HPV-based cervical cancer screening in Nicaragua: from testing to treatment.

Background: In Nicaragua, cervical cancer is the leading cause of cancer death among women. Human papillomavirus (HPV) testing, primarily using self-sampling, was introduced between 2014 and 2018 in three provinces. We analyzed data from the HPV screening program with the goal of describing key characteristics including reach, HPV prevalence, triage and treatment, and factors associated with follow-up completion.

Predictors of diffuse alveolar damage in patients with acute respiratory distress syndrome: a retrospective analysis of clinical autopsies.

Background: Although diffuse alveolar damage (DAD) is considered the typical histological pattern of acute respiratory distress syndrome (ARDS), only half of patients exhibit this morphological hallmark. Patients with DAD may have higher mortality than those without DAD. Therefore, we aimed to identify the factors associated with DAD in patients with ARDS.

Increased risk of malignancy for non-atypical urothelial cell groups compared to negative cytology in voided urine. Morphological changes with LBC.

Liquid-based cytology (LBC) has recently become the preferred method for urine cytology analysis, but differences with conventional cytology (CC) have been observed. The purpose of this study is to analyze these differences and the clinical relevance of non-atypical urothelial cell groups (UCG) in voided urine specimens. Reporting terminology is discussed.

Chronology of histological lesions in acute respiratory distress syndrome with diffuse alveolar damage: a prospective cohort study of clinical autopsies.

Background: Diffuse alveolar damage is the histological hallmark of acute respiratory distress syndrome (ARDS). However, the chronology of histological lesions is not well established. We aimed to determine the time to onset of exudative or proliferative changes and end-stage fibrosis in ARDS.

Comparison of the Berlin definition for acute respiratory distress syndrome with autopsy.

Rationale: A revised definition of clinical criteria for acute respiratory distress syndrome (ARDS), the Berlin definition, was recently established to classify patients according to their severity.

Objective: To evaluate the accuracy of these clinical criteria using diffuse alveolar damage (DAD) at autopsy as the reference standard.

Methods: All patients who died and had a clinical autopsy in our intensive care unit over a 20-year period (1991-2010) were included.

Risk factors for second primary tumours in breast cancer survivors.

Breast cancer (BC) survivors have an increased risk of developing second primary cancer (SPC). The aim of this study was to detect and compare SPC predictors linked to the host, the first BC and its treatment. Two hundred and seventeen patients with a nonbreast SPC and 465 matched controls, nested in the cohort of BC patients diagnosed in a Spanish region between 1975 and 2003, were involved in a case-control study.

Cytopathology of a primary follicular dendritic cell sarcoma of the liver of the inflammatory pseudotumor-like type.

Follicular dendritic cell (FDC) sarcoma is an exceedingly uncommon tumor of lymph nodes and extranodal tissues. The inflammatory pseudotumor (IPT)-like variant of FDC sarcoma of intraabdominal location is considered a separate entity, with different clinical and pathological features than those of the classic FDC tumor. There have been only 12 cytological reports of FDC sarcomas in the literature.

[Thrombotic occlusion of an abdominal aortic aneurysm].

The clinical condition of a 78 years old male is reported, with a thrombotic occlusion of an abdominal aortic aneurysm, expressed by the acute onset of intermittent claudication of both legs, two months previously to the observation. On physical examination a pulsatile mass was observed in the abdomen, with no expansion, with 7 cms of diameter; femoral pulses were absent. CT-scans confirmed the clinical diagnosis, revealing the presence of a recent thrombus occluding the aortic lumen.

[Surgical management of a chronic post traumatic dissection of the abdominal aorta].

The clinical case of a 34 years old male is reported, who was referred to our clinic complaining of disabling claudication of the lower extremities. No risk factors for atherosclerotic disease could be identified. Six years previously he sustained a severe automobile crush injury, resulting in cranio-encephalic and abdominal trauma, and fractures of the left knee and both legs.

[Traumatic vasculo-orthopedic combined lesions: 18-years retrospective evaluation of epidemiology and risks factors for amputation].

This study was undertaken to assess retrospectively the epidemiology and risk factors for amputation of combined vasculo-orthopaedic traumatic lesions, during a 18-year period, from March 1987 to May 2005, comprising the review of the clinical charts of 149 patients. The series includes a predominance of male patients (84%) with an average age of 34 years. Eighty-five per cent of the lesions resulted from traffic accidents (49% velocipedes, 39% automobiles, 12% trampling), 10% were consequence of falls and 5% resulted from agriculture activities.

[Thoracic outlet syndrome].

The thoracic outlet syndrome is a polymorphic clinical entity, whose nature is essentially anatomic, caused by the chronic compression of the neurovascular structures that are originated in the chest or neck and course to the upper extremity. According to the most affected structure, they can be classified as neurologic, arterial or venous syndromes, that may cause discomfort, pain and disability, sometimes definite and irreparable. Thoracic outlet syndrome are often difficult to recognize in clinical practice and it is important to emphasize some peculiar symptoms or signs that each syndrome may present, through specific maneuvers or adequate complementary studies.

A comparison of learning algorithms for Bayesian networks: a case study based on data from an emergency medical service.

Due to the uncertainty of many of the factors that influence the performance of an emergency medical service, we propose using Bayesian networks to model this kind of system. We use different algorithms for learning Bayesian networks in order to build several models, from the hospital manager's point of view, and apply them to the specific case of the emergency service of a Spanish hospital. This first study of a real problem includes preliminary data processing, the experiments carried out, the comparison of the algorithms from different perspectives, and some potential uses of Bayesian networks for management problems in the health service.