Examinando por Autor "Quezada Poblete, Orlando"

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    Ítem
    Clinical management of the first ASCUS report in Chile. Prospective single-cohort study
    (Associação Paulista de Medicina - APM, 2015) López-Alegría, Fanny; Quezada Poblete, Orlando; De Lorenzi, Dino Soares; Sepúlveda Oyanedel, Juan Carlos
    CONTEXT AND OBJECTIVE: Worldwide, there is no single strategy for optimal management of patients with ASCUS (atypical squamous cells of undetermined significance) cytology reports. The objective of this study was to determine the kind of clinical management conducted among women with a first ASCUS Pap smear report. DESIGN AND SETTING: Prospective single cohort study at a cervical pathology unit in Santiago, Chile. METHODS: This was an epidemiological, descriptive, observational and quantitative follow-up study on a cohort of women with ASCUS cytological reports. RESULTS: In the screening phase, 92,001 cervical cytological smears were collected in primary healthcare clinics. In the diagnostic phase, all women with a first ASCUS report were selected (n = 446). These women were asked to undergo the Pap test again and it was found that 301 women had normal results, 62 women had abnormal results and 83 did not repeat the test. In the diagnostic confirmation phase, the 62 women with abnormal results underwent colposcopy and, from these results, 58 of them underwent a biopsy. The results from the biopsies showed that 16 women had negative histological reports, 13 had CIN 1 and 29 had CIN 2+. In the treatment phase, the 42 women with lesions underwent a variety of treatments, according to the type of lesion. In the post-treatment phase, cytological and colposcopic monitoring was instituted. CONCLUSION: The clinical management consisted of traditional management of screening, diagnosis, diagnostic confirmation, treatment and post-treatment monitoring.
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    Ítem
    Follow-up of women with inadequate Pap smears: a prospective cohort study
    (Associação Paulista de Medicina - APM, 2015) López-Alegría, Fanny; De Lorenzi, Dino Roberto Soares; Quezada Poblete, Orlando
    CONTEXT AND OBJECTIVE: Inadequate Pap smears do not provide satisfactory cell samples for evaluation, thus making it more difficult to detect cervical cytological abnormalities. The objective of this study was to determine the cytological and histological follow-up results from women with inadequate smear reports in primary healthcare centers in Santiago, Chile 2010-2011. 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 organized 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 insufficient and hemorrhagic specimens) to 4.1% (poor fixation). CONCLUSION: The large proportion of normal results justifies revision of the current clinical guidelines. The results showed that it is not necessary to repeat the Pap test early on, with the exception of inadequate hemorrhagic and inflammatory cytological results.
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    Ítem
    Patologías glandulares del endocervix y su correlación citohistológica
    (Universidad Andrés Bello (Chile), 2015) Figueroa Muñoz, Daniela Francisca; Meneses Pérez, Ives Ana; Quezada Poblete, Orlando; Facultad de Medicina
    El desarrollo de neoplasias en epitelio glandular del cuello uterino difiere de las que se originan en epitelio escamoso, principalmente porque la etiopatogenia si bien en la literatura está asociado al virus papiloma humano, a excepción de la cepa 18 se mencionan diferentes tipos oncogénicos que serían propios de lesiones glandulares (De la FuenteVillarreal, D., 2010) Hoy en día, exceptuando los adenocarcinomas poco o mal diferenciados, el aporte de la citología a la concordancia cito-histológica es bastante. Si bien la conferencia Bethesda del año 2001 estableció patrones citológicos para el informe de adenocarcinoma in situ endocervical, están las lesiones benignas que pueden presentar células glandulares con ciertas alteraciones que varían, pudiendo ser diagnosticadas como negativos, atípicos e incluso adenocarcinoma para un ojo inexperto, condiciones que se deben considerar para un diagnóstico citológico diferencial de las lesiones glandulares malignas (Alonso de Ruiz, Lazcano y Hernández, 2000, p 222). Establecer patrones citomorfológicos para células glandulares podría ser de gran ayuda para esta problemática. Este estudio tiene un carácter retrospectivo en donde se cruzará el informe diagnóstico de las biopsias endocervicales de un año, con el diagnóstico de citologías de estas mismas pacientes, hasta tres años hacia atrás, teniendo como objetivo reevaluar los cambios o alteraciones de las células glandulares que estén presentes en dichos extendidos. Observando por ejemplo cambios de aumento de celularidad en patologías benignas como pólipos e hiperplasias y poder diferenciarlos de atipias más severas como las que ocurrirían en patologías malignas.