Age Under 30 Years As a Predictor of Poor Survival in a Cohort of Mexican Women With Breast Cancer.

INTRODUCTION: Young women under 30 years with breast cancer (BC) are an emerging challenge. The purpose is to identify prognostic factors for survival in young women under 30 years of age with BC. MATERIAL AND METHODS: A retrospective cohort study was conducted among women younger than or equal to 40 years with BC and who were treated at the State Cancer Center during the period 2012-2017. Overall survival was assessed using the Kaplan-Meier method and the log-rank test. Univariate and multivariate analysis assessed survival predictors using Cox proportional hazards regression model. RESULTS: 282 young women were included. The >30-year-old subgroup showed a significant association with excess weight (P = .002) compared to the <30-year-old group. The <30-year-old subgroup showed a poor overall survival (56.7%), as well as highly significant values in advanced clinical stages, metastatic nodules, metastasis, and neoadjuvant therapy (P < .001). In Model 3 of the multivariate analysis, age <30 years (HR = 3.0; 95% CI 1.1 to 8.6), triple negative subtype (HR = 2.6; 95% CI 1.1 to 6.0), tumor size >5 cm HR = 2.3; 95% CI 1.03 to 5.1), and advanced clinical stages (HR = 6.6 95% CI 1.3 to 35.5) persisted as predictors. CONCLUSIONS: Being very young (<30 years) is a predictor for limited survival compared to the age of 30-40 years, as well as the tumor covariates for a worse prognosis: triple negative subtype, advanced stages, positive lymph nodes, and distant metastases in liver.

Influence of type 2 diabetes mellitus on mortality in women with breast cancer: A matched case-control study.

AIMS: The study assessed the association between the presence of type2 diabetes mellitus (T2DM) and mortality in women with breast cancer (BC). METHODS: A matched pair case-control study was conducted at the State Cancer Center, which is located in Xalapa, Veracruz, Mexico. It was matched by age (±3 years) within a cohort of 1442 patients with BC. Descriptive statistics were performed. Analysis through paired odds ratio (OR and multivariate analyses were used to calculate the association between BC mortality and the variables studied. RESULTS: 166 cases and 166 controls with confirmed diagnosis of BC were studied, with a mean age of 52.9 ± 11.9 years. The T2DM was associated with an increased mortality of women with BC (OR = 1.75 95 %CI 1.06-2.89). Similarly, metastasis (OR = 14.17 95 %CI 6.19-32.342), advanced clinical stage (OR = 3.04 95 %CI 1.45 - 6.38), and the molecular subtypes Her2 (OR = 2.0 95 %CI 1.02-3.92), and triple negative (OR = 3.54 95 %CI 1.72-7.32). There was no difference in mean glucose between cases and controls (208.9 ± 132 vs 194.4 ± 90.4 mg/dL, respectively). CONCLUSION: T2DM was found to be a relevant risk factor for BC mortality in this Mexican population. Thus, it is important to consider the presence and evolution of DM in the prevention programs, diagnostic algorithms and treatments established for BC.

Association of Family History and Life Habits in the Development of Colorectal Cancer: A Matched Case-Control Study in Mexico.

Colorectal cancer (CRC) is one of the most frequently diagnosed cancers and, as such, is important for public health. The increased incidence of this neoplasm is attributed to non-modifiable controls such as family history and modifiable variable behavioral risk factors involved in lifestyle like diets in Mexico. The presence of these factors is unknown. Therefore, the aim of this study was to evaluate family history and lifestyle factors associated with developing colorectal cancer in a Mexican population. Descriptive statistics and multivariate logistic regression were used to estimate the adjusted odds ratios (OR), as well as the 95% confidence intervals (CI). In this paper, significant differences were demonstrated between cases and controls. A family history of cancer (FHC) increased the probability of CRC [OR = 3.19 (95% CI: 1.81-5.60)]. The area of urban residence was found to be a protective factor compared to the rural area. This was also the case for frequent consumption of fruits [OR = 0.49 (95% CI: 0.28-0.88)], the frequent consumption of beef [OR = 2.95 (95% CI: 1.05-8.26)], pork [OR = 3.26 (95% CI: 1.34-7.90)], and region-typical fried food [OR = 2.79 (95% CI (1.32-5.89)]. These results provide additional evidence supporting the association of some CRC risk factors with family history of cancer, low fruit consumption, high consumption of red meat, and fried foods typical of the region of México. It is important to establish intervention methods, as well as genetic counseling to relatives of patients with CRC.

Characteristics of healthy behavior in Mexican women who survived breast cancer.

OBJECTIVE: This paper aims to assess diet and lifestyle by designing a healthy behavior index (HBI) related to the educational level and time of breast cancer (BC) diagnosis. METHODS: 241 female breast cancer survivors treated at Centro Estatal de Cancerología (State Cancer Center) in Mexico were assessed based on dietary pattern, physical activity, smoking, alcohol consumption, body size and shape, sleep disorders with increasing scores that represent less healthy characteristics. The odds ratios (OR) and quartiles of the healthy behavior index and the time of diagnosis were estimated. The regression model was used to assess the association between HBI and the BC covariates. RESULTS: The healthy behavior index for the two first quartiles was that of p < 0.001. The graphic behavior of correspondence with the covariates (age, schooling and moderate physical activity) showed a different three-dimensional effect on healthy behaviors. According to diagnosis time ≤ three years, the following covariates were significant: socioeconomic status, (OR: 4.34 CI 95% 1.2-9.5), sleep disturbances (p = 020) and protective intake of fruits and vegetables (p = 0.001). In the multivariate analysis, survivors with a high level of education are significantly more likely to show a healthy behavior (OR: 0.3 95% CI 0.12 - 0.8); as well as the early clinical stages (OR: 0.4 95% CI 0.2-0.9). CONCLUSION: In breast cancer survivors, both the high level of education and early clinical stages were important healthy behavior modifiers. PRACTICE IMPLICATIONS: Since diets are potentially modifiable, the findings may have further implications to promote a careful dietary pattern to prevent breast cancer. These variables should be assessed as a strategy in cancer survivor preventive programs.

Knowledge, Attitudes, and Practices about Zika among a University Community Located in an Endemic Zone in Mexico.

To assess the knowledge, attitudes, and practices about the Zika virus in both students and workers at the University of Veracruz, an online survey was conducted. The participants were divided into two groups: one according to sex, the other according to whether they were workers or students. Their answers were classified into knowledge, attitudes, and practices and they were rated as low, medium, and high. The results showed that knowledge about Zika prevailing among the university population is considered as medium in 79.4% of the study population. Most respondents know that the mosquito spreads the Zika virus (98.8%) and the clinical characteristics, while sexual transmission by the virus is little known (36.85%). Both the univariate analysis (OR (CI5) 0.227 (0.070⁻0.735), p = 0.013] and multivariate analysis (OR (CI95) 0.234 (0.071⁻778), p = 0.018] showed that belonging to the health sciences area is related to having a greater knowledge about Zika. Despite the existing knowledge, a low level of prevention practices prevails in the whole community (55%). A medium level of knowledge about Zika prevailed, while proper implementation of preventive measures for Zika is low, despite the fact that the state of Veracruz-the place where the University is located-is an endemic area.

Intervención digital basada en la atención plena para estrés y ansiedad generalizada en trabajadores universitarios / Digital intervention based on mindfulness for stress and generalized anxiety in university workers

Resumen Objetivo: Analizar el efecto y la percepción de una intervención digital, basada en atención plena para disminuir el estrés y ansiedad generalizada entre los trabajadores de la Universidad Veracruzana (UV). Materiales y Métodos: Un ensayo clínico aleatorizado se llevó a cabo con 102 participantes, divididos en un grupo experimental y un grupo control para evaluar el efecto de una intervención a través de WhatsApp, en la reducción del estrés y la ansiedad. El grupo experimental recibió un programa de meditación con el fin de capacitarlos y enseñarles a practicar la atención plena. Se utilizaron las escalas de estrés percibido PSS-10 y del trastorno de la ansiedad generalizada GAD-7 para evaluar el efecto de la intervención. Los participantes expresaron su opinión sobre la intervención mediante entrevistas focalizadas con preguntas estandarizadas. Resultados: Se encuentra una disminución en las medianas del nivel de estrés percibido y ansiedad generalizada del grupo experimental entre el momento pre-intervención y post-intervención, con una diferencia estadísticamente significativa, p=0.012 y p=0.013, respectivamente. En el grupo control se visualiza un ligero aumento en dichos niveles y no se identifican diferencias significativas entre la medición basal y final, tanto en estrés como en ansiedad. En el análisis del espectro del discurso, se examinó la categoría de "Usabilidad" y se identificaron diferentes aspectos relacionados con la percepción, participación y recomendación de la intervención. Conclusiones: Se encontró una mejoría estadísticamente significativa en los niveles de estrés y ansiedad generalizada. Se demuestra que, realizar intervenciones en salud pública que involucren la tecnología, es cada vez más adaptable y contribuye al avance del conocimiento dentro del autocuidado de la salud mental entre los trabajadores de la Universidad Veracruzana.

Abstract Objective: To analyze the effect and perception of a digital intervention, based on mindfulness to reduce stress and generalized anxiety among workers at the Universidad Veracruzana (UV). Materials and Methods: A randomized clinical trial was carried out with 102 participants, divided into an experimental group and a control group to evaluate the effect of an intervention through WhatsApp in reducing stress and anxiety. The experimental group received a meditation program in order to train and teach them to practice mindfulness. The PSS-10 Perceived Stress and GAD-7 Generalized Anxiety Disorder scales were used to assess the effect of the intervention. Participants expressed their opinion about the intervention through focused interviews with standardized questions. Results: There is a decrease in the median level of perceived stress and generalized anxiety of the experimental group between the pre-intervention and post-intervention moments, with a statistically significant difference, p=0.012 and p=0.013, respectively. In the control group, a slight increase in said levels was observed and no significant differences were identified between the baseline and final measurement, both in stress and anxiety. In the discourse spectrum analysis, the "Usability" category was examined and different aspects related to the perception, participation and recommendation of the intervention were identified. Conclusions: A statistically significant improvement was found in the levels of stress and generalized anxiety. It is shown that carrying out public health interventions that involve technology is increasingly adaptable and contributes to the advancement of knowledge within mental health self-care among workers at the Universidad Veracruzana.

Aducto-ADN-aflatoxina como biomarcadores de exposición en grupos de riesgo de cáncer de higado / Alotoxin-DNA-adductus as exposure biomarkers in groups at risk for liver cancer

La aflatoxina B1 está entre los más potentes carcinógenos conocidos. La presencia de esta toxina parece ser más frecuente en la orina de personas que han sufrido infecciones por el virus B de la hepatitis. En nuestro trabajo se estudió un grupo de 210 pacientes provenientes del Instituto de Nutrición Salvador Zubirán de México con diagnóstico de hepatitis B y C crónicas, cirrosis viral y alcohólica, y grupos controles. Las muestras de orina fueron procesadas y purificadas con columnas de afinidad y cuantificadas por ELISA y HPLC. Los resultados revelaron que el niel más alto de aflatoxinas obtenido correspondió a los grupos de riesgo de hepatitis B crónica (50 por ciento) seguido por los de cirrosis (26 por ciento) y por último el de hepatitis C (16,6 por ciento). Estos resultados apoyan la validez de los aductos alfatoxina-ADN como un buen biomarcador de la expresión de este cancerígeno y su importancia en relación con las enfermedades hepáticas estudiadas

La oncología en Cuba: registro de cáncer de mama hereditario / Hereditary breast cancer registry

El cáncer de mama es la neoplasia más frecuente entre las mujeres. Una porción de aproximadamente el 10 por ciento de estos cánceres son causados por mutaciones germinales que pueden ser transmitidas de padres a hijos, son los llamados cánceres hereditarios. Las mutaciones germinales de al menos 2 genes supresores tumorales, los BRCA1 y BRCA2, cuentan aproximadamente el 85 por ciento de todos los cánceres hereditarios. En las familias con estas mutaciones es frecuente la aparición de cáncer de mama en miembros de generaciones sucesivas. Dada la importancia de identificar esas familias tanto para la práctica clínica con fines de lograr diagnósticos tempranos, como para la investigación de los genes implicados en el proceso tumoral, se creó con la colaboración del Servicio de Mastología del Instituto Nacional de Oncología y Radiobiología, un Registro de Cáncer de Mama Hereditario, del cual se muestran 3 familias que evidencian la transmisión del factor genético a través de varias generaciones.

Cáncer de mama: Edad de inicio como factor de riesgo familiar / Breast cancer: Age as a risk factor

Es sabido que el cáncer de mama tiene un componente hereditario en algunas familias y la aparición de la enfermedad a edades tempranas puede ser signo de susceptibilidad genética. Realizamos un estudio de caso-control en familias cubanas para determinar la variabilidad del riesgo relativo familiar, según la edad de aparición de la enfermedad en el caso índice. Estudiamos 219 casos con diagnóstico positivo de cáncer de mama diagnosticados en nuestro Centro durante un año. Los controles fueron tomados de centros hospitalarios próximos y pareados por edad y sexo con los casos. Para determinar la variación del riesgo familiar propuesto, consideramos dos grupos de estudio según la edad al diagnóstico de la enfermedad en el caso índice. Estos grupos fueron: grupo 1, menores de 50 años, y grupo 2 a partir de esa edad. De acuerdo a estos dos grupos de edades, calculamos estadísticamente el riesgo relativo familiar según el número de casos y controles con familiares afectados. Encontramos que el riesgo relativo de los familiares afectados. Encontramos que el riesgo relativo de los familiares de los casos en el grupo 1 fue estadísticamente signficativo, (6.97), disminuyendo en el grupo 2, donde el riesgo fue de sólo 2.66, y estadísticamente significativo también