RESUMO
Cervical cancer is the second most common form of cancer and a leading cause of premature death among women aged 15 to 44 worldwide. In Brazil, there is a high prevalence of infection by the human papillomavirus - HPV. Digital pathology optimizes time and space for reading cervicovaginal cytology slides. We evaluated the feasibility of using whole slide images (WSI) for the routine interpretation of cytology exams. A total of 99 cases of vaginal cytology were selected from a reference laboratory in Northeastern Brazil. Three cytotechnicians participated in the study. Cellular atypia was the one that most presented concordance values. Two observers almost perfectly agreed (k = 0.86 and k = 0.84, respectively) on the negative diagnoses. The performance of the evaluators for NILM (negative for intraepithelial lesion and malignancy) showed high reproducibility and sensitivity in the digital slides, mainly between evaluators A and C. In contrast, the microbiology group showed disagreement between the diagnoses by digital slides and the standard- gold. The concordance between the digital diagnoses and the gold standard for ASCUS was 89%. In the inflammatory category, Spearman's test showed similar results between raters A, B, and C (rs = 0.47, rs = 0.41, and rs = 0.47, respectively). This study reports the diagnostic validation using digital slides in view of the need to optimize the cytology visualization process. Our experience shows good diagnostic agreement between digital and optical microscopy in several analyzed categories, but mainly in relation to cellular atypia and inflammatory processes.
Assuntos
Processamento de Imagem Assistida por Computador , Neoplasias do Colo do Útero , Feminino , Humanos , Reprodutibilidade dos Testes , Processamento de Imagem Assistida por Computador/métodos , Colo do Útero/patologia , Citodiagnóstico/métodos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/patologia , Papillomavirus Humano , Esfregaço Vaginal/métodosRESUMO
O artigo compara a forma como Sigmund Freud, Otto Gross e Sabina Spielrein se referem às mulheres e aos homens, ao feminino e ao masculino e ao binômio sadismo e masoquismo. O objetivo é localizar determinações machistas e patriarcais, condicionadas historicamente nas primeiras teorias sobre a etiologia das neuroses, e sua sobrevivência em utilizações e atualizações mais recentes. A releitura de psicanalistas contemporâneos a Freud que foram silenciados e esquecidos mas que recentemente retornaram do recalque histórico dentro da história oficial da psicanálise nos permite considerar de que forma a lógica patriarcal influenciou a vida e as teorias dos primeiros psicanalistas.(AU)
The article compares how Sigmund Freud, Otto Gross, and Sabina Spielrein refer to women and men, the feminine and the masculine, and the binomial opposition of sadism and masochism. The objective is to locate historically conditioned sexist and patriarchal determinations in the early theories of the etiology of neuroses; and their survival in more recent uses and updates. The rereading of psychoanalysts contemporary to Freud who have been silenced and forgotten but who recently returned from historical repression within the official history of psychoanalysis allows us to consider how a patriarchal logic influenced the life and theories of early psychoanalysts.(AU)