Purity and passion: risk and morality in Latina immigrants' and physicians' beliefs about cervical cancer.

This paper examines how physicians' beliefs about risk factors for cervical cancer compare with Mexican and Salvadoran immigrant women's views (hereafter Latina immigrants). Between August 15, 1991 and August 15, 1992, we conducted ethnographic interviews with 39 Mexican immigrant women, 28 Salvadoran immigrant women, and 30 physicians in northern Orange County, California. Physicians and Latina immigrants converge on their beliefs that sexual behavior is a predominant risk factor for cervical cancer. They diverge, however, on their reasons. Latina immigrants' perceptions of health risks are embedded in a larger set of cultural values centering around gender relations, sexuality, and morality. Latina immigrants also emphasized men's behavior as risk factors. Physicians' views, on the other hand, are largely based on the epidemiology of cervical cancer risk factors. They emphasized beginning sexual relations at an early age, multiple sexual partners, and infection with sexually transmitted viruses. Some physicians, however, displayed moral interpretations of the sex-based risk factors for cervical cancer through the use of the culturally-loaded term "promiscuous" in place of "multiple sexual partners," through specific references to morality, and through characterizations of women at risk for cervical cancer. Both the physicians and the Latina immigrants in our study paid considerably less attention to socioeconomic factors. Our results have important implications for physicians who provide health care for Latina immigrants. Physicians should be clear to point out that women need not be "promiscuous" to get cervical cancer.

Structure and meaning in models of breast and cervical cancer risk factors: a comparison of perceptions among Latinas, Anglo women, and physicians.

This article reports on a study of perceptions of breast and cervical cancer risk factors among 27 U.S.-born Chicanas, 39 Mexican and 28 Salvadoran immigrants, 27 Anglo women, and 30 physicians in northern Orange County, California. In open-ended responses explaining why women might be at risk for both cancers, Latinas expressed two general themes: physical stress and trauma to the body, and behavior and lifestyle choices. Interviewees ranked the specific risk factors that they themselves mentioned. Cultural consensus of ranked data revealed that Mexican and Salvadoran immigrants had a model of cancer risks that was different from those of Anglo women and physicians. U.S.-born Chicanas were bicultural in their views, which overlapped with both Mexican women's and Anglo women's views, but less so with physicians' views. Comparing views about the two cancers revealed that general themes apply across both cancers, that Latina immigrants agreed less on the risk factors for cervical cancer than for breast cancer, and that there is a consistent pattern in the different ways Latinas, Anglos, and physicians perceive risk factors for both cancers.

Understanding knowledge and attitudes about breast cancer. A cultural analysis.

OBJECTIVE: To evaluate knowledge and attitudes about breast cancer risk factors among Latinas, Anglo-American women, and physicians. DESIGN: Ethnographic interviews employing systematic data collection methods. PARTICIPANTS: Twenty-eight Salvadoran immigrants, 39 Mexican immigrants, 27 Chicanas, and 27 Anglo-American women selected through an organization-based network sampling and a convenience sample of 30 primary care physicians in Orange County, Calif. MAIN OUTCOME MEASURES AND RESULTS: Data analysis using qualitative content analysis and quantitative cultural consensus analysis, a mathematical technique that determines the degree of shared knowledge within groups and estimates "culturally correct" answers (cultural models), was employed. The content analysis revealed different beliefs about breast cancer risk factors, particularly between the Latinas and the physicians. The cultural consensus analysis found two broad cultural models (defined as groups with ratios between the first and second eigenvalues of > or = 3 and no negative competency scores). A Latina model (ratio = 3.4), formed by the Salvadorans, Mexicans, and Chicanas, emphasized breast trauma and "bad" behaviors, including drinking alcohol and using illegal drugs as risk factors. A biomedical model (ratio = 3.0), embraced by physicians and Anglo-American women, emphasized risk factors described in the medical literature, such as family history and age. Within these broad models, each group of respondents also differed enough in their beliefs to form their own, often stronger, cultural models. CONCLUSIONS: Ethnography can provide important insights about culturally based knowledge and attitudes about disease. An understanding of the distinctive cultural models regarding breast cancer risk factors will aid future cancer control interventions.

Poliartrite, paniculite e necrose ossea pos-pancreatite aguda recidivante / Polyarthritis, panniculitis and bone necrosis after acute recurrent pancreatitis

Um caso de pancreatite aguda recurrente, com lesoes osteoliticas metafisarias e diafisarias, artralgia e paniculite, foi relatado. O diagnostico clinico foi de pancreatite aguda recurrente por alcoolismo, com comprovacao laboratorial, cirurgica, radiologica, anatomopatologica e pelo mapeamento osseo. Apesar de a patogenese exata destas alteracoes osseas nao estar totalmente conhecida, algumas hipoteses foram discutidas, havendo concordancia nos autores de que o infarto osseo seria o resultado da isquemia do tecido osseo decorrente da necrose gordurosa intramedular por acao da lipase do pancreas lesado, com niveis circulantes aumentados. O diagnostico diferencial foi sumariamente discutido frente aos achados clinicos e laboratoriais