme, which is implicated in obesity and diabetes. Self- and cross-docking experiments revealed that a number of non-native 11ß-HSD1 inhibitors were able to accurately dock within the 11ß-HSD1 X-ray structure 4C7J. The molecular docking of the adamantane-linked 1,2,4-triazoles have similar predicted binding affinity scores compared to the 4C7J native ligand 4YQ. However, they were unable to form interactions with key active site residues. Based on these docking results, a series of potentially improved compounds were designed using computer aided drug design tools. The docking results of the new compounds showed similar predicted 11ß-HSD1 binding affinity scores as well as interactions to a known potent 11ß-HSD1 inhibitor.

Non-Hodgkin Lymphoma Epidemiology in Children From 2 Socioeconomic Regions in Mexico: 20-Year Registry (1996-2015).

PURPOSE: We analyzed the epidemiologic characteristics of different types of non-Hodgkin Lymphoma (NHL), excluding Burkitt Lymphoma, in 2 Mexican regions with different socioeconomic status. MATERIALS AND METHODS: In this surveillance study, we analyzed the incidence rates (cases per million children/year) of different types of NHL according to the ICCC3, registered in 1996-2015, from 2 different socioeconomic regions in Mexico: central and southern, with higher and lower status, respectively. RESULTS: The principal NHL subgroups were precursor (IIb1), mature B cell (IIb2), mature T/NK cell, and no other specification (NOS; 42.3%, 15.8%, 14.1%, and 27.8%, respectively). In both regions, the overall incidence rates were similar (central=5.3, 95% confidence interval [CI], 4.6-6.1 vs. southern=6.3, 95% CI, 4.6-8.4); also, there were no differences by types (precursor cell LNH, 2.3 vs. 2.5; mature B cell, 0.9 vs. 0.8; mature T/NK cells, 0.8 vs. 0.8; and NOS, 1.4 vs. 2.3). In both regions, a decreasing trend was found (central= -0.17%, 95% CI, -0.03 to -0.3, P=0.04; southern= -0.32%, 95% CI, -0.07 to -0.57, P=0.02), with major reduction of NHL NOS from 1996 to 2000. In both regions, men predominated (2.1:1). CONCLUSIONS: Socioeconomic status did not influence the incidence rates of NHL. In this study, we found a reduction of NHL NOS, possibly due to better typing.

Information and Communication Technology, Mobile Devices, and Medical Education.

Information and communication technologies (ICT) are practical and highly available tools. In medical education, ICTs allow physicians to update their knowledge and remember the necessary information within reach of current mobile devices. ICTs as preparation tools for medical education have not been reported for medical students in Mexico. To assess the use of mobile devices as ICTs with medical education purposes, we distributed a questionnaire through an online survey management system to all the medical students (n = 180) from a private university in Mexico City, 100% agreed to participate. We developed a questionnaire based on previous surveys and adapted it to our university. All participants reported possession of an electronic mobile device, and 95% used it regularly for learning purposes. Regardless of the school year, the most frequent usage given to these devices was the search and reading of medical articles, the use of medical calculators, and taking notes. As the levels in career advances, there was a reduction in the use of electronic devices. According to the students, the main barriers towards using mobile devices for learning purposes were both the lack of access to the Internet and permission from the professor to use them. Most medical students use mobile devices for learning purposes, but usage changes during their education. It is convenient to encourage the use of mobile devices and the development of ICT skills as tools for educational purposes rather than banning their use in schools and hospitals.

Neurological repercussions of changes in cerebral blood flow in neonates undergoing cardiovascular surgery.

INTRODUCTION: Surgery for congenital heart disease can generate cerebral perfusion-associated alterations with neurological repercussions. OBJECTIVE: To analyze the relationship of peri-surgical cerebrovascular resistance index (RI) with mediate neurological functions after congenital heart disease surgery. METHOD: Prospective cohort study of 34 neonates in whom basilar artery RI, serum oxygen, carbon dioxide and lactate levels were determined before and after palliative or corrective procedures. We related pre-surgical RI with post-surgical ability to initiate the enteral route or to restore unassisted spontaneous breathing. RESULTS: Three groups were formed: 79 neonates with high RI (> 0.73), 73 with normal RI (0.63 to 0.73) and eight with low RI (< 0.63). In the former group, high RI persisted in the postoperative period, with persistent hyperlactatemia and hypoxia; in 86 %, the enteral route could not be initiated, and neither could assisted ventilation be withdrawn. In the second group, RI remained within normal values. In the third group, although RI, serum lactate and arterial oxygen pressure tended to normalize, 71 % had severe neurological damage. CONCLUSIONS: RI changes were common, although neurological damage appears to occur more commonly when RI remains high, possibly associated with low cerebral blood flow.

INTRODUCCIÓN: La cirugía de cardiopatías congénitas puede generar alteraciones perfusorias cerebrales con repercusión neurológica. OBJETIVO: Analizar la relación del índice de resistencia (IR) vascular cerebral periquirúrgico con funciones neurológicas mediatas posteriores a cirugía de cardiopatía congénita. MÉTODO: Estudio de cohorte prospectivo de 34 neonatos en quienes se determinó IR de la arteria basilar, niveles séricos de oxígeno, dióxido de carbono y lactato, antes y después de procedimientos paliativos o correctivos. Relacionamos el IR prequirúrgico con la capacidad posquirúrgica para iniciar la vía enteral o restablecer la respiración espontánea no asistida. RESULTADOS: Se integraron tres grupos: 79 neonatos con IR alto > 0.73, 73 con IR normal de 0.63 a 0.73 y ocho con IR bajo < 0.63. En los primeros persistió IR elevado en el posquirúrgico, con hiperlactatemia e hipoxia persistentes; en 86 % no se logró iniciar la vía enteral ni retirar la ventilación asistida. En los segundos, el IR se mantuvo en valores normales. En los terceros, si bien el IR, el lactato sérico y la presión arterial de oxígeno tendieron a normalizarse, 71 % presentó daño neurológico grave. CONCLUSIONES: Los cambios en el IR fueron frecuentes, aunque el daño neurológico parece presentarse más cuando el IR se mantiene alto, posiblemente asociado con flujos cerebrales bajos.

Socioeconomic inequalities in survival of children with acute lymphoblastic leukemia insured by social security in Mexico: a study of the 2007-2009 cohorts.

BACKGROUND: Although acute lymphoblastic leukemia (ALL) 5 years survival in minors has reached 90%, socioeconomic differences have been reported among and within countries. Within countries, the difference has been related to the socioeconomic status of the parents, even in the context of public health services with universal coverage. In Mexico, differences in the mortality of children with cancer have been reported among sociodemographic zones. The Instituto Mexicano del Seguro Social (IMSS), the country's main social security institution, has reported socioeconomic differences in life expectancy within its affiliated population. Here, the socioeconomic inequalities in the survival of children (< 15 years old) enrolled in the IMSS were analyzed. METHODS: Five-year survival data were analyzed in cohorts of patients diagnosed with ALL during the period 2007-2009 in the two IMSS networks of medical services that serve 7 states of the central region of Mexico. A Cox proportional risk model was developed and adjusted for the socioeconomic characteristics of family, community of residence and for the clinical characteristics of the children. The slope of socioeconomic inequality of the probability of dying within five years after the diagnosis of ALL was estimated. RESULTS: For the 294 patients studied, the 5 years survival rate was 53.7%; the median survival was 4.06 years (4.9 years for standard-risk diagnosis; 2.5 years for high-risk diagnosis). The attrition rate was 12%. The Cox model showed that children who had been IMSS-insured for less than half their lives had more than double the risk of dying than those who had been insured for their entire lives. CONCLUSIONS: We did not find evidence of socioeconomic inequalities in the survival of children with ALL associated with family income, educational and occupational level of parents. However, we found a relevant gradient related social security protection: the longer children's life insured by social security, the higher their probability of surviving ALL was. These results add evidence of the effectiveness of social security, as a mechanism of wealth redistribution and a promoter of social mobility. Extending these social security benefits to the entire Mexican population could promote better health outcomes.

Correction to: socioeconomic inequalities in survival of children with acute lymphoblastic leukemia insured by social security in Mexico: a study of the 2007-2009 cohorts.

Following publication of the original article [1], the author reported her name has been erroneously spelled as Blanca E. Pelcastre. The full name is Blanca E. Pelcastre-Villafuerte.

Inhibition of C. albicans Dimorphic Switch by Cobalt(II) Complexes with Ligands Derived from Pyrazoles and Dinitrobenzoate: Synthesis, Characterization and Biological Activity.

Seven cobalt(II) complexes of pyrazole derivatives and dinitrobenzoate ligands were synthesized and characterized. The single-crystal X-ray diffraction structure was determined for one of the ligands and one of the complexes. The analysis and spectral data showed that all the cobalt complexes had octahedral geometries, which was supported by DFT calculations. The complexes and their free ligands were evaluated against fungal strains of Candida albicans and emerging non-albicans species and epimastigotes of Trypanosoma cruzi. We obtained antifungal activity with a minimum inhibitory concentration (MIC) ranging from 31.3 to 250 µg mL-1. The complexes were more active against C. krusei, showing MIC values between 31.25 and 62.5 µg mL-1. In addition, some ligands (L1-L6) and complexes (5 and Co(OAc)2 · 4H2O) significantly reduced the yeast to hypha transition of C. albicans at 500 µg mL-1 (inhibition ranging from 30 to 54%). Finally, the complexes and ligands did not present trypanocidal activity and were not toxic to Vero cells. Our results suggest that complexes of cobalt(II) with ligands derived from pyrazoles and dinitrobenzoate may be an attractive alternative for the treatment of diseases caused by fungi, especially because they target one of the most important virulence factors of C. albicans.

General Method for the Synthesis of (-)-Conduritol C and Analogs from Chiral Cyclohexadienediol Scaffolds.

An efficient and facile general method for the synthesis of conduritol C analogs, taking advantage of an enantioselective biocatalysis process of monosubstituted benzenes, is described. The absolute stereochemical patterns of the target molecules (−)-conduritol C, (−)-bromo-conduritol C, and (−)-methyl-conduritol C were achieved by means of chemoenzymatic methods. The stereochemistry present at the homochiral cyclohexadiene-cis-1,2-diols derived from the arene biotransformation and the enantioselective ring opening of a non-isolated vinylepoxide derivative permitted the absolute configuration of the carbon bearing the hydroxyl groups at the target molecules to be established. All three conduritols and two intermediates were crystallized, and their structures were confirmed by X-ray diffraction. The three conduritols and intermediates were isostructural. The versatility of our methodology is noteworthy to expand the preparation of conduritol C analogs starting from toluene dioxygenase (TDO) monosubstituted arene substrates.

Importancia del "diagnóstico temprano" en los niños con cáncer para mejorar el pronóstico: concepto con poco sustento científico.

La mortalidad por cáncer en niños mexicanos no ha disminuido a los niveles informados en países desarrollados. Una explicación frecuentemente declarada es el alto porcentaje (57.3 %) de pacientes diagnosticados en estadios avanzados (III/IV), atribuible a errores en la sospecha o en la metodología empleada, consideración dudosa si se toma en cuenta que el tiempo de diagnóstico y la proporción de estadios avanzados en México son semejantes a los de países desarrollados. En la mayoría de los niños con cáncer, los días transcurridos desde el primer síntoma a momento del diagnóstico oncológico no correlacionan con el estadio clínico y tampoco con la probabilidad de supervivencia. El éxito en la supervivencia depende en gran medida del tratamiento integral (específico y de la atención a las complicaciones). Esta visión obliga a estrategias dirigidas principalmente a invertir más recursos en opciones terapéuticas eficaces y eficientes, capacitación oncológica integral del equipo de salud (médicos, enfermeras, técnicos), tecnologías diagnósticas, fomento a la colaboración interinstitucional e internacional y apoyo socioeconómico a las familias durante el proceso terapéutico.Cancer mortality in Mexican children has not decreased to the levels reported in developed countries. A commonly proposed explanation is the high percentage (53.7%) of patients diagnosed at advanced stages (III/IV), which is attributed to erroneous assumptions or mistakes in the diagnostic approach ­a questionable consideration taking into account that both time to diagnosis and the proportion of advanced stage cases in Mexico are similar to those in developed countries. In most cancer cases in children, the number of days elapsed from the moment of the first symptom to the cancer diagnosis is not correlated with clinical stage, and neither with the probability of survival. Survival success largely depends on comprehensive treatment (specific and for the care of complications). This view calls for strategies mainly aimed at spending more resources on efficacious and efficient therapeutic strategies, comprehensive oncology training of healthcare personnel (physicians, nurses and technicians), diagnostic technologies, promotion of interinstitutional and international collaboration and socioeconomic support to families during the therapeutic process.

One-Step Synthesis of Fully Functionalized Pyrazolo[3,4-b]pyridines via Isobenzofuranone Ring Opening.

A novel series of fully substituted pyrazolo[3,4-b]pyridines 4 has been prepared in a regioselective manner by the microwave-assisted reaction between N-substituted 5-aminopyrazoles 1 and 3-(3-oxo-2-benzofuran-1(3H)-ylidene)pentane-2,4-dione (2). This is the second reported example of a cyclocondensation reaction using substrate 2 as a 1,3-bis-electrophilic reagent. Remarkably, this synthesis offers functionalized products with acetyl and carboxyl groups in one step, in good yields, and with short reaction times. Additionally, the cyclization intermediate 3 was isolated, allowing us to postulate a mechanism for this reaction, which is initiated via isobenzofuranone ring opening of 2 in a Michael-type reaction. The structures of the products and regioselectivity of the reactions were determined on the basis of NMR measurements and X-ray diffraction. For this new reaction using substrate 2, the optimal reaction conditions and its scope were investigated.

Clinical and Epidemiological Characteristics of Burkitt Lymphomas in Pediatric Patients from Two Defined Socioeconomic Regions in Mexico.

We analyzed clinical and epidemiological characteristics of Burkitt lymphoma (BL) in two defined socioeconomic regions in Mexico: high socioeconomic region (HSER; with two political jurisdictions) and low socioeconomic region (LSER; with three jurisdictions). Of the 63 cases registered in the Childhood Cancer Registry (1996-2013), 45 (71.4%) were from HSER and 18 (28.6%) from LSER. The incidence was higher in the LSER (3.1 vs. 1.4 cases per million children/year). The sporadic form and Stages III/IV predominated in both regions. Only one post-renal transplant (HSER) was found. The male/female ratio was higher in the LSER (5.0 vs. 1.4). The peak incidence was in the 1-4 age group for LSER, and in the 5-9 age group for HSER. This difference in the sporadic BL by socioeconomic regions may be related to different exposure factors.

Coordination Polymers Containing 1,3-Phenylenebis-((1H-1,2,4-triazol-1-yl)methanone) Ligand: Synthesis and ε-Caprolactone Polymerization Behavior.

The reaction of isophthaloyl dichloride with 1H-1,2,4-triazole afforded the new ligand 1,3-phenylenebis(1,2,4-triazole-1-yl)methanone (1). A series of Co(II), Cu(II), Zn(II) and Ni(II) complexes were synthesized using 1 and then characterized by melting point analysis, elemental analysis, theoretical calculations, thermogravimetric analysis, X-ray powder diffraction, nuclear magnetic resonance, infrared and Raman spectroscopy. Experimental and computational studies predict the formation of coordination polymers (CPs). The cobalt and copper CPs and zinc(II) complex were found to be good initiators for the ring-opening polymerization of ε-caprolactone (CL) under solvent-free conditions. ¹H-NMR analysis showed that the obtained polymers of CL were mainly linear and had terminal hydroxymethylene groups. Differential scanning calorimetry showed that the obtained polycaprolactones had high crystallinity, and TGA showed that they had decomposition temperatures above 400 °C. These results provide insight and guidance for the design of metal complexes with potential applications in the polymerization of CL.

Incidence of Childhood Hodgkin Lymphoma in Mexico by Histologic Subtypes and Socioeconomic Regions.

BACKGROUND: Incidence rates of the histologic subtypes of Hodgkin lymphoma (HL) differed with socioeconomic conditions. MATERIALS AND METHODS: HL cases from the Register of Childhood Cancer (below 15 y of age) for 2 socioeconomic regions were analyzed. Central region has a high socioeconomic index; and the southern region a low index. The incidence rates (cases per million children/year) were estimated according to histologic subtypes, age groups, sex, clinical stages, time to diagnosis, and overall survival by regions. RESULTS: The overall incidence was greater in the south (6.8 vs. 4.6), principally due to higher incidence of mixed cellularity subtype (3.8 vs. 1.0). In the south, the highest incidence was found in the 5- to 9-year-old group (9.2), whereas in the central region it was found in the 10- to 14-year-old group (7.4). There was a delay of ∼3 weeks in the time to diagnosis (P=0.36) in the south, but no difference in the percentage of advanced stages, adjusted by histologic subtype (61%, III and IV). The overall survival was 71%, differences were identified only for mixed cellularity cases (center=89.2 vs. south=61.5%, P=0.03). CONCLUSIONS: Incidences of HL subtypes differed in relation to socioeconomic conditions in Mexico. In the south, the incidence of mixed cellularity was higher and there was an earlier peak of presentation.

Cancer incidence and mortality in children in the Mexican Social Security Institute (1996-2013).

OBJECTIVE: To identify the cancer incidence and mortality in Mexican Social Security Institute beneficiary (MSSI-B) children during 1996-2013. MATERIALS AND METHODS: Both cancer cases (n=4 728) and deaths (n=2 378) were analyzed in MSSI-B children who were registered in five states of the Mexican Republic. The incidence and mortality trends and the incidences (rate x 1 000 000 children / year) of the type of cancer, age, sex, and place of residence were obtained. RESULTS: For both indicators (incidence and mortality), there was a downward trend for the period of 1996-2001 and a stable trend for 2002-2013. This occurred in the overall mortality and incidence trends of the Estado de México and Chiapas and in the leukemia and the acute lymphoid subgroups. The annual overall incidence was 128 cases per 1 000 000 children. Leukemia, lymphomas, and central nervous system tumors were the principal cancer groups. CONCLUSIONS: Cancer mortality for the period of 2002-2013 did not diminish. Interinstitutional and/or international research should be designed to improve the care of these children.

Childhood lymphoma incidence patterns by ICCC-3 subtype in Mexico City metropolitan area population insured by Instituto Mexicano del Seguro Social, 1996-2010.

PURPOSE: We reviewed the childhood lymphomas epidemiological data for the Mexico City metropolitan area (MCMA). METHODS: Data analysis from children (0-14 years old) diagnosed with lymphoma during the period 1996-2010 was performed at the Mexican Childhood Cancer Registry. Histological subtype was determined according to the International Classification of Childhood Cancer 3 (ICCC-3). Age-adjusted incidence rates were calculated per 1,000,000 children/year by age, gender, and ICCC-3 subtype; trends, by average annual percent change (AAPC). RESULTS: A total of 328 lymphoma cases included in the study had an incidence rate of 11.8, showing a decreasing trend [AAPC: -3.5; CI 95% (-5.9, -1.0)], primarily due to non-Hodgkin lymphomas (NHL) and Hodgkin lymphoma (HL) mixed cellularity subtype. NHL had the major incidence (5.8), with the precursor cell subtype being the most frequent (38.3%). Nodular sclerosis was the most frequent HL subtype. The incidence of Burkitt lymphoma was low (1.3). During the study period, there was an important reduction in the not-otherwise-specified subtype of NHL, which translated into a relative increase in the IIb3 subtype [AAPC: 7.3 (1.2, 13.8)]. Low incidences of NHL and of HL and NHL were found for < 1-year-olds and for 10- to 14-year-olds, respectively. Incidence rates for children in the MCMA, particularly the < 1 and 10-14 age groups, were lower than those for developed countries. The overall male/female ratio was 2.3. CONCLUSIONS: There was a trend toward a reduced incidence, for some lymphoma subtypes, in particular for NOS lymphomas, which may be the result of improvement in diagnostic techniques.

[Medical treatment of the uterine miomas in perimenopausal patients]. / Tratamiento de los miomas uterinos con medroxiprogesterona en pacientes perimenopáusicas.

BACKGROUND: Leiomyomas are the most common benign tumors of the uterus, frequently associated with abnormal uterine bleeding. Medroxyprogesterone (MP) acetate it is a therapeutic alternative. OBJECTIVE: To determine the efficacy of the medroxyprogesterone for abnormal uterine bleeding associated with leiomyomatosis in perimenopause women. METHODS: An observational, prospective, longitudinal study. We selected 31 patients with uterine myomas and abnormal uterine bleeding. Two years monthly doses of 150 mg of MP were given. If the bleeding did not stop at six months of treatment or increased a hysterectomy was performed. RESULTS: Two (6.4%) patients abandoned the treatment after a first doses; 21 (67.7%) completed the treatment without uterine bleeding (efficacy observed of 72.4%; CI 95% 54.4 to 90.4%, intention to treat efficacy 67.7%, CI 95% 49.6 to 86.8%). Eight (25.8%) patients persisted with uterine bleeding before 6 months of treatment and a hysterectomy was performed. There was no severity secondary effect informed. CONCLUSIONS: Management with medroxyprogesterone may be an effective treatment to control the uterine bleeding associated with myomatosis. Their use could reduce the necessity of some hysterectomies.