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  • 1
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 83, No. 5_Supplement ( 2023-03-01), p. P5-04-09-P5-04-09
    Abstract: Introduction A minority of women with breast cancer in Mexico are diagnosed through a screening program with a low rate of national coverage of about 20%, which translates into late diagnosis and worse outcomes. The detection of high-risk groups through easy-access interventions is essential to increase the screening rate. OBJECTIVE To identify and analyze patients at high risk of breast cancer, through a web app specially designed for this purpose. MATERIAL AND METHODS The web app stratified respondents according to breast cancer risk into 4 categories: very high risk (symptomatic), high lifetime risk, average risk (usual screening recommendations), or low risk. The app was programmed to guide patients to a risk-based information page or urge them to seek medical advice if indicated (https://cuccuanl.com/tamiz_mama/). The web app also provided the contact information of our center, or an appointment could also be scheduled within the app. Distribution was made via social media. An upgrade of the app was launched, which expanded the functionality with the inclusion of the Gail model to identify women with a high lifetime risk for developing breast cancer and the option for a simple interpretation of mammographic results. In version 2.0, the patients were divided into 2 populations, the first one which already had a breast imaging test but wished to know what the BIRADS score obtained meant and the other group were those who answered a simple survey similar to the one available on version 1.0, with added questions to calculate the Gail model risk. RESULTS The web app was originally released in October 2021 with a total number of 1,012 women answering the survey. The update was released in June 2022 with 406 new subjects. 281 patients wished for a risk calculation with no prior breast imaging tests and 124 patients already had a breast image diagnosis test that wanted a simple interpretation. Table1 depicts the answers given between both versions. Among the group of patients that had a mammography but had doubts about the result 12.9% (n=16) reported a BIRADS 0, 12.1% (n=15) BIRADS 1, 46% (n=57) BIRADS 2, 14.5% (n=18) BIRADS 3, and 14.4% (n=18) BIRADS 4 or 5. To date 41 patients have booked an appointment at the cancer prevention clinic directly within the webapp for further evaluation. DISCUSSION AND CONCLUSION The changes in the criteria of high risk did not translate into changes in the proportion of patients considered at high lifetime risk of breast cancer, but these changes made might be more specific for subsequent screening and chemoprevention strategies. The app persisted with a high proportion of symptomatic patients. The results of integration of the simple mammography interpretation were surprising, with a high proportion of subjects with indication for a biopsy founded. In the Mexican population there is a significant gap between the screening mammography and the first consultation with a specialist, averaging 113 days from an abnormal screening test to a diagnosis of breast cancer (1), which delays treatment initiation resulting on a worst outcome. These kinds of apps may empower patients to seek earlier consultation if warranted or educate patients on their personal risk for developing cancer so they may have a closer adherence to early detection programs. These results and subsequent updates might help evolve the app into something more akin to a digital navigator for patients. Bibliography 1)Unger-Saldaña K, Cedano Guadiamos M. Delays to diagnosis and barriers to care for breast cancer in Mexico and Peru: a cross sectional study. The Lancet Global Health. 2020 Apr 1;8:S16. Table 1 Results stratified by risk groups between version 1.0 and 2.0 Citation Format: Jose F. Muñoz Lozano, Omar Zayas Villanueva, Estefania Abundis Marquez, Fernando Alcorta Nuñez, Maria Fernanda Noriega, Carlos Salazar Mejia, Celia B. Gonzalez Alcorta, Diana Cristina Pérez Ibave, Victor Oyervides Juarez, Larisa M. Renteria Garcia, Adelina Alcorta Garza, Juan Francisco Gonzalez Guerrero, David Hernandez, Rafael Piñeiro Retif, Oscar Vidal Gutiérrez. Analysis of an update to a novel breast cancer screening web-app [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-04-09.
    Type of Medium: Online Resource
    ISSN: 1538-7445
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2023
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  • 2
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 83, No. 5_Supplement ( 2023-03-01), p. P1-08-03-P1-08-03
    Abstract: INTRODUCTION Radiotherapy is an area of medicine that is little known by patients and that requires a long time for the doctor to be able to explain and resolve the doubts that arise in the first consultation, which may cause anxiety and low adherence to treatment recommendations. A mobile app called Canswer was developed to address this problem in a novel way to help patients learn about radiation oncology in their free time. OBJECTIVE Developed a mobile app that provides oncology radiotherapy information to patients. MATERIAL AND METHODS The patients who attended the consultation for the first time were provided with information and obtained verbal consent, later they were provided with the Canswer application on their mobile device, and at the end, a Likert-type perception survey was applied and the Cancer Treatment Survey (CATS), which analyzed the information needs of patients. Anxiety and depression were analyzed through the Hospital Anxiety and Depression Scale (HADS). RESULTS Of the total number of patients recruited, 17 patients from northeast Mexico with breast cancer agreed that the use of the application would be useful to them and were interested in receiving additional information after their first-time radiotherapy consultation from March to June 2022. Average age of respondents was 45 years. A total of 7 patients (41%) had doubts about radiotherapy after consultation. When analyzing their knowledge, only 1 patient identified that radiotherapy works by DNA damage, the rest had wrong information, 14 patients thought that this treatment works by heating the cells; 2 thought that radiation therapy causes cells to burst. 8 patients (47%) understood how teletherapy works and 5 how brachytherapy works (19%). A question was included about the best skin care during breast radiotherapy in which 76% correctly answered that the skin should be washed daily with water and neutral soap, but 24% answered that hydrating creams should be applied just before stepping into the machine. Regarding the duration of the consultation, a total of 10 patients (60%) thought it was too short. 47% felt the limited time of the consultation did not allow an adequate evaluation. 100% of the respondents were satisfied with the information provided about the type of treatment, its benefits, and adverse effects, however, 47% persisted with doubts at the end of the consultation. 47% of patients (n=8) had some level of anxiety with 29% mild, 11% moderate and 6% severe. Incidence of depression was 24% with 18% having mild form and 6% severe. Regarding the information provided by the doctor during the consultation, 8 patients (47%) would like their doctor to have told them more about anxiety and depression, 7 about sexuality concerns (41%), and 6 (35%) about alternative medicine. 79% of patients wanted to know more about the side effects the treatment might cause after their visit, and 71% reported wanting to know more about how to prevent side effects. 66% also reported that they would like more information about how the treatment feels when it begins. DISCUSSION AND CONCLUSION This analysis revealed that most patients have doubts about radiotherapy, even after the information provided in their first consultation. This may be multifactorial but a key factor may be work overload at radiotherapy centers and a consultation of short duration. This application seems to be an effective, easily accessible, free tool that provides the necessary information, even on topics that are difficult to explain in a standard consultation. Important aspects that the app needs to focus on in future updates include side effects and their management, sexuality, nutrition, depression, and alternative medicine. This application also revealed misconceptions that should be routinely addressed, such as skin care during treatment. Link to app: https://www.canswer.info/?page_id=393 Citation Format: Jose F. Muñoz Lozano, Diana Cristina Pérez Ibave, Estefania Abundis Marquez, Fernando Alcorta Nuñez, Celia B. Gonzalez Alcorta, Carlos Salazar Mejia, Maria Fernanda Noriega, Omar Zayas Villanueva, Victor Oyervides Juarez, Larisa M. Renteria Garcia, Adelina Alcorta Garza, Juan Francisco Gonzalez Guerrero, Valeria Luna, David Hernandez, Rafael Piñeiro Retif, Oscar Vidal Gutiérrez. EXPLORATORY ANALYSIS OF A MOBILE APP THAT ADDRESSES RADIOTHERAPY INFORMATIONAL NEEDS FOR BREAST CANCER PATIENTS [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-08-03.
    Type of Medium: Online Resource
    ISSN: 1538-7445
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2023
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  • 3
    In: The Lancet Infectious Diseases, Elsevier BV, Vol. 21, No. 6 ( 2021-06), p. 783-792
    Type of Medium: Online Resource
    ISSN: 1473-3099
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
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  • 4
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 37, No. 15_suppl ( 2019-05-20), p. e23113-e23113
    Abstract: e23113 Background: Most studies report that tumor related pain occurs between 46% and 92%. The prevalence of pain by clinical stage is 15% in initial stages, 30% in middle stages, 74% in metastatic cancer and, 87% in terminal disease. In the face of chronic diseases such as cancer, patient's relationships with their social networks are affected; among them the interpersonal relationships between the patient and his networks and these towards the patient. With this, the patient’s quality of life is affected. Most of the recent studies on health-related quality of life come from pharmaceutical groups, so it is necessary for other groups to be vigorously involved in the study of the effect of medical interventions on the quality of life, as well as on the impact on health and on the social support of patients with chronic diseases. Methods: In order to obtain the data, validated questionnaires were used as instruments to evaluate the quality of life, measuring psychosocial and health variables, as well as for the detection of the type and quality of psychosocial support perceived by the subjects. The instruments were applied to 207 patients of the Oncology Service of the University Center Against Cancer of the University Hospital “Dr. Jose Eleuterio Gonzalez” in Nuevo Leon, Mexico, during a session of 25 to 30 minutes. Results: Data were collected from 207 patients with chronic oncological pain. The satisfaction index with psychosocial support had a high linear correlation ( r = .640) with the quality of life index. On the other hand, the number of caregivers was not correlated with this last index. Fatigue was the symptom most frequently associated with a decrease in the quality of life index. In addition, pain correlated with all variables except the cognitive index. Conclusions: Satisfaction with the perceived social support is a factor associated with the quality of life in patients with chronic oncological pain; however, the number of caregivers is not. There was no relationship between the size of the network and satisfaction with it. Also, the symptoms associated with chronic oncological pain affect quality of life, identity and social functionality and roles, which in turn impact on the quality of life perceived by patients.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2019
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  • 5
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 15_suppl ( 2020-05-20), p. e24113-e24113
    Abstract: e24113 Background: Chronic cancer pain generates fear and anguish in cancer patients. It is suffered by 64% of patients with metastatic or terminal disease, 59% of patients in early and intermediate stages, and 33% of patients cured from cancer. They require a psychosocial support network. This network has been proposed as an essential tool to reduce the negative impact of the symptoms and psychosocial implications of cancer on the quality of life of patients. Patients with dysfunctional family networks can add to the pain of suffering cancer when they suffered or suffer violence. Cancer and pain test all personal resources and the patient's support network where family functioning is capital for quality of life. Methods: Descriptive, comparative and correlational study. A sample was taken for convenience with the prior consent of the patients who attend the outpatient clinic of the Pain Clinic of the Oncology Service, of the University Center Against Cancer of the University Hospital “Dr. José Eleuterio González” in Nuevo León. The questionnaires were applied during a session of 25 to 30 minutes. It was requested to answer the scales to assess the level of intra-family functioning, intra-family violence, quality of life, measuring psychosocial and health variables; as well as for the detection of the type and quality of psychosocial support perceived by the subjects. Results: A total of 207 research subjects were included in the study, the average age was 49 years of age (minimum 12, maximum 81 years of age), 23% men and 77% women. Marital status: married 52%, home-based 63%; monthly income less than $120 USD (n = 75, 37%). The quality of life index and chronic cancer pain had a high linear correlation with the variables of family violence, psychosocial support, family functioning, somatic symptoms, among other variables studied. Fatigue was the symptom most frequently associated with the decrease in the quality of life index. Conclusions: The satisfaction of perceived social support is a factor associated with the quality of life in patients with chronic cancer pain, however, the number of caregivers is not. There was no relationship between the size of the network and satisfaction with it. Also, the symptoms associated with chronic cancer pain affect the quality of life, identity, social functionality and roles, which in turn impact the quality of life perceived by the patient. This study supports our comprehensive intervention programs and new protocols to promote the quality of life of cancer patients.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
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  • 6
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 37, No. 15_suppl ( 2019-05-20), p. e15536-e15536
    Abstract: e15536 Background: Squamous cell carcinoma and adenocarcinoma represent approximately 95% of malignant tumors of the esophagus. For most cases of the 20th century, squamous cell carcinoma was the predominant lineage. In the 1960s, squamous cell carcinoma accounted for more than 90% of all esophageal tumors in the United States of America, and adenocarcinoma was considered so uncommon that some oncological associations questioned its existence. However over time the incidence of esophageal adenocarcinoma (predominantly in the distal esophagus and gastroesophageal junction) has increased dramatically in Western countries, with adenocarcinoma now causing more than 60% of all esophageal cancers in the United States of America, unlike the rest of the world, where squamous cell carcinoma continues to predominate. Squamous cell carcinoma and adenocarcinoma differ in a significant number of clinical features, including tumor location and predisposing factors. Smoking and alcoholism are major risk factors for the development of squamous cell carcinoma, while the Barrett's esophagus with intestinal metaplasia (a complication of gastroesophageal reflux disease), obesity, and smoking are the risk factors related to adenocarcinoma of the esophagus. Objectives: To determine the incidence of esophageal adenocarcinoma in Mexico and its main characteristics, such as epidemiology, histological type and main risk factors. Methods: A descriptive analysis was conducted in which the histological type, age of diagnosis, location, age of the patients and risk factors were compared. Results: Average age on the studied population was 67.4 years (minimum 37, maximum 91); 74.3% of the subjects were male and 20.4%, female. It was found that the predominant histological type was Adenocarcinoma in 40.7% against 28.3% of the Epidermoid. Average age of diagnosis was at 65.88 years (minimum 37, maximum 89). In frequency of localization, lower third in 22.1%, union GE in 20.4%, middle third in 15%, and upper third in 12.4%). The predominant risk factors in our study were smoking (31%), alcoholism (36.3%) and GERD (12.4%). Conclusions: Oesophageal adenocarcinoma continues to be the most prevalent presentation of esophageal cancer in our population, despite epidemiological changes over time.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2019
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  • 7
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2019
    In:  Journal of Clinical Oncology Vol. 37, No. 15_suppl ( 2019-05-20), p. 10513-10513
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 37, No. 15_suppl ( 2019-05-20), p. 10513-10513
    Abstract: 10513 Background: The Burnout Syndrome takes relevance for its investigation since 1986, when Maslach developed a survey for its study with 3 subscales that include the symptoms generated by exhaustion and chronic labor stress. Health workers are especially vulnerable to the development of this syndrome, which is greater centers with exposure to patients with severe and/or chronic ailments. Thus, the mental structure maturity level with which the individual functions takes relevance, since it is linked to the quality of judgment of the clinician. Few studies consider this aspect because of the complexity of having the instruments and professionals to assess it. It has been questioned whether Burnout or this occupational exhaustion damages the quality of life of the individual, and if it also negatively impacts their work performance, and the quality of care provided to patients. Methods: Observational, cross-sectional and correlational study. It analyses the relationship between Burnout and the characteristics of the mental-structural functioning level in oncology staff, and its association with the level of functionality of the mental structures within the work environment. Prior validation of the instrument was conducted, FIAD-15, with acceptable Alpha of 0.81. Results: Data were obtained from 1,060 subjects, including administrative, nursing and medical members of the Oncology Service staff, as well as, students. Out of these, 1,036 subjects answered the questionnaire appropriately and were considered in the analysis. 413 (39.86%) presented Burnout. The prevalence was higher in men (45.17%) than in women (34.56%). A significant association was found between Burnout frequency and levels of mental functioning. On the functionality of the mental structures, 80% had functional, high and intermediate levels, while 20% of the total population showed a borderline level of functionality (severe). In women, Burnout frequency was higher in borderline levels, followed by those of functional and high level. In men, Burnout was higher in those at the borderline level, followed by functional and intermediate; it was much lower in high level subjects. Conclusions: The mental structure functionality levels found in the oncology staff are associated with Burnout; which is lower in men with structures with high functionality and in women in the intermediate level. Subjects with borderline structures suffer greater Burnout. Further studies should be carried out to support these findings in the future and open new lines of research.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2019
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  • 8
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 15_suppl ( 2020-05-20), p. e16515-e16515
    Abstract: e16515 Background: Esophageal cancer is a highly lethal entity. Within this group of tumors, squamous cell carcinoma (SCC) and esophageal adenocarcinoma (ACE) represent 95% of the total. For most of the twentieth century, the SCC predominated throughout the world, however, this trend has changed dramatically in Western countries, including ours. Mexican patients with esophageal cancer are diagnosed at later stages of the disease and have worse therapeutic outcomes than reported in the world literature. Methods: Retrospective, observational and descriptive study. The research subjects were obtained from the population of patients who attended the service of the Centro Universitario Contra el Cancer of the University Hospital "Dr. José Eleuterio González” between 2012 and 2017 (sample size calculated n = 120).The clinical and demographic characteristics of patients with esophageal cancer in our population were described. The results from international guides (AIMS65, New International Score, Glasgow-Blatchford scale and Rockall pre-endoscopic) were used to compare cut-off points with our population and their correlation with mortality. Results: A total of 179 research subjects were included in the study. The average age was 55 years, 62% male and 38% female. Various demographic characteristics such as in-hospital mortality (n = 42, 23.5%), 30-day mortality (n = 36, 20.1%), re-bleeding (n = 49, 27.4%) and transfusions (n = 99, 55.3%) were studied as incidence of positive cases to the event. We also studied the mean days of hospital stay (4.6 days), systolic blood pressure (108 mmHg) and diastolic blood pressure (66mmHg), hemoglobin (8.9 g / dL), among others. The type of bleeding was variceal in 122 subjects, and non-variceal in 57. In total, 117 subjects were treated with endoscopic treatment and 53, without endoscopic treatment. The Glasgow Blatchford scale obtained a higher discriminative score (AUROC 0.73) to predict in-hospital mortality in our subjects, compared to ASA (0.72 p 〈 0.001), New International score (0.76 p 〈 0.001) and AIMS65 (0.66 p 〈 0.001). Conclusions: The used scales had no positive predictive value for bleeding risk. The Glasgow Blatchford scale was the only score that showed an AUROC of 0.65 p 〈 0.001 to predict the efficiency of transfusion in patients compared to the other scores that showed no significant value. ASA was the predictive discriminative score (AUROC 0.73) for a 30-day in-hospital mortality (p 〈 0.001), followed by the Glasgow Blatchford scale (0.61 p 〈 0.04).
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
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  • 9
    In: Diagnostics, MDPI AG, Vol. 13, No. 6 ( 2023-03-22), p. 1194-
    Abstract: Neutralizing antibodies (NAs) are key immunological markers and are part of the humoral response of the adaptive immune system. NA assays determine the presence of functional antibodies to prevent SARS-CoV-2 infection. We performed a real-world evidence study to detect NAs that confer protection against SARS-CoV-2 after the application of five vaccines (Pfizer/BioNTech, AstraZeneca, Sinovac, Moderna, and CanSino) in the Mexican population. Side effects of COVID-19 vaccines and clinical and demographic factors associated with low immunogenicity were also evaluated. A total of 242 SARS-CoV-2-vaccinated subjects were recruited. Pfizer/BioNTech and Moderna proved the highest percentage of inhibition in a mono-vaccine scheme. Muscular pain, headache, and fatigue were the most common adverse events. None of the patients reported severe adverse events. We found an estimated contagion-free time of 207 (IQR: 182–231) and 187 (IQR: 184–189) days for Pfizer/BioNTech and CanSino in 12 cases in each group. On the basis of our results, we consider that the emerging vaccination strategy in Mexico is effective and safe.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662336-5
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  • 10
    In: Genes, MDPI AG, Vol. 14, No. 2 ( 2023-01-28), p. 341-
    Abstract: Hereditary cancer syndromes (HCS) are genetic diseases with an increased risk of developing cancer. This research describes the implementation of a cancer prevention model, genetic counseling, and germline variants testing in an oncologic center in Mexico. A total of 315 patients received genetic counseling, genetic testing was offered, and 205 individuals were tested for HCS. In 6 years, 131 (63.90%) probands and 74 (36.09%) relatives were tested. Among the probands, we found that 85 (63.9%) had at least one germline variant. We identified founder mutations in BRCA1 and a novel variant in APC that led to the creation of an in-house detection process for the whole family. The most frequent syndrome was hereditary breast and ovarian cancer syndrome (HBOC) (41 cases with BRCA1 germline variants in most of the cases), followed by eight cases of hereditary non-polyposic cancer syndrome (HNPCC or Lynch syndrome) (with MLH1 as the primarily responsible gene), and other high cancer risk syndromes. Genetic counseling in HCS is still a global challenge. Multigene panels are an essential tool to detect the variants frequency. Our program has a high detection rate of probands with HCS and pathogenic variants (40%), compared with other reports that detect 10% in other populations.
    Type of Medium: Online Resource
    ISSN: 2073-4425
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2527218-4
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