Derm dotting: una técnica novedosa para mejorar la precisión diagnóstica de lesiones cutáneas / Derm Dotting: A New Technique That Improves Diagnostic Precision in the Evaluation of Skin Lesions

La dermatoscopia ha aumentado la precisión en el diagnóstico clínico de lesiones cutáneas complejas. Es una herramienta que permite identificar pequeñas áreas de sospecha, no apreciables a simple vista y que requieren examen histopatológico específico. El derm dotting es un método de marcaje selectivo de zonas de interés para asegurar que estos focos son estudiados microscópicamente, puesto que por su pequeño tamaño podrían no aparecer en las secciones de rutina o ser difíciles de correlacionar con la imagen dermatoscópica. Combina la dermatoscopia in vivo o ex vivo con la aplicación de esmalte ungueal. A diferencia de los colorantes usuales, el uso de esmalte ungueal no altera la histología. Puede ser aplicado por parte del dermatólogo o durante el procesamiento macroscópico en el laboratorio. El derm dotting es una técnica novedosa, sencilla y económica, que puede implementarse rápidamente en cualquier Laboratorio de Dermatopatología. Mejora la precisión diagnóstica ya que traslada los hallazgos dermatoscópicos al estudio histológico

Dermoscopy has improved diagnostic precision in the clinical evaluation of complex skin lesions by helping to pinpoint small clinically suspicious areas that are not visible to the naked eye but require histopathologic examination. Derm dotting is a new technique for selectively marking areas of interest to ensure they are examined under a microscope. Left unmarked, suspicious areas might not appear in routinely prepared cross sections or might be difficult to correlate with dermoscopic images. In vivo or ex vivo derm dotting involves the application of nail polish, which, unlike stains, leaves tissues unaltered. Dots can be placed by the dermatologist or laboratory staff during macroscopic preparation of the sample. Derm dotting is a simple, inexpensive technique that any dermatopathology laboratory can quickly adopt to improve diagnostic precision through better dermoscopic-histologic correlation

Derm Dotting: A New Technique That Improves Diagnostic Precision in the Evaluation of Skin Lesions. / Derm dotting: una técnica novedosa para mejorar la precisión diagnóstica de lesiones cutáneas.

Dermoscopy has improved diagnostic precision in the clinical evaluation of complex skin lesions by helping to pinpoint small clinically suspicious areas that are not visible to the naked eye but require histopathologic examination. Derm dotting is a new technique for selectively marking areas of interest to ensure they are examined under a microscope. Left unmarked, suspicious areas might not appear in routinely prepared cross sections or might be difficult to correlate with dermoscopic images. In vivo or ex vivo derm dotting involves the application of nail polish, which, unlike stains, leaves tissues unaltered. Dots can be placed by the dermatologist or laboratory staff during macroscopic preparation of the sample. Derm dotting is a simple, inexpensive technique that any dermatopathology laboratory can quickly adopt to improve diagnostic precision through better dermoscopic-histologic correlation.

Intervenciones conductuales para la prevención de infecciones de transmisión sexual y embarazo no deseado: revisión de revisiones sistemáticas / Behavioral Interventions for Preventing Sexually Transmitted Infections and Unintended Pregnancies: An Overview of Systematic Reviews

INTRODUCCIÓN: En los últimos decenios se han desarrollado muchos programas de educación sexual en todo el mundo. Los datos epidemiológicos no indican una mejoría en las tasas de infecciones de transmisión sexual y embarazo no deseado. OBJETIVOS: Sintetizar la evidencia de las revisiones sistemáticas de mayor calidad sobre la eficacia de las intervenciones conductuales para la prevención de infecciones de transmisión sexual y embarazo no deseado. MÉTODOS: Se diseñó una «revisión de revisiones» seleccionando revisiones sistemáticas que cumpliesen unos criterios de calidad mínimos (en función del diseño de los estudios que incluyen). Se compararon los resultados obtenidos al evaluar los efectos de las intervenciones mediante criterios objetivos (datos biológicos) con los conseguidos al evaluarlos mediante criterios subjetivos (autoinforme), así como en función de si se trataba o no de una revisión Cochrane. RESULTADOS: Se identificaron 55 revisiones sistemáticas. En el 72,5% no se observó efecto global de las intervenciones en la conducta sexual de los participantes, evaluada mediante variables objetivas. Cuando se evaluaban las intervenciones mediante resultados subjetivos, no se detectó efecto global en el 48,1% de las revisiones. El 86,6% de las revisiones Cochrane no observaron efecto al usar variables objetivas, y el 70,5% no lo detectaron mediante variables subjetivas. CONCLUSIÓN: No hay evidencia de que las intervenciones conductuales modifiquen las tasas de infección de transmisión sexual (incluyendo el virus de la inmunodeficiencia humana) ni de embarazo no deseado, sobre todo cuando se evalúan mediante resultados biológicos objetivos. Es importante reevaluar las estrategias de prevención primaria en infecciones de transmisión sexual y embarazo no deseado

BACKGROUND: Countless sex education programs have been implemented worldwide in recent decades, but epidemiological data show no improvement in rates of sexually transmitted infections or unintended pregnancies. OBJECTIVE: To summarize the evidence from higher-quality systematic reviews on the efficacy of behavioral interventions for the prevention of sexually transmitted infections and unintended pregnancies. METHODS: We conducted an overview of reviews by selecting systematic reviews that met minimum quality criteria in terms of the design of the studies reviewed. We compared the results obtained when the effects of interventions were assessed on the basis of objective criteria (biological data) to those obtained when outcomes were assessed on the basis of subjective criteria (self-reports). The results of Cochrane and non-Cochrane reviews were also compared. RESULTS: We identified 55 systematic reviews. No overall effect on the sexual behavior of program participants was observed in 72.5% of the reviews that used objective criteria and in 48.1% of the reviews based on subjective criteria. In the Cochrane reviews, no evidence of an overall effect was observed in 86% of reviews based on objective variables and in 70.5% of those based on subjective variables. CONCLUSIONS: There is no evidence that behavioral interventions modify rates of sexually transmitted infections (including human immunodeficiency virus infections) or unintended pregnancies, particularly when effects are assessed using objective, biological data. Primary prevention strategies for sexually transmitted infections and unintended pregnancies need to be re-evaluated

Behavioral Interventions for Preventing Sexually Transmitted Infections and Unintended Pregnancies: An Overview of Systematic Reviews. / Intervenciones conductuales para la prevención de infecciones de transmisión sexual y embarazo no deseado: revisión de revisiones sistemáticas.

BACKGROUND: Countless sex education programs have been implemented worldwide in recent decades, but epidemiological data show no improvement in rates of sexually transmitted infections or unintended pregnancies. OBJECTIVE: To summarize the evidence from higher-quality systematic reviews on the efficacy of behavioral interventions for the prevention of sexually transmitted infections and unintended pregnancies. METHODS: We conducted an overview of reviews by selecting systematic reviews that met minimum quality criteria in terms of the design of the studies reviewed. We compared the results obtained when the effects of interventions were assessed on the basis of objective criteria (biological data) to those obtained when outcomes were assessed on the basis of subjective criteria (self-reports). The results of Cochrane and non-Cochrane reviews were also compared. RESULTS: We identified 55 systematic reviews. No overall effect on the sexual behavior of program participants was observed in 72.5% of the reviews that used objective criteria and in 48.1% of the reviews based on subjective criteria. In the Cochrane reviews, no evidence of an overall effect was observed in 86% of reviews based on objective variables and in 70.5% of those based on subjective variables. CONCLUSIONS: There is no evidence that behavioral interventions modify rates of sexually transmitted infections (including human immunodeficiency virus infections) or unintended pregnancies, particularly when effects are assessed using objective, biological data. Primary prevention strategies for sexually transmitted infections and unintended pregnancies need to be re-evaluated.