RESUMO
Objetivo: Analizar los resultados de la escisión de la zona de transformación del cérvix efectuadas en la Unidad de Patología Cervical del Hospital Guillermo Grant de Concepción. Método: Estudio descriptivo, retrospectivo, de los antecedentes clínicos e histológicos de 1.141 casos de escisión electro quirúrgica efectuados entre 1999 a 2005, con seguimiento mínimo de 18 meses. Resultados: De las 3.004 mujeres derivadas por citología positiva para neoplasia y/o HPV, a 1.141 (37,9%) se les realizó escisión de la zona de transformación; 1.113 con asa electroquirúrgica (97,5%) y 28 (2,5%) cono frío con bisturí. Las lesiones intraepiteliales (LIE) de alto grado fueron las más frecuentes (66,7%), seguidas por las LIE de bajo grado (7,8%); el 6,5% de las pacientes presentan etapas iniciales de carcinoma invasor; 33% de las piezas histológicaspresentaron bordes comprometidos; 18,4% no presentaron lesión histológica, que sumadas a 7,8% de LIE de bajo grado representan un 26,2% de mujeres consideradas como sobretratadas. El porcentaje a 18 meses de seguimiento en mujeres con LIE de alto grado fue de 85,5%. Necesitaron de una segunda intervención 194 pacientes (17%), 110 (9,6%) por persistencia y recidivas de la lesión. Conclusión: Los resultados presentados son satisfactorios en el porcentaje de curación de las LIE de alto grado como en el aporte al diagnóstico precoz de carcinomas del cérvix y similares a estudios publicados tanto nacionales como extranjeros.
Objective: To analyze the results of 1,141 cervical excisions. Method: Descriptive and retrospective study of the clinical charts and biopsies of 1,141 cases with surgical resection of the uterine cervix performed from 1999 to 2005. Only patients with a minimum of 18 months of follow up were included. Results: From 3,004 patients with a positive Papanicolaou smear for neoplastic cells and/or condyloma, 1,113 (97.5%) were treated with loop electrosurgical excisional procedure (LEEP) and 28 (2.5%) with cold-knife conization. The most frequent lesion (66.7%) found was high grade squamous intraepithelial lesions (SIL), follow by low grade SIL (7.8%); 74 patients (6.5%) presented with early stage of squamous cell carcinoma and 377 (33%) of the histological specimens revealed positive margins; 210 (18.4%) of the cases showed no histological lesion. There were a 26.2% of females that were considered to receive over treatment. After 18 months follow up 85.5% of patient were free of high grade SIL. A second surgical treatment was done in 194 patients (17%) including 110 cases (9.6%) with persistent or recurrence of the lesion. Conclusions: The results are satisfactory related to treatment of high grade SIL and it contributes to the early diagnosis of cervical cancer. The results are similar to other national and international series previously published.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Conização , Eletrocirurgia/métodos , Displasia do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/cirurgia , Epidemiologia Descritiva , Seguimentos , Displasia do Colo do Útero/patologia , Neoplasias do Colo do Útero/patologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Two evaluation studies were carried out in 1995 and 1997. The first evaluation assessed tile effectiveness of the Psychiatric Nurse Practitioner's education program and its impact on mental health and psychiatry in Belize. The second study was done to determine if the mental health services were sustained in the country. Interviews and focus groups were used for data collection. In this paper the focus is on the findings from the focus groups. The findings show that the PNP's role performance was adequate, they have made an impact on the mental health services and the services are sustained.
Assuntos
Grupos Focais/métodos , Descrição de Cargo , Profissionais de Enfermagem/educação , Profissionais de Enfermagem/organização & administração , Avaliação de Programas e Projetos de Saúde/métodos , Enfermagem Psiquiátrica/educação , Enfermagem Psiquiátrica/organização & administração , Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Belize , Humanos , Intercâmbio Educacional Internacional , Pesquisa em Educação em Enfermagem , Pesquisa em Avaliação de EnfermagemRESUMO
Two evaluation studies were carried out in 1995 and 1997. The first evaluation assessed tile effectiveness of the Psychiatric Nurse Practitioner's education program and its impact on mental health and psychiatry in Belize. The second study was done to determine if the mental health services were sustained in the country. Interviews and focus groups were used for data collection. In this paper the focus is on the findings from the focus groups. The findings show that the PNP's role performance was adequate, they have made an impact on the mental health services and the services are maintained (Au)
Assuntos
Humanos , Estudos de Casos e Controles/métodos , Descrição de Cargo , Supervisão de Enfermagem/educação , Supervisão de Enfermagem/organização & administração , Avaliação de Programas e Projetos de Saúde/métodos , Enfermagem Psiquiátrica/educação , Enfermagem Psiquiátrica/organização & administração , Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Belize , Intercâmbio Educacional Internacional , Pesquisa em Educação em Enfermagem , Pesquisa em Avaliação de EnfermagemRESUMO
Two patients hyperinfected with Strongyloides stercoralis (an intestinal nematode) are described. Both were both in Puerto Rico and had left the island six to 15 years previously; both were receiving adrenal steroids (one for Hodgkin's disease and the other for Goodpasture's syndrome). One died shortly after diagnosis, but the other survived the hyperinfection syndrome and complicating bacterial sepsis and meningitis. In addition to our case reports, 103 previously described cases of presumed strongyloides hyperinfection are reviewed. Among 89 patients immunocompromised by therapy or disease, the mortality rate was 86%; bacterial sepsis often contributed to the fatal outcome. In most cases, infection was acquired in an endemic area, sometimes long before the hyperinfection syndrome occurred. The few patients who had never been to an endemic area had a history of prolonged contact with highly soiled material, an observation suggesting cross infection from a contaminated person. When administered in time, thiabendazole, the drug of choice for strongyloidiasis, was effective in 70% of cases. If intestinal infection with S. stercoralis is detected and treated before immunosuppressive therapy is initiated and if a high index of suspicion for the hyperinfection syndrome is maintained while immunosuppressive therapy is given, the mortality from this disease should decrease.