Prostitution and other cofactors in preinvasive and invasive lesions of the cervix.

OBJECTIVE: To examine risk factors for preinvasive and invasive lesions of the cervix in Venezuelan female sex workers (FSW). METHODS: A total of 438 FSW were analysed. Each FSW had their clinical history recorded, a gynaecological examination, a Pap smear and a colposcopic examination of the cervix. A cervical biopsy was taken under colposcopic guidance when there was an abnormal epithelium. The statistical methods used were Student's t-test, chi(2) test and logistic regression. RESULTS: The sex workers' mean age was 32.1 +/- 7.9 years old (mean +/- standard deviation). The age of the first sexual intercourse activity for the FSW was 15.9 +/- 2.1 years. Sixty-four of the 84 women (76.2%) who had cervical biopsies had preinvasive and invasive lesions; 41 (9.4%) had cervical intra-epithelial neoplasia (CIN) 1, 12 (2.7%) had CIN 2, eight (1.8%) had CIN 3, two (0.5%) had microinvasive carcinoma, and one (0.2%) had invasive carcinoma. Forty of these 64 women (62.5%) with preinvasive or invasive lesions had a concurrent histological diagnosis of human papilloma virus (HPV) infection (P < 0.0001). The FSW with cervical pathology were younger (P < 0.05) and had their first sexual intercourse earlier (P < 0.02) than FSW with no pathology. Two hundred and seventy-six (63%) of the FSW were current smokers, and 47 of these women (17.6%) had cervical pathology (P < 0.03). CONCLUSIONS: First sexual experience before 20 years of age, cigarette smoking and HPV infection were high-risk factors for preinvasive and invasive lesions of the cervix in Venezuelan FSW.

Efecto de la terapia hormonal de reemplazo sobre la función cognitiva en la menopausia

Objetivo: Determinar el efecto de la terapia de reemplazo hormonal (TRH) sobre la función cognitiva en mujeres postmenopáusicas. Métodos: Del registro de participantes en el “Estudio Maracaibo del Envejecimiento”, se seleccionaron 72 mujeres menopáusicas, entre 55 y 79 años. Treinta y seis mujeres fueron tratadas con TRH combinada continua con estrógenos equinos conjugados (EEC) y acetato de medroxiprogesterona (AMP) durante un año, y 36 mujeres no recibieron THR: controles, pareados. El grupo1: recibió EEC 0,625mg + AMP 2,5mg; el grupo2: EEC 1,25mg + AMP 5,0mg. A todas las mujeres se le aplicaron pruebas neuropsicológicas, antes y después del tratamiento. Resultados: Al comparar cada grupo experimental y control consigo mismo al inicio y luego de 12 meses, se observaron cambios en el área de la memoria, especialmente acentuada en el grupo control. También se compararon las mediciones de cada grupo experimental con su respectivo grupo control luego de un año de la evaluación inicial, se observaron diferencias significativas a favor del grupo control 2 en las pruebas de memoria de reconocimiento, orientación y razonamiento . Conclusiones: Los cambios en la función cognitiva, observados en esta muestra, no pueden ser atribuidos a la TRH.

Objective: to evaluate the effect of hormone replacement therapy (HRT) on cognitive function in posmenopausal women. Methods: seventy two posmenopausal women aged 55-79 years were selected from the Aging Maracaibo Study. Thirty-six women were treated with combined continued HRT (conjugated equine estrogen-CEE plus medroxyprogesterone acetate-MPA) during one year: Group 1 were treated with CEE 0,625 mg plus MPA 2,5 mg; Group 2 were treated with CEE 1,25 mg plus MPA 5 mg. Thirty-six not treated women served as paired controls. Neuropsycological tests were performed in all women before and after treatment. Results: after one year of treatment with any of the CEE/MPA regimens, no significant changes in memory, recognition, orientation and rationalization were noted as compared with paired control groups. Unexpectedly, in these controls, beneficial effects on cognitive parameters were observed. Conclusion: HRT did not changed cognitive function after one year of follow-up in posmenopausal women.

Prevalence of preinvasive and invasive lesions of the cervix in sexual workers.

OBJECTIVE: To determine the prevalence of preinvasive and invasive lesions of the cervix in sexual workers. MATERIALS AND METHODS: A total of 438 prostitutes were analyzed. Each prostitute had a clinical history, gynecological examination, Pap smear, and a colposcopic examination of the cervix. A cervical biopsy was taken under colposcopic guidance when there was abnormal epithelium. RESULTS: The sexual workers' mean age was 32.2 + 8 years (mean + SD), age of first sexual intercourse was 15.9 + 2 years, parity mean was 4.1 + 2, births were 3 + 3, and age of first delivery was 16.6 + 4.7 years. Cervical biopsies were taken from 84 patients because of atypical epithelium under colposcopic examination. Sixty-four (76.2%) patients had preinvasive and invasive lesions: 41(64%) had cervical intraepithelial neoplasia (CIN) 1, 12 (18.8%) had CIN 2, 8 (12.5%) had CIN 3, 2 (3.2%) had microinvasive carcinoma (Ca), and 1 (1.5%) had invasive Ca 1. Sexual workers with cervical pathology were younger (p < .05) and had their first sexual intercourse experience earlier than those sexual workers who did not have lesions (p < .02).Preinvasive lesions were found in sexual workers in their 30s, and invasive lesions were found in sexual workers under the age of 40. CONCLUSIONS: Preinvasive lesions of the cervix have increased 2-fold in Venezuelan sexual workers and the invasive lesions are stable but found in younger sexual workers.

Relación entre monitoreo ambulatorio de presión arterial de 24 horas y alteraciones en la memoria reciente de adultos mayores de 55 años / Ambulatory blood pressure monitorzation statement with recent memory disturbs in adults oldness than 55 years

Presentamos un grupo poblacional, de coherte transversal que incluyó 402 personas de uno u otro sexo, con edades igual o mayor de 55 años, provenientes de la parroquia Santa Lucía de la ciudad de Maracaibo. Se les practicaron pruebas neuropsicológicas para evaluar memoria reciente: subpruebas de memoria total (MT) y memoria a largo plazo (MLP) del test de recuerdo selectivo de Bushke y Fuld; según los resultados de estas pruebas se clasificaron en dos grupos: con memoria reciente alterada y con memoria reciente normal. También se les práctico determinaciones antropométricas como peso (Kg), talla (m), índice de masa corporal (peso/talla²) según Quetelot. La presión arterial casual (P.A.C) fue determinada por método oscilométrico con Dinamap Critikon, en brazo derecho de paciente sentado, con brazalete adecuado, según la circunferencia bronquial. A todos los pacientes se les colocó un aparato (M.A.P.A) debidamente programado para registros cada 15 minutos de horas de vigilia (6am - 11pm) y cada 30 minutos durante el sueño (11 pm - a 6 am). Obtuvimos los siguientes resultados: 1) las variaciones de la P.A sistólica determinada por M.A.P.A están asociadas con alteraciones de la memoria reciente en mayores de 55 años. 2) Los valores de la P.A sistólica durante el sueño con mejores predictores de alteraciones de la memoria reciente. 3) Las determinaciones de P.A casual no guardaron correlación con trastornos de la memoria. 4) Proponemos la utilización del MAPA en mayores de 55 años para la pesquisa de alteraciones de la función cognitiva temprana