Contraception, fertilite, sexualite (1992)最新文献

To advance in their strategies to manage patients, clinicians need new research results. To be accessible, medical research must be published. Writing and publishing medical articles should respect principles that are described in this article. Good writing is based on a logical organization and the application of scientific style. Organization according to the IMRD structure (Introduction, Methods, Results, Discussion) allows one to present the reasons for and objectives of the study (Introduction), details on whatever has been done to answer the question (Methods), data on the actual study population and answers to the main question (Results), and a critical appraisal of these results, given the limits of the study and current knowledge (Discussion). The main elements of scientific style are precision, clarity, fluidity and concision. Finally, submitting a paper to a scientific journal implies presenting the work in a covering letter and respecting rules for formatting a manuscript (order of presentation, typography, etc.).

The electroconization with diathermic loop is a good procedure in the cervical dysplasia because there is a respect of the cervical tissue with a low cost, low complications, easy and quickly technic and a precise histological analysis of the histologic specimen. The indications are represented by high grade lesions, cyto-histologic discordance and endocervical squamo-columnar junction with a low grade lesion. The authors proposed a retrospective study about 307 cases of the electroconization with diathermic loop realised between January 1993 and June 1998.

Low-grade squamous intraepithelial lesions and atypical squamous cells of undetermined significance are the most frequent cytologic abnormalities. Their management is still highly controversial because of the many uncertainties associated with them concerning their histology and their natural history. Cervical smears HPV testing were proposed as an alternative to colposcopy. Neither have a sensitivity equivalent to that of colposcopy. The diagnosis of these abnormalities could be delayed, and a severe lesion may even remain undetected because the cytologic surveillance is frequently omitted, smear sensitivity is far from being perfect and correlation is poor between cytology and histology. The combination of smears with the detection of high risk HPV types increases the triage sensitivity before colposcopy to the detriment of specificity and predictive value, and, therefore, of cost. With colposcopy the histologic diagnosis is rapidly reached and therapeutic management becomes easier because the size and location of the lesion are precisely known. However, the long-term outcome of patients with a normal colposcopy is very poorly known. Our study including 212 patients with a mean follow-up of 79 months, showed an incidence of lesions similar to that found in a control group; 12 CIN (5.7%) were identified, but no cancer. The prevalence of CIN was significantly lower in patients whose initial colposcopy was normal or became normal within the first six months that in patients whose control smear was normal or became normal within six months (1/81 = 1.2% versus 8/143 = 5.6%; P > 0.05). No lesions were observed in patients whose colposcopy and control smear were normal. These results confirm the reliability of colposcopy in patients with minor cytologic abnormalities.

The objectives of our study are to assess the prevalence of STD agents in Tunisia and to validate the WHO algorithm of STD management. The most frequent STD agents are Trichomonas vaginalis and Chlamydiae trachomatis, respectively with a prevalence of 5.6% and 1.7%. The assessment of the syndromic approach shows that the sensitivity and specificity of the WHO algorithm can be improved by the introduction of risk factors. The training of health care service providers and the use of an algorithm including risk factors can improve this approach, which is useful when laboratories services are not available.

The prognosis for patients with ovarian serous borderline tumors is generally considered to be excellent. It is worse for women with an advanced stage, especially when invasive peritoneal implants are present. There is no general agreement regarding standard treatment in such cases. To clarify the significance of this invasive peritoneal proliferation and to devise a rational treatment approach, we review the available series. From this review of literature, it appears necessary to emphasize the importance of an initial adequate peritoneal staging of all ovarian tumors. After a complete removal of the lesions, the question of adjuvant therapy must be discussed.