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- PublicationLesión endobronquial por Aspergillus fumigatus en un paciente inmunodeprimido.(Revista de Patología Respiratoria, 2025) Becerra-Espinosa, Pamela A.; Jarrín-Estupiñán, Miguel; Rosales, María F.; Mariño-Brito, EstefaníaLa aspergilosis está asociada a una alta morbimortalidad. La mayoría de las infecciones por Aspergillus sp. afectan al parénquima pulmonar, mientras que las lesiones traqueobronquiales son infrecuentes. Presentamos el caso de un paciente inmunodeprimido con diagnóstico reciente de asma, con sibilancias persistentes a pesar del tratamiento inhalado. Se realizó una broncoscopia diagnóstica con el hallazgo de lesiones endobronquiales, cuya biopsia reportó una inflamación supurativa de etiología micótica y en el cultivo se asiló Aspergillus fumigatus.
- PublicationImplementing the WHO Indicators for Assessing Palliative Care Development in Three Countries: A Do-It-Yourself Approach(2024) Tripodoro, Vilma A.; Ray, Anna; Garralda, Eduardo; Bastos, Fernanda; Montero, Álvaro; Béjar, Ana Cristina; Pons, Juan José; Bouësseau, Marie-Charlotte; Centeno, CarlosContext. Palliative care is an essential health service, with over 56.8 million people needing it yearly, particularly in low- and middle-income countries. The World Health Assembly has recognized palliative care as an ethical responsibility and called for comprehensive primary health care. The World Health Organization has published a technical report titled "Assessing the Development of Palliative Care Worldwide," as a crucial first step in addressing palliative care. The report includes 14 indicators to help decision-makers identify service provision gaps and inform health priorities, piloted by WHO’s ATLANTES in Benin, Morocco, and Uruguay as part of a global assessment. Objectives. To describe, for the three countries, the primary outcomes and lessons learned to enable replication in further countries. Methods. A step-by-step description of the assessment project, a summary of the main results obtained through evaluations, and a description of how the selected countries effectively implemented the WHO indicators through a six-step process, including a phase of action plan design. We advocated a ’Do-it-yourself’ approach. Results. The summary data from three country reports reveals national development at a national level. A SWOT analysis involving consultants and program managers was conducted. A stakeholder guide was developed, providing trigger questions and practical recommendations for assessing development using specific indicators. Full information can be found in the specific published reports. Conclusion. The WHO approach has proven effective in identifying health system deficiencies and disseminating information about palliative care evaluation processes. The report provides a ’Do-it-yourself’ approach, encouraging self-management without expert guidance.
- PublicationDesarrollo y creación de infografía y tríptico para comunicar EVAT a los familiares de pacientes pediátricos oncológicos(2024) Conde Morelos Zaragoza, Tania María; Aguilar Luna, Karla Virginia; Nuñez Martínez, Matilde; Quelal González, Janeth Melba; López Facundo, Norma Araceli; Cárdenas Aguirre, Adolfo; Graetz, Dylan; Agulnik, AsyaLa Escala de Valoración de Alerta Temprana (EVAT) permite predecir el riesgo y detectar de manera oportuna el deterioro en los pacientes oncológicos hospitalizados. En 2017 se creó la colaboración del proyecto EVAT multicéntrico, como herramienta para la mejora de la calidad del cuidado para niños con cáncer, en centros de altos y bajos recursos. Hasta 2024, se han concentrado 98 hospitales dentro de la región latinoamericana y europea para capacitar al área médica y de enfermería cuya meta es lograr una implementación exitosa del proyecto. A través del periodo transcurrido, los centros capacitados han realizado interrogantes que no se habían planteado con anterioridad, sobre todo en lo que respecta al transmitir EVAT a los cuidadores. Por tanto, el objetivo de este artículo es explicar el desarrollo y creación de una infografía y un tríptico que apoyen a los líderes EVAT de los hospitales y orienten a los familiares, ya que la preocupación del cuidador representa un punto dentro de la escala de EVAT. El método para recopilar la información de las herramientas fue a través de un grupo especializado, principalmente conformado de enfermeras que pertenecen a centros con EVAT. Para obtener los resultados finales fue necesaria la creación de cinco versiones que representaran de manera creativa y concisa la información deseada a transmitir a los cuidadores de los pacientes oncológicos. Se espera que con los materiales realizados se conduzca a mejorar la comunicación entre los familiares y el personal médico.Palabras clave:EVAT, familiares/cuidadores, comunicación, infografía, tríptico.
- PublicationTechnological Improvements in Low- and Middle-Income Countries (LMICs): A Review of the Literature and the “Sociedad de Lucha Contra el Cáncer” (SOLCA) Institutional Experience in Neuro-Radiosurgery During the Coronavirus Disease 2019 (COVID-19) Pandemic(World Neurosurgery, 2022-06-18) Ochoa, Pamela; Loza, Felipe; Cueva, Fiorella; Leon Rojas, Jose; Puente Vallejo, RaúlOBJECTIVE: Neurosurgery is a medical field that requires specialized professionals and equipment, 2 important but scarce resources in low- and middle-income countries. Our goal was to report our experience with the replacement and implementation of linear accelerators with radiosurgery capabilities at “Sociedad de Lucha Contra el Cáncer” (SOLCA) Hospital in Quito, Ecuador, and give some recommendations for future technological replacements (TRs). - METHODS: Two surveys were performed in SOLCA’s radiosurgery department, one before the TR was finalized and one after, consisting of an open and multiple-choice questionnaire. Questions focused on the performance of the new equipment, perceptions regarding the training, and the influence of the pandemic on the whole process. In addition, we share our experience regarding the difficulties and benefits of TR at SOLCA. - RESULTS: The most-reported limitation was lack of training (48%). By the time of the second survey, 95.2% of the staff had already treated patients or planned a radiosurgical procedure; 42.9% considered training to have been adequate, and 76.2% felt that the pandemic hindered the training process. Currently, 33 radiosurgeries have been done (26 for the central nervous system and 7 stereotactic radiation body therapies). - CONCLUSIONS: The TR in SOLCA had similarities with other experiences in low- and middle-income countries, but the pandemic brought additional limitations, mainly complicating the staff training. Nevertheless, those limitations can be resolved with a structured training program and international collaboration. Overall, the benefits obtained from a TR result in exponentially better medical care and accessibility to novel treatments.
- PublicationComparative study of chromosome aberrations induced with aphidicolin in women affected by breast cancer and cervix uterine cancer(Cancer Genetics and Cytogenetics, 1997-04-01) Paz-y-Miño, César; Peñaherrera, María Serena; Sánchez, María Eugenia; Córdova, Augusta; Gutiérrez, Sara; Ocampo, Ligia; Leone, Paola E.Blood samples were obtained from 80 women: Twenty of these samples were from women affected by ductal infiltrating breast carcinoma, twenty from women affected by cervix uterine cancer, and forty individuals were screened for a control group. The search for chromosome instability that is known to affect individuals with cancer was performed through chromosome analysis in nontumor cells, intending to establish frequency and different types of numerical and structural aberrations. The results, in regard to spontaneous and aphidicolin induced chromosome aberrations, showed a significantly greater frequency (p < 0.001) of chromosome fragility, as well as other numerical and structural aberrations in breast cancer patients when compared to the control group. Similar results were obtained from cervix uterine cancer patients with the exception of certain numerical aberrations in which no significant differences were found. This suggests the existence of a certain degree of chromosomal instability affecting individuals with both types of cancer. The increase in fragility may play an important role in the biologic behavior and progression of cancer.