RESUMO
Mortality rates for cervical cancer (CC) in Chile are higher than those of developed countries and it has an unequal socioeconomic distribution. The recognition of human papilloma virus (HPV) as the causal agent of cervical cancer in the early 80's changed the prevention paradigms. Current goals are to prevent HPV infection by vaccination before the onset of sexual activity and to detect HPV infection in women older than 30 years. This article reviews CC prevention and early detection methods, discusses relevant evidence to support a change in Chile and presents an innovation proposal. A strategy of primary screening based on HPV detection followed by triage of HPV-positive women by colposcopy in primary care or by cytological or molecular reflex testing is proposed. Due to the existence in Chile of a well-organized nationwide CC prevention program, the replacement of a low-sensitivity screening test such as the Papanicolau test with a highly sensitive one such as HPV detection, could quickly improve the effectiveness of the program. The program also has a network of personnel qualified to conduct naked-eye inspections of the cervix, who could easily be trained to perform triage colposcopy. The incorporation of new prevention strategies could reduce the deaths of Chilean women and correct inequities.
Assuntos
Neoplasias do Colo do Útero/diagnóstico , Alphapapillomavirus/genética , Alphapapillomavirus/isolamento & purificação , Chile , Colposcopia , DNA Viral/análise , Detecção Precoce de Câncer , Feminino , Testes de DNA para Papilomavírus Humano , Humanos , Programas de Rastreamento , Teste de Papanicolaou , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/prevenção & controle , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/virologiaRESUMO
El propósito de este estudio consistió en precisar la utilidad de la colecistectomía en la supresión del estado de portador de salmonelas, mediante el examen de deposiciones y bilis, en enfermos que habían sido operados y cuyo bilicultivo, en el momento de extirpar la vesícula, reveló la presencia de Salmonella typhi o paratyphi (AU)
Assuntos
Colecistectomia/estatística & dados numéricos , Salmonella typhi/isolamento & purificação , Salmonella paratyphi A/isolamento & purificação , ChileRESUMO
El propósito de este estudio consistió en precisar la utilidad de la colecistectomía en la supresión del estado de portador de salmonelas, mediante el examen de deposiciones y bilis, en enfermos que habían sido operados y cuyo bilicultivo, en el momento de extirpar la vesícula, reveló la presencia de Salmonella typhi o paratyphi (AU)
Assuntos
Colecistectomia , Salmonella typhi , Salmonella paratyphi A , ChileRESUMO
El proposito de este estudio consistio en precisar la utilidad de la colecistectomia en la supresion del estado de portador de salmonelas, mediante el examen de deposiciones y bilis, en enfermos que habian sido operados y cuyo bilicultivo, en el momento de extirpar la vesicula, revelo la presencia de Salmonella typhi o paratyphi
Assuntos
Colecistectomia , Salmonella paratyphi A/isolamento & purificação , Salmonella typhi/isolamento & purificação , ChileRESUMO
Subjects and methods: The prevalence of IgG antibodies against Cytomegalovirus and Toxoplasma gondii were studied in 560 subjetcs under 30 years old, using and ELISA technique. Age, socioeconomic level, breast feeding, assistance to nurseries and number of family members were considered as risk factors for these infections. Results: Infection by Cytomegalovirus and Toxoplasma gondii were studied in 560 subjetcs under 30 years old, using an ELISA technique. Age, socioeconomic level, breast feeding, assistance to nurseries and number of family members were considered as risk factors for these infections. Results: Infection by Cytomegalovirus had a global prevalence of 60 percent. It showed an epidemiological pattern of late adquisition in high socioeconomic levels and a pattern of early infection in medium and low socioeconomic levels. Eighty to 90 percent of sera were positive for the infection in adult subjetcs of the three socioeconomic levels. There was a positive correlation between the duration of breast feeding and the frequency of Cytomegalovirus infection. Infection by Toxoplasma gondii had a global prevalence of 24.6 percent. The rates of susceptible individuals were 80 and 50 percent in high and medium-low socioeconomic levels respectively. Conclusions: The knowledge about the frequency of these infections in high risk populations such as women during their reproductive years and immunodepressed individuals, will allow the implementation of preventive measures