• Title/Summary/Keyword: Cervix

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Translating Evidence into Practice in Low Resource Settings: Cervical Cancer Screening Tests are Only Part of the Solution in Rural India

  • Isaac, Rita;Finkel, Madelon;Olver, Ian;Annie, I.K.;Prashanth, H.R.;Subhashini, J.;Viswanathan, P.N.;Trevena, Lyndal J.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.4169-4172
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    • 2012
  • Background: The majority of women in rural India have poor or no access to cervical cancer screening services, although one.quarter of all cervical cancers in the world occur there. Several large trials have proven the efficacy of low-tech cervical cancer screening methods in the Indian context but none have documented the necessary components and processes of implementing this evidence in a low-resource setting. Methods: This paper discusses a feasible model of implementation of cervical cancer screening programme in low-resource settings developed through a pilot research project carried out in rural Tamilnadu, India. The programme used visual inspection of cervix after acetic acid application (VIA) as a screening tool, nurses in the primary care centres as the primary screeners and peer educators within Self-Help Women groups to raise community awareness. Results: The uptake of screening was initially low despite the access to a screening programme. However, the programme witnessed an incremental increase in the number of women accessing screening with increasing community awareness. Conclusions: The investigators recommend 4 key components to programme implementation in low-resource setting: 1) Evidence-based, cost-effective test and treatment available within the reach of the community; 2) Appropriate referral pathways; 3) Skilled health workers and necessary equipment; and 4) Optimisation of health literacy, beliefs, attitudes of the community.

Follow-Up Consultations for Cervical Cancer Patients in a Mexican Cancer Center. Comparison with NCCN Guidelines

  • Serrano-Olvera, Alberto;Cetina, Lucely;Coronel, Jaime;Duenas-Gonzalez, Alfonso
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8749-8752
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    • 2014
  • Purpose: This study aimed to determine the patterns of follow-up visits for cervix cancer in a national cancer center in Mexico. Materials and Methods: The National Cancer Institute of Mexico is cancer center with 119 beds that mostly cares for an underserved and socially disadvantaged population. The medical records of cases of cervical cancer that had at least one year of clinical follow-up after being in complete response at the end of primary treatment were analyzed. We recorded the numbers of total and yearly follow-up visits and these were compared with the number of follow-up visits recommended by the National Comprehensive Cancer Network 2013, version 2 for cervical cancer. Results: Between March and June 2007, the medical records of 96 consecutive patients were reviewed. Twenty (21%) of these met inclusion criteria and were selected. In the first year the median number of visits was 11 (4-20). In the ensuing years, $2^{nd}$, $3^{rd}$, $4^{th}$ and $5^{th}$, the number of analyzed patients remaining in follow-up decreased to 17, 14, 13 and 9 respectively. There were 462 follow-up visits to primary treating services (Gynecology Oncology, Radiation Oncology and Medical Oncology) as compared to 220 suggested by the NCCN guidelines ($X^2$ test p<0.0001). There were 150 additional visits to other services. Conclusions: Our results suggest that in our institution there is an overuse of oncological services by cervical cancer patients once treatment is completed.

PREGNANCY RATES IN PHILIPPINE SWAMP BUFFALOES(CARABAOS) FOLLOWING CLITORAL STIMULATION DURING TIMED INSEMINATIONS

  • Capitan, S.S.;Momongan, V.G.;Obsioma, A.R.;del Barrio, A.N.
    • Asian-Australasian Journal of Animal Sciences
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    • v.5 no.2
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    • pp.275-278
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    • 1992
  • One hundred sixty three (163) animals were used in $2{\times}2$ and $3{\times}2$ factorial experiment in randomized complete block design (RCBD) to determine the effect of clitoral stimulation during timed inseminations on the fertility of Philippine swamp buffaloes (carabaos). There were 3 separate trials conducted with two treatment groups per trial : control and with 30 second clitoral stimulation after each insemination. Parity, tone of uterus and site of semen deposition were also used as criteria in subdividing the main groups. The pregnancy rates of animals that received clitoral stimulation were significantly (p<0.05 or p<0.01) higher than those of control for both caraheifers (52.98 vs 31.41%) and caracows (52.68 vs 27.07%) ; under all uterine conditions : tone 1 (53.33 vs 31.75%), tone 2 (35.83 vs 22.82%) and tone 3 (75.65 vs 42.44%) ; and in both site of semen placement, cervix (43.99 vs 22.85%) and uterus (60.92% vs 37.81%). Fertility was also significantly (p<0.05) higher when semen was deposited in the uterus (49.37%) than in the cervix (33.42%). Interaction effect was insignificant. Clitoral stimulation should be utilized as a routine procedure following artificial insemination in carabaos.

p16INK4A Expression in Squamous Cell Carcinomas of the Vagina and the Vulva in Tunisian Women

  • Missaoui, Nabiha;Abdelkarim, Soumaya Ben;Mokni, Moncef;Hmissa, Sihem
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10803-10808
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    • 2015
  • Background: The role of $p16^{INK4A}$ expression in uterine cervix cancer is well established. In the remaining female lower genital tract cancers, the importance of $p16^{INK4A}$ up-regulation is less clear. In our study, we analyzed the role of $p16^{INK4A}$ expression and HPV infection in carcinomas of the vulva and the vagina in Tunisian women. Materials and Methods: We conducted a retrospective study of 30 carcinomas including 15 vulvar squamous cell carcinomas (SCCs) and 15 vaginal SCCs. Immunohistochemistry was used to determine $p16^{INK4A}$ expression. HPV detection and typing was by in situ hybridization. Results: $p16^{INK4A}$ expression was detected in 86.7% of vaginal SCCs with a strong and diffuse immunostaining in 60% of cases, and also in 73.3% of vulvar SCCs with focal immunoreactivity in 53.3% The association between $p16^{INK4A}$ expression and HPV infection was significant in vaginal SCCs (p=0.001) but not vulvar SCCs (p>0.05). Conclusions: $p16^{INK4A}$ expression could be used as a useful marker for HPV positivity in vaginal SCCs similar to that described in uterine cervix cancers. However, our data support the presence of 2 different mechanisms for $p16^{INK4A}$ expression in HPV-related and HPV-unrelated vulvar carcinomas.

Opportunistic Screening for Cervical Cancer in a Tertiary Hospital in Karnataka, India

  • Kulkarni, Padmaja Ramesh;Rani, Hephzibah;Vimalambike, Manjunath Gubbanna;Ravishankar, Sunila
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5101-5105
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    • 2013
  • The incidence and mortality of cervical cancer remains high in India even after sixty years of introduction of the Pap smear (cervical cytology) which is an effective means of identifying preinvasive lesions of carcinoma cervix. The morbidity and mortality due to cervical cancer has come down drastically in countries with well established screening programmes at national level. This study aims at screening women for cervical cancer opportunistically during their visit to hospital and to study various types of neoplastic and non-neoplastic lesions of the cervix by cervical smear study (Pap smear study). In the present study, a total of 350 cervical smears were studied. The age of patients ranged from 19 years to 80 years with mean age being 37.5 years. Out of 350 cases, the diagnosis of neoplasia was given in 43 cases and 258 cases were diagnosed as inflammatory smears. Forty-cases were normal and 9 cases were inadequate to evaluate. Forty-three patients who were found to have neoplastic lesions on cytology were referred for further investigations like colposcopy and biopsy to confirm the diagnosis and avail proper treatment. Limitation of the present study was small sample size as all female patients aged between 20 and 60 years visiting hospital were not included in the screening, other screening tests like VIA (visual inspection with acetic acid test) and HPV DNA (human papilloma virus) tests were not done. Until the time centrally organised screening programmes for cervical cancer are established in India, arrangements should be made for hospital based opportunistic screening for all women attending hospital. The cost effectiveness of different screening tests for cervical cancer should be evaluated.

Uterine Involution and Ovarian Follicular Growth during Early Postpartum Period of Murrah Buffaloes (Bubalus bubalis)

  • Lohan, I.S.;Malik, R.K.;Kaker, M.L.
    • Asian-Australasian Journal of Animal Sciences
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    • v.17 no.3
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    • pp.313-316
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    • 2004
  • Ultrasonographic studies were conducted on eight Murrah buffaloes daily from day 6 postpartum (pp) onwards till day 77 pp to monitor changes in the cervix, uterine horn and ovarian follicular growth and development. The mean size of horn and cervix on day six ($9.07{\pm}0.74$ and $8.58{\pm}0.00cm$) decreased significantly to $4.09{\pm}0.09$ and $3.56{\pm}0.08cm$ by day 27 pp, respectively. Follicles in 50% of the buffaloes ovulated within 24 to 54 days pp and the size of the largest follicle on different days increased to more than 5 mm. The remaining 50 percent of animals ovulated after 65 days postpartum. Large size follicles (>8.5 mm) appeared in six out of eight buffaloes between 10 to 30 days pp and five animals had ovulated during early postpartum period. Waves pattern of follicular growth was observed during early postpartum period. Ovulatory follicles growth rate was more than the anovulatory follicles and increase in size was more as compared to the subordinate follicle. Anovulatory follicles persisted for longer period. Mean size of large follicle was more from day 6 to 41 pp and again from 50 to 65 pp in cyclic animals. Second large follicle were large during early postpartum (18days), thereafter, its size was more in acyclic animals. Small follicles population was less in cyclic animals upto day 50 postpartum. Mean medium size follicle growth pattern did not differ in cyclic and acyclic groups. Large size follicle number was more in cyclic group (5/8) during 14 to 20 days postpartum. Presence of large follicles (>8.5 mm) showed initiation of ovarian activity.

Cytologic Features of Papillary Immature Metaplasia of Uterine Cervix (유두상 미성숙 화생의 자궁경부 세포진 소견)

  • Kim, Hye-Sun;Seon, Mee-Im;Kim, Yee-Jung;Kim, Hy-Sook
    • The Korean Journal of Cytopathology
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    • v.13 no.1
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    • pp.21-27
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    • 2002
  • Papillary immature metaplasia (PIM) of the uterine cervix (Immature condyloma) is a subset of low grade squamous intraepithelial lesion (LSIL) which is frequently associated with human papilloma virus (HPV) types 6 and 11. The histologic features of PIM include filiform papillae lined by evenly spaced immature metaplastic-type cells with frequent nucleoli, mild anisokaryosis, and a low mitotic index. To characterize the cytologic changes associated with PIM, we analyzed 14 cases of PIM from our file. We reviewed biopsy slides and the cervicovaginal smears taken proximate to the time of blopsy. Histologically, nine cases had either flat condyloma (7 cases) or high grade squamous intraepithelial lesion (HSIL) (2 cases). Cytologic changes included cells in various stages of maturation with karyomegaly (14 cases), cells with irregularities in the nuclear membrane (13 cases), intermediate cells with karyomegaly(13 cases), cells with binucleatlon (13 cases), and aborted koliocytes (11 cases) Cervicovaginal smears from all cases were interpreted as atypical squamous cells of undetermined significance (ASCUS), NOS or ASCUS, rule out squamous intraepithelial lesion (SIL) or LSIL in two cases with flat condyloma or HSIL in a case with severe dysplasia. PIM is a distinct histologic entity that can present with a spectrum of cytologic findings, but cytologic findings may resemble variable reactive conditions and immature HSIL. Therefore, it is difficult to diagnose PIM by cytology alone. However, the meticulous efforts for making the cytologic diagnoses which can Induce active management of patients are recommended because PIM is a variant of LSIL and frequently has a flat condyloma or HSIL.

Discrepancies Between Public Perceptions and Epidemiological Facts Regarding Cancer Survival Rate in Korea : An Online Survey (암 생존율에 대한 한국 대중의 인식과 역학적 사실 사이에서 발생하는 불일치 : 온라인 설문을 중심으로)

  • Kim, Jae-Woo;Kang, Jung-Kyu;Kim, Sung-Ho
    • The Journal of the Korea Contents Association
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    • v.17 no.1
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    • pp.113-119
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    • 2017
  • This study aims at investigating which factors affect the public perceptions of the survival rate of cancer. To this end, this study compares the public perception for 5-year survival rates of five major cancer(stomach, colorectal, liver, breast, uterine cervix) and actual epidemiological fact thereof. Data was collected from 19th to 24th April 2016 through online cross-sectional survey on 354 people. Frequency analysis was conducted to understand the characteristics of the subjects, histograms were presented for the comparison with the epidemiological fact, and multiple regression analysis was conducted. The subjects tended to aware the survival rates of stomach cancer, colorectal cancer, breast cancer, and uterine cervix cancer as lower than they epidemiologically represented. Finally, the factors that substantially affect the perception of 5-year survival rates were revealed as the experience of diagnosed as cancer, the age, and whether the subject regularly involved in a workout.

A Study on Automatic Detection of Uterine' Cervical Pap- Smears by Image Processing (영상처리를 이용한 자궁경부 세포진의 자동탐색 방법에 관한 연구)

  • Un, Sung-Kyung;Park, Chan-Mo;Park, Hwa-Choon;Yoon, So-Young;Cho, Min-Sun;Cho, Soo-Yeon;Kim, Sung-Sook
    • The Korean Journal of Cytopathology
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    • v.5 no.1
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    • pp.15-22
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    • 1994
  • Cancer of the cervix is the most common malignancy in women in developing countries and the second most common cancer in women throughout the world with approximately 500,000 new cases each year. Prevention of this large number of premature deaths among women is, therefore, a goal worthy of urgent and serious consideration. Due to its high diagnostic disagreement among pathologists and large quantity of specimens, it is necessary to develop an automatic screening system measuring morphologic and densitometric features of the samples. Many research works have been published but most of them used Feulgen stained specimens which are not a usual staining method used in clinics. In this thesis, an automatic cancerous nucleus detection method essential to a screening system with papanicolaou stained specimens called Pap-smear is proposed which employs image processing techniques. It uses edge information to segment objects and morphologic as well as densitometric information to distinguish cancerous nuclei from dirts or normal nuclei. It has produced useful results in our study.

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STRESS ANALYSIS ON THE ALVEOLAR BONE OF CANTILEVER BRIDGES REPLACING MAXILLARY LATERAL INCISOR (상악측절치 수복을 위한 Cantilever bridge)

  • Kim Hyoung-Soo;Yang Hong-So
    • The Journal of Korean Academy of Prosthodontics
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    • v.31 no.3
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    • pp.303-316
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    • 1993
  • The purpose of this study was to analysis the stress distribution induced by three unit PFM bridges and various cantilever bridges replacing maxillary latersal incisor. The simplified two-dimensional photoelastic models used for this study was contructed in the folio- wing way. CR/R ratio was designed to be 1 : 1, 1 : 1.25 and 1 : 1.5. The pontics of cantilever bridge supported by maxillary canines consisted of wrap-around type, rest-extension type, and simple type. 3-unit PFM bridge was constructed with traditional method. 1kg vertical static load was applied on the center of the incisal edge of the pontic. The stress pattern was examined and recorded by photography. The results obtained were as follows ; 1. The magnitude of stress on the abutment root apex area of a traditional 3-unit bridge was the lowest. 2. The model of cantilevered pontic with a rest showed the relatively well distributed stress around the abutment tooth. The model with simple pontic generated the greatest stress concentration in the supporting structure of the abutment tooth. 3. As the height of bone level reduced, the rotational and vertical force increased around the abutment tooth. 4. The stress concentration of the 3-unit bridges occured on the root apex and stress concentration of the cantilever briage occured on the root apex and cervix area, 5. In the case of the cantilever bridge, stress concentrated distally on the root apex area of the abutment tooth and additional stress was observed mesially on the upper part of the root. Especially in the case of the simple pontic, was phenomenon was more apparent than the others. 6. Force applied to cantilevered pontic was transmitted to the adjacent central incisor through the contact surface. Stress was markedly observed on the mesial cervix area in the case of simple pontic and on the root apex area in the case of wrap-around type and rest-extension type.

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