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  • Trabalhos Originais

    Necrotizing Fasciitis in Obstetric Patients

    Rev Bras Ginecol Obstet. 1998;20(10):557-561

    Summary

    Trabalhos Originais

    Necrotizing Fasciitis in Obstetric Patients

    Rev Bras Ginecol Obstet. 1998;20(10):557-561

    DOI 10.1590/S0100-72031998001000003

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    Purpose: the authors report their experience with necrotizing fasciitis (NF) cases which occurred in the Gynecology and Obstetrics Service of the Hospital de Clínicas de Porto Alegre, assessing the frequency of NF and analyzing the association between NF and certain risk factors cited in the literature. Methods: a retrospective study of patients a with diagnosis of necrotizing fasciitis at the Hospital de Clínicas de Porto Alegre from January 1990 to December 1997. Results: two post-cesarean section and one post-surgical (because of ectopic pregnancy) NF cases were found. None of the patients presented clinical complications nor NF risk factors and all surgeries were urgent. The NF frequency in this study was 2.6/10.000 cesarians and mortality was zero. Discussion: NF is a clinical syndrome which does not occur very often but is associated with high morbidity and mortality. This disease involves the surgical wound and the fascial plans. Fast handling and early and intensive treatment bring about good results and decrease in the mortality rate.

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  • Original Article

    Association between age at first sexual intercourse and subsequent human papillomavirus infection: results of a Brazilian screening program

    Rev Bras Ginecol Obstet. 2007;29(11):580-587

    Summary

    Original Article

    Association between age at first sexual intercourse and subsequent human papillomavirus infection: results of a Brazilian screening program

    Rev Bras Ginecol Obstet. 2007;29(11):580-587

    DOI 10.1590/S0100-72032007001100006

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    PURPOSE: to investigate women’s age at their first sexual intercourse and its correlation with their present age, human papillomavirus (HPV) infection and cytological abnormalities at Pap smear. METHODS: women from the general population were invited to be screened for cervical cancer and pre-malignant lesions. After answering a behavior questionnaire, they were submitted to screening with cervical cytology and high-risk HPV testing with Hybrid Capture 2 (HC2). This report is part of the Latin American Screening (LAMS) study, that comprises centers from Brazil and Argentina, and the data presented herein refer to the Brazilian women evaluated at the cities of Porto Alegre, São Paulo and Campinas. RESULTS: from 8,649 women that answered the questionnaire, 8,641 reported previous sexual activity and were included in this analysis. The mean age at the interview was 38.1±11.0 years and the mean age at the first sexual intercourse was 18.5±4.0 years. The age at the first sexual intercourse increased along with the age at the interview, i.e., younger women reported they had begun their sexual life earlier than older women (p<0.001). From the total of women who had already begun having sexual intercourse, 3,643 patients were tested for high-risk HPV infection and 17.3% of them had positive results. In all the centers, it became clear that the women with the first sexual intercourse at ages below the mean age of all the population interviewed presented higher rates of HPV infection (20.2%) than the women with the first sexual intercourse at ages above the mean (12.5%) - Odds Ratio (OR) 1.8 (IC95% 1.5-2.2;p<0,001). According to the cytology, the women with first sexual intercourse at ages under the mean, presented higher percentage of abnormal cytology > or = ASC-US (6.7%) than the women with the first sexual intercourse at ages above the mean (4.3%) - OR 1.6 (IC95% 1.3-2.;p<0.001). CONCLUSIONS: the high-risk HPV infection and cytological abnormalities identified during the asymptomatic population screening were significantly associated to the women’s age at the first sexual intercourse. Additionally, we have also identified that the women’s age at the first sexual intercourse has decreased during the last decades, suggesting an important contribution to the increase of HPV infection and the subsequent cervical lesions.

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    Association between age at first sexual intercourse and subsequent human papillomavirus infection: results of a Brazilian screening program

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