PDF superior Follow up of women with inadequate Pap smears: a prospective cohort study

Follow up of women with inadequate Pap smears: a prospective cohort study

Follow up of women with inadequate Pap smears: a prospective cohort study

DESIGN AND SETTING: Prospective cohort study at primary healthcare clinics in Santiago, Chile. METHODS: The population was taken from the “Cito-Expert” database of 2010. The data were then or- ganized according to the cytological and histological follow-up results of 2,547 women with inadequate cervical cytological reports over the 12-month period. The samples were assigned to groups based on the cause of inadequacy (smears with endocervical cells alone; insufficient, hemorrhagic, inflammatory or poorly fixed samples; insufficient and hemorrhagic samples; or insufficient and inflammatory specimens). The data were analyzed using the “conditional probability tree diagram” and descriptive statistics. RESULT: Half of the women (n = 1,285) met the requirements of the Ministry of Health for repeating these inadequate smears, and 1,104 of these women had normal cytological results (85.9%). The detection rate for cervical lesions according to group ranged from 0% (smears with endocervical cells alone or insuf- ficient and hemorrhagic specimens) to 4.1% (poor fixation).
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Clinical management of the first ASCUS report in Chile  Prospective single cohort study

Clinical management of the first ASCUS report in Chile Prospective single cohort study

The diagnostic confirmation stage was followed by the treat- ment stage, which was conducted in accordance with the literature. Lastly, the follow-up was conducted on 363 cases in our cohort of women with a first ASCUS report. The 83 cases that were lost from the follow-up were not taken into consider- ation. The women who returned for follow-up evaluation pre- sented a LSIL rate of 3.6% and a HSIL rate of 11.6%, both of which are within the range of results from other studies over the last five years, from 0% to 47.1% for LSIL and 0.8% to 8.6% for HSIL. 17,18,25,26 It is clear that the percentage of HSIL lesions was
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Follow up of women with atypical squamous cells cannot exclude high grade squamous intraepithelial lesions (ASC H)

Follow up of women with atypical squamous cells cannot exclude high grade squamous intraepithelial lesions (ASC H)

In the present study, women with ASC-H atypia underwent on average 1.8 cytological tests per woman (0 to 5 Pap smears) and half of them (46 women) underwent a minimum of two biopsies, in order to reach the definite CIN II+ diagnosis. It is possible to compare these outcomes with Bonvicino’s data, in which among 260 ASC-H smears, there was an average cytologi- cal-histological follow-up of 1.35 Pap smears per woman, with a range of 1 to 4, and the biopsy follow-up consisted of an average of 0.64 biopsies per woman. In other words, the majority of the women (72%) underwent only one biopsy for a diagnosis of CIN II+ to be reached. 6
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Is it still necessary to perform the fundal height measurement in pregnancy antenatal care follow-up examinations?. An exploratory prospective cohort study in Spain.

Is it still necessary to perform the fundal height measurement in pregnancy antenatal care follow-up examinations?. An exploratory prospective cohort study in Spain.

A two-stage sampling study was performed. In the first stage, two surgeries (Carlet and Benimodo) were chosen using a simple random probability, sampling from all Pri- mary Care Centres of the La Ribera Health Department (Spain). In the second stage, pregnant women were selected using a probability sampling with random start and systematic monitoring depending on the number of pregnancies per year obtained in both of them.

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Human Papillomavirus (HPV) Type Distribution in Females with Abnormal Cervical Cytology. A Correlation with Histological Study

Human Papillomavirus (HPV) Type Distribution in Females with Abnormal Cervical Cytology. A Correlation with Histological Study

The patients included in this study were first-visited from February 2006 to February 2007; a population-based cohort of women with cytological abnormalities visualized by means of Pap smears (presence of non-reactive atypical cells) was used in this study. The total number of Pap smears performed during the study period by the Early Cervical Cancer Detection Program (ECCDP) was 45,000, approximately. The population came from a health area of approximately 450,000 inhabitants corresponding to the North of the province of Granada (Andalucía, Spain). From these, 250,000 are eligible women for participation in the ECCDP, but only 1,500 women were send from the health basic centres to the CCDU of our Hospital to complete the study. Finally, 232 samples for HPV typing and 173 biopsies corresponding to 135 women were included in this report. The main inclusion criterion was the presence of cytological alterations in the Pap smears and further remission to our hospital in order to complete the study. The only exclusion criteria were women who refusing to continue in follow up. The follow-up visits were established each 6 months during 3 years. The collected data were the patient age, HPV types and biopsy sample diagnosis. This histological diagnosis was classified in five categories as follows: inflammatory/reactive lesions, undetermined/not conclusive lesions such as atypia borderline, LSIL (low-grade squamous intraepithelial lesions), HSIL (high-grade squamous intraepithelial lesions), and invasive carcinoma.
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Reasons for adherence of incontinent elderly women after a follow-up of 24 months of muscle training

Reasons for adherence of incontinent elderly women after a follow-up of 24 months of muscle training

Observa-se no presente estudo que após o follow-up de 24 meses do ensaio clínico a taxa de cura da IU das idosas foi expressiva (30,4%). Tal percentual é superior à taxa de cura apresentada no estudo de Plotti (2018), que foi de 24% após um follow-up de 8,3 ± 3,5 anos, em média, de um procedimento cirúrgico de implante de agentes de volume para correção da IU e, do estudo de Lsooes (2017) que verificou uma melhora de 28,3%, após um follow up de 2 anos de uso de um aplicativo móvel para tratar a IU de esforço com foco no TMAP.
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Reappraisal of the outcome of healthcare-associated and community-acquired bacteramia: a prospective cohort study.

Reappraisal of the outcome of healthcare-associated and community-acquired bacteramia: a prospective cohort study.

increased mortality. When we compared our data against those reported by McDonald et al. [6], who used similar definitions, we found that inappropriate empir- ical therapy was less frequently administered in HCA episodes in our study (18% vs 25%). The fact that carbapenems and glycopeptides were the second and third antibiotic groups used in HCA episodes suggests that physicians were aware of HCA-acquisition as a risk factor for antibiotic-resistant organisms. On the other hand, in our study, inappropriate empirical therapy was more frequent in CA episodes (using Friedman’s criteria) than in the study by McDonald et al. [6], which may re- flect higher frequencies of antimicrobial resistance in community isolates, at least in our area, and the need to include other types of healthcare relation—such as urin- ary tract procedures—or other invasive ambulatory pro- cedures within the definition of an HCA episode. A Table 3 Antimicrobial resistance among the most relevant aetiologies of community-onset bloodstream infections in community-acquired and healthcare-related episodes
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The natural course of HCV infection and the need for treatment

The natural course of HCV infection and the need for treatment

37. Nishise Y, Saito T, Sugahara K, Ito JI, Togashi H, Nagano-Fujii M, Hotta H, et al. Risk of hepatocellular carcinoma and second- ary structure of hepatitis C Virus NS3 protein amino-terminus, in patients infected with HCV subtype 1b. JID 2007; 196: 1006-9. 38. Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, Borg PC. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology 2000; 31: 864-71. 39. Wiesner RH, McDiarmid SV, Kamath PS, Edwards EB, Malinchoc M, Kremers WK, Krom RA, et al. MELD and PELD: application of survival models to liver allocation. Liver Transpl 2001; 7: 567-580.
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Relación entre la Anestesia del Nervio Mandibular y el Índice de Masa Corporal en Niños

Relación entre la Anestesia del Nervio Mandibular y el Índice de Masa Corporal en Niños

classifying nutritional situation among children and adolescents based on WHO criteria (MINSAL, 2004) whose distribution is: underweight <p10, normal between p10 and <p85, p85 up to p94 for overweight and obese for greater than or equal to p95 (Loaiza et al., 2009). Each child was measured and weighed with a DETECTO® (Colombia) stadiometer with balance. This procedure was performed by two investigators (AC and VC), previously calibrated by a Nutritionist of Frutillar Health Service. After determining the BMI of each patient, they were classified into two weight cohorts according to WHO criteria:
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Anthropometric Indexes Predicting Cardiometabolic Risk  Prospective Cohort Study in a Population of Employees of Public Hospitals

Anthropometric Indexes Predicting Cardiometabolic Risk Prospective Cohort Study in a Population of Employees of Public Hospitals

we selected 259 subjects with normal blood pressure, no hypercholesterolemia and no diabetes at baseline. Personal interviews, anthropometric and blood pressure measurements were performed and blood samples were collected after a 12-hour fast. For the event analysis, the Cox proportional hazards model was used, calculating the corresponding Hazard Ratio (HR) adjusted for age and sex. BMI significantly predicted the development of hypertension (HR: 1.100, CI: 1.054 to 1.148, p < 0.001) and DM2 (HR: 1.253, CI: 1.122 to 1.40, P < 0.001). The waist circumference was associated with hypertension (HR: 2.273, CI: 1.465 to 3.826, p < 0.001) and DM2 (HR: 5.578, CI: 1.247 to 24.92, p = 0.024). The waist / height ratio significantly pre- dicted the development of hypertension (HR: 2.173, CI: 1.438 to 3.283, p < 0.001) and DM2 (HR: 5.875, CI: 1.140 to 30.28, p = 0.034). None of the indicators of obesity evaluated was significantly associated with the development of hypercholesterolemia. We conclude that BMI, waist circumference and waist / height ratio predicted the development of hypertension and type 2 diabetes. This underlines the usefulness of these indicators for monitoring the above-referred conditions by traditional anthropometric measurements. Rev Argent Endocrinol Metab 51:185-191, 2014
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Band ligation vs  N Butyl 2 cyanoacrylate injection in acute gastric variceal bleeding: a prospective follow up study

Band ligation vs N Butyl 2 cyanoacrylate injection in acute gastric variceal bleeding: a prospective follow up study

Background. Treatment of gastric varices (GV) implies a number of several difficulties and sometimes entails complications. The best endoscopic success rate was attributed until now to the use of tissue adhesives(N-Butyl-2-Cyanoacrylate) and band ligation. Aim. To assess the therapeutic efficacy and safety of cyanoacrylate injection compared to band ligation in patients with acute GV hemorrhage. Material and methods. Thirty-seven patients with upper gastrointestinal bleeding from GV were included in the study, treated with cyanoacrylate injection (GVO)-19 patients or band ligations (GVL)-18 patients. They were followed up for overall results, complications and survival rate. Results. The mean age of the study group was 60.22 ± 9.34 years, with a male/female ratio of 21:16. The mean follow-up period was 427.26 ± 214.16 days in the GVO group and 406.21 ± 213.23 days in the GVL group (p = 0.76). Initial hemostasis was achieved in all patients treated with cyanoacrylate and in 88.88% from the GVL group (p = 0.43). Rebleeding occurred in 72.22% of the GVL group and in 31.57% of the GVO patients (p = 0.03). Patients in the GVO group had a significantly larger rebleeding-free period(p = 0.006). No difference was found in survival rates(p = 0.75). The Child Class (p = 0.003 for Class C) and treatment method (p = 0.01) were independently associated with the rate of rebleeding. No differences were found regarding the rate of complications. Conclusion. The use of cyanoacrylate in acute GV bleeding had better results when compared with band ligation in terms of controlling the hemorrhage and recurrence of bleeding. The overall survival rate was not influenced by the method used for the treatment of complicated GV.
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Biblioteca Bucaramanga Universidad Santo Tomas

Biblioteca Bucaramanga Universidad Santo Tomas

2.1.3. Clasificación de la Enfermedad Periodontal. La Asociación Americana de Periodoncia ha clasificado las enfermedades periodontales en gingivitis y periodontitis (suave, moderada, severa y refractaria), en función de la región periodontal afectada. Sin embargo, para 1989 en el World Workshop on Clinical Periodontics se estableció una nueva clasificación, ya para el Primer Workshop Europeo de Periodoncia (1993) se propuso una nueva clasificación más simple de las enfermedades periodontales la cual se basa en los factores causales asociados a las mismas y en la diferente respuesta del hospedador. Ya que no se encontraba una unificaficacion en cuanto a la forma de clasificación en 1999 en el International Workshop for a Clasification of Periodontal Diseases and Conditions (1999) se llevo una nueva clasificación la cual fue aprobada por unanimidad, dando ocho grandes clasificaciones; enfermedades gingivales, periodontitis crónica, periodontitis agresiva, periodontitis como manifestación de enfermedad sistémica, enfermedad periodontal necrotizante, abscesos del periodonto, periodontitis asociada a lesiones endodoncias, condiciones y deformidades adquirida o del desarrollo (35).
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Analysis of personal and family factors in the persistence of attention deficit hyperactivity disorder: results of a prospective follow up study in childhood

Analysis of personal and family factors in the persistence of attention deficit hyperactivity disorder: results of a prospective follow up study in childhood

Hence, the present study, which is part of a longitudinal study that followed the course of children with an ADHD diagnosis, proposed two specific objectives. The first was to study the ADHD course during childhood, determining the rates of children who presented persistent, contextually persistent and remitted ADHD, and analyze possible differences among the groups on associated psychological disorders. The second objective was to compare the persis- tent, contextually persistent and remitted groups on baseline measures related to ADHD char- acteristics (ADHD symptoms and impairment), child psychopathology, executive functions (verbal working memory, visuo-spatial working memory and inhibition) and parenting charac- teristics (parental stress and dysfunctional discipline). We hypothesized that the different out- comes would be influenced by the effects of personal and family risk characteristics. Based on the proposals of a multifactorial model, we hypothesized that the persistent groups, especially if the persistence was cross-contextual, would have more severe ADHD symptoms and related child psychopathologies, greater impairments in executive functions, and worse results on par- enting measures at baseline than the ADHD remitted group.
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Discontinuous vs  continuous drinking of ethanol in peripubertal rats : effect on 24 hour pattern of hypophyseal gonadal axis activity and anterior pituitary oxidative stress

Discontinuous vs continuous drinking of ethanol in peripubertal rats : effect on 24 hour pattern of hypophyseal gonadal axis activity and anterior pituitary oxidative stress

Previous data on the anterior hypophysis of rats under ad libitum solid diet indicated that the peak of Per1 and Per2 expression occurred at the beginning of the light phase, in antiphase with the peaks of Clock and Bmal1 expression [44]. The present results on anterior pituitary Per1 and Per2 expression in control animals under a liquid diet paradigm are in agreement with those observations. Such a pattern of expression of Per1 and Per2 became disrupted in discontinuously or chronically ethanol-fed rats, pointing to an effect of ethanol on the molecular mechanisms regulating circadian rhythmicity. It must be noted, however, that all experiments were done under entrained light-dark conditions (versus free running conditions in constant environments). Hence, further experiments are necessary to assess whether the changes in amplitude as well as in timing of 24-h hormone and gene expression rhythms hereby examined can be attributed either to an effect on the endogenous clock that modulates the circadian variation of pituitary or testicular release, or to a masking effect on some output(s) of the clock.
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Functional and structural brain connectivity of young binge drinkers: a follow-up study

Functional and structural brain connectivity of young binge drinkers: a follow-up study

confirmed by a MEG expert. The artifact-free data were segmented in continuous 4 seconds fragments (trials). At least 15 clean trials were obtained from all participants and preserved for further analyses. The number of surviving trials did not differ significantly between groups. To calculate the source´s reconstruction, the time series were filtered in the following frequency bands: delta (2–3.9 Hz), theta (4.1–7.9 Hz) alpha (8.1–11.9 Hz) and beta (12.1–29.9 Hz). The filtering was performed with a finite impulse response filter of order 1500. This filter was applied using a two-pass procedure over the whole four-minute registers, in order to avoid phase distortion and edge effects.
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Saturación Renal de Oxígeno como nuevo marcador para la Insuficiencia Renal Aguda asociada a la Cirugía Cardiaca en el Adulto

Saturación Renal de Oxígeno como nuevo marcador para la Insuficiencia Renal Aguda asociada a la Cirugía Cardiaca en el Adulto

effectiveness study addressing the feasibility of introducing this new strategy in daily care should be considered. Last, the available NIRS sensor can only measure the regional level of tissue oxygen saturation 3 to 4 cm beneath the local tissue area. As a result, we had to exclude those patients with renal depths 4 cm or greater. The median renal depths for the study population were 1.7 cm for the right kidney and 1.9 cm for the left kidney. A sensor that permits deeper monitoring is necessary to include patients with deeper renal depths like those from the general population, given that obesity is a common morbidity. Despite these limita- tions, this study provides a useful insight into the incidence of postoperative CSA-AKI and its relationship with postop- erative bSo and kSo in adult cardiac surgery.
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LOST to follow up Information in Trials (LOST IT): a protocol on the potential impact

LOST to follow up Information in Trials (LOST IT): a protocol on the potential impact

We thank Ann Grifasi, Deborah Maddock Shelley Anderson and Monica Owen for their administrative assistance. We thank Aravin Duraik for developing the study electronic forms. Pfizer Inc is funding this study. The funder had no role in the study design, in the writing of the manuscript, or in the decision to submit this or future manuscripts for publication. Matth- ias Briel is supported by a scholarship for advanced researchers from the Swiss National Foundation (PASMA-112951/1). John You is supported by a Career Scientist Award from the Ontario Ministry of Health and Long- Term Care. Xin Sun is supported by two research scholarships from the National Natural Science Foundation of China (70503021, 70703025). Kara Nerenberg is supported by a RCT Mentorship Award from the Canadian Institutes of Health Research (CIHR). Bradley Johnston is supported by a Duncan L. Gordon Fellowship from SickKids Foundation. Jason Busse is funded by a New Investigator Award from the CIHR and Canadian Chiro-
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Telemedicine influence on the follow-up of type 2 diabetes patients.

Telemedicine influence on the follow-up of type 2 diabetes patients.

In both groups, levels of all lipids have improved (total cholesterol, triglycerides, and LDL and high-density lipo- protein [HDL] cholesterol), with improvements being statis- tically significant in the LDL cholesterol levels of the two groups and in the cholesterol level of the telemedicine group. Besides, at 6 and 12 months of follow-up we observed an improvement in mean blood pressure, both diastolic and systolic, with respect to baseline values in both study groups. At the end of the trial, such improvements were only statis- tically significant for the telemedicine group. We only found another study in the literature, the IDEATel Project, 20 that, like ours, reports significant simultaneous improvements in HbA1c, lipids, and blood pressure levels in the intervention group, with little change in lipid and blood pressure levels in the control group.
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The association between dietary energy density and type 2 diabetes in Europe: results from the EPIC-InterAct Study

The association between dietary energy density and type 2 diabetes in Europe: results from the EPIC-InterAct Study

T2D may be prone to bias due to obesity-related under-reporting. A recent analysis in EPIC showed that the BMI effect on under- reporting is the same across countries and that exclusion of individuals who misreported energy according to the Goldberg cut-off removed the obesity-related bias [34]. Results from our stratified analysis showed that among overweight and obese individuals HRs were close to unity for those categorized as under- reporters and those categorized as plausible reporters. However, in normal weight individuals categorized as under-reporters an inverse association between DED and risk of T2D was seen, whereas DED tended to be positively associated with incidence of T2D among normal weight individuals classified as plausible reporters. Risk of T2D was 15% higher per 1 kcal/g increase in DED, which corresponds to a change in DED from the lowest to the highest quintile. This association was not statistically signifi- cant, despite the large sample size in this sub group analysis. Overall, our results indicate that the obesity related underreport- ing did not affect our overall results much. Still, we cannot exclude an overall bias in energy reporting across all BMI categories.
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Postural and Load Distribution Asymmetries in Preschoolers

Postural and Load Distribution Asymmetries in Preschoolers

higher CVs were found for the baropodometric parameters, ranging from 29% to 82%. In a study that assessed the ratio of anteroposterior foot pressure in children aged 3.5–6.5 years, the interindividual differences were great but tended to decrease with age (Matsuda & Demura, 2013). Postural asymmetries in childhood have a multifactorial etiology. Although no consensus has been reached regarding its definition, classifications, and nomenclature, and data regarding its natural course are scarce, there is a great need for systematic management of asymmetry in infancy (van Vlimmeren et al., 2004). Future studies should be conducted with a larger sample size to allow the establishment of age categories in a prospective study to follow up asymmetry postures throughout early childhood by using the load and foot morphology assessment methods used in this study.
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