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I was unsure of how to manage a pt's pap and HPV results. The pt is a 30 y/o who had a pap with HPV co-testing, which showed normal cytology, but positive untyped HPV (so it was negative for the high risk types of HPV). From what I could find in her previous records, she had had a previous pap 3 years prior that showed ASCUS. I used the ASCCP app to try to figure out what needed to be done next. The app didn't help. It said to use clinical judgment. So I asked one of the OB/Gyn docs and she said to repeat the pap in 1 year. So if this ever happens again, now I know how to manage it. I think it's the ASCCP app that's supposed to help you make the management decisions, but it didn't help with this. I think there may be another app that helps with this, but I don't know what it's called.
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Modern Colposcopy Textbook and Atlas (3rd Edition) – eBook
Modern Colposcopy Textbook and Atlas (3rd Edition) – eBook PDF
The previous two editions of this book were published by the American Society for Colposcopy and Cervical Pathology (ASCCP). Modern Colposcopy Textbook and Atlas, 3rd Edition, (PDF) is considered the standard of colposcopy and is known for being the best selling educational teaching module for the physician, resident, or advanced…
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Modern Colposcopy Textbook and Atlas (3rd Edition) – eBook
Modern Colposcopy Textbook and Atlas (3rd Edition) – eBook
Modern Colposcopy Textbook and Atlas (3rd Edition) – eBook PDF
The previous two editions of this book were published by the American Society for Colposcopy and Cervical Pathology (ASCCP). Modern Colposcopy Textbook and Atlas, 3rd Edition, (PDF) is considered the standard of colposcopy and is known for being the best selling educational teaching module for the physician, resident, or advanced…
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Modern Colposcopy Textbook and Atlas (3rd Edition) – PDF
Modern Colposcopy Textbook and Atlas (3rd Edition) – PDF
Modern Colposcopy Textbook and Atlas (3rd Edition) – eBook PDF
The previous two editions of this book were published by the American Society for Colposcopy and Cervical Pathology (ASCCP). Modern Colposcopy Textbook and Atlas, 3rd Edition, (PDF) is considered the standard of colposcopy and is known for being the best selling educational teaching module for the physician, resident, or advanced…
View On WordPress
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Modern Colposcopy Textbook and Atlas (3rd Edition) – eBook PDF
Modern Colposcopy Textbook and Atlas (3rd Edition) – eBook PDF
Modern Colposcopy Textbook and Atlas (3rd Edition) – eBook PDF
The previous two editions of this book were published by the American Society for Colposcopy and Cervical Pathology (ASCCP). Modern Colposcopy Textbook and Atlas, 3rd Edition, (PDF) is considered the standard of colposcopy and is known for being the best selling educational teaching module for the physician, resident, or advanced…
View On WordPress
0 notes
Text
Modern Colposcopy Textbook and Atlas (3rd Edition) – PDF
Modern Colposcopy Textbook and Atlas (3rd Edition) – PDF
Modern Colposcopy Textbook and Atlas (3rd Edition) – eBook PDF
The previous two editions of this book were published by the American Society for Colposcopy and Cervical Pathology (ASCCP). Modern Colposcopy Textbook and Atlas, 3rd Edition, (PDF) is considered the standard of colposcopy and is known for being the best selling educational teaching module for the physician, resident, or advanced…
View On WordPress
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Modern Colposcopy Textbook and Atlas (3rd Edition) – eBook PDF
Modern Colposcopy Textbook and Atlas (3rd Edition) – eBook PDF
Modern Colposcopy Textbook and Atlas (3rd Edition) – eBook PDF
The previous two editions of this book were published by the American Society for Colposcopy and Cervical Pathology (ASCCP). Modern Colposcopy Textbook and Atlas, 3rd Edition, (PDF) is considered the standard of colposcopy and is known for being the best selling educational teaching module for the physician, resident, or advanced…
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Los 5 mejores libros sobre colposcopia
Gestión inicial
Para la mayoría de las pacientes con resultados anormales en las pruebas de Papanicolaou y/o VPH, el manejo en 2020 es similar a las pautas de 2012.5,29 Se recomienda la colposcopia para la mayoría de las pacientes con pruebas de VPH positivas y pruebas de Papanicolaou anormales. Las circunstancias, en las que los pacientes pueden recibir cuidados inmediatos más o menos intensivos de lo que habrían recibido con las pautas de 2012, se describen en la Tabla 2.
Tabla 2.
Comparación de las recomendaciones de consenso de 2012 y 2019 para el manejo de anomalías comunes (ASCCP)
La negrita indica la diferencia entre las pautas de 2012 y 2019.
AGC, células glandulares atípicas; ASC-H, las células escamosas atípicas no pueden excluir HSIL; ASC-US, células escamosas atípicas de significado indeterminado; LSIL, lesión intraepitelial escamosa de bajo grado; NILM, negativo para lesión intraepitelial o malignidad; Pap, Papanicolau.
Nuevos datos indican que la historia previa es muy importante cuando se considera el manejo de resultados comunes de bajo grado: ASC-US o LSIL positivos para VPH. Cuando un paciente con un historial de resultados de detección normales, cuyo resultado de prueba de detección más reciente es una prueba de VPH negativa o una prueba conjunta dentro de un intervalo de detección normal (∼5 años), un nuevo resultado de ASC-US o LSIL VPH positivo no indica un alto riesgo de una lesión precancerosa actual de alto grado (definida como CIN3 o superior).32 El riesgo es bajo en este caso porque la infección se revela como nueva y, por lo tanto, típicamente benigna, independientemente de la edad del paciente. Por lo tanto, se recomienda el seguimiento con la prueba del VPH o la prueba conjunta en 1 año en lugar de la colposcopia.
Una colposcopia en la que no se encontró CIN2 también reduce el riesgo de que una paciente desarrolle un precáncer de cuello uterino en el próximo año. Específicamente, muchos pacientes tienen resultados persistentes de bajo grado (es decir, , HPV-positivo NILM, ASC-US o LSIL), y según las pautas de 2012 recibieron colposcopia anualmente.29 Las nuevas estimaciones de riesgo indican que una colposcopia donde no se encontró CIN2, realizada en el último año, reduce sustancialmente el riesgo de desarrollar una alta lesión precancerosa de alto grado dentro del próximo año.32 Por lo tanto, la colposcopia puede diferirse en estos pacientes y, en su lugar, se recomienda un seguimiento de 1 año. Debido a que las infecciones persistentes por VPH son un factor de riesgo importante para desarrollar precáncer de cuello uterino, se recomienda la colposcopia si la paciente sigue siendo VPH positiva en el seguimiento de 1 año.5
Para las pacientes cuyos antecedentes no se conocen, no están documentados o solo incluyen la prueba de Papanicolaou, el tratamiento se basa en los resultados actuales de la prueba de Papanicolaou y del VPH, y es en gran medida igual al recomendado en 2012.32 Se recomienda la colposcopia para todas las pacientes con dos pruebas de VPH positivas consecutivas. y resultados normales (NILM) de la prueba de Papanicolaou, y todos los resultados de ASC-US positivos para VPH o una interpretación de citología más severa. Los pacientes con ASC-US VPH negativos pueden ser seguidos en 3 años.
El genotipado parcial del VPH, que está disponible en varios ensayos actuales basados en PCR, afecta la evaluación y el manejo del riesgo. Los tipos de VPH 16 y 18 son juntos responsables de ~70 % de los cánceres de cuello uterino invasivos,34 por lo que estos resultados requieren un seguimiento particularmente estrecho. Como mínimo, todas las pacientes con infecciones por VPH 16 y/o VPH 18 deben someterse a una colposcopia, incluso si los resultados de la prueba de Papanicolaou son normales. a la asociación del VPH 18 con adenocarcinomas, que surgen del endocérvix.35
Al reconocer que la colposcopia es imperfecta y que los pacientes pueden preferir el tratamiento a la observación, las pautas de manejo de 2019 brindan la opción de tratamiento acelerado para combinaciones de resultados donde el riesgo de tener un precáncer (CIN3 o superior) supera el 25 %. El tratamiento acelerado se define como proceder directamente a un tratamiento de escisión (p. ej., procedimiento de escisión electroquirúrgica con asa o [LEEP] o escisión con asa grande de la zona de transformación [LLETZ]) sin requerir una biopsia colposcópica confirmatoria. Al considerar un tratamiento acelerado, es crucial participar en la toma de decisiones compartida con el paciente. Los temas a considerar incluyen la edad, las preocupaciones sobre los efectos potenciales del tratamiento en un futuro embarazo, la ansiedad relacionada con el cáncer y el deseo/capacidad de someterse a una colposcopia repetida a intervalos de 6 y 12 meses.5
Se prefiere el tratamiento acelerado para pacientes cuyos resultados actuales de la prueba son HSIL positivos para VPH16 porque su riesgo actual de tener una lesión CIN2 o superior es del 77 %.5 También se prefiere el tratamiento acelerado para HSIL positivos para VPH independientemente del genotipo del VPH para pacientes sido examinado en más de 5 años. El tratamiento acelerado es una opción para los pacientes con células escamosas atípicas positivas para el VPH que no pueden excluir un grado alto (ASC-H) y para los resultados de la prueba de Papanicolaou HSIL, independientemente del estado del VPH.
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The American Society for Colposcopy and Cervical Pathology (ASCCP). Module 2: What is the Role of HPV Testing.
The American Society for Colposcopy and Cervical Pathology (ASCCP). Module 2: What is the Role of HPV Testing.
The American Society for Colposcopy and Cervical Pathology (ASCCP)
Webinar.
Activity Summary:
Studies have shown that certain Human papillomavirus (HPV) types are a requisite for the development of cervical cancer and other cancers of the lower genital tract. The introduction of molecular testing for HPV has facilitated the earlier detection of cervical cancer precursors and identify those…
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#Año 2017#ASCCP#Cáncer de Cuello Uterino#Cribado#Cuello uterino#Ginecopatología#HPV#Patología Ginecológica#VPH
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“Siempre se hizo así”: rutinas en ginecología
En ginecología, al menos en Buenos Aires, hay una tendencia a exponer a las personas a una gran cantidad de pruebas: ecografías de mama y transvaginales, mamografías, PAP, colposcopía, etc. Muchas veces no hay una justificación real, y se usa la excusa del screening/rastreo.
Voy a hablar de tamizaje, con lo cual son recomendaciones en torno a población asintomática; y suponiendo siempre que son personas con un riesgo promedio de cáncer (sin factores de mayor riesgo).
¿Qué pruebas de rastreo están recomendadas y en qué forma?
Rastreo para Cáncer Cervicouterino
En Argentina: a partir de los 25 años, y con 3 años desde el inicio de las relaciones sexuales, se realiza citología (PAP) cada 3 años luego de dos tomas anuales consecutivas (1-1-3); luego VPH + citología (PAP) cada 5 años desde los 30 años (si el VPH es negativo, no se lee el PAP). No se realiza tamizaje en adolescentes.
En EEUU (USPSTF y ACS/ASCCP/ASCP): citología cada 3 años entre los 21 y 30 años; entre los 30 y 65 años, citología cada 3 años o bien HPV con o sin PAP cada 5 años. No se realiza tamizaje en menores de 21 ni mayores de 65 (que antes hayan realizado screening adecuado), ni en personas histerectomizadas. Quienes hayan recibido vacuna contra el HPV siguen las mismas recomendaciones por edad.
En Canadá: inicio del screening a los 25 años y hasta los 70, PAP cada 3 años. En mayores de 70 que previamente no hayan realizado screening: continuar hasta tres resultados negativos.
La colposcopía es un estudio de seguimiento frente a resultados anormales de la citología, no un estudio de rutina
Rastreo para Cáncer de Mama
En Argentina: se recomienda mamografía cada 2 años al menos, entre los 50 y 70 años. Se recomienda también examen físico de la mama cada 1-3 años para menores de 40 y mayores de 70; anual entre los 40-70 años.
En EEUU (USPSTF): la principal recomendación es el rastreo con mamografía cada 2 años entre los 50 y 75 años; entre los 40 y los 50, deberían tomarse decisiones individualizadas, informando sobre riesgos y beneficios.
En Canadá las recomendaciones son similares, pero se hace eje en que son recomendaciones “condicionales” con baja calidad de evidencia, debiendo informar sobre riesgos y beneficios para llegar a una toma de decisiones conjunta. Se recomienda contra la realización del examen físico como screening (recomendación condicional, sin evidencia).
La ecografía mamaría no es un método de screening, ni debe usarse de forma rutinaria junto a la mamografía (Cochrane). La autoexploración mamaria no debe recomendarse (Cochrane).
Dejo un texto que había preparado hace tiempo sobre rastreo de cáncer de mama, con un análisis un poco más detallado: https://medium.com/@matiasducasa/rastreo-para-c%C3%A1ncer-de-mama-394670fffecc
¿Y la ecografía transvaginal?
No hay evidencia que soporte la realización de tamizaje para cáncer de endometrio ni para cáncer de ovario. Las lesiones benignas generalmente no requieren tratamiento en tanto sean asintomáticas. Entonces no parecería haber una lógica clara detrás de la solicitud rutinaria de EcoTV.
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Modern Colposcopy Textbook and Atlas Third Edition PDF EPUB EBOOK
Modern Colposcopy Textbook and Atlas Third Edition PDF EPUB EBOOK
Modern Colposcopy Textbook and Atlas Third Edition PDF EPUB EBOOK
Modern Colposcopy, 3rd Edition, has been updated to include the 2012 American Cancer Society/ASCCP/American Society for Clinical Pathology (ACS/ASCCP/ASCP) primary cervical screening guidelines and the new 2012/2013 ASCCP updated guidelines for the management of abnormal cervical cytology and cervical precancer.
The first two…
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Reviewing questions:
Succinylcholine is a depolarizing paralytic agent that is degraded by the enzyme pseudocholinesterase. Pseudocholinesterase is synthesized in the liver. Metabolites include succinyl and choline, which are then excreted in the urine. In renal failure patients, hyperkalemia is a common occurrence, and succinylcholine results in an increase in serum potassium levels in normal subjects by 0.5 to 2 mEq/L. Given this fact, succinylcholine should not be used in a pt with elevated potassium level, as it puts her at high risk for arrhythmias.
Other adverse effects of succinylcholine toxicity include malignant hyperthermia, muscle pains, acute rhabdomyolysis with hyperkalemia, transient ocular hypertension, constipation, and changes in cardiac rhythm, including bradycardia and cardiac arrest. In patients with neuromuscular disease or burns, a single injection of succinylcholine can lead to massive release of potassium from skeletal muscles, potentially resulting in cardiac arrest. Conditions having susceptibility to succinylcholine-induced hyperkalemia are burns, closed-head injury, acidosis, Guillain–Barré syndrome, cerebral stroke, drowning, severe intra-abdominal sepsis, massive trauma, myopathy, and tetanus. In addition, the additive/synergistic effects of succinylcholine and an opioid, sedative, or anesthetic agent can lead to succinylcholine toxicity. In rare cases, acute rhabdomyolysis with hyperkalemia followed by ventricular dysrhythmias, cardiac arrest, and death have been reported in apparently healthy children and adolescents.
Bottom Line: In renal failure patients, hyperkalemia is a common occurence, and succinylcholine results in an increase in serum potassium levels in normal subjects by 0.5 to 2 mEq/L. Given this fact, succinylcholine should not be used in patients with preexisting hyperkalemia.
AIDS = CD4 count less than 200/mcL. There is a long list of AIDS-defining conditions that would qualify as AIDS even with a CD4 count above 200/mcL, but this list is beyond the scope of COMLEX Level 3, aside from a few commonly tested conditions.
The most current guidelines recommend against administering prophylactic therapy for Mycobacterium avium complex if antiretroviral therapy has been initiated. One should start prophylactic therapy with trimethoprim/sulfamethoxazole to protect against Pneumocystis pneumonia and toxoplasmosis in a pt with CD4 count of 45.
According to the American Society for Colposcopy and Cervical Pathology guidelines, there are 2 options after ASCUS results: a repeat Pap smear in 1 year or human papillomavirus (HPV) testing. In the 25- to 29-year-old age group, the preferred option is HPV testing. If the HPV test is positive, then the patient should undergo colposcopy. If the HPV is negative, then the patient should have repeat cotesting with cervical cytology and HPV testing in 3 years. If the option was chosen to repeat the Pap in 1 year and the repeat Pap is normal, then the patient can resume normal testing. If the repeat Pap is abnormal (ASCUS or any other worse pathology), then the patient should undergo colposcopy.
If the patient was in the 21- to 24-year-old age group, then the guidelines give the same 2 options of repeat testing in 1 year or HPV testing. However, in this age group, the repeat testing in 1 year is the preferred method.
After age 30, routine screening involves cotesting (Pap and HPV test every 5 years) or Pap alone every 3 years. The same guidelines apply as for the 25- to 29-year-old age group for ASCUS pathology.
Bottom Line: A cytology report of atypical squamous cells of undetermined significance should be followed up with a human papillomavirus screen or repeat Pap smear in 1 year. If the screen is positive or the cytology at 1 year is abnormal, the patient should get a colposcopy.
High-grade squamous intraepithelial lesion (HSIL) is considered a premalignant lesion. Management per the American Society for Colposcopy and Cervical Pathology (ASCCP) is an immediate loop electrosurgical excisional procedure (LEEP) or a colposcopy. If a colposcopy is chosen, further treatment depends on the grade of cervical intraepithelial neoplasia. For grade 1 dysplasia found on the colposcopy, the options are to co-test at 12 and 24 months or perform a LEEP. If either of the co-tests shows the HSIL again, then the LEEP should be performed. If the initial colposcopy shows grade 2 or 3 dysplasia, then excision or ablation of the transformation zone is recommended.
Bottom Line: HSIL is considered a premalignant lesion, and thus an excisional procedure is indicated. The provider may go directly to a LEEP procedure or may first perform a colposcopy.
In order to respond to various pathogens, the CDC has grouped many different agents that could be used as biological terrorism into categories. This allows early detection and therefore appropriate response if there is concern for biological terrorism. The grouping of pathogens primarily depends on their capacity to cause harm and ease of dissemination. The organisms/toxins of concern are categorized as:
Category A - organisms that can be grown easily in large quantities, easily disseminated, and have a high mortality rate.
Category B - agents that are modestly easy to spread, cause less morbidity and mortality than Category A, but often require special diagnostic or surveillance techniques.
Category C - agents that could be engineered for mass dissemination and cause significant potential morbidity and/or mortality.
Category A Agents include Variola major (smallpox), Bacillus anthracis (anthrax), Yersinia pestis (plague), Clostridium botulinum toxin (botulism), Francisella tularensis (tularemia), Filoviruses (Ebola, Marburg), and Arenaviruses (Lassa, Junin, and related viruses).
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Modern Colposcopy Textbook and Atlas Third Edition PDF EPUB EBOOK
Modern Colposcopy Textbook and Atlas Third Edition PDF EPUB EBOOK
Modern Colposcopy Textbook and Atlas Third Edition PDF EPUB EBOOK
Modern Colposcopy, 3rd Edition, has been updated to include the 2012 American Cancer Society/ASCCP/American Society for Clinical Pathology (ACS/ASCCP/ASCP) primary cervical screening guidelines and the new 2012/2013 ASCCP updated guidelines for the management of abnormal cervical cytology and cervical precancer.
The first two…
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Modern Colposcopy Textbook and Atlas (3rd Edition) – eBook PDF
Modern Colposcopy Textbook and Atlas (3rd Edition) – eBook PDF
Modern Colposcopy Textbook and Atlas (3rd Edition) – eBook PDF
The previous two editions of this book were published by the American Society for Colposcopy and Cervical Pathology (ASCCP). Modern Colposcopy Textbook and Atlas, 3rd Edition, (PDF) is considered the standard of colposcopy and is known for being the best selling educational teaching module for the physician, resident, or advanced…
View On WordPress
0 notes
Text
Modern Colposcopy Textbook and Atlas Third Edition PDF EPUB EBOOK
Modern Colposcopy Textbook and Atlas Third Edition PDF EPUB EBOOK
Modern Colposcopy Textbook and Atlas Third Edition PDF EPUB EBOOK
Modern Colposcopy, 3rd Edition, has been updated to include the 2012 American Cancer Society/ASCCP/American Society for Clinical Pathology (ACS/ASCCP/ASCP) primary cervical screening guidelines and the new 2012/2013 ASCCP updated guidelines for the management of abnormal cervical cytology and cervical precancer.
The first two…
View On WordPress
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Women’s Health App Market Analysis, Market Size, In-Depth Insights, Growth and Forecast 2025
Earlier a small sector in mHealth space, women’s health tech (more popularly femtech) has been in the spotlight over the recent past. While it was initially limited to period trackers, health monitors, nutrition and diet apps, and pregnancy assistants, the umbrella of femtech currently covers a number of women’s health apps under it. Fairfield Market Research in its new ongoing study says that global women’s health app market awaits a bright future on the back of its growing abilities to enhance women’s health. Dramatically rising number of start-ups making their forays into the femtech space has been indicated as one of the strongest signs of rapid market proliferation in the near future, says the report.
Get a Sample Copy of Women’s Health App Market: https://www.fairfieldmarketresearch.com/report/womens-health-app-market
mHealth Expansion Continues to Favour Market Growth
Femtech, all set to make a lot of women’s lives easier, plays an important role in helping them understand their bodies better, give the essential attention to health, and at times mystify certain health issues. Women’s health applications have also been boosting crucial medical research around certain critical health issues, as well as untapped women’s needs. Increasing technology adoption especially by working women, and exciting prospects of mHealth are expected to favour the growth of women’s health app market. Highly disruptive potential of smartphone technology, and growing ubiquity of smartphones are accelerating adoption of a variety of women’s health apps worldwide.
Apps Targeting Specific Health Needs to Gain Ground
Apps that aim specific health interest of women are more likely to perform remarkably. Such applications intend to provide personalised health solutions by facilitating individual resource access. Constantly growing need for improved healthcare engagement along with effective personal health management is projected to serve as a strong push factor for women’s health app market expansion. Concerns around data safety and security however will remain prevalent as the key challenges to rapid market expansion, highlights the report.
Widening Range of Health App Coverage Augurs Well for Market
The coverage of femtech has been broadening continuously to involve general health and wellbeing, menstrual health, reproductive and fertility issues, sexual health solutions, pregnancy and post-care, hormonal conditions, chronic ailments, fitness and wight management, dietary solutions, bladder issues, adolescence health and wellbeing, menopause, cancer detection, and mental health management. This is likely to continue creating a strong breeding ground for women’s health application companies. Considering the growing role of preventive healthcare (to avoid expensive healthcare costs), femtech warrants to discover impressive growth prospects. Investors are thus likely to look at women’s health app market as a massive opportunity.
Most Sought-after Women’s Health Apps
A large number of companies are driving competition in global women’s health app market, some of which have been profiled in the report of Fairfield Market Research. Elvie, Samsung Health App, ASCCP Mobile, ACOG, Clue, Dot, Bonzun, Biem, Cycles, Breast Cancer, Eve, Glow, Health Saathi, WebMD Symptom Checker, Flo, Gyan Jyoti, IBody, LactMed, Maven Clinic, My Flo, Pocket Kamasutra, Maya, MagicGirl, MyFitnessPal, Ovia, Pregnascan, The Pill, Oral Contraceptive Pill Reference, and Yoga Stretch represent some of the popular apps opted for by women worldwide.
For More Information Visit: https://www.fairfieldmarketresearch.com/report/womens-health-app-market
About Us
Fairfield Market Research is a UK-based market research provider. Fairfield offers a wide spectrum of services, ranging from customized reports to consulting solutions. With a strong European footprint, Fairfield operates globally and helps businesses navigate through business cycles, with quick responses and multi-pronged approaches. The company values an eye for insightful take on global matters, ably backed by a team of exceptionally experienced researchers. With a strong repository of syndicated market research reports that are continuously published & updated to ensure the ever-changing needs of customers are met with absolute promptness.
#health app market#women health apps#women health apps market#women’s health apps#women’s health app market#women’s health app market trends#women’s health app market demand#women’s health app market growth#women’s health app market forecast#fairfield market research
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