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1.
World Neurosurg ; 2024 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-38759786

RESUMEN

BACKGROUND: Traumatic brain injury (TBI) has become a major source of disability worldwide, increasing the interest in algorithms that use Artificial Intelligence (AI) to optimize the interpretation of imaging studies, prognosis estimation, and critical care issues. In this study we present a bibliometric analysis and Mini Review on the main uses that have been developed for TBI in AI. METHODS: The results informing this review come from a Scopus database search as of April 15, 2023. The bibliometric analysis was carried out via the mapping bibliographic metrics method. Knowledge mapping was made in the VOSviewer software (V1.6.18), analyzing the "link strength" of networks based on co-occurrence of keywords, countries co-authorship and co-cited authors. In the mini-review section, we highlight the main findings and contributions of the studies. RESULTS: A total of 495 scientific publications were identified from 2000 to 2023, with 9262 citations published since 2013. Among the 160 journals identified, The Journal of Neurotrauma, Frontiers in Neurology, and Plos One where those with the greatest number of publications. The most frequently co-occurring keywords were: "machine learning", "deep learning", "magnetic resonance imaging", and "intracranial pressure". The United States accounted for more collaborations than any other country, followed by United Kingdom and China. Four co-citation author clusters were found, and the top 20 papers were divided into reviews and original articles. CONCLUSION: AI has become a relevant research field in TBI during the last 20 years, demonstrating great potential in imaging, but a more modest performance for prognostic estimation and neuromonitoring.

2.
Int J Sex Health ; 36(2): 221-235, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38616798

RESUMEN

Objective: To contextualize condom use in the transgender women population utilizing the HIV syndemic framework. Methods: Studies reporting condom use frequency and syndemic factors associated with HIV risk in transgender women were systematically searched. We followed the Scoping Reviews (PRISMA-ScR) checklist. Results: Social factors have a proven relationship with using condoms and HIV among transgender women. Syndemic factors, defined as co-occurring adverse factors that interact to contribute to risk behaviors, deserve a specific analysis to develop strategies to face HIV among transgender women. Conclusions: A syndemic perspective allows to generate specific health intervention and prevention policies to protect transgender women.

3.
Artículo en Inglés | MEDLINE | ID: mdl-38546455

RESUMEN

OBJECTIVE: To compare the pelvic lymph node involvement and risk of recurrence in patients with human papillomavirus (HPV)-associated endocervical adenocarcinoma stage IA2-IB1 undergoing hysterectomy and/or trachelectomy plus lymphadenectomy, according to Silva's classification system. METHODS: A retrospective cohort study was performed in two Colombian cancer centers. The cases were classified according to the Silva classification system. Clinical, surgical, and histopathological variables were evaluated. Recurrence risk was analyzed by patterns A, B, or C. A logistic regression model was performed for tumor recurrence. The Kaplan-Meier method was used to estimate overall survival and disease-free survival (DFS). A weighted kappa was performed to determine the degree of concordance between pathologists. RESULTS: A total of 100 patients were identified, 33% pattern A, 29% pattern B, and 38% pattern C. The median follow-up time was 42.5 months. No evidence of lymph node involvement was found in patients classified as A and B, while in the C pattern was observed in 15.8% (n = 6) of cases (P < 0.01). There were 7% of cases with recurrent disease, of which 71.5% corresponded to type C pattern. Patients with Silva pattern B and C had 1.22- and 4.46-fold increased risk of relapse, respectively, compared with pattern A. The 5-year DFS values by group were 100%, 96.1%, and 80.3% for patterns A, B, and C, respectively. CONCLUSION: For patients with early-stage HPV-associated endocervical adenocarcinoma, the type C pattern presented more lymph node involvement and risk of recurrence compared to the A and B patterns. The concordance in diagnosis of different Silva's patterns by independents pathologists were good.

4.
AIDS Educ Prev ; 35(5): 362-375, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37843906

RESUMEN

Prevalence of human immunodeficiency virus (HIV) is higher in transgender populations. Pre-exposure prophylaxis (PrEP) intervention is successful in reducing HIV acquisition. We aimed to investigate the adherence to oral PrEP by HIV-negative transgender women (TW). We followed the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA Statement. We searched in WoS, OVID, Scopus, MEDLINE, and the Cochrane Central Register of Controlled Trials databases. Participation and adherence to the intervention were low for TW compared to cisgender men who have sex with men (cMSM), and it was measured mostly by self-report (72.7%) or tenofovir-diphosphate/emtricitabine triphosphate dried blood spot (45.5%). Awareness should increase and the effect of oral PrEP on gender-affirming hormone therapy should be explained to TW at the beginning of the trials. One limitation is that our sample size was dominated by two Thai studies with TW sex workers. Future studies should evaluate adherence to new PrEP modalities.


Asunto(s)
Fármacos Anti-VIH , Infecciones por VIH , Profilaxis Pre-Exposición , Minorías Sexuales y de Género , Personas Transgénero , Masculino , Humanos , Femenino , Infecciones por VIH/prevención & control , Tenofovir/uso terapéutico , Homosexualidad Masculina , Fármacos Anti-VIH/uso terapéutico , Cumplimiento de la Medicación
5.
Int J Gynecol Cancer ; 31(4): 504-511, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33504547

RESUMEN

INTRODUCTION: Recent evidence has shown adverse oncological outcomes when minimally invasive surgery is used in early-stage cervical cancer. The objective of this study was to compare disease-free survival in patients that had undergone radical hysterectomy and pelvic lymphadenectomy, either by laparoscopy or laparotomy. METHODS: We performed a multicenter, retrospective cohort study of patients with cervical cancer stage IA1 with lymph-vascular invasion, IA2, and IB1 (FIGO 2009 classification), between January 1, 2006 to December 31, 2017, at seven cancer centers from six countries. We included squamous, adenocarcinoma, and adenosquamous histologies. We used an inverse probability of treatment weighting based on propensity score to construct a weighted cohort of women, including predictor variables selected a priori with the possibility of confounding the relationship between the surgical approach and survival. We estimated the HR for all-cause mortality after radical hysterectomy with weighted Cox proportional hazard models. RESULTS: A total of 1379 patients were included in the final analysis, with 681 (49.4%) operated by laparoscopy and 698 (50.6%) by laparotomy. There were no differences regarding the surgical approach in the rates of positive vaginal margins, deep stromal invasion, and lymphovascular space invasion. Median follow-up was 52.1 months (range, 0.8-201.2) in the laparoscopic group and 52.6 months (range, 0.4-166.6) in the laparotomy group. Women who underwent laparoscopic radical hysterectomy had a lower rate of disease-free survival compared with the laparotomy group (4-year rate, 88.7% vs 93.0%; HR for recurrence or death from cervical cancer 1.64; 95% CI 1.09-2.46; P=0.02). In sensitivity analyzes, after adjustment for adjuvant treatment, radical hysterectomy by laparoscopy compared with laparotomy was associated with increased hazards of recurrence or death from cervical cancer (HR 1.7; 95% CI 1.13 to 2.57; P=0.01) and death for any cause (HR 2.14; 95% CI 1.05-4.37; P=0.03). CONCLUSION: In this retrospective multicenter study, laparoscopy was associated with worse disease-free survival, compared to laparotomy.


Asunto(s)
Histerectomía/métodos , Laparoscopía/métodos , Neoplasias del Cuello Uterino/cirugía , Adulto , Estudios de Cohortes , Supervivencia sin Enfermedad , Femenino , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Estudios Retrospectivos , Resultado del Tratamiento , Neoplasias del Cuello Uterino/mortalidad , Adulto Joven
6.
CES odontol ; 33(2): 213-232, jul.-dic. 2020. tab
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1285763

RESUMEN

Resumen El control periódico en un tratamiento de Ortodoncia permite establecer una buena secuencia de tratamiento sin riesgos para el paciente. Un tratamiento sin la vigilancia adecuada puede llegar a generar daños irreversibles. Sin embargo, por la pandemia de COVID-19 que enfrenta el mundo actualmente y los riesgos en el área de la salud, se han suspendido temporalmente los servicios no vitales y potencialmente expuestos a contagios como lo son los servicios odontológicos de consulta programada. Teniendo en cuenta esta situación, y que este virus puede llegar a ser endémico en la población humana, se hace necesario establecer protocolos de bioseguridad que permitan reactivar las prácticas odontológicas, y a su vez genear garantías para operadores, personal de apoyo, pacientes y el entorno de los mismos. En este contexto, es de gran importancia desarrollar un protocolo con profesionales expertos en tratamientos ortodóncicos y en el manejo de la pandemia, para delinear procesos de calidad que garanticen un ambiente seguro y minimicen los riesgos de contagio.


Abstract Periodic control in an Orthodontic treatment allows establishing a good treatment sequence without risks for the patient. Treatment without proper monitoring can lead to irreversible damage. However, due to the COVID-19 pandemic facing the world today and the risks in the health area, non-vital and potentially contagious services such as scheduled consultation dental services have been temporarily closed. Taking into account this situation, and that this virus will end up being endemic, it is necessary to establish biosafety protocols that allow reactivating dental practices, and in turn generate guarantees for operators, support staff, patients and the environment of the themselves. In this context, it is of great importance to develop a protocol carried out with expert professionals in orthodontic treatments and in the pandemic, to outline the quality protocol that guarantees a safe environment and minimizes the risks of infection.


Resumo O controle periódico em um tratamento ortodôntico permite estabelecer uma boa sequência de tratamento sem riscos para o paciente. O tratamento sem monitoramento adequado pode levar a danos irreversíveis. No entanto, devido à pandemia do COVID-19 que o mundo enfrenta atualmente e aos riscos na área da saúde, serviços não vitais e potencialmente contagiosos foram temporariamente suspensos, como serviços odontológicos agendados para consultas. Considerando essa situação e que esse vírus pode se tornar endêmico na população humana, é necessário estabelecer protocolos de biossegurança que permitam reativar as práticas odontológicas e, por sua vez, gerar garantias aos operadores, pessoal de apoio, pacientes e meio ambiente. Dos mesmos. Nesse contexto, é de grande importância o desenvolvimento de um protocolo com profissionais especialistas em tratamentos ortodônticos e no manejo da pandemia, para delinear processos de qualidade que garantam um ambiente seguro e minimizem os riscos de infecção.

7.
Int J Gynaecol Obstet ; 150(3): 368-378, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32526044

RESUMEN

OBJECTIVE: To determine the acceptance rate of treatment alternatives for women with either preinvasive conditions or gynecologic cancers during the COVID-19 pandemic among Latin American gynecological cancer specialists. METHODS: Twelve experts in gynecological cancer designed an electronic survey, according to recommendations from international societies, using an online platform. The survey included 22 questions on five topics: consultation care, preinvasive cervical pathology, and cervical, ovarian, and endometrial cancer. The questionnaire was distributed to 1052 specialists in 14 Latin American countries. A descriptive analysis was carried out using statistical software. RESULTS: A total of 610 responses were received, for an overall response rate of 58.0%. Respondents favored offering teleconsultation as triage for post-cancer treatment follow-up (94.6%), neoadjuvant chemotherapy in advanced stage epithelial ovarian cancer (95.6%), and total hysterectomy with bilateral salpingo-oophorectomy and defining adjuvant treatment with histopathological features in early stage endometrial cancer (85.4%). Other questions showed agreement rates of over 64%, except for review of pathology results in person and use of upfront concurrent chemoradiation for early stage cervical cancer (disagreement 56.4% and 58.9%, respectively). CONCLUSION: Latin American specialists accepted some alternative management strategies for gynecological cancer care during the COVID-19 pandemic, which may reflect the region's particularities. The COVID-19 pandemic led Latin American specialists to accept alternative management strategies for gynecological cancer care, especially regarding surgical decisions.


Asunto(s)
COVID-19/terapia , Neoplasias de los Genitales Femeninos/terapia , Complicaciones Neoplásicas del Embarazo/terapia , SARS-CoV-2 , Femenino , Directrices para la Planificación en Salud , Humanos , Histerectomía , América Latina , Terapia Neoadyuvante , Neoplasias Ováricas/terapia , Embarazo , Salpingooforectomía , Neoplasias del Cuello Uterino/terapia
8.
Rev. colomb. cancerol ; 23(3): 82-91, jul.-set. 2019. tab, graf
Artículo en Español | LILACS | ID: biblio-1042759

RESUMEN

Resumen Objetivo: Proporcionar características demográficas y clínicas, así como estimaciones de supervivencia global a tres años de pacientes con cáncer epitelial de ovario (CEO) tratadas entre 2005 y 2014 en el Instituto Nacional de Cancerología de Colombia (INC). Métodos: Se incluyeron 783 pacientes diagnosticadas y tratadas por primera vez en el INC por CEO en los periodos 2005-2008, 2009-2011 y 2012-2014 sin un diagnóstico previo de otro cáncer. Se cruzaron datos del registro hospitalario de cáncer con bases de datos gubernamentales para obtener información de seguimiento. Utilizando el método Kaplan-Meier se estimó la probabilidad de sobrevivir a 36 meses a partir de la fecha de ingreso, evaluando diferencias en supervivencia entre grupos con la prueba de rango logarítmico. Se utilizaron modelos multivariados de riesgos proporcionales de Cox para evaluar: el efecto relativo de edad, el estadio clínico, el subtipo histológico y el tipo de tratamiento inicial en la supervivencia. Resultados: La probabilidad de supervivencia global a 36 meses fue de 56,5% (IC 95%: 53,0; 60,0), que se mantuvo estable en los tres periodos. La edad avanzada, el estadio clínico y el subtipo histológico afectaron significativamente la supervivencia global a tres años: 49,5% (IC 95%: 43; 55,6) para mujeres >59 años; 21,9% (IC 95%: 14,7; 29,2) para la enfermedad en estadio IV y 56,3% (IC 95%: 37,5; 54,3) para los tumores serosos. Las estimaciones de hazard fueron significativamente más altas en pacientes de 59 años o más (HR 1,54 (IC del 95%: 1,04 a 2,27)) y en cánceres con estadio avanzado (HR 13,47 (IC 95%: 7,92-22,92)); la cirugía más quimioterapia tuvo una reducción en el riesgo en comparación con otros tratamientos (HR 0,84 (IC 95% 0,52-1,36). Conclusiones: La supervivencia del cáncer epitelial de ovario se mantuvo estable con el tiempo. La variación se presentó en factores como: la edad, el estadio clínico y el primer tratamiento.


Abstract Aims: To provide demographical and clinical characteristics and estimations of 3-year overall survival of epithelial ovarian cancer (EOC) patients treated at the Colombian National Cancer Institute (INC) between 2005 and 2014. Methods: All 783 patients first treated at INC for EOC in the three periods: (2005-2008, 2009-2011, 2012-2014), without a prior cancer diagnosis, were included in this study. Follow-up was realized by cross-linkage with governmental databases using person identification numbers. Probability of surviving 36 months since the date of entry at INC was estimated using Kaplan-Meier methods, using the log-rank test to evaluate differences between groups. We used multivariate Cox proportional hazard models to evaluate the relative effect of age, clinical stage, histological subtype and treatment first on survival. Results: The overall survival probability at 36 months was 56.5% (95% CI: 53.0, 60.0), which was stable over time. Advanced age and clinical stage significantly affected 3-year overall survival, being 49.5°% (95°% CI: 43.4, 55.6) for age > 59, 21.9°% (95°% CI: 14.7, 29.2) for stage IV disease and 56.3% (95% CI: 37.5, 54.3) for serous tumors. Hazard ratios were significantly higher for patients aged 59 and over (HR 1.54 (95%CI 1.04-2.27)) and advanced stage cancers (HR 13.47 (95%CI 7.92-22.92)), whereas patients with surgery plus chemotherapy had a strongly reduced risks compared to other treatments (HR 0.84 (95%CI 0.52-1.36)). Conclusions: Survival of epithelial ovarian cancer was stable over time, with a variation according to age, clinical stage and first treatment.


Asunto(s)
Humanos , Registros de Hospitales , Carcinoma Epitelial de Ovario , Sistema de Registros
9.
Bogotá; Alcaldía Mayor de Bogotá;Secretaría Distrital de Salud; 2019. 9 p. graf.
No convencional en Español | Coleciona SUS | ID: biblio-1415833

RESUMEN

Vigilancia de virus respiratorios y tosferina, Bogotá


Asunto(s)
Humanos , Virus , Informe de Investigación , Tos Ferina
10.
Iatreia ; 26(4): 397-407, oct.-dic. 2013. ilus
Artículo en Español | LILACS | ID: lil-695809

RESUMEN

Introducción: el accidente cerebrovascular es la primera causa de discapacidad y la tercera de muerte en Colombia y en el resto del mundo y está asociado a enfermedades mentales y neurodegenerativas. Objetivo: determinar los efectos de la asociación atorvastatina-meloxicam sobre la gliosis reactiva en un modelo de isquemia cerebral por embolización arterial. Materiales y métodos: se utilizaron 56 ratas Wistar macho adultas, distribuidas en cuatro grupos isquémicos y cuatro controles, además de otras 10 para determinar la distribución y extensión del infarto, induciendo lesión en seis de ellas y simulación (sham) en las cuatro restantes. Los tratamientos fueron: placebo, atorvastatina (ATV), meloxicam (MELOX) y ATV + MELOX en isquémicos y simulados. Veinticuatro horas después de la isquemia se evaluó la actividad enzimática mitocondrial con trifeniltetrazolio (TTC) y a las 120 horas, la reactividad astrocitaria (anti-GFAP), mediante inmunohistoquímica convencional. Resultados: la asociación ATV+MELOX favoreció la modulación en la respuesta de los astrocitos protoplasmáticos y fibrosos del hipocampo y de la zona paraventricular, reduciendo su hiperreactividad. Conclusión: ATV y MELOX, aisladamente o asociados, reducen el daño cerebral atenuando la gliosis reactiva consecuente a la embolización arterial, lo que sugiere nuevos mecanismos de neuroprotección frente a la isquemia cerebral tromboembólica y abre nuevas perspectivas para su tratamiento temprano.


Introduction: Stroke is the leading cause of disability and the third of death in Colombia and in the world and it is associated with neurodegenerative and mental diseases. Objective: To determine the effects of the atorvastatin- meloxicam association on reactive gliosis in a model of cerebral ischemia produced by arterial embolization. Materials and methods: 56 adult male Wistar rats were used, divided into four ischemic and four control groups, plus 10 additional animals to determine the distribution and extent of infarction by injury in six of them and simulation (sham) in the remaining four. The treatments were: placebo, atorvastatin (ATV), meloxicam (MELOX) and ATV + MELOX in ischemic and simulated animals. 24 hours post-ischemia mitochondrial enzymatic activity was evaluated with triphenyl- tetrazolium (TTC), and at 120 hours astrocytic reactivity (anti-GFAP) was analyzed by conventional immunohistochemistry. Results: The association ATV + MELOX favored the modulation of the response of protoplasmatic and fibrous astrocytes in both the hippocampus and the paraventricular zone by reducing their hypereactivity. Conclusion: Atorvastatin and meloxicam, either individually or associated, reduce cerebral damage by lessening the reactive gliosis produced by arterial embolization; this suggests new mechanisms of neuroprotection against thromboembolic cerebral ischemia, and opens new perspectives in its early treatment.


Asunto(s)
Humanos , Ratas , Embolia/terapia , Isquemia Encefálica/terapia , Relación Dosis-Respuesta a Droga , Ratas Wistar
11.
Cad Saude Publica ; 26(5): 900-8, 2010 May.
Artículo en Inglés | MEDLINE | ID: mdl-20563390

RESUMEN

In most developing countries, HPV vaccines have been licensed but there are no national policy recommendations, nor is it clear how decisions on the introduction of this new vaccine are made. Decentralization processes in many Latin American countries favor decision-making at the local level. Through a qualitative study we explored knowledge regarding the HPV vaccine and the criteria that influence decision-making among local health actors in four regions of Colombia. We conducted a total of 14 in-depths interviews with different actors; for the analysis we performed content analysis. Results indicate that decision-making on the HPV vaccine at the local level has mainly been driven by pressure from local political actors, in a setting where there is low technical knowledge of the vaccine. This increases the risk of initiatives that may foster inequity. Local decisions and initiatives need to be strengthened technically and supported by national-level decisions, guidelines and follow-up.


Asunto(s)
Toma de Decisiones , Política de Salud , Vacunas contra Papillomavirus/uso terapéutico , Neoplasias del Cuello Uterino/prevención & control , Adolescente , Colombia , Países en Desarrollo , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Investigación Cualitativa , Neoplasias del Cuello Uterino/virología
12.
Cad. saúde pública ; 26(5): 900-908, maio 2010. tab
Artículo en Inglés | LILACS | ID: lil-548356

RESUMEN

In most developing countries, HPV vaccines have been licensed but there are no national policy recommendations, nor is it clear how decisions on the introduction of this new vaccine are made. Decentralization processes in many Latin American countries favor decision-making at the local level. Through a qualitative study we explored knowledge regarding the HPV vaccine and the criteria that influence decision-making among local health actors in four regions of Colombia. We conducted a total of 14 in-depths interviews with different actors; for the analysis we performed content analysis. Results indicate that decision-making on the HPV vaccine at the local level has mainly been driven by pressure from local political actors, in a setting where there is low technical knowledge of the vaccine. This increases the risk of initiatives that may foster inequity. Local decisions and initiatives need to be strengthened technically and supported by national-level decisions, guidelines and follow-up.


En gran parte de los países en vías de desarrollo, las vacunas contra el VPH tienen aprobación para su comercialización. Sin embargo, no hay recomendaciones y tampoco hay claridad sobre la forma en la que se toman las decisiones para su introducción. La reforma del sistema de salud en muchos países latinoamericanos permite la toma de decisiones en el nivel local. Mediante un estudio cualitativo con actores claves del sector salud en cuatro regiones de Colombia, exploramos el conocimiento sobre la vacuna del VPH y los criterios que influyen en la toma de decisiones. Se realizaron 14 entrevistas en profundidad y análisis de contenido. Los resultados indican que en el nivel local la toma de decisiones sobre la introducción de la vacuna está determinada en gran parte por la presión ejercida por figuras políticas locales. Esto, sumado a un bajo nivel de conocimiento técnico, incrementa la posibilidad de iniciativas con implicaciones éticas considerables. Las decisiones e iniciativas locales relacionadas con esta vacuna necesitan fortalecerse técnicamente y apoyarse desde el nivel nacional.


Asunto(s)
Adolescente , Femenino , Humanos , Toma de Decisiones , Política de Salud , Vacunas contra Papillomavirus/uso terapéutico , Neoplasias del Cuello Uterino/prevención & control , Colombia , Países en Desarrollo , Conocimientos, Actitudes y Práctica en Salud , Investigación Cualitativa , Neoplasias del Cuello Uterino/virología
13.
Rev. colomb. obstet. ginecol ; 60(3): 213-222, jul.-sept. 2003. ilus, tab
Artículo en Español | LILACS | ID: lil-532747

RESUMEN

Objetivo: evaluar la exactitud de la prueba ADNHPV en el diagnóstico de lesiones premalignas cervicales de alto grado (HSIL, por sus siglas en inglés) en mujeres con alteraciones citológicas ASC-US (células escamosas atípicas de significado indeterminado) y LSIL (lesión escamosa intraepitelial de bajo grado). Metodología: estudio de validez diagnóstica y de cohorte transversal, realizado en mujeres con diagnóstico citológico de ASC-US o LSIL entre octubre de 2006 y enero de 2008, pertenecientes al Programa de Tamizaje de Cáncer de Cérvix de una aseguradora privada en Bogotá (Colombia). Se comparó el resultado de la colposcopia y de la prueba de ADN-HPV con la patología del cérvix como patrón de oro. Resultados: de las 429 mujeres, 344 (80,2%) presentaron ASC-US y 85 (19,8%) LSIL. Las prevalencias de infección por HPV de alto riesgo fueron 52,9% y 75,7% en pacientes con reporte citológico de ASC-US y LSIL, respectivamente. A las 379 de las 425 pacientes se les practicó biopsia, 24 (6,3%) dieron positivas para HSIL. La sensibilidad de la prueba ADN-HPV para detectar lesiones de alto grado (NIC 2+) en las mujeres con reportes de citología ASC-US y LSIL fue 88% y la especificidad fue 44%. En 21 (87.5%) de los 24 casos de HSIL se detectó la presencia de HPV de alto riesgo. Conclusión: debido a que la prueba ADN-HPV tiene una sensibilidad superior a la citología cervicovaginal (CCV), ésta puede considerarse una alternativa útil para estratificar el riesgo y mejorar la aproximación diagnóstica de lesiones premalignas del cuello uterino en mujeres con reporte de ASC-US.


Objective: evaluating the accuracy of the HPV DNA test as a complementary test for diagnosing highgrade cervical disease (high-grade squamous intra epithelia lesions-HSIL) in women with minor cytological abnormalities (atypical squamous cells of undetermined significance ASC-US) and low-grade squamous intraepithelial lesions (LSIL). Methodology: a diagnostic validity study based on a cross-sectional design was applied to 429 women who had had a cytological report of ASC-US and/or LSIL who were attending a health maintenance organisation’s cervical cancer screening programme in Bogotá, Colombia between January 2006 and October 2008. Colposcopy reports and HPV-DNA testresultswerecomparedwithpathologicalreports which were considered the gold standard. Results: 344 (80.2%) of the 429 women had a cytological report of ASC-US and 85 (19.8%) of them one for LSIL. High-risk HPV infection prevalence was 52.9% and 75.7% in patients having an ASC-US and LSIL report, respectively. A biopsy specimen was obtained in 379 of the 429 participants and 24 high-grade cases (6.3%) were diagnosed. DNA-HPV test sensitivity was 88% and specificity was 44% for detecting high-grade disease (CIN 2+) in women having an ASC-US and LSIL cytology report . The presence of high-risk HPV virus was detected in 21 of the 24 HSIL cases (87.5%). Conclusion: the DNA-HPV test’s higher sensitivity compared to the PAP smear (due to high NPV) means that it could be considered a useful tool for stratifying risk and improving the diagnostic approach to premalignant lesions of the uterine cervix in patients having a cytological report of ASC-US.


Asunto(s)
Humanos , Femenino , Biología Celular , Displasia del Cuello del Útero , Colposcopía
14.
Investig. segur. soc. salud ; 10: 91-108, 2008. tab
Artículo en Español | LILACS, COLNAL | ID: lil-610100

RESUMEN

La salmonelosis es reconocida como una de las enfermedades más frecuentes entre las transmitidas por alimentos, razón por la cual es necesario evaluar el riesgo de contraerla. El reporte de investigación del Programa activo de investigación de enfermedades transmitidas a través de los alimentos (FoodNet, por sus siglas en inglés) del 2004, identifica a la Salmonella como la infección bacteriana más comúnmente reportada (42% Salmonella, 37% Campylobacter, 15% Shigella, 2,6% E. coli O157:H7 y 3,4% otros como Yersinia, Listeria y Vibrio). El Laboratorio de Salud Pública de Bogotá, según los lineamentos contenidos en el Decreto 2323 de 2006, hace parte de la Red Nacional de Laboratorios, donde se definen las funciones de inspección, vigilancia y control de los riesgos asociados a los factores del consumo. En el Laboratorio de Salud Pública se realiza análisis físico-químico y microbiológico de los alimentos según un enfoque de riesgo. Como parte de los exámenes de rutina, en el área de microbiología se llevó a cabo la investigación de Salmonella en las diferentes matrices de alimentos y a partir de los resultados obtenidos se efectuó un análisis de prevalencia de este patógeno. Para el análisis se tuvo en cuenta el total de muestras procesadas que llegaron al Laboratorio de Microbiología de Alimentos de la Secretaría Distrital de Salud durante los años 2001 al 2004, a las cuales se les practicó análisis de Salmonella spp. en 25 g por el método oficial AOAC 967.26. Se observó una prevalencia que osciló entre el 2,8% y el 0,5% según el año analizado; los alimentos de mayor riesgo son los derivados cárnicos (chorizo), y se expone el riesgo de la contaminación cruzada.


Salmonella infections are recognized as one of the largest food-borne diseases, making it necessary to assess the risk of transmission to the final consumer. The research report of the Programme Assets Investigation of Diseases Transmitted by Food (FoodNet, by its acronym in English) in 2004, identified Salmonella as the most commonly reported bacterial infection (42% Salmonella, Campylobacter 37%, 15% Shigella, 2.6% E. coli O157: H7 and 3.4% others such as Yersinia, Listeria, and Vibrio). The public health laboratory in Bogota following Decree 2323 of 2006 guidelines is part of the national network of laboratories which define the roles of inspection, monitoring and control of risk factors associated with consumption. In the public health laboratory, physical, chemical and microbiological analysis of foods are carried out daily in the area of microbiology research on Salmonella in different food matrices. From the results obtained, a report of the prevalence of this pathogen was elaborated. For this analysis, account was taken of the samples processed during the years 2001 to 2004 from the District Secretary of Health and which were analyzed for Salmonella spp. in 25g by AOAC official method 967.26 (3). We obtained prevalence between 2.8% and 0.5% depending on the year analyzed. It has been shown that the highest risk foods are meat products (sausage), which presents a risk of cross contamination.


Asunto(s)
Humanos , Animales , Masculino , Femenino , Enfermedades Transmitidas por los Alimentos , Prevalencia , Salmonella , Campylobacter , Factores de Riesgo , Técnicas Microbiológicas , Escherichia coli , Infecciones por Salmonella
15.
Investig. segur. soc. salud ; 8: 187-211, 2006. tab
Artículo en Español | LILACS, COLNAL | ID: lil-601225

RESUMEN

Antecedentes. La Listeria monocytogenes es un bacilo Gram positivo, aerobio o anaerobio facultativo ubicuo; aislado en el hombre y en mamíferos domésticos, salvajes, pájaros, peces y crustáceos. Causa la listeriosis, provocando abortos, septicemias y meningitis. Es una enfermedad transmitida por alimentos. En los Estados Unidos, cada año un promedio 1.100 personas sufre esta enfermedad. Objetivo. Determinar la prevalencia de L. monocytogenes en derivados cárnicos cocidos, en muestras analizadas en el Laboratorio de Salud Pública (LSP) de Bogotá, entre el 1 de septiembre de 2001 y el 31 de agosto de 2004. Método. Estudio descriptivo de los productos cárnicos procesados que se producen en el Distrito Capital, muestreados por las Empresas Sociales del Estado; es una muestra no probabilística ni representativa. El estudio analizó los resultados microbiológicos en los derivados cárnicos durante tres años.Resultados. De una muestra total de 1.071 derivados cárnicos, 120 fueron positivos para L. monocytogenes (11,2%). La prevalencia en cada año fue 11,70%, 10,1% y 11,5%, respectivamente. De los serotipos identificados, 45% corresponde al serotipo 4b, seguido por el ½b (10,0%) y el 3b (9,2%). Conclusiones. El jamón, fue el producto con mayor positividad para la Listeria monocytogenes (55,8%), superior a las salchichas (17,5%) y la mortadela (12,5%). Se evidencia la importancia en Salud Pública de la Listeria monocytogenes por su elevada prevalencia. Otros microorganismos detectados en las muestras indican que los alimentos tienen fallas de manipulación, mala calidad de materias primas y contaminación cruzada con Salmonella s.ps, Estafilococo coagulasa positivo y L. monocytogenes, en alimentos listos para el consumo.


Background. Listeria monocytogenes is a Gram-positive bacillus, ubiquitous aerobic or facultative anaerobic facultative; isolated in man and in domestic and wild mammals, birds, fish and crustaceans. It causes listeriosis, causing abortions, septicemia and meningitis. It is a foodborne disease. In the United States, an average of 1,100 people suffer from this disease each year. Objective. To determine the prevalence of L. monocytogenes in cooked meat derivatives, in samples analyzed at the Public Health Laboratory (LSP) of Bogotá, between September 1, 2001 and August 31, 2004. Method. Descriptive study of processed meat products produced in the Capital District, sampled by the State Social Enterprises; it is a non-probabilistic and non-representative sample. The study analyzed the microbiological results in meat derivatives during three years.Results. From a total sample of 1,071 meat derivatives, 120 were positive for L. monocytogenes (11.2%). The prevalence in each year was 11.70%, 10.1% and 11.5%, respectively. Of the serotypes identified, 45% corresponded to serotype 4b, followed by ½b (10.0%) and 3b (9.2%). Conclusions. Ham was the product with the highest positivity for Listeria monocytogenes (55.8%), higher than sausages (17.5%) and mortadella (12.5%). The importance of Listeria monocytogenes in public health is evidenced by its high prevalence. Other microorganisms detected in the samples indicate that the food has handling failures, poor quality of raw materials and cross contamination with Salmonella s.ps, coagulase positive Staphylococcus and L. monocytogenes, in ready-to-eat foods.


Asunto(s)
Humanos , Masculino , Femenino , Prevalencia , Enfermedades Transmitidas por los Alimentos , Listeria monocytogenes , Salud Pública , Contaminación Ambiental , Serogrupo , Laboratorios
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