Factores de riesgo asociados a infecciones vaginales y lesiones escamosas intraepiteliales en estudiantes universitarias de Medellín - Colombia / Risk factors associated to vaginal infections and squamous intraepithelial lesions in university students in Medellín, Colombia

Objetivo: Explorar factores de riesgo asociados a infecciones vaginales y Lesiones Intraepiteliales Escamosas de Cuello Uterino (LEICU) en estudiantes universitarias de Medellín-Colombia. Materiales y métodos: Estudio observacional analítico transversal con una muestra a conveniencia de 176 estudiantes del área de la salud. Los datos se obtuvieron mediante encuesta anónima que incluyó variables demográficas, clínicas, académicas y de hábitos sexuales. Se realizó toma de muestra por medio de citología cérvico uterina y Gram-Directo de flujo vaginal. Se exploró la asociación estadística de la presencia de IV o LEICU con variables de interés a través de la Odds Ratio (OR) y su intervalo de confianza de 95% (IC95%). Se asumió asociación estadística con p<0,05. Resultados: Se encontró ASCUS en el 9,1%; LEICU de bajo grado en el 4,5%, e infecciones vaginales en el 30.7% de las participantes, siendo la vaginosis bacteriana la infección más común. Además los antecedentes previos de VPH tienen asociación estadística con el ASCUS OR=36,69 IC 95% (3,56-378,15) y con las vaginosis por Gardnerella OR=10,57 IC 95%(1,07-104,64), mientras que las infecciones urinarias tuvieron asociación estadística con la candidiasis OR=4,46 IC 95% (1,21-16,5). Conclusiones: Los hallazgos encontrados pueden servir como información descriptiva acerca de la frecuencia de IV y LEICU en poblaciones universitarias para continuar o mejorar programas de promoción y prevención de la salud sexual y reproductiva, en poblaciones jóvenes

Objective: To explore the risk factors associated with vaginal infections and squamous intraepithelial lesions of the cervix in university students in Medellín, Colombia. Materials and methods: Cross-sectional study; a convenience sample of 176 students from the health care field were included. Data were obtained through an anonymous survey that included demographic, clinical, and academic variables, as well as those pertaining to sexual habits. Cervical cytology and direct gram stain of vaginal fluid were taken. The statistical association for vaginal infections and squamous intraepithelial lesions of the cervix was explored through the odds ratio and the 95% confidence intervals (95% CI). A p value <0.05 was considered statistically significant. Results: Atypical squamous cells of undetermined significance (ASCUS) was found in 9.1% of participants; low-grade cervical squamous intraepithelial lesions in 4.5%, and vaginal infections in 30.7%; bacterial vaginosis was the most common infection. Previous history of HPV has a statistical association with ASCUS OR = 36.69 95% CI (3.56-378.15) and vaginosis by Gardnerella OR = 10.57 CI 95% (1.07-104.64), whereas urinary infections had a statistical association for candidiasis OR = 4.46 CI 95% (1.21-16.5). Conclusions: Our findings can be used as descriptive information regarding the frequency of vaginal infections and squamous intraepithelial lesions of the cervix in university populations, to continue or improve programs for the promotion and prevention of sexual and reproductive health in young populations

"I hope I don't have cancer": colposcopy and minority women.

PURPOSE: To determine what women scheduled for colposcopy knew about the procedure and to understand their concerns about the test and its implications. DESIGN: Descriptive, exploratory, qualitative. SAMPLE AND SETTING: All women scheduled for colposcopy in a three-month period (n = 29) in an inner-city academic center in the northeast United States. The sample consisted of African American (66%), Hispanic (31%), and white (3%) women ranging in age from 17-59 years (x = 39 years). METHODS: Women were interviewed on the telephone or in person and were asked seven open-ended questions about why they were referred and what they expected would happen at the appointment. Interviews were content analyzed. FINDINGS: Four themes common to the women's responses emerged from the interview data: fear about their health, apprehension about the colposcopy, uncertainty about the meaning of the Pap test, and pervasive lack of knowledge. CONCLUSIONS: These results suggest that women in this study scheduled for colposcopy had little factual information about the test or its implications, were anxious about the appointment, and wanted more complete information. IMPLICATIONS FOR NURSING PRACTICE: Nurses cannot assume that women understand the reasons for their referral for colposcopy or the implications of the test. These study results imply that lengthened appointment time might be required to provide appropriate education and help alleviate women's anxiety. Future nursing research should examine the effect of anticipatory counselling and education for this group of women.

Nurse-midwifery evaluation and management of cervical pathology and the colposcopic examination.

Over the last several years, there has been a steady increase in the number of women experiencing abnormal Papanicolaou test results. Whether the nurse-midwife is performing a colposcopic examination or making a referral, she or he needs to have a clear understanding of cervical pathophysiology, diagnostic modalities, and therapeutic management. This article provides the nurse-midwife with a basic review of the cytologic and histologic findings of the cervix, a description of the colposcopy procedure, observations, terminology, and follow-up treatment, and considerations for adding colposcopy to a nurse-midwifery practice.

Cervical screening: default and compliance.

Health visitors could play a key role in educating at risk women about the benefits of cervical screening. Jane Martin and Peter J Main examine some of the models which outline barriers to screening uptake and consider which will help the health visitor to increase the knowledge and understanding of at risk clients.

Precursor lesions of the cervix.

Screening has played a major role in decreasing the morbidity and mortality associated with carcinoma of the cervix. Aggressive management of lesions recognized as precursor to invasive squamous carcinoma, (cervical intraepithelial neoplasia), has markedly reduced the incidence of invasive cancer. Squamous carcinomas constitute most of the cervical cancers. The relationship between human papilloma virus and cervical abnormalities is reviewed. Nursing diagnoses and care planning ideas are discussed.