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Cancer immunotherapy-associated hypophysitis
(2019-08-19) Castillero Rodríguez, Franklin Agustín; Castillo Fernández, Omar; Jiménez Jiménez, Geiner; Fallas Ramírez, José Manuel; Peralta Álvarez, Marco Polo; Arrieta Rodríguez, Óscar Gerardo
The advances in cancer therapy have included the development of drugs that inhibit immune checkpoint ligands. Two types of immune checkpoint inhibitors, both antibodies that target CTLA-4 and PD-1, have been approved for its use in NSCLC and melanoma as first-line or second-line therapy. Sadly, not desirable consequences of immunotherapy are immune-related adverse events. immune-related hypophysitis is the most common endocrine adverse event after thyroid disfunction. The particularity of endocrine immunerelated adverse events is their non-reversibility, with incidence and prevalence destined to increase in the coming years, particularly if this form of therapy is used in the future for earlier stages of cancer. Therefore, hypophysitis represents a challenge for the physician, sometimes occurring without specific symptomatology and which should be considered for clinical management. In this review, we describe the current data regarding the pathophysiology and management for immune-related hypophysitis.
"Amigos a la distancia": una iniciativa de trabajo comunal universitario para el acompañamiento de las personas adultas mayores en tiempo de la pandemia ocasionada por el COVID-19
(2022-12-01) Brokke Morales, Melissa; Mora Román, Juan José; Weng Huang, Nien-Tzu; Fallas Ramírez, José Manuel; Porras Navarro, Marta; Arévalo Aguilón, Mercedes
El 11 de marzo de 2020, la Organización Mundial de la Salud declaró una pandemia causada por el COVID-19, generando cambios radicales en el estilo de vida de la población. Todas las personas tuvieron que modificar su forma de vivir y adaptarse a una nueva realidad. Este contexto promovió el desarrollo de iniciativas como la denominada "Amigos a la distancia", dentro del proyecto de trabajo comunal TC-678 Promoción del envejecimiento saludable y de la solidaridad intergeneracional en las comunidades de Cartago de la Universidad de Costa Rica. Por lo anterior, el propósito es sistematizar la experiencia de las personas adultas mayores y del estudiantado con esta actividad. La intervención consistió en la realización de llamadas telefónicas a personas adultas mayores con mayor vulnerabilidad, que asistían al Centro Diurno de Quebradilla, para brindarles el correspondiente acompañamiento. La información recopilada durante las mismas fue registrada y sistematizada mediante un análisis de contenido. Asimismo, se llevó a cabo una evaluación, tanto a la población beneficiaria como al estudiantado con participación activa. Los resultados principales incluyeron el establecimiento de siete categorías: información personal de las personas adultas mayores, situación de salud actual de las personas participantes, actividades cotidianas, limitaciones experimentadas como consecuencia de las restricciones sanitarias impuestas por la pandemia, problemas originados por la pandemia del COVID-19, aspectos positivos percibidos durante la pandemia, y otros aspectos de importancia. Con ello, fue posible notar con mayor claridad las vivencias de esta población durante el inicio de la pandemia, y la influencia en su estado físico y emocional. Como complemento, las personas beneficiarias refirieron haber tenido una muy buena percepción de la misma, al igual que el estudiantado participante. Ante la evaluación recibida, iniciativas de esta naturaleza deben mantenerse en el corto y mediano plazo, inclusive si se vuelve a las actividades presenciales.
P-179: Identifying successful cognitive aging endophenotypes in the Central Valley of Costa Rica
(2007-07-01) Silverman, Jeremy M.; Schnaider Beeri, Michal; Edland, Steven; Raventós Vorst, Henriette; Valerio Aguilar, Daniel; Pereira Castro, Mariana; Grossman, Hillel; Hannigan, Christine
Background: Successful cognitive aging (SCA) is a genetically complex desirable trait. Gene identification will thus be facilitated through the delineation of cognitive endophenotypes, i.e., intermediate traits that are more direct expressions of single specific genes or a small number of genes. Strong delayed recall and psychomotor speed are both promising candidates for such endophenotypes. We looked at these functions in the offspring of very elderly (90+) nondemented (VEND) probands and two comparison groups from the Central Valley of Costa Rica (CVCR), a population with increased genetic homogeneity. Objective(s): To identify cognitive endophenotypes for SCA.
Methods
Delayed recall and psychomotor speed were assessed in 52 VEND probands from the CVCR and 76 of their aged 60+ year old offspring. Two CVCR comparison family groups were also assessed: 1) 24 very elderly demented (VED) probands and 43 of their 60+ year old offspring; 2) 31 young nondemented elderly (YND) probands and 67 of their 60+ year old siblings. Results: Using a random effects model controlling for age, sex, and education delayed recall was significantly better among VEND offspring than VED offspring (P<.05) and nominally better than YND siblings. Psychomotor speed was significantly better among VEND offspring then YND siblings (P<.05) and nominally better than VED offspring. Conclusions: These data offer preliminary evidence that delayed recall and psychomotor speed functions are useful endophenotypes for SCA.
Exploring the FAO Minimum Dietary Diversity Indicator as a Suitable Proxy of Micronutrient Adequacy in Men and Women Across Reproductive and Non-reproductive Ages in 8 Latin American Countries
(2024-05-28) Gómez Salas, Georgina; Monge Rojas, Rafael; Vargas Quesada, Rulamán; Nogueira Previdelli, Agatha; Quesada Quesada, Dayana María; Kovalskys, Irina; Herrera Cuenca, Marianella; Cortes, Lilia Yadira; Yepez García, Martha Cecilia; Liria Domínguez, Reyna; Rigotti, Attilio; Mara Fisberg, Regina; Ferrari, Gerson Luis de Morais; Fisberg, Mauro; Brenes Sáenz, Juan Carlos
Background:
Women’s Dietary Diversity Score (WDDS) is an indicator of dietary diversity, a key component of diet quality in women of reproductive age (WRA). Limited information is available regarding its applicability in other population groups.
Objective:
To examine the ability of the Minimum Dietary Diversity for Women (MDD-W) of 5-food groups cutoff to predict micronutrient adequacy in men and women 15 to 65 years old from 8 Latin American countries.
Methods:
We used a 24-hour recall from 9216 participants in the Latin American Study on Nutrition and Health (ELANS) to determine Dietary Diversity Score (DDS) based on the consumption of 10 food groups. The Mean Probability of Adequacy (MPA) was associated with DDS for the overall sample, for men, WRA, and women of nonreproductive age (WNRA). Sensitivity and specificity analyses were performed to determine if the 5-food groups cutoff point for MDD can be used to correctly identify men, WRA, and WNRA with adequate micronutrient adequacy (MPA ≥ 0.70).
Results:
We found a mean DDS of 4.78 ± 1.33 and an MPA of 0.64 ± 0.16, with 59% of participants showing a diverse diet (DDS ≥ 5). The 5-food groups-cutoff point showed a better balance between sensitivity and specificity predicting an MPA ≥0.70 in men, WRA, and WNRA. MPA was significantly associated with DDS in WRA and for men and WNRA, as well.
Conclusion:
The 5-food group MDD, originally intended to be used in WRA, performed equally well in predicting MPA ≥0.70 in men, WRA, and WNRA, and can be used as a proxy of micronutrient adequacy in Latin American population.
Role of Residence Area on Diet Diversity and Micronutrient Intake Adequacy in Urban and Rural Costa Rican Adolescents
(2022-12-01) Monge Rojas, Rafael; Vargas Quesada, Rulamán; Gómez Salas, Georgina
Dietary diversity might be essential to meet nutritional demands during adolescence. Diet diversity among 818 urban and rural Costa Rican adolescents aged 13–18 years was studied using the Minimum Dietary Diversity Score for Women. The Nutrient Adequacy Ratio (NAR) was calculated for 11 nutrients to estimate the nutrient adequacy of the diet. A NAR < 0.7 was considered inadequate for micronutrient intake. The optimal Diet Diversity Score (DDS) cut-off point for this study was 4, established using receiver-operating characteristic curves. The mean DDS for the overall sample was 4.17 ± 1.43, although DDS was significantly higher in adolescents from rural vs. urban areas (4.33 ± 1.43 vs. 4.00 ± 1.42, p-value = 0.001). The odds of having a diverse diet were 62% higher in rural vs. urban adolescents. Overall, 80–95% of adolescents reached a NAR ≥ 0.70 for 8 nutrients except for calcium, zinc, and vitamin A. The residence area plays a key role in adolescent dietary diversity. Although overall DDS was low, foods that make up the rural adolescent diet were nutritionally dense enough to satisfy the EAR for most micronutrients. A high DDS is not necessarily required for the diet to meet most micronutrient demands in adolescence. Improved dietary adequacy of vitamin A, zinc, and calcium is required due to the importance of these micronutrients in maintaining optimal health.