Caracterización epidemiológica, clínica e histopatológica de los tumores malignos de cérvix en las pacientes sometidas a histerectomía radical tipo Wertheim-Meigs que acuden al servicio de Ginecología y Obstetricia del Hospital General San Juan de Dios, de Guatemala (enero 2017 a diciembre del 2018) / Epidemiological, clinical and histopathological characterization of malignant tumors of the cervix in patients undergoing Wertheim-Meigs radical hysterectomy who attend the Gynecology and Obstetrics service of the San Juan de Dios General Hospital, Guatemala (January 2017 to December 2018)

Los tumores malignos de cérvix continúan siendo un problema de salud pública para nuestro país, es por ello que se consideró de importancia realizar este estudio. Se estudiaron las características clínicas más frecuentes encontradas en las pacientes sometidas dentro de los cuales encontramos como principal motivo de consulta el dolor pélvico con un 86.75%, seguido del sangrado con un 84.34% finalizando con la leucorrea con el 79.52%. En cuanto a la clasificación de los tumores malignos se comprobó que la mayoría de las pacientes presentaron el estadio CaCu IB1 con el 91.57% seguido del CaCu IA1 con el 6.02% finalizando con el CaCu IB2 con el 2.41%. Así mismo, se pudo determinar que los tumores malignos de cérvix más frecuentes en las pacientes estudiadas fue el carcinoma epitelial, seguido del adenocarcinoma de cérvix, siendo su histopatología más encontrada el carcinoma epidermoide no queratinizante de células grandes con el 53.01%. (AU)

Uterine Cervical Cancer continues to be one of the main public health problems in Guatemala, thus being important to do this type of research. The most frequent clinical characteristics found in the present study were pelvic pain (86.75%) followed by bleeding in 84.34% and vaginal discharge in 79.52%. Most of the patients were classified as Stage IB1 (91.57%) followed by Stage IA1(6/02%) and Stage IB2 (2.41%). The most frequent Histologic Type was Squamous Carcinoma. (AU)

[Detection of white blood cells in microscopic leucorrhea images based on deep active learning].

The number of white blood cells in the leucorrhea microscopic image can indicate the severity of vaginal inflammation. At present, the detection of white blood cells in leucorrhea mainly relies on manual microscopy by medical experts, which is time-consuming, expensive and error-prone. In recent years, some studies have proposed to implement intelligent detection of leucorrhea white blood cells based on deep learning technology. However, such methods usually require manual labeling of a large number of samples as training sets, and the labeling cost is high. Therefore, this study proposes the use of deep active learning algorithms to achieve intelligent detection of white blood cells in leucorrhea microscopic images. In the active learning framework, a small number of labeled samples were firstly used as the basic training set, and a faster region convolutional neural network (Faster R-CNN) training detection model was performed. Then the most valuable samples were automatically selected for manual annotation, and the training set and the corresponding detection model were iteratively updated, which made the performance of the model continue to increase. The experimental results show that the deep active learning technology can obtain higher detection accuracy under less manual labeling samples, and the average precision of white blood cell detection could reach 90.6%, which meets the requirements of clinical routine examination.

Trichomonas Detection in Leucorrhea Based on VIBE Method.

Trichomonas examination is one of the important items in the leucorrhea routine detection. And it cannot be recognized by still images because of the unstable morphology and unfixed focal location caused by motion characteristic. We proposed an improved VIBE algorithm. 6 videos (totally 1414 frames) are collected for testing. In order to compare the effects of the algorithms, we segment each frame artificially as ground truth. Experiments show that percentage of correct classification (PCC) achieves 88%. The proposed improved method can effectively suppress the false detection caused by the formed components such as epithelial cells in the leucorrhea microscopic image and the missed detection caused by the background model update during the movement. At the same time, improvements can effectively suppress smear and ghost areas. The algorithm proposed in this paper can be integrated into the leucorrhea automatic detection system.

Automatic identification of fungi in microscopic leucorrhea images.

Identifying fungi in microscopic leucorrhea images provides important information for evaluating gynecological diseases. Subjective judgment and fatigue can greatly affect recognition accuracy. This paper proposes an automatic identification system to detect fungi in leucorrhea images that incorporates a convolutional neural network, the histogram of oriented gradients algorithm, and a binary support vector machine. In experiments, the detection rate of the positive samples was as high as 99.8%. The experimental results demonstrate the effectiveness of the proposed method and its potential as a primary software component of a completely automated system.

Liquen escleroso en niños: el gran simulador / Lichen sclerosus in children: the great simulator

El liquen escleroso es un trastorno mucocutáneo que afecta típicamente a mujeres en la etapa posmenopáusica. Aunque es una entidad poco conocida por los pediatras, hasta un 7-15% de los casos se dan en niñas prepuberales. Presentamos 3 casos de niñas diagnosticadas de liquen escleroso. En todos los casos, el diagnóstico inicial fue erróneo; de ahí la importancia de conocer este cuadro (AU)

Lichen sclerosus is a chronic mucocutaneous disorder that affects typically post-menopausical women. Although it's not well known by pediatricians, up to 7-15% of all cases happen in pre-puberal girls. We reported three cases of lichen esclerosus. In all three cases, the initial diagnosis was wrong, so the importance of knowing this cutaneous disorder (AU)

Leucorrea como signo de infecciones cérvicovaginales / Leucorrhea as a sign of cervico-vaginal infections

Las infecciones vaginales representan uno de los problemas ginecológicos más comunes en mujeres en edad reproductiva. Objetivo: Clasificar la leucorrea fisiológica y patológica de las pacientes investigadas, además de analizar si esta última obedece a infecciones cervico-vaginales. Método: La presente investigación se realizó a población abierta de todas las pacientes que acudieron al laboratorio de biología celular de la Benemérita Universidad Autónoma de Puebla al programa de detección oportuna de cáncer (Papanicolaou) desde enero del 2001 a Diciembre 2012, en las que se obtuvo un total de 1 679 muestras vaginales mismas que fueron teñidas con el tren de tinción de Papanicolaou modificado para su posterior diagnóstico microscópico. Resultados: Se encontró que 923 fueron positivas a leucorrea, de las cuales 489 corresponden a leucorrea fisiológica, 285 leucorrea patológica y las 149 no se ubican en ningún grupo. Discusión: Las infecciones cervico-vaginales se pueden presentar como respuesta a la presencia polimicrobiana que coloniza la cavidad vaginal y que esto conlleva un conjunto de signos y síntomas no específicos de los agentes que las causen, entre los que se encuentra la leucorrea como dato clínico que motiva en muchos casos a la consulta ginecológica. De las infecciones cervico-vaginales, la vaginitis es la causa más común de descarga vaginal patológica o leucorrea seguida de la cervicitis siendo ambas causadas por diversos agentes y de los que se mencionan los más frecuentes.

Vaginal infections are one of the most common gynecological problems in women of reproductive age. Objective: To classify physiological and pathological leucorrhoea in patients investigated, in addition to analyzing whether the latter is due to cervico-vaginal infections. Methods: This research was performed with an open population of all patients who came to the cancer screening program (Pap) at the Cell Biology Laboratory of the Benemérita Universidad Autónoma de Puebla from January 2001 to December 2012, where 1 679 vaginal samples were stained with the Papanicolaou stain set, modified for subsequent microscopic diagnosis. Results: Nine hundred twenty three were found to be positive for leucorrhea; of which 489 correspond to physiological leucorrhea and 285 to pathological leucorrhea; 149 are not located in any group. Discussion: Cervico-vaginal infections may occur in response to polymicrobial presence which colonizes the vaginal cavity; and this entails a set of signs and symptoms produced by nonspecific agents, among which is leucorrhoea as a clinical manifestation that motivates, in many case, a gynecological consultation. Among cervicovaginal infections, vaginitis is the most common cause of pathological vaginal discharge or leucorrhoea; followed by cervicitis; both of which are caused by various agents, of which we mention here those most frequently found.

Leukorrhea and bacterial vaginosis as in-office predictors of cervical infection in high-risk women.

OBJECTIVE: To evaluate 1) whether microscopic detection of leukorrhea or bacterial vaginosis identifies patients at high risk for cervical infection with Chlamydia trachomatis or Neisseria gonorrhoeae, and 2) if pregnancy alters the predictive value of these findings. METHODS: Wet-mount screening examination of vaginal discharge was performed on all new patients seen at two resident-staffed clinics serving primarily indigent women. Leukorrhea was defined as >10 white blood cells per high-power field on microscopic examination; Amsel criteria were used to determine the presence of bacterial vaginosis, with a positive clue cell test result defined as >20% of epithelial cells. The diagnoses of C trachomatis and N gonorrhoeae infection were established by deoxyribonucleic acid amplification tests. RESULTS: The study population consisted of 194 women, 118 (61%) of whom were pregnant. Overall, 11% of women had positive cultures for chlamydia or gonorrhea. Although both leukorrhea and clue cells were independently associated with positive cervical cultures, multivariate analysis found that clue cells did not contribute to the predictive value of leukorrhea alone among both pregnant (relative risk [RR] = 15.7) and nonpregnant (RR = 58.7) women. Negative predictive values for the screening test were comparably high (98-100%), independent of pregnancy status. CONCLUSION: Leukorrhea, in the presence or absence of bacterial vaginosis, was strongly associated with cervical infections with C trachomatis or N gonorrhoeae among both pregnant and nonpregnant patients. In settings where patient follow-up is uncertain, on-site screening tests identify women for whom empiric antibiotic therapy for sexually transmitted diseases may be appropriate.

[Sexual transmissible diseases and "returning leukorrhea"]. / Maladies sexuellement transmissibles et les "leucorrhées de la rentrée".

White discharges and sexual transmissive diseases are now increasing. Confronted to this symptom, the general practician can easily diagnose and treat his patient. Therefore he must keep in his mind that behind this common symptom, a much more serious disease can be hidden.

Adenocarcinoma en un pólipo endometrial / Adenocarcinoma in endometrial polyp

No disponible

Quiste vaginal de inclusión gigante / Giant vaginal inclusion cyst

No disponible

[Colpocytology in a preventive gynecological ambulatory service]. / Colpocitologia em ambulatório de ginecologia preventiva.

BACKGROUND: evaluate the results of Pap smear in women attended at a gynecology preventive ambulatory (University of São Paulo Medical School Clinical Hospital). METHODS: 6821 women were submitted to a medical interview, clinical and gynecologic exam. Cervical and vaginal cytology (Pap smear) were analyzed according to the Papanicolaou method and classification. All women were grouped according to their age into three categories:under 40 years old, between 41 and 60 years and over 60 years. RESULTS: most of them, and mainly the younger ones, had been submitted to a previous Pap smear in a period shorter than 1 year (44.2%). The majority of women recognized the usefulness of the exam and knew its interval; the group that best knew its importance and interval was the one with ages between 41 and 60 years, while most women over 60 years did not know both its importance and interval. Cytological material was considered insufficient for analysis in 15,1% and inadequate in 1.1%, and for those with adequate material results were classes I (21.7%), II (59.9%), III (2.0%), IV (0.1%) and V (0.1%). Distribution of cervical intraepithelial neoplasia (CIN) were similar in the three groups. The main microbiologic findings was Gardnerella sp. (8,6%) and Human papillomavirus (HPV) incidence was significantly lower among women over 60 years. CONCLUSION: Cytological diagnoses of neoplastic modifications were performed in 2,2% and Gardnerella sp. was the most prevalent microbiologic agent. Distribution of HPV showed a decrease with age. Older women had lower knowledge on the importance of regular Pap smear examination.

Vaginal discharge in the adult: a practice guideline.

A practice guideline as a preformatted chart is presented. It is designed to be simple in concept and design, easy to use, parsimonious of data, easily scanned for quality assurance, and to provide clinical and cost-effectiveness prompts. It has supporting medical information for all recommendations that is literature- and experience-based. A patient aftercare instruction sheet is appended. An abbreviated "pocket practice guideline" is also provided. This format is clearly appropriate only for simple, not complex, clinical encounters.

Estudio descriptivo sobre gardnerella vaginalis asociada a leucorrea en 112 pacientes

Se describe un estudio sobre leucorrea asociada a Gardnerella vaginalis demostrada en 112 pacientes que consultaron entre el 1 de Octubre de 1989 y el 31 de Marzo de 1993. La infección por Gardnerella se estableció según los siguientes criterios: Flujo homogéneo y adherente a la pared vaginal, pH mayor de 4.5, prueba de aminas positiva si se alcaliniza la secresión vaginal y presencia de "células guía" o "clave" en los extendidos citológicos. Se describen las principales manifestaciones clínicas encontradas en el presente estudio que pueden sugerir leucorrea asociada a G. vaginalis haciendo énfasis en la nila o escasa reacción inflamatoria y la ausencia de bacilos de Doderlein.