RESUMO
PIP: This article describes the objectives and content of a workshop held in Managua, Nicaragua, during November 1995, on screening for cervical cancer. The aims were to discuss cost-effective models of screening in countries with a high incidence of cervical cancer and to reach a consensus on principles for screening that is balanced with a country's resources. The workshop aimed to develop a planning framework and to identify program strengths and weaknesses by country. In 1990 there were 25,000 deaths due to cervical cancer in Central America; even so, most countries attach a low priority to cervical cancer screening. Workshop plenary sessions were devoted to discussions about the natural history of cancer of the cervix and the implications for screening, the high costs of human papillomavirus (HPV) tests, approaches to national registries of cervical cancer, screening issues in Central America, downstaging, laboratory quality control issues, treatment of abnormalities, recruitment of women, and IEC. This report includes individual country program reports for Nicaragua, Panama, Haiti, the Dominican Republic, Guatemala, Honduras, and St. Vincent and the Grenadines. Participants concluded that priority should be placed on education about cancer and cancer of the cervix and education of primary health care professionals. It was agreed that all participating countries should begin pilot programs adapted to resource availability, with the idea of a later nationwide expansion. Health care professionals who treat women during the prime reproductive years should use the opportunity to identify women at high risk of invasive cancer. There is overcoverage of women aged under 35 years and insufficient coverage of women aged 35-64 years. Health programs need to enlist the help of women's groups in creating a need and demand in communities. Cytology laboratories need to provide quality services.^ieng
Assuntos
Programas de Rastreamento/organização & administração , Neoplasias do Colo do Útero/prevenção & controle , Adolescente , Adulto , Idoso , América Central , Análise Custo-Benefício , Técnicas Citológicas/normas , Feminino , Educação em Saúde , Humanos , Programas de Rastreamento/economia , Pessoa de Meia-Idade , Papillomaviridae/isolamento & purificação , Controle de Qualidade , Neoplasias do Colo do Útero/patologiaRESUMO
We studied the relationship between risk factor information and breast cancer mortality by means of a case control study, nested within the population of the National Breast Screening Study of Canada (NBSS). The characteristics of women aged 40-59 years, identified at the initial screen, who subsequently died of breast cancer up to 7 years from the initial screen, were compared with those of controls drawn from the same population. Among the factors evaluated in this study, number of live births and presence of symptoms in the breast revealed on direct questioning were found to be significantly related to breast cancer mortality. The results suggest a decrease in risk of dying of breast cancer associated with one or more live births (OR: 0.79, 95% CI: 0.68, 0.93), and an increase in risk of dying of breast cancer associated with symptoms in the breast revealed on direct questioning at the initial screen (OR: 2.01, 95% CI: 1.20, 3.37).
Assuntos
Neoplasias da Mama/mortalidade , Neoplasias da Mama/prevenção & controle , Programas de Rastreamento , Adulto , Antropometria , Doenças Mamárias/genética , Neoplasias da Mama/genética , Autoexame de Mama , Canadá/epidemiologia , Estudos de Casos e Controles , Demografia , Feminino , Hormônios/uso terapêutico , Humanos , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Pós-Menopausa , História Reprodutiva , Fatores de RiscoRESUMO
Este trabajo está basado en el artículo de A.B. Miller, "What is the role of early and screening in cancer control?" J Public Health Policy 14:403-412, 1993
Assuntos
Neoplasias , Exames Médicos , Prevenção PrimáriaRESUMO
As part of a large-scale international cooperative investigation into the side effects of thioacetazone-containing regimens in the treatment of tuberculosis, an evaluation has been made of the variation in the frequency of side effects between different countries and between different centres in the same country and of the likely reasons for this variation. In 3 countries patients of different racial origin were under observation in the same hospital. Over a 12-week period of treatment there was considerable variation between the countries and centres in the overall frequency of side effects and of those leading to a major departure from prescribed treatment, the variation being similar for the two thioacetazone-containing regimens and for the streptomycin plus isoniazid control regimen, though at a lower level for the latter. In Malaysia, Singapore, and Trinidad, where different racial groups were under treatment, there was no clear indication that race was an important factor in explaining the differences between countries, except for cutaneous side effects in Trinidad and possibly in Malaysia.It is concluded that the differences in the frequency of side effects to thioacetazone-containing regimens probably result from variation in the closeness of supervision of patients, in the recording and interpretation of side effects, and in environmental factors including the previous use of other medicaments or exposure to sensitizing substances.
Assuntos
Antituberculosos/efeitos adversos , Hipersensibilidade a Drogas , Tioacetazona/efeitos adversos , Tuberculose Pulmonar/tratamento farmacológico , Adulto , África do Norte , Ásia , Tchecoslováquia , Feminino , Geografia , Humanos , Cooperação Internacional , Masculino , Pessoa de Meia-Idade , Grupos Raciais , Trinidad e TobagoAssuntos
Toxidermias/etiologia , Tioacetazona/efeitos adversos , Corticosteroides/uso terapêutico , Argélia , Tchecoslováquia , Dessensibilização Imunológica , Toxidermias/epidemiologia , Toxidermias/terapia , Etiópia , Antagonistas dos Receptores Histamínicos H1/uso terapêutico , Humanos , Índia , Isoniazida/administração & dosagem , Isoniazida/efeitos adversos , Malásia , Marrocos , Paquistão , Singapura , Estreptomicina/administração & dosagem , Estreptomicina/efeitos adversos , Tioacetazona/administração & dosagem , Trinidad e TobagoRESUMO
Rifampicin in urine was detected by a simple plate diffusion assay using as the test organism a strain of Staphylococcus aureus made resistant to other antituberculosis drugs. The specificity of the method was ensured by a parallel test with a rifampicin-resistant variant of this strain. The method was more sensitive than available chemical techniques and yieldeld reliably positive results for at least twelve hours after a 600 mg. dose of rifampicin.