Background: HPV primary screening has shown effectiveness for cancer prevention; however, gynaecological examination is considered uncomfortable. Self-sampling methods increase the acceptance of screening. The aim of this study is to compare the sensitivity and specificity of clinician sampling versus vaginal and urine self-sampling for HPV diagnosis. Methods: A diagnostic test study was conducted in a rural parish of Cuenca, Ecuador. A total of 120 women participated. Each participant self-collected urine and vaginal samples and underwent clinician sampling for HPV testing. The latter was considered as the golden standard. All three samples were processed with the same amplification and hybridization protocol for HPV detection (Hybribio) following the manufacturer’s instructions. Results: Characteristics of the participants were: median age 35 years; 40.8% married; 46.7% had a primary level of education; and median age of sexual onset, 17.6 years. The prevalence of any type of HPV with clinician sampling was 15.0%, 17.5% with urine sampling and 18.3% with vaginal self-sampling. Self-sampling sensitivity reached 94.4% (IC 74.2–99.9), and specificity 92.1% (IC 85.2–95.9). Urine sampling had a sensitivity of 88.8% (IC 67.2, 96.9), and specificity 94.1% (IC 67.2–96.9). The negative predictive value was 98.9% (IC 94.2–99.8) for vaginal self-sampling and 97.6% (IC 92.6–99.4) for urine sampling. Conclusions: This study shows that vaginal and urine self-sampling methods have similar sensitivity and specificity compared with clinician sampling for the diagnosis of HPV. The correlation between HPV genotypes among the three tests is satisfactory.

Self-sampling methods for HPV testing have been demonstrated to be highly sensitive and specific. The implementation of these methods in settings with a lack of infrastructure or medical attention has been shown to increase the coverage of cervical cancer screening and detect cervical abnormalities in the early stages. The aim of this study is to compare the acceptability of urine and vaginal self-sampling methods versus clinician sampling among rural women. A total of 120 women participated. Each participant self-collected urine and vaginal samples and underwent clinician sampling for Pap smear and HPV testing. After the sample collection, a questionnaire to qualify the device, technique, and individual acceptability was applied, and the additional overall preference of three sample tests was evaluated. Results: The characteristics of the participants were as follows: median age of 35 years; 40.8% were married; 46.7% had a primary level of education; median age of sexual onset of 17.6 years. Compared with clinician sampling, both vaginal self-sampling, OR 20.12 (7.67–52.8), and urine sampling, OR 16.63 (6.79–40.72), were more comfortable; granted more privacy: vaginal self-sampling, OR 8.07 (3.44–18.93), and urine sampling, OR 19.5 (5.83–65.21); were less painful: vaginal self-sampling, OR 0.07 (0.03–0.16), and urine sampling, OR 0.01 (0–0.06); were less difficult to apply: vaginal self-sampling, OR 0.16 (0.07–0.34), and urine sampling, OR 0.05 (0.01–0.17). The overall preference has shown an advantage for vaginal self-sampling, OR 4.97 (2.71–9.12). No statistically significant preference was demonstrated with urine self-sampling versus clinician sampling. Conclusions: Self-sampling methods have a high acceptance in rural communities. Doubts on the reliability of self-sampling often appear to be a limitation on its acceptability. However, the training and education of the community could increase the uptake of these methods.

Background: Cervical cancer continues to be a major health problem in developing countries. Educational programs, as well as Pap and HPV screening and vaccination, are important tools to reduce the morbidity and mortality rates associated with this disease. The objective of this study is to explore the diverse knowledge and perceptions about cervical cancer and the different diagnostic tests for HPV of populations living in the rural parish “El Valle”. Method: A qualitative study was conducted through eight focus groups, which included 46 participants from mixed ethnic groups. A phenomenological analysis was performed. Results: Four topics and seven sub-topics were identified. By analyzing all the narratives, it was possible to identify that the perception of cervical cancer was focused on its severity, secondary to its infectious process and screening periodicity. However, despite the diverse knowledge, indigenous people do not relate it to the human papilloma virus; in addition, there is also certain resistance to undergo the Pap smear test, for reasons such as inaccessibility and its sampling process. Conclusions: It is necessary to develop educational programs for the prevention of cervical cancer and to implement diagnostic alternatives to reach populations with precarious accessibility, as well as women who refuse to undergo the Pap smear test.

Age-related liver changes can have important implications for health and metabolic function. This study aimed to describe the morphoquantitative alterations of the liver in senescent rats compared to adult rats. Twelve male rats were used, divided into 6-month-old adults (group A) and 36-month-old senescent rats (group S). Morphometric and histopathological studies, quantification of collagen types I and III, and stereological analyses were performed to determine the volume density of mononucleated (Vv_hepM) and binucleated (Vv_hepB) hepatocyte nuclei, surface area density (Sv_hepM), and number density (Nv_hepM) of mononucleated hepatocyte nuclei. The findings reveal an alteration of the normal liver tissue architecture in senescent rats and the presence of inflammatory lesions and fibrosis. In addition, there was a decrease in body and liver mass and volume. Group S showed a significant reduction in Vv_hepM and Nv_hepM; however, Sv_hepM was significantly higher. No significant differences were noted in the percentage of binucleated hepatocytes between the two groups. This study reveals substantial morphological changes in the aging liver, with possible functional implications. More research is needed on the underlying mechanisms and their consequences at older ages.

Introduction: Depression is one of the most prevalent mental illnesses worldwide, and its etiology is still the subject of multiple studies that strive to clearly identify the causes of this disorder and guide the appropriate form of treatment. The present study aimed to establish the correlation between elevated levels of circulating proinflammatory cytokines such as interleukin 6 (IL-6) and tumor necrosis factor-alpha (TNF-α) with depression. Materials and Methods: An analytical correlational study was conducted in which 300 medicine and nursing students from a university in the city of Loja, Ecuador participated. They were assessed with the Beck Depression Inventory II (BDI II) to determine the presence of depression, and peripheral levels of interleukin 6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were measured using the ELISA technique. Results: 65% of the participants reported depression according to the Beck Depression Inventory II, which in turn were divided into mild (23%), moderate (20.3%) and severe depression (21.7%) according to the score obtained. A statistically significant correlation was found between elevated levels of IL-6 and TNF-α with depression in the group of nursing students. However, no such correlation was found in the group of medical students. Discussion: Elevations in both inflammatory cytokines measured in this study were evident in both study groups. This could be explained by the high emotional stress generally associated with healthcare career training, which in turn could reinforce the hypothesis of inflammatory states and their relation to the pathophysiology of depression. However, the percentage of depression cases was higher in the nursing student group, in which the female gender accounted for 83.3% of the group, a fact that could explain the reason why in this group there was a statistically significant relationship between elevated cytokines and the presence of depression.

En terminología médica el término amígdala cerebral es utilizado para denominar a la estructura que según la Terminologia Neuroanatomica y Terminologia Anatomica se conoce como cuerpo amigadaloide, la cual está constituida por diversos núcleos y es responsable de las emociones, el comportamiento, regulación de la ansiedad, la agresión, el miedo, la memoria emocional, la cognición social y las respuestas al estrés. Siendo la amígdala cerebral una estructura tan importante el objetivo de este estudio fue: analizar el significado del término amígdala cerebral en la Terminologia Neuronatomica y en la Terminologia Anatomica y contrastar si el origen de sus raíces greco latinas concuerdan con la función de esta estructura acorde con los requerimientos de la FIPAT. Para ello se consultó los diccionarios de la Lengua Española, Diccionario DGE Griego Español, Diccionario VOX Griego Español, Diccionario Médico, Biológico, Histológico y Etimológico de la Universidad de Salamanca y Diccionario de Términos Médicos de la Real Academia Nacional de Medicina, así como algunos artículos y libros clásicos de anatomía. Los resultados indicaron que el término amígdala tiene el mismo significado en griego como en latín, en donde ἀμυγδαλέα, ἀμυγδαλέας (pr. amygdaléa, amygdaléas) es el árbol del almedro y ἀμυγδάλη, ἀμυγδάλης (pr. amygdále, amygdáles) significa almendra. Conociendo tanto la anatomía como la fisiología de esta estructura su forma no se asemeja a la de una almendra y su denominación actual no está acorde con los requerimientos de la FIPAT por lo cual consideramos que esta debe ser revisada.