GINECOLOGIA DE NOVAK BY BROS PDF

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In conclusion, it is currently not clear for the physicians and personnel who broz involved in sampling the cervix what the optimal way to handle CS is.

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Thus, gently removing the CS without touching the cervical surface should be recommended in any procedure for obtaining a cervical cytology sample. The quality of samples according to the Bethesda System, the presence of CIN, and inflammatory giecologia were recorded. The methods for obtaining samples have been described elsewhere [ 4 – 8 ].

When obtaining cervical samples, whether the samples are taken from the transformation zone and whether abnormal cells are missing must be considered. Statistical analysis The results are expressed in percentages and frequencies for all parameters.

Koss [ 19 ] answers this question by referring to some very early papers, including Sedlis et al. Cervical mucus, liquid-based cytology, sampling studies, cervical cytology. Accordingly, the authors concluded that the cervix should be wiped at the discretion of the clinician. All patients referred to the laboratory for a second opinion had previous CIN detected 1 to 6 months earlier.

The results of the present study raise an important question: The brush is rolled gently without touching the cervical surface. A modified terminology for cervical intraepithelial neoplasia. Out of consecutive patients who attended our laboratory for cytology and colposcopy between June and March In this study, we compared the CS removed without touching the cervical surface to the SS to evaluate the adequacy of both samples, and to obtain and compare their sensitivity, specificity, and positive and negative predictive values.

La crétinisation par la culture pdf

Examples of different cervix, both with large ectopia, abundant mucus, with the brush, showing how to clean it getting the mucus to the top in A and left in B. The results are expressed in percentages and frequencies for all parameters.

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Results Of the cases, ASs were found in In our study, colposcopy was used to detect small lesions, which were confirmed by ginecoloogia and diagnosed by biopsy.

False positive frequency in CS samples. However, when the cervix is cleaned using a cytobrush, the abundance of the mucus becomes apparent, and these CS samples were found to have less epithelial cells and more inflammatory reactions than the samples obtained from the cleaned cervix.

The age of the study cohort ranged from years, with an average age of 33 years. Thieme Medical Publishers; If the CS is removed with an oversized or normal-sized cotton swab, it is likely that the swab touches the cervical surface and may result in some CIN cells being removed; and these would hence not be present in the clean, second sample SS.

Received Jul 4; Accepted Aug In cytology cases of atypical squamous cells of undetermined significance ASC-US or in which a high-grade squamous intraepithelial lesion could not be excluded ASC-Hadditional slides were analyzed for p16 expression to confirm or btos out CIN.

La crétinisation par la culture

Does liquid-based technology really improve detection of cervical neoplasia? The following parameters were recorded in all samples according to TBS: Sensitivity of cervical cytology is suboptimal, especially in developing countries ny as Mexico, despite available guidelines aimed at improving this.

J Lower Gen Tract Dis. Author information Article notes Copyright and License information Disclaimer.

In this study, we analyzed samples obtained with or without cleaning the cervix, and compared their contents in order to determine the sensitivity and specificity of these two methods. Moreover, a higher rate of inflammatory bu was found to be present in the CS compared to the SS, whereas more epithelial cells with clear nuclear details were present in the SS compared with the CS Figure 2likely owing to the fact that these are living cells that are attached to the cervical surface, and if these are actively removed, their cytological characteristics will be more well-preserved at the time of fixation Figure 3.

An example of the amout of mucus retired. The SS was obtained from the transformation zone using a cervical cytobrush or broom depending of the nature of the TZ. In our study, the only positive case detected in the CS not detected in the SS was a lesion in the vaginal wall that nvoak not accessible to the instrument for sampling the cervix in the SS.

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Int J Clin Exp Pathol. Cervicovaginal cytology based on the Papanicolaou technique: If not cleaned, the mucus may prevent the instrument from obtaining cells from the cervical surface. False negative frequency in the cervical secretion CS samples and clean, second samples SS. The cervix in most women is coated with mucus or secretions of varying appearances, ranging from very scant to abundant.

Open in a separate window. Dysplastic cells of the same patient, in A from the Cs, with more inflammatory cells, and the nucleus of the atypical cells are note clearly seen. Am J Obstet Gynecol. CS is the result of exfoliated cells from the cervix and vaginal wall, novaak contains inflammatory cells and bacteria in addition to the mucus secreted from the endocervical glands, which are normally found in the cervical orifice.

Support Center Support Center. A biopsy was performed in cases, in xe acetowhite imaging was seen; of these, 24 cases had a previous positive biopsy. The sensitivities for CS and SS were All biopsy samples were stained with hematoxylin and eosin as per standard protocol and analyzed by immunohistochemical staining for cyclin-dependent kinase inhibitor 2A p16 clone J6; Cell Marke, CA, USAusing the CIN classification [ 16 ].

In cases of atrophy or if the SQCJ was not visible in endocervical canal gineecologia a very small orifice, two devices were used: Solomon D, Nayar R. This case was diagnosed as vaginal condyloma, and the biopsy showed characteristic papillary and koilocytic changes.

Disclosure of conflict of interest None. Table 1 Sample characteristic and kind of inflammation detected in the histophatologycal analyze in CS and SS respectively.