Prevalence and genotype distribution of cervical human papilomavirus infection in the pre-vaccination era: a population-based study in the Canary Islands.

OBJECTIVE: National Spanish studies show that prevalence of cervical human papillomavirus (HPV) infection in the female population is increasingly frequent, with an overall estimate of 14% in women aged 18-65 years. The objective of this study is to know the prevalence and distribution of HPV types in the female population of the Canary Islands prior to the introduction of HPV vaccines and to investigate the associated clinical and sociodemographic factors. METHODS: Based on the Primary Health Care database, a sample of adult women (aged 18-65 years) of Gran Canaria (GC) and Tenerife (TF) stratified into nine age groups was carried out between 2002 and 2007. Women were contacted by postal letter and telephone call and were visited in their primary care centre. A clinical-epidemiological survey was completed and cervical samples were taken for cytological study and HPV detection. HPV prevalence and its 95% CI were estimated, and multivariate analyses were performed using logistic regression to identify factors associated with the infection. RESULTS: 6010 women participated in the study, 3847 from GC and 2163 from TF. The overall prevalence of HPV infection was 13.6% (CI 12.8%-14.5%) and 11.1% (CI 10.3%-11.9%) for high-risk types. The most frequent HPV type was 16 followed by types 51, 53, 31, 42 and 59. HPV types included in the nonavalent vaccine were detected in 54.1% of infected women. Factors associated with an increased risk of infection were: young ages (18-29 years), the number of sexual partners throughout life, not being married, being a smoker, and having had previous cervical lesions or genital warts. CONCLUSIONS: It is confirmed that prevalence of HPV infection in the female population of the Canary Islands is high, but similar to that of Spain, HPV 16 being the most frequent genotype. The determinants of infection are consistent with those of other populations.

Short and long term outcomes associated with fetal cholelithiasis: a report of two cases with antenatal diagnosis and postnatal follow-up.

The aims of this study were to present and discuss ultrasound findings of prenatal fetal cholelithiasis in two cases with different etiology and evolution. Case 1: a pregnant woman from sub-Saharan Africa, suffering from Lyme disease, was treated with ceftriaxone sodium. Six weeks later, biliary sludge associated with polyhydramnios was detected in the fetus and the fetal growth percentile was 14. Emergency caesarean was performed at 36 weeks of gestation due to fetal distress. Biliary sludge persists in the two-and-a-half-year-old child. Case 2: the fetus of a Caucasian woman with normal pregnancy showed multiple cholelithiasis associated with polyhydramnios at 31 weeks of gestation. At 39 weeks and 4 days, cesarean section was performed due to lack of dilation. The biliary disease resolved spontaneously at seven months of age, with no associated abnormalities. In conclusion, prenatal diagnosis of cholelithiasis is straightforward, but prognosis cannot be defined yet. Serious complications do not arise in 70% of cases, but severe diseases may ensue in 20%. Persistence of cholelithiasis after one year of age results in cholelithiasis in childhood and beyond. Biliary sludge is associated with worse prognosis than cholelithiasis when it appears before 28 weeks of gestation.

Time to desaturation less than one minute predicts the need for long-term home oxygen therapy.

BACKGROUND: Exercise desaturation in patients with COPD is a pathophysiological phenomenon that is not wholly understood and whose clinical consequences are still unclear. METHODS: Eighty-three patients with moderate to severe COPD and P(aO(2)) > 60 mm Hg who desaturated during the 6-min walk test were followed for 5 years. Forty-eight patients had early desaturation (S(pO(2)) fell below 90% less than one minute after starting the walk test). Spirometry, blood-gas measurements, and 6-min walk tests were performed every 6 months. We recorded 6-min walk distance, baseline S(pO(2)), lowest S(pO(2)), and the time to S(pO(2)) < 90%. In each control, stable patients with severe hypoxia at rest who required long-term oxygen therapy were identified. RESULTS: Upon completion of the study, 65% of the early desaturators had developed severe hypoxemia and required long-term home oxygen, versus 11% in the non-early desaturators (P < .001). CONCLUSIONS: In patients with moderate to severe COPD, desaturation within the first minute of the 6-min walk test predicts the need for long-term home oxygen at 5-year follow-up.

Adenocarcinoma de vagina escasamente diferenciado: caso y revisión de la literatura / Poorly differentiated adenocarcinoma of the vagina: case report and review of the literature

El adenocarcinoma de vagina es un tumor extremadamente infrecuente. Presentamos un caso clínico-patológico de adenocarcinoma de vagina escasamente diferenciado. El estudio inmunohistoquímico es fundamental para conocer el origen de los adenocarcinomas poco diferenciados con afectación de órganos ginecológicos y digestivos(AU)

Primary adenocarcinoma of the vagina is an extremely rare malignancy. We report the case of a poorly differentiated adenocarcinoma of the vagina. Immunochemical analysis is the key to determining the origin of undifferentiated adenocarcinomas affecting gynecologic and digestive organs(AU)

Personality characteristics in obsessive-compulsive disorder and individuals with subclinical obsessive-compulsive problems.

OBJECTIVE: To assess the relationship between normal personality traits and obsessive-compulsive (OC) phenomena in individuals with subclinical OC problems and patients whose problems met diagnostic criteria for obsessive-compulsive disorder (OCD). METHOD: In Study 1, 25 healthy volunteers with high scores on the Padua Inventory (PI) and 28 controls with low scores on the PI were compared on the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ), the Eysenck Personality Questionnaire (EPQ), and measures of depression and state anxiety. In Study 2, 56 treatment-seeking participants meeting DSM-IV criteria for OCD and 40 healthy volunteers of similar sociodemographic characteristics were compared on the same measures. RESULTS: Both individuals with subclinical OC problems and OCD patients scored significantly higher than their respective control groups on sensitivity to punishment, neuroticism and psychoticism. OCD patients, but not individuals with subclinical OC problems, scored lower in extraversion than their respective controls. Neuroticism was the strongest predictor of high scores on the PI in Study 1, while psychoticism was the strongest predictor of the presence of an OCD diagnosis in Study 2. CONCLUSION: Healthy participants with high scores on OC measures and OCD patients share various personality traits but can also be distinguished according to the level of extraversion, neuroticism and psychoticism.

[Variations in a 24-year period of colorectal and gastric cancer in Mexico]. / Variaciones en un periodo de 24 años del cáncer colorrectal y gástrico en México.

OBJECTIVE: Gastric cancer (CG) and colorectal cancer (CCR) are the two most common neoplasms of the digestive system in the world. We performed a study to determine incidence and relation between CG and CCR in five hospitals in Mexico City. METHODS: Patients with admitted diagnosis of CG and CCR at Hospital General de Mexico, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Hospital Español de México, Centro Médico Nacional "20 de Noviembre" from the Instituto de Salud y Seguridad Social para Trabajadores del Estado, and Hospital Central Militar from January 1978 to December 2001 were studied. RESULTS: A total of 7,136 patients were studied. (CG 3,830, CCR 3,306). At Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" CG was the most common digestive neoplasm; from 1999, ratio was inverted to < 1. At Hospital General de México, from the beginning and until 1984, ratio was > 2, and later had an average of 1.31. For Hospital Español, ratio always was < 1 without changes. At Centro Médico Nacional "20 de Noviembre", initially CCR was more frequent, then CG, and finally CCR. At Hospital Central Militar ratio was constant, > CG. At the beginning, was global behavior > CG, ratio seemed to invert, but since 1998 CG/CCR ratio was < 1 and continued that way. CONCLUSIONS: In this study, we found that changes of CG/CCR ratio in a period of 24 years showed elevation of CCR incidence at five Mexican hospitals.