RESUMEN
In Costa Rica (CR), only one report on head and neck cancer (HNC) incidence trends (1985-2007) has been published and no investigations on the epidemiology of potentially human papillomavirus (HPV)-related and HPV-unrelated HNCs have been done. We examined the age-standardized incidence rates (IRs) and trends of head and neck squamous cell carcinomas (HNSCC) and compared incidence trends of potentially HPV-related and HPV-unrelated HNSCCs. We obtained all available HNC cases for the period 2006-2015 from the Costa Rican National Cancer Registry of Tumors and the population estimates from the Costa Rican National Institute of Statistics and Census. The analysis was restricted to invasive HNSCCs (n = 1577). IRs and incidence rate ratios were calculated using SEER*Stat software and were age-standardized for the 2010 Costa Rican population. Joinpoint regression analysis program was used to calculate trends and annual percent changes (APCs) in rates. For all HNSCCs, the age-standardized IR was 34.0/million person-years; 95% CI 32.4, 35.8. There was a significant decline in the incidence of nasopharyngeal cancer (APC: -5.9% per year; 95% CI -10.8, -0.7) and laryngeal cancer (APC: -5.4% per year; -9.2, 1.5). The incidence trends for hypopharyngeal, oropharyngeal and oral cavity cancers each remained stable over time. HNSCCs were categorized by their potential relatedness to HPV infection. Though the APCs were not statistically significant, IRs of potentially HPV-related HNSCCs trended upward, while HPV-unrelated HNSCCs trended downward. HNSCCs are uncommon in CR and decreased over time. We observed a divergent pattern of decreasing HPV-unrelated with increasing HPV-related HNSCCs that should be further informed by HPV genotyping tumor samples.
Asunto(s)
Neoplasias de Cabeza y Cuello , Neoplasias Nasofaríngeas , Infecciones por Papillomavirus , Humanos , Adulto , Carcinoma de Células Escamosas de Cabeza y Cuello , Incidencia , Virus del Papiloma Humano , Costa RicaRESUMEN
El estudio clínico fetal relaciona aspectos críticos como la intensidad de las contracciones uterinas, movimientos del feto y frecuencia cardiaca de manera simultánea para evaluar el bienestar fetal. Los cambios periódicos o transitorios de la frecuencia cardiaca son objeto de estudio y aparecen en relación a diversos estímulos fetales como movimientos espontáneos o provocados, contracciones uterinas, hipo fetal, etc. Con este propósito, en una valoración de los mismos es necesario disponer de una constante monitorización, en la que se exprese la frecuencia y la variabilidad cardiaca fetal de manera eficiente. En este artículo se presenta el desarrollo de un sistema de tococardiografía para el registro de la frecuencia cardiaca fetal y la intensidad de las contracciones uterinas compuesto por tres tarjetas electrónicas, una unidad de procesamiento digital paralela, una campana acústica y una pantalla para adquirir y procesar de manera no invasiva las señales tococardiográficas.
Clinical evaluation on fetuses is related to simultaneous critical aspects such as intensity of uterine contractions, fetal movements, and heart rate. Periodic or transient changes in heart rate are studied and appear in relation to various fetal stimuli as spontaneous or induced movements, uterine contractions, fetal hiccups, and so on. Thus, their evaluation is necessary to obtain constant monitoring in which the frequency and variability are expressed efficiently. This paper presents the development of a cardiotochography system for recording fetal heart rate and intensity of uterine contractions, which is composed by three electronic boards, a digital parallel processing unit, a sounds bell and a screen to acquire non-invasively and process tococardiography’s signals.
O estudo clinico fetal relaciona aspectos críticos, como a intensidade das contrações uterinas, movimentos fetais e batimentos cardíacos simultaneamente para avaliar o bem-estar fetal. As mudanças periódicas ou transitórias da frequência cardíaca são estudados e aparecem em relação a vários movimentos fetais espontâneas ou induzidas, as contrações uterinas, soluços fetais, etc. Para este efeito, em uma revisão do mesmo é necessário ter monitoramento constante, na que se exprese a freqüência e variabilidade do ritmo cardíaco fetal de forma eficiente. Este artigo é apresentado o desenvolvimento de um sistema de tococardiografía para registar o ritmo cardíaco fetal e intensidade das contrações uterinas composto por três placas eletrônicas, uma unidade de processamento digital paralelo, uma cabine acústica e uma tela para adquirir e processar de maneira não invasiva as sinais tococardiográficas.