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Impact of COVID-19 infection on patients with cancer: experience in a Latin American country: the ACHOCC-19 study / Alicia Quiroga Echeverri  

Público ISBD Título : Impact of COVID-19 infection on patients with cancer: experience in a Latin American country: the ACHOCC-19 study Tipo de documento : documento electrónico Autores : Alicia Quiroga Echeverri, Fecha de publicación : 2021 Títulos uniformes : The Oncologist Idioma : Inglés (eng) Palabras clave : Cancer  Covid-19  Latin America  mortality  survival Resumen : Introduction: The ACHOCC-19 study was performed to characterize COVID-19 infection in our oncological population. Methodology: Analytical cohort study of patients with cancer and COVID-19 infection in Colombia. From April 1 to October 31, 2020. Demographic and clinical variables related to cancer and COVID-19 infection were collected. The primary outcome was 30-day mortality from all causes. The association between the outcome and the prognostic variables was analyzed using logistic regression models and survival analysis with Cox regression. Results: 742 patients were included. 72% > 51 years. The most prevalent neoplasms were breast (132 [17,77%]), colorectal (92 12,34%), and prostate (81 [10,9%]). 220 (29,6%) patients were asymptomatic and 96 (26,3%) died. In the bivariate descriptive analysis, higher mortality in patients > 70 years, lung cancer, ≥2 comorbidities, former smokers, receiving antibiotics, corticosteroids, and anticoagulants, residents of rural areas, low socioeconomic status, and increased acute phase reactants. In the logistic regression analysis, higher mortality with ECOG 3 OR 28,67 (8,2-99,6), ECOG 4 OR 20,89 (3,36-129,7), two complications from COVID-19 OR 5,3 (1,50-18,1), and cancer in progression OR 02,08 (1,01-4,27). In the Cox regression analysis, the statistically significant HRs were metastatic disease HR 1,58 (1,16 - 2,16), cancer in progression HR 1,08 (1,24 - 2,61) vs partial response HR 0,31 (0,11 - 0,88), use of steroids HR 1,44 (1,01 - 2,06) and antibiotics HR 2,11 (1,47 - 2,95). Interpretations: In our study, cancer patients have higher mortality due to COVID-19 infection if they have active cancer, metastatic or progressive cancer, ECOG status >2 and low socioeconomic status. Implications for practice: Our findings raise the need to carefully evaluate patients with metastatic cancer, in progression, and with impaired ECOG to define the relevance of cancer treatment during the pandemic, consider the risk/benefit of the interventions, and establish clear and complete communication with the patients and their families about the risk of complications. There is also the importance of offering additional support to patients with low income and residence in rural areas so that they can have more support during cancer treatment. Mención de responsabilidad : Aylen Vanessa Ospina, Ricardo Bruges, William Mantilla, Iván Triana, Pedro Ramos, Sandra Aruachan, Alicia Quiroga, Isabel Munevar, Juan Ortiz, Néstor Llinás, Paola Pinilla, Henry Vargas, Henry Idrobo, Andrea Russi, Ray Manneh Kopp, Giovanna Rivas, Héctor González, Daniel Santa, Jesús Insuasty, Laura Bernal, Jorge Otero, Carlos Vargas, Javier Pacheco, Carmen Alcalá, Paola Jiménez, Milton Lombana, Fernando Contreras, Javier Segovia, Luis Pino, José Lobatón, Manuel González, Javier Cuello, Juliana Bogoya, Angela Barrero, Gilberto de Lima Lopes Jr Referencia : Oncologist. 2021 Oct;26(10):e1761-e1773. DOI (Digital Object Identifier) : 10.1002/onco.13861 PMID : 34132449 En línea : https://theoncologist.onlinelibrary.wiley.com/doi/10.1002/onco.13861 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5791 Impact of COVID-19 infection on patients with cancer: experience in a Latin American country: the ACHOCC-19 study [documento electrónico] / Alicia Quiroga Echeverri,  . - 2021. Obra : The Oncologist Idioma : Inglés (eng) Palabras clave : Cancer  Covid-19  Latin America  mortality  survival Resumen : Introduction: The ACHOCC-19 study was performed to characterize COVID-19 infection in our oncological population. Methodology: Analytical cohort study of patients with cancer and COVID-19 infection in Colombia. From April 1 to October 31, 2020. Demographic and clinical variables related to cancer and COVID-19 infection were collected. The primary outcome was 30-day mortality from all causes. The association between the outcome and the prognostic variables was analyzed using logistic regression models and survival analysis with Cox regression. Results: 742 patients were included. 72% > 51 years. The most prevalent neoplasms were breast (132 [17,77%]), colorectal (92 12,34%), and prostate (81 [10,9%]). 220 (29,6%) patients were asymptomatic and 96 (26,3%) died. In the bivariate descriptive analysis, higher mortality in patients > 70 years, lung cancer, ≥2 comorbidities, former smokers, receiving antibiotics, corticosteroids, and anticoagulants, residents of rural areas, low socioeconomic status, and increased acute phase reactants. In the logistic regression analysis, higher mortality with ECOG 3 OR 28,67 (8,2-99,6), ECOG 4 OR 20,89 (3,36-129,7), two complications from COVID-19 OR 5,3 (1,50-18,1), and cancer in progression OR 02,08 (1,01-4,27). In the Cox regression analysis, the statistically significant HRs were metastatic disease HR 1,58 (1,16 - 2,16), cancer in progression HR 1,08 (1,24 - 2,61) vs partial response HR 0,31 (0,11 - 0,88), use of steroids HR 1,44 (1,01 - 2,06) and antibiotics HR 2,11 (1,47 - 2,95). Interpretations: In our study, cancer patients have higher mortality due to COVID-19 infection if they have active cancer, metastatic or progressive cancer, ECOG status >2 and low socioeconomic status. Implications for practice: Our findings raise the need to carefully evaluate patients with metastatic cancer, in progression, and with impaired ECOG to define the relevance of cancer treatment during the pandemic, consider the risk/benefit of the interventions, and establish clear and complete communication with the patients and their families about the risk of complications. There is also the importance of offering additional support to patients with low income and residence in rural areas so that they can have more support during cancer treatment. Mención de responsabilidad : Aylen Vanessa Ospina, Ricardo Bruges, William Mantilla, Iván Triana, Pedro Ramos, Sandra Aruachan, Alicia Quiroga, Isabel Munevar, Juan Ortiz, Néstor Llinás, Paola Pinilla, Henry Vargas, Henry Idrobo, Andrea Russi, Ray Manneh Kopp, Giovanna Rivas, Héctor González, Daniel Santa, Jesús Insuasty, Laura Bernal, Jorge Otero, Carlos Vargas, Javier Pacheco, Carmen Alcalá, Paola Jiménez, Milton Lombana, Fernando Contreras, Javier Segovia, Luis Pino, José Lobatón, Manuel González, Javier Cuello, Juliana Bogoya, Angela Barrero, Gilberto de Lima Lopes Jr Referencia : Oncologist. 2021 Oct;26(10):e1761-e1773. DOI (Digital Object Identifier) : 10.1002/onco.13861 PMID : 34132449 En línea : https://theoncologist.onlinelibrary.wiley.com/doi/10.1002/onco.13861 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5791

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International and multicenter real‐world study of sorafenib‐treated patients with hepatocellular carcinoma under dialysis / Juan Ignacio Marín Zuluaga  

Público ISBD Título : International and multicenter real‐world study of sorafenib‐treated patients with hepatocellular carcinoma under dialysis Tipo de documento : documento electrónico Autores : Juan Ignacio Marín Zuluaga, Fecha de publicación : 2020 Títulos uniformes : Liver International Idioma : Inglés (eng) Palabras clave : Hepatocellular carcinoma  sorafenib  dialysis  adverse events  safety  survival Resumen : Background & Aims: Information on safety and efficacy of systemic treatment in patients with hepatocellular carcinoma (HCC) under dialysis are limited due to patient exclusion from clinical trials. Thus, we aimed to evaluate the rate, prevalence, tolerability, and outcome of sorafenib in this population. Methods: We report a multicenter study comprising patients from Latin America and Europe. Patients treated with sorafenib were enrolled; demographics, dose modifications, adverse events (AEs), treatment duration, and outcome of patients undergoing dialysis were recorded. Results: As of March 2018, 6156 HCC patients were treated in 44 centres and 22 patients were concomitantly under dialysis (0.36%). The median age was 65.5 years, 40.9% had hepatitis C, 75% had Child‐Pugh A, and 85% were Barcelona Clinic Liver Cancer‐C. The median time to first dose modification, treatment duration and overall survival rate were 2.4 months (interquartile ranges [IQR], 0.8‐3.8), 10.8 months (IQR, 4.5‐16.9), and 17.5 months (95% CI, 7.2‐24.5), respectively. Seventeen patients required at least 1 dose modification. The main causes of first dose modification were asthenia/worsening of Eastern Cooperative Oncology Group‐Performance Status and diarrhoea. At the time of death or last follow‐up, four patients were still on treatment and 18 had discontinued sorafenib: 14 were due to tumour progression, 2 were sorafenib‐related, and 2 were non‐sorafenib‐related AE. Conclusions: The outcomes observed in this cohort seem comparable to those in the non‐dialysis population. Thus, to the best of our knowledge, this is the largest and most informative dataset regarding systemic treatment outcomes in HCC patients undergoing dialysis. Mención de responsabilidad : Álvaro Díaz-González, Marco Sanduzzi-Zamparelli, Leonardo G da Fonseca, Giovan G Di Costanzo, Rogerio Alves, Massimo Iavarone, Cassia Leal, Rodolfo Sacco, Ana M Matilla, Manuel Hernández-Guerra, Gabriel Aballay Soteras, Marcus-Alexander Wörns, Matthias Pinter, María Varela, Morten Ladekarl, Aline L Chagas, Beatriz Mínguez, Juan I Arenas, Alessandro Granito, Yolanda Sánchez-Torrijos, Ángela Rojas, Carlos Rodríguez de Lope, Mario R Alvares-da-Silva, Sonia Pascual, Lorenza Rimassa, José L Lledó, Carlos Huertas, Bruno Sangro, Edoardo G Giannini, Manuel Delgado, Mercedes Vergara, Christie Perelló, Alberto Lue, Margarita Sala, Adolfo Gallego, Susanna Coll, Tania Hernáez, Federico Piñero, Gustavo Pereira, Alex França, Juan Marín, Margarita Anders, Vivianne Mello, Mar Lozano, Jean C Nault, Josemaría Menéndez, Ignacio García Juárez, Jordi Bruix, María Reig Referencia : Liver Int. 2020 Jun;40(6):1467-1476. DOI (Digital Object Identifier) : 10.1111/liv.14436 PMID : 32170821 En línea : https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.14436 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5102 International and multicenter real‐world study of sorafenib‐treated patients with hepatocellular carcinoma under dialysis [documento electrónico] / Juan Ignacio Marín Zuluaga,  . - 2020. Obra : Liver International Idioma : Inglés (eng) Palabras clave : Hepatocellular carcinoma  sorafenib  dialysis  adverse events  safety  survival Resumen : Background & Aims: Information on safety and efficacy of systemic treatment in patients with hepatocellular carcinoma (HCC) under dialysis are limited due to patient exclusion from clinical trials. Thus, we aimed to evaluate the rate, prevalence, tolerability, and outcome of sorafenib in this population. Methods: We report a multicenter study comprising patients from Latin America and Europe. Patients treated with sorafenib were enrolled; demographics, dose modifications, adverse events (AEs), treatment duration, and outcome of patients undergoing dialysis were recorded. Results: As of March 2018, 6156 HCC patients were treated in 44 centres and 22 patients were concomitantly under dialysis (0.36%). The median age was 65.5 years, 40.9% had hepatitis C, 75% had Child‐Pugh A, and 85% were Barcelona Clinic Liver Cancer‐C. The median time to first dose modification, treatment duration and overall survival rate were 2.4 months (interquartile ranges [IQR], 0.8‐3.8), 10.8 months (IQR, 4.5‐16.9), and 17.5 months (95% CI, 7.2‐24.5), respectively. Seventeen patients required at least 1 dose modification. The main causes of first dose modification were asthenia/worsening of Eastern Cooperative Oncology Group‐Performance Status and diarrhoea. At the time of death or last follow‐up, four patients were still on treatment and 18 had discontinued sorafenib: 14 were due to tumour progression, 2 were sorafenib‐related, and 2 were non‐sorafenib‐related AE. Conclusions: The outcomes observed in this cohort seem comparable to those in the non‐dialysis population. Thus, to the best of our knowledge, this is the largest and most informative dataset regarding systemic treatment outcomes in HCC patients undergoing dialysis. Mención de responsabilidad : Álvaro Díaz-González, Marco Sanduzzi-Zamparelli, Leonardo G da Fonseca, Giovan G Di Costanzo, Rogerio Alves, Massimo Iavarone, Cassia Leal, Rodolfo Sacco, Ana M Matilla, Manuel Hernández-Guerra, Gabriel Aballay Soteras, Marcus-Alexander Wörns, Matthias Pinter, María Varela, Morten Ladekarl, Aline L Chagas, Beatriz Mínguez, Juan I Arenas, Alessandro Granito, Yolanda Sánchez-Torrijos, Ángela Rojas, Carlos Rodríguez de Lope, Mario R Alvares-da-Silva, Sonia Pascual, Lorenza Rimassa, José L Lledó, Carlos Huertas, Bruno Sangro, Edoardo G Giannini, Manuel Delgado, Mercedes Vergara, Christie Perelló, Alberto Lue, Margarita Sala, Adolfo Gallego, Susanna Coll, Tania Hernáez, Federico Piñero, Gustavo Pereira, Alex França, Juan Marín, Margarita Anders, Vivianne Mello, Mar Lozano, Jean C Nault, Josemaría Menéndez, Ignacio García Juárez, Jordi Bruix, María Reig Referencia : Liver Int. 2020 Jun;40(6):1467-1476. DOI (Digital Object Identifier) : 10.1111/liv.14436 PMID : 32170821 En línea : https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.14436 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5102

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Modeling data with semicompeting risks: An application to chronic kidney disease in Colombia / María Isabel Múnera Jaramillo    

Público ISBD Título : Modeling data with semicompeting risks: An application to chronic kidney disease in Colombia Otros títulos : Modelo para datos con riesgos semi competitivos: Una aplicación a insuficiencia renal crónica en Colombia Tipo de documento : documento electrónico Autores : María Isabel Múnera Jaramillo, Fecha de publicación : 2019 Títulos uniformes : Revista Colombiana de Estadística Idioma : Inglés (eng) Palabras clave : Archimedean Copula  Frailty model  Semicompeting risks  Survival Resumen : In this paper, the structure of semicompeting risks data, dened by Fine, Jiang & Chappell (2001), is studied. Two events are of interest: a nonterminal and a terminal event, the last one, can censor the non-terminal event, but not vice versa. Due to the possible dependence between the times until the occurrence of such events, two approaches are evaluated: modelling the bivariate survival function through Archimedean copulas and a shared frailty model. A simulation is conducted to examine its performance and both approaches are applied to a real data set of patients with chronic kidney disease (CKD). Mención de responsabilidad : Elizabeth González Patiño, Gisela Tunes, Maria Isabel Munera DOI (Digital Object Identifier) : 10.15446/rce.v42n1.68572 Derechos de uso : CC BY En línea : https://revistas.unal.edu.co/index.php/estad/article/view/68572 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4291 Modeling data with semicompeting risks: An application to chronic kidney disease in Colombia = Modelo para datos con riesgos semi competitivos: Una aplicación a insuficiencia renal crónica en Colombia [documento electrónico] / María Isabel Múnera Jaramillo,  . - 2019. Obra : Revista Colombiana de Estadística Idioma : Inglés (eng) Palabras clave : Archimedean Copula  Frailty model  Semicompeting risks  Survival Resumen : In this paper, the structure of semicompeting risks data, dened by Fine, Jiang & Chappell (2001), is studied. Two events are of interest: a nonterminal and a terminal event, the last one, can censor the non-terminal event, but not vice versa. Due to the possible dependence between the times until the occurrence of such events, two approaches are evaluated: modelling the bivariate survival function through Archimedean copulas and a shared frailty model. A simulation is conducted to examine its performance and both approaches are applied to a real data set of patients with chronic kidney disease (CKD). Mención de responsabilidad : Elizabeth González Patiño, Gisela Tunes, Maria Isabel Munera DOI (Digital Object Identifier) : 10.15446/rce.v42n1.68572 Derechos de uso : CC BY En línea : https://revistas.unal.edu.co/index.php/estad/article/view/68572 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4291

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Immunological characterization of compensatory anti-inflammatory response syndrome in patients with severe sepsis : a longitudinal study / Fabián Alberto Jaimes Barragán  

Público ISBD Título : Immunological characterization of compensatory anti-inflammatory response syndrome in patients with severe sepsis : a longitudinal study Tipo de documento : documento electrónico Autores : Fabián Alberto Jaimes Barragán, Fecha de publicación : 2014 Títulos uniformes : Critical Care Medicine Idioma : Inglés (eng) Palabras clave : Immunosuppression  longitudinal studies  physio pathology  secondary infection  sepsis  survival Resumen : Objectives: To perform a complete immunological characterization of compensatory anti-inflammatory response syndrome in patients with sepsis and to explore the relationship between these changes and clinical outcomes of 28-day mortality and secondary infections. Design: Prospective single-center study conducted between April 2011 and December 2012. Setting: ICUs from Hospital Universitario San Vicente Fundación at Medellin, Colombia. Patients: One hundred forty-eight patients with severe sepsis. Interventions: None. Measurements and Main Results: At days 0, 1, 3, 5, 10, and 28, we determined the expression of HLA-DR in monocytes and the apoptosis and the proliferation index in T lymphocytes, as well as the levels of tumor necrosis factor-α, interleukin-6, interleukin-1β, interleukin-10, and transforming growth factor-β in both plasma and cell culture supernatants of peripheral blood mononuclear cells. The mean percentage of HLA-DR+ was 60.7 at enrollment and increased by 0.9% (95% CI, 0.7–1.2%) per day. The mean percentage of CD4 T cells and CD8 T cells AV+/7-AAD– at enrollment was 37.2% and 20.4%, respectively, but it diminished at a rate of –0.5% (95% CI, –0.7% to –0.3%) and –0.3% (95% CI, –0.4% to –0.2%) per day, respectively. Plasma levels of interleukin-6 and interleukin-10 were 290 and 166 pg/mL and decreased at a rate of –7.8 pg/mL (95% CI, –9.5 to –6.1 pg/mL) and –4 pg/mL (95% CI, –5.1 to –2.8 pg/mL) per day, respectively. After controlling for confounders, only sustained plasma levels of interleukin-6 increase the risk of death (hazard ratio 1.003; 95% CI, 1.001–1.006). Conclusions: We found no evidence to support a two-phase model of sepsis pathophysiology. However, immunological variables did behave in a mixed and time-dependent manner. Further studies should evaluate changes over time of interleukin-6 plasma levels as a prognostic biomarker for critically ill patients. Mención de responsabilidad : Henry G Gomez, Sandra M Gonzalez, Jessica M Londoño, Natalia A Hoyos, Cesar D Niño, Alba L Leon, Paula A Velilla, Maria T Rugeles, Fabián A Jaimes Referencia : Crit Care Med. 2014 Apr;42(4):771-80. DOI (Digital Object Identifier) : 10.1097/CCM.0000000000000100 PMID : 24365860 En línea : https://journals.lww.com/ccmjournal/Abstract/2014/04000/Immunological_Characteri [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3798 Immunological characterization of compensatory anti-inflammatory response syndrome in patients with severe sepsis : a longitudinal study [documento electrónico] / Fabián Alberto Jaimes Barragán,  . - 2014. Obra : Critical Care Medicine Idioma : Inglés (eng) Palabras clave : Immunosuppression  longitudinal studies  physio pathology  secondary infection  sepsis  survival Resumen : Objectives: To perform a complete immunological characterization of compensatory anti-inflammatory response syndrome in patients with sepsis and to explore the relationship between these changes and clinical outcomes of 28-day mortality and secondary infections. Design: Prospective single-center study conducted between April 2011 and December 2012. Setting: ICUs from Hospital Universitario San Vicente Fundación at Medellin, Colombia. Patients: One hundred forty-eight patients with severe sepsis. Interventions: None. Measurements and Main Results: At days 0, 1, 3, 5, 10, and 28, we determined the expression of HLA-DR in monocytes and the apoptosis and the proliferation index in T lymphocytes, as well as the levels of tumor necrosis factor-α, interleukin-6, interleukin-1β, interleukin-10, and transforming growth factor-β in both plasma and cell culture supernatants of peripheral blood mononuclear cells. The mean percentage of HLA-DR+ was 60.7 at enrollment and increased by 0.9% (95% CI, 0.7–1.2%) per day. The mean percentage of CD4 T cells and CD8 T cells AV+/7-AAD– at enrollment was 37.2% and 20.4%, respectively, but it diminished at a rate of –0.5% (95% CI, –0.7% to –0.3%) and –0.3% (95% CI, –0.4% to –0.2%) per day, respectively. Plasma levels of interleukin-6 and interleukin-10 were 290 and 166 pg/mL and decreased at a rate of –7.8 pg/mL (95% CI, –9.5 to –6.1 pg/mL) and –4 pg/mL (95% CI, –5.1 to –2.8 pg/mL) per day, respectively. After controlling for confounders, only sustained plasma levels of interleukin-6 increase the risk of death (hazard ratio 1.003; 95% CI, 1.001–1.006). Conclusions: We found no evidence to support a two-phase model of sepsis pathophysiology. However, immunological variables did behave in a mixed and time-dependent manner. Further studies should evaluate changes over time of interleukin-6 plasma levels as a prognostic biomarker for critically ill patients. Mención de responsabilidad : Henry G Gomez, Sandra M Gonzalez, Jessica M Londoño, Natalia A Hoyos, Cesar D Niño, Alba L Leon, Paula A Velilla, Maria T Rugeles, Fabián A Jaimes Referencia : Crit Care Med. 2014 Apr;42(4):771-80. DOI (Digital Object Identifier) : 10.1097/CCM.0000000000000100 PMID : 24365860 En línea : https://journals.lww.com/ccmjournal/Abstract/2014/04000/Immunological_Characteri [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3798

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