scholarly journals A Very Rare Case: HPV-Negative Vulvar Cancer in an Adolescent

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Ilker Kahramanoglu ◽  
Hasan Turan ◽  
Yahya Ozgun Oner ◽  
Tugan Bese ◽  
Sennur Ilvan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Women ◽  
Vulvar Cancer ◽  
Hpv Infection ◽  
Predisposing Factor ◽  
Patient Falls ◽  
Surgery Patient ◽  
High Index Of Suspicion ◽  
Age Range

Carcinoma of the vulva is usually regarded as a disease of older women, with the typical age of 65–85 years. There are a limited number of reports of vulvar cancer cases younger than 30 years. These patients have usually risk factors such as human papillomavirus (HPV) infection and immunosuppression. Herein, we present a case of invasive squamous vulvar cancer in an 18-year-old patient without any risk factor. Vulvar radical local excision and bilateral inguinal sentinel lymph node biopsies were performed. The clitoris was preserved during the surgery. Patient did not receive adjuvant therapy. Follow-up after 12 months of the disease showed no evidence of disease. Vulvar carcinoma in very young women may develop without any predisposing factor. Early detection will result in better survival. So, there should be a high index of suspicion when a vulvar lesion is seen, even if the patient falls below the typical age range and does not carry any well-known risk factors such as HPV infection and immunodeficiency.

Trichomonas Vaginalis (TV) Infection and Its Association With Risk of Cervical Cancer and HPV Status

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S92-S93
Author(s):  
Herleen Rai ◽  
Wissam Dahoud
Keyword(s):  
Trichomonas Vaginalis ◽  
Cervical Screening ◽  
Age Groups ◽  
Developed Countries ◽  
Hpv Infection ◽  
Hpv Status ◽  
Age Range ◽  
The Relationship ◽  
Intraepithelial Lesions

Abstract Background The prevalence of trichomonas vaginalis (TV) infection is low in developed countries and may be due to its incidental diagnosis and treatment during routine screening. Many countries are adopting a new model based on testing for high-risk (HR) human papillomavirus (HPV) instead of cytology. HPV is known to be associated with squamous intraepithelial lesions (SIL). There is limited and conflicting literature on the relationship between TV and SIL. The aim of this study is to determine the prevalence of TV in different age groups and evaluate the association between TV with SIL, BV (bacterial vaginosis), and HPV infection. Design Retrospective study for cytological histologic correlation was performed on 10,546 cases dated between January 2012 and December 2017. HPV results were available in 7,081 cases. Results The age range was 15 to 84 with a mean of 49 years; 249 patients were TV positive (2.3%). The prevalence was highest in 30 to 65 age group (71.5%). HPV was present in 4,386/7,081 cases (61.9%). The associated between TV and HPV infection was not significant (P < .07). There was a significant association between TV and BV infection (P < .001). In total, 4,649/10,546 patients showed squamous abnormalities (44%), of which 52.6% were TV positive and 43.9% were TV negative. CIN2-3/SCC was significantly greater in TV-positive versus TV-negative patients (P < .007). HPV-positive patients that were TV positive showed more squamous abnormalities than those that were TV negative (P < .043). TV-positive patients with ASCH showed higher grade lesions (CIN2-3/SCC) on follow-up than TV-negative patients (P < .003). Conclusion TV is more common among patients with BV and HPV infection and significantly associated with squamous abnormalities. HPV and ASCH patients with TV showed significant squamous abnormalities. Although TV can be detected incidentally through cytology-based cervical screening, a transition to HPV testing is likely to result in increasing TV prevalence over time.

scholarly journals HPV-Negative Vulvar Squamous Cell Carcinoma in a 21-year-old Patient

2021 ◽  
pp. 36
Author(s):  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Rare Case ◽  
Vulvar Cancer ◽  
Hpv Infection ◽  
Adjuvant Radiation ◽  
Vulvar Squamous Cell Carcinoma ◽  
Adjuvant Radiation Therapy

Vulvar Squamous Cell Carcinoma usually occurs among women in their 60s or 70s. There are a limited number of reports of vulvar cancer cases younger than 30 years. These patients have usually risk factors such as human papillomavirus (HPV) infection. In this report, the authors present a rare case of invasive vulvar squamous cell carcinoma in a 21-year-old patient without HPV infection. Surgical treatment was performed, followed by adjuvant radiation therapy.

scholarly journals HPV Infection: a Prospective Follow-up Study of Virus Elimination with an Assessment of Risk Factors for Persistence

Doctor Ru ◽  
2019 ◽  
Vol 159 (4) ◽  
pp. 31-35
Author(s):  
O.V. Turanova ◽  
◽  
T.E. Belokrinitskaya ◽  
E.P. Belozertseva ◽  
A.V. Avrachenkova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hpv Infection ◽  
Virus Elimination ◽  
Follow Up Study

Policies of screening for colorectal cancer in European countries

2008 ◽  
Vol 24 (03) ◽  
pp. 270-276 ◽  
Author(s):  
Iñaki Gutiérrez-Ibarluzea ◽  
José Asua ◽  
Kepa Latorre
Keyword(s):  
Risk Factors ◽  
Population Screening ◽  
European Countries ◽  
Current Status ◽  
Rectum Cancer ◽  
Ongoing Research ◽  
Key Informants ◽  
Age Range ◽  
Research Studies

Objectives:The aim of this study was to analyze the current status of population screening for colon/rectum cancer in Europe to compare the different strategies, the coverage, the existence of pilot experiences, regional coverages, and the risk factors considered in each strategy.Methods:A comprehensive, systematic search was performed in the literature for documents addressing population screening for colon/rectum cancer in Europe. An ad hoc questionnaire was prepared including questions considered relevant. The questionnaire was reviewed by experts in the area. To identify key informants, colleague members of the International Network of Agencies for Health Technology Assessment (INAHTA), participants in the EUnetHTA project, or representatives of the ministries of health of the different European countries were contacted. The information provided by key informants was checked with information directly obtained from the ministries of health, gray literature, and research documents.Results:An 88 percent response rate was obtained. In countries for which no questionnaire data were collected, information was directly retrieved from the Web sites of the corresponding ministries. Four countries were found to perform population screenings: Austria, France, Germany, and the United Kingdom. However, they used different strategies. Five countries had begun regional or local strategies: Denmark, Finland, Italy, Spain, and Switzerland, and two additional countries (the Netherlands and Norway) reported ongoing research studies intended to determine the best strategy to implement a population-based screening program. Differences were found in age range, procedure chosen, and follow-up period.Conclusions:Even though the European Council recommended a wider implementation of population screening for colon/rectum cancer, our results suggest that this recommendation continues to be valid. The differences found in screening strategies (in terms of age range, procedures, risk factors considered, and follow-up periods) are not warranted by the results obtained in research studies or regional-national cancer registries.

scholarly journals Retrospective Radiographic Evaluation of AugmentTM Bone Graft Fusion

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0038
Author(s):  
Trevor J. Shelton ◽  
Alvin K. Sheih ◽  
Eric Chang ◽  
Amy E. Steele ◽  
Eric Giza ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Bone Graft ◽  
Ankle Arthrodesis ◽  
Smoking History ◽  
Categorical Variables ◽  
Foot And Ankle ◽  
Surgery Patient ◽  
Number Of Patients

Category: Ankle, Ankle Arthritis, Hindfoot, Midfoot/Forefoot Introduction/Purpose: Augment is the first Food and Drug Administration approved synthetic bone substitute specifically formulated for foot and ankle procedures and have shown results comparable to autograft. Initial studies on the use of Augment for fusion procedures of the foot and ankle are encouraging but there remains a lack of radiographic outcomes on its use. The purposes of this study were to report on the radiographic fusion rate of Augment and identify risk factors for nonunion in patients treated with Augment. Methods: After institutional review board approval, a retrospective study was performed of all patients ages 18-85 who underwent arthrodesis of the ankle, hindfoot, or midfoot and used Augment alone or in combination with autograft and/or allograft. Patients were excluded if they did not have regular radiographic follow-up. Each operative report was examined for procedure performed and location of the foot involved. Post-operative radiographs were reviewed to look at union rate following surgery. Patient charts were reviewed for age, gender, Body Mass Index (BMI), smoking history, and diabetes to examine potential risk factors for nonunion. Continuous variables were reported in means ± standard deviations and differences determined between those that fused and those that did not using a Wilcoxon Rank Sums test. Categorical variables reported as number of patients (percent of patients) and differences determined between those that fused and those that did not using a Fisher’s exact test. Results: A total of 71 patients (average age at injury 57±14 years; 35 males (49%), 36 females (50%); BMI 31±6) underwent 33 (46%) midfoot arthrodesis, 41 (58%) hindfoot arthrodesis, and 27 (38%) ankle arthrodesis. A total of 58 patients (82%) went on to achieve fusion while 13 (18%) did not. There was no difference in gender (p=0.135), age (p=0.345) or BMI (p=0.196) between those who achieved fusion and those who did not. Patients with diabetes had a greater risk of nonunion compared to those who did not (p=0.033) while current smoking status or revision fusion did not pose a risk factor (p=1.000) (Table 1). There were no differences in part of the foot/ankle involved (p=0.445) or bone graft used (p=0.303). Conclusion: This the first study to examine the radiographic follow up of union using Augment. The most important finding of this study is that the rate of fusion in foot and ankle arthrodesis using Augment is near 82%. Diabetes is a risk factor for nonunion when using Augment. Smoking, gender, age, BMI, autograft vs allograft, and part of the foot or ankle fused did not pose a risk factor.

scholarly journals Multifactorial assessment of the risk of falls in low bone density older women

2016 ◽  
Vol 29 (3) ◽  
pp. 439-448 ◽  
Author(s):  
Patrícia Azevedo Garcia ◽  
João Marcos Domingues Dias ◽  
Rosane Liliane dos Reis ◽  
Rosângela Corrêa Dias
Keyword(s):  
Risk Factors ◽  
Older Women ◽  
Assessment Instruments ◽  
Mineral Density ◽  
Lateral Instability ◽  
Falls Risk ◽  
Phone Calls ◽  
Risk Of Falls ◽  
Risk Factors For Falls

Abstract Introduction: Identifying effective assessment instruments for predicting falls, specifically in older women with low bone mineral density (BMD) that are more susceptible to fractures remains a challenge. Objective: To evaluate risk factors for falls at baseline, to identify the falls occurrence over six months of follow-up and to investigate the predictive validity of the Quickscreen Clinical Falls Risk Assessment for predicting multiple falls among low BMD older women. Methods: A methodological study with 110 older women with diagnosis of osteoporosis or osteopenia (70.26 ± 6.24 years). The presence of two or more of the eight risk factors assessed by the QuickScreen characterized the risk of falling (baseline) and monthly phone calls identified the occurrence of falls during the six months of follow-up. Results: The most prevalent falls risk factors were self-reported previous falls, polypharmacy and impairment in shifting weight and lateral instability. Most of the older women (67.3%) had two or more risk factors, 24.5% reported a single fall and 13.6% reported multiple falls over the six months. The QuickScreen (cutoff ≥ 2 risk factors) showed good sensitivity (73.3%) and high negative predictive value (88.89%) for predicting multiple falls among low BMD older women. Conclusions: The results indicated a high frequency of falls among low BMD older women. Additionally, the results highlighted that the QuickScreen instrument was able to predict multiple falls in the six months of follow-up among these older women.

Delayed Detection of Coarctation in Infancy: Implications for Timing of Newborn Follow-up

PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 972-976
Author(s):  
Kent E. Ward ◽  
Robert W. Pryor ◽  
James R. Matson ◽  
Jerry D. Razook ◽  
Webb M. Thompson ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Blood Pressure Measurement ◽  
Ductus Arteriosus ◽  
Coarctation Of The Aorta ◽  
Cardiac Defects ◽  
Peripheral Pulse ◽  
Clinical Illness ◽  
High Index Of Suspicion ◽  
Age Range

During a recent 5-year period, 74 patients younger than 6 months of age were diagnosed with coarctation of the aorta. Coarctation was correctly diagnosed in only 22% of patients prior to referral despite readily apparent femoral pulse abnormalities in 86%. Infants whose symptoms were detected between 5 and 14 days of age were significantly more ill than infants outside this age range and had a high mortality rate (25%). The number of associated cardiac defects was not related to the severity of clinical illness in this group, suggesting that closure of the ductus arteriosus is the primary determinate of disease severity. Observations in two patients suggested that a detectable pulse discrepancy occurs between 3 and 5 days postnatally. Upper extremity hypertension was found commonly in infants after 5 days of age despite the presence of congestive heart failure. Earlier detection of coarctation in the newborn requires a diligent cardiovascular and peripheral pulse examination between 3 and 7 days of life, upper extremity and lower extremity blood pressure measurement, and a high index of suspicion.

scholarly journals 0388 Predictors of Incident Reduced Sleep Efficiency in Community-Dwelling Older Women

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A148-A149
Author(s):  
T Vo ◽  
T Blackwell ◽  
A Kats ◽  
L Langsetmo ◽  
B Taylor ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Women ◽  
Potential Risk ◽  
Osteoporotic Fractures ◽  
Community Dwelling ◽  
Sleep Efficiency ◽  
Benzodiazepine Use ◽  
Potential Risk Factors ◽  
Antidepressant Use

Abstract Introduction There is a paucity of longitudinal studies with sleep efficiency (SE) as an outcome measure. Our objective was to examine potential risk factors for incident reduced SE among community-dwelling women in late life. Methods We studied 700 women (mean age 82.5 [SD=3.0] years) with a SE ≥70% at the Year 16 (2002-04) visit of the Study of Osteoporotic Fractures with a follow-up measure of SE at the Year 20 (2006-08) visit. SE (percentage of time sleeping while in bed) at both visits was measured using a wrist actigraph with data collected for an average of four 24-hour periods. Women were classified as having incident reduced SE if they had SE &lt;70% at Year 20. Logistic regression was used to estimate the associations between potential risk factors (demographics, lifestyle, use of medications, self-reported medical conditions, functional impairment, frailty, mental and physical health) at Year 16 and reduced SE at Year 20. The association of each candidate risk factor with reduced SE at Year 20 was examined in models adjusted for age, clinical site and continuous SE at Year 16. Candidate risk factors with Benjamin Hochberg false-discovery rate q-values &lt;0.10 were included in a final multivariate model. Results Among the 700 eligible women, 62 (8.9%) developed incident reduced SE between the Year 16 and Year 20 visits. After adjusting for age, site and baseline SE, antidepressant use [OR=3.06; 95% CI: 1.50-6.25], benzodiazepine use [OR=2.97; 95% CI: 1.30-6.80] and the presence of hypertension [OR=2.83; 95% CI: 1.47-5.45] at Year 16 were independently associated with a higher odds of having reduced SE at follow-up. Conclusion These findings suggest that antidepressant use, benzodiazepine use and hypertension are risk factors or markers for the development of reduced sleep efficiency in older women. Future studies are warranted to examine the underlying mechanisms for these associations. Support The Study of Osteoporotic Fractures (SOF) is supported by National Institutes of Health funding. The National Institute on Aging (NIA) provides support under the following grant numbers: R01 AG005407, R01 AR35582, R01 AR35583, R01 AR35584, R01 AG005394, R01 AG027574, and R01 AG027576.

Complementary Effects of Multivitamin and Omega-3 Fatty Acid Supplementation on Indices of Cardiovascular Health in Individuals with Elevated Homocysteine

2012 ◽  
Vol 82 (1) ◽  
pp. 41-52 ◽  
Author(s):  
P. Earnest ◽  
S. Kupper ◽  
M. Thompson ◽  
Guo ◽  
S. Church
Keyword(s):  
Risk Factors ◽  
Cardiovascular Health ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
C Reactive Protein ◽  
Fatty Acid Supplementation ◽  
Omega 3 Fatty Acid ◽  
Reactive Protein ◽  
Daily Ingestion

Homocysteine (HCY), C-reactive protein (hsCRP), and triglycerides (TG) are risk factors for cardiovascular disease (CVD). While multivitamins (MVit) may reduce HCY and hsCRP, omega-3 fatty acids (N3) reduce TG; yet, they are seldom studied simultaneously. We randomly assigned 100 participants with baseline HCY (> 8.0 umol/L) to the daily ingestion of: (1) placebo, (2) MVit (VitC: 200 mg; VitE: 400 IU; VitB6: 25 mg; Folic Acid: 400 ug; VitB12: 400 ug) + placebo, (3) N3 (2 g N3, 760 mg EPA, 440 mg DHA)+placebo, or (4) MVit + N3 for 12 weeks. At follow-up, we observed significant reductions in HCY (umol/L) for the MVit (- 1.43, 95 %CI, - 2.39, - 0.47) and MVit + N3 groups (- 1.01, 95 %CI, - 1.98, - 0.04) groups, both being significant (p < 0.05) vs. placebo (- 0.57, 95 %CI, - 1.49, 0.35) and N3 (1.11, 95 % CI, 0.07, 2.17). hsCRP (nmol/L) was significantly reduced in the MVit (- 6.00, 95 %CI, - 1.04, - 0.15) and MVit + N3 (- 0.98, 95 %CI, - 1.51, - 0.46) groups, but not vs. placebo (- 0.15, 95 %CI, - 0.74, 0.43) or N3 (- 0.53, 95 %CI, - 1.18, 0.12). Lastly, we observed significant reductions in TG for the N3 (- 0.41, 95 %CI, - 0.69, - 0.13) and MVit + N3 (- 0.71, 95 %CI, - 0.93, - 0.46) groups, both significant vs. placebo (- 0.10, 95 %CI, - 0.36, 0.17) and MVit groups (0.15, 95 %CI, - 12, 0.42). The co-ingestion of MVit + N3 provides synergistic affects on HCY, hsCRP, and plasma TG.

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