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Does neoadjuvant chemotherapy provide any benefit for surgical de-escalation in luminal B, HER2(-) breast cancers? 新辅助化疗对腔内B型、HER2(-)型乳腺癌的手术缓解有任何益处吗?
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.22000277
Aysegul Aktas, Meryem Gunay-Gurleyik, Fugen Aker, Yasar Kaan-Akgok, Elif Atag

Background: The use of neoadjuvant chemotherapy (NAC) in less aggressive breast cancer (BC) is controversial.

Objective: To investigate the effect of neoadjuvant chemotherapy in HER2 negative luminal B breast cancer.

Patients and methods: Patients between January 2016 and December 2021 were retrospectively evaluated.

Results: A total of 128 patients were included in the study. Patients with pathological complete response (pCR) were younger and had higher ki67 levels. Cutoff levels for ki67 based on pCR and ypT status were ≤ 40% and ≤ 35%, respectively. According to pre-NAC magnetic resonance imaging findings, only mastectomy was viable in 90 patients, but after NAC breast-conserving surgery (BCS) was possible in 29 (32%). Moreover, 68.5% became eligible for sentinel lymph node biopsy (SLNB) after NAC. Since SLNB was positive in 45 (54.2%), axillary lymph node dissection (ALND) was performed and the remainder, 38 (31.4%), avoided ALND.

Conclusion: In patients with Luminal B, HER2(-) BC a low pCR rate should not discourage the use of NAC. The ki67 level is a guide for individualizing treatment. Especially in young patients with high ki67 levels, NAC increases the chance of breast-conserving surgery and may spare patients from ALND.

背景:在低侵袭性乳腺癌(BC)中使用新辅助化疗(NAC)是有争议的。目的:探讨新辅助化疗对HER2阴性B腔乳腺癌的治疗效果。患者和方法:回顾性评估2016年1月至2021年12月的患者。结果:共纳入128例患者。病理完全缓解(pCR)的患者年龄较小,ki67水平较高。基于pCR和ypT状态的ki67的截止水平分别为≤40%和≤35%。根据NAC前的磁共振成像结果,只有90例患者可以进行乳房切除术,但NAC后可以进行保乳手术(BCS) 29例(32%)。此外,68.5%的患者在NAC后符合前哨淋巴结活检(SLNB)的条件。由于SLNB阳性45例(54.2%),行腋窝淋巴结清扫术(ALND),其余38例(31.4%)避免行ALND。结论:在Luminal B、HER2(-) BC患者中,低pCR率不应阻碍NAC的使用。ki67水平是个体化治疗的指导。特别是在ki67水平高的年轻患者中,NAC增加了保乳手术的机会,并可能使患者免于ALND。
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引用次数: 0
Two pandemics to fight: metabolic surgery and its effects on COVID-19 and obesity. 需要对抗的两大流行病:代谢手术及其对COVID-19和肥胖的影响。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.22000206
Enrique Cervantes-Pérez, Gabino Cervantes-Guevara, Alejandro González-Ojeda, Clotilde Fuentes-Orozco, Sol Ramírez-Ochoa, Guillermo A Cervantes-Cardona, Blanca M Torres-Mendoza, Gabino Cervantes-Pérez, Eduardo Gómez-Sánchez
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引用次数: 0
Infectious endocarditis without intracardiac devices or underlying structural heart disease. 感染性心内膜炎,无心内装置或潜在的结构性心脏病。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000666
Abelardo Flores-Morales, Andrés Jacobo-Ruvalcaba, Ariana C Acevedo-Meléndez, María J Fernández-Muñoz, Héctor A Carmona-Ruiz, Gabriela Borrayo-Sánchez, Alberto Chaparro-Sánchez, Óscar Orihuela-Rodríguez

Objective: To describe clinical, microbiological and echocardiographic aspects of endocarditis in a specific group of patients without intracardiac devices or underlying structural heart disease.

Method: Retrospective study, clinical records and echocardiographic reports were reviewed during the period 1997 to 2020. Duke's modified criteria were applied. Statistical analysis: univariate expressed in frequencies, using measures of dispersion and central tendency.

Results: 30,000 echocardiographic reports were reviewed, only 1350 had infectious endocarditis as a reason for sending, of which 248 cases were selected. The mean age was 48.1 ± 16.7 years. 140 men (56%) and 108 women (44%). The most frequent echocardiographic sign was vegetation, in 278 (93.60%), and most common location was mitral (35.55%), with a higher number of cases in the right ventricle than expected. The most common systemic disease was kidney disease, in 135 (41.08%). A case of Streptococcus thoraltensis not previously reported in Mexico was identified.

Conclusions: The presence of infectious endocarditis has increased due to invasive in-hospital and drug procedures. Due to their complexity, multidisciplinary teams are indispensable.

目的:描述无心脏内装置或潜在结构性心脏病的特定患者的心内膜炎的临床、微生物学和超声心动图方面。方法:回顾1997 ~ 2020年的回顾性研究、临床记录和超声心动图报告。采用杜克大学修改后的标准。统计分析:用频率表示的单变量,使用分散和集中趋势的措施。结果:回顾3万份超声心动图报告,以感染性心内膜炎为寄送原因的仅有1350例,入选248例。平均年龄48.1±16.7岁。140名男性(56%)和108名女性(44%)。最常见的超声心动图征象是植被,278例(93.60%),最常见的位置是二尖瓣(35.55%),其中右心室的病例数高于预期。最常见的全身性疾病是肾脏疾病,135例(41.08%)。发现了一例墨西哥以前未报告的胸廓链球菌感染病例。结论:感染性心内膜炎的存在由于侵入性住院和药物治疗而增加。由于其复杂性,多学科团队是不可或缺的。
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引用次数: 0
Terapia médico-nutricional en pacientes politraumatizados: una carrera contra el tiempo. 多重创伤患者的医学营养治疗:与时间的赛跑。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.220001901
María F Padilla-Rubio, Miguel Robledo-Valdez, Miguel Morante-Ruiz, Andrea Pérez de Acha-Chávez, Gabino Cervantes-Guevara, Guillermo A Cervantes-Cardona, Sol Ramírez-Ochoa, Gabino Cervantes-Pérez, Alejandro González-Ojeda, Clotilde Fuentes-Orozco, Eduardo Gómez-Sánchez, Enrique Cervantes-Pérez

A polytraumatized patient is defined as one who has multiple lesions involving different organs and systems, which are usually serious and lead to life-threatening respiratory or circulatory dysfunction. Traumatic stress in the polytraumatized patient results in many metabolic changes that are evident from the first days, but usually persist for weeks, requiring adequate nutritional support as they influence outcomes. Nutritional treatment should be a priority in the comprehensive treatment of polytraumatized patients since it attenuates the metabolic response to trauma and prevents the deterioration of body reserves. It should be noted that some patients present previous nutritional risk. Nutritional intervention should be considered at the same level as any other therapy that supports organic functions, especially in patients in the intensive care unit. Nutritional intervention in polytraumatized patients is a pillar of treatment that has multiple benefits and can improve prognosis. All efforts must be aimed at the early detection of malnourished patients at nutritional risk and providing timely therapies that improve clinical outcomes.

多重创伤患者被定义为有涉及不同器官和系统的多重病变的患者,这些病变通常很严重,并导致危及生命的呼吸或循环功能障碍。多创伤患者的创伤应激导致许多代谢变化,这些变化在第一天就很明显,但通常会持续数周,需要足够的营养支持,因为它们会影响结果。营养治疗应该是综合治疗多创伤患者的优先考虑,因为它可以减轻对创伤的代谢反应,防止身体储备的恶化。需要注意的是,有些患者以前存在营养风险。营养干预应与任何其他支持器官功能的治疗同等重视,特别是对重症监护病房的患者。对多重创伤患者进行营养干预是治疗的一个支柱,具有多重益处,可以改善预后。所有努力的目标必须是早期发现有营养风险的营养不良患者,并及时提供改善临床结果的治疗。
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引用次数: 0
The safety and efficacy of percutaneous transforaminal endoscopic discectomy and fenestration discectomy in the treatment of lumbar disc herniation. 经皮经椎间孔内镜椎间盘切除术和开窗椎间盘切除术治疗腰椎间盘突出症的安全性和有效性。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000774
Tiantian Zhao, Yang Liu, Feng Li, Yang Zhang, Shuai Zhang, Bin Zhang, Junmao Gao

Background: The aim of the study was to explore the safety and efficacy of percutaneous transforaminal endoscopic discectomy (PTED) and fenestration discectomy (FD) in the treatment of lumbar disc herniation (LDH).

Material and methods: The complete clinical data from 87 patients with LDH from our hospital were retrospectively analyzed. Patients were divided into a control group (n = 39, treated with FD) and a research group (n = 48, treated with PTED) according to the prescribed treatments. The basic operation conditions were compared across the two groups. Surgical outcomes were assessed. The incidences of complications and the life quality of patients were evaluated 1 year after surgery.

Results: The patients in both groups completed the operation. The visual analog scale and Oswestry Disability Index score of patients in the research group was significantly lower while the Orthopaedic Association Score was significantly higher after surgery. The success rate of the operation in the research group which was significantly higher and the rate of complications was significantly lower. No statistical differences in the quality of life were observed between the patients (p > 0.05).

Conclusions: PTED and FD are effective in the treatment of LDH. However, our study showed that PTED has a higher rate of treatment success, faster recovery times and is safer than FD.

背景:本研究的目的是探讨经皮经椎间孔内镜椎间盘切除术(PTED)和开窗椎间盘切除术(FD)治疗腰椎间盘突出症(LDH)的安全性和有效性。材料与方法:回顾性分析我院87例LDH患者的完整临床资料。按照规定的治疗方法将患者分为对照组(n = 39,采用FD治疗)和研究组(n = 48,采用PTED治疗)。比较两组患者的基本手术条件。评估手术结果。术后1年观察并发症发生率及患者生活质量。结果:两组患者均完成手术。研究组患者术后视觉模拟量表和Oswestry残疾指数评分显著低于对照组,骨科协会评分显著高于对照组。研究组手术成功率明显高于对照组,并发症发生率明显低于对照组。两组患者生活质量比较差异无统计学意义(p > 0.05)。结论:PTED联合FD治疗LDH疗效显著。然而,我们的研究表明,PTED比FD具有更高的治疗成功率,更快的恢复时间和更安全。
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引用次数: 0
Donación renal pareada: beneficio de este programa en la tasa de trasplantes y sobrevida del injerto. 配对肾捐献:该计划在移植率和移植生存率方面的好处。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000865
Lucino Bahena-Carrera, Héctor F Noyola-Villalobos, Edgar E Ramos-Díaz, Marco A Loera-Torres, Ricardo Mendiola-Fernández, Mónica L Razo-Padilla

Objective: To demonstrate the experience since the transplant program under paired kidney donation implementation; program that increases the donation rate by 25-30% in hospitals with no inferior graft survival compared to directed living donor kidney transplantation.

Method: Observational, analytical, longitudinal and prospective study from December 2018 to July 2021. All G5 KDIGO chronic kidney patients who were HLA or ABO incompatible with their original donors in the pretransplant protocol and who were transplanted under the paired kidney donation program, were included.

Results: 22 kidney transplants were performed under this program. Survival of the graft and the patient 1 year after transplantation was 100%. The post-transplant glomerular filtration rate was 72.5 ± 17 ml/min/1.73 m2 body surface. 36.3% of hypersensitized patients were successfully transplanted. The in-hospital donation rate increased by 33.33%.

Conclusions: Transplantation under the kidney paired donation program constitutes a real modality of successful transplantation when there is incompatibility with the original donor. The greater use and socialization of this program can increase the country kidney transplantation rate, reducing the waiting list. Our hospital represents the largest experience published in Mexico with this transplant program.

目的:阐述配对肾捐献移植项目实施以来的经验;该项目将医院的捐赠率提高了25-30%,与直接活体肾脏移植相比,移植物存活率没有下降。方法:2018年12月至2021年7月进行观察性、分析性、纵向和前瞻性研究。所有G5 KDIGO慢性肾脏病患者,在移植前方案中与原供者HLA或ABO不相容,并在配对肾脏捐赠计划下进行移植。结果:在此方案下共完成肾移植22例。移植后1年移植物和患者的生存率均为100%。移植后肾小球滤过率为72.5±17 ml/min/1.73 m2体表。超敏患者移植成功率为36.3%。院内献血率提高33.33%。结论:在肾脏配对捐献计划下,当与原供体不相容时,移植是一种真正成功的移植模式。该方案的更广泛使用和社会化可以提高国家肾移植率,减少等待名单。我们医院代表了墨西哥在这个移植项目上最大的经验。
{"title":"Donación renal pareada: beneficio de este programa en la tasa de trasplantes y sobrevida del injerto.","authors":"Lucino Bahena-Carrera,&nbsp;Héctor F Noyola-Villalobos,&nbsp;Edgar E Ramos-Díaz,&nbsp;Marco A Loera-Torres,&nbsp;Ricardo Mendiola-Fernández,&nbsp;Mónica L Razo-Padilla","doi":"10.24875/CIRU.21000865","DOIUrl":"https://doi.org/10.24875/CIRU.21000865","url":null,"abstract":"<p><strong>Objective: </strong>To demonstrate the experience since the transplant program under paired kidney donation implementation; program that increases the donation rate by 25-30% in hospitals with no inferior graft survival compared to directed living donor kidney transplantation.</p><p><strong>Method: </strong>Observational, analytical, longitudinal and prospective study from December 2018 to July 2021. All G5 KDIGO chronic kidney patients who were HLA or ABO incompatible with their original donors in the pretransplant protocol and who were transplanted under the paired kidney donation program, were included.</p><p><strong>Results: </strong>22 kidney transplants were performed under this program. Survival of the graft and the patient 1 year after transplantation was 100%. The post-transplant glomerular filtration rate was 72.5 ± 17 ml/min/1.73 m<sup>2</sup> body surface. 36.3% of hypersensitized patients were successfully transplanted. The in-hospital donation rate increased by 33.33%.</p><p><strong>Conclusions: </strong>Transplantation under the kidney paired donation program constitutes a real modality of successful transplantation when there is incompatibility with the original donor. The greater use and socialization of this program can increase the country kidney transplantation rate, reducing the waiting list. Our hospital represents the largest experience published in Mexico with this transplant program.</p>","PeriodicalId":50990,"journal":{"name":"Cirugia Y Cirujanos","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10748375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perforación traqueal diferida tras cirugía tiroidea en un paciente con radioterapia cervical. 宫颈放疗患者甲状腺手术后延迟气管穿孔。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000627
Pedro López-Morales, M Fe Candel-Arenas, Nuria Martínez-Sanz, Esther Medina-Manuel, Clara Giménez-Francés, Antonio Albarracín-Marín-Blázquez

Tracheal perforation is a rare complication of thyroid surgery. A 36-year-old man with previous neck radiotherapy due to a nasopharyngeal cancer. After right hemithyoidectomy and isthmusectomy, the patient presented a tracheal perforation. The diagnosis was confirmed with computed tomography and bronchoscopy. A conservative management was performed with drainage and antibiotic therapy, and the evolution was satisfactory. If recognized at the time of the surgery, perforations should be closed primarily. Delayed perforations will be treated with an emergency surgery or conservatively depending on the clinical situation of the patient.

气管穿孔是甲状腺手术中一种罕见的并发症。一位36岁男性,先前因鼻咽癌接受颈部放疗。在右半突切除和峡部切除后,患者出现气管穿孔。计算机断层扫描和支气管镜检查证实了诊断。保守处理,引流和抗生素治疗,进展令人满意。如果在手术时发现,应首先关闭穿孔。延迟性穿孔将根据患者的临床情况采取紧急手术或保守治疗。
{"title":"Perforación traqueal diferida tras cirugía tiroidea en un paciente con radioterapia cervical.","authors":"Pedro López-Morales,&nbsp;M Fe Candel-Arenas,&nbsp;Nuria Martínez-Sanz,&nbsp;Esther Medina-Manuel,&nbsp;Clara Giménez-Francés,&nbsp;Antonio Albarracín-Marín-Blázquez","doi":"10.24875/CIRU.21000627","DOIUrl":"https://doi.org/10.24875/CIRU.21000627","url":null,"abstract":"<p><p>Tracheal perforation is a rare complication of thyroid surgery. A 36-year-old man with previous neck radiotherapy due to a nasopharyngeal cancer. After right hemithyoidectomy and isthmusectomy, the patient presented a tracheal perforation. The diagnosis was confirmed with computed tomography and bronchoscopy. A conservative management was performed with drainage and antibiotic therapy, and the evolution was satisfactory. If recognized at the time of the surgery, perforations should be closed primarily. Delayed perforations will be treated with an emergency surgery or conservatively depending on the clinical situation of the patient.</p>","PeriodicalId":50990,"journal":{"name":"Cirugia Y Cirujanos","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9297153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The relationship between bile reflux and common bile duct diameter after cholecystectomy: a clinical case-control study. 胆囊切除术后胆汁反流与胆总管直径的关系:一项临床病例对照研究
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.22000490
Mustafa Sami-Bostan, Celil Ugurlu, Murat Yildirim, Bulent Koca

Objective: The present study aims to investigate the relationship between bile reflux (BR) and diameter of the common bile duct (CBD) in patients after cholecystectomy.

Materials and methods: In our case series analysis, according to the endoscopy results, the patients who underwent cholecystectomy were divided into two groups as those with BR and those non-BR. Age, sex, CBD diameter measured on ultrasonography, computed tomography, magnetic resonance cholangiopancreatography, and endoscopic biopsy results of the patients were statistically analyzed.

Results: In a total of 188 patients included in the study, BR was detected in 93 patients, it was not observed in 95 patients. The CBD diameter of the patients was observed to be 7 mm or less in 70.9% (n = 66) in the BR group, and 23% (n = 22) in the non-BR group. The statistical analysis revealed that while there was a significant difference between the two groups in terms of CBD diameter and intestinal metaplasia, the results were similar in both groups in terms of inflammation, activity, atrophy, and Helicobacter pylori.

Conclusion: We believe that CBD diameter may be a predictive factor in the detection of BR after cholecystectomy.

目的:探讨胆囊切除术后患者胆汁反流(BR)与胆总管(CBD)直径的关系。材料与方法:在我们的病例系列分析中,根据内镜检查结果,将行胆囊切除术的患者分为有BR组和无BR组。对患者的年龄、性别、超声、ct、磁共振胰胆管造影及内镜活检结果进行统计分析。结果:纳入研究的188例患者中,93例患者检测到BR, 95例患者未观察到BR。BR组中70.9% (n = 66)患者的CBD直径小于或等于7mm,非BR组中23% (n = 22)患者的CBD直径小于或等于7mm。统计分析显示,两组在CBD直径和肠化生方面存在显著差异,但在炎症、活动性、萎缩和幽门螺杆菌方面结果相似。结论:我们认为CBD直径可能是胆囊切除术后BR检测的预测因素。
{"title":"The relationship between bile reflux and common bile duct diameter after cholecystectomy: a clinical case-control study.","authors":"Mustafa Sami-Bostan,&nbsp;Celil Ugurlu,&nbsp;Murat Yildirim,&nbsp;Bulent Koca","doi":"10.24875/CIRU.22000490","DOIUrl":"https://doi.org/10.24875/CIRU.22000490","url":null,"abstract":"<p><strong>Objective: </strong>The present study aims to investigate the relationship between bile reflux (BR) and diameter of the common bile duct (CBD) in patients after cholecystectomy.</p><p><strong>Materials and methods: </strong>In our case series analysis, according to the endoscopy results, the patients who underwent cholecystectomy were divided into two groups as those with BR and those non-BR. Age, sex, CBD diameter measured on ultrasonography, computed tomography, magnetic resonance cholangiopancreatography, and endoscopic biopsy results of the patients were statistically analyzed.</p><p><strong>Results: </strong>In a total of 188 patients included in the study, BR was detected in 93 patients, it was not observed in 95 patients. The CBD diameter of the patients was observed to be 7 mm or less in 70.9% (n = 66) in the BR group, and 23% (n = 22) in the non-BR group. The statistical analysis revealed that while there was a significant difference between the two groups in terms of CBD diameter and intestinal metaplasia, the results were similar in both groups in terms of inflammation, activity, atrophy, and Helicobacter pylori.</p><p><strong>Conclusion: </strong>We believe that CBD diameter may be a predictive factor in the detection of BR after cholecystectomy.</p>","PeriodicalId":50990,"journal":{"name":"Cirugia Y Cirujanos","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9297154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Análisis del coste directo de la atención médica y quirúrgica del cáncer de mama. Estudio comparativo entre etapas temprana y tardía en tercer nivel de atención. 乳腺癌医疗和外科护理的直接成本分析。早期和晚期三级护理的比较研究。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000624
Álvaro J Montiel-Jarquín, Marco A Santiago-Carrillo, Arturo García-Galicia, Carlos A López-Bernal, Miriam A Miranda-Martínez, Jorge Loria-Castellanos

Background: Management of breast cancer is increased by late diagnoses.

Objective: To analyse direct costs of breast cancer in early and advanced stage in a third level medical facility at Mexican Social Security Institute.

Method: Observational study, direct costs of care in breast cancer in initial and advanced clinical stages are compared. Variables analysed were laboratory and diagnostic imaging studies, drugs, as well as hospitalization costs. The evaluated period included from the first care to the completion of the treatment. Costs were determined according to the table of Unit Costs by Level of Medical Care for the year 2019 of the Mexican Social Security Institute. Student's t test was used to determinate differences between groups, as well as descriptive statistics.

Results: The advanced stage compared to the initial stage, causes a greater number of laboratory-cabinet studies, surgeries, day/bed and interconsultations. The average cost of breast cancer care per patient is $99,280.36 (US$5,230.78) and $148,023.60 (US$7,789.92) for the initial and advanced stages, respectively (p = 0.024).

Conclusions: Cost of medical attention in the initial stage is lower than that of the advanced stage.

背景:乳腺癌的治疗因晚期诊断而增加。目的:分析墨西哥社会保障研究所三级医疗机构早期和晚期乳腺癌的直接费用。方法:观察性研究,比较早期和晚期乳腺癌患者的直接护理费用。分析的变量包括实验室和诊断成像研究、药物以及住院费用。评估期包括从第一次护理到治疗完成。费用根据墨西哥社会保障研究所2019年按医疗保健水平分列的单位成本表确定。使用学生t检验来确定组间差异,以及描述性统计。结果:与初期相比,晚期引起更多的实验室检查,手术,日/床和会诊。乳腺癌初期和晚期患者的平均护理费用分别为99,280.36美元(5,230.78美元)和148,023.60美元(7,789.92美元)(p = 0.024)。结论:早期患者的就医费用低于晚期患者。
{"title":"Análisis del coste directo de la atención médica y quirúrgica del cáncer de mama. Estudio comparativo entre etapas temprana y tardía en tercer nivel de atención.","authors":"Álvaro J Montiel-Jarquín,&nbsp;Marco A Santiago-Carrillo,&nbsp;Arturo García-Galicia,&nbsp;Carlos A López-Bernal,&nbsp;Miriam A Miranda-Martínez,&nbsp;Jorge Loria-Castellanos","doi":"10.24875/CIRU.21000624","DOIUrl":"https://doi.org/10.24875/CIRU.21000624","url":null,"abstract":"<p><strong>Background: </strong>Management of breast cancer is increased by late diagnoses.</p><p><strong>Objective: </strong>To analyse direct costs of breast cancer in early and advanced stage in a third level medical facility at Mexican Social Security Institute.</p><p><strong>Method: </strong>Observational study, direct costs of care in breast cancer in initial and advanced clinical stages are compared. Variables analysed were laboratory and diagnostic imaging studies, drugs, as well as hospitalization costs. The evaluated period included from the first care to the completion of the treatment. Costs were determined according to the table of Unit Costs by Level of Medical Care for the year 2019 of the Mexican Social Security Institute. Student's t test was used to determinate differences between groups, as well as descriptive statistics.</p><p><strong>Results: </strong>The advanced stage compared to the initial stage, causes a greater number of laboratory-cabinet studies, surgeries, day/bed and interconsultations. The average cost of breast cancer care per patient is $99,280.36 (US$5,230.78) and $148,023.60 (US$7,789.92) for the initial and advanced stages, respectively (p = 0.024).</p><p><strong>Conclusions: </strong>Cost of medical attention in the initial stage is lower than that of the advanced stage.</p>","PeriodicalId":50990,"journal":{"name":"Cirugia Y Cirujanos","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9297156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Aprendizaje en las residencias quirúrgicas durante la pandemia de COVID-19 en México. 在墨西哥COVID-19大流行期间在手术室学习。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.22000294
María N Gómez-Herrera, Celina Cuéllar-Aguirre, María E Baridó-Murguía, Irma Sánchez-Montes, María C Barradas-Guevara, Gloria González-Uribe

Objective: To bring up which was the surgical resident's perception about their learning experience during COVID-19 pandemic and if it interfered or not with their classes.

Method: Cross-sectional observational study through an anonymous survey conducted among surgical residents. The Mexican Association of General Surgery, through its Women in Surgery Committee, created a questionnaire that included 40 questions.

Results: 465 participants were included in the survey: 225 women (48.3%), 240 men (51.7%); of 32 entities, only 26 participated. A great part of them said their skills and abilities were affected because elective surgeries were called off. While 303 residents stayed at hybrid hospitals, while a third of them were at 100% Covid facilities. Residents who were on call worked at COVID-19 units. They continued attending class through online platforms and only 134 were able to practice their skills using simulators. 71% of the residents were infected with COVID-19, all were tested to confirm it, and the number of asymptomatic cases was unknown.

Conclusions: COVID-19 pandemic has affected the learning process of surgical residents in Mexico.

目的:了解外科住院医师对新冠肺炎大流行期间学习经历的看法,以及这种看法是否影响了他们的学习。方法:通过匿名调查对外科住院医师进行横断面观察研究。墨西哥普通外科协会通过其女性外科委员会制作了一份包含40个问题的调查问卷。结果:共纳入调查对象465人:女性225人(48.3%),男性240人(51.7%);在32个实体中,只有26个参与。他们中的很大一部分人表示,由于选择性手术被取消,他们的技能和能力受到了影响。303名居民住在混合医院,其中三分之一住在100%感染新冠病毒的医院。随叫随到的居民在COVID-19部门工作。他们继续通过在线平台上课,只有134人能够使用模拟器练习他们的技能。71%的居民感染了新冠病毒,所有人都被检测为确诊病例,无症状病例数量不详。结论:新冠肺炎疫情影响了墨西哥外科住院医师的学习过程。
{"title":"Aprendizaje en las residencias quirúrgicas durante la pandemia de COVID-19 en México.","authors":"María N Gómez-Herrera,&nbsp;Celina Cuéllar-Aguirre,&nbsp;María E Baridó-Murguía,&nbsp;Irma Sánchez-Montes,&nbsp;María C Barradas-Guevara,&nbsp;Gloria González-Uribe","doi":"10.24875/CIRU.22000294","DOIUrl":"https://doi.org/10.24875/CIRU.22000294","url":null,"abstract":"<p><strong>Objective: </strong>To bring up which was the surgical resident's perception about their learning experience during COVID-19 pandemic and if it interfered or not with their classes.</p><p><strong>Method: </strong>Cross-sectional observational study through an anonymous survey conducted among surgical residents. The Mexican Association of General Surgery, through its Women in Surgery Committee, created a questionnaire that included 40 questions.</p><p><strong>Results: </strong>465 participants were included in the survey: 225 women (48.3%), 240 men (51.7%); of 32 entities, only 26 participated. A great part of them said their skills and abilities were affected because elective surgeries were called off. While 303 residents stayed at hybrid hospitals, while a third of them were at 100% Covid facilities. Residents who were on call worked at COVID-19 units. They continued attending class through online platforms and only 134 were able to practice their skills using simulators. 71% of the residents were infected with COVID-19, all were tested to confirm it, and the number of asymptomatic cases was unknown.</p><p><strong>Conclusions: </strong>COVID-19 pandemic has affected the learning process of surgical residents in Mexico.</p>","PeriodicalId":50990,"journal":{"name":"Cirugia Y Cirujanos","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9811339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Cirugia Y Cirujanos
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