RESUMO
BACKGROUND: Cervical cancer is a major public health problem worldwide. In Mexico there are an estimated 50 cases per 100,000 women. Cervical intraepithelial neoplasia (CIN) is a precursor of inva- sive cancer. Early detection and treatment of this condition lead to a cure rate close to 100%. OBJECTIVES: To know the percentage of patients who, following a loop diathermy conization, present premalignant lesion recurrence within a cyto-colpo-histological follow-up period of one year; to identify risk factors for patients with persistent lesions. METHODS: A descriptive, retrospective, observational and analytical study of cases and controls conducted at the Hospital General Dr. Miguel Silva in Morelia, Mexico from January 2012 to June 2014. The subjects were patients who had undergone diathermy loop conization due to intraepithelial lesions. RESULTS: The population was comprised of 251 patients, of whom 53 (21.1%) presented recurrence within a one-year follow-up period. The average period between the conization procedure and the diagnosis of a persistent lesion was 8.92 ± 3.2 months. The average patient age was 36.1 ± 7.49 in the group that presented post-procedure recurrence, while that of patients without recurrence was 39.1 ± 7.58, with a p value of 0.025. The only risk factor that showed a statistically significant differ- ence was the persistence of oncogenic hybrids, with an odds ratio of 17.568 (8.33-37.02); p = 0.0001. CONCLUSIONS: Despite the high effectiveness of loop diathermy conization, cyto-colpo-histological follow-up is necessary owing to the high risk of persistent lesions.
Assuntos
Conização/métodos , Eletrocoagulação/métodos , Displasia do Colo do Útero/patologia , Neoplasias do Colo do Útero/patologia , Adulto , Feminino , Seguimentos , Humanos , México , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estudos Retrospectivos , Fatores de Risco , Neoplasias do Colo do Útero/cirurgia , Displasia do Colo do Útero/cirurgiaRESUMO
BACKGROUND: We conducted a study evaluating the clinical and radiologic results of the open tibial shaft fractures using an external fixator as definitive treatment. METHODS: Clinical, observational, descriptive, prospective and longitudinal study. Forty-six patients were included, 40 males (87%) and 6 females (13%), whose age was 31.02 +/- 14.62 years; the time elapsed from the accident to admission in the Emergency Room was 1-16 hours, with a mean of 5.1 +/- 3.35 hours. Ten patients (21.74%) had a Gustilo grade I open fracture, and 36 patients (78.26%) a Gustilo grade II fracture. They were also classified according to the AO classification, with the following resulting groups: 13 (28.9%) patients were A3, 12 (26.1%) were B3, 8 (17.4%) B1, 8 (17.4%) were B2, and 5 (10.9%) were A2. The dynamization of the fixator was done at a mean of 11.56 +/- 1.10 weeks. RESULTS: Forty-three patients had healing at 23.51 +/- 3.62 weeks; Gustilo I fractures healed at 22.8 +/- 3.5 weeks; Gustilo II fractures at 23.7 +/- 3.7 weeks, with a P value of 0.48. In 3 patients (6.53%), due to absence of healing, the external fixator was exchanged for an intramedullary nail with a bone graft, with healing occurring at 18 weeks. Six infections (13%) were reported at the nail insertion site; angulations ranged from 0 degrees to 8 degrees, which is tolerable. CONCLUSIONS: This fixator is safe in properly selected patients, since the few complications that occurred are similar to other reports using different internal fixation methods.