Browsing by Author "Fuentes I."

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    Implementation of cancer prevention practices in primary care: results of a cohort study in Chile 2018–2022
    (2024) Puschel Illanes, Klaus; Rioseco A.; Soto M.; Paz S.; Martinez J.; Soto G.; Faundez M.; Arenas E.; Vescovi Z.; Fuentes I.; Thompson B.; Emery J.
    Objectives: The burden of cancer is increasing rapidly in Latin America. Primary care has an essential role in cancer prevention, but implementation levels of prevention practices are not well known. This study evaluated implementation levels and associated factors of cancer preventive practices in primary care over time. Study design: The study incorporated a retrospective multicentre cohort study. Methods: A population of 59,949 patients registered at three primary care clinics was followed from January 2018 to December 2022 in Santiago, Chile. We studied human papillomavirus (HPV) and hepatitis B virus (HBV) immunisation, brief counselling for smoking cessation and alcohol consumption, and cervical and breast cancer screening practices. Standardised electronic medical records were utilised as the source of information. Social, clinical, and organisational factors associated with prevention practices were studied. Results: The cohort attrition level was 17.1%. Most of the population was of a low socioeconomic status, and 70% visited a primary health centre yearly. Implementation rates of immunisation practices were 90.84% for HPV and 80.94% for HBV in 2022. In contrast, brief counselling for smoking and alcohol consumption was below 20% during the study period. Cervical cancer screening decreased by 25.58% between 2018 and 2022, whereas breast cancer screening reached only 41.71% of the target population. Opportunistic medical visits were strongly associated with brief counselling and breast cancer screening. Conclusion: Implementation practices for cancer prevention in a Chilean primary care cohort are high for immunisation and very low for brief counselling and screening practices. A comprehensive non-medical-based model is needed to improve cancer prevention in primary care.
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    Lobectomy in patients with differentiated thyroid cancer: experience of a Chilean tertiary center
    (2024) Fuentes I.; Santana R.; Espinoza M.; Arteaga E.; Uslar T.; Baudrand R.; Gonzalez G.; Guarda F.J.; Lustig N.; Mosso L.; Nilo F.; Valenzuela F.; Dominguez F.; Gonzalez H.E.; Montero P.H.; Cruz F.; Solar A.; Dominguez J.M.; NCD Risk Factor Collaboration (NCD-RisC)
    © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.Purpose: Thyroid lobectomy (TL) is an appropriate treatment for up to 4 cm intrathyroidal differentiated thyroid cancer (DTC). There is scarce data regarding TL outside first-world centers. Our aim is to report a cohort of patients with DTC treated with TL in Chile. Methods: We included DTC patients treated with TL, followed for at least 6 months, characterized their clinicopathological features and classified their risk of recurrence and response to treatment. Results: Eighty-two patients followed for a median of 2.3 years (0.5–7.0). Seventy-three (89%) patients had papillary, 8 (9.8%) follicular and 1 (1.2%) high-grade DTC. The risk of recurrence was low in 56 (68.3%) and intermediate in 26 (31.7%). Eight (9.8%) patients required early completion thyroidectomy and radioiodine. At last follow-up, 52 (70.3%) had excellent, 19 (25.7%) had indeterminate, and 1 (1.4%) had structural incomplete response. Conclusion: In a developing country, TL is an adequate option for appropriately selected DTC patients.