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Conhecimento, atitude e prática do exame de Papanicolaou em mulheres com cancer de colo uterino  [cached]
Brenna Sylvia Michelina Fernandes,Hardy Ellen,Zeferino Luiz Carlos,Namura Iara
Cadernos de Saúde Pública , 2001,
Abstract: O cancer de colo uterino apresenta alta mortalidade no Brasil, apesar dos programas para rastreamento. O objetivo deste estudo, de corte transversal, foi analisar conhecimento, atitude e prática do exame de Papanicolaou e entender a n o ades o das mulheres a este exame. Foram entrevistadas 138 mulheres: noventa com neoplasia intra-epitelial de alto grau e 48 com cancer invasivo de colo uterino. As mulheres com cancer invasivo tiveram prática mais inadequada do exame. No entanto, independente do diagnóstico, mais de 80% delas referiram desmotiva o/vergonha, 60% relataram que os médicos n o examinavam e, cerca de 50% apontaram o tempo de espera para a consulta e a demora no agendamento como dificuldades para serem atendidas. Em geral, a prática do exame dependeu da iniciativa do médico e a periodicidade da coleta foi determinada pela procura de consulta devido a sintomas. As mulheres com 56 anos ou mais mostraram maior inadequa o no conhecimento, na atitude e na prática. No entanto, aquelas com maior escolaridade conheciam melhor o exame. A maior idade e a menor escolaridade podem estar associados a n o ades o das mulheres ao exame, porém as dificuldades sociais e econ micas para conseguir atendimento em saúde precisam ser consideradas para aumentar a prática do exame.
Coloración de Papanicolaou y su importancia en el diagnóstico de las infecciones cervicovaginales Papanicolaou-stained smears: its importance in the diagnosis of cervicovaginal infections  [cached]
María Isabel Castro,Oscar Abratte,Miguel Barocchi,María Laura Musacchio
Acta bioqu?-mica cl?-nica latinoamericana , 2004,
Abstract: La coloración de Papanicolaou, además de la detección temprana del carcinoma de cuello uterino, brinda información sobre el estado hormonal y es orientativa al diagnóstico de infecciones cervicovaginales. La importancia de su detección y tratamiento radica en que pueden evitarse complicaciones posteriores, como enfermedad pélvica inflamatoria, ruptura prematura de membranas, abortos, sepsis del recién nacido, esterilidad. Se procesaron 251 muestras. Se estudió la correlación entre la información brindada por la coloración de Papanicolaou y el examen microbiológico (observación en fresco y coloración de Gram), con el fin de verificar la utilidad que puede brindar la coloración de Papanicolaou como alerta de las infecciones cervicovaginales. Para clasificar las muestras como vaginosis bacterianas se aplicaron los criterios de Amsel. Sobre el total de las muestras se obtuvo para las vaginosis 80% de correlación. En el caso de las infecciones micóticas el porcentaje representa 69%, valor que asciende a 75% si se consideran las muestras inflamatorias. Para Trichomonas vaginalis se obtuvo 100% de concordancia. La comparación de estos dos procedimientos revela un alto porcentaje de correlación, siendo el examen de Papanicolaou un valioso auxiliar para el diagnóstico de ciertas infecciones cervicovaginales. The Papanicolaou (Pap) smearis not only a mean of early detection of cervical cancer, but also a cytologic screening which reports on the hormonal condition and helps in the diagnosis of cervicovaginal infections. The importance of the early detection and management of this kind of infections is based on the possibility of preventing from later complications such as pelvic inflammatory disease, early breaking of water, abortions, neonatal sepsis and infertility. In order to prove the uses of the Pap-stained smears as a way of diagnosis on potential cervicovaginal infections, 251 samples have been studied focusing on the correlation between the results of Pap-stained smears and those of wet preparations and Gram-stained. The Amsel criteria has been used to classify the samples as Bacterial Vaginosis cases. Taking the Vaginosis cases, 80% of them showed correlation between cytologic and bacteriological techniques. Mycotic infections were detected in 69% of the samples, rate which increased to 75% considering the inflammatory samples. The correlation between the Pap-stained smears and wet preparations/Gram-stained was of 100% for Trichomonas vaginalis samples. In conclusion, there is a high correlation between these two methods that proves the importance of the
PAPANICOLAOU: FROTIS SIN COMPONENTE ENDOCERVICAL  [cached]
Luisa Sánchez L,Andrea Rojas S,María Riquelme D,Orlando Quezada P
Revista Chilena de Obstetricia y Ginecología , 2008,
Abstract: Objetivo: Evaluar la calidad de la toma del Papanicolaou (PAP) informados como frotis menos que óptimos (I-G7) en 2002 (sin componente endocervical), y conocer el seguimiento de las mujeres en el resultado del PAP siguiente 2003 - 2005. Método: Estudio descriptivo, cuantitativo y de seguimiento de cohorte. Se incluyó el resultado de 42.281 frotis de citología cervical, que correspondieron al universo de los PAP recolectados en 2002 en los consultorios de Atención Primaria de Salud del área Metropolitana Sur de Santiago. Posteriormente, fueron seleccionados todos los PAP I-G7 de una cohorte de mujeres entre 25 a 50 a os y sin antecedentes de lesiones o procedimientos cervicales. Resultados: El estudio evidenció que la toma de muestra de PAP en los consultorios, a excepción de 2 establecimientos, está dentro de los índices de calidad preconizados por el Ministerio de Salud. En el seguimiento de la cohorte de mujeres con PAP I-G7, se pesquisó la existencia de lesión cervical en un 3,38% de las mujeres que se repitieron el examen. Conclusión: Los PAP informados como frotis sin componente endocervical constituyen una categoría de riesgo, ya que el seguimiento de esas mujeres que se repitieron el examen de PAP en un período de hasta 3 a os se detectaron lesiones cervicales de alto grado. Objective: To evaluate the quality of sampling cervical cytological through the Papanicolaou (PAP) reported as less than optimal smears (I-G7), i.e. without endocervical component in theyear2002. To know the follow up of a women cohort, in the next PAP smears between 2003 to 2005. Method: Descriptive study, quantitative and follow up of a cohort. It included the results from 42.281 smears cervical cytological according to the national classification, which corresponded to the universe of PAP collected in the 2002 at clinics Primary Health Care in the South Metropolitan Area of Santiago. All PAP with outcome I-G7 from a cohort of women between 25 to 50 years and without history of injury or cervical procedures were selected. In addition, it was identified the clinics provenance. Results: The study showed that the sample of PAP in the clinics, with the exception of 2 establishments, it is within the quality indices expected by the Ministry of Health. In the follow-up of the cohort of women with PAP I-G7 was detected the existence of a cervical lesion 3.38% of the women who were repeated this smear. Conclusion: PAP smears reported as without component endocervical constitute a category of risk, since the follow up the women who were repeated this PAP smear over a period of up to
PAPANICOLAOU: FROTIS SIN COMPONENTE ENDOCERVICAL
Sánchez L,Luisa; Rojas S,Andrea; Riquelme D,María; Quezada P,Orlando; López A,Fanny;
Revista chilena de obstetricia y ginecología , 2008, DOI: 10.4067/S0717-75262008000300006
Abstract: objective: to evaluate the quality of sampling cervical cytological through the papanicolaou (pap) reported as less than optimal smears (i-g7), i.e. without endocervical component in theyear2002. to know the follow up of a women cohort, in the next pap smears between 2003 to 2005. method: descriptive study, quantitative and follow up of a cohort. it included the results from 42.281 smears cervical cytological according to the national classification, which corresponded to the universe of pap collected in the 2002 at clinics primary health care in the south metropolitan area of santiago. all pap with outcome i-g7 from a cohort of women between 25 to 50 years and without history of injury or cervical procedures were selected. in addition, it was identified the clinics provenance. results: the study showed that the sample of pap in the clinics, with the exception of 2 establishments, it is within the quality indices expected by the ministry of health. in the follow-up of the cohort of women with pap i-g7 was detected the existence of a cervical lesion 3.38% of the women who were repeated this smear. conclusion: pap smears reported as without component endocervical constitute a category of risk, since the follow up the women who were repeated this pap smear over a period of up to 3 years high-grade cervical lesions were detected.
CLINICOPATHOLOGIC CORRELATION OF THE UNSATISFACTORY PAPANICOLAOU SMEAR
N. Izadi Mood,S.N. Jazayeri Z. Eftekhar
Acta Medica Iranica , 2004,
Abstract: The 1991 Bethesda System for cervical/vaginal cytology reporting has defined adequacy criteria, including unsatisfactory designation. Most laboratories in USA and a few laboratories in Iran have implemented these criteria, but only few studies about clinical implications have been performed. All unsatisfactory Papanicolaou (Pap) smears taken between August 2000 and March 2002 were retrieved from the file of cytologic reports of Mirza Koochak Khan Hospital's Department of Pathology. Of 4,598 total Pap smears 204 (4.4%) were unsatisfactory (corresponding atypical rate of 2.5% and a SIL/carcinoma rate of 0.97%). About 20.2% of unsatisfactory Pap smears were from patients with a history of epithelial abnormalities. The majority (71 of 204 specimens; 35%) of follow-up Pap smears or biopsies occurred within 6 months,12% within 6-12 months,1% within 12-18 months and 1% after 18 months. Approximately 59% had no follow-up. The first repeat Pap smear or histologic specimen in 83 patients with follow-up was negative in 71 (85%), unsatisfactory in 2(2.4%), epithelial cell abnormality in 11 (13.2%) and atypical squamous cells of undetermined significance in 4(4.8%). Nonmalignant conditions contributing to the unsatisfactory smears on histologic specimens (23%) included cervicitis, endocervical polyp and endometritis. Majority of patients with unsatisfactory Pap smears were followed up within 6 months. A significant number(13.2%) of those with follow-up had eventual diagnosis of epithelial cell abnormality. Benign pathologic conditions also contributed to unsatisfactory smears. These patients were more likely to have a history of abnormalities. Unsatisfactory specimens are associated with benign as well as preneoplastic/neoplastic conditions. Clinical correlation should be the first step in delineating the cause of the unsatisfactory diagnosis.
Rapid Economic, Acetic Acid, Papanicolaou Stain (REAP) -
Ranu RoyBiswas
Al Ameen Journal of Medical Sciences , 2008,
Abstract: The universal stain for cervical cytological screening is Papanicolaou stain which has been used in different laboratories with many modifications. Aims: The study is designed to search for a superior and improved qualitative staining technique which is cheaper but rapid in cancer screening by cytology. The modified technique is referred as Rapid, economic, acetic acid Papanicolaou stain (REAP).Material & methods: 220 PAP smears from 110 patients ( 2 per subject) were collected . One set of smears was stained by conventional Papanicolaou stain & the other set by REAP stain. Pre- Orange G 6 & post- Orange G 6 and post- EA50 ethanol baths in REAP stain were replaced by 1% acetic acid. Tap water was used instead of Scott’s tap water to reduce cost. Hematoxylin was preheated in waterbath to 60 C before staining for rapid penetration. Methanol was used for final dehydration. Results: The two methods were compared in respect of optimal cytoplasmic & nuclear staining, stain preservation, cost & total time for the procedure. In REAP technique, cytoplasmic & nuclear staining was optimal in 100 & 105 cases respectively. The cost was reduced to 25% due to limited alcohol use. The staining-time was minimised to 3 minutes. Conclusion: REAP stain, in comparison to conventional Papanicolaou, provides a suitable, excellent & rapid alternative for cytological screening with minimum cost. The stain preservation is also good in REAP method.
Estimulación oportuna: ventajas para el desarrollo de su hijo  [cached]
Natalia Salas Guzmán,María Ester Morales Ramírez
Revista Electrónica Educare , 2004,
Abstract: Resumen. La estimulación oportuna tiene como principio que “cuanto antes se aprende, mejor se aprende y más provecho se obtiene en el futuro” (Bravo y Pons, a o 1, N° 5, p. 66). La familia, como ente social primario, cumple un rol fundamental en la formación y desarrollo de la personalidad de los miembros que la conforman, y se presenta además como el primer ámbito donde se estimula y educa al ni o/ni a, por lo tanto, la estimulación oportuna empieza en el hogar. El presente artículo hace referencia a la estimulación oportuna, como objetivo primordial para el crecimiento y educación, estimulando los cinco sentidos, y marcando la importancia del papel de los padres como entes altamente significativos para el adecuado desarrollo integral de la personalidad de los ni os/ni as, en sus áreas física, cognitiva, lingüística, psicológica y social. Abstract. Early stimulation presents as it’s principle that “the earlier the child learns, better and more advantages he/she will obtain from the future” (Bravo and Pons, a o 1, No5, p.66). The family, as a unique and first encounter for the child, supplies a fundamental role in the structure and development of the child's personality, presenting itself as main environment where the child is educated and stimulated; therefore, early stimulation starts at home. The present article establishes the importance of early stimulation in children's objectives for life, in it’s development and educational compounds, showing the five sense in wich it can be worked, and explaining the highly significant role that the parent has in integral development of the personality in the child, in it’s physical, cognitive, psychological and social areas.
Causes of non-useful Papanicolaou smear in two health areas. Cienfuegos, 2005. Causas de las pruebas citológicas no útiles en dos áreas de salud. Cienfuegos, 2005.
Miryam González González del Pino,Mayrim Hernández González
MediSur , 2010,
Abstract: Background: Cervicouterine cancer represents 10 % of all types of cancer, and it is one of the three main death causes in women. Objectives: to determine the factors that may influence in the diagnosis of non-useful Papanicolaou smear in health areas II and III of Cienfuegos municipality, Cuba. Method: An ambispective analytic study was carried out in the second semester of the year 2005, in Cienfuegos municipality, Cuba. 122 non-useful Papanicolaou smear from health areas II and III were collected and those carrier women of the above mentioned samples were dated to repeat the test. The variables were; requisites and conditions to perform the test, visualization of the cervix and presence of vaginal sepsis. Results: An inadequated sample taking was observed in 93 patients (76,2 %), as well as the bad conditions of the place where the samples were taken. There was also instrumentation deficiency. The interview in more than 50 % of women was not the adequate one. Conclusions: Yet, existing an acceptable index of non useful Papanicolaou smear in Cienfuegos province, the program to detect cervicouterine cancer confront difficulties in its application and results. Fundamento: El cáncer cérvico uterino representa el 10 % de todos los cánceres, y es una de las 3 primeras causas de muerte en las mujeres. Objetivo: Determinar los factores que influyen en el diagnóstico de citologías no útiles en las áreas de salud II y III del Municipio de Cienfuegos. Métodos: Se realizó un trabajo ambiespectivo y analítico, en el segundo semestre del a o 2005, en el municipio de Cienfuegos. Se tomaron como muestra las 122 pruebas citológicas no útiles de las áreas II y III y se citó a las mujeres portadoras de dichas muestras para repetir la prueba citológica y aplicarles una encuesta. Las variables de análisis fueron: requisitos y condiciones para realizar la prueba, visualización del cuello uterino y presencia de sepsis vaginal. Resultados: Se observó la inadecuada toma de muestra en 93 pacientes (76,2 %), así como malas condiciones del local e instrumentación deficiente. Se detectó que en más del 50 % de las mujeres el interrogatorio no fue adecuado. Conclusiones: Aún existiendo un índice aceptable de citologías no útiles en la provincia de Cienfuegos, el Programa de Detección del Cáncer Cérvico Uterino, confronta dificultades en su aplicación y resultados.
Teste de Papanicolaou: constru o e valida o de material educativo para usuárias de servi os de saúde  [cached]
Marlene Bueno Gon?ales,Márcia Barbieri,Maria Cristina Gabrielloni
Saúde Coletiva , 2008,
Abstract: El cáncer de cuello uterino, es uno de los más comunes que padecen las mujeres en el mundo. En Brasil, se estima que sea la tercera neoplasia maligna encontrada entre las mujeres. Por lo tanto, hay una enorme necesidad de conscientización, que debe ser realizada por medio de la educación en salud. Este trabajo tuvo como objetivo construir y validar material educativo, con claras orientaciones paso a paso sobre la importancia y la realización del Papanicolaou, a la pacientes de los Servicios Públicos de Salud de la cuidad de San Paulo. La preparación y su utilización, fue realizada con mujeres, utilizándose un lenguaje y también dibujos de fácil compresión. Este trabajo fue evaluado por profesionales especialistas del área y aceptado por las pacientes de las Unidades Básicas de Salud de Sao Paulo. Se concluyó que el material educativo construido y aceptado, podrá colaborar en el aumento del conocimiento de las mujeres que son atendidas en las Unidades de Salud, cuando se sometan al examen de Papanicolaou y así, contribuir para la conscietización de la población, para que realicen este examen simples e indispensable para la prevención del cáncer de cuello de útero, con el objetivo de disminuir los índices de mortalidad femenina por cáncer.
Preven o do cancer de colo do útero: um modelo teórico para analisar o acesso e a utiliza o do teste de Papanicolaou  [cached]
Pinho Adriana de Araujo,Fran?a-Junior Ivan
Revista Brasileira de Saúde Materno Infantil , 2003,
Abstract: Vários estudos têm apontado que a permanência das altas taxas de incidência e mortalidade por cancer cérvico-uterino deve-se à baixa qualidade e cobertura do teste de Papanicolaou, principalmente em países em desenvolvimento. Pretende-se neste artigo analizar alguns pontos relacionados às medidas de preven o e controle do cancer cervical quanto à efetividade do teste de Papanicolaou, a lógica operacional e científica por detrás das políticas públicas de preven o ao cancer cervical e a cobertura do teste em países norte-americanos, europeus e na América Latina. Consideram-se, ainda, os modelos explicativos que est o sendo propostos para avaliar o acesso e a utiliza o deste servi o, a partir da análise dos fatores associados à realiza o do teste de Papanicolaou descritos pela literatura. Prop e-se uma nova abordagem na investiga o destes fatores, buscando a integra o e interlocu o de outros aspectos de cunho social, cultural e organizacional na análise do acesso e da utiliza o deste exame, visando um planejamento mais coerente das a es de preven o e promo o à saúde com as necessidades e direitos das mulheres.
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