Long-term follow up of Hodgkin lymphoma

Background: Hodgkin lymphoma (HL) is the paradigm of curable disease. This study analyzed the overall survival (OS) of patients with HL and compared their survival between decades and with the expected survival of a general population. Results: The median follow-up was 22 years. The median OS was 33 years. The incidence mortality rate for all causes is 2 per every 100 patients per year. The OS of our cohort at 10 years from diagnosis was 76% (95% CI: 72-79) and 52% at 30 years (95% CI: 48-57). Overall SMR (1980-2013) was 2,943 (95% CI: 2,518-3,439). Excluding the primary tumor as the cause of death, the SMR obtained is 2,266 (95% CI: 1,895-2,710). The SMR for those patients diagnosed before the year 2000 was 2,097 (95% CI: 1,732-2,539); and for those diagnosed after 2000 was 5,218 (95% CI: 8,655). The group of patients diagnosed after 2000 had statistically significant more advanced stages, were older and less responsive to treatment. Conclusions: Despite the advances achieved, the risk of death remains higher than in the general population, mainly for those patients diagnosed after year 2000, even after almost 40 years of follow-up. This data might suggest a shift to more aggressive forms of disease in recent years. Patients and methods: A total of 595 patients diagnosed with HL were included between January 1966 and February 2014. The standardized mortality ratio (SMR) was analyzed using the annual rate of mortality in the general Spanish population, adjusted for age, sex and time period

Concordance between circulating tumor cells and clinical status during follow-up in anaplastic lymphoma kinase (ALK) non-small-cell lung cancer patients

Background: The identification of anaplastic lymphoma kinase (ALK) rearrangements is found in approximately 5% of non-small-cell lung cancers (NSCLCs). However, the development of liquid biopsies as a diagnostic tool is less developed in these cases. This study investigates the use of CTCs during treatment, together with an extended follow-up to correlate with clinical evolution. Patients and Methods: A total of 13 patients out of a cohort of 212 patients with lung adenocarcinoma, presented ALK rearrangements (6%) confirmed by tumor biopsy. A total of 60 serial blood samples were collected from these patients who were prospectively enrolled in the study. Results: All patients had a positive CTC count at baseline (mean = 3). The median follow-up was 9 months (range 1-17 months). Three patients underwent surgery and their CTC counts decreased after the procedure but still remained detectable. After radiotherapy, 3 cases showed an average decrease of 5 CTCs. A total of 6 patients were treated with ALK inhibitors and a partial response was observed in 3 of them, who also presented decreased CTC counts. The other 3 patients presented primary resistance, and their CTC counts were higher than those obtained prior to progression. Conclusion: We believe that the use of CTCs for dynamic monitoring of NSCLC with ALK rearrangement and to detect disease persistence or recurrence may be a reliable technique. CTC counts may also have potential use to monitor the efficacy of ALK inhibitors, facilitating detection of resistance to treatmentThis study was supported by Carlos III Institute of Health, Spanish Ministry of Science and Innovation, and European Regional Development Fund (grant number: PI16/01818 and PIE14/00064), D. Pérez-Callejo is supported by SEOM-Río-Hortega contract, A Romero is supported by Joan Rodés fellowship (grant number: JR14/00017) and M Sánchez-Beato is supported by Miguel Servet contract (CP11/00018 and CPII16/00024

To burn-out or not to burn-out: A cross-sectional study in healthcare professionals in Spain during COVID-19 pandemic

Objective To assess the prevalence of burn-out syndrome in healthcare workers working on the front line (FL) in Spain during COVID-19. Design Cross-sectional, online survey-based study. Settings Sampling was performed between 21st April and 3rd May 2020. The survey collected demographic data and questions regarding participants' working position since pandemic outbreak. Participants Spanish healthcare workers working on the FL or usual ward were eligible. A total of 674 healthcare professionals answered the survey. Main outcomes and measures Burn-out syndrome was assessed by the Maslach Burnout Inventory-Medical Personnel. Results Of the 643 eligible responding participants, 408 (63.5%) were physicians, 172 (26.8%) were nurses and 63 (9.8%) other technical occupations. 377 (58.6%) worked on the FL. Most participants were women (472 (73.4%)), aged 31-40 years (163 (25.3%)) and worked in tertiary hospitals (>600 beds) (260 (40.4%)). Prevalence of burn-out syndrome was 43.4% (95% CI 39.5% to 47.2%), higher in COVID-19 FL workers (49.6%, p<0.001) than in non-COVID-19 FL workers (34.6%, p<0.001). Women felt more burn-out (60.8%, p=0.016), were more afraid of self-infection (61.9%, p=0.021) and of their performance and quality of care provided to the patients (75.8%, p=0.015) than men. More burn-out were those between 20 and 30 years old (65.2%, p=0.026) and those with more than 15 years of experience (53.7%, p=0.035). Multivariable logistic regression analysis revealed that, working on COVID-19 FL (OR 1.93; 95% CI 1.37 to 2.71, p<0.001), being a woman (OR 1.56; 95% CI 1.06 to 2.29, p=0.022), being under 30 years old (OR 1.75; 95% CI 1.06 to 2.89, p=0.028) and being a physician (OR 1.64; 95% CI 1.11 to 2.41, p=0.011) were associated with high risk of burn-out syndrome. Conclusions This survey study of healthcare professionals reported high rates of burn-out syndrome. Interventions to promote mental well-being in healthcare workers exposed to COVID-19 need to be immediately implemented.publishersversionpublishe

On Predicting Recurrence in Early Stage Non-small Cell Lung Cancer

Early detection and mitigation of disease recurrence in non-small cell lung cancer (NSCLC) patients is a nontrivial problem that is typically addressed either by rather generic follow-up screening guidelines, self-reporting, simple nomograms, or by models that predict relapse risk in individual patients using statistical analysis of retrospective data. We posit that machine learning models trained on patient data can provide an alternative approach that allows for more efficient development of many complementary models at once, superior accuracy, less dependency on the data collection protocols and increased support for explainability of the predictions. In this preliminary study, we describe an experimental suite of various machine learning models applied on a patient cohort of 2442 early stage NSCLC patients. We discuss the promising results achieved, as well as the lessons we learned while developing this baseline for further, more advanced studies in this area

Clinical factors influencing long-term survival in a real-life cohort of early stage non-small-cell lung cancer patients in Spain

Funding Information: This work was supported in part by Centro de Matematica e Aplicaçoes, UID (MAT/00297/2020), Portuguese Foundation of Science and Technology. Acknowledgments Publisher Copyright: Copyright © 2023 Torrente, Sousa, Guerreiro, Franco, Hernández, Parejo, Sousa, Campo-Cañaveral, Pimentão and Provencio.Background: Current prognosis in oncology is reduced to the tumour stage and performance status, leaving out many other factors that may impact the patient´s management. Prognostic stratification of early stage non-small-cell lung cancer (NSCLC) patients with poor prognosis after surgery is of considerable clinical relevance. The objective of this study was to identify clinical factors associated with long-term overall survival in a real-life cohort of patients with stage I-II NSCLC and develop a prognostic model that identifies features associated with poor prognosis and stratifies patients by risk. Methods: This is a cohort study including 505 patients, diagnosed with stage I-II NSCLC, who underwent curative surgical procedures at a tertiary hospital in Madrid, Spain. Results: Median OS (in months) was 63.7 (95% CI, 58.7-68.7) for the whole cohort, 62.4 in patients submitted to surgery and 65 in patients submitted to surgery and adjuvant treatment. The univariate analysis estimated that a female diagnosed with NSCLC has a 0.967 (95% CI 0.936 - 0.999) probability of survival one year after diagnosis and a 0.784 (95% CI 0.712 - 0.863) five years after diagnosis. For males, these probabilities drop to 0.904 (95% CI 0.875 - 0.934) and 0.613 (95% CI 0.566 - 0.665), respectively. Multivariable analysis shows that sex, age at diagnosis, type of treatment, ECOG-PS, and stage are statistically significant variables (p1) while adjuvant chemotherapy is a good prognostic variable (HR<1). The prognostic model identified a high-risk profile defined by males over 71 years old, former smokers, treated with surgery, ECOG-PS 2. Conclusions: The results of the present study found that, overall, adjuvant chemotherapy was associated with the best long-term OS in patients with resected NSCLC. Age, stage and ECOG-PS were also significant factors to take into account when making decisions regarding adjuvant therapy.publishersversionpublishe

Ru complexes containing Cp, mPTA and natural purine bases (mPTA = methyl-N-1,3,5-triaza-7-phosphaadamantane): Evaluation of their antiproliferative activity, solubility and redox properties

Complexes [RuCp(Adeninate–κN9)(mPTA)2](Cl0.5)(CF3SO3)2.5⋅H2O (1⋅H2O), [RuCp(Guaninate-κN7)(mPTA)2] (CF3SO3)2⋅H2O (2⋅H2O), [RuCp(Theophyllinate-κN7)(mPTA)2](CF3SO3)2⋅1.5H2O (3⋅1.5H2O) and [RuCp(Pur- κN)(mPTA)(PPh3)](CF3SO3) (4–6) (Pur = Adeninate, Guaninate, Teophyllinate; mPTA = N-methyl 1,3,5-triaza- 7-phosphaadamantane) have been synthesized and characterized. Structure of complexes 1⋅H2O and 3⋅1.5H2O were determined by single-crystal X-ray diffraction. Solubility in water, Log P, electrochemical properties and antiproliferative activities of the complexes (against cisplatin-sensitive T2 and cisplatin-resistant SKOV3 cell lines) have been assessed and discussed

Encuesta nacional de tendencias en salud y fitness Chile 2024

El objetivocentral de este estudio fue identificar y comparar las tendencias fitness más destacadas para el año 2024 en Chile, contrastándolas con los hallazgos obtenidos a través de la encuesta internacional llevada a cabo por el American College of Sport Medicine (ACSM). La recopilación de información se realizó mediante una encuesta online que replicó la metodología utilizada por la ACSM en sus encuestas globales sobre tendencias en fitness. El cuestionario se distribuyó entre 3,359 profesionales que actualmente ejercen en el ámbito del fitness a lo largo de todo el país. La tasa de respuesta fue de un 21.55%, con un total de 724 respuestas. En la evaluación de los resultados, las cinco tendencias principales identificadas en Chile fueron: 1)"Entrenadores personales", 2) "Ejercicios para perder peso", 3) "Grupos interdisciplinarios de trabajo", 4) "Contratación de profesionales del ejercicio certificados" y 5) "Afi-liación basada en suscripciones". Cabe destacar que 10de estas tendencias coinciden con la encuesta internacional del año anterior. Los resultados revelan una marcada relevancia de la práctica de actividad física con objetivos orientados a la salud y el bienestar en el contexto chileno. Además, se evidencia unbajointerés en el uso de tecnología en el sector del fitness, señalando posiblemente una preferencia por enfoques más tradicionales en la práctica de ejercicio físico. Este análisis contribuye a una comprensión más detallada de las preferencias y dinámicas actuales en el área del fitness en Chile.Palabras clave:encuesta chilenafitness, tendencias fitness, industria fitness, encuesta ACS

Chronodisruption and Ambulatory Circadian Monitoring in Cancer Patients: Beyond the Body Clock.

Purpose of Review Circadian rhythms impose daily rhythms a remarkable variety of metabolic and physiological functions, such as cell proliferation, infammation, and DNA damage response. Accumulating epidemiological and genetic evidence indicates that circadian rhythms’ disruption may be linked to cancer. The integration of circadian biology into cancer research may ofer new options for increasing cancer treatment efectiveness and would encompass the prevention, diagnosis, and treatment of this disease. Recent Findings In recent years, there has been a signifcant development and use of multi-modal sensors to monitor physical activity, sleep, and circadian rhythms, allowing, for the very frst time, scaling accurate sleep monitoring to epidemiological research linking sleep patterns to disease, and wellness applications providing new potential applications. Summary This review highlights the role of circadian clock in tumorigenesis, cancer hallmarks and introduces the stateof-the-art in sleep-monitoring technologies, discussing the eventual application of insights in clinical settings and cancer research.post-print1077 K