Hereditary cancer syndromes (HCS) are genetic diseases with an increased risk of developing cancer. This research describes the implementation of a cancer prevention model, genetic counseling, and germline variants testing in an oncologic center in Mexico. A total of 315 patients received genetic counseling, genetic testing was offered, and 205 individuals were tested for HCS. In 6 years, 131 (63.90%) probands and 74 (36.09%) relatives were tested. Among the probands, we found that 85 (63.9%) had at least one germline variant. We identified founder mutations in BRCA1 and a novel variant in APC that led to the creation of an in-house detection process for the whole family. The most frequent syndrome was hereditary breast and ovarian cancer syndrome (HBOC) (41 cases with BRCA1 germline variants in most of the cases), followed by eight cases of hereditary non-polyposic cancer syndrome (HNPCC or Lynch syndrome) (with MLH1 as the primarily responsible gene), and other high cancer risk syndromes. Genetic counseling in HCS is still a global challenge. Multigene panels are an essential tool to detect the variants frequency. Our program has a high detection rate of probands with HCS and pathogenic variants (40%), compared with other reports that detect 10% in other populations.
Neutralizing antibodies (NAs) are key immunological markers and are part of the humoral response of the adaptive immune system. NA assays determine the presence of functional antibodies to prevent SARS-CoV-2 infection. We performed a real-world evidence study to detect NAs that confer protection against SARS-CoV-2 after the application of five vaccines (Pfizer/BioNTech, AstraZeneca, Sinovac, Moderna, and CanSino) in the Mexican population. Side effects of COVID-19 vaccines and clinical and demographic factors associated with low immunogenicity were also evaluated. A total of 242 SARS-CoV-2-vaccinated subjects were recruited. Pfizer/BioNTech and Moderna proved the highest percentage of inhibition in a mono-vaccine scheme. Muscular pain, headache, and fatigue were the most common adverse events. None of the patients reported severe adverse events. We found an estimated contagion-free time of 207 (IQR: 182–231) and 187 (IQR: 184–189) days for Pfizer/BioNTech and CanSino in 12 cases in each group. On the basis of our results, we consider that the emerging vaccination strategy in Mexico is effective and safe.
e23113 Background: Most studies report that tumor related pain occurs between 46% and 92%. The prevalence of pain by clinical stage is 15% in initial stages, 30% in middle stages, 74% in metastatic cancer and, 87% in terminal disease. In the face of chronic diseases such as cancer, patient's relationships with their social networks are affected; among them the interpersonal relationships between the patient and his networks and these towards the patient. With this, the patient’s quality of life is affected. Most of the recent studies on health-related quality of life come from pharmaceutical groups, so it is necessary for other groups to be vigorously involved in the study of the effect of medical interventions on the quality of life, as well as on the impact on health and on the social support of patients with chronic diseases. Methods: In order to obtain the data, validated questionnaires were used as instruments to evaluate the quality of life, measuring psychosocial and health variables, as well as for the detection of the type and quality of psychosocial support perceived by the subjects. The instruments were applied to 207 patients of the Oncology Service of the University Center Against Cancer of the University Hospital “Dr. Jose Eleuterio Gonzalez” in Nuevo Leon, Mexico, during a session of 25 to 30 minutes. Results: Data were collected from 207 patients with chronic oncological pain. The satisfaction index with psychosocial support had a high linear correlation ( r = .640) with the quality of life index. On the other hand, the number of caregivers was not correlated with this last index. Fatigue was the symptom most frequently associated with a decrease in the quality of life index. In addition, pain correlated with all variables except the cognitive index. Conclusions: Satisfaction with the perceived social support is a factor associated with the quality of life in patients with chronic oncological pain; however, the number of caregivers is not. There was no relationship between the size of the network and satisfaction with it. Also, the symptoms associated with chronic oncological pain affect quality of life, identity and social functionality and roles, which in turn impact on the quality of life perceived by patients.
Breast cancer (BC) has one of the highest incidences and mortality worldwide. Single nucleotide polymorphisms (SNPs) in TOX3 rs3803662 and MMP7 rs1943779 have been associated with susceptibility to BC. In this case-control study, we evaluated the association of rs3803662 (TOX3)/rs1943779 (MMP7) SNPs with clinical features, immunohistochemical reactivity, and risk association with BC in women from northeastern Mexico. We compared 212 BC cases and 212 controls. DNA was isolated from peripheral blood to perform the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. We calculated genotype frequencies, odds ratios, and 95% confidence intervals. We found that CT (Cytocine–Thymine) and TT (Thymine –Thymine) genotypes, and T alleles of TOX3 rs3803662, were associated with BC risk (p = 0.034, p = 0.011, respectively). SNP TOX3 rs3803662 was associated with positive progesterone receptors (PR) and triple-negative BC (TNBC) but not with estrogen receptor (ER) or HER2 reactivity. CT and TT genotypes (p = 0.006) and T alleles (p = 0.002) of SNP MMP7 rs1943779 were associated with risk of BC. We found that T alleles of TOX3 rs3803662 and MMP7 rs1943779 SNPs are associated with BC risk. These findings contribute to personalized medicine in Mexican women.
e24113 Background: Chronic cancer pain generates fear and anguish in cancer patients. It is suffered by 64% of patients with metastatic or terminal disease, 59% of patients in early and intermediate stages, and 33% of patients cured from cancer. They require a psychosocial support network. This network has been proposed as an essential tool to reduce the negative impact of the symptoms and psychosocial implications of cancer on the quality of life of patients. Patients with dysfunctional family networks can add to the pain of suffering cancer when they suffered or suffer violence. Cancer and pain test all personal resources and the patient's support network where family functioning is capital for quality of life. Methods: Descriptive, comparative and correlational study. A sample was taken for convenience with the prior consent of the patients who attend the outpatient clinic of the Pain Clinic of the Oncology Service, of the University Center Against Cancer of the University Hospital “Dr. José Eleuterio González” in Nuevo León. The questionnaires were applied during a session of 25 to 30 minutes. It was requested to answer the scales to assess the level of intra-family functioning, intra-family violence, quality of life, measuring psychosocial and health variables; as well as for the detection of the type and quality of psychosocial support perceived by the subjects. Results: A total of 207 research subjects were included in the study, the average age was 49 years of age (minimum 12, maximum 81 years of age), 23% men and 77% women. Marital status: married 52%, home-based 63%; monthly income less than $120 USD (n = 75, 37%). The quality of life index and chronic cancer pain had a high linear correlation with the variables of family violence, psychosocial support, family functioning, somatic symptoms, among other variables studied. Fatigue was the symptom most frequently associated with the decrease in the quality of life index. Conclusions: The satisfaction of perceived social support is a factor associated with the quality of life in patients with chronic cancer pain, however, the number of caregivers is not. There was no relationship between the size of the network and satisfaction with it. Also, the symptoms associated with chronic cancer pain affect the quality of life, identity, social functionality and roles, which in turn impact the quality of life perceived by the patient. This study supports our comprehensive intervention programs and new protocols to promote the quality of life of cancer patients.
10513 Background: The Burnout Syndrome takes relevance for its investigation since 1986, when Maslach developed a survey for its study with 3 subscales that include the symptoms generated by exhaustion and chronic labor stress. Health workers are especially vulnerable to the development of this syndrome, which is greater centers with exposure to patients with severe and/or chronic ailments. Thus, the mental structure maturity level with which the individual functions takes relevance, since it is linked to the quality of judgment of the clinician. Few studies consider this aspect because of the complexity of having the instruments and professionals to assess it. It has been questioned whether Burnout or this occupational exhaustion damages the quality of life of the individual, and if it also negatively impacts their work performance, and the quality of care provided to patients. Methods: Observational, cross-sectional and correlational study. It analyses the relationship between Burnout and the characteristics of the mental-structural functioning level in oncology staff, and its association with the level of functionality of the mental structures within the work environment. Prior validation of the instrument was conducted, FIAD-15, with acceptable Alpha of 0.81. Results: Data were obtained from 1,060 subjects, including administrative, nursing and medical members of the Oncology Service staff, as well as, students. Out of these, 1,036 subjects answered the questionnaire appropriately and were considered in the analysis. 413 (39.86%) presented Burnout. The prevalence was higher in men (45.17%) than in women (34.56%). A significant association was found between Burnout frequency and levels of mental functioning. On the functionality of the mental structures, 80% had functional, high and intermediate levels, while 20% of the total population showed a borderline level of functionality (severe). In women, Burnout frequency was higher in borderline levels, followed by those of functional and high level. In men, Burnout was higher in those at the borderline level, followed by functional and intermediate; it was much lower in high level subjects. Conclusions: The mental structure functionality levels found in the oncology staff are associated with Burnout; which is lower in men with structures with high functionality and in women in the intermediate level. Subjects with borderline structures suffer greater Burnout. Further studies should be carried out to support these findings in the future and open new lines of research.
e15536 Background: Squamous cell carcinoma and adenocarcinoma represent approximately 95% of malignant tumors of the esophagus. For most cases of the 20th century, squamous cell carcinoma was the predominant lineage. In the 1960s, squamous cell carcinoma accounted for more than 90% of all esophageal tumors in the United States of America, and adenocarcinoma was considered so uncommon that some oncological associations questioned its existence. However over time the incidence of esophageal adenocarcinoma (predominantly in the distal esophagus and gastroesophageal junction) has increased dramatically in Western countries, with adenocarcinoma now causing more than 60% of all esophageal cancers in the United States of America, unlike the rest of the world, where squamous cell carcinoma continues to predominate. Squamous cell carcinoma and adenocarcinoma differ in a significant number of clinical features, including tumor location and predisposing factors. Smoking and alcoholism are major risk factors for the development of squamous cell carcinoma, while the Barrett's esophagus with intestinal metaplasia (a complication of gastroesophageal reflux disease), obesity, and smoking are the risk factors related to adenocarcinoma of the esophagus. Objectives: To determine the incidence of esophageal adenocarcinoma in Mexico and its main characteristics, such as epidemiology, histological type and main risk factors. Methods: A descriptive analysis was conducted in which the histological type, age of diagnosis, location, age of the patients and risk factors were compared. Results: Average age on the studied population was 67.4 years (minimum 37, maximum 91); 74.3% of the subjects were male and 20.4%, female. It was found that the predominant histological type was Adenocarcinoma in 40.7% against 28.3% of the Epidermoid. Average age of diagnosis was at 65.88 years (minimum 37, maximum 89). In frequency of localization, lower third in 22.1%, union GE in 20.4%, middle third in 15%, and upper third in 12.4%). The predominant risk factors in our study were smoking (31%), alcoholism (36.3%) and GERD (12.4%). Conclusions: Oesophageal adenocarcinoma continues to be the most prevalent presentation of esophageal cancer in our population, despite epidemiological changes over time.
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