e19505 Background: NHL was the 6th leading cause of cancer among USA Hispanics from 2005-2009. There is limited literature about lymphoma among Hispanics outside USA. The goal of this study is to assess the incidence, trends, survival and histological distribution in a population of Puerto Ricans and compare the results with USA. We report data on 3,184 pts diagnosed with lymphoma from the PR Cancer Center Registry during 2004-2009. Methods: Rates of sex-specific, age-adjusted incidence (AAIR) with 95% CI were estimated and standardized by age-adjustment according to the world standard population. The annual percent change (APC) using joint point regression analysis was determined. Data was compared with the SEER Cancer Statistic Review (1975-2009). Results: NHL comprises 82% of lymphomas in PR. As in USA it is the 6th most common cancer in males and the 7th in females. AAIR per 100,000 for NHL in PR was lower as compared to USA: 11.8 for males in PR vs 23.2 in USA, while for females it was 9.8 in PR vs 16.2 in USA. Despite a lower AAIR, there was an increase of 3.2% APC in NHL for PR during 2004-09. When analyzed according to gender, this rise was attributed only to females: 6.3% increase vs 0.5% in males. In contrast, in USA a decreasing trend in APC (-0.8%) was seen for females. B cell lymphomas in PR comprise 92% of NHL and 90% in USA. DLBCL represents 53% of all B cell-NHL in PR which is markedly higher than the 28% reported in USA. Follicular NHL in PR represents 22% of all NHL, in contrast to 32% in USA. There is a noticeable difference in the distribution of T cell lymphoma subtypes in PR as compared with USA, with a higher number of cases of anaplastic large cell and cutaneous T cell lymphomas and a lower frequency of angioimmunoblastic T cell lymphomas in PR. In terms of relative survival rate (RSR), our results are comparable to USA. Follicular NHL has a 5 year RSR of 74% in PR vs 75% in USA and DLBCL has a 5 year RSR of 47% in PR, vs 50% RSR in USA. Conclusions: Despite a lower AAIR, a significant increasing trend of NHL was observed in PR and we determined this to be exclusively observed among females. We also identified marked differences between the distribution of histologic subtypes of NHL in PR and USA. We plan to assess which histologic subtypes are increasing and in which regions of the island.
RESUMENFundamento: Se describe un brote de gastroenteritis por Salmonella Enteritidis, fagotipo 1, declarado en una residencia de ancianos de Burgos el 15 de noviembre de 1999. El objetivo de la investigación del brote ha sido determinar la fuente de infección, el mecanismo de transmisión y proponer las medidas adecuadas para evitar la recurrencia del problema.Métodos: Se ha realizado un estudio observacional de cohortes retrospectivo encuestando a 106 de un total de 119 residentes y a 9 trabajadores del centro. Se ha estimado el Riesgo Relativo de enfermar en función del consumo de diversos alimentos. Se ha utilizado la Regresión Logística para calcular las odds ratio ajustadas por edad, sexo y por el consumo de alimentos y vino. Se ha estudiado la concordancia del diagnóstico clí-nico frente al diagnóstico por coprocultivo mediante el índice de concordancia Kappa de Cohen.Resultados: Un total de 42 personas refirieron sintomatología (37 residentes y 5 empleados). La tasa de ataque clínico fue de 36,5 %. De 91 coprocultivos realizados (82 en residentes y 9 en empleados) 45 resultaron positivos (41 en residentes y 4 en empleados). La Tasa de ataque de casos confirmados por coprocultivo fue de 49,5% en los investigados. La leche frita ha sido el alimento implicado epidemiológicamente con la aparición del brote: RR: 3,25 (IC95% 1,10-9,59). El efecto protector del vino (Odds Ratio: 0,68) no alcanzó significación estadística (p=0,36). El índice Kappa resultó 0,43 (p < 0,001), lo que demuestra la escasa concordancia del diagnóstico clínico frente al diagnóstico mediante coprocultivo.Conclusiones: Existe evidencia epidemiológica de que el consumo de leche frita ha sido el mecanismo de transmisión de la infección, y la conservación a temperatura inadecuada del alimento ha sido el factor contribuyente determinante en la eclosión del brote. Esto demuestra que lo más idóneo para prevenir este tipo de brotes son las prácticas y hábitos higiénicos por parte de todos los implicados en el sector alimentario.Palabras Clave: Toxiinfecciones alimentarias. Brotes epidémicos. Salmonella enteritidis. Ancianos.
No abstract
e19510 Background: MZL is an indolent NHL composed of 3 subtypes: extranodal (MALT), splenic marginal zone (SMZL) and nodal marginal zone (NML). While MALT usually presents with early stage, the others frequently present with advanced disease. Early stage MALT is usually treated with XRT or antibiotics with ~85-90% failure free survival (FFS) and overall survival (OS), while for SMZL watch and wait or splenectomy (Spl) have been the mainstay of therapy. Spl leads to improvement but rarely to CR. 5 yr FFS and OS with Spl have been 45% and 80%. At 10 yrs FFS and OS are 22% and 62%. NML is usually managed with watch and wait. The 5 yr FFS and OS for NML have been 30% and 60%. Watch and wait and Spl are used in part because advanced MZL is considered incurable. Rituximab (R) as well fludarabine (F) are active in this disorder but traditionally are given after relapse. Methods: Instead of watch and wait or Spl, we have used upfront chemo with curative intent for SMZL and NML as well as for advanced MALT. For early stage MALT we used either XRT alone or antibiotics. We hereby report on 44 pts with MZL of which 31 were MALT, 9 SMZL, 4 NMZL. For the purpose of analysis we divided the pts in 2 groups. Group 1 consists of 22 early stage MALT who were all treated with either XRT (N=17) or antibiotics +/- surgery (N=5). Group 2 consists of 22 cases who were treated with chemo alone. This group is made up of 9 MALT (4 advanced stage, 3 early stage but with transformation, 2 early stage but in whom XRT was contraindicated), 9 advanced stage SMZL, 4 NML. Chemo for group 2 consisted of F, mitoxantrone, dexamethasone, rituximab (FND-R) (N=14) or R-CHOP (N=8). Maintenance R was used in 70% of group 2. Results: Of the whole group, 100% were CR and only 2 relapsed at 70 and 75 months; both relapses were stage I MALT and had received XRT only. Both were salvaged with FND-R and remain NED 27 and 39 months from relapse. At 10 yrs, FFS was 80% and OS=100%. None of the 22 in group 2 have relapsed. The long-term toxicity has been acceptable. Conclusions: The excellent FFS and OS using upfront chemotherapy in group 2, suggests that this disorder is curable and our results should be confirmed in a prospective trial. For those with early stage MALT, XRT alone +/- antibiotics and when necessary salvage with FND-R, should be tested.
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