[Infection with human papillomavirus in men]. / Infección por el virus del papiloma humano en varones.

OBJECTIVE: Review updated (HPV) HPV in Man virus information, the role as a sexually transmitted infection (STI) that negatively impacts your partner(s) sexual(s) and represents a public health problem globally. In the case of men they have been identified specific risk factors that place it as the main factor in the transmission of the disease (infection, cancer and cancer precursor lesions in the genital tract), both heterosexual and homosexual practice as the subjects infected with HIV (HIV) in whom HPV prevalence rises to 95%. SEARCH METHODOLOGY: A systematic review of the literature of the past six years to date (2015) was made. Human papilloma virus vaccine, warts and sexually transmitted: In the database PubMed, LILACS and EMBASE were searched keywords. Only items that directly related to studies in men and that referred to the vaccine were analyzed. RESULTS: The mean time of disappearance of persistent injuries HPV-6, 11, 16, and 18 (defined as two consecutive negative results) was 6.7; 3.2; 9.2; and 4.7 months respectively. In conclusion, this study showed that the acquisition of HPV-6, 11, 16, or 18 is common among men. Differences in detection rates of HPV DNA in anogenital different anatomical sites were found. It has been found that the average time of dlisappearance of lesions is ≥ 6 months. In another study conducted on a sample that included Mexican population, the median duration of HPV infection was 7.52 months (6.80-8.61) for any type of HPV and 12-19 months (7.16-18.17) for HPV-16. CONCLUSION: The prevention of this disease has had a significant change with the introduction of the HPV vaccine, which has led organizations like the World Health Organization (WHO) to take a position in favor of including these biological in national immunization programs, to thereby contribute to the eradication of not only genital cancer in women, also in man, which is being reflected gradually in such programs.

[Third National Ovarian Consensus. 2011. Grupo de Investigación en Cáncer de Ovario y Tumores Ginecológicos de México "GICOM"]. / Tercer Consenso Nacional de Cáncer de Ovario 2011. Grupo de Investigación en Cáncer de Ovario y Tumores Ginecológicos de México "GICOM".

INTRODUCTION: Ovarian cancer (OC) is the third most common gynecologic malignancy worldwide. Most of cases it is of epithelial origin. At the present time there is not a standardized screening method, which makes difficult the early diagnosis. The 5-year survival is 90% for early stages, however most cases present at advanced stages, which have a 5-year survival of only 5-20%. GICOM collaborative group, under the auspice of different institutions, have made the following consensus in order to make recommendations for the diagnosis and management regarding to this neoplasia. MATERIAL AND METHODS: The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of two days in which a debate was held. These statements are the conclusions reached by agreement of the participant members. RESULTS: No screening method is recommended at the time for the detection of early lesions of ovarian cancer in general population. Staging is surgical, according to FIGO. In regards to the pre-surgery evaluation of the patient, it is recommended to perform chest radiography and CT scan of abdomen and pelvis with IV contrast. According to the histopathology of the tumor, in order to consider it as borderline, the minimum percentage of proliferative component must be 10% of tumor's surface. The recommended standardized treatment includes primary surgery for diagnosis, staging and cytoreduction, followed by adjuvant chemotherapy Surgery must be performed by an Oncologist Gynecologist or an Oncologist Surgeon because inadequate surgery performed by another specialist has been reported in 75% of cases. In regards to surgery it is recommended to perform total omentectomy since subclinic metastasis have been documented in 10-30% of all cases, and systematic limphadenectomy, necessary to be able to obtain an adequate surgical staging. Fertility-sparing surgery will be performed in certain cases, the procedure should include a detailed inspection of the contralateral ovary and also negative for malignancy omentum and ovary biopsy. Until now, laparoscopy for diagnostic-staging surgery is not well known as a recommended method. The recommended chemotherapy is based on platin and taxanes for 6 cycles, except in Stage IA, IB and grade 1, which have a good prognosis. In advanced stages, primary cytoreduction is recommended as initial treatment. Minimal invasion surgery is not a recommended procedure for the treatment of advanced ovarian cancer. Radiotherapy can be used to palliate symptoms. Follow up of the patients every 2-4 months for 2 years, every 3-6 months for 3 years and anually after the 5th year is recommended. Evaluation of quality of life of the patient must be done periodically. CONCLUSIONS: In the present, there is not a standardized screening method. Diagnosis in early stages means a better survival. Standardized treatment includes primary surgery with the objective to perform an optimal cytoreduction followed by chemotherapy Treatment must be individualized according to each patient. Radiotherapy can be indicated to palliate symptoms.

[The first Mexican consensus of endometrial cancer. Grupo de Investigación en Cáncer de Ovario y Tumores Ginecológicos de México]. / Primer consenso Mexicano de cancer de endometrio.

INTRODUCTION: Endometrial cancer (EC) is the second most common gynecologic malignancy worldwide in the peri and postmenopausal period. Most often for the endometrioid variety. In early clinical stages long-term survival is greater than 80%, while in advanced stages it is less than 50%. In our country there is not a standard management between institutions. GICOM collaborative group under the auspice of different institutions have made the following consensus in order to make recommendations for the management of patients with this type of neoplasm. MATERIAL AND METHODS: The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of four days in which a debate was held. These statements are the conclusions reached by agreement of the participant members. RESULTS: Screening should be performed women at high risk (diabetics, family history of inherited colon cancer, Lynch S. type II). Endometrial thickness in postmenopausal patients is best evaluated by transvaginal US, a thickness greater than or equal to 5 mm must be evaluated. Women taking tamoxifen should be monitored using this method. Abnormal bleeding in the usual main symptom, all post menopausal women with vaginal bleeding should be evaluated. Diagnosis is made by histerescopy-guided biopsy. Magnetic resonance is the best image method as preoperative evaluation. Frozen section evaluates histologic grade, myometrial invasion, cervical and adnexal involvement. Total abdominal hysterectomy, bilateral salpingo oophorectomy, pelvic and para-aortic lymphadenectomy should be performed except in endometrial histology grades 1 and 2, less than 50% invasion of the myometrium without evidence of disease out of the uterus. Omentectomy should be done in histologies other than endometriod. Surgery should be always performed by a Gynecologic Oncologist or Surgical Oncologist, laparoscopy is an alternative, especially in patients with hypertension and diabetes for being less morbid. Adjuvant treatment after surgery includes radiation therapy to the pelvis, brachytherapy, and chemotherapy. Patients with Stages III and IV should have surgery with intention to achieve optimal cytoreduction because of the impact on survival (51 m vs. 14 m), the treatment of recurrence can be with surgery depending on the pattern of relapse, systemic chemotherapy or hormonal therapy. Follow-up of patients is basically clinical in a regular basis. CONCLUSIONS: Screening programme is only for high risk patients. Multidisciplinary treatment impacts on survival and local control of the disease, including surgery, radiation therapy and chemotherapy, hormonal treatment is reserved to selected cases of recurrence. This is the first attempt of a Mexican Collaborative Group in Gynecology to give recommendations is a special type of neoplasm.

[Surgical approach of breast nodules during pregnancy]. / Abordaje quirúrgico de nódulos mamarios durante el embarazo.

BACKGROUND: Only in Mexico, about four thousand women die from breast cancer of which 11 thousand are diagnosed. Is undoubtedly the most malignant disease throughout the world are diagnosed each year as over one million every year and the figure grows. OBJECTIVE: To analyze the results of six years of experience in the therapeutic treatment of breast nodules during pregnancy which describes the treatment, establishing the diagnosis of breast biopsies, reported complications associated with obtaining the same. MATERIAL AND METHODS: We reviewed a database of search terms: pregnancy and breast nodule from January 1 2001 to December 31, 2006. RESULTS: Of the 20 lesions found, 19 were diagnosed with ultrasound as a solid type of injury, and as a mixed lesion. 18 biopsies were performed on pregnant women and post-natal period. In 10 (50%) patients, biopsy was performed by fine needle aspiration. In 13 of the patients were breast fibroadenoma, and only one was diagnosed with infiltrating ductal carcinoma le. In 10 patients operated lumpectomy was performed. A patient in modified radical mastectomy was performed because of the finding of ductal carcinoma. CONCLUSION: Our study was the Breast fibroadenoma lesion was found in more common. In our experience with the management of breast nodules in pregnancy, we can say that most of the lesions are benign, and usually are commonly encountered pathologies in nonpregnant women. In the case of diagnosing breast cancer, we must make the decision about the best treatment to offer the best possible forecasts.