ABSTRACT
BACKGROUND: Human papillomavirus (HPV) causes one of the most common sexually transmitted infections. The causal relationship between HPV and cervical cancer is one of the most important advances in the field of the prevention of this disease. The Food and Drug Administration recently approved two vaccines to prevent HPV infection. OBJECTIVE: To assess the degree of knowledge about HPV and the acceptance of the vaccine against these viruses in mothers of 9 to 15 years old female students from the city of Durango, Mexico. MATERIAL AND METHOD: A prospective, observational, cross-sectional and descriptive study of 470 mothers. The selection was made through random sampling stratified by age and socio-economic status of students from public and private schools in the city of Durango. We applied a questionnaire of 60 questions, 12 open and 48 closed. Groups of acceptance of the vaccine were compared by Student's t and chi2, depending on the type of variable. Reasons for prevalence of non-acceptance and its 95% of risk confidence interval were estimated. RESULTS: The 94% of the women surveyed knew about the vaccine. The 89% would accept vaccination of their daughters if it was free of charge, but only 40% would be willing to buy it; 88% considered that was important to their daughters to receive extensive information about the vaccine from nine years of age. The risk factors identified in this study to not allow vaccination were: not knowing the existence of the vaccine, which increased this risk 3.5 times; not having comprehensive information of the sexually transmitted diseases, which increased it by 2.49 times; and the fear to initiate their sexual life at younger age, which raised it 4.58 times. No difference was found in acceptance to the vaccine for religious or socio-economic reasons; 9% of mothers did not accept the vaccine despite of knowing its existence and the role of HPV in the genesis of cervical cancer. CONCLUSION: The vast majority of surveyed mothers accepted vaccination. The degree of knowledge about the vaccine is an important factor for its acceptance.
Subject(s)
Health Knowledge, Attitudes, Practice , Mothers , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines , Patient Acceptance of Health Care , Adolescent , Adult , Child , Cross-Sectional Studies , Female , Humans , Mexico , Prospective Studies , Urban HealthABSTRACT
BACKGROUND: In Mexico, cervical cancer is the second leading cause of death in women after breast cancer. The human papillomavirus is associated with intraepithelial lesions, detected up to 99.7% of cervical carcinomas. Despite being easy to detect is a condition that many women suffer. OBJECTIVE: To determine the diagnostic utility of the visual inspection with acetic acid of the uterine cervix compared with the cervical cytology. PATIENTS AND METHOD: Study of diagnostic tests. The study was realized in the Centro de Atención Materno Infantil y Planificación Familiar of the Instituto de Investigación Científica, Durango, Mexico, research of the Juárez University of the State of Durango, from August 23, 2005 to November 13, 2006. 1,521 participants were examined who went consecutively to opportune detection of cervical cancer. One doctor practiced the test of acetic acid and cervical cytology to them, and one digital photograph, which was evaluated by three inter-observers triple blind. Those that was positive to anyone of these tests, were remitted to colposcopy and/or biopsy; also to 10% of selected negative population randomly was realized this procedure. Sensitivity, specificity, positive and negative predictive values and exactitude were determined. For the agreement inter-observer index of Kappa was used. RESULTS: Sensitivity, specificity, values predictive positive, negative and exactitude for the visual inspection with acetic acid were 20, 97, 5 and 99%, respectively. For the cervical cytology were of 80, 99, 57 and 99%, respectively. The force of agreement between the interobservant was poor. CONCLUSIONS: In this study cervical cytology was more useful than visual inspection with acetic acid to detect dysplasias or cervical cancer opportunely, due to detect all the positive true cases confirmed by biopsy.
Subject(s)
Acetic Acid , Physical Examination , Uterine Cervical Neoplasms/diagnosis , Vaginal Smears , Adolescent , Adult , Biopsy , Colposcopy , Double-Blind Method , Female , Humans , Middle Aged , Observer Variation , Photography , Predictive Value of Tests , Sensitivity and Specificity , Uterine Cervical Neoplasms/pathology , Young AdultABSTRACT
BACKGROUND: The endometrium is a very dynamic organ that experience several half-full processes by the ovarian secretion of estradiol and progesterone. The effect of hormones steroids, in the epithelial cells, endoteliales and estromales of the endometrium, is influenced by receptors of estrogens and progesterone. OBJECTIVE: determine if there are any differences in the density of the estrogen receptors (ER) between the normal endometrial, the simple and complex hyperplasia, the atypical hyperplasia and the. MATERIAL AND METHODS: A retrospective study comparative was made. We included 143 samples that were knit together in 5 categories of the following way: Normal endometrial (n = 38), Simple hyperplasia (n = 58), Complex hyperplasia (n = 22), Atypical hyperplasia (n = 9), Adenocarcinoma (n = 16). Immunohistochemistry method was used through estreptavidin biotin peroxidase diaminobenzidine. The samples were analyzed for computer image. Mendez modified technique for cell count was used. The statistical analysis included descriptive statistical. The differences between groups were analyzed using ANOVA-MANOVA and t of Student for independent samples (alpha = 0.05) and other statistical test. RESULTS: there were no statistical significant differences on the cell density with ER between the normal endometrial and the simple and complex hyperplasia. The estrogen receptors are decreased in the atypical hyperplasia and the endometrial adenocarcinoma. DISCUSSION: The gravity of the injury increases proportionally with the age; the most important factor in the reduction of the cells with estrogénicos receivers is the neoplastic transformation.
Subject(s)
Adenocarcinoma/chemistry , Endometrial Neoplasms/chemistry , Receptors, Estrogen/analysis , Endometrial Hyperplasia , Female , Humans , Immunohistochemistry , Middle Aged , Retrospective StudiesABSTRACT
A partir del conocimiento de la infección subclínica por VPH se han intentado múltiples tratamientos, con diversos resultados. El objetivo de esta comunicación es establecer la utilidad del asa diatérmica como procedimiento de consultorio en el tratamiento de la infección cervical subclínical por VPH. Durante el periodo comprendido de enero de 1992 a dicimebre de 1993, 49 pacientes portadores de infección cervical por VPH fueron tratadas en la Clínica de Colposcopia Privada mediante asa diatérmica. La edad fue entre 20 y 49 años, con una media de 36.1, siendo la mayoría multíparas. Los conos obtenidos fueron satisfactorios para estudio histopatológico y los márgenes de excisión se encontraron libres de infección por VPH. El procedimiento quirúrgico fue bien tolerado en 45 pacientes (91.8 por ciento) y sólo 4 pacientes (8.1 por ciento) se quejaron de molestias moderadas. Cinco pacientes (10.2 por ciento) presentaron sangrado genital tardío y 3 (6.1 por ciento) infección cervical. La base media del cono cervical fue de 1.43 cm, con un rango de 1.0 a 3.0 cm. La tasa de éxito fue de 98 por ciento ya que solo en un caso se confirmó falla en el tratamiento. Se concluye que los resultados a corto plazo son satisfactorios
