Treatment of endometriosis: a review with comparison of 8 guidelines.

BACKGROUND: Endometriosis, the presence of endometrial-like tissue outside the uterus, is a common clinical entity between women of reproductive age, with a prevalence of about 10%. Due to the variety of endometriosis-associated symptoms, a great variety of treatments have been implemented. The aim of this review is to give an overview on therapeutical approaches of eight national and international widely used guidelines. METHODS: Six national (College National des Gynecologues et Obstetriciens Francais, National German Guideline (S2k), Society of Obstetricians and Gynaecologists of Canada, American College of Obstetricians (ACOG) and Gynecologists, American Society for Reproductive Medicine (ASRM) and National Institute for Health and Care (NICE) and two international (World Endometriosis Society, European Society of Human Reproduction and Embryology) guidelines are included in this review. CONCLUSION: All the above-mentioned guidelines agree that the combined oral contraceptive pill, progestogens are therapies recommended for endometriosis associated pain. Concerning infertility, there is no clear consensus about surgical treatment. Discrepancies are also found on recommendation of the second- and third-line treatments.

Human papillomavirus and cervical screening: misconceptions undermine adherence.

PURPOSE: Prophylactic vaccination programs in conjunction with cervical screening can significantly reduce the incidence of cervical cancer worldwide. This study tested the hypothesis that human papillomavirus (HPV) vaccination can adversely affect adherence to cervical screening if the public develops the misconception that the HPV vaccination has removed the need for screening. DESIGN: A postal survey using a stratified random sample was employed. PARTICIPANTS: Overall, 500 medical students and 500 nonmedical students of the Aristotle University of Thessaloniki were invited to participate. The response rate was 82%. MEASURES: A questionnaire was developed assessing demographic characteristics, adherence to cervical screening, and awareness and attitudes toward HPV. ANALYSIS: Logistic regression was used to assess the impact of HPV awareness and attitudes towards HPV vaccination on adherence to Papanicolaou screening, controlling for place of origin and mother's screening behavior. RESULTS: Students who believed that vaccination against HPV obviated the need for a Papanicolaou test were two times less likely to adhere to cervical screening (adjusted odds ratio, 1.89; 95% confidence interval, 1.37-2.57; p  =  .0004). The effect was stronger in the nonmedical subgroup (adjusted odds ratio, 3.05; 95% confidence interval, 1.85-5.160; p  =  .0003). CONCLUSION: Findings highlight that misconceptions can adversely affect preventive behaviors and reduce the probability of an early diagnosis of cervical cancer.