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Jaime Tamez-Salazar Teresa Mireles-Aguilar Cynthia de la Garza-Ramos Marisol Garcia-Garcia Ana S. Ferrigno Alejandra Platas Cynthia Villarreal-Garza 《The oncologist》2020,25(12):1047-1054
IntroductionIn Mexico, there are considerable health system delays in the diagnosis and treatment initiation of women with breast cancer. Alerta Rosa is a navigation program in Nuevo Leon that aims to reduce barriers that impede the timely management of these patients.Patients and MethodsSince December 2017, women who registered to receive medical evaluations by Alerta Rosa were stratified based on their clinical characteristics into three priority groups (“Red,” “Yellow,” and “Green”). According to the category assigned, patients were scheduled imaging studies and medical appointments with breast specialists on a preferential basis.ResultsUp until December 2019, 561 patients were scheduled for medical evaluations. Of them, 59% were classified as “Red,” 25% “Yellow,” and 16% “Green” priority. The median time from stratification to first medical evaluation was 4, 6, and 7 days, respectively (p = .003). Excluding those who had a prior breast cancer diagnosis, 21 patients were diagnosed by Alerta Rosa, with the initial “Red” priority classification demonstrating a sensitivity of 95% (95% confidence interval [CI], 75.1%–99.9%) and specificity of 42% (95% CI, 37.1%–47.1%) for breast cancer. The median time elapsed from initial patient contact to diagnosis and treatment initiation was 16 days and 39 days, respectively. The majority (72%) of patients were diagnosed at an early stage (0–II).ConclusionThis patient prioritization system adequately identified women with different probabilities of having breast cancer. Efforts to replicate similar triage systems in resource‐constrained settings where screening programs are ineffective could prove to be beneficial in reducing diagnostic intervals and achieving early‐stage diagnoses.Implications for PracticeLow‐ and middle‐income countries such as Mexico currently lack the infrastructure to achieve effective breast cancer screening and guarantee prompt access to health care when required. To reduce the disease burden in such settings, strategies targeting early detection are urgently needed. Patient navigation programs aid in the reduction of health system intervals and optimize the use of available resources. This article presents the introduction of a triage system based on initial patient concern. Appointment prioritization proved to be successful at reducing health system intervals and achieving early‐stage diagnoses by overcoming barriers that impede early access to quality medical care. 相似文献
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Jaime Feliu Beatriz Jiménez-Munárriz Laura Basterretxea Irene Paredero Elisenda Llabrés Maite Antonio-Rebollo Beatriz Losada Enrique Espinosa Regina Gironés Ana Belén Custodio María del Mar Muñoz Mariana Díaz-Almirón Jeniffer Gómez-Mediavilla Alvaro Pinto María-Dolores Torregrosa Gema Soler Patricia Cruz Oliver Higuera María José Molina-Garrido 《The oncologist》2020,25(10):e1516-e1524
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Anahi González-Acevedo Juan A. García-Salas Jaime Gosálvez José Luis Fernández Martha I. Dávila- Rodríguez Ricardo M. Cerda-Flores 《Toxicology mechanisms and methods》2016,26(1):61-66
The concentrations of recognized or suspected genotoxic and carcinogenic agents found in the air of large cities and, in particular, developing countries, have raised concerns about the potential for chronic health effects in the populations exposed to them. The biomonitoring of environmental genotoxicity requires the selection of representative organisms as “sentinels,” as well as the development of suitable and sensitive assays, such as those aimed at assessing DNA damage. The aim of this study was to evaluate DNA damage levels in erythrocytes from Columba livia living in the metropolitan area of Monterrey, Mexico, compared with control animals via comet assay, and to confirm the results via Micronuclei test (MN) and DNA breakage detection–fluorescence in situ hybridization (DBD–FISH). Our results showed a significant increase in DNA migration in animals from the area assayed compared with that observed in control animals sampled in non-contaminated areas. These results were confirmed by MN test and DBD–FISH. In conclusion, these observations confirm that the examination of erythrocytes from Columba livia via alkaline comet assay provides a sensitive and reliable end point for the detection of environmental genotoxicants. 相似文献
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Jaime Signes-Costa José Ignacio de Granda-Orive Ángela Ramos Pinedo Ana Camarasa Escrig Eva de Higes Martínez Carlos Rábade Castedo Eva Cabrera César Carlos A. Jiménez-Ruiz 《Archivos de bronconeumología》2019,55(11):581-586
The use of novel tobacco products, particularly the electronic cigarette (EC) and partial tobacco combustion devices (HnB systems: Heat not Burn), has increased exponentially, particularly among adolescents and young people. The health authorities and scientific societies have shown concern about issues surrounding safety and effectiveness (as a method of smoking cessation). A study of the available scientific evidence has concluded that the safety of the vapor or fumes inhaled by the users of these devices cannot be guaranteed. Contradictory results from various clinical trials and meta-analyses also mean that these devices cannot be recommended for their effectiveness in cessation, especially when safe and effective treatments are available to help quit smoking (varenicline, nicotine replacement therapy, and bupropion, combined with psychological counseling). 相似文献