Background: High-grade osteosarcoma is the most common malignant bone tumor in children and adolescents. This study aimed to evaluate the histologic response to neoadjuvant chemotherapy and overall and event-free survival rates in patients < 21 years of age with a diagnosis of conventional osteosarcoma. Methods: We conducted an analytical and observational study of a cohort of patients < 21 years old with a diagnosis of conventional osteosarcoma treated with the OS INC-2009 protocol (based on EURAMOS-1). Descriptive analysis was performed, and overall and event-free survival rates were calculated by the Kaplan-Meier method. Results: Between April 2009 and October 2016, 84 patients with conventional osteosarcoma (mean age 13.5 ± 3.2 years) were admitted. Metastatic disease at diagnosis was observed in 36 patients (42.8%). Of the 41 patients who received neoadjuvant chemotherapy (50.6%), 15 (36.6%; confidence interval [95%CI]: 49.9-75.6) were classified as good responders and 26 (63%; 95%CI: 22.5-58.0) as poor responders. The 5-year overall and event-free survival rates in good responders were ; in poor responders it was 66. , respectively. Conclusions: Good responders' evaluation of histologic response to neoadjuvant chemotherapy showed improved overall and event-free survival rates. Specialized centers with multidisciplinary and comprehensive management are required to make the application of high-toxicity protocols feasible.
e18764 Background: Reliable, timely and detailed information of lung cancer mortality and costs from low- and middle-income countries is essential to policy design. We aimed to develop an electronic algorithm to identify lung cancer prevalent patient in Colombia using official databases and to estimate prevalence rates by age, sex, and geographic region. Methods: We performed a cross sectional study based on national claim databases in Colombia ( Base de datos de suficiencia de la Unidad de Pago por Capitación and Base de Datos Única de Afiliados) to identify lung cancer prevalent patients in 2017. Several algorithms based on the presence or absence of oncological procedures (Chemotherapy, radiotherapy and surgery), and a minimum number of months that each individual had lung cancer ICD-10 codes in the previous 3 years, were developed. After testing 16 algorithms, those with the closest prevalence rates to the ones reported by aggregated official sources (GLOBOCAN, National Cancer Institute and Cuenta de Alto Costo) were selected . We estimated prevalence rates by age, sex, and geographic region. Results: Two algorithm s were selected: i) it was defined as the presence of ICD-10 codes for 4 months or more (sensitive algorithm); and ii) adding the presence of at least one oncological procedure (specific algorithm). Estimated prevalence rates per 100,000 population were 15.3 and 9.7 for the sensitive and specific algorithms, respectively. These rates were higher in men (9.9), over 65 years old (37.1), who lived in Central and Bogota regions (14.7 and 10.9, respectively) (Table). Conclusions: Selected algorithms showed similar prevalence estimations to those reported by official sources and allowed us to estimate prevalence rates in specific aging, regional and gender groups for Colombia using national claims databases. These findings could be useful to identify clinical and economical outcomes related to lung cancer patients using national individual-level databases. [Table: see text]
Introducción. La hipocalcemia es la complicación más frecuente de la tiroidectomía. La profilaxis con calcio/ calcitriol es una alternativa costo-efectiva, sencilla y expedita para disminuir esta situación, sin alterar la función paratiroidea residual. Lo que no está claro es si hay superioridad de una dosis frente a otra, por lo que el objetivo de este estudio fue evaluar el comportamiento entre diferentes esquemas de profilaxis para hipocalcemia. Métodos. Estudio de cohorte retrospectivo de adultos operados en un hospital de cuarto nivel, entre febrero de 2017 y diciembre de 2020. Se calculó la tasa de síntomas, la hipocalcemia e hipercalcemia bioquímica en el control postquirúrgico durante las siguientes dos semanas. Se hizo análisis bivariado y multivariado entre dosis de calcio/ calcitriol, otros factores asociados y los desenlaces mencionados. Resultados. Se incluyeron 967 pacientes. El 10 % presentaron síntomas. No hubo diferencias significativas en el calcio sérico del control posquirúrgico entre los grupos con distintas dosis de calcio. La dosis de carbonato de calcio >3600 mg/día y el calcio en las primeras 24 horas de cirugía se asociaron a la presencia de síntomas. La dosis de calcitriol <1 mcg/día y el bocio aumentaron el riesgo de hipocalcemia bioquímica, mientras que la dosis de 1,5 mcg/día lo disminuyó. Ninguna variable evaluada se asoció a hipercalcemia bioquímica. Conclusiones. Teniendo en cuenta los resultados observados con las dosis de calcio y calcitriol, sugerimos iniciar la profilaxis con un esquema de 3600 mg/día de carbonato de calcio y 1,5 mcg/día de calcitriol. Sin embargo, esta dosis debe modificarse en situaciones como bocio o calcio sérico temprano anormal, que fueron las variables asociadas a mayor riesgo en nuestro estudio.
Reliable, timely and detailed information on lung cancer prevalence, mortality and costs from middle-income countries is essential to policy design. Thus, we aimed to develop an electronic algorithm to identify lung cancer prevalent patients in Colombia by using administrative claims databases, as well as to estimate prevalence rates by age, sex and geographic region. We performed a cross-sectional study based on national claim databases in Colombia (Base de datos de suficiencia de la Unidad de Pago por Capitación and Base de Datos Única de Afiliados) to identify lung cancer prevalent patients in 2017, 2018 and 2019. Several algorithms based on the presence or absence of oncological procedures (chemotherapy, radiotherapy and surgery) and a minimum number of months that each individual had lung cancer ICD-10 codes were developed. After testing 16 algorithms, those with the closest prevalence rates to those rates reported by aggregated official sources (Global Cancer Observatory and Cuenta de Alto Costo) were selected. We estimated prevalence rates by age, sex and geographic region. Two algorithms were selected: i) one algorithm that was defined as the presence of ICD-10 codes for 4 months or more (the sensitive algorithm); and ii) one algorithm that was defined by adding the presence of at least one oncological procedure (the specific algorithm). The estimated prevalence rates per 100,000 inhabitants ranged between 11.14 and 18.05 for both, the contributory and subsidized regimes over years 2017, 2018 and 2019. These rates in the contributory regime were higher in women (15.43, 15.61 and 17.03 per 100,000 for years 2017, 2018 and 2019), over 65-years-old (63.45, 56.92 and 61.79 per 100,000 for years 2017, 2018 and 2019) who lived in Central, Bogota and Pacific regions. Selected algorithms showed similar aggregated prevalence estimations to those rates reported by official sources and allowed us to estimate prevalence rates in specific aging, regional and gender groups for Colombia by using national claims databases. These findings could be useful to identify clinical and economical outcomes related to lung cancer patients by using national individual-level databases.
La nefrectomía laparoscópica en donante vivo es la mejor opción en el proceso del trasplante para pacientes con enfermedad renal crónica en estadio cuatro y cinco. El objetivo del artículo es describir la experiencia en el programa de donante vivo de riñón entre el 2013 y el 2018 en Colombiana de Trasplantes en la costa Caribe colombiana. Se realizó un estudio descriptivo que incluyó una muestra consecutiva de 55 donantes vivos de riñón operados por Colombiana de Trasplantes, entre enero de 2013 y enero de 2018; se llevó a cabo el análisis estadístico de las variables relevantes. La media de la edad fue de 41 años. El 57,4% de los donantes fueron mujeres. El tiempo de cirugía tuvo una media de 1,9 horas. Ninguno de los pacientes falleció en el seguimiento a los seis meses y el promedio de la estancia hospitalaria posterior a la cirugía fue de dos días. Las variables relevantes y los desenlaces de los pacientes son similares a los de otros grupos de trasplantes, sin embargo, hay características específicas que pueden ayudar a mejorar las estrategias en salud en la costa Caribe colombiana.
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