Hermanos Ameijeiras Hospital

This study critically evaluates the outcomes of the first Asynchronous Virtual Course organized by the Latin American Association of Medical Physics (ALFIM), titled “Reference Levels for Diagnosis in Nuclear Medicine”, designed for professionals in the field, comprised both theoretical and practical components. The teaching outcomes were analyzed quantitatively and qualitatively, digital tracking of participant engagement in the pre-recorded theoretical activities on YouTube, as well as the results of the theoretical (Google questionnaire) and practical (exercise and report) formative assessments. Additionally, a quality survey was also conducted to gather participants’ opinions on various aspects of the course. The course had 315 participants from 21 countries. 99 completed the theoretical evaluation with 100% achieving satisfactory results. 43 participants finished the planned practical activities, demonstrating the application of acquired competencies. The quality survey, completed by 40 attendees, indicated that 68% considered this type of course entirely feasible and beneficial, 17% deemed it very feasible, and 15% found it sufficiently feasible. The survey also identified areas for improvement. The strategy for developing virtual courses using YouTube and Google tools is viable and effective for establishing continuous education programs in the region.

Abstract Introduction: Non-melanoma skin cancer is the most common tumor. The combination of IFN-alpha 2b and IFN-gamma has been used as a new therapeutic opportunity to treat basal cell carcinomas and cutaneous squamous cell carcinomas. The aim of this report is to record prospectively the recurrence and new lesions rates in patients participating in phase II clinical trials. Methods Phase II clinical trials (double-blind randomized one center study, InCarbacel-III, in patients with basal cell carcinoma; and open, non-randomized multicenter study, CECIN, in patients with cutaneous squamous cell carcinomas, with the use of the combination of IFN-alpha 2b and IFN-gamma) were conducted to evaluate the efficacy, safety and the 5-year duration of clinical responses. Both studies were approved by institutional ethics committees, from the Hermanos Ameijeiras (INCARBACEL-III) and Amalia Simoni (INCARBACEL-III and CECIN) hospitals, in Havana and Camaguey respectively. All patients gave their written informed consent to participate in them. The investigational treatment was administered, peri- or intralesionally, three times per week, during 3 weeks. Clinical (RECIST 1.0) responses were evaluated three months after the end of treatment. Results The combination of IFNs in InCarbacel-III study showed the best clinical response (complete response of 64.3%, overall response of 85.7%) with the highest doses (10.5 MIU); without patient’s recurrence at 5 years follow-up (3.5 MUI and 10.5 MUI groups). The frequency of new lesions decreased in the treated patients 8 times. In the CECIN study 14 patients achieved complete response and 4 partial responses (overall response rate 67%). Up to the 5-year follow-up none of the patients with complete response had recurrence or new lesion. In both studies the cosmetic results were excellent and the reported adverse events were mostly of mild intensity. Conclusions: The use of the combination of IFN-alpha 2b and IFN-gamma showed efficacy in basal cell carcinoma and cutaneous squamous cell carcinoma promoting a long term response for at least 5 years and decreasing the rate of new lesions, safely and with excellent cosmetic effects.

Abstract Background: Breast cancer (BC) is the most common malignancy and one of the leading causes of cancer death in women in Latin America (LATAM). Studies have highlighted the importance of understanding contextual characteristics of each patient population to inform health policy-making. However, few data are available on women from LATAM, a region with marked inequalities. Methods: LATINA (LACOG 0615/MO39485) is a multicenter prospective cohort study designed to describe sociodemographic characteristics, diagnosis, treatment, and outcomes of patients with BC in LATAM. Female and male patients aged ≥18 years newly diagnosed (i.e., < 12 months from research site activation) histologically confirmed clinical stage I-IV BC were enrolled. Eligible patients provided informed consent and had data collected from medical records at diagnosis and every 6 months up to 5 years. Results: Between February 2020 and August 2022, 3276 patients with BC from 31 research sites in 10 LATAM countries were included. Median age was 54 years (range 23–95), 91.8% (N=3008) were Hispanic or Latinos, the majority (68%, N=2224) were diagnosed with stage II or III BC, and 73% (N=2362) were treated in the public health system. Age, stage and detection method stratified by education level, marital status and employment status are shown in Table 1. Overall, 38.8% (N=1149) of patients had not completed high school. These patients were more frequently diagnosed by symptoms and diagnosed at later stages than those who had completed high school or college. Half of the patients were married/in a civil partnership at BC diagnosis (50.5%, N=1497). Unmarried patients were more commonly diagnosed by symptoms (71.7%, N=835 vs. 64%, N=916, p< 0.001) and with stage II/III BC (71.4%, N=868 vs. 67.6%, N=1038, p< 0.001) than married patients. Most patients (54.1%, N=1603) were not employed at BC diagnosis. Patients not employed were more frequently diagnosed by symptoms (68.8%, N=1044) than employees/self-employed (61.6%, N=675). After adjusting for age, country, health care provision (public or private), stage, and BC subtype, being diagnosed by symptoms was associated with not being married (adjusted odds ratio [aOR] 1.41, 95% CI 1.11–1.82, p=0.004), being not employed (aOR 1.41, 95% CI 1.08–1.84, p=0.011), and not having completed high school (aOR 1.46, 95% CI 1.00–2.13, p=0.031). Conclusions: Patients with a lower level of education, unmarried and not employed, are more likely not to perform BC screening and to be diagnosed by symptoms. Socioeconomic characteristics impact the method of detection of BC in LATAM and are associated with diagnosis at later stages. Further analyses of the LATINA study will provide invaluable data for informing regional health policy-making in LATAM. Citation Format: Gustavo Werutsky, Cynthia Villarreal-Garza, Henry Gómez, Juan Manuel Donaire, José Bines, Luis Henrique Fein, Maria Clara Horsburgh, Paula Cabrera-Galeana, Heloísa Resende, Rosa Vasallo Veras, Miriam Raimondo, Ricardo Elías Brugés Maya, Vidal Maria Del Rosario, Yeni Nerón, Ana Maria Donoso, Fernanda B. Damian, José D'Oliveira, Couto Filho, Maria Isabel Alonso, Victoria Costanzo, Tomás Reinert, Adriana Elizabeth Borello, Eduardo Cronenberger, Luis Fein, Marcela Urrego, Enrique Alanya, Jorge Luis Soriano García, Saúl Campos-Gomez, Eduardo A. Richardet, Hugo Castro-Salguero, Felipe Cruz, Diego Gómez, Angel Hernández, Carlos Alberto Farfan Tello, Ronald Rodríguez, Rafaela Jesus, Gustavo Gössling, Carlos Barrios. The Impact of Socioeconomic Factors on Breast Cancer Diagnosis in Latin America: The LATINA study (LACOG 0615/MO39485) [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-10-05.

Em equipamentos híbridos, tanto a dose de radiação quanto a qualidade da imagem envolvem o envolvimento de ambos os componentes. Este trabalho teve como objetivo avaliar a qualidade da imagem clínica do híbrido SPECT/CT CT através de parâmetros físicos como ruído, razão de contraste do ruído (RCR) e resolução espacial através da largura a meia altura (FWHM) da Função de Dispersão Linear (LDF), obtido a partir da função de dispersão da borda (LDF) de importantes estruturas anatômicas do tórax. Parâmetros relacionados à dose do componente CT e principalmente a estimativa de dose de espessura específica do paciente (SSDE) também foram estudados. Para isso, 20 estudos clínicos de TC híbrida foram processados com uma ferramenta de desenvolvimento local. O SSDE variou de 2,6-23,6mGy. O ruído típico das diferentes estruturas ficou na faixa de 2,1-42,3% entre os diferentes pacientes, mostrando padrões muito diferentes entre as várias estruturas, uma vez que órgãos como os pulmões e o esôfago apresentam um ruído médio inferior a 5%. O conjunto de RCRs apresentou diferenças significativas entre os estudos, com variação entre 1 e 57. A faixa de variação da FWHM estimada para uma mesma estrutura de borda, nos diferentes estudos, varia entre 14,8-50,5%, mostrando diferenças significativas entre si. A média de SSDE e FWHM para cada estudo mostrou um índice de correlação de Pearson significativo de -0,454 (p=0,045). Conclusões: SSDE foi inversamente correlacionado com alguns dos descritores de qualidade de imagem estudados. Estimar o FWHM, em um cenário clínico, a partir da função de dispersão de bordas, é viável e mostrou a capacidade de detectar particularidades das imagens que poderiam descrever aspectos de sua qualidade.

Molecular biology screening techniques for early detection of human papillomavirus (HPV) infection in the National CervicalUterine Cancer Program in Cuba provide the opportunity to treat premalignant lesions and prevent progression to cervicaluterine cancer. Objectives: To identify 14 high-risk HPV genotypes in women aged 30 to 50 with negative previous cytology and to identify the polymorphism of killer immunoglobulin-like receptor (KIR) genes in a subsample of HPV-positive women. Methods: HPV screening tests were performed on 3,115 women using the COBAS 4800 system with the HPV COBAS kit (Roche, Germany). For KIR gene typing, 60 randomly selected HPV-positive women were analyzed using a molecular method based on hybridization probes on a LUMINEX flow analyzer with the LIFECODES KIR-SSO typing kit (Immucor, USA). Results: 295 (9.5%) women tested positive for one of the 14 high-risk genotypes. The highest percentage of positive women was found among those aged 30 to 39 years (12.0%). Fourteen women had coinfection with HPV16 or HPV18 along with another highrisk genotype. There was a high frequency of genes encoding activating receptors such as KIR 2DL1 (98.3%), KIR 2DL3 (98.3%), and KIR 2DS4*all full length (93.3%). Conclusions: The prevalence of HPV in Cuban women with normal cytology is lower than the global average, with activating KIR genes predominating among positive cases.

Objetivo: Aplicar el proceso de atención de enfermería (PAE) en el personal de enfermería con síndrome de burnout (SB). Caso clínico: Modelo de adaptación de Roy, basado en la concepción del ser humano como individuo biopsicosocial en constante interacción con su entorno cambiante del que recibe estímulos que deben adaptarse para conservar la salud. Métodos: Se describieron las características más importantes del síndrome de burnout como un problema de salud. Se hizo un análisis y síntesis de la información y se aplicó el PAE. Resultados: Los resultados después de la intervención mostraron cambios eficaces en procesos adaptativos y en las dimensiones de calidad de vida. Conclusiones: Se reconoce la necesidad de aplicación del PAE en intervenciones de cuidado a las respuestas humanas que influyan en mejorar la calidad de vida a personas con síndrome de burnout.