Geolocation of uterine cervical neoplasms (UCN) in the context of a prevention program in Tucumán, Argentina.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13535-e13535
Author(s):  
Silvia Victoria Holgado ◽  
Ana Vinuales ◽  
Daniel Gustavo Goroso ◽  
William Tsutomu Watanabe ◽  
Juan Jose Zarba ◽  
...  
Keyword(s):  
Squamous Carcinoma ◽  
Cross Sectional Study ◽  
Adenocarcinoma In Situ ◽  
Online Information ◽  
Cervical Lesions ◽  
Invasive Adenocarcinoma ◽  
Cross Sectional ◽  
Screening Population ◽  
Short Time

e13535 Background: : UCN is one of the major public health problems in Tucumán, that must be related to the type of population to which it belongs (Rural or Urban). Geolocation allows the processing and analysis of geographic information whose results support decision-making in solving complex planning and management problems on the territory. The objective of this study is to carry out management quality controls of the PPCCUT (Programa de Prevención de Cáncer Cervical Uterino-Tucumán) to achieve adequate prevention and detection of uterine cervical lesions in the province. Methods: An observational cross-sectional study of 1343 women, (16-90 years), with a biopsy diagnosis UCN, under PPCCUT (years 2013-2020). Preanalytical work: allowed the review quality the registries and the diagnoses follow-up. Data recollection from SITAM (Online Information System for Screening), population registry database. Variables: Address: registered in SITAM, joined by information from the provincial female electoral roll 2019. Histological Diagnosis: High grade squamous intraepithelial lesion (HSIL), Invasive Squamous Carcinoma (ISC), Adenocarcinoma In situ (AIS), Invasive Adenocarcinoma (IDA). Analytical work: The conversion from address to latitude and longitude was performed by programming Google Sheet. This data was segmented by hospital center and opened in layers inside QGIS, as well as the map of Argentina. Results: Preanalytical. Register showed from 1343 patients received 1748 biopsies, were excluded 160 without address (incomplete data loading by the effectors). Lack of coordination in diagnosis area: 33 patients received first “in situ diagnosis” and in a short time later were consider “invasive lesions”. Some Patients had 2 bis 6 biopsies with same diagnosis. Analytical (geolocation): showed the influence of PPCCUT outside the province, including living abroad. It was found correlation between patients’ distribution with the population density. Conclusions: The importance of the work lays in the lack of antecedents in the application of the geolocation tool in programs of UCN in Tucumán and in other regions of Argentina. This allowed monitoring in different aspects of the programmatic management.

scholarly journals Performance of three colposcopic images for the identification of squamous and glandular cervical precursor neoplasias

2021 ◽  
Author(s):  
Giselle Fachetti-Machado ◽  
Rosane Ribeiro Figueiredo-Alves ◽  
Marise Amaral Rebouças Moreira
Keyword(s):  
Likelihood Ratio ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Cross Sectional Study ◽  
Adenocarcinoma In Situ ◽  
Cross Sectional ◽  
Sensitivity Specificity

Abstract Purpose To evaluate prevalence and diagnostic performance of three colposcopic images to diagnose squamous and glandular cervical precursor neoplasias. Methods Cross-sectional study, conducted through analysis of stored digital colposcopic images. To evaluate the diagnostic performance of three images, herein named grouped glands, aceto-white villi, and atypical vessels, for detection of adenocarcinoma in situ (AIS) and cervical squamous intraepithelial neoplasias (CIN) grades 2 and 3, calculations of sensitivity, specificity, accuracy, positive likelihood ratio, receiver operating characteristic (ROC) curve, and area under the curve (AUC) were made, with their respective 95% confidence intervals. Results Grouped glands, aceto-white villi, and atypical vessels images had: prevalence of 21.3, 53.8, and 33.8% in patients with AIS, and 16.2, 19.5, and 9.3% in those with CIN 2 and 3; for the diagnosis of AIS, sensitivity of 21.3, 53.8, and 33.8%, specificity of 89.8, 95.2, and 94.9%, accuracy of 76.6, 87.2, and 83.1%, positive likelihood ratio of 2.1, 11.2, and 6.6, and AUC of 0.55, 0.74, and 0.64; for the diagnosis of CIN 2 and 3, sensitivity of 16.2, 19.5, and 9.3%, specificity of 89.8, 95.2, and 94.9%, accuracy of 39.4, 43.4, and 36.3%, positive likelihood ratio of 1.6, 4.1, and 1, 8, and AUC of 0.53, 0.57, and 0.52, respectively. Conclusion Prevalence and accuracy of the three images were higher for the diagnosis of glandular than squamous cervical precursor neoplasias. Sensitivity, specificity, positive likelihood, and AUC of aceto-white villi and atypical vessels images were higher for the diagnosis of glandular than squamous cervical precursor neoplasias.

scholarly journals Perceived Efficiency Outcomes, Sources and Awareness of Online Health Information among the Elderly during COVID-19

2021 ◽  
Vol 18 (15) ◽  
pp. 8121
Author(s):  
Gizell Green ◽  
Riki Tesler ◽  
Cochava Sharon
Keyword(s):  
Health Status ◽  
Health Information ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Online Health Information ◽  
Online Information ◽  
Safety Skills ◽  
Cross Sectional ◽  
Information Efficiency ◽  
Online Sources

The Internet and social media are crucial platforms for health information. Factors such as the efficiency of online health information, the outcomes of seeking online health information and the awareness of reliable sources have become increasingly important for the elderly during the COVID-19 pandemic. This study aimed to examine differences between elderly individuals’ income above and below the average monthly wage in relation to their online health information efficiency and the outcomes of seeking online health information; to evaluate types of online information sources with online health information efficiency and the outcomes of seeking online health information; and to explore online health information efficiency as a mediator between health status and awareness of online sources. A cross-sectional study design was conducted with 336 elderly participants age 65 or older. The participants volunteered to complete a questionnaire. No differences were found between the two groups regarding efficiency in retrieving health information from official online health sites and Google. Perceived efficiency mediated health status and awareness of online sources. In these challenging times, it is important to provide a tailor-made education strategy plan for reliable sources of online health information for the elderly, in order to enhance their technology safety skills. It is also important to explore other mediating variables between health status and awareness of online sources.

scholarly journals Genotypic distribution of human oncogenic papillomaviruses in sexually active women in Burkina Faso: Central, Central-Eastern and Hauts-Bassins regions

2020 ◽  
Vol 11 (1) ◽  
pp. 125-136
Author(s):  
Rogomenoma Alice Ouedraogo ◽  
Théodora Mahoukèdè Zohoncon ◽  
Ina Marie Angèle Traore ◽  
Abdoul Karim Ouattara ◽  
Sindimalgdé Patricia Guigma ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Large Scale ◽  
Hpv Infection ◽  
Cross Sectional Study ◽  
Sexually Active ◽  
Cervical Lesions ◽  
Cross Sectional ◽  
Genotypic Distribution ◽  
Hpv Genotypes ◽  
Central Eastern

AbstractObjectivethis study was conducted to determine the distribution of high-risk human papillomavirus (HR-HPV) genotypes in women in the general population of three regions of Burkina Faso.MethodThis multicenter, descriptive cross-sectional study involved 1321 sexually active women in five cities in three regions of Burkina Faso: Central, Central-Eastern and Hauts-Bassins regions. After collection of endocervical specimens, pre-cervical lesions were screened by visual inspection with acetic acid and lugol (VIA / VILI). HR-HPV genotypes were characterized by multiplex real-time PCR after extraction of viral DNA.ResultsThe mean age of women was 31.98 ± 10.09 years. The HR-HPV infection in the three regions ranged from 26.16% to 43.26% with 35.42% as overall prevalence in women. The most common HR-HPV genotypes in descending order were: HPV 56, 52, 66, 59, 39, 51, 18, 35. The prevalence of bivalent vaccine genotypes (HPV16 / 18) was 7.83% against 63.78% of genotypes not covered by HPV vaccine; 36.32% (170/468) of women had multiple concomitant HR-HPV infections.Conclusionthis study showed significant regional variation and high prevalence of HR-HPV infection in women. The predominant genotypes differ from those covered by available vaccines in Burkina Faso. These results will help guide our health policies towards better prevention of cervical cancer. The diversity of oncogenic genotypes is sparking a large-scale study in the West African sub-region, particularly in cases of cancer and the introduction of the nonavalent vaccine which includes HPV 52 found among the predominant genotypes in this study.

scholarly journals Reduced Oxygenation in Human Obese Adipose Tissue Is Associated with Impaired Insulin Suppression of Lipolysis

2010 ◽  
Vol 95 (8) ◽  
pp. 4052-4055 ◽  
Author(s):  
Magdalena Pasarica ◽  
Jennifer Rood ◽  
Eric Ravussin ◽  
Jean-Marc Schwarz ◽  
Steven R. Smith ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Insulin Sensitivity ◽  
Capillary Density ◽  
Cross Sectional Study ◽  
Fat Cell ◽  
Euglycemic Hyperinsulinemic Clamp ◽  
Cross Sectional ◽  
Clinical Research Center ◽  
Endothelial Growth Factor

Context: Adipose tissue in obese individuals is characterized by reduced capillary density and reduced oxygenation. Objective: Our objective was to test whether hypoxia is associated with reduced antilipolytic effect of insulin. Participants, Design, and Setting: Twenty-one lean and obese individuals participated in this cross-sectional study at a university-based clinical research center. Intervention: In all subjects, in situ adipose tissue (AT) oxygenation [AT oxygen partial pressure (ATpO2)] was measured with a Clark electrode, insulin sensitivity as well as basal and insulin-suppressed lipolysis (continuous infusion of (2H5)glycerol) were measured during a euglycemic-hyperinsulinemic clamp, and abdominal sc AT biopsies were collected to assess fat cell size (Coulter counting of osmium-fixed cells), capillary density (by staining of histological sections), and gene expression (by quantitative RT-PCR). Main Outcome Measure: In situ ATpO2 was evaluated. Results: The ability of insulin to suppress lipolysis (percent) was positively correlated with insulin sensitivity (r = 0.43; P < 0.05), ATpO2 (r = 0.44; P < 0.05), vascular endothelial growth factor mRNA (r = 0.73; P < 0.01), and capillary density (r = 0.75; P < 0.01). Conclusion: These results indicate that low capillary density and ATpO2 in AT are potentially upstream causes of AT dysfunction.

A Clinicopathological Study of Small Lung Adenocarcinoma 1 cm or Less in Size: Emphasis on Histological Subtypes Associated With Lymph Node Metastasis and Recurrence

2017 ◽  
Vol 26 (1) ◽  
pp. 4-11 ◽  
Author(s):  
Wei Zhao ◽  
Hui Wang ◽  
Jun Xie ◽  
Bo Tian
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lung Adenocarcinoma ◽  
Who Classification ◽  
Limited Resection ◽  
Adenocarcinoma In Situ ◽  
Invasive Adenocarcinoma ◽  
Node Metastasis ◽  
Minimally Invasive Adenocarcinoma

Background. The aim of this study was to assess the prognostic significance of the newly proposed 2015 World Health Organization (WHO) lung adenocarcinoma classification for patients undergoing resection for small (≤1 cm) lung adenocarcinoma. We also investigated whether lobectomy offers prognostic advantage over limited resection for this category of tumors. Methods. A retrospective study of resected pulmonary adenocarcinomas (n = 83) in sizes 1 cm or less was carried out in which comprehensive histologic subtyping was assessed according to the 2015 WHO classification on all consecutive patients who underwent lobectomy or limited resection between 1998 and 2012. Correlation between clinicopathologic parameters and the difference in recurrence between lobectomy and limited resection group was evaluated. Results. Our data show that the proposed 2015 WHO classification identifies histological subsets of small lung adenocarcinomas with significant differences in prognosis. No recurrence was noted for patients with adenocarcinoma in situ and minimally invasive adenocarcinoma. Invasive adenocarcinomas displayed high heterogeneity and the presence of micropapillary component of 5% or greater in adenocarcinomas was significantly related to lymph node involvement and recurrence ( P < .001). Stage IA patients who underwent limited resection had a higher risk of recurrence than did those treated by lobectomy ( P < .05). Conclusions. Application of the 2015 WHO classification identifies patients with adenocarcinoma in situ and minimally invasive adenocarcinoma had excellent prognosis. Micropapillary pattern was associated with high risk of lymph node metastasis and recurrence.

scholarly journals Intake of dietary fibre and lifetime non-steroidal anti-inflammatory drug (NSAID) use and the incidence of colorectal polyps in a population screened for colorectal cancer

2017 ◽  
Vol 71 (10) ◽  
pp. 961-969 ◽  
Author(s):  
Eileen Shaw ◽  
Matthew T Warkentin ◽  
S Elizabeth McGregor ◽  
Susanna Town ◽  
Robert J Hilsden ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Dietary Fibre ◽  
Cross Sectional Study ◽  
Colorectal Polyps ◽  
Cross Sectional ◽  
Fibre Intake ◽  
Screening Population ◽  
Lifestyle Questionnaire ◽  
Dietary Fibre Intake ◽  
Anti Inflammatory

BackgroundThere is suggestive evidence that increased intake of dietary fibre and the use of non-steroidal anti-inflammatory drugs (NSAIDs) are generally associated with decreased colorectal cancer risk. However, the effects on precursors of colorectal cancer, such as adenomatous polyps, are mixed. We present the associations between dietary fibre intake and NSAID use on the presence and type of colorectal polyps in a screening population.MethodsA cross-sectional study of 2548 individuals undergoing colonoscopy at the Forzani & MacPhail Colon Cancer Screening Centre (Calgary, Canada) was conducted. Dietary fibre intake and NSAID use were assessed using the Diet History Questionnaire I or II and the Health and Lifestyle Questionnaire. Colorectal outcomes were documented as a polyp or high-risk adenomatous polyp (HRAP; villous histology, high-grade dysplasia, ≥10 mm or ≥3 adenomas). Crude and ORs and 95% CIs were estimated using unconditional logistic regression.ResultsThere were 1450 negative colonoscopies and 1098 patients with polyps, of which 189 patients had HRAPs. Total dietary fibre intake was associated with a decreased presence of HRAPs (OR=0.50, 95% CI: 0.29 to 0.86) when comparing the highest to lowest quartiles and was observed with both soluble (OR=0.51, 95% CI: 0.30 to 0.88) and insoluble (OR=0.51, 95% CI: 0.30 to 0.86) fibres. Ever use of NSAIDs was also inversely associated with HRAPs (OR=0.65, 95% CI: 0.47 to 0.89), observed with monthly (OR=0.60, 95% CI: 0.37 to 0.95) and daily (OR=0.53, 95% CI: 0.32 to 0.86) use.ConclusionsDietary fibre intake and NSAID use were associated with a decreased risk of having a HRAP at screening.

scholarly journals Immunohistochemical Expression of the Tumor Suppressor Protein p16INK4a in Cervical Adenocarcinoma

2017 ◽  
Vol 39 (01) ◽  
pp. 21-25 ◽  
Author(s):  
José Eleutério Jr ◽  
Thiago Lima ◽  
Maria Cunha ◽  
Diane Cavalcante ◽  
Angélica Silva
Keyword(s):  
Strong Association ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Cervical Adenocarcinoma ◽  
Kappa Index ◽  
Immunohistochemical Expression ◽  
Invasive Adenocarcinoma ◽  
Cross Sectional ◽  
High Negative Predictive Value ◽  
Negative Controls

Objective To evaluate the diagnostic utility of the p16ink4a protein expression as a marker for adenocarcinoma of the cervix. Methods In a cross-sectional study, p16ink4a expression was evaluated in 30 cervical biopsies from patients diagnosed with invasive adenocarcinoma from 2 reference clinics in Brazil, and compared with 18 biopsies of endocervical polyps (control cases). The performance of the tests for p16ink4a was evaluated using a conventional contingency table, and the Kappa (κ) index was used to evaluate the agreement of the marker with the tissue diagnosis. Results In total, 66% of the invasive adenocarcinoma cases were positive for p16ink4a. All of the adenomatous polyps cases used as negative controls were shown to be negative for p16ink4a. The marker showed a high sensitivity and a high negative predictive value. The Kappa index was good for p16ink4a (κ = 0.6). Conclusion Considering the strong association between the p16ink4a marker and the cervical adenocarcinoma, its use represents an important tool for reducing incorrect diagnoses of adenocarcinoma and thereby avoiding overtreatment.

Invasive Adenocarcinoma of the Cervix Following LLETZ (Large Loop Excision of the Transformation Zone) for Adenocarcinoma in Situ

1995 ◽  
Vol 58 (2) ◽  
pp. 274-277 ◽  
Author(s):  
Alexander W. Kennedy ◽  
Gamal H. ElTabbakh ◽  
Charles V. Biscotti ◽  
Susan Wirth
Keyword(s):  
Adenocarcinoma In Situ ◽  
Invasive Adenocarcinoma ◽  
Transformation Zone ◽  
Large Loop
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