Infección por virus del papiloma humano en mujeres del Cantón Cañar, Ecuador / Human papillomavirus infection among women from Cañar Canton in Ecuador

Introducción: Existen pocos estudios sobre la circulación del virus del papiloma humano en mujeres ecuatorianas, particularmente residentes en el Cantón Cañar. Objetivo: Determinar la circulación del virus del papiloma humano, las alteraciones en la citología cérvico-vaginal de mujeres cañaríes y el comportamiento de algunas variables sociodemográficas y clínico-epidemiológicas. Métodos: Estudio analítico de corte transversal desde julio 2017-septiembre 2018. Se colectaron células cervicouterinas de 100 mujeres entre 15 y 55 años de edad para determinar la infección viral y alteraciones citológicas. Se investigó la asociación entre variables sociodemográficas y clínico-epidemiológicas con la infección viral. Resultados: El 51 por ciento (51/100) de las mujeres examinadas resultó positivo al virus, con predominio de los genotipos oncogénicos. El genotipo 31 fue el más frecuente (56,9 por ciento; 29/51), seguido por el genotipo 58 (43,1 por ciento; 22/51). Las mujeres mayores de 50 años, tenían una probabilidad menor de estar infectadas (3,9 por ciento; 2/51). La probabilidad de infección fue mayor en mujeres solteras, con antecedentes de infecciones de transmisión sexual, que padecían procesos cervicales inflamatorios, y en las fumadoras. La infección con genotipo 66 estuvo asociada al uso de anticonceptivos hormonales (53,3 por ciento; 8/15); p= 0,045, RP= 3,08 IC95 por ciento (1,00-9,46). Se obtuvo el 97 por ciento de citologías negativas para malignidad; no se diagnosticaron casos con lesiones de alto grado. Conclusiones: La elevada prevalencia de infección con genotipos oncogénicos en contraste con la baja frecuencia de citologías positivas, indica la necesidad de implementar programas eficientes para la detección precoz del cáncer cervicouterino en la población del Cañar y divulgar campañas de educación sexual y reproductiva(AU)

Introduction: Few studies are available about the circulation of human papillomavirus among Ecuadorian women, particularly those from Cañar Canton. Objectives: Determine the circulation of human papillomavirus, alterations in the cervical-vaginal cytology of women from Cañar Canton, and the behavior of some sociodemographic and clinical-epidemiological variables. Methods: An analytical cross-sectional study was conducted from July 2017 to September 2018. Cervical cells were collected from 100 women aged 15-55 years to determine viral infection and cytological alterations. An analysis was performed of the relationship of sociodemographic and clinical-epidemiological variables to viral infection. Results: Of the women examined, 51 percent; (51/100) tested positive for the virus, with a predominance of oncogenic genotypes. Genotype 31 was the most common (56.9 percent;; 29/51), followed by genotype 58 (43.1 percent; 22/51). Women aged over 50 years had a lesser probability of being infected (3.9 percent;; 2/51). Infection probability was greater among single women, with a history of sexually transmitted infections, who suffered from inflammatory cervical processes, and smokers. Infection by genotype 66 was associated to the use of hormonal contraceptives (53.3 percent;; 8/15); p= 0.045, PR= 3.08 CI95 percent; (1.00-9.46). Of the sample cytologies, 97 percent; were negative for malignancy; no case was diagnosed of high-grade lesions. Conclusions: The high prevalence of infection by oncogenic genotypes, as opposed to the low frequency of positive cytologies, points to the need to implement efficient programs aimed at early detection of cervical cancer in the population of Cañar Canton, as well as sexual and reproductive education campaigns(AU)

Pancreatic islet stereology: estimation of beta cells mass / Estereología de los islotes pancreáticos: estimación de la masa de células beta

Obesity and its comorbidities are becoming epidemic in the Western world. Beta cell mass estimation is an important indicator to track the progression of insulin resistance/type 2 diabetes, particularly in experimental studies, where it can be performed with stereological tools in an unbiased way. In this work, we present a simple protocol that can contribute to doing the practice of estimating the mass of beta cells more frequent and reproducible. As with any quantitative study, the necessary precautions regarding sampling and randomness must be respected.

La obesidad y sus comorbilidades se están convirtiendo en una epidemia en el mundo occidental. La estimación de la masa de células beta es un indicador importante para rastrear la progresión de la resistencia a la insulina/diabetes tipo 2, particularmente en estudios experimentales, donde se puede realizar con herramientas estereológicas de manera imparcial. En este trabajo presentamos un protocolo simple que puede contribuir a que la práctica de estimar la masa de células beta sea más frecuente y reproducible. Como en cualquier estudio cuantitativo, deben respetarse las precauciones necesarias con respecto al muestreo y la aleatoriedad.

Citología aspirativa con aguja fina transbroncoscópica guiada por ultrasonido endobronquial / Endobronchial ultrasound-guided transbronchoscopic fine needle aspiration cytology

Introducción: El enfrentamiento diagnóstico de las lesiones sospechosas de cáncer pulmonar ha cambiado en los últimos años. Objetivo: Describir el primer caso diagnosticado en Cuba de carcinoma de pulmón por aspiración transbronquial por aguja fina guiada por ultrasonografía endobronquial. Presentación del caso: Se presenta un caso de carcinoma indiferenciado de células pequeñas. El diagnóstico se obtiene mediante la realización de una citología aspirativa con aguja fina de ganglios mediastinales, transbroncoscópica y guiada por ultrasonido endobronquial. Conclusiones: El uso de EBUS-TBNA es una herramienta con un alto rendimiento diagnóstico, con escasas complicaciones descritas y debe considerarse como una posibilidad en el estudio de lesiones adyacentes a la vía aérea central(AU)

Introduction: The diagnostic confrontation of lesions suspected of lung cancer has changed in recent years. Objective: To describe the first case of lung carcinoma, diagnosed in Cuba by endobronchial ultrasound-guided transbronchoscopic fine needle aspiration cytology. Case report: A case of undifferentiated small cell carcinoma is reported. Diagnosis is obtained by performing a fine needle aspiration cytology of the mediastinal lymph nodes, transbronchoscopic and guided by endobronchial ultrasound. Conclusions: The use of EBUS-TBNA is a tool with high diagnostic yield, with few described complications and should be considered as a possibility in the study of lesions adjacent to the central airway(AU)

Brush Biopsy Sample Quality: Preliminary Investigation of a Metal Brush Prototype

Objective: To qualitatively investigate whether a prototype brush composed of metal bristles collects oral epithelial cells effectively for cytological evaluation of oral mucosal lesions. Material and Methods: Twenty patients with suspicious oral mucosal lesions were enrolled. Patients were asked to gargle with saline and to deposit the oral rinse into specimen cup. Then, oral mucosal cell samples were collected using a metal oral brush, via sweeping motion. Punch biopsy was performed for histological examination. All samples were evaluated with liquid based cytology (LBC) according to the cellularity, the depth of the epithelial layer, cellular integrity by an oral pathologist. Results: Oral rinse provided samples with 100% cellular integrity and cellularity, mostly from the intermediary layers. With metal brush, both inadequate cellularity and cellular integrity was observed in 25% of the cases. Cellular integrity was adequate in 65%, cellularity was adequate in 45% of the lesions. Samples were dominantly from the intermediary layers, but in one case, metal brush collected cells from the parabasal layer. Conclusion: The narrow spiral pitch and width of metal bristles may have resisted to release the cellular samples collected. With adjustment of the spiral pitch and diameter of metal brush bristles, its' efficacy could be enhanced.

Comparative study of metachromatic staining methods in assessing the exfoliative cell types during oestrous cycle in Sprague-Dawley laboratory rats / Estudio comparativo de los métodos de tinción metacromática en la evaluación de los tipos de células exfoliativas durante el ciclo estral en ratas Sprague-Dawley de laboratorio

This study was aimed at comparing the commonly used metachromatic stains viz., Papanicolaou stain, WrightGiemsa, Toluidine blue and Methylene blue in the assessment of cell types of the oestrous cycle in rats. Eight female Sprague-Dawley rats aged 8-9 weeks were used for this assessment. Cotton Swabs were gently inserted in the animals vagina to obtain cells from which they were then transferred to glass slides for staining and evaluation under microscopy. The different cell types were compared for their morphological features and clarity of cellular detail under all four stains. The application, advantages and limitations of all stains were then discussed. It was concluded that the selection of the most effective stain in the assessment of vaginal cytology depends on their application to clinical or research which was based on the cellular detail of interest, time, cost and availability of each staining procedure.

El presente estudio tuvo como objetivo comparar las tinciones metacromáticas comúnmente utilizadas, Wright's-Giemsa, azul de toluidina, azul de metileno y tinción de Papanicolaou, en la evaluación de los tipos de células del ciclo estral en ratas. El estudio se realizó en ocho ratas hembras SpragueDawley, con edades entre 8 y 9 semanas, y se usaron hisopos vaginales de algodón para preparar portaobjetos. Los diferentes tipos de células se compararon por sus características morfológicas y claridad en las cuatro tinciones. La aplicación, ventajas y limitaciones de todas las tinciones fueron discutidas. Se concluye que la selección de la tinción más efectiva en la evaluación de la citología vaginal depende de su uso, es decir, clínico o de investigación, el detalle celular de interés, tiempo, costo y disponibilidad.

Lesiones epiteliales del cérvix en pacientes sin citología alterada en la Isla de la Juventud (2014-2015) / Cervix Epithelial Lesions in Patients with No Altered Cytology in the Isle of Youth (2014-2015)

Introducción: el estudio de las lesiones epiteliales del cérvix constituye una prioridad en la prevención de este cáncer que muestra un incremento evidente de la morbimortalidad, a pesar de programas de pesquiza poblacional. Objetivo: describir el comportamiento de las lesiones epiteliales según variables clínico - epidemiológicas de interés. Métodos: estudio descriptivo retrospectivo para caracterizar el comportamiento de lesiones epiteliales del cuello uterino en las 1 148 pacientes atendidas en la Consulta de Patología de Cuello en el Hospital General Docente de la Isla de la Juventud desde 2014 hasta 2015. Resultados: del total de pacientes, 71 por ciento tenían entre 25 y 51 años de edad, 44 por ciento procede de los Consejos Populares de Santa Fé y Pueblo Nuevo. El inicio de las relaciones sexuales supera los 16 años y el número promedio de partos y abortos no es mayor de dos. Del total, 42 % tenía una citología con infección por el virus del papiloma humano y 30 por ciento acudió por una lesión evidente del cérvix sin una citología alterada y 57 por ciento tenían un área lesional menor a 200 mm2. En los estudios colposcópico e histológico predominaron las lesiones de alto grado con más del 60 por ciento y las lesiones invasoras sólo representaron 4 por ciento. El número de pacientes jóvenes es significativamente alto. No se evidenció un comportamiento anormal de los factores de riesgo clásicos para esta enfermedad. Conclusiones: los resultados de este estudio pueden servir de base para trazar estrategias locales del Sistema de Salud encaminadas a la disminución de la morbimortalidad por cáncer en el territorio(AU)

Introduction: The study of cervix epithelial lesions is a priority in preventing this type of cancer because of the evident morbidity and mortality increase, despite population screening programs. Objective: To describe epithelial lesion behavior according to clinical - epidemiological variables of interest. Methods: A retrospective descriptive study was conducted to characterize the cervix epithelial lesion behavior in 1148 patients treated in the Consultation of Neck Pathology at the General Teaching Hospital of the Isle of Youth from 2014 to 2015. Results: 71 percent of the total number of patients aged between 25 and 51 years, 44 percent came from Santa Fé and Pueblo Nuevo territories. These subjects' first sexual relations were after they were 16 and the average number of deliveries and abortions is less than two. Forty-two percent had human papillomavirus infection confirmed by cytology. Thirty percent came to consultation for an obvious cervix lesion with no cytology altered. Fifty-seven percent had a lesion area less than 200 mm2. The colposcopy and histological studies, high-grade lesions predominated in more than 60 percent. Invasive lesions only represented 4 percent. The number of young patients is significantly high. There was no evidence of abnormal behavior of this disease's classic risk factors. Conclusions: The results of this study can serve as a basis to draw local strategies for the Health System aiming to reduce morbidity and mortality from cancer in the territory(AU)

Alteraciones cérvico uterinas en mujeres de Santa Marta / Cervical alterations in Santa Marta women

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)

Avaliação crítica do papel da citologia cervical em meio líquido no rastreamento do câncer do colo uterino / Critical evaluation of the role of liquid based cervical cytology in screening for cervical cancer

A citologia cervical em meio líquido (CML) foi aprovada pela Administração de Drogas e Alimentos dos EUA (Food and Drug Administration - FDA) com objetivo de reduzir as falhas da citologia cervical convencional (CC). Segundo a literatura atual, a CML aumenta a sensibilidade da citologia cervical, a adequabilidade das amostras e diminui o número de esfregaços insatisfatórios quando comparada com a CC. Embora alguns países tenham legitimado o modelo de CML no rastreio de neoplasia do colo do útero, há controvérsias a respeito da escolha do melhor método de exame citopatológico cervical. Dessa forma, o objetivo da presente revisão é avaliar o impacto da introdução da CML em termos de eficácia, custos, conhecimento técnico necessário e implicações para a sua introdução.(AU)

The liquid based cervical cytology has been approved by the Food and Drug Administration (FDA) in order to reduce failures of conventional cervical cytology (CC). According to current literature, CML increases the sensitivity of cervical cytology, the suitability of the samples and reduce the number of poor smears compared with CC. Although some countries have legitimized the CML model in screening cancer of the cervix, there is a controversy about the choice of the best cervical Pap smear method. Thus, the aim of the current review is to evaluate the impact of the introduction of CML in terms of effectiveness, costs, necessary technical knowledge and implications of its introduction.(AU)

Frecuencia de candidiasis oral asociada al uso de prótesis dentales en pacientes de la clínica odontológica de la Universidad Anáhuac Norte / The frequency of oral candidiasis associated with the use of dental prostheses in patients of the dental clinic at the Anahuac University

La candidiasis es la infección micótica más común de la cavidad bucaly es causada por el hongo Candida. Dentro de la población geriátricala candidiasis oral es uno de los tres principales motivos de consulta. El crecimiento en superfi cies es parte natural del modo de vivir del hongo Candida y es común que colonice las prótesis dentales, dando como resultado estomatitis por uso de dentadura o estomatitis subplaca.El diagnóstico de estomatitis por dentadura es relevante, ya quealrededor de 50 por ciento de las personas de edad promedio de 65 a 74 años, y 70 por ciento de 75 a 84 años utilizan prótesis dentales removibles. El objetivo del presente estudio fue determinar la frecuencia de candidiasis oral asociada a prótesis dentales removibles en los pacientes de la ClínicaOdontológica de la Universidad Anáhuac México Norte durante el periodo enero-mayo de 2016. Material y métodos: Se realizó un estudiodescriptivo, transversal y observacional. La muestra estuvo conformada por pacientes portadores de prótesis dentales removibles que acudieron a la Clínica Odontológica de la Universidad Anáhuac México Norte.Se interrogó al paciente respecto al uso de la prótesis y su condición de salud, posterior a la exploración clínica se tomó la citología exfoliativa de la mucosa debajo de la prótesis removible. Resultados: La muestraestuvo constituida por 22 pacientes de la clínica de prótesis removible,seis eran portadores de prótesis, de éstos 83 por ciento fueron positivos a candidiasis. Conclusiones: La falta de indicaciones sobre el cuidado, uso ehigiene de las prótesis dentales o la falta de apego a estas indicacionespor parte del paciente ocasionan el desarrollo de estomatitis subplaca.

Candidiasis is the most common mycotic infection in oral cavity andcaused by fungi candid. Oral candidiasis is one of three principalreasons for consultation in a geriatric population. A natural part of theway of living of the fungi Candida is the growth on surfaces. It growthmakes common that the fungi Candida colonize the dental prostheses,so the denture stomatitis or dental-related stomatitis is development.Denture stomatitis diagnosis is quite important because from the totalpopulation using dental removable prostheses around of 50% is between65-74 years old and 70% is between 75-84 years old. The ofthis study was identifying oral candidiasis frequency related to dentalremovable prostheses in patients from Universidad Anahuac, DentalSchool (México Norte), from January 2016 to May 2016. Material andmethods: Was made a descriptive, cross and observational study. Thesample was integrated by patients using dental removable prostheses,who went to Universidad Anahuac’s dental school (México Norte). Thepatients were interrogated about dental removable prostheses use andtheir health condition, after clinic exploration and exfoliative cytologywas taken from mucosa below dental removable prostheses. Results: 22patients from dental service using removable prosthesis constituted thesample, from this 22 patients only 6 were using a removable prosthesisand from this 6 patients only 83% were positive to oral candidiasis.Conclusions: Instructions scare about care, use, and hygiene of dentalprosthesis as well as not follow these instructions for patient’s partmake possible denture stomatitis development.

Prevalencia del virus del papiloma humano en mujeres con citología negativa / Prevalence of Human Papillomavirus Infection in Women with Negative Cytology

Introducción: la infección persistente por los subtipos oncogénicos del virus del papiloma humano es la causa principal del desarrollo del cáncer cérvico-uterino. Las mujeres que presentan citología normal pueden estar infectadas por subtipos de alto riesgo carcinogénico. Objetivo: brindar información actualizada existente en la literatura científica internacional acerca de la prevalencia de la infección por el virus del papiloma humano a nivel mundial y de la importancia de la detección temprana de estos virus en mujeres con citología negativa. Método: se realizó una revisión de los estudios desarrollados a nivel global y para esto se utilizaron las bases de datos PubMed, MedLine, BioMed Central y SciELO. Resultados: la prevalencia de la infección por los subtipos de alto riesgo del virus del papiloma humano en las mujeres con citología normal fue del 10 - 12 por ciento, con algunas diferencias entre países. El mayor pico de frecuencia de esta infección viral se localizó en jóvenes menores de 25 años y, en algunas regiones geográficas, se observó un segundo pico en mayores de 49 años. Los cinco subtipos oncogénicos más frecuentes de estos virus fueron 16, 18, 31, 52 y 58 con ciertas variaciones a nivel global. Conclusiones: el diagnóstico precoz de la infección por el virus del papiloma humano, especialmente los genotipos de alto riesgo, es un factor importante para una mejor prevención del cáncer cérvico-uterino(AU)

Introduction: Persistent infection with the oncogenic subtypes of human papillomavirus is the leading cause of cervical cancer. Women with normal cytology may be infected with subtypes of high carcinogenic risk. Objective: Provide updated information on the prevalence of human papillomavirus infection worldwide and the importance of their early detection in women with negative cytology. Methods: A review of the studies developed at a global level was carried out and PubMed, MedLine, BioMed Central, and SciELO databases were used. Results: The prevalence of infection with high - risk subtypes of human papillomavirus in women with normal cytology was 10 - 12 percent, with some differences between countries. The highest peak of frequency of this viral infection was located in young women under 25 years old and, in some geographic regions a second peak could be observed in those older than 49 years. The five most frequent oncogenic subtypes of these viruses were 16, 18, 31, 52 and 58 with certain variations globally. Conclusions: Early diagnosis of human papillomavirus infection, especially high-risk genotypes, is an important factor for better prevention of cervical-uterine cancer(AU)

Infiltración traqueal por carcinoma tiroideo diferenciado / Tracheal Infiltration by Differentiated Thyroid Carcinoma

La invasión traqueal por carcinomas tiroideos bien diferenciados es poco frecuente y la técnica quirúrgica a realizar todavía es motivo de controversia entre los cirujanos. El objetivo del artículo fue revisar la literatura disponible sobre la invasión traqueal por carcinomas diferenciados del tiroides. Se realizó una revisión bibliográfica en PubMed/Medlinede la literatura relacionada con la invasión traqueal por carcinomas diferenciados del tiroides(2000 - 2016). Se utilizaron las siguientes palabras y frases clave en inglés: thyroid, carcinoma, differentiated thyroid cancer, tracheal invasión y las correspondientes a su traducción al español. No se encontraron ensayos clínicos aleatorizados. La mayoría de los artículos fueron de carácter retrospectivo. Se evaluaron las características clínicas de la lesión y los métodos de diagnóstico: laringotraqueoscopia, citología aspirativa y estudios imaginológicos. Se definieron las indicaciones quirúrgicas y los cuidados de anestesiología. Por último, se realizóla discusión crítica de los métodos de diagnóstico y de las técnicas quirúrgicas utilizadas y el valor e indicación de cada una de estas. El cuadro clínico, la traqueoscopia, la imaginología y el estudio citopatológico son fundamentales para establecer el diagnóstico preoperatorio. Siempre que sea posible,la resección circunferencial de la tráquea debe ser la técnica de elección en el tratamiento de pacientes afectados por infiltración traqueal por carcinomas tiroideos diferenciados(AU)

Tracheal invasion by differentiated thyroid carcinomas is rare and surgical technique to be performed is still controversial among surgeons. The aim of this article was to review the available literature on the tracheal invasion by differentiated thyroid carcinomas. A literature review on the literature related to tracheal invasion by differentiated thyroid carcinomas (- 2016 2000) was performed in PubMed / MEDLINE. The following keywords and phrases in English were used: thyroid, carcinoma, differentiated thyroid cancer, tracheal invasion and their corresponding translation into Spanish. No randomized clinical trials were found. Most articles were retrospective. Clinical characteristics of this lesion and its diagnostic methods were evaluated: laryngo-tracheoscopy, aspiration cytology, and imaging studies: clinical characteristics of the lesion and diagnostic methods were evaluated. Surgical indications and anesthesiology care were defined. Finally, a critical discussion was made on the diagnostic methods and surgical techniques used and the value and indication of each. The clinical condition, the tracheoscopy, imaging and cytopathology study are essential to establish the preoperative diagnosis. Wherever possible, the circumferential resection of the trachea should be the technique of choice in the treatment of patients with tracheal infiltration by differentiated thyroid carcinomas(AU)

Estudio comparativo de factores de riesgo en mujeres con citología vaginal positiva / Comparative Study of Risk Factors in Women with Positive Pap Smear

Introducción: el cáncer cervicouterino es la segunda causa de muerte en la mujer a nivel mundial, y la principal por enfermedades malignas en las mujeres de los países en desarrollo. Mundialmente, cada año se reportan alrededor de 500 000 nuevos casos y cerca del 80 % corresponde a los países en desarrollo. Mueren anualmente 272 000 mujeres por esta causa. Objetivo: describir los factores de riesgo en mujeres con citología vaginal positiva. Métodos: estudio descriptivo retrospectivo sobre las lesiones premalignas y el cáncer cérvico uterino, así como el comportamiento de los diferentes factores de riesgo asociados a dichas patologías en el Policlínico Docente "Dr. Mario Escalona Reguera" perteneciente al municipio La Habana del Este, en el periodo comprendido entre enero de 2008 a diciembre de 2010 comparado con el periodo de enero de 2011 a diciembre de 2013. Resultados: la mayor frecuencia de alteraciones citológicas correspondió a la neoplasia intraepitelial cervical I (44,3 por ciento) en el periodo 2008-2010, manteniéndose este comportamiento en el 2011-2013 con el 63,2 por ciento. El mayor por ciento de citología positivas fue en edades entre los 25-39 años, con un 55,7 por ciento de frecuencia. Los antecedentes obstétricos más frecuentes fueron la multiparidad y el aborto. Predomina el grupo de mujeres con referencia de más de 4 compañeros sexuales, 93 casos (80,9 por ciento). Conclusiones: las mujeres jóvenes son las más afectadas. Las relaciones sexuales en edades tempranas (antes de los 20 años) aumentan el riesgo de cáncer de cuello uterino(AU)

Introduction: Cervical cancer is the second leading cause of death in women worldwide, and the main malignant disease in women of developing countries. Globally, each year about 500,000 new cases are reported and about 80% are in developing countries. 272 000 women die a year as a result. Objective: Describe risk factors in women with a positive Pap smear. Methods: A retrospective descriptive study of premalignant lesions and cervical cancer was conducted, as well as the behavior of associated different risk factors with these diseases at Dr. Mario Escalona Reguera Teaching Polyclinic in Havana del Este, from January 2008 to December 2010 compared with the period January 2011 to December 2013. Results: More frequent cytological abnormalities corresponded to cervical intraepithelial neoplasia I (44.3 percent) in 2008-2010. This behavior was maintained in 2011-2013 to 63.2 percent. The highest percentage of positive cytology was between the ages of 25-39 years, with a 55.7 percent frequency. The most common obstetric history were multiparity and abortion. The group of women with more than 4 sexual partners, 93 cases (80.9 percent) was higher. Conclusions: Young women are most affected. Sexual intercourse at an early age (before age 20) increases the risk of cervical cancer(AU)

Association between respiratory and postural adaptations and self-perception of school-aged children with mouth breathing in relation to their quality of life

Objective: To investigate the respiratory and postural adaptations associated with mouth and nasal breathing and to evaluate the associations of such adaptations in mouth breathers' self-perceived quality of life. Method: Cross-sectional study with mouth breathers (initial n=116 and final n=48) and nasal breathers (initial n=131 and final n=24) from elementary school, aged between 7 and 14 years. Chest expansion, using cirtometry, the breathing pattern and the use of accessory muscles, by means of clinical evaluations and photogrammetry, and flexibility tests were evaluated in both groups. Subsequently, the mouth breathers were asked to complete the quality of life questionnaire. Statistical tests: Chi-square, odds ratio, Mann-Whitney, and binomial tests were first applied followed by logistic regressions. Results: Thoracic breathing (p=0.04), using of accessory muscles (p=0.03) and reductions in flexibility (p=0.001) increased the chances of an individual being a mouth breather when compared to nasal breathers. Subsequently, using of accessory muscles decreased the chances of snoring among mouth breathers (p=0.03); the presence of shoulder asymmetry reduced the chances of experiencing quiet sleep (p=0.05) and increased the chances of coughing or being tired when playing or running (p=0.008). Finally, forward head position reduced the chances of waking up at night (p=0.04) and experiencing shortness of breath (p=0.05). Conclusions: Respiratory and postural adaptations increased the chances of individuals persisting with mouth breathing. Additionally, these adaptations could be associated with mouth breathers' self-perceived quality of life. .

Citoinclusão de capa leucocitária e medula óssea de cães: padronização da técnica / Cell block of canine buffy coat and bone marrow in paraffin blocks: technique standardization

A técnica de citoinclusão é amplamente utilizada e reconhecida por profissionais da área da saúde, em particular médicos patologistas, porém as informações sobre a aplicação desse método em medicina veterinária ainda são raras. Análises citológicas de medula óssea e da capa leucocitária (porção do sangue formada por concentrados de leucócitos) são amplamente utilizadas no diagnóstico de patologias de origem neoplásica e não neoplásica e de agentes infecciosos. Embora a importância do uso da técnica seja amplamente reconhecida, não há registro da utilização de amostras citológicas de medula óssea e capa leucocitária na confecção de citoinclusões em blocos de parafina, como meio de diagnóstico no segmento médico veterinário. Assim, este trabalho tem como objetivo elaborar um protocolo de citoinclusão em parafina para amostras citológicas de medula óssea e capa leucocitária de cães. Foram submetidas à técnica de citoinclusão 110 amostras de capa leucocitária e 44 de medula óssea de cães portadores ou não de enfermidade sistêmica, sendo que em 68% destas, tanto para a capa leucocitária quanto para a medula óssea, as amostras se mostraram viáveis. A utilização do álcool 95% como fixador e de etapas no processamento histológico de 20 minutos (álcool absoluto, xilol e parafina, três banhos cada) foi crucial para a qualidade dos cortes histológicos e para a análise microscópica dos espécimes corados pela hematoxilina-eosina. A separação mecânica da capa leucocitária e a centrifugação do aspirado de medula óssea foram eficientes e de baixo custo no preparo das citoinclusões. Ressalta-se a importância na padronização da técnica de citoinclusão, em particular para amostras de capa leucocitária e medula óssea, visando à obtenção de espécimes de qualidade independentemente das limitações de equipamentos...

The cell block technique is widely used and recognized by health professionals, but lacks in information regarding the specific contribution of this method to veterinary medicine. The cytology of bone marrow and buffy coat (cellular portion of the hole blood) are widely used in the diagnosis of neoplastic and non-neoplastic diseases, and also for the detection of infectious agents. Although the importance of these samples is widely recognized, there is no information about the use of buffy coat and bone marrow samples in the cell block procedure among the research material used for this paper. This work aims for the cell block standardization for canine buffy coat and bone marrow samples. We collected 110 buffy coat samples and 44 bone marrow samples for the cell block preparation, and 68.2% of buffy coat and bone marrow proved to be viable at the end of the procedure. The 95% ethanol fixatives along with the 20 minute processing steps (absolute ethanol, xilol and paraffin, 3 of each) were crucial for the quality of the material both in microtomy and optical microscopy. Mechanical separation of the buffy coat proved to be easy and cheap and was used to compose the cell block technique. In this research we emphasized the importance of cell block standardization in order to develop and easy, inexpensive and reproducible method, regardless of any of the professionals' limitations...

Citologia do escarro induzido em asmáticos infectados pelo Schistosoma mansoni / Induced sputum cytology in asthmatics infected with Schistosoma mansoni

A infecção pelo Schistosoma mansoni inibe manifestação da asma. A avaliação do escarro induzido em pacientes infectados pelo parasita pode trazer informações importantes sobre a relação entre doenças alérgicas e parasitoses. Objetivo: Avaliar a celularidade do escarro em asmáticos em uma área endêmica em esquistossomose na Bahia. Métodos: Estudo randomizado, duplo cego, controlado com placebo, incluindo asmáticos infectados pelo S. mansoni e um grupo de asmáticos não infectados. Foi utilizada a celularidade do escarro induzido, em contagens sequenciais pré (D0) e pós-tratamento (D7, D60 e D90), para avaliar os efeitos do tratamento da parasitose com praziquantel sobre a asma. Resultados: Avaliados 22 indivíduos asmáticos infectados pelo S. mansoni e grupo controle adicional composto por oito asmáticos não infectados. O grupo que usou praziquantel não diferiu do grupo placebo quando comparada a celularidade do escarro. Houve aumento no número de eosinófilos nos D7, D60 e D90 no grupo placebo, quando comparados ao basal, e no D60 no grupo praziquantel. O número total de células aumentou em relação ao basal no D7 e no D90 para o grupo placebo, e no D90 para o grupo praziquantel. O grupo que usou praziquantel apresentou uma redução do volume expiratório forçado no 1º segundo (VEF1) no D7, D60 e D90. Não houve associação entre a eosinofilia e a gravidade da asma. Conclusão: No presente estudo não foi encontrada correlação entre os tipos celulares encontrados e a gravidade da asma, nem houve variação significativa do percentualde eosinófilos em resposta ao tratamento da esquistossomose...

Schistosoma mansoni infection inhibits asthma symptoms. Assessment of induced sputum in infected patients may shed light on the relationship between allergic diseases and parasite infections. Objective: To assess the cellularity of induced sputum in asthmatic patients living in an endemic area of schistosomiasis in the Brazilian state Bahia. Methods: This randomized, double blind, placebo-controlled study included asthmatic patients infected with S. mansoni and a group of non-infected asthmatics (controls). Cellularity of induced sputum was analyzed based on cell counts before (D0) and after treatment (D7, D60, and D90), to evaluate the effects of treatment with praziquantel on asthma. Results: A total of 22 asthmatics infected with S. mansoni and 8 controls were assessed. Induced sputum cellularity in the group treated with praziquantel did not differ from that of the group treated with placebo. However, compared to baseline counts, a higher number of eosinophils was found in the placebo group on D7, D60, and D90, and on D60 in the treatment group. Total cell counts increased from baseline to D7 and D90 in the placebo group, and from baseline to D90 in the treatment group. Moreover, the treatment group showed a reduction in forced expiratory volume in 1 second (FEV1) on D7, D60, and D90. There was no association between eosinophilia and asthma severity. Conclusion: In the present study, there was no correlation between asthma severity and the cell types found during cellularity assessment, nor was there an association between treatment of schistosomiasis and sputum eosinophilia...

Sediment cytology in diagnostic evaluation of oral neoplasms.

Aim: To evaluate the role of sediment cytology of biopsy specimen fixatives in early diagnosis of oral neoplasms. Materials and Methods: Cytological smears were prepared by centrifuging the fixatives in which the biopsy specimens were received. The smears were analyzed and the cytological results were compared with histological diagnosis. Results: Of 20 lesions studied by sediment cytology, 8 were labeled as benign, 9 as malignant and 3 cases as inconclusive. Final histopathological diagnosis labeled 12 lesions as malignant and 8 lesions as benign. Comparing the cytological diagnosis with histological sections, 17 out of 20 cases were concordant. The overall diagnostic accuracy of 85% was achieved. Conclusion: Biopsy sediment cytology is a good complimentary method to histopathology in the study of oral biopsy material.

Validez de la citología de impresión para neoplasias de la superficie ocular: resultados preliminares / Validation of impression cytology for ocular surface neoplasia: preliminary results

Objetivo: determinar la validez de la citología de impresión en lesiones conjuntivales clínicamente sospechosas de neoplasia comparada con la histopatología. Diseño: estudio de prueba diagnóstica. Métodos: pacientes que ingresaron a la Fundación Oftalmológica Nacional de Colombia con diagnóstico clínico de neoplasia de superficie ocular o lesión sospechosa de neoplasia quienes fueron sometidos a citología de impresión y posterior resección quirúrgica completa más estudio patológico de la lesión. Resultados: se examinaron 54 pacientes de los cuales 27 fueron mujeres y 27 hombres correspondiendo a 50% en cada grupo. La media de edad fue 52.3 años. La lesión más frecuente fue la neoplasia conjuntival escamosa intraepitelial (NIC) en los diagnósticos clínico, citológico y patológico. Se encontró que la sensibilidad de la citología de impresión fue de 92.86% y la especifi cidad de 50%. Con respecto al diagnóstico clínico relacionado con la patología se obtuvo una sensibilidad de 92.86% y una especificidad de 80.77%. Conclusiones: Se encontró que la citología de impresión es una prueba sensible mas no específica para el tamizaje de neoplasias de superficie ocular, sin embargo no muestra una superioridad frente a un buen diagnóstico clínico. Se debe aclarar que son observaciones preliminares de un estudio que se encuentra en curso.

Objective: to determine impression cytology validity for conjunctival malignant lesions compared to pathology. Design: diagnostic test study. Methods: patients admitted to Fundación Oftalmológica Nacional of Colombia with clinical diagnosis of ocular surface neoplasia or suspicious ocular surface neoplasia who underwent impression cytology before excisional surgery of the lesion and pathologic study. Results: fifty four patients were obtained for this initial analysis, 27 were of female sex and 27 males, each group corresponded to 50%. Mean age obtained was 52.3 years. The most frequent lesion found was ocular surface squamous cell neoplasia in the clinical diagnosis, impression cytology and pathology. Impression cytology sensitivity found is 92.86% and 50% of specificity. Clinical diagnosis was found to have 92.68% sensitivity and 80.77% Conclusions: impression cytology was found to be a sensitive test but not specific, which is adequate for a screening test, however it does not demonstrate to be superior to a clinical diagnosis made by a trained specialist. It must be clear that these are preliminary observations and calculations of a study that is still in course and the sample is incomplete.

Síndrome de Sjögren y utilidad de la citología de impresión conjuntival / Sjögren's Syndrome and usefulness of impression cytology of conjunctiva

El Síndrome de Sjögren es considerado una enfermedad crónica y autoinmune que se caracteriza por resequedad de mucosas principalmente oral ocular dada por una disminución o ausencia de las secreciones glandulares por interacción celular y humoral cuyo resultado es un infiltrado linfoplasmocítico y presencia de auto anticuerpos y mediadores inflamatorios solubles respectivamente. Dichas características, los cambios histopatológicos y la ausencia de patógenos identificados son los que permiten determinar el carácter autoinmune de esta patología. La confirmación del componente inflamatorio se hace mediante el análisis histopatológico de la glándula salivar donde se observa presencia de infiltrado linfoplasmocítico benigno, focal observado en la mayoría de los acinos examinados. Para determinar el compromiso ocular es importante una anamnesis y examen oftalmológico completo que incluya pruebas para determinación de la calidad y cantidad de la película lagrimal, complementado con pruebas como la citología de impresión conjuntival, la cual se considera una prueba fácil, automatizada y que permite determinar las anormalidades morfológicas de las células conjuntivales superficiales; esta es una ayudadiagnóstica que determina el grado de afectación existente a nivel ocular, no sólo en esta sino en otras patologías que tengan compromiso de la superficie ocular. Se realizó una búsqueda electrónica que incluyera los términos claves, se identificaron las publicaciones relevantes y se realizó una síntesis de la información que comprendiera síndrome de Sjögren y citología de impresión conjuntival.

The Sjögren syndrome is considered an autoimmune chronic disease that dries up the mucus, specially the oral and ocular ones due to an absence or decrease of the glandular secretions because of a cellular and a humoral interaction causing a linfoplasmocithic filtering and showing auto-antibodies and soluble inflammatory mediators. The characteristics described above, plus the histopathological changes and the nonappearance of identifi ed pathogens, allows us to determine the autoimmune nature of this pathology. In order to confirm the infl ammatory component, a histopathological analysis can be placed in the salivary gland where it shows benign linfoplasmocithic filtering in almost all of the analyzed acini. A full anamnesis is very important to establish the ocular damage as well as an ophthalmic examination that include tests to determine the quantity and quality of the lacrimal layer along with other tests such as the conjunctival impression citology. This examination is considered an easy automatized test that let to determine morphological anomalies in the conjunctival surface cells. It is definitely a diagnosis tool to determine the ocular damage level not only for this disease but also for others in which the ocular surface is compromised. An electronic search was performed including MeSH terms, all relevant publications were identifi ed and a summary of reports considering Sjögren Syndrome and conjunctival impression citology is presented.