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This book offers clear, up-to-date guidance on how to report cytologic findings in cervical, vaginal and anal samples in accordance with the 2014 Bethesda System Update. The new edition has been expanded and revised to take into account the advances and experience of the past decade. A new chapter has been added, the terminology and text have been updated, and various terminological and morphologic questions have been clarified. In addition, new images are included that reflect the experience gained with liquid-based cytology since the publication of the last edition in 2004. Among more than 300 images, some represent classic examples of an entity while others illustrate interpretative dilemmas, borderline cytomorphologic features or mimics of epithelial abnormalities. The Bethesda System for Reporting Cervical Cytology, with its user-friendly format, is a “must have” for pathologists, cytopathologists, pathology residents, cytotechnologists, and clinicians.
Most women who die from cervical cancer, particularly in developing countries, are in the prime of their life. They may be raising children, caring for their family, and contributing to the social and economic life of their town or village. Their death is both a personal tragedy, and a sad and unnecessary loss to their family and their community. Unnecessary, because there is compelling evidence, as this Guide makes clear, that cervical cancer is one of the most preventable and treatable forms of cancer, as long as it is detected early and managed effectively. Unfortunately, the majority of women in developing countries still do not have access to cervical cancer prevention programmes. The consequence is that, often, cervical cancer is not detected until it is too late to be cured. An urgent effort is required if this situation is to be corrected. This Guide is intended to help those responsible for providing services aimed at reducing the burden posed by cervical cancer for women, communities and health systems. It focuses on the knowledge and skills needed by health care providers, at different levels of care.
Written with the busy practice in mind, this book delivers clinically focused, evidence-based gynecology guidance in a quick-reference format. It explores etiology, screening, tests, diagnosis, and treatment for a full range of gynecologic health issues. The coverage includes the full range of gynecologic malignancies, reproductive endocrinology and infertility, infectious diseases, urogynecologic problems, gynecologic concerns in children and adolescents, and surgical interventions including minimally invasive surgical procedures. Information is easy to find and absorb owing to the extensive use of full-color diagrams, algorithms, and illustrations. The new edition has been expanded to include aspects of gynecology important in international and resource-poor settings.
Recoge: 1. Epidemiological guidelines for quality assurance in cervical cancer screening - 2. Methods for screening and diagnosis - 3. Laboratory guidelines and quality assurance practices for cytology - 4. Techniques and quality assurance guidelines for histopathology - 5. Management of abnormal cervical cytology - 6. Key performance indicators - 7. Annexes.
Self-care interventions are among the most promising and exciting new approaches to improve health and well-being, both from a health systems perspective and for people who use these interventions. The World Health Organization (WHO) uses the following working definition of self-care: Self-care is the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health worker. The scope of self-care as described in this definition includes health promotion; disease prevention and control; self-medication; providing care to dependent persons; seeking hospital/specialist/primary care if necessary; and rehabilitation, including palliative care. It includes a range of self-care modes and approaches. While this is a broad definition that includes many activities, it is important for health policy to recognize the importance of self-care, especially where it intersects with health systems and health professionals. Worldwide, an estimated shortage of 18 million health workers is anticipated by 2030, a record 130 million people are currently in need of humanitarian assistance, and disease outbreaks are a constant global threat. At least 400 million people worldwide lack access to the most essential health services, and every year 100 million people are plunged into poverty because they have to pay for health care out of their own pockets. There is an urgent need to find innovative strategies that go beyond the conventional health sector response. While "self-care" is not a new term or concept, self-care interventions have the potential to increase choice, when they are accessible and affordable, and they can also provide more opportunities for individuals to make informed decisions regarding their health and health care. In humanitarian settings, for example, due to lack of or limited health infrastructure and medical services in the crisis-affected areas, self-care could play an important role to improve health-related outcomes. Self-care also builds upon existing movements, such as task sharing, which are powerful strategies to support health systems.
This book is a comprehensive and easy-to-read guide to obstetrics and gynecology in developing countries. Although significant progress has been made towards the reduction of maternal mortality and morbidity globally, they are still unacceptably high in developing countries. This can be directly or indirectly tied to poor quality maternal health care and lack of access to cost-effective, comprehensive healthcare. Health practitioners in developing countries also contend with trying to keep abreast of recent developments in obstetrics and gynecology while dealing with lack of time, resources, and access to relevant information. This textbook was thus created by experts in obstetrics and gynecology with extensive experience in African clinical settings and consultants in developed countries to teach proper and accurate diagnosis, treatment and management of gynecologic and obstetric health issues within the context of developing countries. This second edition has been fully updated throughout with an added 25+ chapters that cover topics such as reproductive health, gynecological cancers and research methods. The book is divided into six sections: Women’s Reproductive Health; Obstetrics; Medical and Surgical Disorders in Pregnancy; General Gynecology; Gynecological Malignancies; Health Systems Organization, Research Methodology and Biostatistics. These section topics have been carefully covered by expert authors with the use of valid scientific data, policy instruments, and adapted to the cultural and social context of developing countries, with particular in depth coverage of conditions that have greater prevalence and incidence in developing countries. Each chapter also focuses on filling gaps in knowledge with a distinct pedagogical approach, starting with a set of learning objectives and ending with key takeaways for the chapter. This is an ideal guide for residents, medical students, practitioners of obstetrics and gynecology, midwives, general practitioners, and pediatricians, particularly those working in developing companies.
This colposcopy manual was developed in the context of the cervical cancer screening research studies of the International Agency for Research on Cancer (IARC) and the related technical support provided to national programs. It is thus a highly comprehensive manual, both for the training of new colposcopists and for the continuing education and reorientation of those who are more experienced. This manual offers a valuable learning resource, incorporating recent developments in the understanding of the etiology and pathogenesis of cervical intraepithelial neoplasia (CIN), as well as in colposcopy and cervical pathology. Expertise in performing satisfactory, safe, and accurate colposcopic examinations requires high competence in the technical, interpretive, and cognitive aspects, and the capability to develop pragmatic and effective management plans and treatment. This comprehensive and concise manual covers all these aspects and serves as a useful handbook for acquiring the necessary skills for the visual recognition and interpretation of colposcopic findings and for developing the personal and professional attributes required for competence in colposcopy.
For many women in developing countries, such as sub-Saharan Africa, south and south-east Asia, and central and south America, there is a high risk of cervical cancer, but a lack of effective programmes to detect and treat such a problem. This introductory manual is intended to simply the learning of colposcopy (a diagnostic and evaluation method for cervical intraepithelia neoplasia, or cervical cancer).
This book explores all aspects of preventive oncology of the female genital tract and provides readers with detailed insights on the topic. Preventive oncology has long been recognized as a pressing need, though formally few steps have been taken to actively promote it. The book's respective chapters holistically cover the concept of cancer prevention for the female genital tract & breast. In addition, it explains the evidence-based value of each screening modality, and the rationale behind the recommended screening guidelines. In closing, the book highlights a wealth of recent evidence-based literature, making it a highly informative resource that will significantly broaden readers' understanding of preventive oncology.
In 1984 the medical journal Obstetrics and Gynecology published a paper that would initiate an investigation into one of the greatest medical scandals of the late twentieth century. Titled "The Invasive Potential of Carcinoma in Situ of the Cervix", it discussed the results of an experiment that had been run at the National Women’s Hospital in Auckland, New Zealand, since 1955. The experiment looked at the natural history of cervical carcinoma in situ (CIS) – in other words, what happens if no treatment is initiated in a condition suspected (when the experiment began) to lead to cervical cancer. The paper divided participants into two groups, one that had negative results after biopsy or treatment, and one smaller group that continued to test positive. This second group had a significant rate of cervical cancer; some of these women were followed for twenty-five years without treatment, and in only 5% did the disease spontaneously resolve. For the other 95%, outcomes ranged from positive but localised results to metastatic disease and death. The authors said these results were in contrast with other, earlier papers about the experiment. After much research, Sandra Coney, one-time editor of a NZ feminist magazine, and Phyllida Bunkle, a women’s studies lecturer, wrote an article about the experiment, exposing the unauthorised research performed by one prominent gynaecologist in support of his belief that CIS was not associated with cervical cancer. Professor Herbert Green, a physician of considerable influence and power throughout New Zealand, persisted in his belief despite increasingly convincing proof of a progressive connection between the two conditions, never sought permission from his patients, or even told them what he was doing.