Relación entre tiempo de pesquisa de alteraciones del neurodesarrollo por parte de cuidadores y diagnóstico de TEA de alto funcionamiento / Relationship between time of detection of neurodevelopmental alterations by caregivers and diagnosis of high functioning ASD

INTRODUCCIÓN: La intervención precoz en el trastorno del espectro autista (TEA) ha demostrado ser fundamental para un mejor pronóstico a largo plazo. Se han descrito importantes latencias entre la pesquisa de sintomatología y el diagnóstico, retardando el inicio de terapia. OBJETIVO: Correlacionar el tiempo entre la pesquisa de alteración del neurodesarrollo por parte de los cuidadores y el diagnóstico de TEA. METODOLOGÍA: Estudio observacional retrospectivo de pacientes diagnosticados con TEA en el Centro de Terapia del Comportamiento. RESULTADOS: 28 pacientes (24 hombres) con diagnóstico de TEA. Mediana de edad de inicio de síntomas de 24 meses y de diagnóstico de 62,5 meses. No existe una correlación entre la edad de pesquisa de síntomas y del diagnóstico (r2=0,1). CONCLUSIONES: No hubo relación entre edad de pesquisa de síntomas por los cuidadores y diagnóstico de TEA. Este estudio refleja la necesidad de ampliar el conocimiento poblacional sobre sintomatología temprana de TEA, siendo una herramienta de salud pública para lograr el manejo precoz y mejorar el pronóstico de estos sujetos.

INTRODUCTION: Early intervention in autism spectrum disorder (ASD) has shown to be essential for better long-term prognosis. Significant delays have been described between symptom assessment and diagnosis, deferring therapy initiation. OBJECTIVE: To relate the moment of symptom detection by caregivers and the medical diagnosis of ASD. METHODOLOGY: Observational retrospective study, including patients diagnosed with ASD at a private behavioral therapy center. Results: 28 patients (24 male) with diagnosis of ASD. Median age of symptom assessment was at 24 months and of diagnosis at 62.5 months. There is no relation between the age of symptoms assessment and diagnosis (r2 = 0.1). CONCLUSIONS: There was no relationship between the age at which symptoms were detected by caregivers and medical diagnosis of ASD. This study reflects the need to increase the awareness about early symptoms of ASD, being a public health tool to achieve early management and improve the prognosis of these subjects.

Conditional Survival and Associated Prognostic Factors in Patients with Upper Tract Urothelial Carcinoma after Radical Nephroureterectomy: A Retrospective Study at a Single Institution / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The purpose of this study is to evaluate the changes of conditional survival (CS) probabilities and to identify the prognostic parameters that significantly affect CS over time post-surgery in upper tract urothelial carcinoma (UTUC) patients. MATERIALS AND METHODS: A total of 330 patients were examined in the final analysis. Primary end point was conditional cancer-specific survival (CSS), overall survival (OS), and intravesical recurrence-free survival (IVRFS) after surgery. The Kaplan-Meier method was used for calculation of CS. Cox regression hazard ratio model was used to determine the predictors of CS. RESULTS: UTUC patients who had already survived 5 years after radical nephroureterectomy had a more favorable CS probability in all given survivorships compared to those with shorter survival times. Patients with unfavorable pathologic features showed a higher increment of 5-year conditional CSS and OS compared to their counterparts. For 5-year conditional CSS, several factors, including high-grade tumor, lymphovascular invasion, and tumor location showed significant association with risk elevation over time. Only age remained as a predictor of 5-year conditional OS with increased risk in all given survivorships. For 5-year IVRFS, no variables remained as significant predictive factors over time after surgery. CONCLUSION: Our study provides valuable information for practical survival estimation and relevant prognostic factors for patients with UTUC after surgery.