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1.
Int J Gynecol Cancer ; 2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33504547

RESUMO

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.

2.
Future Oncol ; 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33415992

RESUMO

Aim: FLABRA (NCT02984423) evaluated prevalence of BRCA mutations, genetic counseling and management approaches in patients with ovarian cancer in Latin America. Patients & methods: Patients with ovarian cancer from six Latin American countries were enrolled. Tumor samples were tested for BRCA mutations. In cases with BRCA mutations (BRCAmut), blood samples were analyzed to determine germline versus somatic mutations. Medical records were reviewed for counseling approach and treatment plan. Results: From 472 patients enrolled, 406 samples yielded conclusive results: 282 were BRCA wild-type (BRCAwt), 115 were BRCAmut and nine were variants of uncertain significance. In total, 110/115 were tested for germline mutations (77 germline and 33 somatic). Conclusion: Tumor testing to identify mutations in BRCA1/2 in ovarian cancer can help optimize treatment choices, meaning fewer patients require germline testing and genetic counseling, a scant resource in Latin America. Clinical trial registration: NCT02984423 (https://ClinicalTrials.gov).

3.
JCO Glob Oncol ; 6: 1376-1383, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32903119

RESUMO

PURPOSE: Locally advanced cervical cancer may present with uncontrollable vaginal bleeding in up to 70% of cases. Pelvic vessel embolization has been used as an urgent maneuver for achieving fast hemostatic control. This report describes outcomes of selective pelvic vessel embolization in patients with severe bleeding due to a locally advanced cervical cancer. METHODS: In this retrospective study, technical aspects, clinical variables, and bleeding-related morbidity were described. The frequency of recurrent disease and the vital status at 1 year of follow-up were determined. Analysis was performed with statistical software R, version 3.6.2. The setting was Instituto Nacional de Cancerología- Bogotá, Colombia, between January 2009 and July 2017. RESULTS: A total of 47 patients were included. Median age was 44 years (range, 26-70 years). The pre-embolization median hemoglobin level was 7.9 g/dL (range, 5.0-11.3 g/dL). Blood transfusions were administered to 41 women (87.2%). Bleeding control was achieved in 95.7% of cases in the first 24 hours after the embolization. There were no major complications. In 17 cases (36.2%), minor complications were reported; the most common was pelvic pain. In 17.1% of cases, a second embolization was required. After 12 months of follow-up, 27.7% of patients were alive without disease, 44.7% were alive with disease, and 25.5% of them have died of cervical cancer progression. CONCLUSION: Selective pelvic vessel embolization is a useful alternative in patients with locally advanced cervical cancer and life-threatening bleeding. Its impact on recurrent disease and death due to oncologic cause is not clear.

4.
Int J Gynaecol Obstet ; 150(3): 368-378, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32526044

RESUMO

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.

5.
BMC Proc ; 14(Suppl 9): 8, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32577128

RESUMO

The Human Papillomavirus (HPV) Prevention and Control Board is an independent multidisciplinary board of international experts that disseminates relevant information on HPV to a broad array of stakeholders and provides guidance on strategic, technical and policy issues in the implementation of HPV control programs. In response to drastic drop of vaccine coverage following the adverse event crisis in Carmen del Bolivar, Colombia, the HPV Prevention and Control Board in collaboration with the Colombian National Cancer Institute and Colombian League Against Cancer convened a meeting in Bogota, Columbia (November 2018). The goal of the meeting was to bring together national and international group of experts to report the disease burden, epidemiology and surveillance of HPV and HPV-related cancers, to discuss the successes and especially the challenges of HPV vaccination and screening in Colombia, as well as the lessons learnt from neighbouring countries. The meeting provided a platform to confer various stakeholder's perspectives, including the role of the Colombian healthcare system and to catalyse various parts of the public health community in Colombia into effective action. The conclusion of the meeting included following suggestions to strengthen HPV prevention and control: 1) Re-introducing school-based vaccine programs, 2) Integrating primary and secondary prevention programs, 3) Developing an innovative crisis communication plan targeting healthcare workers, teachers and general population, 4) Building trust through efficient and timely communication, 5) Building strong relationship with media to ensure a stable vaccination campaign support, and 6) Promoting empathy among healthcare professionals towards patients to build trust and communicate effectively.

6.
Rev. colomb. cancerol ; 23(3): 82-91, jul.-set. 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1042759

RESUMO

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.


Assuntos
Humanos , Registros Hospitalares , Carcinoma Epitelial do Ovário , Sistema de Registros
7.
Rev. cienc. cuidad ; 15(1): 58-70, 2018.
Artigo em Espanhol | LILACS, BDENF - Enfermagem, COLNAL | ID: biblio-906364

RESUMO

Objetivo: Describir el conocimiento y las prácticas relacionadas con la salud sexual y reproductiva en los estudiantes de una Universidad del suroccidente colombiano. Materiales y métodos: Investigación cuantitativa, descriptiva y prospectiva de corte transversal realizada con estudiantes matriculados en I y II semestre en el primer periodo académico 2016. El cálculo de la muestra se obtuvo utilizando la fórmula de varianza desconocida y población total conocida (3.489), obteniendo un tamaño de muestra de 415 estudiantes. Se utilizó un instrumento tipo encuesta estructurado a partir del formato de consejería del programa de salud sexual y reproductiva universitario. Los datos se procesaron a través de Excel y el paquete estadístico SPSS versión 22. Para determinar la significación de la asociación se utilizó la prueba Chi cuadrado con una confiabilidad de 95 %. Resultados: En la población estudiada se encontró un predominio masculino del 50,7 %, la edad promedio fue de 19 años, encontrando que el 81 % está en una etapa de adolescencia tardía, el 62 % tiene un nivel de conocimientos defi cientes sobre salud sexual y reproductiva, el 78 % inició vida sexual con edad promedio de 16 años, un gran porcentaje de estos estudiantes tiene entre 1 y 3 compañeros(as) sexuales al año. El 70 % utilizó condón en su primera relación sexual y el 12,3 % de la población utilizó la píldora de emergencia. Conclusiones: El nivel de conocimiento acerca de salud sexual y reproductiva es deficiente. La mayoría de los estudiantes encuestados utiliza al menos un método de planificación familiar en sus relaciones sexuales.


Objective: To describe the knowledge and practices related to Sexual and Reproductive Health in the students of a University of the Suroccidente Colombiano. Materials and methods: Quantitative descriptive prospective cross-sectional study; was carried out in students enrolled in I and II semester in the first academic period 2016; the calculation of the sample was obtained using the formula of unknown variance and known total population (3,489), obtaining a sample size of 415 students. A structured survey-type instrument was developed based on the counseling format of the university's sexual and reproductive health program. Data were processed through Excel and the SPSS version 22 statistical package, to determine the significance of the association was used Chi square test with a reliability of 95%. Results: A male prevalence of 50.7% was found in the study population, the mean age was 19 years, and 81% were in the late teens, 62% had a poor level of knowledge about sexual health and reproductive, 78% start sexual life with average age of 16 years, a large percentage of these students have between 1 and 3 sexual partners a year. Seventy percent used a condom at their first sexual intercourse and 12.3% of the population used the emergency pill. Conclusions: The level of knowledge about sexual and reproductive health is deficient. Most students surveyed use at least one method of family planning in their sexual relationships.


Objetivos: Descrever os conhecimentos e práticas relacionados com a saúde sexual e reprodutiva em estudantes de uma Universidado sudoeste Colombiano. Materiais e Métodos: A pesquisa quantitativa transversal descritiva prospectiva; foi realizado em estudantes matriculados em I e II, semestre 2016; cálculo da amostra foi obtida utilizando a fórmula de variância desconhecida e a população total conhecido (3489), obtendo-se um tamanho de amostra de 415 estudantes. Foi utilizado um tipo de instrumento de pesquisa estruturada. Os dados foram processados pelo pacote estatístico Excel versão 2010 e SPSS versão 22, para determinar o significado do teste foram utilizados do qui-quadrado de associação com uma confiabilidade de 95%. Resultados: Na população estudada predominância do sexo masculino de 50,7%, a idade média dos alunos era de 19 anos, descobrindo que 81% estão em uma fase de adolescência tardia, 62% têm um nível de conhecimentos regulares saúde sexual e reprodutiva, 78% inicio vida sexual com uma idade média de 16 anos, uma grande porcentagem desses estudantes estão entre 1 e 3 parceiro (s) ano sexual. 70% usam preservativo em sua primeira relação sexual e 12,3% da população usava a pílula de emergência. Conclusões: O nível de conhecimento sobre a saúde sexual e reprodutiva é regular. A maioria dos estudantes pesquisados usar pelo menos um método de planejamento familiar em suas relações sexuais.


Assuntos
Sexualidade , Estudantes , Saúde Reprodutiva
8.
Int J Surg Case Rep ; 27: 155-161, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27621097

RESUMO

INTRODUCTION: Müllerian adenosarcoma of the cervix with sarcomatous overgrowth and lymphovascular invasion is a rare and aggressive disease. We report a case of a young patient with Müllerian adenosarcoma with sarcomatous overgrowth in the uterine cervix and pelvic lymph node involvement. The patient received radical surgery but not adjuvant treatment, and the disease was aggressive with rapid relapse. PRESENTATION OF CASE: A 39-year-old woman was diagnosed with Müllerian adenosarcoma of the cervix with sarcomatous overgrowth, International Federation of Gynecology and Obstetrics (FIGO) stage IB2. She underwent abdominal radical hysterectomy and resection of the left external iliac lymph nodes for suspected metastatic involvement detected during surgical exploration but undetected via imaging. She refused adjuvant treatment, and the disease recurred 8 months after primary oncologic surgery, with rapid local, regional, and bone relapse. DISCUSSION: Our report suggests that sarcomatous overgrowth, a high mitotic index, a rhabdomyoblastic component, and lymphovascular compromise are risk factors for aggressive recurrence. Positron emission tomography-computed tomography (PET-CT) was used to identify relapse locations in addition to those detected via clinical examination of the vaginal vault. However, whether PET-CT is indicated for the initial detection of lymph node and bone metastases in FIGO stage IB tumors with surgical indication is unclear. CONCLUSION: A young woman with Müllerian adenosarcoma of the cervix with sarcomatous overgrowth presenting the risk factors for its recurrence experienced a rapid relapse after receiving radical surgery but not adjuvant therapy. Control of this aggressive disease via sequential radiotherapy and chemotherapy are recommended.

9.
Rev. colomb. cancerol ; 20(3): 117-123, jul.-sep. 2016. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-830281

RESUMO

Objetivo: Describir las características sociodemográficas, epidemiológicas, clínico-patológicas, de tratamiento y complicaciones de las pacientes con diagnóstico de cáncer que se embarazaron y aquellas que estando en embarazo fueron diagnosticadas con cáncer. Métodos: Serie de casos. Pacientes atendidas en el Instituto Nacional de Cancerología (Bogotá, Colombia) entre agosto de 2007 a julio de 2013. Se revisaron datos epidemiológicos, clínicos, tratamientos y complicaciones de las historias clínicas. Se describió la adherencia al tratamiento y se realizó análisis descriptivo de la información. Resultados: Durante el periodo de estudio se incluyeron 38 pacientes, de las cuales 28 ya contaban con el diagnóstico de cáncer. El principal diagnóstico fue cáncer de cérvix. La mediana de edad gestacional al final del embarazo fue 35 semanas (rango intercuartílico 12 semanas). La principal vía de nacimiento fue vaginal (60%), seguida de cesárea (40%). Con respecto al tratamiento, el 55,5% requirió su suspensión, 38,9% tuvo cambios y en 5,6% se modificó la dosis del tratamiento. Las complicaciones presentadas durante el embarazo fueron parto pretérmino, abortos, hemorragia, óbitos fetales, oligohidramnios y anemia. Se describen los casos de pacientes que durante su estado de embarazo fueron diagnosticadas con enfermedad neoplásica. La adherencia al tratamiento fue buena en 26 pacientes y 8 no la tuvieron. Conclusiones: La paciente con cáncer y embarazo representa un reto diagnóstico y terapéutico para el obstetra y el grupo oncológico. Se debe resaltar la consejería en anticoncepción y en salud sexual y reproductiva.


Objective: To describe the socio-demographic, epidemiological, clinical and pathological characteristics, as well as the treatment and complications of patients diagnosed with cancer who became pregnant and those that were diagnosed with cancer when pregnant. Methods: Case series study. Patients treated in the National Cancer Institute (Bogotá, Colombia) from August 2007 to July 2013. The epidemiological, clinical, treatment, and complications were reviewed in the medical records. Adherence treatment was recorded. A descriptive data analysis was performed. Results: The study included 38 patients, of whom 28 already had a cancer diagnosis. The main diagnosis was cervical cancer. The median gestational age at the end of pregnancy was 35 weeks (interquartile range 12 weeks). The main route was vaginal birth (60%), followed by caesarean section (40%). Treatment had to be suspended in 55.5% of cases, 38.9% had changes, and the therapeutic dose was modified in 5.6%. The complications presented during pregnancy were preterm birth, abortions, bleeding, stillbirths, oligohydramnios, and anaemia. A description is presented of the cases of patients who were diagnosed with neoplastic disease during their pregnancy. Adherence to treatment was good in 26 patients and not good in 8 cases. Conclusions: The patient with cancer and pregnancy represents a diagnostic and therapeutic challenge to the obstetrician and the oncology group. Counselling on contraception and sexual and reproductive health should be emphasised.


Assuntos
Humanos , Feminino , Pesquisa , Gravidez , Neoplasias , Neoplasias do Colo do Útero , Registros Médicos
10.
Bogotá; IETS; jun. 2016. tab, ilus.
Monografia em Espanhol | LILACS, BRISA/RedTESA | ID: biblio-847277

RESUMO

Introducción: el cáncer de cuello uterino es en Colombia el segundo cáncer con mayor frecuencia y mortalidad en mujeres. Las vacunas contra el virus del papiloma humano (VPH) han mostrado efectividad para prevenir la infección por el virus y las lesiones precancerosas asociadas, sin embargo, se han reportado eventos negativos en salud, posiblemente asociados con la aplicación de la vacuna. Objetivo: examinar la seguridad del uso de la vacuna profiláctica contra el VPH. Metodología: se realizó una búsqueda sistemática en MEDLINE, EMBASE, Cochrane Database, IBECS, LILACS y fuentes complementarias. La selección de estudios se realizó por dos revisores independientes de acuerdo con criterios de elegibilidad predefinidos. Se incluyeron estudios experimentales, observacionales analíticos y observacionales descriptivos que reportaran desenlaces de seguridad y efectividad de la vacuna contra el VPH. La calidad de los estudios analíticos fue valorada mediante herramientas previamente definidas, de acuerdo a cada diseño. Los estudios descriptivos fueron considerados con alta probabilidad de sesgo. La calidad de la evidencia fue evaluada para cada desenlace reportado mediante la etodología Grading of Recommendations Assessment, Development and Evaluation (GRADE). Los resultados por cada desenlace fueron reportados de forma narrativa y presentados en perfiles de evidencia GRADE (estudios analíticos) y tablas de evidencia genéricas (estudios descriptivos). Resultados: fueron seleccionados 112 estudios que reportaron 305 resultados de desenlaces de seguridad reportados \r\nposterior a la aplicación de la vacuna contra el VPH, que incluyeron desenlaces para los cuales la vacunación mostró asociación estadísticamente significativa como factor de riesgo, desenlaces para los cuales la vacunación no mostró asociación como factor de riesgo, y desenlaces para los cuales la vacunación mostró resultados inconsistentes. La calidad de la evidencia fue baja y muy baja para la mayoría de los resultados reportados. Discusión y conclusión: Las principales debilidades de la evidencia identificada fueron falta de periodos adecuados de seguimiento para eventos de aparición tardía, falta de precisión de los resultados, y limitaciones en la medición de los desenlaces, verificación del periodo de latencia de \r\nlos mismos y control de los potenciales factores de confusión. Los determinantes más relevantes de \r\nla calidad fueron la falta de precisión de los resultados, probablemente por la baja frecuencia de los \r\neventos, y el carácter observacional de los estudios que evaluaron la mayor parte de los desenlaces \r\nreportados. Los resultados de asociación reportados no permiten establecer causalidad entre los \r\neventos y la vacunación. La baja calidad de la evidencia no implica que los resultados no sustenten \r\nla existencia, o no, de las asociaciones evaluadas; ni que los resultados no sean suficientes para \r\norientar decisiones; sino que es probable que estudios con mayor rigor metodológico muestren \r\nresultados diferentes. La mejor evidencia disponible hasta la fecha sustenta un adecuado perfil de \r\nseguridad de la vacuna contra el VPH, similar al reportado por la OMS para otras vacunas, que apoya \r\nsu utilización teniendo en cuenta los beneficios reportados en la literatura; sin que sea posible descartar la ocurrencia de eventos adversos graves raros, por lo cual es recomendable la \r\nimplementación de un sistema de vigilancia posvacunación, que garantice un apropiado reporte, \r\ndiagnóstico, seguimiento, análisis y retroalimentación a los usuarios, de los posibles eventos adversos de la vacunación, con enfoque en los eventos descritos en esta evaluación. (AU)


Assuntos
Humanos , Papillomaviridae , Vacinas contra Papillomavirus/administração & dosagem , Vacinas contra Papillomavirus/efeitos adversos , Neoplasias do Colo do Útero/tratamento farmacológico , Tecnologia Biomédica , Colômbia , Avaliação de Medicamentos , Imunização , Resultado do Tratamento
11.
Iatreia ; 26(4): 397-407, oct.-dic. 2013. ilus
Artigo em Espanhol | LILACS | ID: lil-695809

RESUMO

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.


Assuntos
Humanos , Ratos , Relação Dose-Resposta a Droga , Embolia/terapia , Isquemia Encefálica/terapia , Ratos Wistar
12.
Rev. colomb. cancerol ; 17(3): 103-110, jul.-sep. 2013. ilus, tab
Artigo em Inglês | LILACS | ID: lil-727561

RESUMO

Objective: To analyze whether the immune response to HPV-16, -18, -31, -45 and -58 capsids in women vaccinated with the quadrivalent vaccine induces cross-reactivity against other HPV virus-like particles (VLPs). Methods: A total of 88 women aged between 18 and 27 years attending the HPV clinic at the Instituto Nacional de Cancerología were enrolled and vaccinated against HPV. Follow-up visits were scheduled at months 7, 12, and 24. Samples were collected for cytology, HPV-DNA typing, and detection of HPV antibodies. IgG antibodies were measured by ELISA using HPV-16, -18, -31, -45, and -58 VLPs. HPV-DNA detection was done by GP5+/GP6+PCR-ELISA and HPV typing was performed by Reverse Line-Blot assay. Results: Pre-vaccination, the seroprevalence of HPV-16, -18, -31, -45, and -58 was 39%, 31.7%, 15.9%, 31.7%, and 23.2%, respectively. One month post-vaccination, the seroprevalence increased close to 100% for all types. At month 24, this response was maintained only for HPV-16 and -18. For HPV-31, -45 and -58, the seroprevalence decreased to below 50%. The prevalence of HPV DNA types 16, 18 and 58 before vaccination was little changed 1 month after vaccination. No new infections were observed at 24 months. For HPV-16 and -18 related types, no differences were observed before vaccination and at month 24. For other high-risk HPV types, the prevalence increased 18 months post-vaccination (15.5%) compared with pre-vaccination (9.8%). Conclusion: Immune response to all HPV types increased after vaccination, but this increase was maintained only for HPV-16 and -18. These results suggest a possible cross-reactivity against HPV types 31, 45 and 58, but this cross-reactivity wanes with time. © 2012 Instituto Nacional de Cancerología. Publicado por Elsevier España, S.L. Todos los derechos reservados.


Objetivo: Analizar si la respuesta inmune hacia las cápsides del VPH tipos 16, 18, 31, 45 y 58 en mujeres que recibieron la vacuna tetravalente induce reactividad cruzada hacia otros tipos virales. Métodos: Ochenta y ocho mujeres entre 18 y 27 años, asistentes al Grupo VPH del Instituto Nacional de Cancerología, recibieron la vacuna de VPH. Visitas de seguimiento en los meses 7, 12 y 24. Se tomaron muestras para prueba de Papanicolaou, tipificación de VPH y detección de anticuerpos. Los anticuerpos se detectaron por ELISA, usando VLP-VPH. La detección del ADN-VPH se realizó por Reverse Line Blot. Resultados: Prevacunación, la seroprevalencia de VPH tipos 16, 18, 31, 45 y 58 fue de 39, 31,7, 15,9, 31,7 y 23,2%, respectivamente. Al mes 7 aumentó cerca del 100% para todos los tipos. Al mes 24 esta respuesta se mantuvo para VPH tipos 16 y 18. Para VPH tipos 31, 45 y 58 disminuyó por debajo del 50%. La prevalencia de ADN-VPH tipos 16, 18 y 58 tuvo poca variación antes y un mes después de la vacunación. Al mes 24, no se observaron nuevas infecciones. Para VPH tipos 16 y 18, no se observaron diferencias antes ni al mes 24. En otros tipos de HR-VPH aumentó la prevalencia al mes 24 (15,5%), comparada con la prevacunación (9,8%). Conclusión: Se observó un aumento de la respuesta inmune a todos los tipos de VPH después de la vacunación, pero esta se mantuvo solamente para los VPH tipos 16 y 18. Los resultados sugieren una posible reactividad cruzada contra VPH tipos 31, 45 y 58. Sin embargo, esta reactividad cruzada disminuye con el tiempo.


Assuntos
Humanos , Feminino , Adolescente , Adulto , Papiloma , Estudos Soroepidemiológicos , Prevalência , Vacinação , Ensaio de Imunoadsorção Enzimática , Papillomavirus Humano 16 , Papillomavirus Humano 31
13.
Rev. salud pública ; 12(6): 961-973, dic. 2010. tab
Artigo em Espanhol | LILACS | ID: lil-602844

RESUMO

Objetivo La vacuna contra el VPH es una nueva tecnología disponible para el control del cáncer de cuello uterino. Se espera, que en el menor tiempo posible esta vacuna pueda tener cobertura universal. Este artículo presenta la aceptabilidad que tiene los padres de adolescentes en Colombia hacia la vacuna contra el VPH y hace una aproximación a sus determinantes. Métodos Estudio cualitativo en cuatro regiones en Colombia. Se realizaron 17 grupos focales con padres de niñas y niños entre 11 a 14 años estudiantes de colegios públicos y privado. Se realizó análisis de contenido por etapas: lectura abierta, codificación, análisis estructural e interpretación crítica. Se compararon los resultados por región. Resultados El 85 por ciento de los convocados participaron. Los padres de colegios oficiales, estaban dispuestos a vacunar a su hija (o) s y harían un esfuerzo frente a los altos costos de la vacuna. Vacunar a la edad de 12 años para prevenir una infección de transmisión sexual, genera resistencia. Los padres de colegios privados fueron más críticos y expresaron una menor aceptabilidad. En dos regiones consideran que vacunar tiene el riesgo de promover la promiscuidad. Conclusiones La aceptabilidad a la vacuna varía en relación con el contexto sociocultural y educativo. Promover la vacuna para prevenir una infección de transmisión sexual en niñas muy jóvenes (<12 años) puede generar obstáculos para su aceptabilidad; se recomienda promoverla para prevención del cáncer de cuello uterino.


Objective The recently licensed vaccine for preventing cervical cancer offers a fresh opportunity for cancer control; vaccination coverage is a major determinant in its effectiveness. This article presents perceived knowledge and acceptability by parents of adolescents in Colombia regarding the HPV vaccine. Methods A qualitative study was carried out in four areas of Colombia. 16 focus groups were conducted with parents selected from a sample of private and official schools;4 focus groups were run in each region according to gender. All groups were tape-recorded for further transcription and analysis. Content was analyzed via the following steps: reading, coding, structural analysis and critical appraisal. Results 85 percent of parents so contacted participated. Parents from state schools were willing for their children to be vaccinated and make an effort to pay the high cost of such vaccine. Resistance is produced by vaccinating at age 12 to prevent sexually-transmitted infection. Private school parents were more critical and expressed lower acceptability. In two areas parents considered that vaccination involved the risk of promoting promiscuity. Conclusions Parents' acceptability of vaccination varied according to socio-cultural and educational context. Promoting vaccination for preventing a sexually-transmitted infection amongst the parents of very young girls (<12 years) can hamper their acceptability of it; it is thus recommended that it be promoted for preventing cervical cancer and that it should be aimed at a wider age-range for vaccination.


Assuntos
Adolescente , Adulto , Criança , Feminino , Humanos , Pessoa de Meia-Idade , Vacinas contra Papillomavirus , Aceitação pelo Paciente de Cuidados de Saúde , Pais/psicologia , Fatores Etários , Colômbia , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Fatores Socioeconômicos
14.
Cad Saude Publica ; 26(5): 900-8, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20563390

RESUMO

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.


Assuntos
Tomada de Decisões , Política de Saúde , Vacinas contra Papillomavirus/uso terapêutico , Neoplasias do Colo do Útero/prevenção & controle , Adolescente , Colômbia , Países em Desenvolvimento , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pesquisa Qualitativa , Neoplasias do Colo do Útero/virologia
15.
Cad. saúde pública ; 26(5): 900-908, maio 2010. tab
Artigo em Inglês | LILACS | ID: lil-548356

RESUMO

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.


Assuntos
Adolescente , Feminino , Humanos , Tomada de Decisões , Política de Saúde , Vacinas contra Papillomavirus/uso terapêutico , Neoplasias do Colo do Útero/prevenção & controle , Colômbia , Países em Desenvolvimento , Conhecimentos, Atitudes e Prática em Saúde , Pesquisa Qualitativa , Neoplasias do Colo do Útero/virologia
16.
Rev. colomb. cancerol ; 14(1): 22-28, mar. 2010. graf, tab
Artigo em Espanhol | LILACS | ID: lil-666392

RESUMO

Objetivo: Describir la prevalencia de anormalidades citológicas y de neoplasias de cuello uterino en un grupo de mujeres de Bogotá, Colombia. Métodos: Se realizó un estudio descriptivo en el que se incluyeron mujeres atendidas en centros de salud de tres localidades del sur de Bogotá, pertenecientes a estratos socioeconómicos bajos, entre 25 y 59 años de edad y con antecedente de al menos una relación sexual penetrante. Resultados: Se analizaron 4.957 casos. La edad promedio fue 39,2 años. El 69,1% de las 4.957 citologías fueron negativas, 24,7% reportaron ASC-US; 4,3%, LIE-BG; 1,2%, LIE-AG, y 0,1%, lesión sospechosa de carcinoma infiltrante. Se realizaron 762 biopsias (15,4% de la población). De éstas, 48,29% se reportaron como negativas para neoplasia, y 49,08%, con algún cambio neoplásico. La prevalencia global de neoplasias intraepiteliales y de carcinoma infiltrante fue 7,54%. La prevalencia de NIC II y NIC III fue 1,3% (0,4% y 0,9%). Se detectaron dos carcinomas infiltrantes (0,04%). Conclusiones: La prevalencia de anormalidades citológicas fue inusualmente elevada; por el contrario, los hallazgos de anormalidades histológicas (NIC I o mayor) muestran datos de alta confiabilidad, ya que son producto de biopsias tomadas por indicación de tres métodos de tamización (inspección visual, citología o colposcopia). La prevalencia de neoplasias de alto grado (NIC II y III) y cáncer infiltrante observada en nuestro estudio es mayor que la reportada para otros países.


Objective: To describe the prevalence of cytological abnormalities and neoplasias in a group of women from Bogotá, Colombia. Methods: A descriptive analysis was done among women attended health services in a low-resource area of Bogotá. All women had history of sexual onset, aged 25 to 59 years, and were investigated with conventional cytology. Results: 4,957 cases were analyzed. The average age was 39.2 years. In total 69.1% of pap smears were negative, 24.7% reported ASC-US, 4.3% LSIL, 1.2% HSIL, and 0.1% invasive cancer. 762 biopsies were done (48.29% negative and 49,08% neoplasic changes). The global prevalence of intraepithelial neoplasias and carcinoma was 7.54%. The prevalence of CIN 2 and CIN 3 was 1.3% (0.4% y 0.9%). Two invasive carcinomas were detected (0.04%). Conclusions: The prevalence of cytological abnormalities was unusually high. Histological abnormalities were investigated through three different screening methods representing highly reliable data. The prevalence of HSIL (CIN II and CIN III) and invasive cancer observed is higher than previous reports from other countries.


Assuntos
Humanos , Adulto , Feminino , Biologia Celular/instrumentação , Epidemiologia Descritiva , Prevalência , Neoplasias do Colo do Útero , Colômbia , Cobertura de Serviços de Saúde
17.
Rev Salud Publica (Bogota) ; 12(6): 961-73, 2010 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-22030683

RESUMO

OBJECTIVE: The recently licensed vaccine for preventing cervical cancer offers a fresh opportunity for cancer control; vaccination coverage is a major determinant in its effectiveness. This article presents perceived knowledge and acceptability by parents of adolescents in Colombia regarding the HPV vaccine. METHODS: A qualitative study was carried out in four areas of Colombia. 16 focus groups were conducted with parents selected from a sample of private and official schools; 4 focus groups were run in each region according to gender. All groups were tape-recorded for further transcription and analysis. Content was analyzed via the following steps: reading, coding, structural analysis and critical appraisal. RESULTS: 85 % of parents so contacted participated. Parents from state schools were willing for their children to be vaccinated and make an effort to pay the high cost of such vaccine. Resistance is produced by vaccinating at age 12 to prevent sexually-transmitted infection. Private school parents were more critical and expressed lower acceptability. In two areas parents considered that vaccination involved the risk of promoting promiscuity. CONCLUSIONS: Parents' acceptability of vaccination varied according to socio-cultural and educational context. Promoting vaccination for preventing a sexually-transmitted infection amongst the parents of very young girls (<12 years) can hamper their acceptability of it; it is thus recommended that it be promoted for preventing cervical cancer and that it should be aimed at a wider age-range for vaccination.


Assuntos
Vacinas contra Papillomavirus , Pais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Adolescente , Adulto , Fatores Etários , Criança , Colômbia , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pessoa de Meia-Idade , Fatores Socioeconômicos
18.
Rev. colomb. obstet. ginecol ; 60(3): 213-222, jul.-sept. 2003. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-532747

RESUMO

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.


Assuntos
Humanos , Feminino , Biologia Celular , Neoplasia Intraepitelial Cervical , Colposcopia
19.
Rev. colomb. cancerol ; 13(2): 88-98, jun. 2009. tab
Artigo em Espanhol | LILACS | ID: lil-661679

RESUMO

Objetivo: Explorar en médicos generales, ginecólogos y pediatras colombianos sus conocimientos generales sobre el virus del papiloma humano (VPH), así como la actitud, disposición personal y percepción que tienen sobre la vacuna contra el VPH. Método: Estudio exploratorio con metodología cualitativa en cuatro regiones de Colombia. En cada una se conformó un grupo focal con médicos generales, ginecólogos y pediatras. Todas las sesiones se grabaron y se transcribieron. Se realizó un análisis de contenido siguiendo las etapas de lectura abierta, codificación, análisis estructural e interpretación crítica. Resultados: Los médicos generales tienen bajos conocimientos del VPH y de la vacuna, mientras que los ginecólogos y los pediatras tienen buenos y excelentes conocimientos, respectivamente. Muchos de los médicos ven una oportunidad de negocio en esta vacuna; en dos regiones son muy escépticos sobre la introducción de la vacuna por la ausencia de protección total y por la dificultad de llegar a la población más necesitada. Conclusiones: En el ámbito médico hay confusión sobre las distintas vacunas, se requiere profundizar en los conocimientos y hay necesidad de dar recomendaciones e indicaciones claras a los médicos. Debe brindarse amplia capacitación y educación, particularmente a los médicos generales, en relación con el VPH, la vacuna y la necesidad de continuar tamizando.


Objective: To survey basic knowledge of the humanpapillomavirus (HPV) among Colombian general paractitioners, gynecologists and pediatricians, as well as their attitudes, personal feelings and perceptions towards the HPV vaccine. Methods: An exploratory, qualitative study was carried out in four regions in Colombia. In each region a focus group made up of general practitioners, gynecologists and pediatricians was set up. Each session was taped and transcribed. Content analysis was based upon the stages of open reading, coding, structural analysis and critical interpretation. Results: General practitioners have scant knowledge of HPV and the vaccine; gynecologists and pediatricians command good and excellent knowledge, respectively. Many physicians espy the commercial gain that could be made off the vaccine. In two regions there was skepticism about introducing the vaccine locally, where it was deemed to be too difficult to achieve total protection, and where it would be unable to reach the needworthy population. Conclusion: Among Colombian physicians, confusion exists concerning the different types of HPV vaccines; therefore, steps should be taken to improve their knowledge on the subject as well as to provide recommendations and clear instructions concerning vaccine application. Educational and training courses, particularly for general practitioners, on HPV, HPV vaccines, and screening should be widely available.


Assuntos
Humanos , Biologia Celular/instrumentação , Cobertura de Serviços de Saúde , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Colômbia , Grupos Focais
20.
Investig. segur. soc. salud ; 10: 91-108, ene.-dic. 2008. tab
Artigo em Espanhol | LILACS | ID: lil-610100

RESUMO

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.


Assuntos
Prevalência , Salmonella , Infecções por Salmonella
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