Screening and early detection are essential for the management and control of most diseases. It is important for women to practice routine health care that includes both clinical and self examinations. Today, many women go without health care due to barriers which prevent them from obtaining adequate care. The present study was designed to investigate, using the Health Belief Model, whether there is a difference between heterosexual and lesbian women in obtaining gynecological exams. Responses from 23 8 participants, 70 heterosexuals and 168 lesbians, indicated that the Health Belief Model was a significant predictor of whether women complied with recommended guidelines for Pap smears. Further analyses indicated that the most predictive components of the model were self-efficacy and perceived barriers. The more self-efficacy the women reported, the more likely they were to comply; whereas, the more barriers the women reported, the less likely they were to comply. Surprisingly, there were no interactions between sexual orientation and the components of the Health BeliefModel with respect to compliance. Thus, the model predicts compliance in the same way for both lesbian and heterosexual women. The results are consistent with past research indicating that the Health Belief Model is a good predictor of health behavior for some groups. Suggestions for future studies are discussed.

El proyecto contempla el diseño de un Centro Gineco-Oncológico ubicado en Chorrillos, con la meta de brindar atención a la población femenina no solo de este distrito sino ser un Centro especializado con miras de carácter metropolitano. El diseño de este Centro se basó en el exhaustivo análisis de proyectos referenciales y entrevistas a especialistas de la salud y de la construcción de esta tipología. Se concluye que la distribución ideal para un Centro de este tipo es mediante la separación de dos espacios principales, los cuales marcan el inicio del diseño, el área pública en el que circularán pacientes y acompañantes, y el área de servicio, el cual es el espacio para la circulación de los pacientes internos, personal de salud, personal de nutrición y personal de mantenimiento. Del mismo modo, las circulaciones verticales guardan esta misma clasificación con la finalidad de salvaguardar la asepsia en todo momento del usuario principal y familias. Es destacable, como la arquitectura participa en la recuperación de los pacientes, mediante ambientes luminosos, amplios y destinados no solo al área de hospitalizaciones o consultas, sino también ambientes creados para el familiar y al tiempo entre pacientes y acompañantes, hasta la curación de la neoplasia. Con este resumen comienzo la explicación detallada de esta tesis. / The project contemplates the design of a Gynecologic-Oncology Center located in Chorrillos, with the goal of providing attention to the female population not only of this district but also to be a specialized Center with a view to metropolitan character. The design of this Center was based on the exhaustive analysis of referential projects and interviews with health specialists and the construction of this typology. It is concluded that the ideal distribution for such a Center is through the separation of two main spaces, which mark the beginning of the design, the public area in which patients and companions will circulate, and the service area, which is the space for the circulation of internal patients, health staff, nutrition staff and maintenance staff. Similarly, vertical circulations keep this same classification in order to safeguard the asepsis at all times of the main user and families. It is noteworthy, as the architecture participates in the recovery of patients, through bright, spacious and intended environments not only to the area of ​​hospitalizations or consultations, but also environments created for the family and at the time between patients and companions, until the healing of the neoplasia with this summary I begin the detailed explanation of this thesis. / Trabajo de suficiencia profesional

No description available.

No description available.

No description available.

Syftet med denna litteraturstudie var att beskriva hur patienter upplever information inför gynekologiska ingrepp och undersökningar. Metoden som användes för att belysa syftet var beskrivande litteraturstudie. Data insamlades via två databaser, Medline och Cinahl. Andra sökstrategier var manuell sökning i valda källor. 15 vetenskapliga artiklar inkluderades i resultatet, dessa kvalitetsgranskades, analyserades och sammanställdes. Huvudresultat: Resultatet visade att vissa kvinnor saknade information om olika behandlingsalternativ, information om förberedelser samt information om postoperativa perioden. Många kvinnor tyckte dock att denna information varit bra. Många tyckte information angående indikationer för operation som bra, många ville inte ha för detaljerad information, vissa saknade information för att kunna ställa följdfrågor och kvinnor tyckte information om bl.a. kirurgisk teknik var bra. Kvinnorna var ofta nöjda med informationen och att lita till vårdpersonalen. Kvinnorna upplevde oftast den givna informationen som tillräcklig. Slutsats: Författarna anser att vidare forskning bör bedrivas inom området då det i studien framkommit att kvinnor många gånger saknar information kring sin undersökning samt ingrepp. Då upplevd informationsbrist kan göra att hela vårdupplevelsen blir lidande behövs vidare studier och då främst om hur informationen når patienten bäst då vi sett att information som finns hos personalen inte kommer patienten till nytta alla gånger. / The purpose of this study was to describe how patients perceive information prior gynecological surgery and examinations. Method: The method used to illuminate the purpose was descriptive literature. Data were collected via two databases, Medline and Cinahl. Other search strategies were manual search of selected sources. 15 numbers of articles were included in the result. Quality was reviewed, analyzed then summarized. Main results: Results showed that some women lacked information about treatment options, information about preparation and information about the postoperative period. Many felt that this information was good. Many thought that the information about indications for surgery were good, many women didn´t want the information to detailed, some lacked information to come up with additional questions and women thought that the information about such as surgical technique was good. Women were often satisfied with the information and with trusting the caregivers. Women usually experienced the given information to be adequate. Conlusion: The authors believe that further research should be conducted in the area where the study found that women often lack information about their investigation and intervention. This perceived lack of information can make the entire health care experience suffer, therefore further studies are needed, mainly on how to reach the patient with the information as we have seen that information given by the staff is not always received or recognized by the patient.

Bakgrund: Benigna gynekologiska åkommor är något som påverkar kvinnors hälsa och livskvalitet. Hysterektomi är den andra vanligaste operationen inom gynekologin och kvinnor som är drabbade av benigna gynekologiska åkommor kan genomgå en hysterektomi som behandling. Livskvaliteten påverkas även av att genomgå en hysterektomi. Syfte: Att beskriva livskvaliteten efter genomgången hysterektomi för kvinnor som drabbats av benigna gynekologiska åkommor. Metod: En litteraturöversikt baserad på 14 artiklar har utförts. Artiklarna är publicerade mellan 2000-2016 och är från olika länder. Sökningar har gjorts i databaserna PubMed, Cinahl, Web of Science och psykINFO. Resultat: Resultatet presenteras i sju kategorier där undertexten handlar om kvinnors livskvalitet efter hysterektomi. Kategorierna presenterar livskvalitetens olika aspekter och om förbättring eller försämring i symtom kan ses. Kategorierna är: smärta och blödning kan kvarstå, för tidig menopaus inträder, det sexuella samlivet, förlust av fertilitet, faktorer som kan påverka livskvaliteten relaterat till total hysterektomi, psykiska upplevelser av att ha genomgått en hysterektomi och informationsbehov. Slutsats: Livskvaliteten förbättras för de allra flesta kvinnor efter genomgången hysterektomi. Vissa symtom kan kvarstå, även om de blir förbättrade. / Background: Benign gynecologic condition are something that affects women's health and quality of life. Hysterectomy is the second most common surgery in gynecology and women who suffer from benign condition may undergo a hysterectomy as treatment. The quality of life is also affected by undergoing a hysterectomy. Aim: To describe the quality of life after a hysterectomy for women who suffers from benign gynecologic condition. Method: A literature review based on 14 articles have been performed. The articles are published between 2000-2016 and are from different countries. Searches have been made in the databases PubMed, CINAHL, Web of Science and psykINFO. Results: The result are presented in seven categories and the sub-texts describes women's quality of life after hysterectomy. The results present quality of life in different aspects, and if the symptoms gets worse or improves. The categories are: early menopaus, the sexual life, loss of infertility, factors that affects the quality of life related to total hysterectomy, psychological experience of undergoing hysterectomy and information needs. Conclusion: Quality of life were improved for most women after the hysterectomy. Some symptoms may persist, although the most were improved.

The existence of fetal microchimerism has been demonstrated many years ago. This phenomenon is associated with observation of two or more genetically different populations of cells present in one person. Fetal microchimerism originates naturally during pregnancy, by bidirectional transfer of the cells through placenta from fetus to mother (fetal microchimerism) and from mother to fetus (maternal microchimerism). In some cases fetal cells persisted in mother for decades after pregnancy. In my thesis I showed the presence of fetal microchimerism in tissues of endometrial cancer, breast cancer and ovarian cancer and in control, nonmalignant tissues. I worked with deep-frozen tissues, native tissues and cell cultures created from native tissues. I planed also the analysis of paraffin-embedded tissues; however this type of material showed to be unusable for fetal cells detection. On the contrary, native and deep-frozen tumor and control tissues are suitable for this type of research and fetal microchimerism was observed in part of samples. For detection and amplification of DNA extracted from tissues and cell cultures I used quantitative real-time PCR and SRY gene located on the Y chromosome as a marker of fetal cells. I detected the presence of male fetal cells. Fetal genome was found in both tumor and...

El Virus del Papil•loma Humà (VPH) està implicat en la patogènesis dels tumors del tracte genital femení i es detecta en la pràctica totalitat dels carcinomes de cèrvix, considerant-se una causa necessària per al seu desenvolupament. El VPH també sembla estar involucrat en una proporció de tumors de la vulva i de la vagina, però al contrari que en el cèrvix, els carcinomes escamosos de la vulva (CEV) i de la vagina (CEVa) es desenvolupen seguint dues vies etiopatogèniques diferents: una relacionada amb la infecció pel VPH i una independent de la infecció viral. Degut a la baixa incidència de tumors en aquestes localitzacions, hi ha molt pocs coneixements sobre la epidemiologia, les característiques histològiques i les conseqüències clíniques dels tumors relacionats amb el VPH. Per altra banda, en totes aquestes localitzacions, tant les lesions premalignes com els carcinomes relacionats amb el VPH semblen presentar una morfologia basaloide o condilomatosa, mentre que els carcinomes no relacionats amb el VPH són generalment queratinitzants. Des de fa un temps s’ha evidenciat que la sobrexpressió de p16ink4a es troba de manera uniforme en totes les lesions premalignes i malignes del cèrvix uterí i d’altres localitzacions, com l’amígdala, la vulva o la regió anorectal, associades a la infecció el VPH i s’ha proposat coma marcador d’aquesta infecció viral. L’objectiu de la tesi va ser estudiar un grup ampli de lesions de vulva i de vagina analitzant la presència o no de VPH i determinar si existeixen característiques morfològiques, immunohistoquímiques i clínico-patològiques diferencials entre els tumors positius i els negatius per al VPH. Com a metodologia es va avaluar retrospectivament els casos de CEVa i CEV diagnosticats a l’Hospital Clínic, a l’Hospital de la Vall d’Hebrón, a l’Instituto Portugués de Oncología de Lisboa i a l’Hospital de Vic, entre 1989 i el 2009. El VPH es va detectar mitjançant tècniques de PCR utilitzant primers SPF-10 i tipificat amb el mètode INNO-LIPA HPV. També es van realitzar tècniques de immunohistoquímica per la detecció de p16ink4A i p53. Es va realitzar l’anàlisi de la supervivència global (OS) i de la supervivència lliure de malaltia (DFS) mitjançant corbes de Kaplan- Meier i anàlisis multivariades utilitzant el model de Cox. Els resultats que es van obtenir van ser que tant el CEV com el CEVa presenten dues vies etiopatogèniques, una en relació a la infecció pel VPH i una independent de la infecció viral. El tipus viral més freqüent és el VPH de tipus 16. La tinció immunohistoquímica amb p16ink4 mostra una gran especificitat i sensibilitat per al diagnòstic dels carcinomes escamosos de vagina associats al VPH, i és una tècnica útil i simple per a classificar-los etiològicament. Les dones amb CEV associat al VPH presenten un pronòstic similar a les dones amb carcinomes no relacionats amb el VPH, mentre que les pacients amb CEVa relacionat amb el VPH tenen una millor supervivència global i supervivència lliure de malaltia. Aquesta supervivència està limitada als estadis I i II de la malaltia. Les lesions vulvars intraepitelials negatives per a la infecció del VPH poden adoptar, ocasionalment, una morfologia basaloide i confondre’s amb un VIN de tipus clàssic (relacionat amb el VPH), per això, la tinció immunohistoquímica amb p16(ink4a) i p53 poden ser útils en l’adequada classificació d’aquestes lesions. / HUMAM PAPILLOMA VIRUS AS A PROGNOSTIC FACTOR IN THE CARCINOMAS OF THE VULVA AND THE VAGINA Human Papilloma Virus (HPV) has been clearly implicated in the pathogenesis of maligmant and premalignant tumours of the female lower genital tract and has been detected in almost 100% of cervical carcinomas. HPV also seems to be involved in a proportion of vulva and vagina tumours, but unlike the cervix, these tumors develop following two different etiopathogenic pathways: one group is related to HPV infection whereas a second group arises via independent- HPV infection. Premalignant and malignant tumours related to to HPV are histologicaly squamous cell carcinoma of non-keratinizing, basaloid or warty types, whereas most HPV-negative tumors are commonly of keratinizing type. However some overlap exists between the histological types and the association with HPV and immunohistochemical studies with p16ink4a has been proposed as a marker of this viral infection in the neoplasms. As a methodology, cases of carcinoma of the vulva and the vagina diagnosed in Hospital Clinic, Hospital de la Vall d'Hebron, Portuguese Institute of Oncology and Hospital de Vic, were analyzed between 1989 and 2009. HPV was detected by PCR. Immunohistochemical techniques were carried out for the detection of p p16ink4a and p53. The analysis of the overall survival (OS) and disease-free survival (DFS) was made through Kaplan Meier analysis and multivariate curves using the Cox model. The results show that in vagina, as in vulva, there are two independent pathways in the development of tha carcinomas, one related an another independant of the HPV infection.The most common HPV viral type is the 16 . Immunohistochemical p16ink4 staining shows a great sensitivity and specificity for HPV related neoplasms, and is a useful technique to classify them. In vulva, women with HPV-tumours present a similar prognosis that women with non-HPV related tumours, while in vagina patients with HPV-related tumours stand a better overall survival and disease-free survival. This survival is limited to stages I and II of the disease. Vulvars negative intraepitelials neoplasms for HPV infection can adopt an basaloide morphology and p16ink4a staining with may be helpful in the proper classification.

Η δραστικότητα των λυοσωματικών ενζύμων είναι αυξημένη στο εξωκυττάριο υγρό ασθενών με μηνιγγίτιδα και περιτονίτιδα μικροβιακής αιτιολογίας. Ο σκοπός της παρούσας μελέτης ήταν να ερευνήσουμε αν η δραστικότητα αυτών των ενζύμων ήταν αυξημένη στο περιτοναϊκό υγρό ασθενών με πυελική φλεγμονή και γυναικολογικό καρκίνο. Η δραστικότητα της β-γλυκουρονιδάσης, β-γαλακτοσιδάσης και α-μαννοσιδάσης μετρήθηκε στο περιτοναϊκό υγρό 5 ασθενών με PID, 10 ασθενών με γυναικολογικό καρκίνο, 10 ασθενών που χρησιμοποιήθηκαν σαν σημείο αναφοράς και το υγρό 7 ασθενών με καλοήθεις κύστεις ωοθηκών. Η μέση τιμή της +/-SD της δραστικότητας της β- γλυκουρονιδάσης , β-γαλακτοσιδάσης, και της α- μανοσιδάσης στην PID ήταν 148+/-82, 278+/ -112, και 291+/-140 nmol 4 -methylummbelliferone/ ml / h αντίστοιχα. Στα δείγματα αναφοράς ήταν 22+/-9, 48+/-10 και80+/-23 , αντίστοιχα (p<=0,003 - 0.00001). Στο γυναικολογικό καρκίνο η δραστικότητα ήταν 113+/-35, 210+/- 82, και 243+/-123 αντίστοιχα ( διαφορά από τα δείγματα αναφοράς p<=0,0006-0,000001). Υπήρξε θετική συσχέτιση μεταξύ της δραστικότητας της β- γλυκουρονιδάσης και του σταδίου του καρκίνου. Η μέτρηση της δραστικότητας των ενζύμων στο υγρό των ωοθηκικών κύστεων δεν διέφερε σημαντικά σε σχέση με αυτή των δειγμάτων αναφοράς. Η δραστικότητα των λυοσωματικών ενζύμων είναι αυξημένη στο περιτοναϊκό υγρό ασθενών με (PID), πυελική φλεγμονή και γυναικολογικό καρκίνο. Η απουσία επικάλυψης των μετρηθέντων τιμών δραστικότητας των ανωτέρω ενζύμων μεταξύ ασθενών με γυναικολογικό καρκίνο και PID σε σχέση με τα δείγματα αναφοράς δείχνει οτι κάποιες μετρήσεις πρέπει να αρχίζουν να εφαρμόζονται για διαγνωστικούς σκοπούς. / The activity of lysosomal enzymes is increased in extracellular fluids οf patients with bacterial maningitis and peritonitis. Our objective was to investigate whether the activity of these enzymes is increased in the peritoneal fluid of pelvic inflammatory disease (PID) and gynecologic cancers. The activity of β-glucuronidase, β-galactosidase and α-mannosidase was measured in the peritoneal fluid of 5 patients with PID, 10 with gynecologic cancer, 10 control subjects, and the flouid of 7 benign ovarian cysts. The mean +/- SD β-glucoronidase, β-galactosidase, and α-mannosidase activity in PID was 148+/-82, 278+/-112, and 291+/-140 nmol 4- methylumbelliferone/ ml/h, respectively; in the controls it was 22+/-9, 48+/-10 and 80+/-23, respectively ( p<=0,003-0,00001). In the gynecologic cancers the activity was 113+/-35, 210+/-82, and 243+/-123, respectively (difference from controls p<=0.0006-0.000001). There was a positive correlaton between β-glucoronidase activity and stage of cancer.The activity of the ovarian cysts fluid did not differ significantly from the controls. The lysosomal enzyme activity is increased in the peritoneal fluid of PID and gynecologic cancers. The absence of overlapping values between patients and controls indicates that such measurements may be applied for diagnostic purposes.