ACTIVIDADES DE TAMIZACION Y MANTEIMIENTO DE LA SALUD MAS FRECUENTES

Hipertensión Arterial:  USPSTF Recomienda toma PA en ≥18 años. La periodicidad se deja a criterio médico (los expertos recomiendan cada 2 años si la PAS es <120 y la PAD <80 y con mas frecuencia si se superan esas cifras. Recomienda consejos para instaurar una dieta sana y potenciar el ejercicio físico como forma de prevención. Las evidencias son insuficientes para recomendar o evitar la medida de la TA de forma rutinaria en niños y adolescentes.

Hipercolesterolemia: USPSTF Recomienda controles a partir de los 35 años en varones y 45 en mujeres. Si hay otros factores de riesgo cardiovascular, recomienda iniciar los controles entre los 20-35 años en varones y 20-45 años en mujeres. Se recomienda medir el colesterol total y HDL, no hay evidencias suficientes para incluir los triglicéridos El intervalo del control sería cada 5 años en ausencia de otros factores de riesgo cardiovascular y niveles elevados de colesterol. No hay una edad para finalizar los controles, aunque a partir de los 65 años estos serían menos importantes, dado que las cifras de colesterol tienden a estabilizarse a partir de esa edad. No hay evidencias para recomendar el cribado en niños y adolescentes.

Tabaquismo:  CONSEJERIA. USPSTF Recomienda que los médicos interroguen sobre el hábito de fumar en todos los adultos, aconsejando y ayudando a su abandono. Investigar el hábito de tabaco en embarazadas recomendando su abandono. Las evidencias son insuficientes para recomendar o no la investigación del tabaquismo, así como, las intervenciones para prevenir su habito entre niños y adolescentes.

Abuso de alcohol: USPSTF Recomienda investigar en adultos y mujeres embarazadas sobre el abuso en la ingesta de alcohol y aconsejar su reducción, esta evidencias son insuficientes para realizarlas o no en niños y adolescentes.

Diabetes: USPSTF Recomienda el cribado de diabetes en adultos asintomáticos con Tensión arterial (tratada o no) igual o superior a 135/85 No hay datos para recomendar o no el cribado en adultos asintomáticos con TA inferior a las cifras señaladas ni para la detección de diabetes gestacional.

Cáncer de mama: USPSTF Recomienda la mamografía bienal para las mujeres de 50-74 años. La decisión de comenzar la mamografía de cribado antes de los 50 debe ser individual y tener en cuenta los riesgos y beneficios. No encuentra evidencias para recomendar mamografía de cribado después de los 75 años. No recomienda la autoexploración de la mama y no encuentra pruebas suficientes para recomendar la exploración clínica de la mama.

Cáncer de cérvix: USPSTF recomienda comenzar con el Test a los 3 años del inicio de las relaciones sexuales o a los 21 años y hasta los 65 con periodicidad de 3 años (según perfil de riesgo) Suspender test desde los 65 si los previos fueron negativos y no hay factores de riesgo para desarrollar cáncer de cérvix. Evitar test en mujeres con histerectomía total por causa benigna. No hay evidencias para recomendar de forma rutinaria el test para el virus de papiloma humano.

Cáncer de endometrio: BIOPSIA. ACS Recomienda que las mujeres que tienen un riesgo elevado (edad avanzada, toma de estrógenos en la menopausia, menopausia tardía, terapia con tanoxifeno, obesidad, HTA, diabetes, infertilidad….) se les debe informar de su riesgo, así como recomendarles que consulten a su médico en cuanto se presente un sangrado uterino anormal. Las mujeres con cáncer de colon hereditario no polipoideo o con riesgo de ello, se deben someter a un examen anual para cáncer del endometrio mediante biopsia a partir de los 35 años.

Menopausia: USPSTF, ACOG, AHA, CTF Y NORH AMERICAN MENOPAUSE SOCIETY Recomienda no usar la terapia hormonal para la prevención de enfermedades crónicas en mujeres posmenopáusicas.

Osteoporosis posmenopausica: USPSTF Desaconseja el cribado en < de 60 años, pero si lo aconseja en >65, entre los 60-65 podría estar indicado si la mujer presenta factores de riesgo de osteoporosis.

Cáncer colorrectal: USPSTF Recomienda el cribado mediante la prueba de SOH, la sigmoidoscopía o colonoscopia en adultos a partir de los 50 años y hasta los 75. Entre los 76 y 85 la decisión se tomará de forma individual y según factores de riesgo, pues los beneficios a esta edad son pequeños. No se recomienda cribado después del os 85. Estas recomendaciones no son válidas para pacientes con factores de riesgo. El intervalo de pruebas sería para cada prueba: -SOH anual. -Sigmoidoscopia cada 5 años combinada con SOH cada 3 años. -Colonoscopia cada 10 años.

Cáncer de próstata: USPSTF El cribado rutinario no es aconsejable. Los pacientes que lo solicitan deben ser informados acerca del beneficio y perjuicios de la detección precoz así como del tratamiento. Si se lleva a cabo lo mejor es con tacto rectal y marcadores tumorales y limitarse a personas con expectativa de vida >10 años. No hay información para determinar un intervalo.

Aneurisma Aorta Abdominal: Hombres entre 65 y 75 años que hallan fumado. una sola vez y con ecografia.


AQUI ESTA EL TEXTO ORIGINAL DE LOS SERVICIOS PREVENTIVOS DE LOS ESTADOS UNIDOS

USPSTF A and B Recommendations

The following is a list of preventive services that have a rating of A or B from the U.S. Preventive Services Task Force that are relevant for implementing the Affordable Care Act.

Topic
Description
Grade
Date in Effect

Abdominal aortic aneurysm screening: men
The USPSTF recommends one-time screening for abdominal aortic aneurysm by ultrasonography in men aged 65 to 75 who have ever smoked.
B
February 2005

Alcohol misuse counseling
The USPSTF recommends screening and behavioral counseling interventions to reduce alcohol misuse by adults, including pregnant women, in primary care settings.
B
April 2004

Anemia screening: pregnant women
The USPSTF recommends routine screening for iron deficiency anemia in asymptomatic pregnant women.
B
May 2006

Aspirin to prevent CVD: men
The USPSTF recommends the use of aspirin for men age 45 to 79 years when the potential benefit due to a reduction in myocardial infarctions outweighs the potential harm due to an increase in gastrointestinal hemorrhage.
A
March 2009

Aspirin to prevent CVD: women
The USPSTF recommends the use of aspirin for women age 55 to 79 years when the potential benefit of a reduction in ischemic strokes outweighs the potential harm of an increase in gastrointestinal hemorrhage.
A
March 2009

Bacteriuria screening: pregnant women
The USPSTF recommends screening for asymptomatic bacteriuria with urine culture for pregnant women at 12 to 16 weeks' gestation or at the first prenatal visit, if later. 
A
July 2008

Blood pressure screening in adults
The USPSTF recommends screening for high blood pressure in adults aged 18 and older.
A
December 2007

BRCA screening, counseling about
The USPSTF recommends that women whose family history is associated with an increased risk for deleterious mutations in BRCA1 or BRCA2 genes be referred for genetic counseling and evaluation for BRCA testing.
B
September 2005

Breast cancer preventive medication
The USPSTF recommends that clinicians discuss chemoprevention with women at high risk for breast cancer and at low risk for adverse effects of chemoprevention. Clinicians should inform patients of the potential benefits and harms of chemoprevention.
B
July 2002

Breast cancer screening
The USPSTF recommends screening mammography for women, with or without clinical breast examination, every 1-2 years for women aged 40 and older.
B
September 2002*

Breastfeeding counseling
The USPSTF recommends interventions during pregnancy and after birth to promote and support breastfeeding.
B
October 2008

Cervical cancer screening
The USPSTF strongly recommends screening for cervical cancer in women who have been sexually active and have a cervix.
A
January 2003

Chlamydial infection screening: non-pregnant women
The USPSTF recommends screening for chlamydial infection for all sexually active non-pregnant young women aged 24 and younger and for older non-pregnant women who are at increased risk.
A
June 2007

Chlamydial infection screening: pregnant women
The USPSTF recommends screening for chlamydial infection for all pregnant women aged 24 and younger and for older pregnant women who are at increased risk.
B
June 2007

Cholesterol abnormalities screening: men 35 and older
The USPSTF strongly recommends screening men aged 35 and older for lipid disorders.
A
June 2008

Cholesterol abnormalities screening: men younger than 35
The USPSTF recommends screening men aged 20 to 35 for lipid disorders if they are at increased risk for coronary heart disease.
B
June 2008

Cholesterol abnormalities screening: women 45 and older
The USPSTF strongly recommends screening women aged 45 and older for lipid disorders if they are at increased risk for coronary heart disease.
A
June 2008

Cholesterol abnormalities screening: women younger than 45
The USPSTF recommends screening women aged 20 to 45 for lipid disorders if they are at increased risk for coronary heart disease.
B
June 2008

Colorectal cancer screening
The USPSTF recommends screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonoscopy, in adults, beginning at age 50 years and continuing until age 75 years. The risks and benefits of these screening methods vary.
A
October 2008

Dental caries chemoprevention: preschool children
The USPSTF recommends that primary care clinicians prescribe oral fluoride supplementation at currently recommended doses to preschool children older than 6 months of age whose primary water source is deficient in fluoride.
B
April 2004

Depression screening: adolescents
The USPSTF recommends screening of adolescents (12-18 years of age) for major depressive disorder when systems are in place to ensure accurate diagnosis, psychotherapy (cognitive-behavioral or interpersonal), and follow-up.
B
March 2009

Depression screening: adults
The USPSTF recommends screening adults for depression when staff-assisted depression care supports are in place to assure accurate diagnosis, effective treatment, and follow-up.
B
December 2009

Diabetes screening
The USPSTF recommends screening for type 2 diabetes in asymptomatic adults with sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg.
B
June 2008

Folic acid supplementation
The USPSTF recommends that all women planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg (400 to 800 μg) of folic acid.
A
May 2009

Gonorrhea prophylactic medication: newborns
The USPSTF strongly recommends prophylactic ocular topical medication for all newborns against gonococcal ophthalmia neonatorum.
A
May 2005

Gonorrhea screening: women
The USPSTF recommends that clinicians screen all sexually active women, including those who are pregnant, for gonorrhea infection if they are at increased risk for infection (that is, if they are young or have other individual or population risk factors).
B
May 2005

Healthy diet counseling
The USPSTF recommends intensive behavioral dietary counseling for adult patients with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease. Intensive counseling can be delivered by primary care clinicians or by referral to other specialists, such as nutritionists or dietitians.
B
January 2003

Hearing loss screening: newborns
The USPSTF recommends screening for hearing loss in all newborn infants.
B
July 2008

Hemoglobinopathies screening: newborns
The USPSTF recommends screening for sickle cell disease in newborns.
A
September 2007

Hepatitis B screening: pregnant women
The USPSTF strongly recommends screening for hepatitis B virus infection in pregnant women at their first prenatal visit.
A
June 2009

HIV screening
The USPSTF strongly recommends that clinicians screen for human immunodeficiency virus (HIV) all adolescents and adults at increased risk for HIV infection.
A
July 2005

Hypothyrodism screening: newborns
The USPSTF recommends screening for congenital hypothyroidism in newborns.
A
March 2008

Iron supplementation in children
The USPSTF recommends routine iron supplementation for asymptomatic children aged 6 to 12 months who are at increased risk for iron deficiency anemia.
B
May 2006

Obesity screening and counseling: adults
The USPSTF recommends that clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults.
B
December 2003

Obesity screening and counseling: children
The USPSTF recommends that clinicians screen children aged 6 years and older for obesity and offer them or refer them to comprehensive, intensive behavioral interventions to promote improvement in weight status.
B
January 2010

Osteoporosis screening: women
The USPSTF recommends that women aged 65 and older be screened routinely for osteoporosis. The USPSTF recommends that routine screening begin at age 60 for women at increased risk for osteoporotic fractures.
B
September 2002

PKU screening: newborns
The USPSTF recommends screening for phenylketonuria (PKU) in newborns.
A
March 2008

Rh incompatibility screening: first pregnancy visit
The USPSTF strongly recommends Rh (D) blood typing and antibody testing for all pregnant women during their first visit for pregnancy-related care.
A
February 2004

Rh incompatibility screening: 24-28 weeks gestation
The USPSTF recommends repeated Rh (D) antibody testing for all unsensitized Rh (D)-negative women at 24-28 weeks' gestation, unless the
B
February 2004

biological father is known to be Rh (D)-negative.
STIs counseling
The USPSTF recommends high-intensity behavioral counseling to prevent sexually transmitted infections (STIs) for all sexually active adolescents and for adults at increased risk for STIs.
B
October 2008

Tobacco use counseling and interventions: non-pregnant adults
The USPSTF recommends that clinicians ask all adults about tobacco use and provide tobacco cessation interventions for those who use tobacco products.
A
April 2009

Tobacco use counseling: pregnant women
The USPSTF recommends that clinicians ask all pregnant women about tobacco use and provide augmented, pregnancy-tailored counseling to those who smoke.
A
April 2009

Syphilis screening: non-pregnant persons
The USPSTF strongly recommends that clinicians screen persons at increased risk for syphilis infection.
A
July 2004

Syphilis screening: pregnant women
The USPSTF recommends that clinicians screen all pregnant women for syphilis infection.
A
May 2009

Visual acuity screening in children
The USPSTF recommends screening to detect amblyopia, strabismus, and defects in visual acuity in children younger than age 5 years.
B
May 2004

* The Department of Health and Human Services, in implementing the Affordable Care Act under the standard it sets out in revised Section 2713(a)(5) of the Public Health Service Act, utilizes the 2002 recommendation on breast cancer screening of the U.S. Preventive Services Task Force.

Current as of August 2010

USPSTF: us preventive services task force