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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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Marisol Perez-Toledo 《Platelets》2020,31(4):412-414
Abstract Thrombocytopenia and vascular leakage are clinical hallmarks in dengue hemorrhagic fever. Sung et al. present a new mechanism where platelet-derived extracellular vesicles participate in increasing vascular permeability during dengue virus infection in mice. 相似文献
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Evidence‐ and consensus‐based (S3) Guidelines for the Treatment of Actinic Keratosis – International League of Dermatological Societies in cooperation with the European Dermatology Forum – Short version 下载免费PDF全文
R.N. Werner E. Stockfleth S.M. Connolly O. Correia R. Erdmann P. Foley A.K. Gupta A. Jacobs H. Kerl H.W. Lim G. Martin M. Paquet D.M. Pariser S. Rosumeck H.‐J. Röwert‐Huber A. Sahota O.P. Sangueza S. Shumack B. Sporbeck N.A. Swanson L. Torezan A. Nast 《Journal of the European Academy of Dermatology and Venereology》2015,29(11):2069-2079
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Robson Frederico Cunha Alberto Carlos Botazzo Delbem Adriana Sales Cunha Correia Renata Zoccal Novais 《Dental traumatology》2008,24(6):e81-e84
Abstract – This article reports a longitudinal follow‐up of a 15‐month‐old child with dental trauma resulting from an attack by a dog. The injury consisted of laceration of the facial tissues and loss of the upper central deciduous incisors, in addition to loss of bone tissue in the same area. A malformation of the crown of the right central permanent incisor and complete change of the shape of the left central permanent incisor were observed. The etiological factors of childhood injuries as well as the importance of dental emergency care are discussed and the 14‐year clinical and radiographic follow up of the case is presented. 相似文献