Quantification of human papilloma virus (HPV) DNA using the Cobas 4800 system in women with and without pathological alterations attributable to the virus.

BACKGROUND AND PURPOSE: Surrogate markers such as viral load are necessary to follow the evolution of disease resulting from infection with Human Papilloma virus (HPV), especially in this era of vaccination. As such, this paper uses the automated system Cobas-4800-HPV to define viral load as number of HPV copies/cell and apply the results to clinical samples. STUDY DESIGN: A curve to determine viral load per cell was constructed from HPV plasmid and cell concentrations using the Cobas-4800-HPV system. According to these curves, HPV viral load was determined in 309 positive endocervical swabs (58 from patients with previous HPV-infection, 118 with current lesions and 133 symptom-free patients presenting for screening) from women attending gynaecology consultations from January to June 2013. RESULTS: In curves with r(2)≥0.95 the Cobas-4800-HPV system has a detection limit of 150 (2.18 log) viral copies, and the limit for ß-globin corresponds to that of a single cell. In women reporting for screening, viral load was under 10(4) (4 log) copies/10(3) cells. For women with lesions or previous HPV infection loads were significantly higher particularly in the 30-45 year group (p=0.038). Elevated viral loads were especially noticeable in non-HPV 16/HPV 18. CONCLUSIONS: Automated system Cobas-4800-HPV is suitable for define viral load of HPV. Correlation between viral load and number of cells established. Higher viral load in women with disease, and those between 30 and 45 years. Increased viral load of non-16/18 high-risk HPV genotypes detected in patients with lesions compared to screening patients. A difference not observed for HPV 16/18, or in coinfections.

Factors associated with induced abortion in women prostitutes in Asturias (Spain).

BACKGROUND: The aim is to investigate the factors that might be associated with the presence of induced abortion (IA) in women prostitutes in Asturias (Spain). METHODOLOGY/PRINCIPAL FINDINGS: Cross-sectional descriptive study by self-completion questionnaire of 212 women prostitutes who attended the three Sexually Transmitted Disease Clinics in Asturias, between January-December 2003. The questionnaire was designed to investigate the women's perceived knowledge (what they claimed to know), their real knowledge (what they really knew), the use of contraceptive methods and socio-demographic variables. Multivariate analysis was carried out. 92% of the participants were immigrants. 76% were practising at brothel. 37.6% (95%CI:30.7-44.4%) reported to have undergone at least one IA during their life. According to the logistic regression the "presence of IA" was directly associated with the variables "number of pregnancies" (OR:65.82;95%IC:7.73-560.14) and "years of practising prostitution" (OR:1.13;95%CI:0.99-1.29); and inversely associated with "children" (0 = no children;1 = one or more children; OR:0.005;95%CI:0.000-0.057), "women's age" (OR:0.89;95%CI:0.82-0.97) and "real contraceptive knowledge" (OR:0.50; 95%CI:0.34-0.75). Married women were more likely to have undergone an IA (OR:2.74;95%IC:1.05-7.13). No association with "perceived contraceptive knowledge" was found. CONCLUSIONS/SIGNIFICANCE: The characteristics more closely linked to the reproductive history of the women (such as "pregnancies", "children"), together with the "real contraceptive knowledge" and the "time practising prostitution" explain the presence of IA better than factors more closely linked to the conditions in which the women practise prostitution ("place of activity", "other activities compatible with prostitution", "use of safe method in commercial relation"). It is possible that IA is being used as a birth control method, hypothesis suggested by the inverse association observed between the variable "children" and the "presence of IA". Therefore, the promotion of the use of safe contraceptive methods should be a high-priority. If the real contraceptive knowledge was measured correctly, all strategies to increase it would be justified because it was inversely associated with the presence of IA.

[Knowledge and use of contraceptive methods in female sex workers in Asturias [Spain]]. / Conocimiento y uso de métodos anticonceptivos en mujeres que ejercen la prostitución en Asturias.

OBJECTIVE: To describe the knowledge and use of contraceptive methods among female sex workers in Asturias (Spain). METHODS: We performed a descriptive cross-sectional study of 212 female sex workers by means of a self-completed questionnaire. RESULTS: 61.2% of the women claimed to have sufficient information about contraceptive methods, although the real knowledge measured was much lower. Effective contraception was not used by 2.4% of the women in their last commercial relationship and by 20.4% in their private relationships. The most commonly employed method was the condom, but only 52.2% of the women who had used one in their previous commercial relationships did so together with another effective method. In the event of breakage, 40% of women did not have an attitude that would be effective in avoiding pregnancy. CONCLUSIONS: Knowledge about contraceptive methods among these women is lower than might be expected from their occupation. The use of another effective method together with the condom is insufficient to avoid unwanted pregnancies. Many of the women do not have an attitude that would be effective in avoiding pregnancy in the event of condom breakage.

Conocimiento y uso de métodos anticonceptivos en mujeres que ejercen la prostitución en Asturias / Knowledge and use of contraceptive methods in female sex workers in Asturias [Spain]

Objetivo: Describir el conocimiento de los métodos contraceptivos y el uso que hacen de ellos las mujeres que ejercen la prostitución en Asturias. Métodos: Estudio transversal mediante cuestionario autoadministrado a 212 mujeres. Resultados: El 61,2% refería tener información suficiente sobre métodos contraceptivos, aunque el conocimiento real es menor. En su última relación comercial en un 2,4% no tuvo una actitud eficaz para prevenir el embarazo y en la última privada, el 20,4%. El método más usado fue el preservativo y el 52,2% de quienes lo usaron en la última relación comercial añadieron otro método eficaz. En caso de rotura, el 40% de las encuestadas no tuvo una actitud eficaz para evitar el embarazo. Conclusiones: El conocimiento contraceptivo en estas mujeres es menor del que cabría esperar por la actividad que realizan. El uso de otro método eficaz asociado al preservativo es escaso para evitar embarazos no deseados. Muchas mujeres no tienen una actitud eficaz para evitarlos en caso de rotura del preservativo

Objective: To describe the knowledge and use of contraceptive methods among female sex workers in Asturias (Spain). Methods: We performed a descriptive cross-sectional study of 212 female sex workers by means of a self-completed questionnaire. Results: 61.2% of the women claimed to have sufficient information about contraceptive methods, although the real knowledge measured was much lower. Effective contraception was not used by 2.4% of the women in their last commercial relationship and by 20.4% in their private relationships. The most commonly employed method was the condom, but only 52.2% of the women who had used one in their previous commercial relationships did so together with another effective method. In the event of breakage, 40% of women did not have an attitude that would be effective in avoiding pregnancy. Conclusions: Knowledge about contraceptive methods among these women is lower than might be expected from their occupation. The use of another effective method together with the condom is insufficient to avoid unwanted pregnancies. Many of the women do not have an attitude that would be effective in avoiding pregnancy in the event of condom breakage

Xantogranulomatosis subcutánea elastolítica (piel laxa xantogranulomatosa) / Elastolytic subcutaneous xanthogranulomatosis (xanthogranulomatous slack skin)

La xantogranulomatosis subcutánea es una peculiar xantomatosis que probablemente corresponde a una variante muy xantomatizada y con elementos múltiples del xantogranuloma juvenil subcutáneo. Los individuos afectados presentan múltiples nódulos subcutáneos de consistencia firme y localización preferente en el tronco. Los nódulos corresponden a masas xantomatosas subcutáneas que no se acompañan de xantomas cutáneos. Desde el punto de vista histológico se trata de cúmulos celulares bien circunscritos, localizados en dermis profunda e hipodermis y compuestos por una mezcla de células xantomatosas y células gigantes de tipo cuerpo extraño y de tipo Touton. Los estudios analíticos de los lípidos séricos resultan normales. Un varón de 52 años consultó porque a lo largo de los últimos años toda la piel de la espalda y zona superior del tórax había ido adquiriendo un aspecto irregular, laxo y plegado. En estas zonas presentaba múltiples lesiones nodulares subcutáneas, de consistencia firme. Microscópicamente los nódulos estaban constituidos por una población predominante de células xantomatosas y algunas células gigantes multinucleadas. En el interior del citoplasma de muchas de las células gigantes se observó la presencia de cuerpos asteroides. Además presentaba xantomas en las conjuntivas bulbares y un intenso linfedema en ambas piernas. Consideramos que este caso es un ejemplo más de la denominada xantogranulomatosis subcutánea con dos peculiaridades clínicas: el hallazgo de piel laxa en las zonas afectadas y la asociación con linfedema y elefantiasis cutánea en miembros inferiores. Por otra parte hemos reseñado el peculiar hallazgo histológico de cuerpos asteroides en el interior de las células gigantes del infiltrado xantomatoso (AU)