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La educación sexual (ES) desde la escolaridad ha sido un tema de intereses con diversas variaciones ante posturas biologicistas, moralistas, preventivas, además de aquellas con un eje integrador y de derechos. La actitud de los educadores frente a la sexualidad representa un componente que puede influir en la enseñanza de la ES, por lo cual se planteó como objetivo: describir la evidencia científica respecto a las actitudes relacionadas con la educación sexual (ES) en docentes de instituciones educativas de secundaria. Materiales y métodos: se realizó una revisión sistemática exploratoria de la literatura científica publicada en el mundo, utilizando las palabras clave school teacher, sex education y attitude; en los idiomas inglés, portugués y español; de los años 2003 a 2019, mediante búsqueda en las bases de datos SciELO, Scopus, Cinhal, Ovid y BVSL y en artículos de referencias. Fueron evaluadas por dos autores de manera independiente empleando herramientas de Joanna Briggs Institute. Se estableció como medida de rigor el cumplimiento del 70 % de los criterios a evaluar. Resultados: 13 artículos superaron la valoración de rigor, ocho de tipo cualitativo y seis de cuantitativo, de Europa [1], Sudeste Asiático [3], Sudáfrica [6], Norteamérica [1], Suramérica [1] y Australia [1]. Los estudios muestran que aspectos como cultura, género, conocimiento, metodologías, valores y prejuicios del docente se constituyen en condicionantes de las actitudes del docente frente a la ES. Conclusiones: se evidencia que la clave de una mejor ES, son buenas capacitaciones docentes y el entendimiento de todos los actores de la comunidad para evitar mitos y demás.

Cytogenetic abnormalities (CA) such as t(4;14), t(14;16), and del(17p), are associated with a poor prognosis in Multiple Myeloma (MM) patients. However, there is scarce information regarding the Latin-American population. This study aims to analyze the impact of t(4;14), t(14;16), and del(17p) on the progression-free survival (PFS) and overall survival (OS) of transplant-eligible newly-diagnosed MM (NDMM) patients in Latin America. Retrospective survival analysis based on the Grupo de Estudio Latinoamericano de MM (GELAMM) registry, including all adult patients with NDMM harboring CA t(4;14), t(14;16), and/or del(17p). Fifty-nine patients were included; the median age was 57 years, 55.9% males, 22% ISS-I, 25.4% ISS-II, and 47.5% ISS-III. The majority (89.8%) had 1 alteration, whereas 10.2% had del(17p) and t(4;14). The frequencies of CA were del(17p) in 61.0%, t(4;14) in 25.4%, and t(14;16) in 3,4%. Autologous stem cell transplantation (ASCT) was performed in 61.0% of cases. Five-year OS for the entire cohort was 60.8% and 5-year PFS was 28.1%. Bortezomib-based induction regimen (BBR) (P = 0.029), consolidation with ASCT (P0.001), and maintenance therapy (P = 0.004) were associated with an improved 5-year OS. In the multivariate analysis, ASCT was the only variable with a positive impact on OS (HR 0.11, 95% CI 0.033 to 0.34, P0.001). The median PFS presented a non-statistically significant benefit in BBR, ASCT, and maintenance therapy groups. BBR induction, ASCT, and maintenance therapy were associated with improved OS in high-risk NDMM patients.

The inclusion of 7-diethylamino-coumarin derivatives, bearing an ethyl acetoacetate (CAM1) and a methyl β-ketodithioester moiety (CAM2) in the cavity of cucurbit[7]uril (CB7), leads to different interaction forms with mercuric ions (Hg2+). The interaction between these ions and CAM1, in the presence of CB7, occurs through the lateral ethyl acetoacetate moiety of the keto form of CAM1, leading to the formation of binary assemblies such as Hg2+@CAM1 and Hg2+@CB7. As a consequence, the metal restricts the insertion of the dye into the CB7 cavity, decreasing the apparent binding constant between them. Interestingly, for the other derivative CAM2, a mercury-induced desulfurisation reaction of its β-ketodithioester moiety is kinetically accelerated by CB7 (by a factor ≈25), which subsequently leads to the generation of binary and ternary complexes among the analogue oxygenised from CAM2, metal and CB7. The later effect is a promising strategy that could be considered for the mercury sensing methodology.

La responsabilidad social está orientada en la educación a la institución como organización, los entes profesionales que en ella participan y la comunidad educativa en general. Para participar activa y responsablemente en las decisiones colectivas de manera democrática, resolviendo conflictos en forma pacífica y a su vez para respetar la diversidad humana, entre otros importantes factores a los que hace relación la ciudadanía actual. La investigación tuvo como objetivo fundamental develar la responsabilidad social y los principios de la formación ciudadana como elementos de incorporación en la educación. La metodología usada en el presente estudio fue descriptiva con un enfoque bibliográfico, utilizando un cuestionario que arrojó como resultado la pertinencia de intervenir en el proceso educativo, teniendo para ello que deben haber factores externos que refuercen los valores ya existentes y para eso se planteó en este trabajo la responsabilidad social y la formación ciudadana como elementos claves en este proceso.

La investigación tuvo como objetivo analizar estudios de caso sobre riesgos naturales en la historia de Venezuela para la formación multidisciplinaria de docentes de Ciencias Sociales. Los trabajos realizados dan cuenta de los desastres ocurridos sobre: los terremotos de 1673 y 1674 en los andes venezolanos, un estudio de caso en Gibraltar durante el siglo XVII por historiadores zulianos, y sobre el temblor de Caracas en 1812. Para el trabajo se recurrió al método histórico, el cual permitió localizar, transcribir e inferir sobre periódicos y otras fuentes localizadas en el Acervo Histórico del Zulia y otros repertorios documentales de la ciudad. La metodología es descriptiva, soportada por una revisión documental cuyos resultados confirmaron que son pocos los estudios históricos realizados desde las distintas disciplinas, pero que sin duda dan contribuciones significativas riesgos de desastres en la historia de Venezuela que merecen ser profundizados en todos los niveles escolares.

The aim of this study was to describe clinical and survival characteristics of transplant-eligible multiple myeloma (MM) patients in Latin America (LA), with a special focus on differences between public and private healthcare facilities. We included 1293 patients diagnosed between 2010 and 2018. A great disparity in outcomes and survival between both groups was observed. Late diagnosis and low access to adequate frontline therapy and ASCT in public institutions probably explain these differences. Patients treated with novel drug induction protocols, followed by autologous stem cell transplantation (ASCT) and maintenance, have similar overall survival compared to that published internationally.

La presente investigación tuvo como objetivo general analizar la aplicación de un entorno virtual para el aprendizaje de contenidos de Historia Universal, en la carrera Educación mención Ciencias Sociales de las universidades del estado Zulia. Se fundamentó en los aportes teóricos de Gorocica (2012), Mariño (2008), Godoy (2008), entre otros. El tipo de investigación empleado fue descriptiva y proyectiva, con un diseño no experimental y de campo. Los resultados arrojados permiten confirmar que los profesores deben afianzar sus estrategias didácticas a través del empleo de competencias tecnológicas, herramientas síncronas y asíncronas e incorporar las plataformas virtuales institucionales que ofrecen sus casas de estudios para promover en el estudiante el uso de aulas virtuales, con el que se promovería el aprendizaje de contenidos de una materia que presenta contenidos extensos, pero apoyados en las nuevas tecnologías contextualizadas favorecería la aprehensión de conocimientos de procesos históricos actuales vinculados a su quehacer cotidiano.

Objetivo. Analizar el perfil del turismo receptivo merideño durante la Semana Santa de los últimos años; temporada que concentra la mayor cantidad de manifestaciones y acontecimientos culturales y religiosos del Estado. Metodología. A partir de un análisis multivariante de correspondencia múltiple se hallaron cuatro perfiles sobre la base de variables diferenciadas significativamente. Resultados. En Venezuela, incluido el EstadoMérida, urge impulsar múltiples tipologías de turismos especializados basados en su patrimonio histórico-cultural y religioso; por ello se recomienda el fortalecimiento y lacombinación de los atractivos turísticos. Conclusiones. Se concluye que la demanda turística en el Estado Mérida durante la temporada objeto de estudio es moderadamente homogénea, en donde una considerable cantidad de turistas mostró motivos de visita diferentes al aspecto religioso.

Objetivo: El RENEHOC (Registro Epidemiológico de Neoplasias Hematológicas en Colombia) es una base de datos multicéntrica establecida en enero de 2018. Su objetivo principal es proveer información local sobre los patrones de diagnóstico y tratamiento de neoplasias hematológicas, que consideramos de vital importancia para mostrar a los tomadores de decisiones los cambios que deben suceder en el sistema para mejorar los desenlaces en enfermedades como mieloma múltiple (MM) y plantear preguntas de investigación de interés específico en nuestro país. Previamente se han descrito las características y desenlaces de los pacientes enfocados en la primera línea de tratamiento. El objetivo de este análisis es describir las características de los pacientes con MM incluidos en el registro, hasta el momento en que requirieron una segunda línea de tratamiento. Materiales y métodos: con base en el registro, se están incluyendo ambispectivamente pacientes con diagnóstico de MM tratados durante los últimos 10 años, en 14 centros de aprobados, en cuatrociudades del país. El análisis de la información se realizó con estadística descriptiva para las características demográficas y clínicas. Se realizó un análisis de sobrevida (Kaplan-Meier) para evaluar la SLE y la SG. Se estimaron las razones de riesgo (HR) utilizando el modelo de regresión de riesgos proporcionales de Cox. Resultados: hasta enero de 2021, 949 casos han sido registrados, de los cuales 383 (40.3 %) pacientes requirieron una segunda línea (310 por recaída y 73 por refractariedad); de ellos, 203 hombres (53 %) y 180 mujeres (47 %). La mediana de edad al diagnóstico fue 68 años (IQR 60-75). El pico monoclonal más frecuente fue IgG (59 %). La mayoría de pacientes se diagnosticaron en fases avanzadas de la enfermedad, 80 % tenían un estado Durie Salmon III y 48.7 % un ISS de 3. La Tabla 1 muestra las características iniciales de los pacientes que requirieron segunda línea. No hubo diferencia entre los pacientes que recayeron, fueron refractarios o no requirieron una segunda línea, excepto en cuanto a la consolidación con trasplante autólogo que solo se realizó en 3 % de los pacientes refractarios, en comparación con 26 y 31 % en pacientes que recayeron y quienes no requieren una segunda línea, respectivamente. En promedio, hubo 16.29 meses entre final de la primera línea y el inicio de la segunda (DS 24.5). Los tratamientos de segunda línea más frecuentes fueron combinaciones de Lenalidomida sin Bortezomib (79, 21 %), CyBorD (51, 13 %) y los basados en Carfilzomib (54, 14 %). Hay una alta heterogeneidad en los protocolos utilizados, solo 9 pacientes fueron rescatados con daratumumab en segunda línea; 190 (49.6%) recibieron una tercera línea de tratamiento, en promedio 9.48 meses (DS 17.1) después de la segunda línea; la supervivencia libre de progresión 2 estimada a 5 años fue 49.9 %. La mediana de seguimiento para todo el grupo fue 18.5 meses, 12 para los que no requieren una segunda línea, 22 para los refractarios y 34 para los que recayeron; la mediana de supervivencia global fue 162, 106 y 57 meses respectivamente y la supervivencia global a 5 años fue 69.7, 66.8 y 45.8 %. Conclusiones: en este momento la información registrada en RENEHOC todavía es limitada, el seguimiento es corto y probablemente no refleje la situación de todo el país; sin embargo, es evidente su potencial para delinear la realidad de los pacientes con MM en el país. En este análisis reportamos la información referente a los pacientes que requirieron una segunda línea de tratamiento, mostrando que los pacientes refractarios tienen peores desenlaces que los pacientes que la reciben después de una recaída. Es llamativa en esta serie la baja utilización de trasplante autólogo, en especial en los pacientes refractarios. Se requiere un seguimiento más prolongado para llegar a conclusiones más precisas.

Aims: To obtain real-world data on ramucirumab use and effectiveness for the treatment of advanced gastric cancer (AGC) or gastroesophageal junction adenocarcinoma (GEJ). Methods: Observational, retrospective study carried out in 20 Spanish hospitals, in patients who started ramucirumab treatment between December 2015 and December 2018. Descriptive analysis was conducted for patient characteristics, treatment patterns and effectiveness outcomes. Results: Three hundred seventeen patients were included (93.7% treated with ramucirumab-paclitaxel and 6.3% with ramucirumab); age 62.5 (11.3) years; 66.9% male. Median progression-free survival and overall survival were 3.9 months (95% CI: 3.4–4.3) and 7.4 (95% CI: 6.4–8.9) in combination regimen and 2.0 (1.1–2.8) and 4.3 (95% CI: 1.9–7.3) in monotherapy, respectively. Conclusion: The study findings were consistent with available real-world studies and randomized clinical trials.

Objective and Outcomes Measures: Our aim was to characterize the population of patients diagnosed with AML who were attended in 7 health institutions in Colombia, from 2009 to 2020, included based on RENEHOC (online platform) and PETHEMA (Spanish Program for Hematology Treatments). Kaplan-Meier analysis was used to assess overall survival at 1 year (1-OS) and 5 years (5-OS) of follow-up and relapse-free survival (1-RFS, 5-RFS). Results: A total of 289 patients were included; almost half (50.2%) were female, and the median age at diagnosis was 62 years old (14–95). Most patients were ECOG 1 (39.3%) and ECOG 2 (38.8%). The patients (12.5%) presented with secondary AML, and 0.3% had hereditary predisposition syndromes to AML (Down syndrome). Complete remission was achieved in 45.0% of patients, 17.8% absolute resistance, and 13.6% patients died in induction, the majority after day 15 (66.7%). Most of the patients received intensive chemotherapy 7+3 induction regimen (55.8%). Hematopoietic stem cell transplantation (HSCT) was a treatment option for 21.2% of patients, and 77.4% met criteria for HSCT. Allogeneic HSCT (alloTPH) was performed in 19% and autologous HSCT (autoTPH) in 2.2%. The survival at 1-OS and 5-OS was 56.1% (95%CI 48.0–63.4) and 26.7% (95%CI 18.1–36.1), respectively. The RFS was 56.6% (95%CI 48.4–64.0) at 1-year and 22.2% (95%CI 14.0–31.6) at 5-years. For patients younger than 65 years ( Conclusion: Our results also show AML in an older population and that age is associated with shorter survival. We identified a low proportion of AlloHSCT, despite the survival benefit compared to non-transplant patients.

Context The most frequently used induction treatments for newly diagnosed multiple myeloma in Colombia are VTD and CyBorD for transplant-eligible patients. Objective At present, there are no clinical studies in our region that compare the effectiveness of these two regimens. Design To reduce the bias between the groups, we performed a 1:1 propensity score matching (PSM) technique for analysis. Setting The Registro Epidemiologico de Neoplasias Hematologicas en Colombia (RENEHOC) collected data electronically on Colombian patients with multiple myeloma between 2010 and 2018. Patients or Other Participants After pairing using PSM by nearest neighbor, a total of 448 patients, 224 in each group, were identified. Patients in the two groups were matched for age, sex, myeloma type, international staging system stage at diagnosis, kidney injury, dialysis, extramedullary involvement, and transplantation. Interventions None. Main Outcomes Measures Overall response rate and overall survival. Results In the unpaired model, statistically significant differences were shown in age, which was corrected after running the PSM. In all the variables used for the model, no differences were shown between the two groups. The VTD regimen tends to be favored 73.47% vs 63.68% p = 0.061 in the unpaired model; however, when the analysis is made after the PSM, the differences dissipate and become non-significant 68.75% vs 73.66% p = 0.565. There were no statistically significant differences for complete response or very good partial response. We did an overall survival analysis for each regimen whether or not they had undergone transplantation. The median overall survival in the transplanted VTD group was 34 months IQR (20–54) and in VTD not taken to transplantation, it was 8 months IQR (5–17) p Conclusions VTD or CyBorD were equally effective in terms of response and survivability in real world practice. Overall survival was adversely affected when patients did not undergo autologous bone marrow transplantation, regardless of the regimen used in induction.

La determinación de la capacidad antioxidante es útil para valorar la calidad de un alimento, la cantidad de antioxidantes presentes en un sistema, o la biodisponibilidad de compuestos antioxidantes en el cuerpo humano. Los métodos disponibles realizan la determinación del efecto potencial de las sustancias antioxidantes, presentes en los alimentos y en el organismo humano, contra las reacciones de oxidación. El objetivo fue comparar los resultados de la detección de la capacidad antioxidante total (CAT) en muestras de alimentos y plasma humano, mediante la quimioluminiscencia por fotosensibilización (PCL), en contraste con métodos que cuantifican la capacidad de absorbancia del radical de oxígeno (ORAC) y el poder antioxidante reductor del hierro (FRAP). Se obtuvieron extractos hidrosolubles y liposolubles de salvado de arroz estabilizado (SAE) y de harina de Ulva clathrata (HUC). El plasma se obtuvo de muestras de sangre humana (PHU). Se procesaron tres muestras en cada caso. Los resultados se analizaron mediante análisis de varianza de una vía y correlación de Pearson, p < 0.05. La CAT determinada mediante PCL fue: SAE 246.37 ± 5.37, HUC 21.05 ± 0.41 y PHU 90.59 ± 1.17 equivalentes Trolox (ET) μmol /100 g ó 100 mL, p < 0.05; ORAC: SAE 5015.62 ± 12.83, HUC 852.37 ± 3.45 y PHU 2563.31 ± 39.47 ET μmol /100 g ó 100 mL, p < 0.05. FRAP: SAE 519.37 ± 0.04, HUC 52.78 ± 0.01 y PHU 90.26 ± 0.01 equivalentes Fe2+ (EFe2+) µmol /100 g ó 100 mL. Se observaron correlaciones entre PCL y ORAC, r = 0.99; y la PCL y FRAP, r = 0.94, ambas estadísticamente significativas (p < 0.05). La PCL mostró ser un método confiable y alternativo para cuantificar la CAT, que se puede aplicar en estudios de alimentos y de intervenciones en salud.

[Purpose] To evaluate the health-related quality of life (HRQoL), global health status (GHS), and deterioration-free survival of an elderly population (> 70 years) with unresectable locally advanced (LAPC) or metastatic pancreatic cancer (mPC) treated with nab-paclitaxel in combination with gemcitabine., [Methods] In this open-label, single-arm, multicenter, phase II trial, patients received 4-week cycles of intravenous (i.v.) nab-paclitaxel at a dose of 125 mg/m2, followed by i.v. injections of gemcitabine at a dose of 1000 mg/m2 on days 1, 8 and 15 until disease progression or unacceptable toxicity was observed. The primary outcome was the HRQoL (deterioration-free rate at 3 months as evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30., [Results] Eighty patients (median age: 74.6 years) were enrolled (56 with mPC, 24 with LAPC). The percentage of patients who had not experienced deterioration at 3 months was 54.3% (95% CI 41.6–67.0%). The median (interquartile range) time until definite deterioration was 1.6 (1.1–3.7) months. The objective response rate and clinical benefit rate were achieved by 11 (13.8%, 95% CI 6.2–21.3%) and 54 patients (67.5%, 95% CI 57.2–77.8%), respectively. The median overall survival was 9.2 months (95% CI 6.9–11.5), and the median progression-free survival was 7.2 months (95% CI 5.8–8.5). Only fatigue and neutropenia demonstrated a grade 3–4 toxicity incidence > 20%., [Conclusions] Our study confirms the clinical benefit of the combination of nab-paclitaxel and gemcitabine in an elderly population with pancreatic cancer in terms of improved survival and clinical response. However, we were unable to confirm a benefit in terms of quality-of-life., The BIBABRAX study was funded by Celgene. Medical writing assistance in the preparation of this paper was provided by Apices with financial support from Celgene.

This is a post hoc analysis of biomarkers from a large cohort of patients with chemo-naive metastatic colorectal cancer. Both high baseline circulating tumor cell count and RAS mutated were associated with clinical or pathologic features classically associated with poor prognosis. Selection of high- and low-risk populations may help to individualize approaches in the future. Background: Clinicopathologic characteristics and prognostic and predictive factors offer valuable guidance when selecting optimal first-line treatment in patients with metastatic colorectal cancer (CRC). The association between baseline circulating tumor cell (bCTC) count, molecular tumor profile, and clinicopathologic features was analyzed in a chemo-naive metastatic CRC population. Patients and Methods: A total of 1202 patients from the Spanish VISNU-1 (FOLFIRINOX/bevacizumab vs. FOLFOX/bevacizumab) and VISNU-2 (FOLFIRI/bevacizumab vs. FOLFIRI/cetuximab; RAS-wildtype) studies were analyzed for mutational status and bCTC count. The association between clinicopathologic characteristics and bCTC count, mutational status, and microsatellite instability (MSI) was analyzed in 589 eligible patients. Results: Interestingly, 41% of the population studied presented >= 3 bCTC count. bCTC count >= 3 was associated with worse performance status (according Eastern Cooperative Oncology Group scale), stage IV at diagnosis, at least 3 metastatic sites, and elevated carcinoembryonic antigen (CEA) levels; but not with RAS or BRAF mutations or high MSI. BRAFmut (BRAF mutated) tumors were associated with right-sided primary tumors, peritoneum, distant lymph node metastasis, and less frequent liver involvement. RASmut (RAS mutated) was associated with worse performance status; stage IV at diagnosis; right-sided primary tumors; liver, lung, and bone metastases; at least 3 metastatic sites; and elevated CEA, whereas PIK3CAmut (PIK3CA mutated) tumors were associated with right-sided primary tumors, high CEA serum levels, and older age. High MSI was associated with right-sided primary tumors, distant lymph nodes metastasis, and lower CEA levels. Conclusions: In our study, elevated bCTCs and RASmut were associated with clinicopathologic features known to be associated with poor prognosis; whereas the poor prognosis of BRAFmut tumors in chemo-naive metastatic CRC is not explained by associations with poor clinicopathologic prognostic factors, except right-sided primary tumors. (C) 2020 Elsevier Inc. All rights reserved.

The land node (also called wireless or cableless) seismic acquisition revolution hit North America in 2008-2009 and very quickly proved to be a technical and economic success. The rationale for the choice to use wireless rather than cable systems has been presented in numerous publications and venues (e.g., Caldwell, 2010; Mougenot et al., 2014; Munoz et al., 2015; Uribe et al., 2016; Yates et al., 2016; Dean et al., 2018), so suffice it to say that increased productivity, reduced costs, comparable or better data quality, and reduced health, safety, and environmental (HSE) risks have catalyzed its acceptance by the industry, particularly in North America, but also in Europe. Furthermore, the wireless systems are evolving to address what some have perceived as the inherent weaknesses of these systems: the inability to provide sufficient information in real-time about the status of the live spread of receiver stations, and to deliver in real-time substantial amounts of seismic data. It has taken longer for wireless systems to make significant inroads in other places in the world outside of North America, but that has been in the process of changing over the last few years. One place in particular where that has been changing is South America. In a geographic area where seismic activity has not been that strong over the last 5-6 years, at least 23 seismic surveys (9 2D and 14 3D) have been acquired since the beginning of 2011 using wireless acquisition systems. This paper describes how quality checking (QC) during acquisition operations was accomplished for a node system (Geospace GSX) used to acquire two 3D surveys by SAExploration for Hocol in Colombia in 2016 and 2017.

Background Proteasome inhibitors (PIs) are approved for treating newly diagnosed and relapsed multiple myeloma (MM) in Colombia. This propensity score matching (PSM) analysis using data from the real-world, was designed to establish the role PIs (bortezomib or carfilzomib) at first relapsed or refractory MM. The primary endpoint was overall response rate (ORR) and secondary endpoint included was overall survival (OS). Moreover, an analysis of OS was done regarding response attained. On Behalf of RENEHOC-GRIMMCO (Colombian Registry for Hemato-Oncological Diseases and Colombian Mieloma Múltiple study group). Methods PSM by nearest neighbor analysis to evaluate the role of PIs used at first relapse in multiple myeloma of patients belonging to RENEHOC registry, between 2010 and 2020. Results 390 patients were identified in the first relapse of the Colombian registry, 269 patients with PI and 121 patients without PI. One hundred and ten patients were included in each group after PSM. Patients were matched for age, ISS, extramedullary disease, and use of lenalidomide to define the influence of this immunomodulatory drug in the PI group. A difference was found in the use of lenalidomide because only 1 patient was treated with PI and lenalidomide concomitantly (0.91%) compared to 31 patients in the group without PI (28.18%), (p Regarding ORR, no differences were found between the 2 groups 38.18% in PIs vs 37.27% in non-PIs group (p = 0.801). A trend towards better OS was found in the PIs group with a median of 58 months versus 39 months (p = 0.179). Overall survival in patients who achieved at least PR was better compared to those who did not reach 79 months versus 32 months in non-responders (p = 0.0001). Conclusion In this study, we found that the use of PI has a tendency to improve overall survival in real-world in MM patients when used in the first relapse and that this effect could possibly be enhanced with the combination with lenalidomide. Regardless of the treatment used, better responses are associated with better survival. Figure 1 Figure 1. Disclosures Abello: Janssen: Honoraria; Amgen: Honoraria; Dr Reddy's: Research Funding. Sossa: Amgen: Research Funding.

Context: Tyrosine kinase inhibitors (TKIs) dramatically changed outcomes in CML; achieving and maintaining treatment milestones is highly dependent on adherence. Colombia subscribes a principle of universal health coverage; however, there is significant difference in access to high-cost drugs between different insurance types (Subsidized [SS] vs Contributory [SC]). Objective: To describe the current patient management and outcomes of CML in Colombia and possible factors associated with outcomes. Design: ACHO’s hematological disease registry (RENEHOC) is a multicenter study that has collected information on CML patients since 2019. Setting: RENEHOC is a real-world registry that captures information from 16 academic and general community centers in 5 cities in Colombia. Patients or Other Participants: Adult CML patients. Interventions: Due to its observational nature, all treatment decisions depend on treating investigator preferences. Main Outcomes Measures: RENEHOC is an online database. This report summarizes data on CML patients as of May 2020, focused on general descriptive statistics. The Kaplan-Meier method was used to assess progression free survival (PFS) rates, defined as progression to AP/BP or death. Hazard ratios (HR) using Cox proportional hazards regression modeling were estimated. Results: A total of 442 patients have been registered with a median follow-up of 60 months (IQR 26.5–106.5). At diagnosis, mean age was 54 years (SD 15.23), 58.6% (259) were males, most patients were in chronic phase (92.3%) and most had intermediate or high risk Sokal (35.6% and 36%, respectively). Median time from symptoms to diagnosis was 4 weeks (IQR 1–11), with no difference between SS and CS (p=0.54) and from diagnosis to treatment 4 in SS vs 0 in CS (p=0.041). Imatinib was the first-line treatment in 62.9%, dasatinib in 20%, and nilotinib 15%. Median OS and EFS were 60 (IQR 26.5–106.5) and 51 months (IQR 21–91), respectively. Only 7 (2.5%) patients died; all deaths were CML-related. Type of insurance (median EFS 51 CS vs 38.5 months SS; p=0.04), phase at diagnosis (p=0.039), and achieving MMR with first-line were the only factors related with EFS. Conclusions: OS for CML is excellent (97.5%) in Colombian patients. Unequal treatment between insurance types appears to have an impact on outcomes, which has to be addressed.

Aim: RENEHOC (Registro Epidemiológico de Neoplasias Hematológicas en Colombia) is a multicenter clinical quality database established in January 2018. The primary aim of the database is to provide local information on diagnosis and treatment of Multiple Myeloma (MM) and other hematologic neoplasms; this is key to show authorities the improvements that must be made to achieve better outcomes for Colombian patients and pose research questions relevant to our population. The aim of this report is to analyze variables related to event free survival (EFS) and overall survival (OS) in MM Colombian patients. Study population: An ambispective registry of adult MM patients, treated in approved centers over the last 10 years in Colombia. As of July 2020, 890 patients have been registered. Descriptive statistics were used for patient's demographic and clinical characteristics. The Kaplan-Meier method was used to assess DFS and OS. Hazard Ratios (HR) using Cox proportional hazards regression modeling was estimated. Results: Data from 890 MM patients were reviewed. Median age at diagnosis was 66.8 (SD 11.17) years (TE 57 yrs., SD 6.71; TI 74.8 yrs., SD 6.87); 398 (57%) were TE; 52.9% were male. At diagnosis median hemoglobin was 10.1 (SD 2.5), 242 (27.2%) had renal failure, and 379 (42.6%) pathological fractures. IgG was the most common M component (n=328, 36.8%). Most patients were in an advanced stage by Durie Salmon at diagnosis (DS IIIA or IIIB: n=523, 77.4%), and had high risk ISS (ISS 1: n=128, 20.6%; ISS 2: n=180, 29.0%; ISS 3: n=312, 50.3%; NA n=270). Only 17,9% (n=160) had cytogenetic prognostic characterization. There were not significant differences in clinical characteristics at diagnosis between TE and TI patients. The most common induction regimen for TE were Cyclophosphamide-Bortezomib-Dexamethasone (CyBorD) (n=190, 49%) and Bortezomib-Thalidomide-Dexamethasone (VTD) (n=103, 27%). For TI patients, most common regimens in first line were CyBorD (n=111, 245), VTD (n=90, 19%) and Bortezomib-Dexamethasone (Vd) (n=84, 18%). 69% TE and 59% TI patients had partial response or better after first line. 41% of TE patients actually received an Autologous Stem Cell Transplantation (ASCT) after 1 line. 19% of TI patients received an ASCT. Of note, in 78% of patients considered to have indication not taken to transplant, administrative barriers of access are reported. Mean follow-up for the entire group was 28.35 months (SD 29.27, CI 26.41-30.29). The median DFS was 62 months being significantly longer in TE patients (74 vs 53 months for TI, p=0.0002), estimated 5 years DFS 52% (TE 56% vs 46% for TI). Median OS was 88 months (Not reached for TE vs 75 moths for TI, p=0.0001), estimated 5 years OS 62% (TE 70% vs 56% for TI). Univariate analysis showed ISS at diagnosis, age and ASCT were significantly related to OS. On multivariate analysis ISS 3 (HR 1.89; p=0.004; CI 1.22-2.93) at diagnosis and ASCT (HR 0.26, p=0.0001, CI (0.18-0.39) were the only factors significantly associated with OS. 5 yrs. OS for patients that received ASCT was 80% in comparison to 48% if not done. Conclusion: At this timepoint data from RENEHOC is still limited, however, the potential of this growing registry is evident; until now little information about hematologic neoplasms in Colombia was available, this effort allows us to know the reality of our patients and plan relevant trials in our settings. We report here characteristic of a large cohort of MM patients in Colombia. OS and DFS are comparable with what have been published for similar patients in other latitudes. Consolidation with ASCT was the most important factor affecting prognosis in this cohort; the low transplant rate has to be addressed to improve outcomes for myeloma patients in Colombia. Figure Disclosures Abello: Abbvie: Consultancy, Research Funding; Dr. Reddy's: Consultancy, Research Funding; Takeda: Honoraria, Research Funding; Amgen: Consultancy, Research Funding; Novartis: Consultancy, Honoraria. Sossa:Takeda: Honoraria; Novo: Honoraria; Astellas: Honoraria; Roche: Honoraria. Idrobo:Takeda: Honoraria, Speakers Bureau; Abbvie: Honoraria, Speakers Bureau; Janssen: Honoraria, Speakers Bureau; Tecnofarma: Honoraria, Speakers Bureau; Amgen: Honoraria, Speakers Bureau. Henao-Uribe:Alexion: Consultancy, Speakers Bureau; Pfizer: Speakers Bureau; Takeda: Consultancy, Speakers Bureau.

Context Adherence is a key factor for good outcomes in CML. There are two types of insurance in Colombia: Contributory (CS) and Subsidized Systems (SS), which provide highly unequal access to Tyrosine Kinase Inhibitors (TKI) for CML. Objective The aim of this report is to compare outcomes in patients with different access to TKI and analyze other factors that affect progression-free survival (PFS). Design The Colombian Association of Hematology and Oncology (ACHO)'s hematological disease registry (RENEHOC) is a multicenter study; it has collected information on CML patients since 2019, in 14 centers with institutional Ethics Committee approval. Setting RENEHOC is a real-world registry and captures information from academic and general community centers. Patients or other participants 357 CML adult patients treated in the last 20 years. Interventions Treatment was according to investigators' preferences. Imatinib was first-line treatment for 223 patients (62.4%), dasatinib for 69 (19.4%) and nilotinib 53 (14.8%); 47.9% required a second line of treatment. Main outcome measures Primary end points were Optimal Response (OR) according to LeukemiaNet 2020 definition and progression-free survival (PFS) rates. The Kaplan-Meier method was used to assess PFS, and hazard ratios (HR) using Cox proportional regression modeling were estimated. Results Mean age was 54 years (19–92), 60.1% were males, most patient were diagnosed in chronic phase (92%) and 36% were high Sokal. At a median follow for the entire cohort of 69 months (1–228), 60% of patients were in OR, including 11 patients in treatment-free remission (TFR). There were no significant differences between contributory and subsidized cohorts in terms of patient or disease characteristics. 76% of patients were in OP at the last visit in the CS in comparison to 48% for the SS cohort. Ten patients died, all CML-related. The only significant prognosis factors associated with PFS were Sokal score (mean PFS: 57 months low/int vs 39 high; p=0.012) and type of insurance (mean PFS 70 months for CS vs 57.7 for SS; p=0003). Conclusions This report suggests that differences in access to TKI in CML according to insurance regimes results in significantly different PFS. This is the first time in the country that the impact of these attention inequalities in CML patient care have been demonstrated. Funding ACHO has received grants for RENEHOC project from Takeda, Abbvie, Amgen, Dr. Reddy's.

Acute leukemia is a heterogeneous set of diseases affecting children and adults. Current prognostic factors are not accurate predictors of the clinical outcome of adult patients and the stratification of risk groups remains insufficient. For that reason, this study proposes a multifactorial analysis which integrates clinical parameters, ex vivo tumor characterization and behavioral in vivo analysis in zebrafish. This model represents a new approach to understand leukemic primary cells behavior and features associated with aggressiveness and metastatic potential. Xenotransplantation of primary samples from patients newly diagnosed with acute leukemia in zebrafish embryos at 48 hpf was used to asses survival rate, dissemination pattern, and metastatic potential. Seven samples from young adults classified in adverse, favorable or intermediate risk group were characterized. Tumor heterogeneity defined by Leukemic stem cell (LSC) proportion, was performed by metabolic and cell membrane biomarkers characterization. Thus, our work combines all these parameters with a robust quantification strategy that provides important information about leukemia biology, their relationship with specific niches and the existent inter and intra-tumor heterogeneity in acute leukemia. In regard to prognostic factors, leukemic stem cell proportion and Patient-derived xenografts (PDX) migration into zebrafish were the variables with highest weights for the prediction analysis. Higher ALDH activity, less differentiated cells and a broader and random migration pattern are related with worse clinical outcome after induction chemotherapy. This model also recapitulates multiple aspects of human acute leukemia and therefore is a promising tool to be employed not only for preclinical studies but also supposes a new tool with a higher resolution compared to traditional methods for an accurate stratification of patients into worse or favorable clinical outcome.

Introducción: El síndrome metabólico (SM) es un problema de salud asociado a diabetes y enfermedades cardiovasculares. Se desconoce la prevalencia de SM en adolescentes del estado de Morelos. Ciertas conductas alimentarias de riesgo podrían estar asociadas a ese fenotipo.Objetivo: Determinar la prevalencia de SM en adolescentes y su asociación con las conductas alimentarias de riesgo.Métodos: Estudio transversal en escuelas secundarias y preparatorias de Morelos. Se investigaron datos antropométricos, clínicos, percepción de la imagen corporal y de conductas alimentarias de riesgo (CAR). El síndrome metabólico se diagnosticó con criterios internacionales para adolescentes y se analizó su asociación con las CAR. Mediante análisis de regresión logística se estimaron razones de momios ajustadas e intervalos de confianza al 95%.Resultados: Fueron estudiados 869 adolescentes de 14.6 ±1.6 años. Reportaron 2.6±1.8 CAR, el puntaje global fue 5.9 ± 0.33. El 16.6% presentaban riesgo CAR moderado o alto. La prevalencia de SM (6.4%) estuvo asociada al puntaje de CAR, OR 1.2 (1.1 - 1.3), valor que permaneció después de ajustar por edad, sexo, omisión del desayuno, región de residencia, percepción de la imagen corporal y de antecedentes familiares de obesidad, diabetes, hipertensión o infarto (ODHI), ORaj 1.2 (1.1- 1.3), pseudo R2= 0.14, Chi2 47.2, p

Background: Treatment with nab-paclitaxel plus gemcitabine increases survival in patients with metastatic pancreatic cancer. However, the assessment of treatment efficacy and safety in non-selected patients in a real-life setting may provide useful information to support decision-making processes in routine practice. Methods: Retrospective, multicenter study including patients with metastatic pancreatic cancer, who started first-line treatment with nab-paclitaxel plus gemcitabine between December 2013 and June 2015 according to routine clinical practice. In addition to describing the treatment pattern, overall survival (OS) and progression-free survival (PFS) were assessed for the total sample and the exploratory subgroups based on the treatment and patients' clinical characteristics. Results: All 210 eligible patients had a median age of 65.0 years (range 37-81). Metastatic pancreatic adenocarcinoma was recurrent in 46 (21.9%) patients and de novo in 164 (78.1%); 38 (18%) patients had a biliary stent. At baseline, 33 (18.1%) patients had an ECOG performance status =2. Patients received a median of four cycles of treatment (range 1-21), with a median duration of 3.5 months; 137 (65.2%) patients had a dose reduction of nab-paclitaxel and/or gemcitabine during treatment, and 33 (17.2%) discontinued treatment due to toxicity. Relative dose intensity (RDI) for nab-paclitaxel, gemcitabine, and the combined treatment was 66.7%. Median OS was 7.2 months (95% CI 6.0-8.5), and median PFS was 5.0 months (95% CI 4.3-5.9); 50 patients achieved either a partial or complete response (ORR 24.6%). OS was influenced by baseline ECOG PS, NLR and CA 19.9, but not by age = 70 years and/or the presence of hepatobiliary stent or RDI < 85%. All included variables, computed as dichotomous, showed a significant contribution to the Cox regression model to build a nomogram for predicting survival in these patients: baseline ECOG 0-1 vs. 2-3 (p = 0.030), baseline NLR > 3 vs. = 3 (p = 0.043), and baseline CA 19.9 > 37 U/mL vs. =37 U/mL (p = 0.004). Conclusions: Nab-Paclitaxel plus gemcitabine remain effective in a real-life setting, despite the high burden of dose reductions and poorer performance of these patients. A nomogram to predict survival using baseline ECOG performance status, NLR and CA 19.9 is proposed.

Introduccion y objetivos: las neoplasias mieloproliferativas cronicas (NMPC) son relativamente raras, con incidencias que varian entre 0.47-1.03/100 000 habitantes. Se presenta el primer informe del trabajo del registro colombiano de NMPC, cuyo objetivo es describir las caracteristicas clinicas de estos pacientes en nuestro pais. Material y metodos: estudio descriptivo observacional, multicentrico, retrospectivo y prospectivo en ocho centros del pais, de abril de 2013 a diciembre de 2014. Las variables cualitativas se presentan con frecuencias absolutas y relativas; y las cuantitativas se resumen en medidas de tendencia central y dispersion. Resultados: once centros fueron aprobados, ocho ingresaron pacientes. En los primeros 179 casos reportados, 50% eran hombres, la edad promedio al diagnostico 58.7 anos (rango 19-92). Noventa y tres muestran trombocitemia esencial (TE); 55, policitemia vera (PV); y 31, mielofibrosis (MF). El 41% tenia esplenomegalia al diagnostico; el 20% tuvo complicaciones tromboticas; y 12.85%, sangrado. Solo en 57.5% se realizo JAK; de ellos, en 53.5% fue positivo, en especial solo 60% de las PV. El 8% de los casos no tenia estudio de medula osea, el 29.3% tiene algun grado de fibrosis. El hallazgo mas frecuente fue hiperplasia megacariocitica en 59.78%. Mas de 50% de pacientes estaban sintomaticos al diagnostico. Solo el 11% no recibio tratamiento farmacologico; los mas frecuentes fueron hidroxiurea en 149 casos y ASA en 79. Con promedio de seguimiento de 52.6 meses; el 97.21% de los pacientes estan vivos. Conclusiones: los hallazgos sugieren que algunas caracteristicas de las NMPC podrian ser diferentes a lo reportado en otras series, lo que valida la importancia del esfuerzo de recoger informacion local.

metabolic syndrome (MS) is a health problem associated with diabetes and cardiovascular diseases. The prevalence of MS in adolescents from Morelos is unknown. Certain risk eating behaviors (REB) may be associated with this phenotype.to determine the prevalence of MS in adolescents and its association with REB.cross-sectional study in junior high schools and high schools from Morelos. Anthropometric, clinical data, perception of body image and REB were investigated. MS was diagnosed with international criteria for adolescents and their association with REB was analyzed. Logistic regression analysis was utilized to estimate adjusted odds ratios (ORadj) and 95% confidence intervals (CI95).a total of 869 adolescents aged 14.6 ± 1.6 years were studied. They reported 2.6 ± 1.8 REB; the overall score was 5.9 ± 0.33. The 16.6% presented moderate or high REB risk. The prevalence of MS (6.7%) was associated with the REB score (OR 1.2 [1.1-1.3]), a value that remained after adjusting for age, sex, breakfast omission, residence region, perception of body image and background family of obesity, diabetes, hypertension or infarction (ODHI), ORadj 1.2 (1.1-1.3), pseudo R2 = 0.14, Chi-squared 16.7, p0.03.MS was more frequent in men, who were perceived to be thinner and with two or more family history of ODHI. It is suggested to influence the self-perception of overweight or obesity, to educate about compulsive behaviors, undergo diets, fasting and exercise to prevent MS.Introducción: el síndrome metabólico (SM) es un problema de salud asociado a diabetes y enfermedades cardiovasculares. Se desconoce la prevalencia de SM en adolescentes del estado de Morelos. Ciertas conductas alimentarias de riesgo (CAR) podrían estar asociadas a ese fenotipo.Objetivo: determinar la prevalencia de SM en adolescentes y su asociación con las CAR.Métodos: estudio transversal en escuelas secundarias y preparatorias de Morelos. Se investigaron datos antropométricos, clínicos, percepción de la imagen corporal y de las CAR. El SM se diagnosticó con criterios internacionales para adolescentes y se analizó su asociación con las CAR. Mediante análisis de regresión logística se estimaron razones de momios (RM) e intervalos de confianza al 95% (IC95).Resultados: fueron estudiados 869 adolescentes de 14,6 ± 1,6 años. Reportaron 2,6 ± 1,8 CAR; el puntaje global fue 5,9 ± 0,33. El 16,6% presentaba riesgo CAR moderado o alto. La prevalencia de SM (6,7%) estuvo asociada al puntaje de CAR, RM 1,2 (1,1-1,3), valor que permaneció después de ajustar por edad, sexo, omisión del desayuno, región de residencia, percepción de la imagen corporal y de antecedentes familiares de obesidad, diabetes, hipertensión o infarto (ODHI), RMaj 1,2 (1,1-1,3), pseudo R2 = 0,14, Chi cuadrado 16,7, p0,03.Conclusión: el SM fue más frecuente en hombres, que se percibían más delgados y con dos o más antecedentes familiares ODHI. Se sugiere incidir sobre la autopercepción del sobrepeso u obesidad y educar sobre conductas compulsivas, seguimiento de dietas, ayunos y ejercicio para prevenir el SM.

The purpose of this article was to assess the nutritional status, eating habits, social, physical activity and blood parameters, and breakfast consumption in a sample of 2488 children and adolescents from public schools in Morelos. BMI allowed classify nutritional status. Dietary intake was assessed using reminder the day before. Glucose, triglycerides, total cholesterol, and HDL cholesterol were measured in blood samples. Three categories of consumption were defined as: skip breakfast, eat breakfast occasionally, and always eat breakfast. With ANOVA and Chi-square, significant associations of skipping breakfast with age, BMI, family size, place of residence, caloric intake and protein-energy balance, anemia, high triglycerides, time spent in moderate or vigorous physical activity, and time spent in sedentary and light activities were observed. Focused interventions are required to promote breakfast consumption for children and adolescents to prevent chronic diseases and associated nutritional deficiencies.

Background Multiple myeloma (MM) is a heterogeneous disease that is most frequently diagnosed in the elderly. Therefore, data on clinical characteristics and outcomes in the young population are scarce and it is recognized that it remains incurable even in this group of patients. We present here the outcomes of patients under 40 years old cohort in Latin-American countries. On behalf of GELAMM (Grupo de Estudio Latino-Americano de Mieloma Múltiple). Methods Retrospective international multicenter cohort study. We analyzed MM patients under 40 years old who received treatment in 6 Latin-American countries, between 2010 and 2018. Demographics and disease features were analyzed using descriptive statics. We examined treatment characteristics and response rates. The overall survival (OS) of the entire cohort was analyzed using Kaplan-Meier curves. Results Eighty-six patients of 6 countries were analyzed (Table1). The mean age was 35.4 years old, and 60% were male. The most frequent monoclonal component type was IgG followed by light chain MM. Risk determined by ISS was distributed in almost equal percentages. The most frequent cytogenetic alteration was the t (4;14) that was found in four patients out of 25 evaluated. The missing data were greater than 70%. Skeleton-related events were the most frequent clinical feature, followed by anemia and renal failure. Plasmacytomas and fractures were present in more than 20 percent of cases. With regard to treatment, VCD / CyBorD was the most used regimen, followed by VTD. The overall response rate (ORR) was 63%. Fifty-three patients received high dose therapy and autologous stem cell transplantation (62%). Only 8% received post-transplant consolidation, and 45% received maintenance therapy. The median OS of the entire cohort was 45 months, and a plateau in the survival curve was not observed, suggesting that patients continue relapsing over the time. Conclusion In this Latin American multicenter study, we found that the young population with MM has similar presentation characteristics to those of elderly patients. A significant amount of information is lost regarding the risk characterization, especially in regard with cytogenetics. With respect to treatment, less than half of the patients achieve very good partial response or better. It is striking that more than a third of this young patients did not access to high doses of chemotherapy and bone marrow transplantation. Maintenance therapy is offered to less than half patients. The median OS is lower than in other series of patients younger than 40 years, even than in the elderly cohorts. Prospective multicentric studies are required to elucidate the behavior of the disease in this group of patients. Disclosures Peña: Pfizer: Membership on an entity's Board of Directors or advisory committees; Janssen: Other: Congress inscription and flights; Biotoscana: Other: Congress inscription and flights; Novartis: Other: Congress inscription and flights; Tecnofarma: Other: Congress inscription and flights; Roche: Other: Congress inscription and flights. Rojas:Novartis: Membership on an entity's Board of Directors or advisory committees; Pfeizer: Membership on an entity's Board of Directors or advisory committees; Abbvie: Membership on an entity's Board of Directors or advisory committees; Roche: Membership on an entity's Board of Directors or advisory committees. Abello:Takeda: Other: Participation in advisory board meeting. Gomez-Almaguer:Takeda: Consultancy, Speakers Bureau; Celgene: Consultancy, Speakers Bureau; Amgen: Consultancy, Speakers Bureau; Janssen: Consultancy, Speakers Bureau; Teva: Consultancy, Speakers Bureau.

Background Multiple myeloma (MM) is a frequent hematologic malignancy. The current gold standard frontline strategy includes a proteasome inhibitor (PI)-based induction, followed by autologous stem cell transplant (ASCT). Access to novel drugs in Latin America (LA) is limited. ASCT is available in most countries, but real access to it is highly heterogeneous. Data regarding patients´ outcomes in candidates to ASCT in the region is scarce. The aim of this study was to describe clinical characteristics and outcomes of MM transplant eligible patients in LA countries. Material and Methods Retrospective international multicenter cohort study. Consecutive MM transplant- eligible patients diagnosed between 2010 and 2018 from participating centers in Chile, Argentina, Ecuador, Mexico, Colombia, and Uruguay were included. Data were collected from clinical records in a standardized report form. We analyzed clinical characteristics at diagnosis and frontline therapy outcomes, including ASCT. Transplant-eligible patients were defined as fit patients younger than 66 years old. Active MM and response to treatment were defined according to current IMWG criteria. Inclusion criteria: 1.- Patients with newly diagnosed active MM between 2010 and 2018. 2.- Older than 18 years, and younger than 66 years. 3- Candidates for ASCT according to the evaluation of the attending physician Exclusion criteria: 1- Lack of minimum data in the clinical history 2- Plasma cell leukemia, AL amyloidosis or solitary plasmacytoma. 3- HIV infection 4-No consent and/or Ethics Committee approvals. Statistical analysis A descriptive statistic has been done. Comparisons of characteristics between groups was made usingT-student, Chi2 or ANOVA, as appropriate. Survival analysis was performed using Kaplan-Meier curves. Comparisons of survival between groups were made by the logarithmic recording method and the calculations of the risk relationships by Cox regression. Statistical analysis was performed by using STATA 13. Results We included 1293 patients in the study, 363 from Chile, 395 from Argentina, 209 from Colombia, 45 from Ecuador, 151 from Mexico, and 130 from Uruguay. The main characteristics at diagnosis and therapeutic strategies are shown in Table 1. Optimal response (sCR, CR and VGPR) was achieved in 38% of the patients in the cyclophosphamide, bortezomib, and dexamethasone (CyBorD) group, in 46% in the bortezomib, thalidomide, and dexamethasone (VTD) group, and in 36% in the cyclophosphamide, thalidomide, and dexamethasone (CTD) group, the 3 main induction regimens used. Only 53% of patients finally received ASCT. Significant differences were found between both groups, private and public institutions, regarding burden of symptoms, ISS staging, access to PI based induction, ASCT completion and adequate maintenance, with patients from the latter being more symptomatic, and receiving suboptimal therapy. FISH analysis was performed in less than 50% of patients, both in the public and private setting. With a median follow up of 34 months (range 1-113), median overall survival (OS) was 86 months. The 5-year progression free survival (PFS) was 38% and 5- year overall survival (OS) was 64%. When comparing public vs private settings, 5 year OS was 45% vs 80%, with a median OS of 56 months vs not reached, respectively (P In the multivariable analysis renal failure (p=0.03), achieving less than VGPR response (p Conclusion This is the largest report on transplant eligible patients with MM in LA. Great inequities are shown between public and private health systems. Survival in transplant-eligible patients is lower than that described in other regions. Only one third of patients had FISH performed. This means that very few patients are treated with a risk-based induction in LA. Patients in the public setting are diagnosed with a more symptomatic disease, probably due to a late diagnosis. OS is significantly worse in the public setting. This might be explained by the significant differences in access to PI-based induction, ASCT and maintenance between private and public institutions, with patients from the latter receiving suboptimal frontline therapy and maintenance. Reasons for 47% of potential candidates not being transplanted merit further analysis. Table 1 Disclosures Peña: Novartis: Other: Congress inscription and flights; Tecnofarma: Other: Congress inscription and flights; Roche: Other: Congress inscription and flights; Biotoscana: Other: Congress inscription and flights; Janssen: Other: Congress inscription and flights; Pfizer: Membership on an entity's Board of Directors or advisory committees. Rojas:Roche: Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees; Pfeizer: Membership on an entity's Board of Directors or advisory committees; Abbvie: Membership on an entity's Board of Directors or advisory committees. Abello:Takeda: Other: Participation in advisory board meeting. Gomez-Almaguer:Amgen: Consultancy, Speakers Bureau; Janssen: Consultancy, Speakers Bureau; Teva: Consultancy, Speakers Bureau; Takeda: Consultancy, Speakers Bureau; Celgene: Consultancy, Speakers Bureau.

Introducción: La esplenectomía representa una herramienta diagnóstica y terapéutica para múltiples patologías hematológicas benignas y malignas. Se presenta el análisis de una cohorte de pacientes esplenectomizados por enfermedad hematológica en la Fundación Santa Fe de Bogotá. Materiales y métodos: entre 2004 y 2011, se identificaron 30 pacientes esplenectomizados por indicación hematológica benigna (n = 23) y maligna (n = 7). Se evaluaron las historias clínicas respecto de diversos parámetros y desenlaces a largo plazo. Resultados: La edad promedio de los sujetos fue de 54 años; la mayoría fueron mujeres (64%) y la patología más frecuente fue la trombocitopenia inmunológica (60%). Previo al procedimiento, el 23% requirió algún tipo de soporte transfusional y en el 60% la esplenectomía se utilizó como primera o segunda línea terapéutica. En cuatro casos, el procedimiento se hizo como método diagnóstico y en otros tres, no hubo información de seguimiento. El análisis de desenlaces se realizó sobre 23 pacientes. Durante los primeros 30 días posoperatorios, se presentaron complicaciones infecciosas (17.4%) y hemorrágicas (13%) sin ninguna muerte atribuible al procedimiento. El 78% tuvo respuesta hematológica global y la mediana de supervivencia global fue de 133 meses (r, 108 a 157), período que fue menor entre quienes tuvieron dependencia transfusional preoperatoria (p = 0.04) y para quienes lograron la respuesta hematológica (p = 0.026). La tasa de complicaciones a largo plazo fue inferior al 10%. Conclusiones: La esplenectomía obtiene frecuencias importantes de respuesta para patologías benignas y malignas de la sangre y se corresponde con una elevada supervivencia global relacionada a una baja tasa de complicaciones a largo plazo. La supervivencia se modifica principalmente por la dependencia transfusional preoperatoria, por lo que se sugiere explorar esta variable como determinante en otros estudios.

Introducción: La trombosis venosa profunda iliofemoral extensa (TVPIF) tiene un importante impacto a largo plazo en términos de insuficiencia venosa crónica e incapacidad secundaria. La trombolisis dirigida por catéter (TDC) puede reducir la morbilidad asociada a este evento. Materiales y métodos: Se diseñó y proyectó un registro monográfico de seguimiento, que incluyó una serie de pacientes tratados con TDC en la Fundación Santa Fe de Bogotá (FSFB) entre el 2008 y 2011. Se describieron las características clínicas de los pacientes, el procedimiento y los desenlaces a corto y a largo plazo. Resultados: La TDC se realizó en cuatro pacientes con TVPIF izquierda, tres mujeres y un hombre; la mediana de edad fue 58 años (rango 35 a 70). En tres casos, se documentó un síndrome de May-Thurner asociado (SMT). Las trombosis agudas y subagudas, caracterizadas por ultrasonografía, se encontraron cada una en dos pacientes. La TDC se llevó a cabo utilizando alteplase y tenecteplase en uno y tres pacientes, respectivamente. Al finalizar la TDC, todos los casos catalogados con SMT fueron manejados con angioplastia por balón más stent (ABS). El éxito trombolítico fue completo en los dos casos de TVPIF aguda, y parcial en los dos casos de TVPIF subaguda. Solo hubo un evento hemorrágico mayor y la permeabilidad del vaso a largo plazo se mantuvo en los cuatro pacientes, sin eventos trombóticos reincidentes o reestenosis. No se diagnosticó síndrome postrombótico en ninguno después de seis meses de seguimiento. Conclusiones: La TDC para la TVPIF es un procedimiento factible de efectuar en nuestra institución, ofreciendo una frecuencia aceptable de complicaciones con importantes beneficios clínicos a largo plazo. En los casos de TVPIF y SMT, el uso concomitante de ABS pudo mantener la permeabilidad venosa durante el tiempo de seguimiento.

Bioavailability and acceptability of heme-iron obtained from swine hemoglobin (Hb) included in the chocolate-flavored filling of biscuits was assessed in adolescent girls. The supplemented groups received biscuits fortified with 9.5 mg of iron per day for 13 weeks (65 days) of either iron sulfate (IS, n = 64) or heme-iron concentrate (HIC, n = 59). The control (C) group consisted of 70 teenagers with the highest baseline Hb concentrations. The iron-supplemented biscuits were well accepted by the adolescents. Blood chemistry analyses were performed at baseline and the 7th and 13th weeks. The Hb levels in the HIC group increased (p

Marigold (Tagetes erecta) flowers are primarily used in industry for their high pigment content. Flower color development implies that chloroplast–chromoplast transition is associated with carotenoid biosynthesis. We report the recovery of undifferentiated pigmented marigold cells, various callus tissues, and their analysis by transmission electron microscopy in order to observe accumulating pigment and development of subcellular structures. Callus was generated from leaf explants and after several rounds of recurrent selection. Green-, yellow-, and brown-colored callus were obtained that showed distinct carotenoid profiles. For green material, violaxanthin, lutein, zeaxanthin, and β-carotene were produced, while yellow callus generated mainly lutein, as did the brown callus. Chloroplast–chromoplast transition was followed by measuring plastid size and shape in undifferentiated marigold cells by digital image analysis. Cellular alterations were evident in brown callus. Chloroplasts were the main structure in green callus, while yellow callus clearly showed the formation of plastoglobules, structures that are correlated with chloroplast–chromoplast transition. The high number of plastoglobules observed in yellow callus is possibly directly related to pigment synthesis and accumulation.

Background In plasma cell neoplasms, the percentage of plasma cells in bone marrow (PPCBM) is important for diagnosis and assessment of the treatment. This quantification is performed using bone marrow multiparameter flow cytometry (FC), aspirate smears (BMA) and biopsy. Differences among the percentage of infiltration detected by these techniques have been reported, which can be related to a heterogeneous pattern of infiltration of multiple myeloma (MM) or sample quality. However, a simultaneous evaluation of these three techniques has not been reported nor their ability to detect bone marrow involvement with high or low infiltration, associated with different stages of this disease. Purpose The aim of this study was to compare the results of PPCBM obtained by FC, BMA, and biopsy with CD138 immunohistochemistry (BMB) in different stages of the disease with high and low infiltration, and the ability of these techniques to correctly classify the disease. Methods Pathological studies of patients referred to Hospital Fundación Santa Fe, Colombia were reviewed between January 2015 and June 2018. The selection of patients was based on both, a diagnosis of plasma cell neoplasms, classified according to the International Myeloma Working Group criteria and the simultaneous use of FC by FACSCanto II flow cytometer (Infinicyt 2.0 software program), wright-stained aspirate smears and biopsy with CD138 immunohistochemistry in the detection. Descriptive analysis was performed and PPCBM was expressed as the mean± standard error of the mean (SEM). The Kruskal-Wallis test was used to compare the mean of PPCBM among the three methods. Lineal regression and Spearman´s coefficient were used to correlate the variables. Statistical association was considered significant for p values Results A total of 130 patients with plasma cells neoplasms were included in this study, 57 with newly diagnosed MM (N), 58 following therapy MM (F) and 15 MGUS patients. In the N patients, the mean of infiltration was 12.3% ±1.8, 30.3% ±3.4 and 52.2% ±3.74 detected by FC, BMA and BMB, respectively. The PPCBM detected by this three analysis were significantly different (p In the comparative analysis of the three methods in all patients, the highest infiltration was always detected by BMB, followed by BMA and finally by FC (p 0.8). Finally, given that there are important PPCBM such as ≥10 that allows establishing the diagnosis of MM or ≥60%, considered an MM definitive event, we found that 21% and 52% of cases assessed by BMA and FC had PPCBM Conclusion In the comparison of the PCBM was observed a high linear correlation between MFC, BMA, and BMB, although we found a differential behavior of these methods, depending on the level of tumor infiltration. High percentages of infiltration, such as newly diagnosed MM patients, the BMB detected significantly more PPCBM than the others two methods (1.7 to 4-fold compared to BMA and FC). This supports the systematic incorporation of BMB into the analysis of patients with suspected MM for allowing a proper classification of disease. With low percentages of infiltration, such as MGUS and following therapy patients, the difference of PPCBM between BMA and BMB was not significant. Although, FC detected the lowest percentage of infiltration, it known its high specificity to discriminate tumor and normal plasma cells, being in one of the most important analysis to monitor minimal residual. Disclosures No relevant conflicts of interest to declare.

Background: Combination of bevacizumab and FOLFIRI has currently become one of the standard therapeutic regimens. However, published information is still limited. The objective of the present retrospective observational study is to analyse the response and toxicity of first-line treatment with FOLFIRI+bevacizumab in patients with metastatic colorectal cancer (mCRC). Methods: Data were collected from patients from nine Spanish sites diagnosed with mCRC, ECOG⩽2, whose first treatment for advanced disease was at least three cycles of FOLFIRI+bevacizumab. Results: A total of 95 patients were enrolled into the study: 64.2% males, median age of 59 years (53.2–67.1 years), ECOG=0–1 in 96.9% of patients. The main site of primary tumour was the colon (69.7%), and most metastases occurred in the liver (71.6%). Clinical benefit was detected in 67.4% (57.0–76.6; 95% confidence interval (CI)), with 8.4% of CR and 42.1% of PR. Median TTP was 10.6 months (10.0–11.3; 95% CI), PFS was 10.6 months (9.8–11.3; 95% CI), and OS was 20.7 months (17.1–24.2; 95% CI). Main grade I–II toxicities included haematological toxicity (35.8%), diarrhea (27.3%), mucositis (25.3%), asthenia (19.0%), haemorrhages (11.6%), and emesis (10.6%). Toxicities reaching grades III–IV were haematological toxicity (9.5%), diarrhea (8.5%), mucositis (5.3%), hepatic toxicity (2.1%), asthenia (2.1%), proteinuria (1.1%), emesis (1.1%), pain (1.1%), and colics (1.1%). Conclusion: Results of this study support the beneficial effect of adding bevacizumab to FOLFIRI regimen in terms of efficacy and show a favourable tolerability profile.

Background: We gathered data from multiple institutions on the cetuximab regimen of patients with metastatic colorectal cancer. Methods: 126 patients from 19 centers were included from July 2006 to July 2007 in this prospective non-controlled study. Irinotecan-refractory metastatic colorectal cancer patients with Karnofsky ≧70 received cetuximab 500 mg/m2 every 2 weeks (q2w) in combination with irinotecan 180 mg/m2 q2w until disease progression or unacceptable toxicity. The primary endpoint was the progression-free rate at 12 weeks. Results: Median age was 65 years; 65.9% male; colon/rectum 64.3/34.1%; Karnofsky status ≤80/≧90% in 45.3/54.7% of the patients. The progression-free rate was 42.7 (95% CI 32.8–52.6) and 22.4% (95% CI 14.2–30.7) at 12 and 24 weeks, respectively. The main grade 3 or 4 toxicities were: diarrhea 13.5% and acne-like rash 10.3%. No grade 3 or 4 infusional or allergic reactions were reported. Conclusions: The progression-free rates confirm that cetuximab q2w in combination with irinotecan is an option, and is as active and safe as the standard weekly regimen.

Resumen es: El objetivo de este estudio fue probar la utilidad de la dosis semanal de hierro en el tratamiento y prevencion de la anemia ferropenica en mujeres adole...

La investigación se lleva acabo con la ayuda de la reforestadora GUASIMO S.A. endos fincas de su propiedad y de las cuales se quería estimar su productividad, ya que los encargados de los bosques no cuentan con el tiempo disponible para realizar unas evaluaciones satisfactorias que puedan demostrar cual es el estado actual de los bosques.En el transcurso de esta investigación se toma unas variables representativas dela calidad de sitio y con las cuales por medio de programas estadísticos, se puedeentender cual es el comportamiento de dichos bosques y así de una manera fácil ypedagógica, se pueden tomar los datos y determinar los momentos de corte en loslotes.

in Mexico, although there are low intakes of some nutrients; there are higher total energy, fat and sodium and common inadequate physical activity in schools, which originates the presence of overweight and obesity. Objetive: the aim of this study was to identify the prevalence of overweight and obesity in school children full- time state of Morelos (Mexico).a cross sectional study in 30 966 students 3-15 years attending 186 schools. The nutritional status was obtained through the Body Mass Index, considering the age and sex; weight was measured with SECA 813 scales and height with stadiometer SECA 213; international benchmarks were used.36 482 boys and girls censused, it's measured at 30 966 (84.9%) attended the day of visit. The overall prevalence of underweight was close to 8%, and the combined prevalence of overweight and obesity exceeded 25%. Were higher prevalences of underweight and obesity in men.one in 12 children are underweight; one in four, overweight and one in nine obese. The male population is more vulnerable to suffer consequences for nutritional deficiencies and excesses. Specific studies are needed to differentiate and address obesity primary type and associated risks to define future actions.Introducción: es común que los escolares en México presenten bajos consumos de algunos nutrimentos, y elevados consumos de energía total, grasas y sodio; también es frecuente que su actividad física sea insuficiente, lo que propicia la presencia de sobrepeso y obesidad. Objetivo: el propósito de este estudio fue identificar la prevalencia de sobrepeso y obesidad en los alumnos de escuelas de tiempo completo del estado de Morelos (México). Sujetos y métodos: estudio transversal en 30.966 alumnos de 3 a 15 años, asistentes a 186 escuelas. El estado nutricional se obtuvo a través del Índice de Masa Corporal, considerando la edad y el género; el peso se midió con básculas SECA 813 y la talla con estadímetros SECA 213; se utilizaron patrones de referencia internacionales. Resultados: de 36.482 niños y niñas censados, se midió a 30.966 (84,9%) que asistieron el día de visita. La prevalencia global de bajo peso se aproximó al 8% y la prevalencia conjunta de sobrepeso y obesidad superó el 25%. Fueron más altas las prevalencias de bajo peso y obesidad en los hombres. Conclusiones: uno de cada 12 niños tiene bajo peso; uno de cada cuatro, sobrepeso y uno de cada nueve, obesidad. La población masculina es más vulnerable a padecer consecuencias por deficiencias y excesos nutricionales. Son necesarios estudios específicos para diferenciar y atender la obesidad de tipo primario y los riesgos asociados, para definir acciones futuras.