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1.
Pediatrics ; 146(2)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32636237

RESUMO

OBJECTIVE: The Centers for Disease Control and Prevention recommend testing for Chlamydia trachomatis in sexually active female patients <25 years old using nucleic-acid amplification tests (NAAT) from a vaginal swab. Our providers were typically testing using the less sensitive urine NAATs. We aimed to increase the percentage of urogenital C trachomatis NAATs performed by using vaginal swabs in adolescent female patients ages 10 through 20 years from 1.4% to 25%. METHODS: We implemented 3 interventions at 3 pediatric practices over 12 months including education, process standardization, and cross-training. We used statistical process control to analyze the effect of interventions on our primary outcome: the percentage of urogenital C trachomatis tests performed with a vaginal swab. Our balance measure was the total number of urogenital C trachomatis tests. RESULTS: There were 818 urogenital C trachomatis tests performed: 289 before and 529 after the first intervention. Of urogenital C trachomatis tests in the preintervention time period, 1.4% were performed by using vaginal swabs. We surpassed our aim of 25% 6 weeks after the first intervention. We noted sustained improvement after the second intervention, with an average of 68.3% of tests performed by using vaginal swabs for the remaining postintervention period. There was no difference in the overall number of urogenital C trachomatis tests pre- and postintervention. CONCLUSIONS: Using quality improvement methodology and implementing easily replicable interventions, we significantly and sustainably increased use of vaginal swabs. The interventions standardizing processes were associated with a higher impact than the educational intervention.


Assuntos
Infecções por Chlamydia/diagnóstico , Chlamydia trachomatis/isolamento & purificação , Técnicas de Amplificação de Ácido Nucleico/métodos , Pediatras/educação , Padrões de Prática Médica/tendências , Vagina/microbiologia , Esfregaço Vaginal/tendências , Adolescente , Criança , Infecções por Chlamydia/epidemiologia , Feminino , Humanos , Massachusetts/epidemiologia , Técnicas de Amplificação de Ácido Nucleico/estatística & dados numéricos , Folhetos , Guias de Prática Clínica como Assunto , Padrões de Prática Médica/estatística & dados numéricos , Utilização de Procedimentos e Técnicas/tendências , Avaliação de Programas e Projetos de Saúde , Melhoria de Qualidade , Comportamento Sexual , Adulto Jovem
3.
Gynecol Oncol ; 154(1): 3-7, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30995961

RESUMO

George Papanicolaou, a Greek immigrant and cytopathologist, was responsible for what is now colloquially known as the "Pap smear"-undoubtedly one of the greatest advances in medicine and public health of the last century. However, his landmark research on the development of cervical cytology for the detection of precancerous lesions of the cervix ("New Cancer Diagnosis," 1928) made a rather inauspicious debut in an unlikely venue: John Harvey Kellogg's Third Race Betterment Conference-a meeting devoted to the furtherance of the concept and implementation of eugenics. Herein, we discuss the stark juxtaposition of Papanicolaou's landmark discovery amid the pseudoscience of the third Race Betterment Conference. We discuss the latency of Papnicolaou's discovery-its potential implications unrealized-until co-publication with Herbert Traut, which catapulted Papanicolaou's research to the scientific foreground. This gave rise to public health initiatives aimed at establishing the Pap smear as a screening tool. We further delineate the progress made in recent decades with the identification of HPV as the etiological agent for cervical cancer, and the subsequent development of the HPV vaccine, and discuss ongoing research in the present day. In this way, we hope to provide a background and historical context for the development of the Pap smear.


Assuntos
Neoplasia Intraepitelial Cervical/diagnóstico , Teste de Papanicolaou/história , Infecções por Papillomavirus/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Esfregaço Vaginal/história , Neoplasia Intraepitelial Cervical/patologia , Neoplasia Intraepitelial Cervical/virologia , Colo do Útero/patologia , Colo do Útero/virologia , Feminino , História do Século XX , História do Século XXI , Humanos , Programas de Rastreamento/história , Programas de Rastreamento/tendências , Teste de Papanicolaou/tendências , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/patologia , Infecções por Papillomavirus/virologia , Estados Unidos , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/virologia , Esfregaço Vaginal/tendências
4.
Medicine (Baltimore) ; 98(13): e14600, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30921178

RESUMO

Ghana does not have a universal population-based cervical cancer screening program and there is very limited information about the distribution of cervical epithelial cell lesions. This study provides evidence that a moderately high prevalence of cervical cancer and precancerous lesions exists among unscreened women in Kumasi.The prevalence of cervical epithelial cell abnormalities among a cross-section of women attending cervical cancer screening for the first time in a suburb of Ghana from 2011 to 2014 was studied. Cervical smears were prepared and examined independently by 2 cytotechnologists and confirmed by a pathologist. Cervical lesions were classified according to the Bethesda System for cervical cytology 2001.Out of the 592 women for whom a Pap smear was available for evaluation, 555 (93.8%) were negative for intraepithelial lesion or malignancy. Eight women (1.4%) showed atypical squamous cells of undetermined significance (ASCUS), 9 (1.4%) low-grade squamous intraepithelial lesions, and 2 (0.3%) high-grade squamous intraepithelial lesions. A total of 15 (2.5%) smears were unsatisfactory for cervical cytology. Additionally, 3 women (0.5%) had squamous cell carcinoma, giving an overall rate of 3.7% for epithelial cell abnormalities.Cervical cancer and precursor epithelial cell abnormalities are common among women in Kumasi for a disease that can be prevented by early detection through routine screening and management. This study provides adequate background data to recommend the implementation of cervical cancer screening in all eligible women in Ghana.


Assuntos
Lesões Pré-Cancerosas/epidemiologia , Lesões Pré-Cancerosas/patologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Células Escamosas Atípicas do Colo do Útero/citologia , Células Escamosas Atípicas do Colo do Útero/patologia , Carcinoma de Células Escamosas/patologia , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Programas de Rastreamento/normas , Pessoa de Meia-Idade , Teste de Papanicolaou/estatística & dados numéricos , Teste de Papanicolaou/tendências , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/patologia , Lesões Pré-Cancerosas/diagnóstico , Prevalência , Lesões Intraepiteliais Escamosas Cervicais/patologia , Neoplasias do Colo do Útero/diagnóstico , Esfregaço Vaginal/estatística & dados numéricos , Esfregaço Vaginal/tendências
5.
Surg Pathol Clin ; 11(3): 589-599, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30190142

RESUMO

Ninety years ago, at the Battle Creek conference, Papanicolaou introduced cervical exfoliative cytology. Since then, the "Pap test" has come a long way. The discovery of a causal relationship between cervical carcinoma and HPV infection opened the door for molecular testing and immunomarkers for HPV. The Clinical Laboratory Improvement Amendments, 1988, established quality assurance and quality control programs to monitor performance of cytology laboratories. The Bethesda System for reporting cervical cytology laid the foundations for cervical cytology education, implementation of management guidelines, and further research on cervical carcinogenesis. HPV vaccine penetration in both genders remains 62% or less.


Assuntos
Citodiagnóstico/métodos , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/patologia , Neoplasias do Colo do Útero/patologia , Consenso , Citodiagnóstico/tendências , Feminino , Humanos , Programas de Rastreamento , Teste de Papanicolaou/tendências , Guias de Prática Clínica como Assunto , Esfregaço Vaginal/tendências
6.
BMC Cancer ; 18(1): 126, 2018 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-29394915

RESUMO

BACKGROUND: Quality indicators for the Brazilian cervical cancer screening programme can provide a perspective on its effectiveness in Brazilian macro-regions and states. The aim of this study was to perform a trend analysis of the cervical cancer screening program's quality indicators, according to Brazilian regions and states, from 2006 to 2013. METHODS: Using information from approximately 62,000,000 exams obtained from the Information System of Cervical Cancer Screening (SISCOLO), joinpoint analysis was used to calculate the Annual Percentage Change (APC). RESULTS: The estimated number of women in the target age group (25-64 years) who underwent Pap testing over a three-year interval was lower than that recommended by international guidelines in the North, Northeast and Midwest regions, and the trends for this indicator remained stationary over the years in all regions of Brazil. Overall, the index of positivity in Brazilian regions and states is below that preconized by the Brazilian National Cancer Institute (INCA). Additionally, the frequencies of unsatisfactory cases are in line with international guidelines but above those preconized by INCA guidelines. All positive cytological diagnoses were lower than those preconized by INCA. CONCLUSIONS: The results show that the cervical cancer screening programme is still far from efficient because most of the quality indicators in Brazilian regions and states are outside of the parameters preconized by national and international organizations.


Assuntos
Detecção Precoce de Câncer/tendências , Programas de Rastreamento/tendências , Garantia da Qualidade dos Cuidados de Saúde , Neoplasias do Colo do Útero/diagnóstico , Adulto , Brasil , Feminino , Humanos , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Esfregaço Vaginal/estatística & dados numéricos , Esfregaço Vaginal/tendências
7.
Eur J Cancer Prev ; 27(2): 158-163, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-27824660

RESUMO

The national cervical screening programme, CervicalCheck, commenced in Ireland in 2008. Free cervical smear tests are offered to over 1.2 million women aged 25-60 every 3 (aged 25-44) and 5 (aged 45-60) years. The purpose of this paper is to highlight the achievements and document the experience of the first 6 years of a new cervical screening programme. Data were extracted from the programme screening register and colposcopy management systems. SAS, version 9.4 was used for statistical analysis. Over 1.98 million smear tests were performed in over 1 million women during the first 6 years of the programme. Overall 5-year coverage at the end of the sixth year was 77.0%, where coverage is presented for the target population of women aged 25-60 years and is adjusted for hysterectomy rates. The numbers of women attending colposcopy increased significantly from 10 000 new patients attending for the first time in the first year to a peak of almost 17 500 in the third year. Increased capacity in colposcopy has delivered significant improvements in waiting times; the percentage of women referred to colposcopy offered an appointment within 8 weeks increased from 41.5% in year 1 to 93.4% in year 4 and has remained above the greater than 90% standard thereafter. The number of biopsies increased markedly, with 33 768 women being diagnosed with cervical intraepithelial neoplasia-grade 2 (CIN2), CIN3 or adenocarcinoma in situ and 860 being diagnosed with invasive cancer by the end of the sixth year. Lessons from CervicalCheck include the importance of capacity planning in programme delivery. The programme continues to evolve, particularly with the increased usage of human papillomavirus testing and planning for future testing of the human papillomavirus (HPV)-vaccinated cohort.


Assuntos
Neoplasia Intraepitelial Cervical/diagnóstico , Detecção Precoce de Câncer/métodos , Programas de Rastreamento/métodos , Sistema de Registros/estatística & dados numéricos , Neoplasias do Colo do Útero/diagnóstico , Adulto , Biópsia , Neoplasia Intraepitelial Cervical/patologia , Neoplasia Intraepitelial Cervical/cirurgia , Neoplasia Intraepitelial Cervical/virologia , Colo do Útero/diagnóstico por imagem , Colo do Útero/patologia , Colo do Útero/cirurgia , Colposcopia/estatística & dados numéricos , Colposcopia/tendências , Detecção Precoce de Câncer/estatística & dados numéricos , Detecção Precoce de Câncer/tendências , Feminino , Humanos , Histerectomia/estatística & dados numéricos , Irlanda , Programas de Rastreamento/estatística & dados numéricos , Programas de Rastreamento/tendências , Pessoa de Meia-Idade , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/virologia , Avaliação de Programas e Projetos de Saúde , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/virologia , Esfregaço Vaginal/estatística & dados numéricos , Esfregaço Vaginal/tendências
8.
J Am Coll Health ; 65(7): 474-481, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28622120

RESUMO

OBJECTIVE: To conduct a trend analysis of Pap test practices, Pap test results and related women's services and guidelines of college health centers. PARTICIPANTS: College health centers who participated in the annual ACHA Pap Test and STI (sexually transmitted infection) Survey years 2004-2014 (n ranged from 127 to 181 depending on year). METHODS: Descriptive analyses are presented with ANOVAs (Analysis of Variance) and chi-square tests calculated to examine trends over time. RESULTS: The number of Pap tests significantly decreased over time; however, the percentage of normal and HSIL (high-grade squamous intraepithelial lesion) results did not vary. Availability of conventional cytology slides and cryotherapy were significantly associated with year. Over time, college health centers' guidelines related to initiation of Pap testing evolved to consistently conform to national recommendations for cervical screening. CONCLUSIONS: The results indicate most college health centers are following the current national guidelines regarding Pap testing for young adult women.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Teste de Papanicolaou/tendências , Estudantes/psicologia , Neoplasias do Colo do Útero/prevenção & controle , Esfregaço Vaginal/tendências , Adulto , Feminino , Humanos , Doenças Sexualmente Transmissíveis/prevenção & controle , Universidades , Neoplasias do Colo do Útero/diagnóstico , Adulto Jovem
9.
Acta Cytol ; 61(2): 91-95, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28324872

RESUMO

OBJECTIVE: To explore the current and anticipated changes in the practice of cytopathology. STUDY DESIGN: The present review is based on a review of recent literature and an evaluation of the authors' personal experiences. RESULTS AND CONCLUSION: In recent years the practice of cytopathology, nationwide and in our institute, has witnessed a major change affecting gynecologic and nongynecologic cytology. There has been a decline in the number of Papanicolaou tests which has affected the utilization of cytotechnologists and provoked a reorganization of their work flow. The "need to do more with less" in the era of targeted therapy/personalized medicine has resulted in an increasing preference for needle core biopsy when performing a rapid on-site evaluation. We feel that this change is unavoidable. It is pertinent that cytopathologists as a group recognize this change and prepare themselves and the trainees not only to become adapt but also to use this as an opportunity to discover the yet unexplored world of cytology.


Assuntos
Biologia Celular/tendências , Técnicas Citológicas/tendências , Patologia Clínica/tendências , Padrões de Prática Médica/tendências , Neoplasias do Colo do Útero/diagnóstico , Adulto , Idoso , Biópsia com Agulha de Grande Calibre/tendências , Competência Clínica , Difusão de Inovações , Feminino , Humanos , Curva de Aprendizado , Pessoa de Meia-Idade , Teste de Papanicolaou/tendências , Patologia Molecular/tendências , Valor Preditivo dos Testes , Fatores de Tempo , Neoplasias do Colo do Útero/genética , Neoplasias do Colo do Útero/patologia , Esfregaço Vaginal/tendências , Fluxo de Trabalho , Adulto Jovem
11.
Womens Health Issues ; 26(2): 176-82, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26781749

RESUMO

BACKGROUND: Since the 1990s, policymakers have successfully increased cervical cancer screening through federal and state public policies. However, the most dramatic gains in Pap smear use occurred in the 1960's and 70's, during the establishment of federal support for family planning clinics through the War on Poverty and Title X. This study estimated the effect of this support on cervical cancer screening, and quantified its role in dramatic increases in Pap smear use. METHODS: Using a natural experiment in the timing and receipt of federal family planning grants, the screening behavior of women who did and did not have access to a federally funded family planning clinic were analyzed. Cross-sectional probability models of annual and lifetime Pap smear use using the 1970 National Fertility Survey were estimated and linked to administrative data on grant timing and receipt between 1964 and 1973. FINDINGS: Federal support for family planning clinics was associated with a 7-percentage point increase in annual use (p < .01), and a 5-percentage point decrease in never use of the Pap smear (p < .001). Scaled by the fraction of women who used funded clinics, federal support for family planning was associated with a roughly 70% increase in Pap smear use. Estimates suggest that the establishment of federal support could explain as much as 15% of the national increase in Pap smear use between 1966 and 1973. CONCLUSIONS: Federal support for family planning played an important--and previously unacknowledged--role in promoting cervical cancer screening and investments in future health.


Assuntos
Serviços de Planejamento Familiar/estatística & dados numéricos , Financiamento Governamental , Gastos em Saúde , Programas de Rastreamento/estatística & dados numéricos , Neoplasias do Colo do Útero/diagnóstico , Esfregaço Vaginal/estatística & dados numéricos , Adulto , Estudos Transversais , Detecção Precoce de Câncer/estatística & dados numéricos , Serviços de Planejamento Familiar/legislação & jurisprudência , Serviços de Planejamento Familiar/tendências , Feminino , Alocação de Recursos para a Atenção à Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Programas de Rastreamento/tendências , Objetivos Organizacionais , Teste de Papanicolaou/estatística & dados numéricos , Teste de Papanicolaou/tendências , Política Pública , Inquéritos e Questionários , Estados Unidos , Neoplasias do Colo do Útero/prevenção & controle , Esfregaço Vaginal/tendências
12.
Arch Pathol Lab Med ; 140(1): 13-21, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26046490

RESUMO

CONTEXT: The College of American Pathologists periodically surveys laboratories to determine changes in cytopathology practices. We report the results of a 2011 gynecologic cytology survey. OBJECTIVE: To provide a cross-sectional survey of gynecologic cytology practices in 2010. DESIGN: In 2011, a survey was sent to 1604 laboratories participating in the College of American Pathologists gynecologic cytology interlaboratory comparison education program and proficiency testing programs requesting data from 2010 on the following topics: terminology/reporting, cytotechnologist workload, quality assurance, reagents, and ancillary testing. RESULTS: Six hundred and twenty-five laboratories (39%) replied to the survey. The nonstandard use of "low-grade squamous intraepithelial lesion cannot exclude high-grade squamous intraepithelial lesion" is used by most laboratories to report the presence of low-grade squamous intraepithelial lesion with possibility of high-grade squamous intraepithelial lesion. Most laboratories also report the presence or absence of cells from the transformation zone. Most respondents do not limit cytotechnologist screening workload during the work shift. Only about one-third of laboratories (188 of 582; 32%) use image-assisted screening devices. Rapid prescreening as a quality assurance measure is used by only 3.5% (21 of 594) of the laboratories. When used for screening, most laboratories use the imager for retrospective review of slides to detect human locator and interpretive errors. Most laboratories receive both liquid-based cytology samples (mainly ThinPrep, Hologic, Marlborough, Massachusetts) and conventional Papanicolaou tests. Expiration dates of liquid-based cytology test vials are not usually recorded. CONCLUSIONS: The field of gynecologic cytology is evolving rapidly. These survey results offer a snapshot of national gynecologic cytology practices in 2010.


Assuntos
Ginecologia/tendências , Interpretação de Imagem Assistida por Computador/estatística & dados numéricos , Patologia Clínica/normas , Patologia Clínica/tendências , Neoplasias do Colo do Útero/diagnóstico , Esfregaço Vaginal/tendências , Estudos Transversais , Detecção Precoce de Câncer/normas , Detecção Precoce de Câncer/tendências , Feminino , Ginecologia/normas , Humanos , Interpretação de Imagem Assistida por Computador/normas , Laboratórios/normas , Ensaio de Proficiência Laboratorial/normas , Garantia da Qualidade dos Cuidados de Saúde/normas , Garantia da Qualidade dos Cuidados de Saúde/tendências , Inquéritos e Questionários , Estados Unidos , Esfregaço Vaginal/normas , Carga de Trabalho
13.
Asian Pac J Cancer Prev ; 16(15): 6375-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26434845

RESUMO

BACKGROUND: Cervical cancer is the second most common cancer in women worldwide, with about 500,000 new cases and 270,000 deaths each year. Globally, it is estimated that over one million women currently have cervical cancer, most of whom have not been diagnosed, or have no access to treatment that could cure them or prolong their lives. In the United Arab Emirates (UAE) cervical cancer is the third most common cancer in women. MATERIALS AND METHODS: A population-based cross-sectional retrospective survey of cervical smear abnormalities was conducted in the Emirate of Abu Dhabi, UAE, from January 2013 to December 2013 by collecting consecutive liquid-based cytology samples from the Department of Pathology at the SKMC Hospital in Abu Dhabi city. RESULTS: The total number of women screened for cervical cancer for the year 2013 at SKMC was 4,593, with 225 (4.89%) abnormal smears. The majority of the abnormal smear results were atypical squamous cells of undetermined significance (ASCUS) 114 (2.48%). This study showed 60% increase in the rate of abnormal cervical smears in the UAE over the last 10 years. In this study the highest incidence of high grade abnormalities were seen in women above the age of 61 years (1.73%), this might be due to the fact that this group of women missed the chance of screening of cervical cancer earlier in their lives or could be explained by the well-known second peak of HPV infection seen in many prevalence studies. CONCLUSIONS: We conclude that the rate of abnormal cervical smear in the screened Abu Dhabi women is not different from the rate in developed countries. A notable increase in both low and high grade abnormalities has occurred within the last decade.


Assuntos
Células Escamosas Atípicas do Colo do Útero/patologia , Lesões Intraepiteliais Escamosas Cervicais/epidemiologia , Lesões Intraepiteliais Escamosas Cervicais/patologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/patologia , Esfregaço Vaginal , Adulto , Fatores Etários , Estudos Transversais , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Teste de Papanicolaou , Prevalência , Estudos Retrospectivos , Emirados Árabes Unidos/epidemiologia , Esfregaço Vaginal/tendências
14.
Acta Cytol ; 59(6): 445-51, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26789332

RESUMO

OBJECTIVE: The Obstetrics and Gynecology Hospital of Fudan University (OGHFU) in Shanghai is the largest academic women's hospital in China. Between 2009 and 2014, the use of liquid-based cytology (LBC) significantly increased while gradually adopting the Bethesda System (TBS), and in 2012 local regulations mandated that pathologists replace technicians to sign out Pap tests. DESIGN: A retrospective OGHFU database search documented all Pap test reports between 2009 and 2014 by specimen type, either LBC or conventional Pap smears (CPS), and final reporting category. A total of 1,224,785 Pap reports were analyzed to document variations in Pap test reporting during a period of major change in cervical screening in China. RESULTS: LBC gradually replaced CPS, which declined from over 65% of Pap tests in 2010 to 6.4% in 2014. Of 514,811 Pap reports using the traditional class system, class I (negative) reports accounted for 98.3% of results. With the introduction of TBS reporting, pathologist reviews and substantial replacement of CPS by LBC, the laboratory abnormal Pap test rate increased significantly to almost 5%. CONCLUSIONS: Changes in cervical cytology reporting between 2009 and 2014 in China's largest academic women's hospital reflected both increased use of LBC and the introduction of pathologist TBS reporting. Abnormality rates increased significantly and fell within CAP benchmark ranges.


Assuntos
Centros Médicos Acadêmicos/tendências , Teste de Papanicolaou/tendências , Neoplasias do Colo do Útero/patologia , Esfregaço Vaginal/tendências , Centros Médicos Acadêmicos/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Benchmarking/tendências , China , Bases de Dados Factuais , Feminino , Humanos , Pessoa de Meia-Idade , Teste de Papanicolaou/normas , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos , Esfregaço Vaginal/normas , Adulto Jovem
16.
Bol Asoc Med P R ; 106(4): 6-10, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-26148391

RESUMO

OBJECTIVE OF THE STUDY: To describe cervical cytology trends in a sample of patients with Inflammatory Bowel Disease (IBD) and to provide an overview of aspects such as contraception and menstrual patterns. STUDY DESIGN: We identified women with diagnosis of IBD of ages between 21-49 years followed at the IBD clinics of the Medical Sciences Campus from June 2012 to April 2014. A 15-minute questionnaire was administered. Data was entered and analyzed calculating frequencies and percentages. RESULTS: Sixty-three subjects were recruited. After reviewing the questionnaires, 52 subjects remained for analysis. All women were between 21 and 49 years of age. Thirty (58%) patients had a diagnosis of ulcerative colitis (UC), while 22 (42%) patients had Crohn's Disease (CD). Twenty-seven IBD patients (52%) were in remission. Use of immunomodulators was reported in ten (33%) and seventeen (61%) of patients for UC and CD respectively. Sixty six percent (67%) of participants specified having their cervical cytology for cervical cancer screening done a nually. Twenty patients (38%) reported abnormal cytology including 13 patients (43%) with UC and 7 patients (23%) with CD. No significant relation was found between the two conditions and the self-reported history of abnormal cervical cytology. Almost one-half of IBD patients reported a menstrual cycle of 25-30 days (45%). Duration of menses was described as normal (lasting between 4-6 days) in 45% of IBD patients (95% CI 31.13-59.66). Patients with UC were more likely to report regular menses than patients with CD. Eighty-six percent of participants reported no use of contraception. CONCLUSION: This is the first descriptive report of gynecologic conditions in which Puerto Rican patients with IBD have been studied. It is imperative to continue with similar larger studies to gain a broader idea of what are the gynecological needs of this population.


Assuntos
Doenças Inflamatórias Intestinais , Esfregaço Vaginal/estatística & dados numéricos , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Porto Rico , Esfregaço Vaginal/tendências , Adulto Jovem
18.
Vopr Onkol ; 60(4): 517-21, 2014.
Artigo em Russo | MEDLINE | ID: mdl-25552076

RESUMO

The dynamics is presented of the rates of virus dependent diseases, in particular cervical cancer (CC), which are directly connected with the level of organization of screening and subsequent treatment of cancer. It is shown that in conditions of insurance medicine a reduction of examination rooms and female enrollment in cytology screening is observed. As a result, over the past 5 years, CC incidence in the Novgorod region increased 1.2 times, and in Russia as a whole, the proportion of such cases in female population under 29 years since 2000 increased 4.5 times (from 2.0% to 9%). The urgent task of cancer control is to restore examination rooms, to overcome disagreements between government institutions and medical departments, to increase coverage of women by cytology screening by means of formation of the program of individual accounting of women.


Assuntos
Detecção Precoce de Câncer/economia , Cobertura do Seguro , Seguro Saúde , Programas de Rastreamento/economia , Neoplasias do Colo do Útero/economia , Neoplasias do Colo do Útero/virologia , Detecção Precoce de Câncer/estatística & dados numéricos , Detecção Precoce de Câncer/tendências , Feminino , Humanos , Incidência , Programas de Rastreamento/estatística & dados numéricos , Programas de Rastreamento/tendências , Federação Russa/epidemiologia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Esfregaço Vaginal/estatística & dados numéricos , Esfregaço Vaginal/tendências
19.
Cuad. Hosp. Clín ; 55(2): 63-63, 2014.
Artigo em Espanhol | LILACS | ID: biblio-972720

RESUMO

Objetivo. Determinar la magnitud y los motivos del abandono del proceso de diagnóstico y tratamiento de la smujeres con citología anormal, así como la relación entre las características socioeconómicas de las mujeres y dicho abandono...


Assuntos
Esfregaço Vaginal/estatística & dados numéricos , Esfregaço Vaginal/tendências
20.
J Womens Health (Larchmt) ; 22(12): 1016-22, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23992102

RESUMO

BACKGROUND: Women infected by human immunodeficiency virus (HIV) have a higher risk of contracting cervical cancer. Recent guidelines recommend that all HIV-positive women should receive two Pap smears in the first year after their HIV diagnosis. METHODS: This was a population-based cohort study, and the National Health Insurance Research Database (NHIRD) in Taiwan was used to estimate the Pap smear screening rate for 1449 HIV-infected women aged 18 years and over from 2000 to 2010. A multiple logistic regression analysis was used to identify factors associated with HIV-infected women who had received Pap smears. RESULTS: Of 1449 women, 618 (43%) women received at least one Pap smear. Only 14.7% of the HIV-infected women received Pap smears within one year after being diagnosed with HIV. A logistic regression analysis showed that the factors associated with receiving at least one Pap smear after HIV diagnosis were increasing age (AOR 1.04, 95% CI 1.03-1.05), high monthly income (AOR 1.83, 95% CI 1.51-2.23), any history of antiretroviral therapy (AOR 1.78, 95% CI 1.38-2.29), retention in HIV care (AOR 1.36, 95% CI 1.04-1.77), a history of sexually transmitted diseases (AOR 1.96, 95% CI 1.50-2.56), and any history of treatment for opportunistic infections (AOR 2.46, 95% CI 1.91-3.16). CONCLUSIONS: A great need exists to develop strategies for promoting receipt of Pap smear screening services that specifically target severely disadvantaged women with HIV, particularly younger, lower income women and those in an asymptomatic phase.


Assuntos
Infecções por HIV/complicações , Teste de Papanicolaou/estatística & dados numéricos , Neoplasias do Colo do Útero/diagnóstico , Esfregaço Vaginal/estatística & dados numéricos , Adolescente , Adulto , Idoso , Instituições de Assistência Ambulatorial , Detecção Precoce de Câncer , Feminino , Humanos , Modelos Logísticos , Programas de Rastreamento/estatística & dados numéricos , Programas de Rastreamento/tendências , Pessoa de Meia-Idade , Vigilância da População , Prevalência , Estudos Retrospectivos , Fatores Socioeconômicos , Taiwan/epidemiologia , Neoplasias do Colo do Útero/etnologia , Neoplasias do Colo do Útero/prevenção & controle , Esfregaço Vaginal/tendências , Adulto Jovem
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