Evaluation of the accuracy of mammography, ultrasound and magnetic resonance imaging in suspect breast lesions.

OBJECTIVES: In breast cancer diagnosis, mammography (MMG), ultrasonography (USG) and magnetic resonance imaging (MRI) are the imaging methods most used. There is a scarcity of comparative studies that evaluate the accuracy of these methods in the diagnosis of breast cancer. METHODS: A cross-sectional study was carried out through the review of electronic medical records of 32 female patients who underwent breast imaging examinations at a imaging diagnostic center in Teresina, State of Piauí, Brazil. Patients who had these three imaging methods at the time of the evaluation of the same nodule were included. The nodule must have been classified as suspect by the BI-RADS® system in at least one of the methods. Data from each method were compared with the histopathological examination. Statistical analysis used the calculation of proportions in Excel 2010. RESULTS: MMG showed 56.2%, 87.5%, 81.8%, 66.7% and 71.8% of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy, respectively. USG had 75%, 18.8%, 48%, 42.8% and 46.9% of sensitivity, specificity, PPV, NPV and accuracy, respectively. In turn, MRI had 100%, 50%, 66.7%, 100% and 75% of sensitivity, specificity, PPV, NPV and accuracy, respectively. CONCLUSION: Thus, MRI and MMG were more accurate in evaluating suspicious breast lumps. MRI had a low specificity, mainly to high breast density, while MMG had also sensitivity limited due to high breast density and USG has been proven to be useful in these patients.

Evaluation of the accuracy of mammography, ultrasound and magnetic resonance imaging in suspect breast lesions

OBJECTIVES: In breast cancer diagnosis, mammography (MMG), ultrasonography (USG) and magnetic resonance imaging (MRI) are the imaging methods most used. There is a scarcity of comparative studies that evaluate the accuracy of these methods in the diagnosis of breast cancer. METHODS: A cross-sectional study was carried out through the review of electronic medical records of 32 female patients who underwent breast imaging examinations at a imaging diagnostic center in Teresina, State of Piauí, Brazil. Patients who had these three imaging methods at the time of the evaluation of the same nodule were included. The nodule must have been classified as suspect by the BI-RADS® system in at least one of the methods. Data from each method were compared with the histopathological examination. Statistical analysis used the calculation of proportions in Excel 2010. RESULTS: MMG showed 56.2%, 87.5%, 81.8%, 66.7% and 71.8% of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy, respectively. USG had 75%, 18.8%, 48%, 42.8% and 46.9% of sensitivity, specificity, PPV, NPV and accuracy, respectively. In turn, MRI had 100%, 50%, 66.7%, 100% and 75% of sensitivity, specificity, PPV, NPV and accuracy, respectively. CONCLUSION: Thus, MRI and MMG were more accurate in evaluating suspicious breast lumps. MRI had a low specificity, mainly to high breast density, while MMG had also sensitivity limited due to high breast density and USG has been proven to be useful in these patients.

Avaliação das ações estratégicas na atenção à saúde do idoso em Unidades Básicas de Saúde de Teresina-PI / Evaluation of strategic actions in the health of the elderly in Basic Health Units of Teresina-PI / Evaluación de las acciones estratégicas en el cuidado de la salud en las personas mayores Unidades de Salud Básica de Teresina-PI

A cada ano, cerca de 650 mil novos idosos são incorporados à população surgindo a necessidade de reorganizar os modelos sociais para atender à saúde no envelhecimento como uma prioridade, os quais visam recuperar, manter e promover autonomia e independência, direcionando medidas coletivas e individuais de saúde para esse fim. O objetivo desta pesquisa foi avaliar as ações estratégicas na atenção à saúde do idoso em Unidades Básicas de Saúde (UBS) de Teresina-PI. Realizado estudo observacional transversal, através da aplicação de questionários de Avaliação para Melhoria da Qualidade da Estratégia Saúde da Família Modificado - Cadernos de Autoavaliação 4 e 5 - Equipe Saúde da Família ­ Parte II ­ SAÚDE DE IDOSOS, aplicados aos representantes da diretoria colegiada de 20 UBS de Teresina-PI, após assinatura de TCLE, conforme resolução 196/96, observou-se que 70% das UBS desenvolvem ações coletivas; 60% desenvolvem atividades educativas; 100% apresentam registro dos idosos atualizado; 95% apresentam vacinação em dia; 50% apresentam exame da cavidade oral como rotina; 70% negam acompanhamento pela Saúde Bucal; 70% apresentam exame da superfície corporal como rotina; 60% intervém na capacitação de cuidadores domiciliares; 65% intervém na detecção precoce de demências; 80% dos profissionais conhecem a Política Nacional de Saúde da Pessoa Idosa (PNSPI); 80% negam capacitação para desenvolvimento das ações da PNSPI; 65% não atuam na identificação de incapacidades. Concluiu-se através da avaliação das ações estratégicas na atenção à saúde do idoso que há déficits que se correlacionam com a prática profissional no âmbito interno das UBS de Teresina-PI.

Each year, about 650,000 elderly people are incorporated to the population, raising the necessity to reorganize, primarily, the social models in order to meet decent health care standards for the aging population. These models seek to recover, maintain and promote autonomy and independence, directing individual and collective health measures to this end. The purpose of this research was to evaluate the strategic actions in the health care of the elderly in Basic Health Units (BHU) in Teresina, State of Piaui. A cross-sectional observational study was carried out through questionnaires of the 'Modified Assessment to Improve the Quality of Family Health Strategy - Self-assessment brochures 4 and 5 - Family Health Team - Part II - HEALTH OF THE ELDERLY' applied to the 20 BHU executive board members in Teresina, after signing the term of consent, according to resolution 196/96. It was possible to observe that 70% of the units develop collective actions, 60% develop educational activities, 100% have updated registration of elderly patients, 95% monitor vaccination to date, 50% have a complete oral examination as a routine activity, 70% are not monitored by the Dental Health Team; 70% develop examination of the body surface as a routine, 60% are involved in the training of home care workers, 65% are involved in early detection of dementia, 80% of the professionals know the National Health Policy for the Elderly (PNSPI), 80% refuse training for action development at the PNSPI, 65% do not work at the identification of disabilities. It was possible to conclude, through the evaluation of the strategic actions in health care for the elderly, that there are deficits related to the internal professional practice at the UBS system in Teresina.

Cada año, alrededor de 650,000 nuevos ancianos son incorporados a la población surgiendo la necesidad de reorganizar los modelos sociales para cumplir con el envejecimiento saludable como una prioridad, cuyo objetivo es restaurar, mantener y promover la autonomía y la independencia, la dirección de medidas colectivas e individuales de salud para este propósito. El objetivo de este estudio fue evaluar las acciones estratégicas en el cuidado de la salud de los ancianos en Unidades Básicas de Salud (UBS) Teresina-PI. Estudio transversal observacional, a través de cuestionarios de evaluación para la mejora de la calidad de estrategia salud de la familia Modificado - Diario de la Auto-evaluación 4 y 5 - Equipo de Salud Familiar - Parte II - SALUD DE LOS ANCIANOS, aplicados a los representantes de la junta directiva UBS 20 Teresina-PI, después de la firma del consentimiento informado, en conformidad con la Resolución 196/96, se observó que el 70% de UBS desarrollan acciones conjuntas, 60% desarrollan actividades educativas, 100% presentan registro actualizado de los, ancianos, 95% presentan vacunación al día, 50% presentan examen de cavidad oral como una rutina, 70% niegan acompañamiento mediante el control de la Salud Bucal, 70% presentan examen de la superficie del cuerpo como una rutina, 60% participan en la formación de cuidadores a domicilio, 65% participan en la detección precoz de la demencia, 80% de los profesionales conocen la Política Nacional de Salud de la Persona Anciana (PNSPA); 80% niegan capacitación el desarrollo de las acciones de PNSPA, 65% no actúan en la identificación de incapacidad. Se concluyó a través de una revisión de las acciones estratégicas en el cuidado de la salud del anciano que hay déficits los cuales se correlacionan con la práctica profesional en el ámbito interno de las UBS Teresina-PI.