AVALIAÇÃO DO USO DE AGRUPAMENTO SEMISSUPERVISIONADO NA SEGMENTAÇÃO DO DISCO ÓPTICO PARA FINS DE DETECÇÃO DO GLAUCOMA

Glaucoma is a slowly progressive disease, asymptomatic and can cause irreversibly blindness. Among the main tests used by ophthalmologists for diagnosis the retinography is known for being the lowest cost and the least invasive. This exam consists of observe and record retinal photographs and the diagnosis is made taking into account the ratio between the radii outside the Optic Disc (OD) and the inner part, called cup. In order to segment these regions, this study evaluates the performance of six semi-supervised clustering algorithms and two supervised in 209 images of two public databases.  The results demonstrated that the K-meanski algorithm obtained respectively 99.59% and 97.71% of precision in segmenting the contour of cup and OD.O glaucoma é uma doença lentamente progressiva, assintomática e que pode causar cegueira de forma irreversível. Dentre os principais exames utilizados por oftalmologistas para seu diagnóstico, a retinografia se destaca por ser o de menor custo e o menos invasivo. Esse exame consiste em registrar fotografias da retina e observá-las. O diagnóstico é realizado levando-se em consideração a razão entre os raios da parte externa do Disco Óptico (DO) e da parte interna, denominada escavação. Com o objetivo de segmentar essas regiões este trabalho avalia o desempenho de seis algoritmos de agrupamento semissupervisionado e dois supervisionado em 209 imagens de duas bases públicas. Os resultados demonstraram que o algoritmo K-meanski obteve, respectivamente, 99,59% e 97,71% de precisão na segmentação da escavação e contorno do DO

CÂNCER DE COLO DO ÚTERO, GENOTIPAGEM DO PAPILOMA VÍRUS HUMANO (HPV) EM MULHERES QUILOMBOLAS DE UM MUNICÍPIO BRASILEIRO: ACEITABILIDADE DA VACINA

O câncer de colo uterino é o segundo câncer feminino mais comum no Brasil. O papilomavírus humano (HPV) é causa necessária para seu desenvolvimento. A vacina surge como uma arma contra a infecção por HPV e, consequentemente, contra o câncer. Mas existem mais de 100 genótipos diferentes de HPV, que são divididos em baixo risco e alto risco, de acordo com o potencial oncogênico. Analisam-se os aspectos epidemiológicos e biomoleculares da infecção por HPV na mucosa genital de mulheres qui-lombolas, verificando a associação os achados citológicos e biomoleculares e observando a frequência do papilomavírus nessa população e de seus tipos, para avaliar a aplicabilidade da vacina na população em estudo. A população deste estudo é de 101 mulheres pertencentes à comunidade quilombola de Ju-çatuba, no estado do Maranhão. Foram coletadas amostras de mucosa genital, submetidas à pesquisa para a presença do HPV pela técnica de PCR Nested. As amostras positivas foram sequenciadas para fins de genotipagem viral. Em uma população predominante de mulheres em idade fértil, com parceiro fixo e baixo nível de escolaridade, verificou-se que 10 amostras da cérvice uterina foram positivas paraHPV, sendo 7 positivas para os tipos de alto risco. Mediante a presença dos tipos virais de alta oncoge-nicidade, observa-se a necessidade de implementação de condutas gestoras para redução do risco de aparecimento de câncer do colo do útero.Palavras-chave: Papilomavírus humano. Câncer. Colo uterino. Reação em cadeia da polimerase.CANCER OF THE CERVIX, GENOTYPING OF HUMAN PAPILLOMAVIRUS (HPV) IN QUILOMBOLA WOMEN IN A BRAZILIAN CITY: ACCEPTABILITY OF THE VACCINE.ABSTRACT: Cervical cancer is the second most common female cancer in Brazil. The human papilloma-virus (HPV) is a need cause for its development. The vaccine appears as a weapon against HPV infection and therefore against cancer. But there are more than 100 different HPV genotypes, which are divided into low risk and high risk according to the oncogenic potential. To analyze the epidemiological and biomolecu-lar aspects of HPV infection in the genital mucosa of women Maroons, verifying the association cytological and molecular biological findings and noting the frequency of this population papillomavirus and its types, to evaluate the applicability of the vaccine in the study population. The study population was 101 women belonging to the maroon community of Juçatuba in the state of Maranhão. Genital mucosa samples were collected and submitted to search for the presence of HPV by PCR Nested. The positive samples were sequenced for the purpose of viral genotyping. In a predominant population of women of childbearing age, with a steady partner, and low level of education, it was found that 10 samples of uterine cervix were positive for HPV, with 7 positive for high-risk types. Through the presence of viral types of high tumorige-nicity, there is a need to implement management practices for reducing the risk of developing cancer of the cervix.KEYWORDS: Human Papillomavirus. Cancer. Cervix. Polymerase Chain Reaction.EL CÁNCER DEL CUELLO UTERINO, LA GENOTIPIFICACIÓN DEL VIRUS DEL PAPILOMA HUMANO (VPH) EN MUJERES QUILOMBOLAS EN UNA CIUDAD BRASILEÑA: LA ACEPTABILIDAD DE LA VACUNA.RESUMEN: El cáncer cervical es el segundo cáncer femenino más común en Brasil. El virus del papiloma humano (VPH) es la causa necesaria para su desarrollo. La vacuna se presenta como un arma contra la infección por VPH y, por tanto, contra el cáncer. Pero hay más de 100 genotipos diferentes de VPH, que se dividen en bajo riesgo y de alto riesgo de acuerdo con el potencial oncogénico. Analizar los aspectos epidemiológicos y biomoleculares de la infección por el VPH en la mucosa genital de la mujer cimarrones, la verificación de la citología asociación y hallazgos de biología molecular y tomando nota de la frecuen-cia de este virus del papiloma de la población y sus tipos, para evaluar la aplicabilidad de la vacuna en la población de estudio. La populación de estudio fue de 101 mujeres pertenecientes a la comunidad marrón de Juçatuba en el Estado de Maranhão. Se recogieron muestras de mucosa genital presentados para buscar la presencia de VPH por PCR anidada. Las muestras positivas se secuenciaron con el propósito de determinación del genotipo viral . RESULTADOS: En una población predominante de las mujeres en edad fértil, con una pareja estable, y el bajo nivel de la educación, se encontró que 10 muestras fueron positivas para el VPH cervical, 7 siendo positivo para los tipos de alto riesgo. A través de la presencia de tipos virales de alta tumorigenicidad, hay una necesidad de aplicar prácticas de gestión para reducir el riesgo de desarrollar cáncer de la cérvix.PALABRAS CLAVE: Virus del papiloma humano. Cáncer. Cérvix. Reacción en Cadena de la Polimerasa

Knowledge and perceptions on toxoplasmosis among pregnant women and nurses who provide prenatal in primary care

Background Toxoplasmosis is an infection that affects almost a third of the world population. In adults, it is often asymptomatic, although having important manifestation in children- infected by placental transmission. The prenatal is an important moment, requiring actions in women’s care during pregnancy, in order to prevent diseases that could compromise the mother and the child’s life. Methods This is a descriptive study of qualitative approach aimed to understand the perception of nurses and pregnant women about toxoplasmosis during primary – prenatal care. The study was conducted in five selected primary health care units, in the municipality of São Luis - MA. The sample consisted of 15 nurses working in nursing consultation and 15 pregnant women attended in prenatal care. For data collection, a semi-structured questionnaire and an interview guide covering issues related to knowledge and conduct on toxoplasmosis were used. For analysis, the content analysis technique was used. Results The answers were transcribed, organized and grouped thematically, where the following categories emerged: knowledge about examination requests; knowledge about toxoplasmosis; guidance during prenatal consultation; knowledge of nurses about the avidity test; procedures and guidelines on reagent cases. Pregnant women showed unawareness about toxoplasmosis and its effects. Nurses, although having basic knowledge about the subject, showed little applicability regarding pregnant women’s guidance. Conclusion The nurse plays an important role in educational activities regarding pregnant women, contributing to the quality of prenatal care. Pregnant women were shown to have some knowledge about toxoplasmosis, although they said they did not have assurance about prevention

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease