[Agreement between cytology, colposcopy and cervical histopathology]. / Concordância entre citologia, colposcopia e histopatologia cervical.

PURPOSE: to evaluate the agreement between conventional cytology using the Papanicolaou test, repeated at the time of colposcopy, with colposcopic and histopathological findings. METHODS: the study was carried out at the central public health laboratory of the state of Pernambuco between January and July, 2008, involving 397 women referred for colposcopic evaluation following an abnormal cervical smear test. Cytology was repeated at the time of colposcopy using conventional method, with particular attention being paid to the presence of abnormal colposcopic findings. The nomenclature used for cytology was the 2001 Bethesda system terminology, while that used for histology was the World Health Organization 1994 classification. Cytology performed at the time of colposcopy was compared with colposcopy and with histopathology obtained by colposcopy-directed biopsy. The Kappa coefficient was used to evaluate the agreement between methods, as well as the χ2 test, with the level of significance set at 5%. RESULTS: poor agreement was found between cytology performed at the time of colposcopy and colposcopic findings (K=0.33; 95%CI=0.21-0.45) and between colposcopy and histopathology (K=0.35; 95%CI=0.39-0.51). Cytology performed at the time of colposcopy compared with histopathology revealed a Kappa of 0.41 (95%CI=0.29-0.530), which was considered to reflect moderate agreement. CONCLUSIONS: agreement was better between cytology and histopathology than between colposcopy and cytology or between colposcopy and histopathology.

Concordância entre citologia, colposcopia e histopatologia cervical / Agreement between cytology, colposcopy and cervical histopathology

OBJETIVO: avaliar a concordância da citologia convencional por Papanicolaou repetida no momento da colposcopia com os achados colposcópicos e a histopatologia. MÉTODOS: o estudo foi realizado no Laboratório Central de Saúde Pública do Estado de Pernambuco (LACEN), de janeiro a julho de 2008, em 397 mulheres com exame citopatológico alterado encaminhadas para avaliação colposcópica. No momento da colposcopia, repetiu-se a citologia em meio convencional, pesquisando-se os achados colposcópicos anormais. A nomenclatura citológica utilizada foi a de Bethesda e a histopatológica, da Organização Mundial de Saúde. A citologia no momento da colposcopia e a colposcopia foram comparadas entre si e com o resultado do histopatológico obtido por biópsia dirigida. A concordância entre os métodos foi avaliada pelo coeficiente Kappa (K), além do teste χ2 a um nível de significância de 5 por cento. RESULTADOS: foi encontrada uma concordância fraca entre a citologia realizada no momento da colposcopia e a colposcopia, K=0,33 (IC95 por cento=0,21-0,45) e entre a colposcopia e a histopatologia, K=0,35 (IC95 por cento=0,39-0,51). Para a concordância entre citologia no momento da colposcopia e histopatologia, o Kappa foi de 0,41 (IC95 por cento=0,29-0,530), considerado moderado. CONCLUSÕES: houve melhor concordância entre citologia e histopatologia do que entre colposcopia e citologia ou colposcopia e histopatologia.

PURPOSE: to evaluate the agreement between conventional cytology using the Papanicolaou test, repeated at the time of colposcopy, with colposcopic and histopathological findings. METHODS: the study was carried out at the central public health laboratory of the state of Pernambuco between January and July, 2008, involving 397 women referred for colposcopic evaluation following an abnormal cervical smear test. Cytology was repeated at the time of colposcopy using conventional method, with particular attention being paid to the presence of abnormal colposcopic findings. The nomenclature used for cytology was the 2001 Bethesda system terminology, while that used for histology was the World Health Organization 1994 classification. Cytology performed at the time of colposcopy was compared with colposcopy and with histopathology obtained by colposcopy-directed biopsy. The Kappa coefficient was used to evaluate the agreement between methods, as well as the χ2 test, with the level of significance set at 5 percent. RESULTS: poor agreement was found between cytology performed at the time of colposcopy and colposcopic findings (K=0.33; 95 percentCI=0.21-0.45) and between colposcopy and histopathology (K=0.35; 95 percentCI=0.39-0.51). Cytology performed at the time of colposcopy compared with histopathology revealed a Kappa of 0.41 (95 percentCI=0.29-0.530), which was considered to reflect moderate agreement. CONCLUSIONS: agreement was better between cytology and histopathology than between colposcopy and cytology or between colposcopy and histopathology.

Encefalopatia mioclônica da infância: relato de caso / Encephalopatia myoclonica infantilis: a case report

Os autores apresentam um caso de encefalopatia mioclônica da infância em uma criança de 3 anos de idade, na qual alteraçÖes licóricas säo constatadas. Uma breve exposiçäo dos aspectos clínicos, evolutivos e terapêuticos desta afecçäo rara é realizada