Factores relacionados con las diferentes estrategias de afrontamiento al cáncer de mama en pacientes de recién diagnótico / Factors related with different strategies to cope breast cancer in recent diagnosis patients

Objetivo: Identificar los factores relacionados con las diferentes estrategias de afrontamiento al cáncer de mama en pacientes con reciente diagnóstico. Método: Estudio descriptivo trasversal, de correlación en pacientes con cáncer de mama de la clínica de mama del Hospital General Regional 1 y Unidad Médica de Atención Ambulatoria, del Instituto Mexicano del Seguro Social, Querétaro, México, en el 2011. Se estudiaron 98 pacientes con el diagnóstico referido, entre seis y doce meses de evolución, de cualquier edad. Se estudiaron variables socio-demográficas, tipo de familia, tratamiento recibido, la capacidad y estrategias de afrontamiento utilizadas, medidas con el instrumento "Inventario de Estrategias de Afrontamiento" modificado y adaptado al castellano por Cano et al. en el año 2007, replicado en México en el 2010 por Nava et al. Se respetaron las consideraciones éticas. Se analizó con estadística descriptiva, Rho de Spearman, Pearson y con la X2. Resultados: El sentimiento que con mayor frecuencia se presentó al recibir el diagnóstico fue el temor (28,6%), la estrategia de afrontamiento más usada fue la resolución de problemas. Los factores que se vieron estrechamente relacionados con el afrontamiento fueron la edad, la escolaridad, el tipo de familia y tratamiento utilizado. Conclusiones: El tipo de familia, de tratamiento recibido la edad y la escolaridad se encuentran estrechamente relacionados con el estilo de estrategias de afrontamiento que presentan las pacientes con cáncer de mama

Objetive: To identify factors relating to the strategies for coping with breast cancer recently diagnosed patients. Methods: cross-sectional design, descriptive study of correlation among patients with breast cancer at the Clinica de Mama of the Hospital General Regional N°1 (HGR N°1) and Unidad Medica de Atencion Ambulatoria (UMAA), Instituto Mexicano del Seguro Social, Queretaro, Mexico in 2011. 98 patients of all ages with this diagnosis were studied with a background of diagnosis of between six to twelve months. Sociodemographic variables were studied (age, schooling, occupation, marital status), type of family, type of treatment received, and capability for coping strategies by them with "Inventory of strategies of coping",modified and adapted in Spain by Cano et al. (2007) and reproduced in Mexico by Nava et al.(2010). In all procedures were applied with ethical considerations. An analysis was carried out using descriptive statistics, Spearman's Rho, Pearson's r and X2. Results: The predominant emotion upon hearing the diagnosis was fear (28,6%), the most coping strategy was problem solving. The related factors with the ability to cope were age, schooling, type of treatment received. Conclusions: Type of family, treatment received, age and schooling are strongly related tocoping strategies among patients with recent diagnosed breast cancer

Costo del proceso diagnóstico del cáncer de mama en las Unidades de Medicina Familiar del Instituto Mexicano del Seguro Social, Querétaro, México / Cost of the diagnostic process for breast cancer in the Family Medicine Units of the Mexican Social Security Institute

Objetivo: determinar el costo del proceso diagnóstico del cáncer de mama. Métodos: estudio de costos, en mujeres de 40 años y más, de enero a diciembre del 2010 de las unidades de medicina familiar del Instituto Mexicano del Seguro Social. La muestra se calculó con la fórmula de promedios para población infinita para un total de 245 mujeres. El costo se estimó mediante la técnica de tiempos y movimientos y consulta de expertos; el costo por uso de intervención se calculó con el uso promedio por intervención multiplicado por el costo unitario del mismo. El costo total del proceso diagnóstico se obtuvo de la suma de los costos de cada uno de las intervenciones. El plan de análisis incluyó promedios, porcentajes e intervalos de confianza. Resultados: el costo promedio del proceso diagnóstico fue de $852,45. Conclusión: el proceso diagnóstico de cáncer de mama incluye tamizaje y casos confirmados. El costo del proceso diagnóstico es relativamente bajo ofreciendo mejores perspectivas para el paciente y el sistema de salud.

Objective: to determine the cost of the diagnostic process for breast cancer. Methods: costs were calculated, in women 40 years and older, from January to December 2010 of the Family Medicine Units of the Mexican Social Security Institute. The sample was calculated with the formula for infinite population averages for a total of 245 women. The cost was estimated by time and motion technique and expert consultation, the intervention cost was calculated using the average usage per intervention multiplied by the unit cost thereof. The total cost of the diagnostic process was obtained from the sum of the costs of each of the interventions. The analysis plan included means, percentages and confidence interval. Results: the average cost of the diagnostic process was $852.45. Conclusions: the diagnostic process for breast cancer include screening and confirmatory cases. The cost of the diagnostic process is low, offers better prospects for the patient and the health system.

[Human papillomavirus: association with head and neck cancer]. / Virus del papiloma humano asociado a cáncer de cabeza y cuello.

BACKGROUND: Head and neck squamous cell carcinoma (HNSCC) is the 6th most common cancer worldwide. In 2005, 400,000 cases of HNSCC were diagnosed worldwide. The most frequently affected site is the oral cavity. Alcohol/tobacco consumption is the most important risk factor for this neoplasia; nevertheless, since 1983 it has been suggested that human papilloma viruses (HPV) have a role in HNSCC, mainly in the oropharynx (level 1 evidence). We undertook this study to determine HPV prevalence and types in patients with HNSCC. METHODS: Presence of HPV was determined by polymerase chain reaction and staged by in situ hybridization. We analyzed stage, tumor site of origin, sexual practices, and alcohol/tobacco consumption. Fisher's exact test and Student's t-test were used for statistical analysis. We performed a multiple regression analysis for adjustment of variables. RESULTS: There were 118 patients were HPV positive and oropharyngeal and laryngeal cancer patients were the most frequently affected (55% and 50%, respectively). HPV-16 was most frequently isolated (70%). Laryngeal cancer patients suffered the highest ratio of HPV-16 infection (68.7%). Factors associated with HPV (univariate analysis) were age >50 years, tobacco/alcohol consumption and male gender. In multivariate analysis, none of the variables showed importance (p >0.5); HPV infection was more frequent in patients with history of alcohol/tobacco consumption (p = 0.6). CONCLUSIONS: There was HPV presence in 42% of HNSCC patients, HPV-16 in 70%, with the oropharynx and larynx being the most affected sites. No variables are associated with the virus presence. HPV is a co-factor in HNSCC etiology.