Barriers to Breast Cancer Screening among Diverse Cultural Groups in Melbourne, Australia.

This study explored the association between health literacy, barriers to breast cancer screening, and breast screening participation for women from culturally and linguistically diverse (CALD) backgrounds. English-, Arabic- and Italian-speaking women (n = 317) between the ages of 50 to 74 in North West Melbourne, Australia were recruited to complete a survey exploring health literacy, barriers to breast cancer screening, and self-reported screening participation. A total of 219 women (69%) reported having a breast screen within the past two years. Results revealed that health literacy was not associated with screening participation. Instead, emotional barriers were a significant factor in the self-reported uptake of screening. Three health literacy domains were related to lower emotional breast screening barriers, feeling understood and supported by healthcare providers, social support for health and understanding health information well enough to know what to do. Compared with English- and Italian-speaking women, Arabic-speaking women reported more emotional barriers to screening and greater challenges in understanding health information well enough to know what to do. Interventions that can improve breast screening participation rates should aim to reduce emotional barriers to breast screening, particularly for Arabic-speaking women.

Asociación entre la presencia de depresión y tipo de amputación mayor en el paciente diabético amputado / Association between presence of depression and the type of major amputation in amputee diabetic patient

Objetivo: determinar la presencia de depresión en pacientes amputados por pie diabético y su posible asociación con el tiempo de conocida la diabetes y el tipo de amputación mayor.Métodos: se estudiaron 41 pacientes diabéticos, adultos mayores, sin distinción de sexos y tipo de diabetes. A todos se les realizó una amputación mayor como consecuencia de un pie diabético.Resultados: se encontró una elevada proporción de pacientes con depresión severa (n= 19; 46,34 por ciento); seguida en orden por la leve (n= 8; 19,51 por ciento) y la moderada (n= 5; 12,19 por ciento). El 21,95 por ciento (n= 9) de los enfermos no mostraron ni signos ni síntomas de depresión. Al relacionar el tiempo de conocida la diabetes con la depresión, se observó que los pacientes más deprimidos (n= 28; 68,29 por ciento) eran los que tenían menos de 20 años de evolución. En este grupo, el 46,43 % (n= 13) mostró una depresión moderada. Al asociar la depresión con el tipo de amputación, se encontró que el 40,47 por ciento de los enfermos con amputación supracondílea (n= 11) presentaron una depresión de tipo moderada. Proporciones similares (22,22 por ciento) se observaron para la depresión de tipo leve y la ausencia de depresión. En el caso de la amputación infracondílea la depresión de tipo moderada tuvo una frecuencia del 57,14 por ciento (n= 8).Conclusiones: la depresión está casi siempre presente en los diabéticos amputados independientemente del tiempo de conocida la diabetes y del tipo de amputación mayor realizada(AU)

Objective: to determine the presence of depression in amputee patients due to diabetic foot and its possible association with the length of time that they have known about their diabetes and the type of major amputation.Methods: forty one aged diabetic patients, regardless of sex and type of diabetes, were studied. All underwent a major amputation as a consequence of diabetic foot.Results: there was found a high proportion of patients with a severe depression (n =19, 46.34 percent), followed by slight depression (n = 8, 19.51 percent) and moderate depression (n = 5, 12.19 percent). Nine patients (21.95 percent) showed neither symptoms nor signs of depression. When relating how long the patient knows about his /her diabetic with depression, it was noted that the more depressed patients (n =13) were those having this disease for less than 20 years. In this group, 46.43 percent (n= 13) showed moderate depression. The association of depression with the type of amputation disclosed that 40,47 percent of patients with a supracondylar amputation (n = 11) showed moderate depression. Similar proportions (22.22 percent) were observed for the slight depression and the lack of depression. In the case of infracondylar amputation, the frequency of moderate depression was 57,14 percent (n = 8). Conclusions: depression is very frequent in amputee diabetic patients regardless of how long they have been aware of their disease and the type of amputation(AU)

Mejora de la calidad de vida de pacientes con dolor crónico no oncológico por el seguimiento farmacoterapéutico desde la farmacia comunitaria / No disponible

No disponible

Pharmacist intervention reduces gastropathy risk in patients using NSAIDs.

OBJECTIVE: To establish a detection and intervention strategy in order to reduce the number of non-steroidal anti-inflammatory drug (NSAIDs) users at risk of gastropathy from receiving either inadequate or no gastroprotection. SETTING: Community Pharmacies in Valencia, Spain. METHOD: Prospective longitudinal intervention study without control group carried out by 79 Community Pharmacies. Patients over 18 who asked for any systemic NSAID were interviewed according to standard procedure. Pharmacist intervention was carried out when a patient at risk of serious NSAID-induced gastrointestinal complications due to inadequate or no gastric protection was identified. The doctor responsible was informed in order to then be able to assess the need to prescribe gastroprotection or change it if inadequate. In the case of over-the-counter (OTC) drugs, pharmacist intervention mainly involved replacing NSAIDs for safer medications. MAIN OUTCOME MEASURE: Firstly, the number of patients who had no prescribed gastroprotection or inadequate gastroprotection was determined. Pharmacist intervention then brought about changes in pharmacotherapy in this situation. RESULTS: Of the 6,965 patients who asked for NSAIDs during the study period, 3,054 (43.9%) presented NSAID gastropathy risk factors. 35.6% of the latter (1,089) were not prescribed gastroprotection or were prescribed inadequate gastroprotection. Pharmacist intervention was carried out in 1,075 of these cases. On 391 occasions such risk situations were reported to doctors, who accepted pharmacist intervention on 309 occasions (79.0%) and then either prescribed gastroprotection (77% of cases); changed it (13.9%); withdrew the NSAID (5.8%) or substituted it (3.2%). 235 Pharmacist interventions took place when dispensing OTC NSAIDs. CONCLUSION: Our strategy allowed us to identify a large number of patients who asked for NSAIDs in Community Pharmacies and who were at risk of NSAID gastropathy, as they received either inadequate gastroprotection or no gastroprotection whatsoever. Moreover, the pharmacist intervention carried out has reduced the number of these risk situations.

Acropigmentación reticulada de Kitamura en un niño argentino de tres años de edad / Kitamura reticulate acropigmentación an Argentinian child three years old

La acropigmentación reticulada de Kitamura (ARK) es un genodermatosis de herencia autosómica dominante, con expresión y penetrancia variables. Se caracteriza por presentar máculas hiperpigmentadas de 1 a 4 milímetros de diámetro, deprimidas, similares a efélides, con patrón reticulado, que comienzan en las regiones acrales y posteriormente pueden extenderse en forma centrípeta. Fue descripta por Kitamura et al. en 1943 y, en 1976, Griffiths publicó siete casos en los que analizó los antecedentes familiares y dedujo el carácter genético de la patología. El diagnóstico de ARK se realiza en forma clínica e histopatológica, observándose al microscopio óptico atrofia epidérmica y aumento del número de los melanocitos y de melanina en la capa basal. Debe plantearse el diagnóstico diferencial con la acropigmentación de Dohi (APD), que consiste en máculas hiper e hipopigmentadas en la misma localización, a nivel histológico estas presentan aumento de melanina en la capa basal de la epidermis con número de melanocitos conservados que alterna con regiones de falta de pigmento así como ausencia de pits palmares. Y, también, debe diferenciarse de la enfermedad de Dowling-Degos (EDD) que presenta máculas hiperpigmentadas reticuladas predominantemente en los pliegues. Estas entidades se describen con más frecuencia en poblaciones orientales, no así en nuestro grupo étnico. Presentamos el caso de un niño argentino de tres años de edad, con clínica y biopsia de piel compatibles con ARK, sin antecedentes familiares de esta entidad.

Reticulate acropigmentation of Kitamura (ARK) is a pigmentary genodermatosis of autosomal dominant trait, with variable expresion and penetrance. It is characterized by reticulate patterns of hiperpigmented freckel-like atrophic macules of 1-4 mm, in acral areas, subsequently spreading over the body, with palmar pits. First described by Kitamura et al. in 1943; Griffiths reported in 1976 seven cases and described its inheritance pattern. Microscopic examination of ARK lesions shows epidermic atrophy with increased number of melanocytes and melanin in the basal layer. The main differential diagnosis is with Dohi acropigmentation (DA) whose clinical features are hyperpigmented and hypopigmented reticulate macules in the same location, without palmar pits and which histopathology shows increased melanin in the basal layer and epidermis with normal number of melanocytes and areas with absence of melanin. ARK must also be differentiated from Dowling-Degos disease (DDD) that presents hyperpigmented reticulated macules predominantly located on flexural sites. These entities are frequent in Japanese population but not in ours. We report an Argentinian 3-year-old boy, without family history of ARK and with clinical and histopathological features of this entity.