<p>La manera en que las personas y grupos explican la pobreza condiciona cómo se relacionan con ella. El presente trabajo indaga las explicaciones sobre el origen de la pobreza de estudiantes universitarios y analiza la relación de este posicionamiento con su área de formación profesional. Se administró un instrumento de evaluación que considera tres tipos de atribuciones -individualista, socioestructural y fatalista- a una muestra de 448 estudiantes universitarios avanzados de nueve carreras de ciencias sociales, con edades entre 19 y 42 años (<em>M</em> = 22,92; <em>DT</em> = 3,12). Los resultados obtenidos indican importantes variaciones en las explicaciones de la pobreza según área de formación profesional. Estudiantes de ciencias económicas enfatizaron la importancia de los factores individuales, estudiantes de psicología y abogacía tendieron a explicaciones mixtas y estudiantes de sociología mostraron una amplia preferencia por las causas socioestructurales. Se discuten las implicancias de los procesos atribucionales en las actuaciones de estos futuros profesionales hacia poblaciones en desventaja económica.</p>

Introduction It is increasingly recognized that transformed (T) diffuse large B cell lymphoma (DLBCL) is a clinically and biologically distinct entity from de novo DLBCL. Dose escalated etoposide, doxorubicin, vincristine, cyclophosphamide and prednisone with rituximab (DA-EPOCH-R) is effective in aggressive large B cell lymphomas including de novo DLBCL, Burkitt lymphoma, high grade B cell lymphoma with BCL2-Myc rearrangement and primary mediastinal B cell lymphoma. However, outcomes of transformed DLBCL (T-DLBCL) treated with DA-EPOCH-R are not well-studied. Here, we describe our experience with T-DLBCL after treatment with DA-EPOCH-R. Methods All adult patients with DLBCL diagnosed and treated with DA-EPOCH-R at Medstar Washington Hospital Center from January 2000 to November 2018 were included in this retrospective study. Data was collected from review of electronic medical records. All transformations were biopsy-proven. T-DLBCL was defined as either biopsy-confirmed DLBCL with background of indolent lymphoma (concurrently transformed (CT) DLBCL) or sequential development of DLBCL in a case of known indolent lymphoma (sequentially transformed, (ST) DLBCL). Patient characteristics including age, sex, race were recorded. Stage, extranodal disease, international prognostic index (IPI) of DLBCL were recorded. For patients with CT and ST DLBCL, histology and prior treatment of indolent lymphoma were recorded. Study objectives were to assess response rates, progression free survival (PFS) and overall survival (OS) for de novo DLBCL, CT-DLBCL and ST-DLBCL treated with DA-EPOCH-R. Fisher's exact test was used to compare categorical variables between the groups. Kaplan-Meier method was used to calculate survival curves. Log rank test was used to compare survival between de novo DLBCL, CT-DLBCL and ST-DLBCL. Results Of 183 DLBCL patients treated during the study period, 34 had T-DLBCL (17 CT-DLBCL and 17 ST-DLBCL). Total 91 received DA-EPOCH-R (25 transformed, 66 de novo) and were included in our study. Median age was 56 (23-84). Sixty percent patients were males and 42% were white. Out of 25 Tx DLBCL, 11 had CT-DLBCL and 14 had ST-DLBCL. Patients with T-DLBCL (CT and ST) had higher odds of being white, having advanced stage, extra-nodal disease and high IPI. [OR: 2.6 (CI951.7-6), 4.1 (CI951.6-10), 2.8 (CI95 2.8 (1.8-7) and 2.7 (CI951.2-6), respectively. P &lt;0.001]. Cell of origin, BCL2 and BCL6 expression was not available for all DLBCL patients. Follicular lymphoma was the most common underlying indolent lymphoma (13), followed by chronic lymphocytic leukemia (5), marginal zone lymphoma (3), low grade non-Hodgkin lymphoma not otherwise specified (3) and lymphoplasmacytic lymphoma (1). Seven of T-DLBCL had received prior rituximab and 2 had received prior anthracycline. For ST-DLBCL patients, median time to transformation was 2.25 years (0.3-15). There was no significant difference in ORR (85%, 86%, 91%) and CR (82%, 84%, 89%) of DA-EPOCH-R treated CT, ST and de novo DLBCL, respectively. Median follow up was 5 years. Median PFS and OS for CT and de novo DLBCL were not reached. ST DLBCL had median PFS and OS of 21 years and 37 years, respectively. There was no significant difference between 2-year PFS and OS of CT, ST and de novo DLBCL treated with DA-R-EPOCH. (Table 1). Conclusion T-DLBCL is more likely to have aggressive features such as advance stage, extra nodal disease and high IPI. Despite this, DA-EPOCH-R treated T-DLBCL has outcomes comparable to de novo DLBCL. Large, prospective studies are needed to examine efficacy of DA-EPOCH-R in T-DLBCL. Figure. Disclosures No relevant conflicts of interest to declare.

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Background:Uterine fibroids, also called leiomyomas, are diagnosed in over two-third of females of reproductive age; about a quarter warrant treatment. Venous thromboembolism (VTE) is a challenging complication in patients with fibroids due to the increased risk of bleeding with anticoagulation, especially in the setting of associated menorrhagia. The incidence of deep vein thrombosis (DVT) is increased with higher uterine weight which may be related to the extrinsic venous compression of the iliac veins or the inferior vena cava. However, there is reported discordance between the site of uterine fibroid and the site of the DVT along with pulmonary embolism (PE) without evidence of lower extremity DVT suggesting an underlying hypercoagulable state that is more complex than mere hormonal and mechanical factors. Data regarding VTE in patients with uterine fibroids in the US is sparse and is limited to case reports. We performed a retrospective case control study to describe the rate and associated risk factors of VTE in patients with uterine fibroids. Objectives:Evaluate the incidence of VTE events in patients with uterine fibroids and explore trends and associations. Methods:A retrospective chart review of patients at our single, academic, DC metropolitan hospital was conducted. Patients were identified using electronic medical records via ICD-10 codes. Those seen as an inpatient or outpatient in our tertiary care fibroid center with a new diagnosis of uterine fibroids between January 1, 2015, and December 31, 2019 were included and compared to age matched controls of patients with uterine fibroids without VTE in a 1:2 ratio. Statistical analysis was reported as means and medians for descriptive data. Pearson's correlation was performed to determine associations. Results:A total of 6095 patients were diagnosed with uterine fibroids in 5 years, of which 2.2% (n=139) were found to have VTE after the diagnosis of uterine fibroid was made (see table 1). Of the patients with VTE, 88 had DVTs,63 had PE and 12 developed both DVT and PE. The mean age at diagnosis of VTE was 54 (SD=14.95) years. The majority of the patients in the VTE group were African Americans (86%) and mean BMI was 34.52 (SD =9.53), of which about 2/3 were obese or morbidly obese. Average weight of fibroid(s) for those who underwent surgical resection who had available records was noted to be 321 grams (n=11). Data regarding anticoagulation was available for 78% of the patients; the anticoagulant of choice being enoxaparin in 59%, warfarin in 9% and DOACs in 10% of the patients. Two Hundred and thirty-six age matched controls were identified. Statistically significant associations with BMI, race and comorbidities (including atrial fibrillation, congestive heart failure, diabetes, hypertension, HIV, pregnancy and cancer) were found in cases when compared to the control population. Furthermore, cases were found to have a lower mean hemoglobin (10.4 mg/dL) and higher platelet count (311,000/microL) which were statistically significant (p=0.0003). The use of non-steroidal anti-inflammatory drugs and iron supplementation was significantly more in cases than controls. D-dimer and ferritin levels seemed to trend higher and iron saturation lower in cases than controls but were not found to be statistically significant. Conclusions:VTE was found in 2.2% of patients with uterine fibroids, which is higher than the reported VTE incidence of 1-2 per 1000 in the general population. A significant association was found with race, which is consistent with literature that suggests African American patients have a higher rate of incident VTE and also comorbid conditions. Women with low hemoglobin and higher platelet count were more likely to experience VTE. The next steps include understanding more associations, laboratory and clinical, that will assist in risk stratification and tailoring management. Future prospective studies to recognize biomarkers that contribute the hypercoagulable state of uterine fibroids is warranted. Disclosures Morozov: Medtronic:Consultancy;Lumenis:Speakers Bureau;AbbVie:Speakers Bureau.Fitzpatrick:Pfizer:Honoraria.

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