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Pyogenic cryptogenic liver abscesses (HA) have been called precursors of colorectal cancer (CRC). The importance of the relationship between these pathologies resides in the diagnosis and early treatment of cancer, so the investigation of the underlying causes of the development of cryptogenic liver abscesses is required. The objective of this review was to expose the studies that show the prevalence of AH as a preceding sign of CRC, from which a range of 1.9 to 13.9% was identified, according to studies of Asian populations. The location, number, and symptoms of AH did not show a specific relationship with the intestinal pathology, while diabetes mellitus and the presence of klebsiella pneumoniae were the incident factors in most CRC cases. One of the mechanisms identified was bacterial translocation from the altered intestinal wall, the pathogenesis of the microorganisms involved, and immunocompromised states. Together, these factors determine the development of liver abscesses as precursors of colonic neoplastic processes. [ABSTRACT FROM AUTHOR]

Antecedentes A partir del 2014 en Colombia se incorporó la Tamización primaria con prueba de Virus del Papiloma Humano (VPH) desde los 30 hasta los 65 años, cuando la prueba es positiva se hace triage con citología para remisión a colposcopia. Actualmente se discute la conveniencia de iniciar la tamización con prueba de ADN de VPH a partir de los 25 años. De esta manera, el objetivo de esta evaluación de tecnologías sanitarias es analizar la evidencia disponible en torno a la seguridad, efectividad, costoefectividad, valores y preferencias, dilemas éticos y aspectos relacionados con la implementación para el contexto colombiano de la prueba ADN-VPH como estrategia de tamización cervical en mujeres menores de 30 años. Dominios a evaluar Eficacia clínica y seguridad 1. Tasa acumulada de neoplasia intraepitelial cervical (NIC) grado 2 o más avanzado luego de 2 rondas de tamización. 2. Tasas acumuladas de cáncer invasor de cérvix luego de 2 rondas de tamización. 3. Seguridad: remisión a colposcopia. Costo-efectividad Costo efectividad para Colombia. Otros dominios considerados Aspectos éticos asociados a la tamización cervical en mujeres menores de 30 años. Aspectos organizacionales y del individuo. Barreras y facilitadores relacionados con la implementación en el contexto colombiano de la tamización cervical en mujeres menores de 30 años. Métodos Evaluación de efectividad y seguridad clínicas Se realizó una búsqueda sistemática de la literatura en MEDLINE, Embase y CENTRAL de revisiones sistemáticas y ensayos clínicos. Se calificó el cuerpo de la evidencia con la aproximación GRADE. Posteriormente, se convocó a un grupo interdisciplinario a una mesa de trabajo en donde se presentó la evidencia recuperada, dando paso a la discusión y a la construcción de las conclusiones, siguiendo los lineamientos de un consenso formal acorde a la metodología RAND/UCLA. Estudio económico Se hizo una búsqueda sistemática de la literatura de estudios que hubieran evaluado el costo-efectividad para Colombia. Resultados De 7.659 referencias recuperadas se incluyeron 8 estudios. Resultados clínicos Se realizó un análisis integrativo de 5 ensayos clínicos aleatorizados que cumplieron con los citerios de inclusión. Cuando se compara frente a la citología, la tamización primaria con ADN-VPH en mujeres menores de 30 años, podría asociarse con una mayor frecuencia de detección de lesiones NIC2+ durante la primera ronda de cribado (RR: 1.57; IC: 1,20 a 2,04; certeza en la evidencia baja), con una menor incidencia de NIC2+ (RR:0,67; IC: 0,48 a 0,92; certeza en la evidencia baja) y se asocia con una menor frecuencia de carcinoma invasor al término del seguimiento (RR: 0,19; IC: 0,07 a 0,53; certeza en la evidencia alta). Resultados económicos Desde el punto de vista económico, la alternativa de ADN-VPH y triage con citología desde los 25 años quizás representa la alternativa más costo-efectiva para Colombia (razón costo-efectividad incremental $8.820.980 COP año 2013). Otras implicaciones Dos estudios sugieren que las barreras de implementación, atribuibles a circunstancias de intermediación, de orden público y de carácter geográfico, podrían ser solventadas por nuevas tecnologías o estrategias de cribado. Es importante considerar alternativas de forma de administración y de prestación de servicios para solventar algunas barreras de aceptabilidad y acceso. Todo programa de tamización cervical debe contemplar los principios éticos de no maleficencia, beneficencia, autonomía y equidad. Futuros estudios deben enfocarse en analizar nuevas tecnologías de cribado con énfasis en población menor de 30 años. Conclusiones El uso de la prueba ADN-VPH como estrategia de tamización en mujeres menores de 30 años es una intervención probablemente efectiva y costoefectiva para Colombia. Futuros estudios deben enfocarse en analizar nuevas tecnologías de cribado con énfasis en población menor de 30 años.

Background Primary screening with Human Papilloma Virus (HPV) testing was introduced in Colombia in 2014 for individuals between 30 and 65 years of age. When the result is positive, cytology triage is performed for colposcopy referral. The convenience of initiating HPV-DNA testing for screening at 25 years of age is currently a subject of discussion. Therefore, the objective of this health technology assessment (HTA) is to analyze the available evidence regarding safety, efficacy, cost-effectiveness, values and preferences, ethical dilemmas and considerations pertaining to the implementation of the HPV-DNA test as a cervical screening strategy in women under 30 years of age in the Colombian context. Domains to be assessed Clinical efficacy and safety 1. Cumulative rate of cervical intraepithelial neoplasia (CIN) grade 2 or high-er after 2 screening rounds. 2. Cumulative rates of invasive cancer of the uterine cervix after 2 screening rounds. 3. Safety: referral to colposcopy. Cost-effectiveness Cost-effectiveness for Colombia. Other domains considered Ethical considerations associated with cervical screening in women under 30 years of age. Organizational and individual considerations. Barriers and facilitators pertaining to the implementation of cervical screening in women under 30 years of age in the Colombian context. Methods Clinical efficacy and safety assessment A systematic literature search of systematic reviews and clinical trials was conducted in MEDLINE, Embase and CENTR AL. The body of evidence was rated using the GRADE approach. An interdisciplinary team was then convened to create a working group to review the retrieved evidence. This led to the discussion and construction of the conclusions following the guidelines of a formal consensus in accordance with the RAND/UCLA methodology. Economic study Systematic literature research of studies that had assessed cost-effectiveness for Colombia. Results Out of the 7,659 references retrieved, 8 studies were included. Clinical outcomes An integrative analysis of 5 randomized clinical trials that met the inclusion critera was performed. Compared with cytology, primary HPV-DNA testing in women under 30 years of age could be associated with a lower frequency of CIN2+ lesions during the first screening round (RR: 1.57; CI 95 %: 1.20 to 2.04; low evidence certainty), and a lower incidence of CIN2+ (RR: 0.67; CI 95 %: 0.48 to 0.92; low evidence certainty). Moreover, it is associated with a lower frequency of invasive carcinoma at the end of follow-up (RR: 0.19; CI 95 %: 0.07 to 0.53; high evidence certainty). Economic results From the financial point of view, the use of HPV- DNA testing plus cytology-based triage starting at 25 years of age is perhaps the most cost-effective option for Colombia (incremental cost-effectiveness ratio, COP 8,820,980 in 2013). Other implications Two studies suggest that barriers to implementation attributable to intermediation, public unrest and geographic considerations could be overcome with the use of new screening technologies or strategies. It is important to consider administration and service provision alternatives in order to overcome some acceptability and access barriers. Any cervical screening program must take into consideration ethical principles of nonmaleficence, beneficence, autonomy and equity. Future studies should focus on analyzing new screening techniques with emphasis on the population under 30 years of age. Conclusions The use of HPV-DNA testing as a screening strategy in women under 30 years of age is a potentially efficacious and cost-effective intervention for Colombia. Future studies should focus on analyzing new screening technologies, with emphasis on the population under 30 years of age. [ABSTRACT FROM AUTHOR]

Objective: To identify factors that influence the prevention of cervical cancer in quilombola women. Methodo: It is an ethnographic study, the study population was composed of women attending the Basic Health Unit of this community. For the data collection were used: form, observation and health education workshops. The analysis consisted of reading and re-reading the interviews, systematizing them, classifying the units of significance and then categorizing them. Results: The non-adherence of the women was higher in black, elderly and low schooling. The shame and fear of exposure were other points, which hinder the performance of the preventive examination. Conclusion: It is important to emphasize that health education is a factor that can contribute to these women know more about the preventive exam and can acquire information, clarify doubts and prevent cervical cancer. [ABSTRACT FROM AUTHOR]

Background: Oral cancer is one of the most aggressive diseases with a high likelihood of metastases; it is undetectable during initial stages with low medical visits, making it difficult to provide conservative treatment. Several techniques such as microscopy (using for instance immunofluorescence) and immunohistochemistry make early diagnosis and cancer detection easier. In addition, advances in nanomedicine offer new tools to detect molecular changes (biological markers/biomarkers) in cells during a malignant process. Purpose: Describe molecular and clinic characteristics of premalignant lesions and oral cancer, as well as techniques involving nanotechnology (lab-on-a-chip devices, nanosensors, etc.) as effective methods for early cancer diagnosis. Methods: A literature review on nanotechnology and oral cancer using databases such as Science Direct and PubMed was carried out; data from each article were summarized, grouped, and described. Results: 46 articles were selected and grouped according to their main topic; data were compiled in an Excel 2007 spreadsheet. Conclusions: The literature reviewed suggests that tools using nanotechnology can be a useful and a quick alternative, though expensive, to detect specific biomarkers that are present in early stages of oral cancer. It is important to point out that their clinical use in countries like Colombia is still limited by factors like the lack of resources allocated for research and the little research carried out on this subject. [ABSTRACT FROM AUTHOR]