The low prevalence of vasectomy among Latino men in the United States is often attributed to cultural characteristics despite limited evidence supporting this hypothesis. We assessed male partners' perceived willingness to undergo vasectomy through surveys with 470 Mexican-origin women who did not want more children in El Paso, Texas. Overall, 32% of women reported that their partner would be interested in getting a vasectomy. In multivariable analysis, completing high school (OR=2.03 [1.05, 3.95]), having some college education (OR=2.97 [1.36, 6.48]) or receiving US government assistance (OR=1.95 [1.1, 3.45]) was associated with partners' perceived interest. Additionally, we conducted two focus groups on men's knowledge and attitudes about vasectomy with partners of a subsample of these women. Despite some misperceptions, male partners were willing to get a vasectomy, but were concerned about cost and taking time off work to recover. Health education and affordable vasectomy services could increase vasectomy use among Mexican-origin men.

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Perceived Interest in Vasectomy among Latina Women and their Partners in a Community with Limited Access to Female Sterilization.

Background: The vasectomy is a definitive masculine contraceptive method that is made in the Ambulatory Surgery Center (ISSSTE) since 1985. Objective: To describe the results obtained during the 25 years of the vasectomy in the Ambulatory Surgery Center, the intra-operative findings and the contributions of the multidisciplinary work. Patients and method: Retrospective, descriptive and qualitative study. The statistics of vasectomies made since July 1985 to July 2010 were analyzed. Socio-demographic data of the last five years were considered as a sample of the whole vasectomized popu lation, and field notes were elaborated. Results: 4,106 vasectomies have been made. The practice of the technique of vasectomy without bistouries began in 1995. The age average of the men with vasectomy was 36.6 years. The condom was the contraceptive method most used before the vasectomy. The age average of sexual initiation of men was 17.4 years. The majority of men had two children at the time of the vasectomy. Intraoperative findings were: agenesia, supernumerary vas deferens and bilateral duplication of vas deferens. Conclusions: The accomplishment of the vasectomy without bistouries requires of qualification. It is an ambulatory procedure of low morbidity and effectiveness of 99%. It is necessary to continue with the multidisciplinary work to offer integral attention to the patient, before, during and after surgery.

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Vasectomía: reseña de 25 años en el Centro de Cirugía Ambulatoria del ISSSTE

De 1976 a 1992 se incremento la demanda de procedimientos anticonceptivos ambulatorios: de 0.6 a 1.4 % para vasectomia y de 8.9 a 43 % para oclusion tubaria bilateral. El objetivo de esta investigacion fue conocer la frecuencia de cirugias anticonceptivas efectuadas por cirujanos generales entre 2001 y 2005 en hospitales rurales de segundo nivel de San Luis Potosi, Mexico. Material y metodos: Estudio retrospectivo observacional, descriptivo, transversal. Se registro el numero de vasectomias y oclusiones tubarias bilaterales y sus complicaciones, efectuadas en dos hospitales rurales por cirujanos generales o ginecoobstetras, asi como la informacion relativa a la edad de los usuarios y numero de gestas, estableciendo diferencias por χ2. Resultados: De 19 622 cirugias, se revisaron 4821 cirugias anticonceptivas (24.6 %), 1942 efectuadas por cirujano general (40.3 %) y 2879 (59.7 %) por ginecoobstetra: 4687 oclusiones tubarias bilaterales y 134 vasectomias (todas por cirujano general, con seis complicaciones). Las complicaciones en las oclusiones tubarias bilaterales fueron 10 para el cirujano general (0.55 %) y 19 para el ginecoobstetra (0.65 %), sin diferencia estadistica (p = 0.5). Conclusiones: La oclusiones tubarias bilaterales y las vasectomias representaron 25 % de la productividad quirurgica en los hospitales rurales; el cirujano general realiza 40 %, sin diferencia entre la morbilidad en relacion con el ginecoobstetra. El cirujano general evito el retardo en la atencion

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Experiencia en vasectomía y oclusión tubaria bilateral por cirugía ambulatoria en dos hospitales rurales

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Perfil del varón que elige vasectomía sin bisturí en un centro de salud de la ciudad de México: 15 años de experiencia

Microcystic adenomas of the pancreas and constitutional abnormalities.

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Vasectomía sin bisturí. Experiencia de 10 años

Summary Background: Cystic neoplasms of the pancreas represent between 5% and 10% of all pancreatic tumors. Due to their malignant potential, surgery is indicated. Because of the uncommon nature of this pathology, the aim of this study was to present a series of six patients who were operated on for a cystic tumor and to analyze the morphological characteristics, surgical experience and follow-up. Methods: This was a retrospective study. Clinical files were studied, as well as surgical and pathological registries from patients diagnosed with cystic neoplasms of the pancreas. Five females and one male were included with mean ages of 54 ± 15 years. The main symptom was abdominal pain. Results: Clinical course and CT scan results were the criteria for suspecting the diagnosis. In four out of six patients, the tumor was located within the body and tail of pancreas. The most frequent intervention was distal pancreatectomy. There was no mediate operative mortality in a 30-day period. Histopatological diagnoses were three serum cystoadenomas, two mucinous cystoadenomas and one cystoadenocarcinoma. After a 4-year follow-up, no recurrences of tumor have been reported in the surviving patients. Conclusions: The natural history of cystic neoplasms of the pancreas is generally benign, but complications may occur by direct invasion of neighboring structures. Clinical course, tomography, pancreatography and punction are fundamental for its treatment.

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Neoplasias quísticas pancreáticas

Resumen Introducción: El objetivo de este estudio fue comparar la eficacia de dexametasona versus ondansetrón en la prevención de náusea/vómito en pacientes con colecistectomía laparoscópica. Pacientes y métodos: Se realizó un ensayo clínico ciego simple. Se seleccionaron 75 pacientes tanto de un sexo como de otro programados para colecistectomía laparoscópica. los pacientes fueron asignados aleatoriamente a los tratamientos que se administraron 90 minutos antes de la cirugía: 1) dexametasona 8 mg IV dosis única (n = 36) y 2) ondansetrón 8 mg IV dosis única (n = 39). las variables de interés fueron evaluadas al término de la cirugía, a las seis y 24 horas de postoperatorio se registró frecuencia e intensidad de náusea y vómito. Resultados. los pacientes experimentaron mayor proporción de episodios de NVPO en el grupo de dexametasona que en el grupo de ondansetrón (p = 0.2), en aquellos que lo presentaron fue significativamente más intenso en el grupo de ondansetrón. Veinticuatro pacientes no experimentaron episodio de náusea comparados con 28 a quienes se les administró ondansetrón (p = 0.6). Así mismo, 29 pacientes que recibieron dexametasona no vomitaron contra 33 que recibieron ondansetrón (p = 0.4). la reducción del riesgo absoluto (RRA) para náuseas fue de 5.1 con un número necesario a tratar (NNT) de 20 (IC 26-15). En tanto que la RRA para vómitos fue de 4.06 con un NNT de 25 (IC 21-13).

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Emilio Prieto Díaz Chávez

Papers

Vasectomía sin bisturí. Experiencia de 10 años

Neoplasias quísticas pancreáticas

Comparación de Dexametasona vs Ondansetrón en la Prevención de Náuseas y Vómitos Postoperatorios, Posterior a Colecistectomía Laparoscópica