Duración de la valoración diagnóstica del cáncer de pulmón frente a otros tumores sólidos en el Instituto Oncológico Nacional de Ecuador
Duration of the diagnostic process for lung cancer versus other solid tumors at the National Oncology Institute of Ecuador
A.X. Freirea,
, S. Benítezb, K. Brionesb, N.V. Freireb
Corresponding author
afreire@utmem.edu
Correspondencia: Associate Professor of Medicine & Preventive Medicine. Uthsc-College of Medicine-Memphis, Coleman Bldg.956 Court Ave, Room H-314. Memphis, TN 38163. USA
Correspondencia: Associate Professor of Medicine & Preventive Medicine. Uthsc-College of Medicine-Memphis, Coleman Bldg.956 Court Ave, Room H-314. Memphis, TN 38163. USA
Read
8758
Timeswas read the article
1802
Total PDF
6956
Total HTML
Share statistics
array:23 [ "pii" => "S0300289603753514" "issn" => "03002896" "doi" => "10.1016/S0300-2896(03)75351-4" "estado" => "S300" "fechaPublicacion" => "2003-04-01" "aid" => "75351" "copyright" => "Sociedad Española de Neumología y Cirugía Torácica" "copyrightAnyo" => "2003" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Arch Bronconeumol. 2003;39:167-70" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 6290 "formatos" => array:3 [ "EPUB" => 65 "HTML" => 5691 "PDF" => 534 ] ] "itemSiguiente" => array:18 [ "pii" => "S0300289603753526" "issn" => "03002896" "doi" => "10.1016/S0300-2896(03)75352-6" "estado" => "S300" "fechaPublicacion" => "2003-04-01" "aid" => "75352" "copyright" => "Sociedad Española de Neumología y Cirugía Torácica" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Arch Bronconeumol. 2003;39:171-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 9929 "formatos" => array:3 [ "EPUB" => 89 "HTML" => 8325 "PDF" => 1515 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Neumotórax espontáneo: sínfisis pleural con solución hidroalcohólica de povidona yodada" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "171" "paginaFinal" => "174" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Spontaneous pneumothorax: pleurodesis with an iodo-povidone hydroalcoholic solution" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "G. Estrada Saló, C. Farina Ríos, J.J. Fibla Alfara, G. Gómez Sebastián, M.C. Unzueta, Carlos León González" "autores" => array:6 [ 0 => array:2 [ "nombre" => "G." "apellidos" => "Estrada Saló" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Farina Ríos" ] 2 => array:2 [ "nombre" => "J.J." "apellidos" => "Fibla Alfara" ] 3 => array:2 [ "nombre" => "G." "apellidos" => "Gómez Sebastián" ] 4 => array:2 [ "nombre" => "M.C." "apellidos" => "Unzueta" ] 5 => array:2 [ "nombre" => "Carlos" "apellidos" => "León González" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289603753526?idApp=UINPBA00003Z" "url" => "/03002896/0000003900000004/v1_201307081453/S0300289603753526/v1_201307081453/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0300289603753502" "issn" => "03002896" "doi" => "10.1016/S0300-2896(03)75350-2" "estado" => "S300" "fechaPublicacion" => "2003-04-01" "aid" => "75350" "copyright" => "Sociedad Española de Neumología y Cirugía Torácica" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Arch Bronconeumol. 2003;39:159-66" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 20915 "formatos" => array:3 [ "EPUB" => 71 "HTML" => 19994 "PDF" => 850 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Estudio de fiabilidad de una encuesta utilizada para valorar la prevalencia, los conocimientos y las actitudes sobre el tabaquismo en estudiantes de medicina" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "159" "paginaFinal" => "166" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Reliability of a questionnaire on smoking to evaluate prevalence, knowledge and attitudes of medical students" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "D. Guillén, I. Nerín, A. Mas, A. Crucelaegui" "autores" => array:4 [ 0 => array:2 [ "nombre" => "D." "apellidos" => "Guillén" ] 1 => array:2 [ "nombre" => "I." "apellidos" => "Nerín" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Mas" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Crucelaegui" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289603753502?idApp=UINPBA00003Z" "url" => "/03002896/0000003900000004/v1_201307081453/S0300289603753502/v1_201307081453/es/main.assets" ] "es" => array:15 [ "idiomaDefecto" => true "titulo" => "Duración de la valoración diagnóstica del cáncer de pulmón frente a otros tumores sólidos en el Instituto Oncológico Nacional de Ecuador" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "167" "paginaFinal" => "170" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A.X. Freire, S. Benítez, K. Briones, N.V. Freire" "autores" => array:4 [ 0 => array:4 [ "nombre" => "A.X." "apellidos" => "Freire" "email" => array:1 [ 0 => "afreire@utmem.edu" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "S." "apellidos" => "Benítez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "K." "apellidos" => "Briones" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "N.V." "apellidos" => "Freire" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Terapia Respiratoria y Cuidados Intensivos. The Regional Medical Center.Universidad de Tennessee Health Science Center. Memphis, TN. EE.UU" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Neumología. Instituto Oncológico Nacional Dr. Juan Tanca Marengo (Ion-Solca). Guayaquil. Ecuador" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Associate Professor of Medicine & Preventive Medicine. Uthsc-College of Medicine-Memphis, Coleman Bldg.956 Court Ave, Room H-314. Memphis, TN 38163. USA" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Duration of the diagnostic process for lung cancer versus other solid tumors at the National Oncology Institute of Ecuador" ] ] "miscelanea" => "Este estudio no ha recibido ninguna ayuda financiera" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2002-08-26" "fechaAceptado" => "2002-10-15" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec190390" "palabras" => array:3 [ 0 => "Cáncer" 1 => "Diagnóstico" 2 => "Pulmón" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec190389" "palabras" => array:3 [ 0 => "Cancer" 1 => "Lung" 2 => "Diagnosis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar la duración del proceso diagnóstico del cáncer (pulmón frente a tumores de órganos sólidos/todos) en el ION-SOLCA utilizando la modalidad de evaluación ambulatoria</p> <span class="elsevierStyleSectionTitle">Población Y Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La totalidad de los pacientes con cáncer de pulmón de células no pequeñas (CPCNP) evaluados durante el período comprendido entre el 1 de enero y el 31 de diciembre de 1995 en el ION-SOLCA de Guayaquil, Ecuador (hospital de referencia terciario), comparando con la duración de la evaluación diagnóstica de otras neoplasias de órganos sólidos en la institución</p> <span class="elsevierStyleSectionTitle">Diseño</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo de servicios de salud que cuantifica la duración de cada etapa del proceso diagnóstico de los pacientes con cáncer en el ION-SOLCA. Se consideró como variable índice del estudio la duración de la evaluación diagnóstica de los casos estudiados en el ION-SOLCA. Simultáneamente se obtuvo la duración de cada componente de la variable índice</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La duración media ± DE de la evaluación diagnóstica global en el ION-SOLCA para los tumores de órganos sólidos (pulmón y otros) es de 54,5 ± 62,3 días (error estándar [EE], 7,6). No se encontró diferencia entre los dos grupos. Los componentes de esta estimación se fraccionan del siguiente modo: primer contacto con el instituto (preadmisión)-visita con el especialista, 12,5 ± 11,4 días (EE, 1,4); visita con el especialista-procedimiento diagnóstico, 33,3 ± 57 días (EE, 7), y procedimiento diagnóstico-resultado de anatomía patológica, 8,7 ± 6,9 días (EE, 0,8)</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La valoración ambulatoria de los pacientes con alta probabilidad de cáncer es un proceso ineficiente, lento y posiblemente peligroso. Una modalidad de ingreso intervencionista podría acelerar el proceso diagnóstico en estos pacientes</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">To determine the duration of the outpatient diagnostic process for lung cancer in comparison to that of other solid organ tumors/all tumors at the National Oncology Institute-Society to Fight Cancer (ION-SOLCA) of Ecuador</p> <span class="elsevierStyleSectionTitle">Patients And methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">All patients with non-small cell lung cancer (NSCLC) seen between January 1 and December 31, 1995 at the ION-SOLCA, a specialized tertiary care hospital in Guayaquil, Ecuador, were studied. The duration of the patients' diagnostic process was compared to that of other patients with solid organ tumors (1 control per NSCLC patient)</p> <span class="elsevierStyleSectionTitle">Design</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Retrospective study of health care services to measure the duration of each stage of the diagnostic process for cancer patients at the ION-SOLCA</p> <span class="elsevierStyleSectionTitle">Measures</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The main variable was the duration of the diagnostic process. The duration of each phase of the process was also recorded</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Results are given as means (± standard deviations, with standard errors between parentheses). The overall duration of the diagnostic process for all solid organ tumors (lung and others) at the ION-SOLCA was 54.5 days ± 62.3 (7.6). No differences were detected between the duration of diagnosis for lung and other tumors. The durations of the different phases of diagnosis were as follows: from the first preadmission contact with the hospital until a visit with a specialist, 12.5 days ± 11.4 (1.4); from the visit with a specialist until a diagnostic procedure, 33.3 days ± 57 (7); and from the diagnostic procedure until the pathological diagnosis, 8.7 days ± 6.9 (0.8)</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Outpatient evaluation is an inefficient, slow and potentially dangerous process in cases in which the probability of a cancer diagnosis is high. A more interventionist process involving hospital admission may accelerate diagnosis in such cases</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:27 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The fight against the delay in the diagnosis of cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "E. Robinson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Biomed Pharmacother" "fecha" => "1984" "volumen" => "38" "paginaInicial" => "321" "paginaFinal" => "322" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6525430" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Medicolegal analysis of the delayed diagnosis of cancer in 338 cases in the United States" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "K.A. Kern" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Surg" "fecha" => "1994" "volumen" => "129" "paginaInicial" => "397" "paginaFinal" => "403" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8154966" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The impact of delayed diagnosis of lung cancer on the stage at the time of operation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E.D. Christensen" 1 => "T. Harvald" 2 => "M. Jendresen" 3 => "S. Aggestrup" 4 => "G. Petterson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur J Cardiothorac Surg" "fecha" => "1997" "volumen" => "12" "paginaInicial" => "880" "paginaFinal" => "884" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9489874" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Colorectal cancer: incidence, delay in diagnosis and stage of disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Robinson" 1 => "J. Mohilever" 2 => "J. Zidan" 3 => "D. Sapir" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur J Cancer Clin Oncol" "fecha" => "1986" "volumen" => "22" "paginaInicial" => "157" "paginaFinal" => "161" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3699078" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Delay in diagnosis of cancer. Possible effects on the stage of disease and survival" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Robinson" 1 => "J. Mohilever" 2 => "J. Zidan" 3 => "D. Sapir" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "1984" "volumen" => "54" "paginaInicial" => "1454" "paginaFinal" => "1460" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6467169" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Delay in diagnosis and survival in testicular cancer: impact of effective therapy and changes during 18 years" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.W. Moul" 1 => "D.F. Paulson" 2 => "R.K. Dodge" 3 => "P.J. Walther" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "1990" "volumen" => "143" "paginaInicial" => "520" "paginaFinal" => "523" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2304163" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Delay in diagnosis and long-term survival in breast cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.M. Elwood" 1 => "W.P. Moorehead" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br Med J" "fecha" => "1980" "volumen" => "280" "paginaInicial" => "1291" "paginaFinal" => "1294" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7388514" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The unintended consequences of measuring quality on the quality of medical care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L.P. Casalino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199910073411511" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1999" "volumen" => "341" "paginaInicial" => "1147" "paginaFinal" => "1150" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10511617" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Delay factors in the diagnosis of lung cancer: a public health problem" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.R. Pereira" 1 => "F.K. Ikari" 2 => "H. Minamoto" 3 => "J.C. Cassioli" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Paul Med" "fecha" => "1991" "volumen" => "109" "paginaInicial" => "109" "paginaFinal" => "112" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1947604" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influence of rural environment on diagnosis, treatment, and prognosis of colorectal cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G. Launoy" 1 => "X. Le Coutour" 2 => "M. Gignoux" 3 => "D. Pottier" 4 => "G. Dugleux" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Epidemiol Community Health" "fecha" => "1992" "volumen" => "46" "paginaInicial" => "365" "paginaFinal" => "367" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1431708" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Delay in diagnosis and treatment of symptomatic colorectal cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H.W. Holliday" 1 => "J.D. Hardcastle" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1979" "volumen" => "1" "paginaInicial" => "309" "paginaFinal" => "311" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2563464" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Stage and delay in breast cancer diagnosis by race, socioeconomic status, age and year" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.L. Richardson" 1 => "B. Langholz" 2 => "L. Bernstein" 3 => "C. Burciaga" 4 => "K. Danley" 5 => "R.K. Ross" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Cancer" "fecha" => "1992" "volumen" => "65" "paginaInicial" => "922" "paginaFinal" => "926" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1616865" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gastric cancer -delay in diagnosis and its causes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "T. Mikulin" 1 => "J.D. Hardcastle" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur J Cancer Clin Oncol" "fecha" => "1987" "volumen" => "23" "paginaInicial" => "1683" "paginaFinal" => "1690" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3428334" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inequality in quality: addressing socioeconomic, racial, and ethnic disparities in health care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. Fiscella" 1 => "P. Franks" 2 => "M.R. Gold" 3 => "C.M. Clancy" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Jama" "fecha" => "2000" "volumen" => "283" "paginaInicial" => "2579" "paginaFinal" => "2584" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10815125" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Racial differences in the treatment of early-stage lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P.B. Bach" 1 => "L.D. Cramer" 2 => "J.L. Warren" 3 => "C.B. Begg" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199910143411606" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1999" "volumen" => "341" "paginaInicial" => "1198" "paginaFinal" => "1205" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10519898" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Time course from first symptom to treatment in patients with non-small cell lung cancer referred for radiotherapy: a report by the CHART Steering Committee" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Dische" 1 => "D. Gibson" 2 => "M. Parmar" 3 => "M.I. Saunders" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "1996" "volumen" => "51" "paginaInicial" => "1262" "paginaFinal" => "1265" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8994526" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Initial mismanagement and delay in diagnosis of oral cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "W.G. Shafer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Dent Assoc" "fecha" => "1975" "volumen" => "90" "paginaInicial" => "1262" "paginaFinal" => "1264" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1095626" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Delay in diagnosis of breast cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P.I. Tartter" 1 => "D. Pace" 2 => "M. Frost" 3 => "J.L. Bernstein" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Surg" "fecha" => "1999" "volumen" => "229" "paginaInicial" => "91" "paginaFinal" => "96" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9923805" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effects of symptoms and delay in seeking diagnosis on stage of disease at diagnosis among women with cancers of the ovary" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E.M. Smith" 1 => "B. Anderson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "1985" "volumen" => "56" "paginaInicial" => "2727" "paginaFinal" => "2732" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4052947" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Delayed diagnosis of endometrial cancer in Italy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Franceschi" 1 => "C. La Vecchia" 2 => "G. Gallus" 3 => "A. DeCarli" 4 => "E. Colombo" 5 => "C. Mangioni" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "1983" "volumen" => "51" "paginaInicial" => "1176" "paginaFinal" => "1178" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6821871" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Delay times to definitive diagnosis after an abnormal Pap smear" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H. Mitchell" 1 => "G. Medley" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Aust N Z J Obstet Gynaecol" "fecha" => "1987" "volumen" => "27" "paginaInicial" => "283" "paginaFinal" => "286" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3453664" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Delays in the management of lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P.J. George" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "1997" "volumen" => "52" "paginaInicial" => "107" "paginaFinal" => "108" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9059467" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Delays in the diagnosis and surgical treatment of lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.S. Billing" 1 => "F.C. Wells" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "1996" "volumen" => "51" "paginaInicial" => "903" "paginaFinal" => "906" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8984700" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary and extrapulmonary manifestations in delayed diagnosis of lung cancer in Bangladesh" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.A. Rahim" 1 => "S.K. Sarma" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Cancer Detect Pre" "fecha" => "1984" "volumen" => "7" "paginaInicial" => "31" "paginaFinal" => "35" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Retraso en el diagnóstico y tratamiento quirúrgico del carcinoma broncogénico. Grupo cooperativo en carcinoma broncogénico de SEPAR (GCCB-S)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. López Encuentra" 1 => "J.L. Martín de Nicolás" 2 => "M. Casado López" 3 => "E. De Miguel Poch" 4 => "C. Marrón Fernández" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "1998" "volumen" => "34" "paginaInicial" => "123" "paginaFinal" => "126" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9611636" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Oficina Panamericana de la Salud -pAHO/WHO World Health Organization [consultado 10/10/2002]. Disponible en:<a class="elsevierStyleInterRef" href="http://www.paho.org/English/SHA/coredata/tabulator/newsqlTabulador.asp">http://www.paho.org/English/SHA/coredata/tabulator/newsqlTabulador.asp</a>" ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "27." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Instituto Nacional de Estadísticas y Censo. Censo Ecuador 2001 [consultado 10/10/2002]. Disponible en:<a class="elsevierStyleInterRef" href="http://www.inec.gov.ec/">http://www.inec.gov.ec/</a>" ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000003900000004/v1_201307081453/S0300289603753514/v1_201307081453/es/main.assets" "Apartado" => array:4 [ "identificador" => "9277" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Originales" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000003900000004/v1_201307081453/S0300289603753514/v1_201307081453/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289603753514?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 3 | 8 |
| 2024 October | 54 | 20 | 74 |
| 2024 September | 50 | 13 | 63 |
| 2024 August | 58 | 46 | 104 |
| 2024 July | 34 | 21 | 55 |
| 2024 June | 60 | 34 | 94 |
| 2024 May | 38 | 38 | 76 |
| 2024 April | 26 | 18 | 44 |
| 2024 March | 35 | 39 | 74 |
| 2024 February | 33 | 36 | 69 |
| 2023 December | 0 | 3 | 3 |
| 2023 November | 0 | 2 | 2 |
| 2023 October | 0 | 2 | 2 |
| 2023 August | 0 | 9 | 9 |
| 2023 July | 0 | 16 | 16 |
| 2023 June | 0 | 2 | 2 |
| 2023 May | 0 | 2 | 2 |
| 2023 April | 0 | 2 | 2 |
| 2023 March | 4 | 6 | 10 |
| 2023 February | 34 | 23 | 57 |
| 2023 January | 44 | 30 | 74 |
| 2022 December | 43 | 46 | 89 |
| 2022 November | 42 | 22 | 64 |
| 2022 October | 30 | 24 | 54 |
| 2022 September | 22 | 30 | 52 |
| 2022 August | 30 | 37 | 67 |
| 2022 July | 22 | 41 | 63 |
| 2022 June | 22 | 27 | 49 |
| 2022 May | 25 | 33 | 58 |
| 2022 April | 37 | 30 | 67 |
| 2022 March | 30 | 34 | 64 |
| 2022 February | 22 | 21 | 43 |
| 2022 January | 28 | 20 | 48 |
| 2021 December | 15 | 35 | 50 |
| 2021 November | 14 | 38 | 52 |
| 2021 October | 30 | 43 | 73 |
| 2021 September | 14 | 50 | 64 |
| 2021 August | 12 | 36 | 48 |
| 2021 July | 14 | 27 | 41 |
| 2021 June | 13 | 37 | 50 |
| 2021 May | 19 | 31 | 50 |
| 2021 April | 17 | 47 | 64 |
| 2021 March | 29 | 30 | 59 |
| 2021 February | 45 | 20 | 65 |
| 2021 January | 27 | 18 | 45 |
| 2020 December | 18 | 23 | 41 |
| 2020 November | 6 | 7 | 13 |
| 2020 October | 11 | 10 | 21 |
| 2020 September | 15 | 5 | 20 |
| 2020 August | 11 | 6 | 17 |
| 2020 July | 18 | 17 | 35 |
| 2020 June | 21 | 6 | 27 |
| 2020 May | 28 | 15 | 43 |
| 2020 April | 21 | 12 | 33 |
| 2020 March | 28 | 14 | 42 |
| 2020 February | 23 | 25 | 48 |
| 2020 January | 37 | 22 | 59 |
| 2019 December | 25 | 23 | 48 |
| 2019 November | 17 | 17 | 34 |
| 2019 October | 19 | 10 | 29 |
| 2019 September | 28 | 21 | 49 |
| 2019 August | 19 | 6 | 25 |
| 2019 July | 17 | 15 | 32 |
| 2019 June | 33 | 10 | 43 |
| 2019 May | 26 | 20 | 46 |
| 2019 April | 41 | 16 | 57 |
| 2019 March | 18 | 15 | 33 |
| 2019 February | 14 | 16 | 30 |
| 2019 January | 13 | 10 | 23 |
| 2018 December | 19 | 21 | 40 |
| 2018 November | 24 | 18 | 42 |
| 2018 October | 46 | 11 | 57 |
| 2018 September | 18 | 8 | 26 |
| 2018 May | 4 | 1 | 5 |
| 2018 April | 7 | 9 | 16 |
| 2018 March | 4 | 5 | 9 |
| 2018 February | 8 | 8 | 16 |
| 2018 January | 10 | 8 | 18 |
| 2017 December | 6 | 10 | 16 |
| 2017 November | 5 | 3 | 8 |
| 2017 October | 7 | 8 | 15 |
| 2017 September | 7 | 8 | 15 |
| 2017 August | 9 | 11 | 20 |
| 2017 July | 13 | 12 | 25 |
| 2017 June | 11 | 16 | 27 |
| 2017 May | 12 | 5 | 17 |
| 2017 April | 6 | 7 | 13 |
| 2017 March | 4 | 3 | 7 |
| 2017 February | 5 | 14 | 19 |
| 2017 January | 6 | 5 | 11 |
| 2016 December | 11 | 3 | 14 |
| 2016 November | 23 | 14 | 37 |
| 2016 October | 27 | 16 | 43 |
| 2016 September | 24 | 16 | 40 |
| 2016 August | 21 | 9 | 30 |
| 2016 July | 17 | 6 | 23 |
| 2016 June | 22 | 11 | 33 |
| 2016 May | 23 | 9 | 32 |
| 2016 April | 17 | 1 | 18 |
| 2016 March | 12 | 3 | 15 |
| 2016 February | 10 | 3 | 13 |
| 2016 January | 22 | 16 | 38 |
| 2015 December | 29 | 13 | 42 |
| 2015 November | 27 | 7 | 34 |
| 2015 October | 56 | 1 | 57 |
| 2015 September | 40 | 0 | 40 |
| 2015 August | 48 | 0 | 48 |
| 2015 July | 45 | 0 | 45 |
| 2015 June | 45 | 0 | 45 |
| 2015 May | 68 | 0 | 68 |
| 2015 April | 35 | 0 | 35 |
| 2015 March | 43 | 0 | 43 |
| 2015 February | 36 | 0 | 36 |
| 2015 January | 49 | 0 | 49 |
| 2014 December | 42 | 0 | 42 |
| 2014 November | 40 | 0 | 40 |
| 2014 October | 71 | 0 | 71 |
| 2014 September | 40 | 0 | 40 |
| 2014 August | 55 | 0 | 55 |
| 2014 July | 52 | 0 | 52 |
| 2014 June | 74 | 0 | 74 |
| 2014 May | 58 | 0 | 58 |
| 2014 April | 65 | 0 | 65 |
| 2014 March | 68 | 0 | 68 |
| 2014 February | 49 | 0 | 49 |
| 2014 January | 50 | 0 | 50 |
| 2013 December | 49 | 0 | 49 |
| 2013 November | 53 | 0 | 53 |
| 2013 October | 53 | 0 | 53 |
| 2013 September | 50 | 0 | 50 |
| 2013 August | 46 | 0 | 46 |
| 2013 July | 63 | 0 | 63 |
| 2013 June | 51 | 0 | 51 |
| 2013 May | 41 | 0 | 41 |
| 2013 April | 30 | 0 | 30 |
| 2013 March | 13 | 0 | 13 |
| 2000 January | 3278 | 0 | 3278 |
Show all
