Assessment of cytology laboratory performance within the Brazilian Unified Health System

Objective: To assess the profile of cytopathology laboratories which render services to the Brazilian Unified Health System (SUS), and to create quality indicators for cytopathological exams. Methods: A postal survey of 1,028 laboratories that render services to the SUS and participated in the Cervix Cancer Information System (SISCOLO) in the year 2002. Information concerning cytopathological exams from the SISCOLO, available on the Internet (www.datasus.gov.br) for the same year was analyzed. Results: Out of the 1,028 laboratories which reported results of cervix-vaginal cytopathology exams to DATASUS in 2002, 739 answered the survey (71.9%). From these, 18.9% processed 15,000 exams or more in that year; 70.2% were private; 50.2% were vinculated to municipal administrations; and 48.7% performed histopathological exams. In 74.8% of cases, a physician was in charge of the technical responsibility. Out of 10,505.773 exams included in the SISCOLO in 2002, 1.66% of samples were considered unsatisfactory. The following alterations were detected: atypical squamous cells of undetermined significance (ASCUS), 1.26%; human papillomavirus (HPV), 0.93%; cervical intraepithelial neoplasia I (CIN I), 0.84%, CIN II = 0.20%, CIN III = 0.17%; invasive squamous carcinoma, 0.05%, atypical glandular cells of undetermined significance (AGUS), 0.14%, in situ adenocarcinoma, 0.01; and invasive adenocarcinoma, 0.01%. Conclusion: This study made it possible to assess the profile of cytopathology laboratories, which rendered services to the SUS in 2002, and the SISCOLO proved to be an excellent tool to assess the quality of cytopathological exams performed in Brazil.Conhecer o perfil dos laboratórios de citopatologia que prestam serviços ao Sistema Único de Saúde (SUS) e elaborar indicadores de qualidade dos exames citopatológicos. MÉTODOS: Foi realizada uma enquete postal dirigida aos 1.028 laboratórios que prestaram serviço ao SUS e participaram do Sistema de Informação do Câncer do Colo do Útero (SISCOLO) em 2002. As informações referentes aos exames citopatológicos constantes do SISCOLO e disponibilizadas na página do Departamento de Informática do Sistema Único de Saúde (DATASUS) na Internet (www.datasus.gov.br) para o mesmo ano foram analisadas. RESULTADOS: Dos 1.028 laboratórios que informaram os resultados dos exames citopatológicos cervicovaginais ao DATASUS, em 2002, 739 responderam à enquete (71,9%). Desses, 18,9% processaram 15 mil exames ou mais no ano; 70,2% eram privados; 50,2% encontravam-se vinculados à gestão municipal; e 48,7% realizavam exames histopatológicos. Em 74,8% dos casos o responsável técnico pelo laboratório era médico. Dos 10.505.773 exames incluídos no SISCOLO em 2002, uma parcela das amostras (1,66%) foi considerada insatisfatória. As alterações detectadas foram: células escamosas atípicas de significado indeterminado (ASCUS), 1,26%; papilomavírus humano (HPV), 0,93%; neoplasia intra-epitelial cervical I (NIC I), 0,84%; NIC II, 0,20%; NIC III, 0,17%; carcinoma escamoso invasivo, 0,05%; células glandulares atípicas de significado indeterminado (AGUS), 0,14%; adenocarcinoma in situ, 0,01; e adenocarcinoma invasivo, 0,01%. CONCLUSÃO: Este estudo permitiu avaliar o perfil dos laboratórios de citopatologia que prestaram serviço ao SUS em 2002, e o SISCOLO se mostrou um excelente instrumento para o monitoramento da qualidade dos exames citopatológicos realizados no país432103114To assess the profile of cytopathology laboratories which render services to the Brazilian Unified Health System (SUS), and to create quality indicators for cytopathological exams. Methods: A postal survey of 1,028 laboratories that render services to the SUS and participated in the Cervix Cancer Information System (SISCOLO) in the year 2002. Information concerning cytopathological exams from the SISCOLO, available on the Internet (www.datasus.gov.br) for the same year was analyzed. Results: Out of the 1,028 laboratories which reported results of cervix-vaginal cytopathology exams to DATASUS in 2002, 739 answered the survey (71.9%). From these, 18.9% processed 15,000 exams or more in that year; 70.2% were private; 50.2% were vinculated to municipal administrations; and 48.7% performed histopathological exams. In 74.8% of cases, a physician was in charge of the technical responsibility. Out of 10,505.773 exams included in the SISCOLO in 2002, 1.66% of samples were considered unsatisfactory. The following alterations were detected: atypical squamous cells of undetermined significance (ASCUS), 1.26%; human papillomavirus (HPV), 0.93%; cervical intraepithelial neoplasia I (CIN I), 0.84%, CIN II = 0.20%, CIN III = 0.17%; invasive squamous carcinoma, 0.05%, atypical glandular cells of undetermined significance (AGUS), 0.14%, in situ adenocarcinoma, 0.01; and invasive adenocarcinoma, 0.01%. Conclusion: This study made it possible to assess the profile of cytopathology laboratories, which rendered services to the SUS in 2002, and the SISCOLO proved to be an excellent tool to assess the quality of cytopathological exams performed in Brazi

Gout, allopurinol intake and clinical outcomes in the hospitalized multimorbid elderly.

Increased serum uric acid has been considered a cardiovascular risk factor but no study has assessed its relation with hospital mortality or length of stay. On the basis of data obtained from a prospective registry, the prevalence of gout/hyperuricemia and its association with these and other clinical parameters was evaluated in an Italian cohort of elderly patients acutely admitted to internal medicine or geriatric wards