ABSTRACT
El tratamiento quirúrgico del cáncer de mama puede dejar secuelas tardías tales como escápula alada, pérdida de movilidad articular del hombro, sobrepeso, etc. Basado en lo anterior, el objetivo del presente estudio fue describir las secuelas morfofuncionales en mujeres operadas de cáncer de mama de las regiones de la Araucanía y del Bío-Bío, Chile, explorando también si el procedimiento quirúrgico conllevaría a la presencia de escápula alada. Para ello, se realizó un estudio cuantitativo, observacional y de corte transversal en treinta mujeres operadas de cáncer de mama, de edades comprendidas entre 28 y 76 años (55,67±11,60). Un profesional entrenado evaluó peso, estatura, índice de masa corporal (IMC), índice de cintura cadera (ICC), rangos articulares de hombro (ROM, Range of Movement) y fuerza prensil, aplicándose además la prueba de Hoppenfeld para identificar escápula alada. Los resultados mostraron diferencias significativas en el ROM a la abducción de hombro (p<0,05), correlación significativa positiva de leve (r=0,370) a moderada (r=0,514) entre el ROM del lado afectado tanto para la flexión como la abducción con la fuerza prensil. Destacan, un IMC de 28,91±5,31 kg/m2, un ICC de 0,86±0,06 cm y la presencia de escápula alada en el 36,7 % de las participantes. No se encontró asociación entre el abordaje quirúrgico y la presencia de escápula alada. Hubo secuelas morfo-funcionales en las mujeres en estudio, destacándose las alteraciones en el rango de movimiento del miembro superior, sobrepeso, riesgo cardiovascular y la presencia de escápula alada, sin asociarse al tipo de abordaje quirúrgico.
Surgical treatment of breast cancer can leave late sequelae such as winged scapula, loss of joint mobility of the shoulder, overweight, etc. Based on the above, the objective of the present study was to describe the morpho-functional sequelae in women operated on for breast cancer from the regions of Araucanía and Del BíoBío, Chile, also exploring whether the surgical procedure would lead to the presence of scapula winged. For this, a quantitative, observational and cross-sectional study was conducted in thirty women operated on for breast cancer, aged between 28 and 76 years (55.67 ± 11.60). A trained professional evaluated weight, height, body mass index (BMI), hip waist index (ICC), shoulder joint ranges(ROM, Range of Movement) and prehensile strength, and applied the Hoppenfeld test to identify the winged scapula. The results showed significant differences in the ROM to shoulder abduction (p <0.05), positive significant correlation of mild (r = 0.370) to moderate (r = 0.514) between the ROM of the affected side for both flexion and abduction with prehensile force. Highlights, a BMI of 28.91 ± 5.31 kg / m2, an ICC of 0.86 ± 0.06 cm and the presence of winged scapula in 36.7 % of the participants. No association was found between the surgical approach and the presence of the winged scapula. There were morphofunctional sequelae in the women under study, highlighting the alterations in the range of movement of the upper limb, overweight, cardiovascular risk and the presence of the winged scapula, without being associated with the type of surgical approach.
Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Scapula/pathology , Breast Neoplasms/surgery , Mastectomy/adverse effects , Bones of Upper Extremity/physiopathology , Bones of Upper Extremity/pathology , Postoperative Complications , Scapula/physiopathology , Body Mass Index , Chile , Cross-Sectional Studies , Range of Motion, Articular , Waist-Hip Ratio , OverweightABSTRACT
PIP: The 5-year-old community contraceptive distribution program developed by PROFAMILIA, Colombia's private family planning organization, has given excellent results, but several cost-effectiveness comparisons with social marketing programs have suggested that commercial distribution programs are superior. The community contraceptive distribution program has a high content of information and education activities, which produced significant increases in knowledge and use of contraception in the communities covered. It has been a fundamental support for the social marketing program, creating much of the demand for contraceptive products that the social marketing program has filled. The social marketing program has given good results in terms of volume of sales and in cost-effectiveness since 1976, prompting calls for replacement of the community contraceptive distribution program by the social marketing program in those sectors where knowledge and use of contraception have achieved acceptable levels. An experiment in the Department of Santander in 1984 and 1985 gave very favorable results, suggesting that community contraceptive distribution programs should be replaced by social marketing programs in all more developed markets. But economic problems in 1985 and the decision of manufacturers to decrease the profit margin for PROFAMILIA jeopardized the social marketing program. The community distribution program covered about 20% of the market. Reduced profits in the social marketing program threatened its continued expansion, at the same time that potential demand was growing because of increases in the fertile aged population and increased use of contraception. To meet the need, PROFAMILIA combined the community contraceptive distribution and social marketing programs into a new entity to be called community marketing. The strategy of the community marketing program will be to maintain PROFAMILIA's participation in the market and aid the growth of demand for contraceptives through educational and informational activities. The distribution scheme must continue to cover all the established points of sale in pharmacies despite the reduced profit margins.^ieng