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2.
Rev. inf. cient ; 98(5): 556-565, 2019. tabs
Artículo en Español | LILACS | ID: biblio-1024922

RESUMEN

Introducción: La broncoscopia desde su surgimiento ha permitido ampliar las posibilidades diagnósticas de las enfermedades respiratorias, en el cáncer de pulmón permite llegar a un diagnóstico de forma rápida y segura. Objetivo: Caracterizar la broncoscopia como método diagnóstico del cáncer de pulmón, sus complicaciones y hallazgos más frecuentes, en el servicio de Neumología del Hospital General Dr Juan Bruno Zayas Alfonso de Santiago de Cuba durante los años 2016-2018. Método: Se realizó un estudio descriptivo y transversal con los datos obtenidos de los pacientes que se les realizó la fibrobroncoscopia diagnóstica durante los años 2016-2018. El universo estuvo constituido por 172 pacientes con sospecha de cáncer de pulmón y la muestra quedó constituida por los 165 pacientes que se les realizó el proceder. Se utilizaron variables como diagnóstico de malignidad, técnicas broncoscópicas, complicaciones y hallazgos broncoscópicos. Resultados: Se encontró que 103 pacientes presentaron diagnóstico de malignidad, la biopsia bronquial presentó un 61,8 por ciento de positividad, el 94,6 por ciento de los pacientes no presentaron complicaciones y el enrojecimiento de la mucosa representó un 82,4 por ciento. Conclusiones: La biopsia bronquial fue el procedimiento que mayor positividad tuvo, las complicaciones fueron mínimas con relación al número de broncoscopias realizadas y el enrojecimiento de la mucosa fue el hallazgo más frecuente(AU)


Introduction: Bronchoscopy since its emergence has allowed to expand the diagnostic possibilities of respiratory diseases, in lung cancer it allows to reach a diagnosis quickly and safely. Objective: To characterize bronchoscopy as a diagnostic method of lung cancer, its complications and most frequent findings, in the Pulmonology department of the General Hospital Dr Juan Bruno Zayas Alfonso from Santiago de Cuba during the years 2016-2018. Method: A descriptive and cross-sectional study was conducted with the data obtained from patients who underwent diagnostic fibrobronchoscopy during the years 2016-2018. The universe consisted of 172 patients with suspected lung cancer and the sample was made up of the 165 patients who underwent the procedure. Variables such as diagnosis of malignancy, bronchoscopic techniques, complications and bronchoscopic findings were used. Results: 103 patients were found to have a diagnosis of malignancy, bronchial biopsy showed 61.8per cent positivity, 94.6per cent of the patients had no complications and mucosal redness represented 82.4per cent. Conclusions: The bronchial biopsy was the procedure that had the greatest positivity, the complications were minimal in relation to the number of bronchoscopies performed and the mucosal redness was the most frequent finding(AU)


Introdução: A broncoscopia desde o seu surgimento permitiu ampliar as possibilidades diagnósticas de doenças respiratórias; no câncer de pulmão, permite chegar a um diagnóstico de forma rápida e segura. Objetivo: Caracterizar a broncoscopia como método diagnóstico de câncer de pulmão, suas complicações e achados mais frequentes, no departamento de Pneumologia do Hospital Geral Dr Juan Bruno Zayas Alfonso de Santiago de Cuba durante os anos de 2016 a 2018. Método: Foi realizado um estudo descritivo e transversal com os dados obtidos de pacientes submetidos à fibrobroncoscopia diagnóstica nos anos de 2016-2018. O universo foi composto por 172 pacientes com suspeita de câncer de pulmão e a amostra foi composta pelos 165 pacientes submetidos ao procedimento. Foram utilizadas variáveis como diagnóstico de malignidade, técnicas broncoscópicas, complicações e achados broncoscópicos. Resultados: 103 pacientes apresentaram diagnóstico de malignidade, a biópsia brônquica mostrou 61,8por cento de positividade, 94,6por cento dos pacientes não apresentaram complicações e a vermelhidão da mucosa representou 82,4por cento. Conclusões: A biópsia brônquica foi o procedimento que apresentou maior positividade, as complicações foram mínimas em relação ao número de broncoscopias realizadas e a vermelhidão da mucosa foi o achado mais frequente(AU)


Asunto(s)
Humanos , Broncoscopía/métodos , Neoplasias Pulmonares/diagnóstico , Epidemiología Descriptiva , Estudios Transversales
3.
Semin Oncol ; 45(1-2): 52-57, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-30318084

RESUMEN

BACKGROUND: Progress in immunotherapy has revolutionized the treatment landscape for advanced lung cancer, with emerging evidence of patients experiencing long-term survivals. The goal of this study was to explore the existence of short- and long-term survival populations and to assess the effect of immunotherapy on them. METHODS: Data from two randomized, multicenter, controlled clinical trials was used to evaluate the effect of two therapeutic vaccines (anti-idiotypic vaccine VAXIRA and anti-EGF vaccine CIMAVAX) on survival curves in advanced non-small cell lung cancer patients. Data were fitted to Kaplan-Meier, standard Weibull survival, and two-component Weibull mixture models. Bayesian Information Criterion was used for model selection. RESULTS: VAXIRA did not modify, neither the fraction of patients with long-term survivals (0.18 in the control group v 0.19 with VAXIRA, P = .88), nor the median overall survival of the patients in the short-term survival subpopulation (6.8 v 7.8 months, P = .24). However, this vaccine showed great benefit for the patients belonging to the subpopulation of patients with long-term survival (33.8 v 76.6 months, P <.0001). CIMAVAX showed impact in the overall survival of both short- and long-term populations (6.8 v 8.8 months, P = .005 and 33.8 v 61.8 months, P = .007). It also increased the proportion of patients with long-term survival (from 0.18 to 0.28, P = .02). CONCLUSIONS: This study shows that therapeutic vaccines produce differential effects on short- and long-term survival populations and illustrates the application of advanced statistical methods to deal with the long-term evolution of patients with advanced lung cancer in the era of immunotherapy.


Asunto(s)
Vacunas contra el Cáncer/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Inmunoterapia/métodos , Neoplasias Pulmonares/tratamiento farmacológico , Anticuerpos Monoclonales/uso terapéutico , Anticuerpos Monoclonales de Origen Murino , Cuba , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Modelos Teóricos , Sistema de Registros/estadística & datos numéricos , Factores de Tiempo
4.
In. Cuba. Ministerio de Salud Pública. Sección Independiente para Control del Cáncer. Programa integral para el control del cáncer en Cuba. Consenso para la oncocirugía pediátrica. La Habana, Editorial Ciencias Médicas, 2017. , tab.
Monografía en Español | CUMED | ID: cum-71666
6.
MEDICC Rev ; 17(1): 55-8, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25725770

RESUMEN

INTRODUCTION: Lung cancer is one of the leading causes of death worldwide and in Cuba, where its incidence and mortality are on the rise. Diagnostic delay is a variable linked to survival and prognosis. Quantifying this delay and comparing it with data from other national and international sources may lead to planning actions to reduce its impact. OBJECTIVE: Assess diagnostic delay of lung cancer in patients at the Joaquín Albarrán Clinical-Surgical Teaching Hospital, Havana, Cuba, from 2007 to 2010. METHODS: A retrospective descriptive study was conducted based on administrative data from patients diagnosed with lung cancer. The length of overall diagnostic delay was determined, as well delay between symptom onset and the patient's first contact with the health system, and delay at the primary and secondary levels of the national health system. Descriptive statistics were used to summarize the different time intervals. RESULTS: The study comprised a total of 54 patients; 74.1% were men; the largest age group was 51-60 years. Of the total, 61.1% sought care first at the primary level. Total diagnostic delay for these patients was 67.4 days: 24.3 days due to patient delay (SD 32.8), 16.2 days due to primary care delay (SD 5.2), and 26.9 days due to secondary care delay (SD 20.1). The total delay for patients first seen at the secondary care level was 79.1 days (SD 81.8): 47.8 days due to patient delay (SD 25.6), and 31.3 days due to secondary level delay (SD 14.4). CONCLUSIONS: Diagnostic delay in lung cancer is high. Patients who went directly to hospital did not benefit from shorter delay in diagnosis.


Asunto(s)
Diagnóstico Tardío/estadística & datos numéricos , Neoplasias Pulmonares/diagnóstico , Anciano , Anciano de 80 o más Años , Cuba/epidemiología , Femenino , Hospitales de Enseñanza/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Aceptación de la Atención de Salud/estadística & datos numéricos , Estudios Retrospectivos , Factores de Tiempo
7.
MEDICC Rev ; 17(4): 44-7, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26947281

RESUMEN

Lung cancer educational programs seek the involvement of different groups in efforts to promote healthier habits and lifestyles. Women are primary agents for targeting prevention actions because of their ability to foster healthy lifestyles within their families. The purpose of this study was to develop a woman-centered educational program to strengthen knowledge and promote responsible behavior aimed at primary prevention of lung cancer. Based on identified learning needs in 133 female participants concerning lung cancer self care, healthy habits and communication skills about self care, a ten-workshop series was designed and validated by specialists and users. Before intervention, 82% of participants were highly aware of smoking-related harm, but only 26% were highly aware of healthy environmental management practices at home and 14% were knowledgeable about self care. Differences in both awareness and practice of health-promoting behaviors were observed by the end of the training: those highly aware of smoking-related harm rose to 86.5%, and those highly aware of environmental management and self care increased to 66.2% and 83.5%, respectively. The proportions reporting acceptable levels of environmental management and self-care practices increased to 86.5% (from 0%) and 91% (from 3.8%), respectively. One year later, a positive impact on families was confirmed, predominantly on children. We conclude that such a woman-centered educational program can increase awareness and promote healthy behaviors aimed at lung cancer prevention. Women's ability to communicate and share lessons learned within their families should be considered in designing community health education programs. KEYWORDS Lung cancer, health education, disease prevention, primary prevention, health promotion, Cuba.


Asunto(s)
Promoción de la Salud/organización & administración , Neoplasias Pulmonares/prevención & control , Educación del Paciente como Asunto , Prevención Primaria , Salud de la Mujer , Adulto , Cuba/epidemiología , Femenino , Humanos , Neoplasias Pulmonares/epidemiología , Persona de Mediana Edad , Desarrollo de Programa
8.
BMC Cancer ; 14: 933, 2014 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-25496392

RESUMEN

BACKGROUND: Recently, with the access of low toxicity biological and targeted therapies, evidence of the existence of a long-term survival subpopulation of cancer patients is appearing. We have studied an unselected population with advanced lung cancer to look for evidence of multimodality in survival distribution, and estimate the proportion of long-term survivors. METHODS: We used survival data of 4944 patients with non-small-cell lung cancer (NSCLC) stages IIIb-IV at diagnostic, registered in the National Cancer Registry of Cuba (NCRC) between January 1998 and December 2006. We fitted one-component survival model and two-component mixture models to identify short- and long- term survivors. Bayesian information criterion was used for model selection. RESULTS: For all of the selected parametric distributions the two components model presented the best fit. The population with short-term survival (almost 4 months median survival) represented 64% of patients. The population of long-term survival included 35% of patients, and showed a median survival around 12 months. None of the patients of short-term survival was still alive at month 24, while 10% of the patients of long-term survival died afterwards. CONCLUSIONS: There is a subgroup showing long-term evolution among patients with advanced lung cancer. As survival rates continue to improve with the new generation of therapies, prognostic models considering short- and long-term survival subpopulations should be considered in clinical research.


Asunto(s)
Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/patología , Carcinoma de Pulmón de Células no Pequeñas/epidemiología , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Carcinoma de Pulmón de Células no Pequeñas/patología , Cuba/epidemiología , Humanos , Neoplasias Pulmonares/mortalidad , Modelos Estadísticos , Estadificación de Neoplasias , Vigilancia de la Población , Pronóstico , Sistema de Registros , Sobrevivientes
9.
MEDICC Rev ; 15(3): 16-21, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23934422

RESUMEN

INTRODUCTION: Cancer has historically been a main cause of death in Cuba, with lung cancer the number one cause of cancer death in both sexes. Cancer morbidity and mortality rates are the basic measures of cancer impact in the community. Cancer mortality has been one of the major applications of geographic analysis and has made important progress in recent decades thanks to access to mortality statistics and to development and availability of geographic information systems. Cuba does not have a strong tradition of etiologic research using spatial analysis. High levels of lung cancer morbidity and mortality in Villa Clara and growing interest in spatial analysis as an epidemiologic tool motivated this study. OBJECTIVE: To identify spatial and/or spatiotemporal clusters of lung cancer morbidity and case fatality in the province of Villa Clara, and to demonstrate the value of cluster analysis as an epidemiologic tool. METHODS: Descriptive observational study based on administrative data, using the technique of space-time scan statistics. The study focused on new cases diagnosed in 2004 and case-fatality for those cases through 2009. Variables used were: cases diagnosed, deaths, date of diagnosis, date of death, municipality and Cartesian geocoding for each municipality. RESULTS: The study identified significant spatial and spatiotemporal clusters of greater than expected lung cancer incidence (municipalities of Encrucijada, Camajuaní, Cifuentes, Sagua la Grande, Caibarién and Santa Clara) and case fatality (Encrucijada, Camajuaní, Cifuentes, Sagua la Grande, Caibarién, Santa Clara, Placetas and Manicaragua). CONCLUSIONS: Although the results are not explanatory, the spatial and spatiotemporal patterns of excess lung cancer risk and case-fatality can support hypothesis generation for research and eventual interventions for targeted prevention and management.


Asunto(s)
Neoplasias Pulmonares/epidemiología , Cuba/epidemiología , Femenino , Humanos , Incidencia , Neoplasias Pulmonares/mortalidad , Masculino , Análisis Espacio-Temporal
10.
Rev. cuba. hig. epidemiol ; 50(1)ene.-abr. 2012. graf
Artículo en Español | CUMED | ID: cum-56454

RESUMEN

Introducción: El cáncer de pulmón es un grave problema sanitario en Cuba y afecta a uno y otro sexos. Su alta incidencia y mortalidad tienen una tendencia al incremento, más ostensible en mujeres. Su diagnóstico se realiza frecuentemente en etapas avanzadas. Objetivos: Estandarizar procederes que permitan, desde el nivel primario de atención, un procedimiento organizado para la prevención y el manejo del cáncer de pulmón, con énfasis en las personas en riesgo, así como contribuir a reducir el diagnóstico tardío de la enfermedad. Métodos: Para la construcción del algoritmo se tuvieron en cuenta los principales factores de riesgo del cáncer de pulmón, y entre ellos el de mayor contribución: el tabaquismo. Se organizó una secuencia estructurada de pasos que incluyó la aplicación de la estrategia de las 3 A (Averiguar, Animar, Asesorar), propuesta por la Organización Mundial de la Salud, adecuada a nuestro contexto y modificada, al ser aplicada por primera vez a fumadores pasivos. El modelo fue sometido a validación según criterios de expertos. Resultados: Fue construido el algoritmo que partió de explorar los principales factores de riesgo del cáncer de pulmón, orientado a sistematizar una conducta preventiva del tabaquismo, así como la sistemática de manejo del individuo en riesgo, con la participación activa del médico y la enfermera de la familia durante todo el proceso de atención. El resultado de la validación fue satisfactorio y se incorporaron las recomendaciones de los expertos. Consideraciones finales: Para el logro del diagnóstico en estadios más tempranos de la enfermedad y de la contribución a la reducción de la morbilidad y mortalidad, retos de la salud pública cubana actual, deberá tenerse en cuenta la propuesta de este modelo de prevención y adecuado manejo del cáncer de pulmón desde el nivel primario de atención(AU)


Introduction: The lung cancer is a serious health problem in Cuba affecting both sexes. Its high incidence and mortality have a trend to increase more evident in women. Its diagnosis frequently is made in the advanced stages. Objectives: To standardize procedures allowing from the primary level of care a procedure organized for prevention and management of lung cancer emphasizing the persons in risk, as well as to contribute to reduce the late diagnosis of disease. Methods: To construction of algorithm authors took into account the main risk factors of lung cancer and among them that of great contribution: smoking. A structured sequence of steps was organized including the implementation of "strategy" of three A (to find out, to encourage, to advice) proposed by WHO, suitable for our context and modified when it was applied for the first time in passive smokers. The form was submitted to validation according to the expert criteria. Results: An algorithm was designed from the exploration of main risk factors of lung cancer, directed to systematize a preventive behavior of smoking, as well as the management systematics of individual in risk with the active participation of family physician and nurse over all the care process. The result of validation was satisfactory and the expert recommendations were incorporated. Final considerations: To achieve the diagnosis in earlier stages of disease and of the contribution to reduction of morbility and mortality which are challenges of current Cuban public health, we must to take into account the proposal of this form of prevention and appropriate management of lung cancer from the primary care level(AU)


Asunto(s)
Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/prevención & control , Factores de Riesgo , Fumar/efectos adversos , Contaminación por Humo de Tabaco/efectos adversos , Atención Primaria de Salud , Encuestas y Cuestionarios , Cuba
11.
Rev. cuba. hig. epidemiol ; 50(1): 37-47, ene.-abr. 2012.
Artículo en Español | LILACS | ID: lil-628709

RESUMEN

Introducción: El cáncer de pulmón es un grave problema sanitario en Cuba y afecta a uno y otro sexos. Su alta incidencia y mortalidad tienen una tendencia al incremento, más ostensible en mujeres. Su diagnóstico se realiza frecuentemente en etapas avanzadas. Objetivos: Estandarizar procederes que permitan, desde el nivel primario de atención, un procedimiento organizado para la prevención y el manejo del cáncer de pulmón, con énfasis en las personas en riesgo, así como contribuir a reducir el diagnóstico tardío de la enfermedad. Métodos: Para la construcción del algoritmo se tuvieron en cuenta los principales factores de riesgo del cáncer de pulmón, y entre ellos el de mayor contribución: el tabaquismo. Se organizó una secuencia estructurada de pasos que incluyó la aplicación de la estrategia de las 3 A (Averiguar, Animar, Asesorar), propuesta por la Organización Mundial de la Salud, adecuada a nuestro contexto y modificada, al ser aplicada por primera vez a fumadores pasivos. El modelo fue sometido a validación según criterios de expertos. Resultados: Fue construido el algoritmo que partió de explorar los principales factores de riesgo del cáncer de pulmón, orientado a sistematizar una conducta preventiva del tabaquismo, así como la sistemática de manejo del individuo en riesgo, con la participación activa del médico y la enfermera de la familia durante todo el proceso de atención. El resultado de la validación fue satisfactorio y se incorporaron las recomendaciones de los expertos. Consideraciones finales: Para el logro del diagnóstico en estadios más tempranos de la enfermedad y de la contribución a la reducción de la morbilidad y mortalidad, retos de la salud pública cubana actual, deberá tenerse en cuenta la propuesta de este modelo de prevención y adecuado manejo del cáncer de pulmón desde el nivel primario de atención


Introduction: The lung cancer is a serious health problem in Cuba affecting both sexes. Its high incidence and mortality have a trend to increase more evident in women. Its diagnosis frequently is made in the advanced stages. Objectives: To standardize procedures allowing from the primary level of care a procedure organized for prevention and management of lung cancer emphasizing the persons in risk, as well as to contribute to reduce the late diagnosis of disease. Methods: To construction of algorithm authors took into account the main risk factors of lung cancer and among them that of great contribution: smoking. A structured sequence of steps was organized including the implementation of "strategy" of three A (to find out, to encourage, to advice) proposed by WHO, suitable for our context and modified when it was applied for the first time in passive smokers. The form was submitted to validation according to the expert criteria. Results: An algorithm was designed from the exploration of main risk factors of lung cancer, directed to systematize a preventive behavior of smoking, as well as the management systematics of individual in risk with the active participation of family physician and nurse over all the care process. The result of validation was satisfactory and the expert recommendations were incorporated. Final considerations: To achieve the diagnosis in earlier stages of disease and of the contribution to reduction of morbility and mortality which are challenges of current Cuban public health, we must to take into account the proposal of this form of prevention and appropriate management of lung cancer from the primary care level


Asunto(s)
Humanos , Contaminación por Humo de Tabaco/efectos adversos , Fumar/efectos adversos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/prevención & control , Atención Primaria de Salud , Factores de Riesgo , Cuba , Encuestas y Cuestionarios
12.
Rev. cuba. salud pública ; 37(4)oct.-dic. 2011.
Artículo en Español | CUMED | ID: cum-49329

RESUMEN

Objetivos Identificar diferencias en la carga integral (combinando mortalidad y morbilidad) asociada al cáncer de pulmón entre sexos y provincias y describir su evolución en los años 1990,1995, 2000 y 2002. Métodos Los Años de Vida Potencial Perdidos por mortalidad se calcularon a partir de la Esperanza de Vida estimada para grupos quinquenales de edad. Los Años de Vida Potencial Perdidos se calcularon como promedio por cada defunción. Los Años de Vida Potencial Perdidos por morbilidad se obtuvieron a partir de las severidades, la incidencia y duración promedio. Resultados La tasa de Años de Vida Potencial Perdidos por mortalidad prematura se incrementó del 1990 al 2002 para ambos sexos, de 6,07 a 7,45 por 1 000 y de 2,52 a 4,21 por 1 000 en hombres y mujeres, respectivamente. Las provincias con mayores valores para esta tasa, en hombres en 1990 y 2002 fueron Ciudad de La Habana, Matanzas, La Habana e Isla de la Juventud, mientras que en el sexo femenino estas fueron Pinar del Río, Villa Clara, Ciudad de La Habana, Isla de la Juventud y Ciego de Ávila; se encontró un incremento de la tasa de Años de Vida Potencial Perdidos por morbilidad para ambos sexos del año 1990 al 2002 de 0,42 a 0,52 por 1 000 y de 0,19 a 0,28 por 1 000 en hombres y mujeres, respectivamente. La tasa de Años de Vida Ajustados por Discapacidad, también mostró una evolución desfavorable en ambos sexos. Los valores mayores de esta tasa se encontraron en La Habana, Ciudad de La Habana y Villa Clara para ambos sexos. El sexo masculino resultó más afectado tanto por mortalidad como por mortalidad. Conclusiones El impacto del cáncer de pulmón en términos de años de vida saludables perdidos tuvo una evolución desfavorable en Cuba en los años seleccionados del período 1990-2002.(AU)


Objectives To identify differences in the integral burden (combined mortality and morbidity) associated to lung cancer between sexes and among provinces, and to describe the evolution in 1990, 1995, 2000 and 2002. Methods The Potential Years of Life Lost due to mortality were calculated on the basis of estimated Life Expectancy for quinquennial groups of age. The Potential Years of Life Lost were calculated per death as an average. The Potential Years of Life Lost due to morbidity were estimated on the basis of severity, incidence and average duration. Results The rate of potential years of life lost due to premature mortality increased for both sexes in the 1990-2002 period; it was 6.07 to 7.45 per 1 000 inhabitants in males and 2.52 to 4.21 per 1 000 inhabitants in females. The provinces with the highest rates for males in 1990 and 2002 were Ciudad de La Habana, Matanzas, La Habana and Isla de la Juventus whereas the highest rates for females were found in Pinar del Río, Villa Clara, Ciudad de La Habana, Isla de la Juventud and Ciego de Avila provinces in the same years. There was found an increase in the rate of Potential Years of Life Lost due to morbidity for both sexes from 1990 to 2002; it was 0.42 to 0.52 and 0.19 to 0.28 per 1 000 inhabitants in males and females respectively. The rate of Disability Adjusted Years of Life also showed unfavourable evolution in both sexes. The highest figures were seen in La Habana, Ciudad de La Habana and Villa Clara for both sexes. The males were more affected in terms of mortality and morbidity. Conclusions The impact of lung cancer in healthy years of life lost had unfavourable evolution in Cuba in the selected years of the 1990-2002 period.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Años Potenciales de Vida Perdidos , Años de vida Ajustados por la Incapacidad , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/epidemiología , Morbilidad
13.
Rev. cuba. salud pública ; 37(4): 428-441, oct.-dic. 2011.
Artículo en Español | LILACS | ID: lil-615763

RESUMEN

Objetivos Identificar diferencias en la carga integral (combinando mortalidad y morbilidad) asociada al cáncer de pulmón entre sexos y provincias y describir su evolución en los años 1990,1995, 2000 y 2002. Métodos Los Años de Vida Potencial Perdidos por mortalidad se calcularon a partir de la Esperanza de Vida estimada para grupos quinquenales de edad. Los Años de Vida Potencial Perdidos se calcularon como promedio por cada defunción. Los Años de Vida Potencial Perdidos por morbilidad se obtuvieron a partir de las severidades, la incidencia y duración promedio. Resultados La tasa de Años de Vida Potencial Perdidos por mortalidad prematura se incrementó del 1990 al 2002 para ambos sexos, de 6,07 a 7,45 por 1 000 y de 2,52 a 4,21 por 1 000 en hombres y mujeres, respectivamente. Las provincias con mayores valores para esta tasa, en hombres en 1990 y 2002 fueron Ciudad de La Habana, Matanzas, La Habana e Isla de la Juventud, mientras que en el sexo femenino estas fueron Pinar del Río, Villa Clara, Ciudad de La Habana, Isla de la Juventud y Ciego de Ávila; se encontró un incremento de la tasa de Años de Vida Potencial Perdidos por morbilidad para ambos sexos del año 1990 al 2002 de 0,42 a 0,52 por 1 000 y de 0,19 a 0,28 por 1 000 en hombres y mujeres, respectivamente. La tasa de Años de Vida Ajustados por Discapacidad, también mostró una evolución desfavorable en ambos sexos. Los valores mayores de esta tasa se encontraron en La Habana, Ciudad de La Habana y Villa Clara para ambos sexos. El sexo masculino resultó más afectado tanto por mortalidad como por mortalidad. Conclusiones El impacto del cáncer de pulmón en términos de años de vida saludables perdidos tuvo una evolución desfavorable en Cuba en los años seleccionados del período 1990-2002.


Objectives To identify differences in the integral burden (combined mortality and morbidity) associated to lung cancer between sexes and among provinces, and to describe the evolution in 1990, 1995, 2000 and 2002. Methods The Potential Years of Life Lost due to mortality were calculated on the basis of estimated Life Expectancy for quinquennial groups of age. The Potential Years of Life Lost were calculated per death as an average. The Potential Years of Life Lost due to morbidity were estimated on the basis of severity, incidence and average duration. Results The rate of potential years of life lost due to premature mortality increased for both sexes in the 1990-2002 period; it was 6.07 to 7.45 per 1 000 inhabitants in males and 2.52 to 4.21 per 1 000 inhabitants in females. The provinces with the highest rates for males in 1990 and 2002 were Ciudad de La Habana, Matanzas, La Habana and Isla de la Juventus whereas the highest rates for females were found in Pinar del Río, Villa Clara, Ciudad de La Habana, Isla de la Juventud and Ciego de Avila provinces in the same years. There was found an increase in the rate of Potential Years of Life Lost due to morbidity for both sexes from 1990 to 2002; it was 0.42 to 0.52 and 0.19 to 0.28 per 1 000 inhabitants in males and females respectively. The rate of Disability Adjusted Years of Life also showed unfavourable evolution in both sexes. The highest figures were seen in La Habana, Ciudad de La Habana and Villa Clara for both sexes. The males were more affected in terms of mortality and morbidity. Conclusions The impact of lung cancer in healthy years of life lost had unfavourable evolution in Cuba in the selected years of the 1990-2002 period.


Asunto(s)
Humanos , Masculino , Femenino , Años de vida Ajustados por la Incapacidad , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/mortalidad , Años Potenciales de Vida Perdidos , Morbilidad
14.
Humanidades Médicas ; 4(2)20040100.
Artículo en Español | CUMED | ID: cum-45256

RESUMEN

El trabajo constituye un análisis al proyecto Diagnóstico temprano del cáncer de pulmón. Establecimiento de un algoritmo de trabajo. El objetivo general es proporcionar un estudio social desde la perspectiva del enfoque Ciencia Tecnología Sociedad y fundamentar el proyecto como un proyecto de innovación tecnológica de tipo organizacional. Se revelan conceptos necesarios, como tecnología en su visión tradicional y moderna y el de innovación tecnológica. Se analiza al cáncer de pulmón como objeto de estudio de la ciencia medica y de acción tecnológica y se valoran las condiciones sociales que en Cuba propician el estudio del cáncer pulmón, y cómo se manifiesta la transferencia de tecnología en esta esfera de la salud. Para ello se concibe el razonamiento a través del contexto social, económico, político y científico; se reconocen los problemas y las soluciones en la investigación. Por último, se identifican los impactos de la innovación tecnológica. Se trata en el presente trabajo de hacer válida la tesis que los estudios CTS en Cuba constituyen un campo de reflexión y acción de carácter crítico e interdisciplinario relacionado con las influencias que cada contexto sociocultural ejerce sobre el desarrollo de la ciencia y la tecnología y los impactos sociales de estos (AU)


This work is an analysis of the project Early diagnosis of lung cancer. Establishment of a work algorithm. The general objective is to provide a social study from the perspective of the Science Technology Society approach and to support the project as a project of technological innovation of organizational type. Necessary concepts are revealed, as technology in their traditional and modern vision and that of technological innovation. Lung cancer is analyzed as object of study of medical science and of technological activity. The social conditions that propitiate the study of the cancer lung in Cuba are valued, and how technology transfer is manifested in this area of health. To do so reasoning through the social, economic, political and scientific context is conceived; and problems and solutions are identified in the investigation. Finally, the impacts of technological innovation are identified. This work is intended to make valid the thesis that CTS studies in Cuba are a reflection and action area of critical and interdisciplinary character, related to the influences that each sociocultural context has in the development of science and technology as well as their social impact (AU)


Asunto(s)
Humanos , Ciencia, Tecnología y Sociedad , Cuba , Neoplasias Pulmonares , Diagnóstico Precoz
15.
Gac méd espirit ; 13(3)mayo-ago 2011. tab
Artículo en Español | CUMED | ID: cum-49562

RESUMEN

Fundamento: El cáncer pulmonar es el responsable de los mayores índices de mortalidad por cáncer a escala mundial y en Cuba; por lo que es necesario estudiar los cambios dinámicos en la presentación clínica de nuevas series de pacientes, para comprender mejor la historia natural de esta enfermedad. Objetivo: Describir las características epidemiológicas, clínicas, imagenológicas e histopatológicas de los pacientes con cáncer primario de pulmón, durante un período de 3 años. Metodología: Un estudio transversal descriptivo se realizó entre enero del 2008 a diciembre del 2010 en el servicio de neumología del Hospital General Universitario Camilo Cienfuegos Sancti Spíritus, Cuba. Se identificaron 180 pacientes. Se obtuvieron datos demográficos, clínicos, imagenológicos e histopatológicos. Resultados: Predominó el sexo masculino y la edad media al diagnóstico fue de 63,4 años. El 95 porciento presentó historia de tabaquismo y el 66,1porciento eran fumadores activos. En el 92,2 porciento se realizó diagnóstico citohistológico. El carcinoma epidermoide fue el más frecuente. Conclusiones: En los pacientes espirituanos el carcinoma epidermoide es el tipo histológico predominante. La mayoría de los pacientes tenían historia de tabaquismo. En las mujeres, la enfermedad se diagnosticó en estadios avanzados y en los hombres en estadios iniciales. La modalidad terapéutica más empleada fue la quimioterapia(AU)


Background: Lung cancer is responsible for the higher rates of cancer mortality worldwide and in Cuba, so it is necessary to study the dynamic changes in the clinical presentation of a new series of patients, to better understand the natural history of this disease. Objective: To describe the epidemiological, clinical, and histopathological imaging of patients with primary lung cancer over a period of 3 years. Methodology: A descriptive cross-sectional study was conducted from January 2008 to December 2010 in the pulmonology department of Hospital General Universitario Camilo Cienfuegos Sancti Spiritus, Cuba. 180 patients were identified. We obtained demographic, clinical, imaging and histological analysis. Results: The predominant male and mean age at diagnosis was 63.4 years. The 95percent had a history of smoking and 66.1percent were active smokers. The diagnosis was made 92.2percent cytohistological. Squamous cell carcinoma was the most frequent. Conclusions: In patients with squamous cell carcinoma Spiritus is the predominant histologic type. Most patients had a history of smoking. In women, the disease was diagnosed in advanced stages and in men in early stages. The therapeutic modality was the most common chemotherapy


Asunto(s)
Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Epidemiología Descriptiva
16.
MEDICC Rev ; 12(1): 17-23, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20387330

RESUMEN

INTRODUCTION: CIMAvax EGF is a therapeutic anticancer vaccine developed entirely in Cuba and licensed in Cuba for use in adult patients with stage IIIB/IV non-small-cell lung cancer (NSCLC). The vaccine is based on active immunotherapy by which an individual's immune response is manipulated to release its own effector antibodies (Abs) against the epidermal growth factor (EGF). OBJECTIVE: Review pre-clinical and clinical research conducted during development of CIMAvax EGF, primarily studies published by Cuban investigators in international peer-reviewed scientific journals. Methods An automated search for "vaccine" and "EGF" was conducted in PubMed, resulting in 17 articles published by Cuban authors between January 1, 1994 and September 30, 2009. Main findings were described and discussed, along with unpublished preliminary findings of an initial ongoing phase III clinical trial. RESULTS: Articles reviewed describe five phase I/II and one phase II clinical trials conducted in Cuba in 1995-2005. A non-controlled 1995-1996 study resulted in the earliest published scientific evidence of the feasibility of inducing an immune response against autologous EGF in patients with different advanced stage tumors. Subsequent controlled, randomized trials included patients with advanced stage (IIIB/IV) NSCLC. The 2 and 3rd phase I/II trials differentiated immunized patients as poor antibody responders (PAR) and good antibody responders (GAR), according to their anti-EGF antibody response, and confirmed greater immunogenicity with Montanide ISA 51 adjuvant in the vaccine formulation, as well as the benefits of low-dose cyclophosphamide treatment 72 hours before the first immunization. The 4th phase I/II trial found increased immunogenicity with an increased dose divided in 2 anatomical sites and also established correlation between Ab titers, serum EGF concentration and length of survival. In the first 4 phase I/II trials and the phase II trial, vaccine was administered after chemotherapy (ChTVV schedule). In the 5th phase I/III trial, longer survival and increased immunogenicity were achieved using a VChTV schedule and dividing the vaccine dose in 4 anatomical sites. The phase II clinical trial confirmed results of earlier studies as well as the mild-to-moderate adverse event profile associated with CIMAvax EGF Longer survival was observed in all vaccinated patients compared to controls, and the difference was significant (p < 0.05) in the group aged <60 years. CONCLUSIONS: CIMAvax EGF's benefits in earlier NSCLC stages and in other tumor locations, as well as in patients unfit for chemotherapy, need to be evaluated. Evidence of the vaccine's safety for chronic use also needs to be systemized.


Asunto(s)
Vacunas contra el Cáncer/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Factor de Crecimiento Epidérmico/inmunología , Inmunoterapia Activa , Neoplasias Pulmonares/tratamiento farmacológico , Adulto , Ensayos Clínicos Fase I como Asunto , Ensayos Clínicos Fase II como Asunto , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Análisis de Supervivencia
17.
MEDICC Rev ; 12(1): 29-32, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20387332

RESUMEN

INTRODUCTION: Despite advances in diagnostic techniques and treatment, lung cancer is the leading cause of cancer death worldwide and in Cuba. Prompt initiation of cancer therapy depends on rapid diagnostic confirmation; however, most patients are diagnosed at an advanced stage. In the Cuban health system, primary, secondary and tertiary levels of care are interrelated; patients may seek care at any level or may be referred from one to another. Lung cancer diagnoses are confirmed at the tertiary level. OBJECTIVE: Determine the length of diagnostic delay in patients diagnosed with non-small-cell lung cancer (NSCLC) at a tertiary care facility in Havana, Cuba, as well as mean diagnostic delay attributable to the patient and to the health system by level of care. METHODS: A descriptive observational study of 96 patients with a cytologically and/or histologically confirmed diagnosis of non-small-cell lung cancer was conducted in 2005-2007. Patients initially sought care for disease symptoms at primary, secondary or tertiary levels in the Cuban public health system, but diagnosis of all patientas was confirmed at a specialized tertiary care facility. Total diagnostic delay was calculated as the time elapsed from onset of symptoms to confirmation of NSCLC diagnosis. Variables also included diagnostic delay attributable to the patient and diagnostic delay attributable to the health system by level of care. Data were arranged in tables and analyzed by absolute value, percentage, mean, and standard deviation. RESULTS: Of the 96 patients studied, 69% were male, and 54% were aged 50-69 years. Fifty-five percent of patients sought medical care within 15 days of onset of symptoms, 21% within 16-30 days, and 3% waited >90 days. Mean diagnostic delay attributable to the patient was 18.19 +/- 3.45 days while mean diagnostic delay attributable to the health system was 61.63 +/- 18.50 days, and overall diagnostic delay was 73.13 +/- 17.53 days. For the 71% of patients seen in primary care, mean diagnostic delay was 29.51 +/- 4.53 days; for the 45% seen exclusively or additionally at the secondary level, mean diagnostic delay was 24.45 +/- 7.31 days. Upon admission at the tertiary care level, mean diagnostic confirmation delay was 18.23 +/- 3.68 days. CONCLUSIONS: Diagnostic delay of lung cancer patients in this study was prolonged. Appropriate strategies are needed for reducing this delay.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Diagnóstico Tardío/estadística & datos numéricos , Accesibilidad a los Servicios de Salud , Neoplasias Pulmonares/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Cuba , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia
18.
Przegl Lek ; 63(10): 1126-30, 2006.
Artículo en Polaco | MEDLINE | ID: mdl-17288235

RESUMEN

Tobacco was brought to Europe by Christopher Columbus, who discovered it in Cuba in October, 1492. Spread of tobacco consumption was initiated by the French diplomat Jean Nicot de Villemain, who in 1560 recommended it in the form of powdered tobacco leaves to the French Queen Catherine de Medice to combat her migraine headaches, and introduced the term Nicotiana tobaccum. Tobacco consumption greatly rose after the I World War, and after the II World War it became very common, especially among man. In the first half of the 20th century the sale of tobacco products rose by 61%, and cigarettes dominated the market of tobacco products. At the beginning of the 20th century cigarettes constituted only 2% of the total sale of tobacco products, while in the middle of the 20th century--more than 80%. Although the first epidemiological papers indicating that "smoking is connected with the shortening of life span" were published in the first half of the 20th century, not until 1950 did Hill and Doll in Great Britain, and Wynder and Graham in USA in 1951 show a statistically significant correlation between cigarettes smoking and lung cancer occurrence. Many controversies according the use of tobacco accompanied it from the beginning of its presence in Europe. The conflicting opinions according to its influence to health coexisted in the 16th to 19th centuries. In this period, especially in the 19th century dominated moral and religious arguments against tobacco. In the 20th century however, and particularly in its second part, development in medical research was enhanced by civil voluntary actions against advertisement and passive smoking. This lead to the significant limitation of tobacco expansion in Europe, USA and Canada in the end of the 20th century.


Asunto(s)
Neoplasias Pulmonares/prevención & control , Fumar/historia , Contaminación por Humo de Tabaco/historia , Tabaquismo/historia , Publicidad/legislación & jurisprudencia , Publicidad/estadística & datos numéricos , Canadá , Comercio/economía , Comercio/estadística & datos numéricos , Cuba , Demografía , Europa (Continente) , Historia del Siglo XV , Historia del Siglo XVI , Historia del Siglo XVII , Historia del Siglo XVIII , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/historia , Sistemas de Información Administrativa/historia , Sistemas de Información Administrativa/estadística & datos numéricos , Fumar/economía , Fumar/legislación & jurisprudencia , Prevención del Hábito de Fumar , Industria del Tabaco/historia , Industria del Tabaco/estadística & datos numéricos , Contaminación por Humo de Tabaco/prevención & control , Tabaquismo/epidemiología , Tabaquismo/prevención & control , Reino Unido , Estados Unidos
20.
Rev. cuba. oncol ; 13(1): 5-11, ene.-jun. 1997. mapas, tab
Artículo en Español | CUMED | ID: cum-16180

RESUMEN

Se analizan las provincias con mayor riesgo de morir por cáncer total. Las zonas investigadas son la mama y el pulmón (masculino) durante el período de 1991 a 1993. Estos resultados fueron comparados con el trienio 1983-1985. En cuanto a todas las localizaciones del cáncer, ambos períodos tuvieron un número similar de provincias con un riesgo mayor que el promedio nacional, pero varió la distribución de éstas y sólo coincidieron en Ciudad de La Habana. También en esta provincia se reitera un mayor riesgo de morir por cáncer de mama en la mujer, y cáncer del pulmón en el hombre, el cual está presenta también en otras provincias de occidente y centro del país. entre las provincias de menor riesgo no hay ninguna en que éste pueda considerarse como bajo(AU)


Asunto(s)
Neoplasias/mortalidad , Neoplasias de la Mama/mortalidad , Neoplasias Pulmonares/mortalidad , Factores de Riesgo , Cuba
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