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Retrospective study on disparities in time-to-treatment by health insurance system in Chilean breast cancer patients
(Medwave Estudios Limitada, 2025-04-10)
ACEVEDO ROMO, JOHANNA PATRICIA
;
Teresa Ip
;
Lea Maureira
;
Cesar Sanchez
;
Claudia Osorio
Introduction Breast cancer is the most common malignancy in the Americas, and the second leading cause of cancer death. Disparities in the time to treatment can significantly impact patient outcomes and typically affect lower socioeconomic individuals and/or ethnic minorities. Our study sought to evaluate disparities in time to treatment at three health institutions in Chile according to their type of health insurance (public or private). Methods Our study analyzed a database of breast cancer patients diagnosed between 2017 and 2018. Analyses included descriptive statistics and a linear regression model that incorporated clinical and demographic variables. Additionally, using a proportional risks model, we analyzed the association between clinical variables and mortality. Results Public health insurance (National Health Fund, FONASA) was associated with longer time-to-treatment and extended treatment times versus private health insurance (Social Security Institutions, ISAPRE; p < 0.0001). As expected, a more advanced stage at diagnosis was associated with lower survival. Our proportional risks model found that age was a predictor of breast cancer mortality in stage II patients. Also, total treatment time significantly increased the risk of breast cancer mortality in stage I patients. Conversely, total treatment time did not affect mortality on stages II or III. Conclusions We found significant disparities in the time to treatment of Chilean breast cancer patients using FONASA versus private ISAPRE. FONASA patients experience delays in the initiation of treatment and longer total treatment times compared to their private insurance counterparts. Finally, longer time-to-treatment was associated with more advanced stages and increased mortality.
3
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Cáncer de vesícula: ¿Es momento de modificar el GES?
(SciELO Agencia Nacional de Investigacion y Desarrollo (ANID), 2024-10)
Camila P. Samaniego
;
Xabier de Aretxabala
;
Felipe Castillo
;
Álvaro Paredes
;
M. Trinidad González
14
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Early prediction of functional mobility severity after stroke: two key milestones
(2024)
Patricia Vargas
;
Marcos Maldonado-Diaz
;
Tania Gutiérrez-Panchana
Scopus© Citations 4
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Porcentaje de éxito de erradicación de Helicobacter pylori con tratamiento antibiótico empírico en pacientes pediátricos de un Hospital Terciario
(2023)
Sofía Darritchon Lama
;
Diego Díaz García
;
Marcela Toledo Cumplido
;
LUCERO ALVAREZ, YALDA CECILIA
<jats:p>La infección por Helicobacter pylori es una condición frecuente, que a largo plazo se asocia con desarrollo de enfermedad ulceropéptica y eventualmente cáncer gástrico, que se podrían prevenir con un tratamiento oportuno. Lo óptimo sería lograr un éxito de erradicación mayor al 90%, pero los tratamientos empíricos recomendados no logran esas tasas en condiciones reales.Objetivo: Determinar el porcentaje de éxito del tratamiento empírico de erradicación de primera línea contra H. pylori en pacientes pediátricos atendidos en un hospital terciario.Pacientes y Método: Estudio descriptivo retrospectivo en pacientes con infección por H. pylori detectado en biopsias gástricas y que hubieran recibido tratamiento antibiótico de primera línea durante el periodo 2017-2021. Se consideró erradicación exitosa el resultado negativo de test de antígeno en deposiciones o nuevas biopsias luego de ≥ 1 mes de finalizado el tratamiento.Resultados: Se identificaron 82 pacientes con infección por H. pylori, de los cuales 53 recibieron tratamiento de erradicación. De éstos, 26 (49%) fueron controlados con test de erradicación luego del tratamiento y en ellos el porcentaje de éxito fue de solo 38% (10/26).Conclusiones: La tasa de erradicación con los esquemas empíricos utilizados fue menor a la esperada, lo que evidencia el desafío de buscar estrategias más efectivas de tratamiento incluyendo el estudio de susceptibilidad a antimicrobianos. La adherencia de los pacientes al protocolo de seguimiento también fue baja, lo que deberá reforzarse en el futuro para poder realizar un manejo clínico más adecuado. </jats:p>
Scopus© Citations 4 2
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Global Impact of COVID-19 on Stroke Care and IV Thrombolysis
(2021)
Raul G. Nogueira
;
Muhammad M. Qureshi
;
Mohamad Abdalkader
;
Sheila Ouriques Martins
;
Hiroshi Yamagami
Scopus© Citations 87 9
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RAI Modificado, una herramienta validada en Chile para tamizaje de fragilidad preoperatoria
(2023)
Javiera Vargas
;
Maricarmen Andrade
;
Macarena Honorato
;
Mariana Rojas
;
María de los Ángeles Gálvez
22
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Prenatal vs postnatal diagnosis of 22q11.2 deletion syndrome: cardiac and noncardiac outcomes through 1 year of age
(2023)
Lindsay R. Freud
;
Stephanie Galloway
;
T. Blaine Crowley
;
Julie Moldenhauer
;
Ann Swillen
1Scopus© Citations 9
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Outcomes of Total Ankle Arthroplasty in Postfracture Ankle Arthritis
(2023)
Jaeyoung Kim
;
Ruben Radkievich
;
Rami Mizher
;
Isabel Shaffrey
;
Martin O’Malley
<jats:sec><jats:title>Background:</jats:title><jats:p> Ankle arthritis that develops after fracture accounts for a significant portion of ankle arthritis necessitating total ankle arthroplasty (TAA). It remains unknown whether TAA in postfracture patients produces equivalent outcomes to those without fracture history. The purpose of this study was to evaluate the medium-term outcomes of TAA in postfracture ankle arthritis compared to those without fracture history. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> This study reviewed 178 ankles from 171 consecutive patients who underwent TAA in our institution between 2007 and 2017 and completed a minimum 5-year follow-up. Four different TAA systems were utilized by 6 surgeons. Based on fracture history, patients were divided into 2 groups: the postfracture group (n = 63; median age 65.7 years; median follow-up 5.9 years) and the nonfracture group (n = 115; median age 64.4 years; median follow-up 6.2 years). Types and rates of complications including revision and reoperation were compared. Minimum 5-year Foot and Ankle Outcome Score (FAOS) and postoperative improvement were investigated. A subgroup analysis was performed to determine whether outcomes differ between intraarticular fracture patients (n = 43) and extraarticular fracture patients (n = 20). </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> Both groups exhibited comparable postoperative improvement and final FAOS scores. The postfracture group had a significantly higher reoperation rate than the nonfracture group (20 of 63, 31.7%, vs 17 of 115, 14.8%; P = .011), with gutter impingement being the most common cause. There were 3 revisions in each group. In the subgroup analysis, we found no evidence of statistical difference between the intraarticular fracture group and the extraarticular fracture group in terms of FAOS scores, revision, and reoperation rates. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> In this single-center, retrospective comparative study, we found total ankle arthroplasty in patients with a history of fractures around the ankle joint had no evidence of statistical difference in patient-reported outcomes and implant survivorship but led to a higher rate of nonrevision reoperation following surgery. In the much smaller subset of patients with previous fracture, we did not find that those with a history of intraarticular fracture had inferior outcomes after TAA when compared to those with a history of extraarticular fracture. </jats:p></jats:sec><jats:sec><jats:title>Level of Evidence:</jats:title><jats:p> Level III, case-control study. </jats:p></jats:sec>
6Scopus© Citations 2
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Granuloma annulare on ultrasound: a diagnosis to consider in pediatric skin lesions
(2023)
WHITTLE PINTO, CAROLINA
;
N. Rossel
;
L. Pérez-Marrero
;
X. Chaparro
Scopus© Citations 1 3
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De-escalating therapy in inflammatory bowel disease: Results from an observational study in clinical practice
(2023)
Alex Aren
;
María José Moreta
;
Ingrid Ordás
;
Agnès Fernández-Clotet
;
Berta Caballol
1Scopus© Citations 1

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