Résumé
Este libro tiene como origen las diversas reflexiones originadas por la ejecución de un trabajo de investigación en el área de la salud con comunidades indígenas de la Amazonia colombiana denominado: "Estrategia de Atención Primaria en Salud con enfoque intercultural e investigación Acción Participativa para la prevención del cáncer de cuello uterino en el resguardo indígena de El Paujil" (Colombia) y desarrollado por lideresas pertenecientes a la región e investigadores de las universidades Fundación Universitaria de Ciencias de la Salud, FUCS; Universidad de Ciencias Aplicadas y Ambientales, UDCA; y Universidad El Bosque, con la cofinanciación del Ministerio de Ciencia, Tecnología e Innovación de Colombia. Los avances del proyecto permitieron explorar las visiones sobre diversos temas de algunas comunidades indígenas de la Amazonia, en especial, los relacionados con la salud de las mujeres y sus roles en las familias y en las comunidades. El trabajo conjunto, mediante una metodología de investigación participativa alrededor de la prevención del cáncer de cuello uterino, incluyó en primer lugar el análisis de la interculturalidad como un enfoque que coincide con los postulados de respeto por los valores culturales y las diferencias.
This book has as origin the diverse reflections originated by the execution of a research work in the area of health with indigenous communities of the Colombian Amazon called: "Primary Health Care Strategy with intercultural approach and Participatory Action Research for the prevention of cervical cancer in the indigenous reservation of El Paujil" (Colombia) and developed by leaders belonging to the region and researchers from the universities Fundación Universitaria de Ciencias de la Salud, FUCS; Universidad de Ciencias Aplicadas y Ambientales, UDCA; and Universidad El Bosque, with co-financing from the Ministry of Science, Technology and Innovation of Colombia. The progress of the project made it possible to explore the views on various topics of some indigenous communities in the Amazon, especially those related to women's health and their roles in the families and communities. The joint work, through a participatory research methodology on cervical cancer prevention, included first of all the analysis of interculturality as an approach that coincides with the postulates of respect for cultural values and differences.
Sujets)
Humains , Femelle , Éducation pour la santé , Colombie , Biologie cellulaire , PapillomaviridaeRésumé
OBJETIVO: Este trabalho aborda sobre características referente aos exames citopatológicos do colo do útero em Altamira, coletado no Sistema de Informação do Câncer, dentro do período de 2014 a 2020. Observou-se também a qualidade da interpretação dos principais resultados encontrados, sobre a técnica de coleta e qualidade de exames. O objetivo é analisar o perfil epidemiológico dos exames citopatológicos do colo do útero do município. MÉTODO: A metodologia realizada foi estudo quantitativo, de corte transversal, epidemiológico, descritiva e analítico. RESULTADOS: Verificou- se um crescimento anual na taxa de cobertura do exame do preventivo no período de 2014 a 2019, que está ligado à implementação do Plano de Desenvolvimento Regional Sustentável do Xingu, e que esse crescimento mostra uma diferença estatística significativa entre a taxa de cobertura de Altamira, Pará, Brasil. Observou-se presença de falhas no preenchimento da ficha de notificação é referente ao campo da escolaridade das pacientes que não apresentam registro. Quanto a faixa etária mais frequente que realizam o exame do preventivo está entre 25 a 34 anos e as lesões intraepiteliais do colo uterino mais frequentes são: a de baixo grau que corresponde à população jovem (<34 anos) e de alto grau entre 25 a 44 anos.
OBJECTIVE: This paper deals with characteristics related to cytopathological examinations of the cervix in Altamira, collected in the Cancer Information System, within the period from 2014 to 2020. It was also observed the quality of interpretation of the main results found, on the technique collection and quality of exams. The objective is to analyze the epidemiological profile of cytopathological tests of the cervix in the city. METHOD: The methodology used was a quantitative, cross- sectional, epidemiological study, descriptive and analytical approach. RESULTS: As a result, there was an annual growth in the coverage rate of the preventive exam in the period from 2014 to 2019, which is linked to the implementation of the Xingu Sustainable Regional Development Plan, and that this growth shows a significant statistical difference between the coverage rate of Altamira, Pará, Brazil. It was observed the presence of failures in completing the notification form referring to the field of education of patients who do not have a record. As for the most frequent age group that undergoes the preventive examination, it is between 25 and 34 years old and the most frequent intraepithelial lesions of the uterine cervix are: low-grade, which corresponds to the young population (<34 years) and high-grade, between 25 and 34 years old. 44 years.
OBJETIVO: En este trabajo se abordan las características relacionadas con los exámenes citopatológicos de cérvix en Altamira, recogidos en el Sistema de Información del Cáncer, en el periodo comprendido entre 2014 y 2020. También se observó la calidad de interpretación de los principales resultados encontrados, sobre la técnica de recolección y calidad de los exámenes. El objetivo es analizar el perfil epidemiológico de los exámenes citopatológicos de cuello uterino en la ciudad. MÉTODO: La metodología utilizada fue un estudio cuantitativo, transversal, epidemiológico, de abordaje descriptivo y analítico. RESULTADOS: Como resultado, se observó un crecimiento anual de la tasa de cobertura del examen preventivo en el período de 2014 a 2019, que está vinculado a la implementación del Plan de Desarrollo Regional Sostenible Xingu, y que este crecimiento muestra una diferencia estadística significativa entre la tasa de cobertura de Altamira, Pará, Brasil. Se observó la presencia de fallas en el llenado del formulario de notificación referente al campo de la educación de los pacientes que no tienen un registro. En cuanto al grupo de edad más frecuente que se somete al examen preventivo, es entre 25 y 34 años y las lesiones intraepiteliales del cuello uterino más frecuentes son: de bajo grado, que corresponde a la población joven (<34 años) y de alto grado, entre 25 y 44 años.
Sujets)
Humains , Femelle , Adulte , Profil de Santé , Études épidémiologiques , Tumeurs du col de l'utérus/épidémiologie , Patients/statistiques et données numériques , Femmes , Systèmes d'information/instrumentation , Test de Papanicolaou , Études cliniques comme sujet/méthodes , Biologie cellulaireRésumé
Abstract Objective To compare cytological and histological results from women > 64 years old who followed the Brazilian national cervical cancer screening guidelines with those who did not. Methods The present observational retrospective study analyzed 207 abnormal cervical smear results from women > 64 years old in a mid-sized city in Brazil over 14 years. All results were reported according to the Bethesda System. The women were divided into those who followed the screening guidelines and those who did not. Results Atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesion cytology results were found in 128 (62.2%) cases. Of these, 112 (87.5%) had repeated cytology with positive results. The other 79 (38.1%) with abnormal results should have been referred to colposcopy and biopsy. Out of 41 (51.9%) biopsied women, 23 (29.1%) had a confirmed diagnosis of neoplasia or precursor lesion. In contrast, among the 78 (37.7%) biopsied patients, 40 (51.3%) followed the guideline recommendations, with 9 (22.5%) positive biopsies. Of the 38 (48.7%) women who did not follow the guidelines, there were 24 (63.1%) positive results. Women who did not follow the guidelines demonstrated higher chances of cancer and precursor lesions (odds ratio [OR]: 5.904; 95% confidence interval [CI]: 2.188-15.932; p = 0.0002). Conclusion Women > 64 years old who did not follow the national screening protocol showed significant differences in the frequency of abnormal results and severity of diagnosis compared with those who followed the protocol.
Resumo Objetivo Comparar os resultados citológicos e histológicos de mulheres > 64 anos que seguiram as diretrizes nacionais brasileiras de rastreamento do câncer do colo do útero com aquelas que não as seguiram. Método O presente estudo observacional retrospectivo analisou 207 resultados anormais de esfregaço cervical de mulheres > 64 anos de idade em uma cidade de médio porte no Brasil durante 14 anos. Todos os resultados foram relatados de acordo com o Sistema Bethesda. As mulheres foram divididas entre as que seguiram as diretrizes de rastreamento e as que não o fizeram. Resultados Resultados citológicos com células escamosas atípicas de significado indeterminado e lesão intraepitelial escamosa de baixo grau foram encontrados em 128 (62,2%) casos. Destes, 112 (87,5%) repetiram a citologia com resultados positivos. Os outros 79 (38,1%) com resultados anormais deveriam ter sido encaminhados para colposcopia e biópsia. Das 41 (51,9%) mulheres biopsiadas, 23 (29,1%) tiveram diagnóstico confirmado de neoplasia ou lesão precursora. Em contrapartida, entre as 78 (37,7%) pacientes biopsiadas, 40 (51,3%) seguiram as recomendações da diretriz, com 9 (22,5%) biópsias positivas. Entre as 38 (48,7%) mulheres que não seguiram as orientações, houve 24 (63,1%) resultados positivos. As mulheres que não seguiram as diretrizes demonstraram maiores chances de câncer e lesões precursoras (odds ratio [OR]: 5,904; intervalo de confiança [IC] de 95%: 2,188-15,932; p = 0,0002). Conclusão Mulheres > 64 anos que não seguiram a diretriz nacional de rastreamento apresentaram diferenças significativas na frequência de resultados anormais e gravidade do diagnóstico em comparação com aquelas que seguiram a diretriz.
Sujets)
Humains , Femelle , Sujet âgé , Tumeurs du col de l'utérus/diagnostic , Dépistage de masse , Santé des Anciens , Test de Papanicolaou , Biologie cellulaireRésumé
Introducción: Aunque la mayoría de los nódulos tiroideos son benignos, asintomáticos y estables en la historia clínica de una paciente mujer; en los estudios ecográficos, citológicos e histopatológicos se ha podido obtener la caracterización subclínica de lesiones sugestivas de malignidad. El actual estudio tuvo por objetivo evaluar los factores de riesgo asociados a la malignidad de nódulos tiroideos en pacientes adultas. Metodología: Se realizó un estudio descriptivo, transversal, retrospectivo correlacional de enfoque mixto en el servicio de endocrinología del Hospital Teodoro Maldonado Carbo entre Enero y Junio del 2019. El universo estuvo compuesto por todos los casos con diagnóstico de nódulo tiroideo. Se utilizó el sistema de Bethesda para los reportes. Resultados: Fueron 132 casos de pacientes con nódulos tiroideos, edad entre 45 a 64 años (57,6%). En estado pre menopáusico (52%), con 1 gestación (12%), glucosa >100 mg/dL (34%), IMC entre 25.0 y 29.9 kg/m2 (49%) y con antecedente patológico familiar de cáncer de tiroides (35%). 30 casos con valores de TSH >4.00 uUI/mL (23%). El sistema de Bethesda, 22 casos (17%) categoria IV, 17 casos (13%) categoria V y 11 casos (8%) categoría VI. Conclusiones: La lesión citológica tiroidea más frecuente que se encontró fue la neoplasia benigna. No obstante, la lesión maligna junto con la lesión folicular indeterminada presentaron una prevalencia del 8%. Se encontró una asociación significativa entre los nódulos de citología maligna con los niveles de TSH elevados y con el antecedente patológico familiar de cáncer de tiroides.
Introduction: Although most thyroid nodules are benign, asymptomatic, and stable in the clinical history of a female patient, in ultrasound, cytological, and histopathological studies, it has been possible to obtain the subclinical characterization of lesions suggestive of malignancy. The current study aimed to evaluate the risk factors associated with the malignancy of thyroid nodules in adult patients. Methodology: A descriptive, cross-sectional, retrospective, correlational study with a mixed approach was carried out in the endocrinology service of the Teodoro Maldonado Carbo Hospital between January and June 2019. The study population consisted of all patients diagnosed with thyroid nodules. The Bethesda system was used for reporting. Results: There were 132 patients with thyroid nodules aged between 45 and 64 (57.6%). In a premenopausal state (52%), there was one pregnancy (12%), glucose >100 mg/dL (34%), BMI between 25.0 and 29.9 kg/m2 (49%) and a family history of thyroid cancer (35%). Thirty patients had TSH values >4.00 µUI/mL (23%). In the Bethesda system, 22 cases (17%) were Category IV, 17 cases (13%) were Category V, and 11 cases (8%) were Category VI. Conclusions: The most frequent thyroid cytological lesion found was a benign neoplasm. However, malignant lesions and indeterminate follicular lesions presented a prevalence of 8%. A significant association was found between malignant cytology nodules with elevated TSH levels and a family history of thyroid cancer.
Sujets)
Humains , Adulte , Tumeurs de la thyroïde , Thyréostimuline , Nodule thyroïdien , Anatomopathologie , Biologie cellulaireRésumé
PONTOS-CHAVE As lesões mamárias compreendem uma ampla variedade de diagnósticos que apresentam comportamentos diversos. As lesões mamárias podem ser classificadas como lesões benignas, de potencial de malignidade indeterminado (B3), carcinoma in situ e carcinoma invasor. Na era da medicina personalizada, individualizar e obter um diagnóstico preciso faz grande diferença no desfecho final da paciente, principalmente no caso do câncer de mama. Exames de imagem direcionados e de qualidade, métodos de biópsia adequadamente selecionados e análises de anatomopatologia convencional, imuno-histoquímica e até molecular são determinantes no diagnóstico e no manejo das pacientes.
Sujets)
Humains , Femelle , Maladies du sein/diagnostic , Tumeurs du sein/diagnostic , Techniques de diagnostic moléculaire/instrumentation , Aisselle/imagerie diagnostique , Immunohistochimie/méthodes , Imagerie par résonance magnétique/méthodes , Mammographie , Glandes mammaires humaines/imagerie diagnostique , Biologie cellulaireRésumé
Objective: To explore the effects of preoperative hysteroscopic guided biopsy and segmental diagnosis and curettage on the risk of abdominal dissemination and prognosis of non-endometrioid carcinoma. Methods: The clinical and pathological data of 97 patients who underwent surgical treatment and were pathologically confirmed as non-endometrioid carcinoma (including serous carcinoma, clear cell carcinoma, mixed adenocarcinoma, and undifferentiated carcinoma, etc.) from October 2008 to December 2021 in Peking University People's Hospital, were collected for retrospective analysis. According to preoperative diagnostic methods, they were divided into hysteroscopic group (n=44) and non-hysteroscopic group (n=53). The impact of hysteroscopy examination on peritoneal cytology and prognosis was analyzed. Results: (1) There were no statistical differences in age, body mass index, tumor size, pathological characteristics, and treatment methods between the hysteroscopic group and the non-hysteroscopic group (all P>0.05), but the proportion of stage Ⅰ-Ⅱ patients in the hysteroscopic group was significantly higher than that in the non-hysteroscopic group [68% (30/44) vs 47% (25/53); χ2=4.32, P=0.038]. (2) Among 97 patients, 25 (26%, 25/97) of them were cytologically positive for ascites. The hysteroscopic group had a lower positive rate of peritoneal cytology than that in the non-hysteroscopy group, which was significantly different [11% (5/44) vs 38% (20/53); χ2=8.74, P=0.003]. Stratification according to surgical and pathological stages showed that the positive rate of peritoneal cytology in the hysteroscopic group (3%, 1/30) was lower than that in the non-hysteroscopic group (12%, 3/25) in the 55 patients with stage Ⅰ-Ⅱ, and that in the hysteroscopic group (4/14) was also lower than that in the non-hysteroscopic group (61%, 17/28) in the 42 patients with stage Ⅲ-Ⅳ. There were no significant differences (all P>0.05). (3) The 5-year disease-free survival (DFS) rate of the hysteroscopic group and the non-hysteroscopic group were respectively 72.7% and 60.4%, and there was no significant difference between the two groups (P=0.186). After stratification according to staging, the 5-year DFS rate were respectively 90.0% and 72.0% (P=0.051) between the hysteroscopic and non-hysteroscopic groups of patients in stage Ⅰ-Ⅱ, and 35.7% and 50.0% (P=0.218) between the hysteroscopic and non-hysteroscopic groups of patients in stage Ⅲ-Ⅳ, in which there were not statistically significant differences. The 5-year overall survival (OS) rate were respectively 86.4% and 81.1% between the hysteroscopic group and the non-hysteroscopic group, with no significant difference between the two groups (P=0.388). The 5-year OS rate were respectively 93.3% and 96.0% in the hysteroscopic group and non-hysteroscopic group for patients with stage Ⅰ-Ⅱ(P=0.872), and 71.4% and 67.9% in the hysteroscopic group and non-hysteroscopic group in patients with stage Ⅲ-Ⅳ (P=0.999), with no statistical significance. Conclusions: Diagnostic hysteroscopy do not increase the rate of positive peritoneal cytology result at the time of surgery in this cohort, and no significant correlation between preoperative hysteroscopy examination and poor prognosis of non-endometrioid carcinoma is observed. Therefore, preoperative hysteroscopic guided biopsy and segmental diagnosis and curettage in non-endometrioid carcinoma maybe safe.
Sujets)
Femelle , Grossesse , Humains , Tumeurs de l'endomètre/anatomopathologie , Études rétrospectives , Hystéroscopie/méthodes , Biologie cellulaire , Pronostic , Carcinomes , Stadification tumoraleRésumé
Abstract Objective To determine if the use of lubricating gel on the speculum during the cervicovaginal cytology examination interferes with the results obtained, as well as whether it reduces reported discomfort in patients. Data sources A systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, with a search in the Pubmed/Medline, Scielo, Cochrane Library, Embase databases of articles published between January 2011 and May 2022. The keywords used were cytology, speculum, lubricant, result, and pain. Selection of studies The initial search resulted in 306 articles, of which were excluded three because they were duplicates, 257 after reading the title and abstract and 41 after reading the full text. Thus, five articles were selected for the study: four randomized clinical trials and one metanalysis. Data collection The selection of articles was performed by two investigators. The 5 selected articles were read in full and submitted to a comparative analysis. Data synthesis Screening through cervicovaginal cytology allows for early diagnosis and reduction of associated mortality, but the procedure can be associated with pain. A small amount of aqueous lubricating gel in the speculum can be used to reduce the discomfort associated with performing cervicovaginal cytology. Conclusion The use of lubricating gel in the speculum does not seem to be associated with a change in the cytology result and reduces the discomfort associated with its insertion into the vagina.
Resumo Objetivo Determinar se o uso de gel lubrificante no espéculo durante o exame de citologia cervicovaginal interfere com os resultados obtidos e se diminui o desconforto relatado por pacientes. Fontes de dados Foi realizada uma revisão sistemática segundo as recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), com pesquisa nas bases de dados Pubmed/Medline, Scielo, Cochrane Library, Embase, de artigos publicados entre janeiro de 2011 e julho de 2022. Utilizaram-se as palavras-chave citologia, espéculo, lubrificante, resultado e dor. Seleção dos estudos A pesquisa inicial resultou em 306 artigos, dos quais foram excluídos três por se encontrarem duplicados, 257 após a leitura do título e do resumo e 41 após a leitura integral. Assim, foram selecionados cinco artigos para o estudo: quatro ensaios clínicos aleatorizados e uma metanálise. Coleta de dados A seleção dos artigos foi realizada por dois investigadores. Os cinco artigos selecionados foram lidos na íntegra e submetidos a uma análise comparativa. Síntese dos dados O rastreio através da citologia cervicovaginal permite um diagnóstico precoce e redução da mortalidade associada, mas a sua realização pode estar associada a dor. Uma pequena quantidade de gel lubrificante aquoso pode ser utilizada no espéculo para diminuir o desconforto associado à realização da citologia cervicovaginal. Conclusão A utilização de gel lubrificante não está associada a alteração do resultado da citologia e diminui o desconforto associado à sua introdução na vagina.
Sujets)
Humains , Femelle , Instruments chirurgicaux , Mesure de la douleur , , Lubrifiants/administration et posologie , Biologie cellulaireRésumé
Resumo Os técnicos em citopatologia são fundamentais para o rastreamento do câncer de colo do útero, porém existem lacunas na sua formação. Nesta revisão de literatura, com abordagem qualitativa, realizada na Biblioteca Virtual em Saúde e na SciELO, sem recorte temporal, descrevemos o histórico das políticas públicas de combate ao câncer de colo de útero, relacionando-o à história da educação profissional técnica em citopatologia, analisando as conexões entre tais sequências de eventos. Numa perspectiva histórica, a educação profissional em anatomia patológica se deu principalmente pela formação em serviço, porém o campo da formação técnica em citopatologia destoa desse modelo. Esforços diversos para estruturar os currículos na área e reduzir as discrepâncias nessa formação foram realizados. Contudo, disputas entre interesses político-econômicos, marcando a divisão técnica do trabalho no país, somadas a embates corporativos no trabalho em citopatologia, e o descompasso entre ações de educação e de rastreamento impediram a materialização efetiva desses esforços. A demanda pela incorporação de novas tecnologias acentua ainda mais a fragilidade na formação da categoria. Somente com ações governamentais concretas de formação e de regulamentação profissional será possível transformar esse cenário, favorecendo o desenvolvimento e a ampliação das campanhas de detecção precoce do câncer.
Abstract Cytopathology technicians are fundamental for cervical cancer screening, but there are gaps in their training. In this literature review, with a qualitative approach, carried out in the Virtual Health Library and in SciELO, without temporal clipping, we describe the history of public policies to combat cervical cancer, relating it to the history of technical professional education in cytopathology, analyzing the connections between such sequences of events. In a historical perspective, professional education in pathological anatomy was mainly through in-service training, but the field of technical training in cytopathology differs from this model. Various efforts have been made to structure curricula in the area and reduce discrepancies in this training. However, disputes between political and economic interests, marking the technical division of labor in the country, added to corporate clashes in the work on cytopathology, and the mismatch between education and screening actions prevented the effective materialization of these efforts. The demand for the incorporation of new technologies further accentuates the fragility in the formation of the category. Only with concrete government actions of training and professional regulation will it be possible to transform this scenario, favoring the development and expansion of campaigns for early detection of cancer in Brazil.
Resumen Los técnicos en citopatología son fundamentales para el rastreo del cáncer de cuello uterino, pero existen lagunas en su formación. En esta revisión bibliográfica, con abordaje cualitativo, realizada en la Biblioteca Virtual en Salud y en SciELO, sin marco temporal, se describe la historia de las políticas públicas de combate al cáncer de cuello uterino, relacionándola con la historia de la formación técnico-profesional en citopatología, analizando las conexiones entre tales secuencias de eventos. Desde una perspectiva histórica, la formación profesional en anatomía patológica se basó principalmente en la formación en servicio, pero el campo de la formación técnica en citopatología difiere de este modelo. Se han hecho varios esfuerzos para estructurar los planes de estudio en el área y reducir las discrepancias en esta formación. Sin embargo, las disputas entre intereses políticos y económicos, que marcan la división técnica del trabajo en el país, sumadas a los enfrentamientos empresariales en el trabajo de citopatología, y la discrepancia entre las acciones de educación y de rastreo impidieron la materialización efectiva de estos esfuerzos. La demanda por la incorporación de nuevas tecnologías acentúa aún más la fragilidad en la formación de la categoría. Solo con acciones gubernamentales concretas de capacitación y regulación profesional será posible transformar este escenario, favoreciendo el desarrollo y la expansión de las campañas de detección temprana del cáncer en Brasil.
Sujets)
Biologie cellulaireRésumé
Aim:This paper aims to report an atypical oral HSV infection diagnosed by cytopathological examination in a patient with acute lymphocytic leukemia. Case report: A nine-year-old white female was admitted with acute lymphocytic leukemia, presenting ulcers covered with pseudomembrane and spontaneous bleeding on the left soft palate, measuring approximately 2 cm, as well as other ulcers measuring 1 cm on the left lateral border of the tongue. Exfoliative cytopathology revealed neutrophils and cytopathic effects of HSV in the keratinocytes in a fibrin background. Based on the exfoliative examination, the diagnosis of HSV infection was obtained. Conclusion: Oral HSV infection can be atypical in immunocompromised patients and can cause high morbidity and mortality. Healthcare professionals, especially those working in a hospital environment, should be aware of the possibility of HSV infection in atypical lesions in these patients and evaluate the need to include antiviral prophylactic therapy.
Objetivo:Este trabalho tem como objetivo relatar uma infecção oral atípica por HSV diagnosticada por exame citopatológico em um paciente com leucemia linfocítica aguda. Relato de caso:Paciente do sexo feminino, nove anos, branca, portadora de leucemia linfocítica aguda, apresentando úlceras recobertas por pseudomembrana e sangramento espontâneo em palato mole esquerdo medindo aproximadamente 2 cm, além de outras úlceras medindo 1 cm na borda lateral esquerda da língua. A citopatologia esfoliativa revelou neutrófilos e efeitos citopáticos do HSV nos ceratinócitos em um fundo de fibrina. Com base no exame esfoliativo, foi obtido o diagnóstico de infecção por HSV. Conclusão: A infecção oral por HSV pode ser atípica em pacientes imunocomprometidos e pode causar alta morbidade e mortalidade. Os profissionais de saúde, principalmente os que atuam em ambiente hospitalar, devem estar atentos à possibilidade de infecção pelo HSV em lesões atípicas nesses pacientes e avaliar a necessidade de inclusão de terapia antiviral profilática.
Sujets)
Simplexvirus , Leucémie-lymphome lymphoblastique à précurseurs B et T , Biologie cellulaire , Herpèsvirus humain de type 1Résumé
La incorporación de estrategias de gamificación en la docencia se ha descrito como una herramienta para aumentar la motivación y el compromiso de los alumnos con la materia. Bajo esta premisa, se ha desarrollado una experiencia de innovación educativa mediante la plataforma Kahoot! en la primera y última práctica de laboratorio de la asignatura de Biología Celular del Grado en Biología. Los participantes fueron 135 alumnos repartidos en 12 grupos de laboratorio, que se dividieron entre experimentales y controles. Todos los grupos resolvieron un cuestionario en papel acerca de los conceptos explicados en clase, al finalizar ambas prácticas (post-test), pero sólo aquellos grupos experimentales resolvían un cuestionario antes de la clase (pre-test). Antes de la primera práctica, los alumnos de los grupos experimentales respondieron al pre-test mediante el Kahoot! Sin embargo, para la última práctica algunos grupos lo resolvieron jugando al Kahoot! y otros, con papel y bolígrafo. Los resultados mostraron que aquellos alumnos que fueron seleccionados para jugar a Kahoot!, obtuvieron un mayor número de aciertos en el test realizado tras la sesión práctica (post-test) con respecto a aquellos que no resolvieron ningún pre-test o, que lo hicieron de un modo clásico. Por lo tanto, nuestros resultados sugieren que implementar la jugabilidad en la docencia incrementa considerablemente la motivación del alumnado debido, probablemente, a cambios fisiológicos experimentados por el cerebro durante el juego y a la creación de un clima positivo, que facilitan el proceso de aprendizaje.
SUMMARY: The incorporation of gamification strategies in teaching has been described as a tool to increase the motivation and engagement of students with the subject. Under this premise, an educational innovation experience has been developed using the Kahoot! platform in the first and last laboratory practice of the Cell Biology course of the Biology degree. The participants were 135 students divided into 12 laboratory groups, which were divided into experimental and control groups. All groups solved a questionnaire on paper about the concepts explained in class, at the end of both practices (post-test), but only the experimental groups solved a questionnaire before the class (pre-test). Before the first practice, students in the experimental groups answered the pre-test using Kahoot! However, for the last practice, some groups solved it by playing Kahoot! and others with pen and paper. The results showed that those students who were selected to play Kahoot! obtained a higher number of correct answers in the test performed after the practical session (post-test) than those who did not solve any pre- test or who did it in a classical way. Therefore, our results suggest that implementing gamification in teaching considerably increases student motivation, probably due to physiological changes experienced by the brain during the game and the creation of a positive climate, which facilitates the learning process.
Sujets)
Humains , Biologie cellulaire/enseignement et éducation , Ludification , Apprentissage , Motivation , UniversitésRésumé
Introducción: Anualmente se diagnostican 500.000 casos nuevos de cáncer de cuello uterino, aproximadamente 80% ocurren en países en desarrollo. La baja incidencia de la enfermedad está relacionada con la presencia de programas de detección temprana. Objetivo: Determinar las variables sociodemográficas y familiares asociadas al conocimiento y uso adecuado de la citología cervicouterina (CCU) en mujeres de una Universidad de Cartagena. Materiales y métodos: Estudio analítico, con 259 mujeres, estudiantes y trabajadoras de una institución universitaria. Los datos fueron recolectados utilizando una encuesta sociodemográfica, una de tipología familiar y preguntas que evaluaban los conocimientos y uso de la CCU. Resultados: 42,3% (109) pertenecían a familias nucleares, seguido de 29,5% (76) a familias atípicas. El 85,3% (221) conoce la citología cervical, la principal fuente de información son las instituciones de salud 22,4% (57). El 54,12% (140) de las mujeres tenía una citología previa, y el 26,5% (67) la realiza anualmente. El Conocimiento estuvo asociado a la percepción de funcionalidad familiar, (OR 2,1245 (1,0338-4,3662). Conclusiones: La percepción de disfuncionalidad familiar es un elemento que reduce la práctica de la citología entre las mujeres estudiadas, siendo más importante esta reducción entre las mujeres de estratos más bajos y sin afiliación en salud.
Introduction: 500,000 new cases of cervical cancer are diagnosed yearly, 80% of which belong to developing countries. The low incidence of this disease is related to implementation of early detection programs. Objective: To determine the sociodemographic and family variables associated with the knowledge and proper use of cervical cytology (CC) in female students from a University in Cartagena. Materials and methods: An analytical study was performed on 259 female students and female employees of a university. The data was collected using sociodemographic and family typology surveys together with questions assessing knowledge and use of CC. Results: 42.3% (109) of participants belonged to nuclear families, followed by atypical families (29.5%; 67). 85.3% (221) have knowledge about cervical cytology and the main source of information being health institutions (22.4%; 57). 54.12% (140) of the female participants had a previous cytology, and 26.5% (67) did it annually. Their knowledge was associated with the perception of family functionality (OR 2.1245 (1.0338-4.3662). Conclusions: Perception of family dysfunction is an element that reduces the practice of cytology in the women studied, this decrease being more important among women from lower social strata and not being covered by health insurance.
Sujets)
Humains , Femelle , Famille , Santé , Maladie , Famille nucléaire , Tumeurs du col de l'utérus , Caractéristiques familiales , Diagnostic , Test de Papanicolaou , Biologie cellulaireRésumé
Objetivo: Comparar la presencia del Virus de Papiloma Humano (VPH) y de lesión Intraepitelial Cervical (LIE) en adolescentes embarazadas y no grávidas atendidas en la Maternidad Dr. Armando Castillo Plaza de Maracaibo, Venezuela. Método: Investigación comparativa con diseño no experimental transeccional y de campo; donde se incluyeron 46 adolescentes embarazadas (casos) y 46adolescentes no embarazadas (controles), escogidas mediante muestreo probabilístico aleatorio, a quienes se les realizó identificación de factores asociados a la patología, evaluación por citología cervicovaginal y Genotipificación del VPH por reacción en cadena de la polimerasa (PCR). Resultados: se encontró que 32,6% de las embarazadas presentaron LIE de bajo grado (VPH o NIC 1) respecto a 21,7% en las no grávidas, común riesgo dos veces mayor (OR [IC95%]= 2,44 [1,05-5,65]). El diagnóstico molecular resultó positivo en la mitad del total de la muestra, siendo mayor en las embarazadas (52,1 vs. 47,9p<0,05);predominado las infecciones pro genotipos de alto riesgo 47,8vs 30,5; p <0,05). El VPH 16 resulto el más prevalente entre las embarazadas (21,7%) y la co-infección por genotipos debajo riesgo (6-11) en las no grávidas (17,4%) Conclusiones: las embarazadas adolescentes presentan una mayor prevalencia de LIE e infección genital por VPH, asociado a un riesgo significativo del doble de probabilidad de presentar una LIE respecto a las adolescentes no grávidas(AU)
Aim: To compare the presence of Human PapillomaVirus (HPV) and Squamous Intraepithelial Lesion (SIL)in pregnant and non-pregnant adolescents treated at the "Maternidad Dr. Armando Castillo Plaza" in Maracaibo, Venezuela. Patients and Methods: A comparative research with non-experimental transectional and field design was performed; where 46 pregnant adolescents (cases) and 46 non-pregnant adolescents (controls) was included, chosen by random probability sampling, who under went identification off actors associated with the pathology, evaluation by pap-smearand HPV genotyping by chain reaction of polymerase (PCR). Results: It was found that 32.6% of pregnant women had lowgrade SIL ( HPV or CIN 1) compared to 21.7% in non-pregnant women, with a risk twice higher (OR [95% CI] = 2.44 [1.05-5.65]). thee molecular diagnosis was positive in half of the total sample, being higher in pregnant women (52.1 vs. 47.9p <0.05);infections with high-risk genotypes predominated 47.8 vs 30.5;p <0.05). HPV 16 was the most prevalent among pregnant women (21.7%) and co-infection by low-risk genotypes (6-11) in non-pregnant women (17.4%). Conclusions: adolescent pregnant women have a higher prevalence of LIE and genital HPV infection, associated with a significant risk of twice the probability of presenting an LIE compared to non-pregnant adolescents(AU)
Sujets)
Humains , Mâle , Adolescent , Grossesse de l'adolescente , Tumeurs du col de l'utérus , Infections à papillomavirus , Papillomaviridae , Maladies sexuellement transmissibles , Cellules épithéliales , Biologie cellulaireRésumé
Abstract Objective The purpose of this study was to compare the frequency of the occurrence of high-risk human papillomavirus (HPV) and abnormal anal cytology in immunocompetent women with and without HPV-induced genital lesions. Methods This analytical cross-sectional, observational study was conducted between July 2017 and December 2018 in a specialized outpatient clinic of a tertiary hospital in Fortaleza, CE. Fifty-seven immunocompetent women with and without genital intraepithelial lesions were assessed; they were divided into two groups: group 1 was comprised of women with HPV-associated genital lesions (n=26), and group 2 was comprised of those without HPV-associated genital lesions (n=31). Samples for liquidbased cytology and high-risk DNA-HPV polymerase chain reaction real-time tests were collected from the cervix and anus. All cases were evaluated using high-resolution anoscopy; biopsies were performed when required. The Fisher exact and chi-squared tests were applied for consolidated data in the contingency table, and the Student ttest and Mann-Whitney U-test for independent variables. Results Anal high-risk HPV infections were more frequent in group 1 (odds ratio [OR], 4.95; 95% confidence interval [CI], 1.34-18.3; p=0.012), along with concomitant highrisk HPV infections in the uterine cervix and the anus (OR 18.8; 95% CI, 2.20-160; p<0.001). The incidence of high-risk cervical HPV infection was associated with highrisk anal HPV infection (OR, 4.95; 95% CI, 1.34-18.3; p=0.012). There was no statistical difference concerning abnormal anal cytology or anoscopy between the groups, and no anal intraepithelial lesion was found in either group. Conclusion Immunocompetent women with HPV-associated genital lesions and high-risk cervical HPV were more likely to have high-risk anal HPV.
Resumo Objetivo O objetivo deste estudo foi comparar a frequência de papilomavírus humano (HPV) de alto risco e citologia anal anormal em mulheres imunocompetentes com e sem lesões genitais induzidas por HPV. Métodos Este estudo transversal analítico e observacional foi realizado entre julho de 2017 e dezembro de 2018 em um ambulatório especializado de um hospital terciário em Fortaleza, CE. Cinquenta e sete mulheres imunocompetentes com e sem lesões intraepiteliais genitais foram avaliadas. Foram divididas em dois grupos: grupo 1, composto por mulheres com lesões genitais associadas ao HPV (n=26) e grupo 2, composto pormulheres sem lesões genitais associadas ao HPV (n=31). Amostras para citologia em meio líquido e testes de reação em cadeia da polimerase em tempo real para DNA-HPV de alto risco foram coletadas do colo do útero e do ânus. Todos os casos foram avaliados por anuscopia de alta resolução; sendo realizada biópsia quando necessária. Os testes exatos de Fisher e qui-quadrado foram aplicados para dados consolidados na tabela de contingência; o teste t de Student e o teste U de Mann-Whitney foram aplicados para variáveis independentes. Resultados As infecções anais por HPV de alto risco forammais frequentes no grupo 1 (razão de chances [RC], 4,95; intervalo de confiança [IC] de 95%, 1,34-18,3; p=0,012), assim como infecções concomitantes por HPV de alto risco em colo uterino e ânus (RC 18,8; IC de 95%, 2,20-160; p<0,001). A incidência de infecção de HPV cervical de alto risco foi associada à infecção de HPV anal de alto risco (RC, 4,95; IC de 95%, 1,34-18,3; p=0,012). Não houve diferença estatística em relação à citologia anal anormal ou anuscopia entre os grupos, e não houve caso de lesão intraepitelial anal em nenhum dos grupos. Conclusão Mulheres imunocompetentes com lesões genitais associadas ao HPV e com HPV cervical de alto risco foram mais propensas a ter HPV anal de alto risco.
Sujets)
Humains , Femelle , Tumeurs de l'anus , Papillomaviridae , Réaction de polymérisation en chaîne , Colposcopie , Biologie cellulaireRésumé
Introducción: La punción aspiración con aguja fina (PAAF) de tiroides se fundamentó y desarrolló por completo en 1950. Los informes citológicos eran descriptivos, no sistematizados, no comparables y rara vez indicaban el manejo del paciente. En 2007, en el Instituto Nacional del Cáncer de los Estados Unidos en Bethesda, se realiza el manual de la Nomenclatura y Sistemática de elaboración de los informes de PAAF tiroidea (Sistema Bethesda). En la actualidad, es una herramienta diagnóstica imprescindible para la evaluación de nódulos tiroideos y útil para decidir conducta e indicar la intervención quirúrgica. Objetivos: determinar el valor de la citología por PAAF en el diagnóstico final de los tumores tiroideos y comparar con el estudio patológico intraoperatorio y definitivo. Diseño: Estudio retrospectivo observacional. Lugar de aplicación: Hospital Público de atención terciaria de oncología. Materiales y métodos: se evaluaron todos los pacientes operados por patología tiroidea de enero de 2018 a diciembre de 2020, con PAAF previa y estudio patológico intraoperatorio. Resultados: La PAAF tuvo una sensibilidad de 96% y una especificidad del 70% con 1 falso negativo (FN) y 6 falsos positivos (FP), un valor predictivo positivo (VPP) de 85% y un valor predictivo negativo (VPN) de 87%. El porcentaje de malignidad según categoría de Bethesda fue: 28% para la categoría IV, 91% para V y 100% para VI. El estudio patológico intraoperatorio (EPI) tuvo una sensibilidad de 97% y especificidad del 83,3%, con 1 FN y 1 FP, un VPP de 96% y un VPN de 86%. Conclusión: El estudio de los tumores de tiroides por medio de la PAAF y su informe mediante el Sistema de Bethesda demostró, en general, ser confiable para evaluar el riesgo de malignidad tiroidea y la adecuada indicación de tratamiento quirúrgico a los pacientes estudiados en el preoperatorio.
Background: Thyroid fine needle aspiration (FNA) was fully founded and developed in 1950. Cytological reports were descriptive, not systematized, and not comparable and rarely indicated patient management. The manual of the Nomenclature and Systematics of preparation of the thyroid FNA reports (Bethesda System) was created in 2007, at the National Cancer Institute of the United States. At present, it is an essential diagnostic tool for the evaluation of thyroid nodules and useful for deciding on the conduct and indicating surgical intervention. Objectives: to determine the value of FNA cytology in the final diagnosis of thyroid tumors and to compare it with the intraoperative and definitive pathological study. Design: Retrospective observational study. Setting: Public Hospital for tertiary care of tumors. Material and methods: all patients surgically intervened for thyroid pathology from January 2018 to December 2020, with previous FNA and intraoperative pathological study, were evaluated. Results: FNA had a sensitivity of 96% and a specificity of 70% with one false negative (FN) and six of them with false positives (FP), a positive predictive value (PPV) of 85% and a negative predictive value (NPV) of 87%. The percentage of malignancy according to Bethesda category was: 28% for category IV, 91% for V and 100% for VI. Intraoperative histologic study (HIS) had a sensitivity of 97% and a specificity of 83.3%, with 1 FN and 1 FP, a PPV of 96% and a NPV of 86%. Conclusions: The study of thyroid tumors using FNA and its report using the Bethesda System proved, generally, to be reliable in evaluating the risk of thyroid malignancy and the adequate indication of surgical treatment in preoperative studied patients.
Sujets)
Humains , Adulte , Adulte d'âge moyen , Sujet âgé , Études rétrospectives , Nodule thyroïdien/chirurgie , Nodule thyroïdien/diagnostic , Biologie cellulaire , Cytoponction/méthodesRésumé
Objetivo: Determinar el nivel de incertidumbre de las usuarias que acuden a la toma de ci-tología cérvico uterina según la teoría de Mishel. Materiales y métodos: Estudio de corte transversal de tipo descriptivo, realizado durante el año 2019 a partir de una muestra por conveniencia; es no probabilística y está conformada por 151 mujeres a quienes se les aplicó la Escala de Incertidumbre en la enfermedad de Mishel adaptada para procedimientos de diagnósticos en Colombia en el año 2017 por la enfermera Leidy Yazmin Díaz Moreno. Tiene validez de contenido de 0.861 y Alfa de Cronbach de 0.90. Además, se realizó un análisis univariado a través de frecuencias y distribución porcentual para las característi-cas sociodemográficas. Para obtener los niveles de incertidumbre se efectuó la sumatoria de ítems y chi cuadrado a fin de identificar la asociación. Resultados: La edad promedio fue de 39 años; el 17,3% de mujeres manifestó acudir a la toma de la citología por primera vez. Aproximadamente el 95% de las mujeres presentó niveles de incertidumbre alto o modera-do. Conclusiones: La incertidumbre provocada por un posible diagnóstico de cáncer, hace que las personas evalúen inadecuadamente una situación estresante como lo es la toma de citología cérvico uterina; es por eso que, la aplicación de la teoría de Mishel lleva a que se identifiquen las primeras percepciones del paciente que servirán para realizar un plan de cuidado enfocado en controlar esta situación y lograr que la persona o familiar afronten y se adapten a la enfermedad.
Objective: Determine the uncertainty level of the user that goes to the taking of cervical cytol-ogy according to the Mishel theory. Materials and methods: Cross-sectional study of descrip-tive type, realized during the 2019 year starting at a convenience sampling, non-probabilistic formed by 151 women's who was apply the Uncertainty in Illness Scale of Mishel adapted to diagnosis procedures in Colombia in 2017 by the nurse Leidy Yazmisn Díaz Moreno. It has conten validity of 0.861 and Cronbach's alpha of 0.9 Was realized a univariate analysis through frequencies and percent distribution for the sociodemographic characteristics and to obtain the levels of uncertainty was carried out the summation of items and chi square to identify association. Results: The average age was 39 years, the 17,3% of women expressed go to the cytology by first time. Approximately the 95% of the women presented level of uncertainty high or moderate. Conclusion: The uncertainty caused for a possible terrible di-agnosis of cancer, can make that the persons evaluate inappropriately a stressful situation like the taking of the cervical cytology; that's why, the application of the Mishel Theory carry to identify the first perceptions of the patient to realize a care plan focus to control this situation and later reach that the person or familiar confront and adapt to the illness
Objetivo: Determinar o nível de incerteza dos clientes que freqüentam a citologia cervical de acordo com a teoria de Mishel. Materiais e métodos: Estudo descritivo transversal, realizado durante 2019 com base em uma amostra de conveniência; é não-probabilístico e é composto por 151 mulheres às quais foi aplicada a Escala de Incerteza Mishel adaptada para procedimentos diagnósticos na Colômbia em 2017 pela enfermeira Leidy Yazmin Díaz Moreno. Tem validade de conteúdo de 0,861 e o alfa do Cronbach de 0,90. Além disso, foi realizada uma análise uni-variada através de freqüências e distribuição percentual para as características sociodemográ-ficas. Para obter os níveis de incerteza, foi utilizada a soma dos itens e o qui-quadrado para iden-tificar a associação. Resultados: A idade média foi de 39 anos; 17,3% das mulheres relataram visitas citológicas pela primeira vez. Aproximadamente 95% das mulheres tinham níveis de incerteza altos ou moderados. Conclusões: A incerteza causada por um possível diagnóstico de câncer faz com que as pessoas avaliem inadequadamente uma situação estressante como a citologia cervical; portanto, a aplicação da teoria de Mishel leva à identificação das primeiras percepções do paciente que servirão para fazer um plano de cuidado focalizado no controle desta situação e fazer com que a pessoa ou membro da família enfrente e se adapte à doença
Sujets)
Biologie cellulaire , Attention , Incertitude , Diagnostic , Enseignement infirmier , Prévention secondaireRésumé
OBJETIVO. Determinar la efectividad del CONO LEEP en pacientes con lesión intraepitelial de Alto Grado (LIE AG). MATERIAL Y MÉTODO. Estudio de tipo descriptivo, retrospectivo y transversal que incluyo a 68 pacientes quienes fueron sometidas a CONO LEEP por lesiones intraepiteliales de alto grado en el año 2014 en la unidad de colposcopia del Hospital de la Mujer. Se analizó la efectividad a través de la persistencia y/o recidiva de los controles posteriores en el año 2015. RESULTADOS. 33 pacientes realizaron control PAP posterior al CONO LEEP siendo el resultado citológico negativo para lesión intraepitelial más frecuente llegando a un porcentaje de 91% (30 pacientes). Se identificó que el 9% (3 pacientes) presento persistencia al tratamiento con CONO LEEP. CONCLUSIONES. El estudio determino la efectividad del procedimiento en las pacientes que acudieron a control citológico, se estimó en 91 %, lo cual demuestra que la conización es un método de ALTA EFECTIVIDAD con un 9% de persistencia encontrándose en los rangos esperados de persistencia de la NIC que es entre el 5 y el 17% de acuerdo a protocolos de Brasil, México y España.
OBJETIVE. To determine the effectiveness of the LEEP CONE in patients with High Grade Intraepithelial Lesion (HLL). MATERIAL AND METHOD. A descriptive, retrospective and crosssectional study that included 68 patients who underwent LEEP CONE for high-grade intraepithelial lesions in 2014 in the colposcopy unit of La Mujer Hospital. The effectiveness was analyzed through the persistence and / or recurrence of subsequent controls in 2015. RESULTS. 33 patients underwent PAP control after the LEEP CONE, the cytological result being negative for the most frequent intraepithelial lesion, reaching a percentage of 91% (30 patients). It was identified that 9% (3 patients) presented persistence to treatment with LEEP CONE. CONCLUSIONS. The study determined the effectiveness of the procedure in patients who attended cytological control, it was estimated at 91%, which shows that conization is a HIGH EFFECTIVENESS method with a 9% persistence, being in the expected ranges of persistence of the NIC which is between 5 and 17% according to the protocols of Brazil, Mexico and Spain.
Sujets)
Conisation/instrumentation , Biologie cellulaire , Test de Papanicolaou , Lésions malpighiennes intra-épithélialesRésumé
One of the biggest dilemmas facing a cytopathology slide is the differential diagnosis of follicular thyroid lesions, grouped as follicular pattern lesions, which include goiter, follicular adenoma and follicular carcinoma, follicular variant of papillary thyroid carcinoma and non-invasive follicular thyroid neoplasm with papillary like nuclear features. Such lesions share many characteristics, which makes the proper identification of malignant follicular lesions a challenge. The cytology obtained through fine needle aspiration puncture is the most effective standard method for diagnosis of thyroid nodules, but its diagnostic efficacy clearly decreases in lesions of thyroid follicular pattern. Thus, a series of auxiliary tools for diagnoses, such as morphometry and nuclear texture analysis, have been increasingly used in the pathologist's practice, as an objective and reproducible tool. These are techniques, which depend on the incorporation of software to digital image analysis and can add accuracy to classical morphological analysis and immunohistochemistry in the evaluation of follicular pattern lesions. In addition to immunocytochemistry and molecular techniques, morphometry allows the estimation of parameters identified in individual cells and represents a tool that, based on quantitative parameters, translates reliable parameters for objective classification of the malignancy. This study aims to review the nuclear characteristics and their role in the diagnosis of follicular thyroid lesions.
Um dos maiores dilemas diante de uma lâmina de citopatologia é o diagnóstico diferencial de lesões foliculares da tiroide agrupadas como lesões de padrão folicular e que incluem; bócio, adenoma e carcinoma foliculares, carcinoma papilífero variante folicular e a neoplasia folicular não invasiva com características nucleares papilares (Uno de los mayores dilemas que presenta una muestra de citopatología es el diagnóstico diferencial de las lesiones foliculares tiroideas reunidas como lesiones de patrón folicular, que incluyen: bocio, adenoma folicular, carcinoma folicular, variante folicular del carcinoma papilar y la neoplasia folicular no invasiva con características nucleares de tipo papilar). Tais lesões compartilham muitas características, o que faz com que a identificação adequada de lesões foliculares malignas represente um desafio. A citologia obtida através de punção aspirativa por agulha fina é o método padrão mais efetivo para diagnóstico em nódulos de tiroide, mas sua eficácia diagnóstica diminui nitidamente em lesões de padrão folicular da tiroide (La citología por punción y aspiración con aguja fina es el método estándar más eficaz para el diagnóstico de los nódulos tiroideos, pero su eficacia diagnóstica se ve notablemente reducida en las lesiones de patrón folicular de la tiroides). Assim, uma série de ferramentas auxiliares ao diagnóstico, como a morfometria e a análise de textura nuclear, têm sido utilizadas cada vez mais na prática do patologista, como ferramenta objetiva e reproduzível. São técnicas que dependem da incorporação de softwares para análise digital de imagens e podem agregar acurácia à análise morfológica clássica e à imunohistoquímica na avaliação de lesões de padrão folicular (para el análisis de imágenes digitales y puede agregar precisión al análisis morfológico clásico y la inmunohistoquímica en la evaluación de lesiones de patrón folicular). Somando-se à imunocitoquímica e às técnicas moleculares, a morfometria permite a estimativa de parâmetros identificados em células individuais e representam uma ferramenta que, a partir de parâmetros quantitativos, traduz parâmetros confiáveis para classificação objetiva de malignidade. O objetivo deste estudo é rever as características nucleares e seu papel no diagnóstico de lesões foliculares da tiroide (es revisar las características nucleares y su papel en el diagnóstico de las lesiones foliculares tiroideas).
Sujets)
Cancer papillaire de la thyroïde , Glande thyroide , Immunohistochimie , Adénomes , Carcinome papillaire folliculaire , Biologie cellulaireRésumé
Background@#A fine needle aspiration biopsy has been established as a safe, minimally invasive procedure in evaluation of salivary gland lesions. The complex overlapping cytomorphology of these lesions are challenging for pathologists, hence the introduction of an evidence-based system, the Milan System of Reporting Salivary Gland Cytopathology, to improve overall patient care. The study was taken up to reclassify salivary gland lesions from previous FNA biopsies in order to determine sensitivity, specificity, positive and negative predictive values of FNA, and evaluate the risk of malignancy of the various categories of the Milan system.@*Methodology@#This was a 6-year retrospective descriptive study in a tertiary medical center. All salivary gland FNA cases were reviewed by two pathologists, and re-classified into the six categories of the Milan System. The number of false positive, false negative, true positive and true negative cases were obtained by comparing with the final histopathology diagnosis, and the risk of malignancy per category were calculated.@*Results@#A total of 76 cases were reviewed and the overall average of the two readers diagnostic accuracy were 85.02% (95% CI: 84.50-85.60%), sensitivity and specificity were 80.77% (95% CI: 79.90-81.60%) and 86.19% (95% CI: 85.70-86.70%), respectively; positive and negative predictive values were 62.16% (95% CI: 60.70-63.60%) and 94.17% (95% CI: 94.00-94.40%), respectively.@*Conclusion@#The Milan System category with highest risk of malignancy was Malignant (Category VI – 100%). FNAB is still a reliable tool for clinicians, and use of the Milan System of Reporting Salivary Gland Cytopathology is beneficial in increasing efficacy of communication among clinicians to improve patient care.
Sujets)
Biologie cellulaire , Glandes salivairesRésumé
Background@#The Milan System for Reporting Salivary Gland Cytopathology (MSRGC) aims to increase the overall effectiveness of salivary gland FNAB by defining six general diagnostic categories with corresponding Rates of Malignancies (ROM). This study aims to use this system to categorize salivary gland FNAB in the Philippine General Hospital and stratify ROM per category.@*Methodology@#In this study a total of 326 cases have been collected and reviewed, of which 154 (47.2%) had either surgical or clinical follow-up. The cases were assigned a Milan category by 3 cytopathologists blinded from the original diagnoses and from each other’s readings.@*Results@#The overall sensitivity, specificity, PPV, and NPV in detecting neoplasm is at 71.6%, 90.9%, 88.3%, and 76.9%, respectively. On the other hand, the sensitivity, specificity, PPV, and NPV in detecting malignancy is at 52%, 92.9%, 59.1%, and 90.7%, respectively. The computed ROM is as follows: Category I 7.89%, Category II 9.43%, Category III 20%, Category IVa 10.53%, Category IVb 60%, Category V 75%, and Category VI 100%.@*Conclusion@#The overall diagnostic utility of salivary gland FNAB, as well as the computed ROM per diagnostic category are comparable to internationally published literature. This study also validates the MSRSGC as a valuable tool in stratifying ROM in salivary gland lesions.
Sujets)
Biologie cellulaire , Glandes salivairesRésumé
Esta cartilla es parte de un proyecto que comenzó en el año 2019 en el Resguardo de Paujil con mujeres de los pueblos Puinave, Curripaco, Sikuani, Cubeo y Piapoco. La idea surgió de nuestras propias lideresas, especialmente de Irene Rojas Acosta, quien logró motivar a investigadores de tres universidades en Bogotá para que se escribiera y se presentara un proyecto de salud para las mujeres indígenas ante el Ministerio de Ciencia, Tecnología e Innovación. Invitó a 5 lideresas representantes de cada etnia para que hicieran parte activa del proyecto y le dieran continuidad; escrita en lenguas ancestrales y en español, representa un paso adelante en el trabajo por uno de estos derechos, como es el de la salud sexual y reproductiva de la mujeres. Con su lectura conoceremos cómo se entiende la enfermedad del cáncer de cuello uterino en la medicina occidental y cómo se puede evitar que las mujeres mueran por este motivo.
This booklet is part of a project that began in 2019 in the Paujil Reservation with women from the towns of Puinave, Curripaco, Sikuani, Cubeo and Piapoco. The idea arose from our own leaders, especially Irene Rojas Acosta, who managed to motivate researchers from three universities in Bogotá to write and present a health project for indigenous women to the Ministry of Science, Technology and Innovation. She invited 5 female leaders representing each ethnic group to take an active part in the project and give it continuity; Written in ancestral languages ââand in Spanish, it represents a step forward in the work for one of these rights, such as that of women's sexual and reproductive health. By reading it we will learn how the disease of cervical cancer is understood in Western medicine and how women can be prevented from dying from this reason.