RESUMO
PURPOSE: We retrospectively analysed overall survival (OS) and potential predictive biomarkers of OS in patients with metastatic melanoma treated with ipilimumab plus nivolumab in a single institution. METHODS AND PATIENTS: Electronic medical records of patients with advanced melanoma receiving ≥ 1 dose of a combined ipilimumab plus nivolumab regimen between March 3, 2016 and March 7, 2020 in a single institution, were reviewed. OS was analysed using the Kaplan-Meier method. Sub-group analyses were conducted to examine several endpoints according to relevant clinical, molecular and pathological variables using logistic and Cox models. RESULTS: Forty-four cases were reviewed, 38 (86.4%), of whom had cutaneous melanoma, 21 (47.7%) were BRAF mutant, 21 (47.7%) presented high lactate dehydrogenase (LDH) values, 23 (52.3%) had ≥ 3 disease sites, and 10 (22.7%) patients had brain metastases. The median follow-up was 37.7 months, and the median OS was 21.1 months (95% CI 8.2-NR). In the multivariate analysis, the OS was significantly longer in patients with an Eastern Cooperative Oncology Group (ECOG) score of 0, LDH ≤ upper limit of normal, absence of liver metastases and neutrophil-to-lymphocyte ratio (NLR) < 5 (all p ≤ 0.05, log-rank test). These factors allowed the classification of patients into three prognostic risk groups (low/intermediate/high risk) for death. CONCLUSION: Overall survival of real-world patients from our cohort receiving ipilimumab plus nivolumab was lower than in previous studies. The ECOG score, LDH values, the presence of liver metastases and the NLR were independent prognostic factors for survival.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Inibidores de Checkpoint Imunológico/uso terapêutico , Ipilimumab/uso terapêutico , Melanoma/tratamento farmacológico , Nivolumabe/uso terapêutico , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Idoso , Feminino , Humanos , Masculino , Melanoma/mortalidade , Melanoma/secundário , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/patologia , Taxa de Sobrevida , Resultado do TratamentoRESUMO
The assessment of the after-licensing efficacy of the Cuban vaccine VA-MENGOC-BC was performed one year after the mass immunization campaign was completed in children under 6 years of age in the Province of Holguín which had the second highest incidence rate of meningococcal disease during 1988 in Cuba. In the design of the study the following aspects were taking into account: case definition; case detection, determination of the state of vaccination, and comparability of exposure. The utilization of 2 case definitions with different sensitivity and specificity is introduced within the methodology, as well as 2 estimation methods. Incidence rates from exposed and nonexposed subjects, as well as the ratio of cases and of the vaccinated population are used. The impact of this prophylactic intervention was determined by the estimation of the percentual preventive population fraction. Among outstanding results, the high efficacy of more than 98% found in both variants of case definition is to be mentioned. It is evidenced that the effect of the vaccine accounts for more than 80% of the observed case reduction. Such reduction in the number of cases was obtained without changing diagnostic criteria since the isolation of the agents was hept at levels similar to the ones from previous years.
Assuntos
Vacinas Bacterianas/imunologia , Neisseria meningitidis/imunologia , Vigilância de Produtos Comercializados , Pré-Escolar , Intervalos de Confiança , Cuba , Humanos , Incidência , Lactente , Meningite Meningocócica/epidemiologia , Meningite Meningocócica/prevenção & controle , Vigilância de Produtos Comercializados/métodos , Vigilância de Produtos Comercializados/estatística & dados numéricos , Risco , Fatores de TempoRESUMO
Outbreaks of diarrhoea associated with mucosal erosions of the mouth, tongue and digestive tract, clinically diagnosed as bovine virus diarrhoea-mucosal disease (BVD-MD), have been reported in Argentina and Brazil since the 1960's. However, primary isolation of the virus of BVD-MD is fairly recent, occurring in 1974 for Brazil, 1984 for Argentina, 1985 for Chile and 1981 for Colombia. In Argentina both cytopathogenic and non-cytopathogenic BVD virus strains have been identified. Elsewhere in South America this differentiation does not seem to have been carried out. Serological surveys have confirmed the existence of BVD virus infection in six countries (Argentina, Brazil, Chile, Colombia, Peru and Uruguay), with an incidence rate ranging between 37 and 77% of cattle in the areas surveyed. Diarrhoea in calves between 3 and 18 months of age, often associated with mucosal erosions, has been the most commonly observed syndrome. In some cases an upper respiratory tract involvement was described. In one epizootic, in the Sabana de Bogota plateau of Colombia, reproductive failure associated with abortions or birth of weak calves was the main clinical syndrome.
Assuntos
Doença das Mucosas por Vírus da Diarreia Viral Bovina/epidemiologia , Animais , Doença das Mucosas por Vírus da Diarreia Viral Bovina/prevenção & controle , Bovinos , Incidência , América do Sul/epidemiologiaRESUMO
Aphthovirus strains used in South America for vaccine production or as reference for diagnostic purposes were analysed by RNA fingerprinting (RNase T1 maps, one- and two-dimensional gels). The results obtained constitute the basis for a data bank containing available information about the genome structure of strains of aphthovirus prevalent in this continent and can be used as an adjunct to serological and immunological information. These data are currently being used in South American countries to assess the genetic stability of strains during vaccine production; to establish possible vaccine origin of field outbreaks and to monitor the origin, behaviour and fate of new strains in the field.
Assuntos
Aphthovirus/genética , RNA Viral/análise , Animais , Aphthovirus/classificação , Aphthovirus/imunologia , América do Sul , Vacinas Virais/análiseRESUMO
[Introducción] La imposibilidad de hacer un diagnóstico diferencial de las enfermedades vesiculares, fiebre aftosa (FA), estomatitis vesicular (EV) y enfermedad vesicular del cerdo (EVC), a partir de la sintomatología en los animales enfermos, exige que la identificación de estas enfermedades y la confirmación diagnóstica se realicen en el laboratorio. La actividad de diagnóstico es realizada por muchos laboratorios, los cuales usan diferentes metodologías y técnicas de diagnóstico. Una excepción es la Red de Laboratorios de Diagnóstico de las Enfermedades Vesiculares de América del Sur. Por otra parte, la relativa complejidad de la clasificación de los virus y el apoyo que los laboratorios deben proporcionar a las diferentes campañas de prevención, control y erradicación de estas enfermedades, con énfasis en la FA, imponen la necesidad de una padronización de la metodología usada en los diferentes laboratorios dedicados al diagnóstico de las enfermedades vesiculares. Este Manual de Diagnóstico de Laboratorio de las Enfermedades Vesiculares pretende satisfacer los aspectos discutidos anteriormente.
Assuntos
Técnicas de Laboratório Clínico , Doenças dos Animais , Diagnóstico Diferencial , Doença Vesicular Suína , Febre Aftosa , Estomatite VesicularRESUMO
En esta comunicación, se extendieron los estudios al análisis de varias cepas relevantes del virus de la fiebre aftosa, subtipos O, A y C, aisladas en diferentes épocas en el campo y en distintas regiones de América del Sur.
In the present communication studies are axtended to the analysis of several relevant strains of FMDV srotypes O, A and C isolated at different times in the field in different regions of South America.
Assuntos
Aphthovirus , Bioquímica , Epidemiologia e Bioestatística , Imunidade , Bioquímica , Imunidade , Epidemiologia e BioestatísticaRESUMO
[Antecedentes] El propósito del CPFA fue prestar a los países miembros servicios de diagnóstico, orientación en el control de la fiebre aftosa, adiestramiento e investigación. El servicio de diagnóstico tiene por objetivo la identificación de los agentes causantes de enfermedades vesiculares de los animales, particularmente para los países que no cuentan con medios para hacer el diagnóstico diferencial entre la fiebre aftosa y otras enfermedades similares. Sirve, además, de Laboratorio de Referencia para las Américas en lo referente al diagnóstico de subtipos y cepas de virus, proporciona adiestramiento y reactivos de referencia en esta actividad y facilita el intercambio de informaciones técnicas entre los laboratorios.
Assuntos
Febre Aftosa , Estomatite Vesicular , Diagnóstico Diferencial , América , Saúde Pública Veterinária , LaboratóriosRESUMO
Field strains of foot-and-mouth disease (FMD) virus which differ immunogenically from vaccine strains appear from time to time and may present serious problems for FMD campaigns. In order that appropriate measures can be taken it is important to determine the degree of differences between the vaccine strain and the variant strain soon after its appearance. With the A strains studied it was observed that a serological relationship by complement fixation test of greater than or equal to 0.40 would indicate sufficient protection of the vaccine strain for the field strain. With a lower relationship, however, the vaccine strains usually do not fully protect against the field strain. The mouse protection test can be used to determine how serious the lack of protection may be. With this test routine it is possible to issue alerts for intensified epidemiological surveillance within 2-3 weeks after the field strain is received at the Center.