RESUMO
BACKGROUND: Cervical cancer incidence and mortality rates in Bolivia are among the highest in Latin America. This investigation aims to evaluate the possibility of using simple devices, e.g. a cotton swab and a glass slide, for self-sampling in order to detect human papillomavirus (HPV) DNA by PCR in cervico-vaginal cells. METHODS: In the first phase of our study we evaluated the use of a glass slide as a transport medium for cervical cells. A physician took paired-cervical samples from 235 women. One sample was transported in Easyfix® solution and the other sample was smeared over a glass slide. Both were further analyzed and compared for human DNA recovery and HPV detection. A kappa value was determined to evaluate the agreement between the HPV DNA detection rates. In the second phase of the study, 222 women from the urban, peri-urban and rural regions of Cochabamba were requested to perform self-sampling using the following devices: a cotton swab combined with a glass slide, and a vaginal tampon. Women gave their opinion about the self-sampling technique. Finally, the agreement for high risk-HPV detection between self- and physician-collected samples was performed in 201 samples in order to evaluate the self-sampling technique. RESULTS: Firstly, the comparison between Easyfix® solution and the glass slide to transport clinical samples gave a good agreement for HPV DNA detection (κ = 0.71, 95% CI 0.60-0.81). Secondly, self-sampling, especially with cotton swab combined with glass slide, would generally be preferred over clinician sampling for a screening program based on HPV detection. Finally, we showed a good agreement between self- and physician collected samples for high risk-HPV detection (κ = 0.71, 95% CI 0.55-0.88). CONCLUSIONS: Simple devices such as a cotton swab and a glass slide can be used to perform self-sampling and HPV DNA detection. Furthermore, most Bolivian women preferred self-sampling over clinician-sampling for cervical cancer screening.
Assuntos
Autoavaliação Diagnóstica , Detecção Precoce de Câncer/métodos , Infecções por Papillomavirus/diagnóstico , Manejo de Espécimes/métodos , Neoplasias do Colo do Útero/diagnóstico , Adulto , Bolívia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Se comunica el caso único de un Recién Nacido (R. N.) con torsión Testicular Derecha In Utero, observado en el Hospital de Especialidades Médicas Belén de Trujillo. Clínicamente la enfermedad a los 17 días post-parto se caracterizó por: aumento de volumen testicular derecho, el cual aparentemente no ocasionó molestias. El examen radiológico de urografía excretora de resultado normal; en el laboratorio las Gonadotrofinas Coriónicas también fueron negativas. El paciente fue sometido a orquiectomía derecha. El examen anatomopatológico reveló Necrosis Hemorrágica del Testículo con fusión de las túnicas albugínea y vaginal. Su evolución fue favorable y se encuentra asintomático. A propósito de este caso se ha hecho la revisión de la literatura pertinente.
We communicate the unique case of a New Born (N.B.) with right Testicular Torsion in utero observed in the Belen Medical Specialities Hospital of Trujillo. Clinically, the disease at the 17th. day post partum was characterized by a rise in volume of the right testicle which apparently caused no problem. In radiologic examination, the excretory urography was normal result; in laboratory tests Corionic Gonadotrophins were also negative. The patient was submitted to right Orchiectomy. The anatomopathologic revealed Hemorragic Necrosis of the testicle with fusion of the vaginal and albumic tunics. Evolution was favorable and is asymptomatic. Revision of pertinent literature has boendone.