5 results on '"Varela-Centelles, Pablo"'
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2. Coronavirus confinement: A chance to learn on oral cancer—The Spanish experience.
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Varela‐Centelles, Pablo, Lopez‐Jornet, Pía, Gonzalez‐Mourelle, Alicia, and Seoane, Juan
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MOUTH tumors , *QUARANTINE , *HUMAN services programs , *SOCIAL distancing , *STAY-at-home orders , *COVID-19 pandemic - Abstract
The article focuses on chance to learn on oral cancer on Spanish experience. Topics include the most important preventive actions implemented so far to contain the virus have been social distancing and barrier and hygiene measures, and the combination of these three factors resulted in dentists treating only medical and dental emergencies has selected under rigorous ethical and technical criteria.
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- 2021
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3. Impact of the Presenting Symptom on Time Intervals and Diagnostic Routes of Patients with Symptomatic Oral Cancer.
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Varela-Centelles, Pablo Ignacio, López, Daniel Pérez, López-Cedrún, José Luis, García-Rozado, Álvaro, Baz, Pablo Castelo, Romero-Méndez, Amparo, and Seoane, Juan
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DELAYED diagnosis , *MOUTH tumors , *CONFIDENCE intervals , *PROFESSIONS , *TIME , *CROSS-sectional method , *DENTISTS , *PRIMARY health care , *CONCEPTUAL structures , *MEDICAL referrals , *DESCRIPTIVE statistics , *EARLY diagnosis , *SYMPTOMS - Abstract
Simple Summary: Information about the relative length of patient stays, primary care, and prereferral intervals (from symptom onset to specialist referral) is very scarce, and how the presenting symptoms influence these intervals and referral routes remains unknown. This study assesses the impact of presenting symptoms on time intervals, number of visits at the primary care level, and referral pattern of patients with symptomatic oral cancer. This approach will allow targets to be identified for future interventions and the optimization of the treatment pathway for symptomatic oral cancer patients. This investigation was aimed at determining the time intervals from the presenting symptoms until the beginning of oral cancer treatment and their relative contribution to the total time, and to assess the impact of the presenting symptom on diagnostic timelines and patient referral routes. A cross-sectional, ambispective study was designed to investigate symptomatic incident cases. The Aarhus statement was used as a conceptual framework. Strategies for minimizing potential recall biases were implemented. A sample of 181 patients was recruited (power: 99.5%; α = 0.05). The patient interval reached 58.2 days (95% CI, 40.3–76.2), which accounted for 74% of the whole prereferral interval and for more than one third of the total time interval. The presenting symptom (trigger for consultation) influenced both the number of primary care consultations and the length of time to diagnosis. General dental practitioners generated longer intervals to diagnosis (p < 0.005) and needed more consultations before referring a patient (RR = 0.76; 95% CI, 0.61–0.93), than general medical practitioners. The current study identifies the patient as the main target for interventions to improve awareness and reinforces the need for increased alertness amongst healthcare professionals about presenting symptoms of oral cancer and to diminish the number of prereferral consultations in order to optimize the primary care interval. [ABSTRACT FROM AUTHOR]
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- 2021
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4. Time-to-Treatment in Oral Cancer: Causes and Implications for Survival.
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Saka-Herrán, Constanza, Jané-Salas, Enric, Mari-Roig, Antoni, Estrugo-Devesa, Albert, López-López, José, and Varela-Centelles, Pablo
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SURVIVAL ,MOUTH tumors ,TIME ,PROGNOSIS ,EARLY detection of cancer ,TREATMENT delay (Medicine) ,COST analysis ,QUALITY of life - Abstract
Simple Summary: Stage of the disease at diagnosis has been recognized as one of the most important prognostic markers for oral cancer. Unfortunately, still two thirds of patients are diagnosed at an advanced stage of disease with a 5-year survival rate of 50% or less. Although the detection of oral cancer at an early stage is the most effective means to improve survival and reduce morbidity, in the past years, there has been little change in the diagnosis of oral cancer at early stages, which is believed to be a result of delays in diagnosis and treatment of oral cancer, among other independent factors. Following the Aarhus statement, developed in effort to standardize the design, methods and reporting of studies concerning time-intervals in early diagnosis research, the review assessed the causes that influence the patient, diagnosis and pre-treatment intervals in the pathway of time-to-treatment in oral cancer and its impact on survival. The purpose of this review was to identify and describe the causes that influence the time-intervals in the pathway of diagnosis and treatment of oral cancer and to assess its impact on prognosis and survival. The review was structured according to the recommendations of the Aarhus statement, considering original data from individual studies and systematic reviews that reported outcomes related to the patient, diagnostic and pre-treatment intervals. The patient interval is the major contributor to the total time-interval. Unawareness of signs and/or symptoms, denial and lack of knowledge about oral cancer are the major contributors to the process of seeking medical attention. The diagnostic interval is influenced by tumor factors, delays in referral due to higher number of consultations and previous treatment with different medicines or dental procedures and by professional factors such as experience and lack of knowledge related to the disease and diagnostic procedures. Patients with advanced stage disease, primary treatment with radiotherapy, treatment at an academic facility and transitions in care are associated with prolonged pre-treatment intervals. An emerging body of evidence supports the impact of prolonged pre-treatment and treatment intervals with poorer survival from oral cancer. [ABSTRACT FROM AUTHOR]
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- 2021
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5. Overall time interval ("Total diagnostic delay") and mortality in symptomatic oral cancer: A U-shaped association.
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Lopez-Cedrún, José L., Varela-Centelles, Pablo, Otero-Rico, Ana, Vázquez-Mahía, Inés, Seoane, Juan, Castelo-Baz, Pablo, and Seoane-Romero, Juan
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ORAL cancer , *CANCER-related mortality , *MORTALITY , *CANCER patients , *DELAYED diagnosis , *MOUTH tumors , *TIME , *RETROSPECTIVE studies ,CANCER associations - Abstract
Objectives: To assess the impact on survival of the total time interval since the first bodily change (sign/symptom) until the start of treatment in symptomatic oral cancer patients.Methods: Retrospective, hospital-based study designed within the "Aarhus Statement" conceptual framework, using the overall interval to treatment of 183 oral cancer patients to analyse their survival rates.Results: Overall time interval (T5): 107.1 ± 85.2 days. Overall survival rate: 58.4 (CI: 51.3-66.4%). Recurrence time (median): 724 days (IQR, 223-2963.5). Median survival time: 1744 days (IQR, 479.5-3438). Overall delay (T5) and mortality showed a U-shaped association, where patients with short (24.0-55.5 days) and long T5 intervals (127.5-420 days) had higher mortality than those with medium T5 intervals (55.5-127.5 days).Conclusion: There is a non-monotonic association between time interval and mortality. Higher mortality rates are linked to shorter and longer time intervals. This may induce underestimation of the association when time intervals are considered dichotomously. [ABSTRACT FROM AUTHOR]- Published
- 2020
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