RESUMO
PURPOSE: To develop a precision tissue sampling technique that uses computed tomography (CT)-based radiomic tumour habitats for ultrasound (US)-guided targeted biopsies that can be integrated in the clinical workflow of patients with high-grade serous ovarian cancer (HGSOC). METHODS: Six patients with suspected HGSOC scheduled for US-guided biopsy before starting neoadjuvant chemotherapy were included in this prospective study from September 2019 to February 2020. The tumour segmentation was performed manually on the pre-biopsy contrast-enhanced CT scan. Spatial radiomic maps were used to identify tumour areas with similar or distinct radiomic patterns, and tumour habitats were identified using the Gaussian mixture modelling. CT images with superimposed habitat maps were co-registered with US images by means of a landmark-based rigid registration method for US-guided targeted biopsies. The dice similarity coefficient (DSC) was used to assess the tumour-specific CT/US fusion accuracy. RESULTS: We successfully co-registered CT-based radiomic tumour habitats with US images in all patients. The median time between CT scan and biopsy was 21 days (range 7-30 days). The median DSC for tumour-specific CT/US fusion accuracy was 0.53 (range 0.79 to 0.37). The CT/US fusion accuracy was high for the larger pelvic tumours (DSC: 0.76-0.79) while it was lower for the smaller omental metastases (DSC: 0.37-0.53). CONCLUSION: We developed a precision tissue sampling technique that uses radiomic habitats to guide in vivo biopsies using CT/US fusion and that can be seamlessly integrated in the clinical routine for patients with HGSOC. KEY POINTS: ⢠We developed a prevision tissue sampling technique that co-registers CT-based radiomics-based tumour habitats with US images. ⢠The CT/US fusion accuracy was high for the larger pelvic tumours (DSC: 0.76-0.79) while it was lower for the smaller omental metastases (DSC: 0.37-0.53).
Assuntos
Neoplasias Ovarianas , Tomografia Computadorizada por Raios X , Ecossistema , Feminino , Humanos , Neoplasias Ovarianas/diagnóstico por imagem , Estudos Prospectivos , Ultrassonografia de IntervençãoRESUMO
Objetivo. Determinar los factores de riesgo asociados al consumo de tabaco en el último año en una población universitaria chilena. Metodología. Estudio observacional analítico, de corte transversal. Se realizó muestreo aleatorio estratificado según unidad académica y año de carrera, siendo el tamaño muestral de 2045 estudiantes de cuatro Campus de la Universidad Católica de Chile. La toma de la información se hizo con ayuda de un cuestionario autoaplicado. Se realizaron análisis descriptivo, bivariado y de regresión logística. Resultados. El promedio de edad fue 20.4±1,6 años, el 46.6% eran de sexo masculino y el70.3% tenían nivel socioeconómico alto. Un 91.0% había iniciado el consumo después de los 18 años. La prevalencia mensual de consumo de tabaco fue de 40.5%, un 20.0% de los encuestados estaría a riesgo de tener diagnóstico de tabaquismo. Se encontró asociación positiva entre consumo de tabaco durante último año y: la edad (p<0.05), el sexo femenino (p<0.001), el nivel socioeconómico (p<0.05) y la percepción de consumo de droga por parte de padres (p<0.001). Se encontró asociación negativa entre consumo de tabaco y la religiosidad (p<0.001).Conclusión. En el grupo universitario en el que se realizó el estudio se encontró que el problema de tabaquismo merece especial atención por su magnitud, estando asociado a factores de riesgo como la edad, el sexo femenino, el estrato socioeconómico y una baja religiosidad.
Objective. To determine the risk factors associated to smokingin the last year of school in a Chilean university population. Methodology. Analytical, observational, transversal cut study. Stratified randomized sampling was conducted according to academic unit and year of career; the size of the sample was of 2045 students from four campuses of the catholic university of Chile. The information was collected with a self-applied questionnaire. A descriptive, bivariate and logistic regression analysis was made. Results. The average age was 20.4±1.6,46% were males and 70.3% had a high socioeconomic status. 91% had started cigarette consumption before the age of 18. The smoking monthly prevalence was of 40.5%, 20% of the surveyed would be atrisk of having diagnosis of smoking. A positive association was found between smoking during the last year of university and: age (p<0.05), female sex (p<0.001), socioeconomic status (p<0.05) and parents drugconsumption perception (p<0.001). A negative association was found between smoking and religiosity(p<0.001). Conclusion. In the studied university group it was found that the smoking problem requires special attention due to its magnitude and association to risk factors as age, female gender, socioeconomic status and a low religiosity.
Objetivo. Determinar os fatores de risco associados ao consumo do cigarro no último ano numa população universitária chilena. Metodologia. Estudo observacional analítico, de corte transversal. Realizou-se amostra gemaleatória estratificado segundo unidade acadêmica e ano de carreira, sendo o tamanho da mostra de2 045 estudantes de quatro Campus da Universidade Católica de Chile. A tomada da informação se fez comajuda de um questionário auto-aplicado. Realizaram-se análise descritiva, bivariado e de regressão logística. Resultados. A média de idade foi 20.4±1,6 anos, o 46.6% eram de sexo masculino e o 70.3% tinham nível socioeconômico alto. Um 91% tinha iniciado o consumo depois dos 18 anos. A prevalência mensal de consumo do cigarro foi de 40.5%, um 20% dos interrogados estaria a risco de ter diagnóstico de tabagismo. Encontrou-se associação positiva entre consumo de fumo durante último ano e: a idade (p<0.05), o sexo feminino (p<0.001), o nível socioeconômico (p<0.05) e a percepção de consumo de droga por parte de pais (p<0.001). Encontrou-se associação negativa entre consumo de fumo e a religiosidade (p<0.001). Conclusão. No grupo universitário no que se realizou o estudo se encontrou que o problema de tabagismo merece especial atendimento por sua magnitude, estando sócio a fatores de risco como a idade, o sexo feminino,o estrato socioeconômico e uma baixa religiosidade.
Assuntos
Tabagismo/epidemiologia , Tabagismo/prevenção & controle , Estudantes/estatística & dados numéricosRESUMO
OBJECTIVE: To design and test a surveillance system to detect and rank the most significant mental health problems in a community and to establish their association with the living conditions in that community. METHODS: The system was designed and tested at a primary health care center in the community of La Florida, which is in the metropolitan region of Santiago, the capital of Chile. The health problems that were under surveillance, with monthly monitoring, were: addiction (to alcohol, tobacco, and benzodiazepines or other drugs), violence (domestic violence and sexual abuse, real or suspected), and disorders in children (attention deficit and behavioral disorders). By means of a computerized geographical information system (GIS), those surveillance data were combined with other data. These other data included sociodemographic information on the persons who went to the health center for care as well as data on local risk factors and protective factors for health problems, some of which are indicators of the local residents' living conditions. RESULTS: The proposed epidemiological surveillance system, which takes into account local living conditions and environmental variables, is a good tool for health action. The proposed system also complements the incomplete perspective of monitoring systems, which do not include variables describing the local context and that focus only on health problems. The information synthesized in the GIS maps makes it possible to simultaneously display different layers of information on factors related to the health problems studied, linked to a specific area and all its environmental variables, in an easy-to-read, self-explanatory format. CONCLUSIONS: These results and the concurring opinions of the participating physicians show that the experimental system effectively met the basic requirements of an epidemiological surveillance system of this kind.
Assuntos
Sistemas de Informação , Transtornos Mentais/epidemiologia , Vigilância da População/métodos , Atenção Primária à Saúde/estatística & dados numéricos , Adulto , Área Programática de Saúde , Criança , Chile/epidemiologia , Planejamento em Saúde Comunitária , Feminino , Geografia , Humanos , Masculino , Fatores de Risco , Saúde da População UrbanaRESUMO
Objetivos. Diseñar y poner a prueba un sistema de vigilancia que permita detectar y jerarquizar los problemas más relevantes de salud mental y establecer su asociación con las condiciones de vida de la comunidad estudiada. Métodos. El sistema se diseñó y puso a prueba en un centro de salud de la comuna La Florida, región metropolitana de Chile. Los problemas de salud que se sometieron a vigilancia con seguimiento mensual fueron: adicción (al alcohol, tabaco, drogas y benzodiazepinas), violencia (violencia o sospecha de violencia intrafamiliar y abuso sexual) y trastornos en niños (déficit de atención y trastornos de conducta). Mediante un sistema computacional de información geográfica se combinaron estos elementos con datos sociodemográficos de las personas que acudieron a consulta y con datos territoriales que pueden considerarse factores protectores o de riesgo de los problemas de salud, y algunos de los cuales constituyen indicadores de las condiciones de vida de las personas. Resultados. Se probó que el sistema de vigilancia epidemiológica propuesto que incorpora las condiciones de vida y las variables ambientales es una buena herramienta para la acción en salud y complementa la visión parcial de los sistemas de seguimiento, que no incluyen variables de contexto y se centran sólo en los problemas de salud. La información sintetizada en mapas permite visualizar simultáneamente diferentes capas de información sobre los factores relacionados con los problemas de salud estudiados, asociados a un territorio específico, con todas las variables ambientales que implican, en un formato de lectura ágil y evidente por sí mismo. Conclusiones. Estos resultados y la opinión convergente de los médicos participantes y usuarios permiten afirmar que el sistema de vigilancia epidemiológica puesto a prueba en fase experimental logró cumplir los requerimientos básicos de un método de esta naturaleza
Objective. To design and test a surveillance system to detect and rank the most significant mental health problems in a community and to establish their association with the living conditions in that community. Methods. The system was designed and tested at a primary health care center in the community of La Florida, which is in the metropolitan region of Santiago, the capital of Chile. The health problems that were under surveillance, with monthly monitoring, drugs), violence (domestic violence and sexual abuse, real or suspected), and disorders in children (attention deficit and behavioral disorders). By means of a computerized geographical information system (GIS), those surveillance data were combined with other data. These other data included sociodemographic information on the persons who went to the health center for care as well as data on local risk factors and protective factors for health problems, some of which are indicators of the local residents' living conditions. Results. The proposed epidemiological surveillance system, which takes into account local living conditions and environmental variables, is a good tool for health action. The proposed system also complements the incomplete perspective of monitoring systems, which do not include variables describing the local context and that focus only on health problems. The information synthesized in the GIS maps makes it possible to simultaneously display different layers of information on factors related to the health problems studied, linked to a specific area and all its environmental variables, in an easy-to-read, self-explanatory format. Conclusions. These results and the concurring opinions of the participating physicians show that the experimental system effectively met the basic requirements of an epidemiological surveillance system of this kind