Human papillomavirus infection and its association with cervical dysplasia in Ecuadorian women attending a private cancer screening clinic.

Women living in Latin American countries bear a disproportionate burden of cervical cancer, a condition caused by infection with the human papillomavirus (HPV). We performed a study in Santa Elena, Guayas (currently Santa Elena Province), Ecuador, to determine how often HPV could be detected in women attending a private cancer screening clinic. Participants underwent a Pap test, and vaginal and cervical swabs were performed for HPV testing by the polymerase chain reaction (PCR). Each participant completed a verbally administered survey. The mean age of 302 participants was 37.7 years (range 18 to 78 years). The majority of cervical and vaginal specimens contained sufficient DNA to perform PCR. Overall, 24.2% of the participants had either a cervical or vaginal swab that tested positive for HPV. In general, there was a good correlation between the HPV types detected in the cervical and vaginal swabs from the participants, but vaginal swabs were more likely to contain HPV DNA than were cervical swabs. The high-risk HPV types 16, 52, 58, and 59 and the low-risk HPV types 62, 71, 72, and 83 were the most frequently detected HPV types. The number of lifetime sexual partners was positively associated with detection of any HPV type, detection of oncogenic HPV, and abnormal Pap smears. Further studies are needed to determine if these results are representative of all Ecuadorian women and to determine if cervical cancers in Ecuadorian women are caused by the same HPV types found in the swab specimens obtained in this study.

Human papillomavirus infection and its association with cervical dysplasia in Ecuadorian women attending a private cancer screening clinic

Women living in Latin American countries bear a disproportionate burden of cervical cancer, a condition caused by infection with the human papillomavirus (HPV). We performed a study in Santa Elena, Guayas (currently Santa Elena Province), Ecuador, to determine how often HPV could be detected in women attending a private cancer screening clinic. Participants underwent a Pap test, and vaginal and cervical swabs were performed for HPV testing by the polymerase chain reaction (PCR). Each participant completed a verbally administered survey. The mean age of 302 participants was 37.7 years (range 18 to 78 years). The majorityof cervical and vaginal specimens contained sufficient DNA to perform PCR. Overall, 24.2% of the participants had either a cervical or vaginal swab that tested positive for HPV. In general, there was a good correlation between the HPV types detected in the cervical and vaginal swabs from the participants, but vaginal swabs were more likely to contain HPV DNA than were cervical swabs. The high-risk HPV types 16, 52, 58, and 59 and the low-risk HPV types 62, 71, 72, and 83 were the most frequently detected HPV types. The number of lifetime sexual partners was positively associated with detection of any HPV type, detection of oncogenic HPV, and abnormal Pap smears. Further studies are needed to determine if these results are representative of all Ecuadorian women and to determine if cervical cancers in Ecuadorian women are caused by the same HPV types found in the swab specimens obtained in this study.

Migration of nurses: a Latin American perspective

This paper documents an exploratory meeting organized by the Pan American Health Organization, that gathered nurses from countries of Latin America, who identified the shortage and migration tendencies as an emerging area in need of investigation. The exploratory meeting was conducted under the direction of the Regional Advisor on Nursing and Allied Health Personnel at the Pan American Health Organization in collaboration with the nursing leadership of Latin America. Fifteen of the 19 Latin American Countries participated in the meeting including: Argentina, Bolivia, Brazil, Chile, Colombia, Dominican Republic, El Salvador, Ecuador, Guatemala, Honduras, Mexico, Panama, Peru, Uruguay, and Venezuela. All agreed that documentation was needed concerning the shortage and migration of nurses including its causes and effects, the distribution of professional nurses, and available public policies to support the needs of professional nurses in Latin America (AU).

[Efficacy of educational sessions to modify the prescription of new drugs]. / Eficacia de las sesiones educativas para modificar la prescripción de fármacos nuevos.

OBJECTIVE: To evaluate the efficacy of an educational intervention to minimise the prescription of those new medicines whose therapeutic effects are of little benefit. DESIGN: Controlled and randomised experimental study. SETTING: 27 health centres in the province of Sevilla, Spain. PARTICIPANTS: 376 general practitioners. The 264 who worked in the same posts were randomised for the 6 pre-intervention months. 10 of them did not complete the post-intervention period. INTERVENTIONS: Four 45-minute training sessions in a 2-month period, given by health team doctors, with a critical reading of the studies available on recently marketed drugs, plus personal feed-back on prescription and bulletins on therapeutic novelties. The control group received only the feed-back and bulletins. MAIN MEASUREMENTS: Prescription of new medication of little benefit, measured as the number of packages out of the total. Second, the amount of coxib and eprosartan measured as defined daily doses. RESULTS: In the 6 months after the educational sessions, the doctors in the intervention group prescribed proportionately fewer therapeutic novelties of little benefit than those allocated to the control group (1.34% vs 1.62%; P<.001). The coxib and eprosartan prescribed showed only a non-significant trend towards less prescription by the intervention group. CONCLUSIONS: The group educational sessions, run by doctors trained in aspects of evidence-based medicine and prepared jointly with the pharmacy unit, reduced discreetly the prescription of new medicines that were not very innovative.

Gamma interferon: a central mediator in atherosclerosis.

Atherosclerosis is a chronic inflammatory disease of the vasculature with lesions developing in the arterial wall, frequently in the coronary and carotid arteries. The interaction between macrophages and lymphocytes within the atherosclerotic lesion microenvironment exemplifies a site where both innate and adaptive immunity contribute towards disease progression. As gamma interferon (IFN-gamma), the classic macrophage activating factor, has been localized to atherosclerotic lesions, this review will focus on its contribution to plaque pathology and will finally consider how current therapies, as exemplified by HMG CoA reductase inhibitors or statins, may impact this process beyond lipid lowering, in part by inhibiting IFN-gamma dependent processes. IFN-gamma sources within the atheroma as well as receptors, signaling pathways and its effects on macrophages as well as on vascular smooth muscle and endothelial cells will be considered. Therapeutic interventions targeting molecular events associated with IFN-gamma signaling offer novel approaches to the treatment of atherosclerosis.

[Sulpiride as initial treatment in tinnitus retraining therapy]. / Sulpirida como tratamiento de inicio en la terapia de rehabilitación del acúfeno.

UNLABELLED: With this study we try to find out the interaction of sulpiride in tinnitus pathology. This, could help us to control better the tinnitus through tinnitus retraining therapy. MATERIAL AND METHODS: A hundred patients with tinnitus were divided into two groups of 50. Fifty milligrams of sulpiride or placebo were administered for three months, three time per day, with monthly controls. Clinical response, audiometry, tympanometry and acufenometry were registered. RESULTS: In the first month of treatment, only 58% of patients treated with sulpiride improved, and 17% of those treated with placebo, with statistical significance. In the second month, 41% and 20% respectively, and in the third month, 42% and 17% respectively. CONCLUSION: In patients with tinnitus, treatment with sulpiride has improved more than half of them in the first month of treatment. This time is crucial to begin tinnitus retraining therapy and to obtain a greater efficacy.

[Analysis of the relationship between chronic pharyngitis and tonsillectomy with the microbiologic study of the cavum]. / Relación de la faringitis crónica con la amigdalectomía mediante estudio microbiológico de cavum.

Chronic pharyngitis is an usual process with difficult treatment. It has been related to tonsillectomy. This study collected 224 patients suffering from chronic pharyngitis, 55 tonsillectomies and 169 without operation. Bacteriological culture was done from nasopharynx in the different seasons. Microorganisms more frequent were Staphylococcus aureus, Corynebacterium sp and Aspergillus. The time between the tonsillectomy and this study has been of more than 17 years. No relationship has been found between chronic pharyngitis and tonsillectomy, considering types of microorganisms, seasons, numbers of microorganisms isolated per culture, Gram stain, and age of the patients.

Total synthesis of (+)-7-deoxypancratistatin from furan.

A new total synthesis of (+)-7-deoxypancratistatin 1 has been accomplished in 19 steps (8% overall yield) from two readly available compounds, furan and trans-1,2-bis(phenylsulfonyl)ethylene.

Colorectal cancer: Lahey Clinic experience, 1972-1976. An analysis of prognostic indicators.

The records of 344 consecutive patients with colorectal cancer treated operatively at the Lahey Clinic from 1972 through 1976 were reviewed, and the effects of 41 clinical and pathologic variables on survival were analyzed. The variables associated with poorer five-year survival rates were advanced Dukes' stage, four or more positive nodes, blood vessel invasion, lymphatic invasion, circumferential involvement, and obstruction at initial presentation. As a group, patients with right colon cancers (cecum and ascending colon) had the best survival rates. When fistula formation or localized perforation had occurred, en bloc resection of locally involved adjacent viscera improved survival rates. These prognostic indicators aid in the selection of patients for wider colonic and mesenteric resections.