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Sample records for pap smear screening

  1. Pap smear

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    ... AGUS - Pap; Atypical squamous cells - Pap; HPV - Pap; Human papilloma virus - Pap cervix - Pap; Colposcopy - Pap Images Female reproductive anatomy Pap smear Uterus Pap smear Cervical erosion References ...

  2. [Pap smear for mass screening: Results of an African experiment].

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    Somé, O-R; Zongo, N; Ka, S; Wardini, R; Dem, A

    2016-06-01

    To assess the impact of smear test in the fight against cervix uteri cancer in Senegal. This was a descriptive cross-sectional study of 1836 Pap smears performed in patients over 15 years during several screening campaigns in Senegal conducted between June 2010 and June 2012. We analyzed epidemiological data, pathological smears, and the proposed management. In 69% of cases, the women were less than 45 years old. They were mostly multiparous and did not use contraceptive methods before. The smears were interpreted in 91.4% (n=1661) and were pathological in 5.2% of cases. They revealed mainly atypical squamous cells of undetermined significance, squamous intraepithelial low-grade lesions, and squamous intraepithelial high-grade lesions, respectively in 2.5% (n=46), 1.7% (n=30) and 1% (n=19) of cases. Multiparity, early marriages were the main risk factors. Patients with pathological smars had colposcopy with cryotherapy (23 cases), and colposcopy and biopsy (13 cases). A hysterectomy was performed in 4 cases. The pathological smear rate found in this study confirms the interest to continue cervical cancer screening with this practice. Strengthening of its geographical and financial access through a national prevention program will effectively help to lower cases of cervical cancer. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  3. Rate of Opportunistic Pap Smear Screening and Patterns of Epithelial Cell Abnormalities in Pap Smears in Ajman, United Arab Emirates

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    Al Eyd, Ghaith J.; Shaik, Rizwana B.

    2012-01-01

    Objectives: The aim of this study was to estimate the proportion of women undergoing Papanicolaou (Pap) smear examinations, and the frequency of epithelial cell abnormalities in a teaching hospital in one emirate of the United Arab Emirates (UAE) during a three-year period. Methods: A retrospective study of 602 patient records from July 2007 to July 2010 was done in a teaching hospital in Ajman, UAE. The variables studied were age, ethnicity, menopausal status, and abnormalities in the Pap smear. Data were analysed using the Statistical Package for the Social Sciences and presented mainly as percentages; to assess associations, the chi-square test was used. Results: The total number of outpatients who attended the Obstetrics & Gynaecology Department from July 2007 to July 2010 was 150,111 patients, of which 602 (0.4% of the total) had a Pap smear test. The sample was 50.1% Arabs and 49.9% other nationalities. While 73% of the outpatients had specific complaints, 27% came for a routine screening. Epithelial cell abnormalities were seen in 3.3% of the sample, with atypical squamous cells of undetermined significance (ASCUS) found in 1.8%, low-grade squamous intraepithelial lesions (LSILs) found in 1.2%, and high-grade squamous intraepithelial lesions (HSILs) found in 0.3%. There were no cases of squamous cell carcinoma. Conclusion: Voluntary routine Pap smear screening was remarkably low in the study group. ASCUS was the most common epithelial cell abnormality. Community health education and opportunistic screening for cervical cancer are recommended for both national and expatriate women in the region. PMID:23275844

  4. Rate of Opportunistic Pap Smear Screening and Patterns of Epithelial Cell Abnormalities in Pap Smears in Ajman, United Arab Emirates

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    Rizwana B. Shaik

    2012-11-01

    Full Text Available Objectives: The aim of this study was to estimate the proportion of women undergoing Papanicolaou (Pap smear examinations, and the frequency of epithelial cell abnormalities in a teaching hospital in one emirate of the United Arab Emirates (UAE during a three-year period. Methods: A retrospective study of 602 patient records from July 2007 to July 2010 was done in a teaching hospital in Ajman, UAE. The variables studied were age, ethnicity, menopausal status, and abnormalities in the Pap smear. Data were analysed using the Statistical Package for the Social Sciences and presented mainly as percentages; to assess associations, the chi-square test was used. Results: The total number of outpatients who attended the Obstetrics & Gynaecology Department from July 2007 to July 2010 was 150,111 patients, of which 602 (0.4% of the total had a Pap smear test. The sample was 50.1% Arabs and 49.9% other nationalities. While 73% of the outpatients had specific complaints, 27% came for a routine screening. Epithelial cell abnormalities were seen in 3.3% of the sample, with atypical squamous cells of undetermined significance (ASCUS found in 1.8%, low-grade squamous intraepithelial lesions (LSILs found in 1.2%, and high-grade squamous intraepithelial lesions (HSILs found in 0.3%. There were no cases of squamous cell carcinoma. Conclusion: Voluntary routine Pap smear screening was remarkably low in the study group. ASCUS was the most common epithelial cell abnormality. Community health education and opportunistic screening for cervical cancer are recommended for both national and expatriate women in the region.

  5. Comparison of visual inspection of cervix and pap smear for cervical cancer screening

    International Nuclear Information System (INIS)

    Tayyeb, R.; Khawaja, N.P.; Malik, N.

    2003-01-01

    Objective: To evaluate the performance of visual inspection of cervix (VIA) after application of 3% acetic acid in cervical cancer screening in comparison with PAP smear. Results: Out of 540 subjects, 356 were negative with both screening techniques. One hundred and fifty-six subjects were positive with VIA (28.9%) while PAP smear was positive in seventy-eight subjects (14.4%). The sensitivity of VIA was 93.9% and of PAP smear was 46.9%. Corresponding specificities were 30.4% and 69.5%. There was no significant difference between the positive predictive value (PPV) of both test (p<0.05). The accuracy of VIA was 77.5% compared to 52.8% of PAP smear. The difference was highly significant (p < 0.01). Conclusion: These results indicate that VIA is more sensitive and has a higher accuracy as compared to PAP smear. It could, therefore, be valuable in detection of precancerous lesions of cervix. Low cost, easy applicability and immediate results make VIA a useful screening test in developing countries like Pakistan as compared to PAP smear. (author)

  6. Comparison of Pap smear screening results between Akha hill tribe and urban women in Chiang Rai province, Thailand.

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    Kritpetcharat, Onanong; Wutichouy, Wiwat; Sirijaichingkul, Suchat; Kritpetcharat, Panutas

    2012-01-01

    Cervical cancer is an important woman's health problems worldwide, especially in low socio-economic countries. The aim of this study was to compare the Pap smear screening results between Akha hill tribe and urban women who live in Chiang Rai province, Thailand. Screening was conducted for 1,100 Akha women and 1,100 urban women who came to have the Pap smear at Chiangrai Prachanukroh Hospital and 1 private cytology laboratory from January to June 2008. The demographic characteristics and factors related to abnormal Pap smears of these women were gathered using closed model questionnaires. Abnormal Rap smears were defined according to the Bethesda 2001 system. The results showed that the prevalence of abnormal Pap smears was 12.2% in Akha women and 4.5% in urban women. The highest prevalence of Pap abnormalities was found in the 41-50 years age group in both populations (4.5% in Akha and 1.7% in urban women). In both populations, abnormal Pap smears were found in education level. In conclusion, cervical cancer control by education and early detection by Pap smear screening is necessary for hill tribe women. More Pap smear screening service units should be set to improve the coverage for the risk group women who got married in young age, especial in ethnic groups.

  7. A Study on Cervical Cancer Screening Using Pap Smear Test and Clinical Correlation

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    Pushp Lata Sachan

    2018-01-01

    Full Text Available Objective: The objective of the study is to evaluate the use of the Pap smear screening method for detection of precancerous lesions. Methods: All women who visited the outpatient gynecology clinic of the Department of Obstetrics and Gynaecology at King Georges Medical University, Lucknow, UP, India, over 1 year for different clinical problems were recruited for the study. A total of 1650 women who were sexually active and over 21 years of age were enrolled in the study. A clinical examination, an examination per speculum, and a vaginal examination were performed and a history taken for all women. A Pap smear was used for all women to screen for cervical cancer. The smear was obtained using an Ayre spatula and spread over a marked glass slide, which was placed in 95% ethyl alcohol and sent to the Department of Pathology for cytopathological examination. All data were recorded using a predetermined pro forma. Women who had visible malignant cervical lesions were excluded from the study. Results: Most women were in the age range of 30–50 years and multiparous. Vaginal discharge was the most common complaint, occurring in 36.96% of the women. An irregular menstrual cycle was the complaint of 12.78% and abdominal pain of 25.63% of women, while 15.15% were asymptomatic. The Pap smear test of 93.57% of the women was adequately taken, while 6.42% of the individuals had an inadequate sample. The test was negative for malignancy in 48.84%, and 42.66% had infection or inflammation. Atypical squamous cells of undetermined significance (ASCUS, low-grade squamous intraepithelial lesion (LSIL, and high-grade squamous intraepithelial lesion (HSIL were detected in 2.90%, 5.09%, and 0.48%, respectively. Women with Pap tests positive for ASCUS, LSIL, and HSIL underwent a colposcopy and guided biopsy. Conclusions: Women with an abnormal Pap test should undergo a colposcopy, and those with abnormal colposcopy findings should be advised to undergo a biopsy. A Pap

  8. Cervical cancer screening attitudes and beliefs of Malaysian women who have never had a pap smear: a qualitative study.

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    Wong, L P; Wong, Y L; Low, W Y; Khoo, E M; Shuib, R

    2008-01-01

    Attitudes toward cervical cancer and participation in early detection and screening services are well known to be profoundly affected by cultural beliefs and norms. This study explored the attitudes and sociocultural beliefs on cervical cancer screening among Malaysian women. In this qualitative study, in-depth interviews were conducted with 20 Malaysian women, ages 21 to 56 years, who have never had a Papanicolaou (Pap) smear. Respondents generally showed a lack of knowledge about cervical cancer screening using Pap smear, and the need for early detection for cervical cancer. Many believed the Pap smear was a diagnostic test for cervical cancer, and since they had no symptoms, they did not go for Pap screening. Other main reasons for not doing the screening included lack of awareness of Pap smear indications and benefits, perceived low susceptibility to cervical cancer, and embarrassment. Other reasons for not being screened were related to fear of pain, misconceptions about cervical cancer, fatalistic attitude, and undervaluation of own health needs versus those of the family. Women need to be educated about the benefits of cervical cancer screening. Health education, counseling, outreach programs, and community-based interventions are needed to improve the uptake of Pap smear in Malaysia.

  9. Perception and Experience of Primary Care Physicians on Pap Smear Screening for Women with Intellectual Disabilities: A Preliminary Finding

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    Lin, Jin-Ding; Sung, Chang-Lin; Lin, Lan-Ping; Liu, Ta-Wen; Lin, Pei-Ying; Chen, Li-Mei; Chu, Cordia M.; Wu, Jia-Ling

    2010-01-01

    This study aims to establish evidence-based data to explore the perceptions and experience of primary care physicians in the Pap smear screening provision for women with intellectual disabilities (ID), and to analyze the associated factors in the delivery of screening services to women with ID in Taiwan. Data obtained by a cross-sectional survey…

  10. The Effect of an Educational Program Based on Protection Motivation Theory on Pap Smear Screening Behavior among Women Referring to Health Centers in Fasa

    OpenAIRE

    Zahra Khiyali; Leila Ghahremani; Mohammad Hossein Kaveh; Sareh Keshavarzi

    2017-01-01

    Background and Objectives: Despite the importance of pap smear in reducing the incidence of cervical cancer and its death, this cancer is still one of the leading causes of death among women around the world. Accordingly, in this study, we aimed to determine the effect of an educational program based on the protection motivation theory on Pap smear screening behavior. Materials and Methods: This quasi-experimental study was conducted on 200 women referring to Fasa health centers, Fasa, Ira...

  11. Knowledge, attitude and practice of cervical cancer screening (pap smear) among female nurses in Nnewi, South Eastern Nigeria.

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    Udigwe, G O

    2006-06-01

    To determine the knowledge and practice of cervical cancer screening among practicing female nurses with a view to sensitizing them as a first step towards increasing screening uptake in the community. A self administered questionnaire survey of all the female nurses working in Nnamdi Azikiwe university Teaching Hospital Nnewi center. 144 out of 166 questionnaires were correctly completed and returned. 122 (87%) were aware of the existence of screening services. Although 9.3% had lost relations to cancer of the cervix, only 5.7% had ever undergone a pap smear. While 52 (37.1%) had no reason for not screening, 21 (15%) were afraid of the possible outcome and 35 (25%) felt they were not likely candidates for cancer of the cervix. knowledge of cervical cancer screening services among female nurses in Nnewi is high while uptake rate is abysmally poor. There is need to further educate the nurses who will play a major role in enlightening the public on the availability and need for cervical screening services.

  12. [Verification of doubtful PAP smear results of women included in the screening program in the Podlaskie province].

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    Błońska, Ewa; Knapp, Piotr Andrzej

    2013-08-01

    Verification of uncertain PAP-smear results in a group of women covered by the cervical screening program in the Podlaski province. The main aim of the study was to identify CIN (Cervical Intraepithelial Neoplasia) lesions present, with varying degrees of severity in women with cytological diagnosis of ASCUS (atypical squamous cells of undetermined significance), LSIL (low grade squamous intraepithelial lesion), and ASC-H (atypical squamous cells - cannot exclude high grade squamous intraepithelial lesion). The study evaluated 101 cervical smears taken from the vaginal part of the cervix in a group of screened women in the Podlaski province. Cytological evaluation was performed according the Bethesda System. We analyzed abnormal smears selected from a total of 7296 cytological examinations performed during 2012 at the University Center for Pathomorphological and Genetic - Molecular Diagnosis, Medical University in Białystok. The cytological results which were of interest to us included 19 cases with ASCUS, 59 with LSIL, and 23 with ASC-H, as well as with morphological features of the presence of Human Papilloma Virus (HPV). Staining was performed using CINtecPLUS test according to the manufacturer's instructions. CINtecPLUS is a immunocytochemical test based on specially designed monoclonal antibodies (E6H4TM) that let us identify protein p16ink4a within the cervical smear Additionally the diagnostic kit was provided with antibodies for diagnosing the presence of Ki-67 protein, a known marker of cell proliferation. The result was considered positive when staining of the nucleus and the cytoplasm appeared in red and brown, respectively. All abnormal results were eventually verified by histological examination of the tissue taken from cervical lesions by diagnostic-therapeutic procedure following colposcopic evaluation of cervical lesion topography In the group of cytological smears with ASCUS, the diagnosis was positive in 5 cases (26.3%), negative in 14 (73

  13. Inequity of healthcare utilization on mammography examination and Pap smear screening in Thailand: Analysis of a population-based household survey.

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    Sukanya Chongthawonsatid

    Full Text Available Healthcare in Thailand is not equally distributed, and not all people can equally access healthcare resources even if they are covered by health insurance. To examine factors associated with the utilization of mammography examination for breast cancer and Pap smear screening for cervical cancer, data from the national reproductive health survey conducted by the National Statistical Office of Thailand in 2009 was examined. The survey was carried out on 15,074,126 women aged 30-59 years. The results showed that the wealthier respondents had more mammograms than did the lower-income groups. The concentration index was 0.144. The data on Pap smears for cervical cancer also showed that the wealthier respondents were more likely to have had a Pap smear than their lower-income counterparts. The concentration index was 0.054. Determinants of mammography examination were education, followed by health welfare and wealth index, whereas the determinants of Pap smear screening were wealth index, followed by health welfare and education. The government should support greater education for women because education was associated with socioeconomic status and wealth. There should be an increase in the number of screening campaigns, mobile clinics, and low-cost mammograms and continued support for accessibility to mammograms, especially in rural areas and low-income communities.

  14. Factors related to the practice of breast self examination (BSE and Pap smear screening among Malaysian women workers in selected electronics factories

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    Shamsuddin K

    2003-05-01

    Full Text Available Abstract Background The Malaysian Ministry of Health promotes breast self-examination (BSE for all women, and Pap smear screening every three years for all sexually active women ages 20 years and above. The objectives of this paper were to examine the practice of these two screening tests among women production workers in electronics factories, and to identify factors related to practice. Methods This was a cross-sectional survey of women production workers from ten electronics factories. Data was collected by a self-administered questionnaire from a total of 1,720 women. The chi-square test, odds ratio and binomial logistic regression were used in bivariate and multivariate analysis. Results Prevalence rates were 24.4% for BSE once a month, and 18.4% for Pap smear examination within the last three years. Women who were significantly more likely to perform BSE every month were 30 years and older, Malays, with upper secondary education and above, answered the BSE question correctly, and had a Pap smear within the last three years. The proportion of women who had a Pap smear within the last three years were significantly higher among those who were older, married, with young children, on the contraceptive pill or intra-uterine device, had a medical examination within the last five years, answered the Pap smear question correctly, and performed BSE monthly. Conclusion Screening practice rates in this study were low when compared to national rates. Socio-demographic and health care factors significantly associated with screening practice are indicative of barriers which should be further understood so that more effective educational and promotional strategies could be developed.

  15. Self-Reports of Pap Smear Screening in Women with Physical Disabilities

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    Lin, Jin-Ding; Chen, Shih-Fan; Lin, Lan-Ping; Sung, Chang-Lin

    2011-01-01

    We collected self reported rate of cervical smear testing to examine the affecting factors in women with physical disabilities in the study, to define the reproductive health care for this group of people. The study population recruited 521 women with physical disabilities aged more than 15 years who were officially registered as having physical…

  16. Cervical pap smear- A prospective study in a tertiary hospital

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    S Pudasaini

    2015-09-01

    Full Text Available Background: Cervical cancer is a leading cause of mortality and morbidity among women worldwide and most common gynaecological cancer in developing countries. Papanicolaou smear is a simple and cost effective screening test for cervical cancer. The aim of this study is to evaluate and interpret the cervical pap smear cytology in a tertiary hospital. The interpretation and reporting of the pap smear is based on 2001Bethesda system.Materials and methods: This is a prospective study conducted in a tertiary hospital, Nepal Medical College over a period of two and a half years (January 2013 to June 2015. All cervical pap smears received in the department of Pathology in the study period were included.Results: A total of 4160 cervical pap smears were reported in the study period. Majority of the cases were Negative for Intraepithelial lesion or malignancy (87.9%. Bacterial vaginosis, atrophy and reactive cellular changes associated with inflammation were seen in 5.3%, 2.4% and 1.5% cases respectively.   Epithelial cell abnormalities (0.5% include Atypical squamous cells of undetermined significance, Low grade squamous intraepithelial lesion and High grade intraepithelial lesion. 88% of Low grade squamous intraepithelial lesion was seen in reproductive age group (20-45 years.Conclusion: Cervical cancer is the most common gynaecological cancer in the developing countries. Pap smear is the simple and cost effective screening tool to detect pre invasive cervical epithelial lesions.

  17. COMPUTER AIDED DIAGNOSIS FOR DETECTION AND STAGE IDENTIFICATION OF CERVICAL CANCER BY USING PAP SMEAR SCREENING TEST IMAGES

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    S. Athinarayanan

    2016-05-01

    Full Text Available The majority of the women of the world were affected by the disease of cervical cancer. As a result of this disease, their death rate was increase as hasty level. Hence so many number of research people was focused this notion as their research interest and also they have done so many number of solutions for finding this cancer by using some image processing technique and achieved a good results only in advanced and high cost techniques of LBC, biopsy or Colposcopy test Images. Therefore the reason, the authors have chosen this problem and also did not only to find whether the patient is affected by a cancer or not. In addition to the patient was affected by this cancer means and also to identify which severity stage of this disease the patient could be live. Then this work has done in based on the images of low cost pap smear screening test by using various image processing techniques with the help of Computerized Image Processing Software Interactive Data Language (IDL-Image Processing Language. Thus the final reports would be very useful to the pathologists for further analysis.

  18. Declining prevalence of cytological squamous intraepithelial lesions of the cervix among women living with well-controlled HIV - Most women living with HIV do not need annual PAP smear screening.

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    Aho, Inka; Kivelä, Pia; Haukka, Jari; Sutinen, Jussi; Heikinheimo, Oskari

    2017-11-01

    Cervical screening by means of annual Papanicolaou (PAP) smears has been recommended for all women living with HIV. We analysed the results of our annual PAP smear screening program to identify low-risk subgroups for less rigorous screening. The study comprised 369 women followed at the Helsinki University Hospital 2002-2013, with a total of 2033 PAP smear results. We analyzed the temporal changes in PAP smear findings. Logistic regression analysis for binominal dependent variables was used for assessing risk factors for ever having cytological squamous intraepithelial lesions (hereafter referred as SIL) using generalized estimating equations taking into account multiple observations of each patient. Most women had well-controlled HIV, especially towards the end of the study. PAP smear results improved substantially. At the time of each individual's last PAP smear, 90.0% of the findings displayed normal results. Conversely, the rate of SIL decreased from 16.8% to 4.6% from 2002 to 2013. In multivariate analysis the risk of SIL was significantly lower in women with consecutive normal PAP smear findings during the first two years of follow up [odds ratio (OR) 0.21, 95% confidence interval (CI) 0.10-0.45, p 500 cells/μL (OR 0.11, 95% CI 0.05-0.26, p < 0.001). Widespread use of combination antiretroviral therapy (cART) and systematic cervical screening has reduced the rate of abnormal PAP smears. It seems feasible to identify low-risk women by combining HIV-related information and PAP smear results. Screening low-risk women living with HIV at three-year intervals similar to HIV-negative women appears justified. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  19. The Effect of an Educational Program Based on Protection Motivation Theory on Pap Smear Screening Behavior among Women Referring to Health Centers in Fasa

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    Zahra Khiyali

    2017-03-01

    Full Text Available Background and Objectives: Despite the importance of pap smear in reducing the incidence of cervical cancer and its death, this cancer is still one of the leading causes of death among women around the world. Accordingly, in this study, we aimed to determine the effect of an educational program based on the protection motivation theory on Pap smear screening behavior. Materials and Methods: This quasi-experimental study was conducted on 200 women referring to Fasa health centers, Fasa, Iran. The participants were randomized into experimental and control groups (n=100 per group. The data collection tool, which consisted of demographic data and protection motivation theory constructs, was completed by both groups before and 2 months after the intervention. For the experimental group, the educational program was implemented during 4 sessions using group discussions and educational pamphlets. To analyze the data, chi-square test, independent t-test, and paired t-test were run in SPSS, version 22. Results: After the intervention, the mean scores of protection motivation theory constructs significantly increased in the experimental group compared to the control group (P<0.001. However, no significant difference was noted between the two groups regarding the response efficacy construct at the post-intervention stage (P=0.552. In addition, after the intervention, the rate of conducting Pap smear test significantly incremented in the experimental group (58%. Conclusions: The study results revealed the effectiveness of the educational intervention based on protection motivation theory in promoting Pap smear screening behavior. Therefore, we recommend designing educational interventions based on this theory to promote public health, especially in women.

  20. Factors affecting compliance with clinical practice guidelines for pap smear screening among healthcare providers in africa: systematic review and meta-summary of 2045 individuals.

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    Etienne Asonganyi

    Full Text Available Although the importance of the Pap smear in reducing cancer incidence and mortality is known, many countries in Africa have not initiated yet widespread national cervical cancer screening programs. The World Health Organization (WHO has published Clinical Practice Guidelines (CPGs on cervical cancer screening in developing countries; however, there is a gap between expectations and clinical performance. Thus, the aim of this study was to conduct a systematic review and meta-summary to identify factors affecting compliance with CPGs for Pap screening among healthcare providers in Africa.And Findings: MEDLINE, Scirus, Opengate and EMBASE databases were searched in January 2012. Studies involving medical personnel practicing in Africa, whose outcome measured any factors that affect medical personnel from using a Pap smear to screen for cervical cancer, were included. Two reviewers independently evaluated titles and abstracts, then full-texts, extracted data and assessed quality of the included studies. A descriptive analysis of the included studies was conducted. We calculated Frequency effect sizes (FES for each finding and Intensity effect sizes (IES for each article to represent their magnitudes in the analyses. Of 1011 studies retrieved, 11 studies were included (2045 individuals. Six different themes related to the factors affecting compliance with CPGs were identified: Insufficient Knowledge/Lack of awareness (FES = 82%, Negligence/Misbeliefs (FES = 82%, Psychological Reasons (FES = 73%, Time/Cost Constraint (FES = 36%, Insufficient infrastructure/training (FES = 45% and also no reason given (FES = 36%. IES for articles ranged between 33 and 83%.These results suggest that prevention initiatives should be comprehensive to include education and resources needs assessments and improvement, Pap smear test training, strategies on costing, and practitioner time studies.

  1. Papshop: Not a 'melon'choly Pap smear workshop!

    African Journals Online (AJOL)

    of cervical cancer will take several decades to be apparent. There are more effective ways of screening, such as HPV DNA testing,[2] ... ARTICLE. Papshop: Not a 'melon'choly Pap smear workshop! C Gordon, MB ChB, Diploma in HIV ...

  2. Cervical screening program and the psychological impact of an abnormal Pap smear: a self-assessment questionnaire study of 590 patients.

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    Thangarajah, Fabinshy; Einzmann, Thomas; Bergauer, Florian; Patzke, Jan; Schmidt-Petruschkat, Silke; Theune, Monika; Engel, Katja; Puppe, Julian; Richters, Lisa; Mallmann, Peter; Kirn, Verena

    2016-02-01

    Invasive cervical cancer is today the fourth most common cancer of women in western civilization. Screening programs have led to a continuously decrease. Nevertheless, both screening and a positive test result are known to be associated with a negative psychological impact. Screening programs in European countries differ and thus psychological impact might as well. The aim of this study was to evaluate the psychological impact of women with an abnormal Pap smear in a German cohort. Between July 2013 and May 2014, a self-assessment questionnaire was distributed to 595 patients that were referred to a special clinic for cervical dysplasia for further evaluation of an abnormal Pap smear. Patients were recruited in five different centers. Most patients (45.9 %) were informed about the test result via phone call by their doctor. 68.8 % of the patients felt anxious and 26.3 % even felt panic. After having talked to their physician, 51.4 % of our cohort still felt worried and only 24.4 % felt reassured. Concerning disease management, 48.4 % underwent a control Pap smear in 6 months. The preferred information source was the physician (63.9 %). Compared to the results in other European countries, our study cohort showed differences concerning age distribution, patients living in a partnership, number of children and especially disease management. Cancer screening itself and abnormal test results have an impact on patient's feelings. To reduce the psychological impact, patients need to be better informed about the risks and benefits of cancer screening programs and in case of cervical cancer screening about the meaning of an abnormal test result. Our results underline the importance of a trustful physician-patient relationship in that matter.

  3. STUDY OF CERVICAL PAP SMEAR STUDY AND ITS UTILITY IN CANCER SCREENING- AN EXPERIENCE IN A TERTIARY CARE HOSPITAL OF TRIPURA, NORTH EASTERN STATE OF INDIA

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    Sutanuka Khasnabish

    2017-06-01

    Full Text Available BACKGROUND Cancer of cervix is a global health problem and is a leading cause of morbidity and mortality of women in India. It is one of the most preventable and curable of all cancers. Simple, noninvasive screening procedures like Papanicolaou smears can help in detection and quick and effective timely treatment. The objective of the study is to assess the role of Pap smear in detecting premalignant, malignant and nonneoplastic lesions of cervix in our institute. MATERIALS AND METHODS This is a one year prospective and four year retrospective study of 1,349 women in age group of 20-80 years carried over a period of 5 years from January 2012-December 2016 in the cytology wing of Department of Pathology, Tripura Medical College. Patients clinically presenting with dyspareunia, postcoital bleeding, vaginal bleeding, frothy vaginal discharge with itching and pain in hypogastrium were included in the study. Samples were collected under direct vision of Cusco’s speculum and transferred to glass slides, fixed and stained by Papanicolaou stain and were examined and reported. Reporting was done as per Bethesda system. RESULTS A total of 1,349 number of cases were screened, out of which 639 number of patients had abnormal Pap smears and 13.63% had unsatisfactory or inadequate samples. LSIL was the most common premalignant lesion with 113 (8.37% number of cases, SCC in 39 (5.2% number of cases, ASCUS in 15 (1.11% and adenocarcinoma in 2 (0.14% number of cases. CONCLUSION It was found that premalignant and malignant lesion in cervix is not uncommon in our setup and Pap smear appears to be an elementary, economical, safe and yet highly sensitive screening test for early detection of various cervical lesions.

  4. Age distribution of abnormal pap smear in a secondary hospital in ...

    African Journals Online (AJOL)

    Age distribution of abnormal pap smear in a secondary hospital in south-west Nigeria. ... Objective: To determine the age distribution pattern of abnormal Paps smear in women in our environment in order to have a basis for the points of entry and exit for cervical cancer screening protocol. Materials and Method: In this ...

  5. Using probabilistic record linkage methods to identify Australian Indigenous women on the Queensland Pap Smear Register: the National Indigenous Cervical Screening Project.

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    Whop, Lisa J; Diaz, Abbey; Baade, Peter; Garvey, Gail; Cunningham, Joan; Brotherton, Julia M L; Canfell, Karen; Valery, Patricia C; O'Connell, Dianne L; Taylor, Catherine; Moore, Suzanne P; Condon, John R

    2016-02-12

    To evaluate the feasibility and reliability of record linkage of existing population-based data sets to determine Indigenous status among women receiving Pap smears. This method may allow for the first ever population measure of Australian Indigenous women's cervical screening participation rates. A linked data set of women aged 20-69 in the Queensland Pap Smear Register (PSR; 1999-2011) and Queensland Cancer Registry (QCR; 1997-2010) formed the Initial Study Cohort. Two extracts (1995-2011) were taken from Queensland public hospitals data (Queensland Hospital Admitted Patient Data Collection, QHAPDC) for women, aged 20-69, who had ever been identified as Indigenous (extract 1) and had a diagnosis or procedure code relating to cervical cancer (extract 2). The Initial Study Cohort was linked to extract 1, and women with cervical cancer in the initial cohort were linked to extract 2. The proportion of women in the Initial Cohort who linked with the extracts (true -pairs) is reported, as well as the proportion of potential pairs that required clerical review. After assigning Indigenous status from QHAPDC to the PSR, the proportion of women identified as Indigenous was calculated using 4 algorithms, and compared. There were 28,872 women (2.1%) from the Initial Study Cohort who matched to an ever Indigenous record in extract 1 (n=76,831). Women with cervical cancer in the Initial Study Cohort linked to 1385 (71%) records in extract 2. The proportion of Indigenous women ranged from 2.00% to 2.08% when using different algorithms to define Indigenous status. The Final Study Cohort included 1,372,823 women (PSR n=1,374,401; QCR n=1955), and 5,062,118 records. Indigenous status in Queensland cervical screening data was successfully ascertained through record linkage, allowing for the crucial assessment of the current cervical screening programme for Indigenous women. Our study highlights the need to include Indigenous status on Pap smear request and report forms in any

  6. Use of and attitudes and knowledge about pap smears among women in Kuwait.

    Science.gov (United States)

    El-Hammasi, Khadija; Samir, Ola; Kettaneh, Soania; Al-Fadli, Athari; Thalib, Lukman

    2009-11-01

    To estimate the lifetime prevalence of Pap smear among women in Kuwait and to assess their knowledge about and attitude toward Pap smears. This was a descriptive cross-sectional study using a multistage cluster sampling method. We interviewed 299 women attending polyclinics in Kuwait using a self-administered questionnaire. Factors related to history of having a Pap smear, knowledge level, and willingness to participate in a screening program were evaluated. The lifetime prevalence of Pap smear was found to be 37% (95% CI 33-43). Forty-four percent of women in our study had a Pap smear only once in their lives. History of having at least one Pap smear was significantly related to such factors as age, total family income, marital status, history of cervical infection, and knowledge. The level of knowledge about cervical cancer varied among the participants. Forty-six percent of women were uncertain about the symptoms of cervical cancer. About half the women recognized cervical infection, smoking, and having multiple sexual partners as risk factors for cervical cancer; however, only 10% recognized early sexual intercourse as a risk factor. Willingness to participate in a future screening program varied significantly according to educational level, employment status, and total family income. Although cervical cancer incidence and mortality are relatively low in Kuwait, they may be underreported in the absence of a screening program. Moreover, lifetime prevalence of having a Pap smear was found to be considerably lower in Kuwait compared with developed countries.

  7. High prevalence of abnormal Pap smears among young women co ...

    African Journals Online (AJOL)

    Standardised questionnaires were used to collect sociodemographic and clinical presentation data from women attending family planning and other reproductive health services. Pap smears were done using standard methods. Pap smear data were linked to HIV serostatus. Results. Four hundred and sixty-six women were ...

  8. The utilization and barriers of Pap smear among women with visual impairment.

    Science.gov (United States)

    Fang, Wen-Hui; Yen, Chia-Feng; Hu, Jung; Lin, Jin-Ding; Loh, Ching-Hui

    2016-04-12

    Many evidences illustrate that the Pap smear screening successfully reduces if the cervical cancer could be detected and treated sufficiently early. People with disability were higher comorbidity prevalence, and less likely to use preventive health care and health promotion activities. There were also to demonstrate that people with visual impairment has less access to appropriate healthcare services and is less likely to receive screening examinations. In Taiwan, there was no study to explore utilization of Pap smear, associated factors and use barriers about Pap smear screening test among women with visual impairment. The purpose is to explore the utilization and barriers of using Pap smear for women with visual impairment in Taiwan. To identify the barriers of women with visual from process of receiving Pap smear screening test. The cross-sectional study was conducted and the totally 316 participators were selected by stratified proportional and random sampling from 15 to 64 year old women with visual impairment who lived in Taipei County during December 2009 to January 2010. The data was been collected by phone interview and the interviewers were well trained before interview. The mean age was 47.1 years old and the highest percentage of disabled severity was mile (40.2 %). Totally, 66.5 % of participators were ever using Pap smear and 38.9 % used it during pass 1 year. Their first time to accept Pap smear was 38.8 year old. There was near 50 % of them not to be explained by professionals before accepting the Pap smear. For non-using cases, the top two percentage of barriers were "feel still younger" (22.3 %), the second was "there's no sexual experience" (21.4 %). We found the gynecology experiences was key factor for women with visual impairment to use Pap smear, especially the experiences was during 1 year (OR = 4). Associated factors and barriers to receive Pap smear screening test for women with visual impairment can be addressed through interventions

  9. Pap smears for men: a vision of the future?

    LENUS (Irish Health Repository)

    Oon, S F

    2012-02-01

    BACKGROUND: Anal intraepithelial neoplasia (AIN) rarely receives as much publicity as its neighbouring orifice, the cervix. As in the cervix, intraepithelial neoplasias are precursors to cancer in the anal canal. AIN and cervical interstitial neoplasia (CIN) undergo dysplasia as a consequence of human papillomavirus (HPV) infection. Since the advent of screening with the Pap smear in CIN, cervical cancer has plummeted to a fifth of its initial incidence. Anal cancer, however, has been rising, with a predilection for human immunodeficiency virus-infected men. HPV causes a squamous epithelial dysplasia and converts healthy tissue into AINs of increasing severity until anal cancer manifests. CLINICAL CASE: This article describes a clinical case of anogenital HPV infection refractory to medical and surgical therapy. It also describes an effective surgical excision technique associated with a good cosmetic outcome. CONCLUSIONS: The paper concludes by briefly discussing the implications of a national screening programme against AIN in the future.

  10. Variability Study between Pap Smear, Colposcopy and Cervical Histopathology Findings

    International Nuclear Information System (INIS)

    Akhter, S.; Bari, A.; Hayat, Z.

    2015-01-01

    Objective: To determine the agreement/variability between colposcopic findings, Pap smear cytology and histopathological diagnosis in gynaecology patients. Methods: The cross-sectional cohort study was conducted from October 2010 to September 2011 at the Fauji Foundation Hospital, Rawalpindi, and comprised women who presented to the out-patient department with various gynaecological complaints. Colposcopy was performed in all women with unhealthy cervix during gynaecological examination, abnormal Pap smear report, recurrent vaginal discharge and postcoital bleeding. Pap smear was performed before colposcopy if not done earlier. Colposcopic findings were recorded on a specially-designed proforma. Biopsies from abnormal areas were taken and sent for histopathology. Colposcopic findings were compared with histopathology and Pap smear reports The agreement between the methods was evaluated by using Kappa coefficient and chi square test at a significance level of 5 percent. Results: The mean age of the 143 women was 44 8.5 years (range: 25-72 years). Colposcopic findings were normal in 66(46 percent) women, while 77(54 percent) had abnormal findings and among the latter, 62(80.5 percent) had abnormal histopathology, indicating strong agreement (K=0.65; p<0.001). Pap smear report was abnormal in 48(33.5 percent) cases and among them histopathology was abnormal in 28(58 percent). In the remaining 95(66.4 percent) patients with normal Pap smear, histopathology was abnormal in 44((46 percent), indicating weak agreement between Pap smear and histopathological diagnosis (K=0.10; p=0.08). Conclusion: There was a strong agreement between colposcopic findings and histopathological diagnosis. However, agreement between cytological findings and colposcopic findings and cytology and histopathological diagnosis remained weak. (author)

  11. Modifying and Pilot Testing the Pap Smear Belief Questionnaire

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    Kelly Ackerson

    2014-12-01

    Full Text Available This study is a report on modifications and pilot testing of a measurement tool to predict Pap testing based on the Interaction Model of Client Health Behavior. Women have been found to avoid routine cervical cancer screening (CCS due to personal influencing factors. For this study, the Pap Smear Belief Questionnaire (PSBQ was modified by adding items and evaluated through content validity index (CVI = .89 and cognitive interviews (think-aloud protocol, resulting in a 31-item instrument with four subscales (Benefits, Barriers, Vulnerability, Experiences. Pilot testing the modified PSBQ was conducted at a local agency. Fifty-three women completed and returned the PSBQ, which had good internal consistency, with a Cronbach’s alpha coefficient of .81 (Benefits α = .51; Barriers α = .85; Vulnerability α = .78; Experiences α = .87. Test–retest reliability of the 31-item PSBQ was also good (.878. Univariate logistic regression indicated that the only significant predictor of seeking/avoiding routine screening by women’s background characteristics was social influence (p = .04. Subscales found to be significant predictors in Pap testing were Barriers (p = .003 and Gynecological Exam Experiences (p = .04. The refined 31-item PSBQ has good psychometric data supporting its use in predicting CCS. However, this research should be replicated in a larger sample enabling further validity and reliability testing of the PSBQ. Understanding women’s attitudes toward CCS will help health care providers, who deal with gynecological health, develop more effective screening programs and interventions facilitating better experiences for women contributing to an increase in routine screening.

  12. Missed Opportunities for Health Education on Pap Smears in Peru

    Science.gov (United States)

    Bayer, Angela M.; Nussbaum, Lauren; Cabrera, Lilia; Paz-Soldan, Valerie A.

    2011-01-01

    Despite cervical cancer being one of the leading causes of cancer-related deaths among women in Peru, cervical Pap smear coverage is low. This article uses findings from 185 direct clinician observations in four cities of Peru (representing the capital and each of the three main geographic regions of the country) to assess missed opportunities for…

  13. Pap-smear Benchmark Data For Pattern Classification

    DEFF Research Database (Denmark)

    Jantzen, Jan; Norup, Jonas; Dounias, Georgios

    2005-01-01

    This case study provides data and a baseline for comparing classification methods. The data consists of 917 images of Pap-smear cells, classified carefully by cyto-technicians and doctors. Each cell is described by 20 numerical features, and the cells fall into 7 classes. A basic data analysis in...

  14. Awareness and practice of cervical cancer and Pap smear testing in a teaching hospital in Tehran

    Directory of Open Access Journals (Sweden)

    Mansoureh Ghaoomi

    2016-06-01

    Full Text Available Background: Cervical cancer is known to be preventable because of long period of pre-invasive stage, availability of screening tools, and effective treatments for early invasive cervical lesions. Screening is main measures to prevent the disease and Pap smear is a screening strategy for cervical cancer. Current paper aimed to evaluate levels of awareness and practice regarding Pap smear screening among women aged between 20 to 65 years in Tehran (Iran. Methods: This was a descriptive-analytical study conducted in Tehran City of Iran in 2015 at Firoozgar Hospital. The research population included all married, widowed and divorced women aged 20-65 years. Data analysis was performed using the Pearson correlation and Student’s t-tests in SPSS, ver. 23 (Chicago, IL, USA. Results: Among 90 individuals who have fill questionnaire completely, 66.6% subjects had Pap smear tests. 40% of the individuals aged between 30 to 39 and the education level is distributed equally between Intermediate, Diploma and graduate and only 3 percent of them, continue their education to higher level. There was a significant relationship between the awareness of Pap smear and educational level (of both wives and husbands. The people who have graduate degree, have the best awareness. Working women revealed higher level of awareness about Pap smear. Shame and fear of taking the cancer were the most common reasons which lead to avoidance in doing the test by the women, while the most encouraging factors for performing the test were the information mostly provided by physicians and after that, the information provided by friends. Conclusion: The awareness of Pap smear test which was measured by weighting different questions in the questionnaire by experts, prove that the women aged above 39, have an average level of awareness of Pap smear test. Due to high prevalence of cervical cancer and prolonged pre invasive course, role of Pap smear for early diagnosis necessitate the use

  15. Knowledge and acceptability of pap smears, self-sampling and HPV vaccination among adult women in Kenya.

    Directory of Open Access Journals (Sweden)

    Anne F Rositch

    Full Text Available Our study aimed to assess adult women's knowledge of human papillomavirus (HPV and cervical cancer, and characterize their attitudes towards potential screening and prevention strategies.Women were participants of an HIV-discordant couples cohort in Nairobi, Kenya. An interviewer-administered questionnaire was used to obtain information on sociodemographic status, and sexual and medical history at baseline and on knowledge and attitudes towards Pap smears, self-sampling, and HPV vaccination at study exit.Only 14% of the 409 women (67% HIV-positive; median age 29 years had ever had a Pap smear prior to study enrollment and very few women had ever heard of HPV (18%. Although most women knew that Pap smears detect cervical cancer (69%, very few knew that routine Pap screening is the main way to prevent ICC (18%. Most women reported a high level of cultural acceptability for Pap smear screening and a low level of physical discomfort during Pap smear collection. In addition, over 80% of women reported that they would feel comfortable using a self-sampling device (82% and would prefer at-home sample collection (84%. Nearly all women (94% reported willingness to be vaccinated to prevent cervical cancer if offered at no or low cost.These findings highlight the need to educate women on routine use of Pap smears in the prevention of cervical cancer and demonstrate that vaccination and self-sampling would be acceptable modalities for cervical cancer prevention and screening.

  16. Pap Smear Abnormalities in Women Admitted to a Tertiary Health Center in Southeast Turkey

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    Alev Ozer

    2014-12-01

    Full Text Available Aim: To analyze the cervical cytological abnormalities which are detected in women undergoing Pap screening in a tertiary health care center within Siirt, a southeastern province of Turkey. Material and Method: A total of 3000 women who underwent Pap screening at the study center between January 1, 2009 and December 31, 2009 were recruited for the study. The women who were diagnosed with benign epithelial changes, infectious alterations, as well as atypical squamous cells with undetermined significance (ASC-US, atypical squamous cells of high significance (ASC-H, and low-grade squamous intraepithelial lesion (LSIL were included. Results: Benign epithelial alterations, infectious changes, ASCUS, ASC-H, and LSIL were detected in 83.7%, 15.3%, 0.8%, 0.1% and 0.1% of the Pap smears respectively. A significant correlation was found between the patient age and the histopathological alterations in the Pap smears (r=0.072, p=0.001. Although no correlation could be detected between gravidity and Pap smear results (r=0.033, p=0.067, a significant correlation existed between parity and the histopathological findings within the Pap smears (r=0.051, p=0.005. Interestingly, the Pap smear results were found to be unrelated to socioeconomic status (r=0.088, p=0.168, education level (r=0.048, p=0.257, and smoking habit (r=0.086, p=0.077. Discussion: The present study has reported a value of 1.0% for the overall prevalence of cervical cytological abnormalities, which is much lower than in western countries. Thus, rather than being dependent on the data reported by clinical studies that have been conducted in western countries, Turkish health care policy should be based on the data obtained from national studies.

  17. HPV vaccination among French girls and women aged 14-23 years and the relationship with their mothers' uptake of Pap smear screening: a study in general practice.

    Science.gov (United States)

    Lutringer-Magnin, D; Cropet, C; Barone, G; Canat, G; Kalecinski, J; Leocmach, Y; Vanhems, P; Chauvin, F; Lasset, C

    2013-10-25

    HPV vaccination is recommended in France for girls aged 14 and for those aged 15-23 before sexual debut or who have become sexually active within the previous year. The first aim was to describe vaccination practice among 14-23-year-old girls visiting a general practitioner. A second objective was to investigate factors associated with starting vaccination among girls aged 14-18, in particular the regular practice of Pap-smear screening (PSS) by their mothers. A cross-sectional study was conducted from June to August 2009. A total of 87 general practitioners from the large Rhône-Alpes region contributed data on 502 girls/women who came for consultation. 231 (46.0%) of these girls/women had begun the process of HPV vaccination (68.2%, 56.9% and 18.7% of the 14-16, 17-20 and 21-23-year-olds respectively) of whom 139 (60.2%) had received all three doses. 92 girls/women (39.8%) had received only one or two doses at the time of study. However, in 71 (77.2%) cases, the gap between the last dose received and the time of study was within the between-dose interval recommended in the vaccination schedule. GPs reported that 16 (11.5%) had mentioned side effects following injections. Having a mother who practised regular PSS (Odds Ratio 6.2 [1.5-25.8]), having never lived with a partner (4.6 [1.6-13.5]) and vaccination against hepatitis B (3.2 [1.6-6.1]) were found to be independently correlated with the initiation of HPV vaccination among girls/women aged 14-18 years. Two years after the start of the programme, only half of girls/women aged 14-23 years had begun the process of HPV vaccination. HPV vaccination status was correlated with PSS in the mother, family status and hepatitis B vaccination. Such information may help to better target girls who are less likely to be vaccinated. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. The Prevalence of Abnormal Pap Smears in females Referred to Health Centers Affiliated to Medical Sciences During the Years 2012 to 2016

    Directory of Open Access Journals (Sweden)

    Zahra Massomi

    2016-06-01

    Full Text Available Background and Objectives: Cervical cancer is one of the most important female reproductive system diseases. The aim of this study was to estimate the prevalence of abnormal Pap smears of pregnant females in public health centers and hospitals of Hamadan. Materials and Methods: In a retrospective study, 36046 Pap smears of females was extracted from the records referred to government health centers affiliated to Hamadan University of Medical Sciences and Fatemiyeh Hospital Hamadan, between 2012 and 2016. After checking the results of Pap smear, abnormal information (605 cases were collected and investigated. Data were then analyzed using the SPSS21-software and descriptive statistics and one-way Analysis of Variance (ANOVA. Results: The majority of females with abnormal Pap smear results (%30.4 were aged 45 to 36 years, and %48.6 of females with abnormal Pap smear had parity (1-3. From a total of 36046 cases, 605 cases of abnormal Pap smear were observed. The highest and lowest frequencies of abnormal Pap smear were related to ASCUS and LSIL, at a prevalence of %78 and %1, respectively. There was a positive relationship between abnormal Pap smear results and age (P = 0.037. Conclusions: The prevalence of abnormal Pap smear in Hamadan was %1.67. Malignant cervical cancer and invasive cancer risk increased with age, hence, screening and Pap smear, especially from age 35 and above, is recommended.

  19. Evaluating the Pap Smear Reports of Pathology Laboratories in Ahvaz, Iran

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    Shirin Zargar Shoushtari

    2016-07-01

    Full Text Available Background & aim: Pap smear is a screening procedure for cervical cancer. The incidence and mortality rate of cervical cancer has decreased up to 90% in the regular screening in women aged 20-65 years. This study aimed to investigate the Pap smear reports of pathology laboratories in Ahvaz, Iran. Methods: In this cross-sectional study, 1,006 Pap smear reports were collected from pathology laboratories via cluster sampling method. Data was analyzed by a self-structured questionnaire. In addition, variables such as age, type of infection, grade of inflammation, metaplastic changes, and epithelial cell abnormalities in cervix were studied in this study. Data analysis was performed in SPSS V.16.0 using descriptive analysis, ANOVA, Fisher’s exact, and Chi-square tests. Results: While no infection was reported in 94.43% (n=950 of cases, the highest incidence rate of infections in the remaining samples (5.56%, n=56 was related to Candida Albicans (4.77%, n=48. Various grades of inflammation were reported in 83.69% (n=842 of the samples. Moreover, the highest grade of inflammation in fungal infections was 2+, whereas the grades in Trichomonas and bacterial infections were 1+ and 3+, respectively. Cervical dysplasia and metaplasia were reported in 0.29% (n=3 and 1.19% (n=12 of the cases, respectively. Conclusion: The prevalence of cervical-vaginal infections, cervical metaplasia, and dysplasia were relatively low in Pap smear reports of laboratories in Ahvaz.

  20. Pap smear receipt among Vietnamese immigrants: the importance of health care factors.

    Science.gov (United States)

    Taylor, Victoria M; Yasui, Yutaka; Nguyen, Tung T; Woodall, Erica; Do, H Hoai; Acorda, Elizabeth; Li, Lin; Choe, John; Jackson, J Carey

    2009-12-01

    Recent US data indicate that women of Vietnamese descent have higher cervical cancer incidence rates than women of any other race/ethnicity, and lower levels of Pap testing than white, black, and Latina women. Our objective was to provide information about Pap testing barriers and facilitators that could be used to develop cervical cancer control intervention programs for Vietnamese American women. We conducted a cross-sectional, community-based survey of Vietnamese immigrants. Our study was conducted in metropolitan Seattle, Washington, DC. A total of 1532 Vietnamese American women participated in the study. Demographic, health care, and knowledge/belief items associated with previous cervical cancer screening participation (ever screened and screened according to interval screening guidelines) were examined. Eighty-one percentage of the respondents had been screened for cervical cancer in the previous three years. Recent Pap testing was strongly associated (p<0.001) with having a regular doctor, having a physical in the last year, previous physician recommendation for testing, and having asked a physician for testing. Women whose regular doctor was a Vietnamese man were no more likely to have received a recent Pap smear than those with no regular doctor. Our findings indicate that cervical cancer screening disparities between Vietnamese and other racial/ethnic groups are decreasing. Efforts to further increase Pap smear receipt in Vietnamese American communities should enable women without a source of health care to find a regular provider. Additionally, intervention programs should improve patient-provider communication by encouraging health care providers (especially male Vietnamese physicians serving women living in ethnic enclaves) to recommend Pap testing, as well as by empowering Vietnamese women to specifically ask their physicians for Pap testing.

  1. .\tA Study on Cervical Pap Smear Examination in Patient Living with HIV.

    Directory of Open Access Journals (Sweden)

    Dr. Devanshi Gosai

    2016-12-01

    Full Text Available Background: Extensive screening programme of cervical Pap smear examination can detect the precancerous and cancerous lesions at an early stage and mortality & morbidity due to these lesions can be reduced. HPV infection is a known etiological agent for cervical cancer. HIV infected women are at higher risk of contracting HPV infection due to immune compromised status. Objective: Present study has been undertaken mainly to detect precancerous & cancerous lesions as well as inflammatory lesions in female patients living with HIV & to emphasize the fact that Pap smear examination should be established as a part of routine protocol for examination in HIV infected women. Methods: The study was carried out on 369 HIV infected females attending Integrated Counselling &Testing Centre of government institute. As controls, 142 females (not falling under high risk category, attending the Obstetrics& Gynaecology OPD with various gynaecological complaints were taken & results were compared. Results: Squamous cell abnormalities were found about four times high as compared to control group. High incidences of squamous cell abnormalities were noted in patients with high parity (parity three or more. Conclusion: Regular gynaecological examination including Pap smear examinations is highly recommended for HIV infected females. Pap smear examination is a simple, cheap, safe & practical diagnostic tool for early detection of cervical cancer in high risk population.

  2. The limits of pap smear in diagnosing preinvasive cervical neoplasias

    Directory of Open Access Journals (Sweden)

    Dorina Neacsu

    2011-12-01

    Full Text Available The cervical-vaginal cytology can be interpreted after many classifications, starting from Babeú- Papanicolaou and ending with the Bethesda system, but no matter what the interpretation manner is it is really important to have a good quality of the smears and an experienced cytologist. If we refer to the total number of cases from the lot presented - 16732 cases, the results are satisfactory; 83% smears having normal limits, 10.14% MCB, 2.71% L-SIL, 0.82% H-SIL, 2.77% ASCUS, 0.10% AGC. In Iaúi there are significantly more patients with benign cell changes and L- SIL, while in Buzău there are significantly more patients with a normal smear, but there is also a higher frequency of theatypical squamous cells with an undetermined significance. Classically specialists say that 50-75% of the false negative results are due to the errors made when harvesting the sample. In conclusion we estimate that considering the present conditions in our country where the lack of interest and financial possibilities do not allow an action of detecting the lesions of the cervix organized nationwide, we can still make a selection of the cases with a high risk by making a free Pap smear for all the patients that come to a specialized service, either state or private, provided they respect the protocol of harvesting the cervical secretions, of preparing and reading/interpreting the smears.

  3. Knowledge, Attitudes and Practices of Sudanese Women Regarding the Pap Smear Test and Cervical Cancer.

    Science.gov (United States)

    Almobarak, Ahmed O; Elbadawi, Ayman A; Elmadhoun, Wadie M; Elhoweris, Mohammed H; Ahmed, Mohammed H

    2016-01-01

    Despite the established role of the Pap smear test (PST) in prevention and early detection of cervical cancer, it is still rarely practiced in Sudan. Many challenges hinder the establishment of an effective cervical cancer screening program, including socio-cultural factors. Therefore, this study aimed to investigate the knowledge, attitudes and practices (KAP) of Sudanese women with regard to the Pap smear test and cervical cancer. A total of 500 married women aged 14 to 58 years were recruited from obstetric clinics, hospitals and universities in Khartoum in 2014. Data were collected using a standardized, pretested questionnaire that inquired socio-demographic characteristics and their KAP about cervical cancer and the PST. More than 52% of participating women were above 30 years of age, and the majority (78.8%) were university degree holders. A total of 486 (97.2 %) of participants were resident in urban areas of Khartoum State. However about 48% of the respondents had never heard about PST, and only 15.8% of the participants had undergone a Pap smear test previously; 46.6% (233/500) knew that the human papilloma virus (HPV) was the causative agent, but only 39.2% (196/500) had heard about HPV vaccination, and only 11.4% (57/500) had received the vaccine. However 68% of the respondents agreed to do Pap smear if properly informed about the test and 75.4% of the respondents agreed to participate in a cervical cancer screening program. Despite a high educational level, less than half of our participants had accurate knowledge about cervical cancer, HPV, and cervical cancer screening. Health education about cervical cancer, HPV and sexually transmitted infections and the role of PST in cervical cancer prevention are crucial when designing interventions aimed at improving cervical cancer screening for Sudanese women.

  4. How group education impacts female factory workers' behavior and readiness to receive mammography and Pap smear.

    Science.gov (United States)

    Seven, Memnun; Bahar, Mine; Akyüz, Aygül; Erdoğan, Hatice

    2015-01-01

    The workplace has been deemed a suitable location for educating many women at once about cancer screening. To determine how group education about early diagnostic methods for breast and cervical cancer effects women's behavior and readiness to receive mammography and Pap smear. This semi-interventional study was conducted at a textile factory in Istanbul, Turkey. Female workers (n= 125) were included in the study. A participant identification form and knowledge evaluation form developed for this study, along with the transtheoretical model, were used to collect data. A 45-min interactive group education was given to the participants. Upon contacting participants 3 months after group education, 15.4% (n = 11) stated that they had since received a mammogram and 9.8% (n = 7) a Pap smear. As suggested by the transtheoretical model, group education increased participants' readiness to receive cancer screening, along with their knowledge of breast and cervical cancer. Group education positively impacted women's knowledge of cancer and their readiness to receive mammography and Pap smear. Group education can potentially create awareness of cancer screening tests among women and improve their readiness to receive such tests.

  5. The Pap smear screening as an occasion for smoking cessation and physical activity counselling: baseline characteristics of women involved in the SPRINT randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Chellini Elisabetta

    2011-12-01

    Full Text Available Abstract Background Gender-specific smoking cessation strategies have rarely been developed. Evidence of effectiveness of physical activity (PA promotion and intervention in adjunct to smoking cessation programs is not strong. SPRINT study is a randomized controlled trial (RCT designed to evaluate a counselling intervention on smoking cessation and PA delivered to women attending the Italian National Health System Cervical Cancer Screening Program. This paper presents study design and baseline characteristics of the study population. Methods/Design Among women undergoing the Pap examination in three study centres (Florence, Turin, Mantua, participants were randomized to the smoking cessation counselling [S], the smoking cessation + PA counselling [S + PA], or the control [C] groups. The program under evaluation is a standard brief counselling on smoking cessation combined with a brief counselling on increasing PA, and was delivered in 2010. A questionnaire, administered before, after 6 months and 1 year from the intervention, was used to track behavioural changes in tobacco use and PA, and to record cessation rates in participants. Discussion Out of the 5,657 women undergoing the Pap examination, 1,100 participants (55% of smokers were randomized in 1 of the 3 study groups (363 in the S, 366 in the S + PA and 371 in the C groups. The three arms did not differ on any demographic, PA, or tobacco-use characteristics. Recruited smokers were older, less educated than non-participant women, more motivated to quit (33% vs.9% in the Preparation stage, p p p Trial registration number ISRCTN: ISRCTN52660565

  6. Increasing Pap smear rates at an urban Aboriginal Community Controlled Health Service through translational research and continuous quality improvement.

    Science.gov (United States)

    Dorrington, Melanie S; Herceg, Ana; Douglas, Kirsty; Tongs, Julie; Bookallil, Marianne

    2015-01-01

    This article describes translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS). Rapid Plan-Do-Study-Act (PDSA) cycles were conducted, informed by client surveys, a data collection tool, focus groups and internal research. There was a statistically significant increase in Pap smear numbers during PDSA cycles, continuing at 10 months follow up. The use of TR with CQI appears to be an effective and acceptable way to affect Pap smear screening. Community and service collaboration should be at the core of research in Aboriginal and Torres Strait Islander health settings. This model is transferrable to other settings and other health issues.

  7. Awareness of cervical cancer and Pap smear among nursing staff at a rural tertiary care hospital in Central India.

    Science.gov (United States)

    Jain, S M; Bagde, M N; Bagde, N D

    2016-01-01

    Cancer cervix is the leading cause of cancer deaths in females in developing countries and one in five women suffering from cervical cancer lives in India. The aim of this study is to determine the awareness about cervical cancer and Pap smear among nurses working in a tertiary care institute. Study Setting and Design: Cross-sectional survey in a tertiary care institute. Nurses working at our institute excluding those who have worked or working in the Obstetrics and Gynecology department were provided with a pre-designed questionnaire testing their knowledge about cervical cancer. Approximately, 86% were aware about cancer cervix and 69% were aware of a pre-cancerous stage. 42.3% were not aware of any risk factor and 27.6% were not aware of any symptom of cancer cervix. 86.2% were aware about Pap smear, but only 58.6% were aware that facilities of Pap smear were available at our hospital. Knowledge about cervical cancer and awareness of Pap smear as screening test was inadequate in nursing staff. Awareness programs about cervical cancer and screening are needed to increase awareness for this preventable condition. There is a need to arrange reorientation programs to sensitize nurses and establish cytology clinics to offer facilities for easily accessible and affordable screening.

  8. Papanicolaou Smear Screening of Women with Intellectual Disabilities: A Cross-Sectional Survey in Taiwan

    Science.gov (United States)

    Lin, Lan-Ping; Lin, Jin-Ding; Sung, Chang-Lin; Liu, Ta-Wen; Liu, Yi-Lian; Chen, Li-Mei; Chu, Cordia M.

    2010-01-01

    Although little is known about the incidence of cervical cancer in women with intellectual disabilities (ID), Pap smear screening is an effective public health program to prevent cervical cancer to this group of people. The purposes of this study were to identify and evaluate the factors regarding the utilization of the Pap smears in women with ID…

  9. Self-reported history of Pap-smear in HIV-positive women in Northern Italy: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Ghinelli Florio

    2010-06-01

    Full Text Available Abstract Background The incidence of invasive cervical cancer in HIV-positive women is higher than in the general population. There is evidence that HIV-positive women do not participate sufficiently in cervical cancer screening in Italy, where cervical cancer is more than 10-fold higher in women with AIDS than in the general population. The aim of the present study was to evaluate the history of Pap-smear in HIV-positive women in Italy in recent years. We also examined the sociodemographic, clinical, and organizational factors associated with adherence to cervical cancer screening. Methods A cross-sectional study was conducted between July 2006 and June 2007 in Emilia-Romagna region (Northern Italy. All HIV-positive women who received a follow-up visit in one of the 10 regional infectivology units were invited to participate. History of Pap-smear, including abnormal smears and subsequent treatment, was investigated through a self-administered anonymous questionnaire. The association between lack of Pap-smear in the year preceding the interview and selected characteristics was assessed by means of odds ratios (OR and 95% confidence intervals adjusted for study centre and age. Results A total of 1,002 HIV-positive women were interviewed. Nine percent reported no history of Pap-smear, and 39% had no Pap-smear in the year prior to the date of questionnaire (last year. The lack of Pap-smear in the last year was significantly associated with age Three hundred five (34% women reported a previous abnormal Pap-smear, and of the 178 (58% referred for treatment, 97% complied. Conclusions In recent years the self-reported history of Pap-smear in HIV-positive women, in some public clinics in Italy, is higher than previously reported, but further efforts are required to make sure cervical cancer screening is accessible to all HIV-positive women.

  10. A survey of awareness of Pap smear and cervical cancer vaccine among women at tertiary care centre in Eastern Uttar Pradesh India

    OpenAIRE

    Anjali Rani; Kalpana Singh; Shreya Thapa

    2015-01-01

    Background: Cervical cancer is very common in developing countries. In Uttar Pradesh the literacy rate of women is low as compared to other states of India. Poverty is very high. Most women report with advance stage of cervical cancer. It can be prevented by early screening with Pap smear. Aim of our study is to know about the awareness of Pap smear and cervical cancer vaccine among women attending a tertiary hospital in Eastern part of Uttar Pradesh India. Methods: A questionnaire based ...

  11. Perceptions and concerns of women undergoing Pap smear examination in a tertiary care hospital of India.

    Science.gov (United States)

    Tiwari, A; Kishore, J; Tiwari, A

    2011-01-01

    Cervical cancer is one of the major causes of deaths due to cancer among women in India. Pap smear is one of the best methods to detect early changes in cervix. However, there is lack of data on awareness level of women about Pap smear and various risk factors for cervical cancer. To study the awareness about various risk factors for cervical cancer, health-seeking behavior and hygienic practices among women and to assess the distress experienced by these women before the Pap smear examination. This cross-sectional study was carried out on women coming for a Pap smear examination in a tertiary teaching hospital in New Delhi. A pretested interview schedule was used to get information after obtaining their informed consent. Fifty-seven percent stated that they did not consult a doctor when they noticed the symptoms the first time. Sixty-one percent did not know what a cervical cancer is and a same percentage of women did not know what a Pap smear examination was. Older age group, Muslim and literate women had higher number of abnormal Pap smear results. Women who reported being stressed in their lives had higher number of abnormal smears as compared to women who claimed to lead a stress free life. Poor hygienic practices among these women from urban areas were also associated with abnormal Pap smear results. The study concluded that factors such as poor awareness, shyness, poor hygiene, and old age could be responsible for abnormal Pap smears and this needs special attention in cancer prevention activities of the government.

  12. Tamizaje en cáncer cervical: conocimiento de la utilidad y uso de citología cervical en México Cervical cancer screening: knowledge of Pap smear benefits and utilization in Mexico

    Directory of Open Access Journals (Sweden)

    José A Aguilar-Pérez

    2003-02-01

    .OBJECTIVE: To identify and evaluate the predisposing factors regarding the utilization of the Pap smears in the population seen in the Cervical Cancer Screening Program in Mexico METHODS: A cross-sectional study was conducted from January 1997 through December 1998 in Mexico city. A questionnaire was applied to a total of 2,107 women of reproductive age who attended a family planning program and data was collected regarding the following topics: social-demographics, reproductive risk factors associated with cervical cancer, sexual behavior and partner history, birth control, knowledge about Pap smear' benefits, and its utilization. Statistic analysis was conducted using Student´s test and non-conditional multiple logistic regression model for determining significance. RESULTS: The predisposing factors were: knowledge about Pap smear's benefits (OR=6.00, CI 95% 4.70-7.67, history of using at least two birth control methods (OR=2.38, CI 95% 1.75-3.24, previous history of vaginal infection (OR=2.18, CI 95% 1.73-2.75, sexual partner's approval of gynecological examinations (OR=1.56, CI 95% 1.07-2.29. CONCLUSIONS: Educational programs on cancer prevention in this population should include the benefits of screening tests. Pap smears for Mexican women of reproductive age are mostly offered opportunely. The previous use of health services is a determinant factor for the utilization of the Cervical Cancer Screening Program. These results show the need to strengthen health promotion programs to women at high risk of cervical cancer and their sexual partners.

  13. PENYULUHAN METODE PAP SMEAR TERHADAP TINGKAT PENGETAHUAN DAN SIKAP WANITA TUNA SUSILA DALAM PENDETEKSIAN KANKER SERVIKS

    Directory of Open Access Journals (Sweden)

    Ismi Wulandari AS

    2015-03-01

    Full Text Available Abstract: The Effectiveness Of Pap smear Test’s Counseling Regarding To The Level Of Knowledge And Behaviour In Prostitution Worker For Detection Of Cervical Cancer In Bintang Mas Kubu Raya 2014. The aim of this study is to evaluate the effectivity of counseling toward knowledge and behavior. in prostitution worker about pap smear and cervical cancer. This research was quasi-experimental with one group pretest-postest design. There are 38 respondents. McNemar test showed there are significant. improvement of knowledge (p<0.05, and significance behavior change (p<0.05 in all respondents before and after counseling. Keyword : knowledge, behaviour, cervical cancer, pap smear Abstrak : Penyuluhan Metode Pap smear Terhadap Tingkat Pengetahuan Dan Sikap Wanita Tuna Susila Dalam Pendeteksian Kanker Serviks. Tujuan penelitian ini yaitu untuk melihat efektivitas terhadap pengetahuan dan sikap melalui penyuluhan mengenai pap smear kepada para wanita tuna susila. Rancangan penelitian yang digunakan dalam penelitian ini adalah quasi eksperimental dengan rancangan one group pretest-postest design. Besar sampel berjumlah 38 orang. Hasil menunjukkan uji McNemar menunjukkan terdapat signifikansi yang bermakna untuk pengetahuan (p < 0,05 dan signifikansi untuk perubahan sikap (p<0.05 pada responden sebelum dan setelah penyuluhan. Kata kunci : pengetahuan, sikap, kanker serviks, pap smear

  14. Frequency and patterns of abnormal Pap smears in Sudanese women with infertility: What are the perspectives?

    Directory of Open Access Journals (Sweden)

    Ahmed O Almobarak

    2013-01-01

    Conclusions: Epithelial cell abnormalities are significantly higher in women with infertility as compared with fertile women. Importantly, inflammatory smears were reported two times more than in the controls. We recommend pap smear as a routine practice for all women assessed for infertility problems. Further studies are necessary to evaluate the incidence of human papilloma virus infections in infertile women with abnormal cervical cytology.

  15. Barriers to Pap Smear Test for the Second Time in Women Referring to Health Care Centers in the South of Tehran: A Qualitative Approach

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    Laleh Hassani

    2017-10-01

    Full Text Available Background: Cervical cancer is a preventable disease with a regular screening program. Many studies have reported a large number of barriers that women had for the first time, but this study decided to find other barriers for the second time pap smear. Methods: In this qualitative research, data were gathered through in-depth interviews and expressed through conventional content analysis in the form of constant comparison. The participants were 15 women with family profile at 30 health care centers who lived in the south of Tehran and had done Pap smear for one time but didn’t do it for the second time. Results: Three main themes emerged from the analysis of the interviews: negative experiences of the first Pap test were as follows: results of the first time test, readiness for performing the test, getting the test itself, and the site of the first Pap test. Personal barriers to getting the second Pap test were: inattention to time, physical barriers to the second Pap test, and inhibitory beliefs. Perceived social barriers to getting the second Pap test with two sub-themes included social supports and abstract norms. Conclusion: This study provided other barriers about Pap smear including lack of the spouse’s support, the role of health care providers and physicians in screening program for early diagnosis in women.

  16. Relationship Between Pelvic Organ Prolapse and Non-Human Papillomavirus Pap Smear Abnormalities.

    Science.gov (United States)

    Menhaji, Kimia; Harvie, Heidi S; Cheston, Emily; Levin, Pamela J; Arya, Lily A; Andy, Uduak U

    2017-07-13

    The aim of this study was to determine the association between pelvic organ prolapse (POP) and non-human papillomavirus (HPV) Papanicolaou (Pap) smear abnormalities. This was a retrospective cohort study of women aged 40 to 70 years who presented for consultation at our institution between 2010 and 2015 and had results of a Pap smear and HPV test available within 5 years of their visit. We extracted demographic information, medical and social history, Pap smear, and HPV results from the electronic medical record. Associations between the presence of POP and non-HPV Pap smear abnormalities were estimated using univariable and multivariable analyses. We reviewed 1590 charts and excluded 980 women, leaving 610 women in the study: 183 with POP and 427 without POP. Women with POP were significantly older (58.2 ± 7.2 vs 55.6 ± 6.6, P 10 year) history of abnormal Pap smear (24.0% vs 14.8%, P women with POP.

  17. Fluorescence Spectrum and Decay Measurement for Hsil VS Normal Cytology Differentiation in Liquid Pap Smear Supernatant

    Science.gov (United States)

    Vaitkuviene, A.; Gegzna, V.; Juodkazis, S.; Jursenas, S.; Miasojedovas, S.; Kurtinaitiene, R.; Rimiene, J.; Vaitkus, J.

    2009-06-01

    Cervical smear material contains endo and exocervical cells, mucus and inflammative, immune cells in cases of pathology. Just not destroyed keratinocytes lay on the glass for microscopy. Liquid cytology supernatant apart other diagnostics could be used for photodiagnostic. The spectroscopic parameters suitable for Normal and HSIL cytology groups supernatant differentiation are demonstrated. The dried liquid PAP supernatant fractions—sediment and liquid were investigated. Excitation and emission matrices (EEM), supernatant fluorescence decay measured under 280 nm diode short pulse excitation and fluorescence spectroscopy by excitation with 355 nm laser light were analyzed. The differences between Normal and HSIL groups were statistically proven in the certain spectral regions. Fluorescence decay peculiarities show spectral regions consisting of few fluorophores. Obtained results on fluorescence differences in Normal and HSIL groups' supernatant shows the potency of photodiagnosis application in cervical screening.

  18. Pap-smear Classification Using Efficient Second Order Neural Network Training Algorithms

    DEFF Research Database (Denmark)

    Ampazis, Nikolaos; Dounias, George; Jantzen, Jan

    2004-01-01

    In this paper we make use of two highly efficient second order neural network training algorithms, namely the LMAM (Levenberg-Marquardt with Adaptive Momentum) and OLMAM (Optimized Levenberg-Marquardt with Adaptive Momentum), for the construction of an efficient pap-smear test classifier. The alg......In this paper we make use of two highly efficient second order neural network training algorithms, namely the LMAM (Levenberg-Marquardt with Adaptive Momentum) and OLMAM (Optimized Levenberg-Marquardt with Adaptive Momentum), for the construction of an efficient pap-smear test classifier...

  19. An institution-based cervical PAP smear study, correlation with clinical findings & histopathology in the Konkan region of Maharashtra state, India

    Directory of Open Access Journals (Sweden)

    Bhushan M. Warpe

    2016-08-01

    Full Text Available Background: Cervical carcinoma is a common cause of death in India. It is presented by spectrum of precancerous lesions, called cervical intraepithelial neoplasia (CIN. Cervical cytological screening is designed to detect over 90% of cytological abnormalities. It has been established that cervical cancers can be diagnosed at the pre-invasive stage with adequate, repetitive cytological screening. Keeping in view of the importance of cervical PAP abnormalities & by classifying them by Bethesda terminology; correlation with clinical findings & histopathological findings was done. Methods: All cervical Pap smears reported in Department of Pathology from 1st August 2015 to 31st July 2016, were prospectively studied and classified according to revised Bethesda terminology, 2014. Also cytoradiological and clinico-cytological, cytohistological correlation was studied. Results: Due to increasing awareness among masses inculcated by social workers, most of the patients for PAP smear cytology came for routine screening to rule out cervical lesions followed by clinical finding of per-vaginal discharge. The 350 screened patients were in the third and fourth decades of life. 99/350 cases were subjected to USG study, with maximum number of cases (34 cases showing normal study, followed by cases with ovarian cysts and fatty liver disease. Negative for intra-epithelial lesion (NILM without any denotable organism was the pre-dominant cytological finding of PAP smear study followed by cases of NILM with bacterial vaginosis (30 cases with two malignancies. Intra-epithelial lesions (IELs were noted in 16.86%. ASCUS comprised 12.29%, ASC-H comprised 1.14%, L-SIL comprised 1.71%, HSIL comprised 1.43%, Atrophic cervical smears comprised 5.14%, Squamous cell carcinoma comprised 0.29% cases. ASC/LSIL ratio was 7.8 and inadequacy rate for PAP smear study was 7.43%. Cytologyhistopathology correlation was possible in 62 cases. Conclusion: Classification of cervical PAP

  20. Papshop: Not a 'melon'choly Pap smear workshop! | Gordon | South ...

    African Journals Online (AJOL)

    As Head of Undergraduate Education in the Department of Obstetrics and Gynaecology at the University of Cape Town, South Africa, I have a particular interest in the competencies needed to perform primary care gynaecological procedures, one of which is the Pap smear. I was approached by a group of keen volunteer ...

  1. Plastic spatula with narrow long tip provides higher satisfactory smears for Pap test

    Directory of Open Access Journals (Sweden)

    Pervinder Kaur

    2013-01-01

    Full Text Available Background: Ayre spatula for cervical smear collection is being used despite the suggestion that different modified spatulas provide more satisfactory sampling. Aims: To see whether the cytological pickup improves with the use of long tipped spatula. Setting and Design: Rurally based University Hospital; crossover study. Materials and Methods: Pap smear using Ayre spatula in 500 and with plastic narrow long tip (Szalay spatula in 500 clinic attending women was taken and analyzed. Crossover smears were taken with modified spatula in 163 and using Ayre spatula in 187 women after 2 weeks of initial smears. The same pathologist made cytological reporting for all smears and was unaware of the type of spatula used. Results: Smears from Ayre spatula had significantly higher reports of inadequate smears (94 of 500 vs. 68 of 500 for Ayre and Szalay, respectively; P = 0.032 and it remained so even after crossover (94 of 187 vs. 70 of 163 for Ayre and Szalay, respectively; P = 0.2. Cellular quality appeared better with smears taken using Szalay spatula, but the overall abnormal smear detection rate remained similar with either collection tool (χ2 = 1.5; P = 0.2. Conclusions: Proportion of satisfactory smears is higher when long tip plastic spatula is used for collection of sample.

  2. Plastic spatula with narrow long tip provides higher satisfactory smears for Pap test.

    Science.gov (United States)

    Kaur, Pervinder; Kushtagi, Pralhad

    2013-07-01

    Ayre spatula for cervical smear collection is being used despite the suggestion that different modified spatulas provide more satisfactory sampling. To see whether the cytological pickup improves with the use of long tipped spatula. Rurally based University Hospital; crossover study. Pap smear using Ayre spatula in 500 and with plastic narrow long tip (Szalay) spatula in 500 clinic attending women was taken and analyzed. Crossover smears were taken with modified spatula in 163 and using Ayre spatula in 187 women after 2 weeks of initial smears. The same pathologist made cytological reporting for all smears and was unaware of the type of spatula used. Smears from Ayre spatula had significantly higher reports of inadequate smears (94 of 500 vs. 68 of 500 for Ayre and Szalay, respectively; P = 0.032) and it remained so even after crossover (94 of 187 vs. 70 of 163 for Ayre and Szalay, respectively; P = 0.2). Cellular quality appeared better with smears taken using Szalay spatula, but the overall abnormal smear detection rate remained similar with either collection tool (χ(2) = 1.5; P = 0.2). Proportion of satisfactory smears is higher when long tip plastic spatula is used for collection of sample.

  3. The Prevalence of Human Papilloma Virus (HPV) in Women using Liquid Base Pap Smear in Rasht, Northern of Iran.

    Science.gov (United States)

    Mehran, Seyed Mohamad Mohseni; Ghanaei, Mandana Mansour; Mojtehadi, Ali

    2015-07-01

    HPV is one of the most common sexually transmitted infections. However, little is known about its prevalence in the female population in Rasht, Northern of Iran. The aim of this study was to find the incidences of HPV viruses in high-risk women in Rasht by wet Pap smear from 2010 to 2015. This cross-sectional study investigated HPV prevalence and its genotype distribution among 103 apparently healthy and non- healthy women with abnormal cells in pap exam. DNA samples were extracted by boiling and phenol - chloroform methods, then used as template for amplifying of specific fragment of HPV genome by PCR using GP5+ / GP6+ primers. PCR products were electrophoresed in 1.5% agarose gel (Roche, Germany) containing Sybrsafe. DNA ladder (Roche Co, Germany) was used to detect the molecular weights of observed bands under UV lamp. Overall, 4/98 women (4.08%) with normal cells and 1/5 women (20%) with abnormal cells were positive for at least one of the high risk HPV types in wet Pap smear. The most HPV infection was found in 26 to 39-year-old individuals. We evidenced a moderate prevalence of HPV infection but needs to be given more attention because in apparently healthy women also, HPV infection was observed. Health officials should conduct the study and wider screening of this infection occurring in this province. Screening for this infection must be recommended in this region.

  4. UV Suppression by Smearing and Screening Correlators

    OpenAIRE

    Gupta, Sourendu; Karthik, Nikhil

    2013-01-01

    We investigate the mechanism of smearing in the APE, Stout, HYP and HEX schemes through their effect on glue and quark Fourier modes. Using this, we non-perturbatively tune the smearing parameters to their optimum values. Smearing causes a super-linear improvement in taste symmetry breaking in the high temperature phase of QCD. We use optimal smearing in the high temperature phase and find close agreement of meson screening masses with weak coupling predictions.

  5. No increased risk for cervical cancer after a broader definition of a negative Pap smear

    DEFF Research Database (Denmark)

    Rebolj, Matejka; van Ballegooijen, Marjolein; van Kemenade, Folkert

    2008-01-01

    in 1996, the proportion of these smears dropped from 10% to less than 2%. Because this may have caused a loss in smear sensitivity, we analysed the changes in the incidence of cervical cancer after a negative Pap smear. All negative smears made at ages 30-64 in 1990-1995 (n = 1,546,252) and 1998-2006 (n...... = 3,552,716), registered in the national registry of histo- and cytopathology (PALGA), were followed for up to 9 years. During follow-up of the 1990-1995 smears, 377 women developed cervical cancer within 5,232,959 woman-years at risk, while during the follow-up of the 1998-2006 smears, 619 women...... developed cervical cancer within 11,210,675 woman-years at risk. The cumulative incidence after the definition change was not significantly higher than before: e.g. at 6 years, the cumulative incidence for smears made in 1990-1995 was 46 per 100,000 (95% CI: 41-52), and for smears in 1998-2006 was 48 per...

  6. Prevalence of abnormal Pap smears in a consecutive and previously unscreened population in Romania.

    Science.gov (United States)

    Stolnicu, Simona; Musca, Simona; Micu, Dorian; Micu, Luminita; Moldovan, Cosmin; Puscasiu, Lucian

    2014-02-01

    To determine the prevalence of abnormal cervical smears in a previously unscreened and asymptomatic population in Romania and to compare the data with those from other countries in Europe. In a retrospective study, data were reviewed from smears obtained from women in Romania who had been referred to the gynecologist between January 2006 and December 2011. The smears were collected through 3 regional opportunistic programs of cervical screening and were classified according to the Bethesda system. During the study period, 50536 smear tests were carried out. Of these, 100 smears (0.2%) were unsatisfactory and excluded from the study. Among the remaining 50436 smears, 2965 patients (5.9%) had abnormal epithelial changes. Most of the abnormal smears were represented by atypical squamous cells of undetermined significance (2.6% of all smears). The data confirmed that there is a high prevalence of high-grade intraepithelial squamous-type lesions (0.9% of all smears) in Romania, and of abnormal smears in women younger than 25years of age (14.0% of all abnormal smears). The data show that there is a high prevalence of epithelial abnormalities among cervical smears in Romania compared with other European countries that run a national screening program. © 2013.

  7. Prevalence of human papilloma virus in cervical smear by DNA PCR testing and its comparison with pap smear

    Directory of Open Access Journals (Sweden)

    Sushil Kumar

    2013-01-01

    Discussion: The study reveals HPV prevalence rate of 28.3% in women attending gynaecology OPD of a tertiary care hospital and also prevalence of HPV was found to be highest in sexually active individuals with parity of 3 or more. These results are in agreement to many published national and international studies [12,13,14]. The study results also indicate lower sensitivity and higher specificity of Pap smear in detecting HPV infection, however it still remains the most important practicably available test in early detection of cervical carcinoma.

  8. Agreement Between Visual Inspection with Acetic Acid and Papanicolaous Smear as Screening Methods for Cervical Cancer

    International Nuclear Information System (INIS)

    Naz, U.; Hanif, S.

    2014-01-01

    Objective: To determine degree of agreement between visual inspection with acetic acid (VIA) and Papanicolaous (Pap) smear as screening methods for cervical cancer. Study Design: A cross-sectional study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Sir Ganga Ram Hospital, Lahore, from July to December 2012. Methodology: Two hundred and fifty women in reproductive age group presenting with various gynaecological complaints were included in the study. A Papanicolaous smear was taken and visual inspection with 5% acetic acid was done. VIA was reported as positive or negative according to acetowhite changes and cytology result was graded as CIN 1, 2, 3 and squamous carcinoma. Those women who showed positive result with either VIA or Pap smear or both were further subjected to colposcopic directed biopsy which was taken as gold standard. Results were computed using Statistical Package for Social Sciences (SPSS) version 16 and statistical test used was kappa. Results: Out of 250 women, VIA was positive in 55 (22%) patients and Pap smear was abnormal in 27 (10.8%). Histological diagnosis of CIN/cancer was made in 36 out of a total 62 patients who underwent biopsy. Conclusion: There was a fair agreement between VIA and Pap smear, with VIA detecting more abnormalities than cytology. In the absence of Pap smear availability, VIA may be a reasonable cervical cancer screening method, especially in low resource settings. (author)

  9. Pap-smear Classification Using Efficient Second Order Neural Network Training Algorithms

    DEFF Research Database (Denmark)

    Ampazis, Nikolaos; Dounias, George; Jantzen, Jan

    2004-01-01

    In this paper we make use of two highly efficient second order neural network training algorithms, namely the LMAM (Levenberg-Marquardt with Adaptive Momentum) and OLMAM (Optimized Levenberg-Marquardt with Adaptive Momentum), for the construction of an efficient pap-smear test classifier. The alg......In this paper we make use of two highly efficient second order neural network training algorithms, namely the LMAM (Levenberg-Marquardt with Adaptive Momentum) and OLMAM (Optimized Levenberg-Marquardt with Adaptive Momentum), for the construction of an efficient pap-smear test classifier....... The algorithms are methodologically similar, and are based on iterations of the form employed in the Levenberg-Marquardt (LM) method for non-linear least squares problems with the inclusion of an additional adaptive momentum term arising from the formulation of the training task as a constrained optimization...

  10. The effect of health education on the knowledge, attitude, and uptake of free Pap smear among female teachers in Birnin-Kebbi, North-Western Nigeria.

    Science.gov (United States)

    Adamu, A N; Abiola, A O; Ibrahim, Mto

    2012-01-01

    The Routine Pap smear test has successfully reduced the incidence of invasive cervical cancer in the presence of a proper structure for its implementation. This study was designed to assess the effect of health education on the knowledge, attitude, and uptake of Pap smear among female teachers. It was a quasi-experimental, controlled study with a pre-test, post-test design. A total of 100 respondents were recruited for each of the intervention and control groups, by the multistage sampling technique. The mean knowledge score of cervical cancer was low in both the interventions (25.5% ± 10.5) and control groups (18.9% ± 10.0) at baseline; a significant rise to 57.2% ± 20.7 was recorded after the intervention in the Intervention group (Pfree Pap smear was poor at the post-intervention phase in both the groups (P=0.45). Reported reasons for poor uptake included the respondents' dislike for the test (38.4%) and the belief that the test was not necessary (24.4%). About 20% of the respondents did not have any reason at all. Health education had no significant effect on the uptake of a free Pap smear among teachers. Despite the significant improvement in the attitude toward the test, many respondents did not like the test after than before the intervention. Sociocultural issues such as the gender of the sample collector, and system factors like few service delivery points, and the time required to access the service could have contributed to the poor uptake recorded in this study. A program designed to improve routine cervical cancer screening by Pap smear should therefore address not only the knowledge and cost, but also the sociocultural and systemic factors.

  11. Bacterial vaginosis, aerobic vaginitis, vaginal inflammation and major Pap smear abnormalities.

    Science.gov (United States)

    Vieira-Baptista, P; Lima-Silva, J; Pinto, C; Saldanha, C; Beires, J; Martinez-de-Oliveira, J; Donders, G

    2016-04-01

    The purpose of this investigation was to evaluate the impact of the vaginal milieu on the presence of abnormal Pap smears and a positive human papilloma virus (HPV) test. A cross-sectional study was conducted between June 2014 and May 2015, evaluating the vaginal discharge by fresh wet mount microscopy and comparing these data with Pap smear findings. Wet mount slides were scored for bacterial vaginosis (BV), aerobic vaginitis (AV), presence of Candida and Trichomonas vaginalis. Cytologic evaluation was done on all Pap smears according to the Bethesda criteria. The cobas© HPV Test (Roche) was performed for HPV detection. A total of 622 cases were evaluated. The mean age of the patients was 41.6 ± 10.65 years (range 21-75). Eighty-three women (13.3 %) had a cytology result worse than low-grade squamous intraepithelial lesion (LSIL). When comparing this group with the one with normal or minor [atypical squamous cells of undetermined significance (ASC-US) or LSIL] Pap smear abnormalities, there were no differences in the presence of Candida (32.5 % vs. 33.2 %, p = 1.0), absence of lactobacilli (38.6 % vs. 32.5 %, p = 0.32) or BV (20.5 % vs. 13.2 %, p = 0.09). On the other hand, moderate or severe inflammation (msI) (41.0 % vs. 28.8 %, p = 0,04), moderate or severe AV (msAV) (16.9 % vs. 7.2 %, p = 0.009) and msAV/BV (37.3 % vs. 20.0 %, p = 0.001) were more common in women with such major cervical abnormalities. No significant association was found between deviations of the vaginal milieu and high-risk HPV infection. The presence of msI or msAV, but not BV, is independently associated with an increased risk of major cervical cytological abnormalities, but not with HPV infection.

  12. Vaginal flora changes on Pap smears after insertion of levonorgestrel-releasing intrauterine device.

    Science.gov (United States)

    Donders, Gilbert G G; Berger, Judith; Heuninckx, Hélène; Bellen, Gert; Cornelis, Ann

    2011-04-01

    The levonorgestrel intrauterine system (LNG-IUS) combines a uterine foreign body and the continuous release of low-dose levonorgestrel for contraception. Its influence on the rate of vulvovaginal infections and flora disturbance is insufficiently known, but important for contraceptive advice in women, especially those who develop recurrent vaginosis or Candida vulvovaginitis. Slides of 286 women who had a Pap smear taken before and 1 to 2 years after placement of a LNG-IUS were blindly reviewed for the presence of abnormal vaginal flora (AVF), bacterial vaginosis (BV), aerobic vaginitis (AV) and Candida vaginitis (CV). Prior to insertion, there were no differences in vaginal flora abnormalities between women using different kinds of contraception. LNG-IUS users did not have different rates of AVF, BV, AV or CV, but the general risk to develop any infection was increased. Uterine bleeding after insertion did not seem to predict a different flora type. We found that Pap smears suggested more vaginal infections after 1 year of LNG-IUS use than prior to insertion of the device. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. The value of colposcopy, high risk HPV-DNA and histopathologic examination in the management of abnormal Pap smear results

    Directory of Open Access Journals (Sweden)

    Vugar Bayramov

    2011-12-01

    Full Text Available Objective: Pap smear test is a major screening test for early diagnosis and treatment of cervix cancer. The aim of our study was to assess the value of HPV-DNA, colposcopy and histopathologic examination in the management of patients with abnormal cervical cytology. Materials and methods: This prospective cohort study was conducted in Ankara University Cebeci Hospital gynecology outpatient clinic. The study compremised 86 patients with smear results of ASCUS, AGC, L-SIL and H-SIL. Age, gravity, parity, age at first coitus, smoking status, number of partners, high risk HPV-DNA status and pathologic colposcopy findings were investigated. Results: Mean age of the patients was 35 years and the most common abnormal smear result was ASCUS, with 55 patients (63%. There was no significant difference between the groups regarding demographic characteristics except age at first coitus and pathologic colposcopy findings. Among patients diagnosed as ASCUS 34.5% had been up-graded with histopathologic examination. Among patients diagnosed as L-SIL 73.6% had been down-graded with histopathologic examination. However, after the histopathologic exam of 9 H-SIL patients two (22.2% were diagnosed as CIN II, two (22.2% were diagnosed as CIN III and one (11.1% was diagnosed as cervical cancer. In the groups of ASCUS, L-SIL and H-SIL the presence of high risk HPV-DNA were 11%, 5% and 33%, respectively. Conclusion: If we are sure that the patient will attend the follow-up visits, then fort he ones with ASCUS and L-SIL a repeat smear test would be the appropriate. However, in the management of patients with H-SIL colposcopic biopsy would be the best approach.

  14. KLASIFIKASI INTI SEL PAP SMEAR BERDASARKAN ANALISIS TEKSTUR MENGGUNAKAN CORRELATION-BASED FEATURE SELECTION BERBASIS ALGORITMA C4.5

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    Toni Arifin

    2014-09-01

    Full Text Available Abstract - Pap Smear is an early examination to diagnose whether there’s indication cervical cancer or not, the process of observations were done by observing pap smear cell under the microscope. There’s so many research has been done to differentiate between normal and abnormal cell. In this research presents a classification of pap smear cell based on texture analysis. This research is using the Harlev image which amounts to 280 images, 140 images are used as training data and 140 images other are used as testing. On the texture analysis used Gray level Co-occurance Matrix (GLCM method with 5 parameters that is correlation, energy, homogeneity and entropy added by counting the value of brightness. For choose which the best attribute used correlation-based feature selection method and than used C45 algorithm for produce classification rule. The result accuracy of the classification normal and abnormal used decision tree C45 is 96,43% and errors in predicting is 3,57%. Keywords : Classification, Pap Smear cell image, texture analysis, Correlation-based feature selection, C45 algorithm. Abstrak - Pap Smear merupakan pemeriksaan dini untuk mendiagnosa apakah ada indikasi kanker serviks atau tidak, proses pengamatan dilakukan dengan mengamati sel pap smear dibawah mikroskop. Banyak penelitian yang telah dilakukan untuk membedakan antara sel normal dan abnormal. Dalam penelitian ini menyajikan klasifikasi inti sel pap smear berdasarkan analisis tektur. Citra yang digunakan dalam penelitian ini adalah citra Harlev yang berjumlah 280 citra, 140 citra digunakan sebagai data training dan 140 citra lain digunakan sebagai testing. Pada analisis tekstur mengunakan metode Gray level Co-occurrence Matrix (GLCM menggunakan 5 parameter yaitu korelasi, energi, homogenitas dan entropi ditambah dengan menghitung nilai brightness. Untuk memilih mana atribut terbaik digunakan metode correlation-based feature selection lalu digunakan algoritma C45 untuk

  15. Knowledge of cervical cancer, attitude and husband’s support of Pap smear among multiparous women which have Pap’s smear examination in Aviati clinic Padang Bulan Medan

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    Feriyawati, L.; Anggraini, D. R.; Fitrie, A. A.; Anggreini, R. N.

    2018-03-01

    Cervical cancer is a serious health problem and stated as the second cause of death of woman worldwide. Several studies have noted a higher incidence of cervical cancer with increasing parity. Early detection with Pap smear is proven to reduce mortality of patients. Knowledge, attitude and husband’s support contributed to theled womanto follow Pap smear examination. This study explores the knowledge of cervical cancer, attitude and husband’ s support of Pap smearin multiparous women that have Pap smear examination. This research is a quantitative study with cross sectional approach recruited 50 respondents as multiparous women that have Pap smear examination inAviati Clinic, Padang Bulan, Medan. The data were collected by self-reports using structured objectives by questionnaires. The result of this study showed that 66% respondents have high knowledge of cervical cancer and 76% respondents have ahigh attitude of Pap smear, but they almost have low husband’s support of Pap smear including information support (62%), emotional support (46%) and real support (50%). This study has revealed that multiparous women that had Pap smear examination generally had high knowledge about cervical cancer and positive attitude about Pap smear, even most of them had low husband’s support.

  16. Application of the Perceptual Factors, Enabling and Reinforcing Model on Pap Smaear Screening in Iranian Northern Woman

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    Abolhassan Naghibi

    2016-03-01

    Full Text Available Background and Purpose: Cervical cancer is the most prevalent cancer among women in the world. Cervical cancer is no symptoms and can be treated if diagnosed in the first stage of the disease. The aim of this study was to survey the affecting factors of the Pap smears test on perceptual factors, enabling and reinforcing (PEN-3 model constructs in women. Materials and Methods: This study was a descriptive cross-sectional study. The sample size was 416 married women with random sampling. The questionnaire had 50 questions based on PEN-3 model structures. Data were analyzed by descriptive statistics and logistic regression method in software SPSS 20. Results: The mean age of women was 32.70 ± 21.00 years. The knowledge of risk factors and screening methods for cervical cancer was 37.2. About 40% of women had a history of Pap smears. The most important of perception factors were effective, family history of the disease, encourage people to Pap smear, and fear of detecting of cervical cancer. The most important enabling factors were the presence of expert health personnel to provide training and Pap smear test (50.3%, lack of time and too busy to do Pap smear test (23.2%. The reinforcing factors were the media advice (41.3%, doctor’s advice (32.5% and neglect and forgetfulness (36.2%. Conclusion: This study has shown the Pap smear screening behavior affected by personal factors, family, cultural and economic. Application of PEN-3 can effective in planning and designing intervention programs for cervical cancer screening.

  17. Pap Smear Diagnosis Using a Hybrid Intelligent Scheme Focusing on Genetic Algorithm Based Feature Selection and Nearest Neighbor Classification

    DEFF Research Database (Denmark)

    Marinakis, Yannis; Dounias, Georgios; Jantzen, Jan

    2009-01-01

    The term pap-smear refers to samples of human cells stained by the so-called Papanicolaou method. The purpose of the Papanicolaou method is to diagnose pre-cancerous cell changes before they progress to invasive carcinoma. In this paper a metaheuristic algorithm is proposed in order to classify t...... other previously applied intelligent approaches....

  18. Applying Sparse Machine Learning Methods to Twitter: Analysis of the 2012 Change in Pap Smear Guidelines. A Sequential Mixed-Methods Study.

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    Lyles, Courtney Rees; Godbehere, Andrew; Le, Gem; El Ghaoui, Laurent; Sarkar, Urmimala

    2016-06-10

    It is difficult to synthesize the vast amount of textual data available from social media websites. Capturing real-world discussions via social media could provide insights into individuals' opinions and the decision-making process. We conducted a sequential mixed methods study to determine the utility of sparse machine learning techniques in summarizing Twitter dialogues. We chose a narrowly defined topic for this approach: cervical cancer discussions over a 6-month time period surrounding a change in Pap smear screening guidelines. We applied statistical methodologies, known as sparse machine learning algorithms, to summarize Twitter messages about cervical cancer before and after the 2012 change in Pap smear screening guidelines by the US Preventive Services Task Force (USPSTF). All messages containing the search terms "cervical cancer," "Pap smear," and "Pap test" were analyzed during: (1) January 1-March 13, 2012, and (2) March 14-June 30, 2012. Topic modeling was used to discern the most common topics from each time period, and determine the singular value criterion for each topic. The results were then qualitatively coded from top 10 relevant topics to determine the efficiency of clustering method in grouping distinct ideas, and how the discussion differed before vs. after the change in guidelines . This machine learning method was effective in grouping the relevant discussion topics about cervical cancer during the respective time periods (~20% overall irrelevant content in both time periods). Qualitative analysis determined that a significant portion of the top discussion topics in the second time period directly reflected the USPSTF guideline change (eg, "New Screening Guidelines for Cervical Cancer"), and many topics in both time periods were addressing basic screening promotion and education (eg, "It is Cervical Cancer Awareness Month! Click the link to see where you can receive a free or low cost Pap test.") It was demonstrated that machine learning

  19. ThinPrep Pap-smear and cervical intraepithelial neoplasia in reproductive-aged Thai women.

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    Rugpao, S; Koonlertkit, S; Ruengkrist, T; Lamlertkittikul, S; Pinjaroen, S; Limtrakul, A; Werawatakul, Y; Sinchai, W

    2009-06-01

    To estimate the incidence of abnormal cervical cytology by ThinPrep Pap-tests and cervical intraepithelial neoplasia (CIN) in young adult reproductive-aged Thai women. A total of 1254 women distributed in all regions of Thailand were monitored from 2002 through 2004. Women were screened for abnormal cervical cytology using the ThinPrep method every 6 months. Interpretation of cervical cytology was based on the Bethesda system, version 2001. Women who had the ThinPrep Pap results as atypical squamous cells of undetermined significance or worse underwent colposcopic examination. The ThinPrep and all cervical tissue samples obtained from diagnostic or therapeutic procedures were analyzed and reviewed by Covance Central Laboratory Service, Inc., Indianapolis, USA. The cumulative incidence of abnormal ThinPrep Pap-tests was as follows: 15.3 per 100 woman years (WY) (95% confidence interval [CI] 12.3, 18.9) at 6 months; 12.3 per 100 WY (95% CI 10.3, 14.6) at 12 months; and 11.6 per 100 WY (95% CI 10.0, 13.5) at 18 months. Of 1448.6 woman years of follow up, the incidence of CIN1 was 4.1 per 100 WY (95% CI 3.2, 5.3); CIN2 0.8 per 100 WY (95% CI 0.4, 1.4); and CIN3 0.6 per 100 WY (95% CI 0.3, 1.2). The incidence of abnormal ThinPrep Pap-test and CIN in young adult Thai women had been reported. No comparable data is available.

  20. Factors Associated with Pap Smear Implementation among Women Referring to Healthcare Centers in Fasa, Iran: An Application of Theory of Planned Behavior

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    Zahra Moradi

    2017-06-01

    Full Text Available Background and Objective: Cervical cancer is the second most common cancer among the females. This cancer is considered as a preventable disease due to having a long period before the invasion, availability of appropriate screening program, and effective treatment of primary lesions. The aim of this study was to determine the factors related to per forming regular Pap smear test based on the Theory of Planned Behavior (TPB among the females living in Fasa, Iran. Materials and Methods: This descriptive-analytic cross-sectional study was conducted on 700 married women in Fasa city in 2016. The study population was selected from the females referring to the healthcare centers of Fasa using simple random sampling technique. The data were collected by means of a three-part questionnaire, including demographic data, knowledge, and TPB constructs. Data analysis was performed using Pearson correlation coefficient test and logistic regression in SPSS, version 22. Results: According to the results, 45.7% of the patients had a history of undergoing a Pap smear test, and 20.7% of them performed this test regularly. The results indicated that knowledge, attitude, subjective norms, and perceived behavioral control were the predictors of intention and behavior of Pap smear test among the women (P<0.05. These components accounted for 57.4% and 31.6% of the intention and behavior variance, respectively. Conclusion: As the findings of this study indicated, it is possible to increase the level of screening behaviors among the women by improving their awareness, attitude, subjective norms, and perceived behavioral control. This measure in turn plays a significant role in the prevention and control of cervical cancer.

  1. Region-based multifocus image fusion for the precise acquisition of Pap smear images.

    Science.gov (United States)

    Tello-Mijares, Santiago; Bescós, Jesús

    2018-05-01

    A multifocus image fusion method to obtain a single focused image from a sequence of microscopic high-magnification Papanicolau source (Pap smear) images is presented. These images, captured each in a different position of the microscope lens, frequently show partially focused cells or parts of cells, which makes them unpractical for the direct application of image analysis techniques. The proposed method obtains a focused image with a high preservation of original pixels information while achieving a negligible visibility of the fusion artifacts. The method starts by identifying the best-focused image of the sequence; then, it performs a mean-shift segmentation over this image; the focus level of the segmented regions is evaluated in all the images of the sequence, and best-focused regions are merged in a single combined image; finally, this image is processed with an adaptive artifact removal process. The combination of a region-oriented approach, instead of block-based approaches, and a minimum modification of the value of focused pixels in the original images achieve a highly contrasted image with no visible artifacts, which makes this method especially convenient for the medical imaging domain. The proposed method is compared with several state-of-the-art alternatives over a representative dataset. The experimental results show that our proposal obtains the best and more stable quality indicators. (2018) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

  2. Compliance with Papanicolaou smear screening following tubal ligation in women with cervical cancer.

    Science.gov (United States)

    Winkler, H A; Anderson, P S; Fields, A L; Runowicz, C D; DeVictoria, C; Goldberg, G L

    1999-01-01

    To evaluate patient compliance with Papanicolaou (Pap) smear screening after tubal ligation compared with other methods of birth control in patients who develop cervical cancer, a retrospective review of 262 women with cervical cancer diagnosed at age Albert Einstein College of Medicine from January 1987 to December 1995. Demographic data, stage of the disease, histologic type, history of smoking, history of sexually transmitted disease (STD), and birth control use were recorded. The Pap screening history was obtained from all the patients. Women who had a bilateral tubal ligation (BTL) were compared with those who did not have this form of birth control. The date and result of their last Pap test prior to their diagnosis of cervical cancer was noted. Two hundred fourteen women with cervical cancer were evaluable. The clinical stage, mean age, history of smoking, and history of STD were similar for both groups. Gravidity among the BTL group was higher than in the non-BTL group (p < 0.01). Forty-eight (22.4%) women had a previous BTL. Twenty-seven of these 48 patients (56.3%) did not have a Pap smear within 3 years prior to the diagnosis of cervical cancer. Of the 166 patients, 61 (36.7%) did not have a Pap test within 3 years (p < 0.05). Fourteen women (29.2%) in the tubal ligation group never returned for a Pap test following the BTL. An average of 6.2+/-5.9 years elapsed since the last Pap test in the BTL group, with 4.0+/-5.1 years in the nontubal ligation group (p < 0.05). There was a correlation between the number of years since BTL (14.2+/-7.7) to the number of years since the last Pap test (6.2+/-5.9) (p < 0.05). Women who have had a BTL should be considered high risk because of poor screening compliance. A Pap test every 3 years is not adequate in this high-risk population group. We advocate improved counseling regarding the importance of continued annual Pap screening for women who are considering tubal ligation.

  3. Factors related to failure to attend the consultation to receive the results of the Pap smear test1

    Science.gov (United States)

    Vasconcelos, Camila Teixeira Moreira; Cunha, Denise de Fátima Fernandes; Coelho, Cássia Fernandes; Pinheiro, Ana Karina Bezerra; Sawada, Namie Okino

    2014-01-01

    Objective to identify the factors related to the failure of women to attend the follow-up consultation to receive the results of the Pap smear test. Method a cross-sectional study, carried out with 775 patients who underwent the Pap smear test in the Centro de Saúde da Família of Fortaleza, between September 2010 and February 2011. Results the majority of the women studied were young (≤35 years), had low levels of education (≤7 years of study), and commenced sexual activity early (≤20 years), with 17.0% of them failing to return to receive the test results. Statistically significant results for the failure to return were related to: young women (p=0.001); early onset of sexual activity (p=0.047); and inadequate knowledge about the Pap smear test (p=0.029). Conclusion the fact that the women failed to return for the result is a problem for the control of cervical cancer and must be addressed through educational strategies that reinforce the importance of the return for the early detection of this cancer. PMID:25029050

  4. Educational intervention on knowledge of cervical cancer and uptake of Pap smear test among market women in Niger State, Nigeria.

    Science.gov (United States)

    Gana, Godwin Jiya; Oche, Mansur O; Ango, Jessica Timane; Kaoje, Aminu Umar; Awosan, Kehinde Joseph; Raji, Ismail A

    2017-12-31

    Cervical cancer is the most common female genital tract carcinoma worldwide. It is increasingly becoming the leading carcinoma seen among women in the developing world. The aim of our study was to showcase the effect of educational intervention on the knowledge of cervical cancer and subsequently the uptake of Pap smear test amongst market women in Niger state, Nigeria. The state has a rich network of markets in all the local government areas because of the fishing activities, bountiful agricultural produce yearly and its situation to the North of the national capital, Abuja. This was a quasi-experimental study conducted in two groups with pre and post intervention data collection. Sample size was determined based on a previous similar study done in Nigeria. Multi stage sampling technique was used for recruiting the study participants. SPSS statistical software was used for data entry, editing and analysis. Respondents' knowledge of cervical cancer were comparable at pre-intervention but were statistically significantly better (P<0.0001) at post-intervention in the intervention group compared to the control group for every variable measured. However, there was only a (Fisher's exact, P=0.621) compared to the control group. This study showed an increase in knowledge about cervical cancer and Pap smear test however the uptake of Pap smear test remained low even after intervention. This underscores the need for sustained intervention programs to eventually translate knowledge acquired to habitual practice.

  5. Factors related to failure to attend the consultation to receive the results of the Pap smear test

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    Camila Teixeira Moreira Vasconcelos

    2014-06-01

    Full Text Available OBJECTIVE: to identify the factors related to the failure of women to attend the follow-up consultation to receive the results of the Pap smear test.METHOD: a cross-sectional study, carried out with 775 patients who underwent the Pap smear test in the Centro de Saúde da Família of Fortaleza, between September 2010 and February 2011.RESULTS: the majority of the women studied were young (≤35 years, had low levels of education (≤7 years of study, and commenced sexual activity early (≤20 years, with 17.0% of them failing to return to receive the test results. Statistically significant results for the failure to return were related to: young women (p=0.001; early onset of sexual activity (p=0.047; and inadequate knowledge about the Pap smear test (p=0.029. Conclusion the fact that the women failed to return for the result is a problem for the control of cervical cancer and must be addressed through educational strategies that reinforce the importance of the return for the early detection of this cancer.

  6. Using poisson regression to compare rates of unsatisfactory pap smears among gynecologists and to evaluate a performance improvement plan.

    Science.gov (United States)

    Wachtel, Mitchell S; Hatley, Warren G; de Riese, Cornelia

    2009-01-01

    To evaluate impact of a performance improvement (PI) plan implemented after initial analysis, comparing 7 gynecologists working in 2 clinics. From January to October 2005, unsatisfactory rates for gynecologists and clinics were calculated. A PI plan was instituted at the end of the first quarter of 2006. Unsatisfactory rates for each quarter of 2006 and the first quarter of 2007 were calculated. Poisson regression analyzed results. A total of 100 ThinPrep Pap smears initially deemed unsatisfactory underwent reprocessing and revaluation. The study's first part evaluated 2890 smears. Clinic unsatisfactory rates, 2.7% and 2.6%, were similar (p > 0.05). Gynecologists' unsatisfactory rates were 4.8-0.6%; differences between each of the highest 2 and lowest rates were significant (p improvement. Reprocessing ThinPrep smears is an important means of reducing unsatisfactory rates but should not be a substitute for attention to quality in sampling.

  7. Qualidade e desempenho das colpocitologias na prevenção de câncer de colo uterino Quality and performance of pap smears in the cervical cancer screening program in a city of southern Brazil

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    Nelson Shozo Uchimura

    2009-01-01

    Full Text Available OBJETIVO: Estimar a prevalência e analisar a qualidade e o desempenho das colpocitologias realizadas no Programa de Prevenção de Câncer de Colo Uterino no município de Maringá-PR. MÉTODOS: Estudo retrospectivo dos dados do SIS-Colo do Ministério da Saúde. Foram analisadas as variáveis idade, resultado de colpocitologia e procedência. As idades foram categorizadas em faixas etárias, a procedência distribuída em cinco regionais de saúde do município de Maringá; a colpocitologia foi categorizada conforme o Sistema Bethesda. Calculou-se a cobertura de colpocitologia dividindo-se o número de exames na população de 25 a 59 anos pelo número de mulheres nesta mesma faixa etária. RESULTADOS: As 17.664 colpocitologias coletadas, no ano de 2005, pela rede pública se distribuíram entre as mulheres com idade mínima de 12 e máxima de 82 anos, sendo 12.961 (73,4% exames na faixa entre 25 e 59 anos, considerada de maior risco para o câncer. Foram negativos para neoplasia 17.458 (98,84% exames e as alterações celulares (ASCUS/AGUS, LIEBG, LIEAG e câncer invasor totalizaram 206 (1,16%. Encontrou-se prevalência de ASCUS de 0,85% (151, de atipias celulares 1,14% (203/17.664 e a relação ASCUS/atipias celulares 2,75% (151/55. CONCLUSÃO: A prevalência das alterações colpocitológicas e da ASCUS abaixo dos índices esperados, a relação ASCUS/atipias celulares em níveis elevados, a cobertura populacional insuficiente de colpocitologia compromete o desempenho da prevenção de câncer de colo uterino. A população de baixa condição sócio-econômica requer uma atenção especial e a população mais privilegiada deve ser orientada quanto a periodicidade do exame e faixa etária de maior risco.OBJECTIVE: To estimate prevalence and analyze quality and performance of colpocytology carried out under the Cervical Cancer Screening Program in Maringá, Paraná, Brazil. METHODS: A retrospective study of the SIS-Colo database of the

  8. Mammography and Pap test screening among low-income foreign-born Hispanic women in the USA

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    Fernandez Maria E.

    1998-01-01

    Full Text Available Little is known about the factors influencing screening among low-income Hispanic women particularly among recent immigrants. A sample of 148 low-income, low-literate, foreign-born Hispanic women residing in the Washington DC metropolitan area participated in the study. The mean age of the sample was 46.2 (SD = 11.5, 84% reported annual household incomes<=$15,000. All women were Spanish speakers and had low acculturation levels. Ninety six percent had reported having a Pap smear, but 24% were not in compliance with recommended screening (Pap test within the last 3 years. Among women 40 and older, 62% had received a mammogram, but only 33% were compliant with age appropriate recommended mammography screening guidelines. Women in this study had more misconceptions about cancer than Hispanics in other studies. Multivariate logistic models for correlates of Pap test and mammography screening behavior indicate that factors such as fear of the screening test, embarrassment, and lack of knowledge influenced screening behavior. In conclusion, women in this study had lower rates of mammography screening than non-Hispanic women and lower rates of compliance with recommended Mammography and Pap test screening guidelines.

  9. OPTIMASI KLASIFIKASI SEL TUNGGAL PAP SMEAR MENGGUNAKAN CORRELATION BASED FEATURES SELECTION (CFS BERBASIS C4.5 DAN NAIVE BAYES

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    Asti Herliana

    2016-11-01

    Full Text Available Abstract – Cervical cancer was the most dangerous disease and generally attacks women. Early detection through Pap Smear method was one way to prevent the desease to grow in womans cervival canal. Based on the result of Pap Smear methode, the single cell of data that known as herlev data is available. This data, then used as a reference by the experts to find the best level classification from each class of cervical cancer. The decision tree C4.5 and Naïve Bayes have proven to give the best result on 280 data trial of herlev with support by Correlation based Features Selection (CFS optimization method. The issues raised in the present study was does CFS optimization methode that combined with the classification method of C4.5 and Naïve Bayes can provide increased the accuracy results when it faced the 917 data of herlev. The results of this study show that CFS method that combined either with C4.5 methods and naïve bayes classification accuracy was decrease when compared without using CFS method. In terms of showing that CFS can not provide the best result when if confronted with big data. Keywords : optimization, classification, single cell of Pap Smear, Correlation based Features Selection, C4.5, Naïve Bayes   Abstrak – Kanker serviks merupakan penyakit yang sangat berbahaya dan pada umumnya menyerang kaum wanita. Deteksi sejak dini melalui metode Pap Smear merupakan salah satu cara untuk mencegah penyakit ini berkembang didalam saluran serviks wanita. Berdasarkan hasil dari metode Pap Smear, didapatkanlah data sel tunggal yang kini dikenal dengan data herlev. Data ini, kemudian dijadikan acuan dalam penelitian oleh para ahli dewasa ini untuk menemukan tingkat klasifikasi terbaik dari masing-masing kelas kanker serviks. Metode Decision tree C4.5 dan Naïve Bayes terbukti memberikan hasil yang terbaik pada ujicoba data herlev sebanyak 280 data dengan dukungan dari metode optimasi Correlation based Features Selection(CFS. Permasalahan

  10. The frequency of having pap-smear tests among women between 15-64 years old and the evaluation of the level of their knowledge

    International Nuclear Information System (INIS)

    Sevil, S.; Kevser, O.; Aleattin, U.

    2013-01-01

    Objective: To determine the frequency of Pap smear testing among women and to evaluate their level of knowledge about the test and other relevant factors. Methods: The study comprised women who presented to the Gynaecology and Obstetrics Polyclinic of Sakarya Training and Research Hospital, Turkey, between April 1 and 30, 2012. The questionnaire was developed in line with the objectives of the study. They were filled by the participants who were supervised during the process. Women who had had at least one Pap smear test in life were considered to have taken a Pap smear test , and those who had heard of the test were accepted as women who k new of the Pap smear test . Data was analysed using SPSS 15.0. Chi-square test was used for analyses, and statistical significance was set at p<0.05. Results: The age of 601 subjects ranged between 15 and 64 years, with a mean of 31.09+-10.49 years. Of the total, 115 (19.1%) had taken a Pap smear test before and 293 (48.8%) knew of the test. The proportion of the women who had had a Pap smear test was higher among those who were over 30 years of age (n=73; 63.47%), had post-high school educational degrees (n=68; 59.13%), had moderate familial income status (n=74; 64.34%), were married (n=109; 94.78%), had first sexual experience after 25 years of age(n=42; 36.52%), and were not using a contraceptive method (n=97; 84.34%) (p<0.05 for each). Besides, more women with previous knowledge of the test had taken the test (p<0.05). Conclusion: The subjects did not have sufficient information on Pap smear and the frequency of having a test was low. Raising awareness would prove beneficial. (author)

  11. Human papilloma virus testing knowledge and attitudes among women attending colposcopy clinic with ASCUS/LGSIL pap smears.

    Science.gov (United States)

    Le, T; Hicks, W; Menard, C; Boyd, D; Hewson, T; Hopkins, L; Kee Fung, M Fung

    2004-09-01

    To study women's knowledge regarding the role of human papilloma virus (HPV) in cervical intraepithelial neoplasia and their attitudes toward the integration of HPV testing as part of routine follow-up of atypical squamous cell of uncertain significance/low-grade squamous intraepithelial lesion (ASCUS/LGSIL) abnormalities. Over a 12-month period, all women attending the University of Ottawa colposcopy clinic for evaluation and follow-up of ASCUS/LGSIL Pap smears were recruited. Demographic data included age, nature of the Pap smear abnormality, gravidity, parity, occupation and education level, smoking history, previous history of abnormal smears, colposcopic examination and treatment, and current method of contraception. The women were asked to rate their level of concern over their Pap smear abnormality, from 0 (not concerned) to 10 (very concerned). Women's knowledge regarding the role of HPV in cervical intraepithelial neoplasia and the rationale behind the use of HPV testing was assessed by the clinic nurse as being minimal, moderate, or good, as defined by pre-specified criteria. Upon explanation by the nurses of the results of the recent ALTS (ASCUS/LGSIL Triage Study) trial, the women were asked to state whether they preferred to continue with regular colposcopic surveillance every 6 months, or to use the results of the HPV test, if negative, to reduce the number of colposcopy examinations to one annually. Descriptive statistics and logistic regression analysis were used to identify significant demographic factors associated with the women's preference for incorporation of HPV testing in their follow-up. All P values less than.10 were considered to be statistically significant, due to the exploratory nature of the study. Of the 100 women who participated in the study, 42% presented with ASCUS. The mean age (+/- SD) of the women was 33.63 +/- 11.25 years (range, 18-75 years); 66% were office workers with at least a community college degree, 86% reported

  12. IMPLEMENTASI HASIL PAP SMEARS PADA PENGEMBANGAN SURVEILANS TERPADU INFEKSI MENULAR SEKSUAL DI JAWA TIMUR (ANALISIS UNTUK MENGEMBANGKAN SURVEILANS-RESPONS IMS

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    Widjiartini Widjiartini

    2012-12-01

    Full Text Available Background: The implementation analysis of Pap Smears result to the integrated Surveillance development of sexual infection in order to respond the IMS and HIV/AIDS cases which increased especially among the housewife and its aim to the implementation Pap Smears result. Results: The Analysis result: 1. Based on the Pap Smears analysis result when its managed properly might be benefited the information not merely detected service cancer which is tend to increase but its also detected fungal infection and 5 types of IMS data: Haemavilus Vaginalis (HV, Gonococoes (Cocen, Trichomonas Vaginalis (TV, Herpes and Virus Papiloma Humanus (HPV which is Cocen and TV tend to increase every years. This data might be used for Surveillance Respond of Pap Smears intended to the productive housewife who is representing susceptible age group against sexual infection and HIV/AIDS. 2. The integrated Surveillance activity of HIV and sexual infection along with eight steps of respond Pap Smears, the structure is matching up with Surveillance of WHO respond and the system and mechanism base on decision of Minister of Health number 1116/2003 to instruct the formation of Surveillance technical implementation and the formation Surveillance technical implementation and the formation Surveillance networking among those units. 3. Developing the integrated Surveillance of sexual infection and HIV/AIDS through the uphold unit Pap Smears is required the determination of basis function, the Surveillance uphold unit, the Respond Surveillance uphold and function, formulation of Protap and Instruction, Training, Monitoring and Evaluation Surveillance System, Communication, Procurement of Coordination and Resources. Exceptional the above mentioned it is necessary pay attention as well as Surveillance structure and quality. Suggestion: 1. Improving the Surveillance Respond System by improving the users of culture information and data for making a decision the unit of Pap Smears

  13. Cobertura e fatores associados à não realização do exame preventivo de Papanicolaou em São Luís, Maranhão Coverage and factors associated with not performing Pap smear screening tests in São Luís, Maranhão, Brazil

    Directory of Open Access Journals (Sweden)

    Márcia Maria Hiluy Nicolau de Oliveira

    2006-09-01

    Full Text Available Com o objetivo de estimar a cobertura, a periodicidade, e identificar fatores associados à não realização do exame preventivo de Papanicolau, 465 mulheres de 25 a 49 anos residentes no município de São Luís foram entrevistadas em 1998. Foi realizado inquérito domiciliar pelo método de amostragem por conglomerados em três estágios. Na análise estatística foram calculados intervalos de confiança de 95% corrigidos pelo desenho do estudo, e os "odds ratio" brutos e ajustados por regressão logística. A cobertura do Papanicolaou pelo menos uma vez na vida foi de 82,4% (Intervalo de Confiança 95%, 76,6 - 87,0%, praticamente atingindo a cobertura mínima necessária de 85% para causar impacto epidemiológico na incidência e mortalidade por câncer cérvico-uterino. O intervalo entre a realização dos exames foi curto, pois 65,8% das mulheres repetiram o exame com até um ano. Após o ajuste para fatores de confundimento foram associados à não realização do Papanicolaou: não ter companheiro, ter cinco a oito anos de escolaridade, não ter realizado consulta médica nos três últimos meses e morar em domicílio cujo chefe de família tem ocupação manual não especializada. Ter tido de dois a quatro parceiros sexuais nos três últimos meses foi associado a menor risco de não realização do preventivo. Em capital do Nordeste, a cobertura do exame preventivo de Papanicolaou foi semelhante à relatada em outros estudos nacionais. Entretanto, algumas mulheres realizaram citologias desnecessárias a intervalos curtos, implicando em desperdício de recursos e dificultando o acesso aos grupos mais vulneráveis que apresentaram maiores riscos de não testagem.In 1998, 465 women from 25 to 49 years of age, inhabitants of the municipality of São Luís, Maranhão, Brazil were interviewed to estimate Pap smear coverage, interval between tests and to identify factors associated with not performing Pap smears. A three-stage household

  14. Comparison of bloody pap smear fixation by Carnoy’s and fixator spray in samples from women with abnormal uterine bleeding

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    Keshavarz Najmeh

    2016-05-01

    Full Text Available Abnormal uterine bleeding is a serious problem among women of late reproductive age. Cervical cancer is one of the reasons of AUB and Pap smear is the best way to diagnose it. Blood has negative effects on Pap smear especially in AUB with great blood. One of the effective solutions for lysing RBC is Carnoy’s. This study aims to compare two methods of fixation in bloody Pap smear by Carnoy’s and normal spray in samples from women with AUB. This study was done on 204 bloody Pap smear from 102 women with AUB that referred to Zeinabieh and Faghihi hospitals of Shiraz University of Medical Sciences from2012-2013. After observing uterine bleeding in each subject, two samples were provided using usual Pap smear method; one of the slides was fixed by normal spray and the other slide fixed by Carnoy’s solution for20 minutes. After staining (Papanicolaou method, two pathologists performed a double-blind trial to analyze them. Data analysis was done using SPSS. 82 samples did not have cell adequacy. Squamous cells in Carnoy’s-fixed slides were more than spray-fixed ones (p=0.024. The decrease in the number of RBC on slides and the increase in the clarity of slides in Carnoy’s-fixed samples were more than sprayfixed slides (p=0.001, while identifying inflammatory cells(p=0.832 and microbial factors (p=1 in both methods showed no significant difference. Carnoy’s solution can be used as an effective fixative in bloody Pap smear from women with abnormal uterine bleeding.

  15. Comparing the effect of the order of cell Collection for Pap Smear on the results of cytologic Diagnosis

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    parvin Rahnama

    2005-08-01

    We observed higher proportion of atypical squamous cells of undetermined significance (ASCUS detection in the spatula- first group (33 cases, 59% compared with brush- first group (20 cases, 3.6% which is insignificant (P=0.09. This study showed that the ability of squamous intraepithelial lesion (SIL detection in spatula- first group (27 cases, 4.8%, was comparable to brush-first group (23 cases, 4.1%. Conclusions: Because reported SIL cases are higher when samples are first taken from exocervix and rate of blood contamination increases when samples are taken from endocervix (p=0.004, it is better to take samples first from exocervix for Pap Smear. This strategy increases the chance of diagnosis of cellular lesions of cervix.

  16. The frequency of herpes simplex virus changes in anal Pap smear and its association with squamous intraepithelial lesions in high-risk male patients.

    Science.gov (United States)

    Greebon, Leslie J; Avery, Diane L; Prihoda, Thomas J; Valente, Philip T; Policarpio-Nicolas, Maria Luisa C

    2014-06-01

    While there are studies postulating a model of synergism between human papillomavirus (HPV) and herpes simplex virus (HSV) in cervical carcinogenesis, the frequency of anal herpes as well as its association with anal squamous intraepithelial lesions (ASILs) has been understudied in men. This study evaluates the frequency of HSV changes in anal Pap smears and its association with ASILs in a high-risk population. A computerized search for specimens associated with anal cytology that had positive findings of HSV was performed. The electronic medical records were examined for past diagnosis of herpes, HSV serology prior to or after cytology, and if the patient received treatment after cytologic diagnosis of HSV. Of the 470 anal Pap smears (Thin-prep) examined, seven had cellular changes consistent with HSV infection. All patients were asymptomatic human immunodeficiency virus (HIV) positive males with no prior HSV serology tests. Two patients had prior diagnoses of HSV infection. Cytologic abnormalities were identified in 86% ranging from atypical squamous cells of undetermined significance to high grade squamous intraepithelial lesion. Three patients were treated after the HSV cytologic diagnosis. The frequency of HSV changes in anal Pap smear is low (1.48%), but the presence of concomitant cytologic abnormalities is high (86%). While our findings suggest the possible role of HSV as a HPV co-factor in ASILs, larger studies are needed to support this. Identification of HSV infection on anal Pap smear is important for institution of patient treatment and subsequent reduction of transmission. Copyright © 2014 Wiley Periodicals, Inc.

  17. PAPNET-assisted primary screening of conventional cervical smears.

    Science.gov (United States)

    Cenci, M; Nagar, C; Vecchione, A

    2000-01-01

    The PAPNET System is the only device with a neural-network-based-artificial intelligence to detect and show the images of abnormal cells on the monitor to be evaluated in an interactive way. We effectively used the PAPNET in rescreening of conventional cervical smears and we detected its advantages and its disadvantages. In this paper, we report our results from PAPNET-assisted primary screening performed on 20,154 conventional smears. The smears were classified as Negative or as Review. The Negative cases were rapidly rescreened mainly near the coverslip edges, which are the slide areas not analyzed by automated devices because of focusing problems. The Review cases were fully reanalyzed by the optic microscope. In summary, 140 positive smears were detected: 57 cases showed changes due to HPV, 63 LSIL, 15 HSIL, and 5 carcinomas. Therefore, the PAPNET System was confirmed as useful in primary screening of conventional cervical samples as well as rescreening.

  18. An audit of a cervical smear screening programme.

    Science.gov (United States)

    Moodie, P J; Kljakovic, M; McLeod, D K

    1989-07-26

    An audit of a computer based screening and recall programme in a Wellington group general practice is reported (practice population 13,866). The records of all women aged between 20 and 59 years (4133 women) were checked to determine if they had had a cervical smear test in the previous two years. A random sample of women who had a cervical smear result recorded in the notes (107 women called "responders") showed that 71% gave "familiarity with the family doctor" and "acting in response to a recall letter" as reasons for choosing the place of their last smear. Satisfaction with the service was indicated by 95% of these women stating they would have their next smear at the medical centre. In the audit of all the records, a group of 667 women who had been sent a letter inviting them to have a smear done and who had apparently declined the procedure was identified (called "nonresponders"). A random sample of this group (168 women) was taken and an attempt made to interview them. In fact only 38 women could be identified as requiring a smear and even if those who refused to be interviewed (13) and those unable to be contacted (23) are added, then less than half of this sample were "true nonresponders". This suggests that the percentage of women in the practice who have been offered a smear and have refused to have one is less than 8%.

  19. Facing possible illness detected through screening--experiences of healthy women with pathological cervical smears

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Petersen, Lone Kjeld; Pedersen, Birthe D

    2007-01-01

    The aim of this study is to gain knowledge about women's perceptions of illness based on their abnormal PAP smears, following screening for cervical cancer. The study uses a phenomenological, hermeneutic approach inspired by Ricoeur's theory of interpretation. Twelve women, aged between 23 and 59...... of a face-value review of participant experiences (naive reading), structural analysis and, critical interpretation of what it means to be potentially ill. The women were unprepared to find that their screening results showed abnormal cells, indicative of incipient genital cancer. They were frustrated...... by the results as they had not experienced any symptoms and felt well, despite being diagnosed with a potential disease. Being diagnosed with abnormal cells caused the participants to feel anxious. Their anxiety had subsided 6 months after the cells had been removed. For those who did not require treatment...

  20. Knowledge, Attitude and Practice of Cervical Smear as a Screening ...

    African Journals Online (AJOL)

    Context: Carcinoma of the cervix is a preventable disease but it remains the most common genital cancer in African women. Objective: To determine the knowledge, attitude and practice of cervical smear as screening procedure for cervical cancer by female health workers in Ilorin, Nigeria. Study Design, Setting and ...

  1. ["Where there's a woman, there's a Pap smear": the meanings assigned to cervical cancer prevention among women in Salvador, Bahia State, Brazil].

    Science.gov (United States)

    Rico, Ana María; Iriart, Jorge Alberto Bernstein

    2013-09-01

    This study focuses on the meanings assigned to practices for cervical cancer prevention among women from low-income neighborhoods in Salvador, Bahia State, Brazil. This was a qualitative study based on content analysis of semi-structured interviews with 15 women 24 to 68 years of age. The results showed high appreciation of the Pap smear test, performed as part of routine gynecological examination (but without the patient necessarily having biomedical knowledge of its role). Besides accessibility and quality of health services, other factors influence the way the women assign meaning to cervical cancer prevention. Moral values associated with sexuality and gender influence risk perception, adoption of preventive practices, and interpretation of cervical cytology results. The ongoing practice of the Pap smear test is part of the construction of femininity, which is associated with maturity and personal responsibility for self care in a context of medicalization of the female body.

  2. Quantitative Assessment of Pap Smear Cells by PC-Based Cytopathologic Image Analysis System and Support Vector Machine

    Science.gov (United States)

    Huang, Po-Chi; Chan, Yung-Kuan; Chan, Po-Chou; Chen, Yung-Fu; Chen, Rung-Ching; Huang, Yu-Ruei

    Cytologic screening has been widely used for controlling the prevalence of cervical cancer. Errors from sampling, screening and interpretation, still concealed some unpleasant results. This study aims at designing a cellular image analysis system based on feasible and available software and hardware for a routine cytologic laboratory. Totally 1814 cellular images from the liquid-based cervical smears with Papanicolaou stain in 100x, 200x, and 400x magnification were captured by a digital camera. Cell images were reviewed by pathologic experts with peer agreement and only 503 images were selected for further study. The images were divided into 4 diagnostic categories. A PC-based cellular image analysis system (PCCIA) was developed for computing morphometric parameters. Then support vector machine (SVM) was used to classify signature patterns. The results show that the selected 13 morphometric parameters can be used to correctly differentiate the dysplastic cells from the normal cells (pgynecologic cytologic specimens.

  3. Pap smear cytology and identification of Human Papillomavirus (HPV) type 16 and 18 in multiparity women at Aviati Clinic Padang Bulan Medan

    Science.gov (United States)

    Anggraini, D. R.; Feriyawati, L.; Fitrie, A. A.; Ginting, R. N. A.

    2018-03-01

    Cervical cancer is the second most frequent cancer in woman in developing countries and one of the most crucial health problems in the world. Human Papillomavirus (HPV) is an agent for sexually transmitted disease which is an act of cervical cancer, especially high-risk of HPV type 16 and 18. In this study, we investigated the Pap smear cytology features and identification of HPV types 16 and18 in multiparity women at Aviati Clinic Padang Bulan, Medan. Samples are cervical swabs of 50 multiparity women who met the inclusion criteria (childbirth ≥ three times) was included in the study. Pap smear examination was conducted using Papanicolaou staining and identification of HPV types 16 and 18 using the Polymerase Chain Reactive (PCR) methods. Pap smearcytology showed 80% Negative for intraepithelial lesion or malignancy (NILM) with inflammation and 20% NILM. The result of PCR amplification showed that there weren’t specific band DNA was found at band 414bp and 216bp. That means there weren’t cervical swabs sample had DNA of HPV type 16 and 18.

  4. Psychosocial burden differences between women of reproductive age and menopausal age due to abnormal Pap smear: A pilot study of the East Coast of Malaysia

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    Shabbir Ahmad Sheikh

    2016-01-01

    Conclusion: Psychosocial burden due to abnormal Pap smear results in terms of mental stress, overwhelming beliefs, and feelings of guilt and worry of HPV infection and possibility of cervical cancer were noted more in reproductive age groups as compared to the menopausal age group. Health-care providers should be aware of these psychosocial effects whereby they can refer such patients to a gynecologic oncologist for proper counseling at the proper time so that the negative impact due to this psychosocial burden can be prevented.

  5. Comparison of Unsatisfactory Samples from Conventional Smear versus Liquid-Based Cytology in Uterine Cervical Cancer Screening Test

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    Hoiseon Jeong

    2017-05-01

    Full Text Available Background Cervical cytology for uterine cervical cancer screening has transitioned from conventional smear (CS to liquid-based cytology (LBC, which has many advantages. The aim of this study was to compare the proportion of unsatisfactory specimens from CS versus LBC at multiple institutions including general hospitals and commercial laboratories. Methods Each participating institution provided a minimum of 500 Papanicolaou (Pap test results for analysis. Pap tests were classified according to the participating institution (commercial laboratory or general hospital and the processing method (CS, ThinPrep, SurePath, or CellPrep. The causes of unsatisfactory results were classified as technical problems, scant cellularity, or complete obscuring factors. Results A total of 38,956 Pap test results from eight general hospitals and three commercial laboratories were analyzed. The mean unsatisfactory rate of LBC was significantly lower than that of CS (1.26% and 3.31%, p = .018. In the LBC method, samples from general hospitals had lower unsatisfactory rates than those from commercial laboratories (0.65% vs 2.89%, p = .006. The reasons for unsatisfactory results were heterogeneous in CS. On the other hand, 66.2% of unsatisfactory results in LBC were due to the scant cellularity. Conclusions Unsatisfactory rate of cervical cancer screening test results varies according to the institution and the processing method. LBC has a significantly lower unsatisfactory rate than CS.

  6. Pap screening as preventive tool against cervical cancer: a report of ...

    African Journals Online (AJOL)

    The incidence of cervical cancer in the developed countries has significantly reduced as a result of well-organized and coordinated Pap screening program, which is aimed at detection of pre-invasive lesions that are then promptly treated. We report a 45-year old woman whose immediate elder sister had breast carcinoma, ...

  7. Prevalence of high-risk human papillomavirus and abnormal pap smears in female sex workers compared to the general population in Antwerp, Belgium

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    Alex Vorsters

    2016-06-01

    Full Text Available Abstract Background Although female sex workers (FSWs are a well-known high-risk group for Human Papillomavirus (HPV infections, few tailored intervention programmes for HPV have been established worldwide. The lack of reliable data on the prevalence of HPV and related cervical lesions hampers the establishment of evidence-based intervention programmes. The objectives of this study were to describe the prevalence of high-risk Human Papillomavirus (hrHPV infections and abnormal pap smears in FSWs compared to a control group in Antwerp, Belgium. Methods HPV genotyping and cytology data were analysed from routine Pap smear tests that were collected from both FSWs and the general population (1334 samples for each group between June 2006 and June 2010. Within the laboratory database, all FSWs were matched 1:1 for age and testing date to determine the ORs of hrHPV genotypes, DNA and cytology outcome. Results The prevalence of hrHPV DNA in FSWs was 41.7 % compared to 19.8 % in the age-matched controls with an overall OR of 2.8 (95 % CI: 2.3–3.4. Significant differences were observed in all age groups, and the most significant differences were observed in the cohort under 21 years of age (prevalence of 64.4 % in FSWs versus 14.8 % in controls; OR 10.3 (95 % CI: 5.0–21.2. Significantly more cervical lesions were observed in FSWs, particularly in the 17- to 21-year old age group (OR for LSIL or HSIL: 10.3 (95 % CI: 3.2–33.8. In both groups, HPV 16 was the most prevalent at 12.1 and 6.6 % in the FSW and control groups, respectively. HPV 18 was the 8th and 7th most frequent genotype at 5.0 and 2.5 % in the FSW and control groups, respectively. Conclusions FSWs have a significantly higher prevalence of hrHPV and more abnormal Pap smears than does the general population in Antwerp, Belgium. The hrHPV prevalence in FSWs is similar to that reported in the literature. The need for tailored intervention programmes should be investigated further.

  8. Honouring Stories: Mi'kmaq Women's Experiences with Pap Screening in Eastern Canada.

    Science.gov (United States)

    MacDonald, Catherine; Martin-Misener, Ruth; Steenbeek, Audrey; Browne, Annette

    2015-03-01

    Mi'kmaq women are reported to have lower rates of Papanicolaou (Pap) screening and higher rates of cervical cancer than non-Aboriginal women. This qualitative participatory study used postcolonial feminist perspectives and Indigenous principles to explore Mi'kmaq women's experiences with Pap screening within the contexts that shaped their experiences. Community facilitators assisted with the research process. Talking circles and individual in-depth interviews were conducted with 16 Mi'kmaq women. Also, health-care providers were interviewed in 2 Mi'kmaq communities. The findings indicate that historical and social contexts are shaping Mi'kmaq women's screening experiences and that these experiences are diverse, as are their understandings about screening. Some women were accessing regular screening despite challenging personal circumstances. The results highlight the need for nurses and other health-care providers to understand the uniqueness of each woman's experiences with Pap screening. Improvements in screening rates depend on multifaceted nursing approaches developed in partnership with Mi'kmaq women. Copyright© by Ingram School of Nursing, McGill University.

  9. Investigation of the Role of Training Health Volunteers in Promoting Pap Smear Test Use among Iranian Women Based on the Protection Motivation Theory.

    Science.gov (United States)

    Ghahremani, Leila; Harami, Zahra Khiyali; Kaveh, Mohammad Hossein; Keshavarzi, Sareh

    2016-01-01

    Cervical cancer is known as one of the most prevalent types of cancers and a major public health problem in developing countries which can be detected by Pap test, prevented, and treated. Despite the effective role of Pap test in decreasing the incidence and mortality due to cervical cancer, it is still one the most common causes of cancer-related deaths among women, especially in developing countries. Thus, this study aimed to examine the effect of educational interventions implemented by health volunteers based on protection motivation theory (PMT) on promoting Pap test use among women. This quasi-experimental study was conducted on 60 health volunteers and 420 women. The study participants were divided into an intervention and a control group. Data were collected using a valid self-reported questionnaire including demographic variables and PMT constructs which was completed by both groups before and 2 months after the intervention. Then, the data were entered into the SPSS statistical software, version 19 and were analyzed using Chi-square test, independent T-test, and descriptive statistical methods. P<0.05 was considered as statistically significant. The findings of this study showed that the mean scores of PMT constructs (i.e. perceived vulnerability, perceived severity, fear, response-costs, self-efficacy, and intention) increased in the intervention group after the intervention (P<0.001). However, no significant difference was found between the two groups regarding response efficacy after the intervention (P=0.06). The rate of Pap test use also increased by about 62.9% among the study women. This study showed a significant positive relationship between PMT-based training and Pap test use. The results also revealed the successful contribution of health volunteers to training cervical cancer screening. Thus, training interventions based on PMT are suggested to be designed and implemented and health volunteers are recommended to be employed for educational

  10. Prevalence of Abnormal Cervical Smears from Sporadic Screening ...

    African Journals Online (AJOL)

    The aim of the study was to find the prevalence of abnormal smears in an unscreened population of sexually active women attending a gynaecological clinic. “Pap” smears were taken sporadically for cytological examination from sexually active women attending gynaecological clinics at the Federal Medical Centre Gombe.

  11. Pap Screening Goals and Perceptions of Pain among Black, Latina, and Arab Women: Steps toward Breaking down Psychological Barriers

    Science.gov (United States)

    Gauss, Julie W.; Mabiso, Athur; Williams, Karen Patricia

    2013-01-01

    BACKGROUND Understanding women’s psychological barriers to getting Papanicolaou (Pap) screening has potential to impact cancer disparities. This study examined pain perceptions of Pap testing among Black, Latina and Arab women and goal setting to receive Pap tests. METHODS Data on 420 women, a longitudinal study, were analyzed using Chi-square tests of differences and generalized linear mixed models. RESULTS At baseline, 30.3% of Black and 35.5% of Latina women perceived Pap tests to be very painful compared to 24.2% of Arab women. Perceptions of pain influenced goal settings, such as scheduling a first ever Pap test (Odds ratio = 0.58, 95% Confidence interval: 0.14-0.94). Immediately following the intervention, women’s perception that Pap tests are very painful significantly declined (P-valuetest is very painful significantly reduces the likelihood of Black, Latina and Arab women setting the goal to schedule their first ever Pap test. Latina women are the least likely to improve their perception that the Pap test is very painful, though national statistics show they have the highest rates of morbidity and mortality from cervical cancer. These findings are instructive for designing tailored interventions to break down psychological barriers to Pap screening among underserved women. PMID:23288606

  12. Virologic versus cytologic triage of women with equivocal Pap smears: a meta-analysis of the accuracy to detect high-grade intraepithelial neoplasia.

    Science.gov (United States)

    Arbyn, Marc; Buntinx, Frank; Van Ranst, Marc; Paraskevaidis, Evangelos; Martin-Hirsch, Pierre; Dillner, Joakim

    2004-02-18

    The appropriate management of women with minor cytologic lesions in their cervix is unclear. We performed a meta-analysis to assess the accuracy of human papillomavirus (HPV) DNA testing as an alternative to repeat cytology in women who had equivocal results on a previous Pap smear. Data were extracted from articles published between 1992 and 2002 that contained results of virologic and cytologic testing followed by colposcopically directed biopsy in women with an index smear showing atypical cells of undetermined significance (ASCUS). Fifteen studies were identified in which HPV triage and the histologic outcome (presence or absence of a cervical intraepithelial neoplasia of grade II or worse [CIN2+]) was documented. Nine, seven, and two studies also documented the accuracy of repeat cytology when the cutoff for abnormal cytology was set at a threshold of ASCUS or worse, low-grade squamous intraepithelial lesion (LSIL) or worse, or high-grade squamous intraepithelial lesion (HSIL) or worse, respectively. Random-effects models were used for pooling of accuracy parameters in case of interstudy heterogeneity. Differences in accuracy were assessed by pooling the ratio of the sensitivity (or specificity) of HPV testing to that of repeat cytology. The sensitivity and specificity were 84.4% (95% confidence interval [CI] = 77.6% to 91.1%) and 72.9% (95% CI = 62.5% to 83.3%), respectively, for HPV testing overall and 94.8% (95% CI = 92.7% to 96.9%) and 67.3% (95% CI = 58.2% to 76.4%), respectively, for HPV testing in the eight studies that used the Hybrid Capture II assay. Sensitivity and specificity of repeat cytology at a threshold for abnormal cytology of ASCUS or worse was 81.8% (95% CI = 73.5% to 84.3%) and 57.6% (95% CI = 49.5% to 65.7%), respectively. Repeat cytology that used higher cytologic thresholds yielded substantially lower sensitivity but higher specificity than triage with the Hybrid Capture II assay. The ratio of the sensitivity of the Hybrid Capture II

  13. Psychological impact, support and information needs for women with an abnormal Pap smear: comparative results of a questionnaire in three European countries

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    Jorge Anna

    2011-05-01

    Full Text Available Abstract Background Extensive information on cervical cancer is currently available. Its effectiveness in reducing anxiety in women receiving abnormal Pap tests is not clear. We investigated current practices of communicating abnormal Pap results to evaluate women's reactions and determine the sources of information they use subsequently. Methods A self-administered questionnaire-based study was performed in 1475 women in France, Spain and Portugal who had received an abnormal Pap smear result in the 12 months prior to completing the questionnaire. Questions covered methods of communication of the result, emotional reactions, support received (from the physician and entourage, and information sources, using pre-specified check box options and rating scales. Data were analyzed by country. Results Pap test results were mostly communicated by phone to Spanish women (76%, while physician letters were common in France (59% and Portugal (36%. Frequent reactions were anxiety, panic and stress, which were less common in Spanish women than their French and Portuguese counterparts. After discussing with their physician, half of the participants were worried, despite rating highly the psychological support received. Over 90% of women in each country discussed their results with family or friends. Partners provided a high level of support. Overall, the abnormal diagnosis and consequences had a low to medium impact on daily, professional and family life and their relationships with their partner. Impact was higher in Spanish women than the French or Portuguese. Information on the diagnosis and its treatment was rated average, and nearly 80% of participants wanted more information, notably French women. Preferred sources were the physician and the Internet. Conclusions Women expressed a strong wish for more information about cervical cancer and other HPV-related diseases, and that their physician play a major role in its provision and in support. There was a

  14. A screening system for smear-negative pulmonary tuberculosis using artificial neural networks

    Directory of Open Access Journals (Sweden)

    João B. de O. Souza Filho

    2016-08-01

    Conclusions: In settings with a high prevalence of smear-negative PTB, the system can be useful for screening and also to aid clinical practice in expediting complementary tests for higher risk patients.

  15. The agreement between self-reported cervical smear abnormalities and screening programme records.

    Science.gov (United States)

    Canfell, Karen; Beral, Valerie; Green, Jane; Cameron, Rebecca; Baker, Krys; Brown, Anna

    2006-01-01

    The Million Women Study is a cohort study of women aged 50-64 years in England and Scotland. As a component of the follow-up questionnaire, participants were asked to indicate if they had an abnormal cervical smear in the previous five years. This study compared self-reported cervical abnormalities with screening records obtained from the National Health Service Cervical Screening Programme. For 1944 randomly selected Million Women Study participants in Oxfordshire, screening records were assessed over a six-year period prior to the date of self-reporting. The six-year period was chosen to allow for errors in the recall of timing of abnormal smears. A total of 68 women (3.5%) had a record of at least one equivocal or abnormal smear within the last six years, whereas 49 women (2.5%) self-reported an abnormality. There was a strong trend for an increased probability of self-reporting a history of an abnormal smear as the severity of the recorded abnormality increased (P screening programme records show an abnormal smear, the proportion self-reporting an abnormality increases with the severity of the recorded lesion. Almost all women with a record of negative or inadequate smear(s) correctly interpret the result and do not self-report an abnormality.

  16. Low cost automated whole smear microscopy screening system for detection of acid fast bacilli.

    Directory of Open Access Journals (Sweden)

    Yan Nei Law

    Full Text Available In countries with high tuberculosis (TB burden, there is urgent need for rapid, large-scale screening to detect smear-positive patients. We developed a computer-aided whole smear screening system that focuses in real-time, captures images and provides diagnostic grading, for both bright-field and fluorescence microscopy for detection of acid-fast-bacilli (AFB from respiratory specimens.To evaluate the performance of dual-mode screening system in AFB diagnostic algorithms on concentrated smears with auramine O (AO staining, as well as direct smears with AO and Ziehl-Neelsen (ZN staining, using mycobacterial culture results as gold standard.Adult patient sputum samples requesting for M. tuberculosis cultures were divided into three batches for staining: direct AO-stained, direct ZN-stained and concentrated smears AO-stained. All slides were graded by an experienced microscopist, in parallel with the automated whole smear screening system. Sensitivity and specificity of a TB diagnostic algorithm in using the screening system alone, and in combination with a microscopist, were evaluated.Of 488 direct AO-stained smears, 228 were culture positive. These yielded a sensitivity of 81.6% and specificity of 74.2%. Of 334 direct smears with ZN staining, 142 were culture positive, which gave a sensitivity of 70.4% and specificity of 76.6%. Of 505 concentrated smears with AO staining, 250 were culture positive, giving a sensitivity of 86.4% and specificity of 71.0%. To further improve performance, machine grading was confirmed by manual smear grading when the number of AFBs detected fell within an uncertainty range. These combined results gave significant improvement in specificity (AO-direct:85.4%; ZN-direct:85.4%; AO-concentrated:92.5% and slight improvement in sensitivity while requiring only limited manual workload.Our system achieved high sensitivity without substantially compromising specificity when compared to culture results. Significant improvement

  17. Access to Adequate Healthcare for Hmong Women: A Patient Navigation Program to Increase Pap Test Screening

    Directory of Open Access Journals (Sweden)

    Moon S. Chen, Jr

    2010-01-01

    Full Text Available This paper describes the development and implementation of a Hmong Cervical Cancer Intervention Program utilizing a patient navigation model to raise cervical cancer awareness for Hmong women through educational workshops and to assist Hmong women in obtaining a Pap test. Out of 402 women who participated in a baseline survey, the Patient Navigation Program was able to enroll 109 participants who had not had a Pap test in the past 3 years and had never had a Pap test. Through utilization of outreach, an awareness campaign and patient navigation support, at least 38 percent of 109 participants obtained a Pap test. Overall, 21 workshops and 43 outreach activities were conducted by the Hmong Women’s Heritage Association, leading to 63 percent of those enrolled in the Patient Navigation Program who could be contacted to obtain a Pap test.

  18. Estimation of Pap-test coverage in an area with an organised screening program: challenges for survey methods

    Directory of Open Access Journals (Sweden)

    Raggi Patrizio

    2006-03-01

    Full Text Available Abstract Background The cytological screening programme of Viterbo has completed the second round of invitations to the entire target population (age 25–64. From a public health perspective, it is important to know the Pap-test coverage rate and the use of opportunistic screening. The most commonly used study design is the survey, but the validity of self-reports and the assumptions made about non respondents are often questioned. Methods From the target population, 940 women were sampled, and responded to a telephone interview about Pap-test utilisation. The answers were compared with the screening program registry; comparing the dates of Pap-tests reported by both sources. Sensitivity analyses were performed for coverage over a 36-month period, according to various assumptions regarding non respondents. Results The response rate was 68%. The coverage over 36 months was 86.4% if we assume that non respondents had the same coverage as respondents, 66% if we assume they were not covered at all, and 74.6% if we adjust for screening compliance in the non respondents. The sensitivity and specificity of the question, "have you ever had a Pap test with the screening programme" were 84.5% and 82.2% respectively. The test dates reported in the interview tended to be more recent than those reported in the registry, but 68% were within 12 months of each other. Conclusion Surveys are useful tools to understand the effectiveness of a screening programme and women's self-report was sufficiently reliable in our setting, but the coverage estimates were strongly influenced by the assumptions we made regarding non respondents.

  19. The Effect of History of Abnormal Pap Smear or Preceding HPV infection on the Humoral Immune Response to Quadrivalent Human Papilloma virus (qHPV) Vaccine in Women with Systemic Lupus Erythematosus.

    Science.gov (United States)

    Dhar, J Patricia; Essenmacher, Lynnette; Dhar, Renee; Magee, Ardella; Ager, Joel; Sokol, Robert J

    2018-04-30

    To determine if natural human papillomavirus (HPV) infection would induce an anamnestic response to quadrivalent (qHPV) vaccine in women with Systemic Lupus Erythematosus (SLE). Thirty four women (19-50 years) with mild to moderate and minimally active or inactive SLE received standard qHPV vaccine. Neutralizing antibody titers to HPV 6, 11, 16 and18 were evaluated pre- and post- vaccine using HPV competitive Luminex Immunoassay. For each HPV type, logistic regressions were performed to explore the relationship between a positive titer at baseline with their final geometric mean titer and with the rise in titer. Fisher's Exact Test was used to assess the association of at least one positive HPV antibody test at baseline and history of abnormal pap. History of abnormal pap smear/cervical neoplasia occurred in 52.9%. Baseline anti HPV antibody titers: 21% = negative for all 4 HPV types, 79% = positive for ≥1 of the HPV types. Statistical analysis showed: those with a history of abnormal pap smear/cervical neoplasia were likely to have a positive anti-HPV antibody result pre-vaccine to ≥ 1 of the 4 types, p = 0.035 Fisher's Exact Test. In general, HPV exposed women showed higher post vaccine GMTs than HPV unexposed women with higher point estimates. However, when examining the rise in titers using logistic regression, there was no evidence of an anamnestic response. Prior HPV infection and cervical neoplasia in SLE are linked with no anamnestic response to HPV vaccine. This supports not checking HPV-antibodies pre-vaccine. Women with SLE should be vaccinated for HPV.

  20. Negative HPV screening test predicts low cervical cancer risk better than negative Pap test

    Science.gov (United States)

    Based on a study that included more than 1 million women, investigators at NCI have determined that a negative test for HPV infection compared to a negative Pap test provides greater safety, or assurance, against future risk of cervical cancer.

  1. Cervical cancer screening among Lebanese women.

    Science.gov (United States)

    Bou-Orm, I R; Sakr, R E; Adib, S M

    2018-02-01

    Cervical cancer is a very common malignancy amongst women worldwide. Pap smear is an effective and inexpensive screening test in asymptomatic women. The aim of this paper was to assess the prevalence of Pap smear screening for cervical cancer among Lebanese women and to determine associated sociodemographic and psychosocial characteristics. This national survey included 2255 women, selected by multi-stage random cluster sampling across Lebanon. A questionnaire about practices and perceptions related to cervical cancer screening was developed based on the "Health Belief Model". The weighted national prevalence of "ever-use" of the Pap smear for screening purposes was 35%. Most important determinants of screening behavior were: residence within Greater Beirut, higher socio-economic status and educational attainment, marriage status, presence of a health coverage, awareness of Pap smear usefulness, knowing someone who had already done it, and a balance between perceived benefits and perceived barriers to Pap smear screening. Regular information campaigns regarding the availability and effectiveness of the test should be devised, targeting in priority the sexually vulnerable women in Lebanon. Moreover, healthcare providers should be encouraged to discuss with their patients the opportunity of obtaining a Pap smear. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  2. Effect of organized screening on incidence and mortality of cervical cancer in Denmark

    DEFF Research Database (Denmark)

    Lynge, E; Madsen, Mette; Engholm, G

    1989-01-01

    Pap smears were used only on a limited scale in Denmark until the late 1960s. Since then smears have been taken both in organized screening programs and outside the programs by general practitioners, private gynecologists, and hospital wards. The present smear-taking activity is equivalent to an ...... from 5 years after introduction of an organized screening program. The level of overall smear-taking activity was found to be of limited importance when organized screening was taken into account....

  3. Cobertura do exame de Papanicolaou no Brasil e seus fatores determinantes: uma revisão sistemática da literatura Coverage of the Pap smear in Brazil and its determining factors: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Luís Felipe Leite Martins

    2005-08-01

    coberturas abaixo de 70,0% nos últimos três anos. Por outro lado, algumas variáveis foram mais freqüentemente observadas nas mulheres não submetidas ao exame de Papanicolaou: ter baixo nível socioeconômico, ter baixa escolaridade, ter baixa renda familiar e pertencer às faixas etárias mais jovens. CONCLUSÃO: os dados aqui apresentados apontam para desigualdades regionais na cobertura do exame de Papanicolaou na população feminina brasileira e para a necessidade de intervenção junto àqueles fatores a ela associados.PURPOSE: to present an overview of the coverage of the Pap smear in Brazil, emphasizing the determinant factors associated with failure of women to submit to the test. METHODS: the literature was reviewed using the LILACS (Latin-American and Caribbean Literature in Sciences of the Health, MEDLINE - 1966 to 2004 (International Literature in Sciences of the Health, PAHO (Collection of the Library of the Pan-American Organization of Health, and WHOLIS (System of Information of the Library of OMS databases. The review was enlarged through the search of bibliographical references of relevant studies, request for published and unpublished studies by specialists, and other sources. Articles that fulfilled the following criteria were selected: to be a cross-sectional study, carried out in Brazil, including information about periodicity of the Pap test (some time in life or in the last three years and/or containing information about factors associated with failure of women to submit to the test. Duplicates and articles without summary were excluded. A total of 13 articles fulfilling these criteria were selected. RESULTS: there are few studies on the coverage of Pap smear in Brazil. Most of them are concentrated in the big cities of the South and Southeast regions of the country. Besides the shortage, little methodological standardization exists in relation to the sampling and profile of the investigated women, which turns difficult the comparison among them

  4. Citologia vaginal a fresco na gravidez: correlação com a citologia corada pela técnica de Papanicolaou Fresh wet mount in pregnancy: correlation with Pap smears

    Directory of Open Access Journals (Sweden)

    Amadeu Ramos da Silva Filho

    2004-01-01

    neste último método propedêutico. Os diagnósticos de tricomoníase observados em ambos os métodos citológicos (3,7 e 2,7% traduzem a baixa prevalência destes parasitas na gestação. O cálculo do índice kappa para avaliação da concordância entre os dois procedimentos citológicos nos diversos achados microbiológicos demonstrou baixa correlação nos diagnósticos da vaginose bacteriana e colpites bacterianas inespecíficas, bem como na identificação da flora vaginal normal. CONCLUSÕES: embora a citologia corada apresente melhor acurácia no diagnóstico de fungos não formadores de micélios, a citologia direta a fresco demonstrou ser melhor avaliador dos elementos não epiteliais dos esfregaços vaginais. Entretanto, a microscopia corada pela técnica de Papanicolaou, por permitir melhor apreciação das células epiteliais cervicovaginais, representa o mais importante instrumento revelador das agressões e reações nucleocitoplasmáticas.PURPOSE: to analyze vaginal contents using the fresh wet mount of a cytological exam in the first prenatal visit of women with or without genital complaints and correlate the conclusion with the results from the Pap smears. Microscopy during pregnancy should be valued and recognized as a method capable of providing immediate diagnosis in 90% of bacterial vaginosis, candidiasis and trichomoniasis cases. METHODS: a prospective study was performed in 216 pregnant women selected from the prenatal department of a public hospital, between October 30, 2001 and November 12, 2002. Two samples were collected from the posterior vaginal vault and deposited onto two separate microscope slides. To one slide, a droplet of 0.9% NaCl was applied and to the other, a droplet of 10% KOH. Both slides were covered with a coverslip for immediate microscopic evaluation. Tests were perfomed in one drop of the material to examine pH and whiff. The microscopic examination of the material was carried out at a 100X, 400X and exceptionally 1000X

  5. The acceptability of vaginal smear self-collection for screening for cervical cancer: a systematic review

    Directory of Open Access Journals (Sweden)

    Natalia Serrano Doratioto Faria Braz

    Full Text Available Cervical cancer is a major cause of death in adult women. However, many women do not undergo cervical cancer screening for the following reasons: fear, shame, physical limitations, cultural or religious considerations and lack of access to health care services. Self-collected vaginal smears maybe an alternative means of including more women in cervical cancer screening programs. The objective of this systematic review was to evaluate the acceptability of vaginal smear self-collection for cervical cancer screening. We selected articles from PubMed, the Cochrane Library and Embase that were published between January 1995 and April 2016. Studies written in English, French, Italian, Portuguese or Spanish that involved women between 18 and 69 years of age who had engaged in sexual intercourse were included in this review. The review was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Nineteen studies were ultimately evaluated in this review. Most of the included studies (n=17 demonstrated that the self-collection method exhibited outstanding acceptability among women with respect to cervical cancer screening, and only two studies indicated that self-collection exhibited low acceptability among women in this context. The acceptability of self-collection was determined subjectively (without standardized questionnaires in 10 studies (53% and via structured and validated questionnaires in the remaining studies. The results of our review suggest that the self-collection method is well-accepted and may therefore encourage greater participation in cervical cancer screening programs. However, additional studies are required to verify these results.

  6. Advances in cervical screening technology.

    Science.gov (United States)

    Stoler, M H

    2000-03-01

    The Pap smear unquestionably is a successful screening test for cervical cancer. However, recent advances in technology have raised questions regarding whether the conventional Pap smear is still the standard of care. This article relates issues of screening and cost-effectiveness to the state of the art in thin layer preparations, cytology automation, human papillomavirus screening, human papillomavirus vaccines, and other cervical screening adjuncts. Perhaps nowhere in medicine is clinical decision making being more strongly influenced by market and other external forces than in cervical cytopathology.

  7. Impact of HPV testing, HPV vaccine development, and changing screening frequency on national Pap test volume: projections from the National Health Interview Survey (NHIS).

    Science.gov (United States)

    Eltoum, Isam A; Roberson, Janie

    2007-02-25

    The frequently cited number of 50 million annual Papanicolaou cervical screening (Pap) tests performed in the US was based on the National Health Interview Survey (NHIS) of the 1980s. Since then, monumental changes have occurred. More change will soon follow when primary human papilloma virus (HPV) testing and/or HPV vaccine delivery are fully accepted and implemented. The objectives of this study were 1) to estimate the total annual Pap tests performed in the US based on recent NHIS surveys, and 2) to estimate the potential change in the total annual Pap volume produced by changing demographics, reduced screening frequency, HPV testing, and the HPV vaccine. In the NHIS 2000 and NHIS 2005, women were asked to report the frequency of their Pap tests for the 6 years prior to the interview and to report whether they had abnormal findings. The authors analyzed the survey respondents answers to these questions by using SAS Survey Procedures (SAS Institute, NC). The results were stratified by age, and the total national volume was then extrapolated from a similarly stratified 2000 US census. The projected increase of total Pap tests for the next 25 years was determined by using the projected census data. Potential reductions of Pap tests performed secondarily to HPV testing of women >30 years old and of HPV vaccination were also determined. Based on NHIS 2000 and NHIS 2005, 66 million (95% CI, 65-68) and 65 million (95% CI, 64-67) Pap tests were performed in the US, respectively. Had HPV testing been performed in women older than 30 years who had both negative HPV and negative 3-year Pap tests, then 30% (95% CI, 29-32%) of Pap tests would not have been performed. If both HPV testing and vaccination are performed, the total number of Pap tests performed annually is predicted to be reduced by 43% (95% CI, 35-38%). Therefore, despite an expected increase in the population of women eligible for Pap tests, the total number will likely decrease substantially in the future

  8. Has the ThinPrep method of cervical screening maintained its improvement over conventional smears in terms of specimen adequacy?

    LENUS (Irish Health Repository)

    Treacy, A

    2009-04-01

    Liquid-based cytology (LBC) has replaced conventional smear assessment in many centers over recent years. In our laboratory this transfer took place in 1999. At that time we performed a split sample study comparing the conventional method of cervical smear evaluation with the ThinPrep system. This split sample study identified a dramatic improvement in specimen adequacy with LBC. While 11% of conventional preparations were reported as unsatisfactory and almost 9% were reported as suboptimal, evaluation of the same cases using LBC saw this combined figure reduced to 2.3%. AIM: To evaluate whether this dramatic fall in unsatisfactory smears has been maintained with the use of LBC. The database for all smears reported for 2005 (100% LBC) was interrogated. The number of unsatisfactory reports was calculated. The reason for an unsatisfactory report was recorded for each case. The overall unsatisfactory rate was compared with that reported in the 1999 split sample study. A total of 41,312 smear tests were reported in 2005. 1,342 (3.25%) were reported as unsatisfactory. Our findings support the ongoing value of LBC in a routine cervical screening laboratory in terms of continuing to maintain a low rate of unsatisfactory smears.

  9. Cervical Cancer Screening Preferences Among Trans-Masculine Individuals: Patient-Collected Human Papillomavirus Vaginal Swabs Versus Provider-Administered Pap Tests.

    Science.gov (United States)

    McDowell, Michal; Pardee, Dana J; Peitzmeier, Sarah; Reisner, Sari L; Agénor, Madina; Alizaga, Natalie; Bernstein, Ida; Potter, Jennifer

    2017-08-01

    Trans-masculine (TM, i.e., persons who have a masculine spectrum gender identity, but were assigned female sex at birth) individuals face disparities in cervical cancer screening rates compared to cisgender women. Some unique barriers to screening in this population are specific to Pap tests. Introduction of self-collected frontal (i.e., vaginal) swabs for human papillomavirus (HPV) testing as a screening strategy may obviate these barriers. This study elucidates cervical cancer screening preferences among TM individuals. TM individuals participated in in-depth interviews (n = 31) and online surveys (n = 32) to explore perceptions and experiences regarding cervical cancer screening, including the acceptability of self-collected frontal HPV swabs for cervical cancer screening compared to provider-administered Pap tests. Provider-collected frontal HPV swab acceptability was also explored. Most TM individuals (94% in-person and 91% online participants) preferred either the self- or provider-collected frontal HPV swab to the Pap test. Participants perceived self- and provider-collected frontal HPV swabs to be less invasive, provoke less gender discordance, and promote a greater sense of agency compared to Pap tests. However, some participants expressed concern about HPV swab accuracy and, regarding the self-collected swab, discomfort about the need to engage with genitals they may not want to acknowledge. Individuals who reported positive provider relationships found Pap tests and provider-collected frontal swabs more acceptable than those who did not. Frontal HPV swabs have the potential to promote regular cervical cancer screening among TM individuals and to narrow screening disparities. Work is ongoing to establish swab accuracy and develop shared decision-making tools.

  10. Less medical intervention after sharp demarcation of grade 1-2 cervical intraepithelial neoplasia smears by neural network screening

    NARCIS (Netherlands)

    Kok, MR; Boon, ME; Schreiner-Kok, PG; Hermans, J; Grobbee, DE; Kok, LP

    2001-01-01

    BACKGROUND. Neural network technology has been used for the daily screening of cervical smears in The Netherlands since 1992. The authors believe this method might have the potential to demarcate diagnoses of Grade 1-2 cervical intraepithelial neoplasia (CIN 1-2). METHODS. Of 133,196 women who were

  11. 分析改良阴道取样巴氏涂片及液基薄层细胞学检查对宫颈癌的诊断价值%Analysis the diagnostic value of improved vaginal sampling Pap smear and thinprep cytology for cervical cancer

    Institute of Scientific and Technical Information of China (English)

    韩胜春

    2015-01-01

    Objective Analysis of the value of improved vaginal sampling Pap smear and liquid based cytologyexamination in diagnosis of cervical cancer.Methods In our hospital for health examination of 683 cases of female, with improved vaginal sampling Pap smear, and ThinPrep cytological test (TCT), TCT for the detection of positive patients who underwent colposcopic multiple biopsy in pathological diagnosis as the criterion.Summary of analysis of test Results .Results In 683 specimens, there are unsatisfactory in 12 cases, specimensof satisfaction is 98.2% (671/683). In 671 specimens including 52 cases of Trichomonas, mold in 17 cases, 42cases of clue cells. TCT detection of squamous cell carcinoma antigen (SCC)、coincidence detection and biopsy of AC and rate of HSIL is higher than LSIL, the difference was Statistically signiifcant (P<0.05).Conclusion The improved vaginal sampling Pap smear and liquid based cytology examination on the positive detection rate of squamous cell carcinoma, adenocarcinoma and high-grade squamous intraepithelial lesion is higher, and the method of economic security, convenient operation, suitable for cervical cancer screening work of the majority of the masses of women.%目的 分析改良阴道取样巴氏涂片及液基薄层细胞学检查对宫颈癌的诊断价值.方法 选取在我院进行健康体检的女性683名,采用改良阴道取样巴氏涂片,并进行液基薄层细胞学检查(TCT),对于TCT检测阳性患者行行阴道镜下宫颈多点活检,以病理诊断为判定标准.总结分析检测结果.结果 683例标本中,有不满意标本12例,标本满意度为98.2%(671/683).671例标本中,滴虫52例,霉菌17例,线索细胞42例.TCT检测对鳞状上皮细胞癌抗原(SCC)、腺癌(AC)及鳞状上皮内高度病变(HSIL)的检测与病理活检的符合率高于LSIL,差异均有统计学意义(P<0.05).结论 改良阴道取样巴氏涂片及液基薄层细胞学检查对鳞癌、腺癌及鳞状上皮内高度病变有

  12. Rationale and design of the iPap trial: a randomized controlled trial of home-based HPV self-sampling for improving participation in cervical screening by never- and under-screened women in Australia

    International Nuclear Information System (INIS)

    Sultana, Farhana; Gertig, Dorota M; English, Dallas R; Simpson, Julie A; Brotherton, Julia ML; Drennan, Kelly; Mullins, Robyn; Heley, Stella; Wrede, C David; Saville, Marion

    2014-01-01

    Organized screening based on Pap tests has substantially reduced deaths from cervical cancer in many countries, including Australia. However, the impact of the program depends upon the degree to which women participate. A new method of screening, testing for human papillomavirus (HPV) DNA to detect the virus that causes cervical cancer, has recently become available. Because women can collect their own samples for this test at home, it has the potential to overcome some of the barriers to Pap tests. The iPap trial will evaluate whether mailing an HPV self-sampling kit increases participation by never- and under-screened women within a cervical screening program. The iPap trial is a parallel randomized controlled, open label, trial. Participants will be Victorian women age 30–69 years, for whom there is either no record on the Victorian Cervical Cytology Registry (VCCR) of a Pap test (never-screened) or the last recorded Pap test was between five to fifteen years ago (under-screened). Enrolment information from the Victorian Electoral Commission will be linked to the VCCR to determine the never-screened women. Variables that will be used for record linkage include full name, address and date of birth. Never- and under-screened women will be randomly allocated to either receive an invitation letter with an HPV self-sampling kit or a reminder letter to attend for a Pap test, which is standard practice for women overdue for a test in Victoria. All resources have been focus group tested. The primary outcome will be the proportion of women who participate, by returning an HPV self-sampling kit for women in the self-sampling arm, and notification of a Pap test result to the Registry for women in the Pap test arm at 3 and 6 months after mailout. The most important secondary outcome is the proportion of test-positive women who undergo further investigations at 6 and 12 months after mailout of results. The iPap trial will provide strong evidence about whether HPV self

  13. Exame citopatológico de colo uterino em mulheres com idade entre 20 e 59 anos em Pelotas, RS: prevalência, foco e fatores associados à sua não realização Pap smears of 20 - 59 year-old women in Pelotas, Southern Brazil: prevalence, approach and factors associated with not undergoing the test

    Directory of Open Access Journals (Sweden)

    Arnildo A. Hackenhaar

    2006-03-01

    Full Text Available OBJETIVO: Determinar a prevalência e o foco de realização do exame citopatológico do colo uterino e também fatores associados à sua não realização em mulheres com idade entre 20 e 59 anos residentes na cidade de Pelotas, RS. MÉTODOS: Entre outubro e dezembro de 2003 foi realizado um estudo transversal de base populacional. Através de amostragem por conglomerados foram sorteados 144 setores censitários em múltiplos estágios. Foram investigadas variáveis sociodemográficas e a realização de exame citopatológico do colo uterino. RESULTADOS: Dentre as 1404 mulheres que constituem a população-alvo dos programas de prevenção do câncer do colo uterino, 83,0% realizaram o exame citopatológico do colo uterino nos três anos antecedentes a este estudo. Mostraram-se significativamente associadas (POBJECTIVE: This study aims to determine the prevalence of and approach of Pap smear tests, as well as associated factors in women living in Pelotas, RS, Southern Brazil, within the 20 - 59 age range, who did not undergo a Pap smear. METHODS: A cross-sectional population-based study was carried out from October to December 2003. 144 census tracts were sampled through a multiple-stage clustered method. Socio-demographic variables were investigated, as well as women's Pap smear tests. RESULTS: Among the 1,404 women who were the target population included in the early detection program of uterine cervix cancer, 83% had had Pap smears in the three years before the study. Variables statistically associated (p<0.05 with women not undergoing the test in the previous three years were: ages ranging from 20-29 to 50-59 years compared with 40-49 year-old women, lower schooling level, lower social level, mixed and black skin color, not having seen a gynecologist in the previous 12 months. CONCLUSIONS: Although this study presents a high coverage of women undergoing Pap smears, women that present higher risk factors for this type of cancer had fewer

  14. High throughput virtual screening and in silico ADMET analysis for rapid and efficient identification of potential PAP248-286 aggregation inhibitors as anti-HIV agents

    Science.gov (United States)

    Malik, Ruchi; Bunkar, Devendra; Choudhary, Bhanwar Singh; Srivastava, Shubham; Mehta, Pakhuri; Sharma, Manish

    2016-10-01

    Human semen is principal vehicle for transmission of HIV-1 and other enveloped viruses. Several endogenous peptides present in semen, including a 39-amino acid fragments of prostatic acid phosphatase (PAP248-286) assemble into amyloid fibrils named as semen-derived enhancer of viral infection (SEVI) that promote virion attachment to target cells which dramatically enhance HIV virus infection by up to 105-fold. Epigallocatechin-3-gallate (EGCG), a polyphenolic compound, is the major catechin found in green tea which disaggregates existing SEVI fibers, and inhibits the formation of SEVI fibers. The aim of this study was to screen a number of relevant polyphenols to develop a rational approach for designing PAP248-286 aggregation inhibitors as potential anti-HIV agents. The molecular docking based virtual screening results showed that polyphenolic compounds 2-6 possessed good docking score and interacted well with the active site residues of PAP248-286. Amino acid residues of binding site namely; Lys255, Ser256, Leu258 and Asn265 are involved in binding of these compounds. In silico ADMET prediction studies on these hits were also found to be promising. Polyphenolic compounds 2-6 identified as hits may act as novel leads for inhibiting aggregation of PAP248-286 into SEVI.

  15. Congress: 50 years of the Papanicolaou test. Istituto Superiore di Sanita`. Rome, March 30, 1995; Convegno: 50 anni di Pap test. Istituto Superiore di Sanita`. Roma, 30 marzo 1995

    Energy Technology Data Exchange (ETDEWEB)

    Branca, Margherita; Cedri, Sabina; Migliore, Giovanna [Istituto Superiore di Sanita` , Rome (Italy). Lab. di Epidemiologia e Biostatistica

    1997-12-01

    The Conference was organized to celebrate the 50th anniversary of the cervical smear test, commonly referred to as the `Pap test` after its creator, George Nicholas Papanicolaou. The reports present the development of the test, its worldwide application, and its performance as the screening test for the detection of cervical cancer. Pap smear screening for precursors of carcinoma of the cervix has led to dramatic decrease in the incidence and deaths from this cancer. The test represents one of the greatest achievements in preventive medicine.

  16. Cervical cancer screening in primary health care setting in Sudan

    DEFF Research Database (Denmark)

    Ibrahim, Ahmed; Aro, Arja R.; Rasch, Vibeke

    2012-01-01

    /119 (73.9%) were positive for cervical intraepithelial neoplasia. VIA had higher sensitivity than Pap smear (74.2% versus 72.9%; P = 0.05) respectively. Out of 88 confirmed positive cases, 22 (25.0%) cases were invasive cervical cancer in stage 1, of which 19 versus three were detected by VIA and Pap......OBJECTIVE: To determine the feasibility of visual inspection with the use of acetic acid (VIA) as a screening method for cervical cancer, an alternative to the Pap smear used in primary health care setting in Sudan, and to compare sensitivity, specificity, positive and negative predictive values...... of this study showed that VIA has higher sensitivity and lower specificity compared to Pap smear, but a combination of both tests has greater sensitivity and specificity than each test independently. It indicates that VIA is useful for screening of cervical cancer in the primary health care setting in Sudan...

  17. How to Interpret Abnormal Pap Smear Results

    Science.gov (United States)

    ... Kids and Teens Pregnancy and Childbirth Women Men Seniors Your Health Resources Healthcare Management End-of-Life Issues Insurance & Bills Self Care Working With Your Doctor Drugs, Procedures & Devices Over-the- ...

  18. A closer look at cervical smear uptake and results pre- and post- introduction of the national screening programme.

    LENUS (Irish Health Repository)

    Gallagher, F

    2012-02-01

    Prior to the introduction of a national cervical screening programme, death rates from cervical cancer in the Republic of Ireland were greater than the death rates in all other regions in Britain and Northern Ireland. The following audit compares the impact of the national cervical screening programme, established on 1 September \\'08, on uptake and results per age group screened before and after its implementation. This retrospective audit was carried out in a four-doctor practice with approximately 1554 GMS and 5000 private patients. Data over a ten month period in \\'08\\/\\'09 was collected from the practice record of cervical smears and compared to the same period in \\'07\\/\\'08. A cohort of 534 Irish urban women was included. A total number of 148 women were screened between October 2007 and July 2008 compared with 386 women screened over the same months in 2008\\/2009. Increase in uptake was most marked in the 25-44 years age group, 100 (\\'07-\\'08) vs. 303 (\\'08-\\'09). The majority of results for both time periods were negative (85% 07\\/08, 81% 08\\/09). There was a higher number of HSIL in \\'08-\\'09 (an increase from 1% to 3.37% of the total screened). This audit clearly supports the introduction of the national cervical screening programme showing both an increase in uptake and a increased pick-up of high grade lesions.

  19. Cervical cancer screening: knowledge, attitude and practices among nursing staff in a tertiary level teaching institution of rural India.

    Science.gov (United States)

    Shekhar, Shashank; Sharma, Chanderdeep; Thakur, Sita; Raina, Nidhi

    2013-01-01

    Assessment of the nursing staff knowledge, attitude and practices about cervical cancer screening in a tertiary care teaching institute of rural India. A cross sectional, descriptive, interview- based survey was conducted with a pretested questionnaire among 262 staff nurses of a tertiary care teaching and research institute. In this study 77% respondents knew that Pap smear is used for detection of cervical cancer, but less than half knew that Pap smear can detect even precancerous lesions of cervix. Only 23.4% knew human papilloma virus infection as a risk factor. Only 26.7% of the respondents were judged as having adequate knowledge based on scores allotted for questions evaluating knowledge about cervical cancer and screening. Only 17 (7%) of the staff nurses had themselves been screened by Pap smear, while 85% had never taken a Pap smear of a patient. Adequate knowledge of cervical cancer and screening, higher parity and age >30 years were significantly associated with self screening for cervical cancer. Most nurses held a view that Pap test is a doctor procedure, and nearly 90% of nurses had never referred a patient for Pap testing. The majority of nursing staff in rural India may have inadequate knowledge about cervical cancer screening, and their attitude and practices towards cervical cancer screening could not be termed positive.

  20. Defined PEG smears as an alternative approach to enhance the search for crystallization conditions and crystal-quality improvement in reduced screens

    Energy Technology Data Exchange (ETDEWEB)

    Chaikuad, Apirat, E-mail: apirat.chaikuad@sgc.ox.ac.uk [University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford OX3 7DQ (United Kingdom); Knapp, Stefan [University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford OX3 7DQ (United Kingdom); Johann Wolfgang Goethe-University, Building N240 Room 3.03, Max-von-Laue-Strasse 9, 60438 Frankfurt am Main (Germany); Delft, Frank von, E-mail: apirat.chaikuad@sgc.ox.ac.uk [University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford OX3 7DQ (United Kingdom)

    2015-07-28

    An alternative strategy for PEG sampling is suggested through the use of four newly defined PEG smears to enhance chemical space in reduced screens with a benefit towards protein crystallization. The quest for an optimal limited set of effective crystallization conditions remains a challenge in macromolecular crystallography, an issue that is complicated by the large number of chemicals which have been deemed to be suitable for promoting crystal growth. The lack of rational approaches towards the selection of successful chemical space and representative combinations has led to significant overlapping conditions, which are currently present in a multitude of commercially available crystallization screens. Here, an alternative approach to the sampling of widely used PEG precipitants is suggested through the use of PEG smears, which are mixtures of different PEGs with a requirement of either neutral or cooperatively positive effects of each component on crystal growth. Four newly defined smears were classified by molecular-weight groups and enabled the preservation of specific properties related to different polymer sizes. These smears not only allowed a wide coverage of properties of these polymers, but also reduced PEG variables, enabling greater sampling of other parameters such as buffers and additives. The efficiency of the smear-based screens was evaluated on more than 220 diverse recombinant human proteins, which overall revealed a good initial crystallization success rate of nearly 50%. In addition, in several cases successful crystallizations were only obtained using PEG smears, while various commercial screens failed to yield crystals. The defined smears therefore offer an alternative approach towards PEG sampling, which will benefit the design of crystallization screens sampling a wide chemical space of this key precipitant.

  1. A malaria diagnostic tool based on computer vision screening and visualization of Plasmodium falciparum candidate areas in digitized blood smears.

    Directory of Open Access Journals (Sweden)

    Nina Linder

    Full Text Available INTRODUCTION: Microscopy is the gold standard for diagnosis of malaria, however, manual evaluation of blood films is highly dependent on skilled personnel in a time-consuming, error-prone and repetitive process. In this study we propose a method using computer vision detection and visualization of only the diagnostically most relevant sample regions in digitized blood smears. METHODS: Giemsa-stained thin blood films with P. falciparum ring-stage trophozoites (n = 27 and uninfected controls (n = 20 were digitally scanned with an oil immersion objective (0.1 µm/pixel to capture approximately 50,000 erythrocytes per sample. Parasite candidate regions were identified based on color and object size, followed by extraction of image features (local binary patterns, local contrast and Scale-invariant feature transform descriptors used as input to a support vector machine classifier. The classifier was trained on digital slides from ten patients and validated on six samples. RESULTS: The diagnostic accuracy was tested on 31 samples (19 infected and 12 controls. From each digitized area of a blood smear, a panel with the 128 most probable parasite candidate regions was generated. Two expert microscopists were asked to visually inspect the panel on a tablet computer and to judge whether the patient was infected with P. falciparum. The method achieved a diagnostic sensitivity and specificity of 95% and 100% as well as 90% and 100% for the two readers respectively using the diagnostic tool. Parasitemia was separately calculated by the automated system and the correlation coefficient between manual and automated parasitemia counts was 0.97. CONCLUSION: We developed a decision support system for detecting malaria parasites using a computer vision algorithm combined with visualization of sample areas with the highest probability of malaria infection. The system provides a novel method for blood smear screening with a significantly reduced need for

  2. Evaluation Of Cervical Cancer Screening Program At A Rural ...

    African Journals Online (AJOL)

    But the condition is preventable through regular screening of women those are 'at risk\\' for abnormal changes in the cervix and treating them who have positive results. Although screening facilities are ... Keywords: Cervical cancer, Pap smear test, knowledge, practice, programme coverage. East African Journal of Public ...

  3. OPPORTUNISTIC CERVICAL CANCER SCREENING IN PREGNANCY

    Directory of Open Access Journals (Sweden)

    Radha Bai Prabhu T

    2016-01-01

    Full Text Available Introduction: Cervical cancer is the most common malignancy diagnosed during pregnancy. In developing countries where organized screening programmes are lacking, antenatal clinics may provide an opportunity for screening. Objectives: The aim of this study was to analyse the prevalence and management of abnormal cervical cytology in pregnancy. Methodology: This was a prospective study conducted at the Meenakshi Medical College and RI, Kancheepuram, India, from July 2013 to June 2014. Convenience sampling technique was used. After adequate counselling, 300 antenatal mothers between 12 and 34 weeks of gestation were screened with conventional Pap smear. Colposcopy directed biopsy was taken where and when necessary. Results: Among the 300 pregnant women, 90 (30% were primigravidae and 210 (70% were multigravidae. 80% were between 21 and 30 years of age. 290 (96.6% women have never had a pap smear in the past. Conventional Pap smear was taken at 21 weeks of gestation in 20% of cases. ASCUS , LSIL and HSIL were reported in one case each. In those with LSIL and HSIL , Colposcopy directed biopsy was reported as CIN 1 and CIN 2 respectively. These two cases were kept under observation during the antenatal period. The CIN II lesion persisted on postpartum follow up and was treated with LLETZ. Conclusion: In countries like India Pap smear screening during pregnancy is worthwhile and the antenatal clinics provide ample opportunities for the screening.

  4. Blood smear

    Science.gov (United States)

    ... smear URL of this page: //medlineplus.gov/ency/article/003665.htm Blood smear To use the sharing features on this ... view of cellular parasites Malaria, photomicrograph of cellular parasites Red blood cells, sickle cells Red blood cells, sickle and ...

  5. HPV, Cervical Cancer and Pap Test Related Knowledge Among a Sample of Female Dental Students in India.

    Science.gov (United States)

    Doshi, Dolar; Reddy, B Srikanth; Karunakar, P; Deshpande, Kopparesh

    2015-01-01

    The present study was designed to ascertain knowledge about HPV, cervical cancer (CC) and the Pap test among female dental students of Panineeya Institute of Dental Sciences and Hospital, Hyderabad, India. A self-administered questionnaire covering demographic details, knowledge relating to human papilloma virus (HPV) (8 items), cervical cancer (4 items) and the Pap smear (6 items) was employed. Responses were coded as "True, False and Don't Know". Mean and standard deviation (SD) for correct answers and levels of knowledge were determined. Based on the year of study, significant differences in knowledge of HPV were noted for questions on symptoms (p=0.01); transmission from asymptomatic partners (p=0.002); treatment with antibiotics (p=0.002); start of sexual activity (p=0.004); and recommended age for HPV vaccination (p=0.01). For knowledge regarding CC, significance was observed for the age group being affected (p=0.008) and symptoms of the disease in early stages (p=0.001). Indications for Pap smear tests like symptoms' of vaginal discharge (p=0.002), marital status (p=0.01) and women with children (p=0.02) had significant difference based on the year of study. Based on religion, transmission of HPV via pregnancy, HPV related diseases except CC and preventive measures except condom use and oral contraceptives showed significant differences. However, significant variation with religion was observed only for two preventive measures of CC (Pap test; p=0.004) and HPV vaccination (p=0.003). Likewise, only the frequency of Pap test showed a significant difference for religion (p=0.001). This study emphasizes the lack of awareness with regard to HPV, CC and screening with pap smear even among health professionals. Hence, regular health campaigns are essential to reduce the disease burden.

  6. A household survey on screening practices of household contacts of smear positive tuberculosis patients in Vietnam

    NARCIS (Netherlands)

    Thanh, Thuy Hoang Thi; Ngoc, Sy Dinh; Viet, Nhung Nguyen; van, Hung Nguyen; Horby, Peter; Cobelens, Frank G. J.; Wertheim, Heiman F. L.

    2014-01-01

    Close contacts of tuberculosis (TB) patients are at increased risk of developing tuberculosis. Although passive contact screening guidelines are incorporated in the national TB control program, currently it is unknown how frequent close contacts are screened for TB in Vietnam. This study assesses

  7. Cervical cancer risk levels in Turkey and compliance to the national cervical cancer screening standard.

    Science.gov (United States)

    Açikgöz, Ayla; Ergör, Gül

    2011-01-01

    Cervical cancer screening with Pap smear test is a cost-effective method. The Ministry of Health in Turkey recommends that it be performed once every five years after age 35. The purpose of this study was to determine the cervical cancer risk levels of women between 35 and 69, and the intervals they have the Pap smear test, and to investigate the relation between the two. This study was performed on 227 women aged between 35 and 69 living in Balçova District of İzmir province. Using the cervical cancer risk index program of Harvard School of Public Health, the cervical cancer risk level of 70% of the women was found below average, 22.1% average, and 7.9% above average. Only 52% of the women have had Pap smear test at least once in their lives. The percentage screening regularly in conformity with the national screening standard was 39.2%. Women in the 40-49 age group, were married, conformed significantly more (pducation and decreased with the cervical cancer risk level (pducation level, menstruation state of the women and the economic level of the family. Not having the Pap smear test in conformity with the national cervical cancer screening standard in 35-39 age group was 2.52 times more than 40-49 age group, while it was 3.26 times more in 60-69 age group (pducation level might cause not having Pap smear test. Under these circumstances, the cervical cancer risk levels should be determined and the individuals should be informed. Providing Pap smear test screening service to individuals in the target group of national screening standard, as a public service may resolve the inequalities due to age and educational differences.

  8. Let's talk about smear tests: social marketing for the National Cervical Screening Programme.

    Science.gov (United States)

    Bethune, G R; Lewis, H J

    2009-09-01

    The overall aim of the work was to increase participation by Māori and Pacific women in the National Cervical Screening Programme (NCSP) in New Zealand using a social marketing informed approach. Key objectives for this target group included: increasing awareness, understanding and discussion of cervical cancer and cervical screening; increasing telephone calls to the NCSP's 0800 number; and increasing uptake of cervical screening. A social marketing intervention with mixed qualitative and quantitative evaluation. Focus groups with priority women and key stakeholder interviews were used to identify a set of key messages from which television, radio and print media advertisements were developed. The advertising campaign was one element of a broader programme of activity, which involved changes to service delivery and improvement to access to services, particularly for the target groups. The campaign was evaluated in three ways: quantitative surveys conducted before, during and after the intervention; monitoring the number of calls to the NCSP's 0800 number; and monitoring NCSP monthly coverage statistics. The social marketing intervention achieved measurable behavioural impacts with its primary target audiences, delivering significant increases in screening uptake by Māori (6.8%) and Pacific women (12.7%) after 12 months. In addition, there was a secondary positive impact on other women (not the immediate target audience) whose rate of update also increased (2.7%). Overall, the intervention helped to reduce inequalities and delivered substantial increases in awareness, understanding and discussion of cervical cancer and cervical screening amongst the target groups. The results demonstrate that social marketing can be effective in targeting marginalized or under-represented groups. The intervention has not only changed the way in which women in New Zealand talk about a previously 'taboo' subject, but it has also provided a platform for significant behaviour change

  9. [How does type of health insurance affect receipt of Pap testing in Peru?].

    Science.gov (United States)

    Barrionuevo-Rosas, Leslie; Palència, Laia; Borrell, Carme

    2013-12-01

    Describe the association between receipt of cervical cytology and type of health insurance in Peruvian women, and determine the role of sociodemographic and sexual health variables in this relationship. A cross-sectional study using information on a sample of 12 272 women aged 30 to 49 years from the Demographic and Family Health Survey (ENDES), Peru, 2005-2008. The dependent variable was receipt of at least one Pap smear in the last five years. The primary independent variables were type of health insurance, educational level, household socioeconomic level, ethnicity, and place of residence. Prevalence ratio, obtained from Poisson regression with robust variance, was used to measure multivariate association. Among sexually active women, 62.7% had received at least one Pap test in the last five years. Percentage of women tested varied by type of health insurance. Women with public or private insurance had a greater probability of having received a Pap smear--1.27 (95% CI, 1.24-1.31) and 1.52 (95% CI, 1.46-1.58) times greater, respectively--than uninsured women. This association was primarily explained by socioeconomic status variables. In addition, women who participated the least in screening were characterized by illiteracy or only a primary education, low socioeconomic level, speaking an indigenous language, and living in a rural area. When they also lacked health insurance, the gap widened, rising to as much as one third compared to more advantaged social groups. Inequalities were found in receipt of Pap testing according to type of health insurance; women without insurance were least likely to be screened, implying existence of a barrier to cervical cancer screening in Peru.

  10. Could FISH on buccal smears become a new method of screening in children suspect of HNF1B anomaly?

    Science.gov (United States)

    Laffargue, Fanny; Bourthoumieu, Sylvie; Bellanné-Chantelot, Christine; Guigonis, Vincent; Yardin, Catherine

    2013-02-01

    HNF1B gene anomalies include renal development defects associated with cysts and are well known by pediatric nephrologists that ask for molecular analysis of this gene. Two types of genomic rearrangements are reported: mutation and more frequently deletion. Using microsatellites or CGH array the size of the deletion was found to be at least of 1.2 Mb including 15 genes among which HNF1B, leading to the diagnosis of chromosomal microdeletion. Fluorescent In Situ Hybridization (FISH) is a simple routinely performed technique, considered as the referring tool to diagnose microdeletion in genetic practice. We performed interphasic FISH on buccal smears from 6 patients known to have HNF1B deletion to valid our technique and to determine the size of the 17q12 deletion. All the patients were found to present a 17q12 microdeletion. Our results showed that FISH is a rapid, reliable and specific technique to diagnose 17q12 microdeletion and might be performed as non invasive sampling procedure useful in pediatric practice. In conclusion we propose to use interphasic FISH to screen pediatric patients presenting with renal abnormalities possibly linked to HNF1B anomaly. Molecular analysis and MLPA (Multiplex Ligand Probe Analysis) could be performed in cases with normal interphasic FISH to detect a point mutation of the gene or more rarely a single exon deletion. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  11. Integrated Review of Barriers to Cervical Cancer Screening in Sub-Saharan Africa.

    Science.gov (United States)

    McFarland, Ditsapelo M; Gueldner, Sarah M; Mogobe, Keitshokile D

    2016-09-01

    The aim of this study was to review published studies to identify and describe barriers to Papanicolaou (Pap) smear screening among women in sub-Saharan Africa. Guided by Cooper's integrative review methodology, studies published between 2006 and 2015 were identified by searching electronic databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, MEDLINE, ProQuest, and PsycINFO using specified search terms. Using this strategy, 224 articles were identified and screened for duplication and by reading titles, abstracts, and full texts. Seventeen articles met the inclusion criteria and were appraised using relevant tools for qualitative and quantitative designs. No relevant articles published in 2006, 2007, and 2014 were found. All 17 articles had good methodological quality and were included in the review. The studies were from 10 sub-Saharan countries and from different settings. Content analysis of the data revealed three major themes coded as client, provider, and system barriers. The most common client barriers were lack of knowledge and awareness about Pap smear screening, fear of cancer, belief of not being at risk for cervical cancer, and that a Pap smear is not important unless one is ill and cultural or religious factors. Provider barriers were failure to inform or encourage women to screen. Major system barriers were unavailability and inaccessibility of the Pap test. The review provided evidence of barriers to Pap smear screening among sub-Saharan women. Although there were some variations from country to country, sub-Saharan countries share similar constraints to Pap smear screening. These findings have important implications for practice and policy. Understanding the client, provider, and system barriers to cervical cancer screening could guide development of effective interventions. © 2016 Sigma Theta Tau International.

  12. CSF smear

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003768.htm CSF smear To use the sharing features on this ... around the spinal cord and brain. Cerebrospinal fluid (CSF) protects the brain and spinal cord from injury. ...

  13. Annual Papanicolaou screening for 5 years among human papillomavirus-negative women

    International Nuclear Information System (INIS)

    Petry, Karl Ulrich; Rinnau, Franziska; Böhmer, Gerd; Hollwitz, Bettina; Luyten, Alexander; Buttmann, Nina; Brünger, Martin; Iftner, Thomas

    2013-01-01

    Primary human papilloma virus (HPV) screening is more effective than cytology in reducing the risk of cervical cancer, but screening intervals should be extended in HPV-negative women. However, some Markov models predicted that long intervals are associated with an excess risk of cervical cancer. The aim of this analysis was to estimate the real-life risks and benefits of annual Papanicolaou (Pap) screening in HPV-negative women with normal cytology. Women with negative Hybrid Capture 2 (HC2) results and normal cytology at the time of inclusion in the Hannover HPV screening trial underwent annual Pap smears for 5 years. A subgroup was randomly selected for retesting with cytology, HC2, and colposcopy 60–68 months after recruitment. Of 4236 women included, 3406 had at least one Pap smear, but only 1185 attended all five annual screening visits. The proportion of women with at least one abnormal smear was 14.4% in 60 months. The probability of abnormal smears increased continuously over time. No case of ≥ CIN2+ was observed during 5 years. Of 605 women selected for subgroup analysis, 292 agreed to be retested (48.3%). The rate of high-risk HPV at 60–68 months was 3.0% (9/296). The long-term risk of high-grade neoplasia after an initial negative HC2 test and normal cytology result was low, while the rate of false-positive abnormal Pap smears was significant and increased constantly over time. Pap smear screening of HPV-negative women more frequently than every 5 years could be potentially harmful and seems to be of little clinical value

  14. A comparative study of cervical smears in an urban Hospital in India and a population-based screening program in Mauritius

    Directory of Open Access Journals (Sweden)

    Mulay Kaustubh

    2009-01-01

    Full Text Available Objective: To study cervical smear abnormalities in urban women in India and women in Mauritius and to compare the results in the two groups. Study Design: An analysis of 6010 cervical smears taken as part of routine check-ups in an urban hospital was done and an analysis of 10,000 cervical smears taken from women participating in a National Cancer Screening Program in Mauritius was done. Emphasis was put on cervical epithelial cell abnormalities and the results in the two populations are compared with that of similar studies in other parts of the world. Results: Non specific inflammation formed 19.6% and 25.34% of the smears in the Indian and Mauritian groups, respectively (with specific infection forming 6.05% and 15.08%. The epithelial abnormalities constituted 1.392% of the Indian group and 0.47% of the Mauritian group. The difference was statistically significant in the atypical squamous cells of uncertain significance (ASCUS and atypical glandular cells of uncertain significance (AGUS group. Conclusions: The prevalence of low-grade squamous intraepithelial lesions (LSIL and high-grade squamous intraepithelial lesions (HSIL is similar to that in the developed world.

  15. Barriers to adoption of recent technology in cervical screening

    Directory of Open Access Journals (Sweden)

    Jhala Darshana

    2007-01-01

    Full Text Available Abstract The Pap smear is one of the modern success stories in the field of preventive medicine. Since its introduction as a screening test, there has been a dramatic reduction in the incidence of cervical cancer. However, the search for a better screening test continues. The new technologies, including liquid-based cytology (LBC, Human Papilloma Virus (HPV testing and automated or machine-assisted screening have been introduced. However, there is continuous debate about whether society's limited resources are better spent on reaching the underserved rather than on these technologies. Another question is whether these technologies create yet another kind of disparity in delivering preventive care. For example, despite the wide use of LBC (99% of tests submitted to our laboratory are LBC, conventional Pap smears are still used to screen/follow up some women. It is not clear why some providers continue to prefer conventional smear over LBC and what are the barriers for adopting LBC in cervical cancer screening. We hypothesize the lower cost of conventional compared to LBC Pap testing, patient's lower socio-economic indices, a patient's medical history and provider's subspecialty/training all appear to play a role in the choice of using conventional Pap testing rather than LBC. Unintentionally, this choice results in repeat testing, delayed treatment and potentially higher costs than intended. The ultimate goal of this review article is to understand and explore possible barriers and disparities to adopting new technology in cancer screening.

  16. A very rare case of HPV-53-related cervical cancer, in a 79-year-old woman with a previous history of negative Pap cytology.

    Science.gov (United States)

    Zappacosta, Roberta; Lattanzio, Giuseppe; Viola, Patrizia; Ianieri, Manuel Maria; Gatta, Daniela Maria Pia; Rosini, Sandra

    2014-01-01

    The introduction of organized cervical cancer (CC) screening programs has drastically reduced the prevalence of CC. However the incidence is still too high, especially among elderly women. All guidelines strongly recommend a regular Papanicolaou (Pap) testing for young and middle-aged patients. On the other hand, many international professional societies no longer advise screening in women who have undergone hysterectomy, and in women aged 65 years and above, who have a previous history of regular Pap smears. Here we report the case of poorly differentiated CC, involving the pelvic lymph nodes and urinary bladder, occurring in a 79-year-old woman who regularly underwent Pap tests, with no reported cytological abnormalities. In this very rare case, the CC cells, as well as cells from metastatic lymph nodes and cells from urinary specimens, molecularly showed human papilloma virus (HPV)-53. With the limitations of a single case, this report brings important information to prevent CC in elderly patients: the utility of molecular tests to increase sensitivity of Pap smears in postmenopausal women; the importance of HPV-53 as one of the four "emergent" genotypes having a possible role in oncogenesis; and the presence of HPV-53 in lymph node metastases from cervical carcinoma, which would support the role of this virus in the maintenance of malignant status.

  17. Awareness and Practice of Cervical Smear as A Screening Procedure for Cervical Cancer among Female Nurses in A Tertiary Hospital in South-South Nigeria

    Directory of Open Access Journals (Sweden)

    Imoh Unang

    2011-12-01

    Full Text Available AIM: Carcinoma of the cervix, the second most common cancer among women remains a public health problem. Though this preventable cancer occurs more commonly in the developing world, it is almost non-existent in developed countries where there are well established screening programs. The aim of this study is to determine the degree of awareness and practice of cervical smear as a screening procedure for cervical cancer among female nurses in a tertiary health facility in south-south Nigeria. METHOD: Semi-structured questionnaires were distributed to all the female nurses at the University of Uyo Teaching Hospital. RESULTS: The ages of the respondents were between 21 - 60 years with the modal age group being 31- 40 years (48.9%. Majority of the respondents were married (59.7% and 36.4% of them had practiced nursing for over 10 years. Majority of the respondents (94.3% had heard of the cervical smear and 79.5% of the nurses knew that cervical smears were used to detect premalignant diseases of the cervix. Only 7.4% of the nurses had undergone screening for cervical cancer. Common reasons given by the respondents who had not screened were not being a candidate for cervical cancer (31.9% and ignorance as to where screening is done (28.8%. The most common sources of information about cervical smear were the hospital (87.5% and textbooks (13.6%. CONCLUSION: The level of awareness of the cervical smear as a preventive tool for cervical cancer was high but utilization of the test was disappointingly low. Modern concepts of cancer prevention and control should be included in the curriculum of the school of nursing and nurses should be involved in the organisation of health talks to members of the community on cervical cancer and its prevention. The print and electronic media should be made to participate in the dissemination of information on the prevention of cervical cancer in our environment. [TAF Prev Med Bull 2011; 10(6.000: 675-680

  18. Status and awareness of cervical, breast, and colon cancer screening in a Turkish city.

    Science.gov (United States)

    Zafer, E; Tanrιkulu, P; Atakul, T; Ömürlü, I K; Yüksel, H

    2017-01-01

    Mortality and morbidity rates of cervical, breast, and colorectal cancers (CRC) can be decreased via effective screening strategies. Developing countries are to be expected to establish and implement their own programs. To evaluate regional awareness and status of cervical, breast, and CRC screening, a questionnaire-based study was conducted in 500 volunteers from a Turkish community hospital. Awareness rates were 57.4% for Pap smear, 61.2% for mammography, and 25.4% for CRC. Implementation rates were 19.2%, 23.9%, and 12%, respectively. Positive family history for gynecologic cancer and past cervical ablative procedure parameters were related to higher Pap smear rates. Educational level, breast self-exam, and positive Pap smear history parameters were related to higher mammography rates. Factors related to higher colorectal cancer screening rates were nulliparity and positive Pap smear history. Cancer screening rates for this Turkish city are still below the expected levels despite recently revitalized national screening program. For success, it is essential not only to educate rural populations but also to train negligent healthcare providers regularly.

  19. The prevalence and factors for cancer screening behavior among people with severe mental illness in Hong Kong.

    Directory of Open Access Journals (Sweden)

    Phoenix Kit Han Mo

    Full Text Available OBJECTIVES: Screening is useful in reducing cancer incidence and mortality. People with severe mental illness (PSMI are vulnerable to cancer as they are exposed to higher levels of cancer risks. Little is known about PSMI's cancer screening behavior and associated factors. The present study examined the utilization of breast, cervical, prostate, and colorectal cancer screening among PSMI in Hong Kong and to identify factors associated with their screening behaviors. METHOD: 591 PSMI from community mental health services completed a cross-sectional survey. RESULTS: The percentage of cancer screening behavior among those who met the criteria for particular screening recommendation was as follows: 20.8% for mammography; 36.5% for clinical breast examination (CBE; 40.5% for pap-smear test; 12.8% for prostate examination; and 21.6% for colorectal cancer screening. Results from logistic regression analyses showed that marital status was a significant factor for mammography, CBE, and pap-smear test; belief that cancer can be healed if found early was a significant factor for pap-smear test and colorectal screening; belief that one can have cancer without having symptoms was a significant factor for CBE and pap-smear test; belief that one will have a higher risk if a family member has had cancer was a significant factor for CBE; and self-efficacy was a significant factor for CBE and pap-smear test behavior. CONCLUSIONS: Cancer screening utilization among PSMI in Hong Kong is low. Beliefs about cancer and self-efficacy are associated with cancer screening behavior. Health care professionals should improve the knowledge and remove the misconceptions about cancer among PSMI; self-efficacy should also be promoted.

  20. Design and evaluation of a theory-based, culturally relevant outreach model for breast and cervical cancer screening for Latina immigrants.

    Science.gov (United States)

    White, Kari; Garces, Isabel C; Bandura, Lisa; McGuire, Allison A; Scarinci, Isabel C

    2012-01-01

    Breast and cervical cancer are common among Latinas, but screening rates among foreign-born Latinas are relatively low. In this article we describe the design and implementation of a theory-based (PEN-3) outreach program to promote breast and cervical cancer screening to Latina immigrants, and evaluate the program's effectiveness. We used data from self-administered questionnaires completed at six annual outreach events to examine the sociodemographic characteristics of attendees and evaluate whether the program reached the priority population - foreign-born Latina immigrants with limited access to health care and screening services. To evaluate the program's effectiveness in connecting women to screening, we examined the proportion and characteristics of women who scheduled and attended Pap smear and mammography appointments. Among the 782 Latinas who attended the outreach program, 60% and 83% had not had a Pap smear or mammogram, respectively, in at least a year. Overall, 80% scheduled a Pap smear and 78% scheduled a mammogram. Women without insurance, who did not know where to get screening and had not been screened in the last year were more likely to schedule appointments (P < .05). Among women who scheduled appointments, 65% attended their Pap smear and 79% attended the mammogram. We did not identify significant differences in sociodemographic characteristics associated with appointment attendance. Using a theoretical approach to outreach design and implementation, it is possible to reach a substantial number of Latina immigrants and connect them to cancer screening services.

  1. Comparison of conventional Papanicolaou smear and SurePath® liquid-based cytology in the Copenhagen population screening programme for cervical cancer

    DEFF Research Database (Denmark)

    Kirschner, Benny; Simonsen, Kåre; Junge, Jette

    2006-01-01

    OBJECTIVE: To compare diagnostic performance of conventional Papanicolaou smear with SurePath liquid-based cytology in a population screening programme. METHODS: A retrospective comparison was performed on data from two 18-month periods of the screening programme for cervical cancer in the munici......OBJECTIVE: To compare diagnostic performance of conventional Papanicolaou smear with SurePath liquid-based cytology in a population screening programme. METHODS: A retrospective comparison was performed on data from two 18-month periods of the screening programme for cervical cancer...... in the municipality of Copenhagen with conventional Papanicolaou technique (n = 82,116) and liquid-based cytology (n = 84,414). RESULTS: After the conversion to liquid-based cytology the percentage of unsatisfactory samples decreased from 2.3% to 0.3% (P ...-based technique. CONCLUSIONS: This study showed the number of unsatisfactory samples to be significantly reduced with the liquid-based technique. The data suggest that there is an increased detection rate of cervical precancerous lesions with liquid-based cytology, but the number of false positive tests is still...

  2. A prospective study of women with ASCUS or LSIL pap smears at baseline and HPV E6/E7 mRNA positive: a 3-year follow-up.

    Science.gov (United States)

    Bruno, M T; Ferrara, M; Fava, V; Barrasso, G; Panella, M M

    2018-04-01

    Human papillomavirus (HPV) testing is used in the triage of women with a borderline smear result. The efficiency of testing women with a low-grade squamous intraepithelial lesion (LSIL) and atypical squamous cells of undetermined significance (ASCUS) is less clear. For this reason we used a new HPV test that detects E6/E7 messenger RNA (mRNA), which might have a higher specificity. The objective of this prospective study was to assess whether HPV E6/E7 mRNA positivity in women with ASCUS and LSIL at baseline, is able to predict those women who have a high risk of developing a histological cervical intraepithelial neoplasia (CIN2) or worse lesion. We took into consideration the women's age and HPV DNA genotype and followed them up for 3 years. Cervical samples from women with high-risk HPV (HR-HPV) DNA-positive ASCUS (n = 90) or LSIL (n = 222) were tested for the presence of HR-HPV E6/E7 mRNA and the women were monitored for the development of histopathologically verified CIN2+. Thirteen patients with ASCUS and 17 with LSIL did not complete follow-up. All patients with LSIL and ASCUS, enrolled in this study, had confirmed lesions at the colposcopic examination. Follow-up was available for 312 women, 193 were positive in the HR-HPV DNA test and 93 had a HPV E6/E7 mRNA positive test. Finally, 22 women positive in the HPV DNA test for high-risk genotypes and with positive E6/E7 mRNA had a histologically confirmed CIN2+. Only two cases with negative HPV E6/E7 mRNA had CIN2+. The study shows that women positive in the HPV E6/E7 mRNA test have a greater risk of malignant progression of cervical lesions and therefore deserve greater attention and earlier check-ups.

  3. Vaccination and Screening for the Prevention of Cervical Cancer: Health Effects and Cost-effectiveness

    NARCIS (Netherlands)

    I.M.C.M. de Kok (Inge)

    2011-01-01

    textabstractCancer of the cervix uteri is the third most common cancer among women worldwide. The incidence and mortality in the Netherlands, however, are very low, partly because of an effective screening programme. Next to the well-known conventional Pap smear, other medical interventions

  4. Resultados histológicos e detecção do HPV em mulheres com células escamosas atípicas de significado indeterminado e lesão escamosa intra-epitelial de baixo grau na colpocitologia oncológica Histological results and HPV detection in women with pap smear showing atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesion

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    André Luis Ferreira Santos

    2004-07-01

    Full Text Available OBJETIVOS: avaliar o desempenho da colpocitologia oncológica (CO e da Captura de Híbridos II (CHII para o diagnóstico de lesão cervical histológica significativa (NIC2/3 em mulheres encaminhadas com CO contendo atipias celulares de significado indeterminado (ASCUS ou lesão escamosa intra-epitelial de baixo grau (LSIL. MÉTODOS: estudo de corte transversal no qual foram incluídas 161 mulheres encaminhadas, entre agosto de 2000 e setembro de 2002, devido a CO com resultado de ASCUS ou LSIL. As mulheres responderam a questionário específico sobre características sociodemográficas e reprodutivas e foram submetidas a exame ginecológico com coleta de CO e CHII, sendo realizada colposcopia com eventual biópsia de áreas suspeitas. Foi aplicado o teste do qui-quadrado para as associações da idade, uso de condom, uso de anticoncepcional oral e tabagismo com os resultados da CHII. Foram calculados a sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo da CO e da CHII para detectar NIC2/3. Todos os cálculos foram realizados com intervalos de confiança estatística de 95%. RESULTADOS: sessenta e sete porcento das mulheres com menos de 30 anos de idade tiveram testes positivos para o HPV. A CO e CHII tiveram sensibilidade de 82% em detectar NIC2/3 quando considerados como positivos ASCUS, LSIL ou HSIL. Quando se consideram como positivas apenas as CO com HSIL, este exame apresenta acentuado ganho de especificidade (de 29 para 95% e valor preditivo positivo (de 12 para 50%, superando a CHII, porém com redução igualmente significativa de sua sensibilidade (de 82 para 41%. CONCLUSÕES: nossos resultados indicaram grande potencial da CHII para detectar mulheres com NIC2/3 entre as pacientes com ASCUS/LSIL na CO de encaminhamento.OBJECTIVE: to assess the ability of Pap smear and hybrid capture II (HCII to detect clinically significant cervical lesions (CIN2/3 in women referred to hospital due to atypical squamous

  5. [HPV-Hr detection by home self sampling in women not compliant with pap test for cervical cancer screening. Results of a pilot programme in Bouches-du-Rhône].

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    Piana, Lucien; Leandri, François-Xavier; Le Retraite, Laurence; Heid, Patrice; Tamalet, Catherine; Sancho-Garnier, Hélène

    2011-07-01

    The non-participation to cervical screening is the major determinant in the risk of mortality due to cervical cancer. In France, around 40% of women do not participate to regular screening. The cultural or economic barriers for performing screening by Pap test are numerous; one of the most frequent is the refusal of gynaecological examination. A persistent HPV(HR) infection is a necessary factor for developing cervical cancer. The HPV(HR) testing has a high sensibility to detect high grade cervical intra-epithelial neoplasia (CIN 2-3) and a satisfactory specificity after 30-35 years old. The principal objective of this study was to compare the participation rates in women 35-69 years old who did not perform a Pap test after a first individual invitation, either when an HPV(HR) auto-test was offered to be performed at home or a second invitation to Pap test was sent. We also evaluated the quality of the two tests, the positive results obtained by age groups and the following histological type of lesions diagnosed in the women with positive results. The study included 9,334 women, 35-69 years old, who did not realized a Pap-test during the 2 previous years and who did not respond at a first individual invitation. These non-responders were randomized into two groups: one group (n=4,934) received a second individual invitation and the other (n=4,400) an offer of receiving and performing an HPV auto-test at home. In women 35-69 years the participation to the second invitation to Pap test was significantly lower (7.2%) than the participation to auto-test (26.4%) with Plaw rate is a consequence of an inversion of the ratio HPV 16 versus other types in women 60 years old and over. In this group, the follow-up of 36 women diagnosed five cases of CIN1, one of CIN2 and four of CIN3; 22 patients are lost of follow up at 6 months. Globally, in the studied population, an individual recall for pap test allowed to diagnose and treat 3 high grade lesions (7‰) and the dispatching

  6. Cervical screening programme in Trabzon county

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    Şafak Ersöz

    2010-03-01

    Full Text Available AIM: Cytological evaluation carries a great significance for the early detection and treatment of invasive cervical carcinoma precursors. Pap-smear test are considered as a quite effective screening method for this purpose. This screening can be easily performed at the first step health care centers without causing an economic burden if only selected patients were referred to second and third step medical care centers. In this program we aimed to perform a cross-sectional survey for cervix cancer in Trabzon center and surrounding area using cervical smears obtained at first step health care centers. MATERIAL-METHOD: A total number of 3000 cases with an age range of 25-64 were screened between March and May of 2007. This program was supported by USIDER. Smears obtained with cytological brushes were prepared with conventional methods and stained with Papanicolaou dye. Pap smears were reviewed by two pathologists according to 2001 Bethesda classification. RESULTS: A great majority of the smears (93.3 % were found to be satisfactory, while only 6.7 were found to be insufficient. Analysis of satisfactory cervical smears revealed cervical epithelial cell anomalies in 73 cases (2.4%; of these cases 57 (1.9% had atypical squamous cell of undetermined significance (ASC-US, 11 (0.4 % had low grade squamous intra-epithelial lesion (LSIL, 3 (0.1% high grade squamous intra-epithelial lesion (HSIL, and 2 (0.07 % had squamous cell carcinoma. CONCLUSION: Smears obtained at the first step health care centers were found to be satisfactory in a major proportion of the cases. Screening programs play a great role in the declining of cancer incidence. These screening programs should be included in national health politics. First step health care centers might be used for this purpose concerning the health economics.

  7. Determinants of Breast and Cervical Cancer Screening Uptake Among Women in Turkey.

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    Sözmen, Kaan; Unal, Belgin; Sakarya, Sibel; Dinc, Gonul; Yardim, Nazan; Keskinkilic, Bekir; Ergör, Gül

    2016-09-01

    The aim of the study was to assess the influence of sociodemographic characteristics on breast and cervical cancer screening among women 30 years and older in Turkey. We used data from the National Chronic Diseases and Risk Factors Survey conducted by the Ministry of Health in 2011. Multivariate logistic regression analysis was used to assess the association of sociodemographic factors, lifestyle variables, and cancer screening. Overall, 22.0% of women ever had a Pap smear test for cervical cancer screening and 19.0% ever had a mammography for breast cancer screening(n = 6846). Individuals with a university degree, social security, doing moderate physical activity, and consuming 5 portions of fruit or vegetable/day were more likely to receive Pap smear test and mammography. Residing in the eastern region and living in rural area was associated with lower likelihood of receiving both types of screening. © 2016 APJPH.

  8. Trends in Pap test practices and results: An 11-year review of the annual ACHA Pap Test and STI Survey.

    Science.gov (United States)

    Eastman-Mueller, Heather P; Oswalt, Sara B

    2017-10-01

    To conduct a trend analysis of Pap test practices, Pap test results and related women's services and guidelines of college health centers. College health centers who participated in the annual ACHA Pap Test and STI (sexually transmitted infection) Survey years 2004-2014 (n ranged from 127 to 181 depending on year). Descriptive analyses are presented with ANOVAs (Analysis of Variance) and chi-square tests calculated to examine trends over time. The number of Pap tests significantly decreased over time; however, the percentage of normal and HSIL (high-grade squamous intraepithelial lesion) results did not vary. Availability of conventional cytology slides and cryotherapy were significantly associated with year. Over time, college health centers' guidelines related to initiation of Pap testing evolved to consistently conform to national recommendations for cervical screening. The results indicate most college health centers are following the current national guidelines regarding Pap testing for young adult women.

  9. Self-Sampling for Human Papillomavirus Testing: Increased Cervical Cancer Screening Participation and Incorporation in International Screening Programs

    Science.gov (United States)

    Gupta, Sarah; Palmer, Christina; Bik, Elisabeth M.; Cardenas, Juan P.; Nuñez, Harold; Kraal, Laurens; Bird, Sara W.; Bowers, Jennie; Smith, Alison; Walton, Nathaniel A.; Goddard, Audrey D.; Almonacid, Daniel E.; Zneimer, Susan; Richman, Jessica; Apte, Zachary S.

    2018-01-01

    In most industrialized countries, screening programs for cervical cancer have shifted from cytology (Pap smear or ThinPrep) alone on clinician-obtained samples to the addition of screening for human papillomavirus (HPV), its main causative agent. For HPV testing, self-sampling instead of clinician-sampling has proven to be equally accurate, in particular for assays that use nucleic acid amplification techniques. In addition, HPV testing of self-collected samples in combination with a follow-up Pap smear in case of a positive result is more effective in detecting precancerous lesions than a Pap smear alone. Self-sampling for HPV testing has already been adopted by some countries, while others have started trials to evaluate its incorporation into national cervical cancer screening programs. Self-sampling may result in more individuals willing to participate in cervical cancer screening, because it removes many of the barriers that prevent women, especially those in low socioeconomic and minority populations, from participating in regular screening programs. Several studies have shown that the majority of women who have been underscreened but who tested HPV-positive in a self-obtained sample will visit a clinic for follow-up diagnosis and management. In addition, a self-collected sample can also be used for vaginal microbiome analysis, which can provide additional information about HPV infection persistence as well as vaginal health in general. PMID:29686981

  10. A very rare case of HPV-53-related cervical cancer, in a 79-year-old woman with a previous history of negative Pap cytology

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    Zappacosta R

    2014-04-01

    Full Text Available Roberta Zappacosta,1 Giuseppe Lattanzio,2 Patrizia Viola,2 Manuel Maria Ianieri,3 Daniela Maria Pia Gatta,1 Sandra Rosini11Cytopathology Unit, Experimental and Clinical Sciences Department, Gabriele d’Annunzio University of Chieti-Pescara, Chieti, Italy; 2Surgical Pathology Unit, 3Obstetrics and Gynecology Unit, SS Annunziata Hospital, Chieti, ItalyAbstract: The introduction of organized cervical cancer (CC screening programs has drastically reduced the prevalence of CC. However the incidence is still too high, especially among elderly women. All guidelines strongly recommend a regular Papanicolaou (Pap testing for young and middle-aged patients. On the other hand, many international professional societies no longer advise screening in women who have undergone hysterectomy, and in women aged 65 years and above, who have a previous history of regular Pap smears. Here we report the case of poorly differentiated CC, involving the pelvic lymph nodes and urinary bladder, occurring in a 79-year-old woman who regularly underwent Pap tests, with no reported cytological abnormalities. In this very rare case, the CC cells, as well as cells from metastatic lymph nodes and cells from urinary specimens, molecularly showed human papilloma virus (HPV-53. With the limitations of a single case, this report brings important information to prevent CC in elderly patients: the utility of molecular tests to increase sensitivity of Pap smears in postmenopausal women; the importance of HPV-53 as one of the four “emergent” genotypes having a possible role in oncogenesis; and the presence of HPV-53 in lymph node metastases from cervical carcinoma, which would support the role of this virus in the maintenance of malignant status.Keywords: old women, molecular tests, cervical cancer screening, HPV-DNA test, HPV genotypingA Letter to the editor has been received and published for this articleCorrigendum for this paper has been published

  11. Evaluation of a low-cost liquid-based Pap test in rural El Salvador: a split-sample study.

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    Guo, Jin; Cremer, Miriam; Maza, Mauricio; Alfaro, Karla; Felix, Juan C

    2014-04-01

    We sought to test the diagnostic efficacy of a low-cost, liquid-based cervical cytology that could be implemented in low-resource settings. A prospective, split-sample Pap study was performed in 595 women attending a cervical cancer screening clinic in rural El Salvador. Collected cervical samples were used to make a conventional Pap (cell sample directly to glass slide), whereas residual material was used to make the liquid-based sample using the ClearPrep method. Selected samples were tested from the residual sample of the liquid-based collection for the presence of high-risk Human papillomaviruses. Of 595 patients, 570 were interpreted with the same diagnosis between the 2 methods (95.8% agreement). There were comparable numbers of unsatisfactory cases; however, ClearPrep significantly increased detection of low-grade squamous intraepithelial lesions and decreased the diagnoses of atypical squamous cells of undetermined significance. ClearPrep identified an equivalent number of high-grade squamous intraepithelial lesion cases as the conventional Pap. High-risk human papillomavirus was identified in all cases of high-grade squamous intraepithelial lesion, adenocarcinoma in situ, and cancer as well as in 78% of low-grade squamous intraepithelial lesions out of the residual fluid of the ClearPrep vials. The low-cost ClearPrep Pap test demonstrated equivalent detection of squamous intraepithelial lesions when compared with the conventional Pap smear and demonstrated the potential for ancillary molecular testing. The test seems a viable option for implementation in low-resource settings.

  12. Women Living with HIV over Age of 65: Cervical Cancer Screening in a Unique and Growing Population

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    Alexandra Aserlind

    2017-01-01

    Full Text Available Objective. Women living with HIV are at increased risk of human papillomavirus (HPV infection, which can lead to cervical cancer. New guidelines recommend indefinite screening. The objective of this study is to describe cervical cancer screening practices and colposcopy results in a cohort of women living with HIV over age of 65 who were followed before the new guidelines. Comorbidities, sexually transmitted infections (STIs, and other risk factors were evaluated. Methods. We conducted a retrospective chart review on 75 women aged 65 or older living with HIV with at least one Pap smear. Results. The mean age of the cohort was 66.5 and at HIV diagnosis was 56. The majority of women were immunocompetent. 80% had serial Pap smears. Of these, 86% of 238 were negative or ASCUS. No women progressed to HSIL. 92% of colposcopies had negative or CIN I results. Three women were treated successfully for high-grade dysplasia. More than half of women had other STIs. 72% were screened for HPV; 50% were positive. Conclusion. The majority of women had negative and low-grade Pap smears. Questions remain regarding the utility of continued Pap screening and the added value of HPV testing in this unique population of older women living with HIV.

  13. Understanding the role of violence in incarcerated women's cervical cancer screening and history.

    Science.gov (United States)

    Ramaswamy, Megha; Kelly, Patricia J; Koblitz, Amber; Kimminau, Kim S; Engelman, Kimberly K

    2011-07-22

    In this exploratory study the authors investigated characteristics, including reported experiences of violence, related to incarcerated women's self-report of cervical cancer screening and cancer history and treatment. During a four month period in 2010, 204 women in Kansas City jails were surveyed. Multiple logistic regression models were used to examine the relations of socio-demographic and community characteristics and history of violence among the women to their cervical cancer screening, diagnosis, and treatment histories. Forty percent of the women in the current sample reported abnormal Pap histories, though only 6% of all Pap smears done in the U.S. are abnormal. Women who reported abuse histories in this study were found to be more likely to report having ever had an abnormal Pap smear (for physical abuse Odds Ratio [OR] = 6.05; CI 2.36, 15.54 and for past year intimate partner violence OR = 2.41; CI 1.09, 5.31). Participants who did not fear neighborhood violence were less likely to report an abnormal Pap history (OR = 0.57; CI 0.34, 0.96) and more likely to visit a family doctor for their Pap screenings (OR = 1.91; CI 1.01, 3.60). Women who perceived greater neighborhood violence had increased odds of reporting that they received Pap screenings in a hospital setting (OR = 1.47; CI 1.08, 2.00). Frequency of Pap screening did not differ in women who did and did not have fear of neighborhood violence. This study highlights the heightened cervical cancer risk experienced by women with criminal justice histories and suggests that violence at several levels has implications for cervical cancer prevention for these women.

  14. Frequency of unsatisfactory cervical cytology smears in cancer screening of Japanese women: A systematic review and meta-analysis.

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    Hosono, Satoyo; Terasawa, Teruhiko; Katayama, Takafumi; Sasaki, Seiju; Hoshi, Keika; Hamashima, Chisato

    2018-04-01

    The Bethesda system (TBS) has been used for cervical cytological diagnosis in Japan since 2008. Evaluation of specimen adequacy is the most important aspect of quality assurance and for precise diagnosis in TBS. A systematic review and meta-analysis were carried out to assess the unsatisfactory specimen rate in the primary cervical cancer screening setting in Japan. Ovid Medline and Ichushi-Web databases were searched from inception through to May 2017. Prospective and retrospective studies that reported the proportion of unsatisfactory specimens in healthy asymptomatic Japanese women in a cervical cancer screening program were eligible for inclusion; 17 studies were included in the meta-analysis. The random-effects model meta-analysis calculated summary estimates of the unsatisfactory rate of 0.60% (95% confidence interval [CI], 0.18-1.96%; I 2 = 99%) for conventional cytology and 0.04% (95% CI, 0.00-0.35%; I 2 = 99%) for liquid-based cytology (LBC). However, comparative results between conventional and liquid-based cytology, based on four direct and nine comparative studies, showed no significant difference (summary odds ratio = 3.5 × 10 -2 favoring LBC [95% CI, 6.9 × 10 -4 -1.7]; I 2 = 98%). In the subgroup analyses and meta-regressions, use of non-cotton devices for conventional cytology and use of a particular platform for LBC were associated with lower unsatisfactory rates. Meta-regression also suggested chronological improvement in unsatisfactory rates for both tests. In Japanese cervical cancer screening programs, conventional cytology remains prevalent. Future research needs to focus on evaluating the impact of screening programs using LBC by comparing the accuracy, performance, and cost-effectiveness with conventional cytology in the Japanese population. © 2018 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

  15. The Cost analysis of cervical cancer screening services provided by Damavand health center in 2013

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    Arezoo Chouhdari

    2015-03-01

    Full Text Available Background: Today, the health sector in many countries is facing with severe resource constraints; hence it is absolutely necessary that cost-benefit and cost-effectiveness assessment have a major role in design of health services. The purpose of this study was to evaluate the cost-benefit and effectiveness of cervical cancer screening service (Pap smear test done by the health centers in Damavand County in 2013.  Methods: This is a descriptive study with cross-sectional method. All data was extracted from existing documents in Damavand health network.Cost of service screening for doing Pap smear test (manpower costs of performing the service, the cost of transferring samples, water, electricity, telephone and gas was estimated in all health centers then results, were compared with the incomes of this service.  Results: Screening program coverage was 22.3%, 6.9% and 6.05% in 2011, 2012 and 2013 respectively. All costs and incomes of units performing Pap smear screening test were calculated. Entire costs and incomes of this service during 2013 were respectively 303,009,000 and 11,640,000 RLS equal $12,227 and $496.73. Therefore, the cost-benefit ratio of this screening test was approximately 0.040.  Conclusion: The costs of units performing cervical cancer screening test in Damavand Health Center were much more than this benefit and because of a none-positive Pap smear test in spite of high cost, performing this test in Damavand health centers was not cost effective.

  16. Awareness and uptake of colorectal, breast, cervical and prostate cancer screening tests in Spain.

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    Carrasco-Garrido, Pilar; Hernandez-Barrera, Valentın; Lopez de Andres, Ana; Jimenez-Trujillo, Isabel; Gallardo Pino, Carmen; Jimenez-Garcıa, Rodrigo

    2014-04-01

    We aim to describe levels of awareness and uptake of colorectal, breast, cervical and prostate cancer screening tests and to analyze the association to socio-demographic and health-related variables. Population-based cross-sectional study conducted using a home-based personal interview survey on a nationwide representative sample (n = 7938) of population aged ≥18 years (Oncobarometro Survey). Awareness was assessed by asking participants: Now I am going to mention several medical tests for cancer detection, please tell me if you already know about them or if this is the first time you have heard of them? The tests mentioned were faecal occult blood test (FOBT), mammography, Pap smear and prostate-specific antigen (PSA). Cancer screening uptake was assessed by asking participants whether they had received tests within the previous 2 years. Awareness rates of 38.55% for FOBT, 95.03% for mammography, 70.84% for Pap smears and 54.72% for PSA were found. Uptake mammography was 74.46%, Pap smears 65.57%, PSA 35.19% and FOBT 9.40%. Factors such as immigration status, lower educational level or income and not suffering from chronic conditions are negative predictors for uptake. Awareness and uptake results showed acceptable figures for mammography, moderate for Pap smears and unacceptably low for FOBT. Inequalities exist in uptake of cancer screening. It is necessary to develop public health educational programmes, especially for the vulnerable populations, aiming to inform and motivate them to use screening services on a regular basis. Our data suggest that although PSA is not recommended, this opportunistic screening is frequently used in Spain.

  17. [Screening of ovarian cancer : not for tomorrow].

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    Vuilleumier, Aurélie; Labidi-Galy, Intidhar

    2017-05-17

    As the worldwide incidence of cancer continuously rises, one of the measures to reduce mortality is early diagnosis while the disease is still curable. Colonoscopy screening and PAP-smears are worthwhile examples illustrating the impact of early diagnosis on mortality. Ovarian cancer is the first cause of mortality by gynecological cancers in Switzerland (incidence of 600 new cases / year), mostly diagnosed at advanced stages with a poor prognosis. Could surveillance measures improve survival ? Three large-scale randomized control trials failed to show mortality reduction from ovarian cancer with the methods currently available. A better comprehension of pathogenesis can allow the development of new strategies of screening.

  18. COLPOSCOPY- A PRIMARY ALTERNATIVE SCREENING TOOL FOR CERVICAL PRE-CANCER

    OpenAIRE

    Srinivas Sangisapu; Prajakta Mehendale; Aruna Menon; Venkatesan Manu

    2017-01-01

    BACKGROUND Cancer cervix is the most common and preventable malignancy in females. 80% of cases in India are detected in advanced stages. Paucity of cytologists in India is one of the important reasons for failure of screening by Pap smear. Visual Inspection of cervix with Acetic acid (VIA) and Visual Inspection of cervix with application of Lugol’s Iodine (VILI) are two alternative strategies in low resource settings. Colposcopy involves the same principles of VIA and VILI under ...

  19. [Attendance rate in the Polish Cervical Cancer Screening Program in the years 2007-2009].

    Science.gov (United States)

    Spaczyński, Marek; Karowicz-Bilinska, Agata; Rokita, Wojciech; Molińska-Glura, Marta; Januszek-Michalecka, Lucyna; Seroczyński, Przemysław; Uchlik, Joanna; Nowak-Markwitz, Ewa

    2010-09-01

    In Poland in 2007, according to the National Cancer Registry 3431 women were diagnosed with cervical cancer and 1907 died. To change the unfavorable epidemiologic situation, in 2005 the Ministry of Health (MH), the National Health Fund (NHF) and the Polish Gynecological Society following WHO/IARC guidelines developed a National Population-Based Cervical Cancer Screening Program. Its implementation and roll-out started in 2006. The target population are women aged 25 to 59 insured in the National Health Fund. A Pap test is done with a three-year interval, free of charge. The system is based on personal invitations sent by regular post. Invitation to screening is supported by a social educational campaign "Choose Life" run under one slogan and logo across the whole country The NHF data base enables identification of women to screen. Pap smears are collected by gynecologists and since 2008 also by midwives trained and certified by the Program National Coordinating Center Pap test results are reported in the Bethesda 2001 system. The Screening Program has its system of quality assurance and control and is supported by a specially designed computer data base called SIMP (System of Information Monitoring in Prophylaxis) with online access to all records. In addition to organized, population-based screening there is also opportunistic screening in Poland practiced either by private gynecological practices or by some units that cooperate with the National Health Fund, but do Pap tests as an element of comprehensive gynecological examination. Those smears are not registered in the SIMP. Our aim was analysis of attendance rate in the Cervical Cancer Screening Program in the years 2007-2009. We also investigated correlation between screening coverage and invitation sending schedule, as well as between coverage and screening accessibility determined by the number of gynaecological practices where Pap smears are collected. Attendance rate in the Screening Program was evaluated

  20. Management of ASCUS findings in Papanicolaou smears. A retrospective study.

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    Iavazzo, C; Boutas, I; Grigoriadis, C; Vrachnis, N; Salakos, N

    2012-01-01

    Atypical squamous cells of undetermined significance (ASCUS) are a cervical cytologic finding category suggestive but not definitive of squamous intraepithelial lesions. ASCUS remains an incompletely described entity and accounts for even 5%-10% of reported Papanicolaou (Pap) smears. The management of women with such cytologic findings remains controversial. The aim of this study was to evaluate the cytology laboratory findings with regards to ASCUS diagnosis, using cervical Pap smears, and colposcopic biopsies, as well as their management. This is a retrospective study of patients with ASCUS Pap smears taken during the period January 2010 - December 2010 in the Second Department of Obstetrics and Gynecology, Aretaieion Hospital. During the study period, 657 Pap smears were examined at the Aretaieion Hospital; moreover, seven patients, whose Pap smears were cytologically diagnosed with ASCUS, were referred from other clinics, providing a total of 42 cases with a descriptive diagnosis of ASCUS for review. Of the 42 cases, eight were not studied because they were either lost in follow-up or they did not have available data. The remaining 34/42 patients were evaluated by colposcopic examination and directed biopsies where necessary. The ratio of ASCUS to low-grade squamous intraepithelial lesion (LGSIL), high-grade squamous cell intraepithelial lesion (HGSIL) or squamous cell carcinoma (SCC) was 5/34, 1/34, and 0/34, respectively. In the 34 ASCUS cases evaluated by colposcopy, the age distribution varied from 22 to 54 years. Eight of 34 cases did not have a child, 7/34 were primigravida, 18/34 were secondi-gravida, and 1/34 had four children. Four out of 34 cases were postmenopausal, 3/34 referred no history of abnormal bleeding, 21/34 were smokers, 6/34 used oral contraceptives, 2/34 used intrauterine devices, 1/34 took replacement of hormones, 4/34 had prior abnormal Pap smears human papillomavirus (HPV), or 1/34 had previous cancer (breast cancer). Colposcopy was

  1. Evaluation and significance of hyperchromatic crowded groups (HCG in liquid-based paps

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    Chivukula Mamatha

    2007-01-01

    Full Text Available Abstract Objective Hyperchromatic crowded groups (HCG, a term first introduced into the cytology literature by DeMay in 1995, are commonly observed in Pap tests and may rarely be associated with serious but difficult to interpret lesions. In this study, we specifically defined HCG as dark crowded cell groups with more than 15 cells which can be identified at 10× screening magnification. Methods We evaluated consecutive liquid-based (Surepath Pap tests from 601 women (age 17–74 years, mean age 29.4 yrs and observed HCG in 477 cases. In all 477 HCG cases, Pap tests were found to be satisfactory and to contain an endocervical sample. HCG were easily detectible at 10× screening magnification (size up to 400 um, mean 239.5 um and ranged from 1 to 50 (mean 19.5 per Pap slide. Results HCG predominantly represented 3-Dimensional groups of endocervical cells with some nuclear overlap (379/477 – 79%, reactive endocervical cells with relatively prominent nucleoli and some nuclear crowding (29/477 – 6%, clusters of inflammatory cells (25/477 – 5.2%, parabasal cells (22/477 – 4.6%, endometrial cells (1/477 – 0.2%. Epithelial cell abnormalities (ECA were present in only 21 of 477 cases (4.6%. 18 of 21 women with HCG-associated ECA were less than 40 years old; only 3 were =/> 40 years. HCG-associated final abnormal Pap test interpretations were as follows: ASCUS (6/21 – 28%, LSIL (12/21 – 57%, ASC-H (2/21 – 9.5%, and HSIL/CIN2-3 (3/21 – 14%. The association of HCG with ECA was statistically significant (p = 0.0174. chi-square test. In patients with ECA, biopsy results were available in 10 cases, and 4 cases of biopsy-proven CIN2/3 were detected. Among these four cases, HCG in the Pap tests, in retrospect represented the lesional high grade cells in three cases (one HSIL case and two ASC-H cases. Interestingly, none of the 124 cases without HCG were found to have an epithelial cell abnormality. Conclusion We conclude: a. HCG are observed

  2. Changes in geographic variation in the uptake of cervical cancer screening in Taiwan: possible effects of "leadership style factor"?

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    Chiou, Shu-Ti; Lu, Tsung-Hsueh

    2014-01-01

    Wennberg proposed the "practice style factor" to explain the large variations in the use of medical care. As a corollary, we propose the "leadership style factor" of the director of the city/county bureau of public health to explain changes in geographic variation in the uptake of cervical cancer screening. We first calculated the triennial Pap smear rates for women aged 30-69 years from 1997 through 2010 for each city/county in Taiwan and the rate difference and rate ratio between the highest and the lowest city/county to illustrate the geographic variation in the uptake of cervical cancer screening. We then created an expert panel to conduct a hypothesis generation process to examine the possible effects of "leadership style factors" in explaining the changes. The Pap smear rate in Taiwan as a whole was 35% in 1997 and increased to 56% in 2001, and was then stable until 2010 (55%). In 2002, the geographic variation in the Pap smear rate was the smallest, ranging from 49% in Penghu County to 63% in I-lan County, with a rate ratio of 1.28. Unfortunately, the rate ratio increased to 1.49 in 2010, the rate being lowest in Penghu County (42%) and highest in Tainan City (63%). We identified four cities/counties with unique patterns of change in Pap smear rates, which were highly associated with the leadership style of the director of the city/county bureau of public health. Despite the launch of an organized cancer screening program in Taiwan, geographic variation in the uptake of cervical cancer screening still exists and has increased during the past decade. The "leadership style factor" of the director of the city/county bureau of public health might play a plausible role in explaining the pattern of change in geographic variation in the use of cervical cancer screening in Taiwan. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. Cervical cancer screening in rural South Africa among HIV-infected migrant farm workers and sex workers.

    Science.gov (United States)

    Afzal, Omara; Lieber, Molly; Dottino, Peter; Beddoe, Ann Marie

    2017-05-01

    At an HIV clinic in the Limpopo province of South Africa, chart reviews revealed long delays in addressing abnormal Pap smears, difficulty in referrals, poor quality and lost results, and increasing cases of cervical cancer. To address these barriers, a "see and treat" approach to screening was proposed. The objective was to integrate this method into current HIV care offered by local providers and to obtain demographic and risk factor data for use in future educational and intervention programs in the region. A cross sectional study of HIV farm workers and at-risk sex workers attending an HIV clinic was performed with visual inspection with acetic acid (VIA). Those with positive screens were offered cryotherapy. Clinic charts were reviewed retrospectively for Pap smear results for the previous year at the time of program initiation and at 12 and 18 months post-program. A total of 403 participants consented and underwent screening with VIA (306 Farm workers and 97 sex workers participated). 83.9% of participants (32.9% sex workers and 100% farm workers) were HIV +. VIA was positive in 30.5% of participants, necessitating cryotherapy. There was no significant difference in VIA positivity between HIV + farm workers and sex workers. There was a positive correlation between Pap smears and VIAs results. We demonstrate successful integration of cervical cancer screening using VIA for HIV + farm workers and sex workers into an existing HIV treatment and prevention clinic in rural South Africa, addressing and treating abnormal results promptly.

  4. COLPOSCOPY- A PRIMARY ALTERNATIVE SCREENING TOOL FOR CERVICAL PRE-CANCER

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    Srinivas Sangisapu

    2017-09-01

    Full Text Available BACKGROUND Cancer cervix is the most common and preventable malignancy in females. 80% of cases in India are detected in advanced stages. Paucity of cytologists in India is one of the important reasons for failure of screening by Pap smear. Visual Inspection of cervix with Acetic acid (VIA and Visual Inspection of cervix with application of Lugol’s Iodine (VILI are two alternative strategies in low resource settings. Colposcopy involves the same principles of VIA and VILI under better magnification. We have hospitals with not so low resource settings, where gynaecologists are available, but cytologists are not. We need to evolve an alternative strategy appropriate to our resources such as colposcopy and guided biopsy. The aim of the present study is to evaluate the feasibility of colposcopy as an alternative screening tool for cervical precancer. The objective of the study is therefore to compare the colposcopy with the known reference standard that is Pap smear and evaluate the sensitivity, specificity and predictive values. MATERIALS AND METHODS 3000 women were compared with simultaneous colposcopy and Pap smear with latter as reference standard. Colposcopy-guided cervical biopsy was performed for suspicious lesions. RESULTS Unsatisfactory colposcopy due to nonvisualisation of transformation zone is an insignificant percentage (1.7%. The sensitivity, specificity, positive and negative predictive values of colposcopy for the threshold of normal versus all grades of abnormality (all age groups and all abnormal reports included are 76.74%, 99.34%, 63.46% and 99.65%, respectively. Pap smear is taken as a reference standard. This is the primary objective of our study. Colposcopy-guided biopsy specimens of minor abnormal colposcopic lesions falling outside the transformation zone have not yielded any abnormal findings on histopathology. Three high-grade lesions were detected by colposcopy as well as Pap smear. They have also positively

  5. Obesity and Cancer Screening according to Race and Gender

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    Heather Bittner Fagan

    2011-01-01

    Full Text Available The relationship between obesity and cancer screening varies by screening test, race, and gender. Most studies on cervical cancer screening found a negative association between increasing weight and screening, and this negative association was most consistent in white women. Recent literature on mammography reports no association with weight. However, some studies show a negative association in white, but not black, women. In contrast, obese/overweight men reported higher rates of prostate-specific antigen (PSA testing. Comparison of prostate cancer screening, mammography, and Pap smears implies a gender difference in the relationship between screening behavior and weight. In colorectal cancer (CRC screening, the relationship between weight and screening in men is inconsistent, while there is a trend towards lower CRC screening in higher weight women.

  6. Incontinência urinária em mulheres que buscam exame preventivo de câncer de colo uterino: fatores sociodemográficos e comportamentais Incontinencia urinaria en mujeres que solicitan un examen preventivo de cáncer de cuello uterino: factores socio-demográficos y de comportamiento Urinary incontinence in women undergoing Pap smear test: socio-demographic and behavioral factors

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    Fernando Luiz Cardoso

    2013-06-01

    baja escolaridad; renta por persona de la familia de hasta un salario mínimo; etnia no caucásica; exceso de peso corporal; peor autoevaluación de estado de salud; estreñimiento y edad. Tras los ajustes, siguiendo un modelo jerarquizado, permanecieron asociados: escolaridad; etnia; estado de salud y edad. La alta prevalencia de incontinencia urinaria de mujeres que solicitaron un examen de indicios de cáncer de cuello uterino justifica aproximaciones preventivas en esos espacios.This cross-sectional study aimed to investigate the association between socio-demographic and behavioral factors and the presence of self-reported urinary incontinence in 784 women undergoing cervical cancer screening in Greater Florianópolis, Santa Catarina State, Brazil. Socio-demographic data, health status, physical activity, constipation, and body mass index were obtained, and the International Consultation on Incontinence Questionnaire-SF was used. Prevalence of urinary incontinence was 30.7% (16.5% reported leakage once a week or less and 23.8% losses in small volumes. Poisson univariate regression showed the following factors associated with urinary incontinence: lower education, lower income, non-white skin color, overweight, worse health status, constipation, and older age. After adjustment, according to a hierarchical model, schooling, ethnicity, health status, and age remained significantly associated. The high prevalence of urinary incontinence in women seeking Pap smear tests justifies preventive approaches in these areas of intervention.

  7. High-risk human papillomavirus detection in self-sampling compared to physician-taken smear in a responder population of the Dutch cervical screening: Results of the VERA study.

    Science.gov (United States)

    Ketelaars, P J W; Bosgraaf, R P; Siebers, A G; Massuger, L F A G; van der Linden, J C; Wauters, C A P; Rahamat-Langendoen, J C; van den Brule, A J C; IntHout, J; Melchers, W J G; Bekkers, R L M

    2017-08-01

    In 2017 the cervical cancer screening program in The Netherlands will be revised. Cervical smears will primarily be tested for the presence of high-risk human papillomavirus (hrHPV) instead of cytology, and vaginal self-sampling will be offered to non-responders. This includes a potential risk that part of the women who would otherwise opt for a cervical smear will wait for self-sampling. However, self-sampling for hrHPV in a responder population has never been studied yet. The aim of this study was to investigate the applicability and accuracy of self-sampling in detecting hrHPV in a screening responder population. A total of 2049 women, aged 30-60years, participating in the screening program in The Netherlands were included from April 2013 to May 2015. After they had their cervical smear taken, women self-collected a cervicovaginal sample with a brush-based device, the Evalyn Brush. Both the cervical smear and self-sample specimen were tested with the COBAS 4800 HPV platform. The hrHPV prevalence was 8.0% (95% CI 6.9-9.2) among the physician-taken samples, and 10.0% (95% CI 8.7-11.3) among the self-samples. There was 96.8% (95% CI 96.0-97.5) concordance of hrHPV prevalence between self-samples and physician-taken samples. Women in our study evaluated self-sampling as convenient (97.1%), user-friendly (98.5%), and 62.8% preferred self-sampling over a physician-taken sampling for the next screening round. In conclusion, self-sampling showed high concordance with physician-taken sampling for hrHPV detection in a responder screening population and highly acceptable to women. Implementation of HPV-self-sampling for the responder population as a primary screening tool may be considered. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Cobertura e motivos para a realização ou não do teste de Papanicolaou no Município de São Paulo Cervical cancer screening in the Municipality of São Paulo: coverage and factors involved in submitting to the Pap test

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    Adriana de Araujo Pinho

    2003-01-01

    Full Text Available Investigou-se a prevalência da realização do teste de Papanicolaou alguma vez na vida e nos últimos três anos entre mulheres de 15 a 49 anos, o recebimento do resultado do último teste realizado e os motivos relatados para a realização ou não do exame. Um inquérito domiciliar foi realizado no Município de São Paulo em 2000, com uma amostra representativa de 1.172 mulheres selecionadas aleatoriamente em seus domicílios. Das mulheres que já tinham iniciado a vida sexual (n = 1.050, 86,1% (932 realizaram o teste alguma vez na vida e 77,3 % (839 nos últimos três anos. Das que já realizaram o teste, 806 (87,0% receberam o resultado do último exame. Os principais motivos para a realização do último teste foram: demanda espontânea (55,5%, recomendação médica (25% e presença de queixas ginecológicas (18,2%. As principais razões para a não realização do exame foram: ausência de problemas ginecológicos, vergonha ou medo e dificuldades de acesso. A despeito do relativo aumento na cobertura do teste de Papanicolaou e de mais da metade das mulheres demandarem espontaneamente pelo exame, sua realização foi menor entre aquelas com as piores condições sócio-econômicas e, portanto, de maior risco para o câncer cervical.This study estimated Pap smear coverage (at least one test in the lifetime and one in the last three years among women aged 15 to 49 years old. The study also discusses whether the women received the results of their last test, as well as self-reported reasons for and against submitting to the test. A population-based survey was conducted in the city of São Paulo in 2000 with a randomly selected representative sample of 1,172 women. Among the women who were already sexually active (n = 1,050, 86.1% reported having had at least one Pap smear during their lifetime, and 77.3% had undergone the test in the previous 3 years. Among those who reported having had at least one Pap smear, 87.0% had received the

  9. Effect of Planned Follow-up on Married Women's Health Beliefs and Behaviors Concerning Breast and Cervical Cancer Screenings.

    Science.gov (United States)

    Kolutek, Rahsan; Avci, Ilknur Aydin; Sevig, Umit

    2018-04-01

    The objective of this study was to identify the effect of planned follow-up visits on married women's health beliefs and behaviors concerning breast and cervical cancer screenings. The study was conducted using the single-group pre-test/post-test and quasi-experimental study designs. The sample of the study included 153 women. Data were collected using a Personal Information Form, the Health Belief Model (HBM) Scale for Breast Cancer Screening, the HBM Scale for Cervical Cancer Screening, and a Pap smear test. Data were collected using the aforementioned tools from September 2012 to March 2013. Four follow-up visits were conducted, nurses were educated, and telephone reminders were utilized. Friedman's test, McNemar's test, and descriptive statistics were used for data analyzing. The frequency of performing breast self-examination (BSE) at the last visit increased to 84.3 % compared to the pre-training. A statistically significant difference was observed between the pre- and post-training median values in four subscales except for the subscale of perceived seriousness of cervical cancer under "the Health Belief Model Scale for Cervical Cancer and the Pap Smear Test" (p < 0.001). The rate of performing BSE significantly increased after the training and follow-up visits. Also, the rate of having a Pap smear significantly increased after the follow-up visits.

  10. The pathogenic microorganisms in papanicolaou vaginal smears and correlation with inflammation.

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    Esmat Barouti

    2013-03-01

    Full Text Available Non-specific cervicitis or inflammatory changes in a smear report are common which are usually unclear for clinical approaches. To investigate the frequency of inflammation and pathogenic vaginal microorganisms in cervical smears among an Iranian population sample.This cross-sectional study was carried out on Pap smear samples of women referred to gynecological clinic of Taleghani Hospital in Tehran, Iran, between October 2008 and March 2009. This study was conducted on 528 conventional Papanicolaou cervical smears. The frequency and severity of inflammation and prevalence of bacterial vaginosis (BV, Trichomonas vaginalis (TV, and vaginal candidiasis (VC was determined in the samples. Also co-infection of the microorganisms in Pap samples was evaluated. percentage, mean±standard deviation of the outcome parameters were calculated. The comparison between data was performed with the Pearson's chi square or Fisher's exact test.The prevalence of BV, VC, and TV in Pap samples was 17%, 11%, and 0.4% respectively. Overall, the prevalence of these microorganisms in women of reproductive age was higher than menopausal women. There was a significant association between VC and the presence of inflammation in our samples.Based on our results, inflammation in the Pap smears can suggest an infection of VC and the patients should be considered for proper VC treatment.

  11. Prevalence of high-risk human papilloma virus types and cervical smear abnormalities in female sex workers in Chandigarh, India.

    Science.gov (United States)

    Singh, M P; Kaur, M; Gupta, N; Kumar, A; Goyal, K; Sharma, A; Majumdar, M; Gupta, M; Ratho, R K

    2016-01-01

    Cervical cancer is the most common cancer among women in developing nations. Nearly 90% of the cases have been linked to the presence of high-risk human papillomavirus (hrHPV) types 16 and 18. The risk of cervical cancer may be high in female sex workers (FSWs) due to multiple sexual partners. This study aimed to determine the prevalence of cytological abnormalities and hrHPV types 16 and 18 in FSWs in Chandigarh, North India using the liquid-based cytology (LBC) approach. The cervical brush samples were collected from 120 FSW and 98 age-matched healthy controls (HCs). These were subjected to pap smear using conventional method, LBC and the detection of hrHPV types 16 and 18 was carried out using polymerase chain reaction. The LBC samples showed better cytological details and also reduced the number of unsatisfactory smears from 11% in Pap to 1.5% in the LBC. A significantly higher number of inflammatory smears were reported in FSWs (51.7% vs. 34.7%, P = 0.01). The hrHPV types 16/18 were detected in 33/120 (27.5%) FSW versus 23/98 (23.5%) HCs. The risk of acquiring hrHPV was higher in FSWs, who had age at first sex ≤25 years, higher income and the habit of smoking. The high prevalence of hrHPV among FSWs and HCs suggests the need for the implementation of effective National Screening Programme for early detection of hrHPV types to decrease the burden of cervical cancer, especially in high-risk population.

  12. Prevalence of high-risk human papilloma virus types and cervical smear abnormalities in female sex workers in Chandigarh, India

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    M P Singh

    2016-01-01

    Full Text Available Purpose: Cervical cancer is the most common cancer among women in developing nations. Nearly 90% of the cases have been linked to the presence of high-risk human papillomavirus (hrHPV types 16 and 18. The risk of cervical cancer may be high in female sex workers (FSWs due to multiple sexual partners. This study aimed to determine the prevalence of cytological abnormalities and hrHPV types 16 and 18 in FSWs in Chandigarh, North India using the liquid-based cytology (LBC approach. Materials and Methods: The cervical brush samples were collected from 120 FSW and 98 age-matched healthy controls (HCs. These were subjected to pap smear using conventional method, LBC and the detection of hrHPV types 16 and 18 was carried out using polymerase chain reaction. Results: The LBC samples showed better cytological details and also reduced the number of unsatisfactory smears from 11% in Pap to 1.5% in the LBC. A significantly higher number of inflammatory smears were reported in FSWs (51.7% vs. 34.7%, P = 0.01. The hrHPV types 16/18 were detected in 33/120 (27.5% FSW versus 23/98 (23.5% HCs. The risk of acquiring hrHPV was higher in FSWs, who had age at first sex ≤25 years, higher income and the habit of smoking. Conclusion: The high prevalence of hrHPV among FSWs and HCs suggests the need for the implementation of effective National Screening Programme for early detection of hrHPV types to decrease the burden of cervical cancer, especially in high-risk population.

  13. How Often to Get a Pap Test (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2013-01-10

    Cervical cancer has declined in the U.S., and the decline is largely due to Pap testing and follow-up. Screening recommendations have changed. In this podcast, Meg Watson discusses Pap testing.  Created: 1/10/2013 by MMWR.   Date Released: 1/10/2013.

  14. Revisão rápida de esfregaços cervicais como método de garantia interna de qualidade Rapid screening of cervical smears as a method of internal quality assurance

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    Rita Goreti Amaral

    2003-06-01

    negative rate. OBJECTIVE: The aim of this study was to compare the performance of 100% rapid re-screening with that of 10% random re-screening as an internal quality assurance method. METHODS: 2,750 first screening negative smears were submitted to 100% rapid re-screening by a senior cytotechnologist followed by 10% random re-screening by another senior cytotechnologist. After re-screening, all smears were analyzed by two independent cytopathologists. Whenever results were divergent the smears were analyzed by a third cytopathologist and the panel established a consensus gold standard diagnosis. RESULTS: 98 suspect smears were selected by rapid re-screening, 62 of which were confirmed as abnormal by the gold standard: 45 Ascus, 11 LSIL and six HSIL (sensitivity 73.8%. Of the nine abnormal smears detected by the 10% random re-screening, six were confirmed by the gold standard, three Ascus, two LSIL and one HSIL (sensitivity 50%. The gold standard detected 57 Ascus, ten LSIL and five HSIL cases among the 2,489 smears that were not submitted to 10% re-screening. CONCLUSIONS: 100% rapid re-screening is an efficient alternative for reduction of cervical screening false negative rates. It also allowed to monitor the individual performance of members of the team.

  15. Understanding Transgender Men's Experiences with and Preferences for Cervical Cancer Screening: A Rapid Assessment Survey.

    Science.gov (United States)

    Seay, Julia; Ranck, Atticus; Weiss, Roy; Salgado, Christopher; Fein, Lydia; Kobetz, Erin

    2017-08-01

    Transgender men are less likely than cisgender women to receive cervical cancer screening. The purpose of the current study was to understand experiences with and preferences for cervical cancer screening among transgender men. Ninety-one transgender men ages 21-63 completed the survey. The survey evaluated experiences with and preferences for screening, including opinions regarding human papillomavirus (HPV) self-sampling as a primary cervical cancer screening. Half (50.5%) of participants did not have Pap smear screening within the past 3 years. The majority (57.1%) of participants preferred HPV self-sampling over provider-collected Pap smear screening. Participants who reported discrimination were more likely to prefer HPV self-sampling (odds ratio = 3.29, 95% confidence interval 1.38-7.84, P = 0.007). Primary HPV testing via HPV self-sampling may improve cervical cancer screening uptake among transgender men. Future work should pilot this innovative cervical cancer screening method within this population.

  16. Validation of cervical cancer screening methods in HIV positive women from Johannesburg South Africa.

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    Cynthia Firnhaber

    Full Text Available HIV-infected women are at increased risk for developing cervical cancer. Women living in resource-limited countries are especially at risk due to poor access to cervical cancer screening and treatment. We evaluated three cervical cancer screening methods to detect cervical intraepithelial neoplasia grade 2 and above (CIN 2+ in HIV-infected women in South Africa; Pap smear, visual inspection with 5% acetic acid (VIA and human papillomavirus detection (HPV.HIV-infected women aged 18-65 were recruited in Johannesburg. A cross-sectional study evaluating three screening methods for the detection of the histologically-defined gold standard CIN-2 + was performed. Women were screened for cervical abnormalities with the Digene HC2 assay (HPV, Pap smear and VIA. VIA was performed by clinic nurses, digital photographs taken and then later reviewed by specialist physicians. The sensitivity, specificity and predictive valves for CIN-2 + were calculated using maximum likelihood estimators.1,202 HIV-infected women participated, with a median age of 38 years and CD4 counts of 394 cells/mm(3. One third of women had a high grade lesion on cytology. VIA and HPV were positive in 45% and 61% of women respectively. Estimated sensitivity/specificity for HPV, Pap smear and VIA for CIN 2+ was 92%/51.4%, 75.8%/83.4% and 65.4/68.5% (nurse reading, respectively. Sensitivities were similar, and specificities appeared significantly lower for the HPV test, cytology and VIA among women with CD4 counts ≤200 cells/mm(3 as compared to CD4 counts >350 cells/mm(3.Although HPV was the most sensitive screening method for detecting CIN 2+, it was less specific than conventional cytology and VIA with digital imaging review. Screening programs may need to be individualized in context of the resources and capacity in each area.

  17. Knowledge and beliefs regarding cervical cancer screening and HPV vaccination among urban and rural women in León, Nicaragua

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    Hannah D. Rees

    2017-10-01

    Full Text Available Background In Nicaragua, cervical cancer is the leading cause of cancer-related death for women ages 15–44, yet access to the HPV vaccine is limited to those with financial resources to pay for it. Cervical cytology is provided free of charge in public clinics; however, only 10% of women receive Pap smears at the nationally recommended frequency. Previous studies have not investigated how beliefs regarding cervical cancer screening may differ for urban and rural populations in Nicaragua. Furthermore, no investigation has assessed Nicaraguan women’s beliefs about a potential HPV immunization campaign. Given beliefs’ influence on health behavior, we investigated the structural, sociocultural, and knowledge-based factors influencing women’s beliefs regarding cervical cancer screening among urban and rural women in León, Nicaragua, and assessed acceptance of a potential HPV immunization program. Methods Our sequential explanatory mixed-methods study consisted of two phases: (1 a close-ended questionnaire, followed by (2 a qualitative, in-depth interview. Our quantitative sample contained 117 urban and 112 rural participants aged 18–49. We assessed beliefs regarding cervical cancer screening using a 22-item scale, with higher scores indicating screening-promoting beliefs in simple linear and multiple linear regressions. Twenty qualitative interviews, exploring the sociocultural dimensions of knowledge and attitudes indicated by our quantitative findings, were conducted with a sample of 13 urban and 7 rural women aged 19–46. Results The multiple linear regression indicates that greater knowledge of Pap smears, HPV, and cervical cancer is significantly associated with screening-promoting beliefs after adjusting for other relevant factors. There was no significant difference in screening knowledge and beliefs for urban and rural women. Four recurrent themes representing determinants of knowledge, beliefs, and attitudes regarding cervical

  18. Knowledge and beliefs regarding cervical cancer screening and HPV vaccination among urban and rural women in León, Nicaragua.

    Science.gov (United States)

    Rees, Hannah D; Lombardo, Alexandra R; Tangoren, Caroline G; Meyers, Sara J; Muppala, Vishnu R; Niccolai, Linda M

    2017-01-01

    In Nicaragua, cervical cancer is the leading cause of cancer-related death for women ages 15-44, yet access to the HPV vaccine is limited to those with financial resources to pay for it. Cervical cytology is provided free of charge in public clinics; however, only 10% of women receive Pap smears at the nationally recommended frequency. Previous studies have not investigated how beliefs regarding cervical cancer screening may differ for urban and rural populations in Nicaragua. Furthermore, no investigation has assessed Nicaraguan women's beliefs about a potential HPV immunization campaign. Given beliefs' influence on health behavior, we investigated the structural, sociocultural, and knowledge-based factors influencing women's beliefs regarding cervical cancer screening among urban and rural women in León, Nicaragua, and assessed acceptance of a potential HPV immunization program. Our sequential explanatory mixed-methods study consisted of two phases: (1) a close-ended questionnaire, followed by (2) a qualitative, in-depth interview. Our quantitative sample contained 117 urban and 112 rural participants aged 18-49. We assessed beliefs regarding cervical cancer screening using a 22-item scale, with higher scores indicating screening-promoting beliefs in simple linear and multiple linear regressions. Twenty qualitative interviews, exploring the sociocultural dimensions of knowledge and attitudes indicated by our quantitative findings, were conducted with a sample of 13 urban and 7 rural women aged 19-46. The multiple linear regression indicates that greater knowledge of Pap smears, HPV, and cervical cancer is significantly associated with screening-promoting beliefs after adjusting for other relevant factors. There was no significant difference in screening knowledge and beliefs for urban and rural women. Four recurrent themes representing determinants of knowledge, beliefs, and attitudes regarding cervical cancer screening arose from interviews and built on

  19. Local Risk Factors in Genital Human Papilloma Virus Infection in Cervical Smears

    Science.gov (United States)

    Ojiyi, EC; Dike, IE; Okeudo, C; Ejikem, C; Nzewuihe, AC; Agbata, A

    2013-01-01

    Background: Infection with human papilloma virus (HPV) is the main cause of cervical cancer, but the local risk factors have not been sufficiently assessed. Aim: The study is aimed at determining the prevalence and to evaluate the local risk factors of HPV infection in cervical smears at the Imo State University Teaching Hospital, Orlu, Nigeria. Subjects and Methods: The participants involved 445 randomly selected sexually active women attending the antenatal, postnatal, gynecology and family planning clinics in the Department of Obstetrics and Gynecology of the university between April 2004 and May 2012. A questionnaire assessing various socio-demographic characteristics of the participants was administered. The pap smears of the participants were examined microscopically for evidence of HPV infection. The SPSS version 17.0 (Chicago, Illinois, USA) was used to compute and analyze the results. The results were presented in tables as simple percentages. Tests of significance using the Chi-square and fisher exact tests were applied where appropriate. Results: The prevalence rate of HPV was 10.3%. The peak age-specific prevalence of 11.7% occurred in the 15-19 years age group. There were significant associations between the occurrence of HPV and multiple sexual partners, coital frequency, multiparity, contraceptive use, marital status, low socio-economic status, abnormal vaginal discharge, irregular menstruation, post-coital and post-menopausal bleeding, (P < 0.05). Conclusion: All sexually active women including teenagers should be screened for cervical HPV infection in an organized systematic program equipped with a good call and recall system. There is, therefore, a need to move emphasis from the current practice of opportunistic screening to a systematic screening of the whole population at risk despite cost implications. PMID:24380003

  20. Reproductive health preventive screening among clinic vs. over-the-counter oral contraceptive users

    Science.gov (United States)

    Hopkins, Kristine; Grossman, Daniel; White, Kari; Amastae, Jon; Potter, Joseph E.

    2015-01-01

    Background Interest is growing in moving oral contraceptives over-the-counter (OTC), although concerns exist about whether women would continue to get preventive health screening. Study Design We recruited cohorts of US-resident women who obtained oral contraceptives from US family planning clinics (n=532) and OTC from pharmacies in Mexico (n=514) and interviewed them four times over 9 months. Based on self-reports of having a Pap smear within 3 years or ever having had a pelvic exam, clinical breast exam and testing for sexually transmitted infections (STIs), we assessed the prevalence of preventive screening using Poisson regression models. Results The prevalence of screening was high for both groups (>88% for Pap smear, pelvic exam and clinical breast exam and >71% for STI screening), while the prevalence ratios for screening were higher for clinic users, even after multivariable adjustment. Conclusions Results suggest that most women would obtain reproductive health preventive screening if oral contraceptives were available OTC, and also highlight the need to improve access to preventive screening for all low-income women. PMID:22520645

  1. Bone scintigraphy, plasma ALP, TAP and PAP in patients with prostatic cancer

    International Nuclear Information System (INIS)

    Imamura, Akihiko; Hoshi, Hiroaki; Jinnouchi, Seishi; Samejima, Masahiko; Watanabe, Katsushi

    1988-01-01

    This study assessed the ability of bone scintigraphy, alkaline phosphatase (ALP), total acid phosphatase (TAP), and prostatic acid phosphatase (PAP) to diagnose bone metastasis in a series of 62 patients with histologically proven prostatic cancer. Abnormal uptake was seen on the bone scan in 49 patients (79 %). A final diagnosis of bone metastasis was made in 40 patients (65 %). The sensitivity and specificity were 100 % and 59 %, respectively, for bone scintigraphy; 50 % and 96 % for ALP; 65 % and 82 % for TAP; and 73 % and 77 % for PAP. For 40 patients with bone metastasis, all of the ALP, TAP, and PAP were positive in 17 patients (43 %) and negative in 8 patients (20 %). Higher levels of ALP, TAP, and PAP tended to be associated with more extensive bone metastasis. Although serological examination showed lower sensitivity than bone scintigraphy in the diagnosis of bone metastasis, PAP may be most frequently used as a screening procedure of bone metastasis. (Namekawa, K.)

  2. Psychosocial predictors of first attendance for organised mammography screening

    DEFF Research Database (Denmark)

    Aro, A R; de Koning, H J; Absetz, P

    1999-01-01

    Scale, Illness Attitude Scale, Health Locus of Control Scale, Anxiety Inventory, and Depression Inventory. Univariate and multivariate logistic regression analyses were used to predict attendance. RESULTS: Those most likely to attend were working, middle income, and averagely educated women, who had...... not had a mass mammogram recently, but who regularly visited gynaecologists, attended for Pap smear screening, practised breast self examination, and who did not smoke. Low confidence in their own capabilities in breast cancer prevention, overoptimism about the sensitivity of mammography, and perception...

  3. Acceptability of cervical cancer screening using visual inspection among women attending a childhood immunization clinic in Uganda

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    Meng Li

    2017-12-01

    Full Text Available Objective: To evaluate the acceptability and performance of cervical cancer (CC screening using visual inspection with acetic acid (VIA integrated into a rural immunization clinic in Uganda. Methods/materials: We conducted a cross-sectional pilot study in rural Uganda. We explored associations between women's characteristics and acceptance of VIA testing. We collected samples for Papanicolaou (Pap smear testing in a random subset of women and used results from this test as a comparator for assessing VIA performance. Results: We enrolled 625 women of whom 571 (91.4% accepted and 54 (8.6% refused CC screening. In the univariate model, age (Odds Ratio (OR=1.10; p-value<0.001 and employment status (OR 2.00; p-value=0.019 were significantly associated with acceptance of VIA screening. In the multivariate model, no characteristic was independently associated with acceptance of VIA screening after adjusting for other factors. Compared to reference Pap smear, CC screening with VIA had a sensitivity of 50% and a specificity of 97.7%. Conclusions: CC screening with VIA is highly acceptable in the setting of rural immunization clinics in Uganda. Studies to assess which screening method would be the most effective and cost-effective are needed before stakeholders can consider adopting screening programs at scale.

  4. Desempenho de enfermeiras na coleta de material cervico uterino para exame de Papanicolaou Desempeño de enfermeras en la recolección de material cérvico uterino para examen de Papanicolaou Performance of nurses in gathering material for Pap smear test

    Directory of Open Access Journals (Sweden)

    Nancy Costa de Oliveira

    2010-06-01

    endocervice; dos colecciones llevó tiempo excesivo para fijación. Espéculos y pinzas Cherron fueron escasas; 63 (100% láminas fueron satisfactorias. CONCLUSION: Ha déficit del conocimiento y técnica, escasez de materiales, y aunque de las imperfecciones observadas en colección, 100% de las láminas tuvieran adecuación conferida.OBJECTIVES: Verify nurses' knowledge and practice to material uterine cervical, to identify availability of material of collection and to verify suitability of the smears. METHODS: Transversal study, at service, was carried from August to October 2006, with 21 nurses. Knowledge was investigated through questionnaire; collection technique and material were researched through observation; suitability of the smears was verified in the lab reports. RESULTS: Seventeen nurses evaluated themselves security to carry through the examination; two had asked about emptiness of bladder and four had explained procedure; none inquired using a shower, sexual abstinence and bleed intermenstrual; two had left to use of spatula correctly and two had considered unnecessary endocervix collection; two collections the time for fixation was excessive. Speculums and Cherron clamps had been insufficient; 63 (100% blades were adjusted. CONCLUSION: It has been detected deficit of knowledge and technique, insufficiency of materials, and although the imperfections observed in the collection, 100% of the findings had conferred adequateness to the blades.

  5. Analysis of cervical smears in a Muslim population

    International Nuclear Information System (INIS)

    Wasti, Shahnaz; Ahmed, Waleed; Jafri, Abbas; Khan, Behram; Sohail, Rizwan; Hassan, Sheema

    2004-01-01

    Screening for the cancer of the cervix remains a neglected health care issue in Pakistan. To provide baseline data for future efforts to improve screening, we conducted a retrospective analysis of cervical smears taken in the obstetrics and gynaecological clinics of the Agha Khan University Hospital, Karachi, Pakistan. We collected data on cervical smear cytology for cervical smears taken from January 1, 1990 to December 31, 1996. We assessed risk factors for dysplasia, including age, age at first marriage, and number of pregnancies. The overall prevalence of abnormal smears in our study was 0.5%. Of 20,995 cervical smears, showed non-specific inflammation, 7302 (34.8%) were reported as normal, 809 (3.85%) showed monillial infection, 148 (0.71%) showed atypia, 105 (0.5%) had dyplastic cytology and 52 (0.25%) samples were inadequate. The highest incidence of dysplastic smears was seen in the age group 35 to 44 years. Of 105 patients with dysplasia 12 were pregnant, and all were asymptomatic. The low prevalence of abnormal smears, compared with the data from Western populations, could be due to the internet bias of health awareness in the women who attended our hospital. The results of this study may serve as baseline for for future comparisons. A large community-based study may establish the exact prevalence of malignant and premalignant lesions so as to plan for future screening. (author)

  6. A qualitative study exploring factors associated with Pap test use among North Korean refugees.

    Science.gov (United States)

    Kim, Kyounghae; Kim, Soohyun; Chung, Yoonkyung

    2017-10-01

    Lack of medical care in North Korea and vulnerability to human trafficking during their migration increase risks of cervical cancer among North Korean refugees. To better understand factors influencing Pap test use, we conducted a qualitative study of eight North Korean refugees in South Korea. Individual barriers were limited knowledge, lack of perceived need for preventive services, and concerns about costs. Environmental facilitators included having female providers, receiving family support, and free screenings. Refugees' health outlook, including viewing cancers as fatal diseases, hindered seeking Pap tests. Multi-faceted approaches to address individual and environmental factors in promoting Pap tests are warranted.

  7. Socioeconomic determinants of cervical cancer screening in Latin America Determinantes socioeconómicos de las pruebas de detección sistemática del cáncer cervicouterino en América Latina

    Directory of Open Access Journals (Sweden)

    Samir Soneji

    2013-03-01

    Full Text Available OBJECTIVE: To assess the impact of health care access and socioeconomic determinants on Pap smear screening in Latin America. METHODS: Individual-level data was collected from the Demographic and Health Surveys in Bolivia, Brazil, Dominican Republic, Ecuador, Guatemala, Nicaragua, Peru, and Trinidad and Tobago between 1987 and 2008. Multivariate logistic regression analyses were used to identify socioeconomic and health care determinants of two outcomes: knowledge of Pap smears and recent Pap smear screening. RESULTS: In all countries, the proportion of women with a recent Pap smear screening remained below 55%. Key determinants of knowledge of Pap smears were age, education, and recent doctor's visit. For recent Pap smear screening, key determinants were wealth and recent doctor's visit. Women were between 1.47 and 3.44 times more likely to have received a recent Pap smear if they had a recent doctor's visit. Even the poorest women with a recent doctor's visit were more likely to screen than the richest women without a recent visit. CONCLUSIONS: These data suggest that visiting a doctor is an important determinant of cervical cancer screening in Latin America. Because screening may coincide with other medical visits, physicians could effectively encourage screening.OBJETIVO: Evaluar las repercusiones del acceso a la atención de salud y de los determinantes socioeconómicos sobre la detección sistemática del cáncer cervicouterino con la prueba de Papanicolaou en América Latina. MÉTODOS: Se recopilaron datos individuales a partir de Encuestas de Demografía y Salud realizadas en Bolivia, Brasil, Ecuador, Guatemala, Nicaragua, Perú, República Dominicana y Trinidad y Tobago entre 1987 y 2008. Se utilizaron análisis de regresión logística con múltiples variables para identificar los determinantes socioeconómicos y de atención de salud de dos resultados: el conocimiento de la existencia de la prueba de Papanicolaou y el tamizaje

  8. Practice Study Outpatient Psychotherapy - Switzerland (PAP-S) : Study design and feasibility (Revised edition)

    OpenAIRE

    Wyl, Agnes von; Crameri, Aureliano; Koemeda, Margit; Tschuschke, Volker; Schulthess, Peter

    2016-01-01

    Revised edition of Von Wyl, A., Crameri, A., Koemeda, M., Tschuchke, V. & Schulthess, P. (2013). The PAP-S (Practice of Ambulant Psychotherapy-Study), Switzerland: Study Design and Feasibility. Zurich University of Applied Sciences, Zurich. The original article was published in German: von Wyl, A., Crameri, A., Koemeda, M., Tschuschke, V. & Schulthess, P. (2013). Praxisstudie ambulante Psychotherapie Schweiz (PAP-S): Studiendesign und Machbarkeit. Psychotherapie-Wissenschaft, 1, 6-22; op...

  9. Quality control in screening programs for cervical cancer

    International Nuclear Information System (INIS)

    Sarduy Napoles, Miguel

    2012-01-01

    The malignancy of the cervix is one of the few locations avoidable cancers, if detected before it progresses to the infiltration. The most efficient way of early detection is through a screening program to provide women undertaking a regular and quality Pap smear. If this test results abnormal, the program offers easier access to specialized care, effective treatment, and follow-up. The objective of this article is to present usefulness of methods for quality control used in screening programs for cervical cancer to detect their inadequacies. Here are some factors and conditions that must be considered in each of the steps to take, for a cervical cancer screening program to be successful and to meet the objectives proposed in reducing mortality due to this cause. This document contains some useful indexes calculated to ensure quality throughout the process. There should be the measurement of quality throughout the screening process that allows collecting of reliable data as well as correcting deficiencies

  10. An experience of qualified preventive screening: shiraz smart screening software.

    Science.gov (United States)

    Islami Parkoohi, Parisa; Zare, Hashem; Abdollahifard, Gholamreza

    2015-01-01

    Computerized preventive screening software is a cost effective intervention tool to address non-communicable chronic diseases. Shiraz Smart Screening Software (SSSS) was developed as an innovative tool for qualified screening. It allows simultaneous smart screening of several high-burden chronic diseases and supports reminder notification functionality. The extent in which SSSS affects screening quality is also described. Following software development, preventive screening and annual health examinations of 261 school staff (Medical School of Shiraz, Iran) was carried out in a software-assisted manner. To evaluate the quality of the software-assisted screening, we used quasi-experimental study design and determined coverage, irregular attendance and inappropriateness proportions in relation with the manual and software-assisted screening as well as the corresponding number of requested tests. In manual screening method, 27% of employees were covered (with 94% irregular attendance) while by software-assisted screening, the coverage proportion was 79% (attendance status will clear after the specified time). The frequency of inappropriate screening test requests, before the software implementation, was 41.37% for fasting plasma glucose, 41.37% for lipid profile, 0.84% for occult blood, 0.19% for flexible sigmoidoscopy/colonoscopy, 35.29% for Pap smear, 19.20% for mammography and 11.2% for prostate specific antigen. All of the above were corrected by the software application. In total, 366 manual screening and 334 software-assisted screening tests were requested. SSSS is an innovative tool to improve the quality of preventive screening plans in terms of increased screening coverage, reduction in inappropriateness and the total number of requested tests.

  11. Knowledge, Attitudes and Practices Regarding Cervical Cancer and Screening among Haitian Health Care Workers

    Directory of Open Access Journals (Sweden)

    Leilah Zahedi

    2014-11-01

    Full Text Available It is estimated that Haiti has the highest incidence of cervical cancer in the Western Hemisphere. There are currently no sustainable and affordable cervical cancer screening programs in Haiti. The current status of screening services and knowledge of health care professionals was assessed through a Knowledge, Attitudes, and Practices survey on cervical cancer screening and prevention. It was distributed to Project Medishare for Haiti health care workers (n = 27 in the Central Plateau. The majority (22/27 of participants stated pre-cancerous cells could be detected through screening, however, only four had ever performed a pap smear. All of the participants felt a screening program should be started in their area. Our data establishes that knowledge is fairly lacking among healthcare workers and there is an opportunity to train them in simple, cost effective “screen-and-treat” programs that could have a great impact on the overall health of the population.

  12. Detecção sorológica de anti-HPV 16 e 18 e sua associação com os achados do papanicolaou em adolescentes e mulheres jovens Serological detection of anti HPV 16/18 and its association with pap smear in adolescents and young women

    Directory of Open Access Journals (Sweden)

    Cristina Helena Rama

    2006-02-01

    September to November 2000. At gynecological examination, a cervical sample on liquid-base for cytology-testing and a bblood sample for ELISA identification of HPV 16 and 18 antibodies were collected and sent to a reference laboratory in Belgium. Statistical analysis estimated the prevalence and prevalence ratio with a 95% confidence interval. RESULTS: Of these young women, 150 (27.7% were seropositive: 79 (14.6% to HPV 16 antibody; 35 (6.4% to HPV 18 antibody and 36 (6.6% to both HPV 16/18 antibodies. Cytological abnormalities were detected in 107 cases (20.5%: 63 presented with atypical squamous cells of undetermined significance (ASCUS, 41 were suggestive of low grade squamous intra-epithelial lesion (LGSIL and 3 of high grade squamous intra-epithelial lesion (HGSIL. Prevalence of abnormal cytology with a positive serology was only 1.75 times that of prevalence of abnormal cytology with a negative serology. Detection of abnormal cytology was not correlated with positive serology. CONCLUSION: Results of this study indicate a high prevalence of HPV 16 and 18 in young healthy women which showed no relation to the abnormal findings of cytology smears.

  13. A Shandon PapSpin liquid-based gynecological test: A split-sample and direct-to-vial test with histology follow-up study

    Directory of Open Access Journals (Sweden)

    Rimiene J

    2010-01-01

    Full Text Available Background: Studies for liquid-based Papanicolaou (Pap tests reveal that liquid-based cytology (LBC is a safe and effective alternative to the conventional Pap smear. Although there is research on ThinPrep and SurePath systems, information is lacking to evaluate the efficiency and effectiveness of systems based on cytocentrifugation. This study is designed to determine the sensitivity and specificity of the Shandon PapSpin (ThermoShandon, Pittsburgh, Pennsylvania, USA liquid-based gynecological system. We used split-sample and direct-to-vial study design. Materials and Methods: 2,945 women referred to prophylactic check-up were enrolled in this study. Split sample design was used in 1,500 women and residual cervical cytology specimen from all these cases was placed in fluid for PapSpin preparation after performing conventional smear. The direct-to-vial study was carried out in another cohort of 1,445 women in whom the entire cervical material was investigated using only the PapSpin technique. Follow up histological diagnoses for 141 women were obtained from both study arms following 189 abnormal cytology cases. 80 LBC cases from the split sample group and 61 LBC cases in the direct-to-vial group were correlated with the histology results. The sensitivity and secificity of the conventional smear and PapSpin tests in both study arms were compared. Results: In the split sample group, conventional smears showed a higher proportion of ASC-US (atypical cells undetermined significance: 31 (2.1% vs 10 (0.7% in PapSpin (P = 0.001. A higher proportion of unsatisfactory samples was found in the conventional smear group: 25 (1.7% vs 6 (0.4% cases (P = 0.001. In the split sample group, the sensitivity of the conventional and PapSpin tests was 68.7% vs 78.1%, and the specificity 93.8% vs 91.8%, respectively. In the direct to vial group PapSpin sensitivity was 75.9% and specificity 96.5%. The differences in sensitivity and specificity were not significant. The

  14. [ASCUS in screening].

    Science.gov (United States)

    Caprara, L; Monari, F; De Bianchi, P S; Amadori, A; Bondi, A

    2001-12-01

    The significance and use of the cytological diagnosis "atypical squamous cells of undetermined significance" (ASCUS) remain a major problem in cervical cancer screening. The prevalence of ASCUS by patient age has seldom been investigated. The present paper reports the prevalence of ASCUS in a large series of screening Pap smears from the Italian region of Emilia-Romagna. The study was based on the data collected by the Department of Health of the Emilia-Romagna Region for the first 3-year round (1997-1999) of a population-based screening programme (target age, 25-64 years). The age-specific frequency of ASCUS has been calculated as a prevalence rate per 1000 screened patients. A total of 597,386 women participated in the programme. Women diagnosed with ASCUS (n = 8205 or 13.7 per 1000) accounted for 49% of the recalls for colposcopy (n = 16,871, or 28.2 per 1000). The prevalence of diagnoses of low-grade squamous intraepithelial lesions (LG-SIL) decreased progressively with age while that of high-grade SIL was slightly higher between 30 and 39 years. The prevalence of ASCUS peaked at age 45-49 years (17.3 per 1000 subjects). The observed peak reflects the prevalence of (1) cytological changes closely associated with perimenopausal age and at least compatible with the ASCUS diagnosis, and (2) cytological abnormalities induced by hormone replacement therapy.

  15. The cervical smear pattern in patients with chronic pelvic ...

    African Journals Online (AJOL)

    Background: Cancer of the cervix is the commonestmalignancy of the genital tract inNigeria. In an atmosphere of opportunistic screening due to lack of a national screening programme, studies are needed to determine patients at risk of premalignant lesions of the cervix. Goal: To determine cervical smear pattern in patients ...

  16. CANCER SCREENING AWARENESS AMONG NURSING STAFF IN GOVERNMENT MEDICAL COLLEGE: A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Mukesh Shanthilal

    2016-07-01

    Full Text Available BACKGROUND Cervical and breast cancers are the common malignancies among female population in India. Though there are approved screening methods available to prevent and detect these cancers at an early stage, there is a lack of awareness about cancer screening among general public as well as the health care professionals. This study is aimed to identify the knowledge, attitude and practice (KAP among the nursing staff regarding cancer screening in these two diseases. METHOD A cross-sectional interview based survey was conducted among 303 female nursing staff working in a government medical college hospital from November 2015 to December 2015. Ethical committee approval was taken. Verbal informed consent was sought from the study subjects. Nursing staff who gave consent to participate in the study were enrolled. There were no specific inclusion or exclusion criteria for the study subjects. A structured pretested questionnaire regarding knowledge, attitude and practice (KAP was used to collect the data. The questions were open-ended. Recall and recognition type of questions were used. The data was entered into MS Excel worksheet and analysed using descriptive statistics. RESULTS Total of 303 nurses included in the study. The age ranged from 21 to 64 years. Median age is 38 years. Only 24.4% (74/303 of Nurses were aware of cancer screening and many of them were aware of Pap smear (55.1%, 167/303 and mammogram (66.3%, 201/303 as investigational tools in diagnosing cancer. Only 17 out of 303 (5.6% nurses had Pap smear test done with an average of 1.23% Pap smear per individual. Mammogram screening was done in 13% (15/115 of the eligible nurses with an average of 1.2% mammogram per individual. The most common reason for not undergoing screening as expressed was they did not feel the need to be screened unless they were symptomatic (55%, they are too young for screening (14.8%, shyness (11.1%, fear (11.1% and lack of time (7.4%. However, 90% of them

  17. Using Social Media to Characterize Public Sentiment Toward Medical Interventions Commonly Used for Cancer Screening: An Observational Study.

    Science.gov (United States)

    Metwally, Omar; Blumberg, Seth; Ladabaum, Uri; Sinha, Sidhartha R

    2017-06-07

    Although cancer screening reduces morbidity and mortality, millions of people worldwide remain unscreened. Social media provide a unique platform to understand public sentiment toward tools that are commonly used for cancer screening. The objective of our study was to examine public sentiment toward colonoscopy, mammography, and Pap smear and how this sentiment spreads by analyzing discourse on Twitter. In this observational study, we classified 32,847 tweets (online postings on Twitter) related to colonoscopy, mammography, or Pap smears using a naive Bayes algorithm as containing positive, negative, or neutral sentiment. Additionally, we characterized the spread of sentiment on Twitter using an established model to study contagion. Colonoscopy-related tweets were more likely to express negative than positive sentiment (negative to positive ratio 1.65, 95% CI 1.51-1.80, Psocial media data provides a unique, quantitative framework to better understand the public's perception of medical interventions that are commonly used for cancer screening. Given the growing use of social media, public health interventions to improve cancer screening should use the health perceptions of the population as expressed in social network postings about tests that are frequently used for cancer screening, as well as other people they may influence with such postings. ©Omar Metwally, Seth Blumberg, Uri Ladabaum, Sidhartha R. Sinha. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 07.06.2017.

  18. Knowledge, attitude and practice of screening for cervical cancer among female students of a tertiary institution in South Eastern Nigeria.

    Science.gov (United States)

    Akujobi, C N; Ikechebelu, J I; Onunkwo, I; Onyiaorah, I V

    2008-09-01

    Cervical cancer is the second commonest cancer of females worldwide and the commonest cancer of the female genital tract in our environment. It can be prevented through early detection by cervical screening (Pap smear). The objective of this study is to determine the knowledge, attitude and practice of cervical cancer screening among female undergraduates. A pre tested questionnaire was administered to third and fourth year female students of the Faculty of Natural Sciences, Nnamdi Azikiwe University Awka, Nigeria. Out of the 220 students involved in the study, 134 (60.9) had knowledge of cervical cancer and 118 (53.6%) were sexually active with the average age at sexual debut being 21.2 years. The mean age of the students was 23.8 years and the age range was 17 to 39 years with 175 (80%) in the age range of 20-29 years. About 2/3 of the students did not know about Pap smear and worse still, none of them had undergone a Pap screening test before. This low participation in screening for cervical cancer was attributed to several reasons including ignorance of the existence of such a test, lack of awareness of centers where such services are obtainable, ignorance of the importance of screening and the risk factors to the development of cervical cancer. There is good level of awareness of cervical cancer among the female undergraduates but poor knowledge and participation in cervical cancer screening. The development of a comprehensive cervical cancer screening strategy is being recommended to improve participation with a view to prevent cervical cancer by early detection and treatment of the pre-malignant stages.

  19. Violence Victimization, Social Support, and Papanicolaou Smear Outcomes: A Longitudinal Study from Adolescence to Young Adulthood.

    Science.gov (United States)

    Hsieh, Hsing-Fang; Heinze, Justin E; Lang, Ian; Mistry, Ritesh; Buu, Anne; Zimmerman, Marc A

    2017-12-01

    African American youth are among those at greatest risk for experiencing violence victimization. Notably, the mortality rate of cervical cancer for African American women is also twice that of white women. To date, we know of no literature using longitudinal data to examine how violence victimization relates to Papanicolaou (Pap) smear results or cervical cancer in this population. Our study examines how violence victimization during adolescence (age 15 to 18) influences psychological distress, perceived social support, heavy substance abuse, and sexual risk behaviors during emerging adulthood (age 20 to 23), and subsequent Pap smear outcomes during young adulthood (age 29 to 32). This study is based on 12 waves of data collected in a longitudinal study of 360 African American women from mid-adolescence (ninth grade, mean age = 14.8 years) to young adulthood (mean age = 32.0 years). We used structural equation modeling analysis to examine the hypothesized model. Violence victimization during adolescence had a direct effect on decreased social support, increased psychological distress, and increased heavy cigarette use during emerging adulthood. Better social support was also associated with fewer sexual partners during emerging adulthood and lower odds of abnormal Pap smear results during young adulthood. The effect of violence victimization on abnormal Pap smear was mediated by social support. Our results show that violence victimization during adolescence has long-term negative effects through multiple pathways that persist into adulthood. Our findings also suggest that social support may help to compensate against other risk factors. Interventions designed to address the perceived support may help victims cope with their experience.

  20. The impact of a community intervention to improve cervical cancer screening uptake in the Amazon region of Brazil

    Directory of Open Access Journals (Sweden)

    Marcus Vinicius Von Zuben

    Full Text Available CONTEXT AND OBJECTIVE: In the northern region of Brazil, cervical cancer is the most important cause of cancer-related deaths among women. There is considerable likelihood, however, that official incidence and mortality figures are greatly underestimated. The aim of this study was to estimate the repercussions from improvement in cervical cancer screening programs on the incidence of pre-invasive and invasive cervical lesions in a municipality in this region. DESIGN AND SETTING: This was a quasi-experimental study that assessed process dimensions relevant to the program objectives. The study comprised a sample of 2,226 women seen at primary healthcare units in Cruzeiro do Sul, a small city in the Brazilian Amazon region, from April 2003 to July 2004. METHODS: Women were recruited through local radio advertisements and by oral communication from the investigators. The women answered a structured questionnaire and underwent pelvic examination, which included Papanicolaou (Pap smears and naked-eye inspection of the cervix after applying diluted acetic acid. Women with positive Pap smears or abnormal gynecological examination were referred for colposcopy and possible biopsy, diathermic large loop excision of the transformation zone or conization. RESULTS: The results obtained were compared with historical official data retrieved from the Brazilian Ministry of Health’s database. Intervention resulted in a 40% increase in positive Pap smears and detection of cancer was nine times higher than had been observed in routine screening. CONCLUSIONS: Detection of pre-invasive and invasive cervical lesions in the intervention group was remarkably higher than among women seen during routine screening.

  1. Knowledge, attitude and practice of cervical cancer screening among women attending gynecology clinics in a tertiary level medical care center in southeastern Nigeria.

    Science.gov (United States)

    Mbamara, Sunday U; Ikpeze, Okechukwu C; Okonkwo, John E N; Onyiaorah, Igwebuike V; Ukah, Cornelius O

    2011-01-01

    To describe the knowledge, attitudes and practices of gynecology clinic attendees in a tertiary level healthcare center in Nigeria. This is a descriptive, cross-sectional, questionnaire-based study conducted at Nnamdi Azikwe University Teaching Hospital in Nigeria in December 2007. A total of 200 questionnaires were distributed, and 198 were properly completed. The 198 completely and properly filled questionnaires formed the basis of the analysis. Twenty-five (12.6%) of the women were aware of the cervical cancer screening test, while 173 (87.4%) had never heard of the test before. Only 8% of the respondents had knowledge of the prevention of cervical cancer, but none of them were aware of the introduction of the human papillomavirus vaccine. Twenty-one (84.0%) of those women who were aware of the cervical cancer screening test got their information from healthcare providers, 3 (12.0%) from television and 2 (8.0%) from radio. Of the 25 respondents who were aware of the cervical cancer screening test, 15 (60.0%) had received at least a Pap smear test. All of the screening was done as an opportunistic screening exercise. A total of 119 (85.0%) of the women were not able to be screened because they were not aware of the cervical cancer smear screening, while 4 (3.2%) felt that it was unnecessary. There is a significant association between the educational status and the knowledge of the cervical smear Pap test (chi2 = 10.14, p value = 0.001). Eighty (57.1%) of the women agreed that they would like to undertake cervical cancer screening, while 60 (42.9%) would decline the cervical cancer screening test. The knowledge about cervical cancer in this study was very low. This poor knowledge may limit the utilization of cervical cancer prevention programs. This study underscores the need to establish an intensive and sustainable awareness campaign on the prevention of cancer of the cervix.

  2. "It Can Promote an Existential Crisis": Factors Influencing Pap Test Acceptability and Utilization Among Transmasculine Individuals.

    Science.gov (United States)

    Peitzmeier, Sarah M; Agénor, Madina; Bernstein, Ida M; McDowell, Michal; Alizaga, Natalie M; Reisner, Sari L; Pardee, Dana J; Potter, Jennifer

    2017-12-01

    Transmasculine (i.e., female-to-male transgender) individuals have lower rates of cervical cancer screening than nontransgender women and often report negative experiences with the Pap test. Deciding to undergo screening and the test experience itself are characterized by the following processes: negotiating identity as the patient, provider, and insurance company wrestle with the degree of (in)congruence between a patient's masculine gender identity and their conception of the Pap test as feminine; bargaining for health as a Pap test may be required to obtain medical transition services or avoid undesired health outcomes; withstanding acute challenges during the Pap test to body, identity, and privacy; or reframing challenges as affirmation. The degree of distress triggered by the Pap test varied from "routine" to traumatic. Participants affirmed that a trusted, trans-competent health care provider could significantly reduce barriers to regular and satisfactory cervical cancer screening. Data are from 32 in-depth interviews conducted in Boston, Massachusetts, with transmasculine individuals; a modified grounded theory approach informed the analysis.

  3. Awareness of Cervical Cancer Causes and Pre-determinants of Likelihood to Screen among Women in Haiti

    Science.gov (United States)

    McCarthy, Schatzi H.; Walmer, Kathy A.; Boggan, Joel C.; Gichane, Margaret W.; Calo, William A.; Beauvais, Harry A.; Brewer, Noel T.

    2017-01-01

    Objectives Cervical cancer is the leading cause of cancer deaths among women in Haiti. Given this high disease burden, we sought to better understand women’s knowledge of its causes and the socio-demographic and health correlates of cervical cancer screening. Methods Participants were 410 adult women presenting at clinics in Léogâne and Port-au-Prince, Haiti. We used bivariate and multivariate logic regression to identify correlates of Pap smear receipt. Results Only 29% of respondents had heard of human papillomavirus (HPV), while 98% were aware of cervical cancer. Of those aware of cervical cancer, 12% believed sexually transmitted infections (STIs) cause it, and only 4% identified HPV infection as the cause. Women with a previous STI were more likely to have had Pap smear (34% vs. 71%, OR=3.45; 95% CI: 1.57–7.59). Screening was also more likely among women who were older than age 39, better educated and employed (all p<.05). Almost all women (97%) were willing to undergo cervical cancer screening. Conclusions This sample of Haitian women had limited awareness of HPV and cervical cancer causes; but when provided with health information, they saw the benefits of cancer screening. Future initiatives should provide health education messages, with efforts targeting young and at-risk women. PMID:27906806

  4. Is there a language divide in pap test use?

    Science.gov (United States)

    Ponce, Ninez A; Chawla, Neetu; Babey, Susan H; Gatchell, Melissa S; Etzioni, David A; Spencer, Benjamin A; Brown, E Richard; Breen, Nancy

    2006-11-01

    We sought to determine whether primary language use, measured by language of interview, is associated with disparities in cervical cancer screening. We undertook a secondary data analysis of a pooled sample of the 2001 and 2003 California Health Interview Surveys. The surveys were conducted in English, Spanish, Cantonese, Mandarin, Korean, and Vietnamese. The study was a cross-sectional analysis of 3-year Pap test use among women ages 18 to 64, with no reported cervical cancer diagnosis or hysterectomy (n = 38,931). In addition to language of interview, other factors studied included race/ethnicity, marital status, income, educational attainment, years lived in the United States, insurance status, usual source of care, smoking status, area of residence, and self-rated health status. We fit weighted multivariate logit models predicting 3-year Pap test use as a function of language of interview, adjusting for the effects of specified covariates. Compared with the referent English interview group, women who interviewed in Spanish were 1.65 times more likely to receive a Pap test in the past 3 years. In contrast, we observed a significantly reduced risk of screening among women who interviewed in Vietnamese (odds ratio [OR] 0.67; confidence interval [CI] 0.48-0.93), Cantonese (OR 0.44; 95% CI 0.30-0.66), Mandarin (OR 0.48; 95% CI 0.33-0.72), and Korean (OR 0.62; 0.40-0.98). Improved language access could reduce cancer screening disparities, especially in the Asian immigrant community.

  5. Pap Tests and Foreign-Born Women

    Centers for Disease Control (CDC) Podcasts

    Foreign-born women living in the U.S. are less likely to have Pap tests to detect cervical cancer than women born in this country. The problem is worse for women from certain countries or regions. Find out why this is a disturbing trend, who these women are and why they are less likely to get a Pap test, and what CDC is doing about it.

  6. Decision making about Pap test use among Korean immigrant women: A qualitative study.

    Science.gov (United States)

    Kim, Kyounghae; Kim, Soohyun; Gallo, Joseph J; Nolan, Marie T; Han, Hae-Ra

    2017-08-01

    Understanding how individuals make decisions about Pap tests concerning their personal values helps health-care providers offer tailored approaches to guide patients' decision making. Yet research has largely ignored decision making about Pap tests among immigrant women who experience increased risk of cervical cancer. To explore decision making about Pap tests among Korean immigrant women. We conducted a qualitative descriptive study using 32 semi-structured, in-depth interviews with Korean immigrant women residing in a north-eastern metropolitan area. Data were audio-recorded, transcribed verbatim and analysed using inductive coding. Although most women with positive decisions made their own decisions, some women deferred to their providers, and others made decisions in collaboration with their providers and significant others. While women making positive decisions tended to consider both barriers to and facilitators of having Pap tests, women making negative decisions predominantly discussed the barriers to having Pap tests, such as modesty and differences between the South Korean and US health-care systems. The women's reflections on their decisions differed regarding their Pap test decisions. Women's desired roles in the decision-making process and reflection on their decision outcome appeared to vary, although most participants with positive decisions made their own decisions and were satisfied with their decisions. Future research should conduct longitudinal, quantitative studies to test our findings regarding decision-making processes and outcomes about Pap tests. The findings should be incorporated into cervical cancer screening practices to fulfil the unmet needs of immigrant women in patient-provider communication and to facilitate women's decision making about Pap tests. © 2016 The Authors. Health Expectations published by John Wiley & Sons Ltd.

  7. Trends in Pap Testing Over Time for Women With and Without Chronic Disability.

    Science.gov (United States)

    Iezzoni, Lisa I; Kurtz, Stephen G; Rao, Sowmya R

    2016-02-01

    Data from 20 years ago--shortly after passage of the Americans with Disabilities Act--showed that women with significant mobility disability had 40% lower Pap test rates than other women. To examine whether disability disparities in Pap test rates have diminished over time, this study analyzed National Health Interview Survey responses from selected years between 1998 and 2010 from women aged 21-65 years without histories of cervical cancer or hysterectomy. Seven chronic disability types were identified using self-reported functional impairments or participation limitations. Self-reported Pap testing within the previous 3 years was studied. Bivariable analyses and multivariable logistic regression analyses controlling for sociodemographic variables were conducted in 2014. Rates of all chronic disability types increased over time. Pap test rates remained relatively constant over time for all women, holding around 84%-87%. Bivariable analyses found statistically significantly lower rates of Pap testing for women with disability compared with nondisabled women. Multivariable analyses failed to find consistent evidence of lower Pap test rates among women across disability types compared with nondisabled women. In 2010, the AOR for reporting Pap testing for women noting the most severe movement difficulty compared with nondisabled women was 0.35 (95% CI=0.15, 0.79). However, the AOR for this disability type varied over time. Little has changed over time in Pap test rates for all women. Women with certain disabilities continue to experience disparities compared with nondisabled women in receipt of this important screening test. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  8. Perceptions of Barriers and Facilitators to Cervical Cancer Screening among Low-Income, HIV-Infected Women from an Integrated HIV Clinic

    Science.gov (United States)

    Buchberg, Meredith; Schover, Leslie; Basen-Engquist, Karen; Kempf, Mirjam-Colette; Arduino, Roberto C.; Vidrine, Damon J.

    2014-01-01

    Significantly elevated rates of cervical cancer and low rates of Papanicolaou (Pap) smear screening have been documented among HIV-infected women. However, little is known about women’s perceptions of cervical cancer screening utilization. Hence, this study describes barriers and facilitators related to cervical cancer screening in a sample of HIV-infected women seeking care at an integrated HIV clinic in Houston, Texas. Using an inductive qualitative methodological approach, data were obtained from five focus group discussions with a total of 33, HIV-infected women. The majority of the study sample consisted of women who self-identified as Black (69.7%), and reported heterosexual contact as the mode of HIV acquisition (75.8%). Barriers to cervical cancer screening were described as pain and discomfort associated with receiving Pap smears and subsequent procedures; lack of awareness of cervical cancer as a preventable disease; limited transportation access; and systemic issues as it relates to scheduling gynecological appointments. Facilitators were described as awareness of HIV-infected women’s increased risk of cervical cancer and strong provider-patient relationships. To address disparities in cervical cancer screening among low-income HIV-infected women, programs should capitalize on the identified facilitators and alleviate modifiable barriers using multi-level strategies. PMID:24635664

  9. Clinicopathological importance of Papanicolaou smears for the diagnosis of premalignant and malignant lesions of the cervix.

    Science.gov (United States)

    Bukhari, Mulazim Hussain; Saba, Kanwal; Qamar, Samina; Majeed, Muhammad Muddasar; Niazi, Shahida; Naeem, Samina

    2012-01-01

    Premalignant and malignant lesions are not uncommon in Pakistani women, especially in the older age-groups This study was conducted to determine the clinicopathological importance of conventional Papanicolaou (Pap) smears for the diagnosis of premalignant and malignant lesions of the cervix. Pap smears of 1000 women were examined from January 2007 to June 2009. Only cases with neoplastic cytology were included. The overall frequency of normal, inadequate, neoplastic, and infective smears was 50%, 1.8%, 10.2%, and 38.3%, respectively. Most of the patients (67%) were in the postmenopausal age-group, with the mean age being 44.7±15.63 years. The commonest clinical signs/symptoms seen among the 102 patients with neoplastic gynecological lesions were vaginal discharge and abnormal bleeding (93/102;(91.2% and 62/102;60.7%). Of the 102 cases with neoplastic lesions 46 patients (45%) had low-grade squamous cell intraepithelial lesions (LSILs), 22 (21.5%) had high-grade squamous cell intraepithelial lesions (HSILs), 14 (13.7%) had squamous cell carcinoma, and 6 (5.8%) showed features of adenocarcinoma. Ten (9.8%) cases showed cytology of atypical squamous cells of undetermined significance (ASCUS) and four (3.9%) cases had atypical glandular cells of undetermined significance (AGUS). We conclude that cervical smear examination is well suited for diagnosing neoplastic disease. It is clear that cervical neoplastic lesions are becoming a problem in Pakistan.

  10. A Hybrid Computational Intelligence Approach Combining Genetic Programming And Heuristic Classification for Pap-Smear Diagnosis

    DEFF Research Database (Denmark)

    Tsakonas, Athanasios; Dounias, Georgios; Jantzen, Jan

    2001-01-01

    The paper suggests the combined use of different computational intelligence (CI) techniques in a hybrid scheme, as an effective approach to medical diagnosis. Getting to know the advantages and disadvantages of each computational intelligence technique in the recent years, the time has come...

  11. Smoking, dietary, and breast and cervical cancer screening knowledge and screening practices of employees in an urban medical center.

    Science.gov (United States)

    Hyman, R B; Greenwald, E S; Hacker, S

    1995-01-01

    This paper reports results of a survey of 500 health care workers in a private New York City Hospital that assessed knowledge and behaviors in the areas of smoking and cancer, diet and cancer, and breast and cervical cancer screening. Given the small number of knowledge items, the results indicated good knowledge concerning diet and cancer, smoking and cancer, and mammography and Pap test guidelines. Conformity with American Cancer Society guidelines for Pap testing was comparable to national figures, but with women over 50 as likely to obtain Pap smears as younger women. Conformity with mammography guidelines was excellent, although compliance with breast self-examination recommendations was low (25.4%). Of female employees over age 50, 87.4% had ever had mammography and 77.6% reported yearly mammography. Only 19% of the respondents admitted to current smoking. Although methodologic differences made comparison of knowledge of diet and cancer with the work of others difficult, knowledge of the risks of smoking was comparable to levels found in other studies.

  12. Cervicovaginal Smear Findings of Endometrial Serous Carcinoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Figen Barut

    2008-08-01

    Although cervicovaginal smear generally is not a sensitive screening test for endometrial carcinomas, it played an important role in determining serous carcinoma. This may be related with advanced stage and/or aggressive features of the neoplastic process.

  13. Patient perception of cervical screening among women living with human immuno-deficiency virus infection attending an antiretroviral therapy clinic in urban South Africa.

    Science.gov (United States)

    Wake, R M; Rebe, K; Burch, V C

    2009-01-01

    This study aims to ascertain the perception of cervical screening practices among HIV-positive women attending an ART clinic in urban South Africa. It is a prospective cross-sectional study of 100 randomly selected patients using semi-structured interviews. Answers to fixed-response questions were recorded for statistical analysis and themes were identified from responses to open-ended questions. The study found that 59% of women surveyed reported ever having had a Papanicolau (Pap) smear and that 41% of these women had never been notified of the result. Many women surveyed lacked understanding of cervical screening; 78% had never heard of cervical cancer and around 40% had no correct knowledge about Pap smears. The findings suggest that cervical screening practices among HIV-positive women living in urban South Africa do not comply with the recommendations that are based on evidence of increased risk for this population. Systematic cervical screening programmes should be offered to HIV-positive women attending ART clinics in South Africa.

  14. papA gene of avian pathogenic Escherichia coli.

    Science.gov (United States)

    Kariyawasam, Subhashinie; Nolan, Lisa K

    2011-12-01

    P fimbrial adhesins may be associated with the virulence of avian pathogenic Escherichia coli (APEC). However, most APECs are unable to express P fimbriae even when they are grown under conditions that favor P fimbrial expression. This failure can be explained by the complete absence of the pap operon or the presence of an incomplete pap operon in Pap-negative APEC strains. In the present study, we analyzed the pap operon, specifically the papA gene that encodes the major fimbrial shaft, to better understand the pap gene cluster at the genetic level. First, by PCR, we examined a collection of 500 APEC strains for the presence of 11 genes comprising the pap operon. Except for papA, all the other genes of the operon were present in 38% to 41.2% of APEC, whereas the papA was present only in 10.4% of the APEC tested. Using multiplex PCR to probe for allelic variants of papA, we sought to determine if the low prevalence of papA among APEC was related to genetic heterogeneity of the gene itself. It was determined that the papA of APEC always belongs to the F11 allelic variant. Finally, we sequenced the 'papA region' from two papA-negative strains, both of which contain all the other genes of the pap operon. Interestingly, both strains had an 11,104-bp contig interruptingpapA at the 281-bp position. This contig harbored a streptomycin resistance gene and a classic Tn10 transposon containing the genes that confer tetracycline resistance. However, we noted that the papA gene of every papA-negative APEC strain was not interrupted by an 11,104-bp contig. It is likely that transposons bearing antibiotic resistance genes have inserted within pap gene cluster of some APEC strains, and such genetic events may have been selected for by antibiotic use.

  15. Cervical cancer screening programs: technical cooperation in the Caribbean.

    Science.gov (United States)

    Barnett, D B

    1996-12-01

    This article presents the findings and recommendations of the evaluation of a project that aimed to decrease mortality from cervical cancer in the Caribbean. The Cervical Cancer Control Project was initiated in 1990 in 10 countries in the Caribbean with a total population of 850,000. The project was directed at women aged 25-69 years and sought to increase cervical screening. The production of education materials was based on a KAP survey conducted in Barbados and Grenada. Findings indicate that Pap smears were more popular among young, better educated women. Men contributed to decision making on reproductive health issues, but women would follow the advice of health professionals. The following informative materials were produced: brochures on prevention, public service announcements, and posters. A follow-up survey indicated little impact of the IEC campaign to increase screenings. Training materials were produced that aimed to assure the quality in performance of Pap smear procedures among health workers. Laboratory-based cervical cytology registries were established that were compatible with PAHO/WHO systems. Quality control in laboratories was reinforced by meetings with pathologists and by exploration of the use of semi-automated cytology screening systems. Meetings were conducted in 1996 to assess whether project goals had been met. It was recommended that cost-benefit studies be conducted in order to prove to policy makers that there was a need to invest in screening programs. It was recommended that community and women's groups be encouraged to participate in awareness creation. Recruitment of the target population should be more flexible and involve possible use of mobile clinics in the workplace and communities. Simple, accurate information needs to be communicated through all available channels, including social marketing. Clinicians need to learn to manage their time and to prioritize their work load.

  16. Pap Tests and Foreign-Born Women

    Centers for Disease Control (CDC) Podcasts

    2007-11-26

    Foreign-born women living in the U.S. are less likely to have Pap tests to detect cervical cancer than women born in this country. The problem is worse for women from certain countries or regions. Find out why this is a disturbing trend, who these women are and why they are less likely to get a Pap test, and what CDC is doing about it.  Created: 11/26/2007 by National Breast and Cervical Cancer Early Detection Program.   Date Released: 12/7/2007.

  17. Quality control in screening programs for cervical cancer; Control de la calidad en los programas de pesquisa de cancer cervicouterino

    Energy Technology Data Exchange (ETDEWEB)

    Sarduy Napoles, Miguel, E-mail: miguel.sarduy@infomed.sld.cu [Centro de Investigaciones Medico Quirurgicas, La Habana (Cuba)

    2012-07-01

    The malignancy of the cervix is one of the few locations avoidable cancers, if detected before it progresses to the infiltration. The most efficient way of early detection is through a screening program to provide women undertaking a regular and quality Pap smear. If this test results abnormal, the program offers easier access to specialized care, effective treatment, and follow-up. The objective of this article is to present usefulness of methods for quality control used in screening programs for cervical cancer to detect their inadequacies. Here are some factors and conditions that must be considered in each of the steps to take, for a cervical cancer screening program to be successful and to meet the objectives proposed in reducing mortality due to this cause. This document contains some useful indexes calculated to ensure quality throughout the process. There should be the measurement of quality throughout the screening process that allows collecting of reliable data as well as correcting deficiencies

  18. Beliefs about cervical cancer and Pap test: a new Chilean questionnaire.

    Science.gov (United States)

    Urrutia, Maria-Teresa; Hall, Rosemary

    2013-06-01

    The purpose of this study was to develop and validate a questionnaire to examine women's beliefs about cervical cancer and the Pap test in Chilean women. The questionnaire, developed following the guidelines by Robert de Vellis, is based on the Health Belief Model. The content validity index was 0.93 upon review by 10 Chilean experts. A cross-sectional design was implemented to validate the questionnaire. The sample included 333 women recruited from a women's healthcare center in Santiago, Chile. Exploratory factor analysis was used to evaluate validity and coefficient α to evaluate reliability. After six models were computed, the questionnaire was reduced from 53 to 28 items. The new questionnaire, CPC-28 (in Spanish, Creencias, Papanicolaou, Cancer -28), includes six domains: the barriers domain to take a Pap test, the cues to action domain, the severity domain, the need to have a Pap test domain, the susceptibility to cervical cancer domain, and the benefit domain. The unexpected salient factor "need to have a Pap test" was found as part of the susceptibility domain proposed in the initial questionnaire. This finding is an important topic for future research. The CPC-28 questionnaire explained 49% of the total variance, and the reliability was .735. It was concluded that the CPC-28 questionnaire will have important implications on research, education, and administration across disciplines. Nursing curricula and healthcare providers must stress the importance and reinforce the importance of prevention of cervical cancer and regular Pap test screenings. © 2013 Sigma Theta Tau International.

  19. Awareness of cervical cancer, Papanicolau′s smear and its utilization among female, final year undergraduates in Durban, South Africa

    Directory of Open Access Journals (Sweden)

    Muhammad Ehsanul Hoque

    2013-01-01

    Statistical Analysis Used: Chi-square test and logistic regression were used to find association and the significant predictor for doing Pap smear test. Results: Over half (53.3% of the participants had heard about cervical cancer and its detection method. More than half (60% and over a third (37.8% of the participants knew about human papilloma virus (HPV and multiple sexual partner respectively as risk factors for cervical cancer. More than half (55.3% indicated that they were not aware if cervical cancer can be prevented. Majority (76.7% knew that Papanicolau′s (Pap smear test is used for detection or prevention of cervical cancer. Among those who were sexually active and knew about Pap smear test 79.3% did not do the test mainly because of personal factors such as fear of the procedure, or were not ill. Conclusions: Level of awareness regarding cervical cancer and its detection method was low among these female students. The university management should focus on developing policies on health education and promotion to prevent transmission of the HPV.

  20. Attitudes and factors affecting acceptability of self-administered cervicovaginal sampling for human papillomavirus (HPV) genotyping as an alternative to Pap testing among multiethnic Malaysian women

    Science.gov (United States)

    Ma'som, Mahirah; Bhoo-Pathy, Nirmala; Nasir, Nazrila Hairizan; Bellinson, Jerome; Subramaniam, Shridevi; Ma, Yuntong; Yap, Siew-Hwei; Goh, Pik-Pin; Gravitt, Patti; Woo, Yin Ling

    2016-01-01

    Objective The objective of this study was to determine the attitudes and acceptability of self-administered cervicovaginal sampling compared with conventional physician-acquired Papanicolaou (Pap) smear among multiethnic Malaysian women. Method A cross-sectional study was carried out via interviewer-administered surveys from August 2013 through August 2015 at five government-run, urban health clinics in the state of Selangor. Subjects were participants from an ongoing community-based human papillomavirus (HPV) prevalence study who answered a standard questionnaire before and after self-sampling. The cervicovaginal self-sampling for HPV genotyping was performed using a simple brush (‘Just for Me’; Preventive Oncology International, Hong Kong). Detailed data on sociodemographics, previous Pap smear experience, and attitudes towards self-administered cervicovaginal sampling were collected and analysed. Acceptability was inferred using a five-item Likert scale that included six different subjective descriptives: experience, difficulty, convenience, embarrassment, discomfort or pain, and confidence in collecting one's own sample. Results Of the 839 participants, 47.9% were Malays, followed by 30.8% Indians, 18.8% Chinese and 2.5% from other ethnicities. The median age of the participants was 38 years (IQR 30–48). Some 68.2% of participants indicated a preference for self-sampling over the Pap test, with 95% indicating willingness to follow-up a positive result at the hospital. Age, ethnicity and previous Pap test experience were significant independent factors associated with preference for self-sampling. The older the individual, the less likely they were to prefer self-sampling (adjusted OR 0.94, 95% CI 0.90 to 0.98). The Chinese were less likely to prefer self-sampling (72.6%) than the Malays (85.1%) (adjusted OR 0.57, 95% CI 0.33 to 0.98, p=0.004). Participants who had never undergone a Pap smear were also more likely to prefer self-sampling (88.5%) than

  1. Knowledge about cervical cancer screening among family physicians: cross-sectional survey.

    Science.gov (United States)

    Del Refugio Gonzalez-Losa, Maria; Gongora-Marfil, Glendy K; Puerto-Solis, Marylin

    2009-04-01

    Cervical cancer (CC) is an important public health problem worldwide. In Mexico, there has been a National Cervical Cancer Screening Program (NCCSP) since 1974. Mexican Social Security Institute attended Mexican workers and family physicians are responsible of the primary care of patients. To evaluate knowledge about the aetiology and prevention of CC among family physicians working in Yucatan, Mexico, at Mexican Social Security Institute. A questionnaire was applied to 187 family doctors. Self-administer questionnaire with 10 item previously used by ours and other researchers, was used for the evaluation. Each correctly answered item was given a point. The maximum grade was 10 and the minimum 0. The knowledge mean was 6.93 points. Fewer than 50% knew what to do with women who are human papillomavirus (HPV) positive without a precancerous cervical lesion and the appropriate age range for Pap smears. A total of 61.1% identified CC as an important health problem in Mexico; however, 95.1% identified CC as a preventive cause of deaths among Mexican women and recognized that HPV is the main CC aetiological agent, and 90.3% mentioned the Pap smear as the main method of diagnosis of CC. The family doctors need to have an adequate knowledge of the practical elements of the NCCSP to give an efficient attention to their patients.

  2. Framing preventive care messaging and cervical cancer screening in a health-insured population in South Africa: Implications for population-based communication?

    Science.gov (United States)

    Adonis, Leegale; Paramanund, Jithen; Basu, Debashis; Luiz, John

    2017-09-01

    The impact of health message framing on cervical cancer screening uptake is poorly understood. In a prospective randomized control study with 748 females, aged 21-65 years with no Pap smear in the previous 3 years, they randomly received a loss-framed, gain-framed, or neutral health message (control) regarding cervical cancer screening by email. Screening rate in the control group was 9.58 percent (CI: 9.29%-9.87%), 5.71 percent (CI: 5.48%-6.98%) in the gain-framed group, and 8.53 percent (CI: 8.24%-8.81%) in the loss-framed group. Statistically there was no difference between the three screening rates. Framing of health messages may not be a significant consideration when communicating through emails.

  3. Daily peer review of abnormal cervical smears in the assessment of individual practice as an additional method of internal quality control.

    Science.gov (United States)

    Confortini, M; Di Stefano, C; Biggeri, A; Bulgaresi, P; Di Claudio, G; Grisotto, L; Maddau, C; Matucci, M; Petreschi, C; Troni, G M; Turco, P; Foxi, P

    2016-02-01

    An important internal quality control system used in the Cancer Prevention and Research Institute cytopathology laboratory in Florence is the peer review procedure, based on the review of all abnormal cytological smears which routinely emerge. Peer review is an important training opportunity for all cytologists, especially for those with less experience. This article shows the results of the peer review procedure. Of the 63 754 Papanicolaou (Pap) smears screened in 2011, 1086 were considered to be abnormal [at least atypical squamous cells of undetermined significance (ASC-US+)] on primary screening (selected by a single cytologist) and were subjected to the peer review procedure. The overall performance of the laboratory's cytologists was evaluated using a multiple rater analysis and the comparison of each cytologist with the final diagnosis. Further, the agreement was assessed by means of Cohen's kappa and weighted kappa statistics. In general, a moderate/substantial level of agreement between the ten cytologists and the final diagnoses was evident. Kappa values for each reader compared with the final diagnosis ranged from 0.54 to 0.69. The overall kappa value was 0.62 [95% confidence interval (CI), 0.58-0.66] and overall weighted kappa value was 0.76 (95% CI, 0.74-0.79). The category-specific agreement showed the lowest values for atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H). In summary, peer review represents an important internal quality control in the evaluation and improvement of inter-observer agreement and of the functioning of the laboratory as a whole. Multi-head microscope sessions may improve particularly the reproducibility of borderline diagnoses and, above all, can be an important training contribution for cytologists. © 2014 John Wiley & Sons Ltd.

  4. Dual p16 and Ki-67 Expression in Liquid-Based Cervical Cytological Samples Compared to Pap Cytology Findings, Biopsies, and HPV Testing in Cervical Cancer Screening: A Diagnostic Accuracy Study.

    Science.gov (United States)

    Prigenzi, Karla Calaça Kabbach; Heinke, Thaís; Salim, Rafael Calil; Focchi, Gustavo Rubino de Azevedo

    2018-01-01

    Our objective was to verify the sensitivity and specificity of dual immunocytochemistry staining for p16 and Ki-67 in liquid-based samples (the "dual" assay) for cervical lesion screening, compared to biopsy findings and human papillomavirus (HPV) DNA molecular detection. Sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values for the "dual immunocytochemistry assay" were calculated and compared to histopathological results and to high-risk HPV DNA detection in adult women or teenagers submitted to cervical cancer screening. A total of 151 women were included. The majority (96.2%) of those with negative dual assay results had lower biopsy grades (p cytology results suggestive of cervical cancer had positive dual immunocytochemistry assay results more frequently (p < 0.001), and these positive results were also significantly associated with biopsy findings (p < 0.001) and with high-risk genotype HPV infection (p = 0.007). Specificity and PPV for the dual assay were 0.972 (0.855-0.999) and 0.800 (0.284-0.995), respectively, and 1.000 (0.590-1.000) and 1.000 (0.631-1.000) for HPV detection. The dual immunocytochemistry assay had high specificity and PPV. It reveals a persistent HPV infection, avoiding the need for new tissue collections for biopsies or hybrid capture. © 2018 S. Karger AG, Basel.

  5. Development of an instrument based on the protection motivation theory to measure factors influencing women's intention to first pap test practice.

    Science.gov (United States)

    Hassani, Lale; Dehdari, Tahereh; Hajizadeh, Ebrahim; Shojaeizadeh, Davoud; Abedini, Mehrandokht; Nedjat, Saharnaz

    2014-01-01

    Given that there are many Iranian women who have never had a Pap smear, this study was designed to develop and validate a measurement tool based on the Protection Motivation Theory to assess factors influencing the Iranian women's intention to perform first Pap testing. In this psychometric research, to determine the Content Validity Index (CVI) and the Content Validity Ratio (CVR), a panel of experts (n=10) reviewed scale items. Reliability was estimated through the Intraclass Correlation Coefficient (n=30) and internal consistency (n=240). Also, factor analysis (exploratory and conformity) was performed on the data of the sample women who had never had a Pap smear test (n=240). A 26-item questionnaire was developed. The CVI and CVR scores of the scale were 0.89 and 0.90, respectively. Exploratory factor analysis loaded a 26-item with seven factors questionnaire (perceived vulnerability and severity, fear, response costs, response efficacy, self-efficacy, and protection motivation (or intention)) that jointly accounted for 72.76% of the observed variance. Confirmatory factor analysis indicated a good fit for the data. Internal consistency (range 0.70-0.93) and test-retest reliability (range 0.72-0.96) of sub-scales were acceptable. This study showed that the designed instrument was a valid and reliable tool for measuring the factors influencing the women's intention to perform their first Pap testing.

  6. Effect of Fee on Cervical Cancer Screening Attendance—ScreenFee, a Swedish Population-Based Randomised Trial

    Science.gov (United States)

    Alfonzo, Emilia; Andersson Ellström, Agneta; Nemes, Szilard; Strander, Björn

    2016-01-01

    Background Attendance in the cervical cancer screening programme is one of the most important factors to lower the risk of contracting the disease. Attendance rates are often low in areas with low socioeconomic status. Charging a fee for screening might possibly decrease attendance in this population. Screening programme coverage is low in low socio-economic status areas in Gothenburg, Sweden, but has increased slightly after multiple interventions in recent years. For many years, women in the region have paid a fee for screening. We studied the effect of abolishing this fee in a trial emanating from the regular cervical cancer screening programme. Method Individually randomised controlled trial. All 3 124 women in three low-resource areas in Gothenburg, due for screening during the study period, were randomised to receive an offer of a free test or the standard invitation stating the regular fee of 100 SEK (≈11 €). The study was conducted during the first six months of 2013. Attendance was defined as a registered Pap smear within 90 days from the date the invitation was sent out. Results Attendance did not differ significantly between women who were charged and those offered free screening (RR 0.93; CI 0.85–1.02). No differences were found within the districts or as an effect of age, attendance after the most recent previous invitation or previous experience of smear taking. Conclusion Abolishment of a modest screening fee in socially disadvantaged urban districts with low coverage, after previous multiple systematic interventions, does not increase attendance in the short term. Other interventions might be more important for increasing attendance in low socio-economic status areas. Trial Registration ClinicalTrials.gov NCT02378324 PMID:26986848

  7. Effect of Fee on Cervical Cancer Screening Attendance--ScreenFee, a Swedish Population-Based Randomised Trial.

    Science.gov (United States)

    Alfonzo, Emilia; Andersson Ellström, Agneta; Nemes, Szilard; Strander, Björn

    2016-01-01

    Attendance in the cervical cancer screening programme is one of the most important factors to lower the risk of contracting the disease. Attendance rates are often low in areas with low socioeconomic status. Charging a fee for screening might possibly decrease attendance in this population. Screening programme coverage is low in low socio-economic status areas in Gothenburg, Sweden, but has increased slightly after multiple interventions in recent years. For many years, women in the region have paid a fee for screening. We studied the effect of abolishing this fee in a trial emanating from the regular cervical cancer screening programme. Individually randomised controlled trial. All 3 124 women in three low-resource areas in Gothenburg, due for screening during the study period, were randomised to receive an offer of a free test or the standard invitation stating the regular fee of 100 SEK (≈11 €). The study was conducted during the first six months of 2013. Attendance was defined as a registered Pap smear within 90 days from the date the invitation was sent out. Attendance did not differ significantly between women who were charged and those offered free screening (RR 0.93; CI 0.85-1.02). No differences were found within the districts or as an effect of age, attendance after the most recent previous invitation or previous experience of smear taking. Abolishment of a modest screening fee in socially disadvantaged urban districts with low coverage, after previous multiple systematic interventions, does not increase attendance in the short term. Other interventions might be more important for increasing attendance in low socio-economic status areas. ClinicalTrials.gov NCT02378324.

  8. Fatores associados à utilização do teste de Papanicolaou entre mulheres idosas no interior do Brasil Factors associated with the use of the Papanicolaou smear screening among older women in the interior of Brazil

    Directory of Open Access Journals (Sweden)

    Mônica Cristina Marzullo de Freitas

    2012-09-01

    Full Text Available OBJETIVOS: Verificar a cobertura, pelo teste de Papanicolaou, de idosas e os fatores associados. MÉTODOS: Foi desenvolvido um estudo de base populacional com inquérito domiciliar. Os critérios de inclusão foram mulheres com 60 anos de idade ou mais, com residência na zona norte do município de Juiz de Fora, com independência para responder ao questionário ou que dispusessem de informante. A entrevista foi composta por questões sociodemográficas, referentes ao estado geral de saúde das idosas, e sobre a prática preventiva em saúde da mulher. A seleção se deu por amostragem aleatória estratificada e conglomerada em múltiplos estágios. Para a análise dos fatores de associação, elaborou-se um modelo teórico com três blocos hierarquizados de variáveis, ajustadas entre si em cada um deles. As variáveis que obtiveram nível de significância menor ou igual a 0,2 foram incluídas no modelo de regressão de Poisson e ajustadas ao nível superior ao seu (pPURPOSE: To verify the coverage, by Pap testing, of older women and the associated factors. METHODS: A population-based study was conducted by home interviews. The inclusion criteria were women aged 60 and over, living on the north side of the city of Juiz de Fora, Minas Gerais, Brazil, self-sufficient to answer the questionnaire or having someone to answer on their behalf. The interview consisted of sociodemographic questions, regarding the general health of the older women, and preventive practices in women's health. The selection was made by random sampling, stratified and clustered in multiple stages. To analyze associated factors, a theoretical model was formulated with three hierarchical blocks of variables, adjusted to each other in each block. The variables that had a level of significance of 0.2 or less were included in the Poisson regression model and adjusted to their next highest level (p<0.1. RESULTS: Pap testing occurred in 84.1% of cases (95%CI 79.0-88.4. Based on

  9. High grade squamous intraepithelial lesion in inmates from Ohio: cervical screening and biopsy follow-up

    Directory of Open Access Journals (Sweden)

    Rofagha Soraya

    2006-01-01

    Full Text Available Abstract Background Cervical carcinoma remains the second leading cause of cancer death in women worldwide and sexual behavior is regarded as the main contributing factor. We studied cervical cytology screening with surgical biopsy follow-up in women prisoners and compared the findings to those in the general population. Methods We reviewed 1024 conventional cervical smears, 73 cervical biopsies and 2 loop electrosurgical excision procedure (LEEP specimens referred to us from the Correctional Center in Columbus, Ohio during a 12-month period. The results were compared to 40,993 Pap smears from the general population for the same 12-month period. Results High grade squamous intraepithelial lesion (HGSIL was diagnosed in 1.3% of the cervical smears from the inmate population versus 0.6% in the general population (p < 0.01. The unsatisfactory rate was 1.6% compared to 0.3% in the general population (p < 0.01. Among the study population, follow-up tissue diagnosis was obtained in 24.3% of the abnormal cytology results (ASCUS, LGSIL, and HGSIL. Of the HGSIL Pap smears, 61.5% had a subsequent tissue diagnosis. Thirty-nine biopsies (52% of the all inmate biopsies and LEEP showed CIN II/III (cervical intraepithelial neoplasia II/III. Eight of these thirty-nine follow-up biopsies diagnosed as CIN II/III had a previous cervical cytology diagnosis of ASCUS. The average age for HGSIL was 30.5 years (S.D. = 5.7 and for low grade squamous intraepithelial lesion (LGSIL was 27.2 years (S.D. = 6.1. Conclusion A significantly higher prevalence of HGSIL cervical cytology and unsatisfactory smears was encountered in female inmates, with tissue follow-up performed in less than two thirds of the patients with HGSIL. These results are in keeping with data available in the literature suggesting that the inmate population is high-risk and may be subject to less screening and tissue follow-up than the general population. Clinicians should proceed with urgency to improve

  10. A Large Cross-Sectional Survey Investigating the Knowledge of Cervical Cancer Risk Aetiology and the Predictors of the Adherence to Cervical Cancer Screening Related to Mass Media Campaign

    Directory of Open Access Journals (Sweden)

    Corrado De Vito

    2014-01-01

    Full Text Available Objectives. The aims of this study were to compare the characteristics of women who got a Pap-test during the mass media campaign, carried out in an Italian region by broadcasts advertising, and two years later and to identify the determinants of knowledge of cervical cancer etiology and of the adherence to the mass media campaign. Methods. A cross-sectional survey was carried out through a self-administered questionnaire. Results. A total of 8570 randomly selected women were surveyed, 823 of these had a Pap-test during the mass media campaign period and 7747 two years later. Higher educational level, being not married, and living in urban areas were the main independent characteristics associated with a higher level of knowledge of cervical cancer etiology, although a previous treatment following a Pap smear abnormality was the strongest predictor (OR = 2.88; 95% CI: 2.43–3.41. During the campaign period women had the Pap-test more frequently as a consequence of the mass media campaign (OR = 8.28; 95% CI; 5.51–12.45. Conclusions. Mass media campaign is a useful tool to foster cervical screening compliance; however, its short-term effect suggests repeating it regularly.

  11. [Abnormalities in cervical smears stored in plastic bags: potential cause of false negatives].

    Science.gov (United States)

    Ortega-González, Patricia; González-Bravo, Margarita S; Jiménez-Muñoz-Ledo, Gustavo; Macías, Alejandro E

    2011-01-01

    Cervical smear is the most economic and efficient diagnostic tool for the screening of cervical cancer. However, since plastic bags have been used in Guanajuato to transport and store smears, we have observed cytological abnormalities which difficult the diagnosis and lead to false negatives. To describe those abnormalities. Out of 340 women registered in a primary care center in Mexico, 68 were selected through systematic random sampling during 2007. A cervical smear was obtained and placed on two slides. The first sample was allowed to dry but the second one was placed into the plastic bag immediately after fixation. After 15 days all the smears were stained with the Papanicolaou technique. A certified pathologist, blinded about the variable of study, interpreted the samples according to the Bethesda system, and evaluated the presence of necrosis, edema, holes, and opportunistic microorganisms. Of the 68 smears exposed to a humid storage, 36 (53%) were inadequate for diagnosis (Fisher's exact probability plastic bags.

  12. Initial results of population based cervical cancer screening program using HPV testing in one million Turkish women.

    Science.gov (United States)

    Gultekin, Murat; Zayifoglu Karaca, Mujdegul; Kucukyildiz, Irem; Dundar, Selin; Boztas, Guledal; Semra Turan, Hatice; Hacikamiloglu, Ezgi; Murtuza, Kamil; Keskinkilic, Bekir; Sencan, Irfan

    2018-05-01

    To evaluate the Turkey's nationwide HPV DNA screening program on the basis of first 1 million screened women. Women over age 30 were invited for population based screening via HPV DNA and conventional cytology. Samples were collected by family physicians and the evaluations and reports had been performed in the National Central HPV laboratories. The acceptance rate for HPV based cervical cancer screening after first invitation was nearly 36.5%. Since HPV DNA tests have been implemented, cervical cancer screening rates have shown 4-5-fold increase in primary level. Through the evaluation of all, HPV positivity was seen in 3.5%. The commonest HPV genotypes were 16, followed by 51, 31, 52 and 18. Among the 37.515 HPV positive cases, cytological abnormality rate was 19.1%. Among HPV positive cases, 16.962 cases had HPV 16 or 18 or other oncogenic HPV types with abnormal cytology (>ASC-US). These patients were referred to colposcopy. The colposcopy referral rate was 1.6%. Among these, final clinico-pathological data of 3.499 patients were normal in 1.985 patients, CIN1 in 708, CIN2 in 285, CIN3 in 436 and cancer in 85 patients and only pap-smear program could miss 45.9% of ≥CIN3 cases. The results of 1 million women including the evaluation of 13 HPV genotypes with respect to prevalence, geographic distribution and abnormal cytology results shows that HPV DNA can be used in primary level settings to have a high coverage rated screening program and is very effective compared to conventional pap-smear. © 2017 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

  13. Raising Awareness About Cervical Cancer Using Twitter: Content Analysis of the 2015 #SmearForSmear Campaign.

    Science.gov (United States)

    Lenoir, Philippe; Moulahi, Bilel; Azé, Jérôme; Bringay, Sandra; Mercier, Gregoire; Carbonnel, François

    2017-10-16

    Cervical cancer is the second most common cancer among women under 45 years of age. To deal with the decrease of smear test coverage in the United Kingdom, a Twitter campaign called #SmearForSmear has been launched in 2015 for the European Cervical Cancer Prevention Week. Its aim was to encourage women to take a selfie showing their lipstick going over the edge and post it on Twitter with a raising awareness message promoting cervical cancer screening. The estimated audience was 500 million people. Other public health campaigns have been launched on social media such as Movember to encourage participation and self-engagement. Their result was unsatisfactory as their aim had been diluted to become mainly a social buzz. The objectives of this study were to identify the tweets delivering a raising awareness message promoting cervical cancer screening (sensitizing tweets) and to understand the characteristics of Twitter users posting about this campaign. We conducted a 3-step content analysis of the English tweets tagged #SmearForSmear posted on Twitter for the 2015 European Cervical Cancer Prevention Week. Data were collected using the Twitter application programming interface. Their extraction was based on an analysis grid generated by 2 independent researchers using a thematic analysis, validated by a strong Cohen kappa coefficient. A total of 7 themes were coded for sensitizing tweets and 14 for Twitter users' status. Verbatims were thematically and then statistically analyzed. A total of 3019 tweets were collected and 1881 were analyzed. Moreover, 69.96% of tweets had been posted by people living in the United Kingdom. A total of 57.36% of users were women, and sex was unknown in 35.99% of cases. In addition, 54.44% of the users had posted at least one selfie with smeared lipstick. Furthermore, 32.32% of tweets were sensitizing. Independent factors associated with posting sensitizing tweets were women who experienced an abnormal smear test (OR [odds ratio] 13

  14. Participant recruitment and motivation for participation in optical technology for cervical cancer screening research trials.

    Science.gov (United States)

    Shuhatovich, Olga M; Sharman, Mathilde P; Mirabal, Yvette N; Earle, Nan R; Follen, Michele; Basen-Engquist, Karen

    2005-12-01

    In order to improve recruitment for cervical cancer screening trials, it is necessary to analyze the effectiveness of recruitment strategies used in current trials. A trial to test optical spectroscopy for the diagnosis of cervical neoplasia recruited 1000 women from the community; the trial evaluated the emerging technology against Pap smears and colposcopically directed biopsies for cervical dysplasia. We have examined women's reasons for participating as well as the effectiveness and efficiency for each recruitment strategy. Reasons for participation were identified and compared between trials. The recruitment method that resulted in the most contacts was newspaper reportorial coverage and advertising, followed by family and friends, then television news coverage. The most cost-effective method for finding eligible women who attend the research appointment is word of mouth from a family member or friend. Recommendations are given for maximizing the efficiency of recruitment for cervical cancer screening trials.

  15. Mammography and Pap test screening among low-income foreign-born Hispanic women in the USA Mamografia e teste Papanicolau em mulheres latinas de baixa renda nos Estados Unidos

    Directory of Open Access Journals (Sweden)

    Maria E. Fernandez

    1998-01-01

    Full Text Available Little is known about the factors influencing screening among low-income Hispanic women particularly among recent immigrants. A sample of 148 low-income, low-literate, foreign-born Hispanic women residing in the Washington DC metropolitan area participated in the study. The mean age of the sample was 46.2 (SD = 11.5, 84% reported annual household incomesEste estudo determinou os fatores que influenciam a conduta de mulheres latinas de baixa renda nos EUA, em face do monitoramento pela mamografia (MM e por meio do teste de Papanicolau (TP, em uma amostra de 148 mulheres latinas, residentes na região metropolitana de Washington DC. A idade média na amostra foi de 46,2 anos (desvio padrão 11,5, e 84% relatavam renda familiar anual menor que quinze mil dólares. Todas as mulheres falavam espanhol e apresentavam níveis reduzidos de aculturação; 96% destas informavam ter realizado TP, mas 24% não relatavam adesão às normas recomendadas de rastreamento. Entre aquelas com quarenta anos ou mais, 62% haviam realizado MM, mas somente 33% de acordo com as normas de rotina. A freqüência de conceitos equivocados sobre o câncer neste grupo de mulheres foi maior que a observada para mulheres latinas em outros estudos. Modelos logísticos multivariados para variáveis correlacionadas à conduta no rastreamento pelo TP e MM indicam que fatores como o medo do teste, vergonha e desconhecimento tiveram influência. Concluiu-se que as mulheres nesse estudo apresentaram menor freqüência de rastreamento por MM que mulheres não latinas, além de apresentarem também níveis mais reduzidos de adesão às normas de rastreamento por TP e MM.

  16. Quality improvement project in cervical cancer screening: practical measures for monitoring laboratory performance.

    Science.gov (United States)

    Tarkkanen, Jussi; Geagea, Antoine; Nieminen, Pekka; Anttila, Ahti

    2003-01-01

    We conducted a quality improvement project in a cervical cancer screening programme in Helsinki in order to see if detection of precancerous lesions could be influenced by external (participation rate) and internal (laboratory praxis) quality measures. In order to increase the participation rate, a second personal invitation to Pap-test was mailed to nonparticipants of the first call. In order to improve the quality of screening, the cytotechnicians monitored their performance longitudinally by recording the number of slides reviewed per day, the pick-up rate of abnormal smears, the report of the consulting cytopathologist, and the number of histologically verified lesions detected from the cases that they had screened. Regular sessions were held to compare the histological findings with the cytological findings of all cases referred for colposcopy. No pressure was applied on the cytotechnicians to ensure that they felt comfortable with their daily workload. A total of 110 000 smears were screened for cervical cancer at the Helsinki City Hospital during 1996-99. Initially, the overall participation rate increased from 62% to 71%. The number of histologically confirmed precancerous lesions (CIN 1-3) more than doubled and their detection rate increased from 0.32% to 0.72%. Continuous education and feedback from daily work performance were important, yet rather inexpensive means in increasing laboratory performance. Additional measures are needed to further increase the participation rate. Impact of the quality measures on cancer incidence needs to be assessed later on.

  17. [Cervical cancer screening: Is active recruitment worth the effort?].

    Science.gov (United States)

    Morales Martínez, Ángeles; Blanco Rodríguez, Lorena; Morales Martínez, Cristina; Tejuca Somoano, Sonia

    2015-12-01

    To determine the percentage of women who have had a Pap smear in the last 5 years, and the place where it was carried out. To detect cytological abnormalities and precursors of cervical cancer in un-screened or inadequately screened women and the prevalence of HPV-positive determinations. Cross sectional study. Natahoyo Health Centre, Gijón (Spain). Women aged 40-50 years living in the area and assigned to the Health Centre. The information was collected from databases, telephone and home surveys. There was active recruitment of unscreened women or inadequately screened in Primary Care as well as offering to perform cytology and HPV determination. Of the 1420 women aged 40 to 50 years, 1236 (87%) had cytology in the last 5 years, and 184 women (13%) had no screening or it was inadequate. Of these 184 women, 108 (58.7%) agreed to have cytology and HPV test performed. No high-grade cervical dysplasia was diagnosed. The prevalence of HPV-positive was 8.3%. In our population there is a high coverage of opportunistic screening for cervical cancer. The active recruitment of women who were not in the screening program was not useful. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  18. Differences in cervical cancer screening between immigrants and nonimmigrants in Norway: a primary healthcare register-based study.

    Science.gov (United States)

    Møen, Kathy A; Kumar, Bernadette; Qureshi, Samera; Diaz, Esperanza

    2017-11-01

    The prevalence of cervical cancer is high among some groups of immigrants. Although there is evidence of low participation in cervical cancer screening programs among immigrants, studies have been subject to selection bias and accounted for few immigrant groups. The aim of this study was to compare the proportion of several groups of immigrants versus nonimmigrants attending the cervical cancer-screening program in Norway. In addition, we aimed to study predictors for attendance to the screening program. Register-based study using merged data from four national registries. All Norwegian-born women (1 168 832) and immigrant women (152 800) of screening age for cervical cancer (25-69 years) registered in Norway in 2008 were included. We grouped the immigrants by world's geographic region and carried out descriptive analyses and constructed several logistic regression models. The main outcome variable was whether the woman was registered with a Pap smear in 2008 or not. Immigrants had lower rates of participation compared with Norwegian-born women; Western Europe [adjusted odds ratio (OR), 95% confidence interval (CI): 0.84, 0.81-0.88], Eastern Europe (OR 0.64, 95% CI: 0.60-0.67), Asia (OR 0.74, 95% CI: 0.71-0.77), Africa (OR 0.61, 95% CI: 0.56-0.67) and South America (OR 0.87, 95% CI: 0.79-0.96). Younger age, higher income, residence in rural areas, and having a female general practitioner (GP) were associated with Pap smear. Longer residential time in Norway and having a nonimmigrant GP were associated with screening for some immigrant groups. Appropriate interventions targeting both immigrants and GPs need to be developed and evaluated.

  19. Barriers and Motivators Related to Cervical and Breast Cancer Screening

    Directory of Open Access Journals (Sweden)

    M Bokaee

    2004-10-01

    Full Text Available Introduction: modern knowledge could protect against cancer for individuals in community with early stage and premalignat state. Screening of cancer is best instrument for early detection of malignancy. Between women’s cancers breast and cervical cancer have more incidence and mortality than other cancers . But could be prevented by simple and cheep screening programs. Despite specific statistics in Iran evidence shows that women’s participation in screening program is poor , so cancers are diagnosed in advanced stage. The purpose of this study was to identify major barriers and motivators for breast and cervical screening . Methods: This survey was a descriptive study in which 400 women participated in health and treatment centers in Yazd. Sampling method was done in two simple and random stages. Data was collected by inventory and questionnaire . Then data were analyzed by SPSS soft ware . Results: Findings showed that 80% of them never refereed to a health provider for clinical breast exam (C B E and only 3% of them did regularly C B E . 46% of them had never done pap smear and only 14.5 % of them did regularly pap smear. The findings showed that major motivators were as follow: advice of health’s personnel , using of contraceptive methods , and awareness of media. Also the major barriers were as follow : Not having knowledge of these exams , not having knowledge of the existence of these centers of education and practice , not having precious health problems , fear of examination , Embarrassment of examination and health providers not to teach them . to consider the most important barriers were propounded which showed that health education role to eliminate barriers for referring women for screening . Discussion: Based on the results of this sample , screening was the least expected . considering barriers and motivators observed it was revealed that health education was required for prevention of common women’s cancers. Also

  20. Perceived discrimination is associated with reduced breast and cervical cancer screening: the Study of Women's Health Across the Nation (SWAN).

    Science.gov (United States)

    Jacobs, Elizabeth A; Rathouz, Paul J; Karavolos, Kelly; Everson-Rose, Susan A; Janssen, Imke; Kravitz, Howard M; Lewis, Tené T; Powell, Lynda H

    2014-02-01

    Racial disparities in breast and cervical cancer screening have been documented in African American, Hispanic, and Asian populations. Perceived discrimination may contribute to this disparity. The aim of this study was to understand the relationship between perceived everyday racial/ethnic and other discrimination and receipt of breast and cervical cancer screening in a multiethnic population of women. We analyzed data from 3,258 women participating in the Study of Women's Health Across the Nation (SWAN), a multiethnic/racial, longitudinal cohort study of the natural history of the menopausal transition conducted at seven U.S. sites. Participants completed a validated measure of perceived discrimination and reasons for believing that they were treated differently, along with Pap smears, clinical breast exams (CBE), and mammography at each follow-up period. We used multiple logistic regression for the binary outcomes of having a Pap smear, CBE, or mammogram in each of the two follow-up years, using self-reported "race discrimination" and "other discrimination" at baseline as the main predictors. African American women reported the highest percentage of racial discrimination (35%), followed by Chinese (20%), Hispanic (12%), Japanese (11%), and non-Hispanic white women (3%). Non-Hispanic white women reported the highest percentage of "other" discrimination (40%), followed by Chinese (33%), African American (24%), Japanese (23%), and Hispanic women (16%). Perceived racial discrimination was not associated with reduced receipt of preventive screening, except in one fully adjusted model. Reported discrimination owing to "other" reasons, such as age or gender, was associated with reduced receipt of Pap smear (odds ratio [OR] 0.85; 95% confidence interval [CI] 0.74-0.99), CBE (OR 0.78; 95% CI 0.67-0.91), and mammography (OR 0.80; 95% CI 0.69-0.92) regardless of patient race. Perceived discrimination is an important issue across racial/ethnic groups and is negatively

  1. Daughter-Initiated Cancer Screening Appeals to Mothers.

    Science.gov (United States)

    Mosavel, M; Genderson, M W

    2016-12-01

    Youth-initiated health interventions may provide a much needed avenue for intergenerational dissemination of health information among families who bear the greatest burden from unequal distribution of morbidity and mortality. The findings presented in this paper are from a pilot study of the feasibility and impact of female youth-initiated messages (mostly daughters) encouraging adult female relatives (mostly mothers) to obtain cancer screening within low-income African American families living in a Southern US state. Results are compared between an intervention and control group. Intervention group youth (n = 22) were exposed to a 60-min interactive workshop where they were assisted to prepare a factual and emotional appeal to their adult relative to obtain specific screening. The face-to-face workshops were guided by the Elaboration Likelihood Model (ELM) and the Theory of Planned Behavior (TPB). Control group girls (n = 18) were only provided with a pamphlet with information about cancer screening and specific steps about how to encourage their relative to obtain screening. Intervention youth (86 %) and adults (82 %) reported that the message was shared while 71 % in the control group reported sharing or receiving the message. Importantly, more women in the intervention group reported that they obtained a screen (e.g., mammogram, Pap smear) directly based on the youth's appeal. These findings can have major implications for youth-initiated health promotion efforts, especially among hard-to-reach populations.

  2. Low sputum smear positive tuberculosis among pulmonary ...

    African Journals Online (AJOL)

    Low sputum smear positive tuberculosis among pulmonary tuberculosis suspects in a tertiary hospital in Mwanza, Tanzania. ... The risk factors among smear positive TB patients were co-illness (32.5%), previous history of TB (7.5%) and history of positive TB contact (4.7%). These findings also show that as CD4+ T Cells ...

  3. Decision Making for Pap Testing among Pacific Islander Women

    Science.gov (United States)

    Weiss, Jie W.; Mouttapa, Michele; Sablan-Santos, Lola; DeGuzman Lacsamana, Jasmine; Quitugua, Lourdes; Park Tanjasiri, Sora

    2016-01-01

    This study employed a Multi-Attribute Utility (MAU) model to examine the Pap test decision-making process among Pacific Islanders (PI) residing in Southern California. A total of 585 PI women were recruited through social networks from Samoan and Tongan churches, and Chamorro family clans. A questionnaire assessed Pap test knowledge, beliefs and…

  4. Identification of mycobacterium tuberculosis in sputum smear slide using automatic scanning microscope

    Science.gov (United States)

    Rulaningtyas, Riries; Suksmono, Andriyan B.; Mengko, Tati L. R.; Saptawati, Putri

    2015-04-01

    Sputum smear observation has an important role in tuberculosis (TB) disease diagnosis, because it needs accurate identification to avoid high errors diagnosis. In development countries, sputum smear slide observation is commonly done with conventional light microscope from Ziehl-Neelsen stained tissue and it doesn't need high cost to maintain the microscope. The clinicians do manual screening process for sputum smear slide which is time consuming and needs highly training to detect the presence of TB bacilli (mycobacterium tuberculosis) accurately, especially for negative slide and slide with less number of TB bacilli. For helping the clinicians, we propose automatic scanning microscope with automatic identification of TB bacilli. The designed system modified the field movement of light microscope with stepper motor which was controlled by microcontroller. Every sputum smear field was captured by camera. After that some image processing techniques were done for the sputum smear images. The color threshold was used for background subtraction with hue canal in HSV color space. Sobel edge detection algorithm was used for TB bacilli image segmentation. We used feature extraction based on shape for bacilli analyzing and then neural network classified TB bacilli or not. The results indicated identification of TB bacilli that we have done worked well and detected TB bacilli accurately in sputum smear slide with normal staining, but not worked well in over staining and less staining tissue slide. However, overall the designed system can help the clinicians in sputum smear observation becomes more easily.

  5. sept 2 edition 2009.cdr

    African Journals Online (AJOL)

    User

    between 40 and 49 years old. Majority of the study women (98%) were married. Four (4%) of the respondents had learned about pap smear and none knew what Pap smear screened for. None of the respondents had ever had a pap smear taken before. Thirty (30%) of the respondents had heard of the cancer of the cervix.

  6. Smears and cultures for diagnosis of pulmonary tuberculosis in an asymptomatic immigrant population

    Directory of Open Access Journals (Sweden)

    Assael R

    2013-09-01

    Full Text Available Roberto Assael, Joaquin Cervantes, Gerardo Barrera Clinica Medica Internacional, Ciudad Juarez, Mexico Background: The World Health Organization estimated in 2010 that 8.8 million new tuberculosis (TB cases. About one-third of the world's population is infected and 10% will develop active TB disease. While cultures remain the international gold standard for diagnosing TB disease, in many other low-income countries, sputum smears remain the only and most accessible tool with which to diagnose active TB disease. As a consequence, in patients with TB who have negative smears, their TB remains undetected. Aim: The objective of the study reported here was to demonstrate the proportion of smear-positive/culture-positive cases compared with smear-negative/culture-positive TB cases in Mexican immigrants bound for the USA. Methods: A retrospective study was undertaken of the medical records of 122 active TB cases diagnosed at a clinic in Ciudad Juarez, Mexico, from 2009 to 2012. All cases were confirmed by culture, regardless of the sputum smear results. Results: Of the cases, 80% (97 active TB cases had negative sputum smears, while only 25 cases (20% had at least one positive smear. All of the cultures were confirmed as positive for Mycobacterium tuberculosis complex. Conclusion: The fact that 80% of the TB cases were smear negative and 20% smear positive shows that there is a clear gap between the actual state of active TB disease within patients under screening conditions, meaning that eight out of ten actual cases are being missed when sputum smear is the only diagnostic tool in asymptomatic patients with abnormal chest X-rays. Based on these results, it is highly recommended that countries that have not standardized culturing as the gold standard for the diagnosis of active TB do so, so that TB cases – which may endanger global public health – are not missed. It is also recommended that further studies be undertaken to determine the clinical

  7. Screens

    OpenAIRE

    2016-01-01

    This Sixth volume in the series The Key Debates. Mutations and Appropriations in European Film Studies investigates the question of screens in the context both of the dematerialization due to digitalization and the multiplication of media screens. Scholars offer various infomations and theories of topics such as the archeology of screen, film and media theories, contemporary art, pragmatics of new ways of screening (from home video to street screening).

  8. Economic analysis of CDC's culture- and smear-based tuberculosis instructions for Filipino immigrants.

    Science.gov (United States)

    Maskery, B; Posey, D L; Coleman, M S; Asis, R; Zhou, W; Painter, J A; Wingate, L T; Roque, M; Cetron, M S

    2018-04-01

    In 2007, the US Centers for Disease Control and Prevention (CDC) revised its tuberculosis (TB) technical instructions for panel physicians who administer mandatory medical examinations among US-bound immigrants. Many US-bound immigrants come from the Philippines, a high TB prevalence country. To quantify economic and health impacts of smear- vs. culture-based TB screening. Decision tree modeling was used to compare three Filipino screening programs: 1) no screening, 2) smear-based screening, and 3) culture-based screening. The model incorporated pre-departure TB screening results from Filipino panel physicians and CDC databases with post-arrival follow-up outcomes. Costs (2013 $US) were examined from societal, immigrant, US Public Health Department and hospitalization perspectives. With no screening, an annual cohort of 35 722 Filipino immigrants would include an estimated 450 TB patients with 264 hospitalizations, at a societal cost of US$9.90 million. Culture-based vs. smear-based screening would result in fewer imported cases (80.9 vs. 310.5), hospitalizations (19.7 vs. 68.1), and treatment costs (US$1.57 million vs. US$4.28 million). Societal screening costs, including US follow-up, were greater for culture-based screening (US$5.98 million) than for smear-based screening (US$3.38 million). Culture-based screening requirements increased immigrant costs by 61% (US$1.7 million), but reduced costs for the US Public Health Department (22%, US$750 000) and of hospitalization (70%, US$1 020 000). Culture-based screening reduced imported TB and US costs among Filipino immigrants.

  9. Aerobic biotransformation of polyfluoroalkyl phosphate esters (PAPs) in soil

    International Nuclear Information System (INIS)

    Liu, Chen; Liu, Jinxia

    2016-01-01

    Microbial transformation of polyfluoroalkyl phosphate esters (PAPs) into perfluorocarboxylic acids (PFCAs) has recently been confirmed to occur in activated sludge and soil. However, there lacks quantitative information about the half-lives of the PAPs and their significance as the precursors to PFCAs. In the present study, the biotransformation of 6:2 and 8:2 diPAP in aerobic soil was investigated in semi-dynamics reactors using improved sample preparation methods. To develop an efficient extraction method for PAPs, six different extraction solvents were compared, and the phenomenon of solvent-enhanced hydrolysis was investigated. It was found that adding acetic acid could enhance the recoveries of the diPAPs and inhibit undesirable hydrolysis during solvent extraction of soil. However 6:2 and 8:2 monoPAPs, which are the first breakdown products from diPAPs, were found to be unstable in the six solvents tested and quickly hydrolyzed to form fluorotelomer alcohols. Therefore reliable measurement of the monoPAPs from a live soil was not achievable. The apparent DT_5_0 values of 6:2 diPAP and 8:2 diPAP biotransformation were estimated to be 12 and > 1000 days, respectively, using a double first-order in parallel model. At the end of incubation of day 112, the major degradation products of 6:2 diPAP were 5:3 fluorotelomer carboxylic acid (5:3 acid, 9.3% by mole), perfluoropentanoic acid (PFPeA, 6.4%) and perfluorohexanoic acid (PFHxA, 6.0%). The primary product of 8:2 diPAP was perfluorooctanoic acid (PFOA, 2.1%). The approximately linear relationship between the half-lives of eleven polyfluoroalkyl and perfluoroalkyl substances (PFASs, including 6:2 and 8:2 diPAPs) that biotransform in aerobic soils and their molecular weights suggested that the molecular weight is a good indicator of the general stability of low-molecular-weight PFAS-based compounds in aerobic soils. - Highlights: • Biotransformation of 6:2 and 8:2 diPAPs in an aerobic soil was investigated.

  10. Cervical cancer screening, human papillomavirus vaccination practices and current infrastructure in Israel.

    Science.gov (United States)

    Schejter, Eduardo; Bornstein, Jacob; Siegler, Efraim

    2013-11-22

    The incidence rates for premalignant lesions in Jewish women in Israel are similar to those observed in Western countries, but the incidence of cervical cancer in Israel is low; this discrepancy is not yet clearly understood. Because of the low incidence of cervical cancer in Israel, it was decided to base cervical cancer prevention on opportunistic screening: every woman from the ages of 35-54 years can have a Pap test smear free of charge every 3 years. Over the last decade 12.2% of the women population had an annual Pap test. From 36 to 50% of women who attended the Clalit Health Maintenance Organization (HMO) and the Maccabi HMO, the two largest HMOs in Israel, did so. There were also discrepancies between women of different socio-economic status (SES): Israel Society of Obstetrics and Gynecology recommends continuing cytologic screening in vaccinated women as recommended for the general population. This article forms part of a regional report entitled "Comprehensive Control of HPV Infections and Related Diseases in Israel" Vaccine Volume 31, Supplement 8, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012. Copyright © 2013. Published by Elsevier Ltd.

  11. Aerobic biotransformation of polyfluoroalkyl phosphate esters (PAPs) in soil.

    Science.gov (United States)

    Liu, Chen; Liu, Jinxia

    2016-05-01

    Microbial transformation of polyfluoroalkyl phosphate esters (PAPs) into perfluorocarboxylic acids (PFCAs) has recently been confirmed to occur in activated sludge and soil. However, there lacks quantitative information about the half-lives of the PAPs and their significance as the precursors to PFCAs. In the present study, the biotransformation of 6:2 and 8:2 diPAP in aerobic soil was investigated in semi-dynamics reactors using improved sample preparation methods. To develop an efficient extraction method for PAPs, six different extraction solvents were compared, and the phenomenon of solvent-enhanced hydrolysis was investigated. It was found that adding acetic acid could enhance the recoveries of the diPAPs and inhibit undesirable hydrolysis during solvent extraction of soil. However 6:2 and 8:2 monoPAPs, which are the first breakdown products from diPAPs, were found to be unstable in the six solvents tested and quickly hydrolyzed to form fluorotelomer alcohols. Therefore reliable measurement of the monoPAPs from a live soil was not achievable. The apparent DT50 values of 6:2 diPAP and 8:2 diPAP biotransformation were estimated to be 12 and > 1000 days, respectively, using a double first-order in parallel model. At the end of incubation of day 112, the major degradation products of 6:2 diPAP were 5:3 fluorotelomer carboxylic acid (5:3 acid, 9.3% by mole), perfluoropentanoic acid (PFPeA, 6.4%) and perfluorohexanoic acid (PFHxA, 6.0%). The primary product of 8:2 diPAP was perfluorooctanoic acid (PFOA, 2.1%). The approximately linear relationship between the half-lives of eleven polyfluoroalkyl and perfluoroalkyl substances (PFASs, including 6:2 and 8:2 diPAPs) that biotransform in aerobic soils and their molecular weights suggested that the molecular weight is a good indicator of the general stability of low-molecular-weight PFAS-based compounds in aerobic soils. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Predictors of cervical cancer screening adherence in the United States: a systematic review.

    Science.gov (United States)

    Limmer, Karen; LoBiondo-Wood, Geri; Dains, Joyce

    2014-01-01

    Cervical cancer incidence rates have decreased dramatically since the implementation of the Papanicolaou (Pap) smear. Nevertheless, the American Cancer Society (ACS) estimates for 2013 predicted more than 12,000 new cases of cervical cancer in the United States. Given that some subpopulations in the United States are at a higher risk for cervical cancer than others, efforts to increase screening adherence are warranted. Many studies have explored the demographics of underscreened women, but no systematic reviews of screening demographics in adult US women were identified in the past 10 years, after release of the 2002 ACS cervical cancer screening guidelines. Knowledge of adherence to these guidelines becomes important as new guidelines were developed and released in 2012. The purpose of this systematic review of relevant studies was to identify factors that predict the use of cervical cancer screening in US women. Variables found to be significantly associated with adherence to screening included education, financial status, acculturation, psychosocial issues, and marital status. Using this information, nurse practitioners and other providers can target specific at-risk populations to increase screening by educating women about the need for cervical cancer screening and ensuring access to methods for prevention and early detection of the disease.

  13. [Cervical screening: toward a new paradigm?].

    Science.gov (United States)

    Lavoué, V; Bergeron, C; Riethmuller, D; Daraï, E; Mergui, J-L; Baldauf, J-J; Gondry, J; Douvier, S; Lopès, P; de Reilhac, P; Quéreux, C; Letombe, B; Marchetta, J; Boulanger, J-C; Levêque, J

    2010-04-01

    Analysis of the trials which compare the virologic testing (HPV testing) and the cytology in the cervical screening. The MedLine database was consulted using the Keywords: "cervical screening", "pap smear", "liquid based cytology", "HPV testing", "adults", "adolescents", "cervical intraepithelial neoplasia (CIN)", "uterine cervix cancer". Articles were selected according their concern about the debate of the uterine cervix cancer screening in France. The HPV testing seems interesting allowing a decreasing delay in the diagnosis of CIN (more diagnosis of CIN2+ in the first round and less during the second one). But, when the two rounds are added, the number of CIN2+ are identical in the two arms (cytology and HPV testing) in all the trials (except the Italian NTCC trial). A negative HPV testing protects the women much longer than cytology can do: a delay of five years between two rounds seems ideal. The HPV testing alone increases the detection rate of cervical lesions, which could regress spontaneously and may induce an overtreatment, especially in the youngest population: a triage is necessary and the cytology appears to be the best way to select the candidates for colposcopy in case of positive HPV testing and cytology. The HPV infection presents some particularities in adolescent females: for this reason, the HPV testing should not be used in this special population. In vaccinated women, a consensus for the screening is necessary. The health care providers in France have to understand the characteristics of the HPV testing: its advantages compared to the cytologic screening are only evident in case of an organization of the screening in France and even in Europe. (c) 2010 Elsevier Masson SAS. All rights reserved.

  14. Cellphone based mobile colposcope for the evaluation of women with abnormal cervical cancer screening

    Science.gov (United States)

    Kahn, Bruce S.; Kass, Alex J.; Waalen, Jill; Levitz, David

    2015-03-01

    Objective: Compare an inexpensive cell-phone based Mobile Colposcope, with a standard colposcope in the evaluation of women with abnormal Pap smear screening. Methodology: The study was a prospective, parallel noninferiority trial. Thirty women underwent colposcopy for the evaluation of an abnormal Pap smear. After application of acetic acid, images of the cervix were obtained with both a standard colposcope and the Mobile Colposcope. An additional set of images using both devices were obtained using the red-free (green filter) mode. Eight experienced gynecologists then evaluated 100 paired images (plain and green filter) from two different sites in random order using a web based assessment program. After reviewing each set of paired images, the expert would make an assessment of: 1) normal (no biopsy/ random biopsy), or 2) abnormal. For abnormal images, the expert then electronically marked the site(s) on the image where a biopsy was recommended. In image analysis, the cervical image was divided into 12 radial sectors and the marked sites for biopsy on the matched pairs were compared. Matched pairs that were considered normal, or those where biopsy site recommendations were within +/- 30° were considered equivalent; unmatched biopsy sites were considered non-equivalent. Results were compared using Wilcoxon Matched Pairs Signed Ranks Test. Expert assessment of Mobile Colposcope images compared with assessment by standard colposcope is currently onging. Conclusions: if the Mobile Colposcope demonstrates non-inferiority to imaging obtained with a standard colposcope and due to its low cost, it has the potential help improve cervical cancer screening in low resource settings.

  15. Effects of interfering constituents on tritium smears

    International Nuclear Information System (INIS)

    Levi, G.D. Jr.; Cheeks, K.E.

    1993-01-01

    Tritium smears are performed by Health Protection Operations (HPO) to assess transferable contamination on work place surfaces, materials for movement outside Radiologically Controlled Areas (RCA), and product containers being shipped between facilities. Historically, gas proportional counters were used to detect transferable tritium contamination collected by smearing. Because tritium is a low-energy beta emitter, gas proportional counters do not provide the sensitivity or the counting efficiency to accurately measure the tritium activity on the smear. Liquid Scintillation Counters (LSC) provide greater counting efficiency for the low-energy beta particles along with greater reliability and reproducibility compared to gas flow proportional counters. The purpose of this technical evaluation was to determine the effects of interfering constituents such as filters, dirt and oil on the counting efficiency and tritium recoveries of tritium smears by LSC

  16. Evaluation of the relationship between smear positivity and high-resolution CT findings in children with pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Bolursaz, Mohammad Reza; Mehrian, Payam; Aghahosseini, Farahnaz; Lotfian, Ferial; Khalilzadeh, Soheila; Baghaie, Nooshin; Hassanzad, Maryam; Velayati, Ali Akbar

    2014-01-01

    The aim of this study is to find a relationship between the radiological manifestations of childhood tuberculosis on a high-resolution computed tomography (HRCT) and the results of sputum smear. This study aims to propose an alternative indicator of infectivity in terms of prevention of disease transmission through selective isolation policy in children whose clinical condition is highly suggestive of tuberculosis. This retrospective comparative study was performed on 95 children under 15 years of age diagnosed with tuberculosis based on both WHO criteria and positive sputum culture for mycobacterium Tuberculosis. The children were admitted for TB screening in the pediatric department of national research institute of tuberculosis and lung disease (NRITLD) between 2008–2012. Direct smear collected from sputum or gastric lavage, as well as HRCT were performed in all children prior to administration of medical therapy. Children were divided into 2 groups based on positive and negative smear results. HRCT abnormalities, as well as their anatomical distribution were compared between these 2 groups using multivariate analytic model. The most prevalent abnormalities in the positive smear group were consolidation, tree-in-bud pattern, upper lobe nodular infiltration and cavitation. The negative smear group featured lymphadenopathy, consolidation, collapse and nodular infiltration in the upper lobe. Cavity, tree- in-bud pattern and upper lobe nodular infiltration were highly associated with smear positivity in children. Conversely, lymphadenopathy and collapse had significant association with a negative smear. This study revealed that cavity, tree-in-bud and upper lobe nodular infiltration has significant association with smear positivity in childhood tuberculosis. On the other hand, lymphadenopathy and collapse were closely associated with smear negativity in this age group. It was also demonstrated that children with a positive smear most likely presented with

  17. Progression and regression of cervical pap test lesions in an urban AIDS clinic in the combined antiretroviral therapy era: a longitudinal, retrospective study.

    Science.gov (United States)

    Lofgren, Sarah M; Tadros, Talaat; Herring-Bailey, Gina; Birdsong, George; Mosunjac, Marina; Flowers, Lisa; Nguyen, Minh Ly

    2015-05-01

    Our objective was to evaluate the progression and regression of cervical dysplasia in human immunodeficiency virus (HIV)-positive women during the late antiretroviral era. Risk factors as well as outcomes after treatment of cancerous or precancerous lesions were examined. This is a longitudinal retrospective review of cervical Pap tests performed on HIV-infected women with an intact cervix between 2004 and 2011. Subjects needed over two Pap tests for at least 2 years of follow-up. Progression was defined as those who developed a squamous intraepithelial lesion (SIL), atypical glandular cells (AGC), had low-grade SIL (LSIL) followed by atypical squamous cells-cannot exclude high-grade SIL (ASC-H) or high-grade SIL (HSIL), or cancer. Regression was defined as an initial SIL with two or more subsequent normal Pap tests. Persistence was defined as having an SIL without progression or regression. High-risk human papillomavirus (HPV) testing started in 2006 on atypical squamous cells of undetermined significance (ASCUS) Pap tests. AGC at enrollment were excluded from progression analysis. Of 1,445 screened, 383 patients had over two Pap tests for a 2-year period. Of those, 309 had an intact cervix. The median age was 40 years and CD4+ cell count was 277 cells/mL. Four had AGC at enrollment. A quarter had persistently normal Pap tests, 64 (31%) regressed, and 50 (24%) progressed. Four developed cancer. The only risk factor associated with progression was CD4 count. In those with treated lesions, 24 (59%) had negative Pap tests at the end of follow-up. More studies are needed to evaluate follow-up strategies of LSIL patients, potentially combined with HPV testing. Guidelines for HIV-seropositive women who are in care, have improved CD4, and have persistently negative Pap tests could likely lengthen the follow-up interval.

  18. TTV and HPV co-infection in cervical smears of patients with cervical lesions

    Directory of Open Access Journals (Sweden)

    Tachezy Ruth

    2009-07-01

    Full Text Available Abstract Background The female lower genital tract is a gateway for pathogens entering the host through the mucous membrane. One of the prevalent human viruses is Torque teno virus (TTV. The major reported routes of TTV transmission are fecal-oral and parenteral. Furthermore, other modes of transmission, e.g. sexual contact, are suggested. To investigate the sexual route of TTV transmission, cervical smears of healthy women and those with cervical lesions were screened for the presence of TTV DNA. Methods TTV DNA was studied in cervical smears of 95 patients with cervical lesions and 55 healthy women. Paired serum samples were available from 55 and 42 women, respectively. All healthy women had normal cytology while 44 patients had histologically confirmed low-grade lesion (LGL and 51 high-grade lesion (HGL. TTV DNA was detected with primers specific for the non-coding region. In 40 paired cervical smears and serum samples, the phylogenetic group of TTV isolates was determined. The presence of HPV DNA in cervical smears was detected by means of PCR with MY09/11 primers. Results The prevalence of TTV DNA in cervical smears of healthy women was 52.7% and was comparable with that in paired serum samples (50%. Symptomatic women had significantly higher prevalence of TTV DNA in cervical smears (74.7% than healthy controls. The TTV DNA prevalence in patient serum samples was 51%. The phylogenetic groups of TTV serum isolates were concordant with those of TTV from cervical smears of the same subjects. In cervical smears, a wider variety of TTV isolates was found. The viral loads in cervical smears were 10 to 1000 times as high as in sera. The HPV-positive study subjects had significantly higher TTV DNA prevalence than HPV negatives. The prevalence of TTV was not associated with disease severity. Conclusion High prevalence of TTV in cervical smears suggests that sexual transmission is another mode of expansion of TTV infection among the population. The

  19. Breast and cervical screening by race/ethnicity: comparative analyses before and during the Great Recession.

    Science.gov (United States)

    King, Christopher J; Chen, Jie; Garza, Mary A; Thomas, Stephen B

    2014-04-01

    Traditionally, economic recessions have resulted in decreased utilization of preventive health services. To explore racial and ethnic differences in breast and cervical cancer screening rates before and during the Great Recession. The Medical Expenditure Panel was the source for identifying 10,894 women, ages 50-74 for breast screening and 19,957 women, ages 21-65 for cervical screening. Survey years included 2004-2005 and 2009-2010. Dependent variables were as follows: 1) receipt of mammogram within the past 2 years; and 2) receipt of a Pap smear within the past 3 years. The interaction of the recession and the likelihood of screening between whites and minorities was analyzed. Multivariate regressions were applied to estimate the likelihood of screening for the two time periods while controlling for a recession variable. Nationally, breast and cervical cancer screening rates dropped during the recession period; white women contributed most to the decline. However, there were significant improvements in timely screening for both cancers among Hispanics during the recession period. After controlling for the recession, African American women were more likely to have timely screenings compared to white women. Screening rates during the recession were lowest in the South, Midwest and West. There was a national reduction in the percentages of women who obtained timely breast and cervical screenings during the Great Recession. Outreach efforts are needed to ensure that women who were not screened during the recession are screened. Widespread education about the Affordable Care Act may be helpful. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  20. A comparison of cervical cancer screening rates among women with traumatic spinal cord injury and the general population.

    Science.gov (United States)

    Guilcher, Sara J T; Newman, Alice; Jaglal, Susan B

    2010-01-01

    Previous qualitative and survey studies have suggested women with spinal cord injury (SCI) are screened less often for cervical cancer compared with the general population. We investigated whether cervical cancer screening rates differ between population-based women with and without traumatic SCI, matched for age and geography. A double cohort design was used, comparing women with SCI to the general population (1:4) using administrative data for Ontario, Canada. Women with SCI, identified using the Discharge Abstract Database for the fiscal years 1995-1996 to 2001-2002, were female residents of Ontario between the ages of 25 and 66, admitted to an acute care facility with a traumatic SCI (ICD-9 CM code 806 or 952). Women in the general Ontario population were randomly matched by age and geography. Screening rates were calculated from fee codes related to Papanicolaou (Pap) smear tests for a 3-year period preinjury and postinjury. There were 339 women with SCI matched to 1506 women in the general Ontario population. Screening rates pre-SCI were 55% for women with SCI and 57% during this same time period for matched women in the general population; post-SCI rates were 58% for both the two groups. Factors predicting the likelihood of receiving a Pap test for SCI cases included younger age and higher socioeconomic status. Utilization data suggest that there are no significant differences in screening rates for women with SCI compared with the general population. However, screening rates for women with SCI were significantly influenced by age as well as income.

  1. A qualitative exploration of Malaysian cancer patients’ perceptions of cancer screening

    Directory of Open Access Journals (Sweden)

    Farooqui Maryam

    2013-01-01

    Full Text Available Abstract Background Despite the existence of different screening methods, the response to cancer screening is poor among Malaysians. The current study aims to examine cancer patients’ perceptions of cancer screening and early diagnosis. Methods A qualitative methodology was used to collect in-depth information from cancer patients. After obtaining institutional ethical approval, patients with different types and stages of cancer from the three major ethnic groups (Malay, Chinese and Indian were approached. Twenty semi-structured interviews were conducted. All interviews were audiotaped, transcribed verbatim, and translated into English for thematic content analysis. Results Thematic content analysis yielded four major themes: awareness of cancer screening, perceived benefits of cancer screening, perceived barriers to cancer screening, and cues to action. The majority of respondents had never heard of cancer screening before their diagnosis. Some participants reported hearing about mammogram and Pap smear tests but did not undergo screening due to a lack of belief in personal susceptibility. Those who had negative results from screening prior to diagnosis perceived such tests as untrustworthy. Lack of knowledge and financial constraints were reported as barriers to cancer screening. Finally, numerous suggestions were given to improve screening behaviour among healthy individuals, including the role of mass media in disseminating the message ‘prevention is better than cure’. Conclusions Patients’ narratives revealed some significant issues that were in line with the Health Belief Model which could explain negative health behaviour. The description of the personal experiences of people with cancer could provide many cues to action for those who have never encountered this potentially deadly disease, if incorporated into health promotion activities.

  2. Removal factor determination of some local smear papers for surface contamination smear test

    International Nuclear Information System (INIS)

    Suratman; Indriyotomo, D.; Aminjoyo, S.

    1996-01-01

    Removal factor determination of some local smear papers has been done, using dry smear test method. The aim of this research is to find removal values of local smear papers on some surfaces, to replace import smear papers. Smear test was done on the various surfaces i.e.: porcelain, formica, glass, stainless steel, steel and PVC, with the local smear papers I.e.: Padalarang, Diagonal, Concorde, Marga, Hard Cloth, and import smear paper. The artificial contaminant which used were I-131 and P-32. The removal factor values of Padalarang paper for surfaces: porcelain, formica, glass stainless steel, steel and PVC were: 24.5%, 20.0%, 27.0%, 6.8%, 4.9%, and 13.6% respectively. The removal factor values of Diagonal paper were:18.4%, 15.9%, 5.7%, 3.5%, and 9.1% respectively. The removal factor values of concord paper were: 18.5%, 20.3%, 23.1%, 6.6%, 3.8%, and 9.0% respectively. The removal factor values of Marga paper were: 16.7%, 13.5%, 21.1%, 4.2%, 4.1% and 8.1% respectively. The removal factor values of Hard Cloth were: 18.6%, 12.6%, 20.5%, 8.2%, and 10.1% respectively. The removal factor values of import smear paper were: 17.8%, 15.0%, 18.8%, 9.1%, 4.8%, and 14.4% respectively . Substitution alternative of import smear paper is Padalarang. (author)

  3. Identifying risk factors associated with smear positivity of pulmonary tuberculosis in Kazakhstan.

    Directory of Open Access Journals (Sweden)

    Sabrina Hermosilla

    Full Text Available Sputum smear-positive tuberculosis (TB patients have a high risk of transmission and are of great epidemiological and infection control significance. Little is known about the smear-positive populations in high TB burden regions, such as Kazakhstan. The objective of this study is to characterize the smear-positive population in Kazakhstan and identify associated modifiable risk factors.Data on incident TB cases' (identified between April 2012 and March 2014 socio-demographic, risk behavior, and comorbidity characteristics were collected in four regions of Kazakhstan through structured survey and medical record review. We used multivariable logistic regression to determine factors associated with smear positivity.Of the total sample, 193 (34.3% of the 562 study participants tested smear-positive. In the final adjusted multivariable logistic regression model, sex (adjusted odds ratio (aOR = 2.0, 95% CI:1.3-3.1, p < 0.01, incarceration (aOR = 3.6, 95% CI:1.2-11.1, p = 0.03, alcohol dependence (aOR = 2.6, 95% CI:1.2-5.7, p = 0.02, diabetes (aOR = 5.0, 95% CI:2.4-10.7, p < 0.01, and physician access (aOR = 2.7, 95% CI:1.3-5.5p < 0.01 were associated with smear-positivity.Incarceration, alcohol dependence, diabetes, and physician access are associated with smear positivity among incident TB cases in Kazakhstan. To stem the TB epidemic, screening, treatment and prevention policies should address these factors.

  4. Actinomyces-like organisms in the cervical smears of IUCD users.

    Science.gov (United States)

    Farida Jamal; Mohd Salleh Mohd Yasin; Zooraidah Zainal; Hamid Arshat

    1983-01-01

    Pelvic inflammatory disease (PID) is a well-documented complication of IUD use. The presence of tails on the IUDs appears to facilitate ascent of bacteria from the vagina into the uterus. In this study, cervical smears of 128 IUD users were stained by Gram's stain and screened for the presence of Actinomyces-like organisms. 5.5% of the smears were positive for these organisms. Pus was seen in 20.1% of the smears, and yeast cells were seen in 10.2%. The average duration of IUD insertion was 8 months. Smears of 103 controls were negative for Actinomyces-like organisms, pus cells were present in 8.7%, and yeast cells in 4.8%. Of the 7 smears positive for the organisms, only 1 was from the user of a plastic device. All cases included were asymptomatic and were visiting the clinic for routine follow-up. These data suggest that colonization by Actinomyces-like organisms does not appear to be a significant problem in IUD users in Malaysia.

  5. Effect of Physician Gender on Demand for Pap Tests

    OpenAIRE

    Lin, Tsui-Fang; Chen, Jennjou

    2014-01-01

    People’s demand for preventive medical care is one type of investment in health. The aim of this paper is to examine women’s demand for secondary prevention in Taiwan, focusing on the role a physician’s gender plays in women’s inclination to undergo Pap tests. Our estimation results show that regional ratio of female doctors has a positive and significant effect on utilization of Pap tests for the full sample and for women aged below 30. In addition, doctor’s gender matters only in utilizatio...

  6. A questionnaire study of cervical cancer screening beliefs and practices of Chinese and Caucasian mother-daughter pairs living in Canada.

    Science.gov (United States)

    Chang, Sabrina C H; Woo, Jane S T; Gorzalka, Boris B; Brotto, Lori A

    2010-03-01

    Papanicolaou (Pap) testing rates among Chinese women remain low compared with their Caucasian counterparts despite extensive efforts to raise awareness of the importance of regular screening. We examined three potential predictors of Pap testing behaviour in Chinese women: acculturation, cervical cancer screening belief accuracy, and intergenerational transmission. Caucasian (n = 78) and Chinese (n = 93) female university students and their mothers completed questionnaires concerning acculturation, Pap testing beliefs, and behaviours. Ethnic group comparisons revealed that Chinese daughters and mothers had lower Pap testing rates and less accurate beliefs regarding cervical cancer screening. Among women who had had at least one Pap test, there was no ethnic difference in the proportion of women who adhered to the recommended screening frequency. Among the Chinese women, lower heritage acculturation was correlated with higher cancer screening belief accuracy in both the daughters and their mothers. Maternal Pap testing behaviour was predicted by level of cancer screening belief accuracy, whereas daughters' Pap testing behaviour was predicted by previous experience of sexual intercourse and heritage acculturation. No intergenerational transmission of Pap testing beliefs or behaviours was found. The accuracy of cancer screening beliefs, level of acculturation and experience of sexual intercourse may be predictors of Pap testing behaviour in Chinese women. Contrary to our prediction, we found no support for intergenerational transmission, suggesting that Pap testing beliefs and behaviours of Chinese women are independent of the beliefs and behaviours of their mothers.

  7. Evaluation of diagnostic value of AgNOR and PAP in early detection of dysplastic changes in leukoplakia and lichen planus - a preliminary case-control study.

    Science.gov (United States)

    Rao, Dhanya S; Ali, I M; Annigeri, Rajeshwari G

    2017-01-01

    Early detection of oral cancer has been the most effective approach to reduce morbidity and mortality of cancer patients. If a lesion is clinically considered suspicious, an easily practicable, non-invasive, painless, safe, and accurate screening method for detection of the dysplastic changes is necessary. In an attempt to procure this, a study was conducted with the aim of determining the diagnostic accuracy of rapid Papanicolaou stain (PAP) and silver-stained nucleolar organizer regions (AgNOR) in brush biopsies of potentially malignant lesions for early detection of oral cancer. Brush biopsies taken from 25 cases of leukoplakia and lichen planus each were stained with rapid PAP and silver nitrate stains. Histopathological correlation was performed and further compared with rapid PAP and AgNOR for its diagnostic validity. Statistically significant increase in the mean AgNOR count was seen from normal epithelium to lichen planus to that of leukoplakia. When compared with rapid PAP, a linear correlation was seen in AgNOR counts and stages of dysplasia in leukoplakia which was also found to be statistically significant. Diagnostic accuracy for AgNOR in leukoplakia was found to be 84%, lichen planus 73%, whereas RAPID PAP showed 72% accuracy. AgNOR analysis may be useful as a quantitative marker of incipient cellular alterations and hence would be helpful in assessing suspicious lesions and thus can be regarded as a valuable adjunct. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Sputum smear examination and time to diagnosis in patients with smear-negative pulmonary tuberculosis in the Pacific.

    Science.gov (United States)

    Viney, K; Bissell, K; Tabutoa, K; Kienene, T; Linh, N N; Briand, K; Harries, A D

    2012-12-21

    National tuberculosis programmes (NTPs) in Kiribati and the Marshall Islands, 2006-2010. To determine the proportion of all tuberculosis (TB) cases that were pulmonary smear-negative, and for these patients to determine how many sputum smears were examined and the time from sputum smear examination to registration. A retrospective cross-sectional study involving a record review of national TB and laboratory registers. Of 2420 TB cases identified, 709 (29%) were registered as smear-negative pulmonary TB. Of the 695 (98%) with information on smear examination, 222 (32%) had no smear recorded, 61 (9%) had one smear, 86 (12%) two smears and 326 (47%) three smears. Among the 473 patients who had at least one smear, 238 (50%) were registered before sputum examination, 131 (28%) within 1 week, 72 (15%) between 1 and 4 weeks, and 34 (7%) >4 weeks after sputum examination. NTPs in Kiribati and the Marshall Islands are diagnosing 29% of all TB patients as smear-negative pulmonary TB. Many patients do not have smears done or are registered before undergoing smear examination. Corrective measures are needed.

  9. Socioeconomic Differences in Use of Low-Value Cancer Screenings and Distributional Effects in Medicare.

    Science.gov (United States)

    Xu, Wendy Yi; Jung, Jeah Kyoungrae

    2017-10-01

    Consuming low-value health care not only highlights inefficient resource use but also brings an important concern regarding the economics of disparities. We identify the relation of socioeconomic characteristics to the use of low-value cancer screenings in Medicare fee-for-service (FFS) settings, and quantify the amount subsidized from nonusers and taxpayers to users of these screenings. 2007-2013 Medicare Current Beneficiary Survey, Medicare FFS claims, and the Area Health Resource Files. Our sample included enrollees in FFS Part B for the entire calendar year. We excluded beneficiaries with a claims-documented or self-reported history of targeted cancers, or those enrolled in Medicaid or Medicare Advantage plans. We identified use of low-value Pap smears, mammograms, and prostate-specific antigen tests based on established algorithms, and estimated a logistic model with year dummies separately for each test. Secondary data analyses. We found a statistically significant positive association between privileged socioeconomic characteristics and use of low-value screenings. Having higher income and supplemental private insurance strongly predicted more net subsidies from Medicare. FFS enrollees who are better off in terms of sociodemographic characteristics receive greater subsidies from taxpayers for using low-value cancer screenings. © Health Research and Educational Trust.

  10. Correlates of women's cancer screening and contraceptive knowledge among female emergency department patients

    Directory of Open Access Journals (Sweden)

    Bock Beth C

    2007-05-01

    Full Text Available Abstract Background Lack of knowledge regarding preventive health services for women might impede campaigns to expand these services in the emergency department setting. For 18–55-year-old English-speaking women visiting an urban emergency department, we aimed to: (1 Ascertain their knowledge regarding the applicability, purpose, and recommended intervals of three women's cancer screening and three contraceptive methods; and (2 Determine if patient age, race/ethnicity, medical insurance status, and current or recent usage of these methods are associated with greater or lesser knowledge about them. Methods Emergency department-based survey on recent or current usage and knowledge about Pap smears, breast self-examinations, mammograms, condoms, birth control, and emergency contraception. Analyses included calculation of summary statistics and creation of multivariable logistic regression models. Results Of 1,100 patients eligible for the study, 69.9% agreed to participate. Most of the participants were Conclusion Although these female ED patients demonstrated strong knowledge on some women's cancer screening and contraceptive methods, there were several areas of knowledge deficit. Women without private medical insurance and those who have not used a particular cancer screening or contraceptive method demonstrated less knowledge. Reduced knowledge about women's cancer screening and contraceptive methods should be considered during clinical encounters and when instituting or evaluating emergency department-based initiatives that assess the need for these methods.

  11. Community Awareness of HPV Screening and Vaccination in Odisha

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    Niharika Khanna

    2015-01-01

    Full Text Available Introduction. A number of new technologies including cervical cancer screening and vaccination have introduced new tools in the fight against cervical cancer. Methods. This study was set in Odisha, India, at the Acharya Harihar Regional Cancer Center and study research infrastructure at the Asian Institute of Public Health. IRB approvals were obtained and a research assistant recruited 286 women aged 18–49 years, who provided informed consent and completed a survey tool. Data were entered into EpiData software and statistical analysis was conducted. Results. 76.3% women participants were married, 45.5% had sexual debut at age 21 or greater, 60.5% used contraception, 12.2% reported having a Pap smear in the past, and 4.9% reported having prior genital warts. Most, 68.8% had never heard of HPV and 11.9% were aware that HPV is the main cause of cervical cancer. 82.9% women thought that vaccinations prevent disease, and 74.8% said they make the decision to vaccinate their children. Conclusion. The Odisha community demonstrated a low level of knowledge about cervical cancer prevention, accepted vaccinations in the prevention of disease and screening, and identified mothers/guardians as the key family contacts.

  12. Evaluation of Antibiotic Resistance and Detection of papC and papG genes in Escherichia coli Strains Isolated from Patients with Urinary Tract Infection

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    Mitra Alishah

    2016-11-01

    Full Text Available Abstract Background and Objectives: Escherichia coli is the most common etiologic factor of urinary tract infection, which its most important virulence factor is P fimbriae. Uropathogenic E. coli expresses various types of adhesins, such as pili adhesins (pyelonephritis-associated pili, Pap that mediates binding to the surface of epithelial cells of the urinary tract. This study aims to identify papC and papG genes and to evaluate antibiotic resistance level in the isolated E. coli samples. Methods: In this descriptive cross-sectional study, 50 samples were collected from patients with urinary tract infection and after isolation of bacteria and DNA extraction, antibiotic susceptibility tests was performed by disc diffusion method using related antibiotics. Presence of papG and papC genes (class I, II, and III was assessed by multiplex PCR method. Statistical data were analyzed using descriptive t-test. Results: The isolated E. coli samples were susceptible to amikacin (100% and cefepime (72% and resistant to ampicillin (100% and nitrofurantoin (94%. Eighteen samples (32.7% had papG gene, of which 17 (30.9% samples had papGII gene and 1 sample (1.8% had papGIII gene; papGI gene was not detected in any of the samples. Conclusion: The results of the present study showed that papC and papGI genes are the most common Pap fimbriae adhesion-encoding genes in E. coli isolated from urinary tract infection. The difference between the results of this study with those of other studies is due to geographic diversity. Keywords: Escherichia coli; Adhesion pap, Disk diffusion antimicrobial tests; Multiplex polymerase chain reaction.

  13. Continuous stress-induced dopamine dysregulation augments PAP-I and PAP-II expression in melanotrophs of the pituitary gland

    Energy Technology Data Exchange (ETDEWEB)

    Konishi, Hiroyuki, E-mail: konishi@med.osaka-cu.ac.jp [Department of Anatomy and Neurobiology, Osaka City University Graduate School of Medicine, Osaka (Japan); The 21st Century COE Program ' Base to Overcome Fatigue' , Osaka City University Graduate School of Medicine, Osaka (Japan); Department of Anatomy and Neuroscience, Nagoya University, Graduate School of Medicine, Nagoya (Japan); Ogawa, Tokiko, E-mail: togawa@med.osaka-cu.ac.jp [Department of Anatomy and Neurobiology, Osaka City University Graduate School of Medicine, Osaka (Japan); The 21st Century COE Program ' Base to Overcome Fatigue' , Osaka City University Graduate School of Medicine, Osaka (Japan); Kawahara, Shinichi, E-mail: kawahara@med.osaka-cu.ac.jp [Department of Anatomy and Neurobiology, Osaka City University Graduate School of Medicine, Osaka (Japan); Matsumoto, Sakiko, E-mail: s-matsumoto@med.osaka-cu.ac.jp [Department of Anatomy and Neurobiology, Osaka City University Graduate School of Medicine, Osaka (Japan); Department of Anatomy and Neuroscience, Nagoya University, Graduate School of Medicine, Nagoya (Japan); Kiyama, Hiroshi, E-mail: kiyama@med.osaka-cu.ac.jp [Department of Anatomy and Neurobiology, Osaka City University Graduate School of Medicine, Osaka (Japan); The 21st Century COE Program ' Base to Overcome Fatigue' , Osaka City University Graduate School of Medicine, Osaka (Japan); Department of Anatomy and Neuroscience, Nagoya University, Graduate School of Medicine, Nagoya (Japan)

    2011-04-01

    Research highlights: {yields} We focused on the rat pituitary intermediate lobe (IL) under continuous stress (CS). {yields} CS induced PAP-I and PAP-II expression in melanotrophs of the IL. {yields} This gene induction was triggered by CS-related dopamine dysregulation. {yields} PAP-I and PAP-II may sustain homeostasis of the IL under CS. -- Abstract: Under continuous stress (CS) in rats, melanotrophs, the predominant cell-type in the intermediate lobe (IL) of the pituitary, are hyperactivated to secrete {alpha}-melanocyte-stimulating hormone and thereafter degenerate. Although these phenomena are drastic, the molecular mechanisms underlying the cellular changes are mostly unknown. In this study, we focused on the pancreatitis-associated protein (PAP) family members of the secretory lectins and characterized their expression in the IL of CS model rats because we had identified two members of this family as up-regulated genes in our previous microarray analysis. RT-PCR and histological studies demonstrated that prominent PAP-I and PAP-II expression was induced in melanotrophs in the early stages of CS, while another family member, PAP-III, was not expressed. We further examined the regulatory mechanisms of PAP-I and PAP-II expression and revealed that both were induced by the decreased dopamine levels in the IL under CS. Because the PAP family members are implicated in cell survival and proliferation, PAP-I and PAP-II secreted from melanotrophs may function to sustain homeostasis of the IL under CS conditions in an autocrine or a paracrine manner.

  14. Continuous stress-induced dopamine dysregulation augments PAP-I and PAP-II expression in melanotrophs of the pituitary gland

    International Nuclear Information System (INIS)

    Konishi, Hiroyuki; Ogawa, Tokiko; Kawahara, Shinichi; Matsumoto, Sakiko; Kiyama, Hiroshi

    2011-01-01

    Research highlights: → We focused on the rat pituitary intermediate lobe (IL) under continuous stress (CS). → CS induced PAP-I and PAP-II expression in melanotrophs of the IL. → This gene induction was triggered by CS-related dopamine dysregulation. → PAP-I and PAP-II may sustain homeostasis of the IL under CS. -- Abstract: Under continuous stress (CS) in rats, melanotrophs, the predominant cell-type in the intermediate lobe (IL) of the pituitary, are hyperactivated to secrete α-melanocyte-stimulating hormone and thereafter degenerate. Although these phenomena are drastic, the molecular mechanisms underlying the cellular changes are mostly unknown. In this study, we focused on the pancreatitis-associated protein (PAP) family members of the secretory lectins and characterized their expression in the IL of CS model rats because we had identified two members of this family as up-regulated genes in our previous microarray analysis. RT-PCR and histological studies demonstrated that prominent PAP-I and PAP-II expression was induced in melanotrophs in the early stages of CS, while another family member, PAP-III, was not expressed. We further examined the regulatory mechanisms of PAP-I and PAP-II expression and revealed that both were induced by the decreased dopamine levels in the IL under CS. Because the PAP family members are implicated in cell survival and proliferation, PAP-I and PAP-II secreted from melanotrophs may function to sustain homeostasis of the IL under CS conditions in an autocrine or a paracrine manner.

  15. CKI isoforms α and ε regulate Star–PAP target messages by controlling Star–PAP poly(A) polymerase activity and phosphoinositide stimulation

    Science.gov (United States)

    Laishram, Rakesh S.; Barlow, Christy A.; Anderson, Richard A.

    2011-01-01

    Star–PAP is a non-canonical, nuclear poly(A) polymerase (PAP) that is regulated by the lipid signaling molecule phosphatidylinositol 4,5 bisphosphate (PI4,5P2), and is required for the expression of a select set of mRNAs. It was previously reported that a PI4,5P2 sensitive CKI isoform, CKIα associates with and phosphorylates Star–PAP in its catalytic domain. Here, we show that the oxidative stress-induced by tBHQ treatment stimulates the CKI mediated phosphorylation of Star–PAP, which is critical for both its polyadenylation activity and stimulation by PI4,5P2. CKI activity was required for the expression and efficient 3′-end processing of its target mRNAs in vivo as well as the polyadenylation activity of Star–PAP in vitro. Specific CKI activity inhibitors (IC261 and CKI7) block in vivo Star–PAP activity, but the knockdown of CKIα did not equivalently inhibit the expression of Star–PAP targets. We show that in addition to CKIα, Star–PAP associates with another CKI isoform, CKIε in the Star–PAP complex that phosphorylates Star–PAP and complements the loss of CKIα. Knockdown of both CKI isoforms (α and ε) resulted in the loss of expression and the 3′-end processing of Star–PAP targets similar to the CKI activity inhibitors. Our results demonstrate that CKI isoforms α and ε modulate Star–PAP activity and regulates Star–PAP target messages. PMID:21729869

  16. Urothelial cells in smears from cervix uteri

    Science.gov (United States)

    Palaoro, Luis Alberto; Guerra, Fernando; Angeleri, Anabela; Palamas, Marta; Melba, Sardi-Segovia; Rocher, Adriana Esther

    2012-01-01

    Objectives: To establish the cytological criteria to identify the urothelial cells in cervical smears in order to avoid mistakes in the cytological diagnosis. Materials and Methods: Cervical smears from 34 post menopausal women with vesicovaginal fistulas, advanced bladder prolapse and genital erosive lichen planes (vulvar kraurosis) (Group 1) and transitional cell metaplasia of the cervix (TCM, Group 2) were stained with Papanicolaou technique. The cervical samples were taken during the routine annual examination for prevention of the uterine cancer. Results: The smears of cervix from Group 1 showed urothelial cells from the three layers of the transitional epithelium. The umbrella cells are the bigger ones with relatively large nuclei. Frequently, they are multinucleated with single or multiple nucleoli and a typical “frothy” cytoplasm (cytoplasmic vacuoles). The cells of the Group 2 showed nuclei with oval to spindled shapes, some tapered ends, less cytoplasm than squamous metaplastic cells, powdery chromatin, small nucleoli and nuclear grooves. Conclusions: The umbrella cells may be mistaken for dysplastic cells originating in low grade squamous intraepithelial lesions lesions (LSILs) due to their nuclear and cytoplasm sizes. Therefore, it is important to know the possibility of their appearance in the cervical smears, especially in post menopausal patients in order to avoid a false diagnosis of an intraepithelial lesion. It is unlikely that deeper cells of urothelium would be confused with high grade squamous intraepithelial lesion (HSIL) cells. However, their presence might be a reason of mistake in the diagnosis. TCM is an under-recognized metaplastic phenomenon of the cervix and vagina, which is a mimicker of high-grade squamous intraepithelial lesion. The differential characteristic between umbrella cells, cells from TCM and the deeper urothelial cells, and LSIL and HSIL are detailed in the present paper. PMID:22438615

  17. The utility of Google Trends data to examine interest in cancer screening.

    Science.gov (United States)

    Schootman, M; Toor, A; Cavazos-Rehg, P; Jeffe, D B; McQueen, A; Eberth, J; Davidson, N O

    2015-06-08

    We examined the utility of January 2004 to April 2014 Google Trends data from information searches for cancer screenings and preparations as a complement to population screening data, which are traditionally estimated through costly population-level surveys. State-level data across the USA. Persons who searched for terms related to cancer screening using Google, and persons who participated in the Behavioral Risk Factor Surveillance System (BRFSS). (1) State-level Google Trends data, providing relative search volume (RSV) data scaled to the highest search proportion per week (RSV100) for search terms over time since 2004 and across different geographical locations. (2) RSV of new screening tests, free/low-cost screening for breast and colorectal cancer, and new preparations for colonoscopy (Prepopik). (3) State-level breast, cervical, colorectal and prostate cancer screening rates. Correlations between Google Trends and BRFSS data ranged from 0.55 for ever having had a colonoscopy to 0.14 for having a Pap smear within the past 3 years. Free/low-cost mammography and colonoscopy showed higher RSV during their respective cancer awareness months. RSV for Miralax remained stable, while interest in Prepopik increased over time. RSV for lung cancer screening, virtual colonoscopy and three-dimensional mammography was low. Google Trends data provides enormous scientific possibilities, but are not a suitable substitute for, but may complement, traditional data collection and analysis about cancer screening and related interests. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Cervical cancer screening and treatment training course in El Salvador: experience and lessons learned.

    Science.gov (United States)

    Masch, Rachel; Ditzian, Lauren R; April, Ayana K; Maza, Mauricio; Peralta, Ethel; Cremer, Miriam L

    2011-09-01

    Visual inspection with acetic acid (VIA) is a simple, low-cost alternative to traditional Pap smears that could greatly benefit the amount of screening and treatment available in low-resource areas, such as rural El Salvador. The objective of this study was to train Salvadoran health providers in VIA and cryotherapy using a week-long competency course. Health providers participated in the VIA training course, which consisted of 1 half-day of didactics, followed by 4 and 1 half days of clinical training. Pretests and posttests were administered. A 1-day didactic refresher course was administered to assess the quality of services being provided. Sixty-eight nurses and physicians completed the training course. Each trainee screened approximately 120 women and performed, on average, seven cryotherapy treatments. The average trainee improved his or her score by 15% on the theoretical test and 16.7% on the image test. At the completion of the 1-day refresher, average test scores were the highest among all the courses. The final assessment was based on 41 providers. The course proved a successful tool for training healthcare providers in methods of cervical cancer screening and treatment. The course is replicable in other low-resource settings in different countries. It also provided trainees with the opportunity to adapt their clinical skills in their realistic work setting.

  19. Cancer screening promotion among medically underserved Asian American women: integration of research and practice.

    Science.gov (United States)

    Yu, Mei-yu; Seetoo, Amy D; Hong, Oi Saeng; Song, Lixin; Raizade, Rekha; Weller, Adelwisa L Agas

    2002-01-01

    Mammography and Pap smear tests are known to be effective early detection measures for breast and cervical cancers, respectively, but Asian Americans are reluctant to make visits for routine preventive care. Quantitative and qualitative research conducted by the Healthy Asian Americans Project (HAAP) between 1996 and 1999 indicated that Asian residents in southeastern Michigan, like the general Asian population in the US, underutilized early cancer screening programs due to cultural, psychosocial, linguistic, and economic barriers. This article reports how the HAAP's research findings guided the Michigan Breast and Cervical Cancer Control Program (BCCCP) promotion (conducted from 2000 to 2001 among medically underserved Asian women residing in southeastern Michigan), and how evaluation of the HAAP's BCCCP promotion will direct future research and health promotion programs. The article presents strategies used to improve access to cancer screening programs for diverse Asian sub-groups as well as outcomes of the 2-year HAAP's BCCCP promotion among the target population. Discussion regarding lessons and experiences gained from integration of research and practice has implications on design and implementation of the cancer screening promotion for the rapidly increasing Asian American population as well as other medically underserved minority populations in the US.

  20. Cytological diagnosis of basal cell carcinoma and actinic keratosis, using Papanicolaou and May-Grünwald-Giemsa stained cutaneous tissue smear.

    Science.gov (United States)

    Christensen, E; Bofin, A; Gudmundsdóttir, I; Skogvoll, E

    2008-10-01

    Cytology may become the diagnostic method of choice with the advent of new non-invasive treatments for non-melanoma skin cancer, as the sampling technique for cytology entails little tissue disfiguration. The aim of this study was to compare and evaluate the diagnostic performance of scrape cytology using two different cytological staining techniques, and to evaluate additional touch imprint cytology, with that of histopathology of basal cell carcinoma (BCC) and actinic keratosis (AK). We investigated 50 BCC and 28 AK histologically verified lesions, from 41 and 25 patients, respectively. Two separate skin scrape samples and one touch imprint sample were taken from each lesion. The smears were stained with Papanicolaou (Pap) or May-Grünwald-Giemsa (MGG) stains. All cytological specimens were examined in random order by pathologists without knowledge of the histology. Cytodiagnostic results were compared with the histopathological report. Scrape cytodiagnosis agreed with histopathology in 48 (Pap) and 47 (MGG) of the 50 BCC cases, and in 26 of 28 (Pap) and 21 of 26 (MGG) AK cases, yielding sensitivities of 96%, 94%, 93% and 81%, respectively. No significant difference in sensitivity between the two staining methods was found but a trend towards higher Pap sensitivity for AK was noted (P = 0.10). Touch imprint cytology confirmed histopathology in 38 of the 77 cases of BCC and AK. Cytological diagnosis with either Pap or MGG stain for BCC and AK is reliable, and differentiates well between BCC and AK. Imprint cytology proved to be non-diagnostic in half of the examined cases.

  1. Cytomorphology of unusual infectious entities in the Pap test

    Directory of Open Access Journals (Sweden)

    Walid E Khalbuss

    2012-01-01

    Full Text Available Rare entities in the Pap test, including neoplastic and non-neoplastic conditions, pose challenges due to their infrequent occurrence in the daily practice of cytology. Furthermore, these conditions give rise to important diagnostic pitfalls. Infections such as tuberculosis cervicitis may be erroneously diagnosed as carcinoma, whereas others, such as schistosomiasis, are associated with squamous cell carcinoma. These cases include granuloma inguinale (donovanosis, tuberculosis, coccidioidomycosis, schistosomiasis, taeniasis, and molluscum contagiosum diagnosed in Pap tests. Granuloma inguinale shows histiocytes that contain intracytoplasmic bacteria (Donovan bodies. Tuberculosis is characterized by necrotizing granulomatous inflammation with Langhans-multinucleated giant cells. Coccidioidomycosis may show large intact or ruptured fungal spherules associated with endospores. Schistosoma haematobium is diagnosed by finding characteristic ova with a terminal spine. Molluscum contagiosum is characterized by the appearance of squamous cells with molluscum bodies. This article reviews the cytomorphology of selected rare infections and focuses on their cytomorphology, differential diagnosis, and role of ancillary diagnostic studies.

  2. Papéis de imprimir e escrever

    OpenAIRE

    Mattos, René Luiz Grion; Valença, Antonio Carlos de Vasconcelos

    2001-01-01

    Este trabalho analisa o comportamento recente da produção, do consumo e da comercialização de papéis de imprimir e escrever no Brasil e no mundo. Em sua parte final mostra as perspectivas de curto prazo do mercado mundial e do Brasil, que apontam para a necessidade de implantação de duas grandes novas máquinas produtoras de papel de imprimir e escrever.

  3. Smears for determinations surface unfixed tritium contamination

    International Nuclear Information System (INIS)

    Postolache, Cristian; Matei, Lidia

    2003-01-01

    The present paper describes a method of obtaining expanded polystyrene with hydrophilized surface smears by radioinduced grafting of acrylic acid. The grafting was carried out by using a 60 Co γ radiation source. The variation of grafting rates as a function of dose range and absorbed dose was established. Grafting radiochemical rates were determined by radiometric methods using acrylic acid labeled with tritium as a grafting agent. The sampling coefficients and the reproducibility were analyzed as a function of the nature of the contaminated surface. (authors)

  4. Social Representations of Gynecologic Cancer Screening Assessment a Qualitative research on Ecuadorian women.

    Science.gov (United States)

    Godoy, Yolanda; Godoy, Clara; Reyes, Juan

    2016-06-01

    The purpose of this work was to explore: knowledge, attitudes, and beliefs regarding gynecologic cancer screening on Ecuadorian women users of primary care facilities, to identify the social representations that users of health services make about these programs and their influence on the decision to undergo a screening. An exploratory and qualitative research design was held using focus groups and in-depth interviews for data collection. A narrative content analysis of the results was conducted. Women's knowledge on gynecological cancer screening was confusing. Most frequent misconceptions related to the pap smear were: the belief that it could be useful for detecting pregnancy, ovarian cysts or infections. Most of the participants stated that the pap smear procedure is a traumatic and painful experience. Regarding to mammography women said it was used for sick woman and this procedure by itself may cause cancer. El propósito de esta investigación fue explorar los conocimientos, actitudes y creencias respecto a los programas de detección del cáncer ginecológico entre usuarias de centros de atención primaria de salud para identificar las representaciones sociales que las usuarias de los servicios de salud elaboran acerca de estos programas y de los diferentes procedimientos que comprenden. El diseño de la investigación fue exploratorio y cualitativo, mediante grupos focales y entrevistas a profundidad, con el respectivo análisis narrativo e interpretativo del contenido. Se encontró conocimiento confuso acerca de los programas de tamizaje de cáncer ginecológico y dificultades asociadas a la realización de los procedimientos. Los significados más frecuentes acerca de los programas fueron: el uso de la citología cérvico-vaginal para detectar embarazo, quistes ováricos o infecciones. La mayoría de los participantes asociaba este procedimiento con una experiencia dolorosa y traumática. Respecto al autoexamen de mamas, lo calificaron como un masaje

  5. Design and preliminary analysis of a vaginal inserter for speculum-free cervical cancer screening.

    Directory of Open Access Journals (Sweden)

    Mercy Nyamewaa Asiedu

    .3% overall preference for the inserter over the speculum and all indicated that the inserter was more comfortable than the speculum. The inserter provides a platform for self-cervical cancer screening and also enables acetic acid/Lugol's iodine application and insertion of swabs for Pap smear sample collection.This study demonstrates the feasibility of an inserter and miniature-imaging device for comfortable cervical image capture of women with potential for synergistic HPV and Pap smear sample collection.

  6. C ERVICAL CANCER SCREENING: KNOWLEDGE, ATTITUDE AND PRACTICES IN A PRIMARY HEALTH CENTRE S IN RURAL INDIA

    Directory of Open Access Journals (Sweden)

    Dhivya

    2015-07-01

    Full Text Available BACKGROUND & OBJECTIVES: Cervical cancer is the most common preventable cancer noted in Indian women , having a major impact on their lives. Approximately , 70% of people reside in villages in India. Hence, the objectives of this study were to find the knowledge of women regarding cervical cancer, to determine attitude and practices towards screening. METHODS : A cross - sectional study was conducted in Primary Health Centre , Periapodu, Tamil Nadu, India between January 2015 and May 2015 where 1670 participants between the ages of 21 - 65 years were randomly chosen by selecting every 3 rd woman attending the PHC for any reason. After exclusion, 1200 participants were included in the study. RESULTS : Mean age of the study population was 45.3 years. An awa reness of 75.42% was noted for cervical cancer, 43.25% for Human Papillomavirus and 32.42% that it was vaccine preventable, the major source of information being Healthcare Providers (70%. Despite 50.58% thinking that they were at risk of cervical cancer, only 31% had undergone a pap smear. However, 69.96% of the unscreened population were ready to undergo screening. Independent predictors for doing Pap test included age >35, higher parity, literacy and adequate knowledge of cervical cancer screening ( P <0. 05. CONCLUSION: This study shows a low level of knowledge, attitude and practice on cervical cancer among women in rural India. Increasing women’s awareness would be a first step in the long chain of conditions to attain a lower incidence and mortality

  7. Tuberculosis treatment among smear positive tuberculosis patients

    International Nuclear Information System (INIS)

    Munir, M.K.; Iqbal, R.; Shabbir, I.; Chaudhry, K

    2012-01-01

    Tuberculosis is a major health problem in many parts of the world. Delay in initiation of the treatment may result in prolonged infectious state, drug resistance, relapse and death. Objectives: To determine the factors responsible for not starting tuberculosis treatment among smear positive tuberculosis patients. Study type, settings and duration: This cross sectional study was done at Pakistan Medical Research Council TB Research Center, King Edward Medical University, Lahore, from fifth March 2010 to fifth December 2010. Patients and Methods: Fifty sputum smear positive patients of tuberculosis who did not register themselves in treatment register and presumably did not initiate anti tuberculosis treatment were contacted using telephone or traced by their home addresses. Once contact was established, they were inquired about the reasons for not starting tuberculosis treatment. Results: Of 50 patients 38(76%)belonged to the lower socio economic class and 12(24%) to the lower middle class. Fourteen patients (28%) were illiterate and 23(46%) had only 8 years of education. Of the 50 cases 41(82%) were taking treatment from traditional healers and 4% did not go back to the DOTS program. Physical condition of the patient, social, domestic and religious issues also played some role in default. Conclusions: Lack of health education and poverty were the main factors responsible for non compliance from treatment. Policy message: Sputum testing sites should have a paramedic who should educate the patients about the benefits of treatment and the dangers of default or partial treatment. (author)

  8. Efficacy of interventions to increase the uptake of chlamydia screening in primary care: a systematic review

    Directory of Open Access Journals (Sweden)

    Donovan Basil

    2011-08-01

    Full Text Available Abstract Background As most genital chlamydia infections are asymptomatic, screening is the main way to detect and cases for treatment. We undertook a systematic review of studies assessing the efficacy of interventions for increasing the uptake of chlamydia screening in primary care. Methods We reviewed studies which compared chlamydia screening in the presence and the absence of an intervention. The primary endpoints were screening rate or total tests. Results We identified 16 intervention strategies; 11 were randomised controlled trials and five observational studies, 10 targeted females only, five both males and females, and one males only. Of the 15 interventions among females, six were associated with significant increases in screening rates at the 0.05 level including a multifaceted quality improvement program that involved provision of a urine jar to patients at registration (44% in intervention clinics vs. 16% in the control clinic; linking screening to routine Pap smears (6.9% vs. 4.5%, computer alerts for doctors (12.2% vs. 10.6%; education workshops for clinic staff; internet-based continuing medical education (15.5% vs. 12.4%; and free sexual health consultations (16.8% vs. 13.2%. Of the six interventions targeting males, two found significant increases including the multifaceted quality improvement program in which urine jars were provided to patients at registration (45% vs. 15%; and the offering by doctors of a test to all presenting young male clients, prior to consultation (29 vs. 4%. Conclusions Interventions that promoted the universal offer of a chlamydia test in young people had the greatest impact on increasing screening in primary care.

  9. Attitudes to Chlamydia screening elicited using the social networking site Facebook for subject recruitment.

    Science.gov (United States)

    Ahmed, Navera; Jayasinghe, Yasmin; Wark, John D; Fenner, Yeshe; Moore, Elya E; Tabrizi, Sepehr N; Fletcher, Ashley; Garland, Suzanne M

    2013-07-01

    Chlamydia (Chlamydia trachomatis) is the commonest bacterial sexually transmissible infection worldwide and contributes to significant morbidity in females. We examined potential barriers and facilitating factors for screening in young Victorian women, using the social networking site, Facebook to recruit participants. This was part of a larger study on young women's health that assessed the feasibility of using social networking sites for recruitment. An advertisement was placed on Facebook between May and September 2010, and was visible to eligible women. Women who clicked on the advertisement and expressed their interest in participating were invited to complete a questionnaire either at a study site or online. In total, 278 participants completed the survey, with 76% reporting willingness to participate in chlamydia screening by recruitment via an online system. Overall, 73% of participants indicated they were comfortable providing a urine sample collected at home for chlamydia screening, with older participants less comfortable with this method (P=0.02, odds ratio (OR)=0.09, 95% confidence interval (CI)=0.01-0.7). Participants expressed comfort with their Pap smear and chlamydia screening being performed together (92.7%), especially those who were aware of human papillomavirus (P<0.01, OR=2.5, 95% CI=1.3-4.7). This study demonstrated willingness by young Victorian women using Facebook to participate in screening for chlamydia. There was strong acceptance of self-collected sampling, and of combined chlamydia and cervical cytology screening. Facebook may therefore be a feasible way for improving screening coverage at a population level.

  10. Diagnosing pre-invasive cervical lesions – experience with pap ...

    African Journals Online (AJOL)

    58.1%), vaginal discharge (20.3%), postcoital bleeding (12.0%) and postmenopausal bleeding 43 (7.6%). Of the total smears reported, epithelial abnormalities seen include low grade SIL 30 (5.3%) and high grade SIL 9 (1.6%) respectively.

  11. Significance of a diagnosis of atypical squamous cells of undetermined significance for Papanicolaou smears in perimenopausal and postmenopausal women.

    Science.gov (United States)

    Keating, J T; Wang, H H

    2001-04-25

    The current study was conducted to determine the significance of a diagnosis of atypical squamous cells of undetermined significance (ASCUS) in perimenopausal and postmenopausal women. The reports for all Papanicolaou (Pap) smears viewed in the study institution's cytology laboratory over a 6-month period were reviewed. Women were divided into premenopausal (age ages 46-54 years), and postmenopausal (age > or = 55 years) categories. Slide review and 2-year follow-up were obtained for selected cases diagnosed as ASCUS. ASCUS cases among the perimenopausal women were compared with an age-matched control group. The total number of abnormal Pap smears in the premenopausal, perimenopausal, and postmenopausal categories were 770 (6.8%), 104 (4.3%), and 67 (2.9%), with 482, 83, and 41 diagnoses of ASCUS, respectively. The ratio of ASCUS to squamous intraepithelial lesions (SIL) was 2.2 overall and 1.9, 7.5, and 4.1, respectively, for each group (P ASCUS cases appeared to have a higher percentage of nuclear-cytoplasmic ratio increase and nuclear membrane irregularities compared with the other categories (P = 0.03 and P = 0.02, respectively) and the perimenopausal group was found to have more ASCUS in metaplastic cells (P = 0.03). In perimenopausal women, slides diagnosed as ASCUS demonstrated more air-drying artifact than the control group (P = 0.004) but had less obvious atrophy (P = 0.01). Despite a decreased abnormality rate with increasing age, the results of the current study show that the perimenopausal and postmenopausal groups appear to have elevated ASCUS-to-SIL ratios. ASCUS appears to have a particularly low positive predictive value for SIL in perimenopausal women, and therefore most likely is overcalled in this age group. This may be attributable in part to air-drying artifact and subtle atrophic changes.

  12. Tuberculosis risk factors in children with smear-positive tuberculosis adult as household contact

    Directory of Open Access Journals (Sweden)

    Nora Hajarsjah

    2018-04-01

    Full Text Available Background Children in household contact of adults with smear-positive tuberculosis (TB are at higher risk of TB infection. Screening of these children is a main strategy for eliminating childhood TB. Objective To determine risk factors of TB among children in household contact with smear-positive adult TB patients. Methods This case-control study was conducted in 5 public health centers at Batu Bara District, North Sumatera. We studied children from birth to 18 year-old living in the same house as adults with smear-positive TB. A tuberculosis scoring system was used to diagnosis TB in the children. Associations between risk factors and the incidence of TB were analyzed using Chi-square, Mann-Whitney U, and logistic regression tests. Results We enrolled 145 children who had household contact with smear-positive adult TB patients. Subjects were allocated to either the case group [TB score >6; 61 subjects (42.0%] or the control group [TB score <6; 84 subjects (58.0%]. Bivariate analysis revealed that nutritional status, immunization status, number of people in the house, sleeping in the same bed, and duration of household contact had significant associations with the incidence of TB. By multivariate logistic regression analysis, nutritional status and duration of household contact were significant risk factors for TB, with OR 5.89 and 8.91, respectively. Conclusion Malnutrition and duration of household contact with smear-positive adult TB patients of more than 6 hours per day were risk factors for TB among children.

  13. Family and cultural influences on cervical cancer screening among immigrant Latinas in Miami-Dade County, USA.

    Science.gov (United States)

    Madhivanan, Purnima; Valderrama, Diana; Krupp, Karl; Ibanez, Gladys

    2016-01-01

    Cervical cancer disproportionately affects minorities, immigrants and low-income women in the USA, with disparities greatest among Latino immigrants. We examined barriers and facilitators to cervical cancer screening practices among a group of immigrant Latino women in Florida, USA. Between January and May 2013, six focus group discussions, involving 35 participants, were conducted among Hispanic women in Miami to explore their knowledge, beliefs about cervical cancer and facilitators and barriers to cervical cancer screening using a theoretical framework. The data showed that family support, especially from female relatives, was an important facilitator of screening and treatment. Women, however, reported prioritising family health over their own, and some expressed fatalistic beliefs about cancer. Major obstacles to receiving a Pap smear included fear that it might result in removal of the uterus, discomfort about being seen by a male doctor and concern that testing might stigmatise them as being sexually promiscuous or having a sexually transmitted disease. Targeted education on cancer and prevention is critically needed in this population. Efforts should focus on women of all ages since younger women often turn to older female relatives for advice.

  14. Adolescents with obstructive sleep apnea adhere poorly to positive airway pressure (PAP, but PAP users show improved attention and school performance.

    Directory of Open Access Journals (Sweden)

    Dean W Beebe

    2011-03-01

    Full Text Available Obstructive Sleep Apnea (OSA is associated with medical and neurobehavioral morbidity across the lifespan. Positive airway pressure (PAP treatment has demonstrated efficacy in treating OSA and has been shown to improve daytime functioning in adults, but treatment adherence can be problematic. There are nearly no published studies examining functional outcomes such as academic functioning in adolescents treated with PAP. This study was conducted as an initial step towards determining whether PAP treatment improves daytime functioning among adolescents with OSA.Self-reported academic grades, self- and parent-reported academic quality of life, and objectively-measured attention were assessed before and after PAP was clinically initiated in a sample of 13 obese adolescents with OSA, as well as 15 untreated obese Controls without OSA. Based on adherence data, the treated group was divided into PAP Users (n = 6 and Non-Adherent participants (n = 7.Though demographically similar, the three groups significantly differed in how their academic performance and attention scores changed from baseline to follow-up. Non-Adherent participants showed worsening functioning over time, while PAP Users showed stable or improved functioning, similar to controls.Although many adolescents prescribed PAP for OSA are non-adherent to the treatment, those who adhere to treatment can display improved attention and academic functioning.

  15. A comparison of cervical smear adequacy using either the cytobrush ...

    African Journals Online (AJOL)

    A comparison of cervical smear adequacy using either the cytobrush or the Ayre spatula: a practice audit. ... The purpose of this study was to compare the adequacy of cervical smears taken with the Ayre spatula as opposed to the cytobrush. Methods: This was a retrospective analytical study. One sampler, an experienced ...

  16. Effects of Different Temperatures for Drying Cervical Mucus Smear ...

    African Journals Online (AJOL)

    The effects of different room temperatures for drying cervical mucus on crystallisation of fern-tree patterns was determined using cervical mucus smears from 60 women undergoing investigation for infertility at the University of Benin Teaching Hospital. Cervical mucus smears were dried in the oven at 15, 20, 25, 30 and 35C ...

  17. Proposal to institutionalize criteria and quality standards for cervical cancer screening within a health care system

    Directory of Open Access Journals (Sweden)

    Salmerón-Castro Jorge

    1998-01-01

    Full Text Available The uterine cervix is the most common cancer site for females. Approximately 52,000 new cases occur annually in Latin America, thus the need to improve efficiency and effectiveness of Cervical Cancer Screening Programs (CCSP is mandatory to decrease the unnecessary suffering women must bear. This paper is addressing essential issues to revamp the CCSP as proposed by the Mexican official norm. A general framework for institutionaling CCSP is outlined. Furthermore, strategies to strengthen CCSP performance through managerial strategies and quality assurance activities are described. The focus is on the following activities: 1 improving coverage; 2 implementing smear-taking quality control; 3 improving quality in interpretation of Pap test; 4 guaranteeing treatment for women for whom abnormalities are detected; 5 improving follow-up; 6 development of quality control measures and 7 development of monitoring and epidemiological surveillance information systems. Changes within the screening on cervical cancer may be advocated as new technologies present themselves and shortcomings in the existing program appear. It is crucial that these changes should be measured through careful evaluation in order to tally up potential benefits.

  18. Crystal structure of the P pilus rod subunit PapA.

    Directory of Open Access Journals (Sweden)

    Denis Verger

    2007-05-01

    Full Text Available P pili are important adhesive fibres involved in kidney infection by uropathogenic Escherichia coli strains. P pili are assembled by the conserved chaperone-usher pathway, which involves the PapD chaperone and the PapC usher. During pilus assembly, subunits are incorporated into the growing fiber via the donor-strand exchange (DSE mechanism, whereby the chaperone's G1 beta-strand that complements the incomplete immunoglobulin-fold of each subunit is displaced by the N-terminal extension (Nte of an incoming subunit. P pili comprise a helical rod, a tip fibrillum, and an adhesin at the distal end. PapA is the rod subunit and is assembled into a superhelical right-handed structure. Here, we have solved the structure of a ternary complex of PapD bound to PapA through donor-strand complementation, itself bound to another PapA subunit through DSE. This structure provides insight into the structural basis of the DSE reaction involving this important pilus subunit. Using gel filtration chromatography and electron microscopy on a number of PapA Nte mutants, we establish that PapA differs in its mode of assembly compared with other Pap subunits, involving a much larger Nte that encompasses not only the DSE region of the Nte but also the region N-terminal to it.

  19. Entirely saturated unilateral smear of laser spot in CCD

    International Nuclear Information System (INIS)

    Zhang Zhen; Zhou Menglian; Zhang Jianmin; Lin Xinwei

    2013-01-01

    In the video of linear CCD camera being irradiated by 532 nm CW laser, the entirely saturated unilateral smear of laser spot was found. The smear area does not represent the distribution of laser. Since this smear lies merely in one side of laser spot, it can not be induced by light leaking or carriers blooming, and it may be induced by charge transfer loss. However, the feature that the smear area is entirely saturated can not be explained by the current constant model of charge transfer inefficiency. Based on the inner structure and operating principle of buried channel CCD, a new model of charge transfer inefficiency that varies with charge quantity is proposed, which can explain the entirely saturated unilateral smear of laser spot. (authors)

  20. Automated segmentation and isolation of touching cell nuclei in cytopathology smear images of pleural effusion using distance transform watershed method

    Science.gov (United States)

    Win, Khin Yadanar; Choomchuay, Somsak; Hamamoto, Kazuhiko

    2017-06-01

    The automated segmentation of cell nuclei is an essential stage in the quantitative image analysis of cell nuclei extracted from smear cytology images of pleural fluid. Cell nuclei can indicate cancer as the characteristics of cell nuclei are associated with cells proliferation and malignancy in term of size, shape and the stained color. Nevertheless, automatic nuclei segmentation has remained challenging due to the artifacts caused by slide preparation, nuclei heterogeneity such as the poor contrast, inconsistent stained color, the cells variation, and cells overlapping. In this paper, we proposed a watershed-based method that is capable to segment the nuclei of the variety of cells from cytology pleural fluid smear images. Firstly, the original image is preprocessed by converting into the grayscale image and enhancing by adjusting and equalizing the intensity using histogram equalization. Next, the cell nuclei are segmented using OTSU thresholding as the binary image. The undesirable artifacts are eliminated using morphological operations. Finally, the distance transform based watershed method is applied to isolate the touching and overlapping cell nuclei. The proposed method is tested with 25 Papanicolaou (Pap) stained pleural fluid images. The accuracy of our proposed method is 92%. The method is relatively simple, and the results are very promising.

  1. Smear grading and the Mantoux skin test can be used to predict sputum smear conversion in patients suffering from tuberculosis

    Directory of Open Access Journals (Sweden)

    Saffari, Mahmood

    2017-08-01

    Full Text Available Purpose: Smear scores and induration sizes resulting from the PPD (tuberculin purified protein derivative test can serve as indicators of whether a patient suffering from tuberculosis shows smear conversion or not. Methods: Using microbiological methods smear and sputum tests, patients diagnosed as infected with between 2002 and 2015 were included in this study. All of the assumed factors that may have a role in smear conversion were studied, in addition to the prolongation of tuberculosis. Results: 398 of 512 patients fulfilled all the inclusion criteria and formed the basis of this study. 215 patients (54% were females and 183 (46% were males. The median age for both men and women was 36 years. We found a statistically significant difference between the size of induration resulting from the PPD skin test and the rate of non-conversion (=0.002. Further univariate analysis also showed that smear grading and an induration size of ≥10 mm were independently associated with delayed smear conversion. Patients with cavitary lesions showed a higher rate of non-conversion after two months, which was not significant. We could not find any association between some of the variables, such as age, sex, weight, smoking, alcoholism, addictions, respiratory diseases, diabetes mellitus, alternative anti-TB treatment, and smear conversion. Conclusion: Intensified treatment and precautions against transmission should be especially considered for TB patients with high smear grading and an induration size of more than 10 mm.

  2. The comparative and cost-effectiveness of HPV-based cervical cancer screening algorithms in El Salvador.

    Science.gov (United States)

    Campos, Nicole G; Maza, Mauricio; Alfaro, Karla; Gage, Julia C; Castle, Philip E; Felix, Juan C; Cremer, Miriam L; Kim, Jane J

    2015-08-15

    Cervical cancer is the leading cause of cancer death among women in El Salvador. Utilizing data from the Cervical Cancer Prevention in El Salvador (CAPE) demonstration project, we assessed the health and economic impact of HPV-based screening and two different algorithms for the management of women who test HPV-positive, relative to existing Pap-based screening. We calibrated a mathematical model of cervical cancer to epidemiologic data from El Salvador and compared three screening algorithms for women aged 30-65 years: (i) HPV screening every 5 years followed by referral to colposcopy for HPV-positive women (Colposcopy Management [CM]); (ii) HPV screening every 5 years followed by treatment with cryotherapy for eligible HPV-positive women (Screen and Treat [ST]); and (iii) Pap screening every 2 years followed by referral to colposcopy for Pap-positive women (Pap). Potential harms and complications associated with overtreatment were not assessed. Under base case assumptions of 65% screening coverage, HPV-based screening was more effective than Pap, reducing cancer risk by ∼ 60% (Pap: 50%). ST was the least costly strategy, and cost $2,040 per year of life saved. ST remained the most attractive strategy as visit compliance, costs, coverage, and test performance were varied. We conclude that a screen-and-treat algorithm within an HPV-based screening program is very cost-effective in El Salvador, with a cost-effectiveness ratio below per capita GDP. © 2015 UICC.

  3. Disparities in vaccinations and cancer screening among U.S.- and foreign-born Arab and European American non-Hispanic White women.

    Science.gov (United States)

    Dallo, Florence J; Kindratt, Tiffany B

    2015-01-01

    Disparities in vaccinations and cancer screening exist when comparing foreign-born and U.S.-born women collectively and disaggregated by race and ethnicity. The purpose of this study was to estimate and compare the age-adjusted prevalence of not receiving a flu or pneumonia vaccine, clinical breast examination, mammogram or Pap smear among U.S.- and foreign-born White women by region of birth and examine associations while controlling for potential confounders. We pooled 12 years of National Health Interview Survey data (n = 117,893). To approximate an "Arab-American" ethnicity, we identified 15 "Arab" countries from the Middle East region that comprise the Arab Nations. Data was requested from the National Center for Health Statistics Research Data Center. We used the χ(2) statistic to compare descriptive statistics and odds ratios (ORs) with 95% CIs were used for inferential statistics. Compared to U.S.-born, foreign-born Whites from the Arab Nations had higher estimates of not receiving recommended vaccinations and cancer screenings. In crude and adjusted analyses, foreign-born Arab-American women were less likely to report receiving a flu vaccine (OR, 0.34; 95% CI, 0.21-0.58), pneumonia vaccine (OR, 0.14; 95% CI, 0.06-0.32), Pap smear (OR, 0.13; 95% CI, 0.05-0.31), or clinical breast examination (OR, 0.16; 95% CI, 0.07-0.37) compared with U.S.-born White women. There were no differences for mammography. This national study examining uptake of flu and pneumonia vaccines and preventive cancer screenings suggests that estimates are lower for foreign-born Arab-American women compared with U.S.-born White women. Future studies should collect qualitative data that assess the cultural context surrounding prevention and screening behaviors among Arab-American women. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  4. [Cervical cancer screening: past--present--future].

    Science.gov (United States)

    Breitenecker, G

    2009-12-01

    in combination with cytology. Various models and approaches are in the testing phase and appear promising. HPV testing is on the other hand well accepted and recommended as a triage test to select women with equivocal smear results (Pap group III, ASCUS) if a biopsy is required or can be followed up and also for follow-up of patients after cone biopsy. However, vaccination of young girls against oncogenic HPV types which has now become widespread still leaves many questions open for the future because the observation period is too short. There is justified hope that this will become a valuable tool in cervical cancer control and may lead to a substantial reduction in the burden of cervical cancer in the future. However, as the current vaccines on the market do not cover all oncogenic virus types and the effects of vaccination will only be observed after many years, the necessity of a cytological screening will remain unrestricted. Therefore, cervical cytology will remain as the trusted, simple to use, economic and proven, like no other method for early cancer detection, efficient procedure even in the foreseeable future. If carried out with the highest quality demands it will play a central role in the early detection of cervical cancer.

  5. [Cloning and sequencing of the papA gene from uropathogenic Escherichia coli 4030 strain].

    Science.gov (United States)

    Wu, Qinggang; Zhang, Jingping; Zhao, Chuncheng; Zhu, Jianguo

    2008-09-01

    Cloning and sequencing of the papA gene from uropathogenic Escherichia coli 4030 strain to investigate the differences of the sequences of the papA of UPEC4030 strain and the ones of related genes, in order to make whether or not it was a new genotype. Cloning and sequencing methods were used to analyze the sequence of the papA of UPEC4030 strain in comparison with related sequences. The sequence analysis of papA revealed a 722 bp gene and encode 192 amino acid polypeptide. The overall homology of the papA genes between UPEC4030 and the standard strains of ten F types were 36.11%-77.95% and 22.20%-78.34% at nucleotide and deduced amino acid levels. The homology between the sequence of the reverse primers and the corresponding sequence of UPEC4030 papA was 10%-66.67%. The results confirmed that UPEC4030 strain contained a novel papA variant. UPEC4030 strain could contain an unknown papA variant or the novel genotype. The pathogenic mechanism and epidemiology related need to be further studied.

  6. Roles of phagocytosis activating protein (PAP) in Aeromonas hydrophila infected Cyprinus carpio.

    Science.gov (United States)

    Wonglapsuwan, Monwadee; Kongmee, Pataraporn; Suanyuk, Naraid; Chotigeat, Wilaiwan

    2016-06-01

    Cyprinus carpio (koi) is one of the most popular ornamental fish. A major problem for C. carpio farming is bacterial infections especially by Aeromonas hydrophila. Previously studies had shown that the Phagocytosis Activating Protein (PAP) gene was involved in the innate immune response of animals. Therefore, we attempted to identify a role for the PAP gene in the immunology of C. carpio. The expression of the PAP was found in C. carpio whole blood and increased when the fish were stimulated by inactivated A. hydrophila. In addition, PAP-phMGFP DNA was injected as an immunostimulant. The survival rate and the phagocytic index were significantly increased in the A. hydrophila infected fish that received the PAP-phMGFP DNA immunostimulant. A chitosan-PAP-phMGFP nanoparticle was then developed and feeded into fish which infected with A. hydrophila. These fish had a significantly lower mortality rate than the control. Therefore, this research confirmed a key role for PAP in protection fish from bacterial infection and the chitosan-PAP-phMGFP nanoparticle could be a good prototype for fish immunostimulant in the future. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. The clinical value of serum PSA and PAP determinations in prostate cancer patients

    International Nuclear Information System (INIS)

    Zeng Lei; Yu Renbo; Du Guowei; Pang Baozhong

    2001-01-01

    Objective: To investigate the clinical value of serum PSA and PAP determinations in diagnosis of prostate cancer patients. Methods: The serum PSA and PAP levels of 98 prostate cancer patients, 45 prostate benign disease patients and 40 normal subjects were tested by IRMA. Results: The serum PSA and PAP levels of prostate cancer patients were significantly higher than those in prostate benign disease patients and normal controls (P < 0.01). The diagnostic sensitivity and specificity of serum PSA for prostate cancer were 93.9% and 93.3% respectively. The diagnostic sensitivity and specificity of serum PAP for prostate cancer were 71.4% and 91.1% respectively. Conclusion: The determination of serum PSA and PAP was of high clinical value for diagnosis of early prostate cancer. It could be used as an important reference parameter for the clinical staging, follow-up of treatment result and prediction of prognosis

  8. Species identification of processed animal proteins (PAPs) in animal feed containing feed materials from animal origin.

    Science.gov (United States)

    Axmann, Sonja; Adler, Andreas; Brandstettner, Agnes Josephine; Spadinger, Gabriela; Weiss, Roland; Strnad, Irmengard

    2015-01-01

    Since June 2013 the total feed ban of processed animal proteins (PAPs) was partially lifted. Now it is possible to mix fish feed with PAPs from non-ruminants (pig and poultry). To guarantee that fish feed, which contains non-ruminant PAPs, is free of ruminant PAPs, it has to be analysed with a ruminant PCR assay to comply with the total ban of feeding PAPs from ruminants. However, PCR analysis cannot distinguish between ruminant DNA, which originates from proteins such as muscle and bones, and ruminant DNA, which comes from feed materials of animal origin such as milk products or fat. Thus, there is the risk of obtaining positive ruminant PCR signals based on these materials. The paper describes the development of the combination of two analysis methods, micro-dissection and PCR, to eliminate the problem of 'false-positive' PCR signals. With micro-dissection, single particles can be isolated and subsequently analysed with PCR.

  9. First experiences with commercial RIA kits for prostatic acid phosphatase (PAP)

    Energy Technology Data Exchange (ETDEWEB)

    Boettger, I; Langhammer, H; Pabst, H W; Sintermann, R

    1980-06-01

    Five commercial PAP RIA kits were intercompared by common RIA quality control criteria. All RIAs performed basically well although some differences existed in respect to concentration range, specific and non-specific binding, 50%-intercept, sensitivity and measurements of serum PAP in male and female controls. The latter finding may have been due to differences in antigen purity, antiserum specificity and composition of the assay medium employed. Good correlation was found between PAP determination by RIA and by enzyme assay. First measurements of PAP in patients treated for prostatic carcinoma being performed for orientation purposes are demonstrated. The PAP RIA has been introduced into our routine diagnostic and follow-up of prostatic carcinoma.

  10. Comparison of Chest X-Ray Findings of Smear Positive and Smear Negative Patients with Pulmonary Tuberculosis

    International Nuclear Information System (INIS)

    Ebrahimzadeh, Azadeh; Mohammadifard, Mahyar; Naseh, Godratallah

    2014-01-01

    Tuberculosis is a chronic pulmonary infectious disease that has affected one-third of the people in the world. It causes nine million new cases and two million deaths per year. Chest radiography associated with Ziehl-Neelsen acid-fast staining procedure significantly helps the diagnosis of pulmonary tuberculosis (PTB). Chest radiography can help the diagnosis of tuberculosis in patients with a negative smear sample result that is mainly diagnosed with delay. In this study, chest X-ray findings of PTB were compared in two groups of smear positive and smear negative patients. In this retrospective descriptive-analytical study, 376 patients who had been confirmed with PTB were referred to Birjand Health Care Center from 2001 to 2006. Out of the 376 patients, 100 patients with a positive smear based on WHO criteria were selected. In addition, among negative smear patients, 100 were selected in whom similar demographic characteristics with positive smear patients were seen. All of them had undergone chest radiographies that were then interpreted by two expert radiologists independently. Moreover, all patients’ sputa were examined by an expert laboratory technician at the reference laboratory of the health center. The obtained data were analyzed by means of frequency distribution table and descriptive statistics using SPSS (version 15) and Chi-square statistical test. Except reticulo-nodular infiltration, the relative frequency of other radiographic findings in positive smear patients were more than negative smear patients; and only differences in calcification variables, mediastinal widening, patchy infiltration and hilar adenopathy were statistically significant (P < 0.05). Based on the results of this study, although radiographic findings are not diagnostic in PTB, they are helpful if the assessment associates with the view of clinical manifestations and sputum smears

  11. Cervical cancer screening and Chinese women: Insights from focus groups

    Directory of Open Access Journals (Sweden)

    Sabrina Chia Hsuan Chang

    2013-02-01

    Full Text Available Objective: Despite extensive efforts to raise awareness, Papanicolaou (Pap testing rates among Chinese women living in North America remain low compared with Euro-American women. Although the lower Pap testing rate and ensuing health repercussions among Chinese women are well characterized, mechanisms underlying such health disparities are not. The aim of this study was to use a qualitative approach to delineate such mechanisms. Qualitative approaches to understand constructs within the domain of sexual and reproductive health have been shown to be particularly appropriate, and offer a nuanced view of sexuality that is not afforded by traditional quantitative methods.Method: We carried out two focus groups aimed at exploring how Mandarin-speaking and English-speaking Chinese women experience Pap testing (N = 12. The women were invited to partake in the focus groups from having participated in a large-scale quantitative study. We used content analyses to analyze transcripts and extract themes. Results: The women heavily endorsed Chinese medicine philosophy, conceptualizing physical health holistically, and valuing preventative measures over screening and interceptive measures. Pap testing was described as qualitatively different from other screening procedures, such that women assigned a sexually charged meaning to Pap testing, often discussing it in relation to sexual activity and promiscuity. Women expressed their preference for the compulsory and depersonalized manner that Pap tests are performed in their home country of China, as this lessens the embarrassment associated with undergoing Pap testing. Conclusion: Three mechanisms may contribute to lower Pap testing among Chinese women: preference for Chinese medicine philosophy, perceived sexualization of Pap testing, and the institutionalization of medical care. Implications for improving the reproductive health of Chinese women are discussed.

  12. Molecular dynamics studies of the P pilus rod subunit PapA.

    Science.gov (United States)

    Vitagliano, Luigi; Ruggiero, Alessia; Pedone, Carlo; Berisio, Rita

    2009-03-01

    Adhesion of uropathogenic Escherichia coli to host tissues is mediated by pili, which extend from the outer cell membrane of the bacterium. Here we report molecular dynamics (MD) characterizations of the major constituent of P pili from the uropathogenic E. coli, PapA, in unliganded state and in complex with the G1 strand of the chaperone PapD. To mimic the PapA response to the gradual dissociation of the PapD G1 strand and to evaluate the role of PapA chaperone recognition sites, we also carried out MD simulations of complexes of PapA with fragments of PapD G1 strand, that leave either the P4 or both P3 and P4 sites unoccupied. Data on the unbound form of PapA indicate that, upon release of the chaperone, PapA evolves toward compact states that are likely not prone to subunit-subunit association. In line with recent experimental reports, this finding implies that chaperone release and subunit-subunit association must be concerted. Our data also indicated that the gradual unbinding of the chaperone from the PapA groove has increasingly strong structural consequences. Indeed, the release of the chaperone from the site P4, which is closest to the initiation site (P5), does not have dramatic effects on the domain structure, whereas its release from both the P4 and the adjacent P3 sites induces a quick structural transition toward a collapsed state, where the subunit groove is obstructed.

  13. A Comparative Scanning Electron Microscopy Evaluation of Smear ...

    African Journals Online (AJOL)

    2018-02-07

    Feb 7, 2018 ... scanning electron microscopy evaluation of smear layer removal with chitosan and .... this compound has considerably increased its concentration in rivers and .... of the images was done by three investigators who calibrated ...

  14. 17 Smear positive pulmonary tuberculosis among HIV patients ...

    African Journals Online (AJOL)

    conducted in February 2009 to assess the effect of the level of CD4 lymphocyte ... development of smear positive pulmonary TB (PTB) among HIV patients before ..... (2000) Impact of combination antiretroviral therapy on the risk of tuberculosis.

  15. Smear-positive pulmonary tuberculosis and AFB examination practices according to the standard checklist of WHO's tuberculosis laboratory assessment tool in three governmental hospitals, Eastern Ethiopia.

    Science.gov (United States)

    Mekonnen, Abiyu

    2014-05-13

    Using the Directly Observed Treatment-Short course (DOTS) program the World Health Organization's global target was to detect 70% of new sputum-smear positive PTB cases. Smear positive PTB cases are more infectious than the smear negative cases. The TB case detection rate remains very low in Ethiopia, but there are increases in smear-negative PTB diagnosis which could be attributed to several factors including poor quality of sputum smear-microscopy. A five years retrospective record review of data between September, 2007 and August, 2012 and an in-depth assessment of AFB staining practices of sputum smear using a standard checklist were made. The proportion of smear positive cases relative to overall Acid Fast Bacilli (AFB) screened was determined over a five year period to indicate the overall prevalence and the trend. Odds ratio with 95 percent confidence interval was calculated for categorical variables using multivariate Logistic Regression model to assess the strength of association. A total of 1266 individuals' data were reviewed. The majority of the study participants were male, 704 (55.6%), and rural residents, 690 (54.5%). The overall prevalence rate of smear positive PTB was 21.6%. Age categories between 15-24 and 25-34 years were independent predictors of smear positive PTB with adjusted odds ratio of 2.246 [95% CI (1.098-4.597)] and 2.267 [95% CI (1.107-4.642)], respectively. More males were affected by PTB than females with an adjusted odds ratio of 1.426 [95% CI (1.083-1.879)]. An in-depth interview with the respective laboratory chiefs showed that quality control measures for sputum smear microscopy were used at different levels of the testing activities; however, equipment function verification as a quality control measure was not accomplished regularly in all of the study hospital laboratories. The smear positive PTB case detection rate indicated in this study is significantly lower than the countries which met the 70% target of the World Health

  16. Applying a gender lens on human papillomavirus infection: cervical cancer screening, HPV DNA testing, and HPV vaccination.

    Science.gov (United States)

    Branković, Ivan; Verdonk, Petra; Klinge, Ineke

    2013-02-08

    Our aim is to provide a state-of-the-art overview of knowledge on sex (biological) and gender (sociocultural) aspects of Human papillomavirus (HPV) and cervical cancer for educational purposes. Considerable disparities exist in cervical cancer incidences between different subgroups of women. We provide an outline on the crucial issues and debates based on the recent literature published in leading gender medicine journals. Intersectionality was applied in order to help categorise the knowledge. Key terms (HPV, cervical cancer) were screened in Gender Medicine, Journal of Women's Health and Women & Health from January 2005-June 2012. Additional searches were conducted for topics insufficiently mentioned, such as HPV vaccination of boys. In total, 71 publications were included (56 original papers, four reviews, six reports, three commentaries, one editorial and one policy statement). Research reveals complexity in the way various subgroups of women adhere to cervical screening. Less educated women, older women, uninsured women, homeless women, migrant women facing language barriers, women who have sex with women and obese women participate in Pap smears less frequently. A series of barriers can act to impede decisions to vaccinate against HPV. Both male and female controlled preventive methods and treatment measures should be developed in order to tackle HPV infection and different strategies are needed for different subgroups. A substantial discussion and research on alternative methods of prevention was and is lacking. In future research, sex and gender aspects of HPV-related diseases of boys and men as well as subgroup differences in HPV risk need to be addressed.

  17. Paediatric ED BiPAP continuous quality improvement programme with patient analysis: 2005-2013.

    Science.gov (United States)

    Abramo, Thomas; Williams, Abby; Mushtaq, Samaiya; Meredith, Mark; Sepaule, Rawle; Crossman, Kristen; Burney Jones, Cheryl; Godbold, Suzanne; Hu, Zhuopei; Nick, Todd

    2017-01-16

    In paediatric moderate-to-severe asthmatics, there is significant bronchospasm, airway obstruction, air trapping causing severe hyperinflation with more positive intraplural pressure preventing passive air movement. These effects cause an increased respiratory rate (RR), less airflow and shortened inspiratory breath time. In certain asthmatics, aerosols are ineffective due to their inadequate ventilation. Bilevel positive airway pressure (BiPAP) in acute paediatric asthmatics can be an effective treatment. BiPAP works by unloading fatigued inspiratory muscles, a direct bronchodilation effect, offsetting intrinsic PEEP and recruiting collapsed alveoli that reduces the patient's work of breathing and achieves their total lung capacity quicker. Unfortunately, paediatric emergency department (PED) BiPAP is underused and quality analysis is non-existent. A PED BiPAP Continuous Quality Improvement Program (CQIP) from 2005 to 2013 was evaluated using descriptive analytics for the primary outcomes of usage, safety, BiPAP settings, therapeutics and patient disposition. PED BiPAP CQIP descriptive analytics. Academic PED. 1157 patients. A PED BiPAP CQIP from 2005 to 2013 for the usage, safety, BiPAP settings, therapeutic response parameters and patient disposition was evaluated using descriptive analytics. Safety, usage, compliance, therapeutic response parameters, BiPAP settings and patient disposition. 1157 patients had excellent compliance without complications. Only 6 (0.5%) BiPAP patients were intubated. BiPAP median settings: IPAP 18 (16,20) cm H 2 O range 12-28; EPAP 8 cmH 2 O (8,8) range 6-10; inspiratory-to-expiratory time (I:E) ratio 1.75 (1.5,1.75). Pediatric Asthma Severity score and RR decreased (pimproved therapeutics times, very low intubations and decreased PICU admissions. CQIP analysis demonstrated that using a higher IPAP, low EPAP with longer I:E optimises the patient's BiPAP settings and showed a significant improvement in PAS, RR and tidal volume. BiPAP

  18. Nuclear Phosphatidylinositol-Phosphate Type I Kinase α-Coupled Star-PAP Polyadenylation Regulates Cell Invasion.

    Science.gov (United States)

    A P, Sudheesh; Laishram, Rakesh S

    2018-03-01

    Star-PAP, a nuclear phosphatidylinositol (PI) signal-regulated poly(A) polymerase (PAP), couples with type I PI phosphate kinase α (PIPKIα) and controls gene expression. We show that Star-PAP and PIPKIα together regulate 3'-end processing and expression of pre-mRNAs encoding key anti-invasive factors ( KISS1R , CDH1 , NME1 , CDH13 , FEZ1 , and WIF1 ) in breast cancer. Consistently, the endogenous Star-PAP level is negatively correlated with the cellular invasiveness of breast cancer cells. While silencing Star-PAP or PIPKIα increases cellular invasiveness in low-invasiveness MCF7 cells, Star-PAP overexpression decreases invasiveness in highly invasive MDA-MB-231 cells in a cellular Star-PAP level-dependent manner. However, expression of the PIPKIα-noninteracting Star-PAP mutant or the phosphodeficient Star-PAP (S6A mutant) has no effect on cellular invasiveness. These results strongly indicate that PIPKIα interaction and Star-PAP S6 phosphorylation are required for Star-PAP-mediated regulation of cancer cell invasion and give specificity to target anti-invasive gene expression. Our study establishes Star-PAP-PIPKIα-mediated 3'-end processing as a key anti-invasive mechanism in breast cancer. Copyright © 2018 A.P. and Laishram.

  19. Cancer Screening Awareness and Practice in a Middle Income Country; A Systematic Review from Iran

    Science.gov (United States)

    Majidi, Azam; Majidi, Somayye; Salimzadeh, Somayye; Khazaee- Pool, Maryam; Sadjadi, Alireza; Salimzadeh, Hamideh; Delavari, Alireza

    2017-12-28

    Objective: Ageing population and noticeable changes in lifestyle in developing countries like Iran caused an increase in cancer incidence. This requires organized cancer prevention and screening programs in population level, but most importantly community should be aware of these programs and willing to use them. This study explored existing evidence on public awareness and practice, as well as, adherence to cancer screening in Iranian population. Methods: Major English databases including Web of Science, PubMed, Scopus, and domestic Persian databases i.e., SID, Magiran, and Barakat search engines were searched. All publications with focus on Iranian public awareness about cancer prevention, screening, and early detection programs which were published until August 2015, were explored in this systematic review. For this purpose, we used sensitive Persian phrases/key terms and English keywords which were extracted from medical subject headings (MeSH). Taking PRISMA guidelines into considerations eligible documents, were evaluated and abstracted by two separate reviewers. Results: We found 72 articles relevant to this topic. Screening tests were known to, or being utilized by only a limited number of Iranians. Most Iranian women relied on physical examination particularly self-examination, instead of taking mammogram, as the most standard test to find breast tumors. Less than half of the average-risk adult populations were familiar with colorectal cancer risk factors and its screening tests, and only very limited number of studies reported taking at least one time colonoscopy or FOBT, at most 5.0% and 15.0%, respectively. Around half of women were familiar with cervical cancer and Pap-smear test with less than 45% having completed at least one lifetime test. The lack of health insurance coverage was a barrier to participate in screening tests. Furthermore some people would not select to be screened only because they do not know how or where they can receive these

  20. A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women.

    Science.gov (United States)

    Lu, Mingshan; Moritz, Sabina; Lorenzetti, Diane; Sykes, Lindsay; Straus, Sharon; Quan, Hude

    2012-06-07

    The Asian population is one of the fastest growing ethnic minority groups in western countries. However, cancer screening uptake is consistently lower in this group than in the native-born populations. As a first step towards developing an effective cancer screening intervention program targeting Asian women, we conducted a comprehensive systematic review, without geographic, language or date limitations, to update current knowledge on the effectiveness of existing intervention strategies to enhance breast and cervical screening uptake in Asian women. This study systematically reviewed studies published as of January 2010 to synthesize knowledge about effectiveness of cancer screening interventions targeting Asian women. Fifteen multidisciplinary peer-reviewed and grey literature databases were searched to identify relevant studies. The results of our systematic review were reported in accordance with the PRISMA Statement. Of 37 selected intervention studies, only 18 studies included valid outcome measures (i.e. self-reported or recorded receipt of mammograms or Pap smear). 11 of the 18 intervention studies with valid outcome measures used multiple intervention strategies to target individuals in a specific Asian ethnic group. This observed pattern of intervention design supports the hypothesis that employing a combination of multiple strategies is more likely to be successful than single interventions. The effectiveness of community-based or workplace-based group education programs increases when additional supports, such as assistance in scheduling/attending screening and mobile screening services are provided. Combining cultural awareness training for health care professionals with outreach workers who can help healthcare professionals overcome language and cultural barriers is likely to improve cancer screening uptake. Media campaigns and mailed culturally sensitive print materials alone may be ineffective in increasing screening uptake. Intervention

  1. A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women

    Directory of Open Access Journals (Sweden)

    Lu Mingshan

    2012-06-01

    Full Text Available Abstract Background The Asian population is one of the fastest growing ethnic minority groups in western countries. However, cancer screening uptake is consistently lower in this group than in the native-born populations. As a first step towards developing an effective cancer screening intervention program targeting Asian women, we conducted a comprehensive systematic review, without geographic, language or date limitations, to update current knowledge on the effectiveness of existing intervention strategies to enhance breast and cervical screening uptake in Asian women. Methods This study systematically reviewed studies published as of January 2010 to synthesize knowledge about effectiveness of cancer screening interventions targeting Asian women. Fifteen multidisciplinary peer-reviewed and grey literature databases were searched to identify relevant studies. Results The results of our systematic review were reported in accordance with the PRISMA Statement. Of 37 selected intervention studies, only 18 studies included valid outcome measures (i.e. self-reported or recorded receipt of mammograms or Pap smear. 11 of the 18 intervention studies with valid outcome measures used multiple intervention strategies to target individuals in a specific Asian ethnic group. This observed pattern of intervention design supports the hypothesis that employing a combination of multiple strategies is more likely to be successful than single interventions. The effectiveness of community-based or workplace-based group education programs increases when additional supports, such as assistance in scheduling/attending screening and mobile screening services are provided. Combining cultural awareness training for health care professionals with outreach workers who can help healthcare professionals overcome language and cultural barriers is likely to improve cancer screening uptake. Media campaigns and mailed culturally sensitive print materials alone may be ineffective

  2. Mexican Cervical Cancer Screening Study II: 6-month and 2-year follow-up of HR-HPV women treated with cryotherapy in a low-resource setting.

    Science.gov (United States)

    Starks, David; Arriba, Lucybeth Nieves; Enerson, Christine L; Brainard, Jennifer; Nagore, Norma; Chiesa-Vottero, Andres; Uribe, Jesús Villagran; Belinson, Jerome

    2014-10-01

    To determine the efficacy and tolerance of cryotherapy in a visual inspection with acetic acid (VIA) triage protocol after primary human papillomavirus (HPV) screening in a low-resource setting. This continuous series conducted over 2 years enrolled nonpregnant, high-risk HPV (HR-HPV)-positive women between the ages of 30 and 50 years, who resided in the state of Michoacán, Mexico, and had a history of no Pap smear screening or knowledge of Pap smear results within the last 3 years. These women were initially enrolled in the Mexican Cervical Cancer Screening Study II (MECCS II) trial and were treated with cryotherapy after VIA triage. They subsequently followed up at 6 months and 2 years for repeat VIA, colposcopy, and biopsy. A total of 291 women were treated with cryotherapy, of whom 226 (78%) followed up at 6 months. Of these 226 women, 153 (68%) were HR-HPV-negative; there were no findings of cervical intraepithelial neoplasia grade 2 (CIN2) or worse. The remaining 73 women (32%) were HR-HPV-positive; of these women, 2 had CIN2 and 3 had CIN3. Only 137 women followed up at 2 years. Of these 137 women, 116 were HR-HPV-negative and 21 were HR-HPV-positive. Of the 21 women positive for HR-HPV, 9 had negative biopsy results, 11 had CIN1, and 1 had no biopsy. The clearance rate of HR-HPV was 83% (95% confidence interval: 0.78-0.87). There were no biopsy findings of CIN2 or worse at 2 years. Before cryotherapy, of the 226 women, 15 (6.6%) were positive for endocervical curettage (ECC) and 5 (2.2%) were referred for surgical management. Of these 15 ECC-positive women, 10 (67%) followed up at 6 months and it was shown that no patient was ECC positive at that time point. Moreover, of the 15 ECC-positive women, 11 (73%) followed up at 2 years and it was shown that no patient was ECC positive at that time point. In our study, VIA had a false-positive rate of 5%. Cryotherapy was an effective, acceptable, and well-tolerated means of treating cervical dysplasia in a low

  3. Cost-effectiveness analysis of different types of human papillomavirus vaccination combined with a cervical cancer screening program in mainland China.

    Science.gov (United States)

    Mo, Xiuting; Gai Tobe, Ruoyan; Wang, Lijie; Liu, Xianchen; Wu, Bin; Luo, Huiwen; Nagata, Chie; Mori, Rintaro; Nakayama, Takeo

    2017-07-18

    China has a high prevalence of human papillomavirus (HPV) and a consequently high burden of disease with respect to cervical cancer. The HPV vaccine has proved to be effective in preventing cervical cancer and is now a part of routine immunization programs worldwide. It has also proved to be cost effective. This study aimed to assess the cost-effectiveness of 2-, 4-, and 9-valent HPV vaccines (hereafter, HPV2, 4 or 9) combined with current screening strategies in China. A Markov model was developed for a cohort of 100,000 HPV-free girls to simulate the natural history to HPV infection. Three recommended screening methods (1. liquid-based cytology test + HPV DNA test; 2. pap smear cytology test + HPV DNA test; 3. visual inspection with acetic acid) and three types of HPV vaccination program (HPV2/4/9) were incorporated into 15 intervention options, and the incremental cost-effectiveness ratio (ICER) was calculated to determine the dominant strategies. Costs, transition probabilities and utilities were obtained from a review of the literature and national databases. One-way sensitivity analyses and threshold analyses were performed for key variables in different vaccination scenarios. HPV9 combined with screening showed the highest health impact in terms of reducing HPV-related diseases and increasing the number of quality-adjusted life years (QALYs). Under the current thresholds of willingness to pay (WTP, 3 times the per capita GDP or USD$ 23,880), HPV4/9 proved highly cost effective, while HPV2 combined with screening cost more and was less cost effective. Only when screening coverage increased to 60% ~ 70% did the HPV2 and screening combination strategy become economically feasible. The combination of the HPV4/9 vaccine with current screening strategies for adolescent girls was highly cost-effective and had a significant impact on reducing the HPV infection-related disease burden in Mainland China.

  4. Preferences for cervical cancer screening: The role of implicit associations

    NARCIS (Netherlands)

    Korfage, I.J.; Kwaadsteniet, E.W. de; Voorst, A. van; Stiggelbout, A.M.; Vries, M. de; Pieterse, A.H.

    2018-01-01

    Objectives: Implicit associations influence behaviour, but their impact on cancer screening intentions is unknown. Methods: We assessed implicit associations with cervical cancer screening using an evaluative priming task. Participants were shown primes ('Pap test', neutral or non-word) followed by

  5. Prevalence of High-Risk Genotypes of Human Papillomavirus: Women Diagnosed with Premalignant and Malignant Pap Smear Tests in Southern Ecuador

    Science.gov (United States)

    Loján González, Cisne; Córdova Rodríguez, Ana; Acurio Páez, Katherine; Arévalo, Ana Paulina; Bobokova, Jana

    2017-01-01

    Human papillomavirus (HPV) is the primary infectious agent for the development of cervical cancer, although the presence of the virus alone is insufficient for viral development and proliferation; this can be attributed to the increase in potential oncogenic risk, along with other risk factors. In the present investigation, the prevalence of high-risk HPV was determined from samples of premalignant or malignant cervical cytology in women from the southern region of Ecuador. The kit we used was able to detect genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59. In addition, 64.5% of the analyzed samples were positive for HPV, with genotypes 16 and 18 being the most prevalent (16 was detected in 148 samples and 18 in 108). Genotypes 58 and 51 were the third most frequent simple and multiple infections, respectively. The data are very similar to those obtained worldwide, suggesting that the strategy of sex education, and the use of vaccines as primary prevention agents, could significantly decrease the incidence and mortality rate of cervical cancer in the southern region of Ecuador. PMID:28717342

  6. Prevalence of High-Risk Genotypes of Human Papillomavirus: Women Diagnosed with Premalignant and Malignant Pap Smear Tests in Southern Ecuador

    Directory of Open Access Journals (Sweden)

    Paola Dalgo Aguilar

    2017-01-01

    Full Text Available Human papillomavirus (HPV is the primary infectious agent for the development of cervical cancer, although the presence of the virus alone is insufficient for viral development and proliferation; this can be attributed to the increase in potential oncogenic risk, along with other risk factors. In the present investigation, the prevalence of high-risk HPV was determined from samples of premalignant or malignant cervical cytology in women from the southern region of Ecuador. The kit we used was able to detect genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59. In addition, 64.5% of the analyzed samples were positive for HPV, with genotypes 16 and 18 being the most prevalent (16 was detected in 148 samples and 18 in 108. Genotypes 58 and 51 were the third most frequent simple and multiple infections, respectively. The data are very similar to those obtained worldwide, suggesting that the strategy of sex education, and the use of vaccines as primary prevention agents, could significantly decrease the incidence and mortality rate of cervical cancer in the southern region of Ecuador.

  7. Influencing Factors of Intention to Receive Pap Tests in Vietnamese Women who Immigrated to Taiwan for Marriage.

    Science.gov (United States)

    Lee, Fang-Hsin; Wang, Hsiu-Hung; Yang, Yung-Mei; Huang, Joh-Jong; Tsai, Hsiu-Min

    2016-09-01

    This study aimed to explore the factors associated with the intention to receive a Pap test among married immigrant women of Vietnamese origin living in Taiwan. This was a cross-sectional community-based study. We enrolled 281 women aged 30 years and over in the study, from July 2013 to January 2014. The participants' characteristics, cervical cancer knowledge, Pap test knowledge, attitudes toward cervical cancer, barriers to receiving a Pap test, fatalism, and intention to receive a Pap test, were measured using self-report questionnaires. Hierarchical multiple regression analyses were performed to examine the variables associated with participants' intentions to receive a Pap test. Vietnamese women with low scores on the measures of cervical cancer knowledge and perceived barriers to receiving a Pap test were more willing to receive the test, as were those with high scores on the measures of Pap test knowledge and fatalism. Women who received a Pap test in the previous year were more willing to receive a Pap test within the next 3 years. Preventive healthcare for immigrant women should be a focus of nurses. The development of culturally appropriate health education and strategies should enhance their knowledge of Pap tests and reduce perceived barriers to Pap test participation. This study's results can be a reference for nurses who work with immigrant women. Copyright © 2016. Published by Elsevier B.V.

  8. PAP-1, the mutated gene underlying the RP9 form of dominant retinitis pigmentosa, is a splicing factor

    International Nuclear Information System (INIS)

    Maita, Hiroshi; Kitaura, Hirotake; Keen, T. Jeffrey; Inglehearn, Chris F.; Ariga, Hiroyoshi; Iguchi-Ariga, Sanae M.M.

    2004-01-01

    PAP-1 is an in vitro phosphorylation target of the Pim-1 oncogene. Although PAP-1 binds to Pim-1, it is not a substrate for phosphorylation by Pim-1 in vivo. PAP-1 has recently been implicated as the defective gene in RP9, one type of autosomal dominant retinitis pigmentosa (adRP). However, RP9 is a rare disease and only two missense mutations have been described, so the report of a link between PAP-1 and RP9 was tentative. The precise cellular role of PAP-1 was also unknown at that time. We now report that PAP-1 localizes in nuclear speckles containing the splicing factor SC35 and interacts directly with another splicing factor, U2AF35. Furthermore, we used in vitro and in vivo splicing assays to show that PAP-1 has an activity, which alters the pattern of pre-mRNA splicing and that this activity is dependent on the phosphorylation state of PAP-1. We used the same splicing assay to examine the activities of two mutant forms of PAP-1 found in RP9 patients. The results showed that while one of the mutations, H137L, had no effect on splicing activity compared with that of wild-type PAP-1, the other, D170G, resulted in both a defect in splicing activity and a decreased proportion of phosphorylated PAP-1. The D170G mutation may therefore cause RP by altering splicing of retinal genes through a decrease in PAP-1 phosphorylation. These results demonstrate that PAP-1 has a role in pre-mRNA splicing and, given that three other splicing factors have been implicated in adRP, this finding provides compelling further evidence that PAP-1 is indeed the RP9 gene

  9. [New guidelines in regard to cervical cancer screening].

    Science.gov (United States)

    Vargas-Hernández, Víctor Manuel; Acosta-Altamirano, Gustavo; Moreno-Eutimio, Mario Adán; Vargas-Aguilar, Víctor Manuel

    2014-01-01

    Cancer screening programs have been successful in reducing the incidence and mortality due to cervical cancer. For more than a decade, the human papillomavirus test has been recommended as part of these programs, however, Pap tests is not currently recommended for women 65 years of age who participated adequately in screening programs, continuing with these screening programs is not needed. Screening programs will be different in special populations at greatest risk where tests are frequently needed or use of alternative methods.

  10. Uptake and Predictors of Anal Cancer Screening in Men Who Have Sex With Men

    Science.gov (United States)

    D'Souza, Gypsyamber; Rajan, Shirani D.; Bhatia, Rohini; Cranston, Ross D.; Plankey, Michael W.; Silvestre, Anthony; Ostrow, David G.; Wiley, Dorothy; Shah, Nisha; Brewer, Noel T.

    2013-01-01

    Objectives. We investigated attitudes about and acceptance of anal Papanicolaou (Pap) screening among men who have sex with men (MSM). Methods. Free anal Pap screening (cytology) was offered to 1742 MSM in the Multicenter AIDS Cohort Study, who reported history of, attitudes about, and experience with screening. We explored predictors of declining screening with multivariate logistic regression. Results. A history of anal Pap screening was uncommon among non–HIV-infected MSM, but more common among HIV-infected MSM (10% vs 39%; P < .001). Most participants expressed moderate or strong interest in screening (86%), no anxiety about screening (66%), and a strong belief in the utility of screening (65%). Acceptance of screening during this study was high (85%) across all 4 US sites. Among those screened, most reported it was “not a big deal” or “not as bad as expected,” and 3% reported that it was “scary.” Declining to have screening was associated with Black race, anxiety about screening, and low interest, but not age or HIV status. Conclusions. This study demonstrated high acceptance of anal Pap screening among both HIV-infected and non–HIV-infected MSM across 4 US sites. PMID:23865658

  11. Comparison of breast and cervical cancer screening utilization among rural and urban Hispanic and American Indian women in the Southwestern United States.

    Science.gov (United States)

    Nuño, Tomas; Gerald, Joe K; Harris, Robin; Martinez, Maria Elena; Estrada, Antonio; García, Francisco

    2012-08-01

    Rural Hispanic and American Indian (AI) women are at risk of non-participation in cancer screening programs. The objective of this study was to compare breast and cervical cancer screening utilization among Hispanic and AI women that reside in rural areas of the Southwestern United States to their urban counterparts and to assess characteristics that influence cancer screening. This study utilizes Behavioral Risk Factor Surveillance System (BRFSS) data from 2006 to 2008 for Arizona and New Mexico. The BRFSS is a federally funded telephone survey to collect data on risk factors contributing to the leading causes of death and chronic diseases. Rural Hispanic and AI populations reported some differences in screening rates compared with their urban counterparts. Among Hispanic women, 58 % of rural residents reported having had a mammogram within the past year, compared with 66 % of urban residents. Among AI women, 81 % of rural residents had ever had a mammogram, compared with 89 % of urban residents. Rural AI women were less likely to have ever had a mammogram (OR = 0.5; 95 % CI = 0.3-0.9) compared with urban AI women. Rural Hispanic women were less likely to have had a mammogram within 1 year (OR = 0.7; 95 % CI = 0.5-0.9) compared with urban Hispanic women. Results suggest that rural Hispanic women were less likely to have had a Pap smear within 3 years (OR = 0.7; 95 % CI = 0.4-1.3) compared with urban Hispanic women. Our results provide some evidence that Hispanic and AI women that reside in rural areas of the Southwestern United States have lower rates of breast and cervical cancer screening use compared with their urban counterparts. Special efforts are needed to identify ways to overcome barriers to breast and cervical cancer screening for rural Hispanic and AI women.

  12. Cervical cancer in women under 25 years of age in Queensland, Australia: To what extent is the diagnosis made by screening cytology?

    Science.gov (United States)

    Morgan, Edwina L; Sanday, Karen; Budd, Alison; Hammond, Ian G; Nicklin, James

    2017-08-01

    The current Australian National Cervical Screening Program (NCSP) involves biennial, cytology-based screening of women from the age of 18 years. From December, 2017 this will change to a five-yearly human papilloma virus-based screening commencing at age 25. There is some concern that the new program may delay the opportunistic detection of cervical cancers in women under 25 years. (1) To review all cases of invasive cervical cancer in Queensland women under the age of 25 over the last 28 years. (2) To determine symptoms and screening history prior to diagnosis. A retrospective cohort study was undertaken at the Queensland Centre for Gynaecological Cancer (QCGC) and the Queensland Cancer Registry (QCR) of all women aged between 13 and 25 years diagnosed with cervical cancer in Queensland between 1984 and 2012. Demographic data and symptoms prior to diagnosis were extracted from the QCGC and QCR databases. A total of 56 women aged 13-25, were diagnosed with cervical cancer and treated at the QCGC between 1984 and 2012. The commonest reason for the diagnosis of cancer was investigation of abnormal symptoms (n = 22, 39%) rather than routine Pap smear abnormalities (n = 15, 26%). Consistent with the world literature, there is a very low incidence of cervical cancer in women under 25 years of age, irrespective of the age of commencement of screening, or the screening interval. Our study lends some support to the proposed commencement age of 25 years in the new NCSP. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  13. Thick Smear is a Good Substitute for the Thin Smear in Parasitological Confirmation of Canine Visceral Leishmaniasis.

    Science.gov (United States)

    de Mello, Cintia Xavier; Figueiredo, Fabiano Borges; Mendes Júnior, Artur Augusto Velho; Miranda, Luciana de Freitas Campos; de Oliveira, Raquel de Vasconcellos Carvalhaes; Madeira, Maria de Fátima

    2016-07-06

    Although direct examination methods are important for diagnosing leishmaniasis, such methods are often neglected because of their low sensitivity relative to other techniques. Our study aimed to evaluate the performance of bone marrow (BM) thick smears and cytocentrifugation tests as alternatives to direct examination for diagnosing canine visceral leishmaniasis (CVL). Ninety-two dogs exhibiting leishmaniasis seroreactivity were evaluated. The animals were euthanized; and healthy skin, spleen, popliteal lymph node, and BM puncture samples were cultured. BM cultures were used as the reference standard. Of the 92 dogs studied, 85.9% exhibited positive cultures, and Leishmania infantum (synonym Leishmania chagasi) was confirmed in all positive culture cases. The sensitivity rates for cytocentrifugation as well as thin and thick smears were 47.1%, 52.8%, and 77%, respectively. However, no association between the dogs' clinical status and culture or direct examination results was found. To our knowledge, this was the first study to use thick smears and cytocentrifugation for diagnosing CVL. Our results indicate that BM thick smears have a good sensitivity and their use reduces the time required to read slides. Therefore, thick smears can provide a rapid and safe alternative to parasitological confirmation of seroreactive dogs. © The American Society of Tropical Medicine and Hygiene.

  14. Analysis of smear in high-resolution remote sensing satellites

    Science.gov (United States)

    Wahballah, Walid A.; Bazan, Taher M.; El-Tohamy, Fawzy; Fathy, Mahmoud

    2016-10-01

    High-resolution remote sensing satellites (HRRSS) that use time delay and integration (TDI) CCDs have the potential to introduce large amounts of image smear. Clocking and velocity mismatch smear are two of the key factors in inducing image smear. Clocking smear is caused by the discrete manner in which the charge is clocked in the TDI-CCDs. The relative motion between the HRRSS and the observed object obliges that the image motion velocity must be strictly synchronized with the velocity of the charge packet transfer (line rate) throughout the integration time. During imaging an object off-nadir, the image motion velocity changes resulting in asynchronization between the image velocity and the CCD's line rate. A Model for estimating the image motion velocity in HRRSS is derived. The influence of this velocity mismatch combined with clocking smear on the modulation transfer function (MTF) is investigated by using Matlab simulation. The analysis is performed for cross-track and along-track imaging with different satellite attitude angles and TDI steps. The results reveal that the velocity mismatch ratio and the number of TDI steps have a serious impact on the smear MTF; a velocity mismatch ratio of 2% degrades the MTFsmear by 32% at Nyquist frequency when the TDI steps change from 32 to 96. In addition, the results show that to achieve the requirement of MTFsmear >= 0.95 , for TDI steps of 16 and 64, the allowable roll angles are 13.7° and 6.85° and the permissible pitch angles are no more than 9.6° and 4.8°, respectively.

  15. Nutritional Composition of Five Varieties of Pap Commonly Consumed in Maroua (Far-North, Cameroon

    Directory of Open Access Journals (Sweden)

    Ponka Roger

    2015-09-01

    Full Text Available The aim of this study was to determine the nutritional composition of five varieties of pap (cereal product commonly consumed in Maroua, city of the Far-North Region of Cameroon. The proximate composition (moisture, ash, protein, lipid, and crude fibre was determined by standard AOAC methods. Minerals (calcium, magnesium, sodium, potassium, iron, zinc, copper and manganese were determined by atomic absorption spectrophotometry and phosphorus was determined colorimetrically. Amino acid composition was determined by ion-exchange chromatography. All the pap varieties had a very high carbohydrate content (79.47-85.29 g/100 g dry matter. Appreciable levels of phosphorus and potassium were recorded in all the pap varieties (137.5-231.0 mg/100 g dry matter and 198.20-322.22 mg/100 g dry matter, respectively. Consumption of each pap (100 g by children 1-2 year old would meet 9.86-17.46% and 0.08-19.51% of their daily recommended intake respectively for protein and minerals. Leucine and glutamic acid were the most abundant essential amino acids and non-essential amino acids respectively in the pap. Essential amino acids in most of the pap samples met the recommended children requirement of the FAO/WHO/UNU for 1-2 year old children except methionine+cysteine and lysine.

  16. Light and the E3 ubiquitin ligase COP1/SPA control the protein stability of the MYB transcription factors PAP1 and PAP2 involved in anthocyanin accumulation in Arabidopsis.

    Science.gov (United States)

    Maier, Alexander; Schrader, Andrea; Kokkelink, Leonie; Falke, Christian; Welter, Bastian; Iniesto, Elisa; Rubio, Vicente; Uhrig, Joachim F; Hülskamp, Martin; Hoecker, Ute

    2013-05-01

    Anthocyanins are natural pigments that accumulate only in light-grown and not in dark-grown Arabidopsis plants. Repression of anthocyanin accumulation in darkness requires the CONSTITUTIVELY PHOTOMORPHOGENIC1/SUPPRESSOR OF PHYA-105 (COP1/SPA) ubiquitin ligase, as cop1 and spa mutants produce anthocyanins also in the dark. Here, we show that COP1 and SPA proteins interact with the myeloblastosis (MYB) transcription factors PRODUCTION OF ANTHOCYANIN PIGMENT1 (PAP)1 and PAP2, two members of a small protein family that is required for anthocyanin accumulation and for the expression of structural genes in the anthocyanin biosynthesis pathway. The increased anthocyanin levels in cop1 mutants requires the PAP1 gene family, indicating that COP1 functions upstream of the PAP1 gene family. PAP1 and PAP2 proteins are degraded in the dark and this degradation is dependent on the proteasome and on COP1. Hence, the light requirement for anthocyanin biosynthesis results, at least in part, from the light-mediated stabilization of PAP1 and PAP2. Consistent with this conclusion, moderate overexpression of PAP1 leads to an increase in anthocyanin levels only in the light and not in darkness. Here we show that SPA genes are also required for reducing PAP1 and PAP2 transcript levels in dark-grown seedlings. Taken together, these results indicate that the COP1/SPA complex affects PAP1 and PAP2 both transcriptionally and post-translationally. Thus, our findings have identified mechanisms via which the COP1/SPA complex controls anthocyanin levels in Arabidopsis that may be useful for applications in biotechnology directed towards increasing anthocyanin content in plants. © 2013 The Authors The Plant Journal © 2013 John Wiley & Sons Ltd.

  17. [The dentinal smear layer. Characteristics and interactions. 2].

    Science.gov (United States)

    Negri, P L; Eramo, S; Lotito, M; De Pino, C

    1991-03-15

    The Authors, after the presentation (in the first part of the Dossier) of a large literature review about the physical, chemical and clinical characteristics of formation, interaction, remotion of "smear layer" during cavity preparation in hard tooth tissue, describe the results of a scanning microelectronic research about the action as cleanser (for the dentinal cavity wall) of the CK101 (Caridex) versus wather, Tubulicid and phosphoric acid. The experimental results obtained "in vitro" show that the substance has relative action, without removing the tubular portion of "smear layer".

  18. Determination of plutonium in air and smear samples

    International Nuclear Information System (INIS)

    Hinton, E.R. Jr.; Tucker, W.O.

    1981-01-01

    A method has been developed for the determination of plutonium in air samples and smear samples that were collected on filter papers. The sample papers are digested in nitric acid, extracted into 2-thenoyltrifluoroacetone (TTA)-xylene, and evaporated onto stainless steel disks. Alpha spectrometry is employed to determine the activity of each plutonium isotope. Each sample is spiked with plutonium-236. All glassware used in the procedure is disposable. The detection limits are 3 and 5 dpm (disintegrations per minute) for air and smear samples, respectively, with an average recovery of 87%

  19. A model to evaluate the costs and clinical effectiveness of human papilloma virus screening compared with annual papanicolaou cytology in Germany.

    Science.gov (United States)

    Petry, Karl Ulrich; Barth, Cordula; Wasem, Jürgen; Neumann, Anja

    2017-05-01

    We modelled human papilloma virus (HPV) primary screening scenarios compared with Pap cytology to evaluate clinical effectiveness and projected annual costs in Germany. A Markov cohort model was built to compare the budget impact of annual Pap cytology with different 5-yearly HPV screening scenarios: (1) a positive HPV test followed by Pap cytology; (2) a positive HPV test followed by p16/Ki-67 dual-stained cytology; (3) a positive HPV test followed by colposcopy if HPV-16/18-positive or p16/Ki-67 dual-stained cytology if positive for other subtypes; (4) co-testing with HPV and Pap. Screening scenarios were based on a 10-year horizon. All HPV screening scenarios in the model were associated with fewer deaths from missed diagnosis of cervical cancer compared with Pap screening; 10-year totals n=172-344 (1.5-3 per 100,000) versus n=477 (4.1 per 100,000), respectively. Total annual costs were lower with HPV screening than Pap cytology. The projected average annual cost for HPV screening ranged from €117 million to €136 million compared with €177 million for Pap screening, representing annual savings of €41-60 million. The greatest clinical impact was achieved with primary HPV screening (with genotyping) followed by colposcopy for HPV 16/18-positive women or p16/Ki-67 dual-stained cytology for women positive for other HPV subtypes. Screening strategies including primary HPV testing for high-risk subtypes (HPV-16/18) in conjunction with p16/Ki-67 dual-stained cytology can improve the detection of cervical cancer at a lower total annual cost than conventional Pap cytology screening. Copyright © 2017. Published by Elsevier B.V.

  20. Pre-trained convolutional neural networks as feature extractors toward improved malaria parasite detection in thin blood smear images

    Directory of Open Access Journals (Sweden)

    Sivaramakrishnan Rajaraman

    2018-04-01

    Full Text Available Malaria is a blood disease caused by the Plasmodium parasites transmitted through the bite of female Anopheles mosquito. Microscopists commonly examine thick and thin blood smears to diagnose disease and compute parasitemia. However, their accuracy depends on smear quality and expertise in classifying and counting parasitized and uninfected cells. Such an examination could be arduous for large-scale diagnoses resulting in poor quality. State-of-the-art image-analysis based computer-aided diagnosis (CADx methods using machine learning (ML techniques, applied to microscopic images of the smears using hand-engineered features demand expertise in analyzing morphological, textural, and positional variations of the region of interest (ROI. In contrast, Convolutional Neural Networks (CNN, a class of deep learning (DL models promise highly scalable and superior results with end-to-end feature extraction and classification. Automated malaria screening using DL techniques could, therefore, serve as an effective diagnostic aid. In this study, we evaluate the performance of pre-trained CNN based DL models as feature extractors toward classifying parasitized and uninfected cells to aid in improved disease screening. We experimentally determine the optimal model layers for feature extraction from the underlying data. Statistical validation of the results demonstrates the use of pre-trained CNNs as a promising tool for feature extraction for this purpose.

  1. Agroecologia: Potencializando os papéis das mulheres rurais

    Directory of Open Access Journals (Sweden)

    Fabiana da Silva Andersson

    2017-04-01

    Full Text Available O artigo analisa se e como a agroecologia potencializa os papéis das mulheres rurais, em sua maioria agricultoras, dos municípios de Arroio do Padre e São Lourenço do Sul (RS. Através da realização de entrevistas em profundidade e da observação participante, o artigo analisa as percepções dessas mulheres a respeito das realidades por elas vivenciadas tanto no âmbito produtivo (lavoura como reprodutivo (doméstico. É importante destacar que, em Arroio do Padre, há um processo incipiente de “agroecologização”, ou seja, as unidades familiares encontram-se nos níveis iniciais da transição agroecológica. Já em São Lourenço do Sul, observou-se que essas mulheres atuam na agroecologia há mais de 40 anos. Estas distintas trajetórias conferem percepções de mundo diferenciadas entre os dois contextos sociais. Enquanto para as interlocutoras de Arroio do Padre a agroecologia pouco interfere em suas escolhas dentro e fora de casa, já para as entrevistadas de São Lourenço do Sul é essencial no repensar das relações estabelecidas no lar e no seu entorno, especialmente nos assuntos que tangem aos mercados e a sua valorização enquanto “agricultora”.

  2. Time-dependent effect of p-Aminophenol (PAP) toxicity in renal slices and development of oxidative stress

    International Nuclear Information System (INIS)

    Harmon, R. Christopher; Terneus, Marcus V.; Kiningham, Kinsley K.; Valentovic, Monica

    2005-01-01

    p-Aminophenol (PAP), a metabolite of acetaminophen, is nephrotoxic. This study investigated PAP-mediated changes as a function of time that occur prior to loss of membrane integrity. Experiments further evaluated the development of oxidative stress by PAP. Renal slices from male Fischer 344 (F344) rats (N = 4-6) were exposed to 0.1, 0.25, and 0.5 mM PAP for 15-120 min under oxygen and constant shaking at 37 o C. Pyruvate-stimulated gluconeogenesis, adenine nucleotide levels, and total glutathione (GSH) levels were diminished in a concentration- and time-dependent manner prior to detection of a rise in lactate dehydrogenase (LDH) leakage. Glutathione disulfide (GSSG) levels were increased by PAP suggesting the induction of oxidative stress. Western blot analysis confirmed a rise in 4-hydroxynonenal (4-HNE)-adducted proteins in tissues exposed to 0.1 and 0.25 mM PAP for 90 min. The appearance of 4-HNE-adducted proteins at the 0.1 mM concentration of PAP occurred prior to development of increased LDH leakage. Pretreatment with 1 mM glutathione (GSH) for 30 min only partially reduced PAP toxicity as LDH values were less severely depleted relative to tissues not pretreated with GSH. In contrast, pretreatment for 15 min with 2 mM ascorbic acid completely protected against PAP toxicity. Further studies showed that ascorbic acid pretreatment prevented PAP-mediated depletion of GSH. In summary, PAP rapidly depletes GSH and adenine nucleotides and inhibits gluconeogenesis prior to a rise in LDH leakage. PAP induces oxidative stress as indicated by an increase in GSSG and 4-HNE-adducted proteins. Ascorbic acid pretreatment prevents PAP toxicity by maintaining GSH status

  3. The quality of sputum smear microscopy diagnosis of pulmonary ...

    African Journals Online (AJOL)

    The quality of sputum smear microscopy diagnosis of pulmonary tuberculosis in Dar es Salaam, Tanzania. G S Mfinanga, E Ngadaya, R Mtandu, B Mutayoba, B Doulla, G Kimaro, T M Chonde, P Ngowi, S Mfaume, A M Kilale, S Egwaga, A Y Kitua ...

  4. A Comparative Scanning Electron Microscopy Evaluation of Smear ...

    African Journals Online (AJOL)

    2018-02-07

    Feb 7, 2018 ... The aim of the present study was to compare the efficacy of chitosan and MTAD for the smear layer removal from the root canal through a scanning electron microscope (SEM). Thirty teeth were randomly divided into three groups according to the final irrigants: 0.2% chitosan, MTAD, saline (control group).

  5. A Comparative Scanning Electron Microscopy Evaluation of Smear ...

    African Journals Online (AJOL)

    The aim of the present study was to compare the efficacy of chitosan and MTAD for the smear layer removal from the root canal through a scanning electron microscope (SEM). Thirty teeth were randomly divided into three groups according to the final irrigants: 0.2% chitosan, MTAD, saline (control group). After the ...

  6. A Correlation Of Symptomatology With Nasal Smear Eosinophilia In ...

    African Journals Online (AJOL)

    There is also low correlation of total symptom score with family history of atopy (r = 0.06). There is positive correlation of total symptom score with number of provocative agents identified (r = 0.34). There is low positive correlation of nasal smear eosinophilia with total symptom score (r = 0.030) and itchy nose score (r = 0.038) ...

  7. Potential application of electronic nose in processed animal proteins (PAP detection in feedstuffs

    Directory of Open Access Journals (Sweden)

    Dell'Orto V.

    2004-01-01

    Full Text Available Electronic nose and olfactometry techniques represent a modern analytical approach in food industry since they could potentially improve quality and safety of food processing. The aim of this study was to evaluate possible application of electronic nose in PA P detection and recognition in feed. For this purpose 6 reference feedstuffs (CRA-W / UE STRAT F E E D Project were used. The basis of the test samples was a compound feed for bovine fortified with processed animal proteins ( PAP consisting of meat and bone meal (MBM and/or fish meal at different concentrations. Each feed sample was tested in glass vials and the odour profile was determined by the ten MOS (metal oxide semi-conductor sensors of the electronic nose. Ten different descriptors, representing each ten sensors of electronic nose, were used to characterise the odour of each sample. In the present study, electronic nose was able to discriminate the blank sample from all other samples containing PA P ( M B M , fish meal or both. Samples containing either 0.5% of MBM or 5% of fish meal were identified, while samples containing a high fish meal content (5% associated with a low MBM content (0.5% were not discriminated from samples containing solely fish meal at that same high level (5%. This latter indicates that probably the high fish meal level, in samples containing both MBM and fish meal, tended to mask MBM odour. It was also evident that two odour descriptors were enough to explain 72.12% of total variability in odour pattern. In view of these results, it could be suggested that electronic nose and olfactometry techniques can provide an interesting approach for screening raw materials in feed industry, even though further studies using a wider set of samples are needed.

  8. [Sexual risk behaviours and PAP testing in university women vaccinated against human papillomavirus].

    Science.gov (United States)

    Fernández-Feito, Ana; Antón-Fernández, Raquel; Paz-Zulueta, María

    2018-05-01

    To estimate the association between the human papillomavirus (HPV) vaccine and sexual risk behaviour, as well as the participation in the Cervical Cancer Screening Program (CCSP). Cross-sectional study. School of Medicine and Health Sciences, School of Law, and School of Economics and Business (University of Oviedo). Female university students. Information was collected about contraceptive methods, sexual behaviours, HPV knowledge, and participation in the CCSP. Furthermore, proportions and odds ratio (OR) were estimated with their corresponding 95% confidence intervals (95%CI). Approximately two-thirds (67.7%) of the sample was vaccinated against HPV, and 216 women (65.3%) were sexually active. Barrier contraceptive methods were used by 67.6% during their current intimate relationships, being less frequent in non-vaccinated women (54.9% vs. 75.4% in vaccinated female students) (P=.002). The risk of having at least one sexual risk behaviour was higher in non-vaccinated women: OR2.29 (95%CI: 1.29-4.07). In addition, the probability of having a PAP test within the CCSP was higher in non-vaccinated women: OR2.18 (95%CI: 1.07-4.47). The prevalence of sexual risk behaviours in non-vaccinated women is elevated, and it is related to the lack of use of barrier contraceptive methods. The vaccination against HPV could affect sexual behaviours and the participation in the CCSP. Therefore, the information received by young people about contraceptive methods, sexually transmitted diseases, and cancer prevention should be reinforced. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  9. Rates of initial acceptance of PAP masks and outcomes of mask switching.

    Science.gov (United States)

    Bachour, Adel; Vitikainen, Pirjo; Maasilta, Paula

    2016-05-01

    Recently, we noticed a considerable development in alleviating problems related to positive airway pressure (PAP) masks. In this study, we report on the initial PAP mask acceptance rates and the effects of mask switching on mask-related symptoms. We prospectively collected all cases of mask switching in our sleep unit for a period of 14 months. At the time of the study, we used ResMed™ CPAP devices and masks. Mask switching was defined as replacing a mask used for at least 1 day with another type of mask. Changing to a different size but keeping the same type of mask did not count as mask switching. Switching outcomes were considered failed if the initial problem persisted or reappeared during the year that followed switching. Our patient pool was 2768. We recorded 343 cases of mask switching among 267 patients. Of the 566 patients who began new PAP therapy, 108 (39 women) had switched masks, yielding an initial mask acceptance rate of 81 %. The reason for switching was poor-fit/uncomfortable mask in 39 %, leak-related in 30 %, outdated model in 25 %, and nasal stuffiness in 6 % of cases; mask switching resolved these problems in 61 %. Mask switching occurred significantly (p = 0.037) more often in women and in new PAP users. The odds ratio for abandoning PAP therapy within 1 year after mask switching was 7.2 times higher (interval 4.7-11.1) than not switching masks. The initial PAP mask acceptance rate was high. Patients who switched their masks are at greater risk for abandoning PAP therapy.

  10. Influencing Cancer Screening Participation Rates—Providing a Combined Cancer Screening Program (a ‘One Stop’ Shop Could Be a Potential Answer

    Directory of Open Access Journals (Sweden)

    Amanda Bobridge

    2017-12-01

    Full Text Available IntroductionParticipation in established cancer screening programs remains variable. Therefore, a renewed focus on how to increase screening uptake, including addressing structural barriers such as time, travel, and cost is needed. One approach could be the provision of combined cancer screening, where multiple screening tests are provided at the same time and location (essentially a ‘One Stop’ screening shop. This cohort study explored both cancer screening behavior and the acceptability of a combined screening approach.MethodsParticipants of the North Western Adelaide Health Study (NWAHS, South Australia were invited to participate in a questionnaire about cancer screening behaviors and the acceptability of a proposed ‘One Stop’ cancer screening shop. Data were collected from 10th August 2015 to 18th January 2016, weighted for selection probability, age, and sex and analyzed using descriptive and multivariable logistic regression analysis.Results1,562 people, 52% female (mean age 54.1 years ± 15.2 participated. Reported screening participation was low, the highest being for Pap Smear (34.4%. Common reasons for screening participation were preventing sickness (56.1%, CI 53.2–59.0%, maintaining health (51%, CI 48–53.9%, and free program provision (30.9%, CI 28.2–33.6%. Females were less likely to state that screening is not beneficial [OR 0.37 (CI 0.21–0.66, p < 0.001] and to cite sickness prevention [OR 2.10 (CI 1.46–3.00, p < 0.001] and free program [OR 1.75 (CI 1.22–2.51, p < 0.003] as reasons for screening participation. Of those who did not participate, 34.6% (CI 30.3–39.1% stated that there was nothing that discouraged them from participation, with 55- to 64-year olds [OR 0.24 (CI 0.07–0.74, p < 0.04] being less likely to cite this reason. 21% (CI 17.2–24.8% thought they did not need screening, while a smaller proportion stated not having time (6.9%, CI 4.9–9.7% and the costs associated

  11. Recombinant mouse PAP has pH-dependent ectonucleotidase activity and acts through A(1-adenosine receptors to mediate antinociception.

    Directory of Open Access Journals (Sweden)

    Nathaniel A Sowa

    Full Text Available Prostatic acid phosphatase (PAP is expressed in nociceptive neurons and functions as an ectonucleotidase. When injected intraspinally, the secretory isoforms of human and bovine PAP protein have potent and long-lasting antinociceptive effects that are dependent on A(1-adenosine receptor (A(1R activation. In this study, we purified the secretory isoform of mouse (mPAP using the baculovirus expression system to determine if recombinant mPAP also had antinociceptive properties. We found that mPAP dephosphorylated AMP, and to a much lesser extent, ADP at neutral pH (pH 7.0. In contrast, mPAP dephosphorylated all purine nucleotides (AMP, ADP, ATP at an acidic pH (pH 5.6. The transmembrane isoform of mPAP had similar pH-dependent ectonucleotidase activity. A single intraspinal injection of mPAP protein had long-lasting (three day antinociceptive properties, including antihyperalgesic and antiallodynic effects in the Complete Freund's Adjuvant (CFA inflammatory pain model. These antinociceptive effects were transiently blocked by the A(1R antagonist 8-cyclopentyl-1, 3-dipropylxanthine (CPX, suggesting mPAP dephosphorylates nucleotides to adenosine to mediate antinociception just like human and bovine PAP. Our studies indicate that PAP has species-conserved antinociceptive effects and has pH-dependent ectonucleotidase activity. The ability to metabolize nucleotides in a pH-dependent manner could be relevant to conditions like inflammation where tissue acidosis and nucleotide release occur. Lastly, our studies demonstrate that recombinant PAP protein can be used to treat chronic pain in animal models.

  12. Hubungan Antara Dislipidemia Dengan Status Penyakit Arteri Perifer (Pap) Pada Pasien Diabetes Melitus Tipe 2 Terkontrol Sedang

    OpenAIRE

    Aryani, Eka; Nugroho HS, K. Heri; Margawati, Ani

    2016-01-01

    Latar Belakang: Penyakit arteri perifer adalah gangguan suplai darah ke ekstremitas atas atau bawah karena obstruksi yang disebabkan aterosklerosis. Pasien PAP memiliki risiko yang lebih besar terhadap kematian akibat stroke, infark miokard dan serangan jantung. Diabetes melitus dan dislipidemia merupakan faktor risiko PAP yang sering ditemukan. Belum terdapat penelitian mengenai hubungan dislipidemia dengan status PAP pada pasien DM tipe II terkontrol sedang.Tujuan: Membuktikan hubungan anta...

  13. Importance of a 5′ Stem-Loop for Longevity of papA mRNA in Escherichia coli

    OpenAIRE

    Bricker, Angela L.; Belasco, Joel G.

    1999-01-01

    High-level expression of the major pilus subunit (PapA) of uropathogenic strains of Escherichia coli results in part from the unusually long lifetime of the mRNA that encodes this protein. Here we report that the longevity of papA mRNA derives in large measure from the protection afforded by its 5′ untranslated region. This papA RNA segment can prolong the lifetime of an otherwise short-lived mRNA to which it is fused. In vivo alkylation studies indicate that, in its natural milieu, the papA ...

  14. Sputum Conversion Among Patients With Smear Positive Pulmonary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Soudbakhsh A R

    2003-06-01

    Full Text Available Introduction: In the patients with smear-positive pulmonary tuberculosis (TB bacteriologic assessment of sputum for detection of acid bacilli (AFB Has essential role. This evaluation is accomplished by direct sputum smear & sputum culture. These examinations must be done in regular and preferably monthly after beginning of treatment. These tests have two important aims, including, determining of treatment efficacy & duration of isolation."nMethods and Materials: Most of the studies have that classic six month regimen led to sputum smear conversion & negative sputum culture in 85% of patient. This treatment regimen has two phases, including, attack phase and maintenance phase. In the attack phase we use four drugs, including, Isoniazid (INH, Rifampin (RMP, Pyrazinamide (PZA and Ethambutol (EMB for the first 2 months and if necessary until the end of third month. In the maintenance phase we use INH and Rif for the remaining of treatment course. The main objectives of this study were to determine the time needed for smear conversion and assessment of probable factors which may influence the smear conversion until 4 months after beginning of therapy. The factors that were assessed, were, Age, nationality, sex, clinical symptoms, underlying diseases, chest radiography (number of cavities, smoking, drug abuse and concentration of AF13 in the sputum Generally, we did this cross sectional study on the patient's records, who had been observed in Imam Khomeni Hospital, west health service center and masih daneshvary hospital between."nResults: This study showed that from totally 218 patients, 138(74.6% patients had sputum conversion at the first 2 months of treatment and until the end of 3rd & 4th month this rate reached to 83.3% respectively. So in the end of fourth month only 32(14.7% patients did not show sputum smear conversion. On the other hand this study showed that two factors including presence of cavities in chest radiography

  15. Combined analysis of cervical smears. Cytopathology, image cytometry and in situ hybridization

    DEFF Research Database (Denmark)

    Multhaupt, H; Bruder, E; Elit, L

    1993-01-01

    . HPV infection correlated with DNA polyploidy but was seen in 15 of 29 smears classified as cytologically normal. Morphologically abnormal Papanicolaou smears correlated with aneuploid DNA content. Smears classified as intraepithelial neoplasia correlated with aneuploid DNA content in all 12 cases...

  16. Dysbacteriosis in silver-stained cervical smears of Dutch-Moroccan immigrants : HPV infection and preneoplasia

    NARCIS (Netherlands)

    Verbruggen, BSM; Boon, ME; van Schie, MA; Wijsman-Grootendorst, R; Kok, LP

    The vaginal/cervical smears of a group of Moroccan immigrants were used to compare vaginal dysbacteriosis (i.e., a bacterial population change with a decrease in lactobacilli and an increase of coccoid bacteria in vaginal/cervical smears) with Dutch women. From our archives, 779 smears from Moroccan

  17. Increasing Cervical Cancer Screening in Underserved Populations.

    Science.gov (United States)

    Dorsainvil, Merlyn A

    The incidence of cervical cancer has declined dramatically due to Papanicolaou smear testing. However, some minority populations continue to suffer with high incidences and/or death rates of cervical cancer, due to lack of screening. This article updates on cervical cancer screening and prevention and discusses cultural impacts on screening. Knowledge deficits disproportionately affect ethnic minority groups and contribute to cancer incidence, whereas lack of healthcare coverage and low socioeconomic status contribute to screening disparities. Although minority women have cultural beliefs and practices that influence screening, recommendation and/or education from a provider often lead to screening.

  18. Eggs containing larvae of Enterobius vermicularis in vaginal smear

    Directory of Open Access Journals (Sweden)

    Jyothi B Shetty

    2012-01-01

    Full Text Available Enterobius vermicularis also known commonly as pinworm is the most common intestinal parasite. It is a nematode that inhabits the human terminal ileum, colon and appendix. The fertilized female migrates to the perianal area where eggs are deposited but occasionally introduces itself into adjacent orifices, most commonly the female genitourinary tract. Thus the eggs can be seen in the vaginal smear as a result of contamination. We report a case wherein the patient presented with signs and symptoms of vulvovaginitis. In her vaginal smear there were eggs of Enterobius vermicularis which showed a coiled larva within it. In the background there were plenty of acute inflammatory cells. This patient responded favorably to antihelminthics. We report this case to highlight the morphology of the parasite and also to emphasize that such findings should not be neglected. Timely reporting and appropriate treatment of such cases will prevent further complications of this parasite including endometritis, salphingitis and peritonitis.

  19. Delay in treatment seeking of smear positive tuberculous patients

    International Nuclear Information System (INIS)

    Bhatti, A.T.; Zahid, M.

    2010-01-01

    To assess and identify the causes and circumstances leading to delays in health seeking and diagnosis of tuberculosis patients as they often present with advance disease resulting in increased morbidity and mortality. Settings Department of Tuberculosis, DOTS clinic DHQ Hospital, Vehari. Methodology One (author) inspiration diagnosed smear positive pulmonary tuberculosis patients were included. Information was gathered through interviews and from TB-01 card. Results Maximum patients were in age group of 16-40 years. Median patient delay was 4-6 months; jobless, homeless personnel had longer delay. The main reason for delay was that the symptoms were not considered serious enough. Delay in presentation of smear positive cases may be due to the lack of awareness of patients and the incompetence of some health workers. Training and supervision of staff and awareness campaigns targeted at the population and involvement of private sector will improve TB control in Vehari. (author)

  20. Effect of cervical cancer education and provider recommendation for screening on screening rates: A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jonah Musa

    be eligible for inclusion in qualitative synthesis (5 of which were included in meta-analysis of educational interventions and 8 combined in meta-analysis of HPV self-sampling interventions, while 45 were excluded for various reasons. The use of theory-based educational interventions significantly increased CCS rates by more than double (OR, 2.46, 95% CI: 1.88, 3.21. Additionally, offering women the option of self-sampling for Human Papillomavirus (HPV testing increased CCS rates by nearly 2-fold (OR = 1.71, 95% CI: 1.32, 2.22. We also found that invitation letters alone (or with a follow up phone contact, making an appointment, and sending reminders to patients who are due or overdue for screening had a significant effect on improving participation and CCS rates in populations at risk.Our findings supports the implementation of theory-based cervical cancer educational interventions to increase women's participation in cervical cancer screening programs, particularly when targeting communities with low literacy levels. Additionally, cervical cancer screening programs should consider the option of offering women the opportunity for self-sample collection particularly when such women have not responded to previous screening invitation or reminder letters for Pap smear collection as a method of screening.

  1. TEMPORAL SMEARING OF TRANSIENT RADIO SOURCES BY THE INTERGALACTIC MEDIUM

    International Nuclear Information System (INIS)

    Macquart, Jean-Pierre; Koay, Jun Yi

    2013-01-01

    The temporal smearing of impulsive radio events at cosmological redshifts probes the properties of the ionized intergalactic medium (IGM). We relate the degree of temporal smearing and the profile of a scattered source to the evolution of a turbulent structure in the IGM as a function of redshift. We estimate the degree of scattering expected by analyzing the contributions to the scattering measure of the various components of baryonic matter embedded in the IGM, including the diffuse IGM, intervening galaxies, and intracluster gas. These estimates predict that the amount of temporal smearing expected at 300 MHz is typically as low as ∼1 ms and suggests that these bursts may be detectable with low-frequency widefield arrays. A generalization of the dispersion-measure-scattering-measure relation observed for Galactic scattering to the densities and turbulent conditions relevant to the IGM suggests that scattering measures on the order of 10 –6 kpc m –20/3 would be expected at z ∼ 1. This scattering is sufficiently low enough that its effects would not, for most lines of sight, be manifested in existing observations of the scatter broadening in images of extragalactic compact sources. The redshift dependence on the temporal smearing discriminates between scattering that occurs in the host galaxy of the burst and the IGM, with τ host ∝(1 + z) –3 if the scattering probes length scales below the inner scale of the turbulence or τ host ∝(1 + z) –17/5 if the turbulence follows a Kolmogorov spectrum. This differs strongly from the expected IGM scaling τ IGM ∼ z 2 for z ∼ 0.2–0.5 for z ∼> 1

  2. The Effect of Smear Layer Removal on Endodontic Outcomes

    Science.gov (United States)

    2012-06-01

    determined with a 0.02 taper #10 stainless steel FlexoFile (Dentsply Maillefer, Tulsa, OK) on all canals using a Root ZX (J Morita, Irvine,CA) apex...of adhesion based root canal filling materials in which smear plugs are removed to allow for the formation of a resin based hybrid layer have not...in eliminating intracanal enterococcus faecalis Biofilm . J Endod 2010; 36:894-98. 23. Chugal NM, Clive JM, Spangberg LSW. A prognostic model for

  3. Pneumocephalus with BiPAP use after transsphenoidal surgery☆,☆☆,★

    Science.gov (United States)

    Kopelovich, Jonathan C.; de la Garza, Gabriel O.; Greenlee, Jeremy D.W.; Graham, Scott M.; Udeh, Chiedozie I.; O'Brien, Erin K.

    2013-01-01

    While the benefits of continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) for patients with obstructive sleep apnea are well described, reports in the literature of complications from its use are rare. A patient who received postoperative BiPAP after undergoing transsphenoidal craniopharyngioma resection developed severe pneumocephalus and unplanned intensive care unit admission. Although the pneumocephalus resolved with conservative management over two weeks, we propose caution in the use of CPAP postoperatively in patients undergoing procedures of the head and neck. PMID:22626688

  4. Evaluation of whole-body cancer screening using 18F-2-deoxy-2-fluoro-D-glucose positron emission tomography. A preliminary report

    International Nuclear Information System (INIS)

    Terauchi, Takashi; Murano, Takeshi; Daisaki, Hiromitsu; Kanou, Daisuke; Shoda, Hiroko; Kakinuma, Ryutaro; Hamashima, Chisato; Moriyama, Noriyuki; Kakizoe, Tadao

    2008-01-01

    18 F-2-deoxy-2-fluoro-d-glucose positron emission tomography (FDG-PET) is a promising screening modality targeting whole body. However, the validity of PET cancer screening remains to be assessed. Even the screening accuracy for whole-body screening using FDG-PET has not been evaluated. In this study, we investigated the screening accuracy of PET cancer screening. A total of 2911 asymptomatic participants (1629 men and 1282 women, mean age 59.79 years) underwent both FDG-PET and other thorough examinations for multiple organs (gastrofiberscopy, total colonofiberscopy or barium enema, low-dose thin section computed tomography and sputum cytology, abdominal ultrasonography, an assay of prostate-specific antigen, mammography, mammary ultrasonography, Pap smear for the uterine cervix, and magnetic resonance imaging for the endometrium and ovaries) between February 2004 and January 2005, and followed sufficiently. The detection rate, sensitivity, specificity, and positive predictive value of FDG-PET were calculated using cancer data obtained from all examinations along with a 1 year follow-up. From among 2911 participants FDG-PET found 28 cancers, 129 cancers were PET negative. PET-positive cancers comprised seven colorectal cancers, four lung cancers, four thyroid cancers, three breast cancers, two gastric cancers, two prostate cancers, two small intestinal sarcomas (gastrointestinal stromal tumors), one malignant lymphoma, one head and neck malignancy (nasopharyngeal carcinoid tumor), one thymoma, and one hepatocellular carcinoma. PET-negative cancers included 22 gastric cancers and 20 prostate cancers that were essentially difficult to detect using FDG-PET. The overall detection rate, sensitivity, specificity, and positive predictive value were estimated to be 0.96%, 17.83%, 95.15%, and 11.20%, respectively. FDG-PET can detect a variety of cancers at an early stage as part of a whole-body screening modality. The detection rate of PET cancer screening was higher than

  5. Anorectal smear in the diagnosis of anorectal adenocarcinoma

    Directory of Open Access Journals (Sweden)

    D Demirel

    2013-01-01

    Full Text Available The purpose of this case report is to point out the diagnostic value of cytologic smears in patients presenting with anorectal complaints, such as bleeding, pain or discomfort, which may suggest a neoplastic lesion. We present a case of a 64-year-old man with a 3 months′ history of anal bleeding and pain during defecation. He was diagnosed as having hemorrhoids and a hemorrhoidectomy was performed. The patient developed an anal stricture postoperatively that required operative dilation. He continued to complain about anorectal pain for 2 months and a subsequent rectoscopy revealed the presence of tumor 5 to 7 cm above the dentate line. The tumor was resected laparoscopically and was reported as an adenocarcinoma. Rectal bleeding recurred 18 months postoperatively and a smear was procured from the anorectal mucosal surface for cytologic evaluation. A definitive diagnosis of adenocarcinoma was rendered based on cytologic and histologic examination of the material. To the best of our knowledge, this is the first case report of anorectal adenocarcinoma diagnosed by cytologic smear in the English literature.

  6. U.S. Preventive Services Task Force recommendations and cancer screening among female Medicare beneficiaries.

    Science.gov (United States)

    Salloum, Ramzi G; Kohler, Racquel E; Jensen, Gail A; Sheridan, Stacey L; Carpenter, William R; Biddle, Andrea K

    2014-03-01

    Medicare covers several cancer screening tests not currently recommended by the U.S. Preventive Services Task Force (Task Force). In September 2002, the Task Force relaxed the upper age limit of 70 years for breast cancer screening recommendations, and in March 2003 an upper age limit of 65 years was introduced for cervical cancer screening recommendations. We assessed whether mammogram and Pap test utilization among women with Medicare coverage is influenced by changes in the Task Force's recommendations for screening. We identified female Medicare beneficiaries aged 66-80 years and used bivariate probit regression to examine the receipt of breast (mammogram) and cervical (Pap test) cancer screening reflecting changes in the Task Force recommendations. We analyzed 9,760 Medicare Current Beneficiary Survey responses from 2001 to 2007. More than two-thirds reported receiving a mammogram and more than one-third a Pap test in the previous 2 years. Lack of recommendation was given as a reason for not getting screened among the majority (51% for mammogram and 75% for Pap). After controlling for beneficiary-level socioeconomic characteristics and access to care factors, we did not observe a significant change in breast and cervical cancer screening patterns following the changes in Task Force recommendations. Although there is evidence that many Medicare beneficiaries adhere to screening guidelines, some women may be receiving non-recommended screening services covered by Medicare.

  7. The contribution of culture to Korean American women's cervical cancer screening behavior: the critical role of prevention orientation.

    Science.gov (United States)

    Lee, Hee Yun; Roh, Soonhee; Vang, Suzanne; Jin, Seok Won

    2011-01-01

    Despite the proven benefits of Pap testing, Korean American women have one of the lowest cervical cancer screening rates in the United States. This study examined how cultural factors are associated with Pap test utilization among Korean American women participants. Quota sampling was used to recruit 202 Korean American women participants residing in New York City. Hierarchical logistic regression was used to assess the association of cultural variables with Pap test receipt. Overall, participants in our study reported significantly lower Pap test utilization; only 58% reported lifetime receipt of this screening test. Logistic regression analysis revealed one of the cultural variables--prevention orientation--was the strongest correlate of recent Pap test use. Older age and married status were also found to be significant predictors of Pap test use. Findings suggest cultural factors should be considered in interventions promoting cervical cancer screening among Korean American women. Furthermore, younger Korean American women and those not living with a spouse/partner should be targeted in cervical cancer screening efforts.

  8. CNS activity of Pokeweed Anti-viral Protein (PAP in mice infected with Lymphocytic Choriomeningitis Virus (LCMV

    Directory of Open Access Journals (Sweden)

    Tibbles Heather E

    2005-02-01

    Full Text Available Abstract Background Others and we have previously described the potent in vivo and in vitro activity of the broad-spectrum antiviral agent PAP (Pokeweed antiviral protein against a wide range of viruses. The purpose of the present study was to further elucidate the anti-viral spectrum of PAP by examining its effects on the survival of mice challenged with lymphocytic choriomeningitis virus (LCMV. Methods We examined the therapeutic effect of PAP in CBA mice inoculated with intracerebral injections of the WE54 strain of LCMV at a 1000 PFU dose level that is lethal to 100% of mice within 7–9 days. Mice were treated either with vehicle or PAP administered intraperitoneally 24 hours prior to, 1 hour prior to and 24 hours, 48 hours 72 hours and 96 hours after virus inoculation. Results PAP exhibits significant in vivo anti- LCMV activity in mice challenged intracerebrally with an otherwise invariably fatal dose of LCMV. At non-toxic dose levels, PAP significantly prolonged survival in the absence of the majority of disease-associated symptoms. The median survival time of PAP-treated mice was >21 days as opposed to 7 days median survival for the control (p = 0.0069. Conclusion Our results presented herein provide unprecedented experimental evidence that PAP exhibits antiviral activity in the CNS of LCMV-infected mice.

  9. Star-PAP Control of BIK Expression and Apoptosis Is Regulated by Nuclear PIPKIα and PKCδ Signaling

    Science.gov (United States)

    Li, Weimin; Laishram, Rakesh S.; Ji, Zhe; Barlow, Christy A.; Tian, Bin; Anderson, Richard A.

    2012-01-01

    SUMMARY BIK protein is an initiator of mitochondrial apoptosis and BIK expression is induced by pro-apoptotic signals including DNA damage. Here we demonstrate that 3′-end processing and expression of BIK mRNA are controlled by the nuclear PI4,5P2-regulated poly(A) polymerase Star-PAP downstream of DNA damage. Nuclear PKCδ is a key mediator of apoptosis and DNA damage stimulates PKCδ association with the Star-PAP complex where PKCδ is required for Star-PAP-dependent BIK expression. PKCδ binds the PI4,5P2-generating enzyme PIPKIα, which is essential for PKCδ interaction with the Star-PAP complex and PKCδ activity is directly stimulated by PI4,5P2. Features in the BIK 3′-UTR uniquely define Star-PAP specificity and may block canonical PAP activity toward BIK mRNA. This reveals a nuclear phosphoinositide signaling nexus where PIPKIα, PI4,5P2 and PKCδ regulate Star-PAP control of BIK expression and induction of apoptosis. This pathway is distinct from the Star-PAP-mediated oxidative stress pathway indicating signal-specific regulation of mRNA 3′-end processing. PMID:22244330

  10. A pilot study of short-duration sputum pretreatment procedures for optimizing smear microscopy for tuberculosis.

    Directory of Open Access Journals (Sweden)

    Peter Daley

    2009-05-01

    Full Text Available Direct sputum smear microscopy for tuberculosis (TB lacks sensitivity for the detection of acid fast bacilli. Sputum pretreatment procedures may enhance sensitivity. We did a pilot study to compare the diagnostic accuracy and incremental yield of two short-duration (<1 hour sputum pretreatment procedures to optimize direct smears among patients with suspected TB at a referral hospital in India.Blinded laboratory comparison of bleach and universal sediment processing (USP pretreated centrifuged auramine smears to direct Ziehl-Neelsen (ZN and direct auramine smears and to solid (Loweinstein-Jensen (LJ and liquid (BACTEC 460 culture. 178 pulmonary and extrapulmonary TB suspects were prospectively recruited during a one year period. Thirty six (20.2% were positive by either solid or liquid culture. Direct ZN smear detected 22 of 36 cases and direct auramine smears detected 26 of 36 cases. Bleach and USP centrifugation detected 24 cases each, providing no incremental yield beyond direct smears. When compared to combined culture, pretreated smears were not more sensitive than direct smears (66.6% vs 61.1 (ZN or 72.2 (auramine, and were not more specific (92.3% vs 93.0 (ZN or 97.2 (auramine.Short duration sputum pretreatment with bleach and USP centrifugation did not increase yield as compared to direct sputum smears. Further work is needed to confirm this in a larger study and also determine if longer duration pre-treatment might be effective in optimizing smear microscopy for TB.

  11. Lot quality assurance sampling of sputum acid-fast bacillus smears for assessing sputum smear microscopy centers.

    Science.gov (United States)

    Selvakumar, N; Murthy, B N; Prabhakaran, E; Sivagamasundari, S; Vasanthan, Samuel; Perumal, M; Govindaraju, R; Chauhan, L S; Wares, Fraser; Santha, T; Narayanan, P R

    2005-02-01

    Assessment of 12 microscopy centers in a tuberculosis unit by blinded checking of eight sputum smears selected by using a lot quality assurance sampling (LQAS) method and by unblinded checking of all positive and five negative slides, among the slides examined in a month in a microscopy centre, revealed that the LQAS method can be implemented in the field to monitor the performance of acid-fast bacillus microscopy centers in national tuberculosis control programs.

  12. Scaling up cervical cancer screening in the midst of human papillomavirus vaccination advocacy in Thailand

    Directory of Open Access Journals (Sweden)

    Teerawattananon Yot

    2010-07-01

    Full Text Available Abstract Background Screening tests for cervical cancer are effective in reducing the disease burden. In Thailand, a Pap smear program has been implemented throughout the country for 40 years. In 2008 the Ministry of Public Health (MoPH unexpectedly decided to scale up the coverage of free cervical cancer screening services, to meet an ambitious target. This study analyzes the processes and factors that drove this policy innovation in the area of cervical cancer control in Thailand. Methods In-depth interviews with key policy actors and review of relevant documents were conducted in 2009. Data analysis was guided by a framework, developed on public policy models and existing literature on scaling-up health care interventions. Results Between 2006 and 2008 international organizations and the vaccine industry advocated the introduction of Human Papillomavirus (HPV vaccine for the primary prevention of cervical cancer. Meanwhile, a local study suggested that the vaccine was considerably less cost-effective than cervical cancer screening in the Thai context. Then, from August to December 2008, the MoPH carried out a campaign to expand the coverage of its cervical cancer screening program, targeting one million women. The study reveals that several factors were influential in focusing the attention of policymakers on strengthening the screening services. These included the high burden of cervical cancer in Thailand, the launch of the HPV vaccine onto the global and domestic markets, the country’s political instability, and the dissemination of scientific evidence regarding the appropriateness of different options for cervical cancer prevention. Influenced by the country’s political crisis, the MoPH’s campaign was devised in a very short time. In the view of the responsible health officials, the campaign was not successful and indeed, did not achieve its ambitious target. Conclusion The Thai case study suggests that the political crisis was a

  13. Scaling up cervical cancer screening in the midst of human papillomavirus vaccination advocacy in Thailand.

    Science.gov (United States)

    Yothasamut, Jomkwan; Putchong, Choenkwan; Sirisamutr, Teera; Teerawattananon, Yot; Tantivess, Sripen

    2010-07-02

    Screening tests for cervical cancer are effective in reducing the disease burden. In Thailand, a Pap smear program has been implemented throughout the country for 40 years. In 2008 the Ministry of Public Health (MoPH) unexpectedly decided to scale up the coverage of free cervical cancer screening services, to meet an ambitious target. This study analyzes the processes and factors that drove this policy innovation in the area of cervical cancer control in Thailand. In-depth interviews with key policy actors and review of relevant documents were conducted in 2009. Data analysis was guided by a framework, developed on public policy models and existing literature on scaling-up health care interventions. Between 2006 and 2008 international organizations and the vaccine industry advocated the introduction of Human Papillomavirus (HPV) vaccine for the primary prevention of cervical cancer. Meanwhile, a local study suggested that the vaccine was considerably less cost-effective than cervical cancer screening in the Thai context. Then, from August to December 2008, the MoPH carried out a campaign to expand the coverage of its cervical cancer screening program, targeting one million women. The study reveals that several factors were influential in focusing the attention of policymakers on strengthening the screening services. These included the high burden of cervical cancer in Thailand, the launch of the HPV vaccine onto the global and domestic markets, the country's political instability, and the dissemination of scientific evidence regarding the appropriateness of different options for cervical cancer prevention. Influenced by the country's political crisis, the MoPH's campaign was devised in a very short time. In the view of the responsible health officials, the campaign was not successful and indeed, did not achieve its ambitious target. The Thai case study suggests that the political crisis was a crucial factor that drew the attention of policymakers to the cervical

  14. Influences on uptake of reproductive health services in Nsangi community of Uganda and their implications for cervical cancer screening

    Directory of Open Access Journals (Sweden)

    Mirembe Florence

    2007-06-01

    Full Text Available Abstract Background Cervical cancer is the most common female cancer in Uganda. Over 80% of women diagnosed or referred with cervical cancer in Mulago national referral and teaching hospital have advanced disease. Plans are underway for systematic screening programmes based on visual inspection, as Pap smear screening is not feasible for this low resource country. Effectiveness of population screening programmes requires high uptake and for cervical cancer, minimal loss to follow up. Uganda has poor indicators of reproductive health (RH services uptake; 10% postnatal care attendance, 23% contraceptive prevalence, and 38% skilled attendance at delivery. For antenatal attendance, attendance to one visit is 90%, but less than 50% for completion of care, i.e. three or more visits. Methods We conducted a qualitative study using eight focus group discussions with a total of 82 participants (16 men, 46 women and 20 health workers. We aimed to better understand factors that influence usage of available reproductive health care services and how they would relate to cervical cancer screening, as well as identify feasible interventions to improve cervical cancer screening uptake. Results Barriers identified after framework analysis included ignorance about cervical cancer, cultural constructs/beliefs about the illness, economic factors, domestic gender power relations, alternative authoritative sources of reproductive health knowledge, and unfriendly health care services. We discuss how these findings may inform future planned screening programmes in the Ugandan context. Conclusion Knowledge about cervical cancer among Ugandan women is very low. For an effective cervical cancer-screening programme, awareness about cervical cancer needs to be increased. Health planners need to note the power of the various authoritative sources of reproductive health knowledge such as paternal aunts (Sengas and involve them in the awareness campaign. Cultural and economic

  15. Cervical Cancer Screening Among Adult Women in China, 2010

    Science.gov (United States)

    Wang, Baohua; He, Minfu; Chao, Ann; Engelgau, Michael M.; Saraiya, Mona; Wang, Limin

    2015-01-01

    Introduction. Cervical cancer is one of the most commonly diagnosed cancers among women in China. The World Health Organization (WHO) recommends routine screening for cervical cancer, and the WHO Global Monitoring Framework suggests that every nation monitors cervical cancer screening. However, little information is available on cervical cancer screening behavior among women in China. Methods. We used data from the 2010 China Chronic Disease and Risk Factor Surveillance System that included 51,989 women aged 18 years and older. We report the proportion of women who reported ever having had a Papanicolaou (Pap) test, stratified by sociodemographic characteristics and geographic region. Multivariable logistic regression modeling was performed to adjust for potential confounders. Results. Overall, 21% of 51,989 women reported having ever had a Pap test. The highest proportion was reported among women aged 30–39 years (30.1%, 95% confidence interval, 26.8%–33.4%). In all geographic regions, women in rural areas were consistently less likely than women in urban areas to report having had a Pap test. Among women who reported ever having a Pap test, 82% reported having the most recent test in the past 3 years. Factors associated with reporting ever having a test were being aged 30–49 years, higher education, being married, and having urban health insurance. Conclusion. Our results indicate that screening programs need to be strengthened along with a more intense focus on specific demographic groups. National cervical cancer screening guidelines and comprehensive implementation strategies are needed to make screening services available and accessible to all women. Implications for Practice: This study is the largest nationwide and population-based assessment of self-reported history of Pap test for cervical cancer screening in China. This article describes cervical cancer screening behavior among women and examines key demographic and geographic factors. Only one

  16. How Often to Get a Pap Test (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2013-01-10

    Cervical cancer has declined in the U.S., however every year over 12,000 women are diagnosed and 4,000 die. This podcast discusses the importance of Pap testing.  Created: 1/10/2013 by MMWR.   Date Released: 1/10/2013.

  17. The Association of Social Support and Education with Breast and Cervical Cancer Screening

    Science.gov (United States)

    Documet, Patricia; Bear, Todd M.; Flatt, Jason D.; Macia, Laura; Trauth, Jeanette; Ricci, Edmund M.

    2015-01-01

    Background: Disparities in breast and cervical cancer screening by socioeconomic status persist in the United States. It has been suggested that social support may facilitate screening, especially among women of low socioeconomic status. However, at present, it is unclear whether social support enables mammogram and Pap test compliance. Purpose:…

  18. Sociocultural barriers to cervical screening in South Auckland, New Zealand.

    Science.gov (United States)

    Lovell, Sarah; Kearns, Robin A; Friesen, Wardlow

    2007-07-01

    Cervical screening has been subject to intense media scrutiny in New Zealand in recent years prompted by a series of health system failings through which a number of women developed cervical cancer despite undergoing regular smears. This paper considers why underscreening persists in a country where cervical screening has a high profile. It explores how the promotion of cervical screening has impacted on the decisions of women to undergo a smear test. Ideas of risk and the new public health are deployed to develop a context for thinking about screening as a form of governing the body. Qualitative interviews with 17 women who were overdue for a cervical smear were undertaken in 2001-2002, yielding understandings of their knowledge of screening and their reasons for postponement. Nine providers of screening services were also interviewed. Concurrent with socioeconomic limitations, concerns over exposing one's body loomed large in women's reasons for delaying being screened. In particular, feelings of shyness and embarrassment were encountered among Maori and Pacific women for whom exposing bodies in the process of smear taking compromises cultural beliefs about sacredness. We conclude that medicalization of the body has, paradoxically, assisted many women in dealing with the intrusion of screening. For others, compliance with the exhortations to be screened brings a high emotional and cultural cost which should at least be considered in health policy debates.

  19. CIR, a corepressor of CBF1, binds to PAP-1 and effects alternative splicing

    International Nuclear Information System (INIS)

    Maita, Hiroshi; Kitaura, Hirotake; Ariga, Hiroyoshi; Iguchi-Ariga, Sanae M.M.

    2005-01-01

    We have reported that PAP-1, a product of a causative gene for autosomal retinitis pigmentosa, plays a role in splicing. In this study, CIR, a protein originally identified as a CBF1-interacting protein and reported to act as a transcriptional corepressor, was identified as a PAP-1 binding protein and its function as a splicing factor was investigated. In addition to a basic lysine and acidic serine-rich (BA) domain and a zinc knuckle-like motif, CIR has an arginine/serine dipeptide repeat (RS) domain in its C terminal region. The RS domain has been reported to be present in the superfamily of SR proteins, which are involved in splicing reactions. We generated CIR mutants with deletions of each BA and RS domain and studied their subcellular localizations and interactions with PAP-1 and other SR proteins, including SC35, SF2/ASF, and U2AF 35 . CIR was found to interact with U2AF 35 through the BA domain, with SC35 and SF2/ASF through the RS domain, and with PAP-1 outside the BA domain in vivo and in vitro. CIR was found to be colocalized with SC35 and PAP-1 in nuclear speckles. Then the effect of CIR on splicing was investigated using the E1a minigene as a reporter in HeLa cells. Ectopic expression of CIR with the E1a minigene changed the ratio of spliced isoforms of E1a that were produced by alternative selection of 5'-splice sites. These results indicate that CIR is a member of the family of SR-related proteins and that CIR plays a role in splicing regulation

  20. Temas das Brincadeiras de Papéis na Educação Infantil

    Directory of Open Access Journals (Sweden)

    Suzana Marcolino

    Full Text Available O objetivo do artigo é discutir os temas da brincadeira de papéis sociais na Educação Infantil, revelados por meio de análise conduzida com base nos estudos da Psicologia Histórico-Cultural. Para Elkonin, na idade pré-escolar a brincadeira atinge o auge de seu desenvolvimento, e se caracteriza pela criação de uma situação imaginária, pela presença de regras e de papéis sociais. Foram observadas situações de brincadeira de crianças de quatro anos e meio a cinco anos e meio em 11 escolas da rede municipal de uma cidade de médio porte do interior paulista. A partir do registro das observações, foram identificadas 27 cenas de brincadeira de papéis. A análise dos dados colhidos confirma a tese de Elkonin de que o desenvolvimento da brincadeira de papéis relaciona-se com o que a criança conhece de sua realidade, e indica a necessidade do estabelecimento de certas condições para que esse desenvolvimento ocorra na Educação Infantil. Nesse sentido, discute-se a necessidade de uma mediação do professor calcada na compreensão da riqueza de implicações que a brincadeira de papéis tem para a formação da pessoa.

  1. Visual inspection with acetic acid for cervical cancer screening outside of low-resource settings La inspección visual con ácido acético para el tamizaje del cáncer cervicouterino donde no hay escasez de recursos

    Directory of Open Access Journals (Sweden)

    Jose Jeronimo

    2005-01-01

    Full Text Available OBJECTIVES: To assess visual inspection with acetic acid (VIA as a screening tool for use in a well-equipped health center in Peru, to evaluate VIA as an alternative or adjunct to the Papanicolaou (Pap smear, and to determine if VIA can play a role in settings other than low-resource ones. METHODS: This was a prospective study of 1 921 asymptomatic women living in Lima, Peru, carried out in 1999 and 2000. The study was performed at a cancer center equipped with the latest-generation technology and highly trained oncologists. The women underwent a complete clinical evaluation, including a Pap smear and VIA. Participants with any positive test were referred for colposcopy and biopsy. RESULTS: More women tested positive by VIA than on the Pap smear (6.9% vs. 4.2%; P = 0.0001. There were 35 women with histologic cervical intraepithelial neoplasia grade 1 (CIN 1; of these, 15 were detected by Pap and 20 by VIA (P = 0.4. A diagnosis of CIN 2 or 3 (CIN 2-3 was confirmed in a total of 13 cases; Pap detected 5 of the cases and VIA 11 of the cases (P = 0.06. The positive predictive value for detection of CIN 2+ was 8.3% for VIA and 6.3% for Pap (P = 0.5. Most importantly, while only 2.3% of patients with a positive VIA were lost to follow-up before colposcopy, that was true for 26.3% of the women with a positive Pap smear (P OBJETIVOS: Determinar si la inspección visual con ácido acético (IVAA es útil como prueba de tamizaje en un centro de salud peruano con buena dotación de equipo; si se presta para uso en lugar del Papanicolaou o en combinación con él, y si tiene alguna utilidad en lugares donde no hay escasez de recursos. MÉTODOS: En 1999 y 2000 se realizó un estudio prospectivo con 1 921 mujeres asintomáticas que habitaban en Lima, Perú. El estudio se llevó a cabo en un centro de cancerología dotado de las tecnologías más modernas y de oncólogos con una sólida formación. A las mujeres se les sometió a un examen clínico completo

  2. Preliminary Experimental Results from Multi-Center Clinical Trials for Detection of Cervical Precancerous Lesions Using the Cerviscan(TM) System: A Novel Full-Field Evoked Tissue Fluorescence Based Imaging Instrument

    National Research Council Canada - National Science Library

    Dattamajumdar, A

    2001-01-01

    Cervical cancer is an important cause of death in women worldwide. Women are currently screened for cervical cancer using Pap smear-an imperfect technology with poor sensitivity and specificity. Furthermore, 5-10...

  3. Significance of micronucleus in cervical intraepithelial lesions and carcinoma

    Directory of Open Access Journals (Sweden)

    B N Gayathri

    2012-01-01

    Conclusions: MN scoring on the epithelial cells of cervix could be used as a biomarker in cancer screening. This is an easy, simple, reliable, reproducible and objective test which can be performed on routinely stained pap smears.

  4. "A Somali girl is Muslim and does not have premarital sex. Is vaccination really necessary?" A qualitative study into the perceptions of Somali women in the Netherlands about the prevention of cervical cancer

    NARCIS (Netherlands)

    Salad, J.; Verdonk, P.; de Boer, F.; Abma, T.A.

    2015-01-01

    Introduction: Participation in Human Papillomavirus (HPV) vaccination and Papanicolaou Screening (Pap smears) is low among ethnic minorities in the Netherlands and hardly any information is available about the cervical cancer prevention methods of Somali women living in the diaspora. This

  5. Download this PDF file

    African Journals Online (AJOL)

    Peter Donald

    secondary prevention of cervical cancer in developing countries. In contrast ... from pap smear and increase the uptake of cervical cancer screening in developed ..... Kruse AJ, Baak JP, de Bruin PC, van de Goot FR,. Kurten N. Relationship ...

  6. CHAPTER 1

    African Journals Online (AJOL)

    Dr Olaleye

    resource settings showed that the use of pap smear for routine screening of women resulted in ..... Research in Mexico, Ecuador and Venezuela for Latin ... University College Hospital by Arulogun and Maxwell (2012) and contradicts a study in ...

  7. Peripheral blood smear image analysis: A comprehensive review

    Directory of Open Access Journals (Sweden)

    Emad A Mohammed

    2014-01-01

    Full Text Available Peripheral blood smear image examination is a part of the routine work of every laboratory. The manual examination of these images is tedious, time-consuming and suffers from interobserver variation. This has motivated researchers to develop different algorithms and methods to automate peripheral blood smear image analysis. Image analysis itself consists of a sequence of steps consisting of image segmentation, features extraction and selection and pattern classification. The image segmentation step addresses the problem of extraction of the object or region of interest from the complicated peripheral blood smear image. Support vector machine (SVM and artificial neural networks (ANNs are two common approaches to image segmentation. Features extraction and selection aims to derive descriptive characteristics of the extracted object, which are similar within the same object class and different between different objects. This will facilitate the last step of the image analysis process: pattern classification. The goal of pattern classification is to assign a class to the selected features from a group of known classes. There are two types of classifier learning algorithms: supervised and unsupervised. Supervised learning algorithms predict the class of the object under test using training data of known classes. The training data have a predefined label for every class and the learning algorithm can utilize this data to predict the class of a test object. Unsupervised learning algorithms use unlabeled training data and divide them into groups using similarity measurements. Unsupervised learning algorithms predict the group to which a new test object belong to, based on the training data without giving an explicit class to that object. ANN, SVM, decision tree and K-nearest neighbor are possible approaches to classification algorithms. Increased discrimination may be obtained by combining several classifiers together.

  8. Diagnostic accuracy of slit skin smears in leprosy

    International Nuclear Information System (INIS)

    Naveed, T.; Shaikh, Z.

    2015-01-01

    To determine the diagnostic accuracy of slit skin smears in clinically suspected patients of leprosy using histopathology as gold standard. Study Design: Validation study Place and Duration of Study: Study was carried out at Rawalpindi Leprosy Hospital, Dermatology Department Military Hospital (MH) and Armed Forces Institute of Pathology (AFIP), Rawalpindi from 18th August 2012 to 18 Feb 2013. Methods: Appropriate technical and ethical approval for the study and patient consent were obtained. All suspected patients of leprosy of any age and either gender having typical hypo-aesthetic or anesthetic, erythematous or hypo-pigmented scaly skin lesions on any part of body were included in this study. All patients who have already received treatment for leprosy, patients with pure neural leprosy, patient not giving their consent for skin biopsy and patients with lepra reactions were excluded from this study. Forty eight patients fulfilling the inclusion criteria were included in the study. Sample size had been calculated by using WHO sample size calculator taking confidence level 95%, absolute precision required 14% and anticipated population proportion 40%. Non-probability consecutive sampling technique was used to collect sample. Results: The results of the study revealed that out of 48 clinically suspected patients of leprosy skin biopsy confirmed the diagnosis in 34 patients (70.8%) and the slit skin smear had diagnostic accuracy of 68.75% with sensitivity 55.8% and specificity and positive predictive value of 100%. Conclusion: Study suggested that although slit skin smears are rapid and inexpensive method of diagnosis but their diagnostic accuracy is low. (author)

  9. Effectiveness of a computer-based tutorial for teaching how to make a blood smear.

    Science.gov (United States)

    Preast, Vanessa; Danielson, Jared; Bender, Holly; Bousson, Maury

    2007-09-01

    Computer-aided instruction (CAI) was developed to teach veterinary students how to make blood smears. This instruction was intended to replace the traditional instructional method in order to promote efficient use of faculty resources while maintaining learning outcomes and student satisfaction. The purpose of this study was to evaluate the effect of a computer-aided blood smear tutorial on 1) instructor's teaching time, 2) students' ability to make blood smears, and 3) students' ability to recognize smear quality. Three laboratory sessions for senior veterinary students were taught using traditional methods (control group) and 4 sessions were taught using the CAI tutorial (experimental group). Students in the control group received a short demonstration and lecture by the instructor at the beginning of the laboratory and then practiced making blood smears. Students in the experimental group received their instruction through the self-paced, multimedia tutorial on a laptop computer and then practiced making blood smears. Data was collected from observation, interview, survey questionnaires, and smear evaluation by students and experts using a scoring rubric. Students using the CAI made better smears and were better able to recognize smear quality. The average time the instructor spent in the room was not significantly different between groups, but the quality of the instructor time was improved with the experimental instruction. The tutorial implementation effectively provided students and instructors with a teaching and learning experience superior to the traditional method of instruction. Using CAI is a viable method of teaching students to make blood smears.

  10. Perception and practices on screening and vaccination for carcinoma cervix among female healthcare professional in tertiary care hospitals in Bangalore, India.

    Science.gov (United States)

    Swapnajaswanth, M; Suman, G; Suryanarayana, S P; Murthy, N S

    2014-01-01

    Cervical cancer is potentially the most preventable and treatable cancer. Despite the known efficacy of cervical screening, a significant number of women do not avail themselves of the procedure due to lack of awareness. This study was conducted to elicit information on the knowledge, attitude and practice (KAP) regarding screening (Pap test) and vaccination for carcinoma cervix among female doctors and nurses in a tertiary care hospital in Bangalore and to assess barriers to acceptance of the Pap test. A cross-sectional, descriptive study was conducted with semi-structured, self-administered questionnaire among female health professionals. The study subjects were interviewed for KAP regarding risk factors for cancer cervix, Pap test and HPV vaccination for protection against carcinoma cervix. Higher proportion of doctors 45 (78.9%) had very good knowledge as compared to only 13 (13.3%) of the nurses, about risk factors for cancer cervix and Pap test (p=0.001). As many as 138(89.6%) of the study subjects had favorable attitude towards Pap test and vaccination, but 114 (73.6%) of the study subjects never had a Pap test and the most common reason 35 (31%) for not practicing was absence of disease symptoms. In spite of good knowledge and attitudes towards cancer cervix and Pap test being good, practice remained low among the study subjects and most common reasons for not undergoing Pap test was absence of disease symptoms. The independent predictors of ever having a Pap test done was found to be the occupation and duration of married life above 9 yrs. Hence there is a strong need to improve uptake of Pap test by health professionals by demystifying the barriers.

  11. Eruptive furunculosis following the soak and smear regimen.

    Science.gov (United States)

    Martires, Kathryn; Sukhdeo, Kumar; Meinhardt, Eric

    2015-02-18

    The 'soak and smear' regimen is a highly effective method for localised topical therapy employed by dermatologists for widespread inflammatory skin conditions. The regimen involves application of topical medication under occlusion after soaking in water. Complications from this treatment method are rare. We present a case of multiple, generalised methicillin-resistant Staphylococcus aureus (MRSA)-positive furuncles arising in a patient as an unexpected consequence of therapy. The case highlights an unanticipated risk of a commonly employed treatment amid an epidemic of MRSA in the community. 2015 BMJ Publishing Group Ltd.

  12. Parton distributions from lattice QCD with momentum smearing

    Energy Technology Data Exchange (ETDEWEB)

    Alexandrou, Constantia [Univ. of Cyprus, Nicosia (Cyprus). Dept. of Physics; Computation-based Science and Technology Research Center, Nicosia (Cyprus). Cyprus Inst.; Cichy, Krzysztof [Frankfurt Univ. (Germany). Inst. fuer Theoretische Physik; Adam Mickiewicz Univ., Poznan (Poland). Inst. of Physics; Constantinou, Martha [Temple Univ., Philadelphia, PA (United States); Hadjiyiannakou, Kyriakos [Univ. of Cyprus, Nicosia (Cyprus). Dept. of Physics; Jansen, Karl; Steffens, Fernanda; Wiese, Christian [Deutsches Elektronen-Synchrotron (DESY), Zeuthen (Germany). John von Neumann-Inst. fuer Computing NIC

    2017-01-15

    In this work we continue our effort to explore a recent proposal, which allows light-cone distributions to be extracted from purely spatial correlations, being thus accessible to lattice methods. In order to test the feasibility of this method, we present our latest results from a twisted mass lattice calculation of the flavor non-singlet momentum, helicity and transversity distributions of the nucleon. Furthermore, we apply a newly proposed momentum improved smearing, which has the potential to reach higher nucleon momenta as required for a safe matching procedure to the physical distribution functions.

  13. Associations Between Religion-Related Factors and Cervical Cancer Screening Among Muslims in Greater Chicago

    Science.gov (United States)

    Padela, Aasim I.; Peek, Monica; Johnson-Agbakwu, Crista E.; Hosseinian, Zahra; Curlin, Farr

    2015-01-01

    Objective This study aimed to assess rates of Papanicolaou (Pap) testing and associations between religion-related factors and these rates among a racially and ethnically diverse sample of American Muslim women. Materials and Methods A community-based participatory research design was used in partnering with the Council of Islamic Organizations of Greater Chicago to recruit Muslim women attending mosque and community events. These participants self-administered surveys incorporating measures of fatalism, religiosity, perceived discrimination, Islamic modesty, and a marker of Pap test use. Results A total of 254 survey respondents were collected with nearly equal numbers of Arabs, South Asians, and African American respondents. Of these respondents, 84% had obtained a Pap test in their lifetime, with individuals who interpret disease as a manifestation of God’s punishment having a lower odds of having had Pap testing after controlling for sociodemographic factors (odds ratio [OR] = 0.87, 95% CI = 0.77–1.0). In multivariate models, living in the United States for more than 20 years (OR = 4.7, 95% CI = 1.4–16) and having a primary care physician (OR = 7.7, 95% CI = 2.5–23.4) were positive predictors of having had a Pap test. Ethnicity, fatalistic beliefs, perceived discrimination, and modesty levels were not significantly associated with Pap testing rates. Conclusions To our knowledge, this is the first study to assess Pap testing behaviors among a diverse sample of American Muslim women and to observe that negative religious coping (e.g., viewing health problems as a punishment from God) is associated with a lower odds of obtaining a Pap test. The relationship between religious coping and cancer screening behaviors deserves further study so that religious values can be appropriately addressed through cancer screening programs. PMID:24914883

  14. To cervixcytologiske metoder til screening for livmoderhalskraeft

    DEFF Research Database (Denmark)

    Kirschner, Benny; Simonsen, Kåre; Junge, Jette

    2008-01-01

    Denmark has had an organized screening programme for cervical cancer since the 1960s. In spite of this, almost 150 Danish women die from the disease each year. There are currently two different methods for preparation of cervical samples: conventional Papanicolaou smear and liquid-based cytology....

  15. Using urbanization profiles to assess screening performance

    NARCIS (Netherlands)

    Boon, ME; Kok, LP

    The large Dutch data sets acquired as a result of population-based cervical smear screening programs can be further exploited to obtain an urbanization-weighted score to gain insight into the quality of the performance of the individual cytology laboratories. Based on the first four digits of the

  16. Simplified Pan-species Real-time PCR-based Detection of Plasmodium Spp. in Blood Smear.

    Science.gov (United States)

    Hassanpour, Gholamreza; Mirhendi, Hossein; Mohebali, Mehdi; Raeisi, Ahmad; Zeraati, Hojjat; Keshavarz, Hossein

    2016-01-01

    We aimed to quicken and simplify the detection of Plasmodium in blood samples by developing and testing a pan- Plasmodium real-time PCR for accurate screening of individuals suspected of malaria. A single primer/probe set for pan-species Plasmodium -specific real time PCR targeting a conserved region of the small subunit 18S ribosomal DNA was designed and evaluated for rapid diagnosis and screening of malaria infections using dried blood smears. FTA cards were used for rapid and simple DNA extraction. The primers and probes showed a positive response with the DNA extracted from bloods infected with P. falciparum and P. vivax but not with DNA extracted from various smears from uninfected blood samples. Seven positive cases positive by both microscopy and nested PCR were found among 280 blood samples taken from in South and Southeast Iran. Five samples were identified as positive for P. vivax and two as positive for P. falciparum . All positive samples were positive by real-time PCR. Furthermore, all 38-blood samples positive by microscopy were positive by real-time PCR. No microscopy-negative samples were positive by real-time PCR. By using a simple FTA card for DNA extraction and by application of the real-time PCR developed in this study, sensitivity similar to nested-PCR and microscopy was achieved. This format simplifies the detection of Plasmodium in large numbers of samples.

  17. Simplified Pan-species Real-time PCR-based Detection of Plasmodium Spp. in Blood Smear

    Directory of Open Access Journals (Sweden)

    Gholamreza HASSANPOUR

    2016-12-01

    Full Text Available Background: We aimed to quicken and simplify the detection of Plasmodium in blood samples by developing and testing a pan-Plasmodium real-time PCR for accurate screening of individuals suspected of malaria.Methods: A single primer/probe set for pan-species Plasmodium-specific real time PCR targeting a conserved region of the small subunit 18S ribosomal DNA was designed and evaluated for rapid diagnosis and screening of malaria infections using dried blood smears. FTA cards were used for rapid and simple DNA extraction.Results: The primers and probes showed a positive response with the DNA extracted from bloods infected with P. falciparum and P. vivax but not with DNA extracted from various smears from uninfected blood samples. Seven positive cases positive by both microscopy and nested PCR were found among 280 blood samples taken from in South and Southeast Iran. Five samples were identified as positive for P. vivax and two as positive for P. falciparum. All positive samples were positive by real-time PCR. Furthermore, all 38-blood samples positive by microscopy were positive by real-time PCR. No microscopy-negative samples were positive by real-time PCR.Conclusion: By using a simple FTA card for DNA extraction and by application of the real-time PCR developed in this study, sensitivity similar to nested-PCR and microscopy was achieved. This format simplifies the detection of Plasmodium in large numbers of samples.

  18. Computer-aided system of evaluation for population-based all-in-one service screening (CASE-PASS): from study design to outcome analysis with bias adjustment.

    Science.gov (United States)

    Chen, Li-Sheng; Yen, Amy Ming-Fang; Duffy, Stephen W; Tabar, Laszlo; Lin, Wen-Chou; Chen, Hsiu-Hsi

    2010-10-01

    Population-based routine service screening has gained popularity following an era of randomized controlled trials. The evaluation of these service screening programs is subject to study design, data availability, and the precise data analysis for adjusting bias. We developed a computer-aided system that allows the evaluation of population-based service screening to unify these aspects and facilitate and guide the program assessor to efficiently perform an evaluation. This system underpins two experimental designs: the posttest-only non-equivalent design and the one-group pretest-posttest design and demonstrates the type of data required at both the population and individual levels. Three major analyses were developed that included a cumulative mortality analysis, survival analysis with lead-time adjustment, and self-selection bias adjustment. We used SAS AF software to develop a graphic interface system with a pull-down menu style. We demonstrate the application of this system with data obtained from a Swedish population-based service screen and a population-based randomized controlled trial for the screening of breast, colorectal, and prostate cancer, and one service screening program for cervical cancer with Pap smears. The system provided automated descriptive results based on the various sources of available data and cumulative mortality curves corresponding to the study designs. The comparison of cumulative survival between clinically and screen-detected cases without a lead-time adjustment are also demonstrated. The intention-to-treat and noncompliance analysis with self-selection bias adjustments are also shown to assess the effectiveness of the population-based service screening program. Model validation was composed of a comparison between our adjusted self-selection bias estimates and the empirical results on effectiveness reported in the literature. We demonstrate a computer-aided system allowing the evaluation of population-based service screening

  19. Sputum, sex and scanty smears: new case definition may reduce sex disparities in smear-positive tuberculosis

    OpenAIRE

    Ramsay, A; Bonnet, M; Gagnidze, L; Githui, W; Varaine, F; Guérin, P J

    2009-01-01

    SETTING: Urban clinic, Nairobi. OBJECTIVES: To evaluate the impact of specimen quality and different smear-positive tuberculosis (TB) case (SPC) definitions on SPC detection by sex. DESIGN: Prospective study among TB suspects. RESULTS: A total of 695 patients were recruited: 644 produced > or =1 specimen for microscopy. The male/female sex ratio was 0.8. There were no significant differences in numbers of men and women submitting three specimens (274/314 vs. 339/380, P = 0.43). Significantly ...

  20. COMPARABLE CYTOLOGICAL DIAGNOSTIC OF BLOOD SMEARS ON BABESIA INFECTION

    Directory of Open Access Journals (Sweden)

    Pokhyl S.І.

    2015-05-01

    Full Text Available In last time Babesiosis as a tick-borne hemoprotozoans human disease have a very important role in differentil diagnostics of modern infectious medicine. It caused by protozon of the genus Babesia, which invade and destory erythrocytes. Babesiosis olso has been called tick fever. So, Babesia has been known by other genus names, including Nuttallia, Microbabesia, Babesialla, and Gonderia. Because all Babesia species are piroplasms, a more inclusive term for anthropozoonotic infections caused by these organisms would be piroplasmosis.They detective complicacy are bild that, tick-borne disease agents from prolongate life cycles involving arthropod and vertebrate host. The complexity is enhanced by the diversity of hosts in different biotopes, which depends on factors life type of vegetation, climate and/or human influence, such as restoration of former industrial sites, which leads to the development of new biotopes. So, on the one hand, new habitats for plants and animals including ticks, and nature are created. About the first case of babesiosis infection was reported as a cause of human sickness in 1969 in northeastern United State. Several hundred cases are now reported from this region each year. The disease is characterized by a grandual oncet of malaise with anorexia, fever, headaches, myalgia, and other vague symptoms, which may persist for long period. Occasionally dangerous fulminating infections occur particularly in immunocompromised or aged individuals. The purpose of the present research was to study of the cytological diagnostic of blood smears from object’s with the Babesia infection. Materials and methods. Blood smears (by Romanovsky- Gimze (standart, Wright’s standart and staining, the author’s modification, 2014 of domestic dogs (n = 31 of both sexes with Babesia infection at the age from 3 months to 6 years served as the material for the study. The preparations were fixed during 1-2 seconds with 96 % ethyl alcohol. Then

  1. DNA typing from vaginal smear slides in suspected rape cases

    Directory of Open Access Journals (Sweden)

    Dayse Aparecida da Silva

    Full Text Available In an investigation of suspected rape, proof of sexual assault with penetration is required. In view of this, detailed descriptions of the genitalia, the thighs and pubic region are made within the forensic medical service. In addition, vaginal swabs are taken from the rape victim and some of the biological material collected is then transferred to glass slides. In this report, we describe two rape cases solved using DNA typing from cells recovered from vaginal smear slides. In 1999, two young women informed the Rio de Janeiro Police Department that they had been victims of sexual assaults. A suspect was arrested and the victims identified him as the offender. The suspect maintained that he was innocent. In order to elucidate these crimes, vaginal smear slides were sent to the DNA Diagnostic Laboratory for DNA analysis three months after the crimes, as unique forensic evidence. To get enough epithelial and sperm cells to perform DNA analysis, we used protocols modified from the previously standard protocols used for DNA extraction from biological material fixed on glass slides. The quantity of cells was sufficient to perform human DNA typing using nine short tandem repeat (STR loci. It was 3.3 billion times more probable that it was the examined suspect who had left sperm cells in the victims, rather than any other individual in the population of Rio de Janeiro.

  2. Computational model for squamous cells characterization during cervical smear cytology

    Directory of Open Access Journals (Sweden)

    Víctor Eduardo Martínez Abaunza

    2005-07-01

    Full Text Available The main goal of the work done by the Biomedical Engineering Research Group (GIIB, and the Structural, Functional and Clinical Pathology Research Group of the Industrial University of Santander (UIS, with Autonomous University of Bucaramanga (UNAB, was to construct a computational model allowing squamous cells characterization of cervical smear cytology to classify them as being either normal or abnormal cells. Slides containing the cell samples were colleted by the pathologist and the images were digitalized by a video-camera coupled to a microscope and connected to a frame acquisition device. Three thresholding algorithms were used, in image segmentation, allowing cell nuclei detection; manual thresholding was used when these algorithms failed to detect cytoplasm. Cell texture was described by the distribution of histogram in each color level, and the borders using Fourier descriptors. The results of the first phase are presented, implementing them in classifying and identifying normal cells. Later stages will involve characterizing each cells stage initially classified as presenting some reactive change or due to infection, to distinguish the reactive cells of intraepithelial lesion cells. Key words: image processing, mathematical morphology, cervical smear cytology, dysplasia, cancer of cervix.

  3. Frequency and organization of papA homologous DNA sequences among uropathogenic digalactoside-binding Escherichia coli strains.

    OpenAIRE

    Denich, K; Craiu, A; Rugo, H; Muralidhar, G; O'Hanley, P

    1991-01-01

    The frequency of selected papA DNA sequences among 89 digalactoside-binding, uropathogenic Escherichia coli strains was evaluated with 12 different synthetic 15-base probes corresponding to papA genes from four digalactoside-binding piliated recombinant strains (HU849, 201B, and 200A). The papA probes encode amino acids which are common at the carboxy terminus of all strains, adjacent to the proximal portion of the intramolecular disulfide loop of strain 210B, or predicted to constitute the t...

  4. Smear correction of highly variable, frame-transfer CCD images with application to polarimetry.

    Science.gov (United States)

    Iglesias, Francisco A; Feller, Alex; Nagaraju, Krishnappa

    2015-07-01

    Image smear, produced by the shutterless operation of frame-transfer CCD detectors, can be detrimental for many imaging applications. Existing algorithms used to numerically remove smear do not contemplate cases where intensity levels change considerably between consecutive frame exposures. In this report, we reformulate the smearing model to include specific variations of the sensor illumination. The corresponding desmearing expression and its noise properties are also presented and demonstrated in the context of fast imaging polarimetry.

  5. [Evaluation of sputum smear examination--from the cases of Nepal, Yemen and the Philippines].

    Science.gov (United States)

    Fujiki, A

    1992-01-01

    Evaluation of sputum smear examination was carried out with smear slides stained by the Ziehl-Neelsen method, which were collected from Nepal, Yemen and the Philippines. The smear slides were checked macroscopically and microscopically according to the following points: 1) smear area size, 2) thickness of smear, 3) evenness of smear, 4) decolorizing condition by Ziehl-Neelsen stain, 5) smear cleanliness, 6) presence of cells in sputum and 7) smear reading accuracy by cross-checking. As the result of smear slide evaluation, it was concluded that proper sputum specimens have been smeared but smears were generally too thin and contaminated with too many dirt . Agreement rate of the slide reading in Nepal, Yemen and the Philippines were 73%, 90% and 88% respectively. Disagreement cases were concentrated in the subtle number of acid-fast bacilli or (+/-) and (+) results. The cause of disagreement might be attributed to contamination with debris, deposit etc., which hindered reading or were misread as acid-fast bacilli. Some improvement should be considered to eliminate the dirt , such as filtration of carbol fuchsin solution, preparation of proper quantity of carbol fuchsin solution to be consumed within three months, mixing the fuchsin stock solution and 5% carbol solution just before use, rinsing the mouth before sputum collection, usage of clean sputum container and slides, and smearing and drying of the slides within clean environment. However, in many developing countries there are many difficulties for facilities, equipments, system and management. Some of these difficulties may be solved by the efforts of laboratory side but some are beyond the limits of their efforts.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Rastreamento anterior para câncer de colo uterino em mulheres com alterações citológicas ou histológicas Previous screening for cervical cancer among women with cytological and histological abnormalities

    Directory of Open Access Journals (Sweden)

    C Rama

    2008-06-01

    do último exame citológico anterior.OBJECTIVE: To examine previous Pap smear history in women screened for cervical cancer with cytological or histological abnormalities. METHODS: Cross-sectional study in a sample of 5,485 women (15-65 years old who self-referred to cervical cancer screening in Sao Paulo and Campinas, Southeastern Brazil, between February 2002 and March 2003. A behavioral questionnaire was applied and cervical specimens were obtained for testing by Pap smears or liquid-based cytology. Women who had abnormal cytology were referred for colposcopic examination and, if abnormal, for cervical punch biopsy. To explore factors associated to cervical abnormalities Pearson's chi-was conduted square test at a 5% significance level. RESULTS: Cytological abnormalities were found in 354 women (6.4% and included 41 high-grade squamous intra-epithelial lesions and 3 carcinomas; 92.7% were normal results. Colposcopy was performed in 289 women, and 145 (50.2% showed abnormal results. Punch biopsies showed 14 cervical intraepithelial neoplasias grade 3 and 4 carcinomas. Previous Pap smears were reported in all women who had cytology suspected of carcinoma, 97.6% of those with high-grade squamous intra-epithelial lesions, all women with histological diagnosis of carcinoma and 92.9% of those who had cervical intraepithelial neoplasias grade 3 histologically. Previous Pap smear in the last tree years was reported by 86.5% and 92.8% of women with abnormal cytology and biopsy, respectively. CONCLUSIONS: There was no statistically significant difference regarding the number of Pap tests and time since their last test between women with histologically diagnosed carcinoma and cervical intraepithelial neoplasia grade 3 compared with those with normal cytology.

  7. Auditing smear microscopy results according to time to detection using the BACTEC™ MGIT™ TB system.

    Science.gov (United States)

    Elsaghier, A A F

    2015-09-01

    Smear microscopy is a rapid method for the identification of the most infectious patients with mycobacterial infection. Suboptimal smear microscopy may significantly compromise or delay patient isolation and contact tracing. A stringent method for auditing mycobacterial smear results is thus needed. This article proposes an auditing tool based on time to detection (TTD) of culture-positive samples using the automated BACTEC™ MGIT™ 960 TB system. In our study, sputum samples subjected to liquefaction and concentration before staining with a TTD of ≤ 13 days using the BACTEC system should be positive on smear microscopy.

  8. Diagnostic performance of HPV E6/E7 mRNA assay for detection of cervical high-grade intraepithelial neoplasia and cancer among women with ASCUS Papanicolaou smears.

    Science.gov (United States)

    Ren, Chenchen; Zhu, Yuanhang; Yang, Li; Zhang, Xiaoan; Liu, Ling; Ren, Chunying

    2018-02-01

    The aim of this study was to investigate the clinical performance of high risk (HR) HPV E6/E7 mRNA assay in detecting cervical high-grade intraepithelial neoplasia and cancer among women with atypical squamous cells of undetermined significance (ASCUS) Papanicolaou (Pap) smears. A total of 160 patients with ASCUS who underwent HR-HPV DNA assay, HR-HPV E6/E7 mRNA assay and colposcopy biopsy at Third Affiliated Hospital of Zhengzhou University, China, from December 2015 to March 2017, were enrolled. Logistic regression analysis was used to evaluate the relationship between pathological results with clinical biologic factors. Univariate analysis showed that the qualitative results of HR-HPV DNA, qualitative results of HR-HPV E6/E7 mRNA and expression levels of HR-HPV E6/E7 mRNA were risk factors of high-grade cervical intraepithelial neoplasia (CIN) and cervical cancer (all P HPV E6/E7 mRNA was associated with high-grade CIN and cervical cancer (OR = 8.971, 95% CI = 2.572-31.289, P = 0.001). An optimal cut-off value of ≥ 558.26 copies/ml was determined using receiver operating characteristic curve, and specificity of cut-off value were higher than E6/E7 mRNA qualitative assay and DNA qualitative assay. HPV E6/E7 mRNA quantitative assay may be a valuable tool in triage of ASCUS pap smears. A high specificity of E6/E7 mRNA quantitative assay as a triage test in women with ASCUS can be translated into a low referral for colposcopy.

  9. Extraction and detection of Mycobacterium leprae DNA from ZNCF-stained skin smear slides for better identification of negative skin smears

    Directory of Open Access Journals (Sweden)

    Kamble R

    2010-01-01

    Full Text Available Abstract Identification of Mycobacterium leprae, which causes leprosy, is done by Ziehl Neelsen Carbol Fuchsin (ZNCF stained slit skin smear microscopy that aids in the diagnosis and quantification of approximate bacterial load carried by the patient. We attempted M. leprae DNA extraction from 46 stained slit skin smear negative slides, using Proteinase K and SDS lysis, followed by ethanol precipitation. M. leprae specific primers (16SrRNA were used for PCR-based amplification of DNA. We could detect M. leprae DNA in 15 (32.6% samples. The method can be useful in the diagnosis of apparently slit skin smear negative leprosy cases.

  10. Drastic anthocyanin increase in response to PAP1 overexpression in fls1 knockout mutant confers enhanced osmotic stress tolerance in Arabidopsis thaliana.

    Science.gov (United States)

    Lee, Won Je; Jeong, Chan Young; Kwon, Jaeyoung; Van Kien, Vu; Lee, Dongho; Hong, Suk-Whan; Lee, Hojoung

    2016-11-01

    KEY MESSAGE : pap1 - D/fls1ko double mutant plants that produce substantial amounts of anthocyanin show tolerance to abiotic stress. Anthocyanins are flavonoids that are abundant in various plants and have beneficial effects on both plants and humans. Many genes in flavonoid biosynthetic pathways have been identified, including those in the MYB-bHLH-WD40 (MBW) complex. The MYB gene Production of Anthocyanin Pigment 1 (PAP1) plays a particularly important role in anthocyanin accumulation. PAP1 expression in many plant systems strongly increases anthocyanin levels, resulting in a dark purple color in many plant organs. In this study, we generated double mutant plants that harbor fls1ko in the pap1-D background (i.e., pap1-D/fls1ko plants), to examine whether anthocyanins can be further enhanced by blocking flavonol biosynthesis under PAP1 overexpression. We also wanted to examine whether the increased anthocyanin levels contribute to defense against osmotic stresses. The pap1-D/fls1ko mutants accumulated higher anthocyanin levels than pap1-D plants in both control and sucrose-treated conditions. However, flavonoid biosynthesis genes were slightly down-regulated in the pap1-D/fls1ko seedlings as compared to their expression in pap1-D seedlings. We also report the performance of pap1-D/fls1ko seedlings in response to plant osmotic stresses.

  11. Sputum, sex and scanty smears: new case definition may reduce sex disparities in smear-positive tuberculosis.

    Science.gov (United States)

    Ramsay, A; Bonnet, M; Gagnidze, L; Githui, W; Varaine, F; Guérin, P J

    2009-05-01

    Urban clinic, Nairobi. To evaluate the impact of specimen quality and different smear-positive tuberculosis (TB) case (SPC) definitions on SPC detection by sex. Prospective study among TB suspects. A total of 695 patients were recruited: 644 produced > or =1 specimen for microscopy. The male/female sex ratio was 0.8. There were no significant differences in numbers of men and women submitting three specimens (274/314 vs. 339/380, P = 0.43). Significantly more men than women produced a set of three 'good' quality specimens (175/274 vs. 182/339, P = 0.01). Lowering thresholds for definitions to include scanty smears resulted in increases in SPC detection in both sexes; the increase was significantly higher for women. The revised World Health Organization (WHO) case definition was associated with the highest detection rates in women. When analysis was restricted only to patients submitting 'good' quality specimen sets, the difference in detection between sexes was on the threshold for significance (P = 0.05). Higher SPC notification rates in men are commonly reported by TB control programmes. The revised WHO SPC definition may reduce sex disparities in notification. This should be considered when evaluating other interventions aimed at reducing these. Further study is required on the effects of the human immuno-deficiency virus and instructed specimen collection on sex-specific impact of new SPC definition.

  12. Teste de Papanicolaou: cobertura em dois inquéritos domiciliários realizados no município de São Paulo em 1987 e em 2001-2002 Papanicolaou smear screening: coverage in two home surveys applied in the city of São Paulo in 1987 and 2001-2002

    Directory of Open Access Journals (Sweden)

    Carolina Ozawa

    2011-05-01

    ção à saúde da mulher.PURPOSE: to compare the coverage of conventional Papanicolaou cytology in women aged 15 to 59 years between two home surveys, related to some personal attributes and to the tendency to die from cervical cancer. METHODS: we analyzed data collected in two home surveys, with complex sampling, in the city of São Paulo, Brazil, over the years from 1987 to 2001 and 2002. The self-reported answers of 968 women in the first inquiry and of 1,125 women in the second inquiry were compared regarding the reply to the question about the execution of the Papanicolaou test "sometimes in a lifetime" in relation to age distribution, black skin, marital status, years of education and tendency to die because cervical cancer during the period from 1980 to 2007. The Fisher exact test was used to compare the sample regarding each item, with the level of significance set at p value >5%. RESULTS: from the first to the second inquiry there was a 24% increase in the execution of conventional Papanicolaou cytology (from 68.8% to 85%. The greatest variations in the increased coverage related to the personal attributes of the women were detected in black skin color, among single women and among women of lower schooling. Regarding the tendency to mortality rates due to cervical cancer, no clear ascending or declining tendency was observed along the 28 years studied (1980 to 2007. CONCLUSION: there was an increase in access to the cytological Papanicolaou test among the most vulnerable women. Since 2001 and 2002, the 85% coverage already reached WHO recommendation, although without a clear trend of decline in mortality due to cervical cancer in the following years, indicating that screening is only part of an effective and organized program for the control of cervical cancer, whose model must guarantee full women's health care.

  13. Diabetes mellitus and its influence on sputum smear positivity at the 2nd month of treatment among pulmonary tuberculosis patients in Kuala Lumpur, Malaysia: A case control study.

    Science.gov (United States)

    Shariff, Noorsuzana Mohd; Safian, Nazarudin

    2015-12-01

    Many studies have suggested that sputum smear conversion after 2 months of antituberculosis treatment is an important determinant of treatment success and can be a predictor for relapse. The objective of this study is to determine the factors that influence sputum smear conversion after 2 months of treatment among pulmonary tuberculosis patients receiving treatment in the Institute of Respiratory Medicine in Kuala Lumpur, Malaysia. A total of 75 cases and 75 controls were interviewed, and their medical records were retrieved in order to extract the information needed. All analyses were conducted using SPSS version 17, and binary logistic regression analysis was used to determine the predictors of sputum smear nonconversion. Results showed that the following factors were associated with sputum smear positivity after 2 months of intensive treatment: diabetes mellitus (p=.013, odds ratio [OR]=2.59, 95% confidence interval [CI] 1.27-5.33), underweight body mass index (p=.025, OR=1.67, 95% CI 0.80-3.49), nonadherent to tuberculosis treatment (p=.024, OR=2.85, 95% CI 1.21-6.74), and previous history of tuberculosis (p=.043, OR=2.53, 95% CI 1.09-5.83). Multivariable analysis identified diabetes mellitus (p=.003, OR=4.01, 95% CI 1.61-9.96) as being independently associated with the risk of persistent sputum smear positivity after 2 months of intensive treatment. Based on the findings, identification of these factors is valuable in strengthening the management and treatment of tuberculosis in Malaysia in the future. This study emphasizes the importance of diabetes screening and integration of diabetic controls among tuberculosis patients in achieving better treatment outcome. Copyright © 2015 Asian-African Society for Mycobacteriology. Published by Elsevier Ltd. All rights reserved.

  14. Arabidopsis AtPAP1 transcription factor induces anthocyanin production in transgenic Taraxacum brevicorniculatum.

    Science.gov (United States)

    Qiu, Jian; Sun, Shuquan; Luo, Shiqiao; Zhang, Jichuan; Xiao, Xianzhou; Zhang, Liqun; Wang, Feng; Liu, Shizhong

    2014-04-01

    This study developed a new purple coloured Taraxacum brevicorniculatum plant through genetic transformation using the Arabidopsis AtPAP1 gene, which overproduced anthocyanins in its vegetative tissues. Rubber-producing Taraxacum plants synthesise high-quality natural rubber (NR) in their roots and so are a promising alternative global source of this raw material. A major factor in its commercialization is the need for multipurpose exploitation of the whole plant. To add value to the aerial tissues, red/purple plants of the rubber-producing Taraxacum brevicorniculatum species were developed through heterologous expression of the production of anthocyanin pigment 1 (AtPAP1) transcription factor from Arabidopsis thaliana. The vegetative tissue of the transgenic plants showed an average of a 48-fold increase in total anthocyanin content over control levels, but with the exception of pigmentation, the transgenic plants were phenotypically comparable to controls and displayed similar growth vigor. Southern blot analysis confirmed that the AtPAP1 gene had been integrated into the genome of the high anthocyanin Taraxacum plants. The AtPAP1 expression levels were estimated by quantitative real-time PCR and were highly correlated with the levels of total anthocyanins in five independent transgenic lines. High levels of three cyanidin glycosides found in the purple plants were characterized by high performance liquid chromatography-mass spectrum analysis. The presence of NR was verified by NMR and infrared spectroscopy, and confirmed that NR biosynthesis had not been affected in the transgenic Taraxacum lines. In addition, other major phenylpropanoid products such as chlorogenic acid and quercetin glycosides were also enhanced in the transgenic Taraxacum. The red/purple transgenic Taraxacum lines described in this study would increase the future application of the species as a rubber-producing crop due to its additional health benefits.

  15. Abnormal pap tests among women living in a Hispanic migrant farmworker community: A narrative of health literacy.

    Science.gov (United States)

    Vamos, Cheryl A; Lockhart, Elizabeth; Vázquez-Otero, Coralia; Thompson, Erika L; Proctor, Sara; Wells, Kristen J; Daley, Ellen M

    2016-08-01

    This study explored narrative responses following abnormal Pap tests among Hispanic migrant farmworkers ( N = 18; ages 22-50 years) via in-depth interviews in Florida. Qualitative analyses utilized health literacy domains (obtain/process/understand/communicate) as a conceptual framework. Participants described how they (1) obtained information about getting a Pap test, (2) processed positive and negative reactions following results, (3) understood results and recommended health-promoting behaviors, and (4) communicated and received social support. Women had disparate reactions and understanding following an abnormal Pap result. Health literacy was a meaningful conceptual framework to understand assets and gaps among women receiving an abnormal Pap test result. Future interventions should incorporate health literacy domains and facilitate patient-provider communications and social support to assist women in decision-making and health-promoting behaviors, ultimately decreasing cancer disparities.

  16. Cancer screening literature in the period 2000-2002: pointers to future research avenues.

    Science.gov (United States)

    Moore, Malcolm A; Kunimoto, Takehiko; Tsuda, Hiroyuki

    2003-01-01

    In order to determine which areas of cancer screening are currently receiving greatest emphasis in different parts of the world a Medline search of the literature for the period 2000-2002 was performed, concentrating attention on research into all aspects of efforts for early detection of tumours, with especial attention to methodology, motivation (including awareness of utility in the general populace and in minority groups), and intervention (professional training and general education). Focus on the skin, lung, cervix, breast, ovary + endometrium, oral cavity-oesophagus, gastric, colorectal, kidney + urinary tract and prostate, demonstrated large numbers of journals to be publishing papers in the field, with 10, 33, 130, 53, 24, 21, 6, 81, 12 and 58, respectively, in the period investigated, the grand total being 259. The average numbers of papers/journal ranged from 1.0-2.4 with only 15-35% appearing in journals with wide coverage. With the exception of oral, oesophageal and gastric cancer screening, an approximately 50% contribution in all areas was made by scientists in the US, followed by Europe (31% overall,) Asia (11%) then Australasia, Central and South America and Africa (3%, 2% and 1%, respectively). Clear differences were evident with the organ regarding specific topics receiving attention, most publications concerning the lung, ovary and urological tract dealing with detection methods. With the cervix and colorectum this topic accounted for half of the papers with especial attention to the relative advantages of the PAP smear, HPV testing and direct visual acetic acid (DVA) in the one, and FOBT and endoscopy in the other. Another major focus was found to be minority attitudes to breast, prostate and cervical screening in the US, whereas only few papers were found dealing with practical intervention, targeting professionals or screenees to increase participation in screening programs. The present approach suggested a number of areas requiring more

  17. Recommendations for cervical cancer screening programs in developing countries: the need for equity and technological development

    Directory of Open Access Journals (Sweden)

    Lazcano-Ponce Eduardo

    2003-01-01

    Full Text Available The cervical cancer screening programs (CCSP have not been very efficient in the developing countries. This explains the need to foster changes on policies, standards, quality control mechanisms, evaluation and integration of new screening alternatives considered as low and high cost, as well as to regulate colposcopy practices and the foundation of HPV laboratories. Cervical cancer (CC is a disease most frequently found in poverty-stricken communities and reflecting a problem of equity at both levels gender and regional, and this, is not only due to social and economic development inequalities, but to the infrastructure and human resources necessary for primary care. For this reason, the CCSP program must be restructured, a to primarily address unprivileged rural and urban areas; b to foster actions aimed at ensuring extensive coverage as well as a similar quality of that coverage in every region; c to use screening strategies in keeping with the availability of health care services. In countries with a great regional heterogeneity, a variety of screening procedures must be regulated and standardized, including a combination of assisted visual inspection, cervical cytology and HPV detection; d regional community intervention must be set up to assess the effectiveness of using HPV detection as an strategy in addition to cervical cytology (pap smear; e the practice of colposcopy must be regulated to prevent the use of it in healthy women at a population level, thus preventing unnecessary diagnosis and treatment which not only are expensive but also causes unnecessary anxiety to women at risk; f the operation of those clinical laboratories using HPV as a detection strategy must likewise be accredited and regulated and g the CCSP program for assuring health care quality should meet the expectations of its beneficiaries, and increase the knowledge in cervical cancer related matters. Finally, though a variety of clinical tests on prophylactic and

  18. Smeared crack modelling approach for corrosion-induced concrete damage

    DEFF Research Database (Denmark)

    Thybo, Anna Emilie Anusha; Michel, Alexander; Stang, Henrik

    2017-01-01

    In this paper a smeared crack modelling approach is used to simulate corrosion-induced damage in reinforced concrete. The presented modelling approach utilizes a thermal analogy to mimic the expansive nature of solid corrosion products, while taking into account the penetration of corrosion...... products into the surrounding concrete, non-uniform precipitation of corrosion products, and creep. To demonstrate the applicability of the presented modelling approach, numerical predictions in terms of corrosion-induced deformations as well as formation and propagation of micro- and macrocracks were......-induced damage phenomena in reinforced concrete. Moreover, good agreements were also found between experimental and numerical data for corrosion-induced deformations along the circumference of the reinforcement....

  19. Domain activities of PapC usher reveal the mechanism of action of an Escherichia coli molecular machine.

    Science.gov (United States)

    Volkan, Ender; Ford, Bradley A; Pinkner, Jerome S; Dodson, Karen W; Henderson, Nadine S; Thanassi, David G; Waksman, Gabriel; Hultgren, Scott J

    2012-06-12

    P pili are prototypical chaperone-usher pathway-assembled pili used by Gram-negative bacteria to adhere to host tissues. The PapC usher contains five functional domains: a transmembrane β-barrel, a β-sandwich Plug, an N-terminal (periplasmic) domain (NTD), and two C-terminal (periplasmic) domains, CTD1 and CTD2. Here, we delineated usher domain interactions between themselves and with chaperone-subunit complexes and showed that overexpression of individual usher domains inhibits pilus assembly. Prior work revealed that the Plug domain occludes the pore of the transmembrane domain of a solitary usher, but the chaperone-adhesin-bound usher has its Plug displaced from the pore, adjacent to the NTD. We demonstrate an interaction between the NTD and Plug domains that suggests a biophysical basis for usher gating. Furthermore, we found that the NTD exhibits high-affinity binding to the chaperone-adhesin (PapDG) complex and low-affinity binding to the major tip subunit PapE (PapDE). We also demonstrate that CTD2 binds with lower affinity to all tested chaperone-subunit complexes except for the chaperone-terminator subunit (PapDH) and has a catalytic role in dissociating the NTD-PapDG complex, suggesting an interplay between recruitment to the NTD and transfer to CTD2 during pilus initiation. The Plug domain and the NTD-Plug complex bound all of the chaperone-subunit complexes tested including PapDH, suggesting that the Plug actively recruits chaperone-subunit complexes to the usher and is the sole recruiter of PapDH. Overall, our studies reveal the cooperative, active roles played by periplasmic domains of the usher to initiate, grow, and terminate a prototypical chaperone-usher pathway pilus.

  20. Crack Models for Concrete, Discrete or Smeared? Fixed, Multi-Directional or Rotating?

    NARCIS (Netherlands)

    Rots, J.G.; Blaauwendraad, J.

    1989-01-01

    Numerical tools to simulate cracking in concrete and similar materials are developed. Firstly, a treatment is given of smeared and discrete crack concepts, which start from the notion of a continuum and a discontinuum respectively. With the smeared crack concept a distinction is furthermore made

  1. Conformational Smear Characterization and Binning of Single-Molecule Conductance Measurements for Enhanced Molecular Recognition.

    Science.gov (United States)

    Korshoj, Lee E; Afsari, Sepideh; Chatterjee, Anushree; Nagpal, Prashant

    2017-11-01

    Electronic conduction or charge transport through single molecules depends primarily on molecular structure and anchoring groups and forms the basis for a wide range of studies from molecular electronics to DNA sequencing. Several high-throughput nanoelectronic methods such as mechanical break junctions, nanopores, conductive atomic force microscopy, scanning tunneling break junctions, and static nanoscale electrodes are often used for measuring single-molecule conductance. In these measurements, "smearing" due to conformational changes and other entropic factors leads to large variances in the observed molecular conductance, especially in individual measurements. Here, we show a method for characterizing smear in single-molecule conductance measurements and demonstrate how binning measurements according to smear can significantly enhance the use of individual conductance measurements for molecular recognition. Using quantum point contact measurements on single nucleotides within DNA macromolecules, we demonstrate that the distance over which molecular junctions are maintained is a measure of smear, and the resulting variance in unbiased single measurements depends on this smear parameter. Our ability to identify individual DNA nucleotides at 20× coverage increases from 81.3% accuracy without smear analysis to 93.9% with smear characterization and binning (SCRIB). Furthermore, merely 7 conductance measurements (7× coverage) are needed to achieve 97.8% accuracy for DNA nucleotide recognition when only low molecular smear measurements are used, which represents a significant improvement over contemporary sequencing methods. These results have important implications in a broad range of molecular electronics applications from designing robust molecular switches to nanoelectronic DNA sequencing.

  2. [Adhesion of sealer cements to dentin with and without smear layer].

    Science.gov (United States)

    Gettleman, B H; Messer, H H; ElDeeb, M E

    1991-01-01

    The influence of a smear layer on the adhesion of sealer cements to dentin was assessed in recently extracted human anterior teeth. A total of 120 samples was tested, 40 per sealer; 20 each with and without the smear layer. The teeth were split longitudinally, and the internal surfaces were ground flat. One-half of each tooth was left with the smear layer intact, while the other half had the smear removed by washing for 3 min with 17% EDTA followed by 5.25% NaOCI. Evidence of the ability to remove the smear layer was verified by scanning electron microscopy. Using a specially designed jig, the sealer was placed into a 4-mm wide x 4 mm deep well which was then set onto the tooth.

  3. Genome-Wide Analysis of PAPS1-Dependent Polyadenylation Identifies Novel Roles for Functionally Specialized Poly(A Polymerases in Arabidopsis thaliana.

    Directory of Open Access Journals (Sweden)

    Christian Kappel

    2015-08-01

    Full Text Available The poly(A tail at 3' ends of eukaryotic mRNAs promotes their nuclear export, stability and translational efficiency, and changes in its length can strongly impact gene expression. The Arabidopsis thaliana genome encodes three canonical nuclear poly(A polymerases, PAPS1, PAPS2 and PAPS4. As shown by their different mutant phenotypes, these three isoforms are functionally specialized, with PAPS1 modifying organ growth and suppressing a constitutive immune response. However, the molecular basis of this specialization is largely unknown. Here, we have estimated poly(A-tail lengths on a transcriptome-wide scale in wild-type and paps1 mutants. This identified categories of genes as particularly strongly affected in paps1 mutants, including genes encoding ribosomal proteins, cell-division factors and major carbohydrate-metabolic proteins. We experimentally verified two novel functions of PAPS1 in ribosome biogenesis and redox homoeostasis that were predicted based on the analysis of poly(A-tail length changes in paps1 mutants. When overlaying the PAPS1-dependent effects observed here with coexpression analysis based on independent microarray data, the two clusters of transcripts that are most closely coexpressed with PAPS1 show the strongest change in poly(A-tail length and transcript abundance in paps1 mutants in our analysis. This suggests that their coexpression reflects at least partly the preferential polyadenylation of these transcripts by PAPS1 versus the other two poly(A-polymerase isoforms. Thus, transcriptome-wide analysis of poly(A-tail lengths identifies novel biological functions and likely target transcripts for polyadenylation by PAPS1. Data integration with large-scale co-expression data suggests that changes in the relative activities of the isoforms are used as an endogenous mechanism to co-ordinately modulate plant gene expression.

  4. Predicting smear negative pulmonary tuberculosis with classification trees and logistic regression: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Kritski Afrânio

    2006-02-01

    Full Text Available Abstract Background Smear negative pulmonary tuberculosis (SNPT accounts for 30% of pulmonary tuberculosis cases reported yearly in Brazil. This study aimed to develop a prediction model for SNPT for outpatients in areas with scarce resources. Methods The study enrolled 551 patients with clinical-radiological suspicion of SNPT, in Rio de Janeiro, Brazil. The original data was divided into two equivalent samples for generation and validation of the prediction models. Symptoms, physical signs and chest X-rays were used for constructing logistic regression and classification and regression tree models. From the logistic regression, we generated a clinical and radiological prediction score. The area under the receiver operator characteristic curve, sensitivity, and specificity were used to evaluate the model's performance in both generation and validation samples. Results It was possible to generate predictive models for SNPT with sensitivity ranging from 64% to 71% and specificity ranging from 58% to 76%. Conclusion The results suggest that those models might be useful as screening tools for estimating the risk of SNPT, optimizing the utilization of more expensive tests, and avoiding costs of unnecessary anti-tuberculosis treatment. Those models might be cost-effective tools in a health care network with hierarchical distribution of scarce resources.

  5. Role of p16 testing in cervical cancer screening among HIV-infected women.

    Directory of Open Access Journals (Sweden)

    Christine J McGrath

    Full Text Available p16 immunohistochemistry is used to evaluate for HPV-associated cervical intraepithelial neoplasia. The diagnostic performance of p16 in HIV infection is unclear.Between June-December 2009, HIV-infected women underwent Papanicolaou (Pap smear, human papillomavirus (HPV testing, visual inspection with acetic acid (VIA, and colposcopy-directed biopsy as the disease gold standard at a HIV clinic in Kenya. Pap smears were evaluated for p16 expression. Sensitivity, specificity, positive predictive value (PPV, and area under the receiver operating characteristic curve (AUC of p16 to detect CIN2/3 on histology and the impact of immunosuppression and ART was assessed.Of 331 cervical samples with p16 expression, p16 sensitivity and specificity to detect CIN2/3 was 54.1% and 72.4% respectively, which was lower than Pap and HPV in sensitivity, but higher in specificity than Pap, HPV, and VIA. Combining tests and p16 reduced sensitivity and increased specificity of Pap from 90.5% to 48.7% and 51.4% to 81.7%; of VIA from 59.5% to 37.8% and 67.6% to 89.9%; and of HPV from 82.4% to 50.0% and 55.3% to 84.8%. Combination p16 increased the PPV of Pap from 34.9% to 43.4%; of HPV from 34.7% to 48.7%; and VIA from 34.9% to 51.9%. Adjunctive p16 did not change AUC (P>0.05. P16 performance was not altered by immunosuppression or ART use. Combining p16 with HPV and VIA reduced the variation in HPV and VIA performance associated with CD4 and ART.As an adjunctive test in HIV-infected women, p16 immunohistochemistry increased specificity and PPV of HPV and VIA for CIN2/3, and was not altered in performance by immunosuppression, ART, or age.

  6. Cervical cancer screening in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) in four US-Affiliated Pacific Islands between 2007 and 2015.

    Science.gov (United States)

    Senkomago, Virginia; Royalty, Janet; Miller, Jacqueline W; Buenconsejo-Lum, Lee E; Benard, Vicki B; Saraiya, Mona

    2017-10-01

    Cervical cancer incidence in the US-Affiliated Pacific Islands (USAPIs) is double that of the US mainland. American Samoa, Commonwealth of Northern Mariana Islands (CNMI), Guam and the Republic of Palau receive funding from the Centers for Disease Control (CDC) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to implement cervical cancer screening to low-income, uninsured or under insured women. The USAPI grantees report data on screening and follow-up activities to the CDC. We examined cervical cancer screening and follow-up data from the NBCCEDP programs in the four USAPIs from 2007 to 2015. We summarized screening done by Papanicolaou (Pap) and oncogenic human papillomavirus (HPV) tests, follow-up and diagnostic tests provided, and histology results observed. A total of 22,249 Pap tests were conducted in 14,206 women in the four USAPIs programs from 2007-2015. The overall percentages of abnormal Pap results (low-grade squamous intraepithelial lesions or worse) was 2.4% for first program screens and 1.8% for subsequent program screens. Histology results showed a high proportion of cervical intraepithelial neoplasia grade 2 or worse (57%) among women with precancers and cancers. Roughly one-third (32%) of Pap test results warranting follow-up had no data recorded on diagnostic tests or follow-up done. This is the first report of cervical cancer screening and outcomes of women served in the USAPI through the NBCCEDP with similar results for abnormal Pap tests, but higher proportion of precancers and cancers, when compared to national NBCCEDP data. The USAPI face significant challenges in implementing cervical cancer screening, particularly in providing and recording data on diagnostic tests and follow-up. The screening programs in the USAPI should further examine specific barriers to follow-up of women with abnormal Pap results and possible solutions to address them. Published by Elsevier Ltd.

  7. Detection of GBV-C/HGV RNA in cervico-vaginal smears from healthy individuals

    Directory of Open Access Journals (Sweden)

    Maria Angelica Ehara Watanabe

    2008-10-01

    Full Text Available The purpose of the present study was to evaluate the sexual transmission of GBV-C/HGV, through RNA detection in cervicovaginal smears. Therefore the GBV-C/HGV RNA in cervicovaginal smears from apparently healthy women was investigated using routine proceedings for prophylactic screening to cervical cancer. GBV-C/HGV RNA was detected by reverse transcriptase and polymerase chain reaction (RT-PCR. Only one woman presented co-infection with human papilloma virus (HPV. The GBV-C/HGV RNA was detected in 13/73 (17.57% healthy women and it's prevalence in participating women between 28-43 years old was 53.85%. No association was found with GBV-C/HGV for the age of first sexual intercourse and number of pregnancies. In GBV-C/HGV RNA positive women, 69.23% were married. In conclusion, the present findings show that cervical and vaginal specimens could contain the GBV-C/HGV RNA.O objetivo do presente estudo foi avaliar a transmissão sexual de GBV-C/HBV, através da detecção do RNA viral em raspados cérvico-vaginais. Portanto, a presença do RNA GBV-C/HGV foi investigada em raspados cérvico-vaginais em mulheres aparentemente saudáveis que realizaram exames preventivos para câncer cervical. GBV-C/HGV RNA foi detectado por reação de transcriptase reversa e reação em cadeia da polimerase (RT-PCR. Apenas uma mulher apresentou a co-infecção com o papiloma vírus humano (HPV. O RNA GBV-C/HGV foi detectado em 13/73 (17,57% mulheres saudáveis e sua prevalência entre participantes da idade de 28-43 anos foi de 53,85%. Não foi observada relação entre a presença do RNA GBV-C/HGV com a idade de primeira relação sexual, nem com o número de gestações. Entre as mulheres que apresentavam o RNA viral, 69,23% eram casadas. O presente estudo demonstrou que secreções cérvico-vaginais podem conter o RNA viral GBV-C/HBV.

  8. Avaliação da influência do uso de métodos contraceptivos sobre os resultados dos esfregaços de Papanicolaou = Evaluation of the influence of contraceptive methods on the results of Papanicolaou smears

    Directory of Open Access Journals (Sweden)

    Fernanda Cristina da Silva

    2006-01-01

    Full Text Available Foi avaliada a influência do uso de métodos contraceptivos como dispositivo intrauterino (DIU, contraceptivos hormonais (CPH e preservativo (PRESER, nos resultados dos esfregaços de Papanicolaou (Pap, por meio de análise retrospectiva de seus laudos e das informações sobre métodos contraceptivos de 2251 mulheres, distribuídas em: DIU (n=80, CPH (n=172, PRESER (n=40 e não usuárias (n=1959. As não usuárias apresentaram mais resultados normais e as com DIU mais alterações benignas. Os três grupos de usuárias, principalmente DIU, manifestaram mais metaplasia escamosa do que as não usuárias. Não houve aumento de ASCUS/LIS ou câncer nas usuárias de métodos contraceptivos. Predominaram as infecções candidíase e vaginose bacteriana e em DIU houve mais vaginose. Actinomyces sp. ocorreu apenas em DIU e Trichomonas vaginalis apenasem não usuárias. Assim, é importante a realização de Pap nas usuárias de DIU e CPH para acompanhar as alterações benignas, pois as mesmas podem predispor e/ou facilitar infecções, incluindo por HPV.This study aimed to evaluate the influence of the use of contraceptive methods, such as the intrauterine device (IDU, the hormonal contraceptive (HCP and the preservative (PRESER, on the results of Papanicolaou smears (Pap. A retrospective analysis was conducted based on Papanicolau results and on information from2251 women's contraceptive methods, distributed in: IDU (n=80, HCP (n=172, PRESER (n=40 and non-users (n=1959. Non-users presented more normal results; and IDU users presented benign alterations. Among the three groups, the IDU users manifested more squaly squamous metaplasia than the non-users. There was no notice of ASCUS/SIL or cancer in the users of contraceptive methods. The infections withcandidiasis and bacterial vaginosis prevailed. Particularly in IDU users, there was more vaginosis. Actinomyces sp. was only noticed in IDU users, and Trichomonas vaginalis in nonusers. Thus

  9. The evidential value of cosmetic foundation smears in forensic casework.

    Science.gov (United States)

    Gordon, Amanda; Coulson, Sally

    2004-11-01

    Cosmetic foundation products are easily transferred to clothing and other surfaces as a result of contact with such objects. Examination of past cases involving cosmetics in New Zealand has shown cosmetic foundation to be one of the more common cosmetic products encountered. The aim of this research was to determine the most discriminating method for the comparison of transferred foundation with samples obtained from a known source in forensic casework. Fifty-three foundation samples were analyzed by Fourier transform infrared spectroscopy (FTIR), gas chromatography with a flame ionization detector (GC-FID) and scanning electron microscopy-energy dispersive X-Ray analysis (SEM-EDX). It was found that a 5 mm2 section of a light smearing was enough to provide detectable results. The discriminating powers for FTIR, SEM-EDX and GC-FID were 98.3, 93.8, and 82.0% respectively. A combination of all three techniques provided a discriminating power of 99.7%, meaning that almost complete discrimination was achieved between the foundation samples.

  10. The incremental role of trait emotional intelligence on perceived cervical screening barriers.

    Science.gov (United States)

    Costa, Sebastiano; Barberis, Nadia; Larcan, Rosalba; Cuzzocrea, Francesca

    2018-02-13

    Researchers have become increasingly interested in investigating the role of the psychological aspects related to the perception of cervical screening barriers. This study investigates the influence of trait EI on perceived cervical screening barriers. Furthermore, this study investigates the incremental validity of trait EI beyond the Big Five, as well as emotion regulation in the perceived barrier towards the Pap test as revealed in a sample of 206 Italian women that were undergoing cervical screening. Results have shown that trait EI is negatively related to cervical screening barriers. Furthermore, trait EI can be considered as a strong incremental predictor of a woman's perception of