Pruebas diagnósticas de tamizaje / Diagnostic screening tests

Introducción. Las pruebas diagnósticas de tamizaje son aquellas pruebas que son capaces de identificar un factor de riesgo o mutaciones genéticas que predicen el inicio ulterior de la enfermedad, así como también las pruebas que ponen de manifiesto alteraciones estructurales de la enfermedad antes que la enfermedad progrese y se vuelva sintomática. Métodos. Se hizo una revisión de la literatura para establecer los fundamentos teóricos científicos que sustentan a las pruebas de diagnóstico de tamizaje y las condiciones y requisitos que se deben cumplir para introducirlas en el ámbito clínico o como programas de salud pública. Resultados. Se estableció la diferencia conceptual entre la detección precoz y el diagnóstico temprano y la diferencia entre tamizaje de prevalencia y tamizaje de incidencia. Se dieron a conocer las indicaciones y criterios científicos para la realización de las pruebas de tamizaje. Se puntualizó la importancia de la duración del tiempo de adelanto en la eficacia de las pruebas diagnósticas de detección precoz. Se argumentaron las razones por las cuales era necesario la realización de experimentos clínicos aleatorizados para evaluar la eficacia de las pruebas diagnósticas de detección precoz en la prevención secundaria de la enfermedad. Conclusiones. Las pruebas diagnósticas de tamizaje hacen posible la introducción de intervenciones en el ámbito de la prevención primaria, como también en el escenario de la prevención secundaria de las enfermedades.

Introduction. Screening diagnostic tests are those tests that help to identify a risk factor or genetic mutations that predict the subsequent onset of the disease, as well as tests that reveal structural alterations of the disease before the disease progresses and becomes symptomatic. Methods. A literature review was performed to establish the scientific theoretical fundamentals that support diagnostic screening tests and the conditions and requirements that must be met to introduce them in the clinical setting or as public health programs. Results. The conceptual difference between early detection and early diagnosis and the difference between prevalence screening and incidence screening was established. Indications and scientific criteria for conducting screening tests were presented. The importance of the duration of the lead time in the efficacy of early detection diagnostic tests was pointed out. The reasons why it was necessary to carry out a randomized clinical experiment to evaluate the efficacy of early detection diagnostic tests for early diagnosis in the secondary prevention of the disease were confronted. Conclusions. Screening diagnostic tests make it possible to introduce interventions in the field of primary prevention, as well as in the setting of secondary prevention of diseases.

Identificação de alterações auditivas em crianças pré-escolares / Identification of hearing disorders in preschool children / Identificación de trastornos auditivos en niños en edad preescolar

Programas de saúde auditiva estão voltados predominantemente para crianças entre 0 e 3 anos de idade ou para os maiores de 7. As crianças entre estas duas faixas etárias não estão em nenhum destes programas, porém é neste grupo que mais ocorrem problemas de orelha média, e, é, neste grupo, possível detectar as perdas auditivas mínimas, leves ou unilaterais que não foram identificadas nos programas de triagem auditiva neonatal. Objetivo: Identificar alterações auditivas em crianças pré-escolares por meio de um programa de triagem auditiva. Método: Trata-se de estudo descritivo, transversal e observacional realizado em duas escolas municipais do município de Mauá. A amostra foi composta por crianças de cinco e seis anos de idade. O programa de triagem auditiva foi composto: a. otoscopia; b. timpanometria, e c. registro das emissões otoacústicas transiente (EOAT) e produto de distorção (EOAPD). Em vista da pandemia iniciada em março de 2020, não foi possível avaliar as crianças de três e quatro anos. Resultados: 28,44% (n= 31) de crianças falharam na otoscopia. Das 78 (71,55%) crianças que passaram na otoscopia, 30,8% falharam na timpanometria; 16,7% nas Emissões Otoacústicas Produto de Distorção (DPOAE) e 19,2% nas Emissões Otoacústicas por estímulo Transiente (TPOAE); 30,76% (n= 24) das crianças falharam em pelo menos um dos três procedimentos. Conclusão: foram identificadas 30,76% de crianças com risco de alteração auditiva que devem ser encaminhadas para avaliação médica e audiológica.

Hearing health programs are predominantly aimed at children between 0 and 3 years of age or those older than 7. Children between these two age groups are not in any of these programs, but it is in this group that the most middle ear problems occur, and, it is in this group, possible to detect minimal, mild, or unilateral hearing loss that was not identified in neonatal hearing screening programs. Objective: To identify hearing alterations in preschool children through a hearing screening program. Method: This is a descriptive, cross-sectional, and observational study conducted in two municipal schools in the municipality of Mauá. The sample consisted of children aged five and six years. The hearing screening program was composed of a. otoscopy; b. tympanometry and, c. recording of transient otoacoustic emissions (TOAE) and distortion product (DPOAE). In view of the pandemic that began in March 2020, it was not possible to evaluate the three and four-year-old children. Results: 28.44% (n= 31) of the children failed otoscopy. Of the 78 (71.55%) children who underwent otoscopy, 30.8% failed tympanometry: 16.7% in Distortion Product Otoacoustic Emissions (DPOAE) and 19.2% in Transient Stimulus Otoacoustic Emissions (TPOAE); 30.76% (n= 24) of the children failed at least one of the three procedures. Conclusion: 30.76% of children at risk of hearing impairment were identified and should be referred for medical and audiological evaluation.

Los programas de salud auditiva están dirigidos principalmente a niños entre 0 y 3 años o mayores de 7 años. Los niños entre estos dos grupos de edad no están en ninguno de estos programas, pero es en este grupo que ocurren la mayoría de los problemas del oído medio, y, es en este grupo, posible detectar la pérdida de audición mínima, leve o unilateral que no se identificó en los programas de cribado auditivo neonatal. Objetivo: Identificar las alteraciones auditivas en niños en edad preescolar a través de un programa de detección auditiva. Método: Se trata de un estudio descriptivo, transversal y observacional realizado en dos colegios municipales del municipio de Mauá. La muestra estuvo constituida por niños de cinco y seis años y sus padres/tutores. El programa de detección de audición estuvo compuesto por: a. Cuestionario para padres/tutores sobre la historia de la salud auditiva de los niños; b. otoscopia; c. timpanometria y, d. Registro de emisiones otoacústicas transitorias (EOT) y producto de distorsión (DPOAE). Ante la pandemia que comenzó en marzo de 2020, no fue posible realizar los reexámenes ni evaluar a los niños de tres y cuatro años. Resultados: 28,44% (n= 31) de los niños no pasaron la otoscopia. De los 78 (71,55%) niños que se sometieron a otoscopia, 30,8% fallaron la timpanometria; 16,7% en emisiones otoacústicas de productos de distorsión (DPOAE) y 19,2% en emisiones otoacústicas de estímulo transitorio (TPOAE); 30,76% (n= 24) de los niños fallaron por lo menos uno de los tres procedimientos. Conclusión: 30,76% de los niños con riesgo de deficiencia auditiva fueron identificados y deben ser referidos para evaluación médica y audiológica.

Retinografia como forma de rastreio de retinopatia diabética em hospital terciário do Sistema Único de Saúde / Color retinography as a means of screening for diabetic retinopathy in the tertiary hospital of Unified Health System

RESUMO Objetivo Avaliar o impacto da triagem de retinopatia diabética de paciente diabéticos realizada com retinografia colorida. Métodos Estudo retrospectivo, de caráter descritivo, avaliando laudos de retinografias realizadas desde a implementação do protocolo da triagem de retinopatia diabética de paciente diabéticos acompanhados no Ambulatório de Endocrinologia de um hospital terciário do Sistema Único de Saúde, de maio de 2018 até maio de 2020. Resultados Realizaram retinografia 727 pacientes diabéticos, que tinham entre 14 e 91 anos, sendo a maioria com 60 anos ou mais (53,2%), do sexo feminino (68%) e brancos (87,6%). Não apresentavam retinopatia diabética 467 (64,2%) pacientes, 125 (17,2%) tinham retinopatia diabética não proliferativa, 37 (5,1%) retinopatia diabética não proliferativa grave e/ou suspeita de edema macular, 65 (8,9%) retinopatia diabética proliferativa, 21 (2,9%) suspeita de outras patologias, e as imagens de 12 (1,7%) pacientes eram insatisfatórias. Foram considerados de alto risco (aqueles com retinopatia diabética não proliferativa grave e/ou edema macular, retinopatia diabética proliferativa ou imagem insatisfatória) 114 (15,68%) pacientes. Conclusão O rastreio de retinopatia diabética com retinografia colorida possibilitou a detecção de pacientes diabéticos de alto risco que necessitavam atendimento com brevidade, permitindo o acesso deles à consulta oftalmológica e diminuindo a morbidade da doença relacionada ao tratamento tardio. Os demais foram encaminhados à Atenção Primária para regulamentação, por meio do Sistema de Regulação.

ABSTRACT Objective To evaluate the impact of diabetic retinopathy (DR) screening using color retinography in diabetic patients. Methods Retrospective descriptive study, evaluating reports of all retinographs performed since the implementation of the protocol for screening for diabetic retinopathy in diabetic patients followed up at the endocrinology outpatient clinic of a tertiary hospital of the Unified Health System, from May 2018 to May 2020. Results 727 diabetic with age range from 14 to 91 years old, the majority being 60 years old or older (53.2%), female (68%) and white (87.6%), patients underwent retinography. Of the patients, 467 (64.2%) did not have DR, 125 (17.2%) had non-proliferative DR, 37 (5.1%) had severe non-proliferative DR and/or suspected macular edema, 65 (8.9%) had proliferative DR, 21 (2.9%) had suspicion signs of other pathologies and 12 (1.7%) had unsatisfactory images. A total of 114 (15.68%) patients were considered at high risk (those with severe non-proliferative NP and/or EM, proliferative DR or poor image) and were referred for comprehensive ophthalmic evaluation. Conclusion The screening of RD with color retinography enabled the detection of high-risk diabetic patients who needed assistance sooner and enabled their access to ophthalmologic consultation, which decreased disease morbidity. The others were referred to primary care for regulation through the Regulation System (SISREG).

Utilisation of village health workers' services for tuberculosis screening in Lesotho

Village health workers (VHWs) play an essential role because they extend the capacity of primary healthcare, particularly for developing countries. In Lesotho, VHWs are part of the primary healthcare connecting the community with clinics in their respective villages. They contribute to the prevention of the spread of tuberculosis (TB) within their catchment areas by encouraging communities to partake in TB screening. This study aimed at identifying factors associated with the utilisation of VHWs' service to undertake TB screenings in Lesotho. Methods: This study emanates from the main study that used a cross-sectional descriptive design. A total of 19 health service areas (HSAs) comprised 17 catchment areas and two clinics, each randomly selected from the District Health Management Team (DHMT) and the Lesotho Flying Doctors Service (LFDS), respectively. A total of 2928 individual household members aged 15 and above were included in the study. Data analysis included descriptive and inferential statistics. Results: There were more female than male respondents, with a majority (77%) below 65 years of age. Tuberculosis knowledge of respondents was mostly on the TB symptoms and curability of TB, but they were less knowledgeable about the causes of TB. The use of VHWs' services for TB screening was very low (23.3%). Conclusion: The study revealed that while respondents were to some extent knowledgeable about TB, their utilisation of VHWs' services for TB screening varied with education level, having worked in South Africa and the household size at α = 0.01.

Rastreamento do risco de sarcopenia em adultos com 50 anos ou mais hospitalizados / Screening the risk of sarcopenia in adults aged 50 years or older hospitalized

Resumo Objetivo Rastrear o risco de sarcopenia em indivíduos hospitalizados por meio dos instrumentos SARC-F e SARC-Calf e verificar a associação entre o risco de sarcopenia com as variáveis sociodemográficas, clínicas e as variáveis que compõem o fenótipo de sarcopenia. Métodos Trata-se de um estudo transversal. Características sociodemográficas, clínicas e todas as variáveis que compõem o fenótipo de sarcopenia (força de prensão palmar, massa muscular e velocidade de marcha) foram investigadas. Para o rastreamento e diagnóstico da sarcopenia adotou-se o algoritmo e critérios propostos pelo European Working Group on Sarcopenia in Older People (EWGSOP2). Resultados Participaram 90 indivíduos. A maioria encontrava-se sem sinais sugestivos de sarcopenia, tanto pelo SARC-F (58,9%) quanto pelo SARC-Calf (68,9%), com força de preensão palmar (FPP) (28,59±9,21;26,74±10,60) e índice de massa muscular esquelética apendicular (IMMEA) (9,31±1,78;9,58±1,62) normais e com baixa velocidade de marcha (VM) (0,69±0,26; 0,68±0,44), respectivamente. O SARC-F apresentou associação significativa com as variáveis sexo (p=0,032), FPP (p<0,001), VM (p=0,001) e sarcopenia (p<0,001). Quando da adição da circunferência da panturrilha (CP), foi encontrado associação com as variáveis grupo etário (p=0,029), atividade laboral (p=0,008), FPP (p<0,001), IMMEA (p=0,033), VM (p=0,019) e sarcopenia (p<0,001). Conclusão O risco de sarcopenia foi observado em aproximadamente um terço dos pacientes avaliados. Sugere-se o uso rotineiro nos hospitais da ferramenta de rastreamento de sarcopenia SARC-Calf, uma vez que apresentou associação com os três fatores preditivos da sarcopenia, além de ser um instrumento de aplicação ágil, baixo custo e não invasivo. A investigação do diagnóstico da sarcopenia deve ser encorajada na prática clínica.

Abstract Objective To screen the risk of sarcopenia in hospitalized individuals using the SARC-F and SARC-Calf instruments and verify the association between the risk of sarcopenia with the sociodemographic and clinical variables and those that make up the sarcopenia phenotype. Methods This is a cross-sectional study. Sociodemographic, clinical characteristics, and all variables (handgrip strength, muscle mass and gait speed) that construct the sarcopenia phenotype were investigated. For the screening and diagnosis of sarcopenia, the algorithm, and criteria proposed by the European Working Group on Sarcopenia in Older People (EWGSOP2). Results A total of 90 individuals participated. Most were without risk of sarcopenia, both by SARC-F (58.9%) and by SARC-Calf (68.9%), with normal handgrip strength (HGS) (28.6±9.2; 26.7±10.6) and appendicular skeletal muscle mass index (ASMI) (9.3±1.78; 9.6±1.6) and with low gait speed (GS) (0.69±0.26; 0.68±0.4), respectively. SARC-F showed a significant association with the variables gender (p=0.032), HGS (p<0.001), GS (p=0.001) and sarcopenia (p<0.001). When adding the calf circumference (CC), an association was found with the variables age group (p=0.029), work activity (p=0.008), HGS (p<0.001), ASMI (p=0.033), GS (p=0.019) and the sarcopenia (p<0.001). Conclusion The risk of sarcopenia was observed in approximately one-third of the evaluated patients. It is suggested the routine use in hospitals of the sarcopenia screening tool SARC-Calf, since it was associated with the three predictive factors of sarcopenia, in addition,it is an instrument of agile application, low cost and non-invasive. When a possible, investigation of the diagnosis of sarcopenia should be encouraged in clinical practice.

Características fenotípicas y factores de riesgo de síndrome de ovario poliquístico en estudiantes enfermeras / Phenotype characteristics and risk factors of polycystic ovarian syndrome among nursing students

Background: Polycystic ovarian syndrome (PCOS) is a common endocrine condition that occurs in women and is associated with problems such as menstrual irregularities; hirsutism; obesity; insulin resistance; acne; and later life with diabetes mellitus and uterine cancer. The study aim was to assess phenotype characteristics and risk factors of polycystic ovarian syndrome among nursing students. Cross sectional study (descriptive) included a sample of 400 females from Faculty of Nursing, Zagazig University, Egypt.Tools were used for data collection; structured-interviewing questionnaire sheet, data related to anthropometric measures, risk factors about PCOS and observational check list about phenotype characteristics of PCO. The results showed that, (6%) of the studied student females had family history of PCO, nearly half of them had fast food, more than half of studied student females had hirsutism, more than one quarter had acne, (14.5%) had menstrual irregularity and one third of them had continuous abnormal weight gain. Also, this study showed that lack of awareness were found among majority of girls about PCOS. Therefore, it could be concluded that, family history of PCOS, obesity and fast food diet habits are found to be the predisposing factors for development of PCOS. The risk of PCOS increases with presence of one or more identified predisposing factors. Most of the factors tested as predisposing factors in our study are interlinked to each other and are mostly modifiable Although that PCOS is prevalent endocrine disorder, there was poor knowledge among student females in Faculty of Nursing Zagazig University. The study recommended screening program from ministry of health for early detection of predisposing factors of PCOS including the secondary school students and faculties students through educational programs and messages through the counseling, brochures, to increase student's awareness about PCOS symptoms. Further research on larger sample size to identify how the problem is risky and how to deal it. Including the problem in social media and healthy channels. K

Evaluacion diagnóstica de la dinámica cardíaca caótica fetal a partir de la evolución del sistema dinámico / Diagnostic evaluation of fetal chaotic cardiac dynamics from the evolution of the dynamic system

Objetivo: Desarrollar una nueva metodología física y matemática para diagnosticar la dinámica cardíaca caótica fetal a partir de atractores de la frecuencia cardíaca. Metodología: Se realizó una inducción matemática con tres trazados de monitorias fetales; una reactiva sin dudas en su evaluación, una plana y una con pérdida aguda de bienestar fetal, para cada una de ellas se generó un atractor caótico a partir de las frecuencias cardíacas, se evaluaron los espacios de ocupación de cada atractor en dos rejillas, y se establacieron diferencias matemáticas entre trazados de monitorias reactivas y no reactivas. Posteriormente se analizaron otros 15 trazados de monitorias fetales, para refinar los parámetros diagnósticos. Resultados: Los espacios evaluados para los atractores de monitorias normales presentaron valores entre 53 y 117 para la rejilla más pequeña; mientras que las monitorias anormales presentaron valores menores a 41 y mayores a 123. Conclusiones: se desarrolló una nueva metodología de ayuda diagnóstica para evaluar la dinámica cardíaca caótica fetal, que diferencia normalidad de enfermedad de forma objetiva y reproducible (AU)

Objective: To develop a new physical and mathematical methodology to diagnose fetal chaotic cardiac dynamics from heart rate attractors. Methods: A mathematical induction was performed with three fetal monitoring tracings;one of them, reactive without doubt in its evaluation, other plane and other with acute loss of fetal well-being, for each of them a chaotic attractor was generated from the cardiac frequencies, the spaces of occupation of each attractor in two grids were evaluated, and mathematical differences were established between reactive and non-reactive monitorin tracings. A further 15 fetal monitoring tracings were then analyzed to refine the diagnostic parameters. Results: The spaces evaluated for the normal monitor attractors presented values between 53 and 177 for the smallest grid; while abnormal monitoring had values lower than 41 and greater than 12.3. conclusions: a new methodology of diagnostic aid was developed to evaluate fetal chaotic cardiac dynamics, which distinguishes normality of disease in an objective and reproductible way (AU)

Modelo de manejo en red y por telemedicina de la retinopatía diabética en dos comunas del Servicio de Salud Metropolitano Oriente / Management of diabetic retinopathy using telemedicine and network integration

Background: If we are able to increase the resolution of complex medical problems at primary health care levels, we would improve the efficiency of the health care systems and would reduce the burden of specialists. Aim: To describe the result of a telemedicine and network management of diabetic retinopathy supervised by an ophthalmological service. Material and Methods: Diabetic patients attended in primary health care centers of the East Metropolitan Health Service in Santiago, Chile, derived for 45° digital retinographies were evaluated using telemedicine by the ophthalmologists of the base hospital. These professionals screened for diabetic retinopathy and classified it. Those patients with diabetic retinopathy were derived to the base hospital for specialized management. Results: Of 2,566 patients evaluated, 22% had signs of diabetic retinopathy, 75% did not have the condition and 2% could not be evaluated with retinography. Seventy percent of patients with retinopathy, equivalent to only fifteen percent of total diabetics, were referred to the specialists for treatment. Conclusions: This model allowed a reduction of referrals to ophthalmologists, reducing the burden of secondary and tertiary health care systems.

Analysis of the application values of different combination schemes of liquid-based cytology and high-risk human papilloma virus test in the screening of high-grade cervical lesions

The aim of this study was to explore the value of different combination schemes of liquid-based cytology (LBC) and high-risk human papilloma virus (HPV) test in the screening of high-grade (≥CIN 2) cervical lesions. From 5727 women who had undergone examinations with LBC and high-risk HPV test, 1884 patients with positive results of either or both LBC and HPV test were included in this study and underwent cervical biopsy. Based on the pathological examination results, comparisons of the assessment indicators of all diagnostic tests were made, and the application values of LBC and high-risk HPV test and different combination schemes of the two in the screening of high-grade (≥CIN II) cervical lesions were estimated. Compared with the single test method, the sensitivity and negative predictive value of the combination scheme of LBC+HPV (with one positive result) were increased significantly (98.7% and 99.7%), but the specificity (60.8%) and accuracy rate (65.4%) dropped significantly (P<0.05). The sensitivity of LBC+HPV (with two positive results) was the lowest (80.7%), but the specificity and accuracy rate were the highest (83.5% and 83.1%, P<0.05). Z test showed that differences in the screening efficiency of four schemes were not statistically significant (P>0.05). Both LBC and HPV test were effective methods in the screening of high-grade cervical lesions; combination of the two tests did not improve the screening efficiency, but the scheme of LBC+HPV (with two positive results) significantly increased the sensitivity and negative predictive value, which was of better cost-benefit value.

Intervención educativa sobre prevención de cardiopatías congénitas en mujeres en edad fértil, consultorios médicos 8 y 9. Policlínico Samuel Fernández. Municipio de Matanzas; 2015-2016 / Educative intervention on congenital heart diseases prevention in fertile aged women. Medical Consultations 8 and 9. Policlinic "Samuel Fernández". Municipality of Matanzas; 2015-2016

Introducción: las cardiopatías congénitas son los defectos más frecuentes y primera causa de muerte en menores de un año, su etiología es multifactorial y los factores de riesgo diversos y muchos prevenibles. Objetivo: implementar un programa educativo para el desarrollo de conocimientos sobre prevención de cardiopatías congénitas en mujeres en edad fértil de dos consultorios médicos del Policlínico Docente "Samuel Fernández "del municipio Matanzas, entre enero 2015 a marzo 2016. Material y métodos: se realizó un estudio de intervención, se diagnosticó el nivel de conocimientos y necesidades educativas sentidas a través de un cuestionario al universo de mujeres en edad fértil de los consultorios médicos declarados. Para determinar la existencia de asociación entre ambas variables, se calculó el Chi cuadrado, para una confiabilidad de 99%. Se aplicó la prueba de la t de Student para comparar las medias aritméticas de la variable conocimiento antes y después de la intervención, para una confiabilidad de 99%. Resultados: el nivel de conocimiento de las féminas fue regular y las necesidades educativas sentidas altas antes de la intervención, modificándose a bien después de implementada la misma, con diferencias estadísticamente altamente significativas. Conclusiones: Se comprueba la eficacia del producto elaborado al constatarse el desarrollo de conocimientos sobre el tema (AU).

Introduction: congenital heart diseases are the most frequent defects and the first cause of death in children aged less than a year. Its etiology is multifactorial and the risk factors are diverse and many of them preventable. Objective: to put into practice an educative program for the development of knowledge on congenital heart diseases in fertile aged women from two medical consultations of the Teaching Policlinic "Samuel Fernández", municipality of Matanzas, from January 2015 to March 2016. Materials and methods: an intervention was carried out. It was diagnosed the level of knowledge and the educative necessities using an questionnaire filled in by the universe of fertile aged women from the declared medical consultations. To determine the existence of association between both variables chi-square was calculated for a reliability of 99 %. The T student test was applied to compare the arithmetic average of knowledge variable before and after the intervention, for a 99 % of reliability. Results: the women´s level of knowledge was regular and the perceived educative necessities were high before the intervention; the level of knowledge turned to good after the intervention, with significantly high statistical differences. Conclusions: the efficacy of the elaborated product was proved when development of knowledge on the theme was stated (AU).

La aplicación del Score de Alvarado en la sospecha de la apendicitis aguda. Estudio prospectivo y protocolizado / APPLICATION OF A CLINICAL SCORE SYSTEM ( ALVARADO´S SCORE ) FOR THE DIAGNOSIS OF ACUTE APPENDICITIS

Antecedentes: La apendicitis aguda no sospechada y diagnosticada puede evolucionar hacia la perforación o por el contrario conduce a la remoción de un apéndice normal. Objetivo: La utilización de un sistema de Score, desde un punto de vista clínico, para el diagnóstico de esta patología y lograr disminuir las apendicetomías negativas. Lugar de Aplicación: Hospital Nacional de Clínicas. Córdoba. (Argentina) Diseño: Estudio prospectivo y protocolizado. Material y Métodos: Comprende a 1119 pacientes estudiados entre agosto del 2000 y diciembre del 2015. De ellos, 588 eran del sexo masculino y 531 del femenino, con una edad promedio de 25,3 años de edad. A todos los pacientes se les realizo al ingreso el Score de Alvarado. En base a la clínica y a una segunda valoración con el Score se decidió la exploración quirúrgica en 1061 pacientes (94,8 %). De los 58 restantes (5,18 %), fueron excluidos por otra patología. El diagnóstico de apendicitis aguda fue confirmado por los hallazgos quirúrgicos y la anatomía patológica. Resultados: En los hallazgos operatorios se encontró en 962 pacientes (90,6%) que tenían una apendicitis aguda. No hubo mortalidad postoperatoria. En relación a la morbilidad hubo un 2,2% de complicaciones médicas y un 16,3% de las quirúrgicas. El informe anatomopatológico mostró en 99 pacientes un apéndice cecal normal. Por lo tanto la incidencia de las apendicetomías negativas fue del 9,3 %. Conclusiones: La utilización del Score en relación a los hallazgos quirúrgicos y anatomopatológicos confirma que fue sensible a partir de 6 puntos para el diagnóstico de apendicitis aguda.

Background: Acute appendicitis neither suspected nor diagnosed could develop a perforation or otherwise it would take to removing of a normal appendix. Objectives: Utilization of a clinical score system for aided diagnosis of this pathology and can reduce a negative appendicitis. Setting: National Clinicas Hospital. Córdoba. Argentina. Design: Prospective and protocoled study. Methods: 1119 patients were studied between August 2000 and December 2015. 588 males and 531 females their age average was 25.3 years. Alvarado score was realized in all patients when they entered. According clinic and second valuation with the score surgical exploration was decided in 1061 (94,8 %) patients. The remaining 58 (5,18 %) were excluded due to other pathology. The diagnosis in acute appendicitis was confirmed by surgical finding and histopathology studies. Results: In surgical finding we showed 962 patients (90,6%) had acute appendicitis. There was no operative mortality. Respects morbidity there was 2,2 % of medical and 16,3 % of surgical complications. The anatomo pathology report showed a normal cecal appendix in 99. Whereas the incidence of negative appendicectomy was about 9,3 %. Conclusions: The utilization of score related to the surgical and anatomo pathology finding confirmed it was appreciable from 6 points to acute appendicitis diagnosis.