Freqüência de realização e acurácia do auto-exame das mamas na detecção de nódulos em mulheres submetidas à mamografia Frequency of performance and accuracy of breast self-examination in the detection of breast lumps in women who underwent mammographic examination

Realizamos um estudo transversal prospectivo cujo objetivo foi avaliar a acurácia do auto-exame de mamas (AEM) na detecção de nódulos mamários palpáveis e a relação com sua freqüência. Foram entrevistadas 2672 mulheres que realizaram mamografia na Região do Vale dos Sinos/RS no período de janeiro de 94 a julho de 97, questionando-se quanto à freqüência da realização de AEM. As mulheres foram divididas em dois grupos: grupo I (mensalmente), grupo II (quase nunca). As mulheres que relataram realizar o AEM ocasionalmente foram excluídas da análise principal. Foi perguntado à paciente se ela ou seu médico haviam palpado alguma lesão mamária. Comparou-se os achados de palpação da paciente com os do médico (relatados pela paciente). A sensibilidade do AEM foi maior no grupo I comparado ao II (57,4% versus 33,3%; P <0,05). Concluímos que existe uma associação entre a realização mensal de AEM e uma maior sensibilidade na detecção de nódulos mamários palpáveis.<br>We conducted a prospective cross-sectional study to evaluate the accuracy of the breast self-examination (BSE) in the detection of palpable breast lumps and the relation to its frequency of performance. Two thousand six hundred and seventy two women who have had a mammogram in a private clinic in Vale dos Sinos-RS between January 1994 and July 1997 were asked about BSE performance frequency. They were divided in two groups: group I (monthly), group II (almost never). The women who referred performing BSE on a occasional basis were excluded from the main analysis. The woman was asked wheter she or her physician had palpated something in her breasts. The patient's BSE findings were compared with those of her physician (based on the patients' report). The sensitivity of the BSE was higher in group I compared to group II (57.4% versus 33.3%; rho<0.05). We concluded that there is an association between frequency of performance and sensitivity of BSE to detect breast lumps

What is the healing time of stage II pressure ulcers? Findings from a secondary analysis

Pressure ulcers (PrUs) remain a concern for clinicians, patients, caregivers, and researchers. Although data on prevalence and incidence are available, as well as evidence-based prevention and management intervention, PrU healing time is underreported. Objective: The objective of this study was to evaluate the healing time of Stage II PrUs. Methods: Secondary analysis of data collected from a multicenter randomized clinical trial was undertaken. Patients (a) with a Stage II PrU, (b) older than 18 years, and (c) who had given informed consent were included. The endpoints of the study were complete re-epithelialization of the PrU measured with the Pressure Ulcer Scale for Healing Tool 3.0 and the healing time. A network of 46 healthcare centers located in northern Italy participated in the study. Results: Two hundred seventy patients with an average age of 83.9 years (95% confidence interval [CI], 82.71-85.10) were recruited. Among 270 Stage II PrUs included, 153 lesions healed (56.7%), whereas 74 (27.4%) were still present after 10 weeks of follow-up. For 43 lesions (15.9%), the follow-up evaluation was interrupted because of patient death or transfer to units not included in the study. The PrUs healed on an average of 22.9 days (95% CI, 20.47-25.37 days), with a median of 18 days. The average healing time for PrUs of less than 3.1 cm2 was significantly shorter (19.2 days; 95% CI, 16.6-21.8) compared with those 3.1 cm2 or greater (31.0 days; 95% CI, 26.4-35.6 days) (P = .000). Conclusions: To achieve complete re-epithelialization in Stage II PrUs, it takes approximately 23 days. This is quite a long time if we consider that pressures of only 60 to 70mmHg for between 30 and 240 minutes are needed to cause tissue damage. On average, a small ulcer heals 12 days faster compared with those with a surface of 3.1 cm2 or greater. Copyright \ua9 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins