RESUMO
Genital human papilloma virus infection (HPV) is the most common sexually transmitted infection worldwide, it is the cause of genital warts, and it is related with cervical cancer, the second most common cause of death from cancer in women in America, and the first in underdeveloped countries, and it is related with penis and prostate cancer in males also, and with anal cancer in both genders. This review examines the most important actual facts about HPV infection, and the new prophylactic vaccines. Two versions of the vaccine had been developed, both target HPV 16 and HPV 18, which involve approximately 70% of cervical cancer. One of them also targets HPV 6 and HPV 11, which account for approximately 90% of external genital warts. Both vaccines have an excellent safety profile, are highly immunogenic, and have atributed complete type specific protection against persistent infection and associated lesions in fully vaccinated girls and young women. The role of men as carriers of HPV as well as vectors for transmission is well documented. Several clinical trials are currently under way to determine the efficacy of vaccinating men. Reducing the cost of vaccination would be a priority for the developing world in order to get a broad target in poor countries.
Assuntos
Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: Varicocele is cause of fertility disorders. The objective was to evaluate usefulness of testicular percutaneous biopsy in the fertility prognosis in patients, who undergone varicocelectomy. METHODS: A cohort study of 50 patients having undergone varicocelectomy due to varicocele was carried out. Five groups were formed according to testicular damage evaluated by percuta-neous biopsy (stage I through V histological lesions). Pregnancy rate and sperm count results were evaluated per group. ANOVA and Fisher exact test were used. RESULTS: Patients aged 30.5 +/- 5 years. Spermatic density and motility had improved one year after varicocelectomy. Pregnancies were achieved 13 +/- 9 months later. Fifteen patients impregnated their partners. Fourteen of them (93 %) had stage I, II or III histological damage and only one case had stage IV. Pregnancy probability was greater in the stage I, II or III testicular damage (OR = 9.3, 95 % CI = 11-79, p < 0.021). CONCLUSIONS: The proposed histological classification of testicular damage allows evaluating fertility prognosis as well as the magnitude of testicular damage in patients with varicocele.
Assuntos
Infertilidade Masculina/etiologia , Infertilidade Masculina/patologia , Testículo/patologia , Varicocele/complicações , Varicocele/patologia , Adulto , Biópsia/métodos , Estudos de Coortes , Estudos Transversais , Humanos , Masculino , PrognósticoRESUMO
La derivación de la orina via suprapúbica mediante cistostomía, desfuncionalizando la uretra en forma temporal y ocasionalmente definitiva, tiene múltiples indicaciones tanto en hombres como mujeres. La manera de practicarla es variada y va desde cirugía abierta, punciones, etc. Empleándose diferentes tipos de instrumental, equipo y accesorios, aglunos de ellos integrados en conjuntos desechables, losque son difíciles de costear por nuestros pacientes o aún por las instituciones. En esta comunicación hago referencia a estos métodos y presento la técnica quirúrgica que he denominado Microcistostomía derivativa, fácil de practicarse en caulquier hospital, económica, ambulatoria y de bajo riesgo. Su efectividad la he podido comprobar desde hace varios años en numerosos enfermos