RESUMO
OBJECTIVES: The S-REAL study aimed to assess the effectiveness of durvalumab as consolidation therapy after definitive chemoradiotherapy (CRT) in a real-world cohort of patients with locally advanced, unresectable stage III non-small cell lung cancer (LA-NSCLC) included in a Spanish early access program (EAP). METHODS: In this multicentre, observational, retrospective study we analysed data from patients treated in 39 Spanish hospitals, who started intravenous durvalumab (10 mg/kg every 2 weeks) between September 2017 and December 2018. The primary endpoint was progression-free survival (PFS). Secondary endpoints included patient characterization and adverse events of special interest (AESI). RESULTS: A total of 244 patients were followed up for a median of 21.9 months [range 1.2-34.7]. Median duration of durvalumab was 45.5 weeks (11.4 months) [0-145]. Median PFS was 16.7 months (95% CI 12.2-25). No remarkable differences in PFS were observed between patients with programmed cell death-ligand 1 (PD-L1) expression ≥ 1% or < 1% (16.7 versus 15.6 months, respectively). However, PFS was higher in patients who had received prior concurrent CRT (cCRT) versus sequential CRT (sCRT) (20.6 versus 9.4 months). AESIs leading to durvalumab discontinuation were registered in 11.1% of patients. CONCLUSIONS: These results are in line with prior published evidence and confirm the benefits of durvalumab in the treatment of LA-NSCLC patients in a real-world setting. We also observed a lower incidence of important treatment-associated toxicities, such as pneumonitis, compared with the pivotal phase III PACIFIC clinical study.
Assuntos
Anticorpos Monoclonais , Carcinoma Pulmonar de Células não Pequenas , Quimiorradioterapia , Neoplasias Pulmonares , Humanos , Carcinoma Pulmonar de Células não Pequenas/terapia , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Masculino , Feminino , Neoplasias Pulmonares/terapia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/mortalidade , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Espanha , Anticorpos Monoclonais/uso terapêutico , Adulto , Idoso de 80 Anos ou mais , Antineoplásicos Imunológicos/uso terapêutico , Estadiamento de Neoplasias , Intervalo Livre de Progressão , Quimioterapia de Consolidação , Antígeno B7-H1/antagonistas & inibidoresRESUMO
PURPOSE: Immune checkpoint inhibitors are one of the most effective treatments available in advanced non-small cell lung cancer. However, at present, there are no clinical or analytical biomarkers that define which patients benefit with certainty from these treatments. In our study, we evaluated whether excess weight could be a good predictive biomarker of benefit from these drugs. METHODS: We studied a population of 79 patients, divided into a study group with 39 patients diagnosed with non-small cell lung cancer treated with immunotherapy and 40 patients in a control group, diagnosed with different advanced cancers, treated with non-immunotherapy treatment. We analyzed according to the presence of excess weight or not, the treatment's outcome in the study group and in the control group (objective response, and progression-free and overall survival). RESULTS: In our study, we detected a better response rate to immunotherapy in patients with excess weight (62.50 vs 26.08%, OR 4.72, p = 0.02), and a better median progression-free survival (14.19 vs 5.03 months, HR 0.50, p = 0.058) and median overall survival (33.84 months vs 20.76 months, HR 0.43, p = 0.01) in the study group. These findings were specific to the immunotherapy group since in the control group, with patients who did not receive immune checkpoint inhibitors, these findings were not found. CONCLUSION: Our study suggests that patients with excess weight who receive anti-PD-1 immune checkpoint inhibitors diagnosed with non-small cell lung cancer have a better outcome. This effect is specific to patients receiving immunotherapy.
Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Humanos , Inibidores de Checkpoint Imunológico/uso terapêutico , Imunoterapia/efeitos adversos , Neoplasias Pulmonares/tratamento farmacológico , Intervalo Livre de ProgressãoRESUMO
ResumenObjetivo:Existe escasa evidencia acerca de la aptitud física y la salud psicológica de los oficiales de seguridad universitarios. El objetivo del estudio fue describir la salud física y psicológica de los oficiales de seguridad de la Universidad de Costa Rica.Método:En el estudio participaron 26 hombres, cuyo promedio (M ± DE) de edad, peso, estatura e índice de masa corporal (IMC) fueron 42,0 ± 7,2 años, 87,3 ± 14.9 kg, 173,3 ± 5,4 cm, y 29,1 ± 4,7 kg/m2, respectivamente. Los participantes llenaron el cuestionario Job Stress Survey (JSS) y se les evaluó la densidad mineral ósea, % de grasa corporal, la capacidad aeróbica, fuerza muscular, resistencia muscular y flexibilidad.Resultados: Se encontraron puntajes bajos en el JSS (M = 14,8 ± 7,3 pts.), y correlaciones significativas (p < 0,05) entre la resistencia muscular y la capacidad aeróbica (r = 0,44), flexibilidad y capacidad aeróbica (r = 0,40) y densidad mineral ósea y fuerza muscular (r = 0,44).Discusión:En conclusión, los oficiales de seguridad de la Universidad de Costa Rica poseen bajo estrés laboral, y de acuerdo a las guías actuales del Colegio Americano de Medicina Deportiva se catalogan como personas con sobrepeso, con capacidad aeróbica y flexibilidad "pobre", fuerza muscular "promedio", aunque con una resistencia muscular "muy buena".
AbstractObjective: There is scarce evidence about the physical fitness and psychological health of university security officers. Therefore, the aim of the study was to describe the physical and psychological health of security officers from the University of Costa Rica.Method:Participants were 26 males, whose mean (M ± SD) age, weight, height and body mass index (BMI) were 42,0 ± 7,2 yr., 87,3 ± 14,9 kg, 173,3 ± 5,4 cm and 29,1 ± 4,7 kg/m2, respectively. Participants completed the Job Stress Survey (JSS) and were evaluated on bone mineral density, % body fat, aerobic capacity, muscular strength, muscular endurance and flexibility.Results:Low scores were found in the JSS (M = 14,8 ± 7,3 pts.), and significant correlations (p <0,05) between muscle strength and aerobic capacity (r = 0,44), flexibility and aerobic capacity (r = 0,40), and bone mineral density and muscle strength (r = 0,44).Discussion:In conclusion, security officers from the University of Costa Rica have low job stress, and according to the current American College of Sports Medicine guidelines are categorized as overweight, with "poor" aerobic capacity and flexibility, "average" muscle strength though with "very good" muscular endurance.
Assuntos
Polícia , Estresse Ocupacional , Universidades , Saúde Ocupacional , Saúde Ocupacional/tendências , Costa Rica , Atenção à SaúdeRESUMO
This paper explores 2 different probabilistic models explaining willingness to pay premium prices for high-quality cured products from the swine industry. Seven cured pork products (sausage, fuet, ham, loin, shoulder, salami and pepperoni) were studied in 9 food-stores in Valladolid, Spain. Consumers of the products were interviewed (686 completed surveys). It was found by using mixed effect statistical models that the relationship between willingness to pay a premium price and customer satisfaction had nonlinear behavior, following an S-shape with inverted slope which was the first empirical evidence of this type of behavior in meat products in real market conditions. It was also established that the interaction between satisfaction and current expenditure on the product was significant and indispensable for explaining consumers' willingness to pay premium price for cured pork products.
Assuntos
Comércio/economia , Comportamento do Consumidor/economia , Carne/economia , Animais , Indústria Alimentícia , Humanos , Entrevistas como Assunto , Espanha , Inquéritos e Questionários , Suínos , PaladarRESUMO
Late blight caused by Phytophthora infestans is one of the most limiting diseases in solanaceous crops in the world. This pathogen is a main constraint in the highland Andes, where these plants are grown under high humidity conditions and continuous cropping. The aim of this research was to increase the available information on the biology of P. infestans, specifically on its level of genetic variation in south-western Colombia, an area where various solanaceous crops susceptible to this pathogen converge. The study was carried out by using AFLP molecular markers with the restriction enzymes EcoRI and MseI and different primer combinations. Results indicated a low level of genetic variation among the 26 isolates evaluated, with only 18 polymorphic bands out of 135 amplicons obtained (13.43%), a Nei's genetic diversity index of 0.04, and a Shannon's information index of 0.06.
Assuntos
Variação Genética , Phytophthora infestans/genética , Colômbia , Phytophthora infestans/isolamento & purificação , Solanum/microbiologiaRESUMO
Objetivo. Determinar la toxicidad de extractos etanólicos de Annona muricata, Melia azedarach, y Ricinus communis sobre larvas de cuarto estadio de Aedes aegypti.Métodos. Mediante un diseño completamente al azar se realizaron bioensayos para determinar la toxicidad de diferentes concentraciones de extractos vegetales sobre Ae. aegypti.Resultados. Los valores de LC50 (concentración letal media) hallados son: A. muricata, 900 ppm (IC 95 por ciento: 380-1300); M. azedarach, 1800 ppm (IC 95 por ciento: 150-2100); R. communis, 860 ppm (IC95 por ciento:451-1500).Conclusiones. Los resultados de toxicidad se consideran promisorios por estar por debajo de la concentración máxima (5 000 ppm) recomendada por la Agenda de Cooperación Técnica Alemana (GTZ). Es necesario evaluar las fracciones de los extractos para detectar posible actividad a concentraciones menores...
Assuntos
Aedes , Dengue , Dengue Grave , Inseticidas , Colômbia , DensovirinaeRESUMO
Se realizaron bioensayos con los extractos etanólicos de las especies vegetales Annona muricata, Mammea americana, Melia azedarach, Ricinus communis y los insecticidas nicotinay deltametrina sobre ninfas y huevos de R. prolixus y R. pallescens. Se determinó la toxicidad, repelencia y actividad ovicida. Los valores mas bajos de CL50 expresados en por ciento p/p obtenidos respectivamente para R. prolixus y R. pallescens fueron: A. muricata 1,02 y 1,74; M. azedarach 1,77 y 1,74. El extracto de M.americana presentó menor actividad insecticida sobre las dos especies de triatominos: CL50 4,33 y 2,61. La repelencia osciló entre 51 y 58% y la eclosión de los huevos fue inhibida entre 10 y 25%. Los resultados de toxicidad se consideran poco promisorios por sersuperiores a la concentración máxima de 5.000 ppm recomendada por la GTZ.
Assuntos
Doença de Chagas , Inseticidas , Rhodnius , Botânica , Colômbia , Medicina TropicalRESUMO
La cardiopatía isquémica en sujetos jóvenes es un fenómeno inusual y poco estudiado. El índice tobillo brazo, el espesor del complejo intima media carotídeo y femoral, se han ido posicionando como parámetros de evaluación y seguimiento en diversos escenarios clínicos, no obstante, todos ellos se han evaluado en sujetos de edad avanzada. Establecer la correlación entre el espesor del complejo intima media carotídeo, complejo intima media carotídeo femoral e índice tobillo brazo con la presencia y severidad de EAC en el adulto joven. Se realizó un estudio retrospectivo, observacional, de corte transversal; que incluyó a pacientes menores de 46 años de edad, con diagnóstico de síndrome coronario agudo (angor inestable, IM Q y no Q) a los cuales se les realizó cateterismo cardíaco; ulteriormente, sin conocer dicho resultado, les fue realizada la determinación del índice tobillo brazo, complejo intima media carotídeo femoral y complejo intima media carotídeo. Fueron incluidos 130 pacientes, 96 hombres y 34 mujeres. El 76,92 por ciento (n= 100) presentó lesiones angiográficas (Grupo A); entre los restantes 30 (Grupo B), el 63,33 por ciento (n= 19) no presentó EAC, el 30 por ciento (n= 9) evidenció flujo lento y el 6,66 por ciento (n= 2) anomalías vasculares. Entre los grupos A y B hubo diferencias significativas para complejo intima media carotídeo 1,43 + 0,25 mm (P < 0,001) como complejo intima media carotídeo femoral 0,95 + 0,04 mm (P <0,01); mas no para el índice tobillo brazo (P= NS). Cuando se correlacionó el espesor del complejo intima media carotídeo y complejo intima media carotídeo femoral con el número de vasos afectados, se evidenció una relación directamente proporcional, aunque no significativa, en el caso de lesiones de uno y dos vasos (P= NS) y significativas en presencia de lesiones de 3 vasos (P < 0,001) complejo intima media carotídeo complejo intima media carotídeo femoral. La presencia del complejo intima media carotídeo y complejo intima media...
Assuntos
Adulto , Humanos , Tornozelo , Braço , Doenças Cardiovasculares , Doença das Coronárias , Isquemia Miocárdica , Cardiologia , VenezuelaRESUMO
El Mycobacterium no se considera entre los principales microorganismos causantes de neumonía adquirida en la comunidad; así mismo, tampoco es una causa frecuente de schok séptico y síndrome de distress respiratorio agudo. Se describe el caso de una paciente diabética, con una neumonía adquirida en la comunidad, que posteriormente desarrolló un infiltrado miliartípco y un shock séptico, observándose en la secreción traqueal, bacilos ácido alcohol resistentes. Se revisa la literatura pertinente a M. tuberculosis como agente de neumonía comunitaria, shock séptico y síndrome de distress respiratorio del aduto