ABSTRACT
Introducción En Latinoamérica uno de los problemas principales de salud pública es el cáncer del cuello uterino (CACU); México no es la excepción ya que se ha decrementado sutilmente su incidencia de esta neoplasia maligna. La mayoría de enfermas que se internan en hospitales oncológicos son casos avanzados por lo que el tratamiento no es tan eficaz como sucedería en estadios precoces. Objetivo Analizar la incidencia de CACU de las enfermas que fueron atendidas en el Centro Estatal de Cancerología (CECAN) ubicado en Xalapa, Veracruz del 1 enero del 2006 al 31 de diciembre del 2010. Las variables fueron: zona de origen, tipo histopatológico, no contar con algún tipo de seguridad social, edad, ocupación, citología cervical previa, tratamiento. Resultados Se registraron 693 casos de CACU, clasificadas en 258 pacientes rurales (37,2%), 139 suburbanas (20,1%) y 296 urbanas (42,7%). El 97,8% de enfermas se dedican a las labores domésticas. La edad media general fue de 45-49 años, zona urbana de 47,5, suburbana 49,6. El 51% no se efectuó la citología cervical, la congruencia histológica del 44%, falsos negativos 35,6%, el estadio IIB fue de más frecuente, carcinoma epidermoide 79,2%, adenocarcinoma 14%. Mayor frecuencia de tratamiento quimioterapia seguida de radioterapia. Conclusión La capacitación del personal en la toma de la muestra de citología cervical debe tener una calidad suficiente para su correcto diagnóstico y así evitar en lo posible los falsos negativos y el alto índice de infecciones cervicovaginales dificulta en gran medida el diagnóstico citológico (AU)
Introduction One of the main public health problems in Latin America is cervical cancer (CC). Mexico is no exception, since the incidence of this disease has decreased subtly. Most patients admitted to cancer hospitals have advanced disease and consequently treatment is less effective than in earlier stages. Objective To analyze the incidence of cervical cancer in patients treated at the Centro Estatal de Cancerologìa in Xalapa, Veracruz, Mexico, from January 1st, 2006 to December 31th, 2010. The variables analyzed were area of origin, histopathologic type, having no social security, age, occupation, cervical cytology, and prior treatment. Results There were 693 cases of cervical cancer classified in 258 patients from rural areas (37.2%), 139 from suburban areas (20.1%) and 296 from urban areas (42.7%). Most (97.8%) were housewives. The overall mean age was 45-49 years, 47.5 in urban areas, and 49.6 in suburban areas. Cervical cytology was not performed in 51% and histological congruence was 44%. The percentage of false-negative results was 35.6%. The most frequent stage was stage IIB. Squamous cell carcinoma accounted for 79.2% and adenocarcinoma for 14%. There was a greater frequency of chemotherapy followed by radiation treatment. Conclusion Staff should be trained to extract samples for cervical cytology of sufficient quality to allow correct diagnosis and thus avoid false negative results and the high rate of cervicovaginal infections, which hamper cytological diagnosis (AU)
Subject(s)
Humans , Female , Uterine Cervical Neoplasms/epidemiology , Vaginal Smears/methods , Cytological Techniques/methods , Mass Screening/methods , Reproductive Tract Infections/diagnosisABSTRACT
BACKGROUND: Few studies have offered comparative information on the mechanical characteristics of different wheelchair seat cushions. The objective of the present study was to compare the benefits of the wheelchair seat cushions most frequently used in a population of patients with spinal cord injury in terms of pressure distribution and contact surface at the user-cushion interface. METHODS: Each one of 48 patients with spinal cord injury was seated in his or her own wheelchair on the four models of cushions analyzed (low-profile air, high-profile air, dual-compartment air, and gel and firm foam), which were presented in randomized order. The pressure distribution readings and support surface area of the user-cushion interface were obtained with a matrix of piezocapacitive sensors. FINDINGS: The dual-compartment air cushion yielded lower readings for all pressure parameters analyzed (P(max), P(mean), P(sd), and P(isch)) than the other three cushion models (P<0.05). The best surface parameter results (S(tot), S>60 and %S>60) also were obtained with the dual-compartment air cushion (P<0.05). INTERPRETATION: In the sample analyzed, the dual-compartment air cushion was the cushion with the best pressure distribution and largest contact surface of the user-cushion interface compared to the other three cushions studied.
Subject(s)
Posture , Pressure Ulcer/prevention & control , Pressure Ulcer/physiopathology , Protective Devices , Spinal Cord Injuries/nursing , Spinal Cord Injuries/physiopathology , Wheelchairs , Equipment Design , Equipment Failure Analysis , Female , Humans , Male , Pressure , Pressure Ulcer/etiology , Spinal Cord Injuries/complications , Young AdultABSTRACT
La revisión sistemática y el metaanálisis forman parte de la investigación secundaria, la cual parte del estudio de las pruebas disponibles sobre una determinada intervención sanitaria, con el objeto de responder a cuestiones concretas, siguiendo una metodología explícita y rigurosa. El primer paso en su elaboración es la formulación de la pregunta de investigación, que definirá los criterios de inclusión de los estudios de nuestra revisión: metodología del estudio, participantes, intervenciones, comparaciones a estudiar y medidas de resultado. Estas características marcarán el protocolo de estudio y su correcta definición facilitará el resto del proceso. La siguiente etapa consiste en la búsqueda de estudios en la literatura científica sobre el tema a tratar, y la lectura crítica de los mismos para descartar en ocasiones simplemente con la lectura del título o el abstract y en otras revisando el artículo completo aquellos que no reúnen nuestros criterios de selección y quedarnos con los que finalmente serán incluidos. Estos estudios constituirán nuestra revisión, de ellos se extraerán los datos necesarios y se evaluarán tanto cualitativa como cuantitativamente. En aquellos casos en los que exista homogeneidad entre los estudios incluidos, y al menos dos de ellos presenten datos razonablemente combinables, se realizará un análisis cuantitativo denominado "metaanálisis", generalmente mediante la ayuda de programas estadísticos informatizados que facilitan este trabajo, y que permiten visualizar los resultados gráficamente en los denominados forest plot. La última fase de una revisión, al igual que en el resto de estudios epidemiológicos, consiste en interpretar los resultados obtenidos y extraer las correspondientes conclusiones, que en este tipo de estudios tendrán repercusiones tanto para la investigación, como para la práctica clínica
The systematic review and meta-analysis form a part of secondary research which begins with the study of the evidence available on a certain health care intervention in order to respond to specific questions by means of an explicit and rigorous methodology. The first step in its elaboration is the writing of the research question that will define the inclusion criteria of the studies of our review: study methodology, participants, interventions, comparisons to be studied and measurements of the results. These characteristics will define the study protocol and their correct definition will facilitate the rest of the procedure. The following stage consists in the search for studies in the scientific literature on the subject in question and the critical reading of them to rule out, sometimes only by reading the title or abstract and others by reading the complete article, those that do not fulfill our selection criteria. Finally, those remaining will be included in the study. These studies will make up our review and will be used to obtain the necessary data and to evaluate them both qualitatively and quantitatively. In those cases where there is homogeneity between the studies included and where at least two of them have reasonably combinable data, a quantitative analysis called meta-analysis will be conducted. This is generally done with the help of computerized statistical programs that aid this work and that make it possible to visualize the results graphically in the so-called forest plot. The last phase of the review, as in the rest of the epidemiological studies, consists in interpreting the results obtained and in drawing the corresponding conclusions. In this type of studies, they will have repercussions in both the research and clinical practice
