Attributes influencing parental decision-making to receive the Tdap vaccine to reduce the risk of pertussis transmission to their newborn - outcome of a cross-sectional conjoint experiment in Spain and Italy.

Pertussis vaccination of parents and household contacts ('cocooning') to protect newborn infants is an established strategy in many countries, although uptake may be low. Many aspects may influence such decision-making. We conducted a cross-sectional survey (NCT01890447) of households and other close contacts of newborns aged ≤6 months (or of expectant mothers in their last trimester) in Spain and Italy, using an adaptive discrete-choice experiment questionnaire. Aims were to assess the relative importance of attributes influencing vaccine adoption, and to estimate variation in vaccine adoption rates and the impact of cost on vaccination rates. Six hundred and fifteen participants (Spain, n = 313; Italy, n = 302) completed the survey. Of 144 available questionnaire scenarios, the most frequently selected (14% of respondents in both countries) were infant protection by household vaccination at vaccination center, recommendation by family physician and health authorities, with information available on leaflets and websites. The attribute with highest median relative importance was 'reduction in source of infection' in Spain (23.1%) and 'vaccination location' in Italy (18.8%). Differences between other attributes were low in both countries, with media attributes showing low importance. Over 80% of respondents indicated a definite or probable response to vaccine adoption (at no-cost) with estimated probability of adoption of 89-98%; applying vaccine costs (25€ per person) would reduce the probability of uptake by 7-20% in definite/probable respondents. Awareness of these determinants is helpful in informing Health Authorities and healthcare practitioners implementing a cocooning strategy for those populations where maternal immunization is not a preferred option.

Evaluación ecográfica de las masas anexiales / No disponible

No disponible

Naprotecnología: ciencia y persona en la infección por el virus del papiloma humano (vph) en mujeres y preadolescentes / NaProTechnology: Science and the Person in Human Papillomavirus (HPV) Infection among Women and Preadolescents / Naprotecnologia: ciência e pessoa na infecção por Papilomavírus Humano (HPV) em mulheres e pré-adolescentes

Resumen En la actualidad hay suficiente evidencia científica que relaciona directamente la adquisición, exposición y prevalencia del virus del papiloma humano (VPH) con el cáncer del cuello de uterino. Por ello, el artículo aborda el VPH en la mujer teniendo en cuenta la naprotecnología, que permite conjugar evidencia científica y planteamientos éticos. Se busca que se tengan en cuenta tanto el aspecto biológico de la sexualidad como la capacidad de hacerse persona en su núcleo sexual. De ahí que se analicen programas dirigidos a la educación sexual, basados tanto en la prevención sanitaria como en la antropología de la sexualidad, y apoyados por las instituciones familiares, que han demostrado una mejor acogida ante los riesgos de las enfermedades de transmisión sexual, y entre ellas la infección por el VPH.

Abstract There currently is sufficient scientific evidence directly linking acquisition, exposure and prevalence of the human papillomavirus (HPV) to cervical cancer. The article addresses HPV in women by taking NaProTechnology into account, which makes it possible to combine scientific evidence with ethical approaches. It looks at both the biological aspect of sexuality and the ability to become a person within one's sexual nucleus. There is an analysis of sex education programs based on preventive health and on the anthropology of sexuality, and supported by family institutions, that have demonstrated better acceptance in dealing with the risk of sexually transmitted diseases, including HPV infection.

Resumo Na atualidade, há suficiente evidência científica que relaciona diretamente aquisição, exposição e prevalência do Papilomavírus Humano (HPV) com o câncer do colo do útero. Por isso, este artigo aborda o HPV na mulher considerando a naprotecnologia, que permite conjugar evidência científica e proposições éticas. Procura-se que sejam levados em conta tanto o aspecto biológico da sexualidade quanto a capacidade de se fazer pessoa em seu núcleo sexual. A partir disso, são analisados programas dirigidos à educação sexual, baseados tanto na prevenção sanitária quanto na antropologia da sexualidade, e apoiados pelas instituições familiares, que têm demonstrado uma melhor acolhida diante dos riscos das infecções de transmissão sexual e, entre elas, a infecção pelo HPV.

Simple descriptors and simple rules of the International Ovarian Tumor Analysis (IOTA) Group: a prospective study of combined use for the description of adnexal masses.

OBJECTIVE: External validation of the IOTA group's three-step diagnostic model (Strategy 1) and comparison with assessment by an expert sonographer (Strategy 2). STUDY DESIGN: Prospective study in patients with persistent adnexal masses, in which an inexperienced sonographer performed transvaginal ultrasound applying simple descriptors (SD) and rules (SR) for classifying as benign or malignant. Any non-classifiable mass was then submitted to an expert examiner for subjective assessment (SA). RESULTS: Eighty-one patients (mean age, 43; 27.2% postmenopausal) were included in this prospective study. Surgery was performed for 30 (8 malignant and 22 benign) masses; 51 masses were considered as benign and managed expectantly (they were assumed to be benign for statistical purposes). Diagnostic performance for Strategy 1 (SD+SR+SA) was sensitivity (SN): 87.5% (7/8, 95% CI, 47.3-99.7%) and specificity (SP): 100% (73/73, 95% CI, 95.1-100%). For Strategy 2 (SA only) it was SN 87.5% (7/8, 95% CI, 47.3-99.7%), SP 98.6% (72/73, 95% CI, 92.6-100%). CONCLUSIONS: The three-step diagnostic strategy designed by the IOTA group for adnexal masses has a diagnostic performance comparable to that of subjective expert assessment and could be used as a triage method by nonexpert sonographers.

Inducción de endometriosis en rata Wistar, mediante autotransplante de fragmento uterino, sobre cicatriz previamente producida en el cuerno uterino izquierdo / Induction of endometriosis in Wistar rats through autologous transplantation of a uterine fragment over a previous scar in the left uterine horn

Objetivo. Estudiar la posibilidad de inducir endometriosis interna/externa en rata wistar, a través de un nuevo modelo microquirúrgico, que denominamos PGR 1. Sujetos y métodos. Se han utilizado 11 ratas Wistar, a las que se ha realizado un autotransplante de fragmento uterino, sobre la cicatriz resultante de la cirugía necesaria para su obtención. Después de 8 semanas se les practicó una nueva intervención, para la inspección de la cavidad abdominal y la toma de muestras relevantes para su estudio anatomopatológico. Resultados. Macroscópicos: adherencias que afectaban fundamentalmente a la zona del implante; vesículas amarillentas. Microscópicos: vesículas/quistes; fenómenos inflamatorios; neovascularización; endometriosis interna en un animal. Conclusiones. Este nuevo modelo de implante nos puede ayudar a comprender mejor los mecanismos involucrados en la aparición de endometriosis, tanto interna como externa (AU)

Objective. To study the possibility of inducing internal or external endometriosis in Wistar rats through a new microsurgical model known as PGR 1. Subjects and methods. Eleven Wistar rats underwent autologous transplantation of a uterine fragment over a deliberately created scar. After 8 weeks, a further intervention was carried out to inspect the abdominal cavity and take samples for pathological analysis. Results. Macroscopic results consisted of adhesions mainly affecting the implant and yellow vesicles. Microscopic findings consisted of vesicles/cysts, inflammatory phenomena, neovascularization, and internal endometriosis in one animal. Conclusions. This new implant model could enhance our understanding of the mechanisms involved in the development of endometriosis, both internal and external (AU)

Influencia de la bibliografía en la calidad de los proyectos de tesis presentados en un departamento universitario. Modelos de regresión / Influence of bibliography on the quality of thesis proposals presented in a university department. Regression models

Objetivo: Evaluar cuál es la situación actual de la bibliografía aportada en los proyectos de tesis doctoral en el Departamento de Obstetricia, Ginecología y Cirugía de la Universidad de Zaragoza entre los años 1995 y 2002, y dilucidar cómo influye ésta en la calidad de los proyectos de tesis, para poder hacer predicciones sobre la calidad de cualquier proyecto de tesis en función de sus parámetros bibliográficos. Material y método: Estudio analítico de casos y controles (proyectos con bibliografía y sin ella, respectivamente) en el que se analizan 273 proyectos de tesis corregidos por dos personas (546 sujetos evaluados) presentados en el Departamento de Obstetricia, Ginecología y Cirugía de la Universidad de Zaragoza entre los años 1995 y 2002. Resultados: Se halló asociación estadística entre la variable bibliografía (existente, incorrecta y no existente) y la calidad del proyecto de tesis (valoración corregida) comprobada mediante dos tests estadísticos. El número de citas bibliográficas parece estar algo relacionada linealmente con la valoración corregida (0,229). Mediante regresión lineal múltiple se proponen varios modelos, pero resultan de escaso poder predictivo. Conclusiones: 1. Para responder a la hipótesis conceptual de trabajo se podría decir que el apartado bibliográfico no influye en la calidad de los proyectos de tesis doctoral. 2. Sí que se observan relaciones ya comentadas, como que a grandes cantidades de citas el trabajo suele estar algo mejor calificado, de ahí que aunque nos salgan algunas variables significativas no nos expliquen prácticamente nada de la variabilidad de la respuesta. 3. La única variable que tiene valor predictivo o explicativo de la calidad del proyecto de tesis es el número de citas: a mayor número de citas, mayor calidad del proyecto de tesis, pero desgraciadamente es muy pobre, apenas un 8,5%

Objective: To evaluate the current situation of the publications cited in doctoral thesis proposals in the Department of Obstetrics, Gynecology and Surgery of the University of Zaragoza (Spain) between 1995 and 2002 and to determine the influence of the bibliography on the quality of thesis proposals with a view to predicting the quality of thesis proposals according to their bibliographic parameters. Material and method: We performed a case-control study (proposals with and without bibliography, respectively). A total of 273 thesis proposals corrected by two evaluators (546 subjects under study) and presented in the Department of Obstetrics, Gynecology and Surgery in the University of Zaragoza between 1995 and 2002 were analyzed. Results: A statistically significant association was found between the variable of bibliography (present, incorrect, or absent) and the quality of thesis proposals (corrected evaluation) verified by two statistical tests. The number of citations seemed to be linearly related to the corrected evaluation (0.229). Various models were proposed through multiple linear regression but these models had little predictive power. Conclusions 1. The publications cited did not influence the quality of doctoral thesis proposals. 2. Although some significant variables were found (a large number of cited publications was weakly correlated with higher quality), these variables explained practically none of the variability in quality. 3. The only variable with predictive or explanatory value on the quality of thesis proposals was the number of citations: the greater the number of citations the higher the quality but this variable explained only 8.5% of the variability in quality