Monitoring of women with positive cytological result in a stateowned company, Medellín, Colombia, 2011- 2012

ABSTRACT: In Colombia, cervical cancer (CxCa) is one of the main causes of death. Every year, 7,000 cases are diagnosed and 3,300 deaths are recorded. 50% are because of late diagnosis and no access to specialized treatments. Objective: This study aims to monitor women who have had a positive cytological results in a state-owned company in Medellin from 2011 to 2012. Methodology: This is a cross-sectional descriptive study conducted on 277 women who had positive cytological results for lesions suggestive of high grade and/or glandular disorders. This research used stratified systematic sampling,and primary and secondary information sources. SPSS was implemented to systematize data like frequency, central tendency, and dispersion measurements were calculated. A descriptive univariate-bivariate analysis was implemented for sociodemographic and clinical related variables, and those related to the healthcare subjects received. Results: 10.7% of women with high grade or invasive lesions did not complete the treatment. The total monitoring opportunity was 52.3%, and the phases with the longest-waiting times were waiting for appointments for diagnosis and treatment. Conclusion: Despite efforts to improve screening coverage and to actively seek patients with a positive cytology evidenced in the study, there are still obstacles that impede patients’ prompt diagnosis and treatment, and this is something that in various cases leads to the progression of the disease and even death.RESUMEN: En Colombia el cáncer cérvico-uterino (Cacu) es una de las principales causas de muerte. Anualmente se diagnostican 7.000 casos y se registran 3.300 muertes, el 50% por diagnóstico tardío y falta de acceso a tratamientos especializados. Objetivo: describir el seguimiento a mujeres con resultado citológico positivo en una ESE de Medellín, 2011-2012. Metodología: estudio descriptivo transversal en 277 mujeres con resultado citológico positivo para lesiones sugestivas de alto grado y/o alteraciones glandulares. Se empleó muestreo estratificado y sistemático. Se utilizaron fuentes de información primaria y secundaria. La sistematización de datos se realizó en el programa SPSS, y se calcularon medidas de frecuencia, tendencia central y dispersión. Se empleó análisis descriptivo uni-bivariado para variables sociodemográficas, clínicas y relacionadas con la atención recibida. Resultados: el 10,7% de mujeres con lesiones de alto grado o invasoras no culminaron el tratamiento. La oportunidad total del seguimiento fue del 52,3% y las fases con mayores tiempos de espera para la atención fueron las citas para diagnóstico y tratamiento. Conclusión: A pesar de los esfuerzos para mejorar la cobertura del cribado y búsqueda activa de pacientes con citología positiva evidenciada en el estudio aún se presentan obstáculos en la atención de pacientes para un diagnóstico y tratamiento oportuno, lo que lleva en varios casos al avance de la enfermedad e incluso la muerte

Evaluating Amphibian Declines with Site Revisits and Occupancy Models: Status of Montane Anurans in the Pacific Northwest USA

Amphibian declines have been reported in mountainous areas around the western USA. Few data quantify the extent of population losses in the Pacific Northwest, a region in which amphibian declines have received much attention. From 2001–2004, we resurveyed historical breeding sites of two species of conservation concern, the Western Toad (Bufo [=Anaxyrus] boreas) and Cascades Frog (Rana cascadae). We detected B. boreas breeding at 75.9% and R. cascadae breeding at 66.6% of historical sites. When we analyzed the data using occupancy models that accounted for detection probability, we estimated the current use of historically occupied sites in our study area was 84.9% (SE = 4.9) for B. boreas and 72.4% (SE = 6.6) for R. cascadae. Our ability to detect B. boreas at sites where they were present was lower in the first year of surveys (a low snowpack year) and higher at sites with introduced fish. Our ability to detect R. cascadae was lower at sites with fish. The probability that B. boreas still uses a historical site for breeding was related to the easting of the site (+) and the age of record (-). None of the variables we analyzed was strongly related to R. cascadae occupancy. Both species had increased odds of occupancy with higher latitude, but model support for this variable was modest. Our analysis suggests that while local losses are possible, these two amphibians have not experienced recent, broad population losses in the Oregon Cascades. Historical site revisitation studies such as ours cannot distinguish between population losses and site switching, and do not account for colonization of new habitats, so our analysis may overestimate declines in occupancy within our study area

Covent Garden drollery /

Wrongly attributed to Alexander Brome.Reproduced from the British museum copy.With reproduction of original t.p.: Covent Garden drolery, or A colection, of all the choice songs, poems, prologues, and epilogures, (sung and spoken at courts and theaters) never in print before. Written by the refined'st witts of the age. And collected by A.B. London, Printed for James Magnes neer the Piazza in Russel-Street, 1672."This edition consists of 575 copies, printed by the Whitefriars press on English unbleached hand-made paper."Mode of access: Internet