Comportamiento de los pacientes con diagnóstico tardío de lepra. Camaguey, Cuba, 2015 / No disponible

Se realizó un estudio descriptivo, longitudinal y retrospectivo con el objetivo de caracterizar el comportamiento de los pacientes con diagnóstico tardío de lepra notificados durante el período comprendido del 1 de enero del 2009 al 30 de septiembre del 2014 residentes en la provincia Camagüey. El universo de estudio estuvo constituido por 26 pacientes con diagnóstico tardío de lepra. Se determinó que el grupo de edad más afectado fue el de 60 años y más, con predominio del sexo masculino, escolaridad primaria y per cápita familiar regular. El mayor tiempo transcurrido entre los primeros síntomas y el diagnóstico fue de 1 a 3 años y la mancha anestésica constituyó el signo más frecuente de inicio de la enfermedad. Aproximadamente la mitad de los pacientes estuvieron evaluados por especialistas de Medicina General Integral antes del diagnóstico. Predominó la lepra lepromatosa, la discapacidad grado I, de localización en los pies y de tipo anestesia. Alrededor de las tres cuartas partes de los pacientes fueron detectados de forma espontánea y casi la mitad de los mismos presentó un tiempo de permanencia en el área de salud de entre 1 y 2 años

A descriptive, longitudinal and retrospective study was made with the aim of characterizing the behavior of the patients with a diagnosis of late leprosy notified during the period of January 1st, 2009 up to September 30th, 2014 in the county of Camagüey. The study consisted of 26 patients with a late diagnosis of leprosy. It was determined that the most affected age group was that of 60 years and above, with prevalence of the men, primary education and middle family per capita. The longest delay between first symptoms and diagnosis went from 1 to 3 years and the anesthetic patch constituted the most frequent sign as initial start of the illness. Approximately half of the patients were evaluated by specialists of Integral General Medicine before the diagnosis. The most frequent type was lepromatous leprosy, disability grade I prevailed mainly on feet. Approximately three fourths of the patients were detected in a spontaneous way and almost half of them were present in the area between 1 and 2 years

Factors influencing diagnosis delay of advanced breast cancer in Moroccan women.

BACKGROUND: Delay in the diagnosis of breast cancer in symptomatic women of 3 months or more is associated with advanced stage and low survival. We conducted this study to learn more about the extent and reasons behind diagnosis delay of advanced breast cancer in Moroccan women. METHODS: A group of patients with advanced breast cancer were interviewed at the National Institute of Oncology in Rabat during the period from February to December 2014. Diagnosis delay was devised into patient delay and system delay. Patient delay was defined as time from first symptoms until first medical consultation. System delay was defined as time from first presentation to a health care provider until definite diagnosis or treatment. Prospective information and clinical data were collected on a form during an interview with each patient and from medical records. RESULTS: In all, 137 patients were interviewed. The mean age of women was 48.3 ± 10.4 years. The median of consultation time was 6[4,12] months and the median of diagnosis time was 1[1,3] months. Diagnosis delay was associated to a personal reason in 96 (70.1 %) patients and to a medical reason in 19 (13.9 %) patients. A number of factors predicted diagnosis delay: symptoms were not considered serious in 66 (55.9 %) patients; traditional therapy was applied in 15 (12.7 %) patients and fear of cancer diagnosis and/or treatment in 14 (11.9 %) patients. A use of traditional methods was significantly associated with rural residence and far away from basic health center (p = 0.000). Paradoxically, a family history of breast cancer was significantly higher in who report a fear of cancer diagnosis and/or treatment to diagnosis delay (p < 0.001). Also, a significantly higher risk of more than 6 months delay was found among rural women (P = 0.035) and women who live far away from specialized care center (P = 0.001). CONCLUSIONS: Diagnosis delay is very serious problem in Morocco. Diagnosis delay was associated with complex interactions between several factors and with advanced stages. There is a need for improving breast cancer information in our populations and training of general practitioners to reduce advanced breast cancer by promoting early detection.

[Analysis of delayed diagnosis of the vertical unstable pelvic fractures].

OBJECTIVE: To explore the causes of delayed diagnosis of the vertical unstable pelvic fractures in patients with multiple trauma so in order to minimize these incidence. METHODS: A retrospective study was conducted in 176 patients with the vertical unstable pelvic fractures from January 2003 to December 2008. The classification of vertical unstable pelvic fractures was recorded. Medical data were compared and statistically analyzed to identify the incidence, and the contributing factors of the delayed diagnosis of the vertical unstable pelvic fractures. Of the 176 patients, 46 (26.1%) had delayed diagnosis of the vertical unstable pelvic fractures. There were 29 males and 17 females with an average age of 34 years old. RESULTS: Of the factors contributing to 46 cases of delayed diagnosis, 41.3% (19/46) closely related to the evaluation by the doctors and were potentially avoidable, and 58.7% (27/46) were associated with the severity of the injuries. CONCLUSION: The patients with multiple trauma had high incidence of delayed diagnosis of the vertical unstable pelvic fractures. The recognition of pelvic fractures, careful clinical assessments, and the awareness of the orthopedic doctors, emergency doctors and ICU doctors. Most of the delayed diagnosis of the vertical unstable pelvic fractures in patients with multiple trauma are potentially avoidable.

Nasopharyngeal carcinoma in Saudi Arabia: clinical presentation and diagnostic delay.

Nasopharyngeal carcinoma is commonly advanced at diagnosis. In this study we evaluated the clinical presentation, diagnostic delay and factors affecting delay in nasopharyngeal carcinoma. Data were collected prospectively for 307 newly diagnosed patients, including detailed demographic data, disease history, health care consultations and referral process. Diagnostic delay was classified as patient, professional and overall. Neck lump and nasal obstruction were the commonest presenting symptoms. There was a significant association between delay time of > or = 3 months and advanced stage. Patient's age and otological symptoms were associated with increased overall delay time. Advanced clinical stage at diagnosis was associated with paitents' sociodemographic characteristics.