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Uso de Plataformas Virtuales por profesionales de Enfermeria para educar al Paciente Oncologico
No full textLa educación es una actividad trascendente para lograr promover el cuidado del paciente oncológico, es así que el uso de las plataformas virtuales se han convertido en herramientas que favorecen la conectividad, mantienen la posibilidad del contacto continuo con el paciente para dar soporte necesario y promover su autocuidado; además de reducir los costos y tiempo. Este estudio tiene como objetivo, analizar el desarrollo de las evidencias científicas sobre educación de enfermería a través de plataformas virtuales a los pacientes oncológicos. La metodología fue una revisión integrativa, utilizando 6 bases de datos: PudMed, Alicia, SciELO, Embase, DOAJ y Google Académico. Se incluyó artículos en inglés y español de los últimos 7 años. Los resultados encontraron 22 artículos sobre recursos digitales, siendo medios que proporcionan información y educación; por lo que la enfermera debe aplicar estrategias pedagógicas para asumir el autocuidado en los pacientes oncológicos. Es importante resaltar que la educación debe estar de acuerdo al tipo de paciente tanto en la virtualidad y en la presencialidad. Se concluye que los enfermeros pueden incluir en las actividades cotidianas las prácticas educativas, utilizando los recursos digitales para sostener el autocuidado del paciente oncológico, favoreciendo su bienestar y calidad de vida
Ocho neoplasias primarias metacrónicas en paciente mujer adulta mayor
No full textMultiple primary neoplasms (MPN) are defined as 2 or more primary malignant tumors of different origin in the same individual. The cause of MPN has not been identified in all cases, however, it may be due to environmental factors, lifestyles and/or genetic factors. We present the case of a patient who has had eight neoplasms (five malignant and three benign) that have been successfully treated and who is currently undergoinf controls, with no evidence of disease recurrence or any other de novo neoplasm
Socioeconomic Impact of Cancer in Latin America and The Caribbean: Socioeconomic Impact of Cancer in Latin America
No full textThe incidence of cancer in Latin America and the Caribbean (LAC) is increasing yearly and is expected to reach 2.4 million new cases by 2040, with a more pronounced effect in Central America and South America. In addition, cancer is already the most frequent cause of premature death for most countries in LAC, and the second cause of death independent of country socioeconomic status, clearly demonstrating that the cancer burden in LAC should be addressed now rather than considered as an issue to be dealt with in the future. LAC countries performed in a mid-range zone in terms of income and mortality-to-incidence ratio compared to other countries globally. The LAC continent has, in general, a median income per capita and a median availability of radiotherapy (RDT) machines per capita. Patients that have private health coverage are more likely to receive preventive care such as pap smears and mammography in many countries of the LAC. The human development index was negatively related to mortality from oral cancer in the LAC countries with medium and low Human Development Index (HDI). Cancer treatment adverse events can negatively affect survivors’ workability compromising their return to work after diagnosis. In conclusion, the cancer burden can be a major public health issue with a considerable socioeconomic impact in LAC countries. It is demonstrated in several studies that unequal access to optimal care is frequent in LAC and that health insurance type may impact patients’ diagnosis and outcome
Riesgo laboral y estrés laboral en enfermeros que atienden pacientes con COVID-19 en Emergencia del Instituto Nacional de Enfermedades Neoplásicas, 2020
No full textThe current COVID-19 pandemic is generating multiple changes in the country's health reality, including situations typical of the nursing professional practice and its environment. Objective: To determine the relationship between occupational risk and work stress in nurses who care for patients with COVID-19 in Emergency at the National Institute of Neoplastic Diseases (INEN). Methodology: The study had a quantitative, correlational, cross-sectional and non-experimental design approach. The population consisted of 58 nurses working in the INEN Emergency Service (Lima-Peru). Two instruments were used: "Questionnaire to measure occupational risk in nurses" and the "Scale for measuring work stress in nurses". Results: 46.6% of the participants presented a high occupational risk level, 43.1% medium risk and 10.3% low occupational risk. The biological risk and psychosocial risk showed a mainly high level (69.0% and 53.4% respectively) and the chemical risk (46.6%), physical (56.9%) and ergonomic (48.3%) a preponderant average level. On the other hand, the work stress present in the participants was 46.6% high level, 32.8% medium level and 10.3% low. Regarding the association of variables, a p = 0.005 (direct correlation) was obtained between occupational risk and occupational stress and a Spearman Rho coefficient of 0.364. On the other hand, values p = 0.029, p = 0.200, p = 0.007, p = 0.102, were obtained for biological risk, chemical risk, physical risk and ergonomic risk respectively, which determines the non-existence of association of these variables with the work stress; On the other hand, a value of p = 0.007 of the social risk (direct correlation) and a Spearman's Rho coefficient = 0.348 were presented. Conclusion: The occupational risk was significantly related to the work stress of the nurses who care for patients with COVID-19 in the INEN Emergency Department. Likewise, regarding the dimensions of occupational risk: psychosocial risk was also significantly related to occupational stress. On the other hand, biological risk, chemical risk, physical risk and ergonomic risk were not related to work stress
SELNET clinical practice guidelines for soft tissue sarcoma and GIST
No full textSoft tissue sarcoma (STS) is a heterogeneous group of neoplasms, encompassing > 80 different histologic subtypes. Approximately three quarter of sarcoma arise from soft-tissue, about 15% are gastrointestinal stromal tumours (GISTs) and bone sarcoma represent the remaining 10%. The current guidelines will focus on soft-tissue and GIST, excluding Kaposi sarcoma and non-pleomorphic rhabdomyosarcoma. Bone sarcomas are covered in a different paper
Tumor neuroectodérmico maligno del tracto gastrointestinal: Reporte de 2 casos y revisión de la literatura
No full textMalignant gastrointestinal neuroectodermal tumour (GNET) is an extremely rare neoplasm first described by Zambrano in 2003 as clear cell sarcoma like tumor of the gastrointestinal tract. In contrast to clear cell sarcoma, it has giant osteoclast cells and shows diffuse and intense positivity for S-100 with no immunohistochemical or ultrastructural melanocyte differentiation. We present the first cases of GNET reported in South America, occurring in Peru. Two cases of GNET, one in a female and one in a male, both between 60 and 70 years of age, were referred to our hospital for reevaluation. One underwent further treatment in our centre, but with an unfavourable evolution. Pathologists should be aware of the diagnostic criteria for GNET in order to avoid misdiagnosis due to confusion with other non-epithelial gastrointestinal neoplasms
Impact of COVID-19 in pediatric oncology care in Latin America during the first year of the pandemic
No full textBackground: The ongoing coronavirus 2019 disease (COVID-19) pandemic strained medical systems worldwide. We report on the impact on pediatric oncology care in Latin American (LATAM) during its first year. Method: Four cross-sectional surveys were electronically distributed among pediatric onco-hematologists in April/June/October 2020, and April/2021 through the Latin American Society of Pediatric Oncology (SLAOP) email list and St Jude Global regional partners. Results: Four hundred fifty-three pediatric onco-hematologists from 20 countries responded to the first survey, with subsequent surveys response rates above 85%. More than 95% of participants reported that treatment continued without interruption for new and active ongoing patients, though with disruptions in treatment availability. During the first three surveys, respondents reported suspensions of outpatient procedures (54.2%), a decrease in oncologic surgeries (43.6%), radiotherapy (28.4%), stem cell transplants (SCT) (69.3%), and surveillance consultations (81.2%). Logistic regression analysis showed that at the beginning of the first wave, participants from countries with healthcare expenditure below 7% were more likely to report a decrease in outpatient procedures (odds ratio [OR]: 1.84, 95% CI: 1.19–2.8), surgeries (OR: 3, 95% CI: 1.9–4.6) and radiotherapy (OR: 6, 95% CI: 3.5–10.4). Suspension of surveillance consultations was higher in countries with COVID-19 case fatality rates above 2% (OR: 3, 95% CI: 1.4–6.2) and SCT suspensions in countries with COVID-19 incidence rate above 100 cases per 100,000 (OR: 3.48, 95% CI: 1.6–7.45). Paradoxically, at the beginning of the second wave with COVID-19 cases rising exponentially, most participants reported improvements in cancer services availability. Conclusion: Our data show the medium-term collateral effects of the pandemic on pediatric oncology care in LATAM, which might help delineate oncology care delivery amid current and future challenges posed by the pandemic. © 2022 Wiley Periodicals LLC
Biomarkers of human papillomavirus (HPV)-driven head and neck cancer in Latin America and Europe study: Study design and HPV DNA/p16INK4a status
No full textBackground: Human papillomavirus (HPV)-driven head/neck squamous cell carcinomas (HNSCC) prevalence varies globally. We evaluated HPV DNA and p16INK4a in formalin fixed paraffin embedded (FFPE) HNSCC from Argentina, Brazil, Colombia, and Peru. Methods: HPV was genotyped by PCR-hybridization. All HPV DNA positive and some HPV DNA negative cases underwent p16INK4a immunohistochemistry. Results: HPV DNA was detected in 32.8%, 11.1%, and 17.8% of oropharyngeal (OPC), oral cavity (OCC) and laryngeal (LC) cancers, respectively. OPC HPV prevalence was higher in Colombia (94.7%), and Argentina (42.6%) compared to Brazil (10.6%) and Peru (0.0%). HPV-16 was the most detected. Other HPVs were found in LC. Higher rates of p16INK4a positivity were observed among HPV positive OPC/OCC cases compared to LC cases. Conclusions: Our results support a role for HPV-16 in a subset of HNSCC, corroborate the heterogeneity observed in samples from different countries, and contribute additional etiological and biomarkers information in tumors of significant impact worldwide.Funding text 1: The authors alone are responsible for the views expressed in this article, and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated. Where authors are identified as personnel of the International Agency for Research on Cancer/World Health Organization, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy or views of the International Agency for Research on Cancer /World Health Organization. This work was supported by the São Paulo Research Foundation (FAPESP) (Grant No. 2017/04020‐7 to LLV); Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (Grant No. 306326/2015‐9 to LLV and 303431/2018‐0 to LS); Merck Sharp and Dohme (Investigator Initiated Studies IISP # 56004 to LLV); Fondo Nacional de Desarollo Científico, Tecnológico y de Innovación Tecnológica (Fondecyt) (096‐2017‐FONDECYT to CAC); Italian Ministry of Health (with Ricerca Corrente and 5x1000 funds to SC, Marta Tagliabue); Instituto de Salud Carlos III (ISCIII) through AESI 2017 (Grant No. AC17CIII/00003 to MP) and within the EU‐LAC Health framework. The authors are particularly grateful to Laura Leguina (Pathology Service, Hospital de Oncologia Maria Curie), Victoria Cachau, Maria Alejandra Avagnina, Andrea Paes de Lima (Pathology Department, Hospital de Clinicas General San Martín) and María Luisa Paparella (Faculty of Odontology, Universidad de Buenos Aires), Buenos Aires, Argentina for their support and commitment in sample recruitment. We also acknowledge the collaboration of Prof. Evandro Sobroza de Mello and Allane dos Santos Ferreira from the Department of Pathology of Faculdade de Medicina, Universidade de São Paulo, at ICESP||Funding text 2: The authors alone are responsible for the views expressed in this article, and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated. Where authors are identified as personnel of the International Agency for Research on Cancer/World Health Organization, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy or views of the International Agency for Research on Cancer /World Health Organization. This work was supported by the São Paulo Research Foundation (FAPESP) (Grant No. 2017/04020-7 to LLV); Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (Grant No. 306326/2015-9 to LLV and 303431/2018-0 to LS); Merck Sharp and Dohme (Investigator Initiated Studies IISP # 56004 to LLV); Fondo Nacional de Desarollo Científico, Tecnológico y de Innovación Tecnológica (Fondecyt) (096-2017-FONDECYT to CAC); Italian Ministry of Health (with Ricerca Corrente and 5x1000 funds to SC, Marta Tagliabue); Instituto de Salud Carlos III (ISCIII) through AESI 2017 (Grant No. AC17CIII/00003 to MP) and within the EU-LAC Health framework. The authors are particularly grateful to Laura Leguina (Pathology Service, Hospital de Oncologia Maria Curie), Victoria Cachau, Maria Alejandra Avagnina, Andrea Paes de Lima (Pathology Department, Hospital de Clinicas General San Martín) and María Luisa Paparella (Faculty of Odontology, Universidad de Buenos Aires), Buenos Aires, Argentina for their support and commitment in sample recruitment. We also acknowledge the collaboration of Prof. Evandro Sobroza de Mello and Allane dos Santos Ferreira from the Department of Pathology of Faculdade de Medicina, Universidade de São Paulo, at ICESP||Funding text 3: Conselho Nacional de Desenvolvimento Científico e Tecnológico, Grant/Award Numbers: 303431/2018‐0, 306326/2015‐9; Fondo Nacional de Desarrollo Científico y Tecnológico, Grant/Award Number: 096‐2017; Fundação de Amparo à Pesquisa do Estado de São Paulo, Grant/Award Number: 2017/04020‐7; Instituto de Salud Carlos III, Grant/Award Number: AC17CIII/00003; Italian Ministry of Health; Merck Sharp and Dohme, Grant/Award Number: IISP#56004 Funding informatio
Factores de riesgo asociados con morbilidad y mortalidad postoperatoria en gastrectomía radical D2 por cáncer gástrico
No full textIntroduction and aims: Surgery is the main treatment for gastric cancer. D2 radical gastrectomy is associated with a variable postoperative morbidity and mortality rate worldwide. The aim of the present study was to identify the risk factors associated with the postoperative morbidity and mortality of D2 radical gastrectomy, with curative intent, for gastric cancer. Materials and methods: A retrospective case series was conducted, in which the medical records were reviewed of patients with gastric cancer that underwent D2 radical gastrectomy, within the time frame of January 2014 and December 2018. Univariate and multivariate analyses were carried out to identify the risk factors related to postoperative morbidity and mortality within 90 days. Results: The percentages of postoperative morbidity and mortality in 691 patients were 23.3% and 3.3%, respectively. In the multivariate analysis, age ≥ 70 years (OR = 1.85, 95% CI: 1.25-2.76), ASA III-IV (OR = 2.06, 95% CI: 1.28-3.34), total gastrectomy (OR = 1.96, 95% CI:1.19-3.23), and pancreatosplenectomy (OR = 5.41, 95% CI: 1.42-20.61) were associated with greater postoperative morbidity, and age ≥ 70 years (OR = 4.92, 95% CI:1.78-13.65), lower BMI (OR = 0.81, 95% CI: 0.71-0.92), and hypoalbuminemia (OR = 0.91, 95% CI: 0.85-0.98) were associated with greater mortality in distal and total D2 radical gastrectomy. Conclusions: D2 radical gastrectomy for gastric cancer was shown to be a safe treatment, with low postoperative morbidity and mortality rates. Age ≥ 70 years, ASA III-IV, total gastrectomy, and pancreatosplenectomy were factors associated with a higher complication rate. Age ≥ 70 years, lower BMI, and hypoalbuminemia were mortality predictors in distal and total radical gastrectomy. © 2021 Asociación Mexicana de Gastroenterologí
Genomic landscape of lung cancer in the young
No full textBackground: Lung cancer in the young is a rare entity of great interest due to the high frequency of targetable mutations. In this study, we explored the genomic landscape of non-small cell lung cancer (NSCLC) in young patients and compared it with genetic alterations in older patients. Methods: Comparative study of the genomic profile of NSCLC young (≤40 years old) vs older patients (>40 years old) from Instituto Nacional de Enfermedades Neoplásicas (INEN) in Lima, Peru. Archival paraffin-embedded tumor samples were profiled with FoundationOne CDx assay to identify short variants alterations (insertions and deletions), copy number variations (CNV), tumor mutational burden and microsatellite instability in 324 driver genes and rearrangements in 28 commonly rearranged genes. A targetable alteration was defined as any alteration in a driver oncogene for which an FDA approved therapy existed at the time of study enrollment. Results: Overall, 62 tumors were profiled, 32 from young and 30 from older patients. All clinicopathological features (smoking status, clinical stage, and histology) were similar between groups, except for gender (65.6% of females in the younger group vs 40% in the older group, P=0.043). At least one actionable mutation was present in 84.4% and 83.3% in younger and older patients, respectively. Alteration rates in the main genes were: BRAF, 3.1%(n=1) vs 0% EGFR, 46.9% (n=15) vs 43.3% (n=13) ERBB2, 12.5% (n=4) vs 16.7% (n=5) KRAS, 15.6% (n=5) vs 16.7% (n=5) ALK, 6.3% (n=2) vs 3.3% (n=1) RET, 0.0% vs 3.3% (n=1) RET, 0.0% vs 3.3% (n=1) ROS1, 3.1% (n=1) vs 3.3% (n=1) NTRK1, 0.0% vs 3.3% (n=1) and MET, 3.1% (n=1) vs 13.3% (n=4). Mean TMB was 4.04 Mut/Mb (SD ± 3.98) for young vs 8.06 Mut/Mb (SD ± 9.84) for older patients (P=0.016). There were not significant differences in CNV, frequency of gene rearrangements, or microsatellites instability. Conclusion: NSCLC in the young in our cohort was characterized by a high frequency of actionable genetic aberrations and a low TMB, which was also true for our older patients. The enrichment of actionable mutations in young patients described in other reports might be attributed to differences in the etiology and clinicopathological characteristics between younger and older patients and therefore not be applicable to all populations