tbuckley/cabot-search huggingface dataset:
A multicenter phase II study of the efficacy and safety of quisinostat (an HDAC inhibitor) in combination with paclitaxel and carboplatin chemotherapy (CT) in patients (pts) with recurrent platinum resistant high grade serous epithelial ovarian, primarily peritoneal or fallopian tube carcinoma cancer (OC).
Authors: Sergei Tjulandin, Mikhail Fedyanin, Vladimir Ivanovich Vladimirov, Vladimir Kostorov, Alla Sergeevua Lisyanskaya, Ludmila Krikunova, Andrew Cakana, Valeria Azarova, Oksana Karavaeva, Natalia Vostokova, Sergey Baranovsky
Journal: Journal of Clinical Oncology (2017)

5541 Background: Quisinostat is an orally bioavailable potent pan-histone deacetylase inhibitor. Combinations of HDAC inhibitors with paclitaxel or cisplatin demonstrate promising results in preclinical models with cisplatin and paclitaxel resistant OC. In phase Ib study the dosage of Quisinostat in combination of paclitaxel and carboplatin recommended for the phase II study was 12 mg. We report results of the phase II study of Quisinostat in combination with paclitaxel and carboplatin in pts with recurrent platinum resistantOC. Methods: the main inclusion criteria was tumor progression observed not less than 1 month and no more than 6 months after completion of the planned number of cycles of 1 st line platinum/paclitaxel based CT. Quisinostat was administered at dose 12 mg p.o. each 3 week cycle on Days 1, 3, 5, 7, 9, 11 with of paclitaxel (175 mg/m 2 ) and carboplatin (AUC5) on Day 7 of each cycle, for 2 nd line. Pts received up to 6 cycles. The primary efficacy endpoint is the objective response rate (ORR) verified by the ICR. The secondary endpoints include safety, progression free survival (PFS) and overall survival. The study design implies the use of the two-stage Simon model: 29 patients who underwent treatment would provide 80% power for hypothesis testing in order to frequency of the ORR 30% (α = 0.05). Results: 31 pts were enrolled (30 pts evaluated). Median age was 57 years. Twenty one pts (67.7%) received all 6 cycles of therapy. ORR was 50.0% (15 pts). Median duration of response was 5 months (4.2-5.7). Median PFS - 6 months (95%CI 4.4-7.6). Any SAE were seen in 16.1% pts, AE of grade 3 and 4 – in 71% and 48.4% pts temporarily discontinued therapy due to AE. Dose reduction of CT due to AE was performed in 22.6% pts. The most common adverse events were neutropenia – 67,7%, nausea – 61.3%, weakness – 29%, thrombocytopenia – 22.6%, neuropathy – 19.4%, vomiting – 19.4%. Conclusions: Quisinostat in combination with paclitaxel and carboplatin in pts with recurrent platinum resistant ovarian cancer showed high efficacy and good tolerability Clinical trial information: NCT02948075.
Nivolumab (N) plus ipilimumab (I) as first-line (1L) treatment for advanced (adv) NSCLC: 2-yr OS and long-term outcomes from CheckMate 012.
Authors: Jonathan Wade Goldman, Scott Joseph Antonia, Scott N. Gettinger, Hossein Borghaei, Julie R. Brahmer, Neal E. Ready, David E. Gerber, Laura Q. Chow, Rosalyn A. Juergens, Frances A. Shepherd, Scott Andrew Laurie, William J. Geese, Ang Li, Xuemei Li, Matthew David Hellmann
Journal: Journal of Clinical Oncology (2017)

9093 Background: The fully human anti–PD-1 antibody N offers long-term OS benefit in patients (pts) with previously treated adv NSCLC. Adding I (anti–CTLA-4 antibody) to N has been shown to improve clinical activity vs either agent alone in multiple tumor types. We present long-term data for 1L N+I treatment of pts with adv NSCLC from CheckMate 012. Methods: In two cohorts in this phase 1 study, pts with recurrent stage IIIb/IV, chemotherapy-naive NSCLC and ECOG PS 0–1 received N 3 mg/kg Q2W combined with I 1 mg/kg Q12W (n=38) or Q6W (n=39) until disease progression, unacceptable toxicity, or consent withdrawal. The primary endpoint was safety and tolerability. Secondary endpoints included investigator-assessed ORR (RECIST v1.1) and PFS. Exploratory endpoints included OS and efficacy by tumor PD-L1 expression. Results: In the N+I Q12W and N+I Q6W cohorts, respectively, 42% and 31% of pts experienced grade 3–4 treatment-related (TR) AEs; 18% in each cohort discontinued due to any-grade TRAEs. The most frequently reported any-grade TRAEs were pruritus (26%) and diarrhea (21%) with N+I Q12W, and fatigue (26%) and diarrhea (23%) with N+I Q6W. There were no TR deaths. N+I showed promising efficacy (table). While efficacy was enhanced with increasing PD-L1 expression, activity was noted in pts with &lt;1% PD-L1 (table). Of 6 complete responses (CRs), 3 were in pts with &lt;1% PD-L1. Conclusions: 1L therapy with N+I demonstrates a manageable safety profile and promising, durable efficacy (including pathological CRs) in adv NSCLC; efficacy was enhanced in pts with ≥1% PD-L1 tumor expression. Longer follow-up data, including 2-yr OS and characteristics of long-term survivors, will be presented. Clinical trial information: NCT01454102. [Table: see text]
Adenocarcinoma of the Pyloric Stomach and Other Gastric Neoplasms in Mice Induced With Carcinogenic Hydrocarbons&lt;xref ref-type="fn" rid="fn1"&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/xref&gt;
Authors: Harold L. Stewart, Egon Lorenz
Journal: JNCI Journal of the National Cancer Institute (1942)

Adenocarcinoma of the Pyloric Stomach and Other Gastric Neoplasms in Mice Induced With Carcinogenic Hydrocarbons Harold L. Stewart, Harold L. Stewart senior pathologist Search for other works by this author on: Oxford Academic PubMed Google Scholar Egon Lorenz Egon Lorenz senior physicist National Cancer Institute, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 3, Issue 2, October 1942, Pages 175–189, https://doi.org/10.1093/jnci/3.2.175 Published: 01 October 1942
GW28-e1095 The impact of serum adiponectin level on morbidity and prognosis in patients with acute myocardial infarction
Authors: Liangping Zhao, Haizhou Shu, Biao Yao, Maosong Wang, Yuqi Chen, Weiting Xu, Jianchang Chen, Liangping Zhao
Journal: Journal of the American College of Cardiology (2017)
Pathological characteristics and prognosis of a cohort of 57 patients (pts) with de novo oligometastatic breast cancer (OMBC)
Authors: S. Chretien, N. Kotecki, J. Wallet, C. Desmedt, A. Mailliez, C. Regis, D. Pasquier, Y-M. Robin, J. Bonneterre
Journal: Annals of Oncology (2017)
Precision Transplant Medicine: Biomarkers to the Rescue
Authors: Maarten Naesens, Dany Anglicheau
Journal: Journal of the American Society of Nephrology (2017)

The concept that individuals with the same disease and a similar clinical presentation may have very different outcomes and need very different therapies is not novel. With the development of many innovative tools derived from the omics technologies, transplant medicine is slowly entering the era of precision medicine. Biomarkers are the cornerstone of precision medicine, which aims to integrate biomarkers with traditional clinical information and tailor medical care to achieve the best outcome for an individual patient. Here, we discuss the basic concepts of precision medicine and biomarkers, with a specific focus on progress in renal transplantation. We delineate the different types of biomarkers and provide a general assessment of the current applications and shortcomings of previously proposed biomarkers. We also outline the potential of precision medicine in transplantation. Moving toward precision medicine in the field of transplantation will require transplant physicians to embrace the increased complexity and expanded decision algorithms and therapeutic options that are associated with improved disease nosology.
Abstract 19823: Japanese Multicenter Study on the Prognostic Efficacy of Out-patient Cardiac Rehabilitation in Patients With Coronary Artery Disease: J-REHAB
Authors: Yoichi Goto, Ryuji Nohara, Hiroyuki Daida, Takashi Masuda, Masahiro Kohzuki, Shigeru Makita, Kenji Ueshima, Hideki Origuchi, Hitoshi Adachi, Masatoshi Nagayama, Kazuto Omiya, Mari Nishizaki, Yutaka Kimura, Takanori Yasu, Toshihiro Tsurukawa, Shin-ichi Momomura
Journal: Circulation (2015)

Introduction: Although the prognostic efficacy of out-patient cardiac rehabilitation (OPCR) in patients with coronary artery disease (CAD) has been established in Western countries, it has not been studied in Japan, where both incidence and mortality of CAD are known to be much lower than in Western counties. Methods: To determine the prognostic efficacy of OPCR in Japan, a prospective, controlled, multicenter study of OPCR (J-REHAB) was conducted in 15 hospitals in Japan. A total of 1047 patients hospitalized with cardiac events were prospectively assigned to either OPCR group (n=848) or Non-OPCR group (n=199) according to patient’s preference at the time of hospital discharge. Patients in OPCR group were scheduled to participate in a comprehensive OPCR program for 3 months and Non-OPCR group received usual care. Event-free survivals for cardiac and all-cause death/rehospitalization were assessed according to the initial group assignment and the “prespecified” actual OPCR performance (attendance &gt;=4 times/month and total exercise time &gt;=150 min/week). Results: Patients were followed-up for 416days on average and the follow-up rate was 99.4%. At baseline, patients were 64±11years of age, 85% was male, 58% acute myocardial infarction, with preserved EF (53±13%). By Kaplan-Meier analysis, OPCR group had significantly better event-free survival for cardiac death/rehospitalization (p&lt;0.05) and all-cause death/rehospitalization (p&lt;0.001) than Non-OPCR group. However, after Cox proportional hazard analysis including patient characteristics (underlying heart disease, NYHA class, EF, residual coronary stenosis, heart rate, peak oxygen uptake, and ACE inhibitor/ARB), these differences were no more significant. In contrast, Cox analysis based on prespecified actual OPCR performance (good [n=352], partial [n=321], and poor [n=374]) revealed that good OPCR performance (i.e., active participation) was a potent independent determinant of both cardiac and all-cause event-free survival (both p&lt;0.01). Conclusions: The first Japanese prospective multicenter J-REHAB study has demonstrated that active participation in OPCR is associated with better event-free survival in CAD patients, independent of baseline clinical characteristics.
Sweet-Like Eruption Associated With Obinutuzumab Therapy for Chronic Lymphocytic Leukemia
Authors: Abraham M. Korman, Justin G. Hastings, John C. Byrd, Benjamin H. Kaffenberger
Journal: JAMA Dermatology (2016)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Dermatology journal
Cobertura vacinal na União Europeia
Authors: N Guérin, C Roure
Journal: Eurosurveillance (1997)

Os 15 paises da Uniao Europeia (UE) ratificaram o 5o objectivo do programa “Saude para todos no ano 2000”, da OMS Regiao Europeia, que declara: “Pelo ano 2000, nao deve existir nenhum caso autoctone de poliomielite, difteria, tetano neonatal, sarampo, parotidite e rubeola congenita, na regiao e deve existir uma reducao importante e continua da incidencia e consequencias nefastas de outras doencas transmissiveis, em particular da infeccao pelo HIV”.
Etanercept‐Induced Lymphocytic Infiltration of Jessner‐Kanof
Authors: Noémie Abbad, Tristan Lanal, Céline Brenuchon, Gauthier Morel, Xavier Deprez
Journal: Arthritis & Rheumatology (2017)

The patient, a 52-year-old man presented a two-week history of asymptomatic multiple erythematous papules on the upper back (Panel A). The skin lesion had arisen 3 weeks after starting therapy with etanercept for axial spondyloarthritis. For several months, the patient had been taking NSAI and tramadol.

A biopsy specimen from a lesion revealed a dense lymphocytic infiltrate of the superficial and mid-dermis (arrow) with perivascular and perifollicular distribution (Panel B).

This article is protected by copyright. All rights reserved.
Efficacy and safety of once-monthly pasireotide in Cushing's disease: a 12 month clinical trial
Authors: André Lacroix, Feng Gu, Wilson Gallardo, Rosario Pivonello, Yerong Yu, Przemysław Witek, Marco Boscaro, Roberto Salvatori, Masanobu Yamada, Libuse Tauchmanova, Michael Roughton, Shoba Ravichandran, Stephan Petersenn, Beverly M K Biller, John Newell-Price, Giorgio Arnaldi, Hesarghatta Shyamasunder Asha, Tushar Bandgar, Ariel Barkan, Henrik Biering, Marie Bex, Marek Bolanowski, Marcello Delano Bronstein, Thierry Brue, Dario Bruera, Francesco Cavagnini, Abdurrahman Comlekci, Christophe De Block, Tuncay Delibasi, Carmen Fajardo-Montañana, Richard Abraham Feelders, Maria Fleseriu, Monica Roberto Gadelha, Eliza Brevoort Geer, Anthony Heaney, Ghislaine Houde, Atsuhiro Ichihara, Syed Ali Imran, Adriana Ioachimescu, Pinar Kadioglu, Yiming Li, Paola Loli, Mitsuru Nishiyama, Liudmila Rozhinskaya, Marek Ruchala, Youichi Saitoh, Christof Schöfl, Jochen Schopohl, Akira Shimatsu, Chikara Shimizu, Thiti Snabboon, Peter Snyder, Noriyuki Suzaki, Antoine Tabarin, Yutaka Takahashi, Susana Tara Britto, Guy T'Sjoen, Marie-Christine Vantyghem, Brigitte Velkeniers, Susan Webb, Shozo Yamada
Journal: The Lancet Diabetes & Endocrinology (2017)
Uomini che hanno rapporti sessuali con altri uomini e prevenzione dell'HIV/AIDS in Svizzera: 1987-2000
Authors: F Dubois-Arber, F Moreau-Gruet
Journal: Eurosurveillance (2002)

Benche l'ultimo studio sui comportamenti preventivi di uomini che hanno rapporti sessuali con altri uomini in Svizzera indichi una diminuzione dei casi di HIV dopo il 1992, e stata osservata anche una diminuzione del livello di protezione. Questo potrebbe portare a un tasso di notifiche di HIV piu alto nel 2001 rispetto al 2000.
Sorveglianza sierologica della rosolia in Europa: la rete europea ESEN2
Authors: A Nardone, E Miller
Journal: Eurosurveillance (2004)

La sorveglianza sierologica e un'importante risorsa per valutare i programmi di vaccinazione, in particolare per le malattie come la rosolia, in cui un programma non ottimale puo condurre a un aumento della morbosita. Una politica di vaccinazione coordinata e necessaria in Europa e l'obiettivo dello European Sero-Epidemiology Network (ESEN2) e di standardizzare nei 22 paesi la sorveglianza sierologia di otto malattie, tra le quali la rosolia.
Association of the rs4567312 variant in the leptin receptor gene with plasma leptin concentrations and lung cancer incidence in the PREDIMED study
Authors: J.B. Ramirez Sabio, J.V. Sorlí, C. Ortega-Azorín, P. Carrasco, E.M. Asensio, R. Barragán, R. Fernández-Carrión, C. Gallego, J.I. González-Arráez, J.A. Perez Fidalgo, Ó. Coltell, D. Corella
Journal: Annals of Oncology (2017)
GW28-e0065 Serial Assessment of Tissue Precursors and Progression of Coronary Artery Calcification Analyzed by Fusion of Intravascular Ultrasound and Optimal Coherent Tomography: A Five Years Follow-up of Scaffold and Non-scaffold Arteries
Authors: Yaping Zeng, Patrick W. Serruys
Journal: Journal of the American College of Cardiology (2017)
Uromodulin p.Cys147Trp mutation drives kidney disease by activating ER stress and apoptosis
Authors: Bryce G. Johnson, Lan T. Dang, Graham Marsh, Allie M. Roach, Zebulon G. Levine, Anthony Monti, Deepak Reyon, Lionel Feigenbaum, Jeremy S. Duffield
Journal: Journal of Clinical Investigation (2017)

Uromodulin-associated kidney disease (UAKD) is caused by mutations in the uromodulin (UMOD) gene that result in a misfolded form of UMOD protein, which is normally secreted by nephrons. In UAKD patients, mutant UMOD is poorly secreted and accumulates in the ER of distal kidney epithelium, but its role in disease progression is largely unknown. Here, we modeled UMOD accumulation in mice by expressing the murine equivalent of the human UMOD p.Cys148Trp point mutation (UmodC147W/+ mice). Like affected humans, these UmodC147W/+ mice developed spontaneous and progressive kidney disease with organ failure over 24 weeks. Analysis of diseased kidneys and purified UMOD-producing cells revealed early activation of the PKR-like ER kinase/activating transcription factor 4 (PERK/ATF4) ER stress pathway, innate immune mediators, and increased apoptotic signaling, including caspase-3 activation. Unexpectedly, we also detected autophagy deficiency. Human cells expressing UMOD p.Cys147Trp recapitulated the findings in UmodC147W/+ mice, and autophagy activation with mTOR inhibitors stimulated the intracellular removal of aggregated mutant UMOD. Human cells producing mutant UMOD were susceptible to TNF-α– and TRAIL-mediated apoptosis due to increased expression of the ER stress mediator tribbles-3. Blocking TNF-α in vivo with the soluble recombinant fusion protein TNFR:Fc slowed disease progression in UmodC147W/+ mice by reducing active caspase-3, thereby preventing tubule cell death and loss of epithelial function. These findings reveal a targetable mechanism for disease processes involved in UAKD.
Multiplexed targeted proteomics signature for serum diagnostic of malignant pleural mesothelioma
Authors: F. Cerciello, M. Choi, K. Lomeo, J.M. Amann, E. Felley-Bosco, R.A. Stahel, B. Robinson, J. Creaney, H.I. Pass, O. Vitek, D.P. Carbone
Journal: Annals of Oncology (2017)
High-Sensitivity Cardiac Troponin and the Risk Stratification of Patients With Renal Impairment Presenting With Suspected Acute Coronary Syndrome
Authors: Eve Miller-Hodges, Atul Anand, Anoop S.V. Shah, Andrew R. Chapman, Peter Gallacher, Kuan Ken Lee, Tariq Farrah, Nynke Halbesma, James P. Blackmur, David E. Newby, Nicholas L. Mills, Neeraj Dhaun
Journal: Circulation (2017)

Background: High-sensitivity cardiac troponin testing may improve the risk stratification and diagnosis of myocardial infarction, but concentrations can be challenging to interpret in patients with renal impairment, and the effectiveness of testing in this group is uncertain. Methods: In a prospective multicenter study of consecutive patients with suspected acute coronary syndrome, we evaluated the performance of high-sensitivity cardiac troponin I in those with and without renal impairment (estimated glomerular filtration rate &lt;60mL/min/1.73m 2 ). The negative predictive value and sensitivity of troponin concentrations below the risk stratification threshold (5 ng/L) at presentation were reported for a primary outcome of index type 1 myocardial infarction, or type 1 myocardial infarction or cardiac death at 30 days. The positive predictive value and specificity at the 99th centile diagnostic threshold (16 ng/L in women, 34 ng/L in men) was determined for index type 1 myocardial infarction. Subsequent type 1 myocardial infarction and cardiac death were reported at 1 year. Results: Of 4726 patients identified, 904 (19%) had renal impairment. Troponin concentrations &lt;5 ng/L at presentation identified 17% of patients with renal impairment as low risk for the primary outcome (negative predictive value, 98.4%; 95% confidence interval [CI], 96.0%–99.7%; sensitivity 98.9%; 95%CI, 97.5%–99.9%), in comparison with 56% without renal impairment ( P &lt;0.001) with similar performance (negative predictive value, 99.7%; 95% CI, 99.4%–99.9%; sensitivity 98.4%; 95% CI, 97.2%–99.4%). The positive predictive value and specificity at the 99th centile were lower in patients with renal impairment at 50.0% (95% CI, 45.2%–54.8%) and 70.9% (95% CI, 67.5%–74.2%), respectively, in comparison with 62.4% (95% CI, 58.8%–65.9%) and 92.1% (95% CI, 91.2%–93.0%) in those without. At 1 year, patients with troponin concentrations &gt;99th centile and renal impairment were at greater risk of subsequent myocardial infarction or cardiac death than those with normal renal function (24% versus 10%; adjusted hazard ratio, 2.19; 95% CI, 1.54–3.11). Conclusions: In suspected acute coronary syndrome, high-sensitivity cardiac troponin identified fewer patients with renal impairment as low risk and more as high risk, but with lower specificity for type 1 myocardial infarction. Irrespective of diagnosis, patients with renal impairment and elevated cardiac troponin concentrations had a 2-fold greater risk of a major cardiac event than those with normal renal function, and should be considered for further investigation and treatment. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT01852123.
GW28-e0861 The role of Holter in the diagnosis of early repolarization pattern
Authors: Chengcheng Ji, Yunjiu Cheng, Lijuan Liu, Xiaoxiong Lin, Kang Tang, Weiqi Zhu, Ying Huang, Yuying Jiang, Hong Ma, Suhua Wu
Journal: Journal of the American College of Cardiology (2017)
Impact of zumor mutation burden on nivolumab efficacy in second-line urothelial carcinoma patients: Exploratory analysis of the phase ii checkmate 275 study
Authors: M.D. Galsky, A. Saci, P.M. Szabo, A. Azrilevich, C. Horak, A. Lambert, A. Siefker-Radtke, A. Necchi, P. Sharma
Journal: Annals of Oncology (2017)
Effects of Behavioral Interventions on Inappropriate Antibiotic Prescribing in Primary Care 12 Months After Stopping Interventions
Authors: Jeffrey A. Linder, Daniella Meeker, Craig R. Fox, Mark W. Friedberg, Stephen D. Persell, Noah J. Goldstein, Jason N. Doctor
Journal: JAMA (2017)

This study examines assesses inappropriate antibiotic prescribing 12 months after stopping a randomized clinical trial of a behavioral intervention intended to reduce the rate of inappropriate antibiotic prescribing for acute respiratory infections.
The <i>HRD</i> Decision<i>—</i>Which PARP Inhibitor to Use for Whom and When
Authors: Elise C. Kohn, Jung-min Lee, S. Percy Ivy
Journal: Clinical Cancer Research (2017)

Rucaparib, a polyADPribose polymerase inhibitor (PARPi), was approved recently for use in women with high-grade serous ovarian cancer (HGSOC). It is now one of three approved PARPi for use in recurrent ovarian cancer, a family of agents that has changed the HGSOC treatment landscape and outcome. Clin Cancer Res; 23(23); 7155-7. ©2017 AACRSee related article by Balasubramaniam et al., p. 7165.
Cobertura vacunal de niños en edad preescolar en Francia, 2000
Authors: D Antona, E Bussière, N. Guignon, G Badeyan, D Lévy-Bruhl
Journal: Eurosurveillance (2003)

Este articulo presenta los resultados de las principales medidas de cobertura vacunal adoptadas en Francia en ninos de hasta seis anos de edad. La cobertura vacunal es muy elevada para enfermedades como la difteria, el tetanos, pertussis y poliomielitis, y satisfactoria en infecciones invasivas por Haemophilus influenzae b. Sin embargo, es necesario aumentar la cobertura vacunal contra el sarampion, la parotiditis y la rubeola en la poblacion infantil y garantizar una campana de barrido eficaz. La cobertura vacunal contra la hepatitis B es deficiente en lactantes, y podria mejorar cuando este disponible la vacuna combinada.