Luis Rosero Bixby
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Item Confirmación histológica del diagnóstico de cáncer cérvico uterino en Costa Rica 1982-84(Acta Médica Costarricense, Vol. 33; No, 3, 1990) Oberle, Mark W.; Rosero Bixby, Luis; Saeed, MekbelUn panel de patólogos costarricenses efectuó un análisis histológico de las biopsias de 677 casos de cáncer de cuello de útero in situ e invasor diagnosticados en Costa Rica en 1982 - 1984. El panel confirmó el diagnóstico inicial del 81% de los casos de cáncer in situ y del 72% de los casos de cáncer invasor. El panel redigo la severidad del diagnóstico a displasia u otra lesión no cancerosa en el 12% de los casos de cáncer in situ y en el 3% de los casos de cáncer invasor. El 8% de los casos de cáncer invasor fueron reclasificados como in situ. Un 9% adicional podrían ser reclasificados en el mismo sentido, pero hay dudas sobre el diagnóstico definitivo. El error más grave ocurrió en 3% de los casos Inicialmente diagnosticados como de cáncer in situ los cuales fueron reclasificados por el panel como cáncer invasor, pero este error probablemente no afectó el tratamiento de las pacientes. Las modificaciones en el diagnóstico obtenidos en el presente estudio pueden derivarse de un examen más cuidadoso efectuado por el panel o de la dificultad propia del diagnóstico histológico del cáncer de cuello de útero.Item Contraceptive use and fertility in Costa Rica, 1986(International Family Planning Perspectives, Vol. 14, No. 3, (September 1988), 1988) Oberle, Mark W.; Sosa Jara, Doris; Madrigal Pana, Johnny; Becker, Stan; Rosero Bixby, LuisContraceptive prevalence in Costa Rica is higher than almost anywhere else in Latin America, with 70 percent of currently married women using a contraceptive method. Differentials in contraceptive use by educational level and between urban and rural areas are actually quite small compared with those in other Latin American countries. While levels of contraceptive use among married women 20-44 years of age remained relatively stable between 1976 and 1986, total fertility rates increased slightly over that period, perhaps because of changing fertility intentions or changing patterns of contraceptive use. For example, Costa Rican women have increased their reliance on barrier methods and decreased use of the pill. The majority of women who were not practicing contraception were either pregnant or breastfeeding an infant; only about one in five nonusers could be considered candidates for contraceptive use. One-fifth of all 15-19-year-old women and two-fifths of all 20-24-year-olds had had premarital intercourse. Most young adults who had had premarital intercourse did not practice contraception at first intercourse.Item A population-based serosurveillance of syphilis in Costa Rica(Reprinted from Sexually Transmitted Diseases, Vol. 18, no. 2 (april-June 1991), 1991) Larsen, Sandra A.; Oberle, Mark W.; Sánchez Braverman, Juana M.; Rosero Bixby, Luis; Vetter, Kathleen M.As part of a case-control study to investigate the high incidence of cervical cancer in Costa Rican women, the seroprevalence of the trepnematoses, in particular, syphilis was determined. In each age group, women with a history of two or more sex partners were two to four times more likely to be seroreactive in tests for syphilis than women with zero or one sex partner. The highest percentage of reactive results in the microhemagglutination assay for antibodies to Trepnema pallidum (MHATP) was seen in samples from women aged 50-59 who had had two or more lifetime partners (23.8%). Three observations from our study support reactivity due to syphilis rather than yaws or pinta: ( /) a similar percent of reactive rapid plasma reagin (RPR) card test results among MHA-TP reactors in the two age groups of women who were surveyed (42 vs. 49%) was observed; (2) women who were seroreactive in the MHA-TP had multiple risk factors for STD (low socioeconomic status (9.4%), urban residence (22.8%), first intercourse under 16 years of age (14.1%), and multiple sex partners (26.3%)|, and (j) only sexually experienced women had reactive results in the MHA-TP test.