Cervical Precancerous Lesions and Cancer among Patients in the Gynaecology Outpatient Department at a Tertiary Hospital in South Africa

Background: Cervical cancer is one of the biggest women’s health issues in developing countries including Indonesia. This study is aimed to describe the characteristics of cervical precancerous lesions at a tertiary hospital in Bali, Indonesia.Methods: This is a descriptive study using data from the medical records of patients with precancerous cervical lesions who attended the Gynecologic Oncology Outpatient Clinic Sanglah Hospital Denpasar, Bali, Indonesia, from January to December 2017. Results: There were 276 cases (2.88%) of the cervical precancerous lesion during the study period. The majority of cases were diagnosed within the age group of 36-45 years (37.7%), had low education levels (42.7%), obese (53.5%), multiparous (73.9%), had first sexual intercourse at the age of 16-20 years (41.3%), had used IUD as a contraceptive method (41.4%), and had a cytologic diagnosis of atypical squamous cells of undetermined significance (ASC-US) that preceded the histologic diagnosis (43.2%). The most common histologic diagnosis was CIN I (43.1%) and the most common treatment was cryotherapy (56.2%).Conclusions: The majority of cervical precancerous lesion cases were diagnosed among women who were between her third and fourth decade of life, had low education level, were obese, multiparous, had a sexual debut at a younger age, and were IUD users. The majority of cases were low-grade lesions.

Download Full-text

Clinical application of the 2011 IFCPC colposcope terminology

BMC Women s Health ◽

10.1186/s12905-021-01395-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Bei Zhang ◽

Shuhui Hong ◽

Guihui Zhang ◽

Fengnian Rong

Keyword(s):

Diagnostic Accuracy ◽

Precancerous Lesions ◽

High Specificity ◽

Diagnostic Value ◽

Low Grade ◽

Squamous Intraepithelial Lesion ◽

Diagnostic Significance ◽

Cervical Precancerous Lesions ◽

Intraepithelial Lesion ◽

Common Sign

Abstract Background Colposcopy offers an accurate way to the diagnose of cervical precancerous lesions. However, the diagnostic accuracy of colposcopy is unsatisfied. This study was to evaluate colposcopic accuracy according to the 2011 International Federation of Cervical Pathology and Colposcopy (IFCPC) terminology. Methods A retrospective cohort study was performed in 1,838 patients who underwent colposcopy in Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University from October 2013 to April 2018. Using conization or cervical biopsy pathology as the gold standard, the agreement between colposcopic diagnosis and pathologic diagnosis was calculated, and correlations between variables were analyzed. Results As an authoritative and widely used terminology for colposcopy diagnosis, the 2011 IFCPC terminology has certain clinical practicality and diagnostic accuracy. However, some signs such as mosaic, punctation, sharp border, inner border sign and ridge sign had high specificity but unsatisfactory sensitivity, which limited the diagnostic value. Therefore, we discussed the Lugol’s staining, a very common sign in colposcopy, and analyzed the diagnostic significance of bright yellow staining in low-grade squamous intraepithelial lesion (LSIL) and mustard yellow staining in high-grade squamous intraepithelial lesion (HSIL). The results showed that mustard yellow may be a valuable indicator in the diagnosis of HSIL. Conclusion The 2011 IFCPC colposcope terminology has standardized interpretations of the colposcopic findings and improved the accuracy of colposcopy diagnosis. The aceto-white epithelium still has important diagnostic value; however, the value of a few signs is needed to be discussed and new signs are expected to be discovered. Although the significance of Lugol’s staining was diminishing, mustard yellow might be a valuable indicator for the diagnosis of HSIL.

Download Full-text

Influence of HIV infection on the distribution of high-risk HPV types among women with cervical precancerous lesions in Yaounde, Cameroon

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2021.07.059 ◽

2021 ◽

Author(s):

Richard TAGNE SIMO ◽

Fonyuy B. KIAFON ◽

Charlette NANGUE ◽

André P. GOURA ◽

Jackson L. EBUNE ◽

...

Keyword(s):

High Risk ◽

Hiv Infection ◽

Precancerous Lesions ◽

Cervical Precancerous Lesions ◽

Hpv Types ◽

High Risk Hpv

Download Full-text

Tube Feeding Practices and Transition to Breastfeeding Experiences of Mothers of Preterm Infants at a Kangaroo Mother Care Unit of a Tertiary Hospital in South Africa

Global Pediatric Health ◽

10.1177/2333794x211037032 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110370

Author(s):

Sphiwe Madiba ◽

Malmsey Sengane

Keyword(s):

South Africa ◽

Breast Milk ◽

Preterm Infants ◽

Neonatal Intensive Care ◽

Tube Feeding ◽

Feeding Practices ◽

Tertiary Hospital ◽

Very Preterm Infants ◽

Mothers Of Preterm Infants ◽

Group Interviews

To receive human milk, most preterm infants initially receive the mothers’ expressed milk through a nasogastric tube. However, breast milk feeding the preterm infant and making the transition to direct breast-feeding come with significant challenges. The study explored and described the experiences of mothers of preterm infants regarding initiation and expressing breast milk, tube feeding practices, and transition to breastfeeding during the infants’ stay in a kangaroo care unit (KMC) of an academic hospital in South Africa. Using a qualitative design, focus group interviews were conducted with 38 mothers of preterm infants after discharge from the neonatal intensive care unit (NICU). We analyzed transcripts following the 5 steps for qualitative thematic data analysis. Tube feeding and breastfeeding preterm infants was challenging and exhausting for the mothers. Many described their experiences of initiating expression and sustaining milk supply as negative. They had constant concerns about their ability to produce adequate milk volumes to feed their infants. They had immense dislike of expressing, which they described as physically exhausting, stressful, and painful. Those who had initiated breastfeeding were highly motivated to breastfeed their preterm infants. They described breastfeeding as a positive bonding experience that they derived pleasure from. The mothers’ dislike of expressing was overshadowed by their emotional obligation toward their preterm infants. Although the KMC unit promotes breastfeeding, mothers encountered problems and struggled to initiate expression and sustain milk production. Mothers of extreme and very preterm infants need support to continue with milk expression during the long NICU and KMC stay.

Download Full-text

The application of CRISPR/Cas9 system in cervical carcinogenesis

Cancer Gene Therapy ◽

10.1038/s41417-021-00366-w ◽

2021 ◽

Author(s):

Chun Gao ◽

Ping Wu ◽

Lan Yu ◽

Liting Liu ◽

Hong Liu ◽

...

Keyword(s):

Cervical Cancer ◽

High Risk ◽

Transgenic Mice ◽

Cell Line ◽

Cell Lines ◽

Cancer Cell ◽

Precancerous Lesions ◽

Cancer Cell Lines ◽

Cervical Carcinogenesis ◽

Cervical Precancerous Lesions

AbstractIntegration of high-risk HPV genomes into cellular chromatin has been confirmed to promote cervical carcinogenesis, with HPV16 being the most prevalent high-risk type. Herein, we evaluated the therapeutic effect of the CRISPR/Cas9 system in cervical carcinogenesis, especially for cervical precancerous lesions. In cervical cancer/pre-cancer cell lines, we transfected the HPV16 E7 targeted CRISPR/Cas9, TALEN, ZFN plasmids, respectively. Compared to previous established ZFN and TALEN systems, CRISPR/Cas9 has shown comparable efficiency and specificity in inhibiting cell growth and colony formation and inducing apoptosis in cervical cancer/pre-cancer cell lines, which seemed to be more pronounced in the S12 cell line derived from the low-grade cervical lesion. Furthermore, in xenograft formation assays, CRISPR/Cas9 inhibited tumor formation of the S12 cell line in vivo and affected the corresponding protein expression. In the K14-HPV16 transgenic mice model of HPV-driven spontaneous cervical carcinogenesis, cervical application of CRISPR/Cas9 treatment caused mutations of the E7 gene and restored the expression of RB, E2F1, and CDK2, thereby reversing the cervical carcinogenesis phenotype. In this study, we have demonstrated that CRISPR/Cas9 targeting HPV16 E7 could effectively revert the HPV-related cervical carcinogenesis in vitro, as well as in K14-HPV16 transgenic mice, which has shown great potential in clinical treatment for cervical precancerous lesions.

Download Full-text

Raman spectroscopic study of cervical precancerous lesions and cervical cancer

Lasers in Medical Science ◽

10.1007/s10103-020-03218-5 ◽

2021 ◽

Author(s):

Jing Wang ◽

Cheng-Xia Zheng ◽

Cai-Ling Ma ◽

Xiang-Xiang Zheng ◽

Xiao-Yi Lv ◽

...

Keyword(s):

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

Raman Spectra ◽

Precancerous Lesions ◽

Cervical Squamous Cell Carcinoma ◽

Cervical Lesions ◽

Cin Iii ◽

Cervical Precancerous Lesions ◽

Biochemical Components ◽

The Difference

AbstractEarly detection of cervical lesions, accurate diagnosis of cervical lesions, and timely and effective therapy can effectively avoid the occurrence of cervical cancer or improve the survival rate of patients. In this paper, the spectra of tissue sections of cervical inflammation (n = 60), CIN (cervical intraepithelial neoplasia) I (n = 30), CIN II (n = 30), CIN III (n = 30), cervical squamous cell carcinoma (n = 30), and cervical adenocarcinoma (n = 30) were collected by a confocal Raman micro-spectrometer (LabRAM HR Evolution, Horiba France SAS, Villeneuve d’Ascq, France). The Raman spectra of six kinds of cervical tissues were analyzed, the dominant Raman peaks of different kinds of tissues were summarized, and the differences in chemical composition between the six tissue samples were compared. An independent sample t test (p ≤ 0.05) was used to analyze the difference of average relative intensity of Raman spectra of six types of cervical tissues. The difference of relative intensity of Raman spectra of six kinds of tissues can reflect the difference of biochemical components in six kinds of tissues and the characteristic of biochemical components in different kinds of tissues. The classification models of cervical inflammation, CIN I, CIN II, CIN III, cervical squamous cell carcinoma, and cervical adenocarcinoma were established by using a support vector machine (SVM) algorithm. Six types of cervical tissues were classified and identified with an overall diagnostic accuracy of 85.7%. This study laid a foundation for the application of Raman spectroscopy in the clinical diagnosis of cervical precancerous lesions and cervical cancer.

Download Full-text

Reasons for inpatients not to seek clarity at Dr George Mukhari Academic Hospital, Pretoria

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v6i1.576 ◽

2014 ◽

Vol 6 (1) ◽

Cited By ~ 1

Author(s):

Langalibalele H. Mabuza ◽

Olufemi B. Omole ◽

Indiran Govender ◽

John V. Ndimande

Keyword(s):

South Africa ◽

Prior Knowledge ◽

Effective Communication ◽

Self Esteem ◽

Tertiary Hospital ◽

Bad News ◽

Academic Hospital ◽

Management Plans ◽

Clinical Conditions

Background: Healthcare practitioners should provide patients with information regarding their clinical conditions. Patients should also feel free to seek clarity on information provided. However, not all patients seek this clarity.Objectives: To explore the reasons inpatients gave for not seeking clarity on information that was received but not understood.Methods: This was a qualitative arm of a larger study, titled ‘Are inpatients aware of the admission reasons and management plans of their clinical conditions? A survey at a tertiary hospital in South Africa’, conducted in 2010. Of the 264 inpatients who participated in the larger study, we extracted the unstructured responses from those participants (n = 152) who had indicated in the questionnaire that there was information they had not understood during their encounter with healthcare practitioners, but that they had nonetheless not sought clarity.Data were analysed thematically.Results: Themes that emerged were that inpatients did not ask for clarity as they perceived healthcare practitioners to be ‘too busy’, aloof, non-communicators and sometimes uncertain about patients’ conditions. Some inpatients had unquestioning trust in healthcare practitioners,whilst others had experiences of bad treatment. Inpatients had poor self-esteem, incapacitating clinical conditions, fear of bad news and prior knowledge of their clinical conditions. Some inpatients stated that they had no reason for not seeking clarity.Conclusion: The reasons for not seeking clarity were based on patients’ experiences with the healthcare practitioners and their perceptions of the latter and of themselves. A programme should be developed in order to educate inpatients on effective communication with their healthcare practitioners.

Download Full-text