Skin Cancer and Dermoscopy Training for Primary Care Physicians: A Pilot Study.

INTRODUCTION: The primary objective of this study was to determine the diagnostic accuracy and effect of an educational training on skin cancer course and dermoscopy use among primary care physicians in rural areas of Colombia. The secondary objective was to assess the diagnostic accuracy of skin cancer diagnosis and detection rate after 3 months of the initial training. METHODS: Twenty-one primary care physicians from 6 rural areas of Colombia participated in a 2-day skin cancer and dermoscopy training, followed by a day-long hands-on session on dermoscopy at a free skin cancer screening event. Pre- and post-tests were performed using clinical and dermoscopic images to evaluate the user's ability to diagnose and differentiate benign and malignant neoplasms. In addition, participants' levels of confidence were assessed. RESULTS: After the training, the sensitivity and specificity of characterizing skin lesions as benign or malignant or providing a specific diagnosis (ie, angioma, seborrheic keratosis, basal cell carcinoma, etc.) increased by 23.6% (62.9% to 86.5%; P < 0.0001) and 21% (54.7% to 75.7%; P < 0.0017), respectively. In addition, levels of confidence when diagnosing skin lesions changed from extremely low or low, to high or extremely high by 20.7% (38.3% to 59%) using dermoscopic images (odds ratio (OR) 3.22; 95% confidence interval (CI): 2.67-3.86; P < 0.0001). The secondary objective was not achieved due to loss of follow-up of the majority of participants. CONCLUSION: Providers serving populations with limited healthcare access may benefit from education in diagnosing and differentiating skin cancer with the use of dermoscopy, which may ultimately improve patient care and reduce healthcare costs.

Actualización del reporte de biopsiapor aspiración con aguja fina de mama / Report of breast fine needle aspiration biopsy: an update

Las recomendaciones para la biopsia por aspiración con aguja fina de mama se desarrollaron y aprobaron en 1997 por el Instituto Nacional de Cáncer en Bethesda, Estados Unidos y fueron adaptadas a nuestro país en 2007, sin embargo, en los últimos años no se han realizado cambios formales en estas indicaciones. El objetivo de este módulo es presentar la actualización del reporte de biopsia por aspiración con aguja fina de mama, usando el sistema de reporte Bethesda, realizado por consenso con un grupo de patólogos, clínicos, radiólogos, cirujanos de mama y otros profesionales de la salud de Colombia y otros países, y con base en la experiencia realizando biopsia por aspiración con aguja fina de mama del Hospital Pablo Tobón Uribe y de Dinámica IPS.

Recommendations for breast fine needle aspiration biopsy were developed and approved in 1997 by The National Cancer Institute of Bethesda, United States, , and were adapted to our country on 2007, however, in last years these indications have not changed in a formal manner. The purpose of this review was to provide an update of the report for breast fine needle aspiration biopsy using the Bethesda system. This guide was made by consensus with pathologists, clinicians, radiologists, breast surgeons and other health professionals of Colombia and other countries. The update was basis on the experience of Hospital Pablo Tobon Uribe and Dinamica IPS in performing breast fine needle aspiration biopsy.

Sensory acceptability and factors predicting the consumption of grain amaranth in Kenya.

This study investigated the effect of adding grain amaranth flour on sensory acceptability of maize porridge in Kenya. Factors influencing the intention of mothers to feed their children on grain amaranth were identified. A significant difference between the various porridge ratios (50:50, 70:30, and 100:0 amaranth:maize) either in unfermented or fermented form could be detected. Preference for the unfermented amaranth enriched maize porridge was observed. Intention significantly correlated and predicted grain amaranth consumption (p < .001). Knowledge and health value significantly predicted health behavior identity. Interaction between barriers and intention negatively influenced behavior. Findings suggest that unfermented amaranth enriched maize porridge is acceptable. Unfermented porridge with 70% amaranth can be considered for use in a program aimed at increasing dietary iron intake among children. Increasing awareness about micronutrient deficiencies and nutritional benefits of grain amaranth could enhance its consumption.

Enfermedad periodontal y preeclampsia: revisión de la literatura / Periodontal disease and preeclampsia: literature review

Introducción: La preeclampsia es una complicación del embarazo que puede comprometer tanto la vida de la madre, como la del bebé. Existen diferentes factores etiológicos para el desarrollo de la preeclampsia, incluidos las infecciones crónicas. La Enfermedad Periodontal, como infección crónica, recientemente ha sido asociada con la aparición de la preeclampsia. Objetivo: Realizar una revisión de la literatura, para constatar la posible asociación entre Enfermedad Periodontal (EP) y Preeclampsia. Métodos y Materiales: Búsqueda en las bases de datos de la red de publicaciones científicas con el fin de revisar los estudios reportados a partir de 1996 hasta 2007, para evaluar la posible asociación entre EP y Preeclampsia. Resultados: Se encontraron 11 estudios y se evaluaron sus diseños y sus resultados. Conclusiones: De esta revisión se concluye que existen muy pocos estudios dirigidos a evaluar la presencia de EP y la incidencia de Preeclampsia. Los estudios evaluados muestran resultados contradictorios lo que se puede deber a los diferentes diseños de los estudios ya que se encontró falta de unificación en los criterios de inclusión en los estudios, falta de unificación en los criterios de diagnóstico para la EP y el tamaño de la muestra es muy diferente según el tipo de estudio. Se necesitan más estudios de intervención, en los cuales se demuestre que al realizar un control o eliminación de la EP, las complicaciones del embarazo descritas anteriormente disminuyen, para reafirmar o descartar esas posibles asociaciones.

Introduction: Preeclampsia is a complication of pregnancy that can threaten both the life of the mother as the baby. There are different etiological factors for the development of preeclampsia, including chronic infections. Periodontal disease as a chronic infection has recently been associated with the onset of preeclampsia. Objective: To review the literature with the purpose of determine the possible association between periodontal disease (PD) and Preeclampsia. Methods and Materials: Database search of scientific publications in order to review studies reported from 1996 to 2007 to assess the possible association between PD and Preeclampsia. Results: There were evaluated designs and results of 11 scientific articles. Conclusions: This review concluded that there are very few studies to evaluate the presence of PD and the incidence of preeclampsia. The evaluated studies show conflicting results which may be due to the different designs of the studies, lack of unification among inclusion criteria between them, lack of standardization in diagnostics criteria for PD, and the sample size is very different depending on the type of study. More intervention studies are needed to demonstrate that controlling or eliminating PD, the previously described complications of pregnancy are minimized, in order to affirm or refute these possible associations.