Histeroscopía quirúrgica: experiencia, resultados y complicaciones según clasificación Clavien-Dindo / Surgical hysteroscopy: experience, results and complications according to Clavien-Dindo classification

OBJETIVO: Describir y analizar la experiencia clínica, resultados y complicaciones según Clavien-Dindo de las histeroscopías quirúrgicas realizadas en pabellón. MÉTODOS: Estudio descriptivo retrospectivo de las histeroscopías quirúrgicas realizadas entre el 1 de enero de 2012 y 1 de enero de 2018 en el Hospital Clínico de la Universidad de Chile. RESULTADOS: Hubo 613 histeroscopías quirúrgicas en el período analizado, de las cuales 593 cumplieron con los requisitos para incluirse en este estudio. Las indicaciones para realizar el procedimiento fueron: pólipo endometrial (56,3%), miomas uterinos (22,1%), sangrado uterino anormal (4,3%) y otras (17,7%). Hubo un 89,2% de concordancia entre el diagnóstico intraoperatorio y el estudio histopatológico. Se pesquisaron 11 hiperplasias endometriales sin atipías, 3 con atipías y 10 neoplasias malignas. Cabe destacar que, del total de pólipos resecados, hubo 8 casos (2,5%) con potencial malignidad (atipías o neoplasia maligna). Según la clasificación Clavien Dindo, hubo 22 complicaciones intraoperatorias (3,7%) grado I o II, cuyo diagnóstico fue realizado en el acto quirúrgico. No hubo complicaciones grado III o más (severas, con reintervención). CONCLUSIÓN: La tasa de éxito, correlación histeroscópica - anatomopatológica final y complicaciones fue similar a lo publicado en la literatura disponible. El diagnóstico intraoperatorio de la lesión y su reparación en el mismo acto quirúrgico, disminuye el riesgo de morbimortalidad de las pacientes, haciéndolo similar al de una paciente sin complicación. Utilizar la clasificación Clavien Dindo para evaluar las complicaciones nos permitirá en adelante, objetivar, mejorar aspectos del procedimiento quirúrgico y plantear estrategias de prevención y manejo de dichos eventos adversos.

OBJECTIVE: To describe and analyze the clinical experience, results and complications according to Clavien-Dindo of surgical hysteroscopies performed in the ward. METHODS: Retrospective descriptive study of surgical hysteroscopies performed between January 1, 2012 and January 1, 2018 at the Hospital Clinico of the University of Chile. RESULTS: There were 613 surgical hysteroscopies in the analyzed period of which 593 fulfilled the requirements to be included in this study. The indications to perform the procedure were: endometrial polyp (56.3%), uterine fibroids (22.1%), abnormal uterine bleeding (4.3%) and others (17.7%). There was an 89.2% agreement between the intraoperative diagnosis and the histopathological study. Eleven endometrial hyperplasias without atypia, 3 with atypia and 10 malignant neoplasms were investigated. It should be noted that, of the total of resected polyps, there were 8 cases (2.5%) with potential malignancy (atypia or malignant neoplasm). According to the Clavien Dindo classification, there were 22 intraoperative complications (3.7%) grade I or II, the diagnosis of which was made during surgery. There were no grade III or more complications (severe, with reoperation). CONCLUSION: The success rate, final hysteroscopic-pathological correlation and complications was similar to that published in the available literature. The intraoperative diagnosis of the lesion and its repair in the same surgical act, reduces the risk of morbidity and mortality of the patients, making it similar to that of a patient without complication. Using the Clavien Dindo classification to assess complications will henceforth allow us to objectify, improve aspects of the surgical procedure and propose strategies for the prevention and management of such adverse events.

Quality assurance and patient safety protocols for breast and gynecologic pathology in an Academic Women's Hospital

Background: Quality assurance and peer-review practices in surgical pathology have been well described in the literature, but the majority of these reports apply to the realm of general surgical pathology. We focused on the peer-review reporting system of a specialty women's health pathology practice consisting exclusively of breast and gynecologic pathology, with the specific aims of identifying diagnostic discrepancies that affected patient care. Methods: The quality measures in this specialty practice are monitored, and the Medical Director reviews all amended/corrected reports. Error types are qualitative, and are categorized according to impact on patient care. QA data of all amended reports from 2012 to 2014 in breast and gynecologic pathology, as a measure of error type and frequency, were reviewed. Results: Of all specimens during this time period, 343 (0.54% of all reports) required amendment due to a QA metric-discovered discrepancy. Breast specimens demonstrated a higher amendment rate than GYN specimens (1.14% of breast specimens versus 0.27% of GYN specimens). The most common error type requiring an amendment for both breast and GYN specimens was a type A, or Minor Disagreement (reports amended for type A discrepancy: 78.7% of total; 81.9% of breast; 72.6% of GYN). Type B, or Moderate Disagreement discrepancies, accounted for 21.3% of all amended cases (reports amended for type B discrepancy: 18.1% of breast; 27.3% of GYN). Of all breast and GYN reports reviewed during the QA evaluation, there were no cases categorized as type C, or Major Disagreements, which would significantly alter patient reatment. Conclusion: When surgical pathology is practiced in a laboratory utilizing comprehensive quality assurance protocols, major diagnostic interpretation errors are infrequent. The practice minimizes error, maximizes patient safety, and maximizes educational opportunities of practicing pathologists in real-time (AU)

Atypical infantile genital Molluscum contagiosum

Abstract Genital molluscum contagiosum is rare in children. We report a molluscum contagiosum around the vulva and anus of 9-year-old girl, which has atypical presentations and was finally confirmed by histopathological and electron microscopy findings.

Paracoccidioidomycosis of external genitalia: report of six new cases and review of the literature / Paracoccidioidomicose de localização genital externa: relato de seis novos casos e revisão da literatura

BACKGROUND: Paracoccidioidomycosis is a systemic mycosis of dermatological interest due to the frequency of cutaneous and mucosal lesions. The involvement of the external genitalia is extremely rare and few cases have been reported. OBJECTIVE: To study the prevalence of external genitalia lesions in paracoccidioidomycosis patients, identify clinical characteristics and compare with what is observed in the specific literature. METHODS: This is a cross-sectional, descriptive study, with focus on paracoccidioiodomycosis patients with external genitalia lesions. The demographic and clinical aspects of cases were compared with what has been reported so far on LILACS, SciELO e MEDLINE data bases. RESULTS: Data of 483 cases of paracoccidioidomycosis were studied in a 42-year period. Six (1.2%) patients showed specific lesions on external genitalia. Five patients were male with mean age of 47.2 years and all of them presented with the chronic multifocal clinical form. Only one, a 15-year-old female patient was observed who showed a subacute clinical form, juvenile type. CONCLUSION: Compromise of the genitourinary tract among paracoccidioidomycosis patients is rare and even rarer when only the external genitalia are considered. As observed in the classical picture of paracoccidioidomycosis patients, the male gender and the chronic multifocal clinical form prevailed in the present study.

FUNDAMENTOS: Paracoccidioidomicose é micose sistêmica de interesse dermatológico pela freqüência de lesões tegumentares. Sua localização em genitália externa é extremamente rara e pouco descrita. OBJETIVOS: estudar a prevalência de lesões de paracoccidioidomicose de localização genital, identificar suas características clínicas e compará-las com a literatura específica. MÉTODOS: estudo descritivo, transversal, de série de casos, com inclusão de casos com lesões específicas de paracoccidioidomicose de localização genital externa, estudo das características demográficas e clínicas dos casos, confrontados com dados de revisão da literatura nas bases LILACS, SciELO e MEDLINE. RESULTADOS: foram revisados de 483 pacientes de paracoccidioidomicose diagnosticados no período de 42 anos. Seis (1,2%) pacientes apresentavam lesão específica de genitália externa. Cinco eram do sexo masculino com idade média de 47,2 anos e todos com a forma crônica multifocal da doença, O único caso do sexo feminino, de 15 anos de idade, apresentava a forma subaguda, tipo juvenil. CONCLUSÕES: o comprometimento do trato geniturinário na paracoccidioidomicose é raro e mais ainda quando se considera apenas as localizações de genitália externa. Como na paracoccidioidomicose clássica, o sexo masculino e a forma crônica da doença predominaram na amostragem estudada.

Infección por virus del papiloma humano: asociación entre infección genital y bucal / Infection with human papillomavirus: association between genital and oral infection

Identificar las características de la infección por VPH en la cavidad bucal asociada a la infección por VPH genital. En el Servicio de Ginecología Maternidad "Concepción Palacios". Caracas. Se estudiaron 60 pacientes con diagnóstico histológico de VPH genital a quienes se les realizó oroscopia, citología bucal y determinación viral por reacción en cadena de polimerasa (PCR) en boca y cérvix. Se aisló el genotipo viral en la cavidad bucal en 48,33 por ciento de las pacientes (29 / 60). Hubo concordancia entre la infección genital y bucal en 44,20 por ciento de los casos. Los genotipos aislados más frecuentes fueron el 6 (71,43 por ciento) y el 11 (22,86 por ciento), solos o en combinación; solo hubo un caso con genotipo 16 (2,86 por ciento). La concordancia entre el genotipo genital y bucal fue de 10,45 por ciento (P=0,1547), sin embargo, cuando el genotipo aislado fue 6 la concordancia fue de 75,86 por ciento. La citología de la cavidad bucal tuvo una sensibilidad de 3,5 por ciento y una especificidad de 93,6 por ciento. La oroscopia tuvo una sensiblidad de 27,6 por ciento y una especificidad de 74,2 por ciento. Es frecuente la asociación entre infección por VPH genital y bucal. Tanto la citología exfoliativa de la boca como la oroscopia, son métodos diagnósticos poco sensibles y específicos.

To describe the characteristics of HPV infection in the oral cavity associated with genital HPV infection. Service of Ginecology of the Maternidad "Concepcion Palacios". Caracas. 60 patients with histological diagnosis of genital HPV were studied with oroscopy, oral cytology and viral determination with polymerase chain reaction (PCR) in the mouth and in the cervix. Viral genotype was isolated in the oral cavity in 48.33 percent of patients (29/60). There was concordance between genital and oral infection in 44.20 percent of cases. Frequently isolated genotypes were 6 (71.43 percent) and 11 (22.86 percent), alone or in combination, there was only one case with genotype 16 (2.86 percent). The concordance between genital and oral genotype was 10.45 percent (p = 0.1547), but when isolated genotype was 6, the agreement was 75.86 percent. The cytology of the oral cavity had a sensitivity of 3.5 percent and a specificity of 93.6 percent. The oroscopy sensitivity was 27.6 percent and the specificity was 74.2 percent. It is often an association between genital and oral HPV infection. Both exfoliative cytology of the mouth and the oroscopy have low sensitivity and specificity as diagnostic methods.

Research advancement of FTIR-MSP mapping and application value in forensic science / 法医学杂志

Fourier transformation infrared microspectroscopy (FTIR-MSP) mapping technique can collect the infrared information from micro-samples and scan the tissue slides and cells. The infrared spectral information of pixels from the collected regions is recorded and infrared spectral maps are constructed by computer software. The 2D and 3D mapping images are reflected based on the distributions of absorbance bands. The biochemical compositions, molecular distribution, metabolic changes of tissues and cells are analyzed by the technique due to infrared spectroscopy being sensitive to biomolecules. The article reviews the recent research of FTIR-MSP mapping and explores the future potential value in forensic science practice.

Infección por virus de papiloma humano: asociación entre infección genital y anal-perianal / Infection with human papillomavirus: association between anal-genital and perianal infection

Describir las características de la infección por virus de papiloma humano anal y perianal asociada a la infección por genital por el mismo virus. Se seleccionaron 65 pacientes con virus de papiloma humano genital, a quienes se les realizó citología, identificación viral por reacción en cadena de polimerasa y colposcopia de región genital, ano y periano. En el Servicio de Ginecología de la Maternidad "Concepción Palacios". Se observó una frecuencia de detección del virus en ano y periano de 31,3 por ciento. En 19,67 por ciento de las pacientes hubo concordancia entre la infección en genitales y la de ano y región perianal (P > 0,397). Entre los genotipos virales hubo concordancia del 33,74 por ciento (P= 0,0053), esta correlación fue mayor para el virus 6. Fueron evaluables 38 citologías anales y perianales (59,4 por ciento) y ninguna diagnosticó anormalidades. Entre estas citologías, al hacer la reacción en cadena de polimerasa, 15 resultaron positivas para virus de papiloma humano, 21 negativas y 2 insatisfactorias. Las lesiones más frecuentes fueron subclínicas. La distribución del resultado de la anoscopia, refleja que la normalidad es lo más frecuente (67,2 por ciento). El riesgo de infección por virus de papiloma humano en ano y periano se incrementa en pacientes con infección genital. Consideramos que es importante extender la evaluación ginecológica a la región anal y perianal a pesar de las limitaciones del uso de la citología y la colposcopia

To describe the characteristics of the anal and perianal human papillomavirus infection associated with genital infection by the same virus. We selected 65 patients, with genital infection by human papillomavirus, who was made them cytology, polymerase chain reaction and colposcopy in genital region, anus and periano. Servicio de Ginecologia de la Maternidad "Concepción Palacios" The frequency of detection of papillomavirus in anus and periano was 31.3 percent. There was consistency between the genital papillomavirus infection and the anus and region parianal in 19.67 percent (P > 0,397) and between viral genotypes in 33.74 percent (P = 0,0053), this correlation was increased to virus 6. They were 38 evaluable Papanicolaou test anal and perianal (59.4 percent) and none diagnosed abnormalities. Among these, 15 were polymerase chain reaction positive for papillomavirus, 21 negative and 2 unsatisfactory. The most common lesions were subclinical. The distribution of the anoscopia result reflects normal is most often (67.2 percent). The risk of HPV infection in anus and periano is increased in patients with genital infection. We believe it is important to extend the gynecologic evaluation to the anal and perianal region despite the limitations of the use of Papanicolaou test and the colposcopy

Factores de riesgo asociados a alteraciones histológicas del aparato genital en pacientes del primer nivel de atención / Risk factors associated with histological alterations of the female genital tract in patients attending a first-level medical care facility

Objetivo: Determinar los factores de riesgo para las alteraciones histológicas del aparato genital en población abierta. Material y métodos: Estudio de casos y controles anidado en una cohorte. Se incluyeron pacientes de la consulta externa que acudieron de forma espontánea al programa de prevención y control de cáncer cervicouterino. Se estudiaron 1933 pacientes, de las cuales 88 fueron diagnosticadas con alteración celular y fueron pareadas con 88 sin alteraciones. El análisis estadístico se realizó con Anova de una vía para la comparación entre grupos y la asociación de las variables con riesgo relativo para un intervalo de confianza de 95 % y p < 0.05. Resultados: El grupo de pacientes consideradas como casos tuvo edad promedio de 36.1 ± 1.6 y el de controles de 35.8 ± 2.1 años. Los diagnósticos obtenidos en el grupo de casos mostró mayor frecuencia de ectropión, infección por virus del papiloma humano y NIC1. Los factores de riesgo analizados solo demostraron diferencia estadística en el número de gestas mayor a dos (RR = 2.33) y el inicio de vida sexual menor a 19 años (RR = 1.14), para padecer algún problema histológico del aparato genital. Conclusiones: La prevención del cáncer cervicouterino se puede realizar por detección oportuna, orientada a evitar o disminuir factores de riesgo, por lo que utilizar preservativo, posponer el inicio de la vida sexual y limitar el número de parejas, son medidas que debe conocer la población general.

BACKGROUND: We undertook this study to determine risk factors for histological alterations of the female genital tract in an open population who attend a first-level care medical facility. METHODS: We conducted a case/control cohort study that included patients from outpatient consultation who responded to a cervical cancer control and prevention program. We studied 1933 patients; 88 patients (cases) had cellular alterations and were matched with 88 patients without alterations (controls). Statistical analysis was carried out with one-way ANOVA for comparison between groups and association of variables with relative risk for 95% confidence interval; p <0.05. RESULTS: Mean age of the case group was 36.1 +/- 1.6 years and the control group had a mean age of 35.8 +/- 2.1 years. Diagnoses obtained in the case group showed a greater frequency of ectropion, human papilloma virus infection and CIN1. Risks factors analyzed in these patients showed statistical differences in number of gestations >2 (RR = 2.33) and the early initiation of sexual activity (<19 years) (RR = 1.14) for experiencing histological problems of the female genital tract. CONCLUSIONS: Prevention of cervical cancer can be accomplished through timely and opportune detection in order to avoid the disease or to decrease risk factors by using condoms, delaying initiation of sexual activity and limiting the number of sexual partners. These are all strategies that the general population should be aware of.

Frecuencia de anticuerpos IgA e IgM anti Chlamydia trachomatis: en mujeres embarazadas procedentes de una consulta prenatal Cumaná, Estado Sucre, Venezuela, marzo-junio de 2006 / Frequency of IgA and IgM anti Chlamydia trachomatis antibodies: in pregnant women coming from a prenatal consult in Cumana, State of Sucre, Venezuela, march-june of 2006

Con el propósito de establecer la frecuencia de anticuerpos IgA e IgM anti-C-trachomatis en mujeres embarazadas se realizó un estudio en 84 mujeres con esa condición, en edades comprendidas entre 14 y 43 años, que acudieron a la consulta prenatal, del Servicio Autónomo Hospital Universitario “Antonio Patricio de Alcalá”, en Cumaná, estado Sucre, Venezuela, durante el período marzo-junio de 2006. Para ello se obtuvieron 84 muestras de suero para la determinación de anticuerpos IgA e IgM anti C-trachomatis a través del método de inmunoabsorción ligado a enzimas ELISA (Diagnostic Automation INC). Del total de muestras analizadas 16 (19,05 por ciento) y 55 (65,48 por ciento) resultaron positivas para la determinación de anticuerpos IgA e IgM anti C-trachomatis respectivamente. No se encontró asociación entre la presencia de estos anticuerpos con la edad de las pacientes, aunque el mayor número de pacientes positivas se ubicó en el intervalo de edades comprendidas entre 14 a 23 años. Asimismo al asociarse las manifestaciones clínicas genitales con la presencia de anticuerpos IgA e IgM anti C- trachomatis no se encontraron valores estadísticamente significativos. Por lo anteriormente expuesto se concluye que la infección genital por Chlamydia trachomatis en mujeres embarazadas es extremadamente frecuente, de manera especial en las edades comprendidas entre 24 a 33 años, y ocurre habitualmente en forma asintomática con las graves repercusiones que esto acarrea a la paciente, al feto y a su pareja.

In order to establish the frequency of IgA and IgM anti-C. Trachomatis antibodies in expectant women, a study was made of 84 women between the ages of 14 and 43, who attended prenatal consults in the Autonomous Service at the University Hospital “Antonio Patricio of Alcalá,” Cumaná, State of Sucre, during the March-June period, 2006. 84 serum samples were obtained to determine IgA and IgM anti-C. trachomatis antibodies using the immunoabsorption method connected to ELISA enzymes (Diagnostic Automation INC). Of the total samples studied, 16 (19.05 percent) and 55 (65.48 percent) resulted positive for the IgA and IgM anti-C. trachomatis antibodies, respectively. No association was found between the presence of these antibodies and the age of the patients, although the greater number of positive patients was in the 14 to 23 year age interval. Likewise, no statistically significant values were found between the association of clinical genital manifestations and the presence of IgA and IgM anti C- trachomatis antibodies; therefore, it was shown that Chlamydia trachomatis is presented asymptomatically in most cases. Conclusions were that genital infection by Chlamydia trachomatis in pregnant women is extremely frequent, especially for ages between 24 and 33 years, and it occurs habitually in an asymptomatic form with the serious repercussions that this produces on the patient, the fetus and the partner.

Genital ulcers in women: clinical, microbiologic and histopathologic characteristics

Female genital ulcer is a disease that affects a large number of women, and its etiologic diagnosis can be difficult. The disease may increase the risk of acquiring HIV. Genital ulcer may be present in sexually transmitted diseases (STD) - syphilis, chancroid, genital herpes, donovanosis, lymphogranuloma venereum and other non-STD disorders (NSTD) - Behçet's syndrome, pemphigus, Crohn's disease, erosive lichen planus and others. This study evaluated the clinical-histopathologic-microbiologic characteristics of female genital ulcers. A cross-sectional descriptive prospective study was conducted during a six-month period to investigate the first 53 women without a definitive diagnosis, seeking medical care for genital ulcers at a genital infections outpatient facility in a university hospital. A detailed and specific history was taken, followed by a dermatologic and gynecologic examination. In addition to collecting material from the lesions for microbiologic study, a biopsy of the ulcer was performed for histopathologic investigation. The average age of the patients was 32.7 years, 56.6 percent had junior high school education and higher education. The most frequent etiology was herpetic lesion, followed by auto-immune ulcers. At the time of their first consultation, around 60 percent of the women were using inadequate medication that was inconsistent with the final diagnosis. Histologic diagnosis was conclusive in only 26.4 percent of the patients (14/53). Cure was obtained in 99 percent of the cases after proper therapy. The female genital ulcers studied were equally distributed between sexually transmitted and non-sexually transmitted causes. Herpes was the most frequent type of genital ulcer, affecting women indiscriminately, mostly between the ages of 20 and 40 years. The etiologic diagnosis of herpetic ulcers is difficult to make even when various diagnostic methods are applied. It is imperative that NSTD should be included in the...

Diagnostic accuracy of transabdominal sonography in the evaluation of pelvic mass of gynecological origin.

A study of 97 cases having clinical manifestations of pelvic mass in female was carried out in the department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University with the cooperation of the department of Obstetrics and Gynecology. This study was designed to determine accuracy of transabdominal sonography in the diagnosis of pelvic mass in female. The findings of transabdominal sonography were compared with histopathological examination. Transabdominal sonography had 87.6% accuracy, but only 3.1% false positive and 9.3% false negative rates. It can be concluded that ultrasonographic findings of different pelvic masses are highly dependable, can be used for preoperative decision making.

Tubo-ovarite xanthogranulomateuse a propos d'un cas

Xanthogranulomatous inflammation in the female genital tract is rare and characterized by a massive infiltration of the tissue by lipid containing histiocytic cells, together with lymphocytes and plasma cells. We report a new case of Xanthogranulomatous inflammation of the female genital tract

Langerhans cell histiocytosis

The authors present a rare case of Langerhans cell histiocytosis in a 31 year old female patient with vulvar, peri-anal and oral lesions, diabetes insipidus, pulmonary skin and bone infiltrations. Skin biopsy immunohistochemistry presented positive S100 protein and vimentine, but the diagnosis was done with the demonstration of Birbeck granules with eletronic mucroscopy. The treatment was based on systemical chemotherapy although vulvar lesion has a bad response to chemotherapy.

Avaliaçäo citopatológica da cavidade bucal em pacientes portadores de infecçäo genital pelo papilomavírus humano (HPV) / Citopathological evaluation of oral cavity in patients with genital infection by human papillomavirus (HPV)

A manifestação clínica da infecção por papilomavírus humano (HPV) na cavidade bucal tem sido pouco investigada e não se conhece praticamente nada sobre as infecções latentes e subclínicas. A utilização te técnicas, como microscopia eletrônica, imuno-histoquímica e biologia molecular, tem demonstrado a presença do vírus na mucosa bucal. Sendo a cavidade bucal de fácil acesso para exame e considerando que a citopatologia pode identificar a presença de células suspeitas por HPV, o objetivo principal desse estudo é a avaliação citopatológica da cavidade bucal de pacientes portadores de infecção genital por HPV. Foram examinados 54 pacientes (13 mulheres e 41 homens), entre 15 e 55 anos de idade, que foram subdivididos em dois grupos. O grupo 1 foi composto de 32 pacientes portadores de condiloma genital e o grupo II, de 22 pacientes portadores de alterações sugestivas de infecção genital por HPV. O grupo controle foi constituído de 23 pacientes (17 mulheres e seis homens), entre 13 e 70 anos de idade, sem alterações clínicas na região genital. Todos os pacientes foram submetidos a exame clínico e colheita de material citopatológico da cavidade bucal. A avaliação clínica da cavidade bucal, à vista desarmada, revelou lesões em dois pacientes do grupo I, com diagnóstico histopatológico de condiloma acuminado e hiperplasia epitelial com alterações sugestivas de infecção por HPV. Ambos os casos foram submetidos à hibridação in situ, quando apenas o condiloma exibiu positividade. Após o enxágüe bucal com ácido acético a 2 por cento, por dois minutos, foram detectadas áreas acetobrancas em 19 por cento dos pacientes do grupo I, 14 por cento do grupo II e 13 por cento do grupo controle. Na avaliação citopatológica dos 54 esfregaços da mucosa bucal, as alterações citoplasmáticas e nucleares mais significativas foram: (1) células sugestivas de coilocitose em 13 por cento, identificadas principalmente no grupo I; (2) disceratose em 54 por cento e; (3) hipercromatismo e irregularidade nuclear em 48 por cento e 7 por cento respectivamente. Nossos resultados sugerem que o exame clínico da cavidade bucal, à vista desarmada, não parece ser o método mais eficiente para investigação de lesões suspeitas de manifestação por HPV e que, embora o HPV infecte a cavidade bucal, esse local não parece ser propício à replicação virótica. Podemos também concluir que a identificação da coilocitose por meio de exame citopatológico é rara na ausência de lesões clínicas.

Análise epidemiológica da patologias genitais associadas a papilomavírus / Epidemiologic analysis of genital pathologies associated to papillomavirus

Estudando-se casos de infecçoes genitais associadas a papilomavírus em um hospital universitário, verificou-se que as patologias mais frequentes eram o condiloma acuminado e câncer epidermóide. Objetivo. Analisar a prevalência das lesoes genitais associadas a papilomavírus e distribuiçao por sexo, idade e cor. Métodos. Foram estudadas 223 pacientes atendidas no Hospital Universitário Antonio Pedro, estado do Rio de Janeiro, durante os anos de 1988 a 1992. Após diagnóstico clínico, biópsias das pacientes foram submetidas a análise histológica. Resultados. Os resultados mostraram que, entre as doenças do trato genital associadas a papilomavírus, o condiloma acuminado e o carcinoma epidermóide eram as mais frequentes. Os casos de carcinoma epidermóide mantiveram prevalência estável ao longo do período, enquanto que o número de casos condiloma acuminado aumentou de três para 33 por ano. As duas patologias foram mais frequentes em indivíduos de cor branca. Nao houve diferença significativa entre sexo e presença de condiloma. A média de idade para carcinoma epidermóide nao sofreu variaçao significativa no período estudado, enquanto decaiu para o condiloma acuminado nos períodos de 1988 para 1989 e de 1991 para 1992. Conclusao. As lesoes genitais associadas a papilomavírus aumentaram significativamente no período de cinco anos. Maior atençao deve ser dada as campanhas de controle de diagnóstico precoce.

prolapsus genital [a propos 150 cas]

Our work is intersted in the retrospective study of 150 cases of genital prolapse, selected at gynecologie-obstetric service <> of maternity Souissi of Rabat over ten years [1894-1983]. The epidemiological profile of our study were dominated by advanced age [mean 56 years], multiparity in 135 cases [90%] and 105 cases [70%] of our women were menopausal. The most of commonest association of lesion was complete prolapse in 84 cases [56%], stress incontinence urinary was found in 43 cases [28,6%] On the therapeutic level, the perineal tract is used in 125 cases. The vaginal hysterectomy with anterior time and posterior time remains the most used in 84 cases [67,5%] Magendie technique in 19 cases [12,7%] Labhardt technique in 8 cases [5,4%]. the immediate evolution were excellents in majority of cases [one death]. But, the remote results were difficults because the number of our cases review is limited and does not allow to conclude