Determinants and evolution of squamous intraepithelial lesions in HIV-infected women, 1991-2004.

This study presents a case-control nested analysis of cervical squamous intraepithelial lesions (SIL) in a cohort of 423 HIV-infected women with registered Pap smears between 1991 and 2004. Data on Pap smear results, CDC HIV classification, CD4 cell count and antiretroviral therapy were prospectively collected. Pap smears were classified using the Bethesda classification. Women had a median of three Pap smears registered in the database. The first Pap smear was registered

[Results of hysteroscopic myomectomy]. / Résultats des myomectomies hystéroscopiques.

Main symptoms related to submucous fibroids are menorrhagia, infertility, and postmenopausal bleeding. First experiences of hysteroscopic transcervical resection of fibroids have been published by Neuwirth in the late seventies. Reports with long-term follow-up in patients with abnormal uterine bleeding are available. After a follow-up period of five years and more, results are satisfactory in 70-85% of the patients. Intramural class 2 and larger fibroids (> 4 cm) constitute the limits of the endoscopic technique. Prior to hysteroscopic myoma resection, pretreatment with GnRH agonists may be indicated in selected cases (large myomas, patients suffering from secondary anemia). Repeat resection is an option after failed primary hysteroscopic operation and may reduce the hysterectomy rate. In infertile women with submucosal or intracavitary fibroids, pregnancy and delivery rates are increased after hysteroscopic myomectomy. Operative hysteroscopy is also safe and effective in controlling persistent postmenopausal bleeding. To conclude, hysteroscopic resection is the gold standard for the treatment of symptomatic submucous fibroids.

[Consultation offices for family planning in Switzerland]. / Die Beratungsstellen für Familienplanung in der Schwiez.

PIP: Questionnaries were sent to the 10 family planning counseling centers in Switzerland, the information organized, and presented in 10 detailed tables. These bureaus (official, clinical, or private) were founded between 1956-1967 and deal with contraception, birth control, sterility, prevention of abortion, and marriage, family, and sexual counseling. They are staffed by physicians, social workers, and to some extent psychiatrists and ministers. Bureaus with clinical affiliations are the most effective, because they are more highly regarded, and because medical treatment, follow-up, and specialized counseling are immediately available. In certain areas improvements should be made. More centers are needed, and the bureaus should coordinate their activities. Research investigations should be increased, and the results shared by the centers and made known to the public. Sex education is a potentially important task, and even more attempts should be made to expose and educate the public concerning family planning. Training of personnel is extremely important, and specialists from other fields can aid the doctors and social workers.^ieng