RESUMO Introdução: Todos os anos são registados mais de 2,3 milhões de casos de cancro da mama, o que o torna o tipo cancro mais comum entre os adultos. A associação entre o cancro da mama e fatores ocupacionais é uma questão que tem vindo a ser estudada na literatura desde o início do século XVIII. Os desenvolvimentos tecnológicos permitiram um estudo mais aprofundado sobre a relação entre o cancro da mama e os fatores profissionais como a exposição a produtos químicos, pesticidas, metais e também fontes de exposição a radiação ionizante e não ionizante. O objetivo da presente revisão de literatura é incidir na relação entre a exposição ocupacional a radiação ionizante em trabalhadores da saúde e o desenvolvimento de cancro da mama. Metodologia: Foi efetuada uma pesquisa na Medline, com o motor de busca PubMed e na Elsevier, com o motor de busca Science Direct. As palavras de pesquisa usadas foram uma combinação dos termos breast cancer, occupational exposure, ionizing radiation e healthcare workers. Foi também realizada pesquisa na Revista Portuguesa de Saúde Ocupacional utilizando os termos “Cancro de mama” e “Radiação Ionizante”. Discussão/Conclusão: A literatura atual não é unânime quanto às características clínicas e patológicas específicas do cancro da mama possivelmente ligadas a contextos profissionais. Os profissionais de saúde, tais como técnicos de radiologia, enfermeiros, cirurgiões ortopédicos e cardiologistas de intervenção são especialmente vulneráveis a este tipo de exposição, nomeadamente à radiação ionizante. No entanto, alguns estudos apontaram para uma dificuldade em estabelecer uma relação causal entre estes fatores e o desenvolvimento de doença devido ao número de variáveis envolvidas, tais como a duração e intensidade da exposição e à influência de outros fatores de risco. As mudanças no equipamento, procedimentos e medidas de proteção resultaram em doses mais baixas nos anos mais recentes, o que significa que o risco de cancro da mama é baixo nos níveis atuais de exposição profissional à radiação ionizante.

ABSTRACT Introduction: Every year more than 2.3 million cases of breast cancer are registered, making it the most common type of cancer among adults. The association between breast cancer and occupational factors is an issue that has been studied in the literature since the beginning of the 18th century. Technological developments have allowed a more in-depth study of the relationship between breast cancer and occupational factors such as exposure to chemicals, pesticides, metals and also sources of exposure to ionising and non-ionising radiation.The aim of the present literature review is to complete an update on the scientific knowledge about the relationship between occupational exposure to ionising radiation in healthcare workers and the development of breast cancer. Methodology: A research was carried using Medline with the PubMed search engine and Elsevier with the Science Direct search engine. The search words used were a combination of breast cancer, occupational exposure, ionizing radiation and healthcare workers. A research was also carried out in Revista Portuguesa de Saúde Ocupacional, using the terms “Breast Cancer” and “Ionizing Radiation”. Discussion/Conclusions: Current literature is not unanimous about the specific clinical and pathological features of breast cancer possibly linked to occupational settings. Healthcare professionals such as radiology technicians, nurses, orthopaedic surgeons and interventional cardiologists are especially vulnerable to this type of exposure, particularly to ionising radiation. However, some studies have pointed to a difficulty in establishing a causal relationship between these factors due to the number of variables involved, such as the duration and intensity of exposure and the influence of other risk factors. Changes in equipment, procedures and protective measures have resulted in lower doses in recent years, which means that the risk of breast cancer is low at current levels of occupational exposure to ionizing radiation.

RESUMO Introdução: A neoplasia da próstata é a segunda mais comummente diagnosticada no sexo masculino, destacando-se como fatores de risco bem estabelecidos a idade avançada, a suscetibilidade familiar e étnica. Recentemente, a associação a fatores ambientais ou de estilo de vida tem vindo a ser investigada, abrindo a possibilidade à associação de fatores de risco ocupacionais com uma maior incidência desta patologia. Apesar de controverso por não significar necessariamente a existência de patologia maligna, o antigénio específico da próstata mantém-se como o pilar no rastreio desta doença. Descrição do caso: Trata-se do caso de um cirurgião de 60 anos, com 36 anos desta atividade profissional, realizando trabalho por turnos e trabalho noturno. No âmbito da vigilância da saúde realizada pela Saúde Ocupacional, é submetido a exames complementares de diagnóstico, detetando-se um aumento do antigénio específico da próstata, que culmina na realização de biópsia, confirmando o diagnóstico de adenocarcinoma da próstata. Discussão/Conclusão: O trabalho por turnos e, particularmente, o trabalho noturno, tem vindo a ser investigado como possivelmente carcinogénico, estando, atualmente, classificado pela Agência Internacional para a Investigação em Cancro como “provavelmente carcinogénico para humanos”. Tendo em conta a crescente evidência relacionando fatores ocupacionais com esta e outras neoplasias, poderá fazer sentido incluir rastreios oncológicos nos protocolos de vigilância da saúde dos trabalhadores, em alguns setores. No caso apresentado, a inclusão da medição de antigénio específico da próstata nos exames complementares pedidos pela Saúde Ocupacional permitiu um diagnóstico atempado, com deteção e tratamento da doença numa fase precoce.

ABSCTRACT Introduction: Prostate neoplasia is the second most diagnosed cancer in men, having well established risk factors such as advanced age, familial and ethnic susceptibility. Recently, the association with environmental or lifestyle factors has been investigated, opening the possibility of certain occupational risk factors being associated with a higher incidence of this disease. Although controversial, as it does not necessarily imply a malignant etiology, prostate-specific antigen remains the mainstay in screening for this disease. Case report: This is the case of a 60-year-old surgeon with 36 years of professional history, including shift and night-work. As part of the health surveillance carried out by Occupational Medicine, he underwent complementary diagnostic tests and an increase in prostate-specific antigen was detected, culminating in a biopsy which ultimately confirmed the diagnosis of prostate adenocarcinoma. Discussion/Conclusion: Shift work, and particularly night work, has been investigated as a possible carcinogen and is currently classified by the International Agency for Research on Cancer as "probably carcinogenic to humans". Given the growing evidence linking certain occupational factors with this and other neoplasms, it may be sensible to include cancer screening in workers' health surveillance protocols, in some sectors. In the case presented, the inclusion of prostate-specific antigen measurement in the complementary tests requested by Occupational Medicine allowed for a timely diagnosis, with detection and treatment of the disease at an early stage.

Resumo O objetivo deste trabalho é elucidar a distribuição e o comportamento da mortalidade por câncer de próstata (CaP) na Costa Rica, com base no acesso geográfico aos serviços de saúde por município. Metodologicamente, é apresentada uma análise de tipo ecológico, cuja fonte de informação é a base de dados de óbitos do Instituto Nacional de Estatísticas e Censo. Para estudar a associação entre a mortalidade e o acesso aos serviços de saúde, foi elaborado o Índice de Acesso Geográfico aos Serviços de Saúde (IAGSS) e foram utilizados modelos de regressão de Poisson à Geographically Weighted Regression (GWR). Como principais resultados, foi identificada uma tendência crescente da doença na população. O IAGSS mostra que o acesso aos serviços de saúde não é distribuído de forma uniforme no território e está associado à mortalidade por CaP. Conclui-se que a região norte do país apresenta a maior desvantagem no acesso aos serviços de saúde, e que os territórios com pior IAGSS tendem a aumentar a mortalidade por CaP.

Abstract This paper aims to explain the distribution and behavior of prostate cancer mortality in Costa Rica based on geographic access to health services by municipalities. Methodologically, an ecological analysis is presented; its information source is the death database of the National Institute of Statistics and Census. To study the association between mortality and access to health services, the authors designed the Geographic Access Index to Health Services (GAIHS) and implemented Poisson regression models and the Geographically Weighted Regression (GWR). As a main result, an increasing trend of the disease in the population was found. The GAIHS shows that access to health services is not evenly distributed in the territory and is associated with PCa mortality. It is concluded that the northern zone of the country presents the greatest disadvantage in access to health services and that the territories with the worst GAIHS tend to increase mortality from PCa.

Resumen El presente trabajo tiene como propósito explicar la distribución y comportamiento de la mortalidad de cáncer de próstata en Costa Rica, a partir del acceso geográfico a los servicios de salud por cantón. Metodológicamente, se presenta un análisis de tipo ecológico, cuya fuente de información es la base de datos de defunciones del Instituto Nacional de Estadísticas y Censo. Para estudiar la asociación entre la mortalidad y el acceso a los servicios de salud, se diseñó el Índice de Acceso Geográfico a los Servicios de Salud (IAGSS), y se aplicaron modelos de regresión de Poisson a la Geographically Weighted Regression (GWR). Como principales resultados, se encontró una tendencia creciente de la enfermedad en la población. El IAGSS, muestra que el acceso a los servicios de salud no se distribuye de manera uniforme en el territorio, y se asocia con la mortalidad por CaP. Se concluye que la zona norte del país presenta la mayor desventaja en el acceso a servicios de salud, y que los territorios con peor IAGSS tienden a incrementar la mortalidad por CaP.

Introdução : Meduloblastoma é um tumor maligno, altamente agressivo e de rápido crescimento que surge no cerebelo ou no assoalho do quarto ventrículo e tronco cerebral, especialmente em crianças. Mesmo com os avanços na terapia, a morbimortalidade permanece um grande desafio. Por isso, novos tratamentos são necessários para reduzir esses estágios. Objetivo : Revisar a relação NRP1 (neuropilina 1) e meduloblastoma como potencial alvo terapêutico e, também, com sobrevida global. Método : Trata-se de revisão narrativa realizada nas bases de dados PubMed e Scielo. A busca utilizou as seguintes palavras-chave: “ neuropilinas, meduloblastoma, tumores malignos, pediatria ”. Os critérios de inclusão foram artigos de revisão, estudos experimentais, pesquisas pré-clínicas e clínicas, em inglês e português, e disponíveis em texto completo. Os artigos selecionados foram analisados ​​com base nas tecnologias abordadas, perspectivas futuras e desafios conceituais, doenças referidas e ideia central do artigo. Resultado : Foram incluídos 30 artigos Conclusão : Os meduloblastomas possuem altos níveis transcricionais de neuropilina (NRP1) e seus baixos níveis relacionados com a menor sobrevida global, especialmente nos SHH. Nesse sentido, o NRP1 e seu complexo sistema de atuação aparecem como alvo potencial de terapias oncológicas para tumores específicos.

Introdução : O meduloblastoma é um tumor maligno, altamente agressivo e de rápido crescimento que surge no cerebelo ou no assoalho do quarto ventrículo e tronco encefálico, principalmente em crianças. Mesmo com os avanços na terapia, a morbidade e a mortalidade continuam sendo um grande desafio. Portanto, novos tratamentos são necessários para reduzir esses resultados. Objetivo : Revisar a relação NRP1 (neuropilina 1) e meduloblastoma como potencial alvo terapêutico e, também, com sobrevida global. Method: This is a narrative review carried out in the PubMed and Scielo databases. The search used the following keywords: “neuropilins, medulloblastoma, brain tumors, pediatrics”. The inclusion criteria were review articles, experimental studies, pre-clinical and clinical research, in English and Portuguese, and available in full text. The selected articles were analyzed based on the technologies covered, future perspectives and challenges mentioned, diseases mentioned and the central idea of the article. Result: 30 articles were included. Conclusion: Medulloblastomas have high transcriptional levels of neuropilin (NRP1) and their low levels are related to lower overall survival, especially in SHH. In this sense, NRP1 and its complex action system appear as a potential target for oncological therapies for brain tumors.

Resumo O comportamento alimentar pode exercer uma influência substancial no desenvolvimento da obesidade, uma condição intrinsecamente ligada a um espetro de comorbilidades (e.g., cancro, doenças cardiovasculares, endócrinas). A obesidade é mais prevalente nas mulheres de meia-idade, particularmente durante a menopausa, coincidindo com um aumento da incidência de comportamentos alimentares disfuncionais. Este estudo tem como objetivo identificar a estrutura fatorial e as propriedades psicométricas da versão portuguesa do Three Fator Eating Questionnaire (TFEQ-R21) em mulheres de meia-idade. Um total de 1895 mulheres portuguesas de meia-idade (M=52,22 anos, DP=5,10) preencheram um questionário sociodemográfico e o TFEQ-R21, composto por 21 itens, distribuídos por três dimensões (restrição cognitiva, descontrolo alimentar e alimentação emocional). Foram realizadas análises descritivas, validade de construto, de critério, e fiabilidade, através do R-Lavaan. O modelo de estrutura de três fatores apresentou um bom ajustamento (Comparative Fit Index=0,97; Tucker-Lewis Index=0,97; Root mean square error of approximation= 0,08 (p<0,001); Standardized root mean square residual=0,07). O TFEQ-R21 apresenta evidências de validade convergente (variância extraída da média: 0,41<VEM<0,80) e fiabilidade (α de Cronbach: 0,82<α<0,96, e ómega de McDonald: 0,66<ω<0,92). O TFEQ-R21 apresentou evidências de validade e fiabilidade com invariância entre mulheres com e sem obesidade, na avaliação do comportamento alimentar em mulheres de meia-idade. É um instrumento útil no domínio das intervenções de gestão de peso, facilitando a identificação e a atenuação de comportamentos alimentares disfuncionais, especialmente durante esta fase da vida.

Abstract Eating behaviour can exert a substantial influence on the development of obesity, a condition intricately linked with a spectrum of comorbidities (e.g., cancer, cardiovascular diseases, endocrine disorders). Obesity is more prevalent among middle-aged women, particularly during menopause, coinciding with an increase in the incidence of disordered eating behaviours. This study aims to identify the factor structure and psychometric properties of the Portuguese version of the Three Factor Eating Questionnaire (TFEQ-R21) in middle-aged women. A total of 1895 middle-aged Portuguese women (M=52.22 years, SD=5.10) completed a sociodemographic questionnaire alongside the TFEQ-R21, comprising 21 items distributed across three dimensions (cognitive restraint, uncontrolled eating, and emotional eating). Descriptive analyses, construct and criterion validities, and reliability were performed using the R-Lavaan. The three-factor structure model presented a good fit (Comparative Fit Index=0.97; Tucker-Lewis Index=0.97; Root mean square error of approximation=0.08 (p<.001); Standardized root mean square residual=0.07). The TFEQ-R21 attests to its convergent validity (average variance extracted: 0.41<AVE<0.80) and reliability (Cronbach´s α: 0.82<α<0.96, and McDonald´s omega: 0.66<ω<0.92). The TFEQ-R21 tool has shown evidence of validity and reliability, displaying invariance between obese and normative women when assessing eating behaviour among middle-aged women. It offers valuable utility within the domain of weight management interventions, facilitating the identification and mitigation of dysfunctional eating behaviours, especially during this life stage.

Resumo A conceção de programas de promoção do bem-estar para companheiros de mulheres diagnosticadas com cancro da mama implica a existência de instrumentos de medida específicos, que considerem os domínios efetivamente relevantes para esta população. O objetivo deste estudo exploratório foi construir e validar uma escala para avaliar o impacto do diagnóstico e tratamento do cancro da mama nos companheiros. Uma amostra de conveniência de 84 companheiros de mulheres que tiveram diagnóstico de cancro da mama respondeu ao questionário desenvolvido no presente estudo, questionário sociodemográfico, Escala de qualidade de vida do familiar/cuidador do doente oncológico (CQOLC) e versão portuguesa da Hospital Anxiety and Depression Scale (HADS). Foi desenvolvida a Escala de Avaliação do Impacto do Cancro da Mama nos Companheiros (EAICMC), com 24 itens, organizados em três fatores. A EAICMC revelou boa fiabilidade (α = 0,82). A correlação item-total e item-subescalas comprovou a sua aceitável validade interna convergente/discriminante e a distribuição das respostas pelos seus itens demonstrou que possui uma razoável sensibilidade. A correlação entre os scores obtidos na EAICMC, HADS e CQOLC confirmou a validade externa da escala. Trata-se de um instrumento bem aceite e que poderá ser útil para a prática clínica.

Abstract The design of wellbeing promotion programs for the partners of women diagnosed with breast cancer requires the existence of specific measuring instruments that take into account the domains that are actually relevant to this population. The aim of this exploratory study was to construct and validate a scale to assess the impact of breast cancer diagnosis and treatment on partners. A convenience sample of 84 partners of women diagnosed with breast cancer answered the questionnaire developed in this study, a sociodemographic questionnaire, the Cancer Patient Family/Caregiver Quality of Life Scale (CQOLC) and the Portuguese version of the Hospital Anxiety and Depression Scale (HADS). The Assessment of the Impact of Breast Cancer on Companions Scale (EAICMC) was developed, with 24 items, organized into three factors. The EAICMC showed good reliability (α=0.82). The item-total and item-subscale correlation proved its acceptable convergent/discriminant internal validity and the distribution of responses across its items showed that it has reasonable sensitivity. The correlation between the scores obtained on the EAICMC, HADS and CQOLC confirmed the scale's external validity. It is a well-accepted instrument that could be useful in clinical practice.

ABSTRACT The Center of Molecular Immunology is an exponent of Cuban biotechnology institution dedicated to basic research, development, production and commercialization of biopharmaceuticals, with the aim of diagnosing and treating cancer and diseases related to the immune system. In this work, a bibliographic synthesis of research that was carried out in this center in the period from 2012 to 2018, was performed, with the purpose of analyzing the application of some Data Mining techniques in the evaluation of fermentation and purification stages of the process for obtaining biopharmaceuticals in three production facilities. The phases of Data Mining were characterized and the practical implication of the results was presented. Principal Components Analysis was applied as a descriptive model using THE UNSCRAMBLER software, and Artificial Neural Networks were applied as a predictive model using the MATLAB neural networks toolbox. The use of these models made it possible to extract useful information for decision making, thereby explaining the behavior of the parameters that influence the quality of the final product, as well as estimating important variables such as the concentration of the protein of interest in the fermentation supernatant and the performance of the purification stage, depending on the process variables that have the greatest influence on its behavior.

RESUMEN El Centro de Inmunología Molecular es una institución exponente de la biotecnología cubana dedicado a la investigación básica, desarrollo, producción y comercialización de biofármacos, con el objetivo de diagnosticar y tratar el cáncer, así como enfermedades relacionadas con el sistema inmune. En este trabajo se realizó una síntesis bibliográfica de investigaciones que se llevaron a cabo en este centro, en el periodo comprendido del 2012 al 2018, con el propósito de analizar la aplicación de algunas técnicas de Minería de Datos en la evaluación de las etapas de fermentación y purificación del proceso de obtención de biofármacos en tres instalaciones productivas. Se caracterizaron las fases de la Minería de Datos y se presentó la implicación práctica de los resultados. Se aplicó como modelo descriptivo el Análisis de Componentes Principales mediante el software THE UNSCRAMBLER, y como modelo predictivo las Redes Neuronales Artificiales con el empleo de la caja de herramientas de redes neuronales del MATLAB. La utilización de estos modelos permitió extraer información útil para la toma de decisiones, se logró con ello explicar el comportamiento de los parámetros que influyen en la calidad del producto final, así como estimar variables de importancia como la concentración de la proteína de interés en el sobrenadante de la fermentación y el rendimiento de la etapa de purificación, en función de las variables del proceso que mayor influencia tienen en su comportamiento.

Breast cancer is the most commonly diagnosed cancer and the second most common cause of cancer death in women. The anthracycline, doxorubicin, is a well-known and highly effective treatment for breast cancer patients; however, many patients present with resistance to chemotherapeutic drugs, which ultimately results in treatment failure and contributes to high mortality rates. It is well established that the mitogen-activated protein kinase phosphatase 1 (MKP-1) mediates the response to chemotherapy, where upregulated MKP-1 is associated with chemoresistance. We investigated whether MKP-1 inhibition or silencing can sensitise triple-negative MDA-MB-231 breast cancer cells to doxorubicin therapy. We found that MKP-1 inhibition and silencing sensitises breast cancer cells to doxorubicin-induced apoptosis. Additionally, the inhibition of MKP-1 in combination with doxorubicin treatment promotes autophagy induction, while doxorubicin and not MKP-1 modulation increased lysosomal acidic compartments. As such, this study demonstrated that MKP-1 inhibition has a potential therapeutic benefit for breast cancer patients by increasing the efficacy of conventional chemotherapy. Therefore, MKP-1 inhibition should be developed as a clinically relevant adjuvant therapy, which could provide a novel avenue for therapeutic intervention in combination with chemotherapy in breast cancer patients. SIGNIFICANCE: • MKP-1 inhibition with sanguinarine and silencing sensitises breast cancer cells to doxorubicin-induced apoptosis. • The inhibition of MKP-1 with sanguinarine in combination with doxorubicin treatment promotes autophagy induction. • MKP-1 inhibition can have a potential therapeutic benefit for breast cancer patients by increasing the efficacy of conventional chemotherapy.

RESUMEN Introducción: El cáncer de laringe es la neoplasia maligna más común de las vías aerodigestivas superiores. La laringectomía total es el tratamiento de elección en casos avanzados, pero se asocia a una alta tasa de complicaciones. Objetivos: Conocer la prevalencia de las complicaciones posquirúrgicas de la laringectomía total y los factores asociados en pacientes con cáncer de laringe. Materiales y métodos: Estudio observacional, descriptivo, retrospectivo, de corte transversal, revisando el comportamiento de la laringectomía total y sus principales complicaciones en la Cátedra y Servicio de Otorrinolaringología del Hospital de Clínicas de la Facultad de Ciencias Médicas de la Universidad Nacional de Asunción, Paraguay, de 2015 a 2022. Se incluyeron pacientes mayores de 18 años, de ambos sexos, postoperados de laringectomía total, con diagnóstico anatomopatológico de neoplasia de laringe. Se excluyeron pacientes no operados, con fichas incompletas o que abandonaron el tratamiento. Se analizaron variables demográficas, clínicas, quirúrgicas y anatomopatológicas. Resultados: Se incluyeron 10 pacientes, todos varones, con edad media de 56,3 ± 10,2 años. El 90% presentaba hábitos tóxicos. La complicación más frecuente fue la fístula faringocutánea (70%), seguida por infección del sitio quirúrgico (10%) y sangrado posoperatorio (10%). El 71,4% de las fístulas se resolvieron con medidas conservadoras. El 30% tenía afectación supraglótica y el 57,1% de los que presentaron complicaciones recibieron radioterapia previa. Conclusión: Las complicaciones de la laringectomía total son frecuentes, principalmente la fístula faringocutánea. La afectación supraglótica y la radioterapia previa se asociaron a mayor tasa de complicaciones. Se requieren estudios prospectivos con muestras más grandes para confirmar estos hallazgos.

ABSTRACT Introduction: Laryngeal cancer is the most common malignant neoplasm of the upper aerodigestive tract. Total laryngectomy is the treatment of choice in advanced cases, but it is associated with a high rate of complications. Objectives: To determine the prevalence of postoperative complications of total laryngectomy and associated factors in patients with laryngeal cancer. Materials and methods: Observational, descriptive, retrospective, cross-sectional study, reviewing the behavior of total laryngectomy and its main complications in the Department of Otorhinolaryngology of the Hospital de Clínicas, Faculty of Medical Sciences, National University of Asunción, Paraguay, from 2015 to 2022. Patients over 18 years of age, of both sexes, who underwent total laryngectomy, with anatomopathological diagnosis of laryngeal neoplasm were included. Non-operated patients, those with incomplete records or who abandoned treatment were excluded. Demographic, clinical, surgical and anatomopathological variables were analyzed. Results: Ten patients were included, all male, with a mean age of 56.3 ± 10.2 years. Ninety percent had toxic habits. The most frequent complication was pharyngocutaneous fistula (70%), followed by surgical site infection (10%) and postoperative bleeding (10%). Conservative measures resolved 71.4% of the fistulas. Thirty percent had supraglottic involvement and 57.1% of those who presented complications received previous radiotherapy. Conclusion: Complications of total laryngectomy are frequent, mainly pharyngocutaneous fistula. Supraglottic involvement and previous radiotherapy were associated with a higher rate of complications. Prospective studies with larger samples are required to confirm these findings.

RESUMEN Introducción: El cáncer de vesícula biliar (CVB) es la neoplasia más frecuente de las vías biliares, su diagnóstico suele hacerse de forma tardía llevando a una reducción en las opciones terapéuticas y alta mortalidad. La importancia de hacer un diagnóstico oportuno es la mejoría en el pronóstico debido a mayores opciones terapéuticas e incluso curación de la enfermedad, lo que hace muy relevante conocer la prevalencia de CVB en pacientes colecistectomizados. Objetivos: Determinar la prevalencia del cáncer de vesícula en la anatomía patológica de pacientes colecistectomizados en el Hospital General de Barrio Obrero en el año de 2021. Materiales y métodos: Estudio observacional, descriptivo, retrospectivo y de corte transversal, con datos colectados de los expedientes clínicos: edad, sexo, motivo de consulta, antecedentes patológicos personales y patologías basales, hallazgo operatorio y resultados de anatomía patológica. Los datos fueron cargados en una planilla Excel y analizados estadísticamente. Resultados: Se diagnosticaron 2 carcinomas mal diferenciados (3,5%) de todas las colecistectomías. El promedio de edad fue de 39a (DS +/- 14;16), sexo femenino (63%). Las comorbilidades más frecuentes fueron obesidad (58,7%), hipertensión arterial (33,8%), diabetes y dislipidemia (12,8% cada). Conclusión: El cáncer de vesícula biliar tiene una alta prevalencia regional, debido a factores de riesgo relacionados al estilo de vida y dieta. El hallazgo más llamativo fue encontrar con una mayor prevalencia en el grupo de edad entre 31-50 años en lugar de mayores a 60 años.

ABSTRACT Introduction: Gallbladder cancer (CVB) is the most common neoplasm of the bile ducts; its diagnosis is usually made late, leading to a reduction in therapeutic options and high mortality. The importance of making a timely diagnosis is the improvement in prognosis due to greater therapeutic options and even cure of the disease, which makes it very relevant to know the prevalence of CVB in cholecystectomized patients. Objectives: Determine the prevalence of gallbladder cancer in the pathological anatomy of cholecystectomized patients at the Barrio Obrero General Hospital in the year 2021. Materials and methods: Observational, descriptive, retrospective and cross-sectional study, with data collected from clinical records: age, sex, reason for consultation, personal pathological history and baseline pathologies, operative finding and pathological anatomy results. The data were loaded into an Excel spreadsheet and analyzed statistically. Results: 2 poorly differentiated carcinomas were diagnosed (3.5%) of all cholecystectomies. The average age was 39 years (SD +/- 14;16), female (63%). The most frequent comorbidities were obesity (58.7%), high blood pressure (33.8%), diabetes and dyslipidemia (12.8% each). Conclusion: Gallbladder cancer has a high regional prevalence, due to risk factors related to lifestyle and diet. The most striking finding was a higher prevalence in the age group between 31-50 years rather than those over 60 years of age.

RESUMEN Introducción: Cada año en América Latina, más de 200,000 mujeres son diagnosticadas con cáncer de mama. Como parte del tratamiento de esta enfermedad, la cirugía es uno de los pilares fundamentales. El acto quirúrgico es una experiencia extrema para el paciente y el cirujano, necesaria en esta patología para el tratamiento completo y, como todo acto médico, no está exento de complicaciones. En Paraguay no se cuentan con estadísticas sobre la prevalencia de las complicaciones debidas a cirugías por cáncer de mama, por lo que este trabajo tiene como principal objetivo establecer dicha frecuencia en un hospital de cuarto nivel de complejidad. Materiales y métodos: Estudio retrospectivo, observacional, de corte transversal. Muestreo no probabilístico de casos consecutivos. La selección de sujetos de estudios se realizó de la población de pacientes que fueron sometidos a cirugía por cáncer de mama, en el Hospital de Clínicas en el periodo enero de 2018 a agosto 2022, y que cumplan con los criterios de inclusión y exclusión. Todas las variables han sido extraídas de la ficha clínica y fueron documentadas en el formulario de registro de datos. Se esperaba una frecuencia de 42 % de complicaciones post quirúrgicas utilizando el programa estadístico EPIINFO 7 para un IC de 95% a precisión de 5%, el tamaño mínimo a incluir debía ser de 143 pacientes. Resultados: Se analizaron 203 historias clínicas de pacientes con diagnóstico de cáncer de mama que fueron sometidas a cirugía como parte del tratamiento, correspondientes al periodo comprendido entre enero de 2018 a agosto de 2022. Cumplieron con los criterios de inclusión 201 pacientes. Se registraron un total de 92 pacientes que presentaron alguna complicación relacionada a la cirugía, que corresponden 46 % del total de pacientes en el periodo de tiempo estudiado. De las complicaciones encontradas, 40 desarrollaron seromas, representando el 43% del total de pacientes con complicaciones; 18 pacientes tuvieron infección de la herida operatoria, representando el 20%. 7 pacientes presentaron dehiscencia de la herida operatoria, siendo el 7,5% del total; y 5 desarrollaron un hematoma, siendo el 5,3%. Entre otras complicaciones encontradas, 4 pacientes presentaron linfedema (4,3%), 4 dolor crónico (4,3%), 3 extrusión de prótesis mamaria (3,2 %), 2 de celulitis del miembro superior afecto (2,1%), 2 presentaron necrosis del complejo areola-pezón (2,1%), 1 sufrimiento de piel sin necrosis, 1 sufrimiento del complejo areola-pezón sin necrosis (1% ambos), 1 presentó fistula (1%), 1 disfunción del miembro superior homolateral (1%), y una contractura capsular (1%). Discusión: Se registraron 92 pacientes con una complicación post quirúrgica luego de una cirugía por cáncer de mama; representa así el 46% del total de pacientes estudiados. Esta prevalencia se corresponde con lo publicado en la literatura. En cuanto a las complicaciones encontradas, la más frecuente en nuestra revisión fue el seroma, que se presentó en un 40% de las complicaciones. Las publicaciones describen a esta como una de las complicaciones más frecuentemente relacionadas a la cirugía mamaria, con frecuencias que varían desde 18 al 86% según diversos autores. Conclusión: De 201 pacientes que cumplieron con los criterios de inclusión y exclusión, se registraron un total de 92 pacientes que presentaron alguna complicación relacionada a la cirugía, que corresponden 46 % del total de pacientes en el periodo de tiempo estudiado. La complicación más frecuente fue el seroma. Todos los hallazgos de este estudio se correlacionan con lo encontrado en la literatura.

ABSTRACT Introduction: Every year in Latin America, more than 200,000 women are diagnosed with breast cancer. As part of the treatment of this disease, surgery is one of the fundamental pillars. The surgical act is an extreme experience for the patient and the surgeon, necessary in this pathology for complete treatment and, like any medical act, it is not exempt from complications. In Paraguay there are no statistics on the prevalence of complications due to surgeries for breast cancer, so the main objective of this work is to establish said frequency in a hospital of fourth level of complexity. Materials and methods: retrospective, observational, cross-sectional study. non-probabilistic sampling of consecutive cases. The selection of study subjects was made from the population of patients who underwent surgery for breast cancer, at the Hospital de Clínicas in the period January 2018 to August 2022, and who met the inclusion and exclusion criteria. All the variables have been extracted from the clinical record and were documented in the data recording form. A frequency of 42% of post-surgical complications was expected using the statistical program EPIINFO 7 for a CI of 95% with a precision of 5%, the minimum size to include had to be 143 patients. Results: 203 medical records of patients diagnosed with breast cancer who underwent surgery as part of the treatment, corresponding to the period from January 2018 to August 2022, were analyzed. 201 patients met the inclusion criteria. A total of 92 patients who presented some complication related to surgery were registered, corresponding to 46% of the total number of patients in the period of time studied. Of the complications found, 40 developed seromas, representing 43% of all patients with complications; 18 patients had surgical wound infection, representing 20%. 7 patients presented dehiscence of the surgical wound, being 7.5% of the total; and 5 developed a hematoma, being 5.3%. Among other complications found, 4 patients presented lymphedema (4.3%), 4 chronic pain (4.3%), 3 extrusion of breast prosthesis (3.2%), 2 cellulitis of the affected upper limb (2.1%), 2 presented necrosis of the nipple-areola complex (2.1%), 1 suffering from skin without necrosis, 1 suffering from the nipple-areola complex without necrosis (1% both), 1 presented fistula (1%), 1 homolateral upper limb dysfunction (1%), and capsular contracture (1%). Discussion: 92 patients with a post-surgical complication after surgery for breast cancer were registered; thus represents 46% of all patients studied. This prevalence corresponds to what has been published in the literature. Regarding the complications found, the most frequent in our review was seroma, which occurred in 40% of the complications. The publications describe this as one of the complications most frequently related to breast surgery, with frequencies ranging from 18 to 86% according to various authors. Conclusion: Of 201 patients who met the inclusion and exclusion criteria, a total of 92 patients who presented some complication related to surgery were registered, corresponding to 46% of the total number of patients in the period of time studied. The most frequent complication was seroma. All the findings of this study correlate with what is found in the literature.

RESUMEN Introducción: El cáncer vesicular es una neoplasia infrecuente mundialmente, exceptuando países donde la mortalidad por su causa es alta como Chile, a pesar de ello es el tumor biliar más común, con una incidencia aproximada de 0,8-1,2% y casi exclusivamente en mujeres. Objetivos: Describir la frecuencia, perfil demográfico, clínica, tratamiento y hallazgos anatomopatológicos del cáncer vesicular en pacientes del Hospital Nacional de Itauguá del 2010 al 2020. Materiales y métodos: Se encontraron 19 casos confirmados por biopsia, pero solo 15 fichas estaban completas. El estudio fue retrospectivo, descriptivo y observacional, muestreo no probabilístico de corte transversal. Resultados: De la muestra final (N=15), 13 pacientes fueron mujeres, la edad promedio fue de 60 años. Del total, 4 pacientes ingresaron para cirugía programada con diagnóstico de colecistopatía crónica litiásica y los otros 11 tenían sospecha de tumor vesicular y/o ictericia o colangitis aguda de origen neoplásico probable, todos fueron operados, el motivo de consulta más frecuente fue dolor en hipocondrio derecho, el 99 % fueron adenocarcinomas por anatomía patológica. Conclusión: La etiología principal del cáncer vesicular fue la colelitiasis, es de baja incidencia a nivel nacional, la mayoría de nuestros pacientes se encontraban en estadios terminales, o con poca oportunidad para la resección R0, por lo cual son de mal pronóstico y hasta hoy en día son de difícil detección en etapa inicial. En algunos casos como en 4 de nuestras pacientes el diagnóstico es fortuito mediante el hallazgo histológico en piezas de colecistectomía que fueron intervenidos en principio por patología benigna.

ABSTRACT Introduction: Gallbladder cancer is an infrequent neoplasm worldwide, except for countries where mortality from its cause is high, such as Chile. Despite this, it is the most common biliary tumor, with an approximate incidence of 0.8-1.2% and almost exclusively in women. Objectives: To describe the frequency, demographic profile, clinic, treatment and anatomopathological findings of gallbladder cancer in patients of the Itauguá National Hospital from 2010 to 2020. Materials and methods: 19 biopsy-confirmed cases were found, but only 15 files were complete. The study was retrospective, descriptive and observational, non-probabilistic cross-sectional sampling. Results: Of the final sample (N=15), 13 patients are women; the average age was 60 years. Of the total, 4 patients were admitted for scheduled surgery with a diagnosis of chronic gallstone gallbladder disease and the other 11 had suspected gallbladder tumor and/or jaundice or acute cholangitis of probable neoplastic origin, all were operated on, the most frequent reason for consultation was pain in the hypochondrium right, 99% were adenocarcinomas by pathology. Conclusion: The main etiology of gallbladder cancer was cholelithiasis, it has a low incidence nationwide, most of our patients were in terminal stages, or with little opportunity for R0 resection, for which they have a poor prognosis and up to today they are difficult to detect in the initial stage. In some cases, such as in 4 of our patients, the diagnosis is fortuitous through the histological finding in cholecystectomy specimens that were initially operated on for benign pathology.

Prostate cancer (PCa) is one of the most commonly diagnosed cancers among men, with a rising global incidence. Currently, the PCa landscape is vastly different between developed countries and Africa. Of note, owing to various biological, socioeconomic and institutional factors, black African men often present with more advanced disease and suffer greater mortality. This review will focus on the burden of PCa globally and in Africa, compare the state of the disease in Africa with that in more developed regions of the world, and answer the question why it can sometimes look like a 'different' disease compared with developed regions. In addition, we address the racial disparities of PCa.

RESUMEN Introducción: las lesiones premalignas y malignas del complejo bucal se incrementan en la población, lo que demanda una correcta ejecución del Programa de Detección Precoz del Cáncer Bucal (PDCB). En el trabajo se exponen las transformaciones en el nivel de conocimientos de pacientes y estomatólogos acerca de las afecciones concernientes al PDCB para perfeccionar su ejecución. Método: se realizó una intervención educativa en el área de salud Julio Antonio Mella del municipio Camagüey desde mayo de 2022 hasta junio de 2023, con la participación de 36 pacientes y 30 estomatólogos. Las fuentes de información fueron la historia clínica, un cuestionario y una prueba de entrada y salida, aplicados a pacientes y estomatólogos respectivamente, antes y después de la intervención; para constatar las transformaciones. Resultados: antes de la intervención los pacientes estaban mal informados sobre las consecuencias nocivas de hábitos tóxicos, higiénicos y dietéticos, así como desconocimiento de la importancia del correcto autoexamen bucal; los que alcanzaron en su mayoría un alto nivel de conocimientos con la intervención. Los estomatólogos mejoraron sus conocimientos sobre diagnóstico y seguimiento de lesiones pre malignas y malignas del complejo maxilofacial. Discusión: la adecuada ejecución del PDCB descansa tanto en pacientes como en estomatólogos y aunque las investigaciones se enfocan a los primeros por los beneficios reportados; la superación de posgrado constituye una vía para sistematizar conocimientos y fortalecer competencias profesionales que impacten de manera positiva en el PDCB. La intervención educativa se considera satisfactoria al elevar el nivel de conocimientos de pacientes y estomatólogos, lo que demuestra sus potencialidades para perfeccionar la ejecución del PDCB.

ABSTRACT Introduction: premalignant and malignant lesions of de oral area increase in the population which demands a correct implementation of the Early Detection of Oral Cancer Program. In this work transformations are exposed knowledge level of both patients and dentists regarding lesions concerning the Early Detection of Oral Cancer Program (EDOCP). Method: educational intervention was carried out in Julio Antonio Mella health area of Camaguey municipality from May 2022 to June 2023 which 36 patients and 30 Deontologists. Information sources were the Clinical History, a questionnaire and a test applied to patients and Deontologists respectively, before and after the intervention, to confirm the transformations in the sample. Results: Prior to intervention patients were poorly informed about consequences of toxic, hygienic and dietetic habits combined with lack of knowledge regarding importance of a correct oral self-examination whose knowledge improved to reach a high level in most of them after the intervention. Deontologists improved their knowledge on diagnosis and follow-up of premalignant and malignant lesions affecting the maxillofacial complex. Discussion: correct application of the EDOCP depends on both patients and deontologists, however reserchers focus on the former due to the reported benefits; the postgraduate training is a way to systematize knowledge and strengthen professional competences with positive impact on EDOCP. The educational intervention was satisfactory since it improved the level of knowledge of both patients and dentists which shows its potential on a correct implementation of the Early Detection of Oral Cancer Program.