Anterior cervical decompression and fusion on neck range of motion, pain, and function: a prospective analysis.

Science.gov (United States)

Landers, Merrill R; Addis, Kate A; Longhurst, Jason K; Vom Steeg, Bree-lyn; Puentedura, Emilio J; Daubs, Michael D

2013-11-01

Intractable cervical radiculopathy secondary to stenosis or herniated nucleus pulposus is commonly treated with an anterior cervical decompression and fusion (ACDF) procedure. However, there is little evidence in the literature that demonstrates the impact such surgery has on long-term range of motion (ROM) outcomes. The objective of this study was to compare cervical ROM and patient-reported outcomes in patients before and after a 1, 2, or 3 level ACDF. Prospective, nonexperimental. Forty-six patients. The following were measured preoperatively and also at 3 and 6 months after ACDF: active ROM (full and painfree) in three planes (ie, sagittal, coronal, and horizontal), pain visual analog scale, Neck Disability Index, and headache frequency. Patients undergoing an ACDF for cervical radiculopathy had their cervical ROM measured preoperatively and also at 3 and 6 months after the procedure. Neck Disability Index and pain visual analog scale values were also recorded at the same time. Both painfree and full active ROM did not change significantly from the preoperative measurement to the 3-month postoperative measurement (ps>.05); however, painfree and full active ROM did increase significantly in all three planes of motion from the preoperative measurement to the 6-month postoperative measurement regardless of the number of levels fused (ps≤.023). Visual analog scale, Neck Disability Index, and headache frequency all improved significantly over time (ps≤.017). Our results suggest that patients who have had an ACDF for cervical radiculopathy will experience improved ROM 6 months postoperatively. In addition, patients can expect a decrease in pain, an improvement in neck function, and a decrease in headache frequency. Copyright © 2013 Elsevier Inc. All rights reserved.

Cervical transforaminal epidural steroid injection for the management of cervical radiculopathy: a comparative study of particulate versus non-particulate steroids

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Lee, Joon Woo; Kang, Heung Sik [Seoul National University Bundang Hospital, Department of Radiology, Gyeonggi-Do (Korea); Park, Kun Woo; Yeom, Jin S. [Seoul National University Bundang Hospital, Department of Orthopaedic Surgery, Gyeonggi-Do (Korea); Chung, Sang-Ki; Kim, Ki-Jeong; Kim, Hyun-Jib [Seoul National University Bundang Hospital, Department of Neurosurgery, Gyeonggi-do (Korea)

2009-11-15

To determine if a particulate steroid which has a risk for embolic infarct would be more effective than a non-particulate steroid for transforaminal epidural steroid injection (TFESI). The purpose of this study was (1) to compare the effect of cervical TFESI using particulate (e.g., triamcinolone) and non-particulate (e.g., dexamethasone) steroids and (2) to evaluate the effectiveness of cervical TFESI in general. From January 2006 to August 2008, 159 consecutive patients [male:female (M:F) 89:70; mean age 53 years, range 33-75 years] who underwent cervical TFESI were included in this non-randomized study. For cervical TFESI, triamcinolone was injected into 97 patients and dexamethasone into 62 patients. Short-term follow-up was conducted within 1 month. The outcome was classified as effective or ineffective. Fisher's exact test was used to analyze the difference of outcome according to the injected steroid (triamcinolone vs dexamethasone). Other possible outcome predictors, such as age, gender, duration of radiculopathy, predominant symptom, attack of radiculopathy, cause of radiculopathy, number of nerve root compression levels, previous operation, and failure of previous interlaminar epidural injection, were also analyzed. Cervical TFESI using triamcinolone (78/97, 80.4%) was slightly more effective than that using dexamethasone (43/62, 69.4%), which was not significant (P = 0.129). In general, cervical TFESIs were effective in 121 of 159 patients (76.1%) at short-term follow-up. The only significant outcome predictor was whether the patient had had a previous operation (6/13, 46/2%) or not (115/146, 78.8%) (P = 0.015). There was no significant difference between particulate or non-particulate steroid for the effect of cervical TFESI. Cervical TFESI was effective in managing cervical radiculopathy in general. (orig.)

Cervical transforaminal epidural steroid injection for the management of cervical radiculopathy: a comparative study of particulate versus non-particulate steroids

International Nuclear Information System (INIS)

Lee, Joon Woo; Kang, Heung Sik; Park, Kun Woo; Yeom, Jin S.; Chung, Sang-Ki; Kim, Ki-Jeong; Kim, Hyun-Jib

2009-01-01

To determine if a particulate steroid which has a risk for embolic infarct would be more effective than a non-particulate steroid for transforaminal epidural steroid injection (TFESI). The purpose of this study was (1) to compare the effect of cervical TFESI using particulate (e.g., triamcinolone) and non-particulate (e.g., dexamethasone) steroids and (2) to evaluate the effectiveness of cervical TFESI in general. From January 2006 to August 2008, 159 consecutive patients [male:female (M:F) 89:70; mean age 53 years, range 33-75 years] who underwent cervical TFESI were included in this non-randomized study. For cervical TFESI, triamcinolone was injected into 97 patients and dexamethasone into 62 patients. Short-term follow-up was conducted within 1 month. The outcome was classified as effective or ineffective. Fisher's exact test was used to analyze the difference of outcome according to the injected steroid (triamcinolone vs dexamethasone). Other possible outcome predictors, such as age, gender, duration of radiculopathy, predominant symptom, attack of radiculopathy, cause of radiculopathy, number of nerve root compression levels, previous operation, and failure of previous interlaminar epidural injection, were also analyzed. Cervical TFESI using triamcinolone (78/97, 80.4%) was slightly more effective than that using dexamethasone (43/62, 69.4%), which was not significant (P = 0.129). In general, cervical TFESIs were effective in 121 of 159 patients (76.1%) at short-term follow-up. The only significant outcome predictor was whether the patient had had a previous operation (6/13, 46/2%) or not (115/146, 78.8%) (P = 0.015). There was no significant difference between particulate or non-particulate steroid for the effect of cervical TFESI. Cervical TFESI was effective in managing cervical radiculopathy in general. (orig.)

Straightened cervical lordosis causes stress concentration: a finite element model study

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Wei, Wei; Shi, Shiyuan; Fei, Jun; Wang, Yifan; Chen, Chunyue [Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, (China); Liao, Shenhui [School of Information Science and Engineering, Central South University, Changsha, Hunan (China)

2013-03-15

In this study, we propose a finite element analysis of the complete cervical spine with straightened and normal physiological curvature by using a specially designed modelling system. An accurate finite element model is established to recommend plausible approaches to treatment of cervical spondylosis through the finite element analysis results. There are few reports of biomechanics influence of the straightened cervical curve. It is difficult to measure internal responses of cervical spine directly. However, the finite element method has been reported to have the capability to quantify both external and internal responses to mechanical loading, such as the strain and stress distribution of spinal components. We choose a subject with a straightened cervical spine from whom to collect the CT scan data, which formed the basis of the finite element analysis. By using a specially designed modelling system, a high quality finite element model of the complete cervical spine with straightened curvature was generated, which was then mapped to reconstruct a normal physiological curvature model by a volumetric mesh deformation method based on discrete differential properties. Then, the same boundary conditions were applied to do a comparison. The result demonstrated that the active movement range of straightened cervical spine decreased by 24–33 %, but the stress increased by 5–95 %. The stress was concentrated at the facet joint cartilage, uncovertebral joint and the disk. The results suggest that cervical lordosis may have a direct impact on cervical spondylosis treatment. These results may be useful for clinical treatment of cervical spondylosis with straightened curvature.

Straightened cervical lordosis causes stress concentration: a finite element model study

International Nuclear Information System (INIS)

Wei, Wei; Shi, Shiyuan; Fei, Jun; Wang, Yifan; Chen, Chunyue; Liao, Shenhui

2013-01-01

In this study, we propose a finite element analysis of the complete cervical spine with straightened and normal physiological curvature by using a specially designed modelling system. An accurate finite element model is established to recommend plausible approaches to treatment of cervical spondylosis through the finite element analysis results. There are few reports of biomechanics influence of the straightened cervical curve. It is difficult to measure internal responses of cervical spine directly. However, the finite element method has been reported to have the capability to quantify both external and internal responses to mechanical loading, such as the strain and stress distribution of spinal components. We choose a subject with a straightened cervical spine from whom to collect the CT scan data, which formed the basis of the finite element analysis. By using a specially designed modelling system, a high quality finite element model of the complete cervical spine with straightened curvature was generated, which was then mapped to reconstruct a normal physiological curvature model by a volumetric mesh deformation method based on discrete differential properties. Then, the same boundary conditions were applied to do a comparison. The result demonstrated that the active movement range of straightened cervical spine decreased by 24–33 %, but the stress increased by 5–95 %. The stress was concentrated at the facet joint cartilage, uncovertebral joint and the disk. The results suggest that cervical lordosis may have a direct impact on cervical spondylosis treatment. These results may be useful for clinical treatment of cervical spondylosis with straightened curvature.

Barriers to cervical cancer screening among ethnic minority women: A qualitative study

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Marlow, L.; Waller, J.; Wardle, J.

2015-01-01

Background Ethnic minority women are less likely to attend cervical screening. Aim To explore self-perceived barriers to cervical screening attendance among ethnic minority women compared to white British women. Design Qualitative interview study. Setting Community groups in ethnically diverse London boroughs. Methods Interviews were carried out with 43 women from a range of ethnic minority backgrounds (Indian, Pakistani, Bangladeshi, Caribbean, African, Black British, Black other, White othe...

Evaluation of the immediate effect of acupuncture on pain, cervical range of motion and electromyographic activity of the upper trapezius muscle in patients with nonspecific neck pain: study protocol for a randomized controlled trial.

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Calamita, Simone Aparecida Penimpedo; Biasotto-Gonzalez, Daniela Aparecida; De Melo, Nivea Cristina; dos Santos, Douglas Meira; de Lassa, Roberta; de Mendonça, Fabiana Sarilho; Oliveira, Claudia Santos; Amorim, César Ferreira; Gonzalez, Tabajara Oliveira; Fumagalli, Marco Antônio; de Gomes, Cid André Fidelis Paula; Politti, Fabiano

2015-03-19

Nonspecific neck pain can cause considerable suffering, possible disability and reductions in quality of life and productivity. The aim of the proposed study is to evaluate the immediate effect of acupuncture on pain, cervical range of motion and electromyographic activity of the upper trapezius muscle in patients with nonspecific neck pain. A total of 12 patients with nonspecific neck pain and 12 healthy subjects will be enrolled in a randomized, single-blind crossover study. Each subject will receive two forms of treatment in random order: a single session of traditional acupuncture (acupoints: triple energizer 5, 'Wai-guan' and large intestine 11, 'Qu-chi') and sham acupuncture. To eliminate carry-over treatment effects, a one-week wash-out period will be respected between sessions. Surface electromyography will be used to determine motor control in the upper trapezius muscle before and after treatment. The outcome measures in the group with neck pain will be a numerical pain rating scale (range: 0 (no pain) to 10 (maximum pain)), documentation of the pain area on a body chart and cervical range of motion. Comparisons before and after acupuncture treatment will demonstrate whether acupoints affect the activity of the upper trapezius muscle, pain and cervical range of motion. The purpose of this randomized clinical trial is to evaluate the immediate effect of acupuncture on pain, cervical range of motion and electromyographic activity of the upper trapezius muscle in patients with nonspecific neck pain. Data will be published after the study is completed. The study will support the practice of evidence-based physical therapy for individuals with nonspecific neck pain. This trial was registered with Clinicaltrials.gov (identifier: NCT0984021 ) on 7 November 2013 ( https://clinicaltrials.gov/ct2/show/NCT01984021 ).

Cervical spinal canal narrowing and cervical neurologi-cal injuries

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ZHANG Ling

2012-04-01

Full Text Available 【Abstract】Cervical spinal canal narrowing can lead to injury of the spinal cord and neurological symptoms in-cluding neck pain, headache, weakness and parasthesisas. According to previous and recent clinical researches, we investigated the geometric parameters of normal cervical spinal canal including the sagittal and transverse diameters as well as Torg ratio. The mean sagittal diameter of cervical spinal canal at C 1 to C 7 ranges from 15.33 mm to 20.46 mm, the mean transverse diameter at the same levels ranges from 24.45 mm to 27.00 mm and the mean value of Torg ratio is 0.96. With respect to narrow cervical spinal canal, the following charaterstics are found: firstly, extension of the cervical spine results in statistically significant stenosis as compared with the flexed or neutral positions; secondly, females sustain cervical spinal canal narrowing more easily than males; finally, the consistent narrowest cervical canal level is at C 4 for all ethnicity, but there is a slight variation in the sagittal diameter of cervical spinal stenosis (≤14 mm in Whites, ≤ 12 mm in Japanese, ≤13.7 mm in Chinese. Narrow sagittal cervical canal diameter brings about an increased risk of neurological injuries in traumatic, degenerative and inflam-matory conditions and is related with extension of cervical spine, gender, as well as ethnicity. It is hoped that this re-view will be helpful in diagnosing spinal cord and neuro-logical injuries with the geometric parameters of cervical spine in the future. Key words: Spinal cord injuries; Spinal stenosis; Trauma, nervous system

Anterior cervical spine surgery-associated complications in a retrospective case-control study.

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Tasiou, Anastasia; Giannis, Theofanis; Brotis, Alexandros G; Siasios, Ioannis; Georgiadis, Iordanis; Gatos, Haralampos; Tsianaka, Eleni; Vagkopoulos, Konstantinos; Paterakis, Konstantinos; Fountas, Kostas N

2017-09-01

Anterior cervical spine procedures have been associated with satisfactory outcomes. However, the occurrence of troublesome complications, although uncommon, needs to be taken into consideration. The purpose of our study was to assess the actual incidence of anterior cervical spine procedure-associated complications and identify any predisposing factors. A total of 114 patients undergoing anterior cervical procedures over a 6-year period were included in our retrospective, case-control study. The diagnosis was cervical radiculopathy, and/or myelopathy due to degenerative disc disease, cervical spondylosis, or traumatic cervical spine injury. All our participants underwent surgical treatment, and complications were recorded. The most commonly performed procedure (79%) was anterior cervical discectomy and fusion (ACDF). Fourteen patients (12.3%) underwent anterior cervical corpectomy and interbody fusion, seven (6.1%) ACDF with plating, two (1.7%) odontoid screw fixation, and one anterior removal of osteophytes for severe Forestier's disease. Mean follow-up time was 42.5 months (range, 6-78 months). The overall complication rate was 13.2%. Specifically, we encountered adjacent intervertebral disc degeneration in 2.7% of our cases, dysphagia in 1.7%, postoperative soft tissue swelling and hematoma in 1.7%, and dural penetration in 1.7%. Additionally, esophageal perforation was observed in 0.9%, aggravation of preexisting myelopathy in 0.9%, symptomatic recurrent laryngeal nerve palsy in 0.9%, mechanical failure in 0.9%, and superficial wound infection in 0.9%. In the vast majority anterior cervical spine surgery-associated complications are minor, requiring no further intervention. Awareness, early recognition, and appropriate management, are of paramount importance for improving the patients' overall functional outcome.

Direction-Specific Impairments in Cervical Range of Motion in Women with Chronic Neck Pain: Influence of Head Posture and Gravitationally Induced Torque.

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Rudolfsson, Thomas; Björklund, Martin; Svedmark, Åsa; Srinivasan, Divya; Djupsjöbacka, Mats

2017-01-01

Cervical range of motion (ROM) is commonly assessed in clinical practice and research. In a previous study we decomposed active cervical sagittal ROM into contributions from lower and upper levels of the cervical spine and found level- and direction-specific impairments in women with chronic non-specific neck pain. The present study aimed to validate these results and investigate if the specific impairments can be explained by the neutral posture (defining zero flexion/extension) or a movement strategy to avoid large gravitationally induced torques on the cervical spine. Kinematics of the head and thorax was assessed in sitting during maximal sagittal cervical flexion/extension (high torque condition) and maximal protraction (low torque condition) in 120 women with chronic non-specific neck pain and 40 controls. We derived the lower and upper cervical angles, and the head centre of mass (HCM), from a 3-segment kinematic model. Neutral head posture was assessed using a standardized procedure. Previous findings of level- and direction-specific impairments in neck pain were confirmed. Neutral head posture was equal between groups and did not explain the direction-specific impairments. The relative magnitude of group difference in HCM migration did not differ between high and low torques conditions, lending no support for our hypothesis that impairments in sagittal ROM are due to torque avoidance behaviour. The direction- and level-specific impairments in cervical sagittal ROM can be generalised to the population of women with non-specific neck pain. Further research is necessary to clarify if torque avoidance behaviour can explain the impairments.

Direction-Specific Impairments in Cervical Range of Motion in Women with Chronic Neck Pain: Influence of Head Posture and Gravitationally Induced Torque.

Directory of Open Access Journals (Sweden)

Thomas Rudolfsson

Full Text Available Cervical range of motion (ROM is commonly assessed in clinical practice and research. In a previous study we decomposed active cervical sagittal ROM into contributions from lower and upper levels of the cervical spine and found level- and direction-specific impairments in women with chronic non-specific neck pain. The present study aimed to validate these results and investigate if the specific impairments can be explained by the neutral posture (defining zero flexion/extension or a movement strategy to avoid large gravitationally induced torques on the cervical spine.Kinematics of the head and thorax was assessed in sitting during maximal sagittal cervical flexion/extension (high torque condition and maximal protraction (low torque condition in 120 women with chronic non-specific neck pain and 40 controls. We derived the lower and upper cervical angles, and the head centre of mass (HCM, from a 3-segment kinematic model. Neutral head posture was assessed using a standardized procedure.Previous findings of level- and direction-specific impairments in neck pain were confirmed. Neutral head posture was equal between groups and did not explain the direction-specific impairments. The relative magnitude of group difference in HCM migration did not differ between high and low torques conditions, lending no support for our hypothesis that impairments in sagittal ROM are due to torque avoidance behaviour.The direction- and level-specific impairments in cervical sagittal ROM can be generalised to the population of women with non-specific neck pain. Further research is necessary to clarify if torque avoidance behaviour can explain the impairments.

Economic burden of cervical cancer in Malaysia

Directory of Open Access Journals (Sweden)

Sharifa E.W. Puteh

2008-12-01

Full Text Available Cervical cancers form the second highest number of female cancers in Malaysia, imposing a substantial amount of cost burden on its management. However, an estimation of cost burden of abnormal smears, cervical pre-invasive and invasive diseases needs to be done to show how much spending has been allocated to the problem. An expert panel committee came up with the clinical pathway and management algorithm of  cervical pre invasive and invasive diseases from July-December 2006 Malaysia. An activity based costing for each clinical pathway was done. Results were converted to USD. The cost of managing pre-invasive cervical cancers stage is USD 420,150 (Range: USD 197,158-879,679. Management of invasive cancer (new cases costs USD 51,533,233.44 (Range: USD 32,405,399.69 - USD 129,014,768.40. The cost of managing existing cases is USD 17,005,966.87 (Range: USD 10,693,781.90 - USD  28,901,587.12. The total cost of managing cervical cancers by health care providers in a public setting is around USD 75,888,329.45 (Range: USD 48,083,804.60 - USD 48,083,804.60. The outcome of this study has shown that preventive modalities such as screening have only contributed to 10.3 % of the total management cost of cervical cancer. The major cost contribution (67% came from treatment of invasive cancer especially at more advanced stages of cancer, followed by treatment of existing cases (22% and lastly on pre-invasive disease (0.6%. This study revealed that proportion of preventive modality in this country was still low, and the major cost came from actual treatment cost of cervical cancer. Therefore, heightened public cervical cancer screening in the country is needed. (Med J Indones 2008; 17: 272-80Keywords: cervical cancers, pre invasive disease, HPV vaccination

Association between cervical screening and prevention of invasive cervical cancer in Ontario: a population-based case-control study.

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Vicus, Danielle; Sutradhar, Rinku; Lu, Yan; Kupets, Rachel; Paszat, Lawrence

2015-01-01

The aim of this study was to estimate the effect of cervical screening in the prevention of invasive cervical cancer among age groups, using a population-based case-control study in the province of Ontario, Canada. Exposure was defined as cervical cytology history greater than 3 months before the diagnosis date of cervical cancer (index date). Cases were women who were diagnosed with cervical cancer between January 1, 1998, and December 31, 2008. Controls were women without a diagnosis of cervical cancer on, or before, December 31, 2008. Two controls were matched to each case on year of birth and income quintile, as of the index date. Conditional logistic regression was used to estimate the odds ratio for having been screened among those with cervical cancer. Cervical cancer screening performed between 3 and 36 months before the index date was protective against invasive cervical cancer in women aged 40 through 69 years. In women younger than 40 years, cervical cancer screening performed 3 to 36 months before the index date was not protective. Cervical screening is associated with a reduced risk for invasive cervical cancer among women older than 40 years. Cervical cancer resources should be focused on maximizing the risk reduction.

Cervical precancerous changes and selected cervical microbial infections, Kiambu County, Kenya, 2014: a cross sectional study.

Science.gov (United States)

Kanyina, Evalyne Wambui; Kamau, Lucy; Muturi, Margaret

2017-09-25

Cervical cancer is the predominant cancer among women in Kenya and second most common in women in developing regions. Population-based cytological screening and early treatment reduces morbidity and mortality associated with the cancer. We determined the occurrence of cervical precancerous changes and cervical microbial infections (Trichomonas vaginalis, Candida albicans, Neisseria gonorrhea and Actinomyces) among women attending Family Health Option Kenya (FHOK) clinic in Thika. This was a hospital based cross sectional study among women attending reproductive health screening clinic from November 2013 to January 2014. Cervical Intraepithelial Neoplasia (CIN) I, II, III, cervical cancer and microbial infection (Actinomyces, Trichomonas vaginalis and Yeast cells) diagnosis was based on Pap smear screening test and High Vaginal Swab wet preparation microscopy. Neisseria gonorrhea was diagnosed through Gram staining. Socio-demographic and reproductive health data was collected using a structured questionnaire administered to the study participants and analyzed using Epi Info version 3.5.1. Of the 244 women screened, 238 (97.5%) presented with cervical inflammation, 80 (32.8%) cervical microbial infections and 12 (4.9%) cervical precancerous changes; 10 (83.3%) with CIN I and 2 (16.7%) CIN II. Of the 80 cervical microbial infections, 62 (77.5%) were yeast cell and 18 (22.5%) T. vaginalis. One thirty four (55%) participants had no history of Pap smear screening of which 84 (62.7%) were 20-40 years. Use of IUCDs (OR: 2.47, 95% CI 1.3-4.6) was associated with cervical inflammation. CIN I was the predominant cervical precancerous change. There is need to scale up cervical screening test to capture all categories of women.

Rheumatoid arthritis: Radiological changes in the cervical spine

International Nuclear Information System (INIS)

Al-Boukai, Ahmad A.; Al-Arfaj, Abdurahman S.

2003-01-01

Objective was to describe the radiographic cervical spine changes in rheumatoid arthritis patients.Forty-nine patients (37 females and 12 males ) diagnosed with rheumatoid arthritis at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between June 1998 and December 2000, were studied for their radiographic cervical spine changes . Their mean age at disease onset was 41.4 + 13.4 years (range of 18-73)and mean duration of disease was 9.1+-6.28 years (range of 2-34). Their demographic data including rheumatoid factor status was obtained. Standard conventional radiographs cervical spine were obtained to study the cervical spine changes. Cervical radiographic changes were found in 34 patients (27 females and 7 males) 10 had subluxation (7 with atlanto-axial subluxation,2 with sub-axial subluxation,and one with lateral subluxation ). No vertical impaction was seen. Erosion of odontoid process was seen in one patient .All were rheumatoid seropositive Cervical spine changes in patients with rheumatoid arthritis are common, in particular subluxation in the upper cervical spine. Our study showed somewhat lesser prevalence of these changes. These were clinically correlated with disease duration, female sex, and rheumatoid factor, but were not clinically significant. (author)

Effects of C5/C6 Intervertebral Space Distraction Height on Pressure on the Adjacent Intervertebral Disks and Articular Processes and Cervical Vertebrae Range of Motion.

Science.gov (United States)

Lu, Tingsheng; Luo, Chunshan; Ouyang, Beiping; Chen, Qiling; Deng, Zhongliang

2018-04-25

BACKGROUND This study aimed to investigate the association between range of motion of the cervical vertebrae and various C5/C6 intervertebral space distraction heights. MATERIAL AND METHODS The cervical vertebrae from 6 fresh adult human cadavers were used to prepare the models. Changes in C4/C5 and C6/C7 intervertebral disk pressures, articular process pressure, and range of motion of the cervical vertebrae before and after the distraction of the C5/C6 intervertebral space at benchmark heights of 100%, 120%, 140%, and 160% were tested under different exercise loads. RESULTS The pressure on the adjacent intervertebral disks was highest with the standing upright position before distraction, varied with different positions of the specimens and distraction heights after distraction, and was closest to that before distraction at a distraction height of 120% (Particular processes was highest with left and right rotations before distraction, varied with different positions of the specimens and distraction heights after distraction, and was lowest under the same exercise load with different positions at a distraction height of 120% (Pdistraction and at a distraction height of 120% after distraction, respectively (Particular processes and range of motion of the cervical vertebrae and is therefore an appropriate intervertebral space distraction height.

Biomechanics of coupled motion in the cervical spine during simulated whiplash in patients with pre-existing cervical or lumbar spinal fusion: A Finite Element Study.

Science.gov (United States)

Huang, H; Nightingale, R W; Dang, A B C

2018-01-01

Loss of motion following spine segment fusion results in increased strain in the adjacent motion segments. However, to date, studies on the biomechanics of the cervical spine have not assessed the role of coupled motions in the lumbar spine. Accordingly, we investigated the biomechanics of the cervical spine following cervical fusion and lumbar fusion during simulated whiplash using a whole-human finite element (FE) model to simulate coupled motions of the spine. A previously validated FE model of the human body in the driver-occupant position was used to investigate cervical hyperextension injury. The cervical spine was subjected to simulated whiplash exposure in accordance with Euro NCAP (the European New Car Assessment Programme) testing using the whole human FE model. The coupled motions between the cervical spine and lumbar spine were assessed by evaluating the biomechanical effects of simulated cervical fusion and lumbar fusion. Peak anterior longitudinal ligament (ALL) strain ranged from 0.106 to 0.382 in a normal spine, and from 0.116 to 0.399 in a fused cervical spine. Strain increased from cranial to caudal levels. The mean strain increase in the motion segment immediately adjacent to the site of fusion from C2-C3 through C5-C6 was 26.1% and 50.8% following single- and two-level cervical fusion, respectively (p = 0.03, unpaired two-way t -test). Peak cervical strains following various lumbar-fusion procedures were 1.0% less than those seen in a healthy spine (p = 0.61, two-way ANOVA). Cervical arthrodesis increases peak ALL strain in the adjacent motion segments. C3-4 experiences greater changes in strain than C6-7. Lumbar fusion did not have a significant effect on cervical spine strain. Cite this article : H. Huang, R. W. Nightingale, A. B. C. Dang. Biomechanics of coupled motion in the cervical spine during simulated whiplash in patients with pre-existing cervical or lumbar spinal fusion: A Finite Element Study. Bone Joint Res 2018;7:28-35. DOI: 10

Impact of Fat Infiltration in Cervical Extensor Muscles on Cervical Lordosis and Neck Pain: A Cross-Sectional Study.

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Kim, Choong-Young; Lee, Sang-Min; Lim, Seong-An; Choi, Yong-Soo

2018-06-01

Weakness of cervical extensor muscles causes loss of cervical lordosis, which could also cause neck pain. The aim of this study was to investigate the impact of fat infiltration in cervical extensor muscles on cervical lordosis and neck pain. Fifty-six patients who suffered from neck pain were included in this study. Fat infiltration in cervical extensor muscles was measured at each level of C2-3 and C6-7 using axial magnetic resonance imaging. The visual analogue scale (VAS), 12-Item Short Form Health Survey (SF-12), and Neck Disability Index (NDI) were used for clinical assessment. The mean fat infiltration was 206.3 mm 2 (20.3%) at C2-3 and 240.6 mm 2 (19.5%) at C6-7. Fat infiltration in cervical extensor muscles was associated with high VAS scores at both levels ( p = 0.047 at C2-3; p = 0.009 at C6-7). At C2-3, there was a negative correlation between fat infiltration of the cervical extensor muscles and cervical lordosis (r = -0.216; p = 0.020). At C6-7, fat infiltration in the cervical extensor muscles was closely related to NDI ( p = 0.003) and SF-12 ( p > 0.05). However, there was no significant correlation between cervical lordosis and clinical outcomes (VAS, p = 0.112; NDI, p = 0.087; and SF-12, p > 0.05). These results suggest that fat infiltration in the upper cervical extensor muscles has relevance to the loss of cervical lordosis, whereas fat infiltration in the lower cervical extensor muscles is associated with cervical functional disability.

Recurrent Laryngeal Nerve Palsy After Cervical Spine Surgery: A Multicenter AOSpine Clinical Research Network Study.

Science.gov (United States)

Gokaslan, Ziya L; Bydon, Mohamad; De la Garza-Ramos, Rafael; Smith, Zachary A; Hsu, Wellington K; Qureshi, Sheeraz A; Cho, Samuel K; Baird, Evan O; Mroz, Thomas E; Fehlings, Michael; Arnold, Paul M; Riew, K Daniel

2017-04-01

Multicenter retrospective study. To investigate the risk of symptomatic recurrent laryngeal nerve palsy (RLNP) following cervical spine surgery, to examine risk factors for its development, and to report its treatment and outcomes. A multicenter study from 21 high-volume surgical centers from the AOSpine North America Clinical Research Network was performed. Each center screened for rare complications following cervical spine surgery, including RLNP. Patients were included if they underwent cervical spine surgery (levels from C2 to C7) between January 1, 2005 and December 31, 2011. Data were analyzed with regard to complication treatment and outcome. Cases were compared to a control group from the AOSpine CSM and CSM-I studies. Three centers reported 19 cases of RLNP from a cohort of 1345 patients. The reported incidence of RLNP ranged from 0.6% to 2.9% between these 3 centers. Fifteen patients (79%) in the RLNP group were approached from the left side. Ten patients (52.6%) required treatment for RLNP-6 required medical therapy (steroids), 1 interventional treatment (injection laryngoplasty), and 3 conservative therapy (speech therapy). When examining outcomes, 73.7% (14/19) of cases resolved completely, 15.8% (3/19) resolved with residual effects, and in 10.5% (2/19) of cases this could not be determined. In this multicenter study examining rare complications following cervical spine surgery, the risk of RLNP after cervical spine surgery ranged from 0.6% to 2.9% between centers. Though rare, it was found that 16% of patients may experience partial resolution with residual effects, and 74% resolve completely.

Barriers to cervical cancer screening among ethnic minority women: a qualitative study.

Science.gov (United States)

Marlow, Laura A V; Waller, Jo; Wardle, Jane

2015-10-01

Ethnic minority women are less likely to attend cervical screening. To explore self-perceived barriers to cervical screening attendance among ethnic minority women compared to white British women. Qualitative interview study. Community groups in ethnically diverse London boroughs. Interviews were carried out with 43 women from a range of ethnic minority backgrounds (Indian, Pakistani, Bangladeshi, Caribbean, African, Black British, Black other, White other) and 11 White British women. Interviews were recorded, transcribed verbatim and analysed using Framework analysis. Fifteen women had delayed screening/had never been screened. Ethnic minority women felt that there was a lack of awareness about cervical cancer in their community, and several did not recognise the terms 'cervical screening' or 'smear test'. Barriers to cervical screening raised by all women were emotional (fear, embarrassment, shame), practical (lack of time) and cognitive (low perceived risk, absence of symptoms). Emotional barriers seemed to be more prominent among Asian women. Low perceived risk of cervical cancer was influenced by beliefs about having sex outside of marriage and some women felt a diagnosis of cervical cancer might be considered shameful. Negative experiences were well remembered by all women and could be a barrier to repeat attendance. Emotional barriers (fear, embarrassment and anticipated shame) and low perceived risk might contribute to explaining lower cervical screening coverage for some ethnic groups. Interventions to improve knowledge and understanding of cervical cancer are needed in ethnic minority communities, and investment in training for health professionals may improve experiences and encourage repeat attendance for all women. 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.

Cervical spondylosis and hypertension: a clinical study of 2 cases.

Science.gov (United States)

Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

2015-03-01

Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully with anterior cervical discectomy and fusion. Stimulation of sympathetic nerve fibers in pathologically degenerative disc could produce sympathetic excitation, and induce a sympathetic reflex to cause cervical vertigo and hypertension. In addition, chronic neck pain could contribute to hypertension development through sympathetic arousal and failure of normal homeostatic pain regulatory mechanisms. Cervical spondylosis may be one of the causes of secondary hypertension. Early treatment for resolution of symptoms of cervical spondylosis may have a beneficial impact on cardiovascular disease risk in patients with cervical spondylosis.

Immediate changes in widespread pressure pain sensitivity, neck pain, and cervical range of motion after cervical or thoracic thrust manipulation in patients with bilateral chronic mechanical neck pain: a randomized clinical trial.

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Martínez-Segura, Raquel; De-la-Llave-Rincón, Ana I; Ortega-Santiago, Ricardo; Cleland, Joshua A; Fernández-de-Las-Peñas, César

2012-09-01

Randomized clinical trial. To compare the effects of cervical versus thoracic thrust manipulation in patients with bilateral chronic mechanical neck pain on pressure pain sensitivity, neck pain, and cervical range of motion (CROM). Evidence suggests that spinal interventions can stimulate descending inhibitory pain pathways. To our knowledge, no study has investigated the neurophysiological effects of thoracic thrust manipulation in individuals with bilateral chronic mechanical neck pain, including widespread changes on pressure sensitivity. Ninety patients (51% female) were randomly assigned to 1 of 3 groups: cervical thrust manipulation on the right, cervical thrust manipulation on the left, or thoracic thrust manipulation. Pressure pain thresholds (PPTs) over the C5-6 zygapophyseal joint, lateral epicondyle, and tibialis anterior muscle, neck pain (11-point numeric pain rating scale), and cervical spine range of motion (CROM) were collected at baseline and 10 minutes after the intervention by an assessor blinded to the treatment allocation of the patients. Mixed-model analyses of covariance were used to examine the effects of the treatment on each outcome variable, with group as the between-subjects variable, time and side as the within-subject variables, and gender as the covariate. The primary analysis was the group-by-time interaction. No significant interactions were found with the mixed-model analyses of covariance for PPT level (C5-6, P>.210; lateral epicondyle, P>.186; tibialis anterior muscle, P>.268), neck pain intensity (P = .923), or CROM (flexion, P = .700; extension, P = .387; lateral flexion, P>.672; rotation, P>.192) as dependent variables. All groups exhibited similar changes in PPT, neck pain, and CROM (all, P.10). The results of the current randomized clinical trial suggest that cervical and thoracic thrust manipulation induce similar changes in PPT, neck pain intensity, and CROM in individuals with bilateral chronic mechanical neck pain

Validity of eyeball estimation for range of motion during the cervical flexion rotation test compared to an ultrasound-based movement analysis system.

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Schäfer, Axel; Lüdtke, Kerstin; Breuel, Franziska; Gerloff, Nikolas; Knust, Maren; Kollitsch, Christian; Laukart, Alex; Matej, Laura; Müller, Antje; Schöttker-Königer, Thomas; Hall, Toby

2018-08-01

Headache is a common and costly health problem. Although pathogenesis of headache is heterogeneous, one reported contributing factor is dysfunction of the upper cervical spine. The flexion rotation test (FRT) is a commonly used diagnostic test to detect upper cervical movement impairment. The aim of this cross-sectional study was to investigate concurrent validity of detecting high cervical ROM impairment during the FRT by comparing measurements established by an ultrasound-based system (gold standard) with eyeball estimation. Secondary aim was to investigate intra-rater reliability of FRT ROM eyeball estimation. The examiner (6 years experience) was blinded to the data from the ultrasound-based device and to the symptoms of the patients. FRT test result (positive or negative) was based on visual estimation of range of rotation less than 34° to either side. Concurrently, range of rotation was evaluated using the ultrasound-based device. A total of 43 subjects with headache (79% female), mean age of 35.05 years (SD 13.26) were included. According to the International Headache Society Classification 23 subjects had migraine, 4 tension type headache, and 16 multiple headache forms. Sensitivity and specificity were 0.96 and 0.89 for combined rotation, indicating good concurrent reliability. The area under the ROC curve was 0.95 (95% CI 0.91-0.98) for rotation to both sides. Intra-rater reliability for eyeball estimation was excellent with Fleiss Kappa 0.79 for right rotation and left rotation. The results of this study indicate that the FRT is a valid and reliable test to detect impairment of upper cervical ROM in patients with headache.

Impact of Cervical Sagittal Alignment on Axial Neck Pain and Health-related Quality of Life After Cervical Laminoplasty in Patients With Cervical Spondylotic Myelopathy or Ossification of the Posterior Longitudinal Ligament: A Prospective Comparative Study.

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Fujiwara, Hiroyasu; Oda, Takenori; Makino, Takahiro; Moriguchi, Yu; Yonenobu, Kazuo; Kaito, Takashi

2018-05-01

This is prospective observational study. To prospectively investigate the correlation among axial neck pain; a newly developed patient-based quality of life outcome measure, the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ); and cervical sagittal alignment after open-door laminoplasty for cervical myelopathy. Many studies have focused on postoperative axial neck pain after laminoplasty. However, the correlation among cervical sagittal alignment, neck pain, and JOACMEQ has not been investigated. In total, 57 consecutive patients treated by open-door laminoplasty for cervical myelopathy were included (mean age, 63.7 y; 15 women and 42 men) and divided into 2 groups according to diagnosis [cervical spondylotic myelopathy (CSM) group: 35 patients, and ossification of the posterior longitudinal ligament (OPLL) group: 22 patients]. JOA score, a subdomain of cervical spine function (CSF) in the JOACMEQ, and the visual analog scale for axial neck pain were assessed preoperatively and 12 months postoperatively. Radiographic cervical sagittal parameters were measured by C2 sagittal vertical axis (C2 SVA), C2-C7 lordosis, C7 sagittal slope (C7 slope), and range of motion. C2 SVA values in both groups shifted slightly anteriorly between preoperative and 12-month postoperative measurements (CSM: +19.7±10.9 mm; OPLL: +22.1±13.4 mm vs. CSM: +23.2±16.1 mm; OPLL: +28.7±15.4 mm, respectively). Postoperative axial neck pain in the OPLL group showed strong negative correlations with C2 SVA and C7 slope. Strong negative correlations were found between axial neck pain and CSF in both the preoperative CSM and OPLL groups (CSM: r=-0.45, P=0.01; OPLL: r=-0.61, Ppain and CSF in the postoperative OPLL group (r=-0.51, P=0.05). This study demonstrated a significant negative correlation between neck pain and CSF in both the CSM and OPLL groups preoperatively and in the OPLL group postoperatively. Radiographic cervical sagittal alignment

A randomized clinical trial to compare the immediate effects of seated thoracic manipulation and targeted supine thoracic manipulation on cervical spine flexion range of motion and pain.

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Karas, Steve; Olson Hunt, Megan J

2014-05-01

Randomized clinical trial. To determine the effectiveness of seated thoracic manipulation versus targeted supine thoracic manipulation on cervical spine pain and flexion range of motion (ROM). There is evidence that thoracic spine manipulation is an effective treatment for patients with cervical spine pain. This evidence includes a variety of techniques to manipulate the thoracic spine. Although each of them is effective, no research has compared techniques to determine which produces the best outcomes. A total of 39 patients with cervical spine pain were randomly assigned to either a seated thoracic manipulation or targeted supine thoracic manipulation group. Pain and flexion ROM measures were taken before and after the intervention. Pain reduction (post-treatment-pre-treatment) was significantly greater in those patients receiving the targeted supine thoracic manipulation compared to the seated thoracic manipulation (Pmanipulation group. The results of this study indicate that a targeted supine thoracic manipulation may be more effective in reducing cervical spine pain and improving cervical flexion ROM than a seated thoracic manipulation. Future studies should include a variety of patients and physical therapists (PTs) to validate our findings.

Cervical carcinoma and sexual behavior: collaborative reanalysis of individual data on 15,461 women with cervical carcinoma and 29,164 women without cervical carcinoma from 21 epidemiological studies

DEFF Research Database (Denmark)

Kjær, Susanne Krüger

2009-01-01

of sexual partners and age at first sexual intercourse from 21 studies, or groups of studies, including 10,773 women with invasive cervical carcinoma, 4,688 women with cervical intraepithelial neoplasia grade 3 (CIN3)/carcinoma in situ, and 29,164 women without cervical carcinoma. Relative risks......High-risk human papillomavirus (HPV) types cause most cervical carcinomas and are sexually transmitted. Sexual behavior therefore affects HPV exposure and its cancer sequelae. The International Collaboration of Epidemiological Studies of Cervical Cancer has combined data on lifetime number...... for invasive cancer and CIN3 were estimated by conditional logistic regression. Risk of invasive cervical carcinoma increased with lifetime number of sexual partners (P for linear trend or =6 versus 1 partner, conditioned on age, study, and age at first intercourse, was 2...

A study of chronic fatigue in Norwegian cervical cancer survivors.

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Steen, Rita; Dahl, Alv A; Hess, Siri Lothe; Kiserud, Cecilie E

2017-09-01

Chronic fatigue after treatment is a common adverse event in cancer patients, but there are few studies in long-term survivors of cervical cancer. The aim of this investigation was to explore the prevalence of chronic fatigue and its association with various clinical and treatment-related factors in a population-based cohort of Norwegian cervical cancer survivors treated by any modality. All patients, treated for cervical cancer from 2000 through 2007 in the Health Region of South-Eastern Norway, cancer-free, alive and aged ≤75years by the end 2013 (n=822) received a questionnaire covering chronic fatigue and other clinical variables. 461 of 822 survivors (56%) completed the questionnaire and 382 entered the analyses. Chronic fatigue was reported by 23% (95% confidence interval 19%-27%) with a median age of 52years (range 32-75) at survey, 11years (range 7-15) after diagnosis. Among survivors treated by minimal invasive- or radical surgery, 19% had chronic fatigue, while the prevalence was 28% in those treated with radiation and concomitant chemotherapy (chemoradiation). The chronic fatigue group reported significantly more cardiovascular disease, obesity, less physical activity, more treatment-related symptom experience, more menopausal symptoms, higher levels of anxiety and depressive symptoms, and poorer quality of life than the non-fatigued group. In multivariate analysis only increased level of depression and poorer global quality of life were significantly associated with chronic fatigue. Chronic fatigue was reported by 23% of long-term survivors after cervical cancer at a mean of 11years after treatment. Some of the associated factors are amenable to prevention and/or treatment and should be subjects of attention at follow-up. Copyright © 2017 Elsevier Inc. All rights reserved.

Cervical Microbiome and Cytokine Profile at Various Stages of Cervical Cancer: A Pilot Study.

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Astride Audirac-Chalifour

Full Text Available Cervical cancer (CC is caused by high-risk human papillomavirus persistence due to the immunosuppressive tumor microenvironment mediated by cytokines. Vaginal microbiota determines the presence of certain cytokines locally. We assessed the association between cervical microbiota diversity and the histopathological diagnosis of each stage of CC, and we evaluated mRNA cervical expression levels of IL-4, IL-6, IL-10, TGF-β1, TNF-α and IFN-γ across the histopathological diagnosis and specific bacterial clusters. We determined the cervical microbiota by high throughput sequencing of 16S rDNA amplicons and classified it in community state types (CST. Mean difference analyses between alpha-diversity and histopathological diagnosis were carried out, as well as a β-diversity analysis within the histological diagnosis. Cervical cytokine mRNA expression was analyzed across the CSTs and the histopathological diagnoses. We found a significant difference in microbiota's diversity in NCL-HPV negative women vs those with squamous intraepithelial lesions (SIL and CC(p = 0.006, p = 0.036.When β-diversity was evaluated, the CC samples showed the highest variation within groups (p<0.0006 and the largest distance compared to NCL-HPV negative ones (p<0.00001. The predominant bacteria in women with normal cytology were L. crispatus and L. iners, whereas for SIL, it was Sneathia spp. and for CC, Fusobacterium spp. We found higher median cervical levels of IL-4 and TGF-β1 mRNA in the CST dominated by Fusobacterium spp. These results suggest that the cervical microbiota may be implicated in cervical cancer pathology. Further cohort studies are needed to validate these findings.

Case Studies - Cervical Cancer

Centers for Disease Control (CDC) Podcasts

Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.

[Effects of an hydrotherapy program in the treatment of cervical dystonia. A pilot study].

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Useros-Olmo, Ana Isabel; Collado-Vázquez, Susana

2010-12-01

Cervical dystonia may also cause limitation in articulation mobility and alteration of the balance, both accompanied with pain. AIM. To evaluate if hydrotherapy produces decrease of pain, increase in mobility and balance in patients diagnosed with cervical dystonia. A pre-post treatment pilot study was carried out without group control, with a sample of 16 patients (13 female and 3 male) diagnosed with cervical dystonia. The patients received an hydrotherapy treatment consisted of three individual sessions and three grupal sessions of aquatic exercises. In the pre-treatment phase the disability, severity and pain were evaluated by means of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS); the balance was evaluated by means of the Get up and Go and Tinetti tests. In addition, the range of active mobility of the neck was measured with tape. The test were measured pre and post-treatment. The Student t showed a significant difference (p hydrotherapy can be related a positive influence in cervical dystonia, producing neck mobility and balance improvements and pain decrease. Future studies are necessary.

Patient side cost and its predictors for cervical cancer in Ethiopia: a cross sectional hospital based study

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Hailu Alemayehu

2013-02-01

Full Text Available Abstract Background Cervical cancer is a leading cause of death from cancer among women in low-resource settings, affecting women at a time of life when they are critical to social and economic stability. In addition, the economic burden is important for policy formulation. The aim of this study is to estimate patient side cost and to determine predictors of its variation for the treatment of cervical cancer. Methods Analytic cross sectional study involving 227 cervical cancer cases at Tikur Anbessa Hospital, Ethiopia was conducted. Cost estimation was based on patients' perspective and using the prevalence-based model as a time frame. Productivity losses were estimated from lost working days. Results The mean outpatient cost per patient for cervical cancer was $407.2 (Median = $206.9. Direct outpatient cost (Mean = $334.2 takes the largest share compared with the indirect counterpart ($150. The outpatient cost for half of the respondent falls in a range between $93.7 and $478. The mean inpatient cost for hospitalized patients was $404.4. The average direct inpatient cost was $329 (74% medical costs and 26% non medical costs. The mean value for total inpatient cost for half of the respondents was in the range of $133.5 and $493.9. For every additional day of inpatient hospital stay, there is a daily incremental inpatient cost of $4.2. Conclusion As has been found in other studies, our findings revealed that cervical cancer creates an immense financial burden on patients. Primary prevention measures, vaccination against HPV and screening, should be initiated and expanded to reduce morbidity from cervical cancer and subsequent costs in both human lives and money resources. Control of co-morbidity and complication should be emphasized during management of cervical cancer patients. Capacitating regional hospitals and provision of low cost or fee exemption schemes should be arranged and strengthened.

Cervical stability training with and without core stability training for patients with cervical disc herniation: A randomized, single-blind study.

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Buyukturan, B; Guclu-Gunduz, A; Buyukturan, O; Dadali, Y; Bilgin, S; Kurt, E E

2017-11-01

This study aims at evaluating and comparing the effects of cervical stability training to combined cervical and core stability training in patients with neck pain and cervical disc herniation. Fifty patients with neck pain and cervical disc herniation were included in the study, randomly divided into two groups as cervical stability and cervical-core stability. Training was applied three times a week in three phases, and lasted for a total duration of 8 weeks. Pain, activation and static endurance of deep cervical flexor muscles, static endurance of neck muscles, cross-sectional diameter of M. Longus Colli, static endurance of trunk muscles, disability and kinesiophobia were assessed. Pain, activation and static endurance of deep cervical flexors, static endurance of neck muscles, cross-sectional diameter of M. Longus Colli, static endurance of trunk muscles, disability and kinesiophobia improved in both groups following the training sessions (p training methods revealed that the cervical stability group produced a greater increase in the right transverse diameter of M. Longus Colli (p training provided benefit to patients with cervical disc herniation. The addition of core stability training did not provide any additional significant benefit. Further research is required to investigate the efficacy of combining other techniques with cervical stability training in patients with cervical disc herniation. Both cervical stability training and its combination with core stability training were significantly and similarly effective on neck pain and neck muscle endurance in patients with cervical disc herniation. © 2017 European Pain Federation - EFIC®.

A Study on Knowledge and Screening for Cervical Cancer among ...

African Journals Online (AJOL)

A Study on Knowledge and Screening for Cervical Cancer among Women in ... and source of information for awareness of women about cervical cancer in India. ... Results: Majority of the women have poor knowledge about cervical cancer ...

Chronic Neck Pain and Cervico-Craniofacial Pain Patients Express Similar Levels of Neck Pain-Related Disability, Pain Catastrophizing, and Cervical Range of Motion

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Muñoz-García, Daniel; Gil-Martínez, Alfonso; López-López, Almudena; Lopez-de-Uralde-Villanueva, Ibai; La Touche, Roy; Fernández-Carnero, Josué

2016-01-01

Background. Neck pain (NP) is strongly associated with cervico-craniofacial pain (CCFP). The primary aim of the present study was to compare the neck pain-related disability, pain catastrophizing, and cervical and mandibular ROM between patients with chronic mechanical NP and patients with CCFP, as well as asymptomatic subjects. Methods. A total of 64 participants formed three groups. All participants underwent a clinical examination evaluating the cervical range of motion and maximum mouth opening, neck disability index (NDI), and psychological factor of Pain Catastrophizing Scale (PCS). Results. There were no statistically significant differences between patients with NP and CCFP for NDI and PCS (P > 0.05). One- way ANOVA revealed significant differences for all ROM measurements. The post hoc analysis showed no statistically significant differences in cervical extension and rotation between the two patient groups (P > 0.05). The Pearson correlation analysis shows a moderate positive association between NDI and the PCS for the group of patients with NP and CCFP. Conclusion. The CCFP and NP patient groups have similar neck disability levels and limitation in cervical ROM in extension and rotation. Both groups had positively correlated the NDI with the PCS. PMID:27119020

Pain during diagnostic hysteroscopy: what is the role of the cervical canal? A pilot study.

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Mazzon, Ivan; Favilli, Alessandro; Horvath, Stefano; Grasso, Mario; Di Renzo, Gian Carlo; Laurenti, Elena; Bini, Vittorio; Gerli, Sandro

2014-12-01

To evaluate whether a correlation exists between the pain perceived during diagnostic anesthesia-free hysteroscopy and the characteristics of the cervical canal. Prospective observational pilot study of 255 women undergoing diagnostic hysteroscopy. Data analysis included characteristics of the patient and the cervical canal, and the pain experience during the procedure, assessed by visual analog score (VAS). A multiple logistic regression was then carried out in order to exclude confounding factors. The degree of pain during hysteroscopy was equal to a median VAS score of 2 (range 0-10). Bivariate analysis between patients with VAS>3 and patients with VAS≤3 demonstrated a significant correlation between pain and the presence of synechiae in the cervical canal (P=0.022), the patient's age (P=0.003) and parity (P=0.001). Multivariate analysis revealed that the presence of cervical synechiae (P=0.0001) [OR=4.99 (95% CI 2.13-11.70)] and parity (P=0.014) [OR=0.42 (95% CI 0.21-0.83)] were significantly correlated with pain. There was no significant correlation with the different angles of the cervical canal. Cervical synechiae appear as a major factor influencing pain during hysteroscopy. While parity acts as a protective factor, the angle of the cervical canal does not seem to play an important role for pain during diagnostic hysteroscopy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Cervical kinematics in patients with vestibular pathology vs. patients with neck pain: A pilot study.

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Williams, Grace; Sarig-Bahat, Hilla; Williams, Katrina; Tyrrell, Ryan; Treleaven, Julia

2017-01-01

Research has consistently shown cervical kinematic impairments in subjects with persistent neck pain (NP). It could be reasoned that those with vestibular pathology (VP) may also have altered kinematics since vestibular stimulation via head movement can cause dizziness and visual disturbances. However, this has not been examined to date. This pilot study investigated changes in cervical kinematics between asymptomatic control, NP and VP subjects using a Virtual Reality (VR) system. It was hypothesised that there would be altered kinematics in VP subjects, which might be associated with dizziness and visual symptoms. Pilot cross sectional observational study. Twenty control, 14 VP and 20 NP subjects. Not applicable. Measures included questionnaires (neck disability index, pain on movement, dizziness and pain intensity, visual disturbances) and cervical kinematics (range, peak and mean velocity, smoothness, symmetry, and accuracy of cervical motion) using a virtual reality system. Results revealed significantly decreased mean velocity and symmetry of motion in both planes in those with NP but no differences in accuracy or range of motion. No significant differences were seen between VP subjects and asymptomatic controls. However, correlation analysis showed some moderate correlations between dizziness to selected kinematics in both the NP and the VP groups. These results support that cervical kinematics are altered in NP patients, with velocity most affected. There is potential for VP subjects to also have altered kinematics, especially those who experience dizziness. More research is required.

Epidemiology and predictors of cervical spine injury in adult major trauma patients: a multicenter cohort study.

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Hasler, Rebecca M; Exadaktylos, Aristomenis K; Bouamra, Omar; Benneker, Lorin M; Clancy, Mike; Sieber, Robert; Zimmermann, Heinz; Lecky, Fiona

2012-04-01

Patients with cervical spine injuries are a high-risk group, with the highest reported early mortality rate in spinal trauma. This cohort study investigated predictors for cervical spine injury in adult (≥ 16 years) major trauma patients using prospectively collected data of the Trauma Audit and Research Network from 1988 to 2009. Univariate and multivariate logistic regression analyses were used to determine predictors for cervical fractures/dislocations or cord injury. A total of 250,584 patients were analyzed. Median age was 47.2 years (interquartile range, 29.8-66.0) and Injury Severity Score 9 (interquartile range, 4-11); 60.2% were male. Six thousand eight hundred two patients (2.3%) sustained cervical fractures/dislocations alone. Two thousand sixty-nine (0.8%) sustained cervical cord injury with/without fractures/dislocations; 39.9% of fracture/dislocation and 25.8% of cord injury patients suffered injuries to other body regions. Age ≥ 65 years (odds ratio [OR], 1.45-1.92), males (females OR, 0.91; 95% CI, 0.86-0.96), Glasgow Coma Scale (GCS) score sports injuries (OR, 3.51; 95% CI, 2.87-4.31), road traffic collisions (OR, 3.24; 95% CI, 3.01-3.49), and falls >2 m (OR, 2.74; 95% CI, 2.53-2.97) were predictive for fractures/dislocations. Age sports injuries (OR, 4.42; 95% CI, 3.28-5.95), road traffic collisions (OR, 2.58; 95% CI, 2.26-2.94), and falls >2 m (OR, 2.24; 95% CI, 1.94-2.58) were predictors for cord injury. 3.5% of patients suffered cervical spine injury. Patients with a lowered GCS or systolic blood pressure, severe facial fractures, dangerous injury mechanism, male gender, and/or age ≥ 35 years are at increased risk. Contrary to common belief, head injury was not predictive for cervical spine involvement.

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.

Barriers to cervical cancer screening in Mulanje, Malawi: a qualitative study

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Victoria K Fort

2011-03-01

Full Text Available Victoria K Fort1, Mary Sue Makin2, Aaron J Siegler1, Kevin Ault3, Roger Rochat11Rollins School of Public Health, Atlanta, Georgia, USA; 2Mulanje Mission Hospital, Mulanje, Malawi; 3Emory University Medical School, Atlanta, Georgia, USABackground: In Malawi, cervical cancer is the most prevalent form of cancer among women, with an 80% mortality rate. The Mulanje Mission Hospital has offered free cervical cancer screening for eight years; however, patients primarily seek medical help for gynecologic complaints after the disease is inoperable.Methods: We investigated how women in rural Malawi make health-seeking decisions regarding cervical cancer screening using qualitative research methods. The study was conducted between May and August of 2009 in Mulanje, Malawi.Results: This study found that the primary cue to action for cervical cancer screening was symptoms of cervical cancer. Major barriers to seeking preventative screening included low knowledge levels, low perceived susceptibility and low perceived benefits from the service. Study participants did not view cervical cancer screening as critical health care. Interviews suggested that use of the service could increase if women are recruited while visiting the hospital for a different service.Conclusion: This study recommends that health care providers and health educators target aspects of perceived susceptibility among their patients, including knowledge levels and personal risk assessment. We believe that continued support and advertisement of cervical cancer screening programs along with innovative recruitment strategies will increase usage density and decrease unnecessary deaths from cervical cancer in Malawi.Keywords: cervical cancer, interviews, health care, Mulanje Mission Hospital

Epidemiology and risk factors of cervical spine injury during heating season in the patients with cervical trauma: a cross-sectional study.

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Sidong Yang

Full Text Available PURPOSE: The purpose of this study was to describe the epidemiology of cervical spine injury in the patients with cervical trauma and analyze its associated risk factors during the special heating season in North China. METHODS: This cross-sectional study investigated predictors for cervical spine injury in cervical trauma patients using retrospectively collected data of Hebei Provincial Orthopaedic Hospital from 11/2011 to 02/2012, and 11/2012 to 02/2013. Binary logistic regression analysis was used to determine risk factors for cervical fractures/dislocations or cord injury. RESULTS: A total of 106 patients were admitted into this study. Of all, 34 patients (32.1% were treated from 11/2011 to 02/2012 and 72 patients (67.9% from 11/2012 to 02/2013. The mean age was 41.9±13.3 years old; 85 patients (80.2% were male and 82 (77.4% from rural areas. Eighty patients (75.5% were caused by fall including 45 (42.5% by severe fall (>2 m. Sixty-five patients (61.3% of all suffered injuries to other body regions and 32 (30.2% got head injury. Thirty-one patients (29.2% sustained cervical cord injury with cervical fractures/dislocations. Twenty-six (83.9% of cervical cord injury patients were from rural areas and 24 (77.4% of those resulted from fall including 15 (48.4% from severe fall (>2 m. Logistic regression displayed that age (OR, 1.47; 95% CI, 1.05-2.07, head injury (OR, 5.63; 95% CI, 2.23-14.26, were risk factors for cervical cord injury and snowing (OR, 8.25; 95% CI, 2.26-30.15 was a risk factor for cervical spine injury due to severe fall (>2 m. CONCLUSIONS: The elder male patients and patients with head trauma are high-risk population for cervical cord injury. As a seasonal factor, snowing during heating season is of note a risk factor for cervical spine injury resulting from severe fall (>2 m in the patients with cervical trauma in North China.

Detecting cervical cancer by quantitative promoter hypermethylation assay on cervical scrapings : A feasibility study

NARCIS (Netherlands)

Reesink-Peters, N; Wisman, G.B.A.; Jeronimo, C; Tokumaru, CY; Cohen, Y; Dong, SM; Klip, HG; Buikema, HJ; Suurmeijer, AJH; Hollema, H; Boezen, HM; Sidransky, D; van der Zee, AGJ

Current morphology-based cervical cancer screening is associated with significant false-positive and false-negative results. Tumor suppressor gene hypermethylation is frequently present in cervical cancer. It is unknown whether a cervical scraping reflects the methylation status of the underlying

Application of the Carolina Framework for Cervical Cancer Prevention.

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Moss, Jennifer L; McCarthy, Schatzi H; Gilkey, Melissa B; Brewer, Noel T

2014-03-01

The Carolina Framework for Cervical Cancer Prevention describes 4 main causes of cervical cancer incidence: human papillomavirus (HPV) infection, lack of screening, screening errors, and not receiving follow-up care. We present 2 applications of the Carolina Framework in which we identify high-need counties in North Carolina and generate recommendations for improving prevention efforts. We created a cervical cancer prevention need index (CCPNI) that ranked counties on cervical cancer mortality, HPV vaccine initiation and completion, Pap smear screening, and provision of Pap tests to rarely- or never-screened women. In addition, we conducted in-depth interviews with 19 key informants from programs and agencies involved in cervical cancer prevention in North Carolina. North Carolina's 100 counties varied widely on individual CCPNI components, including annual cervical cancer mortality (median 2.7/100,000 women; range 0.0-8.0), adolescent girls' HPV vaccine initiation (median 42%; range 15%-62%), and Pap testing in the previous 3 years among Medicaid-insured adult women (median 59%; range 40%-83%). Counties with the greatest prevention needs formed 2 distinct clusters in the northeast and south-central regions of the state. Interviews generated 9 recommendations to improve cervical cancer prevention in North Carolina, identifying applications to specific programs and policies in the state. This study found striking geographic disparities in cervical cancer prevention need in North Carolina. Future prevention efforts in the state should prioritize high-need regions as well as recommended strategies and applications in existing programs. Other states can use the Carolina Framework to increase the impact of their cervical cancer prevention efforts. Copyright © 2013 Elsevier Inc. All rights reserved.

The effectiveness of Kinesio Taping on pain and disability in cervical myofascial pain syndrome

Directory of Open Access Journals (Sweden)

Saime Ay

Full Text Available Abstract Objective: The aim of this study was to investigate the effectiveness of Kinesio Taping and sham Kinesio Taping on pain, pressure pain threshold, cervical range of motion, and disability in cervical myofascial pain syndrome patients (MPS. Methods: This study was designed as a randomized, double-blind placebo controlled study. Sixty-one patients with MPS were randomly assigned into two groups. Group 1 (n = 31 was treated with Kinesio Taping and group 2 (n = 30 was treated sham taping five times by intervals of 3 days for 15 days. Additionally, all patients were given neck exercise program. Patients were evaluated according to pain, pressure pain threshold, cervical range of motion and disability. Pain was assessed by using Visual Analog Scale, pressure pain threshold was measured by using an algometer, and active cervical range of motion was measured by using goniometry. Disability was assessed with the neck pain disability index disability. Measurements were taken before and after the treatment. Results: At the end of the therapy, there were statistically significant improvements on pain, pressure pain threshold, cervical range of motion, and disability (p 0.05. Conclusion: This study shows that Kinesio Taping leads to improvements on pain, pressure pain threshold and cervical range of motion, but not disability in short time. Therefore, Kinesio Taping can be used as an alternative therapy method in the treatment of patients with MPS.

Cervical interfacet spacers and maintenance of cervical lordosis.

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Tan, Lee A; Straus, David C; Traynelis, Vincent C

2015-05-01

OBJECT The cervical interfacet spacer (CIS) is a relatively new technology that can increase foraminal height and area by facet distraction. These offer the potential to provide indirect neuroforaminal decompression while simultaneously enhancing fusion potential due to the relatively large osteoconductive surface area and compressive forces exerted on the grafts. These potential benefits, along with the relative ease of implantation during posterior cervical fusion procedures, make the CIS an attractive adjuvant in the management of cervical pathology. One concern with the use of interfacet spacers is the theoretical risk of inducing iatrogenic kyphosis. This work tests the hypothesis that interfacet spacers are associated with loss of cervical lordosis. METHODS Records from patients undergoing posterior cervical fusion at Rush University Medical Center between March 2011 and December 2012 were reviewed. The FacetLift CISs were used in all patients. Preoperative and postoperative radiographic data were reviewed and the Ishihara indices and cervical lordotic angles were measured and recorded. Statistical analyses were performed using STATA software. RESULTS A total of 64 patients were identified in whom 154 cervical levels were implanted with machined allograft interfacet spacers. Of these, 15 patients underwent anterior-posterior fusions, 4 underwent anterior-posterior-anterior fusions, and the remaining 45 patients underwent posterior-only fusions. In the 45 patients with posterior-only fusions, a total of 110 levels were treated with spacers. There were 14 patients (31%) with a single level treated, 16 patients (36%) with two levels treated, 5 patients (11%) with three levels treated, 5 patients (11%) with four levels treated, 1 patient (2%) with five levels treated, and 4 patients (9%) with six levels treated. Complete radiographic data were available in 38 of 45 patients (84%). On average, radiographic follow-up was obtained at 256.9 days (range 48-524 days

Hypoglossal Nerve Palsy After Cervical Spine Surgery.

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Ames, Christopher P; Clark, Aaron J; Kanter, Adam S; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel

2017-04-01

Multi-institutional retrospective study. The goal of the current study is to quantify the incidence of 2 extremely rare complications of cervical spine surgery; hypoglossal and glossopharyngeal nerve palsies. A total of 8887 patients who underwent cervical spine surgery from 2005 to 2011 were included in the study from 21 institutions. No glossopharyngeal nerve injuries were reported. One hypoglossal nerve injury was reported after a C3-7 laminectomy (0.01%). This deficit resolved with conservative management. The rate by institution ranged from 0% to 1.28%. Although not directly injured by the surgical procedure, the transient nerve injury might have been related to patient positioning as has been described previously in the literature. Hypoglossal nerve injury during cervical spine surgery is an extremely rare complication. Institutional rates may vary. Care should be taken during posterior cervical surgery to avoid hyperflexion of the neck and endotracheal tube malposition.

Gynecologic examination and cervical biopsies after (chemo) radiation for cervical cancer to identify patients eligible for salvage surgery

International Nuclear Information System (INIS)

Nijhuis, Esther R.; Zee, Ate G.J. van der; Hout, Bertha A. in 't; Boomgaard, Jantine J.; Hullu, Joanne A. de; Pras, Elisabeth; Hollema, Harry; Aalders, Jan G.; Nijman, Hans W.; Willemse, Pax H.B.; Mourits, Marian J.E.

2006-01-01

Purpose: The aim of this study was to evaluate efficacy of gynecologic examination under general anesthesia with cervical biopsies after (chemo) radiation for cervical cancer to identify patients with residual disease who may benefit from salvage surgery. Methods and Materials: In a retrospective cohort study data of all cervical cancer patients with the International Federation of Gynecology and Obstetrics (FIGO) Stage IB1 to IVA treated with (chemo) radiation between 1994 and 2001 were analyzed. Patients underwent gynecologic examination under anesthesia 8 to 10 weeks after completion of treatment. Cervical biopsy samples were taken from patients judged to be operable. In case of residual cancer, salvage surgery was performed. Results: Between 1994 and 2001, 169 consecutive cervical cancer patients received primary (chemo) radiation, of whom 4 were lost to follow-up. Median age was 56 years (interquartile range [IQR], 44-71) and median follow-up was 3.5 years (IQR, 1.5-5.9). In each of 111 patients a biopsy sample was taken, of which 90 (81%) showed no residual tumor. Vital tumor cells were found in 21 of 111 patients (19%). Salvage surgery was performed in 13 of 21 (62%) patients; of these patients, 5 (38%) achieved long-term, complete remission after salvage surgery (median follow-up, 5.2 years; range, 3.9-8.8 years). All patients with residual disease who did not undergo operation (8/21) died of progressive disease. Locoregional control was more often obtained in patients who underwent operation (7 of 13) than in patients who were not selected for salvage surgery (0 of 8 patients) (p < 0.05). Conclusions: Gynecologic examination under anesthesia 8 to 10 weeks after (chemo) radiation with cervical biopsies allows identification of those cervical cancer patients who have residual local disease, of whom a small but significant proportion may be salvaged by surgery

CLINICO-PATHOLOGICAL STUDY OF CERVICAL LYMPHADENOPATHY

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Dova Subba

2016-03-01

Full Text Available OBJECTIVES To know the incidence and aetiological factors of cervical lymphadenopathy. To know the most common group of lymph nodes enlarged. To assess the response to management. MATERIALS AND METHODS This study includes 50 patients who attended the Surgical OPD, studied taking detailed clinical history, after physical examination and arriving at clinical diagnosis, confirmation was done by FNAC and biopsy. RESULTS Tuberculous lymphadenopathy is the commonest cause of cervical lymphadenopathy with 68% followed by chronic nonspecific lymphadenopathy with 32%. There was no case of sarcoidosis in this series. Disease commonly affected the 2 nd and 3 rd decades with 19% and 18% respectively. There is comparatively an increased incidence of tuberculous cervical lymphadenopathy in females than males. The average age of presentation was 30.5 years. There was no definite history of contact with tuberculosis in 82% of cases. In this study series, 44% of the patients belonged to the low income group, 46% belonged to the middle income group. There was only unilateral involvement of node in 72% of cases right side was affected in 32% and left side was affected in 40% of cases. Bilateral involvement was seen in 14% of the cases. The lymph nodes were associated with other groups of lymph nodes in 10% of cases. Chest radiography findings showed the evidence of coexisting active tuberculosis lesions in 8 out of 50 cases (16% and normal was 42(84%. CONCLUSION Knowledge about clinico-demographic perspectives of cervical lymphadenopathy in respect to their cytopathological diagnosis will help to detect/refer the respective cases early for investigations and treatment. Surgical intervention is definitely required in many cases, though most of the cases are medically curable.

Cervical Cancer and Human Papilloma Virus Knowledge and ...

African Journals Online (AJOL)

AJRH Managing Editor

This study was aimed at determining the knowledge of cervical cancer and HPV as well as the ... is a global public health issue as it is the second ... younger population with the highest rate in the age range of 20 to 30 years which include many college-aged students5,9. ... If the current mortality trend of cervical cancer.

Cervical endplate and facet arthrosis: an anatomic study of cadaveric specimens.

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Master, Daniel L; Toy, Jason O; Eubanks, Jason D; Ahn, Nicholas U

2012-10-01

An anatomic, epidemiologic study of cervical endplate and facet arthrosis in cadaveric spines. To determine the prevalence of cervical endplate and facet arthrosis and the relationship between these 2 entities in a large population sample. Cervical endplate and facet arthrosis are common radiographic findings, which have both been linked to pain. However, the prevalence and relationship between cervical endplate and facet arthrosis has not been clearly defined. The cervical vertebrae from 234 cadaveric spines were examined by a single investigator for evidence of endplate and facet arthrosis. Arthrosis at each endplate and facet was graded on a continuum from 0 to IV. Race, age at death, and sex of each specimen were also recorded. Stepwise multiple linear regression was used to analyze any association between race, age, sex, endplate arthrosis, and facet arthrosis. Factors with P values arthrosis severity scores among patients within the same decades of life. Concurrent cervical endplate and facet arthrosis was present in 77% of the study population. Stepwise multiple linear regression revealed significant (Parthrosis and between age and facet arthrosis. Race and sex did not correlate with facet arthrosis. In addition, patients in age groups 30 to 39, 40 to 49, 50 to 59, 60 to 69, 70 to 79, and 80 to 89 demonstrated more severe (Parthrosis in comparison with facet arthrosis. Concurrent cervical endplate and facet arthrosis is a common condition. Cervical endplate arthrosis and advancing age are associated with cervical facet arthrosis independent of race and sex. Cervical endplate arthrosis precedes facet arthrosis.

The effectiveness of Kinesio Taping on pain and disability in cervical myofascial pain syndrome.

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Ay, Saime; Konak, Hatice Ecem; Evcik, Deniz; Kibar, Sibel

The aim of this study was to investigate the effectiveness of Kinesio Taping and sham Kinesio Taping on pain, pressure pain threshold, cervical range of motion, and disability in cervical myofascial pain syndrome patients (MPS). This study was designed as a randomized, double-blind placebo controlled study. Sixty-one patients with MPS were randomly assigned into two groups. Group 1 (n=31) was treated with Kinesio Taping and group 2 (n=30) was treated sham taping five times by intervals of 3 days for 15 days. Additionally, all patients were given neck exercise program. Patients were evaluated according to pain, pressure pain threshold, cervical range of motion and disability. Pain was assessed by using Visual Analog Scale, pressure pain threshold was measured by using an algometer, and active cervical range of motion was measured by using goniometry. Disability was assessed with the neck pain disability index disability. Measurements were taken before and after the treatment. At the end of the therapy, there were statistically significant improvements on pain, pressure pain threshold, cervical range of motion, and disability (pdisability (p>0.05). This study shows that Kinesio Taping leads to improvements on pain, pressure pain threshold and cervical range of motion, but not disability in short time. Therefore, Kinesio Taping can be used as an alternative therapy method in the treatment of patients with MPS. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

Ultrasound-guided radiofrequency neurotomy in cervical spine: sonoanatomic study of a new technique in cadavers

International Nuclear Information System (INIS)

Lee, S.-H.; Kang, C.H.; Lee, S.-H.; Derby, R.; Yang, S.N.; Lee, J.E.; Kim, J.H.; Kim, S.S.; Lee, J.-H.

2008-01-01

Aim: To develop an ultrasound-guided technique for radiofrequency (RF) cervical medial branch neurotomy and to validate the accuracy of this new method. Materials and methods: Five non-embalmed, fresh cadavers were used; three male and two female cadavers with a median age at death of 67.2 years (range 50-84 years). This study was conducted in two parts. First, two of the cadavers were used to define the sonographic target point for RF cervical medial branch neurotomy using high-resolution ultrasound (12 to 5 MHz). The needles were guided to five consecutive cervical medial branches in the cadavers under ultrasound guidance. Subsequently, the position of the ultrasound-guided needle was verified using C-arm fluoroscopy. Ultrasound-guided RF neurotomy was performed to the C5 medial branches in all five cadavers. In the three cadavers not used in the first part of the study, ultrasound-guided RF neurotomy without C-arm fluoroscopic confirmation was performed to the C3-C7 medial branches. The accuracy of neurotomy was assessed by pathological examination of the cervical medial branches obtained through cadaver dissection. Results: In all five cadavers, the sonographic target point was identified in all C3-C7 segments with the 12 to 5 MHz linear transducer. In all 20 needle placements for the first and second cadavers, C-arm fluoroscopy validated proper needle tip positions. In all five cadavers, successful neurotomy was pathologically confirmed in 30 of 34 cervical medial branches. Conclusions: Ultrasound-guided cervical medial branch neurotomy was successfully performed in 30 of 34 cervical medial branches in five cadavers. However, before eliminating fluoroscopic validation of final needle tip positioning, the technique should be validated in symptomatic patients

Studi Standarisasi Radioterapi Cobalt-60 Terhadap Kuantitas Sel Darah Pada Penderita Kanker Serviks (Cancer Cervics Di Rsup Sanglah Denpasar

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Retianingsih Oeta Ulan

2017-09-01

Full Text Available After doing research with Title Study of Cobalt-60 radiotherapy Standards Against Quantity Blood Cells In Patients with Cervical Cancer (Cancer Cervics at Sanglah Hospital in Denpasar. This study uses secondary data such as a complete blood from each patient with cervical cancer in 2015 that radiotherapy with fractionation method. The amount of patient data used in this study is 5 pieces. The quantity of blood cells that are analyzed include RBC, HGB, WBC and WBC Components (LY, EO, EO, BA, NE, MO. Fractionation dose is 800-5800cGy. The results of data analysis showed that each blood cell components are still within the range of 2-50%, so a method of radiotherapy is still fit for use.

Atividade elétrica dos músculos cervicais e amplitude de movimento da coluna cervical em indivíduos com e sem DTM Electrical activity of cervical muscles and range of movement of cervical column in individuals with and without DTM

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Jovana de Moura Milanesi

2011-12-01

Full Text Available O objetivo da pesquisa foi avaliar a atividade elétrica e a dor à palpação dos músculos cervicais, a amplitude de movimento (ADM da coluna cervical e a relação entre atividade elétrica e ADM cervical em indivíduos com e sem desordem temporomandibular (DTM. Participaram do estudo 53 voluntários, sendo 24 com DTM e 29 sem, de ambos os gêneros, com 18 a 32 anos de idade. A DTM foi diagnosticada pelo critério de diagnóstico em pesquisa para DTM (Research Diagnostic Criteria for Temporomandibular Disorders. A eletromiografia dos músculos esternocleidomastoídeo (ECOM e trapézio superior foi realizada bilateralmente, na situação de repouso, com frequência de 2 KHz e filtro passa-faixa de 10-1000 Hz. As medidas de ADM de flexão, extensão, lateroflexão e rotação foram realizadas com um flexímetro e a comparação entre os grupos contou com o teste de Mann Whitney. O teste de Spearman foi aplicado para a correlação entre as variáveis, com nível de significância de 5%. Não foi verificada nenhuma diferença na ADM cervical entre os grupos. A atividade elétrica demonstrou-se significativamente maior nos músculos ECOM direito (p=0,0130, trapézio superior direito (p=0,0334 e esquerdo (p=0,0335 no grupo DTM em relação ao grupo controle. Não houve correlação significante entre atividade elétrica e ADM cervical. A dor nos músculos cervicais apresentou-se significativamente maior apenas no músculo ECOM direito (p=0,0055. Conclui-se que os grupos estudados registraram diferença na atividade elétrica dos músculos cervicais, sendo esta maior em indivíduos com DTM.The aim of the research was to evaluate the electrical activity and pain on palpation of the cervical muscles, the cervical range of motion (ROM and the relationship between electrical activity and ROM in individuals with and without temporomandibular disorder (TMD. Fifty three volunteers took part in the study, being 24 with TMD and 29 without, both genders

Cervical facet joint dysfunction: a review.

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Kirpalani, Dhiruj; Mitra, Raj

2008-04-01

To review the relevant literature on cervical facet joint dysfunction and determine findings regarding its anatomy, etiology, prevalence, clinical features, diagnosis, and treatment. A computer-aided search of several databases was performed, including Medline (1966 to present), Ovid (1966 to present), and the Cochrane database (1993 to present). Selected articles had the following criteria: (1) all articles analyzed cervical facet joint pain-anatomy, prevalence, etiology, diagnosis, treatment; (2) only full, published articles were studied, not abstracts; and (3) all articles were published in English. All articles were critically evaluated and included the following categories: randomized controlled trials, meta-analyses, uncontrolled clinical trials, uncontrolled comparison studies, nonquantitative systematic reviews, and literature-based reviews. We examined 45 references that consisted of 44 journal articles and relevant sections from 1 textbook. Cervical facet joints have been well established in the literature as a common nociceptive pain generator, with an estimated prevalence that ranges from 25% to 66% of chronic axial neck pain. No studies have reported clinical examination findings that are diagnostic for cervical facet mediated pain. Overall the literature provides very limited information regarding the treatment of this condition, with only radiofrequency neurotomy showing evidence of effectively reducing pain from cervical facet joint dysfunction.

Do subjects with acute/subacute temporomandibular disorder have associated cervical impairments: A cross-sectional study.

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von Piekartz, Harry; Pudelko, Ani; Danzeisen, Mira; Hall, Toby; Ballenberger, Nikolaus

2016-12-01

There is preliminary evidence of cervical musculoskeletal impairment in some temporomandibular disorder (TMD) pain states. To determine whether people with TMD, classified as either mild or moderate/severe TMD, have more cervical signs of dysfunction than healthy subjects. Cross-sectional survey. Based on the Conti Amnestic Questionnaire and examination of the temporomandibular joint (Axis I classification of the Research Diagnostic Criteria for TMD), of 144 people examined 59 were classified to a mild TMD group, 40 to a moderate/severe TMD group and 45 to an asymptomatic control group without TMD. Subjects were evaluated for signs of cervical musculoskeletal impairment and disability including the Neck Disability Index, active cervical range of motion, the Flexion-Rotation Test, mechanical pain threshold of the upper trapezius and obliquus capitis inferior muscles, Cranio-Cervical Flexion test and passive accessory movements of the upper 3 cervical vertebrae. According to cervical musculoskeletal dysfunction, the control group without TMD were consistently the least impaired and the group with moderate/severe TMD were the most impaired. These results suggest, that the more dysfunction and pain is identified in the temporomandibular region, the greater levels of dysfunction is observable on a number of cervical musculoskeletal function tests. The pattern of cervical musculoskeletal dysfunction is distinct to other cervical referred pain phenomenon such as cervicogenic headache. These findings provide evidence that TMD in an acute/subacute pain state is strongly related with certain cervical spine musculoskeletal impairments which suggests the cervical spine should be examined in patients with TMD as a potential contributing factor. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effect of Cervical Lessions on the Tooth FEM Study

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Gabriela Bereşescu

2010-12-01

Full Text Available The approach used until recently concerning the phenomena of dental abfraction points to the conclusion that the cervical area of the tooth, were this type of lesion usually occur, concentrates the stress resulted from the action of the forces applied on various areas on the crown. Moreover, any lesion in the cervical area facilitates the possibility of its advance into the tooth, ultimately fracturing it. Our paper presents a FEM (finite element method study on the results of a mechanical analysis of the phenomena involving the tooth damaged by cervical lesions.

Cervical motion assessment using virtual reality.

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Sarig-Bahat, Hilla; Weiss, Patrice L; Laufer, Yocheved

2009-05-01

Repeated measures of cervical motion in asymptomatic subjects. To introduce a virtual reality (VR)-based assessment of cervical range of motion (ROM); to establish inter and intratester reliability of the VR-based assessment in comparison with conventional assessment in asymptomatic individuals; and to evaluate the effect of a single VR session on cervical ROM. Cervical ROM and clinical issues related to neck pain is frequently studied. A wide variety of methods is available for evaluation of cervical motion. To date, most methods rely on voluntary responses to an assessor's instructions. However, in day-to-day life, head movement is generally an involuntary response to multiple stimuli. Therefore, there is a need for a more functional assessment method, using sensory stimuli to elicit spontaneous neck motion. VR attributes may provide a methodology for achieving this goal. A novel method was developed for cervical motion assessment utilizing an electromagnetic tracking system and a VR game scenario displayed via a head mounted device. Thirty asymptomatic participants were assessed by both conventional and VR-based methods. Inter and intratester repeatability analyses were performed. The effect of a single VR session on ROM was evaluated. Both assessments showed non-biased results between tests and between testers (P > 0.1). Full-cycle repeatability coefficients ranged between 15.0 degrees and 29.2 degrees with smaller values for rotation and for the VR assessment. A single VR session significantly increased ROM, with largest effect found in the rotation direction. Inter and intratester reliability was supported for both the VR-based and the conventional methods. Results suggest better repeatability for the VR method, with rotation being more precise than flexion/extension. A single VR session was found to be effective in increasing cervical motion, possibly due to its motivating effect.

Cervical spine injuries in suicidal hanging without a long-drop--patterns and possible underlying mechanisms of injury: an autopsy study.

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Nikolić, Slobodan; Zivković, Vladimir

2014-06-01

The incidence of cervical spine injuries in suicidal hangings with a short-drop has been reported to be extremely low or non-existent. The aim of this study was to determine the frequency and pattern of cervical spine injuries in suicidal hanging. A retrospective autopsy study was performed and short-drop suicidal hanging cases with documented cervical spine injuries were identified. This group was further analyzed with regard to the gender and age of the deceased, the position of the ligature knot, the presence of hyoid-laryngeal fractures, and the level of cervical spine injury. Cervical spine injuries were present in 25 of the 766 cases, with an average age of 71.9 ± 10.7 years (range 39-88 years). In 16 of these 25 cases, the ligature knot was in the anterior position. The most common pattern of cervical spine injury included partial or complete disruption of the anterior longitudinal ligament and widening of the lower cervical spine disk spaces, associated with absence of hyoid-laryngeal fractures. Cervical spine injuries are not commonly found in short-drop suicidal hanging, occurring in only 3.3 % of all observed cases. Cervical spine injury may be occurring in 80 % of subjects aged 66.5 years and above. The most common pattern of cervical spine injury included anterior longitudinal ligament disruption of the lower cervical spine, disk space widening, and no vertebral body displacement. These injuries were mainly associated with an anterior knot position, and may be a consequence of loop pressure to the posterior neck and cervical spine hyperextension.

Study to Understand Cervical Cancer Early Endpoints and Determinants (SUCCEED)

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A study to comprehensively assess biomarkers of risk for progressive cervical neoplasia, and thus develop a new set of biomarkers that can distinguish those at highest risk of cervical cancer from those with benign infection

Intrathoracic versus cervical anastomosis after resection of esophageal cancer: a matched pair analysis of 72 patients in a single center study.

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Klink, Christian D; Binnebösel, Marcel; Otto, Jens; Boehm, Gabriele; von Trotha, Klaus T; Hilgers, Ralf-Dieter; Conze, Joachim; Neumann, Ulf P; Jansen, Marc

2012-08-06

The aim of this study was to analyze the early postoperative outcome of esophageal cancer treated by subtotal esophageal resection, gastric interposition and either intrathoracic or cervical anastomosis in a single center study. 72 patients who received either a cervical or intrathoracic anastomosis after esophageal resection for esophageal cancer were matched by age and tumor stage. Collected data from these patients were analyzed retrospectively regarding morbidity and mortality rates. Anastomotic leakage rate was significantly lower in the intrathoracic anastomosis group than in the cervical anastomosis group (4 of 36 patients (11%) vs. 11 of 36 patients (31%); p = 0.040). The hospital stay was significantly shorter in the intrathoracic anastomosis group compared to the cervical anastomosis group (14 (range 10-110) vs. 26 days (range 12 - 105); p = 0.012). Wound infection and temporary paresis of the recurrent laryngeal nerve occurred significantly more often in the cervical anastomosis group compared to the intrathoracic anastomosis group (28% vs. 0%; p = 0.002 and 11% vs. 0%; p = 0.046). The overall In-hospital mortality rate was 6% (4 of 72 patients) without any differences between the study groups. The present data support the assumption that the transthoracic approach with an intrathoracic anastomosis compared to a cervical esophagogastrostomy is the safer and more beneficial procedure in patients with carcinoma of the lower and middle third of the esophagus due to a significant reduction of anastomotic leakage, wound infection, paresis of the recurrent laryngeal nerve and shorter hospital stay.

Cervical Chondrocutaneous Branchial Remnants.

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Klockars, Tuomas; Kajosaari, Lauri

2017-03-01

  Cervical chondrocutaneous branchial remnants are rare malformations usually found in the lower neck. As high as 76% of patients have been reported to have associated anomalies. We review the literature and report a case series of seven patients with cervical cartilaginous remnants.   A retrospective case series of seven patients identified from the electronic hospital records.   Seven patients with cervical chondrocutaneous branchial remnants were identified (six boys and one girl). Only one of the patients had associated anomalies.   A review of the literature revealed no evidence for sinuses or cysts related to cervical chondrocutaneous branchial remnants. Operative treatment can be postponed to a suitable and safe age. There is marked variation in the reported prevalence of associated anomalies, ranging from 11% to 76%.

Comparative Study Between M6-C and Mobi-C Cervical Artificial Disc Replacement: Biomechanical Outcomes and Comparison with Normative Data.

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Pham, My; Phan, Kevin; Teng, Ian; Mobbs, Ralph J

2018-05-01

Cervical spondylosis affects a huge proportion of the middle-aged population. Degenerative changes can occur in multiple regions of the cervical spine typically affecting the joints, intervertebral discs and endplates. These changes lead to compression of adjacent nervous structures, which results in radiculopathic and myelopathic pain. Various treatment modalities are currently available with non-surgical approaches the initial go to if there is no symptomatic cord compression. Anterior cervical discectomy and fusion, or arthroplasty are the two common surgical approaches if non-surgical treatments fail to relieve symptoms of the patients or there are signs of central cord compression. However, studies have shown that there is an increased risk of adjacent segment disease related to fusion. Cervical disc arthroplasty aims to restore normal range of motion (ROM) in patients with pain and disability due to degenerative disc disease resistant to conservative care. Two common disc prostheses used include M6-C and Mobi-C. Both prostheses comprise a mobile polymer segment sandwiched between two metal endplates with mechanisms resembling an actual intervertebral disc. This study aims to compare the kinematics associated with these prostheses, against the normal range of motion in the non-degenerative population. Patients who underwent M6-C or Mobi-C disc replacements by the senior author from 2012 to 2015 were identified at a single tertiary institution. Routine 3-month postoperative lateral radiographs were analyzed for flexion and extension ROM angles at the involved vertebral level by two independent authors. Data was compared to previous published studies investigating cervical spine ROM of asymptomatic patients. There was no statistical significance in the difference of overall flexion range between M6-C and Mobi-C prostheses. However, overall range of extension of Mobi-C was greater compared to M6-C (P = 0.028). At C 5-6 , the range of flexion for both implants

Urothelial cancers following radiation therapy for cervical cancer

International Nuclear Information System (INIS)

Nakata, Seiji; Hasumi, Masaru; Sato, Jin; Mayuzumi, Takuji; Kumasaka, Fuminari; Shimizu, Toshihiro.

1996-01-01

Some reports have indicated that bladder cancer is induced by radiation therapy for cervical cancer. We encountered 6 cases of urothelial cancer (5 cases of bladder cancer and 1 case of ureter cancer) following radiation therapy for cervical cancer. Age at the time of diagnosis of cervical cancer ranged from 38 to 66 years, and the average was 51.2±11.0 (S.D.) years old. Age at the time of diagnosis of urothelial cancer ranged from 53 to 83 years, and the average was 67.5±10.3 years old. The interval between the diagnosis of cervical cancer and urothelial cancer ranged from 3 to 25 years, averaging 16.3 years. It is impossible to evaluate the risk of development of urothelial cancer after radiation therapy based on our data. However, it is important to make an effort to diagnose urothelial cancer at an early stage by educating patients (e.g., advising regular urine tests) after the follow-up period to cervical cancer. (author)

Cervical biomechanics and neck pain of "head-spinning" breakdancers.

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Kauther, M D; Piotrowski, M; Hussmann, B; Lendemans, S; Wedemeyer, C; Jaeger, M

2014-05-01

The cervical spine of breakdancers is at great risk due to reversed body loading during headspin manoeuvers. This study focused on the cervical biomechanics of breakdancers and a correlation with neck pain. A standardized interview and biomechanical testing of the cervical spine of 25 participants with "headspin" ability ages 16-34 years and an age-matched cohort of 25 participants without any cervical spine problems was conducted. Neck pain history, Neck Disability Index (NDI), cervical range of motion (CROM) and cervical torque were recorded. The "headspin" group reported significantly better subjective fitness, more cervical complaints, higher pain intensity, a longer history of neck pain and a worse NDI compared to the "normal" collective. The "headspin" group showed a 2-2.5 times higher rate of neck pain than the normal population, with increased cervical flexion (pcervical torque in all planes (ppain intensity and history of neck pain. Sports medicine practitioners should be aware of headspin maneuver accidents that pose the risk of fractures, dislocations and spinal cord injuries of breakdancers. © Georg Thieme Verlag KG Stuttgart · New York.

A CLINICO PATHOLOGICAL STUDY OF CERVICAL LYMPHADENOPATHY

Directory of Open Access Journals (Sweden)

Shaik Ahmed Sheriff

2017-10-01

Full Text Available BACKGROUND Cervical lymphadenopathy is a common finding in day today surgical practice which poses a challenge to the clinician because clinical findings may not always help in arriving at a possible cause. Meticulous history taking and thorough clinical examination most of the times helps the clinician in diagnosis but for confirmation and planning management histological examination always helps. Fine Needle Aspiration Cytology is emerging as a first line diagnostic tool in evaluating lymphadenopathy. The aim of this study was to identify various causes of cervical lymphadenopathy and to identify the distribution in various age groups and to compare clinical findings with pathological findings. This is a prospective study on Cervical Lymphadenopathy conducted on 130 patients in Department of General Surgery at Sri Venkateswara Ramnarain Ruia Government General Hospital, Tirupati from September 2015 to October 2016. MATERIALS AND METHODS This was a prospective study conducted in department of general surgery in Sri Venkateswara Ramnarain Ruia Government General Hospital, Tirupati from September 2015 to October 2016. A total of 130 patients were included in the study. Detailed history was taken and clinical examination was done, required investigations were done, Fine Needle Aspiration Cytology was done in all the cases. Results were analysed. RESULTS Tuberculosis was the most common cause (42% followed by non-specific lymphadenitis (25%. Women were more affected than men. Young adults in 18-30 years age group were more affected by TB whereas patients in age group 51-60 were affected with malignancy. Fine Needle Aspiration Cytology was conclusive in 125 cases. CONCLUSION Tuberculosis is the most common cause followed by non-specific lymphadenitis, metastatic lymph nodes. Fine Needle Aspiration Cytology is simple, quick and cheap investigative tool in cervical lymphadenitis evaluation.

Case Studies - Cervical Cancer

Centers for Disease Control (CDC) Podcasts

2010-10-15

Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.  Created: 10/15/2010 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

Effects of decompressive cervical surgery on blood pressure in cervical spondylosis patients with hypertension: a time series cohort study.

Science.gov (United States)

Liu, Hong; Wang, Hai-Bo; Wu, Lin; Wang, Shi-Jun; Yang, Ze-Chuan; Ma, Run-Yi; Reilly, Kathleen H; Yan, Xiao-Yan; Ji, Ping; Wu, Yang-feng

2016-01-06

Patients with cervical spondylosis myelopathy (CSM) and complicated with hypertension are often experiencing a blood pressure decrease after taking cervical decompressive surgery in clinical observations, but how this blood pressure reduction is associated with the surgery, which cut cervical sympathetic nervous, has never been rigorously assessed. Thus, the purpose of this study is to investigate the effect of cervical decompressive surgery on blood pressure among CSM patients with hypertension. The study will be a time series cohort study. Fifty eligible patients will be selected consecutively from the Peking University First Hospital. Two 24-h ambulatory blood pressure measurement (ABPM) will be taken before the surgery, apart by at least 3 days. The patients will be followed up for another two ABPMs at 1 and 3 months after the surgery. We will recruit subjects with cervical spondylosis myelopathy meeting operation indications and scheduled for receiving cervical decompressive surgery, aged 18-84 years, have a history of hypertension or office systolic blood pressure ≥140 mmHg on initial screening, and willing to participate in the study and provide informed consent. Exclusion criteria includes a history of known secondary hypertension, visual analogue scale (VAS) score ≥4, and unable to comply with study due to severe psychosis. The change in systolic ABPs over the four times will be analyzed to observe the overall pattern of the blood pressure change in relation to the surgery, but the primary analysis will be the comparison of systolic ABP between the 2(nd) and 3(rd), 4(th) measurements (before and after the surgery). We will also calculate the regression-to-the-mean adjusted changes in systolic ABP as sensitivity analysis. Secondary endpoints are the changes in 24 h ABPM diastolic blood pressure, blood pressure control status, the use and dose adjustment of antihypertensive medication, and the incidence of operative complications. Primary outcome

Bone marrow sparing in intensity modulated proton therapy for cervical cancer: Efficacy and robustness under range and setup uncertainties

International Nuclear Information System (INIS)

Dinges, Eric; Felderman, Nicole; McGuire, Sarah; Gross, Brandie; Bhatia, Sudershan; Mott, Sarah; Buatti, John; Wang, Dongxu

2015-01-01

Background and purpose: This study evaluates the potential efficacy and robustness of functional bone marrow sparing (BMS) using intensity-modulated proton therapy (IMPT) for cervical cancer, with the goal of reducing hematologic toxicity. Material and methods: IMPT plans with prescription dose of 45 Gy were generated for ten patients who have received BMS intensity-modulated X-ray therapy (IMRT). Functional bone marrow was identified by 18 F-flourothymidine positron emission tomography. IMPT plans were designed to minimize the volume of functional bone marrow receiving 5–40 Gy while maintaining similar target coverage and healthy organ sparing as IMRT. IMPT robustness was analyzed with ±3% range uncertainty errors and/or ±3 mm translational setup errors in all three principal dimensions. Results: In the static scenario, the median dose volume reductions for functional bone marrow by IMPT were: 32% for V 5Gy , 47% for V 10Gy , 54% for V 20Gy , and 57% for V 40Gy , all with p < 0.01 compared to IMRT. With assumed errors, even the worst-case reductions by IMPT were: 23% for V 5Gy , 37% for V 10Gy , 41% for V 20Gy , and 39% for V 40Gy , all with p < 0.01. Conclusions: The potential sparing of functional bone marrow by IMPT for cervical cancer is significant and robust under realistic systematic range uncertainties and clinically relevant setup errors

Bone Marrow Sparing in Intensity Modulated Proton Therapy for Cervical Cancer: Efficacy and Robustness under Range and Setup Uncertainties

Science.gov (United States)

Dinges, Eric; Felderman, Nicole; McGuire, Sarah; Gross, Brandie; Bhatia, Sudershan; Mott, Sarah; Buatti, John; Wang, Dongxu

2015-01-01

Background and Purpose This study evaluates the potential efficacy and robustness of functional bone marrow sparing (BMS) using intensity-modulated proton therapy (IMPT) for cervical cancer, with the goal of reducing hematologic toxicity. Material and Methods IMPT plans with prescription dose of 45 Gy were generated for ten patients who have received BMS intensity-modulated x-ray therapy (IMRT). Functional bone marrow was identified by 18F-flourothymidine positron emission tomography. IMPT plans were designed to minimize the volume of functional bone marrow receiving 5–40 Gy while maintaining similar target coverage and healthy organ sparing as IMRT. IMPT robustness was analyzed with ±3% range uncertainty errors and/or ±3mm translational setup errors in all three principal dimensions. Results In the static scenario, the median dose volume reductions for functional bone marrow by IMPT were: 32% for V5GY, 47% for V10Gy, 54% for V20Gy, and 57% for V40Gy, all with p<0.01 compared to IMRT. With assumed errors, even the worst-case reductions by IMPT were: 23% for V5Gy, 37% for V10Gy, 41% for V20Gy, and 39% for V40Gy, all with p<0.01. Conclusions The potential sparing of functional bone marrow by IMPT for cervical cancer is significant and robust under realistic systematic range uncertainties and clinically relevant setup errors. PMID:25981130

Large scale study of HPV genotypes in cervical cancer and different cytological cervical specimens in Thailand.

Science.gov (United States)

Chansaenroj, Jira; Junyangdikul, Pairoj; Chinchai, Teeraporn; Swangvaree, Sukumarn; Karalak, Anant; Gemma, Nobuhiro; Poovorawan, Yong

2014-04-01

Identification of high-risk HPV genotypes in patients is essential for vaccination and prevention programs while the geographic distribution of cervical cancer varies widely. HPV 16 is the major cause of cervical cancer followed by HPV 18, HPV 31, HPV 52, or HPV 58 depending on geographic area. In this study, the distribution of HPV genotypes in cervical specimens from women living in Thailand was analyzed by HPV testing with electrochemical DNA chip and PCR direct sequencing. The 716 specimens were grouped according to their cytological grades; 100 normal, 100 low-grade squamous intraepithelial lesions, 100 high grade squamous intraepithelial lesions, and 416 specimens of cervical cancer. The results showed that HPV 16, HPV 18, HPV 52, and HPV 58 are the most common HPV genotypes in Thailand, respectively. With respect to age, women below the age of 26 years were almost negative for high-risk HPV DNA exclusively. Conversely, high prevalence of high-risk HPV DNA and abnormal cytology were usually found in women between 26 and 45 years while cervical cancer was detected mainly in women above the age of 45 years. To increase protection efficiency, a vaccine including HPV 52 and HPV 58 should be offered to Asian women, and primary HPV screening should start at 26-30 years of age. © 2013 Wiley Periodicals, Inc.

Cervical Spondylosis and Hypertension

OpenAIRE

Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

2015-01-01

Abstract Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully w...

Anterior cervical spine surgery-associated complications in a retrospective case-control study

OpenAIRE

Tasiou, Anastasia; Giannis, Theofanis; Brotis, Alexandros G.; Siasios, Ioannis; Georgiadis, Iordanis; Gatos, Haralampos; Tsianaka, Eleni; Vagkopoulos, Konstantinos; Paterakis, Konstantinos; Fountas, Kostas N.

2017-01-01

Anterior cervical spine procedures have been associated with satisfactory outcomes. However, the occurrence of troublesome complications, although uncommon, needs to be taken into consideration. The purpose of our study was to assess the actual incidence of anterior cervical spine procedure-associated complications and identify any predisposing factors. A total of 114 patients undergoing anterior cervical procedures over a 6-year period were included in our retrospective, case-control study. ...

Impact of Isometric Contraction of Anterior Cervical Muscles on Cervical Lordosis.

Science.gov (United States)

Fedorchuk, Curtis A; McCoy, Matthew; Lightstone, Douglas F; Bak, David A; Moser, Jacque; Kubricht, Brett; Packer, John; Walton, Dustin; Binongo, Jose

2016-09-01

This study investigates the impact of isometric contraction of anterior cervical muscles on cervical lordosis. 29 volunteers were randomly assigned to an anterior head translation (n=15) or anterior head flexion (n=14) group. Resting neutral lateral cervical x-rays were compared to x-rays of sustained isometric contraction of the anterior cervical muscles producing anterior head translation or anterior head flexion. Paired sample t-tests indicate no significant difference between pre and post anterior head translation or anterior head flexion. Analysis of variance suggests that gender and peak force were not associated with change in cervical lordosis. Chamberlain's to atlas plane line angle difference was significantly associated with cervical lordosis difference during anterior head translation (p=0.01). This study shows no evidence that hypertonicity, as seen in muscle spasms, of the muscles responsible for anterior head translation and anterior head flexion have a significant impact on cervical lordosis.

The prevalence of cervical myelopathy among subjects with narrow cervical spinal canal in a population-based magnetic resonance imaging study: the Wakayama Spine Study.

Science.gov (United States)

Nagata, Keiji; Yoshimura, Noriko; Hashizume, Hiroshi; Muraki, Shigeyuki; Ishimoto, Yuyu; Yamada, Hiroshi; Takiguchi, Noboru; Nakagawa, Yukihiro; Minamide, Akihito; Oka, Hiroyuki; Kawaguchi, Hiroshi; Nakamura, Kozo; Akune, Toru; Yoshida, Munehito

2014-12-01

A narrow cervical spinal canal (CSC) is a well-known risk factor for cervical myelopathy (CM). However, no epidemiologic data of the CSC based on a population-based cohort are available. The purpose of the study was to investigate the age-related differences in CSC diameters on plain radiographs and to examine the associated magnetic resonance imaging (MRI) abnormalities including cervical cord compression and increased signal intensity (ISI) as well as the clinical CM with the narrow CSC. This was a cross-sectional study. Data were obtained from the baseline survey of the Wakayama Spine Study that was performed from 2008 to 2010 in a western part of Japan. Finally, a total of 959 subjects (319 men and 640 women; mean age, 66.4 years) were included. The outcome measures included in the study were the CSC diameter at C5 level on plain radiographs, cervical cord compression and ISI on sagittal T2-weighted MRI, and physical signs related to CM (eg, the Hoffmann reflex, hyperreflexia of the patellar tendon, the Babinski reflex, sensory and motor function, and bowel/bladder symptoms). The age-related differences of CSC diameters in men and women were investigated by descriptive statistics. The prevalence of MRI abnormalities and clinical CM was compared among the groups divided by the CSC diameter (less than 13, 13-15, and 15 mm or more). In addition, a logistic regression analysis was performed to determine the association of the CSC diameter with cervical cord compression/clinical CM after overall adjustment for age, sex, and body mass index. The CSC diameter was narrower with increasing age in both men and women. The prevalence of cervical cord compression, ISI, and the clinical CM was significantly higher in the narrower CSC group. The prevalence of cervical cord compression, ISI, and CM among subjects with CSC diameter less than 13 mm was 38.0%, 5.4%, and 10.1%, respectively. In the logistic model, the CSC diameter was a significant predictive factor for the

A study of radiation therapy for the cervical stump cancer

International Nuclear Information System (INIS)

Ohkawa, Reiko; Arai, Tatsuo; Morita, Shinroku; Takamizawa, Hirokichi.

1979-01-01

During a period of 17 years, between 1961 and 1977, 59 cases of the cervical stump cancer were treated at NIRS Hospital. We could not epidemically find the difference between the cervical stump cancer and the cervical cancer. 5-year survival rate of cervical stump cancer was 90% in stage I, 86% in stage II, and 63% in stage III, respectively. These results show higher 5-year survival rates, compared with those of cervical cancer. The frequencies of radiation complication in rectum and bladder were lower in the case of cervical stump cancer than in cervical cancer. It was suggested that the optimal radiation dose for cervical stump cancer was 80 - 90 TDF at point A. (author)

Cervicitis aetiology and case definition: a study in Australian women attending sexually transmitted infection clinics.

Science.gov (United States)

Lusk, M Josephine; Garden, Frances L; Rawlinson, William D; Naing, Zin W; Cumming, Robert G; Konecny, Pam

2016-05-01

Studies examining cervicitis aetiology and prevalence lack comparability due to varying criteria for cervicitis. We aimed to outline cervicitis associations and suggest a best case definition. A cross-sectional study of 558 women at three sexually transmitted infection clinics in Sydney, Australia, 2006-2010, examined pathogen and behavioural associations of cervicitis using three cervicitis definitions: 'microscopy' (>30 pmnl/hpf (polymorphonuclear leucocytes per high-powered field on cervical Gram stain)), 'cervical discharge' (yellow and/or mucopurulent cervical discharge) or 'micro+cervical discharge' (combined 'microscopy' and 'cervical discharge'). Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Trichomonas vaginalis (TV) and Neisseria gonorrhoeae (NG) had the strongest associations with cervicitis definitions 'micro+cervical discharge': CT adjusted prevalence ratio (APR)=2.13 (95% CI 1.38 to 3.30) p=0.0006, MG APR=2.21 (1.33 to 3.69) p=0.002, TV APR=2.37 (1.44 to 3.90) p=0.0007 NG PR=4.42 (3.79 to 5.15) pdefinitions with best clinical utility and pathogen prediction were 'cervical discharge' and 'micro+cervical discharge'. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Kinematics of fast cervical rotations in persons with chronic neck pain: a cross-sectional and reliability study.

Science.gov (United States)

Röijezon, Ulrik; Djupsjöbacka, Mats; Björklund, Martin; Häger-Ross, Charlotte; Grip, Helena; Liebermann, Dario G

2010-09-27

Assessment of sensorimotor function is useful for classification and treatment evaluation of neck pain disorders. Several studies have investigated various aspects of cervical motor functions. Most of these have involved slow or self-paced movements, while few have investigated fast cervical movements. Moreover, the reliability of assessment of fast cervical axial rotation has, to our knowledge, not been evaluated before. Cervical kinematics was assessed during fast axial head rotations in 118 women with chronic nonspecific neck pain (NS) and compared to 49 healthy controls (CON). The relationship between cervical kinematics and symptoms, self-rated functioning and fear of movement was evaluated in the NS group. A sub-sample of 16 NS and 16 CON was re-tested after one week to assess the reliability of kinematic variables. Six cervical kinematic variables were calculated: peak speed, range of movement, conjunct movements and three variables related to the shape of the speed profile. Together, peak speed and conjunct movements had a sensitivity of 76% and a specificity of 78% in discriminating between NS and CON, of which the major part could be attributed to peak speed (NS: 226 ± 88°/s and CON: 348 ± 92°/s, p conjunct movements was poor. Peak speed of fast cervical axial rotations is reduced in people with chronic neck pain, and even further reduced in subjects with concomitant low back pain. Fast cervical rotation test seems to be a reliable and valid tool for assessment of neck pain disorders on group level, while a rather large between subject variation and overlap between groups calls for caution in the interpretation of individual assessments.

Defining the genetic susceptibility to cervical neoplasia-A genome-wide association study.

Directory of Open Access Journals (Sweden)

Paul J Leo

2017-08-01

Full Text Available A small percentage of women with cervical HPV infection progress to cervical neoplasia, and the risk factors determining progression are incompletely understood. We sought to define the genetic loci involved in cervical neoplasia and to assess its heritability using unbiased unrelated case/control statistical approaches. We demonstrated strong association of cervical neoplasia with risk and protective HLA haplotypes that are determined by the amino-acids carried at positions 13 and 71 in pocket 4 of HLA-DRB1 and position 156 in HLA-B. Furthermore, 36% (standard error 2.4% of liability of HPV-associated cervical pre-cancer and cancer is determined by common genetic variants. Women in the highest 10% of genetic risk scores have approximately >7.1% risk, and those in the highest 5% have approximately >21.6% risk, of developing cervical neoplasia. Future studies should examine genetic risk prediction in assessing the risk of cervical neoplasia further, in combination with other screening methods.

A preliminary study comparing the use of cervical/upper thoracic mobilization and manipulation for individuals with mechanical neck pain.

Science.gov (United States)

Griswold, David; Learman, Ken; O'Halloran, Bryan; Cleland, Josh

2015-05-01

Neck pain is routinely managed using manual therapy (MT) to the cervical and thoracic spines. While both mobilizations and manipulations to these areas have been shown to reduce neck pain, increase cervical range of motion, and reduce disability, the most effective option remains elusive. The purpose of this preliminary trial was to compare the pragmatic use of cervical and thoracic mobilizations vs. manipulation for mechanical neck pain. This trial included 20 patients with mechanical neck pain. Each patient was randomized to receive either mobilization or manipulation to both the cervical and thoracic spines during their plan of care. Within-group analyses were made with Wilcoxon signed-rank tests and between-group analyses were made with Mann-Whitney U. There were no between-group differences for any of the dependent variables including cervical active range of motion (CAROM) (P = 0.18), deep cervical flexion (DCF) endurance (P = 0.06), numerical pain rating scale (NPRS) (P = 0.26), the neck disability index (NDI, P = 0.33), patient-specific functional scale (PSFS, P = 0.20), or the global rating of change (GROC) scale (P = 0.94). Within-group results were significant for all outcome variables (Ppain.

Comparison of 2 Zero-Profile Implants in the Treatment of Single-Level Cervical Spondylotic Myelopathy: A Preliminary Clinical Study of Cervical Disc Arthroplasty versus Fusion.

Directory of Open Access Journals (Sweden)

Sheng Shi

Full Text Available Cervical disc arthroplasty (CDA with Discover prosthesis or anterior cervical discectomy and fusion (ACDF with Zero-P cage has been widely used in the treatment of cervical spondylotic myelopathy (CSM. However, little is known about the comparison of the 2 zero-profile implants in the treatment of single-level CSM. The aim was to compare the clinical outcomes and radiographic parameters of CDA with Discover prosthesis and ACDF with Zero-P cage for the treatment of single-level CSM.A total of 128 consecutive patients who underwent 1-level CDA with Discover prosthesis or ACDF with Zero-P cage for single-level CSM between September 2009 and December 2012 were included in this study. Clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA score and Neck Disability Index (NDI. For radiographic assessment, the overall sagittal alignment (OSA, functional spinal unit (FSU angle, and range of motion (ROM at the index and adjacent levels were measured before and after surgery. Additionally, the complications were also recorded.Both treatments significantly improved all clinical parameters (P 0.05. Besides, no significant differences existed in dysphagia, subsidence, or adjacent disc degeneration between the 2 groups (P > 0.05. However, significant differences occurred in prosthesis migration in CDA group.The results of this study showed that clinical outcomes and radiographic parameters were satisfactory and comparable with the 2 techniques. However, more attention to prosthesis migration of artificial cervical disc should be paid in the postoperative early-term follow-up.

Injectable silk-based biomaterials for cervical tissue augmentation: an in vitro study.

Science.gov (United States)

Brown, Joseph E; Partlow, Benjamin P; Berman, Alison M; House, Michael D; Kaplan, David L

2016-01-01

Cerclage therapy is an important treatment option for preterm birth prevention. Several patient populations benefit from cerclage therapy including patients with a classic history of cervical insufficiency; patients who present with advanced cervical dilation prior to viability; and patients with a history of preterm birth and cervical shortening. Although cerclage is an effective treatment option in some patients, it can be associated with limited efficacy and procedure complications. Development of an alternative to cerclage therapy would be an important clinical development. Here we report on an injectable, silk protein-based biomaterial for cervical tissue augmentation. The rationale for the development of an injectable biomaterial is to restore the native properties of cervical tissue. While cerclage provides support to the tissue, it does not address excessive tissue softening, which is a central feature of the pathogenesis of cervical insufficiency. Silk protein-based hydrogels, which are biocompatible and naturally degrade in vivo, are suggested as a platform for restoring the native properties of cervical tissue and improving cervical function. We sought to study the properties of an injectable, silk-based biomaterial for potential use as an alternative treatment for cervical insufficiency. These biomaterials were evaluated for mechanical tunability, biocompatibility, facile injection, and in vitro degradation. Silk protein solutions were cross-linked by an enzyme catalyzed reaction to form elastic biomaterials. Biomaterials were formulated to match the native physical properties of cervical tissue during pregnancy. The cell compatibility of the materials was assessed in vitro using cervical fibroblasts, and biodegradation was evaluated using concentrated protease solution. Tissue augmentation or bulking was demonstrated using human cervical tissue from nonpregnant hysterectomy specimens. Mechanical compression tests measured the tissue stiffness as a

Histological, magnetic resonance imaging, and discographic findings on cervical disc degeneration in cadaver spines. A comparative study

Energy Technology Data Exchange (ETDEWEB)

Maruyama, Yuichiro [Juntendo Univ., Tokyo (Japan). School of Medicine

1995-11-01

A total of 210 cervical intervertebral discs were taken at autopsy from 36 cadavers, and underwent both magnetic resonance imaging (MRI) and discography to compare their diagnostic efficacies for investigating degenerative changes in the cervical spine. The age of the subjects had ranged from 43 to 92 years with an average of 68.1 years. Following the autopsy, MRI and discography were performed on the excised cervical spinal column, and the specimen was then prepared for histological examination. The findings were compared with those of the lumbar spine that had previously been reported by Yasuma et al. on 1238 lumbar discs from 197 cadavers ranging in age from 11 to 92 years. The results were as follows: Low intensity in the T2-weighted MRI was well correlated with histological degeneration in the cervical disc. The rate of appearance of the posterior protrusion of the cervical disc on the MRI was in accordance with the degree of histological disc degeneration, but it did not always correspond with histological posterior protrusion. There was a remarkably high incidence for false-positive posterior protrusion on the MRI, which should be kept in mind on reading the MRI. In the comparison of the MRI with the discography, a certain positive correlation was found as for disc degeneration, but not in complete accordance. There was a considerable difference in the patterns of degeneration and in posterior protrusion of the discs between the cervical spine and the lumbar spine. The posterior protrusion in the cervical disc was more likely related to horizontal fissure and hyalinization of the posterior annulus, while posterior protrusion in the lumbar disc was often related to reversed orientation of the bundles and myxomatous degeneration of the posterior annulus. This difference was attributed to the difference in the mechanical properties of the cervical and lumbar spines. (author).

Histological, magnetic resonance imaging, and discographic findings on cervical disc degeneration in cadaver spines. A comparative study

International Nuclear Information System (INIS)

Maruyama, Yuichiro

1995-01-01

A total of 210 cervical intervertebral discs were taken at autopsy from 36 cadavers, and underwent both magnetic resonance imaging (MRI) and discography to compare their diagnostic efficacies for investigating degenerative changes in the cervical spine. The age of the subjects had ranged from 43 to 92 years with an average of 68.1 years. Following the autopsy, MRI and discography were performed on the excised cervical spinal column, and the specimen was then prepared for histological examination. The findings were compared with those of the lumbar spine that had previously been reported by Yasuma et al. on 1238 lumbar discs from 197 cadavers ranging in age from 11 to 92 years. The results were as follows: Low intensity in the T2-weighted MRI was well correlated with histological degeneration in the cervical disc. The rate of appearance of the posterior protrusion of the cervical disc on the MRI was in accordance with the degree of histological disc degeneration, but it did not always correspond with histological posterior protrusion. There was a remarkably high incidence for false-positive posterior protrusion on the MRI, which should be kept in mind on reading the MRI. In the comparison of the MRI with the discography, a certain positive correlation was found as for disc degeneration, but not in complete accordance. There was a considerable difference in the patterns of degeneration and in posterior protrusion of the discs between the cervical spine and the lumbar spine. The posterior protrusion in the cervical disc was more likely related to horizontal fissure and hyalinization of the posterior annulus, while posterior protrusion in the lumbar disc was often related to reversed orientation of the bundles and myxomatous degeneration of the posterior annulus. This difference was attributed to the difference in the mechanical properties of the cervical and lumbar spines. (author)

Lateral cervical puncture for cervical myelography

International Nuclear Information System (INIS)

Seol, Hae Young; Cha, Sang Hoon; Kim, Yoon Hwan; Suh, Won Hyuck

1985-01-01

Eleven cervical myelograms were performed by lateral cervical puncture using Metrizamide. So, following results were obtained: 1. Site of lateral cervical puncture; Posterior one third of bony cervical canal at C 1-2 level. 2. Advantages as compared with lumbar puncture for cervical myelograms; 1) Small amount of contrast media 2) Excellent image 3) Less position charge 4) Short time 5) Well visualization of superior margin of obstructive lesion in spinal canal 3. Cessation of lateral cervical puncture, when; 1) Pain during injection of contrast media 2) Localized collection of contrast media

Lateral cervical puncture for cervical myelography

Energy Technology Data Exchange (ETDEWEB)

Seol, Hae Young; Cha, Sang Hoon; Kim, Yoon Hwan; Suh, Won Hyuck [Korea University College of Medicine, Seoul (Korea, Republic of)

1985-12-15

Eleven cervical myelograms were performed by lateral cervical puncture using Metrizamide. So, following results were obtained: 1. Site of lateral cervical puncture; Posterior one third of bony cervical canal at C 1-2 level. 2. Advantages as compared with lumbar puncture for cervical myelograms; 1) Small amount of contrast media 2) Excellent image 3) Less position charge 4) Short time 5) Well visualization of superior margin of obstructive lesion in spinal canal 3. Cessation of lateral cervical puncture, when; 1) Pain during injection of contrast media 2) Localized collection of contrast media.

Non-contiguous spinal injury in cervical spinal trauma: evaluation with cervical spine MRI

International Nuclear Information System (INIS)

Choi, Soo Jung; Shin, Myung Jin; Kim, Sung Moon; Bae, Sang Jin

2004-01-01

We wished to evaluate the incidence of non-contiguous spinal injury in the cervicothoracic junction (CTJ) or the upper thoracic spines on cervical spinal MR images in the patients with cervical spinal injuries. Seventy-five cervical spine MR imagings for acute cervical spinal injury were retrospectively reviewed (58 men and 17 women, mean age: 35.3, range: 18-81 years). They were divided into three groups based on the mechanism of injury; axial compression, hyperflexion or hyperextension injury, according to the findings on the MR and CT images. On cervical spine MR images, we evaluated the presence of non-contiguous spinal injury in the CTJ or upper thoracic spine with regard to the presence of marrow contusion or fracture, ligament injury, traumatic disc herniation and spinal cord injury. Twenty-one cases (28%) showed CTJ or upper thoracic spinal injuries (C7-T5) on cervical spinal MR images that were separated from the cervical spinal injuries. Seven of 21 cases revealed overt fractures in the CTJs or upper thoracic spines. Ligament injury in these regions was found in three cases. Traumatic disc herniation and spinal cord injury in these regions were shown in one and two cases, respectively. The incidence of the non-contiguous spinal injuries in CTJ or upper thoracic spines was higher in the axial compression injury group (35.5%) than in the hyperflexion injury group (26.9%) or the hyperextension (25%) injury group. However, there was no statistical significance (ρ > 0.05). Cervical spinal MR revealed non-contiguous CTJ or upper thoracic spinal injuries in 28% of the patients with cervical spinal injury. The mechanism of cervical spinal injury did not significantly affect the incidence of the non-contiguous CTJ or upper thoracic spinal injury

Non-contiguous spinal injury in cervical spinal trauma: evaluation with cervical spine MRI

Energy Technology Data Exchange (ETDEWEB)

Choi, Soo Jung; Shin, Myung Jin; Kim, Sung Moon [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Bae, Sang Jin [Sanggyepaik Hospital, Inje University, Seoul (Korea, Republic of)

2004-12-15

We wished to evaluate the incidence of non-contiguous spinal injury in the cervicothoracic junction (CTJ) or the upper thoracic spines on cervical spinal MR images in the patients with cervical spinal injuries. Seventy-five cervical spine MR imagings for acute cervical spinal injury were retrospectively reviewed (58 men and 17 women, mean age: 35.3, range: 18-81 years). They were divided into three groups based on the mechanism of injury; axial compression, hyperflexion or hyperextension injury, according to the findings on the MR and CT images. On cervical spine MR images, we evaluated the presence of non-contiguous spinal injury in the CTJ or upper thoracic spine with regard to the presence of marrow contusion or fracture, ligament injury, traumatic disc herniation and spinal cord injury. Twenty-one cases (28%) showed CTJ or upper thoracic spinal injuries (C7-T5) on cervical spinal MR images that were separated from the cervical spinal injuries. Seven of 21 cases revealed overt fractures in the CTJs or upper thoracic spines. Ligament injury in these regions was found in three cases. Traumatic disc herniation and spinal cord injury in these regions were shown in one and two cases, respectively. The incidence of the non-contiguous spinal injuries in CTJ or upper thoracic spines was higher in the axial compression injury group (35.5%) than in the hyperflexion injury group (26.9%) or the hyperextension (25%) injury group. However, there was no statistical significance ({rho} > 0.05). Cervical spinal MR revealed non-contiguous CTJ or upper thoracic spinal injuries in 28% of the patients with cervical spinal injury. The mechanism of cervical spinal injury did not significantly affect the incidence of the non-contiguous CTJ or upper thoracic spinal injury.

CT imaging techniques for describing motions of the cervicothoracic junction and cervical spine during flexion, extension, and cervical traction.

Science.gov (United States)

Simon, Scott; Davis, Martin; Odhner, Dewey; Udupa, Jayaram; Winkelstein, Beth

2006-01-01

Computerized tomographic study of human cadavers undergoing traction and flexion-extension bending. To investigate the feasibility of using computerized tomography techniques to quantify relative vertebral motions of the cervical spine and cervicothoracic junction (CTJ), and to define normative CTJ kinematics. Despite developing an understanding of the mechanical behavior of the cervical spine, little remains known about the cervicothoracic junction. The CTJ is more difficult to image than other cervical regions given the anatomic features of the surrounding bones obstructing CTJ visualization. As such, limited data have been reported describing the responses of the CTJ for motions and loading in the sagittal plane, confounding the clinical assessment of its injuries and surgical treatments used at this region. Helical CT images of the cervical spine and CTJ were acquired incrementally during each of flexion, extension, and cervical traction. Vertebral surfaces were reconstructed using the specialized image analysis software, 3DVIEWNIX. A mathematical description of relative vertebral motions was derived by computing rigid transformations. Euler angles and translations were calculated. Regional spine stiffness was defined for traction. The CTJ was found to be much stiffer (779 N/mm) than the cervical spine (317 N/mm) in tension. In flexion-extension bending, the CTJ was similar to the lower cervical spine. The CTJ demonstrated significantly less coupled motion than the cervical spine. The CTJ, as a transition region between the cervical and thoracic spines, has unique kinematic characteristics. This application of kinematic CT methods is useful for quantifying unreported normative ranges of motion for the CTJ, difficult by other conventional radiologic means.

Correlation between dental maturity and cervical vertebral maturity.

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Chen, Jianwei; Hu, Haikun; Guo, Jing; Liu, Zeping; Liu, Renkai; Li, Fan; Zou, Shujuan

2010-12-01

The aim of this study was to investigate the association between dental and skeletal maturity. Digital panoramic radiographs and lateral skull cephalograms of 302 patients (134 boys and 168 girls, ranging from 8 to 16 years of age) were examined. Dental maturity was assessed by calcification stages of the mandibular canines, first and second premolars, and second molars, whereas skeletal maturity was estimated by the cervical vertebral maturation (CVM) stages. The Spearman rank-order correlation coefficient was used to measure the association between CVM stage and dental calcification stage of individual teeth. The mean chronologic age of girls was significantly lower than that of boys in each CVM stage. The Spearman rank-order correlation coefficients between dental maturity and cervical vertebral maturity ranged from 0.391 to 0.582 for girls and from 0.464 to 0.496 for boys (P cervical vertebral maturation stage. The development of the mandibular second molar in females and that of the mandibular canine in males had the strongest correlations with cervical vertebral maturity. Therefore, it is practical to consider the relationship between dental and skeletal maturity when planning orthodontic treatment. Copyright © 2010 Mosby, Inc. All rights reserved.

Macrostructure of the Cranial Cervical Ganglion in the River Buffalo (Bubalus Bubalis

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Hossein Dehghani

2011-09-01

Full Text Available AbstractThe autonomic nervous system consists of a vast range of nerves and ganglions. Anatomical studies have demonstrated that the sympathetic innervations of the head and neck are affected by the neurons that ramify from the cranial cervical ganglion (CCG. The CCG is the end of the sympathetic cervical trunk, which runs with the vagal nerve during its cervical course. In this study sixteen adult (2 - 5 year river buffalo of both sexes (eight male, eight female weighing around 250 - 450 kg were dissected to investigate the weight, situation and arrangement of nerve branches of the cranial cervical ganglion bilaterally. The ganglions showed a fusiform shape and reddish in color. The cranial cervical ganglion covered by the digastricus muscle. It lies in dorsal region of the base of epiglottic cartilage, ventromedial to tympanic bulla and ventrally to atlantic fossa, and medial of the occipital artery. This study showed that the cranial cervical ganglions in river buffalo were well-developed structure. The main branches of cranial cervical ganglion included the internal carotid, external carotid and jugular nerves.

Assessment of neck pain and cervical mobility among female computer workers at Hail University.

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Mohammad, Walaa S; Hamza, Hayat H; ElSais, Walaa M

2015-01-01

The aims of this study were to investigate the prevalence of neck pain among computer workers at Hail University, Saudi Arabia and to compare the cervical range of motion (ROM) of female computer workers suffering from neck pain to the cervical ROM of healthy female computer workers. One hundred and seventy-six female volunteers between 20 and 46 years of age were investigated. Fifty-six of these volunteers were staff members, 22 were administrators and 98 were students. The Cervical Range of Motion (CROM) instrument was used to measure the ROM of the cervical spine. A questionnaire was used to assess participants for the presence of neck pain. The data were analyzed using the Statistical Package for Social Sciences (SPSS) software, and the level of significant was set at p pain (75%) among computer workers at Hail University, particularly among students. There were significant differences in cervical lateral flexion, rotation to the right side and protraction range between the pain and pain-free groups. Our results demonstrated that cervical ROM measurements, particularly cervical lateral flexion, rotation and protraction, could be useful for predicting changes in head and neck posture after long-term computer work.

Cervical Spondylosis and Hypertension

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Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

2015-01-01

Abstract Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully with anterior cervical discectomy and fusion. Stimulation of sympathetic nerve fibers in pathologically degenerative disc could produce sympathetic excitation, and induce a sympathetic reflex to cause cervical vertigo and hypertension. In addition, chronic neck pain could contribute to hypertension development through sympathetic arousal and failure of normal homeostatic pain regulatory mechanisms. Cervical spondylosis may be one of the causes of secondary hypertension. Early treatment for resolution of symptoms of cervical spondylosis may have a beneficial impact on cardiovascular disease risk in patients with cervical spondylosis. PMID:25761188

Concurrent chemoradiotherapy for advanced cervical cancer. A pilot study

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Kodama, Junichi; Hashimoto, Ichiro; Seki, Noriko; Hongo, Atsushi; Mizutani, Yasushi; Miyagi, Yasunari; Yoshinouchi, Mitsuo; Kudo, Takafumi

2001-01-01

Recently, attempts have made to use radiotherapy in combination with chemotherapy in various solid tumors including cervical cancer. Twenty-four patients with locally advanced cervical cancer were treated with concurrent Carboplatin (16-24 mg/m 2 /day) or Nedaplatin (20 mg/m 2 /week) and conventional radiotherapy. Of 13 evaluable patients, there were nine complete responders and four partial responders. There was no renal damage or grade 4 hematological toxicity. Gastrointestinal adverse reactions were mild. One patient had grade 3 dermatologic toxicity after delayed radiation therapy. This pilot study suggests that daily Carboplatin or weekly Nedaplatin administered with standard radiation therapy is safe, well-tolerated, and thus may be useful as a radiation sensitizer in the treatment of locally advanced cervical cancer. (author)

Magnetisation transfer ratio measurement in the cervical spinal cord: a preliminary study in multiple sclerosis

International Nuclear Information System (INIS)

Silver, N.C.; Barker, G.J.; Losseff, N.A.; Gawne-Cain, M.L.; MacManus, D.G.; Thompson, A.J.; Miller, D.H.

1997-01-01

MRI readily detects the lesions of multiple sclerosis (MS) in the brain and spinal cord. Conventional MRI sequences do not, however, permit distinction between the various pathological characteristics (oedema, demyelination, axonal loss and gliosis) of lesions in MS. Magnetisation transfer (MT) imaging may be more specific in distinguishing the pathologies responsible for disability in MS, namely demyelination and axonal loss, and therefore may have a potential role in monitoring treatment. We have applied MT imaging to the cervical spinal cord to see if it is feasible to measure MT ratios (MTR) in this region where pathological changes may result in considerable disability. We studied 12 patients with MS and 12 age- and sex-matched normal controls using a sagittal T2-weighted fast spin-echo sequence with and without an MT pulse. The median value for cervical cord mean MTR measurement in normal controls was 19.30 % units (interquartile range 19.05-19.55), whereas values were significantly lower in MS patients (median = 17.95 % units, interquartile range 17.25-19.00, P 0.0004). There was a low intrarater variability for repeated mean MTR measurements. We conclude that it is possible to measure MTR in the cervical spinal cord, that a significant reduction occurs in patients with MS, and that there may be a role for this measure in future MS treatment trials. (orig.). With 2 figs., 1 tab

Magnetisation transfer ratio measurement in the cervical spinal cord: a preliminary study in multiple sclerosis

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Silver, N.C. [NMR Research Unit and Department of Clinical Neurology, Institute of Neurology, Queen Square, London WC1N 3BG (United Kingdom); Barker, G.J. [NMR Research Unit and Department of Clinical Neurology, Institute of Neurology, Queen Square, London WC1N 3BG (United Kingdom); Losseff, N.A. [NMR Research Unit and Department of Clinical Neurology, Institute of Neurology, Queen Square, London WC1N 3BG (United Kingdom); Gawne-Cain, M.L. [NMR Research Unit and Department of Clinical Neurology, Institute of Neurology, Queen Square, London WC1N 3BG (United Kingdom); MacManus, D.G. [NMR Research Unit and Department of Clinical Neurology, Institute of Neurology, Queen Square, London WC1N 3BG (United Kingdom); Thompson, A.J. [NMR Research Unit and Department of Clinical Neurology, Institute of Neurology, Queen Square, London WC1N 3BG (United Kingdom); Miller, D.H. [NMR Research Unit and Department of Clinical Neurology, Institute of Neurology, Queen Square, London WC1N 3BG (United Kingdom)

1997-06-01

MRI readily detects the lesions of multiple sclerosis (MS) in the brain and spinal cord. Conventional MRI sequences do not, however, permit distinction between the various pathological characteristics (oedema, demyelination, axonal loss and gliosis) of lesions in MS. Magnetisation transfer (MT) imaging may be more specific in distinguishing the pathologies responsible for disability in MS, namely demyelination and axonal loss, and therefore may have a potential role in monitoring treatment. We have applied MT imaging to the cervical spinal cord to see if it is feasible to measure MT ratios (MTR) in this region where pathological changes may result in considerable disability. We studied 12 patients with MS and 12 age- and sex-matched normal controls using a sagittal T2-weighted fast spin-echo sequence with and without an MT pulse. The median value for cervical cord mean MTR measurement in normal controls was 19.30 % units (interquartile range 19.05-19.55), whereas values were significantly lower in MS patients (median = 17.95 % units, interquartile range 17.25-19.00, P = 0.0004). There was a low intrarater variability for repeated mean MTR measurements. We conclude that it is possible to measure MTR in the cervical spinal cord, that a significant reduction occurs in patients with MS, and that there may be a role for this measure in future MS treatment trials. (orig.). With 2 figs., 1 tab.

Does the mesodermal derangement in Chiari Type I malformation extend to the cervical spine? Evidence from an analytical morphometric study on cervical paraspinal muscles.

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Thakar, Sumit; Kurudi Siddappa, Avinash; Aryan, Saritha; Mohan, Dilip; Sai Kiran, Narayanam Anantha; Hegde, Alangar S

2017-10-01

OBJECTIVE The mesodermal derangement in Chiari Type I malformation (CMI) has been postulated to encompass the cervical spine. The objectives of this study were to assess the cross-sectional areas (CSAs) of cervical paraspinal muscles (PSMs) in patients with CMI without syringomyelia, compare them with those in non-CMI subjects, and evaluate their correlations with various factors. METHODS In this retrospective study, the CSAs of cervical PSMs in 25 patients were calculated on T2-weighted axial MR images and computed as ratios with respect to the corresponding vertebral body areas. These values and the cervical taper ratios were then compared with those of age- and sex-matched non-CMI subjects and analyzed with respect to demographic data and clinicoradiological factors. RESULTS Compared with the non-CMI group, the mean CSA values for the rectus capitis minor and all of the subaxial PSMs were lower in the study group, and those of the deep extensors were significantly lower (p = 0.004). The cervical taper ratio was found to be significantly higher in the study cohort (p = 0.0003). A longer duration of symptoms and a steeper cervical taper ratio were independently associated with lower CSA values for the deep extensors (p = 0.04 and p = 0.03, respectively). The presence of neck pain was associated with a lower CSA value for the deep flexors (p = 0.03). CONCLUSIONS Patients with CMI demonstrate alterations in their cervical paraspinal musculature even in the absence of coexistent syringomyelia. Their deep extensor muscles undergo significant atrophic changes that worsen with the duration of their symptoms. This could be related to a significantly steeper cervical taper ratio that their cervical cords are exposed to. Neck pain in these patients is related to atrophy of their deep flexor muscles. A steeper cervical taper ratio and alterations in the PSMs could be additional indicators for surgery in patients with CMI without syringomyelia.

Cervical syndrome - the effectiveness of physical therapy interventions.

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Kasumovic, Mersija; Gorcevic, Emir; Gorcevic, Semir; Osmanovic, Jasna

2013-12-01

The cervical syndrome refers to a set of disorders caused by the changes in the cervical spine and the soft-tissue surrounding it, with pain as the predominant symptom. Sore neck has been a common problem among a large section of today`s population. The factors contributing to this issue include the modern lifestyle, prolonged sitting and incorrect, fixed or constrained working postures. The root of these difficulties is found in the mechanical disorders of the cervical spine structures, poor body posture and jerky body movements. In the Scandinavian countries neck pain is considered to be a public health problem. The study evaluated 25 patients with an established diagnosis of cervical syndrome. The research was conducted at the PI Institute of Occupational and Sports Medicine of Zenica-Doboj Canton. Each patient received twenty physical therapy treatment sessions. The study included 25 patients suffering from the cervical syndrome. The statistical analysis of gender distribution indicated that 36% of the patients were male, while 64% were female. The mean age of study participants was 46.76±4,23. The patients ranged in age from 39 to 54 years, with no statistically significant difference in the mean age of male and female patients, p=0.691. Analysing the types of occupational activities performed by the patients, the study found a positive relation between neck pain and prolonged sitting at work. The patients who performed office work made up 76% of the total number. Each method of physical therapy applied in the treatment of neck pain patients proved useful. However, the combination of electrotherapy, kinesiotherapy and manual massage proved to be most effective. The cervical syndrome is a common medical condition primarily affecting adult population, with prevalence being higher among women and office workers. The condition places a considerable socioeconomic burden on the afflicted. Cervical pain ranges greatly in severity - from moderate to unbearable, thus

Intraoperative Death During Cervical Spinal Surgery: A Retrospective Multicenter Study.

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Wang, Jeffrey C; Buser, Zorica; Fish, David E; Lord, Elizabeth L; Roe, Allison K; Chatterjee, Dhananjay; Gee, Erica L; Mayer, Erik N; Yanez, Marisa Y; McBride, Owen J; Cha, Peter I; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel

2017-04-01

A retrospective multicenter study. Routine cervical spine surgeries are typically associated with low complication rates, but serious complications can occur. Intraoperative death is a very rare complication and there is no literature on its incidence. The purpose of this study was to determine the intraoperative mortality rates and associated risk factors in patients undergoing cervical spine surgery. Twenty-one surgical centers from the AOSpine North America Clinical Research Network participated in the study. Medical records of patients who received cervical spine surgery from January 1, 2005, to December 31, 2011, were reviewed to identify occurrence of intraoperative death. A total of 258 patients across 21 centers met the inclusion criteria. Most of the surgeries were done using the anterior approach (53.9%), followed by posterior (39.1%) and circumferential (7%). Average patient age was 57.1 ± 13.2 years, and there were more male patients (54.7% male and 45.3% female). There was no case of intraoperative death. Death during cervical spine surgery is a very rare complication. In our multicenter study, there was a 0% mortality rate. Using an adequate surgical approach for patient diagnosis and comorbidities may be the reason how the occurrence of this catastrophic adverse event was prevented in our patient population.

Pattern of cervical radiculopathy as diagnosed by electrodiagnostic studies

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Khan, O.J.; Ali, L.

2014-01-01

Objective: To determine the pattern of cervical radiculopathy presenting to a military care set up using electro diagnostic techniques. Study Design: Descriptive cross sectional study. Place and Duration of study: The study was conducted at the Armed Forces Institute of Rehabillitation Medicine Rawalpindi from July 2012 to December 2012. Subjects and Methods: Seventy-three patients who were diagnosed as cases of cervical radiculopathy on electro diagnostic testing were included in the study. Demographics and frequency of involvement of different levels were noted. Results: Of the total 73 patients, 51 (69.9%) were males and 22 (30.1%) females, with a men age of 48.01 +- 13.5 years. Left side predominated with 46.6% involvement whereas 39.7% of the patients had right sided radiculopathy and 13.7% had bilateral involvement. The most common radiculopathy encountered in this study was C7 which affected 25 (34.2%) patients, followed by C6 affecting 17 (23.3%) patients. Radicuolpathy affecting multiple upper segments like C5, C6 and C7 were a close third presenting in 15 (20.5%) patients. C8, TI radiculopathy of the lower segments was diagnosed in 13 (17.8%) patients whereas the lest common upper limp radiculopathy was C54, present in only 3 (4.1%) patients. Conclusion: Cervical radiculopathies affecting C7 and C6 roots were the most common ones encountered in our study, similar to international data. The cervical spine allows for greater movement and therefore is more prone to such developments. The reasons why C7 and C6 roots are most affected need to be studied further. (author)

Reliability of measuring half-cycle cervical range of motion may be increased using a spirit level for calibration.

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Wilke, Jan; Niederer, Daniel; Vogt, Lutz; Banzer, Winfried

2018-02-01

Assessments of range of motion (ROM) represent an essential part of clinical diagnostics. Ultrasonic movement analyses have been demonstrated to provide reliable results when analyzing complete amplitudes (e.g., flexion-extension). However, due to subjective determination of the starting position, the assessment of half-cycle movements (e.g, flexion only) is less reproducible. The present study aimed to examine the reliability of measuring half-cycle cervical ROM using a spirit level for calibration. 20 healthy subjects (30 ± 12yrs, 7♂, 13♀) participated in the randomized, controlled, cross-over trial. In two testing sessions with one week of wash-out in between, cervical ROM was measured by means of an ultrasonic 3D movement analysis system using a test-retest design (baseline and 5 min post baseline). The sessions differed with reference to the mask carrying the ultrasound markers. It was removed during the 5 min break (mask off) or not (mask on). To determine the resting position, a bull's eye spirit level was used in each measurement. With ICC values of 0.90-0.98 (mask on, p spirit level. In contrast to subjective determination of the starting position, analyzing complete movement planes does not increase reliability. Using a defined and objective zero positioning allows the evaluation of repositioning tasks. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Results evaluation in cervical vertigo kinesitherapy--preliminary report].

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Bielińska, Marzena; Olszewski, Jurek

2009-09-01

The work aimed at analyzing results of kinesitherapeutic procedures in patients with cervical vertigo as well as evaluating a mobility range of the cervical spine. The study was conducted on 23 people, including 17 women and 6 men suffering from cervical vertigo, at the age of 23-73 (the average age of 49.5). All the patients had an individually selected cycle of kinesitherapeutic exercises through the period of 2 months. The objective efficiency evaluation of the applied therapy was made on the grounds of the videonystagmographic examination (VNG). Additionally, the range of active mobility of the cervical spine was analyzed and the evaluation of vertigo according to Silvoniemi's criteria was performed. After a 2-month therapy 4 patients (17.4%) out of the examined material showed a total lack of vertigo, 15 patients (65.2%) demonstrated a meaningful decrease in the vertigo intensity, also in the frequency of their occurrence in 14 cases (60.8%). Only 3 patients did not show any decrease in vertigo whereas in 1 patient a slight increase in the intensity was indicated. On the basis of a subjective evaluation of the vertigo increase according to the 5-stage Silvoniemi's scale it was proved that a mean point assessment claimed by the patients at the beginning of the therapy amounts to 3.0 points whereas after the therapy it was as follows: 1.43 pt after 2 weeks, 1.17 pt after 1 month and 1.13 pt after 2 months of kinesitherapy. It is extremely difficult to fully eliminate the symptoms of cervical vertigo (in the studied material in 4 cases--17.3%) because the causes of their occurrence, which are connected with excessive tension and degeneration in the cervical spine, cannot usually be eradicated. Additionally, as a diagnostic means, the videonystagmographic examination (VNG) accompanied by the positioning tests and the cervical rotation test facilitates precise and objective monitoring of the progress in treatment and rehabilitation of vertigo.

Cervical Coupling Motion Characteristics in Healthy People Using a Wireless Inertial Measurement Unit

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Hyunho Kim

2013-01-01

Full Text Available Objective. The objectives were to show the feasibility of a wireless microelectromechanical system inertial measurement unit (MEMS-IMU to assess the time-domain characteristics of cervical motion that are clinically useful to evaluate cervical spine movement. Methods. Cervical spine movements were measured in 18 subjects with wireless IMUs. All rotation data are presented in the Euler angle system. Amount of coupling motions was evaluated by calculating the average angle ratio and the maximum angle ratio of the coupling motion to the primary motion. Reliability is presented with intraclass correlation coefficients (ICC. Results. Entire time-domain characteristics of cervical motion were measured with developed MEMS-IMU system. Cervical range of motion (CROM and coupling motion range were measured with high ICCs. The acquired data and calculated parameters had similar tendency with the previous studies. Conclusions. We evaluated cervical motion with economic system using a wireless IMU of high reliability. We could directly measure the three-dimensional cervical motion in degrees in realtime. The characteristics measured by this system may provide a diagnostic basis for structural or functional dysfunction of cervical spine. This system is also useful to demonstrate the effectiveness of any intervention such as conventional medical treatment, and Korean medical treatment, exercise therapy.

CDC's Cervical Cancer Study

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... Materials Infographics Cancer and Alcohol Web Features Breast Cancer Awareness Breast Cancer in Young Women Cancer and Men ... in Childhood Cancer, the Flu, and You Cervical Cancer Awareness Colorectal Cancer Awareness Gynecologic Cancer Awareness Health Disparities ...

Cervical disc hernia operations through posterior laminoforaminotomy.

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Yolas, Coskun; Ozdemir, Nuriye Guzin; Okay, Hilmi Onder; Kanat, Ayhan; Senol, Mehmet; Atci, Ibrahim Burak; Yilmaz, Hakan; Coban, Mustafa Kemal; Yuksel, Mehmet Onur; Kahraman, Umit

2016-01-01

The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years). Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%). On control examinations, there was no finding of instability or cervical kyphosis. Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis.

Knowledge, facilitators and barriers to cervical cancer screening among women in Uganda: a qualitative study.

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Ndejjo, Rawlance; Mukama, Trasias; Kiguli, Juliet; Musoke, David

2017-06-11

To explore community knowledge, facilitators and barriers to cervical cancer screening among women in rural Uganda so as to generate data to inform interventions. A qualitative study using focus group discussions and key informant interviews. Discussions and interviews carried out in the community within two districts in Eastern Uganda. Ten ( 10) focus group discussions with 119 screening-eligible women aged between 25 and 49 years and 11 key informant interviews with healthcare providers and administrators. Study participants' knowledge about cervical cancer causes, signs and symptoms, testing methods and prevention was poor. Many participants attributed the cause of cervical cancer to use of contraception while key informants said that some believed it was due to witchcraft. Perceptions towards cervical cancer and screening were majorly positive with many participants stating that they were at risk of getting cervical cancer. The facilitators to accessing cervical cancer screening were: experiencing signs and symptoms of cervical cancer, family history of the disease and awareness of the disease/screening service. Lack of knowledge about cervical cancer and screening, health system challenges, fear of test outcome and consequences and financial constraints were barriers to cervical cancer screening. Whereas perceptions towards cervical cancer and screening were positive, knowledge of study participants on cervical cancer was poor. To improve cervical cancer screening, effort should be focused on reducing identified barriers and enhancing facilitators. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Biomechanics of coupled motion in the cervical spine during simulated whiplash in patients with pre-existing cervical or lumbar spinal fusion

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Huang, H.; Nightingale, R. W.

2018-01-01

Objectives Loss of motion following spine segment fusion results in increased strain in the adjacent motion segments. However, to date, studies on the biomechanics of the cervical spine have not assessed the role of coupled motions in the lumbar spine. Accordingly, we investigated the biomechanics of the cervical spine following cervical fusion and lumbar fusion during simulated whiplash using a whole-human finite element (FE) model to simulate coupled motions of the spine. Methods A previously validated FE model of the human body in the driver-occupant position was used to investigate cervical hyperextension injury. The cervical spine was subjected to simulated whiplash exposure in accordance with Euro NCAP (the European New Car Assessment Programme) testing using the whole human FE model. The coupled motions between the cervical spine and lumbar spine were assessed by evaluating the biomechanical effects of simulated cervical fusion and lumbar fusion. Results Peak anterior longitudinal ligament (ALL) strain ranged from 0.106 to 0.382 in a normal spine, and from 0.116 to 0.399 in a fused cervical spine. Strain increased from cranial to caudal levels. The mean strain increase in the motion segment immediately adjacent to the site of fusion from C2-C3 through C5-C6 was 26.1% and 50.8% following single- and two-level cervical fusion, respectively (p = 0.03, unpaired two-way t-test). Peak cervical strains following various lumbar-fusion procedures were 1.0% less than those seen in a healthy spine (p = 0.61, two-way ANOVA). Conclusion Cervical arthrodesis increases peak ALL strain in the adjacent motion segments. C3-4 experiences greater changes in strain than C6-7. Lumbar fusion did not have a significant effect on cervical spine strain. Cite this article: H. Huang, R. W. Nightingale, A. B. C. Dang. Biomechanics of coupled motion in the cervical spine during simulated whiplash in patients with pre-existing cervical or lumbar spinal fusion: A Finite Element Study. Bone

Vietnamese American women’s beliefs and perceptions on cervical cancer, cervical cancer screening, and cancer prevention vaccines: A community-based participatory study

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Connie Kim Yen Nguyen-Truong

2017-12-01

Full Text Available Cervical cancer remains commonly diagnosed in Vietnamese American women. Despite efforts to increase cervical cancer screening among Vietnamese American women, participation rates are persistently lower than the national goal. The objective of this study is to explore beliefs of Vietnamese American women about cervical cancer, cervical cancer screening, and cancer prevention vaccines. A qualitative descriptive investigation captured group perceptions about meaning and beliefs of cervical cancer, screening, and cancer prevention vaccines, and participants’ stories using a community-based participatory research approach. Forty Vietnamese American women were recruited from the Portland, Oregon metropolitan area into four focus groups. Using a process of directed content analysis, focus group transcripts were coded for themes. We found that cervical cancer continues to be a difficult topic to discuss, and Vietnamese American women may not bring the topic up themselves to their health care providers. Some women experienced intense emotions of fear or shame of having their cervix examined. Women delayed seeking cervical cancer screening and needed to have early warning signs, which guided them as to when to seek health care. Women focused on cleanliness through vaginal and/or perineal washing as primary prevention for cervical cancer. There were limited awareness and knowledge about cancer prevention vaccines, specifically the human papillomavirus. Some women relied heavily on their informal social networks of family, friends, or community for health knowledge. Fear and misunderstanding dominated the beliefs of Vietnamese American women about cervical cancer screening and prevention. These findings underscored the importance of having culturally-specific findings, which will inform a multicomponent intervention to promote cervical cancer screening and cancer prevention vaccine uptake within this population.

Assessment of dose in cervical vertebrae radiographic examinations

International Nuclear Information System (INIS)

Owrnasir, Wafa Fadol Orsud

2014-12-01

Reference dose levels provide a framework to reduce doses variability and aid in the optimization of radiation protection.This study was performed in Khartoum Teaching Hospital in period of January to June 2014. This study performed to assess the entrance surface dose ( ESD) received in Cervical Vertebrae radiographic examination and to analyze effective dose distributions among radiological departments under study. The study was performed in Khartoum Teaching Hospital, covering two x-ray units and a sample of 64 patients. The following parameter were recorded; age, weight, height, body mass index (BMI) derived from weight (kg) and height (m) and exposure factors. The dose was measured for Cervical Vertebrae x-ray examinations, the entrance surface dose (ESD) values were estimated from the x-ray tube output parameters for Cervical Vertebrae AP and lateral examinations. The ESD values were then calculated using IAEA calculation methods. The results of ESD values calculated showed than patient exposure were within the normal range of exposure. The mean ED values calculated were ( 3.85 ±0.04) and (4.02 ±0.05) mGy for Cervical Vertebrae AP and lateral examinations, respectively in department Na1 and (3.99± 0.15) and (4.23± 0.34) mGy, for Cervical Vertebrae Ap and lateral examinations respectively in department Na2, the IAEA standard value of ESD for cervical equal (7), (20) mGy AP and LAT, Further studies are recommended with more number of patients and using more than two modalities for comparison. (Author)

Effect of Cervical Lessions on the Tooth FEM Study

OpenAIRE

Gabriela Bereşescu; Ligia Brezeanu; Claudia Şoaita

2010-01-01

The approach used until recently concerning the phenomena of dental abfraction points to the conclusion that the cervical area of the tooth, were this type of lesion usually occur, concentrates the stress resulted from the action of the forces applied on various areas on the crown. Moreover, any lesion in the cervical area facilitates the possibility of its advance into the tooth, ultimately fracturing it. Our paper presents a FEM (finite element method) study on the results of a mechanical a...

Biomechanical analysis of the camelid cervical intervertebral disc

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Dean K. Stolworthy

2015-01-01

Full Text Available Chronic low back pain (LBP is a prevalent global problem, which is often correlated with degenerative disc disease. The development and use of good, relevant animal models of the spine may improve treatment options for this condition. While no animal model is capable of reproducing the exact biology, anatomy, and biomechanics of the human spine, the quality of a particular animal model increases with the number of shared characteristics that are relevant to the human condition. The purpose of this study was to investigate the camelid (specifically, alpaca and llama cervical spine as a model of the human lumbar spine. Cervical spines were obtained from four alpacas and four llamas and individual segments were used for segmental flexibility/biomechanics and/or morphology/anatomy studies. Qualitative and quantitative data were compared for the alpaca and llama cervical spines, and human lumbar specimens in addition to other published large animal data. Results indicate that a camelid cervical intervertebral disc (IVD closely approximates the human lumbar disc with regard to size, spinal posture, and biomechanical flexibility. Specifically, compared with the human lumbar disc, the alpaca and llama cervical disc size are approximately 62%, 83%, and 75% with regard to area, depth, and width, respectively, and the disc flexibility is approximately 133%, 173%, and 254%, with regard to range of motion (ROM in axial-rotation, flexion-extension, and lateral-bending, respectively. These results, combined with the clinical report of disc degeneration in the llama lower cervical spine, suggest that the camelid cervical spine is potentially well suited for use as an animal model in biomechanical studies of the human lumbar spine.

Cervical necrosis after chemoradiation for cervical cancer: case series and literature review

International Nuclear Information System (INIS)

Fawaz, Ziad Simon; Barkati, Maroie; Beauchemin, Marie-Claude; Sauthier, Philippe; Gauthier, Philippe; Nguyen, Thu Van

2013-01-01

The aim of this study was to assess the management of cervical necrosis (CN) following radiotherapy (RT) and the impact of smoking status. This rare complication mimics a neoplastic recurrence, and causes concern among attending physicians. Between July 2008 and March 2013, 5 women on 285 with localized cervical cancer had a CN following RT. Patients were treated with concomitant chemoradiation. The medical records were reviewed to abstract demographic and clinical information until March 2013. 1.75% (95% confidence interval: 0.23 to 3.28%) developed CN. All patients were smokers with a mean of 19.5 pack-years (range: 7.5-45 pack-years). All patients were treated with weekly Cisplatin chemotherapy and external beam radiation to the pelvis, 45 Gy in 25 fractions. Four patients received an extra boost with a median dose of 7.2 Gy (range: 5.4-10 Gy). All patients had intracavitary brachytherapy (range: 27.9 to 30 Gy). Clinical presentation was similar for all the cases: vaginal discharge associated with pain. Mean time for time post-radiation therapy to necrosis was 9.3 months (range: 2.2-20.5 months). Standard workup was done to exclude cancer recurrence: biopsies and radiologic imaging. Conservative treatment was performed with excellent results. Resolution of the necrosis was complete after a few months (range: 1 to 4 months). Median follow-up until March 2013 was 19 months. All the patients were alive with no clinical evidence of disease. This study, the largest to date, shows that conservative management of CN after RT is effective, and should be attempted. This complication is more common in smokers, and counseling intervention should result in fewer complications of CN

Early detection of cervical cancer with visual inspection methods: a summary of completed and on-going studies in India

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Sankaranarayanan R

2003-01-01

Full Text Available India is a high-risk country for cervical cancer which accounts a quarter (126 000 new cases, 71 000 deaths around 2 000 of the world burden. The age-standardized incidence rates range from 16-55 per 100 000 women in different regions with particularly high rates in rural areas. Control of cervical cancer by early detection and treatment is a priority of the National Cancer Control Programme of India. There are no organized cytology screening programmes in the country. The technical and financial constraints to organize cytology screening have encouraged the evaluation of visual inspection approaches as potential alternatives to cervical cytology in India. Four types of visual detection approaches for cervical neoplasia are investigated in India: a naked eye inspection without acetic acid application, widely known as 'downstaging'; b naked eye inspection after application of 3-5% acetic acid (VIA; c VIA using magnification devices (VIAM; d visual inspection after the application of Lugol's iodine (VILI. Downstaging has been shown to be poorly sensitive and specific to detect cervical neoplasia and is no longer considered as a suitable screening test for cervical cancer. VIA, VIAM and VILI are currently being investigated in multicentre cross-sectional studies (without verification bias, in which cytology and HPV testing are also simultaneously evaluated, and the results of these investigations will be available in 2003. These studies will provide valuable information on the average, comparative test performances in detecting high-grade cervical cancer precursors and cancer. Results from pooled analysis of data from two completed studies indicated an approximate sensitivity of 93.4% and specificity of 85.1% for VIA to detect CIN 2 or worse lesions; the corresponding figures for cytology were 72.1% and 91.6%. The efficacy of VIA in reducing incidence of and mortality from cervical cancer and its cost-effectiveness is currently being investigated

Prospective, randomized multicenter study of cervical arthroplasty versus anterior cervical discectomy and fusion: 5-year results with a metal-on-metal artificial disc.

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Coric, Domagoj; Guyer, Richard D; Nunley, Pierce D; Musante, David; Carmody, Cameron; Gordon, Charles; Lauryssen, Carl; Boltes, Margaret O; Ohnmeiss, Donna D

2018-03-01

OBJECTIVE Seven cervical total disc replacement (TDR) devices have received FDA approval since 2006. These devices represent a heterogeneous assortment of implants made from various biomaterials with different biomechanical properties. The majority of these devices are composed of metallic endplates with a polymer core. In this prospective, randomized multicenter study, the authors evaluate the safety and efficacy of a metal-on-metal (MoM) TDR (Kineflex|C) versus anterior cervical discectomy and fusion (ACDF) in the treatment of single-level spondylosis with radiculopathy through a long-term (5-year) follow-up. METHODS An FDA-regulated investigational device exemption (IDE) pivotal trial was conducted at 21 centers across the United States. Standard validated outcome measures including the Neck Disability Index (NDI) and visual analog scale (VAS) for assessing pain were used. Patients were randomized to undergo TDR using the Kineflex|C cervical artificial disc or anterior cervical fusion using structural allograft and an anterior plate. Patients were evaluated preoperatively and at 6 weeks and 3, 6, 12, 24, 36, 48, and 60 months after surgery. Serum ion analysis was performed on a subset of patients randomized to receive the MoM TDR. RESULTS A total of 269 patients were enrolled and randomly assigned to undergo either TDR (136 patients) or ACDF (133 patients). There were no significant differences between the TDR and ACDF groups in terms of operative time, blood loss, or length of hospital stay. In both groups, the mean NDI scores improved significantly by 6 weeks after surgery and remained significantly improved throughout the 60-month follow-up (both p < 0.01). Similarly, VAS pain scores improved significantly by 6 weeks and remained significantly improved through the 60-month follow-up (both p < 0.01). There were no significant changes in outcomes between the 24- and 60-month follow-ups in either group. Range of motion in the TDR group decreased at 3 months but

Cervical chordoma: a case report

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Romera, C.; Wiehoff, A.; Candela, V. P.; Perera, J.

2002-01-01

Chordomas, lesions that develop from notochordal remnants, can arise at any site ranging from the clivus to the sacrum: they represent 3% to 4% of all primary bone tumors. We present the cases of a 45-year-old man with cervical chordoma at the C2 level, the site least frequently reported in the literature. We provide the radiological findings resulting from cervical computed tomography and magnetic resonance imaging. (Author) 11 refs

Concurrent validity and interrater reliability of a new smartphone application to assess 3D active cervical range of motion in patients with neck pain.

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Stenneberg, Martijn S; Busstra, Harm; Eskes, Michel; van Trijffel, Emiel; Cattrysse, Erik; Scholten-Peeters, Gwendolijne G M; de Bie, Rob A

2018-04-01

There is a lack of valid, reliable, and feasible instruments for measuring planar active cervical range of motion (aCROM) and associated 3D coupling motions in patients with neck pain. Smartphones have advanced sensors and appear to be suitable for these measurements. To estimate the concurrent validity and interrater reliability of a new iPhone application for assessing planar aCROM and associated 3D coupling motions in patients with neck pain, using an electromagnetic tracking device as a reference test. Cross-sectional study. Two samples of neck pain patients were recruited; 30 patients for the validity study and 26 patients for the reliability study. Validity was estimated using intraclass correlation coefficients (ICCs), and by calculating 95% limits of agreement (LoA). To estimate interrater reliability, ICCs were calculated. Cervical 3D coupling motions were analyzed by calculating the cross-correlation coefficients and ratio between the main motions and coupled motions for both instruments. ICCs for concurrent validity and interrater reliability ranged from 0.90 to 0.99. The width of the 95% LoA ranged from about 5° for right lateral bending to 11° for total rotation. No significant differences were found between both devices for associated coupling motion analysis. The iPhone application appears to be a useful discriminative tool for the measurement of planar aCROM and associated coupling motions in patients with neck pain. It fulfills the need for a valid, reliable, and feasible instrument in clinical practice and research. Therapists and researchers should consider measurement error when interpreting scores. Copyright © 2017 Elsevier Ltd. All rights reserved.

Study of discography (CTD) for the cervical disc disorders

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Tsuru, Takayuki; Maekawa, Kiyotsugu; Morita, Sunao; Mizuno, Hideo

1985-07-01

Twenty patients suffering from the cervical disc disorders were examined by CT scan after cervical discography. Cervical discs are situated in horizontal plane and contrast medium spreads in horizontal course. The horizontal analysis obtained by CT discography supplies several new findings useful to diagnosis and surgical treatment. Especially it can correct the false negative or the false positive findings of other radiological examinations.

Predictors of cervical lordosis loss after laminoplasty in patients with cervical spondylotic myelopathy.

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Zhang, Jing Tao; Li, Jia Qi; Niu, Rui Jie; Liu, Zhao; Tong, Tong; Shen, Yong

2017-04-01

To determine whether radiological, clinical, and demographic findings in patients with cervical spondylotic myelopathy (CSM) were independently associated with loss of cervical lordosis (LCL) after laminoplasty. The prospective study included 41 consecutive patients who underwent laminoplasty for CSM. The difference in C2-7 Cobb angle between the postoperative and preoperative films was used to evaluate change in cervical alignment. Age, sex, body mass index (BMI), smoking history, preoperative C2-7 Cobb angle, T1 slope, C2-7 range of motion (C2-7 ROM), C2-7 sagittal vertical axis (C2-7 SVA), and cephalad vertebral level undergoing laminoplasty (CVLL) were assessed. Data were analyzed using Pearson and Spearman correlation test, and univariate and stepwise multivariate linear regression. T1 slope, C2-7 SVA, and CVLL significantly correlated with LCL (P < 0.001), whereas age, BMI, and preoperative C2-7 Cobb angle did not. In multiple linear regression analysis, higher T1 slope (B = 0.351, P = 0.037), greater C2-7 SVA (B = 0.393, P < 0.001), and starting laminoplasty at C4 level (B = - 7.038, P < 0.001) were significantly associated with higher postoperative LCL. Cervical alignment was compromised after laminoplasty in patients with CSM, and the degree of LCL was associated with preoperative T1 slope, C2-7 SVA, and CVLL.

Lack of Significant Effects of Chlamydia trachomatis Infection on Cervical Adenocarcinoma Risk: Nested Case-Control Study.

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Vitaly Smelov

Full Text Available A role of Chlamydia trachomatis in HPV-induced cervical carcinogenesis has been reported for cervical cancer but studies on cervical adenocarcinoma are limited.A total of 1,553 cervical smears taken up to 26 years before diagnosis in a large population-based nested case-control study of cervical adenocarcinoma (AC, 132 cases with matched controls, and adenocarcinoma in situ (AIS, 159 cases with matched controls were tested for C. trachomatis and HPV DNA by a type-specific PCR bead-based multiplex genotyping (TS-MPG assay.Only 1.7% of samples were positive for C. trachomatis, with no significant differences between AC/AIS cases and controls. HPV-positivity was detected in 49.3% of C. trachomatis-negative and 65.4% C. trachomatis-positive samples, respectively.A large prospective study did not find any risk for cervical adenocarcinoma and/or AIS conferred by C. trachomatis infection.C. trachomatis appears not to be involved in cervical adenocarcinomas.

Cervical disc hernia operations through posterior laminoforaminotomy

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Coskun Yolas

2016-01-01

Full Text Available Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. Results: The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years. Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%. On control examinations, there was no finding of instability or cervical kyphosis. Conclusion: Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis.

[Analysis of the results of total cervical disc arthroplasty using a M6-C prosthesis: a multicenter study].

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Byval'tsev, V A; Kalinin, A A; Stepanov, I A; Pestryakov, Yu Ya; Shepelev, V V

Cervical spondylosis and intervertebral disc (IVD) degeneration are the most common cause for compression of the spinal cord and/or its roots. Total IVD arthroplasty, as a modern alternative to surgical treatment of IVD degeneration, is gaining popularity in many neurosurgical clinics around the world. Aim - the study aim was to conduct a multicenter analysis of cervical spine arthroplasty with an IVD prosthesis M6-C ('Spinal Kinetics', USA). The study included 112 patients (77 males and 35 females). All patients underwent single-level discectomy with implantation of the artificial IVD prosthesis M6-C. The follow-up period was up to 36 months. Dynamic assessment of the prosthesis was based on clinical parameters (pain intensity in the cervical spine and upper extremities (visual analog scale - VAS); quality of life (Neck Disability Index - NDI)); and subjective satisfaction with the results of surgical treatment (Macnab scale) and instrumental data (range of motion in the operated spinal motion segment, degree of heterotopic ossification (McAfee-Suchomel classification), and time course of degenerative changes in the adjacent segments).

Correlation Between Dental and Cervical Vertebral Maturation in Iranian Females

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Valizadeh, Solmaz; Eil, Nakissa; Ehsani, Sara; Bakhshandeh, Hooman

2012-01-01

Background Considerable variations in the development stage among patients of the same chronological age have led to introduce the concept of the developmental age based on the maturation of different organs such as cervical vertebrae or teeth. Objectives The purpose of this study was to investigate the correlation between the stages of tooth calcification and the cervical vertebral maturation in Iranian females. Patients and Methods Four hundred females (age range, 8 to 14 years) participate...

Increased risk of ischemic stroke in cervical cancer patients: a nationwide population-based study

International Nuclear Information System (INIS)

Tsai, Shiang-Jiun; Su, Yu-Chieh; Hung, Shih-Kai; Huang, Yung-Sung; Tung, Chien-Hsueh; Lee, Ching-Chih; Lee, Moon-Sing; Chiou, Wen-Yen; Lin, Hon-Yi; Hsu, Feng-Chun; Tsai, Chih-Hsin

2013-01-01

Increased risk of ischemic stroke has been validated for several cancers, but limited study evaluated this risk in cervical cancer patients. Our study aimed to evaluate the risk of ischemic stroke in cervical cancer patients. The study analyzed data from the 2003 to 2008 National Health Insurance Research Database (NHIRD) provided by the National Health Research Institutes in Taiwan. Totally, 893 cervical cancer patients after radiotherapy and 1786 appendectomy patients were eligible. The Kaplan-Meier method and the Cox proportional hazards model were used to assess the risk of ischemic stroke. The 5-year cumulative risk of ischemic stroke was significantly higher for the cervical cancer group than for the control group (7.8% vs 5.1%; p <0.005). The risk of stroke was higher in younger (age <51 years) than in older (age ≥51 years) cervical cancer patients (HR = 2.73, p = 0.04; HR = 1.37, p = 0.07) and in patients with more than two comorbid risk factors (5 years cumulative stroke rate of two comorbidities: 15% compared to no comorbidities: 4%). These study demonstrated cervical cancer patients had a higher risk of ischemic stroke than the general population, especially in younger patients. Strategies to reduce this risk should be assessed

Short-term changes in neck pain, widespread pressure pain sensitivity, and cervical range of motion after the application of trigger point dry needling in patients with acute mechanical neck pain: a randomized clinical trial.

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Mejuto-Vázquez, María J; Salom-Moreno, Jaime; Ortega-Santiago, Ricardo; Truyols-Domínguez, Sebastián; Fernández-de-Las-Peñas, César

2014-04-01

Randomized clinical trial. To determine the effects of trigger point dry needling (TrPDN) on neck pain, widespread pressure pain sensitivity, and cervical range of motion in patients with acute mechanical neck pain and active trigger points in the upper trapezius muscle. TrPDN seems to be effective for decreasing pain in individuals with upper-quadrant pain syndromes. Potential effects of TrPDN for decreasing pain and sensitization in individuals with acute mechanical neck pain are needed. Methods Seventeen patients (53% female) were randomly assigned to 1 of 2 groups: a single session of TrPDN or no intervention (waiting list). Pressure pain thresholds over the C5-6 zygapophyseal joint, second metacarpal, and tibialis anterior muscle; neck pain intensity; and cervical spine range-of-motion data were collected at baseline (pretreatment) and 10 minutes and 1 week after the intervention by an assessor blinded to the treatment allocation of the patient. Mixed-model analyses of variance were used to examine the effects of treatment on each outcome variable. Patients treated with 1 session of TrPDN experienced greater decreases in neck pain, greater increases in pressure pain threshold, and higher increases in cervical range of motion than those who did not receive an intervention at both 10 minutes and 1 week after the intervention (Ppain intensity and widespread pressure pain sensitivity, and also increase active cervical range of motion, in patients with acute mechanical neck pain. Changes in pain, pressure pain threshold, and cervical range of motion surpassed their respective minimal detectable change values, supporting clinically relevant treatment effects. Level of Evidence Therapy, level 1b-.

Cervical cancer treatment costs and cost-effectiveness analysis of human papillomavirus vaccination in Vietnam: a PRIME modeling study.

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Van Minh, Hoang; My, Nguyen Thi Tuyet; Jit, Mark

2017-05-15

Cervical cancer is currently the leading cause of cancer mortality among women in South Vietnam and the second leading cause of cancer mortality in North Vietnam. Human papillomavirus (HPV) vaccination has the potential to substantially decrease this burden. The World Health Organization (WHO) recommends that a cost-effectiveness analysis of HPV vaccination is conducted before nationwide introduction. The Papillomavirus Rapid Interface for Modeling and Economics (PRIME) model was used to evaluate the cost-effectiveness of HPV vaccine introduction. A costing study based on expert panel discussions, interviews and hospital case note reviews was conducted to explore the cost of cervical cancer care. The cost of cervical cancer treatment ranged from US$368 - 11400 depending on the type of hospital and treatment involved. Under Gavi-negotiated prices of US$4.55, HPV vaccination is likely to be very cost-effective with an incremental cost per disability-adjusted life year (DALY) averted in the range US$780 - 1120. However, under list prices for Cervarix and Gardasil in Vietnam, the incremental cost per DALY averted for HPV vaccination can exceed US$8000. HPV vaccine introduction appears to be economically attractive only if Vietnam is able to procure the vaccine at Gavi prices. This highlights the importance of initiating a nationwide vaccination programme while such prices are still available.

Correlation between TMD and Cervical Spine Pain and Mobility: Is the Whole Body Balance TMJ Related?

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Walczyńska-Dragon, Karolina; Baron, Stefan; Nitecka-Buchta, Aleksandra; Tkacz, Ewaryst

2014-01-01

Temporomandibular dysfunction (TMD) is considered to be associated with imbalance of the whole body. This study aimed to evaluate the influence of TMD therapy on cervical spine range of movement (ROM) and reduction of spinal pain. The study group consisted of 60 patients with TMD, cervical spine pain, and limited cervical spine range of movements. Subjects were interviewed by a questionnaire about symptoms of TMD and neck pain and had also masticatory motor system physically examined (according to RDC-TMD) and analysed by JMA ultrasound device. The cervical spine motion was analysed using an MCS device. Subjects were randomly admitted to two groups, treated and control. Patients from the treated group were treated with an occlusal splint. Patients from control group were ordered to self-control parafunctional habits. Subsequent examinations were planned in both groups 3 weeks and 3 months after treatment was introduced. The results of tests performed 3 months after the beginning of occlusal splint therapy showed a significant improvement in TMJ function (P > 0.05), cervical spine ROM, and a reduction of spinal pain. The conclusion is that there is a significant association between TMD treatment and reduction of cervical spine pain, as far as improvement of cervical spine mobility. PMID:25050363

Correlation between TMD and Cervical Spine Pain and Mobility: Is the Whole Body Balance TMJ Related?

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Karolina Walczyńska-Dragon

2014-01-01

Full Text Available Temporomandibular dysfunction (TMD is considered to be associated with imbalance of the whole body. This study aimed to evaluate the influence of TMD therapy on cervical spine range of movement (ROM and reduction of spinal pain. The study group consisted of 60 patients with TMD, cervical spine pain, and limited cervical spine range of movements. Subjects were interviewed by a questionnaire about symptoms of TMD and neck pain and had also masticatory motor system physically examined (according to RDC-TMD and analysed by JMA ultrasound device. The cervical spine motion was analysed using an MCS device. Subjects were randomly admitted to two groups, treated and control. Patients from the treated group were treated with an occlusal splint. Patients from control group were ordered to self-control parafunctional habits. Subsequent examinations were planned in both groups 3 weeks and 3 months after treatment was introduced. The results of tests performed 3 months after the beginning of occlusal splint therapy showed a significant improvement in TMJ function (P>0.05, cervical spine ROM, and a reduction of spinal pain. The conclusion is that there is a significant association between TMD treatment and reduction of cervical spine pain, as far as improvement of cervical spine mobility.

Compressive myelopathy of the cervical spine in Komodo dragons (Varanus komodoensis).

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Zimmerman, Dawn M; Douglass, Michael; Sutherland-Smith, Meg; Aguilar, Roberto; Schaftenaar, Willem; Shores, Andy

2009-03-01

Cervical subluxation and compressive myelopathy appears to be a cause of morbidity and mortality in captive Komodo dragons (Varanus komodoensis). Four cases of cervical subluxation resulting in nerve root compression or spinal cord compression were identified. Three were presumptively induced by trauma, and one had an unknown inciting cause. Two dragons exhibited signs of chronic instability. Cervical vertebrae affected included C1-C4. Clinical signs on presentation included ataxia, ambulatory paraparesis or tetraparesis to tetraplegia, depression to stupor, cervical scoliosis, and anorexia. Antemortem diagnosis of compression was only confirmed with magnetic resonance imaging or computed tomography. Treatment ranged from supportive care to attempted surgical decompression. All dragons died or were euthanatized, at 4 days to 12 mo postpresentation. Studies to define normal vertebral anatomy in the species are necessary to determine whether the pathology is linked to cervical malformation, resulting in ligament laxity, subsequent instability, and subluxation.

MRI of cervical spine injuries complicating ankylosing spondylitis

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Koivikko, Mika P.; Koskinen, Seppo K. [Helsinki Medical Imaging Center, Helsinki University Central Hospital, Toeoeloe Hospital, Department of Radiology, Helsinki (Finland)

2008-09-15

The objective was to study characteristic MRI findings in cervical spine fractures complicating ankylosing spondylitis (AS). Technical issues related to MRI are also addressed. A review of 6,774 consecutive cervical spine multidetector CT (MDCT) scans obtained during 6.2 years revealed 33 ankylosed spines studied for suspected acute cervical spine injury complicating AS. Of these, 20 patients also underwent MRI. On MRI, of these 20 patients, 19 had a total of 29 cervical and upper thoracic spine fractures. Of 20 transverse fractures traversing both anterior and posterior columns, 7 were transdiskal and exhibited less bone marrow edema than did those traversing vertebral bodies. One Jefferson's, 1 atlas posterior arch (Jefferson's on MDCT), 2 odontoid process, and 5 non-contiguous spinous process fractures were detectable. MRI showed 2 fractures that were undetected by MDCT, and conversely, MDCT detected 6 fractures not seen on MRI; 16 patients had spinal cord findings ranging from impingement and contusion to complete transection. Magnetic resonance imaging can visualize unstable fractures of the cervical and upper thoracic spine. Paravertebral hemorrhages and any ligamentous injuries should alert radiologists to seek transverse fractures. Multiple fractures are common and often complicated by spinal cord injuries. Diagnostic images can be obtained with a flexible multipurpose coil if the use of standard spine array coil is impossible due to a rigid collar or excessive kyphosis. (orig.)

Orofacial pain of cervical origin: A case report.

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Ganesh, G Shankar; Sahu, Mamata Manjari; Tigga, Pramod

2018-04-01

The etiopathogenesis of orofacial pain remains complex and a number of pain referral patterns for this region have been reported in the literature. The purpose of this report is to describe the assessment and successful clinical management of orofacial pain possibly attributable to cervical origin. A 55-year-old male teacher with a 3-year history of pain in the right lower jaw, radiating to the ear, consulted our institute for assessment and management. The patient was unsuccessfully treated for dental pain and trigeminal neuralgia. The patient's functioning was grossly limited and the patient was unable to sleep because of severe pain. Current and previous medical and physical examinations revealed no infection, malignancies, or sinusitis. Palpation revealed no temporomandibular disorder, tenderness or myofascial trigger points. Examination of the cervical range of motion showed a reduction in rotation to the right side. The patient was treated for upper cervical joint dysfunction involving mobilization of the first three cervical vertebrae and motor control exercises. The patient had an almost complete resolution of symptoms and reported significant improvement in the Patient Specific Functional Scale (PSFS) and the Global Rating of Change (GRC) scale. This case study demonstrates the importance of considering, assessing and treating the cervical spine as a possible source of orofacial pain, and the positive role of cervical mobilization on these disorders. Copyright © 2017 Elsevier Ltd. All rights reserved.

Human papillomavirus infection among Bangladeshi women with cervical intraepithelial neoplasia and chronic cervicitis

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Elisha Khandker

2016-01-01

Full Text Available Background and objectives: Cervical cancer is one of the leading causes of morbidity and mortality. Human papillomavirus (HPV is known to be associated with cervical intraepithelial neoplasia (CIN and cancer. The objective of the present study was to determine the rate of HPV infection among the Bangladeshi women with different grades of CIN and cancer. Methods: Women aged 20 to 55 years, diagnosed as a case of chronic cervicits, cervical intraepithelial neoplasia (CIN or invasive cancer by Papanicolaou (Pap smear and colposcopy directed biopsy were enrolled in the study. High and intermediate risk oncogenic HPV were detected in cervical samples by real time PCR (rt-PCR. Results: Seventy two women with chronic cervicitis and different grades of CIN were included in the study. Out of 72 cases, 28 (38.9% and 44 (61.1% had chronic cervicitis and CIN respectively. Overall, the HPV infection rate was 43.1% (95% CI= 32%-54% among the study population. CIN cases had significantly high (p<0.01 HPV infection (78.6%; 95% CI=60%-89% compared to cases with chronic cervicitis (18.2%; 95% CI=11.1%-34.5%. Women between the age of 20-30 years had the highest positive rate (50.0% followed by 31-40 years age group (43.6%. All CIN grade 2 and 3 had HPV infection. Conclusion: The study showed that HPV was strongly associated with different grades of CIN. Specific HPV types should be determined to find out the most prevalent HPV types among the Bangladeshi women with CIN and cervical cancers. IMC J Med Sci 2016; 10(1: 29-32

Effect of anterior cervical osteophyte in poststroke dysphagia: a case-control study.

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Kim, Youngkook; Park, Geun-Young; Seo, Yu Jung; Im, Sun

2015-07-01

To investigate whether the concomitant presence of anterior cervical osteophytes can influence the severity and outcome of patients with poststroke dysphagia. Retrospective case-control study. Hospital. A total of 40 participants were identified (N=40). Patients with poststroke dysphagia with anterior cervical osteophytes (n=20) were identified and matched by age, sex, location, and laterality of the stroke lesion to a poststroke dysphagia control group with no anterior cervical osteophytes (n=20). Not applicable. Videofluoroscopic swallowing study, Functional Oral Intake Scale (FOIS), and Penetration-Aspiration Scale results assessed within the first month of stroke were analyzed. The FOIS at 6 months was recorded, and severity of dysphagia was compared between the 2 groups. The case group had larger degrees of postswallow residues in the valleculae and pyriform sinuses (P=.020 and Pdysphagia (OR=15.375; 95% CI, 3.195-infinity). The presence of anterior cervical osteophytes, which may cause mechanical obstruction and interfere with residue clearance at the valleculae and pyriform sinuses and result in more postswallow aspiration, may influence initial severity and outcome of poststroke dysphagia. The presence of anterior cervical osteophytes may be considered an important clinical condition that may affect poststroke dysphagia rehabilitation. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The reliability and validity of cervical auscultation in the diagnosis of dysphagia: a systematic review.

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Lagarde, Marloes L J; Kamalski, Digna M A; van den Engel-Hoek, Lenie

2016-02-01

To systematically review the available evidence for the reliability and validity of cervical auscultation in diagnosing the several aspects of dysphagia in adults and children suffering from dysphagia. Medline (PubMed), Embase and the Cochrane Library databases. The systematic review was carried out applying the steps of the PRISMA-statement. The methodological quality of the included studies were evaluated using the Dutch 'Cochrane checklist for diagnostic accuracy studies'. A total of 90 articles were identified through the search strategy, and after applying the inclusion and exclusion criteria, six articles were included in this review. In the six studies, 197 patients were assessed with cervical auscultation. Two of the six articles were considered to be of 'good' quality and three studies were of 'moderate' quality. One article was excluded because of a 'poor' methodological quality. Sensitivity ranges from 23%-94% and specificity ranges from 50%-74%. Inter-rater reliability was 'poor' or 'fair' in all studies. The intra-rater reliability shows a wide variance among speech language therapists. In this systematic review, conflicting evidence is found for the validity of cervical auscultation. The reliability of cervical auscultation is insufficient when used as a stand-alone tool in the diagnosis of dysphagia in adults. There is no available evidence for the validity and reliability of cervical auscultation in children. Cervical auscultation should not be used as a stand-alone instrument to diagnose dysphagia. © The Author(s) 2015.

Cervical spine in patients with diastrophic dysplasia - radiographic findings in 122 patients

International Nuclear Information System (INIS)

Remes, Ville M.; Helenius, Ilkka J.; Peltonen, Jari I.; Marttinen, Eino J.; Poussa, Mikko S.

2002-01-01

Heading AbstractBackground. In previous studies, typical radiological findings in the cervical spine of patients with diastrophic dysplasia (DD) have been kyphosis, displacement of the vertebrae, spina bifida occulta (SBO), anterior hypoplasia of vertebrae C3-5, and hyperplasia and dysmorphism of the odontoid process.Objectives. To make a radiological analysis of the cervical spine in patients with DD.Materials and methods. The study comprised 122 patients (50 males, 72 females), with an average age of 19 years (range newborn-63 years). Follow-up was available on 62 patients (51%), for an average duration of 11 years. Cervical spine alignment was measured according to Cobb's method. The height (H) and depth (D) of the vertebral body and sagittal diameter (S) of the spinal canal were measured. H/D and S/D ratios were then calculated from the measurements. The shape of the vertebrae was assessed. Displacement and movement of cervical vertebrae in neutral and bending radiographs were measured.Results. The average lordosis in the last radiograph was 17 (range 4 -55 ). Five (4%) patients had a cervical kyphosis with an average of 92 (range 10-165 ) on their last radiograph. The H/D ratio increased slowly during growth and showed significant correlation with age. There was no growth spurt at puberty. The S/D ratio was fairly stable until 7-8 years of age, when it started to decline slowly. The percentage of vertebrae with a flat vertebral body and narrow spinal canal value tended to increase with age. Vertebral hypoplasia and displacement between vertebrae were most common in the mid-cervical region and resolved spontaneously with age. Degenerative changes seemed to increase with age and were already visible during the second decade of life. SBO was noted in 79% of patients.Conclusions. The most common alignment in the cervical spine is lordosis in adulthood. The vertebral bodies are flattened and the spinal canal is narrowed. Vertebral body hypoplasia and displacement

Cervical spine in patients with diastrophic dysplasia - radiographic findings in 122 patients

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Remes, Ville M; Helenius, Ilkka J; Peltonen, Jari I [Hospital for Children and Adolescents, Helsinki University Central Hospital, P.O. Box 281, 00029 HUS (Finland); Marttinen, Eino J [Helsinki University Central Hospital (Finland); Poussa, Mikko S [Orton Orthopaedic Hospital, Helsinki (Finland)

2002-09-01

Heading AbstractBackground. In previous studies, typical radiological findings in the cervical spine of patients with diastrophic dysplasia (DD) have been kyphosis, displacement of the vertebrae, spina bifida occulta (SBO), anterior hypoplasia of vertebrae C3-5, and hyperplasia and dysmorphism of the odontoid process.Objectives. To make a radiological analysis of the cervical spine in patients with DD.Materials and methods. The study comprised 122 patients (50 males, 72 females), with an average age of 19 years (range newborn-63 years). Follow-up was available on 62 patients (51%), for an average duration of 11 years. Cervical spine alignment was measured according to Cobb's method. The height (H) and depth (D) of the vertebral body and sagittal diameter (S) of the spinal canal were measured. H/D and S/D ratios were then calculated from the measurements. The shape of the vertebrae was assessed. Displacement and movement of cervical vertebrae in neutral and bending radiographs were measured.Results. The average lordosis in the last radiograph was 17 (range 4 -55 ). Five (4%) patients had a cervical kyphosis with an average of 92 (range 10-165 ) on their last radiograph. The H/D ratio increased slowly during growth and showed significant correlation with age. There was no growth spurt at puberty. The S/D ratio was fairly stable until 7-8 years of age, when it started to decline slowly. The percentage of vertebrae with a flat vertebral body and narrow spinal canal value tended to increase with age. Vertebral hypoplasia and displacement between vertebrae were most common in the mid-cervical region and resolved spontaneously with age. Degenerative changes seemed to increase with age and were already visible during the second decade of life. SBO was noted in 79% of patients.Conclusions. The most common alignment in the cervical spine is lordosis in adulthood. The vertebral bodies are flattened and the spinal canal is narrowed. Vertebral body hypoplasia and displacement

Cervical spine in patients with diastrophic dysplasia - radiographic findings in 122 patients

Energy Technology Data Exchange (ETDEWEB)

Remes, Ville M.; Helenius, Ilkka J.; Peltonen, Jari I. [Hospital for Children and Adolescents, Helsinki University Central Hospital, P.O. Box 281, 00029 HUS (Finland); Marttinen, Eino J. [Helsinki University Central Hospital (Finland); Poussa, Mikko S. [Orton Orthopaedic Hospital, Helsinki (Finland)

2002-09-01

Heading AbstractBackground. In previous studies, typical radiological findings in the cervical spine of patients with diastrophic dysplasia (DD) have been kyphosis, displacement of the vertebrae, spina bifida occulta (SBO), anterior hypoplasia of vertebrae C3-5, and hyperplasia and dysmorphism of the odontoid process.Objectives. To make a radiological analysis of the cervical spine in patients with DD.Materials and methods. The study comprised 122 patients (50 males, 72 females), with an average age of 19 years (range newborn-63 years). Follow-up was available on 62 patients (51%), for an average duration of 11 years. Cervical spine alignment was measured according to Cobb's method. The height (H) and depth (D) of the vertebral body and sagittal diameter (S) of the spinal canal were measured. H/D and S/D ratios were then calculated from the measurements. The shape of the vertebrae was assessed. Displacement and movement of cervical vertebrae in neutral and bending radiographs were measured.Results. The average lordosis in the last radiograph was 17 (range 4 -55 ). Five (4%) patients had a cervical kyphosis with an average of 92 (range 10-165 ) on their last radiograph. The H/D ratio increased slowly during growth and showed significant correlation with age. There was no growth spurt at puberty. The S/D ratio was fairly stable until 7-8 years of age, when it started to decline slowly. The percentage of vertebrae with a flat vertebral body and narrow spinal canal value tended to increase with age. Vertebral hypoplasia and displacement between vertebrae were most common in the mid-cervical region and resolved spontaneously with age. Degenerative changes seemed to increase with age and were already visible during the second decade of life. SBO was noted in 79% of patients.Conclusions. The most common alignment in the cervical spine is lordosis in adulthood. The vertebral bodies are flattened and the spinal canal is narrowed. Vertebral body hypoplasia and

Anterior cervical decompression and fusion with caspar plate fixation

International Nuclear Information System (INIS)

Rehman, L.; Akbar, H.; Das, G.; Hashim, A.S.M.

2013-01-01

Objective: To evaluate the role of anterior cervical decompression and fixation with Caspar plating in cervical spine injury on neurological outcome. Study Design: A case series. Place and Duration of Study: Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, from July 2008 to March 2011. Methodology: Thirty patients admitted with cervical spine injuries were inducted in the study. All cases were evaluated for their clinical features, level of injury and degree of neurological injury was assessed using Frankel grading. Pre and postoperative record with X-rays and MRI were maintained. Cervical traction was applied to patients with sub-luxation. All patients underwent anterior cervical decompression, fusion and Caspar plate fixation. The follow-up period was 6 months with clinical and radiological assessment. Results: Among 30 patients, 24 (80%) were males and 6 (20%) were females. Age ranged from 15 to 55 years. Causes of injury were road traffic accident (n = 20), fall (n = 8) and assault (n = 2). Commonest mode of injury was road traffic accident (66.6%). Postoperative follow-up showed that pain and neurological deficit were improved in 21 patients. There was no improvement in 7 patients, one patient deteriorated and one expired. All patients developed pain at donor site. Conclusion: Anterior decompression, fusion and fixation with Caspar plate is an effective method with good neurological and radiological outcome. However, it is associated with pain at donor site. (author)

Cervical Cap

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... Videos for Educators Search English Español The Cervical Cap KidsHealth / For Teens / The Cervical Cap What's in ... Call the Doctor? Print What Is a Cervical Cap? A cervical cap is a small cup made ...

Systematic review of model-based cervical screening evaluations.

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Mendes, Diana; Bains, Iren; Vanni, Tazio; Jit, Mark

2015-05-01

Optimising population-based cervical screening policies is becoming more complex due to the expanding range of screening technologies available and the interplay with vaccine-induced changes in epidemiology. Mathematical models are increasingly being applied to assess the impact of cervical cancer screening strategies. We systematically reviewed MEDLINE®, Embase, Web of Science®, EconLit, Health Economic Evaluation Database, and The Cochrane Library databases in order to identify the mathematical models of human papillomavirus (HPV) infection and cervical cancer progression used to assess the effectiveness and/or cost-effectiveness of cervical cancer screening strategies. Key model features and conclusions relevant to decision-making were extracted. We found 153 articles meeting our eligibility criteria published up to May 2013. Most studies (72/153) evaluated the introduction of a new screening technology, with particular focus on the comparison of HPV DNA testing and cytology (n = 58). Twenty-eight in forty of these analyses supported HPV DNA primary screening implementation. A few studies analysed more recent technologies - rapid HPV DNA testing (n = 3), HPV DNA self-sampling (n = 4), and genotyping (n = 1) - and were also supportive of their introduction. However, no study was found on emerging molecular markers and their potential utility in future screening programmes. Most evaluations (113/153) were based on models simulating aggregate groups of women at risk of cervical cancer over time without accounting for HPV infection transmission. Calibration to country-specific outcome data is becoming more common, but has not yet become standard practice. Models of cervical screening are increasingly used, and allow extrapolation of trial data to project the population-level health and economic impact of different screening policy. However, post-vaccination analyses have rarely incorporated transmission dynamics. Model calibration to country

Cervical bracing practices after degenerative cervical surgery: a survey of cervical spine research society members.

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Lunardini, David J; Krag, Martin H; Mauser, Nathan S; Lee, Joon Y; Donaldson, William H; Kang, James D

2018-05-21

Context: Prior studies have shown common use of post-operative bracing, despite advances in modern day instrumentation rigidity and little evidence of brace effectiveness. To document current practice patterns of brace use after degenerative cervical spine surgeries among members of the Cervical Spine Research Society (CSRS), to evaluate trends, and to identify areas of further study. A questionnaire survey METHODS: A 10 question survey was sent to members of the Cervical Spine Research Society to document current routine bracing practices after various common degenerative cervical spine surgical scenarios, including fusion and non-fusion procedures. The overall bracing rate was 67%. This included 8.4% who used a hard collar in each scenario. Twenty-two percent of surgeons never used a hard collar, while 34% never used a soft collar, and 3.6% (3 respondents) did not use a brace in any surgical scenario. Bracing frequency for specific surgical scenarios varied from 39% after foraminotomy to 88% after multi-level corpectomy with anterior & posterior fixation. After one, two and three level anterior cervical discectomy & fusion (ACDF), bracing rates were 58%, 65% and 76% for an average of 3.3, 4.3 and 5.3 weeks, respectively. After single level corpectomy, 77% braced for an average of 6.2 weeks. After laminectomy and fusion, 72% braced for an average of 5.4 weeks. Significant variation persists among surgeons on the type and length of post-operative brace usage after cervical spine surgeries. Overall rates of bracing have not changed significantly with time. Given the lack evidence in the literature to support bracing, reconsidering use of a brace after certain surgeries may be warranted. Copyright © 2018. Published by Elsevier Inc.

Beliefs about the causes of cervical cancer in Botswana: implications for nursing.

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McFarland, D M

2009-12-01

Cervical cancer is the most common cause of cancer mortality and morbidity for women in Botswana. Yet, little is known about what women believe to be the causes of the disease. This paper presents data on factors women in Botswana believe are responsible for the high incidence of cervical cancer in their country. Data were part of a larger study that explored knowledge and perceptions about cervical cancer and Pap smear screening from the perspectives of the clients and the healthcare providers. The study that generated the data included 30 women of all socio-economic levels, recruited by network sampling. The women's ages ranged from 31 to 54 years. Demographic data were analysed descriptively. Individualized interview data were content-analysed. The identified causes of cervical cancer were classified as cervical irritants and non-irritants. The most commonly cited cervical irritants were vaginally inserted chemical agents and traditional medicine. Participants identified vaginally inserted chemical substances and traditional medicines as possible explanations for the high incidence of cervical cancer in Botswana. They reported that women used these substances for sexual and hygienic purposes. Although these factors are believed to be the causes of cervical cancer and have not yet been medically acknowledged, verbal reports suggest that their use is problematic. There is a need for health education and for further research to affirm women's beliefs about the harmful effects of intravaginal agents.

Cervical Vertigo: Historical Reviews and Advances.

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Peng, Baogan

2018-01-01

Vertigo is one of the most common presentations in adult patients. Among the various causes of vertigo, so-called cervical vertigo is still a controversial entity. Cervical vertigo was first thought to be due to abnormal input from cervical sympathetic nerves based on the work of Barré and Liéou in 1928. Later studies found that cerebral blood flow is not influenced by sympathetic stimulation. Ryan and Cope in 1955 proposed that abnormal sensory information from the damaged joint receptors of upper cervical regions may be related to pathologies of vertigo of cervical origin. Further studies found that cervical vertigo seems to originate from diseased cervical intervertebral discs. Recent research found that the ingrowth of a large number of Ruffini corpuscles into diseased cervical discs may be related to vertigo of cervical origin. Abnormal neck proprioceptive input integrated from the signals of Ruffini corpuscles in diseased cervical discs and muscle spindles in tense neck muscles secondary to neck pain is transmitted to the central nervous system and leads to a sensory mismatch with vestibular and other sensory information, resulting in a subjective feeling of vertigo and unsteadiness. Further studies are needed to illustrate the complex pathophysiologic mechanisms of cervical vertigo and to better understand and manage this perplexing entity. Copyright © 2017 Elsevier Inc. All rights reserved.

Study of cervical cord injury without radiological abnormality using MRI at injury

International Nuclear Information System (INIS)

Park, Jin-Soo; Ei, Terumi; Uchida, Yoko; Kodai, Yujiro; Yasumatsu, Hideo; Yoshino, Kazutaka; Hirakawa, Takashi.

1994-01-01

This study was undertaken, using MRI at the time of injury, to examine cervical cord injury without radiological abnormality. The subjects were 30 patients (24 men and 6 women) seen during the 4-year period 1989-1993, who ranged in age from 31 to 83 years (an average age of 62.8 years). Of these patients, 10 had a slightly irregular alignment of the vertebral body on plain X-rays. These 10 patients were examined using MRI early after sustaining trauma (within 24 hours in 9 and 48 hours in one). As a result, spinal cord was seen as isointensity on T1-weighted images and hyperintensity on T2-weighted images, corresponding to irregular alignment. These findings suggest that reduction of a dislocation may transiently occur due to patient transfer or natural elasticity, as plain X-rays indicated no evidence of bone abnormalities. Thus injuries like dislocations may have occurred at the time of trauma, and structural changes of the vertebral body may be responsible for the occurrence of cervical spinal cord. Spinal cord injuries, even if not evidenced on plain X-rays, should not be categorized as non-osseous injuries. (N.K.)

Three-dimensional computerized mobilization of the cervical spine for the treatment of chronic neck pain: a pilot study.

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River, Yaron; Aharony, Shelly; Bracha, Jillian; Levital, Tamir; Gerwin, Robert

2014-07-01

Manual therapies for chronic neck pain are imprecise, inconsistent, and brief due to therapist fatigue. A previous study showed that computerized mobilization of the cervical spine in the sagittal plane is a safe and potentially effective treatment of chronic neck pain. To investigate the safety and efficacy of computerized mobilization of the cervical spine in a three-dimensional space for the treatment of chronic neck pain. Pilot, open trial. Physical therapy outpatient department. Nine patients with chronic neck pain. A computerized cradle capable of three-dimensional neck mobilizations was used. Treatment sessions lasted 20 minutes, biweekly, for six weeks. Visual analog scale (VAS) for pain, cervical range of motion (CROM), neck disability index (NDI), joint position error (JPE), and muscle algometry. Comparing baseline at week one with week six (end of treatment), the VAS scores dropped by 2.9 points (P pain threshold in any muscle tested. There were no significant adverse effects. These preliminary results demonstrate that this novel, computerized, three-dimensional cervical mobilization device is probably safe. The data also suggest that this method is effective in alleviating neck pain and associated headache, and in increasing the CROM, although the sample size was small in this open trial. Wiley Periodicals, Inc.

Upper thoracic-spine disc degeneration in patients with cervical pain.

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Arana, Estanislao; Martí-Bonmatí, Luis; Mollá, Enrique; Costa, Salvador

2004-01-01

To study the relationship of upper thoracic spine degenerative disc contour changes on MR imaging in patients with neck pain. The relation between upper thoracic and cervical spine degenerative disc disease is not well established. One hundred and fifty-six patients referred with cervical pain were studied. There were 73 women and 77 men with a mean age of 48.6 +/- 14.6 years (range, 19 to 83 years). All MR studies were performed with a large 23-cm FOV covering at least from the body of T4 to the clivus. Discs were coded as normal, protrusion/bulge or extrusion. Degenerative thoracic disc contour changes were observed in 13.4% of patients with cervical pain. T2-3 was the most commonly affected level of the upper thoracic spine, with 15 bulge/protrusions and one extrusion. Upper degenerative thoracic disc contour changes presented in older patients than the cervical levels (Student-Newman-Keuls test, P < 0.001). Degenerative disc contour changes at the C7-T1, T1-2, T2-3 and T3-4 levels were significantly correlated ( P = 0.001), but unrelated to any other disc disease, patient's gender or age. Degenerative cervical disc disease was closely related together ( P < 0.001), but not with any thoracic disc. A statistically significant relation was found within the upper thoracic discs, reflecting common pathoanatomical changes. The absence of relation to cervical segments is probably due to differences in their pathomechanisms.

Upper thoracic-spine disc degeneration in patients with cervical pain

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Arana, Estanislao; Marti-Bonmati, Luis; Costa, Salvador [Department of Radiology, Clinica Quiron, Avda Blasco Ibanez 14, 46010, Valencia (Spain); Molla, Enrique [Department of Radiology, Clinica Quiron, Avda Blasco Ibanez 14, 46010, Valencia (Spain); Department of Morphological Sciences, University of Valencia, Valencia (Spain)

2004-01-01

To study the relationship of upper thoracic spine degenerative disc contour changes on MR imaging in patients with neck pain. The relation between upper thoracic and cervical spine degenerative disc disease is not well established. One hundred and fifty-six patients referred with cervical pain were studied. There were 73 women and 77 men with a mean age of 48.6{+-}14.6 years (range, 19 to 83 years). All MR studies were performed with a large 23-cm FOV covering at least from the body of T4 to the clivus. Discs were coded as normal, protrusion/bulge or extrusion. Degenerative thoracic disc contour changes were observed in 13.4% of patients with cervical pain. T2-3 was the most commonly affected level of the upper thoracic spine, with 15 bulge/protrusions and one extrusion. Upper degenerative thoracic disc contour changes presented in older patients than the cervical levels (Student-Newman-Keuls test, P<0.001). Degenerative disc contour changes at the C7-T1, T1-2, T2-3 and T3-4 levels were significantly correlated (P=0.001), but unrelated to any other disc disease, patient's gender or age. Degenerative cervical disc disease was closely related together (P<0.001), but not with any thoracic disc. A statistically significant relation was found within the upper thoracic discs, reflecting common pathoanatomical changes. The absence of relation to cervical segments is probably due to differences in their pathomechanisms. (orig.)

Upper thoracic-spine disc degeneration in patients with cervical pain

International Nuclear Information System (INIS)

Arana, Estanislao; Marti-Bonmati, Luis; Costa, Salvador; Molla, Enrique

2004-01-01

To study the relationship of upper thoracic spine degenerative disc contour changes on MR imaging in patients with neck pain. The relation between upper thoracic and cervical spine degenerative disc disease is not well established. One hundred and fifty-six patients referred with cervical pain were studied. There were 73 women and 77 men with a mean age of 48.6±14.6 years (range, 19 to 83 years). All MR studies were performed with a large 23-cm FOV covering at least from the body of T4 to the clivus. Discs were coded as normal, protrusion/bulge or extrusion. Degenerative thoracic disc contour changes were observed in 13.4% of patients with cervical pain. T2-3 was the most commonly affected level of the upper thoracic spine, with 15 bulge/protrusions and one extrusion. Upper degenerative thoracic disc contour changes presented in older patients than the cervical levels (Student-Newman-Keuls test, P<0.001). Degenerative disc contour changes at the C7-T1, T1-2, T2-3 and T3-4 levels were significantly correlated (P=0.001), but unrelated to any other disc disease, patient's gender or age. Degenerative cervical disc disease was closely related together (P<0.001), but not with any thoracic disc. A statistically significant relation was found within the upper thoracic discs, reflecting common pathoanatomical changes. The absence of relation to cervical segments is probably due to differences in their pathomechanisms. (orig.)

Knowledge and attitudes towards cervical cancer and human papillomavirus: a Nigerian pilot study.

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Nnodu, Obiageli; Erinosho, Layi; Jamda, Mustapha; Olaniyi, O; Adelaiye, Rabi; Lawson, Lovett; Odedina, Folakemi; Shuaibu, Fatima; Odumuh, Theresa; Isu, Nnenaya; Imam, Hauwa; Owolabi, Olumide; Yaqub, Nuhu; Zamani, Andrew

2010-03-01

This study aimed to ascertain the knowledge and attitudes of urban and rural dwellers to cervical cancer and HPV in Gwagwalada Area Council of Nigeria. 400 participants aged 15-45 years were selected from Gwagwalada town and the adjourning Giri village to respond to a multi-choice-free response questionnaire designed to obtain information on respondents' biodata, knowledge of STIs, human papilloma virus and cervical cancer, health and communication resources in their communities. This was supplemented by focus group discussions among religious and tribal groups within the urban and rural communities. We found a low level of awareness about HPV and cervical cancer which majority felt could not be prevented. Although awareness of STDs was high in both urban and rural dwellers, condom use was low. The study underscores the need for a well planned and implemented health communication and education program on STIs, HPV and cervical cancer in Nigeria.

Hydronephrosis in patients with cervical cancer: an assessment of morbidity and survival.

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Patel, Krishna; Foster, Nathan R; Kumar, Amanika; Grudem, Megan; Longenbach, Sherri; Bakkum-Gamez, Jamie; Haddock, Michael; Dowdy, Sean; Jatoi, Aminah

2015-05-01

Hydronephrosis is a frequently observed but understudied complication in patients with cervical cancer. To better characterize hydronephrosis in cervical cancer patients, the current study sought (1) to describe hydronephrosis-associated morbidity and (2) to analyze the prognostic effect of hydronephrosis in patients with a broad range of cancer stages over time. The Mayo Clinic Tumor Registry was interrogated for all invasive cervical cancer patients seen at the Mayo Clinic from 2008 through 2013 in Rochester, Minnesota; these patients' medical records were then reviewed in detail. Two hundred seventy-nine cervical cancer patients with a median age of 49 years and a range of cancer stages were included. Sixty-five patients (23 %) were diagnosed with hydronephrosis at some point during their disease course. In univariate analyses, hydronephrosis was associated with advanced cancer stage (p hydronephrosis. All but one patient underwent stent placement or urinary diversion; hydronephrosis-related morbidity included pain, urinary tract infections, nausea and vomiting, renal failure, and urinary tract bleeding. In landmark univariate survival analyses, hydronephrosis was associated with worse survival at all time points. In landmark multivariate analyses (adjusted for patient age, stage, cancer treatment, and tumor histology), hydronephrosis was associated with a trend toward worse survival over time (hazard ratios ranged from 1.47 to 4.69). Hydronephrosis in cervical cancer patients is associated with notable morbidity. It is also associated with trends toward worse survival-even if it occurs after the original cancer diagnosis.

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

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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

Carotid Artery Injury in Anterior Cervical Spine Surgery: Multicenter Cohort Study and Literature Review.

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Härtl, Roger; Alimi, Marjan; Abdelatif Boukebir, Mohamed; Berlin, Connor D; Navarro-Ramirez, Rodrigo; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel

2017-04-01

Retrospective study and literature review. To provide more comprehensive data about carotid artery injury (CAI) or cerebrovascular accident (CVA) related to anterior cervical spine surgery. We conducted a retrospective, multicenter, case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network. Medical records of 17 625 patients who went through cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, were analyzed. Also, we performed a literature review using Medline and PubMed databases. The following terms were used alone, and in combination, to search for relevant articles: cervical, spine, surgery, complication, iatrogenic, carotid artery, injury, cerebrovascular accident, CVA, and carotid stenosis. Among 17 625 patients that were analyzed, no cases were reported to experienced CAI or CVA after cervical spine surgery. Nevertheless, in our PubMed search we found 157 articles, but only 5 articles matched our study objective criteria; 2 cases were reported to present CAI and 3 cases presented CVA. CAI and CVA related to anterior cervical spine surgeries are extremely rare. We were not able to find neither in our retrospective study nor in our literature research a correlation between the type or length of anterior cervical spine procedure with CVA or CAI complications. However, surgeons should be aware of the possibility of vascular complications and minimize intraoperative direct vascular manipulations or retraction. Preoperative screening for underlying vascular pathology and risk factors is also important.

Percutaneous vertebroplasty for multiple myeloma of the cervical spine

International Nuclear Information System (INIS)

Mont'Alverne, Francisco; Vallee, Jean-Noel; Guillevin, Remy; Cormier, Evelyne; Jean, Betty; Rose, Michelle; Chiras, Jacques; Caldas, Jose Guilherme

2009-01-01

Spinal involvement is a common presentation of multiple myeloma (MM); however, the cervical spine is the least common site of myelomatous involvement. Few studies evaluate the results of percutaneous vertebroplasty (PV) in the treatment of MM of the spine. The purpose of this series is to report on the use of PV in the treatment of MM of the cervical spine and to review the literature. From January 1994 to October 2007, four patients (three men and one woman; mean age, 45 years) who underwent five PV for painful MM in the cervical spine were retrospectively reviewed. The pain was estimated by the patient on a verbal analogic scale. Clinical follow-up was available for all patients (mean, 27.5 months; range, 1-96 months). The mean volume of cement injected per vertebral body was 2.3 ± 0.8 mL (range, 1.0-4.0 mL) with a mean vertebral filling of 55.0 ± 12.0% (range, 40.0-75.0%). Analgesic efficacy was achieved in all patients. One patient had a spinal instability due to a progression of spinal deformity noted on follow-up radiographs, without clinical symptoms. Cement leakage was detected in three (60%) of the five treated vertebrae. There was no clinical complication. The present series suggests that PV for MM of the cervical spine is safe and effective for pain control; nonetheless, the detrimental impact of the disease on bone quality should prompt close radiological follow-up after PV owing to the risk of spinal instability. (orig.)

Cervical gland area as an ultrasound marker for prediction of preterm delivery: A cohort study

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Vajiheh Marsoosi

2017-11-01

Full Text Available Background: Preterm labor is a major cause of perinatal morbidity and mortality and it might be predicted by assessing the cervical change. Objective: To assess the association between absence of cervical gland area (CGA and spontaneous preterm labor (SPTL. Materials and Methods: This prospective cohort study was performed on 200 singleton pregnant women with a history of SPTL, second-trimester abortion in the previous pregnancy or lower abdominal pain in current pregnancy. Each patient underwent one transvaginal ultrasound examination between 14-28 wk of gestation. Cervical length was measured and CGA was identified and their relationship with SPTL before 35 and 37 wk gestation was evaluated using STATA software version 10. Results: The mean of cervical length was 36.5 mm (SD=8.4, the shortest measurement was 9 mm, and the longest one was 61 mm. Short cervical length (≤18mm was significantly associated with SPTL before 35 and 37 wk gestation. Cervical gland area (the hypoechogenic or echogenic area around the cervical canal was present in 189 (94.5% patients. Absent of CGA had a significant relationship with SPTL before 35 and 37 wk gestation (p=0.01 and p<0.001, respectively. Cervical length was shorter in women with absent CGA in comparison with subjects with present CGA: 37±10 mm in CGA present group and 23±9 mm in CGA absent group (p<0.001. Conclusion: Our study showed that cervical gland area might be an important predictor of SPTL which should be confirmed with further researches.

The prevalence cervical facet arthrosis: an osseous study in a cadveric population.

Science.gov (United States)

Lee, Michael J; Riew, K Daniel

2009-09-01

Cervical facet arthrosis has been implicated as a cause for neck pain, radiculopathy, occipital headache, and ear pain. The objective of this study was to examine the occurrence of facet arthrosis in the cervical spine. This study examined cadaveric specimens from the Hamann Todd Collection. None. None. Four hundred sixty-five skeletally mature human cervical spines from the Hamann Todd Collection in the Cleveland Museum of Natural History were obtained for analysis. We analyzed the facets for arthrosis. We graded no arthrosis as Grade 0. Facets with peripheral osteophytic reaction, but with no lateral mass distortion were graded as Grade 1. Facets with peripheral osteophytic reaction and lateral mass distortion were graded as Grade 2. Facets that were ankylosed were graded as Grade 3. Each specimen was examined bilaterally at levels from C2-C3 through C6-C7, yielding 4,650 specimen assessments. The data were analyzed to compare cervical levels, gender, facet side, age groups, and race. Proportion analysis, using the Fisher exact test, was used to assess for statistical difference between various groupings. In the entire population of 465 specimens, the upper cervical specimens appeared to be affected by facet arthrosis more frequently than the lower levels; 12.37% of the specimens had bony evidence of arthrosis at the C2-C3 level; 13.33% of the specimens had arthrosis occur at the C3-C4 level; 14.62% at the C4-C5 level; 7.85% at the C5-C6 level, and 4.84% at the C6-C7 level. The large majority of all cervical facet arthrosis was found to be Grade 1 at all levels. In the older population, the prevalence of facet arthrosis is as high as 29.87% for the C4-C5 level. C4-C5 level appears to be affected the most frequently, followed by the C3-C4 level, then C2-C3, C5-C6, and C6-C7. The prevalence of cervical facet arthrosis increases with age, and occurs more commonly in the upper cervical spine.

A comparison of concurrent chemoradiotherapy and radiotherapy in Chinese patients with locally advanced cervical carcinoma: a multi-center study

International Nuclear Information System (INIS)

Li, Zhijie; Yang, Shuyan; Liu, Lei; Han, Shiyu

2014-01-01

We investigated the efficacy of concurrent chemoradiotherapy (CCRT) over radiotherapy (RT) in Chinese patients with locally advanced cervical carcinoma. Between January 2005 and January 2008, 192 patients with squamous cell carcinoma of the cervix were included in the study: 96 in arm A (CCRT with 20 mg/m 2 cisplatin for 5 days) and 96 in arm B (RT). The overall response rate was the primary endpoint. The secondary endpoints included overall survival, progression-free survival, and toxicity. The 5-year overall response rate was 67% and 53% for the CCRT and RT arms, respectively, and the difference was statistically significant, while the median overall survival was 68 months (range 3-85 months) and 61 months (range 4-83 months), respectively (P = 0.009). In addition, the median progression-free survival for CCRT was 62 months (range 3-83 months), whereas it was 51 months (range 4-81 months) for the RT arm (P = 0.025). The toxicity profile, both acute and late, was comparable in both arms. In summary, we demonstrate that CCRT was effective and better tolerated than RT alone in Chinese patients with locally advanced cervical carcinoma.

Simulation tests for cervical nonorganic signs: a study of face validity.

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Vernon, Howard; Proctor, Dan; Bakalovski, Dianna; Moreton, Jesse

2010-01-01

The purpose of this study was to develop and determine the face validity of additional cervical nonorganic simulation tests. Four simulation tests were either selected from the literature or newly designed: simulated sitting trunk/shoulder rotation (SR; test no. 1), active vs passive cervical rotation (CR; test no. 2), Libman's test (LT; test no. 3) of pressure over the mastoid process, and side-lying passive shoulder abduction (SA; test no. 4). Three groups, 1 without neck pain (n = 44) and 2 with neck pain (n = 43 and 27), were formed. Outcome measures consisted of questions on provocation of pain (Yes/No) and appropriateness (Yes/No) as well as measurements of cervical rotation (goniometric) and pressure pain threshold (pressure algometer). Group test responses were evaluated and scored. A threshold of acceptance was established at 80% agreement for face validity. Ranges of rotation and pressure threshold values were analyzed with the Student t test. In nonneck pain subjects, all 4 tests were rated as nonpainful and 3 were rated as "appropriate" for neck pain examination (not SR). In neck pain subjects, this test and SA were rated as nonpainful, whereas LT was rated as painful in 26% of subjects. Only CR and LT were rated as "appropriate." In neck pain subjects, passive rotations exceeded actives by 10% to 14% (P = .000). On a second round of testing with a slightly modified method, SR and SA achieved acceptable "appropriateness." Once 2 tests were slightly modified, all 4 tests were found to have acceptable face validity. Further research into the reliability of these tests as well as into the combinations of these tests is warranted. Copyright 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Factors associated with cervical kinematic impairments in patients with neck pain.

Science.gov (United States)

Treleaven, Julia; Chen, Xiaoqi; Sarig Bahat, Hilla

2016-04-01

Cervical kinematics have functional relevance and are important for assessment and management in patients with neck disorders. A better understanding of factors that might influence cervical kinematics is required. The aim of this study was to determine any relationships between altered kinematics to the symptoms and signs of sensorimotor impairments, neck pain and disability and fear of neck motion in people with neck pain. Kinematics were measured in 39 subjects with chronic neck pain using a customized virtual reality system. Range of cervical motion, mean and peak velocity, time to peak velocity percentage, number of velocity peaks and accuracy were derived. Correlations between these measures to self-reported (neck pain intensity, disability, fear of motion, dizziness, visual disturbances) and sensorimotor measures and regression analyses were conducted. Range and velocity of motion of cervical rotation appeared to be most related to visual disturbances and pain or dynamic balance. Nevertheless these relationships only explained about 30% of the variance of each measure. Signs and symptoms of sensorimotor dysfunction should be considered and monitored in the management of altered cervical rotation kinematics in patients with chronic neck disorders. Future research should consider the effects of addressing these factors on neck kinematics and vice versa to aid functional recovery in those with neck pain. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Experimental evaluation of the stability of goat's cervical spine after percutaneous cervical diskectomy

International Nuclear Information System (INIS)

Du Zhongli; Zhou Yicheng; Wang Chengyuan; Hong Cheng; Liu Hanqiao; Zhang Jiangfan; Ding Hui; Feng Dingyi

1999-01-01

Objective: To evaluate the stability of the goat's cervical spine after PCD (percutaneous cervical diskectomy). Methods: Ten adult goats were studied. Seven had PCD at C 3-4 , and three at C 4-5 . The cervical spine of the goat was studied with MR using axial, corona land sagittal images and with anteroposterior and lateral radiographs before and after PCD. The height of the disk, the disk space angle and dislocation were measured respectively before and after PCD. The data were examined by t-test. Results: The disk space (7 cases, 70%) became narrow obviously, and hyperostosis (5 cases, 50%) disk bulging (4 cases, 40%) appeared after PCD, but there was no obvious dislocation or angulation between the adjacent vertebral bodies. Conclusions: The stability of the goat's cervical spine is not affected after PCD. Indicating that this might also hold true for human cervical spine

Intradiscal Pressure Changes during Manual Cervical Distraction: A Cadaveric Study

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M. R. Gudavalli

2013-01-01

Full Text Available The objective of this study was to measure intradiscal pressure (IDP changes in the lower cervical spine during a manual cervical distraction (MCD procedure. Incisions were made anteriorly, and pressure transducers were inserted into each nucleus at lower cervical discs. Four skilled doctors of chiropractic (DCs performed MCD procedure on nine specimens in prone position with contacts at C5 or at C6 vertebrae with the headpiece in different positions. IDP changes, traction forces, and manually applied posterior-to-anterior forces were analyzed using descriptive statistics. IDP decreases were observed during MCD procedure at all lower cervical levels C4-C5, C5-C6, and C6-C7. The mean IDP decreases were as high as 168.7 KPa. Mean traction forces were as high as 119.2 N. Posterior-to-anterior forces applied during manual traction were as high as 82.6 N. Intraclinician reliability for IDP decrease was high for all four DCs. While two DCs had high intraclinician reliability for applied traction force, the other two DCs demonstrated only moderate reliability. IDP decreases were greatest during moving flexion and traction. They were progressevely less pronouced with neutral traction, fixed flexion and traction, and generalized traction.

Incidence of cervical cancer after several negative smear results by age 50: prospective observational study

DEFF Research Database (Denmark)

Rebolj, Matejka; van Ballegooijen, Marjolein; Lynge, Elsebeth

2009-01-01

/100,000 (95% confidence interval 33 to 51) in the younger group and 36/100,000 (24 to 52) in the older group (P=0.48). The cumulative incidence rate of cervical intraepithelial neoplasia grade I+ was twice as high in the younger than in the older group (Pcervical cancer......OBJECTIVE: To determine the incidence of cervical cancer after several negative cervical smear tests at different ages. DESIGN: Prospective observational study of incidence of cervical cancer after the third consecutive negative result based on individual level data in a national registry...... of histopathology and cytopathology (PALGA). SETTING: Netherlands, national data. Population 218,847 women aged 45-54 and 445,382 aged 30-44 at the time of the third negative smear test. MAIN OUTCOME MEASURES: 10 year cumulative incidence of interval cervical cancer. RESULTS: 105 women developed cervical cancer...

CORRELATION BETWEEN CERVICAL SAGITTAL ALIGNMENT AND FUNCTIONAL CAPACITY IN CERVICAL SPONDYLOSIS

Directory of Open Access Journals (Sweden)

Marcel Machado da Motta

Full Text Available ABSTRACT Objective: To correlate the radiographic parameters of sagittal cervical alignment with quality of life and functional capacity in patients with cervical spondylosis under conservative treatment. Methods: This is an observational and prospective study in patients with cervical spondylosis under conservative treatment and without indication for surgery. The 52 patients included were divided into three groups: axial pain, radiculopathy, and cervical myelopathy. The radiographic parameters considered were cervical lordosis (CL, cervical sagittal vertical axis (CSVA, T1 slope (TS and the discrepancy between TS and CL (TS-CL. Quality of life and functional capacity were evaluated by the Neck Disability Index (NDI questionnaire. Pain was assessed by the Visual Analogue Scale (VAS. The correlation between the radiographic parameters and the clinical scores was evaluated by the Pearson correlations coefficient. Results: There was no difference in cervical radiographic parameters between the three groups. In the total of the sample, the mean value of the CSVA was 17.8o (±8.3o, CL, 22.4° (± 8.8°; TS, 29.3° (±6.6°, and TS-CL, 7.0° (±7.4°. Significant inverse correlation (r= -0.3, p=0.039 was observed between NDI and CL, but there was no significant correlation between CL and VAS. CSVA (p=0.541, TS (p=0.287 and TS-CL (p=0.287 had no significantly correlated with NDI or VAS. Conclusion: Considering patients with cervical spondylosis not candidates for surgery, the only sagittal parameter that correlated with functional capacity was LC. In these patients, the correlation between cervical alignment and quality of life needs to be better characterized.

Socioecological perspectives on cervical cancer and cervical cancer screening among Asian American women.

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Lee, Jongwon; Carvallo, Mauricio

2014-10-01

Although cervical cancer is one of the most commonly diagnosed cancers among Vietnamese American women (VAW) and Korean American women (KAW), both groups consistently report much lower rates of cervical cancer screening compared with other Asian ethnic subgroups and non-Hispanic Whites. This study aimed to explore multilevel factors that may underlie low screening rates among VAW and KAW living in a city where their ethnic communities are relatively small. The socioecological model was used as a conceptual framework. Thirty participants were conveniently recruited from ethnic beauty salons run by VA and KA cosmetologists in Albuquerque, New Mexico. The participants' average age was 44.6 years (SD = .50; range = 21-60). Most participants were married (80 %) and employed (73.3 %), and had health insurance (83.3 %). A qualitative interview was conducted in Vietnamese or Korean and transcribed verbatim. A thematic content analysis was used to identify major codes, categories, and patterns across the transcripts. The study identified several factors at the individual (e.g., pregnancy, poverty, personality), interpersonal (e.g., family responsibility, mother as influential referent), and community (e.g., lack of availability, community size) levels. The study sheds light on four major areas that must be taken into consideration in the development of culturally appropriate, community-based interventions aimed to reduce disparities in cervical cancer screening among ethnic minority women in the United States: (1) ethnic community size and geographic location; (2) cross-cultural similarities and dissimilarities; (3) targeting of not only unmarried young women, but also close referents; and (4) utilization of trusted resources within social networks.

Radiological evaluation of the cervical spinal trauma

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Bae, W. K.; Koh, B. H.; Hahm, C. K.; Kim, J. J. [School of Medicine, Hanyang University, Seoul (Korea, Republic of)

1983-03-15

Acute injuries of the cervical spine are the most common causes of severe disability following trauma, yet the diagnosis of these injuries are often delayed and the treatment, inadequate. Traumatic injuries of the cervical spine are diagnosed by radiological examinations. And complete evaluations of bony structures and soft tissue changes on conventional radiograms are very important for determining the therapeutic plans and prognoses of the injuries patients. During the period of 5 years from June 1976 to May 1981, the radiological and clinical evaluation had been made on 38 patients suffered from acute cervical spinal injuries which were confirmed by the radiological examinations. The results were as follows. 1. Age distribution of total 38 patients was broad ranging from 19 years to 72 years. 2. The most common cause of injury was traffic accident, next fall down, other accident respectively. 3. Levels of the cervical spinal injuries were as follows: Upper cervical spine in 15.8%, lower cervical spine in 84.2%, and the most common injuries level was C 5. Most of the lower cervical spinal injuries were located in the vertebral body and spinous process. 4. Anatomical sites of the cervical spinal injuries were as follows; vertebral body in 55.5%, spinous process in 23.7%, neural arch in 15.8%, and locked facet in 18.4%, etc. 5. Most of the patients with severe mental changes were injuries in upper cervical spine rather than lower. And most of the patients with quadriplegia or paraplegia were shown marked disruption of spinal canal.

Radiological evaluation of the cervical spinal trauma

International Nuclear Information System (INIS)

Bae, W. K.; Koh, B. H.; Hahm, C. K.; Kim, J. J.

1983-01-01

Acute injuries of the cervical spine are the most common causes of severe disability following trauma, yet the diagnosis of these injuries are often delayed and the treatment, inadequate. Traumatic injuries of the cervical spine are diagnosed by radiological examinations. And complete evaluations of bony structures and soft tissue changes on conventional radiograms are very important for determining the therapeutic plans and prognoses of the injuries patients. During the period of 5 years from June 1976 to May 1981, the radiological and clinical evaluation had been made on 38 patients suffered from acute cervical spinal injuries which were confirmed by the radiological examinations. The results were as follows. 1. Age distribution of total 38 patients was broad ranging from 19 years to 72 years. 2. The most common cause of injury was traffic accident, next fall down, other accident respectively. 3. Levels of the cervical spinal injuries were as follows: Upper cervical spine in 15.8%, lower cervical spine in 84.2%, and the most common injuries level was C 5. Most of the lower cervical spinal injuries were located in the vertebral body and spinous process. 4. Anatomical sites of the cervical spinal injuries were as follows; vertebral body in 55.5%, spinous process in 23.7%, neural arch in 15.8%, and locked facet in 18.4%, etc. 5. Most of the patients with severe mental changes were injuries in upper cervical spine rather than lower. And most of the patients with quadriplegia or paraplegia were shown marked disruption of spinal canal

Long-term risk of cervical cancer following conization of cervical intraepithelial neoplasia grade 3-A Danish nationwide cohort study

DEFF Research Database (Denmark)

Sand, Freja Laerke; Frederiksen, Kirsten; Munk, Christian

2018-01-01

Using nationwide Danish registries we examined the long-term risk of cervical cancer in women diagnosed with cervical intraepithelial neoplasia grade 3 (CIN3) (including adenocarcinoma in situ (AIS)) on the cone compared to women with a normal cytology test. Initially, we identified women born 1918......-1990, who were recorded as living in Denmark between January 1, 1978 and December 31, 2012. From the Pathology Data Bank information on CIN3 on the cone, margins status, histological type of CIN3 and cervical cytology results was extracted. Cox proportional hazard model was used to estimate the relative...... risk of subsequent cervical cancer. We included 59,464 women with CIN3 on the cone and 1,918,508 women with a normal cytology test. Overall, women diagnosed with CIN3 had a higher risk of subsequent cervical cancer compared to women with normal cytology (HR = 2.06; 95%CI: 1.81-2.35). Analyses according...

A Study of Radiation Incidence Angle in Anteroposterior Cervical Vertebra Examination

International Nuclear Information System (INIS)

Jeung, Seung Woon; Lim, Cheong Hwan; Jung, Hong Ryang; Joo, Yeong Cheol; Park, Mi Ja; Han, Beon Hee

2012-01-01

In anteroposterior projection for cervical vertebra, it is general that the incidence angle of X-ray is 15 degrees to 20 degrees to head in order to prevent overlap of mandible and occipital bone and to observe array of cervical interbody and shapes of joints. However, the angle is appropriate for foreigners that was determined by foreign literature review long ago, and there have been few researches of incidence angle for Koreans' body type. The purpose of in this study are to identify the incidence angle appropriate for Koreans and to present methodology. In order to measure the incidence angle, 1,044 patients who visited S Hospital located in Seosan were selected and measured of average length of cervical vertebra, OID, axis angle, and FID. The incidence angle was calculated from the applied formula by measuring average values per age groups and sex (see Formula 1 and 2). The average length of cervical vertebra was 6cm: the length was increased from teenagers to twenties but was decreased since thirties. The difference between males and females was around 1cm (p<.01). The OID was almost the same regardless of age groups and sex. As for axis angle, the slope was increased in teenagers and twenties, but was decreased since thirties. The difference between males and females was around 2 degrees (p<.01). The FID measurements were almost the same regardless of age groups and sex, and when the incidence angle was measured from these values, the teenagers were 15.9 degrees, the twenties were 16.9 degrees, the thirties were 16.6 degrees, the forties were 16.2 degrees, the fifties were 15.9 degrees, and the sixties were 14.5 degrees, indicating that the angle was increased from teenagers to the twenties but decreased since the thirties. While the angles of males and females were measured to be the same in the teenagers, the angle was different between males and females by 2 degrees. When the incidence angle statistically analyzed with measurement of average length of

A Study of Radiation Incidence Angle in Anteroposterior Cervical Vertebra Examination

Energy Technology Data Exchange (ETDEWEB)

Jeung, Seung Woon; Lim, Cheong Hwan; Jung, Hong Ryang; Joo, Yeong Cheol; Park, Mi Ja [Dept. of Radiological Science, Hanseo University, Seosan (Korea, Republic of); Han, Beon Hee [Dept. of Radiological Science, Seonam University, Namwon (Korea, Republic of)

2012-06-15

In anteroposterior projection for cervical vertebra, it is general that the incidence angle of X-ray is 15 degrees to 20 degrees to head in order to prevent overlap of mandible and occipital bone and to observe array of cervical interbody and shapes of joints. However, the angle is appropriate for foreigners that was determined by foreign literature review long ago, and there have been few researches of incidence angle for Koreans' body type. The purpose of in this study are to identify the incidence angle appropriate for Koreans and to present methodology. In order to measure the incidence angle, 1,044 patients who visited S Hospital located in Seosan were selected and measured of average length of cervical vertebra, OID, axis angle, and FID. The incidence angle was calculated from the applied formula by measuring average values per age groups and sex (see Formula 1 and 2). The average length of cervical vertebra was 6cm: the length was increased from teenagers to twenties but was decreased since thirties. The difference between males and females was around 1cm (p<.01). The OID was almost the same regardless of age groups and sex. As for axis angle, the slope was increased in teenagers and twenties, but was decreased since thirties. The difference between males and females was around 2 degrees (p<.01). The FID measurements were almost the same regardless of age groups and sex, and when the incidence angle was measured from these values, the teenagers were 15.9 degrees, the twenties were 16.9 degrees, the thirties were 16.6 degrees, the forties were 16.2 degrees, the fifties were 15.9 degrees, and the sixties were 14.5 degrees, indicating that the angle was increased from teenagers to the twenties but decreased since the thirties. While the angles of males and females were measured to be the same in the teenagers, the angle was different between males and females by 2 degrees. When the incidence angle statistically analyzed with measurement of average length

Photographic measurement of head and cervical posture when viewing mobile phone: a pilot study.

Science.gov (United States)

Guan, Xiaofei; Fan, Guoxin; Wu, Xinbo; Zeng, Ying; Su, Hang; Gu, Guangfei; Zhou, Qi; Gu, Xin; Zhang, Hailong; He, Shisheng

2015-12-01

With the dramatic growth of mobile phone usage, concerns have been raised with regard to the adverse health effects of mobile phone on spinal posture. The aim of this study was to determine the head and cervical postures by photogrammetry when viewing the mobile phone screen, compared with those in neutral standing posture. A total of 186 subjects (81 females and 105 males) aged from 17 to 31 years old participated in this study. Subjects were instructed to stand neutrally and using mobile phone as in daily life. Using a photographic method, the sagittal head and cervical postures were assessed by head tilt angle, neck tilt angle, forward head shift and gaze angle. The photographic method showed a high intra-rater and inter-rater reliability in measuring the sagittal posture of cervical spine and gaze angle (ICCs ranged from 0.80 to 0.99). When looking at mobile phone, the head tilt angle significantly increased (from 74.55° to 95.22°, p = 0.000) and the neck angle decreased (from 54.68° to 38.77°, p = 0.000). The forward head posture was also confirmed by the significantly increased head shift (from 10.90 to 13.85 cm, p = 0.000). The posture assumed in mobile phone use was significantly correlated with neutral posture (p phone use. Compared to neutral standing, subjects display a more forward head posture when viewing the mobile phone screen, which is correlated with neutral posture, gaze angle and gender. Future studies will be needed to investigate a dose-response relationship between mobile phone use and assumed posture.

A Multicenter Study of the Presentation, Treatment, and Outcomes of Cervical Dural Tears.

Science.gov (United States)

O'Neill, Kevin R; Fehlings, Michael G; Mroz, Thomas E; Smith, Zachary A; Hsu, Wellington K; Kanter, Adam S; Steinmetz, Michael P; Arnold, Paul M; Mummaneni, Praveen V; Chou, Dean; Nassr, Ahmad; Qureshi, Sheeraz A; Cho, Samuel K; Baird, Evan O; Smith, Justin S; Shaffrey, Christopher; Tannoury, Chadi A; Tannoury, Tony; Gokaslan, Ziya L; Gum, Jeffrey L; Hart, Robert A; Isaacs, Robert E; Sasso, Rick C; Bumpass, David B; Bydon, Mohamad; Corriveau, Mark; De Giacomo, Anthony F; Derakhshan, Adeeb; Jobse, Bruce C; Lubelski, Daniel; Lee, Sungho; Massicotte, Eric M; Pace, Jonathan R; Smith, Gabriel A; Than, Khoi D; Riew, K Daniel

2017-04-01

Retrospective multicenter case series study. Because cervical dural tears are rare, most surgeons have limited experience with this complication. A multicenter study was performed to better understand the presentation, treatment, and outcomes following cervical dural tears. Multiple surgeons from 23 institutions retrospectively identified 21 rare complications that occurred between 2005 and 2011, including unintentional cervical dural tears. Demographic data and surgical history were obtained. Clinical outcomes following surgery were assessed, and any reoperations were recorded. Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA), Nurick classification (NuC), and Short-Form 36 (SF36) scores were recorded at baseline and final follow-up at certain centers. All data were collected, collated, and analyzed by a private research organization. There were 109 cases of cervical dural tears among 18 463 surgeries performed. In 101 cases (93%) there was no clinical sequelae following successful dural tear repair. There were statistical improvements ( P < .05) in mJOA and NuC scores, but not NDI or SF36 scores. No specific baseline or operative factors were found to be associated with the occurrence of dural tears. In most cases, no further postoperative treatments of the dural tear were required, while there were 13 patients (12%) that required subsequent treatment of cerebrospinal fluid drainage. Analysis of those requiring further treatments did not identify an optimum treatment strategy for cervical dural tears. In this multicenter study, we report our findings on the largest reported series (n = 109) of cervical dural tears. In a vast majority of cases, no subsequent interventions were required and no clinical sequelae were observed.

Measuring effectiveness of the cervical cancer vaccine in an Australian setting (the VACCINE study).

Science.gov (United States)

Young, Elisa J; Tabrizi, Sepehr N; Brotherton, Julia Ml; Wark, John D; Pyman, Jan; Saville, Marion; Wrede, C David; Jayasinghe, Yasmin; Tan, Jeffrey; Gertig, Dorota M; Pitts, Marian; Garland, Suzanne M

2013-06-19

The quadrivalent human papillomavirus vaccine has been provided in Australia through the National Human Papillomavirus Vaccination Program since April 2007. National registry data demonstrates good coverage of the vaccine, with 73% of school-aged girls having received all three doses. To evaluate the effectiveness of the program, we propose a two-pronged approach. In one (sub study A), the prevalence of the vaccine-targeted human papillomavirus genotypes in a population cohort is being estimated, and will be analysed in relation to vaccination status, cervical cytology screening status, demographic, social, behavioural, medical and clinical factors. In sub study B, the distribution of human papillomavirus genotypes detected in high grade cervical intraepithelial neoplastic lesions from vaccine eligible women is being assessed. Sub Study A involves the recruitment of 1569 women aged 18-25, residing in Victoria, Australia, through Facebook advertising. Women who are sexually active are being asked to provide a self-collected vaginal swab, collected at home and posted into the study centre, where human papillomavirus DNA detection and genotyping is performed. Participants also complete an online questionnaire regarding sexual history, experience with, knowledge of, and attitudes towards human papillomavirus, the human papillomavirus vaccine, and cervical screening.Sub Study B will involve the collection of 500 cervical biopsies, positively identified as containing high grade cervical intraepithelial neoplastic lesions and/or adenocarcinoma in situ. Five serial sections are being taken from each case: sections 1 and 5 are being assessed to confirm the presence of the high grade cervical intraepithelial neoplastic lesions or adenocarcinoma in situ; human papillomavirus genotyping is performed on sections 2 and 3; single lesions are excised from section 4 using laser capture microdissection to specifically define causality of a human papillomavirus genotyping of each

[Longterm results of cervical arthroplasty with disc prosthesis. A literature review].

Science.gov (United States)

Fransen, P; Schils, F

2014-01-01

Cervical arthroplasty has now been performed for over 10 years. Despite the large number of implanted artificial discs, the quality of the published studies is weak, and very few report a follow up exceeding two years. We reviewed the literature on cervical total disc replacement, focusing on publications reporting a follow-up of more than two years. The selection of patients, the type of implant and the surgical technique seem to influence greatly the quality of the clinical and radiological results. The occurrence of heterotopic ossifications around the implant seems to be the rule rather than the exception. Wear debris are likely to be observed in the vicinity of the prosthesis. Most long term studies also report a progressive decrease in the range of motion of the prosthesis, although without influence on the clinical evolution. It seems reasonable to say that cervical disc prosthesis is not inferior to discectomy and fusion, and that these implants allow a short term preservation of cervical mobility, but the efficacy in preventing adjacent segment disease or a favourable costleffectiveness ratio have yet to be demonstrated. A more widespread use of cervical disc prosthesis can only be suggested when these questions have been answered by long term follow-up studies.

Genetic studies in congenital anterior midline cervical cleft

DEFF Research Database (Denmark)

Jakobsen, L P; Pfeiffer, P; Andersen, M

2012-01-01

Congenital anterior midline cervical cleft (CAMCC) is a rare anomaly, with less than 100 cases reported. The cause of CAMCC is unknown, but genetic factors must be considered as part of the etiology. Three cases of CAMCC are presented. This is the first genetic study of isolated CAMCC. Conventional...

Quality of systematic reviews: an example of studies comparing artificial disc replacement with fusion in the cervical spine.

Science.gov (United States)

Tashani, Osama A; El-Tumi, Hanan; Aneiba, Khaled

2015-01-01

Cervical artificial disc replacement (C-ADR) is now an alternative to anterior cervical discectomy and fusion (ACDF). Many studies have evaluated the efficacy of C-ADR compared with ACDF. This led to a series of systematic reviews and meta-analyses to evaluate the evidence of the superiority of one intervention against the other. The aim of the study presented here was to evaluate the quality of these reviews and meta-analyses. Medline via Ovid, Embase, and Cochrane Library were searched using the keywords: (total disk replacement, prosthesis, implantation, discectomy, and arthroplasty) AND (cervical vertebrae, cervical spine, and spine) AND (systematic reviews, reviews, and meta-analysis). Screening and data extraction were conducted by two reviewers independently. Two reviewers then assessed the quality of the selected reviews and meta-analysis using 11-item AMSTAR score which is a validated measurement tool to assess the methodological quality of systematic reviews. Screening of full reports of 46 relevant abstracts resulted in the selection of 15 systematic reviews and/or meta-analyses as eligible for this study. The two reviewers' inter-rater agreement level was high as indicated by kappa of >0.72. The AMSTAR score of the reviews ranged from 3 to 11. Only one study (a Cochrane review) scored 100% (AMSTAR 11). Five studies scored below (AMSTAR 5) indicating low-quality reviews. The most significant drawbacks of reviews of a score below 5 were not using an extensive search strategy, failure to use the scientific quality of the included studies appropriately in formulating a conclusion, not assessing publication bias, and not reporting the excluded studies. With a significant exception of a Cochrane review, the methodological quality of systematic reviews evaluating the evidence of C-ADR versus ACDF has to be improved.

Cervical cancer: a qualitative study on subjectivity, family, gender and health services.

Science.gov (United States)

Villafuerte, Blanca E Pelcastre; Gómez, Laura L Tirado; Betancourt, Alejandro Mohar; Cervantes, Malaquías López

2007-03-01

In 2002, cervical cancer was one of the leading causes of death in Mexico. Quantitative techniques allowed for the identification of socioeconomic, behavioral and biological characteristics that are part of its etiology. However such characteristics, are inadequate to explain sufficiently the role that emotions, family networks and socially-constructed categories such as gender play in the demand and utilization of health services for cervical cancer diagnosis and treatment and neither the timely undertaking of preventive actions, such as getting a PAP smear or seeking adequate and continuous treatment. A qualitative study was carried out to analyze the role of different social and cultural factors in the timely detection of cervical cancer. As part of a multi-level, multi-method research effort, this particular study was based on individual interviews with women diagnosed with cervical cancer (identified as the "cases"), their female friends and relatives (identified as the "controls") and the cases' husbands. The results showed that both: denial and fear are two important components that regulate the behavior of both the women and their partners. Women with a small support network may have limited opportunities for taking action in favor of their own health and wellbeing. Women tend not to worry about their health, in general and neither about cervical cancer in particular, as a consequence of their conceptualizations regarding their body and feminine identify - both of which are socially determined. Furthermore, it is necessary to improve the quality of information provided in health services.

Pain intensity and cervical range of motion in women with myofascial pain treated with acupuncture and electroacupuncture: a double-blinded, randomized clinical trial

Science.gov (United States)

Aranha, Maria F. M.; Müller, Cristina E. E.; Gavião, Maria B. D.

2015-01-01

BACKGROUND: Acupuncture stimulates points on the body, influencing the perception of myofascial pain or altering physiologic functions. OBJECTIVE: The aim was to evaluate the effect of electroacupuncture (EAC) and acupuncture (AC) for myofascial pain of the upper trapezius and cervical range of motion, using SHAM acupuncture as control. METHOD: Sixty women presenting at least one trigger point at the upper trapezius and local or referred pain for more than six months were randomized into EAC, AC, and SHAM groups. Eight sessions were scheduled and a follow-up was conducted after 28 days. The Visual Analog Scale assessed the intensity of local and general pain. A fleximeter assessed cervical movements. Data were analyzed using paired t or Wilcoxon's tests, ANOVA or Friedman or Kruskal-Wallis tests and Pearson's correlation (α=0.05). RESULTS: There was reduction in general pain in the EAC and AC groups after eight sessions (P<0.001). A significant decrease in pain intensity occurred for the right trapezius in all groups and for the left trapezius in the EAC and AC groups. Intergroup comparisons showed improvement in general pain in the EAC and AC groups and in local pain intensity in the EAC group (P<0.05), which showed an increase in left rotation (P=0.049). The AC group showed increases in inclination (P=0.005) sustained until follow-up and rotation to the right (P=0.032). CONCLUSION : EAC and AC were effective in reducing the pain intensity compared with SHAM. EAC was better than AC for local pain relief. These treatments can assist in increasing cervical range of motion, albeit subtly. PMID:25714602

Risk factors for cervical and trochanteric hip fractures in elderly women: a population-based 10-year follow-up study.

Science.gov (United States)

Jokinen, Heikki; Pulkkinen, Pasi; Korpelainen, Juha; Heikkinen, Jorma; Keinänen-Kiukaanniemi, Sirkka; Jämsä, Timo; Korpelainen, Raija

2010-07-01

We evaluated the contribution of lifestyle-related factors, calcaneal ultrasound, and radial bone mineral density (BMD) to cervical and trochanteric hip fractures in elderly women in a 10-year population-based cohort study. The study population consisted of 1,681 women (age range 70-73 years). Seventy-two percent (n = 1,222) of them participated in the baseline measurements. Calcaneal ultrasound was assessed with a quantitative ultrasound device. BMD measurements were performed at the distal and ultradistal radius by dual-energy X-ray absorptiometry. Forward stepwise logistic regression analysis was used to find the most predictive variables for hip fracture risk. During the follow-up, 53 of the women had hip fractures, including 32 cervical and 21 trochanteric ones. The fractured women were taller and thinner and had lower calcaneal ultrasound values than those without fractures. High body mass index (BMI) was a protective factor against any hip fractures, while low functional mobility was a risk factor of hip fractures. Specifically, high BMI protected against cervical hip fractures, while low physical activity was a significant predictor of these fractures. Similarly, high BMI protected against trochanteric fractures, whereas low functional mobility and high coffee consumption were significant predictors of trochanteric fractures. Cervical and trochanteric hip fractures seem to have different risk factors. Therefore, fracture type should be taken into account in clinical fracture risk assessment and preventative efforts, including patient counseling. However, the study is not conclusive due to the limited number of observed fractures during follow-up, and the results have to be confirmed in future studies.

[Early effectiveness of discover cervical artificial disc replacement in treatment of cervical spondylosis].

Science.gov (United States)

Qian, Yufeng; Xue, Feng; Sheng, Xiaowen; Lu, Jianmin; Chen, Bingqian

2012-03-01

To investigate the early effectiveness of the Discover cervical artificial disc replacement in treating cervical spondylosis. Qualified for the selective standard, 24 patients with cervical spondylosis were treated between March 2010 and March 2011. Of 24 patients, 13 patients underwent anterior cervical decompression and fusion (ACDF) (ACDF group, between March 2010 and September 2010) and 11 patients underwent Discover cervical artificial disc replacement (CADR group, between September 2010 and March 2011). There was no significant difference in gender, age, disease duration, lesions typing, and affected segments between 2 groups (P > 0.05). The operative time, blood loss, and complications were recorded. Japanese Orthopaedic Association (JOA) scores, Neck Disability Index (NDI) scores, and Odom's scores were used to evaluate the postoperative effectiveness. In CADR group, the cervical range of motion (ROM) in all directions, and prosthesis eccentricity were measured before and after operation. Symptoms disappeared and no complication occurred after operation in the patients of 2 groups. The patients were followed up 12 to 18 months (mean, 15.3 months) in ACDF group and 6 to 12 months (mean, 9.6 months) in CADR group. The NDI scores in CADR group were significantly higher than those in ACDF group at 1, 3, and 6 months (P 0.05). According to Odom's score at last follow-up, the results were excellent in 6 cases, good in 4 cases, and fair in 3 cases with an excellent and good rate of 76.92% in ACDF group, and were excellent in 9 cases, good in 1 case, and poor in 1 case with an excellent and good rate of 90.91% in CADR group, showing no significant difference (chi2 = 3.000, P = 0.223). The patients in CADR group had significant limit of cervical joint ROM in flexion and extension and right bending at 1 month (P value (P < 0.05). Meanwhile, ROM in left bending were bigger than that in right bending in replaced segment and upper segment (P < 0.05), and the ROM

Relationship Between T1 Slope and Cervical Alignment Following Multilevel Posterior Cervical Fusion Surgery: Impact of T1 Slope Minus Cervical Lordosis.

Science.gov (United States)

Hyun, Seung-Jae; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Hyun-Jib

2016-04-01

Retrospective study. To assess the relationship between sagittal alignment of the cervical spine and patient-reported health-related quality-of-life scores following multilevel posterior cervical fusion, and to explore whether an analogous relationship exists in the cervical spine using T1 slope minus C2-C7 lordosis (T1S-CL). A recent study demonstrated that, similar to the thoracolumbar spine, the severity of disability increases with sagittal malalignment following cervical reconstruction surgery. From 2007 to 2013, 38 consecutive patients underwent multilevel posterior cervical fusion for cervical stenosis, myelopathy, and deformities. Radiographic measurements included C0-C2 lordosis, C2-C7 lordosis, C2-C7 sagittal vertical axis (SVA), T1 slope, and T1S-CL. Pearson correlation coefficients were calculated between pairs of radiographic measures and health-related quality-of-life. C2-C7 SVA positively correlated with neck disability index (NDI) scores (r = 0.495). C2-C7 lordosis (P = 0.001) and T1S-CL (P = 0.002) changes correlated with NDI score changes after surgery. For significant correlations between C2-C7 SVA and NDI scores, regression models predicted a threshold C2-C7 SVA value of 50 mm, beyond which correlations were most significant. The T1S-CL also correlated positively with C2-C7 SVA and NDI scores (r = 0.871 and r = 0.470, respectively). Results of the regression analysis indicated that a C2-C7 SVA value of 50 mm corresponded to a T1S-CL value of 26.1°. This study showed that disability of the neck increased with cervical sagittal malalignment following surgical reconstruction and a greater T1S-CL mismatch was associated with a greater degree of cervical malalignment. Specifically, a mismatch greater than 26.1° corresponded to positive cervical sagittal malalignment, defined as C2-C7 SVA greater than 50 mm. 3.

Cervical Cancer

Centers for Disease Control (CDC) Podcasts

2007-03-06

Did you know that cervical cancer rates differ by race/ethnicity and region? Or that cervical cancer can usually be prevented if precancerous cervical lesions are found by a Pap test and treated? Find out how getting regular Pap tests can save a woman's life.  Created: 3/6/2007 by National Breast and Cervical Cancer Early Detection Program.   Date Released: 4/25/2007.

Does cervical lordosis change after spinal manipulation for non-specific neck pain? A prospective cohort study.

Science.gov (United States)

Shilton, Michael; Branney, Jonathan; de Vries, Bas Penning; Breen, Alan C

2015-01-01

The association between cervical lordosis (sagittal alignment) and neck pain is controversial. Further, it is unclear whether spinal manipulative therapy can change cervical lordosis. This study aimed to determine whether cervical lordosis changes after a course of spinal manipulation for non-specific neck pain. Posterior tangents of C2 and C6 were drawn on the lateral cervical fluoroscopic images of 29 patients with subacute/chronic non-specific neck pain and 30 healthy volunteers matched for age and gender, recruited August 2011 to April 2013. The resultant angle was measured using 'Image J' digital geometric software. The intra-observer repeatability (measurement error and reliability) and intra-subject repeatability (minimum detectable change (MDC) over 4 weeks) were determined in healthy volunteers. A comparison of cervical lordosis was made between patients and healthy volunteers at baseline. Change in lordosis between baseline and 4-week follow-up was determined in patients receiving spinal manipulation. Intra-observer measurement error for cervical lordosis was acceptable (SEM 3.6°) and reliability was substantial ICC 0.98, 95 % CI 0.962-0991). The intra-subject MDC however, was large (13.5°). There was no significant difference between lordotic angles in patients and healthy volunteers (p = 0.16). The mean cervical lordotic increase over 4 weeks in patients was 2.1° (9.2) which was not significant (p = 0.12). This study found no difference in cervical lordosis (sagittal alignment) between patients with mild non-specific neck pain and matched healthy volunteers. Furthermore, there was no significant change in cervical lordosis in patients after 4 weeks of cervical spinal manipulation.

Danish method study on cervical screening in women offered HPV vaccination as girls (Trial23)

DEFF Research Database (Denmark)

Thamsborg, Lise Holst; Andersen, Berit; Larsen, Lise Grupe

2018-01-01

arm) or present screening plus an HPV test (HPV arm). The study started 1 February 2017 and will run over three screening rounds corresponding to 7-8 years. ANALYSES: The primary endpoint is cervical intraepithelial neoplasia grade 3 or above. The trial is undertaken as a non-inferiority study......INTRODUCTION: The first birth cohorts of women offered human papillomavirus (HPV) vaccination as girls are now entering cervical screening. However, there is no international consensus on how to screen HPV vaccinated women. These women are better protected against cervical cancer and could...... vaccination as girls. METHODS: Trial23 is a method study embedded in the existing cervical screening programme in four out of five Danish regions. Without affecting the screening programme, women born in 1994 are randomised to present screening with liquid-based cytology every third year (present programme...

Human Papilloma Virus 16 and 18 Association in Cervical Intraepithelial Lesions and Cervical Cancers by In Situ Hybridization

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Mohanty Manisa

2017-03-01

Full Text Available Objective: To correlate the association of high risk Human Papilloma Virus (HPV 16, 18 in cervical intraepithelial lesions and cervical cancers by in-situ hybridization (ISH technique. Study Group: Cervical biopsy and hysterectomy specimen of 78 young and adult women, attending Hi-Tech Medical College and Hospital, Bhubaneswar, who were clinically or cytologically suspected of cervical intraepithelial lesion or cervical cancer were taken as source of target viral DNA. Material: Formalin 10% as fixative H & E stain as routine staining agent In-situ hybridization kit for HPV 16 and 18 DNA. Method: After following standard protocol for surgical grossing, HPV 16, 18 In-situ hybridization kit was used on paraffin embedded tissue sections. Results: The percentage of positive cases was highest in cervical cancer patients followed by cervical intraepithelial lesions, high grade, and low grade. Conclusion: This study has been carried out for the first in our state and our results show high degree of positivity of HPV 16/18 in females with cervical intraepithelial lesions and cervical cancers attending our tertiary care hospital.

Histopathological study of surgical cervical biopsies in Lagos, Nigeria

African Journals Online (AJOL)

AbstRACt. Introduction: Benign lesions of the cervix such as hyperplasia, endometriosis, cervicitis and endocervical polyps are health concerns for women globally. Meanwhile, Cervical cancer is the fourth most common cancer among women in the world, with developing countries bearing the brunt of the burden in terms of ...

Ultrasonographic findings of Kikuchi cervical lymphadenopathy in children

Energy Technology Data Exchange (ETDEWEB)

Kim, Ji Young; Lee, Hyun Ju; Yun, Bo La [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

2016-03-15

The purpose of this study was to analyze the ultrasonographic (USG) findings of Kikuchi cervical lymphadenopathy in pediatric patients. Between April 2007 and September 2016, 84 children (42 male and 42 female; mean±standard deviation age, 12.9±3.2 years; range, 5 to 18 years) confirmed with Kikuchi disease were enrolled. Clinical findings and USG findings of Kikuchi cervical lymphadenopathy were retrospectively reviewed. Localized symptoms, systemic symptoms, and laboratory findings including the white blood cell count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were analyzed. An analysis of the USG findings included evaluation of the location, size, and presence of intranodal abscess; intranodal calcification; perinodal fat swelling; localized fluid collection; and loss of nodal echogenic hilum. Among the patients, 49 (58%) showed localized tenderness at the cervical lymphadenopathy. Fever was present in 55 (66%), while 27 (32%) had prolonged fever. Of 74 with lab results, 54 (73%) had leukopenia but none had leukocytosis. Among the same 74, there was a high ESR (>50 mm/hr) in 10 (14%) and a high CRP level (>5 mg/dL) in seven (9%). The USG findings of most of the patients (n=72, 86%) showed unilateral neck involvement, especially in the left side neck (45 of 72, 63%). The most common site of Kikuchi lymphadenopathy involvement was the area at cervical lymph node level V, at the posterior triangle (n=77, 92%). Conglomerated nodal distribution (n=57, 68%), preserved central nodal echogenic hilum (n=84, 98%), and perinodal fat swelling (n=55, 65%) were common USG findings in the children with Kikuchi. In addition, multiple cervical lymph nodes showed a relatively even size distribution (n=73, 87%). The common USG findings of Kikuchi disease in the pediatric population of our study were multiple conglomerated unilateral cervical lymphadenopathy showing perinodal fat swelling and even size distribution.

Withdrawing low risk women from cervical screening programmes: mathematical modelling study.

Science.gov (United States)

Sherlaw-Johnson, C; Gallivan, S; Jenkins, D

1999-02-06

To evaluate the impact of policies for removing women before the recommended age of 64 from screening programmes for cervical cancer in the United Kingdom. A mathematical model of the clinical course of precancerous lesions which accounts for the influence of infection with the human papillomavirus, the effects of screening on the progression of disease, and the accuracy of the testing procedures. Two policies are compared: one in which women are withdrawn from the programme if their current smear is negative and they have a recent history of regular, negative results and one in which women are withdrawn if their current smear test is negative and a simultaneous test is negative for exposure to high risk types of human papillomavirus. United Kingdom cervical screening programme. The incidence of invasive cervical cancer and the use of resources. Early withdrawal of selected women from the programme is predicted to give rise to resource savings of up to 25% for smear tests and 18% for colposcopies when withdrawal occurs from age 50, the youngest age considered in the study. An increase in the incidence of invasive cervical cancer, by up to 2 cases/100 000 women each year is predicted. Testing for human papillomavirus infection to determine which women should be withdrawn from the programme makes little difference to outcome. This model systematically analyses the consequences of screening options using available data and the clinical course of precancerous lesions. If further audit studies confirm the model's forecasts, a policy of early withdrawal might be considered. This would be likely to release substantial resources which could be channelled into other aspects of health care or may be more effectively used within the cervical screening programme to counteract the possible increase in cancer incidence that early withdrawal might bring.

What is the superior surgical strategy for bi-level cervical spondylosis-anterior cervical disc replacement or anterior cervical decompression and fusion?: A meta-analysis from 11 studies.

Science.gov (United States)

Zhao, He; Duan, Li-Jun; Gao, Yu-Shan; Yang, Yong-Dong; Tang, Xiang-Sheng; Zhao, Ding-Yan; Xiong, Yang; Hu, Zhen-Guo; Li, Chuan-Hong; Yu, Xing

2018-03-01

Nowadays, anterior cervical artificial disc replacement (ACDR) has achieved favorable outcomes in treatment for patients with single-level cervical spondylosis. However, It is still controversial that whether or not it will become a potent therapeutic alternation in treating 2 contiguous levels cervical spondylosis compared with anterior cervical decompression and fusion (ACDF). Therefore, we conducted a systematic review and meta-analysis to compare the efficacy and safety of ACDR and ACDF in patients with 2 contiguous levels cervical spondylosis. According to the computer-based online search, PubMed, Embase, Web of Science, and Cochrane Library for articles published before July 1, 2017 were searched. The following outcome measures were extracted: neck disability index (NDI), visual analog scale (VAS) neck, VAS arm, Short Form (SF)-12 mental component summary (MCS), SF-12 physical component summary (PCS), overall clinical success (OCS), patient satisfaction (PS), device-related adverse event (DRAE), subsequent surgical intervention (SSI), neurological deterioration (ND), and adjacent segment degeneration (ASD). Methodological quality was evaluated independently by 2 reviewers using the Furlan for randomized controlled trial (RCT) and MINORS scale for clinical controlled trials (CCT). The chi-squared test and Higgin I test were used to evaluate the heterogeneity. A P bi-level cervical spondylosis, ACDR appears to provide superior clinical effectiveness and safety effects than ACDF. In the future, more high-quality RCTs are warranted to enhance this conclusion.

The polymethyl methacrylate cervical cage for treatment of cervical disk disease Part III. Biomechanical properties.

Science.gov (United States)

Chen, Jyi-Feng; Lee, Shih-Tseng

2006-10-01

In a previous article, we used the PMMA cervical cage in the treatment of single-level cervical disk disease and the preliminary clinical results were satisfactory. However, the mechanical properties of the PMMA cage were not clear. Therefore, we designed a comparative in vitro biomechanical study to determine the mechanical properties of the PMMA cage. The PMMA cervical cage and the Solis PEEK cervical cage were compressed in a materials testing machine to determine the mechanical properties. The compressive yield strength of the PMMA cage (7030 +/- 637 N) was less than that of the Solis polymer cervical cage (8100 +/- 572 N). The ultimate compressive strength of the PMMA cage (8160 +/- 724 N) was less than that of the Solis cage (9100 +/- 634 N). The stiffness of the PMMA cervical cage (8106 +/- 817 N/mm) was greater than that of the Solis cage (6486 +/- 530 N/mm). The elastic modulus of the PMMA cage (623 +/- 57 MPa) was greater than that of the Solis cage (510 +/- 42 MPa). The elongation of PMMA cage (43.5 +/- 5.7%) was larger than that of the Solis cage (36.1 +/- 4.3%). Although the compressive yield strength and ultimate compressive strength of the PMMA cervical cage were less than those of the Solis polymer cage, the mechanical properties are better than those of the cervical vertebral body. The PMMA cage is strong and safe for use as a spacer for cervical interbody fusion. Compared with other cage materials, the PMMA cage has many advantages and no obvious failings at present. However, the PMMA cervical cage warrants further long-term clinical study.

Cervical Cap

Science.gov (United States)

... giving birth vaginally, which means the cervical cap may not fit as well. Inconsistent or incorrect use of the cervical cap increases your risk of pregnancy. For example, you may get pregnant when using the cervical cap if: ...

Predisposition to Cervical Atypia in Systemic Lupus Erythematosus: A Clinical and Cytopathological Study

Directory of Open Access Journals (Sweden)

Hend Hilal Al-Sherbeni

2015-01-01

Full Text Available Introduction. Systemic lupus erythematosus (SLE is a complex disease with variable presentations, course, and prognosis. The female genital tract may be a potential target organ in SLE since cervical inflammation may be associated with disease activity. An increase in cervical dysplasia, a precursor of cervical cancer, has been reported in females with SLE. Aim of the Work. This work aimed to study the prevalence of abnormal cervicovaginal smears in patients with systemic lupus erythematosus (SLE and to correlate abnormal smear findings with exposure to infection with human papilloma virus (HPV in SLE patients. Patients and Methods. Thirty-two patients with SLE, fulfilling the 1997 revised criteria for the classification of SLE, were included in this study. They were subjected to full history taking, clinical examination, laboratory investigations, and cervicovaginal smearing. Twenty healthy subjects not known to suffer from any rheumatological disease were used as controls, and they were subjected to cervicovaginal smearing. Results. Four out of 32 SLE patients showed abnormal Pap smears (12.5% compared to none showing any cervical changes in the control group (0%. Among these 4 patients, 3 were having ASCU and one was having LSIL (HPV. Conclusion. Cervicovaginal smearing is an easy, economic, safe, repeatable, and noninvasive technique for screening and early detection of cervical neoplastic lesions in SLE.

Cervical cancer: a qualitative study on subjectivity, family, gender and health services

Directory of Open Access Journals (Sweden)

López-Cervantes Malaquías

2007-03-01

Full Text Available Abstract Background In 2002, cervical cancer was one of the leading causes of death in Mexico. Quantitative techniques allowed for the identification of socioeconomic, behavioral and biological characteristics that are part of its etiology. However such characteristics, are inadequate to explain sufficiently the role that emotions, family networks and socially-constructed categories such as gender play in the demand and utilization of health services for cervical cancer diagnosis and treatment and neither the timely undertaking of preventive actions, such as getting a PAP smear or seeking adequate and continuons treatment. Methods A qualitative study was carried out to analyze the role of different social and cultural factors in the timely detection of cervical cancer. As part of a multi-level, multi-method research effort, this particular study was based on individual interviews with women diagnosed with cervical cancer (identified as the "cases", their female friends and relatives (identified as the "controls" and the cases' husbands. Results The results showed that both: denial and fear are two important components that regulate the behavior of both the women and their partners. Women with a small support network may have limited opportunities for taking action in favor of their own health and wellbeing. Conclusion Women tend not to worry about their health, in general and neither about cervical cancer in particular, as a consequence of their conceptualizations regarding their body and feminine identify – both of which are socially determined. Furthermore, it is necessary to improve the quality of information provided in health services.

Factors Affecting Myocardial Infarction in Cervical Cancer Patients: A Population-Based Study

Science.gov (United States)

Hsieh, Chen-Hsi; Chiou, Wen-Yen; Lee, Ching-Chih; Lee, Moon-Sing; Lin, Hon-Yi; Su, Yu-Chieh; Hung, Shih-Kai

2013-01-01

Background Radiotherapy (RT) or concurrent chemoradiation therapy has been suggested to increase the risk of coronary heart disease for cervical cancer patients, but the results of studies have been inconsistent. Therefore, we aimed to investigate the factors which influence the risk of developing myocardial infarction (MI) in cervical cancer patients with a large, nationwide cohort. Methods The study analyzed data from the 1996 to 2010 National Health Insurance Research Database provided by the National Health Research Institutes in Taiwan. The assessed number of patients with cervical cancer with radiotherapy only, surgery with bilateral oophorectomy only, and with appendectomy were 308, 323 and 229, respectively. The Kaplan-Meier method and the Cox proportional hazards model were used to assess the risk of myocardial infarction. Results The adjusted hazard ratio for cervical cancer in patients with MI was 1.97 (95% CI, 0.97 - 3.91; P = 0.05) for the group that received RT alone, and 2.13 (95% CI, 1.11 - 3.75; P = 0.01) for the surgery group when compared with controls. The more risk comorbidities they have, the higher the risk of myocardial infarction would be for the patients. Conclusion The incidence of MI was significantly higher among cervical cancer patients with RT alone or surgery with bilateral oophorectomy alone than among general populations. RT might be as a factor to increase risk as bilateral oophorectomy. Whether RT itself triggers menopause or impairs the ovarian hormone production that increases the risk of MI needs to be further investigated. PMID:24171059

Iatrogenic Spinal Cord Injury Resulting From Cervical Spine Surgery.

Science.gov (United States)

Daniels, Alan H; Hart, Robert A; Hilibrand, Alan S; Fish, David E; Wang, Jeffrey C; Lord, Elizabeth L; Buser, Zorica; Tortolani, P Justin; Stroh, D Alex; Nassr, Ahmad; Currier, Bradford L; Sebastian, Arjun S; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel

2017-04-01

Retrospective cohort study of prospectively collected data. To examine the incidence of iatrogenic spinal cord injury following elective cervical spine surgery. A retrospective multicenter case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network was conducted. Medical records for 17 625 patients who received cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, were reviewed to identify occurrence of iatrogenic spinal cord injury. In total, 3 cases of iatrogenic spinal cord injury following cervical spine surgery were identified. Institutional incidence rates ranged from 0.0% to 0.24%. Of the 3 patients with quadriplegia, one underwent anterior-only surgery with 2-level cervical corpectomy, one underwent anterior surgery with corpectomy in addition to posterior surgery, and one underwent posterior decompression and fusion surgery alone. One patient had complete neurologic recovery, one partially recovered, and one did not recover motor function. Iatrogenic spinal cord injury following cervical spine surgery is a rare and devastating adverse event. No standard protocol exists that can guarantee prevention of this complication, and there is a lack of consensus regarding evaluation and treatment when it does occur. Emergent imaging with magnetic resonance imaging or computed tomography myelography to evaluate for compressive etiology or malpositioned instrumentation and avoidance of hypotension should be performed in cases of intraoperative and postoperative spinal cord injury.

Reevaluation of the Pavlov ratio in patients with cervical myelopathy.

Science.gov (United States)

Suk, Kyung-Soo; Kim, Ki-Tack; Lee, Jung-Hee; Lee, Sang-Hun; Kim, Jin-Soo; Kim, Jin-Young

2009-03-01

This study was designed to reevaluate the effectiveness of the Pavlov ratio in patients with cervical myelopathy. We studied 107 patients who underwent open door laminoplasty for the treatment of cervical myelopathy between the C3 to C7 levels. We determined the Pavlov ratio on preoperative and postoperative cervical spine lateral radiographs, the vertebral body-to-canal ratio on sagittal reconstruction CT scans, and the vertebral body-to-cerebrospinal fluid (CSF) column ratio on T2-weighted sagittal MR images from C3 to C6. The severity of myelopathy was determined using the JOA score on both preoperative and postoperative images. The recovery rate was also calculated. The Pavlov ratio in plain radiographs from patients with myelopathy was compared with the ratio of the vertebral body to the spinal canal on CT and MRI. The average Pavlov ratio between C3 and C6 ranged from 0.71 to 0.76. On CT scan, the average vertebral body-to-canal ratio between C3 and C6 ranged from 0.62 to 0.66. On MRI, the vertebral body-to-CSF column ratio between C3 and C6 ranged between 0.53 and 0.57. A positive correlation was noted between the Pavlov ratio and the vertebral body-to-canal ratio on sagittal-reconstruction CT (correlation coefficient = 0.497-0.627, p = 0.000) and between the Pavlov ratio and the vertebral body-to-CSF column ratio on MRI (correlation coefficient = 0.511-0.649, p = 0.000). We demonstrated a good correlation between the Pavlov ratio and both the vertebral body-to-canal ratio on CT and the vertebral body-to-CSF column ratio on MRI. Therefore, the Pavlov ratio can be relied upon to predict narrowing of the cervical spinal canal in the sagittal plane.

Short-term effects of kinesio taping versus cervical thrust manipulation in patients with mechanical neck pain: a randomized clinical trial.

Science.gov (United States)

Saavedra-Hernández, Manuel; Castro-Sánchez, Adelaida M; Arroyo-Morales, Manuel; Cleland, Joshua A; Lara-Palomo, Inmaculada C; Fernández-de-Las-Peñas, César

2012-08-01

changes in active cervical range of motion, except for rotation. Changes in neck pain surpassed the minimal clinically important difference, whereas changes in disability did not. Changes in cervical range of motion were small and not clinically meaningful. Because we did not include a control or placebo group in this study, we cannot rule out a placebo effect or natural changes over time as potential reasons for the improvements measured in both groups. Therapy, level 1b.

Role of Lactobacillus in cervical cancer

Directory of Open Access Journals (Sweden)

Yang X

2018-05-01

Full Text Available Xi Yang,1 Miao Da,2 Wenyuan Zhang,3 Quan Qi,4 Chun Zhang,5 Shuwen Han4 1Department of Intervention and Radiotherapy, Huzhou Central Hospital, 2Medical College of Nursing, Huzhou University, 3Department of Gynaecology, 4Department of Medical Oncology, 5Department of Infectious Diseases, Huzhou Central Hospital, Huzhou, Zhejiang Province, People’s Republic of China Abstract: Cervical cancer is a common malignant cancer among women worldwide. Changes in the vaginal microecological environment lead to multiple gynecological diseases, including cervical cancer. Recent research has shown that Lactobacillus may play an important role in the occurrence and development of cervical cancer. This review explores the role of Lactobacillus in cervical cancer. A total of 29 articles were included after identification and screening. The pertinent literature on Lactobacillus in cervical cancer from two perspectives, including clinical studies and experimental studies, was analyzed. An association network for the mechanism by which Lactobacillus induces cervical cancer was constructed. In addition, we provide direction and insight for further research on the role of Lactobacillus in cervical cancer. Keywords: CIN, cervical cancer, Lactobacillus, microorganism

Study of transpedicular occipital-cervical fusion (report of 17 cases)

International Nuclear Information System (INIS)

Zhang Zhiming; Yang Huilin; Yuan Feng; Tang Tiansi

2004-01-01

Objective: To introduce a new method for occipital-cervical fusion. Method: Seventeen patients, among them C1, C2 tumor patient 16, all were fixed by transpedicular occipital-cervical fusion before cutting off tumor. Another case was odontoid process fracture. Results: Seventeen patients were visited for 2 years and 3 months on average, and all were fixed good. The patient whose tumor was transferred from the cancer of breast died after half a year for the cancer was extensively transferred, not caused by the surgical operation method. Conclusion: Stability of unstable patients or patients with tumor at occipital-cervical area can be re-constructed by transpedicular occipital-cervical fusion. Before and during operation the precise position must be decided and operation should be carried out carefully. Then good clinical treatment results can be obtained

The incidence, clearance and persistence of non-cervical human papillomavirus infections: a systematic review of the literature.

Science.gov (United States)

Taylor, Sylvia; Bunge, Eveline; Bakker, Marina; Castellsagué, Xavier

2016-06-14

Human papillomavirus (HPV) vaccines were designed to prevent cervical cancer in women and their provision remains a major public health need. However, HPV is also a major cause of non-cervical anogenital and oropharyngeal cancers and the potential benefit of vaccination likely extends beyond cervical cancer. A systematic literature search of PubMed (1995-2014) identified publications assessing the incidence, persistence, and clearance of non-cervical anogenital/oral HPV infections. Comparability with cervical HPV was assessed by identifying articles assessing the same or similar populations. Available data suggest high incidence rates of non-cervical HPV infection in men and women, with HPV-16 predominating in all sites. The incidence of high risk HPV per 100 person-years ranged from 11.4 to 72.9 for penile infections, 6.7-47.9 at other male genital sites, and 4.4-36.7 and 5.3-23.4 for anal infections in men and women, respectively. The incidence per 100 person-years of oral infection with any HPV type ranged from 5.7 to 6.7 in men and 6.8-39.6 in women. Within the limitations of the data, there was a general pattern of higher incidence and clearance of non-cervical genital HPV infections, compared to cervical infections. HIV status, circumcision, number of sex partners and partner HPV status significantly influenced high-risk HPV incidence/clearance at male anogenital sites. Few studies assessed risk factors for oral HPV. Parallels appear to exist between the epidemiology of cervical and non-cervical HPV infections in terms of incidence, HPV-type distribution, and risk factors for infection. Available data suggest that non-cervical genital HPV infections may occur more frequently, with higher clearance rates, than cervical infections. More extensive studies could provide useful information for estimating vaccine impact, the wider cost-benefit of HPV vaccination, and guiding vaccination policy. Not applicable, as systematic review of the literature.

Home cervical ripening with dinoprostone gel in nulliparous women with singleton pregnancies.

Science.gov (United States)

Stock, Sarah J; Taylor, Rebecca; Mairs, Rebecca; Azaghdani, Abdulhamid; Hor, Kahyee; Smith, Imogen; Dundas, Kirsty; Kissack, Chris; Norman, Jane E; Denison, Fiona

2014-08-01

To evaluate whether home cervical ripening is safe and results in shorter hospital stay. This was a retrospective cohort study of women with singleton pregnancies having induction of labor for postmaturity at a single center between January 2007 and June 2010. Women were offered home cervical ripening with 1 mg dinoprostone gel if they were nulliparous, had uncomplicated singleton pregnancies, and the indication for induction was postmaturity. Nine hundred seven of 1,536 (59.1%) nulliparous women having induction of labor for postmaturity were eligible for home cervical ripening. The median number of hours at home was 11.76 hours (range 0-24.82 hours). There were no cases of birth outside of the hospital, uterine rupture, or significant neonatal morbidity or neonatal death related to home cervical ripening. Eighty-five (5.5%) women who underwent hospital cervical ripening because of maternal preference or social issues formed a hospital cervical ripening comparison group. There was no significant difference in the total number of hours before delivery spent in the hospital between the two groups (26.25; 95% confidence interval [CI] 25.27-27.23 in home cervical ripening group compared with 24.28; 95% CI 22.5-26.0 in the hospital group; P=.26). Clinical outcomes are comparable in nulliparous women who receive a single dose of dinoprostone gel for home cervical ripening compared with those who undergo hospital cervical ripening. However, preadmission home cervical ripening with 1 mg dinoprostone does not decrease the number of hours women spend in the hospital. II.

Cervical Myomas

Science.gov (United States)

... Adnexal Torsion Bartholin Gland Cysts Cervical Myomas Cervical Stenosis Endometriomas of the Vulva Inclusion and Epidermal Cysts of the Vulva Noncancerous Ovarian Growths Polyps of the Cervix Skene Duct Cyst Cervical myomas are smooth, benign tumors in the cervix. A myoma may bleed, ...

Socio-economic and demographic determinants affecting participation in the Swedish cervical screening program: A population-based case-control study.

Science.gov (United States)

Broberg, Gudrun; Wang, Jiangrong; Östberg, Anna-Lena; Adolfsson, Annsofie; Nemes, Szilard; Sparén, Pär; Strander, Björn

2018-01-01

Cervical screening programs are highly protective for cervical cancer, but only for women attending screening procedure. Identify socio-economic and demographic determinants for non-attendance in cervical screening. Design: Population-based case-control study. Setting: Sweden. Population: Source population was all women eligible for screening. Based on complete screening records, two groups of women aged 30-60 were compared. The case group, non-attending women, (N = 314,302) had no smear registered for 6-8 years. The control group (N = 266,706) attended within 90 days of invitation. Main outcome measures: Risk of non-attendance by 9 groups of socioeconomic and demographic variables. Analysis: Unadjusted odds ratios (OR) and OR after adjustment for all variables in logistic regression models were calculated. Women with low disposable family income (adjOR 2.06; 95% confidence interval (CI) 2.01-2.11), with low education (adjOR 1.77; CI 1.73-1.81) and not cohabiting (adjOR 1.47; CI 1.45-1.50) were more likely to not attend cervical screening. Other important factors for non-attendance were being outside the labour force and receiving welfare benefits. Swedish counties are responsible for running screening programs; adjusted OR for non-participation in counties ranged from OR 4.21 (CI 4.06-4.35) to OR 0.54 (CI 0.52-0.57), compared to the reference county. Being born outside Sweden was a risk factor for non-attendance in the unadjusted analysis but this disappeared in certain large groups after adjustment for socioeconomic factors. County of residence and socio-economic factors were strongly associated with lower attendance in cervical screening, while being born in another country was of less importance. This indicates considerable potential for improvement of cervical screening attendance in several areas if best practice of routines is adopted.

Cervical Cancer

Centers for Disease Control (CDC) Podcasts

Did you know that cervical cancer rates differ by race/ethnicity and region? Or that cervical cancer can usually be prevented if precancerous cervical lesions are found by a Pap test and treated? Find out how getting regular Pap tests can save a woman's life.

Cervical Vertigo(Vertigo)

OpenAIRE

本間, 隆夫; Homma, Takao

1992-01-01

Cervical vertigo was reviewed as to its mechanism, diagnosis and treatment, and nine cases which had operation done were briefly presented. Cervical vertigo has been seen occasionaly in the cases of cervical spondylosis, frequently in the cases of traumatic cervical syndrome. The mechanism is attributed to either vertebrobasilar insufficiency caused by compression on vertebral artery or irritation of poterior cervical sympathetic system. The diagnosis consists of reccurent vertigo attack with...

Treatment of cervical radiculopathy by anterior cervical discectomy and cage fusion

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Osman A Mohamed

2012-01-01

Full Text Available Introduction: Since the pioneering days of the anterior cervical approach introduced by Cloward et al. in the early 1950s, anterior cervical discectomy and fusion (ACDF has been the standard procedure for most discogenic and degenerative cervical spinal lesions. Although traditional interbody fusion using iliac bone can maintain the patency of the neuroforamen and ensure solid fusion, selection of patients, and of surgical procedure for ACDF is a continuous challenge. Aim: The aim of this study was to assess the results of cervical discectomy and fusion with cervical cages in treatment of cervical radiculopathy clinically and radiologically. Materials and Methods: Eighteen patients suffering from cervical radiculopathy were operated upon using this technique. They were 15 males and 3 females. Clinical and radiological assessment, visual analog scale (VAS for neck and arm and modified Oswestery neck disability index (NDI were done preoperatively and at 4 weeks, 3, 6, and 12 months postoperatively. Polyetheretherketone (Peek cages filled with iliac bone graft were used after cervical discectomy. The levels operated upon were C 5-6 in 16 patients and C4-5 in 2 patients. Results: Marked clinical improvement as regard arm and neck pain, and NDI was observed. The pre and post operative mean and standard deviations (SD of the various scores were as follows. VAS for pain in arm reduced from mean of 8 (SD 1.76 to mean 0.4 (SD 0.4, VAS for neck pain reduced from mean of 3.5 (SD 1.58 to mean of 0.8 (SD 0.47, and NDI from mean of 20.2 (SD 0.89 to 2.1(SD 1.05. Fusion occurred in all patients. Subjectively 79% of the patients reported marked improvement in neck pain, and 95% reported marked reduction in arm pain. Conclusion: Anterior cervical discectomy and cage fusion resulted in high fusion rate with minimal preservation of lordosis.

Preoperative cervical sagittal alignment parameters and their impacts on myelopathy in patients with cervical spondylotic myelopathy: a retrospective study

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Wei Yuan

2017-11-01

Full Text Available Background Cervical sagittal alignment plays an important role in the pathogenesis of cervical spondylotic myelopathy (CSM, but there are limited studies on the cervical sagittal parameters in CSM patients and their correlations with myelopathy. The aim of this study is to investigate the correlations among the preoperative cervical sagittal alignment parameters and their correlations with the development of myelopathy in patients with CSM. Methods We retrospectively collected 212 patients with CSM who underwent surgical interventions. Gender, age, modified Japanese Orthopedic Association score (mJOA, cervical lordosis (CL, C2–C7 sagittal vertical axis (C2–C7 SVA, T1 slope (T1S, neck tilt (NT and thoracic inlet angle (TIA were collected before operation. Interobserver and intraobserver reliability were calculated for all measurements (intraclass correlation coefficient, ICC. Data were analyzed with Pearson and Spearman correlation tests and multiple linear regression analysis. Results A total of 212 patients with CSM were included in this study (male: 136, female: 76 with an average age of 54.5 ± 10.1 years old. Intraobserver and interobserver reliability for all included radiographic parameters presented good to excellent agreement (ICC > 0.7. No significant differences in demographic and radiological parameters have been observed between males and females (P > 0.05. We found statistically significant correlations among the following parameters: age with CL (r = 0.135, P = 0.049, age with T1S (r = 0.222, P = 0.001, CL with T1S (r = 0.291, P < 0.001, CL with C2-C7 SVA (r =  − 0.395, P < 0.001, mJOA with age (r =  − 0.274, P < 0.001, mJOA with C2–C7 SVA (r =  − 0.219, P < 0.001 and mJOA with T1S(r =  − 0.171, p = 0.013. Linear regression analysis showed that C2–C7 SVA was the predictor of CL (adjusted R2 = 0.152, P < 0.001 and multiple linear regression showed that age combined with C

Avaliação retrospectiva de artrodese cervical com enxerto autólogo versus hidroxiapatita Estudio retrospectivo de la artrodesis cervical con autoinjerto versus hidroxiapatita Retrospective study of cervical arthrodesis with autograft versus hydroxyapatite graft

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Yoshinobu Nagasse

2010-12-01

ña serie de casos no hubo diferencias significativas entre los resultados de la fusión cervical anterior con injerto de hidroxiapatita en comparación con injerto autólogo ilíaca.OBJECTIVE: the authors carried out a study to compare the radiografic result in the use of hydroxyapatite graft and iliac crest bone graft (autologous in the surgical treatment of cervical discal herniation in one level, and a cervical arthrodesis was carried out previously with plate. METHODS: a retrospective study with patients who were submitted to cervical artrodesis, comparing two groups of ten patients: one in which the hydroxyapatite graft was used and the other in which the autologous iliac crestwas used. Postoperative x-rays were measured and compared, in search for losses of angular alignment. RESULTS: the two types of grafts demonstrated an alignment in similar rates, with consolidation in all patients. The study did not show fragmentation of the hydroxyapatite graft or acquittal of the synthesis material. CONCLUSION: in this small series of cases, no significant difference was observed between the results of the anterior cervical arthrodesis with hydroxyapatite graft in relation to the iliac crest bone graft.

A radiological study on the cervical spine in rheumatoid arthritis

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Taketomi, Eiji; Sakoh, Takashi; Sunahara, Nobuhiko [Kagoshima Univ. (Japan). Faculty of Medicine

1995-03-01

The cervical spine was examined with the magnetic resonance imaging (MRI) and the conventional roentgenograms in 95 patients with rheumatoid arthritis. The MRI findings of upper cervical disorders were compared with various values determined in roentgenograms: the atlanto-dental interval (ADI), the space available for the spinal cord (SAC), and the Ranawat and Redlund-Johnell values. In patients with vertical setting (VS), MRI showed medullary compression in all those with abnormal Redlund-Johnell values and Ranawat values of 7 mm or less. In patients with anterior atlanto-axial subluxation, compression of the upper cervical cord was observed in all patients with SAC of 13 mm or less. In subaxial lesion of the cervical spine, MRI was found to be as good as roentgenograms in evaluating plate erosion and disc space narrowing and MRI showed extradural pannus. (author).

A radiological study on the cervical spine in rheumatoid arthritis

International Nuclear Information System (INIS)

Taketomi, Eiji; Sakoh, Takashi; Sunahara, Nobuhiko

1995-01-01

The cervical spine was examined with the magnetic resonance imaging (MRI) and the conventional roentgenograms in 95 patients with rheumatoid arthritis. The MRI findings of upper cervical disorders were compared with various values determined in roentgenograms: the atlanto-dental interval (ADI), the space available for the spinal cord (SAC), and the Ranawat and Redlund-Johnell values. In patients with vertical setting (VS), MRI showed medullary compression in all those with abnormal Redlund-Johnell values and Ranawat values of 7 mm or less. In patients with anterior atlanto-axial subluxation, compression of the upper cervical cord was observed in all patients with SAC of 13 mm or less. In subaxial lesion of the cervical spine, MRI was found to be as good as roentgenograms in evaluating plate erosion and disc space narrowing and MRI showed extradural pannus. (author)

Temporal Patterns of Cervical Cancer Screening Among Danish Women 55 Years and Older Diagnosed With Cervical Cancer

DEFF Research Database (Denmark)

Hammer, Anne; Hee, Lene; Blaakær, Jan

2018-01-01

OBJECTIVE: The aim of the study was to describe the screening history in postmenopausal women diagnosed with cervical cancer during 1990-2013 by age and screening period. MATERIALS AND METHODS: This hospital-based cohort study included women 55 years and older diagnosed with cervical cancer...... at Aarhus University Hospital, Denmark, during 1990-2013. Information on their previous history of cervical cancer screening was obtained from the Danish Pathology Databank. RESULTS: Overall, 47.0% (95% CI = 42.6-51.4) had no record of screening before their cervical cancer diagnosis. This proportion...

Human Papilloma Virus Identification in Breast Cancer Patients with Previous Cervical Neoplasia.

Science.gov (United States)

Lawson, James S; Glenn, Wendy K; Salyakina, Daria; Clay, Rosemary; Delprado, Warick; Cheerala, Bharathi; Tran, Dinh D; Ngan, Christopher C; Miyauchi, Shingo; Karim, Martha; Antonsson, Annika; Whitaker, Noel J

2015-01-01

Women with human papilloma virus (HPV)-associated cervical neoplasia have a higher risk of developing breast cancer than the general female population. The purpose of this study was to (i) identify high-risk HPVs in cervical neoplasia and subsequent HPV positive breast cancers which developed in the same patients and (ii) determine if these HPVs were biologically active. A range of polymerase chain reaction and immunohistochemical techniques were used to conduct a retrospective cohort study of cervical precancers and subsequent breast cancers in the same patients. The same high-risk HPV types were identified in both the cervical and breast specimens in 13 (46%) of 28 patients. HPV type 18 was the most prevalent. HPVs appeared to be biologically active as demonstrated by the expression of HPV E7 proteins and the presence of HPV-associated koilocytes. The average age of these patients diagnosed with breast cancer following prior cervical precancer was 51 years, as compared to 60 years for all women with breast cancer (p for difference = 0.001). These findings indicate that high-risk HPVs can be associated with cervical neoplasia and subsequent young age breast cancer. However, these associations are unusual and are a very small proportion of breast cancers. These outcomes confirm and extend the observations of two similar previous studies and offer one explanation for the increased prevalence of serious invasive breast cancer among young women.

Human papilloma virus identification in breast cancer patients with previous cervical neoplasia

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James Sutherland Lawson

2016-01-01

Full Text Available Purpose: Women with human papilloma virus (HPV associated cervical neoplasia have a higher risk of developing breast cancer than the general female population. The purpose of this study was to (i identify high risk for cancer HPVs in cervical neoplasia and subsequent HPV positive breast cancers which developed in the same patients and (ii determine if these HPVs were biologically active.Methods: A range of polymerase chain reaction (PCR and immunohistochemical techniques were used to conduct a retrospective cohort study of cervical precancers and subsequent breast cancers in the same patients. Results: The same high risk HPV types were identified in both the cervical and breast specimens in 13 (46% of 28 patients. HPV type 18 was the most prevalent. HPVs appeared to be biologically active as demonstrated by the expression of HPV E7 proteins and the presence of HPV associated koilocytes. The average age of these patients diagnosed with breast cancer following prior cervical precancer was 51 years, as compared to 60 years for all women with breast cancer (p for difference = 0.001. Conclusions: These findings indicate that high risk HPVs can be associated with cervical neoplasia and subsequent young age breast cancer. However these associations are unusual and are a very small proportion of breast cancers. These outcomes confirm and extend the observations of 2 similar previous studies and offer one explanation for the increased prevalence of serious invasive breast cancer among young women.

Tuina treatment in cervical spondylosis

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Florin Mihai Hinoveanu

2010-12-01

Full Text Available Cervical spondylosis is a common, chronic degenerative condition of the cervical spine that affects the vertebral bodies and intervertebral disks of the neck as well as the contents of the spinal canal. Common clinical syndromes associated with cervical spondylosis include cervical pain, cervical radiculopathy and/or mielopathy. This study show the main principles, indication and side effects of tuina in cervical spondylosis´ treatment; tuina is one of the external methods based on the principles of Traditional Chinese Medicine (TCM, especially suitable for use on the elderly population and on infants. While performing Tuina, the therapist concentrates his mind, regulates his breathing, and actuates the Qi and power of his entire body towards his hands. For a better result is recommended to try to combine acupuncture with tuina treatment. Tuina can help relieve the pain associated with spondylosis. After this kind of treatment, the symptomes produced by irritated nerves and sore muscles can find some relief. Tuina helps patients with cervical spondylosis regain muscle control, nerve function and flexibility, all through the restoration of the life force flow.

High-resolution T{sub 2}-weighted cervical cancer imaging: a feasibility study on ultra-high-field 7.0-T MRI with an endorectal monopole antenna

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Hoogendam, Jacob P.; Verheijen, Rene H.M.; Zweemer, Ronald P. [University Medical Centre Utrecht, Department of Gynaecological Oncology, UMC Utrecht Cancer Centre, PO Box 85500, Utrecht (Netherlands); Kalleveen, Irene M.L.; Castro, Catalina S.A. de; Raaijmakers, Alexander J.E.; Bosch, Maurice A.A.J. van den; Klomp, Dennis W.J.; Veldhuis, Wouter B. [University Medical Centre Utrecht, Department of Radiology, Utrecht (Netherlands)

2017-03-15

We studied the feasibility of high-resolution T{sub 2}-weighted cervical cancer imaging on an ultra-high-field 7.0-T magnetic resonance imaging (MRI) system using an endorectal antenna of 4.7-mm thickness. A feasibility study on 20 stage IB1-IIB cervical cancer patients was conducted. All underwent pre-treatment 1.5-T MRI. At 7.0-T MRI, an external transmit/receive array with seven dipole antennae and a single endorectal monopole receive antenna were used. Discomfort levels were assessed. Following individualised phase-based B{sub 1} {sup +} shimming, T{sub 2}-weighted turbo spin echo sequences were completed. Patients had stage IB1 (n = 9), IB2 (n = 4), IIA1 (n = 1) or IIB (n = 6) cervical cancer. Discomfort (ten-point scale) was minimal at placement and removal of the endorectal antenna with a median score of 1 (range, 0-5) and 0 (range, 0-2) respectively. Its use did not result in adverse events or pre-term session discontinuation. To demonstrate feasibility, T{sub 2}-weighted acquisitions from 7.0-T MRI are presented in comparison to 1.5-T MRI. Artefacts on 7.0-T MRI were due to motion, locally destructive B{sub 1} interference, excessive B{sub 1} under the external antennae and SENSE reconstruction. High-resolution T{sub 2}-weighted 7.0-T MRI of stage IB1-IIB cervical cancer is feasible. The addition of an endorectal antenna is well tolerated by patients. (orig.)

Cervicitis

Science.gov (United States)

... that does not go away: discharge may be gray, white or yellow in color Painful sexual intercourse ... Names Cervical inflammation; Inflammation - cervix Images Female reproductive anatomy Cervicitis Uterus References Eckert LO, Lentz GM. Infections ...

HPV and cofactors for invasive cervical cancer in Morocco: a multicentre case-control study.

Science.gov (United States)

Berraho, Mohamed; Amarti-Riffi, Afaf; El-Mzibri, Mohammed; Bezad, Rachid; Benjaafar, Noureddine; Benideer, Abdelatif; Matar, Noureddine; Qmichou, Zinab; Abda, Naima; Attaleb, Mohammed; Znati, Kaoutar; El Fatemi, Hind; Bendahhou, Karima; Obtel, Majdouline; Filali Adib, Abdelhai; Mathoulin-Pelissier, Simone; Nejjari, Chakib

2017-06-20

Limited national information is available in Morocco on the prevalence and distribution of HPV-sub-types of cervical cancer and the role of other risk factors. The aim was to determine the frequency of HPV-sub-types of cervical cancer in Morocco and investigate risk factors for this disease. Between November 2009 and April 2012 a multicentre case-control study was carried out. A total of 144 cases of cervical cancer and 288 age-matched controls were included. Odds-ratios and corresponding confidence-intervals were computed by conditional logistic regression models. Current HPV infection was detected in 92.5% of cases and 13.9% of controls. HPV16 was the most common type for both cases and controls. Very strong associations between HPV-sub-types and cervical cancer were observed: total-HPV (OR = 39), HPV16 (OR = 49), HPV18 (OR = 31), and multiple infections (OR = 13). Education, high parity, sexual intercourse during menstruation, history of sexually transmitted infections, and husband's multiple sexual partners were also significantly associated with cervical cancer in the multivariate analysis. Our results could be used to establish a primary prevention program and to prioritize limited screening to women who have specific characteristics that may put them at an increased risk of cervical cancer.

Carotid Artery Injury in Anterior Cervical Spine Surgery: Multicenter Cohort Study and Literature Review

OpenAIRE

H?rtl, Roger; Alimi, Marjan; Abdelatif Boukebir, Mohamed; Berlin, Connor D.; Navarro-Ramirez, Rodrigo; Arnold, Paul M.; Fehlings, Michael G.; Mroz, Thomas E.; Riew, K. Daniel

2017-01-01

Study Design: Retrospective study and literature review. Objective: To provide more comprehensive data about carotid artery injury (CAI) or cerebrovascular accident (CVA) related to anterior cervical spine surgery. Methods: We conducted a retrospective, multicenter, case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network. Medical records of 17?625 patients who went through cervical spine surgery (levels from C2 to C7) between Januar...

Cervical occlusion in women with cervical insufficiency: protocol for a randomised, controlled trial with cerclage, with and without cervical occlusion

DEFF Research Database (Denmark)

Secher, Niels Jørgen; MaCormack, CD; Weber, Tom

2007-01-01

Kingdom, Spain, South Africa, Australia and India. This gives both a broad spectrum of diversity global and local. We expect a total of 242 women enrolled per year. POPULATION: Prophylactic study: 1. History of cervical incompetence/insufficiency. (Delivery 15 to ..., without the membranes being exposed to the vagina. 6. Tertiary cerclage: Short cervix, membranes exposed to the vagina. Observational study: Eligible women who refuse to be randomised will participate in an observational study. 7. Repeat/requested cervical occlusion. METHODS: The women will be randomised...... between a single (vaginal or abdominal) and a double cerclage. The cervical cerclage (McDonald or Shirodkar) as well as the abdominal suture will be performed with the same material and technique normally used by the participating department. Those randomised to the double cerclage will have...

Contemporary theories of cervical carcinogenesis: the virus, the host, and the stem cell.

Science.gov (United States)

Crum, C P

2000-03-01

Cervical cancer is a complex disease that, by its association with human papillomavirus (HPV), has elicited research in a broad range of areas pertaining to its basic diagnostic and clinical aspects. The complexity of this association lies not only in the fundamental relationship between virus and cancer but also in its translation to pathologic diagnosis and clinical management. Offshoots from the relationship of virus to pathology include studies targeting the link between papillomavirus infection and cervical epithelial abnormalities, the molecular epidemiology of papillomavirus infection, and the potential use of HPV testing as either a screening technique or a tool for managing women who have Pap smear abnormalities. A second variable that is critical to the pathogenesis of cervical neoplasia is the cervical transformation zone. The wide range of invasive and noninvasive lesion phenotypes associated with HPV infection in this region indicate that not only the virus but also specific host target epithelial cells in the transformation zone play an important part in the development of cervical neoplasia. Further understanding of this relationship between the virus and the host epithelium will hinge on determining the subtypes of epithelial cells in the transformation zone and their phenotypic response to infection. New technologies, such as expression arrays, promise to clarify, if not resolve, the complexity of molecular interactions leading to the multiplicity of tumor phenotypes associated with HPV infection of the uterine cervix.

Is there a difference in range of motion, neck pain, and outcomes in patients with ossification of posterior longitudinal ligament versus those with cervical spondylosis, treated with plated laminoplasty?

Science.gov (United States)

Fujimori, Takahito; Le, Hai; Ziewacz, John E; Chou, Dean; Mummaneni, Praveen V

2013-07-01

There are little data on the effects of plated, or plate-only, open-door laminoplasty on cervical range of motion (ROM), neck pain, and clinical outcomes. The purpose of this study was to compare ROM after a plated laminoplasty in patients with ossification of posterior longitudinal ligament (OPLL) versus those with cervical spondylotic myelopathy (CSM) and to correlate ROM with postoperative neck pain and neurological outcomes. The authors retrospectively compared patients with a diagnosis of cervical stenosis due to either OPLL or CSM who had been treated with plated laminoplasty in the period from 2007 to 2012 at the University of California, San Francisco. Clinical outcomes were measured using the modified Japanese Orthopaedic Association (mJOA) scale and neck visual analog scale (VAS). Radiographic outcomes included assessment of changes in the C2-7 Cobb angle at flexion and extension, ROM at C2-7, and ROM of proximal and distal segments adjacent to the plated lamina. Sixty patients (40 men and 20 women) with an average age of 63.1 ± 10.9 years were included in the study. Forty-one patients had degenerative CSM and 19 patients had OPLL. The mean follow-up period was 20.9 ± 13.1 months. The mean mJOA score significantly improved in both the CSM and the OPLL groups (12.8 to 14.5, p cervical ROM, especially in the extension angle. Among patients who have undergone laminoplasty, those with OPLL lose more ROM than do those with CSM. No correlation was observed between neck pain and ROM in either group. Neither group had a change in neck pain that reached the MCID following laminoplasty. Both groups improved in neurological function and outcomes.

Effects of emergency cervical cerclage on pregnancy outcome: a retrospective study of 158 cases.

Science.gov (United States)

Zhu, Li-Qiong; Chen, Hui; Chen, Li-Bin; Liu, Ying-Lin; Tian, Jian-Ping; Wang, Yun-Hui; Zhang, Rui; Zhang, Jian-Ping

2015-05-15

The aim of this study was to evaluate the effectiveness and safety of emergency cervical cerclage in women with advanced cervical dilatation and bulging of fetal membranes. The study included 158 women who underwent emergency cervical cerclage because of cervix dilatation and protruding membranes in mid-trimester at Sun Yat-sen Memorial Hospital of Sun Yat-sen University. Pregnancy outcomes and pregnancy outcome related to clinical features were analyzed retrospectively. Analysis revealed that the placement of emergency cerclage led to the delivery of live infants with a success rate of 82.28%. The mean interval between cerclage and delivery was 52.16.±26.62 days, with a mean gestation at delivery of 30.3±4.7 weeks and a mean birth weight of 1934.69±570.37 g. No severe maternal complications such as maternal death, hematosepsis, and hysterorrhexis occurred after the operation. Two women (1.25%) had laceration of the cervix, 1 woman (0.61%) suffered pulmonary edema, and 2 women (1.25%) developed deep vein thrombosis (DVT). There were significant correlations between the pregnancy outcome and risk factors, including any presenting symptoms, cervical dilatation, postoperative white blood cell count, and C-reactive protein (CRP) value. No significant difference was found in women with good vs. poor outcome in terms of maternal age and obstetric histories. Emergency cervical cerclage is effective in prolonging pregnancy and improving neonatal outcome in women with cervical incompetence. It should be considered a viable option for women with a dilated cervix in mid-trimester.

Ultrasonographic differentiation between Kikuchi's disease and lymphoma in patients with cervical lymphadenopathy

International Nuclear Information System (INIS)

Lo, Wu-Chia; Chang, Wen-Cheng; Lin, Yu-Chin; Hsu, Yao-Peng; Liao, Li-Jen

2012-01-01

Purpose: Kikuchi's disease, or histiocytic necrotizing lymphadenitis, is a self-limited necrotizing lymphadenitis. Clinically, it resembles lymphoma. We want to compare the sonographic features between Kikuchi's disease and lymphoma in patients with cervical lymphadenopathy. Materials and methods: The study protocol was approved by the institutional review board. Two hundred and twenty six cervical lymph nodes (137 nodes from 21 Kikuchi's disease patients and 89 nodes from 20 malignant lymphoma patients) were examined. The demographic and ultrasonographic characteristics of lymph nodes were collected and analyzed. Results: The Kikuchi's disease patients (mean age, 24.2 years; range, 8–57 years) were younger than those with lymphoma (mean age, 54 years; range, 13–81 years). There was no difference in laterality of nodes (p = 0.19). The nodal distribution demonstrated most enlarged neck lymph nodes located at level II, III and V. The ranges of short-axis and long-axis length were 6.5 ± 2.3 mm (mean ± SD) versus 13.4 ± 5.1 mm and 13.4 ± 5.0 mm versus 21.2 ± 9.2 mm for Kikuchi's disease versus lymphoma (p 0.05). Conclusion: Analysis of basic ultrasonographic characteristics (size, shape, rims, matting and echotexture) helps differentiate cervical lymph nodes in patients with Kikuchi's disease and lymphoma. Cervical lymphadenopathies in patients with Kikuchi's disease have smaller size, less round, less micronodular reticular echotexture, and more signs of matting and cortical widening than those with lymphoma examined under ultrasound.

Knot positioning during McDonald cervical cerclage, does it make a difference? A cohort study.

Science.gov (United States)

Atia, Hytham; Ellaithy, Mohamed; Altraigey, Ahmed; Ibrahim, Heba

2018-05-15

To study the effect of McDonald cerclage knot position on the different maternal and neonatal outcomes. This historical cohort study included women with singleton pregnancy who had a prophylactic McDonald cervical cerclage between 1 May 2010 and 31 September 2017. Maternal and neonatal outcome parameters were compared between the anterior and posterior knot cerclage procedures. The primary outcome measure was the rate of term birth. 550 Women had a prophylactic McDonald cervical cerclage, 306 with anterior knot (Group A) and 244 with posterior knot (Group B). There were no statistically significant differences regarding gestational age (GA) at delivery (36.3 ± 4.2 versus 35.8 ± 5.3 for groups A and B respectively), term birth rate, post-cerclage cervical length, symptomatic vaginitis, urinary tract infection, difficult cerclage removal and cervical lacerations. Similarly, there were no statistically significant differences as regards the studied neonatal outcomes including take home babies, neonatal intensive care admission, respiratory distress syndrome and neonatal sepsis. Survival analysis on GA at delivery demonstrated no statistically significant difference as regards the proportion of term deliveries in the anterior and posterior knot cerclage groups (log-rank test p-value = .478). Knot positioning during McDonald cervical cerclage, anteriorly or posteriorly, didn't significantly impact the studied maternal and neonatal outcomes.

Mechanoreceptors in Diseased Cervical Intervertebral Disc and Vertigo.

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Yang, Liang; Yang, Cheng; Pang, Xiaodong; Li, Duanming; Yang, Hong; Zhang, Xinwu; Yang, Yi; Peng, Baogan

2017-04-15

We collected the samples of cervical intervertebral discs from patients with vertigo to examine the distribution and types of mechanoreceptors in diseased cervical disc. The aim of this study was to determine whether mechanoreceptors are distributed more abundantly in cervical discs from patients with cervical spondylosis, and whether they are related to vertigo. Previous limited studies have found that normal cervical intervertebral discs are supplied with mechanoreceptors that have been considered responsible for proprioceptive functions. Several clinical studies have indicated that the patients with cervical spondylosis manifested significantly impaired postural control and subjective balance disturbance. We collected 77 samples of cervical discs from 62 cervical spondylosis patients without vertigo, 61 samples from 54 patients with vertigo, and 40 control samples from 8 cadaveric donors to investigate distribution of mechanoreceptors containing neurofilament (NF200) and S-100 protein immunoreactive nerve endings. The immunohistochemical investigation revealed that the most frequently encountered mechanoreceptors were the Ruffini corpuscles in all groups of cervical disc samples. They were obviously increased in the number and deeply ingrown into inner annulus fibrosus and even into nucleus pulposus in the diseased cervical discs from patients with vertigo in comparison with the discs from patients without vertigo and control discs. Only three Golgi endings were seen in the three samples from patients with vertigo. No Pacinian corpuscles were found in any samples of cervical discs. The diseased cervical discs from patients with vertigo had more abundant distribution of Ruffini corpuscles than other discs. A positive association between the increased number and ingrowth of Ruffini corpuscles in the diseased cervical disc and the incidence of vertigo in the patients with cervical spondylosis was found, which may indicate a key role of Ruffini corpuscles in the

Cervical collagen is reduced in non-pregnant women with a history of cervical insufficiency and a short cervix

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Sundtoft, Iben; Langhoff-Roos, Jens; Sandager, Puk

2017-01-01

INTRODUCTION: Preterm cervical shortening and cervical insufficiency may be caused by a constitutional weakness of the cervix. The aim of this study was to assess the cervical collagen concentration in non-pregnant women with a history of cervical insufficiency or of a short cervix in the second...... trimester of pregnancy. MATERIAL AND METHODS: In this case-control study we included non-pregnant women one year or more after pregnancy: 55 controls with a history of normal delivery; 27 women with a history of cervical insufficiency; and 10 women with a history of a short cervix (... women with a history of a long cervix (>95th percentile) at gestational weeks 18-20. We obtained biopsies (3 × 3-4 mm) from the ectocervix and determined the collagen concentration by measuring the hydroxyproline concentration. RESULTS: Women with cervical insufficiency had lower collagen concentrations...

Late urologic morbidity in 177 consecutive patients after radiotherapy for cervical carcinoma: a longitudinal study

International Nuclear Information System (INIS)

Lajer, Henrik; Thranov, Ingrid R.; Skovgaard, Lene T.; Engelholm, Svend Aa

2002-01-01

Purpose: To provide longitudinal data on urologic morbidity after radiotherapy and brachytherapy for cervical carcinoma. Methods and Materials: Five-year longitudinal urologic morbidity data were recorded from 177 consecutive patients of median age 59 years (range: 22-86 years) with cervical carcinoma receiving radiotherapy with curative intent at the Copenhagen University Hospital, Denmark. FIGO stages (%) were as follows: Stage I (15), Stage II (30), Stage III (54), and Stage IV (1). Late morbidity was calculated as cumulative incidence based on actuarial estimates. Results: The 5-year cumulative incidence based on actuarial estimates of urologic morbidity Grades 1 + 2 + 3, Grades 2 + 3, and Grade 3 were 62%, 32%, and 5%, respectively. Frequencies of urologic morbidity in the 54 recurrence-free survivors at the end of follow-up indicated some reversibility in the case of Grades 1 and 2 morbidity. Conclusion: With the longitudinal design used in the present study, a rate of mild and moderate morbidity higher than that found in most of the previously reported literature was observed, giving cause for concern and underlining the importance of further longitudinal studies on this subject, specifically studies that relate to the background urologic morbidity in the female population, as well as to the fact that urologic morbidity might regress

Knowledge of cervical cancer and HPV vaccine in Bangladeshi women: a population based, cross-sectional study.

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Islam, Jessica Yasmine; Khatun, Fatema; Alam, Anadil; Sultana, Farhana; Bhuiyan, Afsana; Alam, Nazmul; Reichenbach, Laura; Marions, Lena; Rahman, Mustafizur; Nahar, Quamrun

2018-01-11

The objective of this study was to assess the level of knowledge of cervical cancer among Bangladeshi women and to assess their willingness to receive the human papillomavirus (HPV) vaccine. A population-based, cross-sectional survey was conducted from July to December 2011 in one urban and one rural area of Bangladesh. A total of 2037 ever-married women, aged 14 to 64 years, were interviewed using a structured questionnaire. Data on socio-demographic characteristics and knowledge of cervical cancer were collected. Willingness to receive the HPV vaccine was assessed. Univariate analyses were completed using quantitative data collected. Multivariable logistic regression models were developed to identify factors associated with having heard of cervical cancer and the HPV vaccine. The majority of study participants reported to have heard of cervical cancer (urban: 89.7%, rural 93.4%; P = 0.003). The odds of having heard of cervical cancer were significantly higher in urban women aged 35-44 years (aOR: 2.92 (1.34-6.33) and rural women aged 25-34 years (aOR: 2.90 (1.24-6.73) compared to those aged less than 24 years. Very few women reported to have detailed knowledge on risk factors (urban:9.1%, rural: 8.8%) and prevention (urban: 6.4%, rural: 4.4%) of cervical cancer. In our sample, one in five urban women and one in twenty rural women heard about a vaccine that can prevent cervical cancer. Among urban women, secondary education or higher (aOR: 3.48, 95% CI: 1.67-7.25), age of 20 years and above at marriage (aOR: 2.83, 95% CI: 1.61-5.00), and high socioeconomic status (aOR: 2.25, 95% CI: 1.28-3.95) were factors associated with having heard of the HPV vaccine. Willingness to receive the HPV vaccine among study participants either for themselves (urban: 93.9%, rural: 99.4%) or for their daughters (urban: 91.8%, rural: 99.2%) was high. Detailed knowledge of cervical cancer among Bangladeshi women was found to be poor. Education on cervical cancer must include

Percutaneous endoscopic cervical discectomy for discogenic cervical headache due to soft disc herniation

International Nuclear Information System (INIS)

Ahn, Y.; Lee, S.H.; Shin, S.W.; Chung, S.E.; Park, H.S.

2005-01-01

A discogenic cervical headache is a subtype of cervicogenic headache (CEH) that arises from a degenerative cervical disc abnormality. The purpose of this study was to evaluate the clinical outcome of percutaneous endoscopic cervical discectomy (PECD) for patients with chronic cervical headache due to soft cervical disc herniation. Seventeen patients underwent PECD for intractable headache. The inclusion criteria were soft disc herniation without segmental instability, proven by both local anesthesia and provocative discography for headache unresponsive to conservative treatment. The mean follow-up period was 37.6 months. Fifteen of the 17 patients (88.2%) showed successful outcomes based on the Macnab criteria. Pain scores on a visual analog scale (VAS) improved from a preoperative mean of 8.35±0.79 to 2.12±1.17, postoperatively (P<0.01). The mean disc height decreased from 6.81±1.08 to 5.98±1.07 mm (P<0.01). There was no newly developed segmental instability or spontaneous fusion on follow-up radiography. In conclusion, PECD appears to be effective for chronic severe discogenic cervical headache under strict inclusion criteria. (orig.)

Trends in the Incidence of Cervical Cancer in Jordan, 2000–2013

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Ghazi Sharkas

2017-01-01

Full Text Available Objectives. To determine the incidence of cervical cancer in Jordan and assess its trend in over a 14-year period (2000–2013. Methods. This descriptive study was based on secondary analysis of cervical cancer data that are registered in the Jordan Cancer Registry (JCR. Results. A total of 591 women were diagnosed with cervical cancer in Jordan during the period 2000–2013. The age at diagnosis ranged between 15 and 97 years, with a median of 50 years. The average age standardized rate (ASR was 2.0/100,000 women. The incidence of cervical cancer started to decrease after 2006 but it remained relatively constant between 2008 and 2013. Over the 14-year period, ASR for cervical cancer decreased by 28.6% from 2.1 per 100,000 women in 2000 to 1.5 per 100,000 women in 2013. About 46.5% of the cases were of squamous cell carcinoma morphology. Early cancer constituted about 60% of the cases, regional cases constituted 9.6%, and distant metastatic cases constituted 10.7%. Conclusions. The incidence of cervical cancer in Jordan is low compared to regional estimates and remained relatively constant between 2008 and 2013. Implementation of screening measures could lead to better case finding, early diagnosis, and prevention of cervical cancer.

Whole-lesion ADC histogram and texture analysis in predicting recurrence of cervical cancer treated with CCRT.

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Meng, Jie; Zhu, Lijing; Zhu, Li; Xie, Li; Wang, Huanhuan; Liu, Song; Yan, Jing; Liu, Baorui; Guan, Yue; He, Jian; Ge, Yun; Zhou, Zhengyang; Yang, Xiaofeng

2017-11-03

To explore the value of whole-lesion apparent diffusion coefficient (ADC) histogram and texture analysis in predicting tumor recurrence of advanced cervical cancer treated with concurrent chemo-radiotherapy (CCRT). 36 women with pathologically confirmed advanced cervical squamous carcinomas were enrolled in this prospective study. 3.0 T pelvic MR examinations including diffusion weighted imaging (b = 0, 800 s/mm 2 ) were performed before CCRT (pre-CCRT) and at the end of 2nd week of CCRT (mid-CCRT). ADC histogram and texture features were derived from the whole volume of cervical cancers. With a mean follow-up of 25 months (range, 11 ∼ 43), 10/36 (27.8%) patients ended with recurrence. Pre-CCRT 75th, 90th, correlation, autocorrelation and mid-CCRT ADC mean , 10th, 25th, 50th, 75th, 90th, autocorrelation can effectively differentiate the recurrence from nonrecurrence group with area under the curve ranging from 0.742 to 0.850 (P values range, 0.001 ∼ 0.038). Pre- and mid-treatment whole-lesion ADC histogram and texture analysis hold great potential in predicting tumor recurrence of advanced cervical cancer treated with CCRT.

Get Tested for Cervical Cancer

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... Print This Topic En español Get Tested for Cervical Cancer Browse Sections The Basics Overview Cervical Cancer Cervical ... Cervical Cancer 1 of 5 sections The Basics: Cervical Cancer What is cervical cancer? Cervical cancer is cancer ...

Comparative Effectiveness of Different Types of Cervical Laminoplasty

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Heller, John G.; Raich, Annie L.; Dettori, Joseph R.; Riew, K. Daniel

2013-01-01

Study Design Systematic review. Study Rationale Numerous cervical laminoplasty techniques have been described but there are few studies that have compared these to determine the superiority of one over another. Clinical Questions The clinical questions include key question (KQ)1: In adults with cervical myelopathy from ossification of the posterior longitudinal ligament (OPLL) or spondylosis, what is the comparative effectiveness of open door cervical laminoplasty versus French door cervical ...

Imaging findings of primary immunoglobulin G4-related cervical lymphadenopathy

International Nuclear Information System (INIS)

Kawaguchi, Masaya; Kato, Hiroki; Goshima, Satoshi; Matsuo, Masayuki; Kito, Yusuke; Mizuta, Keisuke; Aoki, Mitsuhiro; Kato, Keizo

2017-01-01

The purpose of the present study was to assess imaging findings of primary immunoglobulin G4 (IgG4)-related cervical lymphadenopathy. Five consecutive patients with clinically, serologically, and histopathologically confirmed primary IgG4-related cervical lymphadenopathy without any other organ involvement were included. All patients underwent contrast-enhanced computed tomography (CT), and four underwent 18 F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT. We retrospectively reviewed the images and assessed the number, size, location, central necrosis, perinodal infiltration, penetrating vessels, and maximum standardized uptake values (SUVmax) of the enlarged cervical nodes. Thirteen enlarged cervical nodes measuring larger than 10 mm in minimum diameter were identified. The maximum and minimum diameter of enlarged nodes ranged from 1.2 to 3.2 cm (median, 1.8 cm) and from 1.0 to 1.9 cm (median, 1.2 cm), respectively. Lymphadenopathy was unilateral in all patients, and eight enlarged nodes were located at level IB (62%), one at level II (8%), three at level IV (23%), and one at level V (8%). Central necrosis was not seen in any nodes. Perinodal infiltration was seen in only one node (8%), and penetrating vessels were seen in seven nodes (54%). The median SUVmax of nine nodes was 4.45 (range, 2.08-12.44). Eight enlarged nodes (62%) were located in the submandibular region. Central necrosis was not observed in any nodes and perinodal infiltration was observed in one node (8%). (orig.)

Imaging findings of primary immunoglobulin G4-related cervical lymphadenopathy

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Kawaguchi, Masaya; Kato, Hiroki; Goshima, Satoshi; Matsuo, Masayuki [Gifu University School of Medicine, Department of Radiology, Gifu (Japan); Kito, Yusuke [Gifu University School of Medicine, Department of Pathology and Translational Research, Gifu (Japan); Mizuta, Keisuke; Aoki, Mitsuhiro [Gifu University School of Medicine, Department of Otolaryngology, Gifu (Japan); Kato, Keizo [Gifu University School of Medicine, Department of Oral and Maxillofacial Sciences, Gifu (Japan)

2017-11-15

The purpose of the present study was to assess imaging findings of primary immunoglobulin G4 (IgG4)-related cervical lymphadenopathy. Five consecutive patients with clinically, serologically, and histopathologically confirmed primary IgG4-related cervical lymphadenopathy without any other organ involvement were included. All patients underwent contrast-enhanced computed tomography (CT), and four underwent {sup 18}F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT. We retrospectively reviewed the images and assessed the number, size, location, central necrosis, perinodal infiltration, penetrating vessels, and maximum standardized uptake values (SUVmax) of the enlarged cervical nodes. Thirteen enlarged cervical nodes measuring larger than 10 mm in minimum diameter were identified. The maximum and minimum diameter of enlarged nodes ranged from 1.2 to 3.2 cm (median, 1.8 cm) and from 1.0 to 1.9 cm (median, 1.2 cm), respectively. Lymphadenopathy was unilateral in all patients, and eight enlarged nodes were located at level IB (62%), one at level II (8%), three at level IV (23%), and one at level V (8%). Central necrosis was not seen in any nodes. Perinodal infiltration was seen in only one node (8%), and penetrating vessels were seen in seven nodes (54%). The median SUVmax of nine nodes was 4.45 (range, 2.08-12.44). Eight enlarged nodes (62%) were located in the submandibular region. Central necrosis was not observed in any nodes and perinodal infiltration was observed in one node (8%). (orig.)

January Monthly Spotlight: Cervical Health and Cervical Cancer Disparities

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In January, CRCHD joins the nation in raising awareness for Cervical Health and Cervical Cancer Disparities. This month we share a special focus on NCI/CRCHD research programs that are trying to reduce cervical cancer disparities in underserved communities and the people who are spreading the word about the importance of early detection.

Barriers and facilitators to cervical cancer screening among Pakistani and Somali immigrant women in Oslo: a qualitative study.

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Gele, Abdi A; Qureshi, Samera A; Kour, Prabhjot; Kumar, Bernadette; Diaz, Esperanza

2017-01-01

Norway has a low incidence and mortality rate of cervical cancer, which is mainly due to the high participation rate of women in cervical cancer screening. However, the attendance of cervical cancer screening was reported to be low among immigrant women. For this reason, we conducted a qualitative study to obtain better insight into perceived barriers and challenges to cervical cancer screening among Somali and Pakistani women in the Oslo region. A convenient sample of 35 (18 Pakistani, 17 Somali) women were recruited for the study in collaboration with Somali and Pakistani community partners. Focus group discussions were used to explore barriers and facilitators to cervical cancer screening, whereas the Ecological Model was used as the framework for the study. The study found three levels of barriers to cervical cancer screening. The individual level included a lack of understanding of the benefits of the screening. The sociocultural level included the stigma attached to the disease and the belief that women who are unmarried are sexually inactive. The system-related level included a lack of trust toward the health care system. Based on the study results, and using a common denominator approach for the immigrant groups included, the study recommends three communication strategies with the potential to improve women's participation in cervical cancer screening: 1) in-person communication and information material at health centers; 2) verbal communication with women through seminars and workshops to educate them about their risk of cancer and the importance of screening and 3) the initiation of better recall through SMS and letters written in native languages. Finally, an intervention study that compares the aforementioned strategies and proves their effectiveness in increasing immigrant women's participation in cervical cancer screening is recommended.

Comparative effectiveness of different types of cervical laminoplasty.

Science.gov (United States)

Heller, John G; Raich, Annie L; Dettori, Joseph R; Riew, K Daniel

2013-10-01

Study Design Systematic review. Study Rationale Numerous cervical laminoplasty techniques have been described but there are few studies that have compared these to determine the superiority of one over another. Clinical Questions The clinical questions include key question (KQ)1: In adults with cervical myelopathy from ossification of the posterior longitudinal ligament (OPLL) or spondylosis, what is the comparative effectiveness of open door cervical laminoplasty versus French door cervical laminoplasty? KQ2: In adults with cervical myelopathy from OPLL or spondylosis, are postoperative complications, including pain and infection, different for the use of miniplates versus the use of no plates following laminoplasty? KQ3: Do these results vary based on early active postoperative cervical motion? Materials and Methods A systematic review of the English-language literature was undertaken for articles published between 1970 and March 11, 2013. Electronic databases and reference lists of key articles were searched to identify studies evaluating (1) open door cervical laminoplasty and French door cervical laminoplasty and (2) the use of miniplates or no plates in cervical laminoplasty for the treatment of cervical spondylotic myelopathy or OPLL in adults. Studies involving traumatic onset, cervical fracture, infection, deformity, or neoplasms were excluded, as were noncomparative studies. Two independent reviewers (A.L.R., J.R.D.) assessed the level of evidence quality using the Grades of Recommendations Assessment, Development and Evaluation system, and disagreements were resolved by consensus. Results We identified three studies (one of class of evidence [CoE] II and two of CoE III) meeting our inclusion criteria comparing open door cervical laminoplasty with French door laminoplasty and two studies (one CoE II and one CoE III) comparing the use of miniplates with no plates. Data from one randomized controlled trial (RCT) and two retrospective cohort

Are upright lateral cervical radiographs in the obtunded trauma patient useful? A retrospective study

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Bolles Gene

2007-02-01

Full Text Available Abstract Background The best method for radiographic "clearance" of the cervical spine in obtunded patients prior to removal of cervical immobilization devices remains debated. Dynamic radiographs or MRI are thought to demonstrate unstable injuries, but can be expensive and cumbersome to obtain. An upright lateral cervical radiograph (ULCR was performed in selected patients to investigate whether this study could provide this same information, to enable removal of cervical immobilization devices in the multiple trauma patient. Methods We retrospectively reviewed our experience with ULCR in 683 blunt trauma victims who presented over a 3-year period, with either a Glasgow Coma Score Results ULCR was performed in 163 patients. Seven patients had studies interpreted to be abnormal, of which six were also abnormal, by either CT or MRI. The seventh patient's only abnormality was soft tissue swelling; MRI was otherwise normal. Six patients had ULCR interpreted as normal, but had abnormalities on either CT or MRI. None of the missed injuries required surgical stabilization, although one had a vertebral artery injury demonstrated on subsequent angiography. ULCR had an apparent sensitivity of 45.5% and specificity of 71.4%. Conclusion ULCR are inferior to both CT and MRI in the detection of cervical injury in patients with normal plain radiographs. We therefore cannot recommend the use of ULCR in the obtunded trauma patient.

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

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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.

Effect of changes in treatment practice on survival for cervical cancer: results from a population-based study in Manitoba, Canada

International Nuclear Information System (INIS)

Kang, Yoon-Jung; O’Connell, Dianne L.; Lotocki, Robert; Kliewer, Erich V.; Goldsbury, David E.; Demers, Alain A.; Canfell, Karen

2015-01-01

Results from clinical trials in the 1990s led to changes in the recommended treatment for the standard therapy for stage IIB-IVA cervical cancer from radiotherapy alone to chemo-radiotherapy. We conducted the first population-based study in Canada to investigate temporal treatment patterns for cervical cancer and long-term survival in relation to these changes in the treatment guidelines. Detailed information on stage and treatment for 1085 patients diagnosed with cervical cancer in 1984–2008 and identified from the population-based Manitoba Cancer Registry (MCR) in Canada was obtained from clinical chart review and the MCR. Factors associated with receiving guideline treatment were identified using logistic regression. All cause and cervical cancer specific survival were compared in patients who were and were not treated as recommended in the guidelines, using Cox proportional hazards models. The median follow-up time was 6.4 years (range: 0.05–26.5 years). The proportion of women who received guideline treatment was 79 % (95 % confidence interval [CI]: 76–81 %). However, the likelihood of being treated according to the guidelines over time was modified by age (p < 0.0001) and tumour stage at diagnosis (p = 0.002). Women who were treated according to the guidelines after the change in recommended clinical practice (1999–2008) had a significantly lower risk of death from all causes and from cervical cancer. This was driven by lower mortality rates in cases with stage IIB-IVA tumours (all causes of death: hazard ratio [HR] = 0.60, 95 % CI: 0.43–0.82, p = 0.002; cervical cancer related death: HR = 0.64, 95 % CI: 0.44–0.93, p = 0.02). The management of cervical cancer patients in Manitoba, Canada was in good agreement with treatment guidelines although reasons for departure from the guideline recommendations could not be examined further due to lack of data. Treatment of stage IIB-IVA cervical cancers with recommended concurrent chemo-radiotherapy, which

Combination of microbiological culture and multiplex PCR increases the range of vaginal microorganisms identified in cervical cancer patients at high risk for bacterial vaginosis and vaginitis.

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Schmidt, Katarzyna; Cybulski, Zefiryn; Roszak, Andrzej; Grabiec, Alicja; Talaga, Zofia; Urbański, Bartosz; Odważna, Joanna; Wojciechowicz, Jacek

2015-05-01

Bacterial vaginosis (BV) and vaginitis in cervical cancer patients might becaused by mixed aerobic, anaerobic, and atypical bacteria. Since genital tract infections can be complicated, early and accurate identification of causal pathogens is vital. The purpose of this study was i) to determinate if currently used aerobic culture methods are sufficiently sensitive to identify pathogens that can appear in the cervix of women after cancer treatment; ii) to investigate if molecular methods can improve the diagnostic process of BV and vaginitis, as well as broaden the range of detectable pathogens that would otherwise be difficult to cultivate. A one-year hospital-based study was conducted in 2011/2012. Cervical swabs from 130 patients were examined by microbiological culture and multiplex PCR. Swab samples were positive for 107 and 93 women by microbiological culture and multiplex PCR, respectively The most common bacteria isolated from culture were: Escherichia coli, Enterococcus faecalis, Streptococcus agalactiae, and Staphylococcus aureus, and using the molecular technique were: Gardnerella vaginalis, Bacteroides fragilis, Ureoplasma ureoliticum/parvum, Mobiluncus curtisii and Atopobium vaginae. Multiplex PCR might contribute to the diagnosis of genital tract infections and it broadens the number of detectable microorganisms responsible for BV. Combination of these two methods may become the basis for standardized diagnosis of BV and vaginitis.

A regional cooperative clinical study of radiotherapy for cervical cancer in east and south-east Asian countries

International Nuclear Information System (INIS)

Nakano, Takashi; Kato, Shingo; Cao, Jianping; Zhou Juying; Susworo, Raden; Supriana, Nana; Sato, Shinichiro; Ohno, Tatsuya; Suto, Hisao; Nakamura, Yuzuru; Cho, Chul-Koo; Ismail, Fuad B.; Calaguas, Miriam J.C.; Reyes, Rey H. de los; Chansilpa, Yaowalak; Thephamongkhol, Kullathom; Nguyen Ba Duc; To Anh Dung; Tsujii, Hirohiko

2007-01-01

Purpose: Radiotherapy differed widely in east and south-east Asia because of technical, cultural, and socio-economic differences. With the purpose of standardizing radiotherapy for cervical cancer in the region, an international clinical study was conducted. Materials and methods: Eleven institutions in eight Asian countries participated in the study. Between 1996 and 1998, 210 patients with stage IIIB cervical cancer were enrolled. Patients were treated with a combination of external beam radiotherapy (total dose, 50 Gy) and either high-dose-rate (HDR) or low-dose-rate (LDR) intracavitary brachytherapy (ICBT) according to the institutional practice. The planned point A dose was 20-28 Gy/4 fractions for HDR-ICBT and 30-40 Gy/1-2 fractions for LDR-ICBT. Results: Hundred patients were treated with HDR-ICBT and 110 were treated with LDR-ICBT. The ICBT doses actually delivered to point A ranged widely: 12-32 Gy in the HDR group and 26-52.7 Gy in the LDR group. The 5-year follow-up rate among the countries differed greatly, from 29% to 100%. The 5-year major complication rates were 6% in the HDR group and 10% in the LDR group. The 5-year overall survival rates were 51.1% in the HDR group and 57.5% in the LDR group. Conclusions: Although there were several problems with treatment compliance and patients' follow-up, the study suggests that the protocols provided favorable outcomes with acceptable rates of late complications in the treatment of advanced cervical cancer in east and south-east Asia

Cervical Musculoskeletal Impairments and Temporomandibular Disorders

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Magee, David

2012-01-01

ABSTRACT Objectives The study of cervical muscles and their significance in the development and perpetuation of Temporomandibular Disorders has not been elucidated. Thus this project was designed to investigate the association between cervical musculoskeletal impairments and Temporomandibular Disorders. Material and Methods A sample of 154 subjects participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maximal cervical muscle strength, cervical flexor and extensor muscles endurance, and cervical flexor muscle performance) to determine cervical musculoskeletal impairments. Results A strong relationship between neck disability and jaw disability was found (r = 0.82). Craniocervical posture was statistically different between patients with myogenous Temporomandibular Disorders (TMD) and healthy subjects. However, the difference was too small (3.3º) to be considered clinically relevant. Maximal cervical flexor muscle strength was not statistically or clinically different between patients with TMD and healthy subjects. No statistically significant differences were found in electromyographic activity of the sternocleidomastoid or the anterior scalene muscles in patients with TMD when compared to healthy subjects while executing the craniocervical flexion test (P = 0.07). However, clinically important effect sizes (0.42 - 0.82) were found. Subjects with TMD presented with reduced cervical flexor as well as extensor muscle endurance while performing the flexor and extensor muscle endurance tests when compared to healthy individuals. Conclusions Subjects with Temporomandibular Disorders presented with impairments of the cervical flexors and extensors muscles. These results could help guide clinicians in the assessment and prescription of more effective interventions for individuals with Temporomandibular Disorders. PMID:24422022

Cervical Musculoskeletal Impairments and Temporomandibular Disorders

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Susan Armijo-Olivo

2012-09-01

Full Text Available Objectives: The study of cervical muscles and their significance in the development and perpetuation of Temporomandibular Disorders has not been elucidated. Thus this project was designed to investigate the association between cervical musculoskeletal impairments and Temporomandibular Disorders. Material and Methods: A sample of 154 subjects participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maximal cervical muscle strength, cervical flexor and extensor muscles endurance, and cervical flexor muscle performance to determine cervical musculoskeletal impairments. Results: A strong relationship between neck disability and jaw disability was found (r = 0.82. Craniocervical posture was statistically different between patients with myogenous Temporomandibular Disorders (TMD and healthy subjects. However, the difference was too small (3.3º to be considered clinically relevant. Maximal cervical flexor muscle strength was not statistically or clinically different between patients with TMD and healthy subjects. No statistically significant differences were found in electromyographic activity of the sternocleidomastoid or the anterior scalene muscles in patients with TMD when compared to healthy subjects while executing the craniocervical flexion test (P = 0.07. However, clinically important effect sizes (0.42 - 0.82 were found. Subjects with TMD presented with reduced cervical flexor as well as extensor muscle endurance while performing the flexor and extensor muscle endurance tests when compared to healthy individuals. Conclusions: Subjects with Temporomandibular Disorders presented with impairments of the cervical flexors and extensors muscles. These results could help guide clinicians in the assessment and prescription of more effective interventions for individuals with Temporomandibular Disorders.

High Smac/DIABLO expression is associated with early local recurrence of cervical cancer

International Nuclear Information System (INIS)

Arellano-Llamas, Abril; Garcia, Francisco J; Perez, Delia; Cantu, David; Espinosa, Magali; De la Garza, Jaime G; Maldonado, Vilma; Melendez-Zajgla, Jorge

2006-01-01

In a recent pilot report, we showed that Smac/DIABLO mRNA is expressed de novo in a subset of cervical cancer patients. We have now expanded this study and analyzed Smac/DIABLO expression in the primary lesions in 109 cervical cancer patients. We used immunohistochemistry of formalin-fixed, paraffin-embedded tissue sections to analyze Smac/DIABLO expression in the 109 primary lesions. Seventy-eight samples corresponded to epidermoid cervical cancer and 31 to cervical adenocarcinoma. The median follow up was 46.86 months (range 10–186). Smac/DIABLO was expressed in more adenocarcinoma samples than squamous tumours (71% vs 50%; p = 0.037). Among the pathological variables, a positive correlation was found between Smac/DIABLO immunoreactivity and microvascular density, a marker for angiogenesis (p = 0.04). Most importantly, Smac/DIABLO immunoreactivity was associated with a higher rate of local recurrence in squamous cell carcinoma (p = 0.002, log rank test). No association was found between Smac/DIABLO and survival rates. Smac/DIABLO expression is a potential marker for local recurrence in cervical squamous cell carcinoma patients

Recurrent Laryngeal Nerve Palsy After Cervical Spine Surgery: A Multicenter AOSpine Clinical Research Network Study

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Gokaslan, Ziya L.; Bydon, Mohamad; De la Garza-Ramos, Rafael; Smith, Zachary A.; Hsu, Wellington K.; Qureshi, Sheeraz A.; Cho, Samuel K.; Baird, Evan O.; Mroz, Thomas E.; Fehlings, Michael; Arnold, Paul M.; Riew, K. Daniel

2017-01-01

Study Design: Multicenter retrospective study. Objectives: To investigate the risk of symptomatic recurrent laryngeal nerve palsy (RLNP) following cervical spine surgery, to examine risk factors for its development, and to report its treatment and outcomes. Methods: A multicenter study from 21 high-volume surgical centers from the AOSpine North America Clinical Research Network was performed. Each center screened for rare complications following cervical spine surgery, including RLNP. Patient...

Comparison of Cervical Kinematics, Pain, and Functional Disability Between Single- and Two-level Anterior Cervical Discectomy and Fusion.

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Chien, Andy; Lai, Dar-Ming; Wang, Shwu-Fen; Hsu, Wei-Li; Cheng, Chih-Hsiu; Wang, Jaw-Lin

2016-08-01

A prospective, time series design. The purpose of this study is two-fold: firstly, to investigate the impact of altered cervical alignment and range of motion (ROM) on patients' self-reported outcomes after anterior cervical discectomy and fusion (ACDF), and secondly, to comparatively differentiate the influence of single- and two-level ACDF on the cervical ROM and adjacent segmental kinematics up to 12-month postoperatively. ACDF is one of the most commonly employed surgical interventions to treat degenerative disc disease. However, there are limited in vivo data on the impact of ACDF on the cervical kinematics and its association with patient-reported clinical outcomes. Sixty-two patients (36 males; 55.63 ± 11.6 yrs) undergoing either a single- or consecutive two-level ACDF were recruited. The clinical outcomes were assessed with the Pain Visual Analogue Scale (VAS) and the Neck Disability Index (NDI). Radiological results included cervical lordosis, global C2-C7 ROM, ROM of the Functional Spinal Unit (FSU), and its adjacent segments. The outcome measures were collected preoperatively and then at 3, 6, and 12-month postoperatively. A significant reduction of both VAS and NDI was found for both groups from the preoperative to 3-month period (P < 0.01). Pearson correlation revealed no significant correlation between global ROM with neither VAS (P = 0.667) nor NDI (P = 0.531). A significant reduction of global ROM was identified for the two-level ACDF group at 12 months (P = 0.017) but not for the single-level group. A significant interaction effect was identified for the upper adjacent segment ROM (P = 0.024) but not at the lower adjacent segment. Current study utilized dynamic radiographs to comparatively evaluate the biomechanical impact of single- and two-level ACDF. The results highlighted that the two-level group demonstrated a greater reduction of global ROM coupled with an increased upper adjacent segmental compensatory motions that

Nuclear expression of Rac1 in cervical premalignant lesions and cervical cancer cells

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Mendoza-Catalán, Miguel A; Castañeda-Saucedo, Eduardo; Cristóbal-Mondragón, Gema R; Adame-Gómez, Jesús; Valle-Flores, Heidi N del; Coppe, José Fco; Sierra-López, Laura; Romero-Hernández, Mirna A; Carmen Alarcón-Romero, Luz del; Illades-Aguiar, Berenice

2012-01-01

Abnormal expression of Rho-GTPases has been reported in several human cancers. However, the expression of these proteins in cervical cancer has been poorly investigated. In this study we analyzed the expression of the GTPases Rac1, RhoA, Cdc42, and the Rho-GEFs, Tiam1 and beta-Pix, in cervical pre-malignant lesions and cervical cancer cell lines. Protein expression was analyzed by immunochemistry on 102 cervical paraffin-embedded biopsies: 20 without Squamous Intraepithelial Lesions (SIL), 51 Low- grade SIL, and 31 High-grade SIL; and in cervical cancer cell lines C33A and SiHa, and non-tumorigenic HaCat cells. Nuclear localization of Rac1 in HaCat, C33A and SiHa cells was assessed by cellular fractionation and Western blotting, in the presence or not of a chemical Rac1 inhibitor (NSC23766). Immunoreacivity for Rac1, RhoA, Tiam1 and beta-Pix was stronger in L-SIL and H-SIL, compared to samples without SIL, and it was significantly associated with the histological diagnosis. Nuclear expression of Rac1 was observed in 52.9% L-SIL and 48.4% H-SIL, but not in samples without SIL. Rac1 was found in the nucleus of C33A and SiHa cells but not in HaCat cells. Chemical inhibition of Rac1 resulted in reduced cell proliferation in HaCat, C33A and SiHa cells. Rac1 is expressed in the nucleus of epithelial cells in SILs and cervical cancer cell lines, and chemical inhibition of Rac1 reduces cellular proliferation. Further studies are needed to better understand the role of Rho-GTPases in cervical cancer progression

Cervical spine injuries in American football.

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Rihn, Jeffrey A; Anderson, David T; Lamb, Kathleen; Deluca, Peter F; Bata, Ahmed; Marchetto, Paul A; Neves, Nuno; Vaccaro, Alexander R

2009-01-01

catastrophic injury is felt to be the result of changes in the rules in the mid-1970s that prohibited the use of the head as the initial contact point when blocking and tackling. Evaluation of patients with suspected cervical spine injury includes a complete neurological examination while on the field or the sidelines. Immobilization on a hard board may also be necessary. The decision to obtain radiographs can be made on the basis of the history and physical examination. Treatment depends on severity of diagnosed injury and can range from an individualized cervical spine rehabilitation programme for a 'stinger' to cervical spine decompression and fusion for more serious bony or ligamentous injury. Still under constant debate is the decision to return to play for the athlete.

Cervical syphilitic lesions mimicking cervical cancer: a rare case report

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Xiaoqing Zhu

2015-02-01

Full Text Available A woman presented to the hospital due to postcoital vaginal bleeding. The patient was initially diagnosed with cervical carcinoma by clinicians at a local hospital. However, a biopsy of the cervical lesions revealed chronic inflammation and erosion of the cervical mucosa, and the rapid plasma reagin ratio titer was 1:256. The patient was eventually diagnosed with syphilitic cervicitis and treated with minocycline 0.1 g twice a day. The patient was cured with this treatment.

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

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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

The radiographic observation of the cervical strain

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Rhee, Chung Sik

1972-01-01

A total of 100 cases of cervical disorders were analysed of clinical signs and symptoms. The cervical strain is proved by the loss of normal lordotic curvature of the cervical spinal column on the lateral x-ray film in Ewha University Hospital from January, 1970 to december 1971 with the following results. 1. The 53 cervical strain was diagnosed in radiographic study for its abnormal locations. The hyperextension with abnormal curve is twice more after than hyperflection type. 2. The most frequent location of the cervical strain is demonstrated in the 4-6 th cervical spinal bodies (80%). 3. Most pronounced symptoms of cervical strain are local tenderness (40%), limitation of motion (17%) and radiating pain (15%). 4. The ratio of the sex incidence of male female was 3:2

The radiographic observation of the cervical strain

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Rhee, Chung Sik [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

1972-12-15

A total of 100 cases of cervical disorders were analysed of clinical signs and symptoms. The cervical strain is proved by the loss of normal lordotic curvature of the cervical spinal column on the lateral x-ray film in Ewha University Hospital from January, 1970 to december 1971 with the following results. 1. The 53 cervical strain was diagnosed in radiographic study for its abnormal locations. The hyperextension with abnormal curve is twice more after than hyperflection type. 2. The most frequent location of the cervical strain is demonstrated in the 4-6 th cervical spinal bodies (80%). 3. Most pronounced symptoms of cervical strain are local tenderness (40%), limitation of motion (17%) and radiating pain (15%). 4. The ratio of the sex incidence of male female was 3:2.

Cervical cytology and the diagnosis of cervical cancer in older women.

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Landy, Rebecca; Castanon, Alejandra; Dudding, Nick; Lim, Anita Wey Wey; Hollingworth, Antony; Hamilton, Willie; Sasieni, Peter D

2015-12-01

Most non-screen-detected cervical cancers are advanced stage. We assess the potential for cytology to expedite diagnosis when used outside of routine call and recall screening for cervical cancer. Two cohorts of women with cytology that did not appear to have been taken as part of routine screening, nested within a census of cervical cytology, in England between April 2007 and March 2010 were studied: 93,322 women aged 40-69 at first cytology, and 14,668 women aged ≥70. The diagnostic performance of high grade cervical squamous intraepithelial lesion (HSIL) or worse cytology was estimated. We also estimated case-fatality from stage distribution in women aged ≥66 with and without cytology in the year prior to diagnosis. There were 259 cancers diagnosed in women aged 40-69 at first cytology, and 78 in women aged ≥70. The sensitivity of cytology ≥ HSIL for cancer was 89% and 83% respectively, and the number of women needed to test to identify one cancer was 404 (95% confidence interval [CI]: 355-462) and 226 (95% CI: 177-292) respectively. Women aged ≥66 with cytology within a year of diagnosis had earlier stage cancers than those without, corresponding to a 17-22% reduction in case fatality. Cervical cytology is an excellent identifier of cancer among women tested outside routine screening call and recall. Its use as a triage tool, for instance in women with vague gynaecological symptoms, could facilitate earlier stage diagnosis and reduce cervical cancer mortality. © The Author(s) 2015.

Cervical cancer screening and adherence to follow-up among Hispanic women study protocol: a randomized controlled trial to increase the uptake of cervical cancer screening in Hispanic women

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Duggan Catherine

2012-05-01

Full Text Available Abstract Background In the US, Hispanic women have a higher incidence of, and mortality from, cervical cancer than non-Hispanic white women. The reason for this disparity may be attributable to both low rates of screening and poor adherence to recommended diagnostic follow-up after an abnormal Pap test. The 'Cervical Cancer Screening and Adherence to Follow-up Among Hispanic Women' study is a collaboration between a research institution and community partners made up of members from community based organizations, the Yakima Valley Farm Workers Clinic and the Breast, Cervical, and Colon Health Program of the Yakima District . The study will assess the efficacy of two culturally-appropriate, tailored educational programs designed to increase cervical cancer screening among Hispanic women, based in the Yakima Valley, Washington, US. Methods/design A parallel randomized-controlled trial of 600 Hispanic women aged 21–64, who are non-compliant with Papanicolau (Pap test screening guidelines. Participants will be randomized using block randomization to (1 a control arm (usual care; (2 a low-intensity information program, consisting of a Spanish-language video that educates women on the importance of cervical cancer screening; or (3 a high-intensity program consisting of the video plus a ‘promotora’ or lay-community health educator-led, home based intervention to encourage cervical cancer screening. Participants who attend cervical cancer screening, and receive a diagnosis of an abnormal Pap test will be assigned to a patient navigator who will provide support and information to promote adherence to follow-up tests, and any necessary surgery or treatment. Primary endpoint: Participants will be tracked via medical record review at community-based clinics, to identify women who have had a Pap test within 7 months of baseline assessment. Medical record reviewers will be blinded to randomization arm. Secondary endpoint: An evaluation of the patient

Tracheostomy following anterior cervical spine fusion in trauma patients.

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Binder, Harald; Lang, Nikolaus; Tiefenboeck, Thomas M; Bukaty, Adam; Hajdu, Stefan; Sarahrudi, Kambiz

2016-06-01

Traumatic injuries to the cervical spine are frequently accompanied by cervical spinal cord injuries-often necessitating tracheostomy. The purpose of this study was to evaluate patient characteristics and outcomes after undergoing anterior cervical spine fusion (ACSF) with tracheostomy. All patients with cervical spine injury (CSI) who underwent ACSF and tracheostomy between December 1992 and June 2014 were included in this retrospective data analysis. The study group consisted of 32 men (84 %) and six women (16 %), with an average age of 47 ± 20 years. Blunt trauma to the cervical spine was the cause of CSI in all 38 patients. The mean Injury Severity Score (ISS) was 30.50 ± 6.25. Eighteen patients sustained severe concomitant injuries related to the spinal injury. In 15 patients (39.5 %), traumatic brain injury (TBI) with fractures of the cranium and/or intracranial lesions were observed. The mean Glasgow Coma Scale (GCS) score was 11 ± 4.5 (range 3-15). Two tracheostomies (5.3 %) were performed simultaneously with ACSF. The remaining 36 were performed with an average "delay" of 15 ± ten days. We observed no difference in time to tracheostomy among patients initially presenting with an American Spinal Injury Association (ASIA) score of either A, B, C or D. Only two patients (5.3 %) were identified as having an infection at the site of ACSF after placement of a tracheostomy. There were no deaths directly related to airway difficulties in our cohort. Our data show that tracheostomy is safely performed after an average of 15 days post-ACSF, thereby being associated with a very low rate of complications. However, future prospective randomised studies are needed to identify the optimal timing of tracheostomy placement after ACSF. IV; retrospective case series.

"Wrestling induced cervical spondylosis, fact or fiction? A study conducted in 148 athletes "

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"Fakhr Tabatabai SA

2000-11-01

Full Text Available Traumatic injuries are leading causes of spinal cord damage. The purpose of this study was to evaluate whether wrestling induced cervical spondylosis amongst professional wrestlers or not. To test this assumption, two groups of athletes, 72 wrestlers versus 76 non-wrestlers 15-55 years of age were studied. Radiographic findings and clinical assessment were compared in both groups. Significant difference (Odd ratio=2.91, P=0.007 were noted between the two groups regarding the prevalence of radiological cervical spondylosis. The clinical radiculo-myelopathy was significantly developing in wrestlers in higher ages (odd ratio=77.5, P<0.001. Torg ratio of < 80% was found to be somehow more in the younger age group. Considering the awesome and debilitating implications of this entity among professional wrestlers, it seems prudent to keep an eye on the cervical spine of all new entrants and closely follow up the professional wrestlers to prevent developing myelopathy.

Quantitative skeletal evaluation based on cervical vertebral maturation: a longitudinal study of adolescents with normal occlusion.

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Chen, L; Liu, J; Xu, T; Long, X; Lin, J

2010-07-01

The study aims were to investigate the correlation between vertebral shape and hand-wrist maturation and to select characteristic parameters of C2-C5 (the second to fifth cervical vertebrae) for cervical vertebral maturation determination by mixed longitudinal data. 87 adolescents (32 males, 55 females) aged 8-18 years with normal occlusion were studied. Sequential lateral cephalograms and hand-wrist radiographs were taken annually for 6 consecutive years. Lateral cephalograms were divided into 11 maturation groups according to Fishman Skeletal Maturity Indicators (SMI). 62 morphological measurements of C2-C5 at 11 different developmental stages (SMI1-11) were measured and analysed. Locally weighted scatterplot smoothing, correlation coefficient analysis and variable cluster analysis were used for statistical analysis. Of the 62 cervical vertebral parameters, 44 were positively correlated with SMI, 6 were negatively correlated and 12 were not correlated. The correlation coefficients between cervical vertebral parameters and SMI were relatively high. Characteristic parameters for quantitative analysis of cervical vertebral maturation were selected. In summary, cervical vertebral maturation could be used reliably to evaluate the skeletal stage instead of the hand-wrist radiographic method. Selected characteristic parameters offered a simple and objective reference for the assessment of skeletal maturity and timing of orthognathic surgery. Copyright 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Barriers and facilitators to cervical cancer screening among Pakistani and Somali immigrant women in Oslo: a qualitative study

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Gele AA

2017-07-01

Full Text Available Abdi A Gele,1,2 Samera A Qureshi,1 Prabhjot Kour,1 Bernadette Kumar,1 Esperanza Diaz1,3 1Norwegian Center for Minority Health Research, 2Department of Health, Institute of Nursing and Health Promotion, Oslo and Akershus University College, Oslo; 3Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Abstract: Norway has a low incidence and mortality rate of cervical cancer, which is mainly due to the high participation rate of women in cervical cancer screening. However, the attendance of cervical cancer screening was reported to be low among immigrant women. For this reason, we conducted a qualitative study to obtain better insight into perceived barriers and challenges to cervical cancer screening among Somali and Pakistani women in the Oslo region. A convenient sample of 35 (18 Pakistani, 17 Somali women were recruited for the study in collaboration with Somali and Pakistani community partners. Focus group discussions were used to explore barriers and facilitators to cervical cancer screening, whereas the Ecological Model was used as the framework for the study. The study found three levels of barriers to cervical cancer screening. The individual level included a lack of understanding of the benefits of the screening. The sociocultural level included the stigma attached to the disease and the belief that women who are unmarried are sexually inactive. The system-related level included a lack of trust toward the health care system. Based on the study results, and using a common denominator approach for the immigrant groups included, the study recommends three communication strategies with the potential to improve women’s participation in cervical cancer screening: 1 in-person communication and information material at health centers; 2 verbal communication with women through seminars and workshops to educate them about their risk of cancer and the importance of screening and 3 the initiation of better recall

COMPARATIVE STUDY OF CYTOLOGIC AND COLPOSCOPIC FINDINGS IN PRECLINICAL CERVICAL CANCER

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Penagaluru

2015-11-01

Full Text Available BACKGROUND The cytologic diagnosis of cervical smears has become a very important screening test for the detection of pre-invasive and invasive cervical epithelial abnormalities. MATERIALS AND METHODS It is a prospective study conducted for a period of 1 year in 100 women who fulfilled the inclusion criteria. Colposcopy, PAP smear and biopsy were done. RESULTS Majority 70.5% i.e., (12/17 of CIN occurred in the age group of 30-49 years. Among the 9 women who took OCP, 12% (2/17 had CIN. Incidence of CIN in the permanently sterilized group was 59% (10/17 and among IUCD user was 5.9% (1/17. Among women who were diagnosed to have CIN, 70.5% (12/17 complained of excessive vaginal discharge 11.7% (2/17 of women had post-coital bleeding. PAP smear had a sensitivity of 29% and a specificity of 88% which was attributed to the high number of false, negative smears. Colposcopy showed a sensitivity of 82% and a specificity of 81%. Sensitivity was more than pap smear but specificity was less than pap smear. Accuracy of Colposcopy was found to be 82% which was comparatively more accurate than pap smear (78%. CONCLUSIONS COLPOSCOPY offers an excellent tool in evaluating cervical lesions. It is an easy and perspective method and its importance lies in teaching, diagnosis and management of cervical lesions, both neoplastic and non-neoplastic.

Using tracheal segments for replacement of cervical oesophagus: an experimental study.

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Abbasidezfouli, Azizollah; Sharifi, Davood; Sasani, Farhang; Ansari, Damoon; Abarkar, Mohammad; Rahmanijoo, Nasrin; Abbasidezfouli, Golbahar; Sheikhy, Kambiz

2012-03-01

Segmental resection and anastomosis of oesophageal lesions are not performed as a routine clinical practice because of complications and associated problems, whereas tracheal resection and anastomosis are a routine clinical practice. In this experimental study, we resected a segment of cervical oesophagus and replaced it with a tracheal segment. In eight dogs (mixed races), weighing 20-30 kg, ageing 1-2 years, under general anaesthesia, through a cervical incision, 5 cm of cervical trachea was separated while preserving its attachments to surrounding fibroareolar tissues. Afterwards, 5 cm of the oesophagus was resected and replaced with a prepared segment of the trachea. Oral liquids were started at the first post-operative day; the animals were kept for 2 months and then euthanized. Quality of swallowing and voice were evaluated. After an autopsy, anastomoses were examined grossly and histopathologically. No complications occurred during surgery. Swallowing function and voice were normal in all eight dogs after the operation. No sign of aspiration was seen in clinical and radiographic examinations after starting oral diet. In autopsy examination, anastomoses were patent without narrowing or abnormal mucosal changes. Remarkable histopathological findings in replaced tracheal segments were squamous metaplasia, atrophy and degeneration of mucosal glands and degeneration of cartilages. Replacement of a segment of the oesophagus with an autogenous tracheal segment is a practical procedure with low complications and can probably be used for the treatment of cervical oesophageal lesions in human beings.

Detection of human papillomavirus by hybrid capture and real time PCR methods in patients with chronic cervicitis and cervical intraepithelial

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Elisha Khandker

2016-07-01

Full Text Available Background and objectives:Cervical cancer due to Human papillomavirus (HPV is one of the leading causes of morbidity and mortality in women. Testing of HPV can identify women who are at risk of cervical cancer. Nowadays, molecular methods like real time polymerase chain reaction (PCR and hybrid capture technique are applied for detecting HPV in cervical specimens. The objective of the present study was to determine the rate of HPV infection in women with chronic cervicitis and cervical intraepithelial neoplasia (CIN by a commercial real time polymerase chain reaction test kit and by a hybrid capture HPV DNA test. Methods:Women aged between 20 to 55 years with chronic cervicitis and CIN were enrolled in the study after obtaining informed consent. Cervical specimen was collected by using cervical brush and stored in transport medium until used. HPV was detected by High Risk Screen Real-TM Quant 2x (Sacace, Biotechnologies SrI, Italy real time PCR kit (HR RT-PCR and by Hybrid Capture-2 High-Risk HPV DNA (Hc-2; Digene Corporation, USA test. Results: Total 72 women with chronic cervicitis and CIN of different grades were included in the study. Out of this, HPV infection detected by HR RT-PCR was 31 (43% and by Hc-2 was 14 (19.4%. Both the tests were able to detect HPV infection in all the CIN 3 cases and in most of the CIN 2 cases. However, HR RT-PCR detected higher number of HPV in chronic cervicitis and CIN1 cases. Conclusion:The study has shown that HR RT-PCR and Hc-2 tests are equally effective in detecting HPV infection in patients with CIN 2 and CIN 3 lesions. However, HR RT-PCR is more sensitive test for detecting HPV in chronic cervicitis and early CIN lesions and, therefore can be used in epidemiological study to detect presence of HPV in general population. IMC J Med Sci 2016; 10(2: 45-48

Trends in resource utilization and rate of cervical disc arthroplasty and anterior cervical discectomy and fusion throughout the United States from 2006 to 2013.

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Saifi, Comron; Fein, Arielle W; Cazzulino, Alejandro; Lehman, Ronald A; Phillips, Frank M; An, Howard S; Riew, K Daniel

2017-11-08

The typically accepted surgical procedure for cervical disc pathology has been the anterior cervical discectomy and fusion (ACDF), although recent trials have demonstrated equivalent or improved outcomes with cervical disc arthroplasty (CDA). Trends for these two procedures regarding utilization, revision procedures, and other demographic information have not been sufficiently explored. The present study aims to provide data regarding ACDF and CDA from 2006 to 2013 in the United States. The present study is a retrospective national database analysis. The present study included 20% sample of discharges from US hospitals, which is weighted to provide national estimates. Functional measures such as national incidence, hospital costs, length of stay (LOS), routine discharge, revision burden, and patient characteristics were used in the present study. Patients from the National Inpatient Sample (NIS) database who underwent primary ACDF, revision ACDF, primary CDA, and revision CDA from 2006 to 2013 were included. Demographic and economic data for the procedures' respective International Classification of Diseases, Ninth Revision, Clinical Modification codes were collected. A total of 1,059,403 ACDF and 13,099 CDA surgeries were performed in the United States from 2006 to 2013. The annual number of ACDF increased by 5.7% nonlinearly from 120,617 in 2006 to 127,500 in 2013 (mean per year 132,425; range 120,617-147,966); CDA increased by 190% nonlinearly from 540 in 2006 to 1,565 in 2013 (mean per year 1,637; range 540-2,381). Cervical disc arthroplasty patients were younger and had more private or "other" insurance, including worker's compensation (p<.0001). Mean LOS was longer for ACDF (ACDF 2.3 days vs. CDA 1.5; p<.0001). Routine discharge was higher in the CDA group (CDA 96% vs. ACDF 89%; p-value<.0001). The mean hospital-related cost was more expensive for ACDF (ACDF $16,178 vs. CDA $13,197; p-value=.0007). Cervical disc arthroplasty mean revision burden, defined as

Ultrasound cervical length in predicting preterm birth: Prospective study

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Achour Radhouane

2017-08-01

Full Text Available Background Preterm birth is a leading cause of perinatal morbidity and mortality and represents a major public health problem. It is associated with a 15–20 per cent mortality rate and remains responsible for 75 per cent of perinatal deaths in foetuses without anomalies. Aims The aim of this study was to evaluate the importance of cervical length measured in the first trimester (11–14 Weeks of amenorrhea “WA” and the second trimester (20–24 Weeks of amenorrhea” WA” in an asymptomatic population of singleton pregnancies to assess the risk of spontaneous preterm birth compared to the digital assessment. Methods We conducted a prospective, longitudinal study involving 117 asymptomatic women with singleton pregnancies between January and December 2015. Results In our study, the clinical examination had a low positive predictive value and a low sensibility for screening women at risk of preterm delivery. Cervical length less than 35mm between 12–14WA and 30mm between 22–24WA predicts the occurrence of preterm birth with a high sensitivity (Se, and specificity (Sp. Conclusion We conclude that ultrasound screening of preterm delivery is now highly recommended.

Biologia molecular do câncer cervical Molecular biology of cervical cancer

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Waldemar Augusto Rivoire

2006-01-01

Full Text Available A carcinogênese é um processo de múltiplas etapas. Alterações no equilíbrio citogenético ocorrem na transformação do epitélio normal a câncer cervical. Numerosos estudos apoiam a hipótese de que a infecção por HPV está associada com o desenvolvimento de alterações malignas e pré-malignas do trato genital inferior. Neste trabalho são apresentadas as bases para a compreensão da oncogênese cervical. O ciclo celular é controlado por proto-oncogenes e genes supressores. Quando ocorrem mutações, proto-oncogenes tornam-se oncogenes, que são carcinogênicos e causam multiplicação celular excessiva. A perda da ação de genes supressores funcionais pode levar a célula ao crescimento inadequado. O ciclo celular também pode ser alterado pela ação de vírus, entre eles o HPV (Human Papiloma Virus, de especial interesse na oncogênese cervical. Os tipos de HPV 16 e 18 são os de maior interesse, freqüentemente associados a câncer cervical e anal. O conhecimento das bases moleculares que estão envolvidas na oncogênese cervical tem sido possível devido a utilização de técnicas avançadas de biologia molecular. A associação destas técnicas aos métodos diagnósticos clássicos, poderão levar a uma melhor avaliação das neoplasias cervicais e auxiliar no desenvolvimento de novas terapias, talvez menos invasivas e mais efetivas.Carcinogenesis involves several steps. Disorders of the cytogenetic balance occur during the evolution from normal epithelium to cervical cancer. Several studies support the hypothesis that the Human Papiloma Virus (HPV infection is associated to development of premalignant and malignant lesions of cervical cancer. In this review we show the basis to understand cervical oncogenesis. The cell cycle is controlled by protooncogenes and supressive genes. This orchestrated cell cycle can be affected by virus such as HPV. Of special interest in the cervical carcinogenesis are the HPV subtypes 16 and 18

Does applying the Canadian Cervical Spine rule reduce cervical spine radiography rates in alert patients with blunt trauma to the neck? A retrospective analysis

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Yesupalan Rajam

2008-06-01

Full Text Available Abstract Background A cautious outlook towards neck injuries has been the norm to avoid missing cervical spine injuries. Consequently there has been an increased use of cervical spine radiography. The Canadian Cervical Spine rule was proposed to reduce unnecessary use of cervical spine radiography in alert and stable patients. Our aim was to see whether applying the Canadian Cervical Spine rule reduced the need for cervical spine radiography without missing significant cervical spine injuries. Methods This was a retrospective study conducted in 2 hospitals. 114 alert and stable patients who had cervical spine radiographs for suspected neck injuries were included in the study. Data on patient demographics, high risk & low risk factors as per the Canadian Cervical Spine rule and cervical spine radiography results were collected and analysed. Results 28 patients were included in the high risk category according to the Canadian Cervical Spine rule. 86 patients fell into the low risk category. If the Canadian Cervical Spine rule was applied, there would have been a significant reduction in cervical spine radiographs as 86/114 patients (75.4% would not have needed cervical spine radiograph. 2/114 patients who had significant cervical spine injuries would have been identified when the Canadian Cervical Spine rule was applied. Conclusion Applying the Canadian Cervical Spine rule for neck injuries in alert and stable patients would have reduced the use of cervical spine radiographs without missing out significant cervical spine injuries. This relates to reduction in radiation exposure to patients and health care costs.

Study on pedicle screw fixation of cervical spine assisted CT-based navigation system compared with the individual cervical peddle screws placement technique

International Nuclear Information System (INIS)

He Xishun; Yang Huilin; Zhu Ruofu; Tan Xiangqi; Wang Genlin; Tang Tiansi

2008-01-01

Objective: To explore a safe and effective method for placing the cervical pedicle screws. Methods: There were ten adult cadaver specimens of cervica spine (C 1 -C 7 ) with intact structures including ligament and perivertebral muscles. The spiral computed tomography scan (Elscint CT Twin flash) at the section of 1 mm and three-dimensional reconstruction of all 10 cervical specimens were taken. By CT scan, the parameters of the cervical pedicles were measure,Then taking randomly 5 cervical specimens, according to the CT measurements, an appropriate screw was inserted into pedicle individually. In the other 5 human cadaver cervical vertebraes, Φ3.5 mm screws were inserted into the C 2 -C 7 pedicles by assisted by CT-based navigation system. Cortical integrity of every sample was examined by anatomic dissection, the spiral computed tomography scan and arrows,and coronal reconstruction. Results: Sixty screws was inserted into pedicle individually, and the achievement ratio was 90%, the perfectness ratio was 75%, 60 screws was placed into pedicle assisted by CT-based navigation system, and the achievement ratio was 96.6%, the perfectness ratio was 90%. By chi-square test for statistical analysis, there were no statistical significance between the accuracy rate of two methods(P>0.05). However there was statistical significance between the perfectness ratio between two methods(P<0.05). Conclusion: Compared with the individual cervical peddle screws placement technique, the perfectness ratio of pedicle screw fixation of cervical spine assisted by CT-based navigation system is higher, but there are no significant difference in accuracy. (authors)

The relationship between cervical lordosis and Nurick scores in patients undergoing circumferential vs. posterior alone cervical decompression, instrumentation and fusion for treatment of cervical spondylotic myelopathy.

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Patel, Shalin; Glivar, Phillip; Asgarzadie, Farbod; Cheng, David Juma Wayne; Danisa, Olumide

2017-11-01

The loss of regional cervical sagittal alignment and the progressive development of cervical kyphosis is a factor in the advancement of myelopathy. Adequate decompression of the spinal canal along with reestablishment of cervical lordosis are desired objective with regard to the surgical treatment of patients with cervical spondylotic myelopathy. A retrospective chart review was conducted in which patients who underwent either a combined anterior/posterior instrumentation and decompression or a posterior alone instrumentation and decompression for the treatment of CSM at our institution were identified. Any patient undergoing operative intervention for trauma, infection or tumors were excluded. Similarly, patients undergoing posterior instrumentation with constructs extending beyond the level of C2-C7 were similarly excluded from this study. A total of 67 patients met the inclusion criteria for this study. A total of 32 patients underwent posterior alone surgery and the remaining 35 underwent combined anterior/posterior procedure. Radiographic evaluation of patient's preoperative and postoperative cervical lordosis as measured by the C2-C7 Cobb angle was performed. Each patient's preoperative and postoperative functional disability as enumerated by the Nurick score was also recorded. Statistical analysis was conducted to determine if there was a significant relationship between improvement in cervical lordosis and improvement in patient's clinical outcomes as enumerated by the Nurick Score in patients undergoing posterior alone versus combined anterior/posterior decompression, instrumentation and fusion of the cervical spine. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparison of tracheal intubation using the Airtraq® and Mc Coy laryngoscope in the presence of rigid cervical collar simulating cervical immobilisation for traumatic cervical spine injury

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Padmaja Durga

2012-01-01

Full Text Available Background: It is difficult to visualise the larynx using conventional laryngoscopy in the presence of cervical spine immobilisation. Airtraq® provides for easy and successful intubation in the neutral neck position. Objective: To evaluate the effectiveness of Airtraq in comparison with the Mc Coy laryngoscope, when performing tracheal intubation in patients with neck immobilisation using hard cervical collar and manual in-line axial cervical spine stabilisation. Methods: A randomised, cross-over, open-labelled study was undertaken in 60 ASA I and II patients aged between 20 and 50 years, belonging to either gender, scheduled to undergo elective surgical procedures. Following induction and adequate muscle relaxation, they were intubated using either of the techniques first, followed by the other. Intubation time and Intubation Difficulty Score (IDS were noted using Mc Coy laryngoscope and Airtraq. The anaesthesiologist was asked to grade the ease of intubation on a Visual Analogue Scale (VAS of 1-10. Chi-square test was used for comparison of categorical data between the groups and paired sample t-test for comparison of continuous data. IDS score and VAS were compared using Wilcoxon Signed ranked test. Results: The mean intubation time was 33.27 sec (13.25 for laryngoscopy and 28.95 sec (18.53 for Airtraq (P=0.32. The median IDS values were 4 (interquartile range (IQR 1-6 and 0 (IQR 0-1 for laryngoscopy and Airtraq, respectively (P=0.007. The median Cormack Lehane glottic view grade was 3 (IQR 2-4 and 1 (IQR 1-1 for laryngoscopy and Airtraq, respectively (P=0.003. The ease of intubation on VAS was graded as 4 (IQR 3-5 for laryngoscopy and 2 (IQR 2-2 for Airtraq (P=0.033. There were two failures to intubate with the Airtraq. Conclusion: Airtraq improves the ease of intubation significantly when compared to Mc Coy blade in patients immobilised with cervical collar and manual in-line stabilisation simulating cervical spine injury.

Is the cervical spine clear? Undetected cervical fractures diagnosed only at autopsy.

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Sweeney, J F; Rosemurgy, A S; Gill, S; Albrink, M H

1992-10-01

Undetected cervical-spine injuries are a nemesis to both trauma surgeons and emergency physicians. Radiographic protocols have been developed to avoid missing cervical-spine fractures but are not fail-safe. Three case reports of occult cervical fractures documented at autopsy in the face of normal cervical-spine radiographs and computerized tomography scans are presented.

Cervical disc arthroplasty: Pros and cons.

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Moatz, Bradley; Tortolani, P Justin

2012-01-01

Cervical disc arthroplasty has emerged as a promising potential alternative to anterior cervical discectomy and fusion (ACDF) in appropriately selected patients. Despite a history of excellent outcomes after ACDF, the question as to whether a fusion leads to adjacent segment degeneration remains unanswered. Numerous US investigational device exemption trials comparing cervical arthroplasty to fusion have been conducted to answer this question. This study reviews the current research regarding cervical athroplasty, and emphasizes both the pros and cons of arthroplasty as compared with ACDF. Early clinical outcomes show that cervical arthroplasty is as effective as the standard ACDF. However, this new technology is also associated with an expanding list of novel complications. Although there is no definitive evidence that cervical disc replacement reduces the incidence of adjacent segment degeneration, it does show other advantages; for example, faster return to work, and reduced need for postoperative bracing.

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.

Correlation between dental and cervical vertebral maturation in Iranian females.

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Valizadeh, Solmaz; Eil, Nakissa; Ehsani, Sara; Bakhshandeh, Hooman

2012-12-01

Considerable variations in the development stage among patients of the same chronological age have led to introduce the concept of the developmental age based on the maturation of different organs such as cervical vertebrae or teeth. The purpose of this study was to investigate the correlation between the stages of tooth calcification and the cervical vertebral maturation in Iranian females. Four hundred females (age range, 8 to 14 years) participated in the study. To determine the dental maturational stage, calcification of the mandibular teeth except for third molars were rated according to the method suggested by Demirjian et al. To evaluate the stage of skeletal maturation, cervical vertebral morphologic changes were assessed on lateral cephalometric radiographs according to the method explained by Baccetti et al. Correlations between bone maturation and teeth calcification were showed by Spearman's correlation and Kendall's tau-b coefficients. The relevant associations were investigated by ordinal logistic regression models. Correlations between the two stages were observed in the first and second premolars, canine and central incisors. All these correlations were significant. The association between cervical vertebral maturation and tooth calcification was greatest in the lateral incisor (odds ratio (OR) = 11, 95% confidence interval (CI): 6.6-18.3). However, considering the 95% CI for OR, no significant difference was detected among the second molar, first molar and lateral incisor. The relationship between calcification of teeth and maturation of cervical bones was significant. Bone maturation can be predicted by using teeth calcification stages, especially in the second molar, first molar and lateral incisor.

Impact of Cervical Spine Deformity on Preoperative Disease Severity and Postoperative Outcomes Following Fusion Surgery for Degenerative Cervical Myelopathy: Sub-analysis of AOSpine North America and International Studies.

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Kato, So; Nouri, Aria; Wu, Dongjin; Nori, Satoshi; Tetreault, Lindsay; Fehlings, Michael G

2018-02-15

Sub-analysis of the prospective AOSpine CSM North America and International studies. The aim of this study was to investigate the impact of cervical spine deformity on pre- and postoperative outcomes in fusion surgeries for degenerative cervical myelopathy. The associations between cervical alignment and patient outcomes have been reported but are not well established in a myelopathy cohort. The impact of deformity correction in this population also needs to be elucidated. A total of 757 patients were enrolled in two prospective international multicenter AOSpine studies. Among those who underwent anterior or posterior fusion surgeries, pre- and 1-year postoperative upright neutral lateral radiographs of cervical spine were investigated to measure C2-7 Cobb angle and C2-7 sagittal vertical axis (SVA). Patient outcome measures included the modified Japanese Orthopedic Association score for myelopathy severity, Neck Disability Index (NDI), and Short-form 36 (SF-36). These scores were compared between patients with and without cervical deformity, which was defined as C2-7 Cobb >10° kyphosis and/or SVA >40 mm. A total of 178 patients were included with complete pre- and postoperative radiographs. SVA significantly increased postoperatively (27.4 vs. 30.7 mm, P = 0.004). All outcome measurement showed significant improvements above minimal clinically important differences. 23.6% of the patients had cervical deformity preoperatively; preoperative deformity was associated with worse preoperative NDI scores (45.7 vs. 38.9, P = 0.04). Postoperatively, those with deformity exhibited significantly lower SF-36 physical component scores (37.2 vs. 41.4, P = 0.048). However, when focusing on the preoperatively deformed cohort, we did not find any significant differences in the postoperative outcome scores between those with and without residual deformity. There was a significant association between cervical deformity and both preoperative disease severity and

Immuno-related polymorphisms and cervical cancer risk: The IARC multicentric case-control study.

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James McKay

Full Text Available A small proportion of women who are exposed to infection with human-papillomavirus (HPV develop cervical cancer (CC. Genetic factors may affect the risk of progression from HPV infection to cervical precancer and cancer. We used samples from the International Agency for Research on Cancer (IARC multicentric case-control study to evaluate the association of selected genetic variants with CC. Overall, 790 CC cases and 717 controls from Algeria, Morocco, India and Thailand were included. Cervical exfoliated cells were obtained from control women and cervical exfoliated cells or biopsy specimens from cases. HPV-positivity was determined using a general primer GP5+/6+ mediated PCR. Unconditional logistic regression was used to estimate odds ratios (OR and corresponding 95% confidence intervals (CI of host genotypes with CC risk, using the homozygous wild type genotype as the referent category and adjusting by age and study centre. The association of polymorphisms with the risk of high-risk HPV-positivity among controls was also evaluated. A statistically significant association was observed between single nucleotide polymorphism (SNP CHR6 rs2844511 and CC risk: the OR for carriers of the GA or GG genotypes was 0.70 (95% CI: 0.43-1.14 and 0.61 (95% CI: 0.38-0.98, respectively, relative to carriers of AA genotype (p-value for trend 0.03. We also observed associations of borderline significance with the TIPARP rs2665390 polymorphism, which was previously found to be associated with ovarian and breast cancer, and with the EXOC1 rs13117307 polymorphism, which has been linked to cervical cancer in a large study in a Chinese population. We confirmed the association between CC and the rs2844511 polymorphism previously identified in a GWAS study in a Swedish population. The major histocompatibility region of chromosome 6, or perhaps other SNPs in linkage disequilibrium, may be involved in CC onset.

Contributions and Limitations of National Cervical Cancer Screening Program in Korea: A Retrospective Observational Study

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Jung Hyun Lee, MPH

2018-03-01

Full Text Available Summary: Purpose: The purpose of this study was to evaluate the contributions and limitations of the cervical cancer screening test with accuracy in Korea. Methods: This was a retrospective observational study. The study population consisted of all participants who underwent cervical cancer screening test from 2009 to 2014. The data were obtained from National Health Information Database (NHID which represents medical use records of most Koreans. As the indices for contributions and limitations of the screening test, crude detection rate, incidence rate of interval cancer, sensitivity, specificity, and positive predictive value were used. Results: The crude detection rate of screening test per 100,000 participants increased from 100.7 in 2009 to 102.1 in 2014. The incidence rate of interval cancer per 100,000 negatives decreased from 13.0 in 2009 to 10.2 in 2014. The sensitivities of screening test were 88.7% in 2009 and 91.2% in 2014, and the specificities were 98.5% in 2009 and 97.7% in 2014. The positive predictive value of screening decreased from 6.2% in 2009 to 4.3% in 2014. Conclusion: The Korean national cervical cancer screening program has improved in accuracy and has contributed to detection of early stage of cervical cancer over the years. Along with efforts to promote participation in cancer screening programs, quality control over the screening program should be enhanced. Keywords: carcinoma in situ, early detection of cancer, Papanicolaou test, sensitivity and specificity, uterine cervical neoplasms

A comparative study of the effect of soft and hard cervical collars on static postural

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Minoo Khalkhali Zavieh

2013-01-01

Full Text Available AbstractBackground and Aim: Using cervical collars is one of the treatment methods for releaving cervical pain. The effect of limb orthotics on proprioception and postural stability has been suggested. There is not sufficient studies about the effect of cervical collars on static and dynamic stability, and the effect of soft and hard collars have not been compared with one another. The objective of this study is investigating and comparing the immediate effect of soft and hard cervical collars on static postural stability in healthy young subjects. Methods & Materials: In standing position on firm surface with closed eyes, both soft and hard collars decreased the stability and there was not any significant difference among collars. In standing positions on soft surface with closed and opened eyes, using none of the soft and hard collars did not change the stability. This quasi experimental study through repeated measure method has been conducted on 65 healthy young male and female college students. Static stability was evaluated by modified Clinical Test for Sensory Interaction and Balance (CTSIB in conditions without collar and by soft and hard cervical collars and were compared between the conditions. Results: Conclusion: Our results suggest that in static conditions, without vision, both collars decrease the stability in healthy young subjects. So considering the evaluation of stability and prevention of balance disturbance during the collar prescription seems to be necessary.

In vivo diagnosis of cervical precancer using Raman spectroscopy and genetic algorithm techniques.

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Duraipandian, Shiyamala; Zheng, Wei; Ng, Joseph; Low, Jeffrey J H; Ilancheran, A; Huang, Zhiwei

2011-10-21

This study aimed to evaluate the clinical utility of applying near-infrared (NIR) Raman spectroscopy and genetic algorithm-partial least squares-discriminant analysis (GA-PLS-DA) to identify biomolecular changes of cervical tissues associated with dysplastic transformation during colposcopic examination. A total of 105 in vivo Raman spectra were measured from 57 cervical sites (35 normal and 22 precancer sites) of 29 patients recruited, in which 65 spectra were from normal sites, while 40 spectra were from cervical precancerous lesions (i.e., 7 low-grade CIN and 33 high-grade CIN). The GA feature selection technique incorporated with PLS was utilized to study the significant biochemical Raman bands for differentiation between normal and precancer cervical tissues. The GA-PLS-DA algorithm with double cross-validation (dCV) identified seven diagnostically significant Raman bands in the ranges of 925-935, 979-999, 1080-1090, 1240-1260, 1320-1340, 1400-1420, and 1625-1645 cm(-1) related to proteins, nucleic acids and lipids in tissue, and yielded a diagnostic accuracy of 82.9% (sensitivity of 72.5% (29/40) and specificity of 89.2% (58/65)) for precancer detection. The results of this exploratory study suggest that Raman spectroscopy in conjunction with GA-PLS-DA and dCV methods has the potential to provide clinically significant discrimination between normal and precancer cervical tissues at the molecular level.

Immunohistochemical study of p16 INK4A and survivin expressions in cervical squamous neoplasm

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Tan Geok

2010-01-01

Full Text Available Introduction:Cervical cancer is the second most common cancer affecting Malaysian women. Despite the implementation of pap smear screening, many women are still diagnosed only in the advanced stage of cervical cancer. This could partly be due to failure of detection of its precursor lesions; hence the need to search for novel biomarkers to assist in the screening and diagnosis of cervical neoplasia. This study aims to determine the expression of p16INK4A and survivin as possible predictive biomarkers in cervical squamous neoplasm. Material and Methods: This is a retrospective study on 201 cases of cervical neoplasm comprising of 129 cervical intraepithelial neoplasia (CIN and 72 squamous cell carcinoma (SCC. All samples were evaluated by two independent observers using p16INK4A and survivin monoclonal antibodies. The p16 INK4A expression was graded as negative, focal and diffuse positivity. The intensity for survivin expression was graded as weak, moderate and intense. Results: It is seen that p16 INK4A expression in CIN 1, CIN 2 and CIN 3 were 25.4%, 42.9% and 95.9% respectively. Majority of SCC (98.6% showed p16 INK4A expression. Survivin expressions in CIN 1, CIN 2, CIN 3 and SCC were 56.7%, 33.4%, 87.5% and 98.6%. There was a linear relationship between increasing grade of CIN and p16 INK4A expressions. Conclusion: Our study showed that p16 INK4A expressions correlate well with the increasing grade of CIN. Although survivin does not correlate well to the increasing grade of CIN, it could be useful in differentiating CIN 3 from SCC.

Human papilloma virus infection and cervical dysplasia.

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Melinte-Popescu, Alina; Costăchescu, Gh

2012-01-01

Pap testing is considered to be the best screening tool for cervical cancer but there is currently great interest in the possible application of human papilloma virus (HPV) testing to supplement Pap screening for cervical cancer. To determine the prevalence of high-risk HPV types in the studied population and to explore the association between high-risk HPV types and cervical dysplasia. Cross-sectional study conducted at the Iasi Cuza Voda Obstetrics-Gynecology Hospital and Suceava County Hospital. 332 women who underwent colposcopy for cervical lesions between 2006 and 2011 were included in this study. The overall prevalence of HPV was 57.23%. HPV prevalence differs significantly in the three age groups up to 50 years. It was highest in patients below the age of 40 and progressively lower with advancing age. The overall prevalence of cervical dysplasia was 56.62%. The prevalence of cervical dysplasia was highest in the age groups up to 40 years. The most important determinant of HPV infection is age. Persistence of HPV appears to be associated with progression to squamous intraepithelial lesion. Dysplasia is often missed in a cervical sample either because of human error in screening and interpretation, or because of suboptimal quality of Pap smear. Incorporation of HPV testing into the present Pap screening program has the potential of making screening for cervical cancer more effective, and a necessary prelude to assessing this is by determining the prevalence of the high-risk types.

Cervical cancer

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... bleeding between periods, after intercourse, or after menopause Vaginal discharge that does not stop, and may be pale, ... Instructions Hysterectomy - abdominal - discharge Hysterectomy - laparoscopic - ... Images Cervical cancer Cervical neoplasia ...

Awareness, perception and factors affecting utilization of cervical cancer screening services among women in Ibadan, Nigeria: a qualitative study

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Ndikom Chizoma

2012-08-01

Full Text Available Abstract Background Over the years awareness and uptake of cervical cancer screening services has remained poor in developing countries. Problems associated with cervical cancer incidence include late reporting, ignorance and cultural issues relating to cervical cancer screening. This study sought to explore the awareness, perception and utilization of cervical cancer screening among women in Ibadan as well as factors that influence utilization. Method This is a qualitative study that utilized Eight Focus Group Discussions to collect information from women in selected health facilities in Ibadan, South West, Nigeria. The 82 participants were purposely recruited from women attending Antenatal clinics in 4 secondary and 4 primary health care facilities after approval was received from the Institutional Review Board in charge of the facilities. The focus group discussions were tape recorded and transcribed verbatim. The transcripts were analyzed into themes. Findings The study provided qualitative information on the awareness, perception of the utilization of cervical cancer screening services among women in Ibadan. Participants were mainly married women (92.7%, mean age =27.6, SD =4.5, mainly traders (39% and from Yoruba ethnic backgrounds (87.8% and had secondary education (39%. The respondents reported not being aware of cervical cancer and were not utilizing the services. Though they did not know what cervical cancer screening entailed or the screening methods, they still believed that it is important since like for other diseases will help in early detection and treatment. The participants were eager to get more information from nurses on cervical cancer about cervical cancer screening. The major factors identified by the women that influence screening utilization were ignorance, Illiteracy, belief in not being at risk, having many contending issues, nonchalant attitude to their health, financial constraint and fear of having a positive result

Awareness, perception and factors affecting utilization of cervical cancer screening services among women in Ibadan, Nigeria: a qualitative study.

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Ndikom, Chizoma Millicent; Ofi, Bola Abosede

2012-08-06

Over the years awareness and uptake of cervical cancer screening services has remained poor in developing countries. Problems associated with cervical cancer incidence include late reporting, ignorance and cultural issues relating to cervical cancer screening. This study sought to explore the awareness, perception and utilization of cervical cancer screening among women in Ibadan as well as factors that influence utilization. This is a qualitative study that utilized Eight Focus Group Discussions to collect information from women in selected health facilities in Ibadan, South West, Nigeria. The 82 participants were purposely recruited from women attending Antenatal clinics in 4 secondary and 4 primary health care facilities after approval was received from the Institutional Review Board in charge of the facilities. The focus group discussions were tape recorded and transcribed verbatim. The transcripts were analyzed into themes. The study provided qualitative information on the awareness, perception of the utilization of cervical cancer screening services among women in Ibadan. Participants were mainly married women (92.7%), mean age =27.6, SD =4.5, mainly traders (39%) and from Yoruba ethnic backgrounds (87.8%) and had secondary education (39%). The respondents reported not being aware of cervical cancer and were not utilizing the services. Though they did not know what cervical cancer screening entailed or the screening methods, they still believed that it is important since like for other diseases will help in early detection and treatment. The participants were eager to get more information from nurses on cervical cancer about cervical cancer screening. The major factors identified by the women that influence screening utilization were ignorance, Illiteracy, belief in not being at risk, having many contending issues, nonchalant attitude to their health, financial constraint and fear of having a positive result. There is an urgent need for more enlightenment

Cervical cerclage placement decreases local levels of proinflammatory cytokines in patients with cervical insufficiency.

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Monsanto, Stephany P; Daher, Silvia; Ono, Erika; Pendeloski, Karen Priscilla Tezotto; Trainá, Évelyn; Mattar, Rosiane; Tayade, Chandrakant

2017-10-01

Cervical insufficiency is characterized by premature, progressive dilation and shortening of the cervix during pregnancy. If left unattended, this can lead to the prolapse and rupture of the amniotic membrane, which usually results in midtrimester pregnancy loss or preterm birth. Previous studies have shown that proinflammatory cytokines such as interleukin-1β, interleukin-6, interleukin-8, and tumor necrosis factor alpha are up-regulated in normal parturition but are also associated with preterm birth. Studies evaluating such markers in patients with cervical insufficiency have evaluated only their diagnostic potential. Even fewer studies have studied them within the context of cerclage surgery. The objective of the study was to evaluate the impact of local and systemic inflammatory markers on the pathogenesis of cervical insufficiency and the effect of cerclage surgery on the local immune microenvironment of women with cervical insufficiency. We recruited 28 pregnant women (12-20 weeks' gestation) diagnosed with insufficiency and referred for cerclage surgery and 19 gestational age-matched normal pregnant women as controls. Serum and cervicovaginal fluid samples were collected before and after cerclage surgery and during a routine checkup for normal women and analyzed using a targeted 13-plex proinflammatory cytokine assay. Before surgery, patients with cervical insufficiency had higher levels of interleukin-1β, interleukin-6, interleukin-12, monocyte chemoattractant protein-1 and tumor necrosis factor alpha in cervicovaginal fluid compared to controls, but after surgery, these differences disappeared. No differences were found in serum of insufficiency versus control women. In patients with insufficiency, the levels of interleukin-1β, interleukin-6, interleukin-8, monocyte chemoattractant protein-1, and interferon gamma in cervicovaginal fluid declined significantly after cerclage compared with before intervention, but these changes were not detected in serum

The effect of a mandibular advancement appliance on cervical lordosis in patients with TMD and cervical pain.

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Santander, Hugo; Zúñiga, Claudia; Miralles, Rodolfo; Valenzuela, Saúl; Santander, Montserrat Carolina; Gutiérrez, Mario Felipe; Córdova, Rosa

2014-10-01

A preliminary study to compare cervical lordosis by means of cervical cephalometric analysis, before and after six months of continuous mandibular advancement appliance (MAA) use, and to show how physical therapy posture re-education would improve the cervical lordosis angle. Twenty-two female patients with temporomandibular disorders (TMD) and cervical pain with lordosis 0·05; Shapiro Wilk Test), so the paired comparison of the cephalometric measurements was made by t-test for dependent samples. Angle 1 (OPT/7CVT); angle 3 (CVT/EVT) and angle 4 (2CL/7CL) showed a significant increase in the cervical lordosis. Angle 2 (MGP/OP), angle 5 (HOR/CVT) and the distances C0-C2 and Pt-VER, presented no significant changes. The increase in cervical lordosis implies that six months of continuous MAA use, together with a program of postural re-education, promotes the homeostasis of the craniocervical system.

Cervical osteophyte induced dysphagia

International Nuclear Information System (INIS)

Davies, R.P.; Sage, M.R.; Brophy, B.P.

1989-01-01

Although cervical spondylosis is a common disorder, dysphagia induced by osteophyte formation is uncommon. Fewer than one hundred cases of cervical osteophyte induced dysphagia have been reported, with little attention to the diagnosis by barium swallow. The radiological features of two cases treated surgically with good results are described. Both cases complained of dysphagia while one had associated respiratory obstruction on forward flexion of his neck. The features on barium study of cervical osteophytes causing dysphagia include deformity at the level of osteophyte formation, in both AP and lateral projections. Tracheal aspirations due to deformity at the laryngeal inlet and interference with epiglottic retroversion may be present. 8 refs., 3 figs

[Cervical cerclage].

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Akladios, C Y; Sananes, N; Gaudineau, A; Boudier, E; Langer, B

2015-10-01

Cervical cerclage aims to strengthen not only the mechanical properties of the cervix, but also its immunological and anti-infectious functions. The demonstration of a strong interrelation between cervical insufficiency as well as decreased cervical length at endo-vaginal ultrasonography and infection has changed the indications cerclage. Actually we can distinguish three indications for cerclage: prophylactic, for obstetrical history; therapeutic, for shortened cervical length at ultrasonography in patients at risk and; emergency cerclage in case of threatening cervix at physical examination. The McDonald's technique is the most recommended. In case of failure, it is proposed to realize cerclage at a higher level on the cervix either by vaginal or abdominal route. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Imaging of the cervical articular pillar

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Yeomans, E. [Orange Base Hospital, Orange, NSW (Australia)

1998-12-01

The cervical articular pillar, due to the complex anatomical structure of the cervical spine, is not well demonstrated in routine plain radiographic views. Dedicated views have been devised to demonstrate the pillar, yet their performance has abated considerably since the inception of Computed Tomography (CT) in the 1970`s. It is the consideration that CT does not image the articular pillar with a 10 per cent accuracy that poses the question: Is there still a need for plain radiography of the cervical articular pillar? This paper studies the anatomy, plain radiography, and incidence of injury to the cervical articular pillar. It discusses (with reference to current and historic literature) the efficacy of current imaging protocols in depicting this injury. It deals with plain radiography, CT, complex tomography, and Magnetic Resonance Imaging (MRI) of the cervical spine to conclude there may still be a position in current imaging protocols for plain radiography of the cervical articular pillar. Copyright (1998) Australian Institute of Radiography 43 refs., 5 figs.

p16 as a diagnostic marker of cervical neoplasia: a tissue microarray study of 796 archival specimens

DEFF Research Database (Denmark)

Lesnikova, Iana; Lidang, Marianne; Hamilton-Dutoit, Stephen

2009-01-01

from archival formalin fixed, paraffin-embedded donor tissues from 796 patients, and included cases of cervical intraepithelial neoplasia (CIN)1 (n = 249), CIN2 (n = 233), CIN3 (n = 181), and invasive cervical carcinoma (n = 133). p16INK4a expression was scored using two different protocols: 1......BACKGROUND: To evaluate the usefulness of this biomarker in the diagnosis of cases of cervical neoplasia we studied the immunohistochemical expression of p16INK4a in a large series of archival cervical biopsies arranged into tissue microarray format. METHODS: TMAs were constructed with tissue cores...... dysplasia or the presence of invasive carcinoma. CONCLUSION: Immunohistochemical analysis of p16INK4a expression is a useful diagnostic tool. Expression is related to the degree of histological dysplasia, suggesting that it may have prognostic and predicative value in the management of cervical neoplasia....

Halovest treatment in traumatic cervical spine injury.

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Razak, M; Basir, T; Hyzan, Y; Johari, Z

1998-09-01

This is a cross-sectional study on the use of halovest appliance in the Orthopaedic and Traumatology Department, Kuala Lumpur Hospital from June 1993 to September 1996. Fifty-three patients with cervical spine injuries were treated by halovest stabilization. Majority of cases was caused by motor-vehicle accident; others were fall from height at construction sites, fall at home, hit by falling object and assault. The injuries were Jefferson fracture of C1, odontoid fractures, hangman fractures, open spinous process fracture and fracture body of C2, and fracture, and fracture-dislocation of the lower cervical spines. Majority of patients had hospital stay less than 30 days. The use of the halovest ranges from 4 to 16 weeks and the healing rate was 96%. Two patients of lower cervical spine injury had redislocation and one of them was operated. There was one case of non-union of type II odontoid fracture and treated by posterior fusion. Other complications encountered during halovest treatment were minor. They were pin-site infection, pin-loosening, clamp loosening and neck pain or neck stiffness. This method of treatment enables patient to ambulate early and reduces hospital stay. We found that halovest is easy to apply, safe and tolerable to most of the patients.

Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

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Yoon, Seok Nam [Kwandong Univ. College of Medicine, Seoul (Korea, Republic of)

2012-09-15

A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass

Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

International Nuclear Information System (INIS)

Yoon, Seok Nam

2012-01-01

A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass from

Cervical interlaminar epidural steroid injection for neck pain and cervical radiculopathy: effect and prognostic factors

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Kwon, Jong Won; Lee, Joon Woo; Kim, Sung Hyun; Kwack, Kyu-Sung [Seoul National University Bundang Hospital, Department of Radiology, Gyeonggi-do (Korea); Choi, Ja-Young; Moon, Sung Gyu; Jun, Woo Sun [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea); Yeom, Jin-Sup [Seoul National University Bundang Hospital, Department of Orthopaedic Surgery, Gyeongi-Do (Korea); Kim, Hyun-Jib [Seoul National University Bundang Hospital, Department of Neurosurgery, Gyeongi-Do (Korea); Kang, Heung Sik [Seoul National University Bundang Hospital, Department of Radiology, Gyeonggi-do (Korea); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea)

2007-05-15

To verify the usefulness of a fluoroscopy guided cervical interlaminar epidural steroid injection (CIESI) in patients with neck pain and cervical radiculopathy and to evaluate outcome predictors. We retrospectively analyzed 91 patients from July 2004 to June 2005 in whom CIESI was initially performed for neck pain and cervical radiculopathy. Therapeutic effects were evaluated 2 weeks after the administration of CIESI, and CIESI effectiveness was graded using a five-point scale, namely, whether the pain had disappeared, was much improved, slightly improved, the same, or aggravated. We also used a visual analog scale (VAS) for the clinical evaluation. According to documentation and follow-up charts, we categorized treatments as effective or ineffective. Possible outcome predictors, namely, diagnosis (spinal stenosis vs herniated disc), primary symptoms (neck pain vs radiculopathy vs both), age, gender, and duration of pain (more or less than 6 months) were also analyzed. Fisher's exact test, the chi-square test, and multiple logistic regression analysis were used for the statistical analysis. After their medical records had been reviewed, 76 patients were included in this study. Inclusion criteria were: the availability of a cross-sectional image, such as a CT scan or an MR image, and a follow-up record after injection. The medical records of 76 patients (male:female = 41: 35) of mean age 53.1 years (range 32 years to 82 years) were reviewed. Two weeks after injection, 55 patients (72.4%) had experienced effective pain relief. Patients with herniated discs had significantly better results than patients with spinal stenosis (86.1% vs 60.0%) (P < 0.05). Other non-significant predictors of an improved outcome included: a symptom duration of <6 months, a young age, and the presence of cervical radiculopathy. Multiple regression analysis showed that the only factor that was significantly associated with outcome was the cause of the pain, i.e., herniated disc or

Cervical interlaminar epidural steroid injection for neck pain and cervical radiculopathy: effect and prognostic factors

International Nuclear Information System (INIS)

Kwon, Jong Won; Lee, Joon Woo; Kim, Sung Hyun; Kwack, Kyu-Sung; Choi, Ja-Young; Moon, Sung Gyu; Jun, Woo Sun; Yeom, Jin-Sup; Kim, Hyun-Jib; Kang, Heung Sik

2007-01-01

To verify the usefulness of a fluoroscopy guided cervical interlaminar epidural steroid injection (CIESI) in patients with neck pain and cervical radiculopathy and to evaluate outcome predictors. We retrospectively analyzed 91 patients from July 2004 to June 2005 in whom CIESI was initially performed for neck pain and cervical radiculopathy. Therapeutic effects were evaluated 2 weeks after the administration of CIESI, and CIESI effectiveness was graded using a five-point scale, namely, whether the pain had disappeared, was much improved, slightly improved, the same, or aggravated. We also used a visual analog scale (VAS) for the clinical evaluation. According to documentation and follow-up charts, we categorized treatments as effective or ineffective. Possible outcome predictors, namely, diagnosis (spinal stenosis vs herniated disc), primary symptoms (neck pain vs radiculopathy vs both), age, gender, and duration of pain (more or less than 6 months) were also analyzed. Fisher's exact test, the chi-square test, and multiple logistic regression analysis were used for the statistical analysis. After their medical records had been reviewed, 76 patients were included in this study. Inclusion criteria were: the availability of a cross-sectional image, such as a CT scan or an MR image, and a follow-up record after injection. The medical records of 76 patients (male:female = 41: 35) of mean age 53.1 years (range 32 years to 82 years) were reviewed. Two weeks after injection, 55 patients (72.4%) had experienced effective pain relief. Patients with herniated discs had significantly better results than patients with spinal stenosis (86.1% vs 60.0%) (P < 0.05). Other non-significant predictors of an improved outcome included: a symptom duration of <6 months, a young age, and the presence of cervical radiculopathy. Multiple regression analysis showed that the only factor that was significantly associated with outcome was the cause of the pain, i.e., herniated disc or spinal

Imaging of cervical spine injuries of childhood

Energy Technology Data Exchange (ETDEWEB)

Khanna, Geetika; El-Khoury, Georges Y. [University of Iowa Hospitals and Clinics, Department of Radiology, 3951 JPP, Iowa, IA (United States)

2007-06-15

Cervical spine injuries of children, though rare, have a high morbidity and mortality. The pediatric cervical spine is anatomically and biomechanically different from that of adults. Hence, the type, level and outcome of cervical spine injuries in children are different from those seen in adults. Normal developmental variants seen in children can make evaluation of the pediatric cervical spine challenging. This article reviews the epidemiology of pediatric cervical spine trauma, normal variants seen in children and specific injuries that are more common in the pediatric population. We also propose an evidence-based imaging protocol to avoid unnecessary imaging studies and minimize radiation exposure in children. (orig.)

Incidence and Outcomes of Acute Implant Extrusion Following Anterior Cervical Spine Surgery.

Science.gov (United States)

Smith, Gabriel A; Pace, Jonathan; Corriveau, Mark; Lee, Sungho; Mroz, Thomas E; Nassr, Ahmad; Fehlings, Michael G; Hart, Robert A; Hilibrand, Alan S; Arnold, Paul M; Bumpass, David B; Gokaslan, Ziya; Bydon, Mohamad; Fogelson, Jeremy L; Massicotte, Eric M; Riew, K Daniel; Steinmetz, Michael P

2017-04-01

Multi-institutional retrospective case series of 8887 patients who underwent anterior cervical spine surgery. Anterior decompression from discectomy or corpectomy is not without risk. Surgical morbidity ranges from 9% to 20% and is likely underreported. Little is known of the incidence and effects of rare complications on functional outcomes following anterior spinal surgery. In this retrospective review, we examined implant extrusions (IEs) following anterior cervical fusion. A retrospective multicenter case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network. Medical records for 17 625 patients who received cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, were reviewed to identify occurrence of 21 predefined treatment complications. Following anterior cervical fusion, the incidence of IE ranged from 0.0% to 0.8% across 21 institutions with 11 cases reported. All surgeries involved multiple levels, and 7/11 (64%) involved either multilevel corpectomies or hybrid constructs with at least one adjacent discectomy to a corpectomy. In 7/11 (64%) patients, constructs ended with reconstruction or stabilization at C7. Nine patients required surgery for repair and stabilization following IE. Average length of hospital stay after IE was 5.2 days. Only 2 (18%) had residual deficits after reoperation. IE is a very rare complication after anterior cervical spine surgery often requiring revision. Constructs requiring multilevel reconstruction, especially at the cervicothoracic junction, have a higher risk for failure, and surgeons should proceed with caution in using an anterior-only approach in these demanding cases. Surgeons can expect most patients to regain function after reoperation.

Headache of cervical origin

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Burguet, J L; Wackenheim, A

1984-08-01

The authors recall cervical etiologies of headache. They distinguish on the one hand the cervico-occipital region with minor and major malformations and acquired lesions, and on the other hand the middle and inferior cervical segment. They also recall the original structuralist analysis of the cervical spine and give the example of the ''cervical triplet''.

Perceived cervical cancer risk among women treated for high-grade cervical intraepithelial neoplasia: The importance of specific knowledge.

Directory of Open Access Journals (Sweden)

Sonia Andersson

Full Text Available Women with high-grade cervical intraepithelial neoplasia (CIN are at increased risk for developing cervical cancer. We examine how women with high-grade CIN perceive their own risk, and about pertinent knowledge concerning human high-risk papillomavirus (HPV, CIN and cervical cancer.All patients who underwent first-time treatment of high-grade CIN (grade 2+ were followed-up at 6-months at the Karolinska University Hospital, Stockholm, Sweden and were invited to participate in the present study. This included completion of a questionnaire examining sociodemographic characteristics, self-perceived risk of cervical cancer without regular gynecologic follow-up, and 14 queries about HPV, CIN and cervical cancer knowledge, inter alia.The participation rate was 96.6%, with 479 women enrolled in this study. Over 75% were age 40 or younger, over half had completed university education. Most were married or co-living with their partner and were gainfully employed. On a scale scored from 10 (highest self-perceived risk of cervical cancer without regular gynecologic follow-up to 1 (lowest self-perceived risk, 64% rated their risk ≥ 7; almost 30% viewed their risk ≤ 6 and 7.5% did not rate their risk. A Specific Knowledge Scale with six of the queries explained 58.3% of the total variance. Nearly 30% of the women answered four or fewer of the six queries correctly. The Specific Knowledge Scale predicted self-perceived cervical cancer risk (Odds ratio = 11.3, 95% Confidence Interval 5.6 - 22.6 after adjusting for age, income and education. Most of the women with low self-perceived cervical cancer risk did not rate their HPV-related knowledge as good. However, 32 predominantly university-educated women, with low self-perceived cervical cancer risk, considered their HPV-related knowledge good.It is vital to effectively convey accurate information about these patients' cervical cancer risk, needed preventive and follow-up measures, together with the relevant

Knowledge about cervical cancer screening and its practice among female health care workers in southern Ethiopia: a cross-sectional study

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Dulla D

2017-05-01

Full Text Available Dubale Dulla,1 Deresse Daka,2 Negash Wakgari1 1School of Nursing and Midwifery, 2Department of Medical Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia Background: Cervical cancer remains a major cause of morbidity and mortality among the women in the world. Early screening for cervical cancer is a key intervention in reduction of maternal deaths. Health care workers have a significant contribution to improve cervical cancer screening practice among women. Hence, this study aimed to assess the knowledge and practice of cervical cancer screening among female health care workers in southern Ethiopia.Methods: Institution-based cross-sectional study was conducted during March and April, 2015. All hospitals in Hawassa city administration and Sidama zone were purposively selected. A simple random sampling technique was used to draw the health centers. After proportional allocations to their respective health facilities, a total of 367 female health workers were selected by simple random sampling technique. A structured and pretested questionnaire was used to collect the data. Data were entered to SPSS version 20.0 for further analysis. Logistic regression analyses were used to see the association of different variables.Results: Out of the total respondents, 319 (86.9% had a good level of knowledge on cervical cancer. Similarly, a majority of them, 329 (89.6%, 321 (87.5%, and 295 (80.4%, knew about the risk factors, symptoms, and outcomes of cervical cancer, respectively. More than two thirds of the respondents, 283 (77.1%, knew that there is a procedure used to detect premalignant cervical lesions and 138 (37.6% of them mentioned visual inspection with acetic acid as a screening method. In this study, only 42 (11.4% of the respondents were screened for cervical cancer (confidence interval [CI]: 8.7, 13.9. Being a physician (adjusted odds ratio [AOR] =0.12, 95% CI: 0.02, 0.79 and working in a cervical cancer

The rheumatoid cervical spine: Signs of instability on plain cervical radiographs

International Nuclear Information System (INIS)

Roche, Clare J.; Eyes, Brian E.; Whitehouse, Graham H.

2002-01-01

The cervical spine is a common focus of destruction from rheumatoid arthritis, second only to the metacarpophalangeal joints. Joint, bone and ligament damage in the cervical spine leads to subluxations which can cause cervical cord compression resulting in paralysis and even sudden death. Because many patients with significant subluxations are asymptomatic, the radiologist plays a key role in recognizing the clinically important clues to instability on plain radiographs of the cervical spine-often difficult in rheumatoid arthritis when the bony landmarks are osteoporotic or eroded. This review focuses on the signs of instability on plain radiographs of the cervical spine, using diagrams and clinical examples to illustrate methods of identifying significant subluxations in rheumatoid arthritis. Roche, C.J., Eyes, B.E. and Whitehouse, G.H. (2002)

Uptake of Cervical Cancer Screening and Associated Factors among Women in Rural Uganda: A Cross Sectional Study.

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Rawlance Ndejjo

Full Text Available In developing countries, inadequate access to effective screening for cervical cancer often contributes to the high morbidity and mortality caused by the disease. The largest burden of this falls mostly on underserved populations in rural areas, where health care access is characterized by transport challenges, ill equipped health facilities, and lack of information access. This study assessed uptake of cervical cancer screening and associated factors among women in rural Uganda.This descriptive cross sectional study was carried out in Bugiri and Mayuge districts in eastern Uganda and utilised quantitative data collection methods. Data were collected using a semi-structured questionnaire on cervical cancer screening among females aged between 25 and 49 years who had spent six or more months in the area. Data were entered in Epidata 3.02 and analysed in STATA 12.0 statistical software. Univariate, bivariate and multivariate analyses were performed.Of the 900 women, only 43 (4.8% had ever been screened for cervical cancer. Among respondents who were screened, 21 (48.8% did so because they had been requested by a health worker, 17 (39.5% had certain signs and symptoms they associated with cervical cancer while 16 (37.2% did it voluntarily to know their status. Barriers to cervical cancer screening were negative individual perceptions 553 (64.5% and health facility related challenges 142 (16.6%. Other respondents said they were not aware of the screening service 416 (48.5%. The independent predictors of cervical cancer screening were: being recommended by a health worker [AOR = 87.85, p<0.001], knowing where screening services were offered [AOR = 6.24, p = 0.004], and knowing someone who had ever been screened [AOR = 9.48, p = 0.001].The prevalence of cervical cancer screening is very low in rural Uganda. Interventions to increase uptake of cervical cancer screening should be implemented so as to improve access to the service in rural areas.

Papillary thyroid carcinoma with tuberculous cervical lymphadenopathy mimicking metastasis

International Nuclear Information System (INIS)

Iqbal, M; Subhan, A.; Aslam, A.

2011-01-01

To determine the frequency of tuberculous cervical lymphadenopathy mimicking metastasis from papillary thyroid cancer. Study Design: Case series. Place and Duration of Study: Surgical Unit-I, Ward-3 of Jinnah Postgraduate Medical Centre, Karachi, from March 2005 to March 2010. Methodology: All patients above 12 years of age of either gender diagnosed on investigations as papillary thyroid cancer (PTC) were included in the study. Ultrasound and fine needle aspiration cytology (FNAC), neck of solitary thyroid nodules (STN) and cervical lymph nodes were done. Total thyroidectomy and excision biopsy of cervical lymph nodes was performed, histopathological results were recorded and patients were managed accordingly. Results: A total of 55 patients had PTC and 25 had cervical lymphadenopathy. Eighteen patients of PTC with cervical lymphadenopathy were diagnosed after investigations as cases of tuberculous cervical lymphadenopathy (TCL) initially considered as metastasis from PTC; 5 patients had metastasis from PTC. Two patients proved to be of reactive hyperplasia which initially showed tuberculous cervical lymphadenopathy on FNAC. So 80% patients of cervical lymphadenopathy with PTC were due to benign disease and 20% had metastasis in lymph node due to PTC. Conclusion: PTC with cervical lymphadenopathy due to co-existent tuberculosis is common. Metastasis from PTC in lymph nodes were less common than tuberculous lymphodenitis in this study. Tuberculosis should be considered before deciding for neck dissection in cases of PTC. (author)

[Cervical and breast cancer prevention among underprivileged women in France: an epidemiological study].

Science.gov (United States)

Chappuis, Marielle; Antonielli, Alilla Brossard; Laurence, Sophie; Rochefort, Jeanine; Giboin, Catherine; Corty, Jean François

2014-01-01

If cervical cancer and breast cancer screening are frequent practices in general population, studies indicate that these practices are less common among underprivileged women. Doctors of the World conducted a study to measure cancer prevention and screening among women attending medical consultation in their health care centers (Caso) in France. The survey was conducted in 5 Caso. A questionnaire was proposed to all women (aged 14 years and older) attending medical consultation. 203 women participated in the survey. Only 33.1% of women aged 25-65 declared that they have ever realized a cervical smear in their lives. More than a third of the concerned women did not know cervical smear and 72% of the women under 35 years old do not know the HPV vaccine. 70.8% of women aged 50-74 said they had never realized a mammogram. The survey highlights less use of cancer screening among underprivileged women compared to the general population, underlines the need for appropriate actions for these populations and the need to facilitate health coverage access for women facing multiple vulnerability factors.

Headache of cervical origin

International Nuclear Information System (INIS)

Burguet, J.L.; Wackenheim, A.

1984-01-01

The authors recall cervical etiologies of headache. They distinguish on the one hand the cervico-occipital region with minor and major malformations and acquired lesions, and on the other hand the middle and inferior cervical segment. They also recall the original structuralist analysis of the cervical spine and give the example of the ''cervical triplet''. (orig.) [de

Degeneration and height of cervical discs classified from MRI compared with precise height measurements from radiographs

International Nuclear Information System (INIS)

Kolstad, Frode; Myhr, Gunnar; Kvistad, Kjell Arne; Nygaard, Oystein P.; Leivseth, Gunnar

2005-01-01

Study design: Descriptive study comparing MRI classifications with measurements from radiographs. Objectives: 1.Define the relationship between MRI classified cervical disc degeneration and objectively measured disc height. 2.Assess the level of inter- and intra-observer errors using MRI in defining cervical disc degeneration. Summary of background data: Cervical spine degeneration has been defined radiologically by loss of disc height, decreased disc and bone marrow signal intensity and disc protrusion/herniation on MRI. The intra- and inter-observer error using MRI in defining cervical degeneration influences data interpretation. Few previous studies have addressed this source of error. The relation and time sequence between cervical disc degeneration classified by MRI and cervical disc height decrease measured from radiographs is unclear. Methods: The MRI classification of degeneration was based on nucleus signal, prolaps identification and bone marrow signal. Two neuro-radiologists evaluated the MR-images independently in a blinded fashion. The radiographic disc height measurements were done by a new computer-assisted method compensating for image distortion and permitting comparison with normal level-, age- and gender-appropriate disc height. Results/conclusions: 1.Progressing disc degeneration classified from MRI is on average significantly associated with a decrease of disc height as measured from radiographs. Within each MRI defined category of degeneration measured disc heights, however, scatter in a wide range. 2.The inter-observer agreement between two neuro-radiologists in both defining degeneration and disc height by MRI was only moderate. Studies addressing questions related to cervical disc degeneration should take this into consideration

Degeneration and height of cervical discs classified from MRI compared with precise height measurements from radiographs

Energy Technology Data Exchange (ETDEWEB)

Kolstad, Frode [National Centre of Spinal Disorders, Norwegian University of Science and Technology, University Hospital of Trondheim, 7006 Trondheim (Norway)]. E-mail: frode.kolstad@medisin.ntnu.no; Myhr, Gunnar [Department of Radiology, University Hospital of Trondheim, 7006 Trondheim (Norway); Kvistad, Kjell Arne [Department of Radiology, University Hospital of Trondheim, 7006 Trondheim (Norway); Nygaard, Oystein P. [National Centre of Spinal Disorders, Norwegian University of Science and Technology, University Hospital of Trondheim, 7006 Trondheim (Norway); Leivseth, Gunnar [Department of Neuromedicine, Faculty of Medicine, Norwegian University of Science and Technology, University Hospital of Trondheim, 7006 Trondheim (Norway)

2005-09-01

Study design: Descriptive study comparing MRI classifications with measurements from radiographs. Objectives: 1.Define the relationship between MRI classified cervical disc degeneration and objectively measured disc height. 2.Assess the level of inter- and intra-observer errors using MRI in defining cervical disc degeneration. Summary of background data: Cervical spine degeneration has been defined radiologically by loss of disc height, decreased disc and bone marrow signal intensity and disc protrusion/herniation on MRI. The intra- and inter-observer error using MRI in defining cervical degeneration influences data interpretation. Few previous studies have addressed this source of error. The relation and time sequence between cervical disc degeneration classified by MRI and cervical disc height decrease measured from radiographs is unclear. Methods: The MRI classification of degeneration was based on nucleus signal, prolaps identification and bone marrow signal. Two neuro-radiologists evaluated the MR-images independently in a blinded fashion. The radiographic disc height measurements were done by a new computer-assisted method compensating for image distortion and permitting comparison with normal level-, age- and gender-appropriate disc height. Results/conclusions: 1.Progressing disc degeneration classified from MRI is on average significantly associated with a decrease of disc height as measured from radiographs. Within each MRI defined category of degeneration measured disc heights, however, scatter in a wide range. 2.The inter-observer agreement between two neuro-radiologists in both defining degeneration and disc height by MRI was only moderate. Studies addressing questions related to cervical disc degeneration should take this into consideration.

Cervical Cancer

Science.gov (United States)

... the place where a baby grows during pregnancy. Cervical cancer is caused by a virus called HPV. The ... for a long time, or have HIV infection. Cervical cancer may not cause any symptoms at first. Later, ...

Comparative study of perioperative complication rates of cervical laminoplasty performed by residents and teaching neurosurgeons.

Science.gov (United States)

Niimura, Manabu; Takai, Keisuke; Taniguchi, Makoto

2017-11-01

Early surgical education is required for neurosurgical residents to learn many surgical procedures. However, the participation of less experienced residents may increase perioperative complication rates. Perioperative complication studies in the field of neurosurgery are being increasingly published; however, studies have not yet focused on cervical laminoplasty. The study population included 193 consecutive patients who underwent cervical laminoplasty in Tokyo Metropolitan Neurological Hospital between 2008 and 2014. Patient and surgeon background factors, as well as perioperative complication rates were retrospectively compared between resident and board-certified spine neurosurgeon groups. Deteriorated or newly developed neurological deficits and surgical site complications within 30days of cervical laminoplasty were defined as perioperative complications. Out of 193 patients, 123 (64%) were operated on by residents as the first operator and 70 (36%) by board-certified spine neurosurgeons. No significant differences were observed in patient and surgeon factors between the two groups, except for hyperlipidemia (13 vs 17, p=0.02). Furthermore, no significant differences were noted in perioperative complication rates between the two groups (7 [5.7%] vs 4 [5.7%], p=1). Cervical laminoplasty performed in a standardized manner by residents who received their surgical training in our hospital did not increase perioperative complication rates, and ensured the safety of patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Differences in human papillomavirus type distribution in high-grade cervical intraepithelial neoplasia and invasive cervical cancer in Europe

DEFF Research Database (Denmark)

Tjalma, Wiebren A; Fiander, Alison; Reich, Olaf

2013-01-01

Knowledge of differences in human papillomavirus (HPV)-type prevalence between high-grade cervical intraepithelial neoplasia (HG-CIN) and invasive cervical cancer (ICC) is crucial for understanding the natural history of HPV-infected cervical lesions and the potential impact of HPV vaccination...... on cervical cancer prevention. More than 6,000 women diagnosed with HG-CIN or ICC from 17 European countries were enrolled in two parallel cross-sectional studies (108288/108290). Centralised histopathology review and standardised HPV-DNA typing were applied to formalin-fixed paraffin-embedded cervical...... higher in ICC than in HG-CIN. The difference in age at diagnosis between CIN3 and squamous cervical cancer for HPV18 (9 years) was significantly less compared to HPV31/33/'other' (23/20/17 years), and for HPV45 (1 year) than HPV16/31/33/'other' (15/23/20/17 years). In Europe, HPV16 predominates in both...

A Population-based Study of Invasive Cervical Cancer Patients in Beijing: 1993-2008

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Tong Wang

2015-01-01

Full Text Available Background: In recent years, the incidence of cervical cancer has been rising, particularly in young adults, as the second most common gynecological cancer in China. The aim of this study was to explore the incidence change and the epidemiological characteristics of cervical cancer in Beijing over the past 16 years. Methods: All the cases of the study were limited to Beijing residents diagnosed with cervical cancer and registered in Beijing from January 1, 1993, to December 31, 2008. A total of 4100 patients with cervical cancer were obtained from the Statistics Database of Beijing Cancer Registry (BJCaR. According to the registered data, we retrospectively reviewed all original cases which we can acquired in reported hospital. Cervical situ cancer, cervical metastatic cancer, non-Beijing residents and repeatedly registered cases were excluded. Totally, 3641 registered cases were verified correctly. Meanwhile, we also collected the following data: Age, occupation, detected methods, histological type, and staging. The trends of incidence and mortality were analyzed by Joinpoint Regression Program 4.1.1.1 produced by National Cancer Institute (NCI, USA. The annual percent change (APC was calculated using the Joinpoint regression model. Results: The crude rates of incidence and mortality were 10.4 and 1.0 per 100,000 women, respectively during 1993 to 2008. The average WHO age-standardized incidence rates were 11.5 per 100,000 women. There was a decrease in incidence annually by 8.0% (P = 0.3 during 1993-1996 and a rapid increase annually by 18.9% after 1999 (P < 0.01. The median age was 67 years in 1993, but the median age decreased to 45 years in 2008. The peak of the age-specific incidence curve was at 40 years in the most recent period (2005-2008, which was 25-30 years earlier than that in previous periods (1993-1996. In the 2224 cases, the numbers of patients with stage I, II, III and IV were 910 (40.9%, 601 (27%, 542 (24.4%, 171 (7

Spondilitis Tuberkulosa Cervical

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Roni Eka Saputra

2015-05-01

-3% kasus spondilitistuberkulosa. Keterlibatan spinal biasanya merupakan akibat dari penyebaran hemaKata kunci: spondilitis TB, cervical, pembedahan Abstract Cervical tuberculous spondylitis is a fairly rare disease, only about 2-3% of all cases of tuberculousspondylitis. The clinical features vary widely, ranging from mild and non-specific symptoms until the fatal neurologicalcomplications. A 29-year-old woman came with a complaint weakness of the four limbs become heavy in the last 10days, were preceded by neck pain that radiates to the shoulders and arms since 6 months earlier. Pain was initiallyperceived as a limitation of neck movement when turned to the left and right side, and bowed his head. Perceived painexacerbated by movement and reduced if the rest. Patients lost weight since the last 2 months. Found no history ofcough or chest pain. Neurologic examination showed weakness in four extremities. Laboratory results found increasedErythrocyte Sedimentation Rate (ESR. X-ray radiographic normal. Cervical x-ray photograph shows destruction ashigh as C5. MRI shows destruction in the corpus C5-6 with narrowing at C5-6 intervertebre disc  accompanied byparavertebral abscess with emphasis to the posterior. Found destruction corpus verebre T 4.5 with intervertebral discnarrowing. Suggestive of a tuberculous spondylitis. At 5.6 C spondylitis vertebre anterior corpectomi following surgery,microsurgery with iliac graft, and insertion one level anterior plate. Anatomical Pathology examination showedcaseating tuberculosis spodilitis. At T 4.5 vertebre spondylitis done laminectomi, costotrasversektomi debridement, andstabilization with pedicle screw T2, T3, and T5. Patients also treated with anti-tuberculosis drugs. Present status,patient is able to perform daily activity with sensoric and motoric good. Tuberculous Spondylitis is the most common form of tuberculosis that affect the bone. Cervical Tuberculous spondylitis ranges from 2-3% of cases of tuberculousspondylitis. Spinal

Cervical spine surgery performed in ambulatory surgical centers: Are patients being put at increased risk?

Science.gov (United States)

Epstein, Nancy E

2016-01-01

Spine surgeons are being increasingly encouraged to perform cervical operations in outpatient ambulatory surgical centers (ASC). However, some studies/data coming out of these centers are provided by spine surgeons who are part or full owners/shareholders. In Florida, for example, there was a 50% increase in ASC (5349) established between 2000-2007; physicians had a stake (invested) in 83%, and outright owned 43% of ASC. Data regarding "excessive" surgery by ASC surgeon-owners from Idaho followed shortly thereafter. The risks/complications attributed to 3279 cervical spine operations performed in 6 ASC studies were reviewed. Several studies claimed 99% discharge rates the day of the surgery. They also claimed major complications were "picked up" within the average postoperative observation window (e.g., varying from 4-23 hours), allowing for appropriate treatment without further sequelae. Morbidity rates for outpatient cervical spine ASC studies (e.g. some with conflicts of interest) varied up to 0.8-6%, whereas morbidity rates for 3 inpatient cervical studies ranged up to 19.3%. For both groups, morbidity included postoperative dysphagia, epidural hematomas, neck swelling, vocal cord paralysis, and neurological deterioration. Although we have no clear documentation as to their safety, "excessive" and progressively complex cervical surgical procedures are increasingly being performed in ASC. Furthermore, we cannot rely upon ASC-based data. At least some demonstrate an inherent conflict of interest and do not veridically report major morbidity/mortality rates for outpatient procedures. For now, cervical spine surgery performed in ASC would appear to be putting patients at increased risk for the benefit of their surgeon-owners.

Correlation Between Dental and Cervical Vertebral Maturation in Iranian Females

Science.gov (United States)

Valizadeh, Solmaz; Eil, Nakissa; Ehsani, Sara; Bakhshandeh, Hooman

2012-01-01

Background Considerable variations in the development stage among patients of the same chronological age have led to introduce the concept of the developmental age based on the maturation of different organs such as cervical vertebrae or teeth. Objectives The purpose of this study was to investigate the correlation between the stages of tooth calcification and the cervical vertebral maturation in Iranian females. Patients and Methods Four hundred females (age range, 8 to 14 years) participated in the study. To determine the dental maturational stage, calcification of the mandibular teeth except for third molars were rated according to the method suggested by Demirjian et al. To evaluate the stage of skeletal maturation, cervical vertebral morphologic changes were assessed on lateral cephalometric radiographs according to the method explained by Baccetti et al. Correlations between bone maturation and teeth calcification were showed by Spearman's correlation and Kendall’s tau-b coefficients. The relevant associations were investigated by ordinal logistic regression models. Results Correlations between the two stages were observed in the first and second premolars, canine and central incisors. All these correlations were significant. The association between cervical vertebral maturation and tooth calcification was greatest in the lateral incisor (odds ratio (OR) = 11, 95% confidence interval (CI): 6.6-18.3). However, considering the 95% CI for OR, no significant difference was detected among the second molar, first molar and lateral incisor. Conclusion The relationship between calcification of teeth and maturation of cervical bones was significant. Bone maturation can be predicted by using teeth calcification stages, especially in the second molar, first molar and lateral incisor. PMID:23599706

Low virulence bacterial infections in cervical intervertebral discs: a prospective case series.

Science.gov (United States)

Chen, Yilei; Wang, Xianjun; Zhang, Xuyang; Ren, Hong; Huang, Bao; Chen, Jian; Liu, Junhui; Shan, Zhi; Zhu, Zhihai; Zhao, Fengdong

2018-04-19

A prospective cross-sectional case series study. To investigate the prevalence of low virulence disc infection and its associations with characteristics of patients or discs in the cervical spine. Low virulence bacterial infections could be a possible cause of intervertebral disc degeneration and/or back pain. Controversies are continuing over whether these bacteria, predominantly Propionibacterium acnes (P. acnes), represent infection or contamination. However, the current studies mainly focus on the lumbar spine, with very limited data on the cervical spine. Thirty-two patients (20 men and 12 women) who underwent anterior cervical fusion for degenerative cervical spondylosis or traumatic cervical cord injury were enrolled. Radiological assessments included X-ray, CT, and MRI of the cervical spine. Endplate Modic changes, intervertebral range of motion, and disc herniation type were evaluated. Disc and muscle tissues were collected under strict sterile conditions. Samples were enriched in tryptone soy broth and subcultured under anaerobic conditions, followed by identification of the resulting colonies by the PCR method. Sixty-six intervertebral discs were excised from thirty-two patients. Positive disc cultures were noted in eight patients (25%) and in nine discs (13.6%). The muscle biopsy (control) cultures were negative in 28 patients and positive in 4 patients (12.5%); three of whom had a negative disc culture. Seven discs (10.6%) were positive for coagulase-negative Staphylococci (CNS) and two discs were positive for P. acnes (3.0%). A younger patient age and the extrusion or sequestration type of disc herniation, which represented a complete annulus fibrous failure, were associated with positive disc culture. Our data show that CNS is more prevalent than P. acnes in degenerative cervical discs. The infection route in cervical discs may be predominantly through an annulus fissure. Correlation between these infections and clinical symptoms is uncertain

EXPRESSION OF HPV 16 AND 18 IN CERVICAL INTRAEPITHELIAL NEOPLASIA

OpenAIRE

Kodali Venkataramana; Prasad Usha

2017-01-01

BACKGROUND Cervical cancer is by far the most common human papilloma virus related disease. Nearly, all cases of cervical cancer can be attributable to human papilloma virus infection. Infection with the human papilloma virus is the main risk factors for cervical intraepithelial neoplasia and cervical cancer especially the high-risk types. The aim of the study is to study the prevalence of high-risk human papilloma virus 16 and 18 in various grades of cervical intraepithelia...

Comparative analysis of cervical spine management in a subset of severe traumatic brain injury cases using computer simulation.

Directory of Open Access Journals (Sweden)

Kimbroe J Carter

Full Text Available BACKGROUND: No randomized control trial to date has studied the use of cervical spine management strategies in cases of severe traumatic brain injury (TBI at risk for cervical spine instability solely due to damaged ligaments. A computer algorithm is used to decide between four cervical spine management strategies. A model assumption is that the emergency room evaluation shows no spinal deficit and a computerized tomogram of the cervical spine excludes the possibility of fracture of cervical vertebrae. The study's goal is to determine cervical spine management strategies that maximize brain injury functional survival while minimizing quadriplegia. METHODS/FINDINGS: The severity of TBI is categorized as unstable, high risk and stable based on intracranial hypertension, hypoxemia, hypotension, early ventilator associated pneumonia, admission Glasgow Coma Scale (GCS and age. Complications resulting from cervical spine management are simulated using three decision trees. Each case starts with an amount of primary and secondary brain injury and ends as a functional survivor, severely brain injured, quadriplegic or dead. Cervical spine instability is studied with one-way and two-way sensitivity analyses providing rankings of cervical spine management strategies for probabilities of management complications based on QALYs. Early collar removal received more QALYs than the alternative strategies in most arrangements of these comparisons. A limitation of the model is the absence of testing against an independent data set. CONCLUSIONS: When clinical logic and components of cervical spine management are systematically altered, changes that improve health outcomes are identified. In the absence of controlled clinical studies, the results of this comparative computer assessment show that early collar removal is preferred over a wide range of realistic inputs for this subset of traumatic brain injury. Future research is needed on identifying factors in

Functional diagnostics of the cervical spine by using computer tomography

International Nuclear Information System (INIS)

Dvorak, J.; Hayek, J.; Grob, D.

1988-01-01

35 healthy adults and 137 patients after cervical spine injury were examined by functional CT. The range of axial rotation at the level occiput/atlas, atlas/axis and the segment below were measured in all subjects. A rotation occiput/atlas of more than 7 0 , and C1/C2 more than 54 0 could refer to segmental hypermobility, a rotation at the segment C1/C2 less than 29 0 to hypomobility. According to the postulated normal values based upon a 98% confidence level, out of 137 patients examined after cervical spine injury and with therapy-resistant neck pain, 45 showed signs of segmental hypermobility of the upper cervical spine, 17 showed hyper- or hypomobility at different levels, 10 patients presented segmental hypomobility at C1/C2 level alone. In all patients, according to the clinical assessment, functional pathology was suspected in the upper cervical spine. Surgical correction of rotatory instability should be considered as a possible therapeutic procedure after successful diagnostic stabilisation of the cervical spine by minerva cast. (orig.)

Functional diagnostics of the cervical spine by using computer tomography

Energy Technology Data Exchange (ETDEWEB)

Dvorak, J; Hayek, J; Grob, D; Penning, L; Panjabi, M M; Zehnder, R

1988-04-01

35 healthy adults and 137 patients after cervical spine injury were examined by functional CT. The range of axial rotation at the level occiput/atlas, atlas/axis and the segment below were measured in all subjects. A rotation occiput/atlas of more than 7/sup 0/, and C1/C2 more than 54/sup 0/ could refer to segmental hypermobility, a rotation at the segment C1/C2 less than 29/sup 0/ to hypomobility. According to the postulated normal values based upon a 98% confidence level, out of 137 patients examined after cervical spine injury and with therapy-resistant neck pain, 45 showed signs of segmental hypermobility of the upper cervical spine, 17 showed hyper- or hypomobility at different levels, 10 patients presented segmental hypomobility at C1/C2 level alone. In all patients, according to the clinical assessment, functional pathology was suspected in the upper cervical spine. Surgical correction of rotatory instability should be considered as a possible therapeutic procedure after successful diagnostic stabilisation of the cervical spine by minerva cast.

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

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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.

HPV genotypes in invasive cervical cancer in Danish women

DEFF Research Database (Denmark)

Kirschner, Benny; Junge, Jette; Holl, Katsiaryna

2013-01-01

Human papillomavirus (HPV) genotype distribution in invasive cervical cancers may differ by geographic region. The primary objective of this study was to estimate HPV-genotype distribution in Danish women with a diagnosis of invasive cervical cancer.......Human papillomavirus (HPV) genotype distribution in invasive cervical cancers may differ by geographic region. The primary objective of this study was to estimate HPV-genotype distribution in Danish women with a diagnosis of invasive cervical cancer....

Evaluation of the cervical neural foramina with MR imaging

International Nuclear Information System (INIS)

Czervionke, L.F.; Daniels, D.L.; Ho, P.S.P.; Yu, S.; Williams, A.L.; Haughton, V.M.

1987-01-01

Accurately diagnosing the causes of cervical radiculopathy with MR imaging requires better understanding of the anatomic relationships in the cervical neural foramina. The cervical foramina were studied in three ways: (1) In cadavers, the paravertebral veins were injected with paramagnetic contrast material. Cryomicrotome sections were then correlated with MR images. (2) In patients, the cervical foramina were studied with MR imaging with intravenous Gd-DTPA. (3) Normal volunteers were scanned using spin-echo and gradient-echo techniques. The nerve root sheaths, ganglia, vessels, and bone margins of the cervical foramina can be well demonstrated by MR imaging. Intravenous Gd-DTPA enhances some normal structures in the foramen. The authors report on optimal pulse sequences for evaluating the cervical neural foramina

Factors associated with upper extremity contractures after cervical spinal cord injury: A pilot study.

Science.gov (United States)

Hardwick, Dustin; Bryden, Anne; Kubec, Gina; Kilgore, Kevin

2018-05-01

To examine the prevalence of joint contractures in the upper limb and association with voluntary strength, innervation status, functional status, and demographics in a convenience sample of individuals with cervical spinal cord injury to inform future prospective studies. Cross-sectional convenience sampled pilot study. Department of Veterans Affairs Research Laboratory. Thirty-eight participants with cervical level spinal cord injury. Not applicable. Contractures were measured with goniometric passive range of motion. Every joint in the upper extremity was evaluated bilaterally. Muscle strength was measured with manual muscle testing. Innervation status was determined clinically with surface electrical stimulation. Functional independence was measured with the Spinal Cord Independence Measure III (SCIM-III). Every participant tested had multiple joints with contractures and, on average, participants were unable to achieve the normative values of passive movement in 52% of the joints tested. Contractures were most common in the shoulder and hand. There was a weak negative relationship between percentage of contractures and time post-injury and a moderate positive relationship between percentage of contractures and age. There was a strong negative correlation between SCIM-III score and percentage of contractures. Joint contractures were noted in over half of the joints tested. These joint contractures were associated with decreased functional ability as measured by the SCIM-III. This highlights the need the need for detailed evaluation of the arm and hand early after injury as well as continued monitoring of joint characteristics throughout the life course of the individual with tetraplegia.

Morphological study of the axial view of the cervical spinal cord by MR images

International Nuclear Information System (INIS)

Suzuki, Masahiro; Shimamura, Tadashi

1994-01-01

To investigate the morphological changes in the cervical spinal cord in patients with cervical myelopathy, we examined the axial anatomy of the cervical spinal cord and the spinal canal using MRI and CT scans. This study involved 35 patients (mean age=56.8) with cervical myelopathy and 118 adult normal volunteers (mean age=48.1) as controls. The transverse area of the spinal cord was measured on MR images (T 1 images), while the transverse area of the spinal canal was measured on CT. In normal subjects, the transverse area, the sagittal diameter, and the coronal diameter of the spinal cord showed a significant positive correlation with body height, and a significant negative correlation with age. No significant difference was identified between males and females. The transverse area, the sagittal diameter, the coronal diameter, and the ratio of the sagittal/coronal diameter of the spinal cord and the spinal canal showed significant positive correlations among each other in normal subjects, but no significant correlation was noted in the patients with cervical myelopathy. These was no significant difference between the normal subjects and the patients in the transverse area or in the ratio of the sagittal/coronal diameter of the spinal cord at the levels without cord compression. However, the transverse area of the spinal canal in the patients with myelopathy was significantly smaller than that of normal subjects. In conclusion, a poor or no correlation between the size of the spinal cord and the spinal canal is a frequent finding in patients with myelopathy. Furthermore, this study suggests that patients with myelopathy present a narrow spinal canal more frequently than do normal subjects. (author)

Cervical cancer screening in Greenland, 1997-2011

DEFF Research Database (Denmark)

Holst, Signe; Wohlfahrt, Jan; Kjær, Susanne Krüger

2016-01-01

of the screening program and to examine possible changes in cervical intraepithelial neoplasia (CIN3) incidence in Greenland during 1997-2011 according to calendar period and age. METHODS: Using nationwide registries, we calculated age-standardized incidence rates for all women born and living in Greenland......OBJECTIVE: In spite of the high incidence of cervical cancer in Greenland, no assessment has been made of the impact of organized cervical screening, introduced in 1998, in relation to occurrence of high-grade cervical lesions. The objectives of the present study were to estimate coverage...

Preventing Cervical Cancer with HPV Vaccines

Science.gov (United States)

Cervical cancer can be prevented with HPV vaccines. NCI-supported researchers helped establish HPV as a cause of cervical cancer. They also helped create the first HPV vaccines, were involved in the vaccine trials, and contribute to ongoing studies.

Chlamydia trachomatis detection in cervical PreservCyt specimens from an Irish urban female population.

LENUS (Irish Health Repository)

Keegan, H

2012-02-01

OBJECTIVE: The aim of this study was to determine the prevalence of cervical Chlamydia trachomatis infection by polymerase chain reaction (PCR) in urban women undergoing routine cervical cytological screening and to investigate the relationship with age, cytology, smoking status and concurrent human papillomavirus (HPV) infection. METHODS: A total of 996 women (age range 16-69 years) attending general practitioners for routine liquid-based cervical smear screening in the Dublin area were recruited in the study of prevalence of C. trachomatis. Informed consent was obtained and liquid-based cytology (LBC) specimens were sent for cytological screening. DNA was extracted from residual LBC and tested for C. trachomatis by PCR using the highly sensitive C. trachomatis plasmid (CTP) primers and for HPV infection using the MY09\\/11 primers directed to the HPV L1 gene in a multiplex format. RESULTS: The overall prevalence of C. trachomatis was 5.4%. Prevalence was highest in the <25 years age group (10%). Coinfection with HPV and C. trachomatis occurred in 1% of the screening population. A higher rate of smoking was observed in women positive for C. trachomatis, HPV infections or those with abnormal cervical cytology. Chlamydia trachomatis infection was not associated with abnormal cytology. CONCLUSIONS: Women (5.4%) presenting for routine cervical screening are infected with C. trachomatis. Opportunistic screening for C. trachomatis from PreservCyt sample taken at the time of cervical cytological screening may be a possible strategy to screen for C. trachomatis in the Irish female population.

Radionuclide gastric emptying time study for patients with cervical and thoracic esophageal cancer after resection

International Nuclear Information System (INIS)

Liu Lin; Tang Jin; Wang Yonggang; Li Jiaxiu

1994-01-01

Semi-solid meal was mixed with 99m Tc-DTPA and used as test meal given to patients orally. Gastric emptying time was measured in 70 patients after resection of esophageal cancer and 24 normal subjects. 70 patients were divided into 3 groups: (1) 14 cases with cervical esophageal cancer operated by using colon to replace the esophagus (CRE group). (2) 28 cases with cervical esophageal cancer operated by using stomach to replace the esophagus (SRE group). (3) 28 patients with thoracic esophageal cancer after resection only (TE group). The range of gastric emptying time of normal subjects was 53.9 +- 10.5%/60 minutes. The results showed that SRE group (28 pts) had a more rapid gastric emptying time than that of normal subjects. CRE group (14 pts) and TE group (28 pts) had slower gastric emptying time than that of normal subjects

Risk of high-grade cervical dysplasia and cervical cancer in women with systemic lupus erythematosus receiving immunosuppressive drugs.

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Feldman, C H; Liu, J; Feldman, S; Solomon, D H; Kim, S C

2017-06-01

Objective Prior studies suggest an increased risk of cervical cancer among women with systemic lupus erythematosus. However, the relationship with immunosuppressive drugs is not well studied in US nationwide cohorts. We compared the risk of high-grade cervical dysplasia and cervical cancer among women with systemic lupus erythematosus who started immunosuppressive drugs versus hydroxychloroquine. Methods We identified systemic lupus erythematosus patients initiating immunosuppressive drugs or hydroxychloroquine using claims data from two US commercial health plans and Medicaid (2000-2012). We used a validated claims-based algorithm to identify high-grade cervical dysplasia or cervical cancer. To account for potential confounders, including demographic factors, comorbidities, medication use, HPV vaccination status, and health care utilization, immunosuppressive drugs and hydroxychloroquine initiators were 1:1 matched on the propensity score. We used inverse variance-weighted, fixed effect models to pool hazard ratios from the propensity score-matched Medicaid and commercial cohorts. Results We included 2451 matched pairs of immunosuppressive drugs and hydroxychloroquine new users in the commercial cohort and 7690 matched pairs in Medicaid. In the commercial cohort, there were 14 cases of cervical dysplasia or cervical cancer among immunosuppressive drugs users and five cases among hydroxychloroquine users (hazard ratio 2.47, 95% CI 0.89-6.85, hydroxychloroquine = ref). In Medicaid, there were 46 cases among immunosuppressive drugs users and 29 cases in hydroxychloroquine users (hazard ratio 1.24, 95% CI 0.78-1.98, hydroxychloroquine = ref). The pooled hazard ratio of immunosuppressive drugs was 1.40 (95% CI 0.92-2.12). Conclusion Among women with systemic lupus erythematosus, immunosuppressive drugs may be associated with a greater, albeit not statistically significant, risk of high-grade cervical dysplasia and cervical cancer compared to patients receiving

Women with learning disabilities and access to cervical screening: retrospective cohort study using case control methods

OpenAIRE

Reynolds, Fiona; Stanistreet, Debbi; Elton, Peter

2008-01-01

Abstract Background Several studies in the UK have suggested that women with learning disabilities may be less likely to receive cervical screening tests and a previous local study in had found that GPs considered screening unnecessary for women with learning disabilities. This study set out to ascertain whether women with learning disabilities are more likely to be ceased from a cervical screening programme than women without; and to examine the reasons given for ceasing women with learning ...

Cervical spondylosis in Nepalese porters.

Science.gov (United States)

Bista, P; Roka, Y B

2008-01-01

Neck pain with or without radiculopathy and myelopathy is a very common problem in clinical practice. The incidence is believed to be higher in subgroups carrying load on their head. It has been reported in literature that radiographic spondylosis is appreciable in 25% to 50% of population by the age of 50 years and 75% to 85% by the age of 65 years. One hundred and nineteen lateral X-rays of cervical spine were analyzed as case-control study in patients between 40 and 50 years age with the objective of finding out proportion of cervical spondylosis in this age group and difference in the prevalence between porters and non-porters. Out of the 119 cases 54 (45.4.2%) were porters and 65 (54.6%) were non-porters. There were 98 (82.4%) males and 21 (17.6%) females. The overall prevalence of radiological cervical spondylosis was 69 (58%). The prevalence of cervical spondylosis was significantly lower (x2=14.795, p=0.0001) in porters in comparison to non-porters. The odds ratio was found to be 0.23 (0.10, 0.53) at 95% confidence interval indicating that portering significantly prohibited development of spondylosis. This study concludes that the overall prevalence of cervical spondylosis in the Nepalese population is slightly higher than in the Caucasian and contrary to other studies there is significantly lower prevalence of such degeneration among the Nepalese porters.

The rebirth of the cervical cap.

Science.gov (United States)

Cappiello, J D; Grainger-Harrison, M

1981-01-01

In an effort to dispel myths surrounding the cervical cap, the historical and political factors affecting the cap's use in the U.S. are described. Clinical aspects of cap fitting are also included. The cervical cap has found only limited acceptance in the U.S. Skepticisms on the part of physicians may be the result of 2 factors: confusion of the cervical cap with intracervical devices used for artificial insemination and confusion with stem pessaries; and the lack of clinical research and statistical evaluation of efficacy rates. The latter factor prompted Tietze et al. to conduct the only U.S. statistical study of the cap in 1953. Of the 143 women studied, the pregnancy rate was 7.6/100 years of use. Of the 28 unplanned pregnancies, 6 were related to faulty technique or omission of a spermicide and 10 were instances of admittedly irregular use. When these failures are omitted, the theoretical effectiveness rate is about 98%. Some practitioners are concerned about an increased incidence of cervical erosion with cap use. Possibly currently conducted studies will show that cap and spermicide users have a lower incidence of cervical erosion than women using no contraceptive method. Study findings suggest that the cervical cap may afford protection without any spermicidal supplement, but the use of spermicides continues to be recommended to clients. Advantages of the cervical cap include the following: it can be left in place longer than a diaphragm without additional applications of spermicide in the vagina; and the insertion of the cap is unrelated to the time of intercourse. Despite research on toleration of the cap for 3 weeks at a time, it is recommended that the cap be worn for only a few days at a time. At this time there are no manufacturers of cervical caps for contraceptive use in the U.S. The cap is now being imported from England and it costs $6.00. A factor that has made the cap unpopular with many physicians is the lengthy time required for fitting. An

The effect of halo-vest length on stability of the cervical spine. A study in normal subjects.

Science.gov (United States)

Wang, G J; Moskal, J T; Albert, T; Pritts, C; Schuch, C M; Stamp, W G

1988-03-01

In order to study how the efficiency of the halo vest is affected by different lengths of the vest, an experimental headband was devised that allowed the head of a normal person to be held securely in the halo attachment. The vest was then modified to allow it to be adjusted to three different lengths (Fig. 2): a full vest extended to the iliac crests, a short vest extended to the twelfth ribs, and a half vest extended to the level of the nipples. Twenty normal, healthy adult men participated in the study. For each vest length, radiographs were made of each subject demonstrating rotation, flexion-extension, and lateral bending of the cervical spine. There was no rotation of the cervical spine, regardless of the length of the vest. There was a variable degree of motion in flexion or extension of the upper part of the cervical spine with all vest lengths, but this was not statistically significant. There was definite increase of motion caudad to the level of the fifth cervical vertebra regardless of the length of the vest. We concluded that a lesion of the upper part of the cervical spine can be treated effectively by halo traction with a half vest. This will improve the comfort and care of the patient and avoid the necessity of removing the vest if emergency cardiovascular resuscitation is needed. In the treatment of lesions of the lower part of the cervical spine (caudad to the level of the fourth cervical vertebra), the use of a halo vest that extends caudad to the level of the twelfth ribs does provide additional stability.

Imbalanced Protein Expression Patterns of Anabolic, Catabolic, Anti-Catabolic and Inflammatory Cytokines in Degenerative Cervical Disc Cells: New Indications for Gene Therapeutic Treatments of Cervical Disc Diseases

Science.gov (United States)

Mern, Demissew S.; Beierfuß, Anja; Fontana, Johann; Thomé, Claudius; Hegewald, Aldemar A.

2014-01-01

Degenerative disc disease (DDD) of the cervical spine is common after middle age and can cause loss of disc height with painful nerve impingement, bone and joint inflammation. Despite the clinical importance of these problems, in current publications the pathology of cervical disc degeneration has been studied merely from a morphologic view point using magnetic resonance imaging (MRI), without addressing the issue of biological treatment approaches. So far a wide range of endogenously expressed bioactive factors in degenerative cervical disc cells has not yet been investigated, despite its importance for gene therapeutic approaches. Although degenerative lumbar disc cells have been targeted by different biological treatment approaches, the quantities of disc cells and the concentrations of gene therapeutic factors used in animal models differ extremely. These indicate lack of experimentally acquired data regarding disc cell proliferation and levels of target proteins. Therefore, we analysed proliferation and endogenous expression levels of anabolic, catabolic, ant-catabolic, inflammatory cytokines and matrix proteins of degenerative cervical disc cells in three-dimensional cultures. Preoperative MRI grading of cervical discs was used, then grade III and IV nucleus pulposus (NP) tissues were isolated from 15 patients, operated due to cervical disc herniation. NP cells were cultured for four weeks with low-glucose in collagen I scaffold. Their proliferation rates were analysed using 3-(4, 5-dimethylthiazolyl-2)-2,5-diphenyltetrazolium bromide. Their protein expression levels of 28 therapeutic targets were analysed using enzyme-linked immunosorbent assay. During progressive grades of degeneration NP cell proliferation rates were similar. Significantly decreased aggrecan and collagen II expressions (P<0.0001) were accompanied by accumulations of selective catabolic and inflammatory cytokines (disintegrin and metalloproteinase with thrombospondin motifs 4 and 5, matrix

Cervical cancer - screening and prevention

Science.gov (United States)

Cancer cervix - screening; HPV - cervical cancer screening; Dysplasia - cervical cancer screening; Cervical cancer - HPV vaccine ... Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that spreads through sexual contact. Certain ...

Manual therapy and segmental stabilization in the treatment of cervical radiculopathy

Directory of Open Access Journals (Sweden)

Rafael Souza Aquaroli

Full Text Available Abstract Introduction: Cervical radiculopathy (CR is one of the diseases that most affect the cervical spine, causing radicular symptoms in the ipsilateral limb. Conservative treatment aim recover of both mechanical and physiological functions through neural mobilization techniques, along with the activation of the deep neck flexors with cervical segmental stabilization, combining techniques of joint mobilization and manipulation, which seeks mobility improvement of crucial areas of the cervical spine. The objective of this study was to evaluate a multimodal treatment to enhance the outcomes of conservative care in patients diagnosed with CR. Methods: The sample consisted of 11 patients with CR, between 21 and 59 years old, 3 female and 8 male. It was recorded the Visual Analogue Scale (VAS for pain, the Functional Development of the Neck Pain and Disability Scale (NPDS and the goniometry during shoulder abduction. The intervention plan was composed by neural mobilization, intermittent cervical traction, pompages, stretching, myofascial inhibition techniques, manipulative techniques and cervical segmental stabilization exercises. After 12 weeks of treatment, subjects underwent a new evaluation process. Results: Before the treatment, subjects reported an average pain of 7 (± 1.48 in VAS, whose dropped to average 1.18 (± 1.99 (p < 0.01. Functional disability evaluated in NPDS was 36 (± 10.95 before treatment decreasing to 11.45 (± 9.8 (p < 0.01 after the treatment. Range of motion of the ipsilateral upper limb was restores by increasing from 9.2° (± 8.2 to 137° (± 24.4 (p < 0.01. Conclusion: The proposed treatment approach was effective, significantly improving the results of analgesia and functional disability a series of cases of patients diagnosed with cervical radiculopathy. {#}

Cervical cancer incidence in elderly women

DEFF Research Database (Denmark)

Lynge, Elsebeth; Lönnberg, Stefan; Törnberg, Sven

2017-01-01

Aim: In many countries, the age-specific pattern of cervical cancer incidence is currently bipolar with peaks at for instance 45 and 65 years of age. Consequently, a large proportion of cervical cancer cases are presently diagnosed in women above the screening age. The purpose of the study...... was to determine whether this bipolar pattern in age-specific incidence of cervical cancer reflects underlying biology or can be explained by the fact that the data come from birth cohorts with different screening histories. Methods: Combination of historical data on cervical screening and population-based cancer...... incidence data from Denmark 1943–2013, Finland and Norway 1953–2013, and Sweden 1958–2013. Results: Since the implementation of screening, the incidence of cervical cancer has decreased for each successive birth cohort. All birth cohorts showed a unipolar age-specific pattern. In unscreened women in Denmark...

A Multicenter Review of Superior Laryngeal Nerve Injury Following Anterior Cervical Spine Surgery.

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Tempel, Zachary J; Smith, Justin S; Shaffrey, Christopher; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel; Kanter, Adam S

2017-04-01

A retrospective multicenter case-series study; case report and review of the literature. The anatomy and function of the superior laryngeal nerve (SLN) are well described; however, the consequences of SLN injury remain variable and poorly defined. The prevalence of SLN injury as a consequence of cervical spine surgery is difficult to discern as its clinical manifestations are often inconstant and frequently of a subclinical degree. A multicenter study was performed to better delineate the risk factors, prevalence, and outcomes of SLN injury. A retrospective multicenter case-series study involving 21 high-volume surgical centers from the AO Spine North America Clinical Research Network. Medical records for 17 625 patients who received subaxial cervical spine surgery from 2005 to 2011 were reviewed to identify occurrence of 21 predefined treatment complications. Descriptive statistics were provided for baseline patient characteristics. A retrospective review of the neurosurgical literature on SLN injury was also performed. A total of 8887 patients who underwent anterior cervical spine surgery at the participating institutions were screened, and 1 case of SLN palsy was identified. The prevalence ranged from 0% to 1.25% across all centers. The patient identified underwent a C4 corpectomy. The SLN injury was identified after the patient demonstrated difficulty swallowing postoperatively. He underwent placement of a percutaneous gastrostomy tube and his SLN palsy resolved by 6 weeks. This multicenter study demonstrates that identification of SLN injury occurs very infrequently. Symptomatic SLN injury is an exceedingly rare complication of anterior cervical spine surgery. The SLN is particularly vulnerable when exposing the more rostral levels of the cervical spine. Careful dissection and retraction of the longus coli may decrease the risk of SLN injury during anterior cervical surgery.

Human Papillomavirus and Vaccination in Cervical Cancer

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Kung-Liahng Wang

2007-12-01

Full Text Available Cervical cancer is not only the most frequently reported cancer among women, but also the most common female genital tract neoplasm in Taiwan. Early detection is effective, because the development, maintenance and progression of precursor lesions (cervical intraepithelial neoplasia [CIN] evolve slowly into invasive cancer, typically over a period of more than 10 years. It is now recognized that human papillomavirus (HPV infection is a necessary cause for over 99% of cervical cancer cases. Advances in the understanding of the causative role of HPV in the etiology of high-grade cervical lesions (CIN 2/3 and cervical cancer have led to the development, evaluation and recommendation of HPV-based technologies for cervical cancer prevention and control. The prevention of HPV infection before the onset of CIN is now possible with recently available prophylactic HPV vaccines, e.g. the quadrivalent Gardasil (Merck & Co., NJ, USA and bivalent Cervarix (GlaxoSmithKline, London, UK. This review article provides an up-to-date summary of recent studies and available information concerning HPV and vaccination in cervical cancer.

SCREENING FOR CERVICAL CANCER

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Enrique

Cervical cancer remains a major health concern worldwide, especially in devel- ... Important aspects of cervical cancer screening include the age at which .... High-risk types HPV (16,18) are impli- cated in the pathogenesis of cervical cancer.

Danish method study on cervical screening in women offered HPV vaccination as girls (Trial23): a study protocol.

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Thamsborg, Lise Holst; Andersen, Berit; Larsen, Lise Grupe; Christensen, Jette; Johansen, Tonje; Hariri, Jalil; Christiansen, Sanne; Rygaard, Carsten; Lynge, Elsebeth

2018-05-26

The first birth cohorts of women offered human papillomavirus (HPV) vaccination as girls are now entering cervical screening. However, there is no international consensus on how to screen HPV vaccinated women. These women are better protected against cervical cancer and could therefore be offered less intensive screening. Primary HPV testing is more sensitive than cytology, allowing for a longer screening interval. The aim of Trial23 is to investigate if primary HPV testing with cytology triage of HPV positive samples is a reasonable screening scheme for women offered HPV vaccination as girls. Trial23 is a method study embedded in the existing cervical screening programme in four out of five Danish regions. Without affecting the screening programme, women born in 1994 are randomised to present screening with liquid-based cytology every third year (present programme arm) or present screening plus an HPV test (HPV arm). The study started 1 February 2017 and will run over three screening rounds corresponding to 7-8 years. The primary endpoint is cervical intraepithelial neoplasia grade 3 or above. The trial is undertaken as a non-inferiority study including intention-to-treat and per-protocol analyses. The potential effect of primary HPV screening with a 6-year interval will be calculated from the observed data. The study protocol has been submitted to the ethical committee and deemed a method study. All women are screened according to routine guidelines. The study will contribute new evidence on the future screening of HPV vaccinated birth cohorts of women. All results will be published in open-access journal. NCT03049553; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The role of cytokines in cervical ripening: correlations between the concentrations of cytokines and hyaluronic acid in cervical mucus and the induction of hyaluronic acid production by inflammatory cytokines by human cervical fibroblasts.

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Ogawa, M; Hirano, H; Tsubaki, H; Kodama, H; Tanaka, T

1998-07-01

The purpose of our study was (1) to explain the relationship between levels of inflammatory cytokines and levels of hyaluronic acid in cervical mucus of pregnant women and (2) to investigate whether cytokines promote hyaluronic acid production by human cervical fibroblasts in vitro. The concentration of hyaluronic acid, interleukin-1beta, and interleukin-8 were measured in cervical mucus of pregnant women, and hyaluronic acid production by cytokine-treated (interleukin-1beta and interleukin-8) cultured fibroblasts was measured. Hyaluronic acid concentrations in the mucus of pregnant women with threatened premature labor were higher than in mucus of normal pregnant women (P hyaluronic acid concentrations and interleukin-1beta (P = .018) and interleukin-8 (P = .003) concentrations in cervical mucus. Cytokines (especially interleukin-8) stimulated hyaluronic acid production by cultured cervical fibroblasts. Cytokines induce hyaluronic acid production by human cervical fibroblasts, which may promote cervical ripening.

Morphometric analysis of the cervical facets and the feasibility, safety, and effectiveness of Goel inter-facet spacer distraction technique

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Abhidha Shah

2014-01-01

Full Text Available Aim: Quantitative anatomy of the facets of the sub-axial cervical spine was performed. The purpose of the evaluation was to determine the feasibility of insertion of Goel inter-facetal articular spacers in the sub-axial cervical spine. Only few studies detailing the morphometry of the facets are available in the literature. Materials and Methods: Ten cervical vertebrae from C3 to C7 with a total of 20 facets were evaluated by the author. The anatomic parameters studied were the height, width, thickness, shape, orientation, and inclination of each of the superior and inferior facets. The alterations in a number of intervertebral segmental distances were measured before and after spacer insertion. The distance of the inferior facet from the foramen tranversarium, spinal canal, and neural foramina was measured to assess safety of spacer insertion with respect to the vertebral artery and neural structures. Results: The height, width and thickness of the superior facets from C3 to C7 ranged from 6 to 12 mm, 8 to 12 mm, and 2.5 to 6 mm, respectively. The inferior facets had an average height of 10.5 mm, average width of 11.2 mm and average thickness of 3.5 mm. The inclination of the superior facets with respect to the transverse plane ranged from 22° to 45° and that of the inferior facets ranged from 29° to 53°. The distance of the anterior margin of the inferior facet from the posterior border of the foramen transversium ranged from 5 to 7 mm. This distance was maximum at C3 level, then decreased at C4 and remained constant from C5 to C7. Conclusion: This anatomic evaluation aided in understanding the morphology of the cervical facets and the suitability of the cervical facetal articular cavity for insertion of spacers.

Pathophysiology of cervical myelopathy.

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Baptiste, Darryl C; Fehlings, Michael G

2006-01-01

Cervical myelopathy is a group of closely related disorders usually caused by spondylosis or by ossification of the posterior longitudinal ligament and is characterized by compression of the cervical spinal cord or nerve roots by varying degrees and number of levels. The decrease in diameter of the vertebral canal secondary to disc degeneration and osteophytic spurs compresses the spinal cord and nerve roots at one or several levels, producing direct damage and often secondary ischemic changes. Clinicians who treat cervical myelopathy cord injuries should have a basic understanding of the pathophysiology and the processes that are initiated after the spinal cord has been injured. Literature review. Literature review of human cervical myelopathy and clinically relevant animal models to further our understanding of the pathological mechanisms involved. The pathophysiology of cervical myelopathy involves static factors, which result in acquired or developmental stenosis of the cervical canal and dynamic factors, which involve repetitive injury to the cervical cord. These mechanical factors in turn result in direct injury to neurons and glia as well as a secondary cascade of events including ischemia, excitotoxicity, and apoptosis; a pathobiology similar to that occurring in traumatic spinal cord injury. This review summarizes some of the significant pathophysiological processes involved in cervical myelopathy.

Management of neglected cervical spine dislocation: a study of six cases

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Goni Vijay

2013-08-01

Full Text Available 【Abstract】Objective: To report a case series of six neglected cervical spine dislocations without neurological deficit, which were managed operatively. Methods: The study was conducted from August 2010 to December 2011 and cases were selected from the out-patient department of Postgraduate Institute of Medical Education and Research, India. The patients were in the age group of 30 to 50 years. All patients were operated via both anterior and posterior approaches. Results: During the immediate postoperative period, five (83.33% patients had normal neurological status. One (16.67% patient who had C 5 -C 6 subluxation developed neu-rological deficit with sensory loss below C 6 level and motor power of 2/5 in the lower limb and 3/5 in the upper limb below C 6 level. Conclusion: There is no role of skull traction in ne-glected distractive flexion injuries to cervical spine delayed for more than 3 weeks. Posterior followed by anterior ap-proach saves much time. If both approaches are to be done in the same sitting, there is no need for instrumentation posteriorly. But if staged procedure is planed, posterior sta-bilization is recommended, as there is a risk of deterioration in neurological status. Key words: Cervical vertebrae; Neck; Postoperative complications

The relationship between changes of cervical sagittal alignment after anterior cervical discectomy and fusion and spino-pelvic sagittal alignment under roussouly classification: a four-year follow-up study.

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Huang, Dong-Ning; Yu, Miao; Xu, Nan-Fang; Li, Mai; Wang, Shao-Bo; Sun, Yu; Jiang, Liang; Wei, Feng; Liu, Xiao-Guang; Liu, Zhong-Jun

2017-02-20

Anterior cervical discectomy and fusion (ACDF) is widely used in the treatment of cervical degenerative disease; however, the variation of cervical sagittal alignment changes after ACDF has been rarely explored. The purpose of this study is to determine the relationship between changes of cervical sagittal alignment after ACDF and spino-pelvic sagittal alignment under Roussouly classification. A cohort of 133 Chinese cervical spondylotic patients who received ACDF from 2011 to 2012 was recruited. All patients were categorized with Roussouly Classification. Lateral X-ray images of global spine were obtained, and preoperative and postoperative parameters were measured and analyzed, including C2-C7 angles (C2-C7), C0-C7 angles (C0-C7), external auditory meatus (EAM) tilt, sacral slope (SS), thoracic kyphosis (TK), lumbar lordosis (LL), spinal sacral angles (SSA), Superior adjacent inter-vertebral angle (SAIV), inferior adjacent inter-vertebral angle (IAIV) and et al. The Wilcoxon signed-rank test was used for intragroup comparisons preoperatively and at postoperative 48 months. Among the parameters, C2-C7 and C0-C7 showed significant increase, while EAM TK, and IAIV decreased significantly. In type I, EAM and TK decreased significantly, however SS showed a significant increase; in type II, TK showed a significant decrease, but SSA showed a significant increase; in type III, a significant increase of C0-C7 was observed with a significant decrease in EAM, nevertheless, LL, SS and SSA showed significant decreases; and in type IV, C2-C7 showed a significant increase and EAM decreased significantly. The percentage of lordotic alignment in cervical spine increased, which was presenting in type I, III and IV. Nevertheless, the amount of patients with straight cervical alignment increased in type II. The backward movement of head occurs is the compensatory mechanism in cervical sagittal alignment modifications after ACDF. The compensatory alteration of spino-pelvic sagittal

The relationship between changes of cervical sagittal alignment after anterior cervical discectomy and fusion and spino-pelvic sagittal alignment under roussouly classification: a four-year follow-up study

Directory of Open Access Journals (Sweden)

Dong-Ning Huang

2017-02-01

Full Text Available Abstract Background Anterior cervical discectomy and fusion (ACDF is widely used in the treatment of cervical degenerative disease; however, the variation of cervical sagittal alignment changes after ACDF has been rarely explored. The purpose of this study is to determine the relationship between changes of cervical sagittal alignment after ACDF and spino-pelvic sagittal alignment under Roussouly classification. Methods A cohort of 133 Chinese cervical spondylotic patients who received ACDF from 2011 to 2012 was recruited. All patients were categorized with Roussouly Classification. Lateral X-ray images of global spine were obtained, and preoperative and postoperative parameters were measured and analyzed, including C2–C7 angles (C2–C7, C0–C7 angles (C0–C7, external auditory meatus (EAM tilt, sacral slope (SS, thoracic kyphosis (TK, lumbar lordosis (LL, spinal sacral angles (SSA, Superior adjacent inter-vertebral angle (SAIV, inferior adjacent inter-vertebral angle (IAIV and et al. The Wilcoxon signed-rank test was used for intragroup comparisons preoperatively and at postoperative 48 months. Results Among the parameters, C2–C7 and C0–C7 showed significant increase, while EAM TK, and IAIV decreased significantly. In type I, EAM and TK decreased significantly, however SS showed a significant increase; in type II, TK showed a significant decrease, but SSA showed a significant increase; in type III, a significant increase of C0–C7 was observed with a significant decrease in EAM, nevertheless, LL, SS and SSA showed significant decreases; and in type IV, C2–C7 showed a significant increase and EAM decreased significantly. The percentage of lordotic alignment in cervical spine increased, which was presenting in type I, III and IV. Nevertheless, the amount of patients with straight cervical alignment increased in type II. Conclusion The backward movement of head occurs is the compensatory mechanism in cervical sagittal alignment

Cervical Muscle Strength and Muscle Coactivation During Isometric Contractions in Patients With Migraine: A Cross-Sectional Study.

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Florencio, Lidiane Lima; de Oliveira, Anamaria Siriani; Carvalho, Gabriela Ferreira; Tolentino, Gabriella de Almeida; Dach, Fabiola; Bigal, Marcelo Eduardo; Fernández-de-las-Peñas, César; Bevilaqua Grossi, Débora

2015-01-01

This cross-sectional study investigated potential differences in cervical musculature in groups of migraine headaches vs. non-headache controls. Differences in cervical muscle strength and antagonist coactivation during maximal isometric voluntary contraction (MIVC) were analyzed between individuals with migraine and non-headache subjects and relationships between force with migraine and neck pain clinical aspects. A customized hand-held dynamometer was used to assess cervical flexion, extension, and bilateral lateral flexion strength in subjects with episodic migraine (n=31), chronic migraine (n = 21) and healthy controls (n = 31). Surface electromyography (EMG) from sternocleidomastoid, anterior scalene, and splenius capitis muscles were recorded during MIVC to evaluate antagonist coactivation. Comparison of main outcomes among groups was conducted with one-way analysis of covariance with the presence of neck pain as covariable. Correlations between peak force and clinical variables were demonstrated by Spearman's coefficient. Chronic migraine subjects exhibited lower cervical extension force (mean diff. from controls: 4.4 N/kg; mean diff from episodic migraine: 3.7 N/kg; P = .006) and spent significantly more time to generate peak force during cervical flexion (mean diff. from controls: 0.5 seconds; P = .025) and left lateral-flexion (mean diff. from controls: 0.4 seconds; mean diff. from episodic migraine: 0.5 seconds; P = .007). Both migraine groups showed significantly higher antagonist muscle coactivity of the splenius capitis muscle (mean diff. from controls: 20%MIVC, P = .03) during cervical flexion relative to healthy controls. Cervical extension peak force was moderately associated with the migraine frequency (rs: -0.30, P = .034), neck pain frequency (rs: -0.26, P = .020), and neck pain intensity (rs: -0.27, P = .012). Patients with chronic migraine exhibit altered muscle performance, took longer to reach peak of

Cervical collagen is reduced in non-pregnant women with a history of cervical insufficiency and a short cervix.

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Sundtoft, Iben; Langhoff-Roos, Jens; Sandager, Puk; Sommer, Steffen; Uldbjerg, Niels

2017-08-01

Preterm cervical shortening and cervical insufficiency may be caused by a constitutional weakness of the cervix. The aim of this study was to assess the cervical collagen concentration in non-pregnant women with a history of cervical insufficiency or of a short cervix in the second trimester of pregnancy. In this case-control study we included non-pregnant women one year or more after pregnancy: 55 controls with a history of normal delivery; 27 women with a history of cervical insufficiency; and 10 women with a history of a short cervix (cervix (>95th percentile) at gestational weeks 18-20. We obtained biopsies (3 × 3-4 mm) from the ectocervix and determined the collagen concentration by measuring the hydroxyproline concentration. Women with cervical insufficiency had lower collagen concentrations (63.5 ± 5.1%; mean ± SD) compared with controls (68.2 ± 5.4%; p = 0.0004); area under the ROC curve 0.73 (95% CI 0.62-0.84). A cut-off value at 67.6% collagen resulted in a positive likelihood ratio of 3.2, a sensitivity of 60%, and a specificity of 81%. Also, women with a short cervix in the second trimester had lower collagen concentrations in a non-pregnant state (62.1% ± 4.9%) compared with women with a long cervix (67.8% ± 5.0%; p = 0.02). Both cervical insufficiency and a short cervix in the second trimester of pregnancy are associated with low cervical collagen concentrations in a non-pregnant state more than one year after pregnancy. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Cervical Cancer Stage IA

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... historical Searches are case-insensitive Cervical Cancer Stage IA Add to My Pictures View /Download : Small: 720x576 ... Large: 3000x2400 View Download Title: Cervical Cancer Stage IA Description: Stage IA1 and IA2 cervical cancer; drawing ...

Cervical Cancer Stage IIIA

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... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IIIA Add to My Pictures View /Download : ... 1275x1275 View Download Large: 2550x2550 View Download Title: Cervical Cancer Stage IIIA Description: Stage IIIA cervical cancer; drawing ...

Cervical Cancer—Patient Version

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Cervical cancer is the fourth most common cancer in women worldwide. The primary risk factor for cervical cancer is human papillomavirus (HPV) infection. Start here to find evidence-based information on cervical cancer treatment, causes and prevention, screening, research, and statistics.

Cervical Cancer Stage IVA

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... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IVA Add to My Pictures View /Download : ... 1575x1200 View Download Large: 3150x2400 View Download Title: Cervical Cancer Stage IVA Description: Stage IVA cervical cancer; drawing ...

Cervical Cancer Stage IVB

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... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IVB Add to My Pictures View /Download : ... 1200x1305 View Download Large: 2400x2610 View Download Title: Cervical Cancer Stage IVB Description: Stage IVB cervical cancer; drawing ...

The next Sub Saharan African epidemic? A case study of the determinants of cervical cancer knowledge and screening in Kenya.

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Kangmennaang, Joseph; Onyango, Elizabeth O; Luginaah, Isaac; Elliott, Susan J

2018-01-01

Early cervical cancer screening has been shown to be beneficial in reducing cervical cancer related deaths. Despite the benefits of early cervical cancer screening, uptake remains limited, with wide disparities in access and uptake in most developing countries. As part of a larger study, this paper uses a socio-ecological framework to explain the determinants of cervical cancer knowledge and screening among women of reproductive age (15-49 years) in Kenya. We conducted a multilevel analysis of cervical cancer knowledge (n = 11,138) and screening (n = 10,333) using the 2014 Kenya Demographic and Health Survey (KDHS). Results show regional disparities in cancer knowledge and the utilization of cervical cancer screening services; regions with high wealth inequality (OR = 0.70, 95% CI [0.56-0.87]) emerged as vulnerable regions where women were less likely to screen for cervical cancer. Gender equity, health insurance coverage and education level significantly predicted cervical cancer screening rates. Results further revealed regional as well as rural-urban wealth inequalities in cervical cancer screening. We argue that given that Kenyan women are highly exposed to human papilloma virus (HPV) due to the legacy of human immunodeficiency virus (HIV) in the country, cervical cancer may be the next epidemic if integrated measures are not adopted to increase cervical cancer knowledge and overcome the barriers to utilizing early screening services. The paper concludes with policy recommendations and directions for future research. Copyright © 2017 Elsevier Ltd. All rights reserved.

Congenital spondylolysis of the cervical spine with spinal cord compression: MR and CT studies

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Martinez, M.J.; Marti-Bonmati, L.; Molla, E.; Poyatos, C.; Cerda, E. de la; Urrizola, J.

1997-01-01

Spondylolysis of the cervical spine is a rare disorder that is characterized by a defect in the articular mass between the superior and inferior facets of a cervical vertebra. It is considered to be congenital because it is usually associated with dysplastic changes, especially involving the posterior arch of the vertebra, which differentiates it from its traumatic equivalent. We present two cases of spondylolysis of the cervical spine without spondylolisthesis, which were studied by means of magnetic resonance (MR) and computerized tomography (CT). One patient showed contralateral involvement at two levels and the other had a single lesion presenting canal stenosis with chronic spinal cord compression, an unusual association in previously reported series. the combination of MR and CT makes it possible to limit the spectrum of bone changes and their impact on the spinal cord in these patients. (Author) 12 refs

Visual assessment of the cervical vertebral maturation stages: A study of diagnostic accuracy and repeatability.

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Perinetti, Giuseppe; Caprioglio, Alberto; Contardo, Luca

2014-11-01

To evaluate the diagnostic accuracy and repeatability of the visual assessment of the cervical vertebral maturation (CVM) stages. Ten operators underwent training sessions in visual assessment of CVM staging. Subsequently, they were asked to stage 72 cases equally divided into the six stages. Such assessment was repeated twice in two sessions (T1 and T2) 4 weeks apart. A reference standard for each case was created according to a cephalometric analysis of both the concavities and shapes of the cervical vertebrae. The overall agreement with the reference standard was about 68% for both sessions and 76.9% for intrarater repeatability. The overall kappa coefficients with the reference standard were up to 0.86 for both sessions, and 0.88 for intrarater repeatability. Overall, disagreements one stage and twp stage apart were 23.5% (T1) and 5.1% (T2), respectively. Sensitivity ranged from 53.3% for CS5 (T1) to 99.9% for CS1 (T2), positive predictive values ranged from 52.4% for CS5 (T2) to 94.3% for CS6 (T1), and accuracy ranged from 83.6% for CS4 (T2) to 94.9% for CS1 (T1). Visual assessment of the CVM stages is accurate and repeatable to a satisfactory level. About one in three cases remain misclassified; disagreement is generally limited to one stage and is mostly seen in stages 4 and 5.

The presence of advanced lesions and associating risk factors for advanced cervical carcinoma in patients with atypical sguamous cells of undetermined significance.

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Sun, L L; Chen, W; Fan, Y Y; Wang, M L; Wang, L N

2015-01-01

To characterize histopathological status, high-risk human papillomavirus (hr-HPV) infection status, and associated risk factors in patients with atypical squamous cells of undetermined significance (ASCUS). Cervical biopsies obtained from 130 ASCUS patients were subjected to histopathological examination and hr-HPV testing. Associations between advanced lesions and hr-HPV load or age were analyzed, and the confounding factors for high-grade cervical lesions were identified. Cervical biopsies from ASCUS patients had a wide range of pathological states, ranging from normal to invasive cervical carcinoma. High-risk HPV infection was significantly associated with advanced cervical lesions in ASCUS patients; hr-HPV infection and the number of gestations were risk factors for developing advanced cervical disease. A significant portion of ASCUS patients harbor advanced cervical lesions. The number of gestations and hr-HPV infection can increase the risk of developing advanced cervical lesions in ASCUS patients.