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1.
The Nigerian Health Journal ; 21(2): 45-59, 2021. Tables, figures
Article in English | AIM, AIM | ID: biblio-1342142

ABSTRACT

BACKGROUND: The aim of this study was to assess the usefulness of the beta subunit of hCG in cervicovaginal secretions as a biochemical predictor of spontaneous preterm delivery among pregnant women with and without preterm delivery risk.DESIGN: This was an eight-month prospective case control study of pregnant women with or without risk factors for preterm delivery. SETTING: Ifako- Ijaye General Hospital Lagos/ Lagos State University Teaching Hospital, Ikeja Lagos Nigeria. PARTICIPANTS: 150 pregnant women which consisted of 50 cases with preterm delivery risk and 100 controls without preterm delivery risk. INTERVENTIONS: A structured interviewer administered questionnaire which had been pretested, was used to collect data. Two cervicovaginal fluid samples at 26 weeks and 32 weeks were collected from each of the participants and it was quantitatively assayed using ELISA for presence of beta hCG. The participants were followed up till delivery. RESULTS: 15 participants out of the 50 cases delivered their babies preterm, while only 2 participants out of the 100 controls had preterm delivery. The 15 cases who delivered preterm had significant increase in their mean beta HCG value from 7.44±1.74 at 26 weeks to 32.6±1.32 at 32 weeks with p value<0.001. There was however no statistical difference in the mean beta HCG at 26 weeks and at 32 weeks for the control group. CONCLUSION: The concentration of beta HCG in the cervicovaginal fluid is a useful early predictor of preterm delivery especially among patients with risk factors.


Subject(s)
Uterine Cervical Diseases , Premature Birth , Fluids and Secretions , Chorionic Gonadotropin , Pregnant Women
2.
Rev. enferm. Inst. Mex. Seguro Soc ; 28(2): 92-101, Abr-Jun. 2020. graf
Article in Spanish | LILACS, BDENF | ID: biblio-1121645

ABSTRACT

Introducción: para garantizar la información y la atención de calidad, la Organización Mundial de la Salud, la Organización Panamericana de la Salud y las normas oficiales del cáncer cervicouterino y los sistemas de salud en México sugieren fortalecer los sistemas de información en salud con el uso de herramientas tecnológicas. Objetivo: el propósito de este estudio es conocer la factibilidad de un proyecto para la innovación de procesos, a través de un sistema electrónico para los registros de las citologías cervicales. Metodología: estudio observacional, transversal, prospectivo, realizado del 4 al 25 de junio de 2018 en la Unidad de Cuidados Integrales e Investigación en Salud de la Universidad Autónoma de San Luis Potosí, México. Se estudió al universo del personal sanitario que implementa el Programa de Detección Oportuna de Cáncer Cervico Uterino, con 7 participantes: personal directivo (2) y operativo (5). Resultados: las políticas y recursos institucionales permiten la implementación del proyecto, pues consideran tendría impacto positivo en la atención. Conclusiones: actualmente, la totalidad del personal cuenta con las competencias básicas para el manejo de sistemas electrónicos.


Introduction: To guarantee quality information and care, World Health Organization, Pan American Health Organization and the Official Standards of Cervical Cancer and Health Systems in Mexico suggest strengthening health information systems with the use of technological tools. Objective: The purpose of the study is to know the feasibility of a project for process innovation, through an electronic system for records of cervical cytologies. Methods: An observational, cross-sectional, prospective study conducted from June 4 to 25, 2018 in the Unit of Integral Care and Health Research of the Autonomous University of San Luis Potosí, Mexico. The universe of health personnel that implements the Timely Detection of Cervical Cancer Program was studied, 7 participants: managerial staff (2) and operative staff (5). Results: Institutional policies and resources allow for the implementation of the project, as they consider it would have a positive impact on care. Conclusions: Currently, all the staff has the basic skills for the management of electronic systems.


Subject(s)
Humans , Pan American Health Organization , World Health Organization , Information Systems , Technological Development , Uterine Cervical Diseases , Feasibility Studies , Nursing Records , Cross-Sectional Studies , Prospective Studies , Cytological Techniques , Papanicolaou Test , Observational Study , Mexico
3.
Rev. enferm. UERJ ; 27: e21680, jan.-dez. 2019. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1009977

ABSTRACT

Objetivo: analisar as internações por doença inflamatória do colo do útero e os fatores que influenciam a sua ocorrência. Método: estudo seccional, prospectivo, baseado em um inquérito de morbidade hospitalar realizado em 2013, com amostra de 429 mulheres internadas em hospitais no município de Guarapuava. Os dados foram analisados por meio de análise bivariada e regressão logística. O projeto foi aprovado por Comitê de Ética em Pesquisa. Resultados: do total de mulheres internadas, 45 (10,4%) foram por doença inflamatória do colo do útero. Pertencer ao público alvo, ter realizado o exame no mínimo uma vez, procurar o serviço regularmente para o controle de saúde e apresentar o resultado dentro dos limites de normalidade em 1 ano atuaram como fatores de proteção contra a ocorrência dessas internações. Conclusão: o conhecimento dos fatores que se relacionam ao desfecho fornece subsídios para a readequação dos serviços que prestam assistência às mulheres, a fim de prevenir as internações.


Objective: to examine hospital admissions for inflammatory disease of the cervix uteri and the related factors. Method: this prospective, cross-sectional study based on a hospital morbidity survey was conducted in 2013 with a sample of 429 women admitted to hospitals in the city of Guarapuava. Data were analyzed by bivariate analysis and logistic regression. The project was approved by the institution's research ethics committee. Results: 45 (10.4%) of the women were hospitalized for inflammatory disease of the cervix uteri. Protective factors against the occurrence of such hospitalizations included belonging to the target public, having performed the examination at least once, attending the service regularly for a health check and returning a result within normal limits in the prior year. Conclusion: knowledge of the factors relating to the outcome provides input for adjusting women's care services in order to prevent hospitalizations.


Objetivo: analizar las internaciones por cervicitis y los factores que influencian su ocurrencia. Método: estudio seccional, prospectivo basado en una encuesta de morbilidad hospitalaria realizada en 2013, con muestra de 429 mujeres internadas en hospitales en el municipio de Guarapuava. Los datos se analizaron por medio de análisis bivariado y regresión logística. El estudio fue aprobado por Comité de Ética en Investigación. Resultados: del total de mujeres internadas, 45 (10,4%) lo fueron por cervicitis. Pertenecer al público objetivo, haber realizado el examen al menos una vez, buscar el servicio regularmente para el control de salud y presentar el resultado dentro de los límites de la normalidad en 01 año actuaron como factores de protección respecto a la ocurrencia de estas hospitalizaciones. Conclusión: el conocimiento de los factores que se relacionan al desenlace propo


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Primary Health Care , Uterine Cervical Diseases , Uterine Cervical Diseases/therapy , Cervix Uteri/pathology , Women's Health , Hospitalization , Unified Health System , Brazil , Sexually Transmitted Diseases , Uterine Cervical Diseases/diagnosis , Cervix Uteri/injuries
4.
Rev. cir. (Impr.) ; 71(5): 442-445, oct. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1058298

ABSTRACT

Resumen Introducción: Las fístulas secundarias a una enfermedad diverticular complicada son una indicación formal de cirugía electiva en el 4 a 23% de los casos. Caso Clínico: Se presenta el caso de una mujer de 52 años con antecedentes de una histerectomía subtotal por miomatosis uterina que consulta por cuadro de dolor abdominal en hipogastrio acompañado de fiebre de 4 días de evolución. La tomografía computada (TC) de abdomen y pelvis describe una diverticulitis complicada con absceso peridiverticular. Tratada con antibióticos con buena respuesta clínica consulta a los 3 meses en nuestro servicio por pérdida de material fecal por vagina. Nueva TC confirma la presencia de una colección perisigmoidea y engrosamiento de la pared vesical. La colonoscopía informa una estenosis franqueable a nivel de sigmoides y se constata salida de gases por vagina. La corrección quirúrgica electiva incluyó una sigmoidectomía abierta con traquelectomía en block, cierre de la cúpula vaginal y anastomosis colorrectal mecánica, con buena evolución posoperatoria, sin recidiva a los 12 meses de seguimiento. La fístula sigmoido-cervical es una complicación rarísima de la enfermedad diverticular complicada que puede ocurrir en pacientes sometidas a una histerectomía subtotal previa. Aunque el diagnóstico de la fístula es clínico, la colonoscopía y la TC permiten descartar otras etiologías. La resección radical del segmento afectado es el tratamiento estándar en pacientes aptos.


Introduction: Diverticular disease is complicated by fistulas in 4% to 23% of patients. Case Report: A woman 52 years-old previously operated on with parcial histerectomy was successfully treated with antibiotics due to diverticulitis complicated with an abscess. Three months later the patient presented with vaginal discharge of faeces. Computed tomography showed wall thickening of sigmoid colon and vesical wall. Colonoscopy exclude cancer and confirmed the exit of gas through vagina. En-bloc resection of the sigmoid colon with traquelectomy with primary anastomosis was performed. The postoperative course was good without recurrence after 12 months of follow up. Sigmoido-cervical fistula is a very rare benign fistula due to diverticular disease. Diagnosis is basically clinic, but tomography and colonoscopy are important to exclude other causes of fistulas. Radical surgery with primary anastomosis is the standard treatment.


Subject(s)
Humans , Female , Middle Aged , Sigmoid Diseases/surgery , Sigmoid Diseases/diagnosis , Uterine Cervical Diseases/etiology , Intestinal Fistula/etiology , Diverticular Diseases/complications , Diverticular Diseases/diagnosis , Tomography, X-Ray Computed , Abdominal Pain/etiology , Treatment Outcome , Diverticular Diseases/drug therapy , Hysterectomy/adverse effects , Anti-Bacterial Agents/therapeutic use
5.
Rev. cuba. obstet. ginecol ; 45(3): e478, jul.-set. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1093653

ABSTRACT

Introducción: El cáncer cérvico uterino es la segunda neoplasia más común en mujeres en el mundo. Una buena correlación entre las pruebas de tamizaje, diagnóstico y tratamiento de las lesiones cervicales optimiza su manejo, evita procedimientos innecesarios y maximiza recursos disponibles. Objetivo: Identificar la relación entre los métodos diagnósticos de las patologías del cuello uterino. Métodos: Se realizó un estudio observacional, descriptivo, transversal y prospectivo en el Hospital Provincial Camilo Cienfuegos de Sancti Spíritus, desde septiembre de 2015 a septiembre de 2017. Se tomó una población de 1172 pacientes de la consulta de patología de cuello uterino según los criterios de la investigación. Los métodos científicos fueron: de nivel teórico, empírico-experimental y matemático-estadístico. Se asumieron las variables: edad, factores de riesgo asociados, sintomatología, citología, colposcopia y biopsia. Resultados: El grupo de edad que con mayor frecuencia se presentó estuvo comprendido entre 26 y 35 años de edad. Los principales factores de riesgo asociados fueron: edad de inicio de las relaciones sexuales antes de los 18 años, virus del papiloma humano, paridad de más de dos hijos y antecedentes familiares de alguna patología de cuello. La sintomatología destacada fue el sangramiento poscoital e intermenstrual. Los resultados de los métodos diagnósticos fueron: virus del papiloma humano y displasia leve, tanto en la citología como en la biopsia, y lesiones de bajo grado en la colposcopia. Conclusiones: La asociación entre los métodos diagnósticos estudiados mostró una buena correlación citocolposcópica y colpohistológica, con diagnóstico de confirmación principalmente ante lesiones de alto grado(AU)


Introduction: Cervical cancer is the second most common neoplasm in women in the world. Good correlation between screening tests, diagnosis and treatment of cervical lesions optimizes management, avoiding unnecessary procedures and maximizing available resources. Objective: To identify the relationship between the diagnostic methods of cervical pathologies. Methods: An observational, descriptive, cross-sectional and prospective study was conducted at Camilo Cienfuegos Provincial Hospital in Sancti Spíritus, from September 2015 to September 2017. A population of 1172 patients was taken from the cervical pathology clinic according to the research criteria. The scientific methods were theoretical, empirical-experimental and mathematical-statistical. The assumed variables were age, associated risk factors, symptomatology, cytology, colposcopy and biopsy. Results: The age group that most frequently appeared was ages between 26 and 35 years. The main associated risk factors were age of first sexual intercourse before 18 years old, human papillomavirus, parity of more than two children and family history of some cervix pathology. The outstanding symptomatology was postcoital and intermenstrual bleeding. The results of the diagnostic methods were human papillomavirus and mild dysplasia, both in cytology and biopsy, and low-grade colposcopy lesions. Conclusions: The association between the diagnostic methods studied showed good cytocolposcopic and colpohistological correlation, with confirmation diagnosis mainly in cases of high-grade lesions(AU)


Subject(s)
Humans , Female , Adolescent , Adult , Uterine Cervical Diseases/pathology , Cervical Intraepithelial Neoplasia/diagnosis , Colposcopy/methods , Epidemiology, Descriptive , Cross-Sectional Studies , Prospective Studies
6.
Rev. colomb. obstet. ginecol ; 70(2): 94-102, 20190723. tab
Article in Spanish | LILACS | ID: biblio-1042832

ABSTRACT

RESUMEN Objetivo: evaluar la concordancia interobservador por nivel de entrenamiento al aplicar la escala Swede utilizando imágenes digitales de colposcopias. Materiales y métodos: estudio de concordancia ensamblado en un estudio de corte transversal. Se incluyeron pacientes remitidas para colposcopia por resultado de citología anormal, en un centro de referencia de patología cervical de Bogotá, Colombia. Muestreo por conveniencia. Variables medidas: edad, grado de escolaridad, estado civil, factores de riesgo para cáncer de cérvix (paridad, edad de inicio de la vida sexual, número de contactos sexuales); método de planificación, reporte de la citología y resultado de la colposcopia de acuerdo con los criterios de la escala Swede. Se utilizó estadística descriptiva, la concordancia se calculó usando el estadístico kappa (k) ponderado. Resultados: el análisis se realizó con un set de 3 imágenes colposcópicas digitales de 251 pacientes. Para el puntaje total de la escala, dos ginecólogos expertos mostraron una concordancia baja (k= 0,38; IC 95 %: 0,26-0,44), una pareja de dos ginecólogos con diferente nivel de entrenamiento mostró una concordancia baja (k = 0,27; IC 95 %: 0,20-0,38) y el otro par mostró una concordancia moderada (k= 0,45; IC 95 %: 0,34-0,53). Para los criterios individuales de la escala Swede la mejor concordancia se dio para "reacción acetoblanca" y "tamaño de la lesión" (k= 0,43; IC 95 %: 0,33-0,53). Conclusiones: la concordancia interobservador utilizando la escala Swede en imágenes colposcópicas digitales varió de baja a moderada según el nivel de entrenamiento de los ginecólogos.


Objective: To assess inter-observer concordance by training level when applying the Swede score to digital colposcopy images. Materials and methods: Concordance study assembled in a cross-sectional study. The population consisted of patients referred for colposcopy to a cervical pathology reference center in Bogotá, Colombia, due to abnormal cytology. Convenience sampling was used. Measured variables were age, level of education, marital status, risk factors for cervical cancer such as parity, age of sexual activity initiation and number of sexual contacts, contraceptive method, cytology report and colposcopy result according to the criteria of the Swede score. Concordance was calculated using the weighted kappa (k) index. Results: The analysis was based on a set of 3 digital colposcopic images of 251patients. For the total score on the scale, low agreement (k = 0.38; 95% CI: 0.26-0.44) was found between two expert gynecologists; low agreement (k = 0.27; IC 95 %: 0.20-0.38) was also shown for a pair of gynecologists with different training levels, while moderate agreement (k = 0.45; 95% CI: 0.34-0.53) was found for the third pair. For individual criteria on the Swede scale, the best agreement was found for "acetowhite reaction" and "lesion size" (k = 0.43; 95% CI: 0.33-0.53). Conclusions: Inter-observer concordance using the Swede score for digital colposcopic images ranged from low to moderate according to the level of training of the gynecologists.


Subject(s)
Female , Colposcopy , Uterine Cervical Diseases , Uterine Cervical Neoplasms
7.
J. Health Biol. Sci. (Online) ; 7(1): 9-13, jan.-mar. 2019. ilus, tab
Article in English | LILACS | ID: biblio-969712

ABSTRACT

Introduction: Cervical cancer is a public health problem, and tracking of the disease must follow a set of organized programmed actions, with populations and periodicity defined. Objective: Identifying the prevalence of intraepithelial lesions in preventive examinations performed in the municipality of Sinop-MT between 2010 and 2013. Methods: Statistical data obtained using the DATASUS/SISCOLO system were used. Results: When considering the descriptive diagnosis for cellular alterations, 412 and 167 altered exams with low- and high-grade intraepithelial lesions (respectively) were found. The prevalence of both low-grade (25.45%) and high-grade (10.32%) intraepithelial lesions were higher outside of the recommended age range (25-64 years). Conclusions: Studies on the prevention of cervical cancer are extremely relevant in order to analyze the coverage of screening in areas served by basic health units and to understand the factors associated with non-adherence of women to preventive examination. It is noteworthy that during the time period analyzed, women in the municipality of Sinop did not fulfill the municipal goal.(AU)


Introdução: O câncer do colo do útero é um problema de saúde pública e o rastreamento dessa doença deve seguir um conjunto de ações programadas, organizadas com populações e periodicidade definidas. Objetivo: este estudo teve como objetivo identificar a prevalência da lesão intraepitelial em exames preventivos coletados no município de Sinop-MT, entre 2010 e 2013. Métodos: Estudo retrospectivo realizado no Município de Sinop. Os dados utilizados foram obtidos por meio do sistema DATASUS/SISCOLO, entre 2010 e 2013. As variáveis analisadas foram: número de exames citopatológicos dentro dos limites de normalidade, lesão intraepitelial de baixo grau (LIBG) e lesão intraepitelial de alto grau (LIAG) e faixa etária de 25 a 64 anos. Resultados: ao considerar o diagnóstico descritivo para alterações celulares, foram constatados 412 e 167 exames alterados com lesão intraepitelial de baixo e alto grau, respectivamente. Tanto a prevalência de lesão intraepitelial de baixo grau (25,45%), quanto de alto grau (10,32%), foram maiores fora da faixa etária preconizada (25 a 64 anos). Portanto, estudos sobre a prevenção do câncer do colo do útero são de extrema relevância, a fim de analisar a cobertura do rastreamento em áreas atendidas pelas unidades básicas de saúde e compreender os fatores associados à não adesão das mulheres à realização do exame preventivo. Conclusão: Ressalta-se que o município de Sinop nos quatros anos analisados não cumpriu a meta municipal.(AU)


Subject(s)
Cervical Intraepithelial Neoplasia , Uterine Cervical Diseases , Disease Prevention
8.
Rev. inf. cient ; 98(2): 263-271, 2019. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1017013

ABSTRACT

Se realizó la comunicación de un caso clínico-patológico, diagnosticado en el Hospital Docente Clínico Quirúrgico "Joaquín Albarrán" de La Habana. En dicha entidad se presentó en una paciente femenina de 85 años de edad con antecedentes de diabetes mellitus tipo 2, ingresada por cuadro de insuficiencia arterial de miembro inferior izquierdo por lo cual se le realizan amputación supracondilia y al tercer día de su estadía hospitalaria, fallece. En la autopsia se arribó al diagnóstico anatomopatológico de arterioesclerosis de Mönckeberg de vasos del útero. Esta es una forma de arterioesclerosis muy relacionada con la senectud, pero factores de riesgo como diabetes mellitus y la enfermedad renal crónica pueden contribuir de forma directa en su desarrollo y progresión. Su diagnóstico es un hallazgo incidental en muestras histopatológicas(AU)


A clinical-pathological case was reported, diagnosed at the Joaquín Albarrán Clinical Surgical Teaching Hospital in Havana. In this entity, an 85-year-old female patient with a history of type 2 diabetes mellitus was presented, admitted due to arterial insufficiency of the lower left limb, for which she underwent supracondylar amputation and died on the third day of her hospital stay. At the autopsy, the pathological diagnosis of Mönckeberg arteriosclerosis of vessels of the uterus was reached. This is a form of arteriosclerosis closely related to old age, but risk factors such as diabetes mellitus and chronic kidney disease can directly contribute to its development and progression. Its diagnosis is an incidental finding in histopathological samples(AU)


Um caso clínico-patológico foi relatado, diagnosticado no Hospital de Clínica Cirúrgica "Joaquín Albarrán" em Havana. Nessa entidade, apresentou-se uma paciente de 85 anos, com história de diabetes mellitus tipo 2, internada por insuficiência arterial do membro inferior esquerdo, para a qual sofreu amputação aupracondiliana e faleceu no terceiro dia de internação. Na autopsia, o diagnóstico patológico da arteriosclerose de Mönckeberg de navios do útero foi conseguido. Essa é uma forma de arteriosclerose intimamente relacionada à velhice, mas fatores de risco como diabetes mellitus e doença renal crônica podem contribuir diretamente para seu desenvolvimento e progressão. Seu diagnóstico é um achado incidental em amostras histopatológicas(AU)


Subject(s)
Humans , Aged, 80 and over , Uterine Cervical Diseases/mortality , Uterine Cervical Diseases/pathology , Monckeberg Medial Calcific Sclerosis/diagnosis , Monckeberg Medial Calcific Sclerosis/mortality , Monckeberg Medial Calcific Sclerosis/pathology
9.
Epidemiol. serv. saúde ; 28(1): e2018203, 2019. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-989799

ABSTRACT

Objetivo: estimar a prevalência de exame citopatológico não realizado nos últimos três anos e de nunca realizado em mulheres, e analisar fatores associados. Métodos: estudo transversal, com mulheres de 20 a 69 anos de idade, em São Leopoldo, RS, Brasil, em 2015; calcularam-se as razões de prevalência (RP) por regressão de Poisson. Resultados: entre 919 mulheres, a prevalência de exame atrasado foi 17,8% (intervalo de confiança de 95% [IC95%15,4;20,3), e de nunca realizado, 8,1% (IC95%6,3;9,8); na análise ajustada, o aumento na prevalência de exame atrasado mostrou-se associado à classe econômica D/E (RP=2,1 - IC95%1,3;3,5), idade de 20-29 anos (RP=3,2 - IC95%2,1;4,9) e nenhuma consulta realizada (RP=3,0 - IC95%2,1;4,1); nunca ter realizado exame associou-se com classe econômica D/E (RP=2,6 - IC95%1,4;5,0), idade de 20-29 anos (RP=24,1 - IC95%6,4;90,9) e nenhuma consulta (RP=2,9 - IC95%1,7;4,8). Conclusão: a cobertura de exame foi alta e com iniquidade.


Objetivo: estimar la prevalencia de examen en mujeres, no realizado en los últimos tres años y de nunca realizado, y analizar factores asociados. Métodos: estudio transversal con mujeres de 20 a 69 años de edad de São Leopoldo, RS, Brasil, en 2015; se calcularon las razones de prevalencia (RP) por la regresión de Poisson. Resultados: entre 919 mujeres, la prevalencia de examen retrasado fue 17,8% (intervalo de confianza del 95% [IC95%]15,4;20,3) y de nunca realizado fue del 8,1% (IC95%6,3;9,8); en el análisis ajustado, el aumento en la prevalencia de examen retrasado se asoció con clase económica D/E (RP=2,1 - IC95%1,3;3,5), a edad entre 20-29 años (RP=3,2 - IC95%2,1;4,9) y ninguna consulta (RP=3,0 - IC95%2,1;4,1); nunca haber realizado examen se asoció con clase D/E (RP=2,6 - IC95%1,4;5,0), a 20-29 años de edad (RP=24,1 - IC95%6,4;90,9) y ninguna consulta (RP=2,9 - IC95%1,7;4,8). Conclusión: la cobertura de examen fue alta y con inequidad.


Objective: to estimate the prevalence of Pap tests not performed in the last three years and never performed in women and to analyze factors. Methods: this was a cross-sectional study with women aged 20 to 69 years living in São Leopoldo, RS, Brazil, in 2015; prevalence ratios (PR) were calculated using Poisson regression. Results: among 919 women, prevalence of delayed testing was 17.8% (95% confidence interval [95%CI]15.4;20.3) and never tested prevalence was 8.1% (95%CI6.3%;9.8%); in the adjusted analysis, the increase in the prevalence of delayed testing was associated with economic class D/E (PR=2.1 - 95%CI1.3;3.5), being aged 20-29 years (PR=3.2 - 95%CI2.1;4.9) and not having had a medical appointment (PR=3.0 - 95%CI2.1;4.1); never having tested was associated with economic class D/E (PR=2.6 - 95%CI1.4;5.0), being aged 20-29 years (PR=24.1 - 95%CI6.4;90.9), and not having had a medical appointment (PR=2.9 - 95%CI1.7;4.8). Conclusion: coverage of the test was high but characterized by social inequality.


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Socioeconomic Factors , Vaginal Smears , Uterine Cervical Diseases/prevention & control , Uterine Cervical Diseases/epidemiology , Health Status Disparities , Papanicolaou Test , Brazil , Women's Health Services , Cross-Sectional Studies , Women's Health , Secondary Prevention , Genital Diseases, Female/diagnosis
10.
Oncol. (Guayaquil) ; 28(3): 191-201, 30 de Diciembre 2018.
Article in Spanish | LILACS | ID: biblio-1000264

ABSTRACT

Introducción: Una combinación de radioterapia de haz externo y braquiterapia es el estándar de manejo radiante radical para el cáncer cervical avanzado. Algunas pacientes no pueden recibir braquiterapia, por lo que se administran mayores dosis de radioterapia externa exclusiva. Se describen los resultados obtenidos con dicha modalidad terapéutica. Métodos: En un estudio retrospectivo, descriptivo, entre Julio de 1997 y Agosto del 2005, se evalúa pacientes mayores de 18 años, tratadas en el Instituto del Cáncer de Solca Núcleo de Loja con el diagnóstico inicial de cáncer cervical estadio III B y IVA. Se caracterizan variables: edad, estadio, respuesta al final del tratamiento, tiempo global de tratamiento, sobrevida global, morbilidad tardía y complicaciones. Se presenta los datos usando medidas de resumen de tendencia central y la curva de supervivencia mediante el método Kaplan Meier: Se utilizó el paquete estadístico SPSS 20.0. Resultados: 25 pacientes con una mediana de edad de 65 años, con cáncer en estadios IIIB y IV recibieron una media de 68 Gy con radioterapia externa exclusiva, en una mediana de 65 días de tiempo global de tratamiento. Hubo respuesta clínica completa en 9 pacientes (36 %); residual tumoral clínico en las 16 restantes (64 %). A los 5 años de seguimiento, 6 pacientes (24 %) se encontraban vivas, sin datos de actividad tumoral locorregional, en las 19 pacientes restantes (76 %), hubo falla locorregional. Conclusión: La radioterapia externa exclusiva no ofrece resultados satisfactorios. Debe insistirse en la necesidad de braquiterapia para alcanzar dosis curativas.


Introduction: A combination of external beam radiotherapy and brachytherapy is the standard therapy for advanced cervical cancer. Some patients can not receive brachytherapy, so are given larger doses of exclusive external radiotherapy. Describes the results obtained with this treatment modality. Methods: In a retrospective study, between July 1997 and August 2005, evaluating patients treated in Cancer Institute Core SOLCA Loja. Variables is characterized age, stage, end of treatment response, overall treatment time, overall survival, late morbidity. We present data using summary measures of central tendency and the survival curve using the Kaplan Meier method and the statistical program SPSS 20.0. Results: 25 patients with a median age of 65 years, cancer stage IIIB and IV received a median of 68 Gy with exclusive external radiotherapy at a median of 65 days overall treatment time. Clinical response was complete in 9 patients (36%) clinical residual tumor remaining 16 (64%). At 5 years follow-up, 6 patients (24%) were alive without locoregional tumor activity data in the remaining 19 patients (76%), there locoregional failure. Morbidity low and comparable to that reported in the literature. Conclusion: The exclusive external radiotherapy does not offer satisfactory results. It should be emphasized the need to achieve curative doses with brachytherapy.


Subject(s)
Humans , Radiotherapy , Uterine Neoplasms , Uterine Cervical Diseases , Morbidity , Radiotherapy, Adjuvant , Survivorship
11.
Rev. salud pública ; 20(5): 637-640, oct.-nov. 2018. graf
Article in English | LILACS | ID: biblio-1004481

ABSTRACT

ABSTRACT Objectives Hypoparathyroidism, sensorineural deafness and renal disease (HDR) syndrome, also known as Barakat syndrome, is an autosomal dominant transmission hereditary disease with a wide range of penetrance and expressivity. Haploinsufficiency of the GATA3 two finger zinc transcription factor is believed to be its cause. This is the first time this orphan disease is reported in Latin America, so the publishing of this report is expected to raise awareness on these types of syndrome, that are usually underdiagnosed in our region, which in turn causes an increase in the years lost to disability (YLDs) rates, as well as higher costs to be assumed by public health systems. Methods A 36-year-old Colombian woman diagnosed with parathyroid gland agenesis was referred from the Endocrinology Service to the Outpatient Service. According to her medical record, in the past she had developed hypocalcaemia, left renal agenesis, hypoparathyroidism, bicornate uterus and sensorineural hearing loss. Through a genetic analysis a pathological mutation on the short arm of the GATA 3 gen (c.404dupC, p Ala136 GlyfsTER 167) was confirmed, which led to a HDR syndrome diagnosis. Discussion This case proves that there is a possibility that mutations described in other continents may be developed by individuals from our region. Regardless of ethnicity, Barakat syndrome should be considered as a possible diagnosis in patients presenting the typical triad that has been described for this condition, since there could be underdiagnosis of this disease in Latin-America due to the lack of knowledge on this condition in said region, and that genetic counseling in these patients is of great importance for the implications of the syndrome in future generations.(AU)


RESUMEN Objetivos El síndrome de hipoparatiroidismo, sordera neurosensorial y displasia renal (HDR) también llamado síndrome de Barakat, es una enfermedad hereditaria de transmisión autosómica dominante con amplia penetrancia y expresividad genética. El síndrome es causado por la haploinsuficiencia del factor de transcripción de dedos de Zinc GATA3. Esta es la primera vez que esta enfermedad huérfana es reportada en latinoamerica, y buscamos generar consciencia de la presencia de estas enfermedades, las cuales usualmente son infradiagnósticadas en nuestro medio y llevan a un aumento de años perdidos por discapacidad y costos para el sistema de salud pública. Métodos Una mujer colombiana de 36 años ingresó a consulta externa de genética referida por el servicio de endocrinología por una agenesia de paratiroides. La paciente tenía antecedentes de hipocalcemia, agenesia renal izquierda, hipoparatiroidismo, sordera neurosensorial y útero bicorneo. Se realizó un análisis genético que confirmo una mutación patológica en el brazo corto del gen GATA3 (c.404dupC, p Ala136 GlyfsTER 167) diagnóstica del síndrome de Barakat. Discusión Este caso demuestra la posibilidad de existencia de mutaciones descritas en otros continentes en nuestra población. Sin importar la etnia, el síndrome de Barakat debe ser estudiado en pacientes que presenten la triada típica, ya que podría existir un infra diagnóstico de la enfermedad secundario al desconocimiento de la misma en Latinoamérica y teniendo en cuenta la importancia que tiene la consejería genética en estos pacientes por las implicaciones de la enfermedad en futuras generaciones.(AU)


Subject(s)
Humans , Female , Adult , Uterine Cervical Diseases/physiopathology , Zinc Fingers , GATA3 Transcription Factor/analysis , Hypoparathyroidism/genetics , Colombia , Deafness , Solitary Kidney , Hypocalcemia
12.
Rev. colomb. obstet. ginecol ; 69(3): 208-217, July-Sept. 2018. tab, graf
Article in English | LILACS | ID: biblio-978299

ABSTRACT

ABSTRACT Objective: To report the case of a patient with cervical carcinosarcoma and intra-abdominal bleeding, and to review the available literature on the treatment and prognosis of this condition. Materials and methods: Case report of an 84-year-old patient who presented with an abdominal mass and urinary tract obstruction. During hospital stay, she developed intra-abdominal bleeding with signs of shock, requiring total abdominal hysterectomy with bilateral salpyngo-oophorectomy, hypogastric artery ligation and pelvic packing as interventions to control bleeding. Histology reported a diagnosis of carcinosarcoma of the uterine cervix. The patient evolved adequately and was referred for oncologic management. The search in the literature was conducted in the Medline vía PubMed, SciELO and Ovid databases, using the terms "uterine carcinosarcoma" "treatment" "cancer treatment" "treatment review" and "treatment outcome". The search was limited by language type but not by year of publication. Results: Of the references, 19 met the inclusion and exclusion criteria, and they were predominantly case reports. The clinical stage most frequently reported was FIGO IB in close to 53% of cases, and the most frequent presentation was genital bleeding associated with a pelvic mass. With an average follow-up of 15 months, survival in patients receiving radiotherapy or taken to surgery is 17% and 68%, respectively. Of the patients taken to surgery as primary treatment, 63% remained disease-free during the first two years of follow-up, with a frequency of nearly 100% during the same period when radiotherapy was given after surgery. Conclusions: Cervical carcinosarcoma is an infrequent condition whose most common clinical manifestation is the presence of genital bleeding accompanied by a pelvic mass. Surgery, radiotherapy and chemotherapy are therapeutic options available for the treatment of this entity. However, regardless of the treatment provided, survival prognosis in women with this disease is lower than in women with squamous cell carcinoma or adenocarcinoma. Further studies of high methodological quality are required to assess the safety and effectiveness of the various interventions used as therapeutic approach to this entity.


RESUMEN Objetivo: reportar el caso de una paciente con carcinosarcoma del cuello uterino con sangrado intraabdominal, y revisar la literatura disponible sobre el tratamiento y pronóstico de la entidad. Materiales y métodos: se reporta el caso de una paciente de 84 años, que consultó por masa abdominal y obstrucción del tracto urinario. Durante la estancia hospitalaria presentó sangrado intraabdominal con signos de choque, por lo que fue necesario realizar histerectomía abdominal total con salpingo-oforectomía bilateral, ligadura de hipogástricas y taponamiento de cavidad pélvica como intervenciones para controlar el sangrado. El estudio histológico reportó como diagnóstico carcinosarcoma del cérvix. La paciente evolucionó de forma adecuada y fue remitida para continuar manejo por oncología. Para la búsqueda de la literatura se realizó una pesquisa en las bases de datos Medline vía PubMed, SciELO y Ovid, utilizando los términos "uterinecarcinosarcoma" "treatment "cáncer treatment" "treatmentreview" y "treatmentoutcome". La búsqueda se limitó por tipo de idioma, pero no por año de publicación. Resultados: 19 estudios cumplieron con los criterios de inclusión y de exclusión, estas fueron predominantemente reportes de caso. El estadio clínico reportado con mayor frecuencia fue FIGO IB en cerca del 53 % de los casos, y la presentación más frecuente fue el sangrado genital acompañado de masa pélvica. Con un seguimiento promedio de 15 meses, la sobrevida para este tumor es del 17 % para las pacientes que recibieron radioterapia. El 63 % de las pacientes que recibieron cirugía como tratamiento primario permanecieron libres de enfermedad durante los dos primeros años de seguimiento, con una frecuencia cercana al 100% para este mismo periodo cuando se administró radioterapia posterior a la cirugía. Conclusiones: el carcinosarcoma de cérvix es una entidad poco frecuente, cuya manifestación clínica más común suele ser la presencia de sangrado genital acompañado de masa pélvica. Dentro de las opciones terapéuticas disponibles para tratar esta entidad se encuentran la cirugía, la radio y la quimioterapia. No obstante, independientemente del tratamiento proporcionado, el pronóstico de sobrevida para las mujeres con esta patología es inferior al de las mujeres con carcinomas escamosos o adenocarcinomas. Se requieren estudios de alta calidad metodológica que evalúen la seguridad y la efectividad de las diferentes intervenciones para el abordaje terapéutico de esta entidad.


Subject(s)
Humans , Carcinosarcoma , Prognosis , Therapeutics , Uterus , Uterine Cervical Diseases , Cervix Uteri
13.
Rev. bras. anal. clin ; 50(1): 80-85, jun. 2018. tab
Article in Portuguese | LILACS | ID: biblio-912016

ABSTRACT

Objetivo: Avaliar o impacto da capacitação dos profissionais do SUS envolvidos na coleta de amostras cervicovaginais para rastreamento de lesões precursoras do câncer de colo uterino no município de Videira (SC). Métodos: Estudo de intervenção cujas variáveis estudadas foram: adequabilidade da amostra, epitélios representados e resultado do exame citopatológico. A avaliação da qualificação dos profissionais baseou-se na comparação dos formulários referentes ao período de dezembro de 2015 a junho de 2016, antes da capacitação, com os formulários de junho de 2016 a janeiro de 2017, após a capacitação. Avaliou-se o resultado utilizando-se o teste do c2 de Pearson, com nível de significância de 5%. Resultados: Após a capacitação, houve aumento de amostras satisfatórias, de 97,81% para 99,0%. Observou-se insatisfatoriedade nas amostras coletadas antes e após a capacitação, correspondendo a 2,18% e 1,0%, respectivamente (p<0,0001). Houve índice maior de espécimes com representatividade somente de células escamosas antes da qualificação ­ 44,6 %. Verificou-se aumento da frequência de representação de células endocervicais, 55,39% para 85,03% (p<0,0001). Quanto aos resultados negativos para lesão intraepitelial e/ou malignidade, os percentuais obtidos foram 97,02% e 93,38%, antes e depois da capacitação, respectivamente. Foram constatados 2,41% e 5,14% (p<0,0001) de lesões menos graves, em comparação às lesões mais graves, correspondendo a 0,55% e 1,46% (p=0,0182), nas amostras obtidas antes e após a qualificação, respectivamente. Conclusão: Após a capacitação, houve melhora na adequabilidade da amostra, representação dos epitélios e resultado do exame. Logo, é imprescindível a capacitação dos profissionais coletores do exame citopatológico, proporcionando maior confiabilidade nos resultados.


Subject(s)
Cell Tracking , Cervix Uteri , Professional Training , Unified Health System , Uterine Cervical Diseases , Uterine Cervical Neoplasms
14.
Rev. Eugenio Espejo ; 12(1): 53-63, Jun.- 2018.
Article in Spanish | LILACS | ID: biblio-980680

ABSTRACT

Se realizó un estudio observacional, de tipo descriptivo y corte transversal con enfoque mixto; cuyo objetivo de determinar los factores de riesgo de ruptura prematura de membra-nas en las pacientes ingresadas con ese diagnóstico en el Hospital Provincial General Docen-te Riobamba durante el período noviembre 2017-febrero 2018. Se trabajó con la totalidad de la población, la que estuvo integrada por 17 embarazadas en el contexto de investigación. Se aplicó una guía de entrevista estructurada la misma que fue sometida a valoración por espe-cialistas integrado por siete docentes vinculadas a las tutorías de prácticas preprofesionales en el área del Proceso de Atención de Enfermería en Salud Sexual y Reproductiva de la Universidad Nacional de Chimborazo; el 85,71 % de las consultadas consideraron el instru-mento como muy adecuado. El 52,94 % de las mujeres estudiadas fue mayor de 26 años, tenía estado civil casadas y nivel de instrucción de secundaria. El factor clínico más relevante fue infecciones de vías urinarias y cérvico-vaginales durante el embarazo; sin embargo, entre los obstétricos fueron los controles obstétricos escasos y el oligoamnios. Los datos arrojaron la ausencia de aquellos relativos a ser víctima de violencia familiar, consumo de sustancias tóxicas, auto medicación, relaciones sexuales durante los últimos 15 días del embarazo, tacto vaginal y/o amniocentesis en las horas previas a la presentación de la entidad en cuestión, embarazo múltiple, antecedentes personales de RPM, incompetencia del cérvix y polihi-dramnios.


An observational, descriptive and cross-sectional study with a mixed approach was carried out. This research aimed to determine the risk factors for premature rupture of membranes in patients admitted with this diagnosis in the General Hospital of Riobamba during the period November 2017-February 2018. The entire population was integrated by 17 pregnant women in the research context. A structured interview guide was applied, which was assessed by seven specialists who worked at pre-professional practice tutoring in the area of the Nursing Care Process in Sexual and Reproductive Health of Universidad Nacional de Chimborazo; the instrument was considered as very adequate by 85.71% of interviewed ones. 52.94% of the women studied were over 26 years of age, married, and high school education level. The most relevant clinical factor was urinary tract and cervico-vaginal infections during pregnan-cy. However, the obstetric factors were the controls in this field and oligohydramnios. The data showed the absence of those ones related to being a victim of family violence, consump-tion of toxic substances, self-medication, sexual intercourse during the last 15 days of preg-nancy, vaginal touch and / or amniocentesis in the hours prior to the presentation of the entity in question , multiple pregnancy, personal history of RPM, incompetence of the cervix and polyhydramnios.


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications , Fetal Membranes, Premature Rupture , Standardized Nursing Terminology , Urinary Tract Infections , Obstetrics and Gynecology Department, Hospital , Uterine Cervical Diseases , Risk Factors , Amniocentesis
16.
Mem. Inst. Oswaldo Cruz ; 112(10): 728-731, Oct. 2017. tab
Article in English | LILACS | ID: biblio-894837

ABSTRACT

The classification of human papillomavirus (HPV) intratypic lineages by complete genome sequencing is a determinant in understanding biological differences in association with this disease. In this work, we have characterised complete HPV genomes from southern Brazil. Fifteen cervicovaginal Pap smear negative samples previously categorised as HPV-positive were sequenced using ultradeep sequencing, and 18 complete genomes from 13 different HPV types were assembled. Phylogenetic and genetic distance analyses were performed to classify the HPV genomes into lineages and sublineages. This is the first report describing the distribution of HPV intratype lineages of high and low oncogenic risk in asymptomatic women from southern Brazil.


Subject(s)
Humans , Female , Adult , Papillomaviridae , Papillomaviridae/genetics , Vaginal Smears , DNA, Viral , Uterine Cervical Diseases/virology , Genome, Viral , Papillomavirus Infections/virology , Risk Factors
17.
Rev. cuba. enferm ; 33(2): 0-0, jun. 2017. tab
Article in Spanish | LILACS, BDENF, CUMED | ID: biblio-1093191

ABSTRACT

Introducción: la citología cérvico uterina es la prueba de cribado de bajo costo que permite identificar las alteraciones cervicales en un amplio grupo de mujeres. Objetivos: determinar las alteraciones cérvico uterinas, basadas en el análisis de pruebas citológicas, en mujeres de Santa Marta. Métodos: estudio descriptivo retrospectivo de diseño documental y enfoque cuantitativo, llevado a cabo en una entidad de primer nivel de atención en salud de la ciudad de Santa Marta, Colombia. La recogida de datos se hizo sobre 2 958 registros de pruebas citológicas, correspondientes al periodo comprendido entre 2011 - 2014. Para el análisis de la información se utilizó la hoja de cálculo de Excel, el cual permitió el diseño de las tablas para el análisis de frecuencia de las alteraciones. Resultados: presentó alteraciones cérvico uterinas 7,16 por ciento; el 54,71 por ciento, Ascus; el 22,64 por ciento, neoplasia intraepitelial cervical I; 16,50 por ciento, Virus del papiloma humano; 3,77 por ciento, neoplasia intraepitelial cervical III y 1,88 por ciento, carcinoma. El 8,72 por ciento, infecciones vaginales, compatibles con vaginitis bacteriana el 62,51 por ciento y con cándida albicans 37,20 por ciento. Conclusiones: a pesar de la existencia de programas dirigidos a la prevención y detección precoz de lesiones cérvico uterinas y de las directrices de organismos internacionales y nacionales, estas alteraciones siguen representando un problema de salud pública en la región(AU)


Introduction: The cervical cytology is the low-cost screening test that allows the identification of cervical changes in a large group of women. Objectives: To determine the cervical alterations, based on the analysis of cytological tests, in Santa Marta women. Methods: Retrospective descriptive study of documentary design and quantitative approach, carried out in a first level health care institution in the city of Santa Marta, Colombia. The data collection was done from 2958 records of cytological tests, corresponding to the period between 2011 and 2014. For the analysis of the information we used an Excel processor sheet, which allowed the design of tables for the analysis of frequency of alterations. Results: 7.16 percent presented cervical alterations; 54.71 percent, ascus; 22.64 percent, cervical intraepithelial neoplasia I; 16.50 percent, human papillomavirus; 3.77 percent, cervical intraepithelial neoplasia III; and 1.88 percent, carcinoma. 8.72 percent presented vaginal infections, 62.51 percent compatible with bacterial vaginitis and 37.20 percent with candida albicans. Conclusions: Despite the existence of programs aimed at the prevention and early screening of cervical lesions, and the guidelines of international and national agencies, these alterations continue to represent a public health concern in the region(AU)


Subject(s)
Humans , Female , Uterine Cervical Diseases/prevention & control , Uterine Cervical Neoplasms/prevention & control , Cytological Techniques/methods , Papanicolaou Test/methods , Epidemiology, Descriptive , Cross-Sectional Studies
18.
Rev. bras. ginecol. obstet ; 39(5): 217-223, May 2017. tab, graf
Article in English | LILACS | ID: biblio-898862

ABSTRACT

Abstract Purpose To evaluate the effect of mesenchymal stem cells (MSCs) on fertility in experimental retrocervical endometriosis. Methods A total of 27 New Zealand rabbits were divided into three groups: endometriosis, in which endometrial implants were created; mesenchymal, in which MSCs were applied in addition to the creation of endometrial implants; and control, the group without endometriosis. Fisher's exact test was performed to compare the dichotomous qualitative variables among the groups. The quantitative variables were compared by the nonparametric Mann-Whitney and Kruskal-Wallis tests. The MannWhitney test was used for post-hoc multiple comparison with Boniferroni correction. Results Regarding the beginning of the fertile period, the three groups had medians of 14±12.7, 40±5, and 33±8.9 days respectively (p = 0.005). With regard to fertility (number of pregnancies), the endometriosis and control groups showed a rate of 77.78%, whereas the mesenchymal group showed a rate of 11.20% (p = 0.015). No differences in Keenan's histological classification were observed among the groups (p = 0.730). With regard to the macroscopic appearance of the lesions, the mesenchymal group showed the most pelvic adhesions. Conclusion The use of MSCs in endometriosis negatively contributed to fertility, suggesting the role of these cells in the development of this disease.


Resumo Objetivo Avaliar o efeito das células-tronco mesenquimais sobre a fertilidade na endometriose retrocervical experimental. Métodos Um total de 27 coelhas da raça Nova Zelândia foram divididas em três grupos: endometriose, em que os implantes endometriais foram criados; mesenquimal, em que as células-tronco mesenquimais foram aplicadas complementarmente à criação implantes endometriais; e controle, sem endometriose. O teste exato de Fisher foi realizado para comparar variáveis dicotômicas qualitativas entre os grupos. As variáveis quantitativas foram comparadas pelos testes não paramétricos de MannWhitney e Kruskal-Wallis. O teste de Mann-Whitney foi utilizado para a comparação múltipla pós-hoc com correção de Boniferroni. Resultados em relação ao início do período fértil, os grupos endometriose, mesenquimal e controle tiveram medianas de 14±12,7; 40±5; e 33±8,9 dias, respectivamente (p = 0,005). Sobre a taxa de fertilidade (número de gravidezes), os grupos endometriose e controle mostraram uma taxa de 77,78%, enquanto o grupo mesenquimal mostrou uma taxa de 11,20% (p = 0,015). Não foram observadas diferenças na classificação histológica de Keenan entre os grupos (p = 0,730). No que diz respeito à aparência macroscópica das lesões, o grupo mesenquimal mostrou maiores adesões pélvicas. Conclusão O uso de células-tronco mesenquimais na endometriose contribuiu negativamente para a fertilidade, sugerindo o papel dessas células no desenvolvimento da doença.


Subject(s)
Humans , Animals , Uterine Cervical Diseases/etiology , Endometriosis/etiology , Mesenchymal Stem Cells/physiology , Infertility, Female/etiology , Rabbits , Uterine Cervical Diseases/pathology , Disease Models, Animal , Endometriosis/pathology , Infertility, Female/pathology
19.
Braz. j. infect. dis ; 21(1): 88-91, Jan.-Feb. 2017. tab
Article in English | LILACS | ID: biblio-1039183

ABSTRACT

Abstract Human papillomavirus (HPV) has been found in several regions of the body, including the oral cavity. Recently, this virus has been associated with oropharyngeal cancer, but little is known about HPV transmission to the oral cavity. We carried out a study to investigate concurrent oral and cervical infections in 76 asymptomatic women attending a healthcare program. Demographic and behavior data were obtained through a structured questionnaire. Oral and cervical mucosa scrapings were collected and stored for DNA extraction. HPV DNA amplification was performed by polymerase chain reaction assay (PCR) using both primers My09/My11 and FAP59/64, followed by HPV typing with restriction fragment length polymorphism analysis (RFLP) and sequencing. The data collected revealed no risk factors for HPV infection in these 76 women. HPV prevalence of 9.2 and 5.3% was found in cervical and oral mucosa, respectively. Concurrent infections by discordant types were detected in one case only. Sequencing procedures allowed us to detect a new putative HPV 17 subtype from the Betapapillomavirus genus. Our results support the view that cervical and oral HPV infections are independent events. The observed low prevalence of both oral and cervical HPV infections could be associated with attendance in a healthcare program.


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Uterine Cervical Diseases/virology , Cervix Uteri/virology , Papillomavirus Infections/virology , Asymptomatic Infections , Mouth Diseases/virology , Mouth Mucosa/virology , Papillomaviridae/isolation & purification , Polymorphism, Restriction Fragment Length , Polymerase Chain Reaction , Cross-Sectional Studies , Surveys and Questionnaires , Risk Factors , DNA Viruses , Genotype
20.
Rev. saúde pública (Online) ; 51: 92, 2017. tab, graf
Article in English | LILACS | ID: biblio-903258

ABSTRACT

ABSTRACT OBJECTIVE Estimate the prevalence of cervical HPV infection among women assisted by the Family Health Strategy and identify the factors related to the infection. METHODS A cross-sectional study involving 2,076 women aged 20-59 years old residing in Juiz de Fora, State of Minas Gerais, who were asked to participate in an organized screening carried out in units were the Family Health Strategy had been implemented. Participants answered the standardized questionnaire and underwent a conventional cervical cytology test and HPV test for high oncogenic risk. Estimates of HPV infection prevalence were calculated according to selected characteristics referenced in the literature and related to socioeconomic status, reproductive health and lifestyle. RESULTS The overall prevalence of HPV infection was 12.6% (95%CI 11.16-14.05). The prevalence for the pooled primer contained 12 oncogenic HPV types (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) was 8.6% (95%CI 7.3-9.77). In the multivariate analysis, it was observed that the following variables were significantly associated with a higher prevalence of HPV infection: marital status (single: adjusted PR = 1.40, 95%CI 1.07-1.8), alcohol consumption (any lifetime frequency: adjusted PR = 1.44, 95%CI 1.11-1.86) and number of lifetime sexual partners (≥ 3: adjusted PR = 1.35, 95%CI 1.04-1.74). CONCLUSIONS The prevalence of HPV infection in the study population ranges from average to particularly high among young women. The prevalence of HPV16 and HPV18 infection is similar to the worldwide prevalence. Homogeneous distribution among the pooled primer types would precede the isolated infection by HPV18 in magnitude, which may be a difference greater than the one observed. The identification of high-risk oncogenic HPV prevalence may help identify women at higher risk of developing preneoplastic lesions.


RESUMO OBJETIVO Estimar a prevalência de infecção do colo do útero pelo HPV entre mulheres assistidas pela Estratégia Saúde da Família e identificar os fatores relacionados à infecção. MÉTODOS Trata-se de estudo transversal, no qual participaram 2.076 mulheres de 20 a 59 anos, residentes em Juiz de Fora, MG, convocadas para rastreamento organizado, realizado em unidades com a Estratégia Saúde da Família implantada. As participantes responderam ao questionário padronizado, realizando exame citológico cervical convencional e teste para HPV de alto risco oncogênico. Foram calculadas estimativas de prevalência de infecção pelo HPV segundo características selecionadas, referenciadas na literatura, relacionadas ao status socioeconômico, saúde reprodutiva e estilo de vida. RESULTADOS A prevalência global de infecção pelo HPV foi 12,6% (IC95% 11,16-14,05). A prevalência para o pooled primer contendo 12 tipos de HPV oncogênicos (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 e 68) foi 8,6% (IC95% 7,3-9,77). Na análise multivariada, observou-se que as seguintes variáveis estavam significativamente associadas a uma maior prevalência de infecção por HPV: estado conjugal (solteira: RP ajustada = 1,40; IC95% 1,07-1,8), consumo de bebidas alcoólicas (qualquer frequência durante a vida: RP ajustada = 1,44; IC95% 1,11-1,86) e número de parceiros sexuais ao longo da vida (≥ 3: RP ajustada = 1,35; IC95% 1,04-1,74). CONCLUSÕES A prevalência de infecção pelo HPV na população estudada varia de média a particularmente alta entre as mulheres jovens. A prevalência de infecção por HPV16 e HPV18 se assemelha às mundiais. Uma distribuição homogênea entre os tipos do pooled primer precederia a infecção isolada pelo HPV18 em magnitude, podendo ser a diferença maior que a observada. A identificação da prevalência de HPV de alto risco oncogênico pode auxiliar na identificação de mulheres sob maior risco de evolução para lesão preneoplásica.


Subject(s)
Humans , Female , Adult , Young Adult , Primary Health Care/statistics & numerical data , Uterine Cervical Diseases/epidemiology , Papillomavirus Infections/epidemiology , Papillomaviridae/isolation & purification , Sexual Behavior , Socioeconomic Factors , Brazil/epidemiology , Uterine Cervical Diseases , Family Health , Prevalence , Cross-Sectional Studies , Multivariate Analysis , Risk Factors , Age Distribution , Papillomavirus Infections/etiology , Life Style , Middle Aged , National Health Programs/statistics & numerical data
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