Critical analyses of the introduction of liquid-based cytology in a public health service of the state of São Paulo, Brazil

OBJECTIVE The aim of this study was to compare the performance of the current conventional Pap smear with liquid-based cytology (LBC) preparations. STUDY DESIGN Women routinely undergoing their cytopathological and histopathological examinations at Fundação Oncocentro de São Paulo (FOSP) were recruited for LBC. Conventional smears were analyzed from women from other areas of the State of São Paulo with similar sociodemographic characteristics. RESULTS A total of 218,594 cases were analyzed, consisting of 206,999 conventional smears and 11,595 LBC. Among the conventional smears, 3.0% were of unsatisfactory preparation; conversely, unsatisfactory LBC preparations accounted for 0.3%. The ASC-H (atypical squamous cells - cannot exclude high-grade squamous intraepithelial lesion) frequency did not demonstrate any differences between the two methods. In contrast, the incidence of ASC-US (atypical squamous cells of undetermined significance) was almost twice as frequent between LBC and conventional smears, at 2.9 versus 1.6%, respectively. An equal percentage of high-grade squamous intraepithelial lesions were observed for the two methods, but not for low-grade squamous intraepithelial lesions, which were more significantly observed in LBC preparations than in conventional smears (2.2 vs. 0.7%). The index of positivity was importantly enhanced from 3.0% (conventional smears) to 5.7% (LBC). CONCLUSIONS LBC performed better than conventional smears, and we are truly confident that LBC can improve public health strategies aimed at reducing cervical lesions through prevention programs

Platinum tripods as nanometric frequency multiplexing devices

International audienceElectrical and structural characterization studies of nano-particles are very important steps to determine their potential applications in microelectronics. In this paper, we address the crystallographic and electric transport properties of soft-chemistry-grown nanometric Pt tribranches. We report that Pt nanostars grown from the reduction of H2PtCl6 salt in pure oleylamine present a remarkable crystalline structure and deeply metallic character despite being grown under mild conditions. We demonstrate that such devices are able to operate at current densities surpassing 200 MA cm−2, actuating as highly compact frequency multiplexers in the non-ohmic regime

Avaliação crítica das nomenclaturas diagnósticas dos exames citopatológicos cervicais utilizadas no Sistema Único de Saúde (SUS)

OBJETIVO: identificar as nomenclaturas diagnósticas dos exames citopatológicos cervicais utilizadas pelos laboratórios que atendem o Sistema Único de Saúde (SUS) e participantes do Monitoramento Externo de Qualidade (MEQ). Avaliar as informações adquiridas de profissionais ginecologistas que atuam no SUS sobre os tipos de classificação diagnóstica que recebem nos laudos citopatológicos cervicais. MÉTODOS: foram avaliados 94 laudos citopatológicos liberados pelos laboratórios participantes do MEQ no Estado de São Paulo e 126 questionários aplicados aos ginecologistas que atenderam o SUS. RESULTADOS: dos 94 laboratórios, 81 (86,2%) utilizam uma única nomenclatura diagnóstica: 79 (97,6%) utilizam a Nomenclatura Brasileira para Laudos Citopatológicos (NBLC), 1 (1,2%) utiliza a classificação de Papanicolaou e 1 (1,2%) utiliza a de Richart. Dos 13 (13,8%) laboratórios que utilizam mais de uma nomenclatura, 5 apresentam 2 tipos, e 8, de 3 a 4, 9 dos quais incluem a classificação de Papanicolaou. O estudo demonstrou que 52 (55,3%) laboratórios apresentaram mais de um diagnóstico descritivo num mesmo laudo. Dos 126 ginecologistas que responderam ao questionário de avaliação dos laudos citopatológicos, 78 (61,9%) disseram receber laudos dos laboratórios com apenas uma classificação diagnóstica, 48 (38,1%), laudos com mais de uma classificação, e 2 receberam as 4 classificações. Entre os 93 (73,8%) ginecologistas que preferem uma classificação, 56 (60,2%) alegaram que a NBLC contribui para a conduta clínica, 13 (14,0%) optaram pela nomenclatura de Richart, 8 (8,6%), de Reagan e 16 (17,2%), a de Papanicolaou. De 33 (26,2%) ginecologistas que preferem mais de uma nomenclatura, 5 optaram pelas 4 classificações. CONCLUSÕES: Os dados obtidos mostram que ainda há resistência por parte dos patologistas no emprego da nomenclatura oficial nos laudos citológicos do SUS. Há uma discrepância entre informações que os ginecologistas gostariam que estivessem nos laudos e as que são fornecidas pelos médicos patologistas. Maiores esforços devem ser empregados no sentido de estimular o uso da nomenclatura oficial

High-Risk HPV testing in primary screening for cervical cancer in the public health system, São Paulo, Brazil

Every year there are approximately 16,000 new cases of cervical cancer in Brazil. Novel screening technologies may reduce this number by expanding the population coverage but also by improving the detection rate of precursor lesions. We aimed to evaluate human papillomaviruses (HPV)-DNA testing in the context of routine cervical cancer screening in the public health system of the city of São Paulo, Brazil. Women participating in the primary screening program were invited to enroll. Liquid-based cytology samples were collected and cytology and Hr-HPV DNA testing were performed in parallel. Cytologists were blind to HPV results. Women older than 24 years with a positive high-risk HPV test and/or cytology class ≥ ASC-US were referred to colposcopy. From December 2014 to December 2016, 16,102 women joined the study. High-risk human papillomavirus (HR HPV) DNA prevalence was 14.9%, whereas cytologic abnormalities were found in 7.2% of the women. Per protocol, 1,592 Hr-HPV+ women, in addition to 72 patients with cytologic classification > low-grade squamous intraepithelial lesion (LSIL) were referred. A total of 80 cervical intraepithelial neoplasia (CIN2+) cases were diagnosed, 79 were Hr-HPV DNA+ and 18 had normal cytology. Hr-HPV DNA detected a significant number of patients with premalignant lesions missed by cytology and all 16 CIN3+ cases were Hr-HPV DNA+ HPV genotyping may be useful in the management of Hr-HPV+ women, reducing the burden of colposcopic referral for those harboring genotypes with a weaker association to CIN3+ Use of HPV-DNA testing was shown to be feasible and advantageous over current cytologic screening in the public health system.We would like to acknowledge the invaluable work of the three colposcopists Dr. Monica Christina Rial (Hospital e Maternidade Interlagos), Vivian R. M. de Souza Silva (UBS Vila Sonia), and Noely Paula Cristina Lorenzi (Hospital Universitario). National Research Council (CNPq) grant no. 573799/2008-3, Sao Paulo Research Foundation (FAPESP) grant no. 2008/57889-1

Influence of prior knowledge of human papillomavirus status on the performance of cytology screening

This study aimed to evaluate the influence of prior knowledge of human papillomavirus (HPV) status in cervical cytopathology readings.We thank Becton-Dickinson (BD) for technical support, equipment, and reagents for the study, as well as cytologists and pathologists of the FOSP Laboratory. We also thank the Instituto Nacional de Ciencia e Tecnologia das Doencas do Papilomavirus Humano INCT-HPV (National Institute of Science and Technology of the Diseases Associated to the Papillomavirus) coordinated by Luisa Lina Villa, Sao Paulo, Brazil, for financial support through CNPq 573799/2008-3 and FAPESP 2008/57889-1 grants

Cartographier les ressources pour gérer les priorités

International audienceComment, depuis plusieurs décennies, la recherche scientifique contribue-t-elle au développement des pays du Sud ? À travers plus de 100 succès emblématiques de la recherche en partenariat, cet ouvrage nous plonge au coeur des grandes questions de développement : oeuvrer pour des sociétés plus justes, lutter contre les maladies, faire face aux risques naturels, mettre en place une agriculture durable garantissant la sécurité alimentaire, préserver la biodiversité, partager les savoirs... Il montre ainsi comment la recherche contribue à l'amélioration des conditions de vie et à la préservation de l'environnement dans les pays en développement, en soulignant le rôle de la science pour répondre aux défis du monde actuel et à venir. Composé de textes courts, didactiques et richement illustrés, il s'adresse à tous les publics

Cartographier les ressources pour gérer les priorités

International audienceComment, depuis plusieurs décennies, la recherche scientifique contribue-t-elle au développement des pays du Sud ? À travers plus de 100 succès emblématiques de la recherche en partenariat, cet ouvrage nous plonge au coeur des grandes questions de développement : oeuvrer pour des sociétés plus justes, lutter contre les maladies, faire face aux risques naturels, mettre en place une agriculture durable garantissant la sécurité alimentaire, préserver la biodiversité, partager les savoirs... Il montre ainsi comment la recherche contribue à l'amélioration des conditions de vie et à la préservation de l'environnement dans les pays en développement, en soulignant le rôle de la science pour répondre aux défis du monde actuel et à venir. Composé de textes courts, didactiques et richement illustrés, il s'adresse à tous les publics

Science et développement durable : 75 ans de recherche au Sud

International audienceComment, depuis plusieurs décennies, la recherche scientifique contribue-t-elle au développement des pays du Sud ? À travers plus de 100 succès emblématiques de la recherche en partenariat, cet ouvrage nous plonge au coeur des grandes questions de développement : oeuvrer pour des sociétés plus justes, lutter contre les maladies, faire face aux risques naturels, mettre en place une agriculture durable garantissant la sécurité alimentaire, préserver la biodiversité, partager les savoirs... Il montre ainsi comment la recherche contribue à l'amélioration des conditions de vie et à la préservation de l'environnement dans les pays en développement, en soulignant le rôle de la science pour répondre aux défis du monde actuel et à venir. Composé de textes courts, didactiques et richement illustrés, il s'adresse à tous les publics