Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 29
Filtrar
Mais filtros










Intervalo de ano de publicação
3.
Rev. senol. patol. mamar. (Ed. impr.) ; 29(1): 13-18, ene.-mar. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-149866

RESUMO

Objetivo. Comparar la supervivencia del cáncer de mama en mujeres que han sido cribadas en el programa de Detección Precoz del Cáncer de Mama (DPCM) y en las que no han participado en él. Pacientes y métodos. Es un estudio descriptivo y longitudinal en el que se han estudiado todos los cánceres de mama registrados en el servicio de Anatomía Patológica del Hospital de Tortosa Verge de la Cinta (Tarragona) de mujeres de 50-65 años, que se habían detectado la enfermedad ellas mismas o que la había detectado el programa DPCM, desde junio de 1999 hasta junio de 2003. Se registraron 101 pacientes con cáncer de mama, de las que en 84 se pudieron recoger todos los datos relativos al tumor, la cirugía y el tratamiento. En el 2014, tras un seguimiento de 11,6 ± 1,8 años, se anotó el estado actual. Resultados. No hay diferencia estadísticamente significativa en la supervivencia de los 2 grupos. Pacientes con carcinoma in situ y sin ganglios metastásicos se encuentran entre las fallecidas, mientras que ninguna paciente con carcinoma bien diferenciado falleció. Conclusiones. En nuestro estudio, el cribado del cáncer de mama no mejora la supervivencia y determinados factores en los que se apoyan los programas de cribado, como la detección de carcinomas no infiltrantes y/o de ganglios no metastásicos, no aseguran la curación (AU)


Objective. To compare survival in breast cancer between women diagnosed in an early breast cancer detection programme and those not attending this programme. Patients and methods. We conducted a descriptive and longitudinal study that analysed all types of breast cancer registered in the Pathology Service of the Hospital de Tortosa Verge de la Cinta (Tarragona, Spain). Tumour samples were obtained from 50-65-year-old women who had detected alterations on self-examination and from those attending the early breast cancer detection programme from June 1999 to June 2003. All the information relating to the tumour, surgery or treatment was registered. In 2014, after a follow-up of 11.6 ± 1.8 years, the current status of each patient was recorded. Results. There was no significant statistical difference in survival between the two groups of patients. Non-survivors included patients with in situ carcinoma and without lymph node metastases. Survival was 100% in patients with well differentiated carcinoma. Conclusions. Breast cancer screening did not improve survival in our study. The elements on which screening programs are based, such as non-invasive carcinoma detection and/or non- metastatic lymph nodes, do not ensure recovery (AU)


Assuntos
Humanos , Feminino , Adulto , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Programas de Rastreamento/classificação , Programas de Rastreamento/métodos , Linfonodos/metabolismo , Espanha/etnologia , Biópsia de Linfonodo Sentinela/métodos , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/terapia , Intervalo Livre de Doença , Programas de Rastreamento/normas , Programas de Rastreamento , Linfonodos/anormalidades , Biópsia de Linfonodo Sentinela/normas
5.
Rev. neurol. (Ed. impr.) ; 60(supl.1): s3-s11, mar. 2015.
Artigo em Espanhol | IBECS | ID: ibc-134365

RESUMO

El trastorno del espectro autista (autismo) es una familia de trastornos del neurodesarrollo de origen genético y de elevada prevalencia y heterogeneidad que puede tener efectos devastadores para el niño, la familia, y los sistemas sanitario y educativo. A pesar de los avances en la detección sistemática a través de escalas y cuestionarios y en la armonización de los métodos de diagnósticos, la edad de diagnóstico del autismo en Estados Unidos ronda todavía los 4 o 5 años, y aún más en los colectivos desfavorecidos, lo que supone varios años después del segundo o tercer año de vida en que un especialista puede diagnosticarlo con fiabilidad. Dado que la detección y el tratamiento precoz son dos factores primordiales para optimizar el desenlace del trastorno, y dado que el diagnóstico es casi siempre una condición necesaria para que las familias puedan acceder al tratamiento precoz, la rebaja de la edad de diagnóstico se ha convertido en una de las mayores prioridades de la disciplina. Los últimos avances en la neurociencia del desarrollo social anuncian la aparición de métodos basados en el rendimiento, rentables y viables en el ámbito extrahospitalario, y sugieren un método complementario para fomentar el cribado universal y ampliar el acceso al diagnóstico. Estudios pequeños, pero cruciales, ya han descrito experimentos que diferencian grupos de niños en riesgo de sufrir autismo de los grupos de control y, hasta ahora, por lo menos un estudio ha podido predecir la clasificación diagnóstica y el grado de incapacidad por medio de un experimento breve. A pesar de que el camino para convertir esos métodos en eficaces herramientas de cribado diagnóstico será largo y de que conviene evitar conclusiones precipitadas, tal esfuerzo podría ser crítico para abordar este problema de salud pública de alcance mundial (AU)


Autism spectrum disorder (autism) is a highly prevalent and heterogeneous family of neurodevelopmental disorders of genetic origins with potentially devastating implications for child, family, health and educational systems. Despite advances in paper-and-pencil screening and in standardization of diagnostic procedures, diagnosis of autism in the US still hovers around the ages of four or five years, later still in disadvantaged communities, and several years after the age of two to three years when the condition can be reliably diagnosed by expert clinicians. As early detection and treatment are two of the most important factors optimizing outcome, and given that diagnosis is typically a necessary condition for families to have access to early treatment, reducing age of diagnosis has become one of the greatest priorities of the field. Recent advances in developmental social neuroscience promise the advent of cost-effective and community-viable, performance-based procedures, and suggest a complementary method for promoting universal screening and much greater access to the diagnosis process. Small but critical studies have already reported on experiments that differentiate groups of children at risk for autism from controls, and at least one study so far could predict diagnostic classification and level of disability on the basis of a brief experiment. Although the road to translating such procedures into effective devices for screening and diagnosis is still a long one, and premature claims should be avoided, this effort could be critical in addressing this worldwide public health challenge (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Transtorno Autístico/classificação , Transtorno Autístico/diagnóstico , Neurociências/educação , Saúde Pública/legislação & jurisprudência , Programas de Rastreamento/classificação , Relações Interpessoais , Córtex Visual/anormalidades , Atenção Primária à Saúde/métodos , Transtorno Autístico/genética , Transtorno Autístico/terapia , Neurociências/legislação & jurisprudência , Saúde Pública/métodos , Programas de Rastreamento/análise , Córtex Visual/patologia , Atenção Primária à Saúde/normas
6.
Rev. neurol. (Ed. impr.) ; 60(supl.1): s25-s29, mar. 2015.
Artigo em Espanhol | IBECS | ID: ibc-134368

RESUMO

Introducción. El reto de la detección precoz puede realizarse desde una perspectiva evolutiva. Los tratamientos de intervención emprana han demostrado su eficacia siempre y cuando se apliquen sistemáticamente en el marco de una planificación estratégica del tratamiento. Objetivos. Proporcionar una revisión actualizada para responder a las críticas a la detección precoz y aportar una reflexión sobre la estrategia de intervención, basada en la revisión de las técnicas de atención temprana usuales en el campo del autismo, reflejando los aspectos más relevantes que se deducen de las experiencias y estudios llevados a cabo hasta el momento. Conclusiones. Tras la revisión realizada se concluye que la detección precoz puede ser más eficiente si se lleva a cabo en el marco de la vigilancia del desarrollo, que además ofrece la oportunidad de proporcionar orientación sobre el desarrollo del menor. La atención temprana constituye un recurso eficaz para atender las necesidades del menor con autismo. Los profesionales tienen la responsabilidad de evaluar el trabajo que hacen con una actitud reflexiva y crítica sobre los tratamientos disponibles tomando en consideración los valores y las preferencias de las familias. Los programas deben centrarse en los síntomas nucleares aplicando ingredientes activos del tratamiento (AU)


Introduction. The challenge of early detection can be tackled from an evolutionary perspective. Early intervention treatments have shown themselves to be effective provided that they are applied systematically as part of the strategic planning of the treatment. Aims. The aim of this study is to provide an updated review in response to the criticism targeted towards early detection and to offer some considerations on the intervention strategy. Our research is based on a review of the early care techniques that are commonly used within the field of autism and it intends to reflect the most significant aspects that can be deduced from the experiments and studies carried out to date. Conclusions. From the findings of the review it can be concluded that early detection may be more efficient if carried out within the framework of developmental surveillance, which also offers the opportunity to provide guidance on the child’s development. Early care is an effective resource for attending to the needs of children with autism. Professionals have the duty to assess the work they do on available treatments with a reflexive, judicious attitude, taking into account the values and preferences of the families. Programmes must focus on the core symptoms and apply the active ingredients of the treatment (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Transtorno Autístico/complicações , Transtorno Autístico/psicologia , Determinação/análise , Programas de Rastreamento/classificação , Alerta Rápido , Terapêutica/métodos , Transtorno Autístico/genética , Transtorno Autístico/terapia , Determinação/métodos , Programas de Rastreamento/métodos , Sistemas de Alerta Rápido , Terapêutica/instrumentação , Terapêutica/psicologia
7.
Ugeskr Laeger ; 176(12)2014 Jun 09.
Artigo em Dinamarquês | MEDLINE | ID: mdl-25096933

RESUMO

Screening is often defined as systematic examinations of healthy citizens to identify those with asymptomatic disease. In our modern society many persons have chronic conditions and it is not so easy to draw the line between healthy and unhealthy citizens. Today, many health-care activities aim at detecting conditions at an early non-symptomatic stage of the disease process in order to be able to avoid possible progression to the next stage. On this basis, we suggest to broaden the definition of screening to reflect the realities of modern health care.


Assuntos
Programas de Rastreamento , Técnicas e Procedimentos Diagnósticos/classificação , Técnicas e Procedimentos Diagnósticos/ética , Nível de Saúde , Humanos , Programas de Rastreamento/classificação , Programas de Rastreamento/ética , Guias de Prática Clínica como Assunto
8.
Trop Med Int Health ; 17(12): 1470-7, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23107575

RESUMO

OBJECTIVE: To present an effective classification method based on the prevalence of Schistosoma mansoni in the community. METHODS: We created decision rules (defined by cut-offs for number of positive slides), which account for imperfect sensitivity, both with a simple adjustment of fixed sensitivity and with a more complex adjustment of changing sensitivity with prevalence. To reduce screening costs while maintaining accuracy, we propose a pooled classification method. To estimate sensitivity, we use the De Vlas model for worm and egg distributions. We compare the proposed method with the standard method to investigate differences in efficiency, measured by number of slides read, and accuracy, measured by probability of correct classification. RESULTS: Modelling varying sensitivity lowers the lower cut-off more significantly than the upper cut-off, correctly classifying regions as moderate rather than lower, thus receiving life-saving treatment. The classification method goes directly to classification on the basis of positive pools, avoiding having to know sensitivity to estimate prevalence. For model parameter values describing worm and egg distributions among children, the pooled method with 25 slides achieves an expected 89.9% probability of correct classification, whereas the standard method with 50 slides achieves 88.7%. CONCLUSIONS: Among children, it is more efficient and more accurate to use the pooled method for classification of S. mansoni prevalence than the current standard method.


Assuntos
Técnicas de Apoio para a Decisão , Programas de Rastreamento/classificação , Contagem de Ovos de Parasitas/métodos , Esquistossomose mansoni/epidemiologia , Esquistossomose mansoni/prevenção & controle , Animais , Anti-Helmínticos , Quimioprevenção , Criança , Controle de Custos , Humanos , Programas de Rastreamento/economia , Prevalência , Schistosoma mansoni/isolamento & purificação , Sensibilidade e Especificidade
9.
Sex Health ; 9(6): 562-7, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22951231

RESUMO

Our understanding of the human papillomavirus (HPV) related cytomorphology and histopathology of the anal canal is underpinned by our knowledge of HPV infection in the cervix. In this review, we utilise cervical reporting of cytological and histological specimens as a foundation for the development of standardised and evidence-based terminology and criteria for reporting of anal specimens. We advocate use of the Australian Modified Bethesda System 2004 for reporting anal cytology. We propose the use of a two-tiered histological reporting system for noninvasive disease - low-grade and high-grade anal intraepithelial neoplasia. These classification systems reflect current understanding of the biology of HPV and enhance diagnostic reproducibility. Biomarkers such as p16(INK4A) may prove useful in further improving diagnostic accuracy. Standardisation is important because it will increase the value of the data collected as Australian centres develop programs for screening for anal neoplasia.


Assuntos
Neoplasias do Ânus/classificação , Neoplasias do Ânus/patologia , Infecções por Papillomavirus/classificação , Infecções por Papillomavirus/patologia , Lesões Pré-Cancerosas/classificação , Lesões Pré-Cancerosas/patologia , Adulto , Canal Anal/patologia , Neoplasias do Ânus/virologia , Carcinoma de Células Escamosas/classificação , Carcinoma de Células Escamosas/patologia , Diagnóstico Diferencial , Detecção Precoce de Câncer , Feminino , Saúde Global , Homossexualidade Masculina , Humanos , Masculino , Programas de Rastreamento/classificação , Lesões Pré-Cancerosas/virologia , Fatores de Risco , Assunção de Riscos , Sensibilidade e Especificidade
12.
BMC Public Health ; 10: 734, 2010 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-21110881

RESUMO

BACKGROUND: The National Cervical Screening Program in Australia currently recommends that sexually active women between the ages of 18-70 years attend routine screening every 2 years. The publically funded National HPV Vaccination Program commenced in 2007, with catch-up in females aged 12-26 years conducted until 2009; and this may prompt consideration of whether the screening interval and other aspects of the organized screening program could be reviewed. The aim of the current evaluation was to assess the epidemiologic outcomes and cost implications of changing the recommended screening interval in Australia to 3 years. METHODS: We used a modelling approach to evaluate the effects of moving to a 3-yearly recommended screening interval. We used data from the Victorian Cervical Cytology Registry over the period 1997-2007 to model compliance with routine screening under current practice, and registry data from other countries with 3-yearly recommendations to inform assumptions about future screening behaviour under two alternative systems for screening organisation--retention of a reminder-based system (as in New Zealand), or a move to a call-and-recall system (as in England). RESULTS: A 3-yearly recommendation is predicted to be of similar effectiveness to the current 2-yearly recommendation, resulting in no substantial change to the total number of incident cervical cancer cases or cancer deaths, or to the estimated 0.68% average cumulative lifetime risk of cervical cancer in unvaccinated Australian women. However, a 3-yearly screening policy would be associated with decreases in the annual number of colposcopy and biopsy procedures performed (by 4-10%) and decreases in the number of treatments for pre-invasive lesions (by 2-4%). The magnitude of the decrease in the number of diagnostic procedures and treatments would depend on the method of screening organization, with call-and-recall screening associated with the highest reductions. The cost savings are predicted to be of the order of A$10-18 M annually, equivalent to 6-11% of the total cost of the current program (excluding overheads), with call-and-recall being associated with the greatest savings. CONCLUSIONS: Lengthening the recommended screening interval to 3 years in Australia is not predicted to result in increases in rates of cervical cancer and is predicted to decrease the number of women undergoing diagnostic and treatment procedures. These findings are consistent with a large body of international evidence showing that screening more frequently than every three years with cervical cytology does not result in substantial gains in screening effectiveness.


Assuntos
Programas de Rastreamento/classificação , Formulação de Políticas , Neoplasias do Colo do Útero/diagnóstico , Adolescente , Adulto , Idoso , Austrália , Criança , Feminino , Política de Saúde , Humanos , Programas de Rastreamento/organização & administração , Pessoa de Meia-Idade , Modelos Teóricos , Fatores de Tempo , Adulto Jovem
13.
Fed Regist ; 75(151): 47460-1, 2010 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-20690236

RESUMO

The Department is publishing this final rule to implement section 703 of the National Defense Authorization Act (NDAA) for Fiscal Year 2007 (FY07), Public Law 109-364. Specifically, that legislation authorizes breast cancer screening and cervical cancer screening for female beneficiaries of the Military Health System, instead of constraining such testing to mammograms and Papanicolaou smears. The rule allows coverage for "breast cancer screening" and "cervical cancer screening" for female beneficiaries of the Military Health System, instead of constraining such testing to mammograms and Papanicolaou tests. This rule ensures new breast and cervical cancer screening procedures can be added to the TRICARE benefit as such procedures are proven to be a safe, effective, and nationally accepted medical practice. This amends the cancer specific recommendations for breast and cervical cancer screenings to be brought in line with the processes for updating other cancer screening recommendations. In response to public comment on the proposed rule, this final rule includes a clarification that the benefit encompasses screening based on Health and Human Services guidelines.


Assuntos
Detecção Precoce de Câncer/classificação , Programas de Rastreamento/classificação , Militares/legislação & jurisprudência , Serviços de Saúde da Mulher/legislação & jurisprudência , Neoplasias da Mama/diagnóstico , Feminino , Planos de Assistência de Saúde para Empregados , Humanos , Estados Unidos , Neoplasias do Colo do Útero/diagnóstico , Mulheres
15.
Gac. sanit. (Barc., Ed. impr.) ; 22(supl.1): 205-215, abr. 2008. tab
Artigo em Espanhol | IBECS | ID: ibc-62021

RESUMO

Como se suele suponer que las intervenciones preventivas tienenpocos riesgos, la investigación sobre sus efectos negativoses escasa, tal como pone de manifiesto una revisión de la literaturamédica española. Esos estudios analizan efectos a cortoplazo (como falsos positivos de los cribados), pero no tratan efectosa largo plazo de las medidas poscribado (p. ej., fármacos preventivos)ni efectos negativos más intangibles (como la medicalización).Se produce una expansión acrítica de la medicinapreventiva: continuas propuestas de nuevos cribados (incluidaslas preenfermedades y los factores de riesgo) y vacunas. El balanceentre beneficios y riesgos de esta expansión es, como mínimo,dudoso.En este proceso la industria farmacéutica desempeña un papelclave, pero también hay que revisar cómo actúan otros agentes:profesionales y autoridades sanitarias, medios de comunicacióny sociedad en general. Resaltamos sobre todo el papel de la profesiónmédica, pues sin ella no sería posible definir nuevas enfermedadesy preenfermedades ni recomendar el uso de nuevasintervenciones preventivas.La profesión médica tiene el prestigio suficiente ante el restode los agentes para liderar cualquier cambio. Previamente lassociedades científicas deberían tener un debate interno sobresu papel actual en la adopción de nuevas intervenciones preventivas,sus relaciones con la industria y sus conflictos deinterés. Algunas asociaciones médicas ya están adoptando unenfoque más crítico y analizando el impacto de sus propias recomendacionespreventivas sobre la medicalización de la vida(AU)


Es necesario analizar de forma continuada los efectos adversosde las medidas preventivas implantadas en la práctica y establecermecanismos para la evaluación crítica del balance beneficios-riesgos-costes de las nuevas intervenciones preventivasantes de incluirlas en la cartera de servicios. En la práctica clínicacotidiana habría que fomentar la participación de las personasen las decisiones y que los profesionales adopten el enfoquede la prevención cuaternaria(AU)


Because preventive interventions are usually assumed to carryfew risks, research on their negative effects is scarce, as revealedby a review of the Spanish literature. The studies retrievedanalyze short-term effects (such as false-positive results of screeningtests), but do not evaluate the long-term effects of postscreeninginterventions (for example: preventive drugs) or evenless tangible negative effects (such as medicalization). Uncriticalspread of preventive medicine is occurring, with continual proposalsfor new screening tests (for pre-diseases and risk factors)and new vaccines. The risk-benefit ratio of this spread is, at thevery least, doubtful.The pharmaceutical industry plays a key role in this process butthe role of other stakeholders (health professionals and healthauthorities, mass media and society) should also be reviewed.The present article highlights the role of the medical profession,since, without it, definition of new diseases and pre-diseases andthe creation of guidelines on the use of new preventive interventionswould not be possible.The medical profession has sufficient prestige to lead any change.Before any change occurs, however, scientific societies shouldconduct an internal debate on their current role in the adoptionof new preventive interventions, their relationships with the pharmaceuticalindustry and their conflicts of interest. Some medicalassociations are already adopting a more critical approach to theevaluation of the benefit-risk trade-off of new interventions andare analyzing the impact of their own preventive recommendationson the medicalization of life(AU)


The adverse effects of the preventive measures implementedin health services should be continually assessed and proceduresfor the critical evaluation of the benefit-risk-cost trade-offs ofnew preventive interventions should be established before makingdecisions on their incorporation in the health services’ portfolio.Finally, in daily clinical practice, enhancing citizen participationin decisions and adopting the approach of quaternary preventionwould be desirable(AU)


Assuntos
Humanos , Masculino , Feminino , Programas de Rastreamento/métodos , Programas de Rastreamento/políticas , Serviços Preventivos de Saúde/ética , Serviços Preventivos de Saúde/métodos , Medicina Preventiva/organização & administração , Medicina Preventiva/normas , Vacinas/imunologia , Vacinas/uso terapêutico , Preparações Farmacêuticas/efeitos adversos , Preparações Farmacêuticas/economia , Programas de Rastreamento/análise , Programas de Rastreamento/classificação , Prevenção Primária/legislação & jurisprudência , Prevenção Primária/métodos , Prevenção Primária/tendências
19.
Health Serv Res ; 42(3 Pt 1): 1130-49, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17489907

RESUMO

OBJECTIVE: To identify primary care practice characteristics associated with colorectal cancer (CRC) screening performance, controlling for patient-level factors. DATA SOURCES/STUDY SETTING: Primary care director survey (1999-2000) of 155 VA primary care clinics linked with 38,818 eligible patients' sociodemographics, utilization, and CRC screening experience using centralized administrative and chart-review data (2001). STUDY DESIGN: Practices were characterized by degrees of centralization (e.g., authority over operations, staffing, outside-practice influence); resources (e.g., sufficiency of nonphysician staffing, space, clinical support arrangements); and complexity (e.g., facility size, academic status, managed care penetration), adjusting for patient-level covariates and contextual factors. DATA COLLECTION/EXTRACTION METHODS: Chart-based evidence of CRC screening through direct colonoscopy, sigmoidoscopy, or consecutive fecal occult blood tests, eliminating cases with documented histories of CRC, polyps, or inflammatory bowel disease. PRINCIPAL FINDINGS: After adjusting for sociodemographic characteristics and health care utilization, patients were significantly more likely to be screened for CRC if their primary care practices had greater autonomy over the internal structure of care delivery (p<.04), more clinical support arrangements (p<.03), and smaller size (p<.001). CONCLUSIONS: Deficits in primary care clinical support arrangements and local autonomy over operational management and referral procedures are associated with significantly lower CRC screening performance. Competition with hospital resource demands may impinge on the degree of internal organization of their affiliated primary care practices.


Assuntos
Instituições de Assistência Ambulatorial/organização & administração , Neoplasias Colorretais/prevenção & controle , Programas de Rastreamento/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Atenção Primária à Saúde/organização & administração , United States Department of Veterans Affairs/organização & administração , Veteranos/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , California , Feminino , Pesquisas sobre Serviços de Saúde , Política de Saúde , Humanos , Masculino , Programas de Rastreamento/classificação , Pessoa de Meia-Idade , Política Organizacional , Autonomia Profissional , Qualidade da Assistência à Saúde , Estados Unidos
20.
Gastroenterol. hepatol. (Ed. impr.) ; 29(supl.3): 72-76, nov. 2006. tab
Artigo em Espanhol | IBECS | ID: ibc-147043

RESUMO

Una de las principales novedades presentadas en la Digestive Disease Week (DDW) de 2006 fue la presentación de las guías clínicas de seguimiento de los adenomas colorrectales. Esta nueva guía persigue un doble objetivo: la identificación de los factores de riesgo de recurrencia y diferenciar a 2 grupos de pacientes, los de bajo y los de alto riesgo de recurrencia. Esta división ha de permitir optimizar un recurso escaso, la colonoscopia, evitando colonoscopias innecesarias, y destinar este recurso escaso al cribado. Se dedicó especial atención, además, a recalcar la importancia crítica de una excelente colonoscopia inicial en toda pauta de seguimiento de pacientes con adenoma colorrectal, no únicamente en relación con el requerimiento de una excelente preparación sino también con la importancia del tiempo de duración de la exploración durante la retirada del endoscopio. Finalmente, se presentaron diferentes estudios de seguridad y eficacia de fármacos con potencial efecto quimiopreventivo en el desarrollo de adenomas (AU)


One of the main novelties of Digestive Diseases Week (DDW) of 2006 was the presentation of the clinical guidelines for surveillance of colorectal adenomas. The objective of these guidelines is two-fold: to identify risk factors for recurrence and to differentiate two groups of patients, those with low risk and those with high risk of recurrence. This division should allow a scarce resource – colonoscopy – to be optimized, avoiding unnecessary colonoscopies and allowing this technique to be reserved for screening. The crucial importance of an excellent initial colonoscopy in the follow-up of patients with colorectal adenoma was also highlighted, not only in relation to the requirement of optimal preparation but also the importance of the time and duration of the procedure during endoscope withdrawal. Finally, several studies on the safety and efficacy of drugs with a potential chemopreventive effect in the development of adenomas were presented (AU)


Assuntos
Feminino , Humanos , Masculino , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/prevenção & controle , Congressos como Assunto/organização & administração , Colonoscopia/métodos , Colonoscopia , Fatores de Risco , Prevenção Primária/métodos , Prevenção Primária/tendências , Quimioprevenção/métodos , Seguimentos , Adenocarcinoma/prevenção & controle , Adenoma/prevenção & controle , Programas de Rastreamento/classificação , Programas de Rastreamento/métodos , Programas de Rastreamento/prevenção & controle , Quimioprevenção/instrumentação , Quimioprevenção/normas , Quimioprevenção
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA