ABSTRACT
Aim: CoVid-19 has affected healthcare globally, disrupting cancer care. Two weeks wait (2ww) breast cancer referrals were triaged according to Association of Breast Surgery (ABS) guidelines with patients with no red flag symptoms deemed low risk and able to be discharged back to their GP. This study aimed to assess the safety and efficacy of implementing these guidelines. Method: A database was established to prospectively collect 2ww breast cancer referrals from the outset of CoVid-19. Two Consultants triaged the referrals and if there was disagreement, a third Consultant arbitrated. Data were recorded for patient age, gender, presenting complaint, assessment, investigations, diagnosis, and outcome and also time from initial referral to discharge letter to the GP. Results: 188 patients were referred via the 2ww pathway to St Bartholomew's Hospital from 22/03/2020 to 08/04/2020. 43 (22.9%) were discharged with a median age of 34 (22-83 years) at the time of referral. The mean time from referral receipt to response was 12.1 (0 - 60 days). 15 (34.9%) patients were subsequently re-referred. Mean time from re-referral to one-stop clinic assessment was 9.1 (2 - 22 days), in keeping with NICE two week wait criteria. Of the patients re-referred, all patients underwent imaging in the form of mammogram and/or ultrasound scan. No patients were found to have pre-invasive or invasive disease. Conclusions: Triaging patients based on GP referrals is a safe way of streamlining low risk patients. This has the potential to become standard practice worldwide but requires larger multi-centre studies prior to implementation.
ABSTRACT
Corona virus is a widespread family known to cause diseases ranging from the common cold to more severe illnesses such as Middle East Syndrome and Severe Acute Respiratory Syndrome (SARS). This virus was emerging for the first time on December 31/12/2019 in the Chinese city of Wuhan, after a group of viral pneumonia cases were reported. The risks of this disease increased with severe complications among people aged 60 years and over and people, who suffer from medical problems such as high blood pressure or heart problems. lungs, diabetes, obesity, cancer etc. However, any person may come in contact with this disease and suffer from serious complications or may die at any age. The time required for illness until symptoms appear is from five to six days, but it ranges from one to fourteen days, so the infected are advised to stay at home during this period to prevent the spread of the virus, the most common symptoms of this disease are (fever, dry cough, stress), in addition to other less common symptoms (loss of taste and smell, nasal congestion, headache etc). Almost all people (80%), who do not show symptoms recover from the disease without taking treatment from the hospital. About 15% of them are in critical condition and need oxygen and 5% of them become critical and need intensive care. The seriousness of this disease and the speed of its spread in most countries in the world in general and in Iraq in particular, an applied study was conducted on a sample of 220 patients, who were exposed to infection during a certain period of time (1/6-31/8/2020) in a hospital (Ibn Al-Balady), Epidemiology Department, to find out the factors affecting the disease (age, gender, diabetes, blood pressure, smoking etc.), based on some appropriate health models to study the pandemic (Covid-19) and the bootstrap method was used to find the best estimates. © 2021 DAV College. All rights reserved.