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1.
Med. infant ; 29(1): 30-37, Marzo 2022. Tab, ilus
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1367046

ABSTRACT

Introducción: La malnutrición es un estado de deficiencia o exceso de nutrientes que provoca efectos nocivos y puede alterar el crecimiento aumentando la morbi-mortalidad. Materiales y métodos: estudio retrospectivo, descriptivo. Incluyó niños/as de 1-18 años hospitalizados entre 2016-2018. Se obtuvieron datos de caracterización de la muestra y antropométricos. La herramienta de tamizaje nutricional pediátrico (HTNP) se utilizó para detectar riesgo nutricional y en este subgrupo se analizó: variación de peso, intervención nutricional, complicaciones infecciosas y estadía hospitalaria. El análisis de variables se realizó con SPSS Statistics 20. Resultados: Se evaluaron 745 pacientes, 373 niñas (50,1%). Mediana de edad 7,3 años. Estancia hospitalaria media de 4 días (1-123). Se observó 5,9% emaciados, 56,4% eutróficos, 16,8% sobrepeso y 20,9% obesidad. Con baja talla 13%. Se detectó riesgo nutricional con HTNP en 50,7% de los ingresos. Las patologías de base más frecuentes fueron cardiopatías y neoplasias. En pacientes con riesgo nutricional: estadía hospitalaria media de 5 días, 13,5% cursó con infecciones intrahospitalarias, 68% mantuvo o aumentó de peso durante la internación, 13,5% requirió apoyo nutricional (más utilizado el gavage en 59%). Conclusiones: El niño hospitalizado se encuentra en una situación de vulnerabilidad, por lo que el tamizaje y evaluación nutricional resultan acciones claves para prevenir el deterioro nutricional. En los niños con malnutrición las acciones llevadas a cabo por el Nutricionista Clínico como integrante del equipo de atención, revisten un rol clave para promover y garantizar el derecho de los pacientes a la alimentación adecuada y así mejorar su condición nutricional. (AU)


Introduction: Malnutrition is a state of nutrient deficiency or excess that causes harmful effects and can alter growth increasing morbidity and mortality. Materials and methods: retrospective, descriptive study. Children aged 1-18 years admitted to the hospital between 2016-2018 were included. Sample characterization and anthropometric data were collected. The pediatric nutritional screening tool (PNST) was used to identify nutritional risk and in this subgroup we analyzed: weight variation, nutritional intervention, infectious complications, and length of hospital stay. The analysis of variables was performed with SPSS Statistics 20. Results: 745 patients were evaluated, 373 were girls (50.1%). Median age was 7.3 years. Mean hospital stay was 4 days (1- 123). Among the patients, 5.9% were emaciated, 56.4% eutrophic, 16.8% overweight, and 20.9% obese. Thirteen percent of the patients had short stature. Nutritional risk was detected using HTNP in 50.7% of the admitted patients. The most frequent underlying diseases were heart disease and cancer. In patients at nutritional risk: mean hospital stay was 5 days, 13.5% had hospital-acquired infections, 68% maintained or gained weight during the hospital stay, 13.5% required nutritional support (gavage was the most frequently used in 59%). Conclusions: Hospitalized children are in a vulnerable situation, therefore nutritional screening and evaluation are key actions to prevent nutritional deterioration. In children with malnutrition, the Clinical Nutritionist, as a member of the health care team, plays a key role in promoting and guaranteeing the right of patients to adequate food and thus improve their nutritional condition (AU)


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Child Nutrition Disorders/diagnosis , Child Nutrition Disorders/diet therapy , Nutrition Assessment , Child, Hospitalized , Mass Screening/methods , Nutritional Status , Hospitals, Pediatric , Retrospective Studies , Risk Factors
2.
Cad. Saúde Pública (Online) ; 38(1): e00304820, 2022. tab, graf
Article in English | LILACS | ID: biblio-1355972

ABSTRACT

Cervical cancer screening is a multistage process, therefore access to both the primary test and subsequent diagnostic procedures is essential. Considering women undergoing screening on the public health system in the State of São Paulo, Brazil, we aimed to estimate the proportion of women accessing colposcopy within six months of an abnormal smear result. We retrieved records from two administrative databases, the Information System on Uterine Cervical Cancer (SISCOLO) that contains smear results and the Outpatient Information System of the Brazilian Unified National Health System (SIA/SUS) that records colposcopies. A reference cohort consisted of women, aged 25 years or older, with an abnormal smear result between May 1, 2014, and June 30, 2014. We excluded prevalent cases. We linked the reference cohort and records in the SIA/SUS extending to December 31, 2014. After excluding prevalent cases, 1,761 women with abnormal cytology results were left. A total of 700 (39.8%) women were linked to a colposcopy record within the follow-up period; this dropped to 671 (38.1%) women when follow-up was censored at six months. We could notice a slightly higher attendance in women living in the metropolitan region of São Paulo compared with residents of the rest of the state. We found no association between colposcopy attendance and age or cytology class. These results emphasize that access to colposcopy in the public health system in São Paulo is limited. This compromises the quality of screening, and the issue needs to be prioritized in service planning.


A triagem do câncer de colo uterino é um processo que envolve múltiplas etapas. É essencial o acesso ao teste primário e aos procedimentos diagnósticos subsequentes. Com foco nas mulheres que fazem triagem no sistema de saúde pública no Estado de São Paulo, Brasil, buscamos estimar a proporção daquelas que acessam a colposcopia dentro de seis meses após um resultado anormal no teste de Papanicolau. Recuperamos os registros de duas bases de dados administrativos: o Sistema de Informação do Controle do Câncer do Colo do Útero (SISCOLO), que contém os resultados de Papanicolau, e o Sistema de Informação Ambulatorial do Sistema Único de Saúde (SIA/SUS), com os registros das colposcopias. Uma coorte de referência foi constituída de mulheres com idade de 25 anos ou mais com Papanicolau anormal entre 1º de maio de 2014 e 30 de junho de 2014. Excluímos casos prevalentes. Relacionamos a coorte de referência aos registros no SIA/SUS, estendendo até 31 de dezembro de 2014. Após a exclusão dos casos prevalentes, restaram 1.761 mulheres com citologia anormal. Setecentas delas (39,8%) foram relacionadas a um registro de colposcopia dentro do período de seguimento; esse número diminuiu para 671 (38,1%) quando o seguimento foi censurado aos seis meses. Foi observada uma cobertura ligeiramente maior entre mulheres residentes na Grande São Paulo, em comparação com mulheres residentes do interior do estado. Não houve associação entre realização de colposcopia e idade ou classe citológica. Os resultados destacam o acesso restrito à colposcopia no sistema público de saúde no Estado de São Paulo. O cenário compromete a qualidade da triagem, e a questão deve ser priorizada no planejamento dos serviços.


Las pruebas de detección del cáncer cervical forman parte de un proceso multietapa. El acceso a tanto el test primario, como a los subsiguientes procedimientos de diagnóstico, es esencial. Considerando a las mujeres que se realizan las pruebas de detección en el sistema público de la salud en el Estado de São Paulo, Brasil, el objetivo del estudio fue estimar la proporción de mujeres que acceden a una colposcopía dentro de los seis meses, tras el resultado anormal en una citología. Recuperamos los registros de dos bases de datos administrativas: el Sistema de Información del Cáncer de Cuello de Útero (SISCOLO), que contiene resultados citológicos, y el Sistema de Información Ambulatoria del Sistema Único de Salud (SIA/SUS), que registra colposcopías. La cohorte de referencia consistía en mujeres, con 25 años de edad o mayores, quienes recibieron un resultado anormal en su citología entre el 1º mayo de 2014 y el 30 de junio 2014. Excluimos los casos prevalentes. Vinculamos la cohorte de referencia y los registros en la SIA/SUS, extendiéndolos hasta el 31 de diciembre 2014. Tras excluir los casos prevalentes, quedaron 1.761 mujeres con resultados citológicos anormales; 700 (39.8%), vinculados a un registro de colposcopía dentro del periodo de seguimient. Esta cifra cayó a 671 (38.1%) cuando el seguimiento fue censurado a los seis meses. Se observó una participación ligeramente superior en mujeres que viven en la región metropolitana de la gran São Paulo, comparada con los residentes del resto del estado. No hubo asociación entre la participación en la colposcopía y edad o tipo de citología. Estos resultados resaltan que el acceso a la colposcopía en el sistema público de São Paulo es limitado. Esto compromete la calidad de las pruebas de detección por lo que se necesita darles prioridad en la planificación de los servicios sanitarios.


Subject(s)
Humans , Female , Pregnancy , Adult , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control , Colposcopy , Vaginal Smears , Brazil/epidemiology , Mass Screening/methods , Early Detection of Cancer
3.
Evid. actual. práct. ambul ; 24(1): e002102, 2021. tab
Article in Spanish | LILACS | ID: biblio-1222362

ABSTRACT

El cáncer colorrectal presenta un problema para la salud pública a nivel mundial. En Argentina, se diagnostican aproximadamente 13.500 casos cada año. El tamizaje como medida de prevención secundaria es una medida beneficiosa para lograr un abordaje temprano con mejores resultados. Los dos métodos más utilizados para el tamizaje son la videocolonoscopía y la prueba de sangre oculta en materia fecal, sobre todo la de tipo inmunoquímico que con el paso de los años fue reemplazando a la prueba de guayaco por su mayor practicidad. El primero es un método invasivo y que requiere anestesia, mientras que el segundo no tiene un efecto adverso directo pero debe realizarse con una cadencia mayor. El objetivo de los autores de este artículo fue evaluar la evidencia sobre la sensibilidad y especificidad de ambos métodos, como también sus beneficios y daños a partir de la consulta de un paciente a su médico de familia. Ninguna prueba parecería ser inferior para el tamizaje de cáncer colorrectal en una población de riesgo promedio, y ambas pueden usarse en programas de rastreo. Sin embargo, no existen estudios que comparen ambos métodos de manera directa, y toda prueba inmunoquímica fecal positiva debe ser seguida de una colonoscopía. La elección de la prueba puede depender de los valores y preferencias de los pacientes. (AU)


Colorectal cancer presents a public health problem worldwide. In Argentina, approximately 13,500 cases appear each year. Screening as a secondary prevention measure is a beneficial measure to achieve an early approach with better results. The two most used methods for screening are video colonoscopy and faecal immunochemical test, the former being invasiveand requiring anaesthesia, while the latter does not have a direct adverse effect but must be performed at a higher rate. The objective of this article was to evaluate the evidence for the sensitivity and specificity of both methods, as well as their benefits and harms. No test would appear to be inferior for colorectal cancer screening in an average-risk population, and both can be used in screening programs. However, there are no studies comparing both methods directly, and any positive faecal immunochemical test should be evaluated with a colonoscopy. The choice of the test may depend on the values and preferences of the patients. (AU)


Subject(s)
Humans , Male , Middle Aged , Colonic Neoplasms/prevention & control , Early Detection of Cancer/methods , Patient Participation , Mass Screening/methods , Meta-Analysis as Topic , Public Health , Sensitivity and Specificity , Colonoscopy/statistics & numerical data , Early Detection of Cancer/adverse effects , Secondary Prevention/methods , Patient Preference , Systematic Reviews as Topic , Occult Blood
4.
Rev. habanera cienc. méd ; 19(4): e2854, tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1139175

ABSTRACT

Introducción: Se desconoce qué marcadores de riesgo nutricional estratifican mejor el riesgo en pacientes críticos. Objetivo: Evaluar el riesgo nutricional en pacientes críticos mediante dos escalas. Material y métodos: Estudio descriptivo, prospectivo, transversal, con 222 pacientes ingresados en la Terapia 8B del Hospital "Hermanos Ameijeiras" (septiembre 2017 / mayo 2018). Se utilizaron el Control Nutricional (CONUT) y el Nutrition Risk in the Critically ill modificado (mNutric). Resultados: Según CONUT el 96,4 por ciento estaba desnutrido; según mNutric el 27,5 por ciento eran pacientes en alto riesgo nutricional. Hubo asociación entre las escalas (Kappa = 0,102). El 78.3 por ciento de los sobrevivientes eran bajo riesgo por mNutric (p=0,013). Hubo asociación entre la sepsis y la desnutrición por mNutric (p=0,013), no así entre la ventilación mecánica artificial (VMA) y la desnutrición estimada por dicha escala (p=0,116). No se encontraron diferencias entre la sepsis y la desnutrición según CONUT (p=0,126). Hubo diferencias entre la VMA en relación con la desnutrición según CONUT (p=0,027). La frecuencia de fallecidos se incrementó paralelo al grado de desnutrición según CONUT (p=0,004). La variable que más influyó sobre la mortalidad fue la VMA (OR= 8,5). Conclusiones: Según el CONUT, la mayoría de los pacientes estaban desnutridos, y según el mNutric, predominaron los pacientes en bajo riesgo nutricional. Se demostró el valor predictivo de muerte de la presencia de VMA. La desnutrición ligera y moderada y la variable no desnutrido de la escala CONUT, se consideraron categorías de menor riesgo de muerte con respecto a la desnutrición grave(AU)


Introduction: Nutritional status markers that better stratify risk in critically ill patients have yet to be established. Objective: To assess nutritional risk in critically ill patients through the use of two assessment scales. Material and Methods: A prospective descriptive cross-sectional study was conducted in 222 patients admitted to the Intensive Care Unit (8B) at the "Hermanos Ameijeiras" Hospital from September, 2017 to May, 2018. The Controlling Nutritional Status (CONUT) and the modified Nutrition Risk in the Critically ill (mNutric) were used. Results: According to CONUT, 96.4 percent of patients were alnourished; according to mNutric, 27.5 percent of patients were categorized as high nutritional risk. There was an association between the scales (Kappa = 0.102). Among survivors, 78.3 percent of patients were at low risk according to mNutric score (p=0,013). There was an association between sepsis and malnutrition due to mNutric (p = 0.013) versus artificial mechanical ventilation (AMV) and malnutrition estimated by this scale (p = 0.116). No differences were found between sepsis and malnutrition according to CONUT (p = 0.126). There were differences between the AMV in relation to malnutrition according to CONUT score (p = 0.027). The frequency of deaths increased in parallel to the degree of malnutrition according to CONUT (p = 0.004). AMV was the variable that most influenced mortality (OR = 8,5). Conclusions: According to CONUT, most of the patients were malnourished; according to mNutric, patients at low nutritional risk predominated. The predictive value of death in patients receiving AMV was demonstrated. The light and moderate malnutrition and the variable related with the not malnourished group (CONUT scale) were considered as categories associated with lower risk of death with regard to severe malnutrition(AU)


Subject(s)
Humans , Nutrition Assessment , Mass Screening/methods , Critical Care , Nutrition Disorders/diagnosis , Epidemiology, Descriptive , Cross-Sectional Studies , Prospective Studies , Critical Illness
5.
Rev. cient. Esc. Univ. Cienc. Salud ; 7(1): 13-21, ene.-jun. 2020. tab
Article in Spanish | LILACS | ID: biblio-1223260

ABSTRACT

La Diabetes Mellitus es un problema de salud pública, a nivel mundial se estima que existen aproximadamente 425 millones de personas afectadas, en Honduras para el 2015 reportaron 495,011 personas con Diabetes Mellitus, actualmente se registra que 7%-10% de la población la padece. El Hospital Mario Catarino Rivas (HMCR) es el mayor centro asistencial en San Pedro Sula, donde se brindan 1,500 atenciones mensuales a pacientes con la enfermedad. Objetivo: Determinar los factores de riesgo de padecer diabetes en pacientes que asisten al HMCR de octubre del 2018 a enero del 2019. Metodología: se realizó un estudio cuantitativo, descriptivo, transver-sal. Poblacíón: 6000 pacientes que asistieron a consulta externa. Muestra: 600 pacien-tes, calculándose con el programa estadístico Open Epi. Muestreo: fue por conveniencia Instrumento: cuestionario de Factores de Riesgo FINDRISK para identificar factores de riesgo. Resultados: 37.33% obtuvo un puntaje entre 7-11 puntos teniendo riesgo ligeramente elevado para Diabetes Mellitus, 19.67% adquirieron entre 15-20 puntos y 4.68% obtuvieron más de 20 puntos, lo cual representan tener un riesgo alto y muy alto respectivamente, con una media de 10.9 y una desviación estándar de 5.1; el restante 38.32% no tiene riesgopara Diabetes Mellitus tipo 2. Conclusión: Aproxi-madamente la cuarta parte de la población que participó en el estudio tiene riesgo alto y muy alto y la media de la población total del estudio presenta riesgo ligeramente elevado...(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Mass Screening/methods , Diabetes Mellitus , Public Health , Risk Factors
6.
Int. j. odontostomatol. (Print) ; 14(2): 172-176, June 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1090671

ABSTRACT

El objetivo de este estudio es determinar la prevalencia de lesiones orales malignas y potencialmente malignas (LPM) en funcionarios de la Universidad de Valparaíso y de Viña del Mar durante los años 2016 - 2017. Fueron citados 161 funcionarios, quienes accedieron a una encuesta que evaluaba factores de riesgo de cáncer oral (tabaco y alcohol) y si habían escuchado de la patología, sumado a un examen clínico. De los pacientes examinados, se diagnosticaron 121 lesiones de las cuales 2 fueron diagnosticadas como lesiones potencialmente malignas: Liquen plano y Leucoplasia, con una prevalencia de 1,7 %. El 50,3 % de los pacientes sabía de la existencia de cáncer oral. El Screening es una medida que permite dar a conocer a la población la existencia de cáncer oral y alertarlos sobre la importancia de su examen para su identificación de manera temprana.


The objective of this study is to determine the prevalence of malignant and potentially malignant oral lesions (PML) in University of Valparaíso and Viña del Mar employees, during the years 2016 - 2017. We cited 161 employees, who accessed a survey evaluating risk factors for oral cancer (tobacco and alcohol) and if they had heard of the disease. In addition, a clinical examination was carried out. Of the patients examined, 121 lesions were diagnosed, of which 2 were diagnosed as potentially malignant lesions: Lichen planus and Leukoplakia, with a prevalence of 1.6 %. 50.3 % of patients knew of the existence of oral cancer. Epidemiological designs are needed to better establish causality between risk factors and malignant or, potentially malignant lesions.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Precancerous Conditions/epidemiology , Mouth Neoplasms/epidemiology , Mass Screening/methods , Precancerous Conditions/diagnosis , Alcohol Drinking , Mouth Neoplasms/diagnosis , Health Behavior , Epidemiology, Descriptive , Prevalence , Cross-Sectional Studies , Risk Factors , Early Detection of Cancer/methods , Tobacco Use
7.
Gac. méd. Méx ; 156(3): 202-208, may.-jun. 2020. tab, graf
Article in English, Spanish | LILACS | ID: biblio-1249895

ABSTRACT

Resumen Introducción: La depresión posparto es un episodio depresivo no psicótico con repercusiones graves en el vínculo de la madre con su hijo, de ahí la importancia de detectarla oportunamente. Objetivo: Determinar la exactitud de la Escala de Depresión Posnatal de Edimburgo como prueba diagnóstica y analizar las consecuencias del tamizaje y la probabilidad de depresión después de aplicar la prueba. Método: Tamizaje con la Escala de Depresión Posnatal de Edimburgo a 411 mujeres durante el posparto; se utilizó el Inventario de Depresión de Beck como referencia. Resultados: En un punto de corte de 12, con la Escala de Depresión Posnatal de Edimburgo se obtuvo sensibilidad de 70.4 %, especificidad de 72.2 %, valor predictivo positivo de 36.9 % y valor predictivo negativo de 91.4 %, así como un valor del área bajo la curva de 0.729 y p = 0.0003. De 49 mujeres sin atención para depresión posparto, en cinco se identificó que la necesitaban. Conclusiones: La Escala de Depresión Posnatal de Edimburgo tiene una exactitud moderada; su aplicación es sencilla, accesible y debería ser rutinaria. Es necesario que en México se implementen estrategias para detectar y tratar la depresión posparto.


Abstract Introduction Postpartum depression is a non-psychotic depressive episode with serious repercussions on the bond between the mother and her child, hence the importance of detecting it in a timely manner. Objective: To determine the accuracy of the Edinburgh Postnatal Depression Scale as a diagnostic test and to analyze the consequences of screening and the probability of depression after applying the test. Method: Screening of 411 women with the Edinburgh Postnatal Depression Scale during the postpartum period; Beck's Depression Inventory was used as reference. Results: At a cutoff point of 12, a sensitivity of 70.4 %, specificity of 72.2 %, positive predictive value of 36.9 % and negative predictive value of 91.4 % were obtained with Edinburgh Postnatal Depression Scale, as well as an area under the curve of 0.729 and a p-value of 0.0003. Out of 49 women without treatment for postpartum depression, five were identified to require it. Conclusions: The Edinburgh Postnatal Depression Scale has moderate accuracy; its application is simple, accessible and should be routine. It is necessary for strategies to detect and treat postpartum depression to be implemented in Mexico.


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Young Adult , Psychiatric Status Rating Scales , Mass Screening/methods , Depression, Postpartum/diagnosis , Predictive Value of Tests , Sensitivity and Specificity , Mexico
8.
Arch. endocrinol. metab. (Online) ; 64(2): 159-164, Mar.-Apr. 2020. tab, graf
Article in English | LILACS | ID: biblio-1131077

ABSTRACT

ABSTRACT Objective Maternal hypothyroidism during pregnancy may lead to adverse outcomes. Recently published guidelines by the American Thyroid Association (ATA) do not advocate for universal screening but recommend a case-finding approach in high-risk pregnant women. The present study aims to evaluate the accuracy of this approach in identifying women with thyroid dysfunction during early pregnancy. Subjects and methods This is a multiple-center, cross-sectional study. Three hundred and one pregnant women were enrolled. Anamnesis and a physical examination were performed to detect which women fulfilled the criteria to undergo laboratory screening of thyroid dysfunction, according to the ATA's 2017 guidelines. The Zulewski's validated clinical score was applied to assess signs and symptoms of hypothyroidism. Serum levels of thyrotropin (TSH), free thyroxine (FT4), anti-thyroperoxidase (TPO-Ab), and anti-thyroglobulin (Tg-Ab) antibodies were determined. Results Two hundred and thirty one women (78%) were classified as high risk, and 65 (22%) were classified as low risk for thyroid dysfunction. Regarding the clinical score, 75 patients (31.2%) presented mild symptoms that were compatible with SCH, of which 22 (7.4%) had symptoms as the only risk factor for thyroid disease. 17 patients (5.7%) had SCH, of which 10 (58.8%) belonged to the high-risk group, and 7 (41.2%) belonged to the low-risk group. OH was found in 4 patients (1.4%): 3 (75%) in the high-risk group and 1 (25%) in the low-risk group. Conclusions The ATA's proposed screening criteria were not accurate in the diagnosis of thyroid dysfunction in pregnancy. Testing only the high-risk pregnant women would miss approximately 40% of all hypothyroid patients.


Subject(s)
Humans , Female , Pregnancy , Adult , Pregnancy Complications/diagnosis , Mass Screening/methods , Hypothyroidism/diagnosis , Pregnancy Trimester, First , Thyroid Function Tests , Cross-Sectional Studies , Risk Factors , Risk Assessment
9.
Med. infant ; 27(1): 17-24, Marzo de 2020. tab
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1118590

ABSTRACT

Introducción: El niño hospitalizado se encuentra en estado de vulnerabilidad nutricional. El tamizaje nutricional permite identificar malnutrición y/o el riesgo de desarrollarla, para realizar un abordaje precoz. El Área de Alimentación del Hospital Garrahan desarrolló la "Herramienta de Tamizaje Nutricional Pediátrico" (HTNP), dada la falta de consenso sobre un estándar de oro y para ajustar criterios a la población asistida. El objetivo de esta investigación fue su validación para niños en cuidados intermedios/ moderados. Métodos: estudio prospectivo, descriptivo y transversal. Entre agosto de 2016 y abril de 2018 se reclutaron niños de 1 a 18 años internados en salas de cuidados intermedios/moderados seleccionadas, que cumplieran los criterios de inclusión. Se aplicaron: la HTNP y la valoración nutricional global subjetiva (VNGS) como prueba de comparación. La HTNP consta de tres criterios: Patología de base y motivo de internación- Disminución de peso- Deterioro de la actitud alimentaria. Se define riesgo nutricional si se cumple con dos criterios. Se analizaron: Sensibilidad, especificidad, valor predictivo positivo (VPP) y valor predictivo negativo (VPN), factibilidad y reproducibilidad. Resultados: Se evaluaron 745 niños (50,1% sexo femenino; mediana de edad: 7,2 años). La HTNP detectó riesgo nutricional en 50,7% (n378) de los niños y la VNGS en 48,7% (n363). La HTNP presentó: Sensibilidad 87,3% (IC95% 83,8-90,9), Especificidad 84,0% (IC95% 80,2-87,8), VPP 83,9% (IC95%: 80,0­87,7) y VPN 87,5% (IC95%: 83,9-91,0). Del análisis de reproducibilidad con dos evaluadores independientes (n42) se obtuvo coeficiente kappa de 0,91 (0,74-1,0) y 0,78 (0,5-1,0) respectivamente. Su implementación llevo un promedio de tres minutos y medio (1-5 minutos). Conclusión: La HTNP es un instrumento simple, reproducible, práctico y factible de implementar para identificar pacientes en riesgo nutricional (AU)


Introduction: Hospitalized children are nutritionally vulnerable. Nutritional screening may identify malnutrition and/or the risk of developing malnutrition in order to start early intervention. The Food Services Area of Garrahan Hospital has developed a "Pediatric Nutritional Screening Tool (PNST) because of the lack of consensus on a gold standard and to finetune the criteria to the care population. The aim of this study was to validate the tool in children in intermediate/moderate care. Methods: A prospective, descriptive, cross-sectional study was conducted. Between August 2016 and April 2018 children from 1 to 18 years of age who met the inclusion criteria were enrolled on selected intermediate/ moderate care wards. The PNST was administered together with the Subjective Global Assessment (SGA) as a comparison test. The PNST consists of three criteria: Underlying disease and reason for admission- Weight loss- Deterioration of eating behavior. A patient was defined as being at nutritional risk was defined if two criteria were met. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), feasibility, and reproducibility were analyzed. Results: 745 children (50.1% female; median age: 7.2 years) were assessed. The PNST detected nutritional risk in 50.7% (n378) and the SGA in 48,7% (n363) of the children. The PNST showed: Sensitivity 87.3% (95%CI: 83.8-90.9), specificity 84.0% (95%CI: 80.2-87.8), PPV 83.9% (95%CI: 80.0­87.7), and NPV 87.5% (95%CI: 83,9-91,0). In a reproducibility analysis with two independent evaluators (n42) kappa coefficients of 0.91 (0.74-1.0) and 0.78 (0.5-1.0) were obtained, respectively. Administration of the tool took a mean of 3.5 inutes (1-5 minutes). Conclusion: The PNST is a simple, reproducible, practical, and feasible tool to use for the identification of patients at nutritional risk (AU)


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Child Nutrition Disorders/diagnosis , Nutrition Assessment , Child, Hospitalized , Mass Screening/methods , Nutritional Status , Risk Assessment/methods , Cross-Sectional Studies , Prospective Studies
10.
Rev. méd. Chile ; 148(2): 151-159, feb. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1115771

ABSTRACT

Background: Contact investigation is cardinal in the control of tuberculosis (TB) since it helps to stop its transmission. In Chile, the National TB Program strategy does not include latent TB infection testing, regular chemoprophylaxis or follow-up in adults. Active TB was found in only 1.2% of contacts at country-level during 2018. Aim: To evaluate the performance of a systematic screening of adult household contacts with targeted chemoprophylaxis and prolonged active follow-up. Material and Methods: Prospective cohort of household contacts in Santiago. Two face-to-face visits (at 0 and 12 weeks) that included QuantiFERON TB-Gold plus tests (QFT), chest radiography (CXR) at 0 and 24 weeks and, periodic text messaging or phone call follow-up for up to 48 weeks were implemented. Contacts with positive QFT were referred for TB chemoprophylaxis. Results: A total of 200 contacts were enrolled, 69% were migrants. At baseline evaluation, 45% had a positive QFT result and 1.6% had co-prevalent active TB. At follow-up, 13% contacts further converted to QFT (+), and 5.1% more were diagnosed with active TB (mean follow-up time 32 weeks). Of these 10 further active TB cases, 6 (60%) had a negative QFT and all (100%) had normal CXR at baseline; while three cases occurred in QFT converters. Conclusions: In this cohort of household contacts, 6.7 % were diagnosed with active TB (more than 2/3 at follow-up) and 13% had a late QFT (+) conversion. Active and prolonged contacts' follow-up are essential to detect new infections and tackle the TB epidemic in Chile.


Subject(s)
Humans , Adolescent , Adult , Middle Aged , Young Adult , Sputum/microbiology , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/epidemiology , Mass Screening/methods , Contact Tracing , Tuberculosis, Pulmonary/microbiology , Tuberculin Test , Family Characteristics , Family Health , Prevalence , Follow-Up Studies
11.
Int. braz. j. urol ; 46(1): 34-41, Jan.-Feb. 2020. tab
Article in English | LILACS | ID: biblio-1056354

ABSTRACT

ABSTRACT Purpose: Prostate cancer screening in the elderly is controversial. The Brazilian government and the National Cancer Institute (INCA) do not recommend systematic screening. Our purpose was to assess prevalence and aggressiveness of prostate cancer in men aged 70 years and above, on the first Latin American database to date. Materials and Methods: Cross-sectional study (n=17,571) from 231 municipalities, visited by Mobile Cancer Prevention Units of a prostate-specific antigen (PSA) based opportunistic screening program, between 2004 and 2007. The criteria for biopsy were: PSA>4.0ng/ml, or PSA 2.5-4.0ng/ml with free/total PSA ratio ≤15%, or suspicious digital rectal examination findings. The screened men were stratified in two age groups (45-69 years, and ≥70 years). These groups were compared regarding prostate cancer prevalence and aggressiveness criteria (PSA, Gleason score from biopsy and TNM staging). Results: The prevalence of prostate cancer found was 3.7%. When compared to men aged 45-69 years, individuals aged 70 years and above presented cancer prevalence about three times higher (prevalence ratio 2.9, p<0.01), and greater likelihood to present PSA level above 10.0ng/ml at diagnosis (odds ratio 2.63, p<0.01). The group of elderly men also presented prevalence of histologically aggressive disease (Gleason 8-10) 3.6 times higher (p<0.01), and 5-fold greater prevalence of metastases (PR 4.95, p<0.05). Conclusions: Prostate cancer screening in men aged over 70 may be relevant in Brazil, considering the absence of systematic screening, higher prevalence and higher probability of high-risk disease found in this age range of the population studied.


Subject(s)
Humans , Male , Aged , Aged, 80 and over , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/epidemiology , Mass Screening/methods , Prostatic Neoplasms/pathology , Biopsy , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Risk Factors , Age Factors , Prostate-Specific Antigen/blood , Risk Assessment , Digital Rectal Examination , Early Detection of Cancer , Neoplasm Grading , Middle Aged , Neoplasm Staging
12.
Rev. chil. pediatr ; 91(1): 76-84, feb. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1092790

ABSTRACT

Resumen: Introducción: El tamizaje del desarrollo infantil en encuestas nacionales es un insumo para la formulación de po líticas públicas que contribuyan a su diagnóstico e intervención precoz, dirigidos a favorecer un de sarrollo integral y desempeño escolar exitoso hasta la adolescencia, no obstante, pocos países en La tinoamérica cuentan con esta información. Objetivo: Evaluar la confiabilidad y validez convergente de una adaptación cultural del Cuestionario de Tamizaje de Desarrollo Infantil para Encuestas en Hogares (DIEH) y describir la prevalencia de alteraciones en el desarrollo en niños de 2 meses a 5 años en Bucaramanga-Colombia. Sujetos y Método: Se realizó una evaluación de pruebas diagnósti cas. Participaron 224 niños de dos meses hasta los cinco años y sus padres o cuidadores procedentes de Bucaramanga - Colombia, entre julio y diciembre de 2016. La Escala Abreviada del Desarrollo (EAD) fue aplicada por fisioterapeutas entrenados y el DIEH, fue respondido por los padres o cui dadores. A partir del alpha de Cronbach, el Coeficiente de Correlación Intraclase (CCI) y los límites de acuerdo Bland y Altman se estableció la confiabilidad del DIEH; con el Coeficiente de Correlación de Spearman la validez convergente. Resultados: A partir del DIEH las prevalencias de rezagos y retrasos fueron 38.8% y 11.2% respectivamente; la consistencia interna osciló entre 0.23 y 0.76. La reproducibilidad registró CCI entre 0.60 y 0.92; la validez convergente fue casi perfecta (p: 0.96). Conclusiones: La adaptación cultural del DIEH mostró propiedades psicométricas aceptables, que podrían complementarse con estudios adicionales para recomendar su uso en encuestas nacionales en Latinoamérica.


Abstract Introduction: The child development screening in national surveys supports the formulation of public policies that contribute to its diagnosis and early intervention, aimed at promoting comprehensive development and successful school performance until adolescence, however, few countries in Latin America have this information. Objective: To assess the reliability and convergent validity of a cultural adaptation of the Screening Questionnaire of Child Development for Household Surveys (DIEH) and to des cribe the prevalence of developmental alterations in children aged between 2 months and 5 years in Bucaramanga-Colombia. Subjects and Method: Between July and December 2016, an evaluation of diagnostic tests was carried out in which participated 224 children aged between two months and five years and their parents or caregivers from Bucaramanga, Colombia. The Abbreviated Developmental Scale was applied by trained physiotherapists and the DIEH was answered by the parents or caregi vers. The reliability of the DIEH was established using the Cronbach's alpha, the Intraclass Correla tion Coefficient (ICC) and the Bland and Altman limits of agreement, and the convergent validity was established through the Spearman Correlation Coefficient. Results: Based on the DIEH, the pre valence of lags and delays was 38.8% and 11.2% respectively, internal consistency ranged from 0.23 to 0.76; reproducibility showed an ICC between 0.60 and 0.92; and the convergent validity was almost perfect (p: 0.96). Conclusion: The cultural adaptation of the DIEH showed acceptable psychometric properties, which could be complemented with additional studies to recommend its use in national surveys in Latin America.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Psychological Tests , Child Development , Developmental Disabilities/diagnosis , Mass Screening/methods , Psychometrics , Developmental Disabilities/epidemiology , Reproducibility of Results , Colombia/epidemiology , Early Diagnosis
13.
Article in Chinese | WPRIM | ID: wpr-879911

ABSTRACT

The electronic stethoscope combined with artificial intelligence (AI) technology has realized the digital acquisition of heart sounds and intelligent identification of congenital heart disease, which provides objective basis for heart sound auscultation and improves the accuracy of congenital heart disease diagnosis. At the present stage, the AI based cardiac auscultation technique mainly focuses on the research of AI algorithms, and the researchers have designed and summarized a variety of effective algorithms based on the characteristics of cardiac audio data, among which the mel-frequency cepstral coefficients (MFCC) is the most effective one, and widely used in the cardiac auscultation. However, the current cardiac sound analysis techniques are based on specific data sets, and have not been validated in clinic, so the performance of algorithms need to be further verified. The lack of heart sound data, especially the high-quality, standardized, publicly available heart sound database with disease labeling, further restricts the development of heart sound diagnostic analysis and its application in screening. Therefore, expert consensus is necessary in establishing an authoritative heart sound database and standardizing the heart sound auscultation screening process for congenital heart disease. This paper provides an overview of the research and application status of auscultation algorithm and hardware equipment based on AI in auscultation screening of congenital heart disease, and puts forward the problems to be solved in clinical application of AI auscultation screening technology.


Subject(s)
Algorithms , Artificial Intelligence , Heart Auscultation/trends , Heart Defects, Congenital/diagnosis , Humans , Mass Screening/methods
14.
Ciênc. Saúde Colet ; 25(9): 3445-3458, Mar. 2020. graf
Article in Portuguese | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1133168

ABSTRACT

Resumo A pandemia da "novel coronavirus disease" 2019 (COVID-19), infecção causada pelo coronavírus 2 da síndrome respiratória aguda grave (SARS-CoV-2), tem descortinado uma realidade até então oculta: a vulnerabilidade da população residente em instituições de longa permanência para idosos (ILPI). Diversas publicações científicas têm revelado a concentração de até 60% dos óbitos atribuídos à COVID-19 em tais instituições. A maioria dos residentes em ILPI reúnem os principais fatores de risco para morbimortalidade pela COVID-19, o que torna imprescindível a definição de ações voltadas à prevenção da transmissibilidade do SARS-CoV-2 neste ambiente, além das medidas usuais de distanciamento social e isolamento dos portadores da doença. Propõem-se, no presente artigo, estratégias de rastreamento da infecção em residentes e trabalhadores de ILPI por meio de testes laboratoriais disponíveis no Brasil. A identificação precoce de indivíduos portadores do SARS-CoV-2 com possibilidades de transmissão ativa e continuada do vírus permite a adoção de medidas que interrompam o ciclo de transmissão local da infecção.


Abstract An infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the 2019 Novel Coronavirus Disease (COVID-19) pandemic has unveiled a hitherto hidden reality: the vulnerability of the population living in long-term care facilities for the elderly (LTCF). To date, several scientific publications have revealed a concentration of up to 60% of deaths attributed to COVID-19 in such institutions. Most LTFC residents share the primary risk factors currently associated with increased morbimortality due to the COVID-19 infection. It is crucial to define actions to prevent SARS-CoV-2 spread in this environment, besides the usual measures of social distancing and isolation of the carriers of this disease. This paper proposes strategies for the investigation of this infection in LTCF residents and workers using laboratory tests available in Brazil. The early identification of individuals with SARS-CoV-2, who may actively and continuously spread the virus, allows adopting measures aimed at interrupting the local transmission cycle of this infection.


Subject(s)
Humans , Aged , Pneumonia, Viral/epidemiology , Mass Screening/methods , Coronavirus Infections/epidemiology , Clinical Laboratory Techniques , Homes for the Aged/statistics & numerical data , Pneumonia, Viral/mortality , Pneumonia, Viral/prevention & control , Health Personnel , Long-Term Care , Coronavirus Infections , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Coronavirus Infections/prevention & control , Vulnerable Populations , Pandemics/prevention & control , Betacoronavirus , Betacoronavirus/isolation & purification
15.
CoDAS ; 32(4): e20190105, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1133515

ABSTRACT

RESUMO Objetivo: Analisar a adequação dos itens propostos para o Instrumento de Avaliação Fonológica (INFONO) quanto ao reconhecimento e à produção da palavra-alvo, bem como analisar a consistência interna dos itens selecionados e comparar entre as variáveis sexo, tipo de escola e desenvolvimento fonológico (típico e atípico). Método: Participaram 48 crianças (n=26 com desenvolvimento fonológico típico e n=22 com desenvolvimento fonológico atípico) categorizadas por: idade (seis faixas etárias de 3 a 8 anos e 11 meses); tipo de escola (pública e privada), e sexo (feminino e masculino). Utilizou-se o INFONO por nomeação espontânea para a coleta dos dados da fala. Analisou-se o percentual de reconhecimento e produção dos itens (n=116), as dificuldades de reconhecimento destes, a consistência interna para o total de itens, e o desempenho das crianças (n=84), considerando as variáveis sexo, tipo de escola e desenvolvimento fonológico. Resultados: A maioria dos itens apresentou um percentual de reconhecimento alto, sendo estes considerados adequados para compor o INFONO. Algumas imagens precisaram ser reelaboradas para facilitar a produção espontânea do alvo e outras foram excluídas do instrumento. O instrumento demonstrou excelente consistência interna dos itens. Não houve diferença estatisticamente significante entre as variáveis sexo e tipo de escola, mas sim quanto ao desenvolvimento fonológico. Conclusão: O INFONO permitiu a correta identificação das imagens e a produção do alvo desejado. Ainda, obteve-se uma quantidade mínima de itens que possibilitam a avaliação de todos os fonemas do Português Brasileiro em diferentes posições na sílaba e na palavra, e esses itens apresentaram excelente consistência interna.


ABSTRACT Purpose: To analyze the recognizability and effectiveness of items in the Phonological Assessment Tool (Instrumento de Avaliação Fonológica - INFONO) at eliciting target words, as well as to evaluate the internal consistency of the instrument and compare performance between genders, school types and typical vs. atypical phonological development. Method: Participants were 48 children (n=26 with typical phonological development and n=22 with atypical development) categorized by age (6 age groups ranging from 3 years and 8 years 11 months), type of school (public vs. private) and gender (male vs. female). Data were collected by the spontaneous naming task of the INFONO. Recognition rates, scores, recognition difficulties and internal consistency were examined in 116 items. Performance in a final set of 84 items was also compared between genders, school types and typical/atypical phonological development. Results: Most target words achieved high recognition rates were considered suitable for use in the INFONO. Some images had to be redesigned to facilitate the spontaneous production of target words, while other items were excluded from the instrument altogether. The instrument demonstrated excellent internal consistency. There were no statistically significant differences between genders and school types, though differences were observed between typically and atypically developing children. Conclusion: The images in the INFONO were successfully recognized by participants and were effective at eliciting the target words. The final set of items contained the minimum number of target words which would allow for an assessment of all phonemes in Brazilian Portuguese in different word and syllable positions, and these items presented excellent internal consistency.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Phonetics , Mass Screening/methods , Psychometrics , Schools , Brazil , Pilot Projects , Predictive Value of Tests
17.
Clinics ; 75: e1426, 2020. tab, graf
Article in English | LILACS | ID: biblio-1101096

ABSTRACT

OBJECTIVES: To compare the diagnostic accuracy of a low-cost screening test for identifying children at risk for language disorders with that of a specific language assessment. METHODS: The study was conducted during a polio vaccination campaign in basic health units in western São Paulo, Brazil. The parents/guardians of 1000 children aged between 0 and 5 years were asked to answer questions of a specific screening test. The instrument consisted of a uniform set of questions about the main milestones in language development (from 0 to 5 years of age) with scaled scores to assess responses. There were no exclusion criteria. After the screening test, the children were referred to a specific language assessment by ABFW, following a determined flow of referrals. The results obtained in the screening were compared to those obtained in the specific language assessment; then, the sensitivity, specificity, accuracy, and positive and negative predictive values were determined for the screening test. Children who failed the screening test also underwent an audiological evaluation. The statistical significance was set at 5%. RESULTS: The majority of the participants were aged between 4 and 5 years (21.82%) and were male (51.6%). The sensitivity and specificity values were 82.5% and 98.93%, respectively. The area under the curve was 0.907 (0.887-0.925), and the screening test showed 96% accuracy. CONCLUSIONS: The screening test showed high diagnostic efficiency in determining the risk of language disorders in children aged between 0 and 5 years.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Mass Screening/methods , Language Disorders/diagnosis , Primary Health Care , Referral and Consultation , Brazil , Mass Screening/standards , Risk Factors , Sensitivity and Specificity
18.
Ciênc. Saúde Colet ; 25(9): 3475-3480, Mar. 2020. tab
Article in Portuguese | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1133145

ABSTRACT

Resumo O estudo tem por objetivo identificar elementos precipitadores/intensificadores da violência conjugal em tempos de pandemia da Covid-19. Trata-se de uma revisão narrativa da literatura, tendo a busca sido realizada no mês de maio de 2020. Utilizou-se a plataforma PubCovid-19, a qual está indexada na Biblioteca Nacional de Medicina dos Estados Unidos (PubMed) e no Banco de dados Excerpta Medica (EMBASE). Para a realização da busca foram utilizados os seguintes descritores em inglês: "Domestic violente"; "Covid-19" e "Intimate Partner Violence". Foram selecionados nove artigos para leitura na íntegra. A partir da exploração do material selecionado, foram elaboradas três categorias empíricas a saber: Instabilidade econômica, Uso/abuso de álcool e outras drogas e Enfraquecimento da rede de apoio da mulher. É importante que nesse contexto de pandemia, sejam ampliadas as redes de apoio à mulher em situação de violência conjugal, com destaque para o uso de tecnologias digitais como possíveis ferramentas para a triagem de casos de violência em tempos de pandemia.


Abstract The study aims to identify marital violence precipitating/intensifying elements during the COVID-19 pandemic. This is a narrative review of the literature, and the search was carried out in May 2020. We employed the PubCovid-19 platform, which is indexed in the United States National Library of Medicine (PubMed) and the Excerpta Medica (EMBASE) database. English descriptors "Domestic violence", "COVID-19", and "Intimate Partner Violence" were used in the search, and nine papers were selected for full-text reading. Three empirical categories were elaborated from the exploration of the selected material: Economic instability, Alcohol and other drugs use/abuse, and Weaker women's support network. Support networks for women in situations of marital violence should be expanded in this pandemic context, with emphasis on the use of digital technologies as possible tools for screening pandemic-related violence cases.


Subject(s)
Humans , Male , Female , Pneumonia, Viral/epidemiology , Spouse Abuse/statistics & numerical data , Mass Screening/methods , Coronavirus Infections/epidemiology , Alcohol Drinking/epidemiology , Risk Factors , Coronavirus Infections , Substance-Related Disorders/epidemiology , Pandemics
19.
Prensa méd. argent ; 105(11): 816-826, dic2019. fig, tab, graf
Article in English | LILACS, BINACIS | ID: biblio-1049970

ABSTRACT

Background: To investigate the potential of the phage display-identified tumor cellbinding peptide as a biomarker of epithelial ovarian cancer using phage display technology. Method: The Ph.D.-7 Phage Display Peptide Library was used to identify the specific conjugated phages with SKOV3 epithelial ovarian cancer cells, while Chinese hamster ovary cells formed the basis. After employing the rapid differential screening method invitro, the enzyme-linked immunosorbent assay (ELISA), DNA sequencing, immunohistochemistry, immunofluorescence, and the competitive inhibition test of synthetic peptides were used to determine the affinity and specificity of the phages with SKOV3 cells. Results: Using bio panning, we screened the phages, showing a 3590-fold increase after the third round. A total of 61 titers of the phage were randomly selected for ELISA and 10 kinds of the phages with an optical density >0.5 were used for DNA sequencing. Clones of the phage TRRNIPN were derived from DNA sequencing based on ELISA, exhibiting both the brown granular phenomenon and green fluorescence. The specific targeted peptide TRRNIPN was incorporated in tumor cells through the competitive inhibition test. Conclusion: The results of our study indicate that the phage display identified polypeptide TRRNIPN may be an effective biomarker for the early diagnosis and targeted therapy of ovarian cancer


Subject(s)
Humans , Female , Bacteriophages , DNA/analysis , Enzyme-Linked Immunosorbent Assay , Biomarkers, Tumor , Mass Screening/methods , Peptide Library , Early Diagnosis , Research Report , /therapy
20.
Rev. méd. Urug ; 35(4): 267-280, dic. 2019. tab, fig
Article in Spanish | LILACS | ID: biblio-1026117

ABSTRACT

Introduccción: en Uruguay, el cáncer de cuello uterino ocupó el tercer lugar con una incidencia promedio de 312 nuevos casos por año; fallecieron 134 mujeres promedio por año en el período 2010 - 2014. Objetivo: el objetivo de este trabajo fue analizar los primeros resultados de una experiencia piloto con la aplicación del test de HPV captura híbrida HC2 (QiagenR) como test de tamizaje primario del cáncer de cuello uterino en una zona del departamento de Canelones. Método: se estudiaron 1.010 mujeres asintomáticas entre 30 y 64 años que concurrieron a realizarse el test de PAP a dos unidades de toma de muestras del Programa de prevención del cáncer de cuello uterino. Se realizó la extracción conjunta de la muestra para PAP, que fue derivada a uno de los laboratorios de citología de la Red de Atención Primaria de Salud y la muestra de HPV que fue procesada con la técnica de captura híbrida en el laboratorio de biología molecular del Centro Hospitalario Pereira Rossell. Las usuarias con resultados HPV + y PAP anormales (ASC-US+) fueron derivadas a colposcopia, con biopsia y posterior tratamiento cuando correspondió. Resultados: el test de HPV fue positivo en 126/1.010 mujeres (12,5%) y el PAP anormal en 167/1.010 (16,5%). El test de HPV fue positivo en todos los casos CIN2+ 13/13 (100%) mientras que el PAP fue anormal (ASCUS+) en 7/13 (54%) para CIN2+ por biopsia. Conclusión: el test de HPV resultó más eficaz y eficiente que el PAP para la detección de lesiones precancerosas de cuello uterino.


Introduction: in Uruguay, cervical cancer occupied the third place with an average incidence of 312 new cases per year. 134 women died in the 2010 -2014 period. Objective: the study aims to analyse the first results in a pilot experience with the application of Hybrid Capture® 2 High-Risk HPV DNA Test™ (hc2) (QiagenR) as the primary screening test for cervical cancer, in the Department of Canelones. Method: 1.010 asymptomatic women whose ages ranged between 30 and 64 years old were studied when they requested a pap smear at two units of sample taking within the Cervical Cancer Prevention Program. Samples were taken along with the pap smear, and sent to one of the cytology labs in the primary health care network, the HPV sample being processed with the hybrid capture technique in the molecular biology laboratory of the Pereira Rossell Hospital Center. Users with abnormal HPV+ and abnormal pap smear results (ASCUS+) were referred to colposcopy, with subsequent biopsy and treatment if required. Results: HPV test was positive in 126/1010 women (12.5%) and PAP was abnormal in 167/1010 cases (16.5%). HPV test was positive in all cases CIN2+ 13/13 (100%) whereas PAP was abnormal (ASCUS+) in 7/13 54%) for CIN2+ in biopsy. Conclusion: HPV test was more effective and efficient than pap smear to detect pre-cancer lesions in the cervix.


Introdução: no Uruguai, no período 2010 - 2014, o câncer de colo do útero foi a terceira causa com uma incidência média de 312 novos casos por ano e uma média de 134 mortes por ano. Objetivo: o objetivo deste trabalho foi analisar os primeiros resultados de uma experiência piloto com a utilização do exame de HPV Captura Híbrida HC2 (QiagenR) na tamizagem primária do câncer de colo do útero em una zona do departamento de Canelones. Método: foram estudadas 1010 mulheres assintomáticas, com idades entre 30 e 64 anos que foram a duas unidades do Programa de Prevenção do Câncer do Colo do Útero para a coleta de amostra para exame de Papanicolau (PAP). Realizou-se uma única extração para duas amostras: uma para PAP, que foi encaminhada a um laboratório de citologia da rede de atenção primária de saúde e outra para o exame de HPV que foi processada com a técnica de captura híbrida no laboratório de biologia molecular do Centro Hospitalario Pereira Rossell. As usuárias com resultados HPV + e PAP anormais (ASCUS+) foram encaminhadas para realização de colposcopia, com biopsia e tratamento quando fosse necessário. Resultados: o exame de HPV foi positivo em 126/1010 mulheres (12.5%) e o PAP foi anormal em 167/1010 (16.5%). O exame de HPV foi positivo em todos los casos CIN2+ 13/13 (100%) e o PAP foi anormal (ASCUS+) em 7/13 (54%) para CIN2+ por biopsia. Conclusão: o exame de HPV foi mais eficaz e eficiente que o PAP para detecção de lesões pré-cancerosas de colo do útero.


Subject(s)
Humans , Female , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control , Mass Screening/methods , Papillomavirus Infections/diagnosis , Papanicolaou Test
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