Diagnóstico precoz del cáncer de cérvix: correlación entre citología, colposcopia y biopsia / Early diagnosis of cervix cancer: Correlation between cytology, colposcopy and biopsy

Objetivo: Determinar la concordancia entre citología, colposcopia y biopsia cervical ante una citología alterada. Material y métodos: Se realizó un estudio observacional transversal, de base clínica, en un único centro. La población seleccionada consistió en 416 mujeres, de entre 25 y 65 años, con citología alterada, del 1 de agosto de 2014 al 30 de septiembre de 2016, y remitidas para estudio colposcópico y anatomopatológico al Hospital Reina Sofía de Córdoba. Se realizaron análisis estadísticos, utilizando el índice de Kappa para el grado de concordancia entre citología, colposcopia y biopsia. Resultados: Se encontró una concordancia insignificante entre citología y colposcopia (k=0,16; IC 95% 0,09-0,22); una concordancia moderada entre colposcopia y biopsia (k=0,57; IC 95% 0,47-0,68); y una concordancia insignificante entre citología y biopsia (k=0,21; IC 95% 0,08-0,34). Conclusiones: El grado de acuerdo fue mejor entre colposcopia y biopsia que entre citología y biopsia o entre citología y colposcopia

Objective: To determine the concordance between cytology, colposcopy and cervical biopsy in abnormal cytologies. Material and methods: An observational cross-sectional, clinically based, single center study was performed. The selected population consisted of 416 women between the ages of 25 and 65 who had undergone colposcopy for abnormal cytologies at the Reina Sofía Hospital, Córdoba, between August 1st, 2014, and September 30th, 2016. Statistical analysis was performed using the Kappa index for the degree of concordance between cytology, colposcopy and biopsy. Results: There was an insignificant concordance between cytology and colposcopy (k=0.16; 95% CI 0.09-0.22), a moderate concordance between colposcopy and biopsy (k=0.57; 95% CI 0.47-0.68) and an insignificant concordance between cytology and biopsy (k=0.21 (95% CI 0.08-0.34). Conclusions: Better concordance was found between colposcopy and biopsy than between either cytology and biopsy or cytology and colposcopy

[Early diagnosis of cervix cancer: Correlation between cytology, colposcopy and biopsy]. / Diagnóstico precoz del cáncer de cérvix: correlación entre citología, colposcopia y biopsia.

OBJECTIVE: To determine the concordance between cytology, colposcopy and cervical biopsy in abnormal cytologies. MATERIAL AND METHODS: An observational cross-sectional, clinically based, single center study was performed. The selected population consisted of 416 women between the ages of 25 and 65 who had undergone colposcopy for abnormal cytologies at the Reina Sofía Hospital, Córdoba, between August 1st, 2014, and September 30th, 2016. Statistical analysis was performed using the Kappa index for the degree of concordance between cytology, colposcopy and biopsy. RESULTS: There was an insignificant concordance between cytology and colposcopy (k=0.16; 95% CI 0.09-0.22), a moderate concordance between colposcopy and biopsy (k=0.57; 95% CI 0.47-0.68) and an insignificant concordance between cytology and biopsy (k=0.21 (95% CI 0.08-0.34). CONCLUSIONS: Better concordance was found between colposcopy and biopsy than between either cytology and biopsy or cytology and colposcopy.

Diagnóstico precoz del cáncer de cérvix: correlación entre citología, colposcopia y biopsia / Early diagnosis of cérvix cancer: correlation between cytology, colposcopy and biopsy

Objetivo: determinar la concordancia entre citología, colposcopia y biopsia cervical ante una citología alterada. Material y métodos: se realizó un estudio observacional retrospectivo transversal, de base clínica, único centro. La población seleccionada fue 416 mujeres, entre 25 y 65 años con citología alterada, del 1 de agosto de 2014 al 30 de septiembre de 2016, y remitidas para estudio colposcópico y anatomopatológico al Hospital Reina Sofía, Córdoba. Se realizaron análisis estadísticos, utilizando el índice de Kappa para el grado de concordancia entre citología, colposcopia y biopsia. Resultados: se encontró una concordancia insignificante entre citología: colposcopia, k = 0,16 (IC 95% = 0,09- 0,22); una concordancia moderada entre colposcopia: biopsia, k = 0,57 (IC 95% = 0,47-0,68); y una concordancia insignificante entre citología: biopsia, k = 0,21 (IC 95%, 0,08-0,34). Conclusiones: el grado de acuerdo fue mejor entre colposcopia y biopsia; que entre citología y biopsia o entre citología y colposcopia (AU)

Objective: To determine the concordance between cytology, colposcopy and cervical biopsy in altered cytology. Material and methods: An observational cross-sectional, clinically based, single center study was performed. The selected population were 416 women between 25 and 65 years old with altered cytology, from August 1, 2014 to September 30, 2016, and submitted for colposcopic and anatomopathological study to the Reina Sofía Hospital, Córdoba. Statistical analyzes were performed using the Kappa index for the degree of concordance between cytology, colposcopy and biopsy. Results: There was an insignificant concordance between cytology: colposcopy, k = 0.16 (95% CI = 0.09-0.22), a moderate concordance between colposcopy: biopsy, k = 0.57 (95% CI = 0.47-0.68); And an insignificant concordance between cytology: biopsy, k = 0.21 (95% CI, 0.08-0.34). Conclusions: The degree of agreement was better between colposcopy and biopsy; that between cytology and biopsy or between cytology and colposcopy (AU)

Incontinencia urinaria 6 meses tras parto. Factores de riesgo asociados / Urinary incontinence since 6 months after delivery. Associated risk factors

Este estudio permite aproximarnos a la incidencia de incontinencia urinaria de esfuerzo a los 6 meses postparto en nuestro medio, lo que puede ser útil para proponer una actuación tanto a nivel de atención primaria como hospitalaria para poder disminuir el impacto que los posibles factores de riesgo ejercen, como por ejemplo un buen programa de entrenamiento de la musculatura pélvica con ejercicios de Kegel podría reducir la aparición de esta patología, de esta forma, se podría minimizar la morbilidad que sufren estas pacientes. Handa y cols. (21) concluyó que las pacientes que presentaban incontinencia urinaria o anal presentaban un moderado o alto impacto negativo en su vida diaria tras encuestar a 759 pacientes. Para finalizar, se concluye que existen diferentes evidencias en cuanto a los factores de riesgo asociados a la aparición de incontinencia urinaria postparto. El tipo de parto no tiene relación estadísticamente significativa con la aparición de esta sintomatología. No obstante, al existir literatura a favor y en contra de esta hipótesis se precisan más estudios que permiten concluir que vía del parto es la menos favorable para presentar incontinencia urinaria. Los autores, admiten que se podrían inferir más datos si se aumenta el número de pacientes evaluadas (AU)

This study allows us to approach the incidence of stress urinary incontinence at 6 months postpartum in our setting, which may be useful to propose a performance at both primary and hospital care levels, in order to reduce the impact that possible risk factors exert, such as for example, a good pelvic muscle training program with Kegel exercises could reduce the onset of this pathology, thus minimizing the morbidity of these patients. Handa et al. (21) concluded that patients with urinary incontinence or anal had a moderate or high negative impact in their daily lives after surveying 759 patients. Finally, we conclude that there is different evidence regarding the risk factors associated with the occurrence of postpartum urinary incontinence. The type of delivery has no statistically significant relationship with the appearance of this symptomatology. However, because there is literature for and against this hypothesis, more studies are needed to conclude that the way of delivery is the least favorable for presenting urinary incontinence. The authors admit that more data could be evidenced by increasing the number of patients evaluated (AU)