Incidence of Anal Dysplasia in a Population of High-Risk Women: Observations at a Cervical Pathology Unit.

OBJECTIVES: This study aimed to evaluate the incidence of anal dysplasia in women at high risk of developing those lesions and to assess the relationships between positive anal cytology and different risk factors. MATERIALS AND METHODS: We performed an observational cross-sectional study involving a patient survey and chart review. The study was conducted at the cervical pathology unit at the Hospital Universitario 12 de Octubre, Madrid, Spain, from 2011 to 2015. Patients were 215 women aged 18 to 65 years old with risk factors for anal dysplasia, for whom anal evaluation was indicated. Anal cytology was performed in all patients. High-resolution anoscopy and anal biopsy were used to investigate abnormalities. All patients completed a survey regarding sexual practices. The patients' demographic and clinical data were collected by using a retrospective chart review. The main outcome measure was the incidence of anal dysplasia in this population. RESULTS: Of the 215 patients, 45 (21.0%) presented with cytological abnormalities (atypical squamous cells of undetermined significance, 13.5%; low-grade squamous intraepithelial lesion, 5.6%; high-grade squamous intraepithelial lesion, 1.9%). Anoscopy was performed in 31 patients (14.4%) and 2 patients (0.9%) had abnormal findings. One case (0.5%) of low-grade anal intraepithelial neoplasia was identified. Only immunosuppression (p = .01) and smoking status (p = .02) were significantly correlated with positive anal cytology results. Limitations of the study include the small single-center sample, a lack of controls, the retrospective design, potential survey response biases, and the nonstandardized survey. CONCLUSIONS: The incidence of abnormal cytological findings was 21.0%, whereas low-grade anal intraepithelial was confirmed in 0.5% of the patients. There is a higher incidence of cytological abnormalities among immunosuppressed women and smokers.

Cesárea humanizada / Humanized cesarean sections

Objetivo. Demostrar la ausencia de efectos negativos a corto plazo en aquellas cesáreas en las que se realiza piel con piel, con o sin la entrada del acompañante, así como una mayor satisfacción de dichas gestantes. Material y método. Se diseñó una encuesta de satisfacción que debía ser cumplimentada por todas las madres a las que se les había realizado una cesárea. Se analizaron 300 encuestas. Resultado. El 98,2% de las mujeres que estuvieron acompañadas consideraron que esto les sirvió de apoyo. El 94,2% de las mujeres con una cesárea con acompañante tuvieron un puerperio normal, frente al 87,2% de cesáreas sin acompañante (p = 0,69). Conclusiones. Tanto el contacto piel con piel como la entrada del acompañante durante una cesárea son actuaciones sin efectos negativos sobre la madre o su recién nacido(AU)

Objective. To demonstrate the absence of short-term negative effects in cesarean sections followed by skin-to-skin contact, with or without the presence of a companion, and the greater satisfaction of these women. Material and method. A satisfaction survey was designed for use in all women who had undergone a cesarean section. A total of 300 questionnaires were analyzed. Results. Among women accompanied by companions, 98.2% considered this measure to be a source of support. The puerperium was normal in 94.2% of accompanied women versus 87.2% of those who were unaccompanied (p = 0.69). Conclusions. No negative effects on the mother or newborn are associated with either skin-to-skin contact after delivery or the presence of a companion during cesarean section(AU)