Arterioesclerosis de Monckeberg en vasos uterinos: un interesante hallazgo incidental / Arteriosclerose de Monckeberg nos vasos uterinos: um achado incidental interessante / Monckeberg arteriosclerosis in uterine vessels: an interesting incidental finding

Se realizó la comunicación de un caso clínico-patológico, diagnosticado en el Hospital Docente Clínico Quirúrgico "Joaquín Albarrán" de La Habana. En dicha entidad se presentó en una paciente femenina de 85 años de edad con antecedentes de diabetes mellitus tipo 2, ingresada por cuadro de insuficiencia arterial de miembro inferior izquierdo por lo cual se le realizan amputación supracondilia y al tercer día de su estadía hospitalaria, fallece. En la autopsia se arribó al diagnóstico anatomopatológico de arterioesclerosis de Mönckeberg de vasos del útero. Esta es una forma de arterioesclerosis muy relacionada con la senectud, pero factores de riesgo como diabetes mellitus y la enfermedad renal crónica pueden contribuir de forma directa en su desarrollo y progresión. Su diagnóstico es un hallazgo incidental en muestras histopatológicas(AU)

A clinical-pathological case was reported, diagnosed at the Joaquín Albarrán Clinical Surgical Teaching Hospital in Havana. In this entity, an 85-year-old female patient with a history of type 2 diabetes mellitus was presented, admitted due to arterial insufficiency of the lower left limb, for which she underwent supracondylar amputation and died on the third day of her hospital stay. At the autopsy, the pathological diagnosis of Mönckeberg arteriosclerosis of vessels of the uterus was reached. This is a form of arteriosclerosis closely related to old age, but risk factors such as diabetes mellitus and chronic kidney disease can directly contribute to its development and progression. Its diagnosis is an incidental finding in histopathological samples(AU)

Um caso clínico-patológico foi relatado, diagnosticado no Hospital de Clínica Cirúrgica "Joaquín Albarrán" em Havana. Nessa entidade, apresentou-se uma paciente de 85 anos, com história de diabetes mellitus tipo 2, internada por insuficiência arterial do membro inferior esquerdo, para a qual sofreu amputação aupracondiliana e faleceu no terceiro dia de internação. Na autopsia, o diagnóstico patológico da arteriosclerose de Mönckeberg de navios do útero foi conseguido. Essa é uma forma de arteriosclerose intimamente relacionada à velhice, mas fatores de risco como diabetes mellitus e doença renal crônica podem contribuir diretamente para seu desenvolvimento e progressão. Seu diagnóstico é um achado incidental em amostras histopatológicas(AU)

Factores de riesgo de alteraciones citológicas del cuello uterino en mujeres chilenas: Un estudio de casos y controles / Risk factors associated with abnormal cervical cytology among Chilean women: A case control study

Background: Cervical cancer is the third cause of cancer death among Chilean women, affecting mainly women from low socioeconomic status. Aim: To determine main risk factors (RF) including human papilomavirus (HPV) types associated with abnormal cervical cytology (Atypical Squamous Cells of Undetermined Significance or ASCUS) among Chilean women from low socioeconomic status in Santiago, Chile. Material and Methods: A random population based sample of616 women from La Pintana (a low-income district in Santiago) participated in 2001 in a HPV prevalence study and were re-evaluated in 2006 through a risk factors questionnaire, Papanicolaou test and DNA detection for HPV. The Papanicolaou test was analyzed in Santiago and HPV analysis (PCR_GP5+/GP6+) was conducted in Vrije University, Amsterdam. Cases included 42 women with cervical lesions and controls included 574 women with normal cytology during the period 2001-2006. Logistic regression with uni and multivariate analysis was performed to identify RF for cervical lesions. Results: During the study period, there was a significant increase in the proportion of single women, from 8.3 to 14.8 percent (p < 0.05), of women with 3 or more sexual partners from 8.9 to 13.3 and of women high risk HPV, from 9.1 to 14.3 percent. The proportion of abnormal Papanicolaou tests remained stable (3.08 and 3.9 percent > ASCUS). High risk HPV was the most significant factor associated with cervical lesions (odds ratio (OR) = 9.695 percent> confidence intervals (CI) = 4.4-21.1) followed by oral contraceptive use (OR = 2.58 95 percent> CI= 1.2-5.7). Among women infected by high risk HPV, the use of oral contraceptives was a risk factor while compliance with screening was protective for cervical lesions. Conclusions: From 2001 to 2006, there was an increase in the proportion of women with high-risk HPV infections.

Seguimiento de mujeres con anormalidad citológica de cuello uterino, en Colombia / Following-up females having an abnormal Pap smear in Colombia

Objetivo Evaluar el acceso y la oportunidad al diagnóstico y al tratamiento que tienen las pacientes con lesiones cervicales de alto grado o cáncer de acuerdo con el reporte citológico, en Colombia entre junio 2005 a junio del 2006. Metodología Estudio retrospectivo mediante encuestas a una muestra de mujeres con anormalidad citológica residentes de cuatro departamentos de Colombia seleccionados por conveniencia en relación con diferentes tasas de mortalidad. Se realizó análisis descriptivo y se compararon las diferencias entre los departamentos. Resultados El 27 por ciento de las mujeres con lesiones de alto grado o invasoras no tuvieron acceso a alguno de los servicios diagnósticos o terapéuticos por razones de tipo administrativo de los servicios de salud, razones clínicas y culturales de las mujeres. Discusión Un elemento crítico que explica el bajo impacto en la mortalidad por cáncer de cuello uterino en la mayoría de los países de Latino América es la disociación entre actividades de tamización y las de tratamiento.

Objective Evaluating the opportunity and access to diagnosis and treatment for females having had an abnormal Pap smear (high-grade epithelial lesion and cervical cancer) in Colombia from June 2005 to June 2006. Materials and Methods This was a retrospective appraisal using a semi-closed survey of females having had an abnormal Pap smear with high squamous intraepithelial lesions or cervical cancer living in four Colombian departments. These areas were conveniently selected according to their different mortality rates. A descriptive analysis was made and the departments differences compared. Results It was found that 27 percent of females having high-grade squamous intraepithelial lesion or cervical cancer had no access to any of the diagnostic or therapeutic services. Health service administration problems and clinical and cultural ones affecting the females in the study could explain such results. Discussion Follow-up care after abnormal cytology was very poor and could explain the lack of cervical cancer screening impact in Colombia and in most Latin-American countries.

Treinamento em patologia cérvico - uterina / Training in uterine cervical pathology

o treinamento de profissionais de saúde realizado no Instituto Fernandes Figueira / Fiocruz, enfocando o funcionamento do serviço como referência para a patologia cérvico-uterina e relatando o perfil epidemiológico deste tipo de câncer no Brasil...