Background: Cervical cancer is the most common gynecological malignant disorder worldwide. Activated platelets play a key role in cancer development and progression. Mean platelet volume (MPV) is an early indicator of platelet activation. The aim of the present study was to evaluate MPV levels in patients with cervical cancer. Materials and methods: A total of 181 patients with cervical cancer and 181 controls between January 2015 and June 2015 were included in the study. Patient characteristics and hematologic test data at initial diagnosis were collected and odds ratios (ORs) and 95% confidence intervals (CIs) for risk of cervical cancer were calculated using multivariate logistic regression analyses across MPV quartiles. Results: MPV levels were decreased in patients with cervical cancer compared with control subjects. A significant correlation between MPV and FIGO stage was found. Moreover, after adjusting for other risk factors, the ORs (95%CIs) for cervical cancer according to MPV quartiles were 4.450 (1.975-10.026), 2.505 (1.206-5.202), 0.573 (0.261-1.259), and 1.000, respectively. Conclusions: MPV was found to be independently associated with the presence of cervical cancer. Our results suggest that MPV could be potential diagnostic screening tool.

No description available.

Indiana University-Purdue University Indianapolis (IUPUI) / Women who are medically underserved may be less likely to obtain provider-based cervical cancer screening because of structural and intrapersonal barriers. Self-collection for human papillomavirus (HPV) testing, a method for women to collect their own sample through a vaginal swab or urine collection, has accuracy comparable to provider-based cervico-vaginal HPV testing and may be useful in overcoming barriers to provider-based cervical cancer screening. The purpose of this dissertation study is to examine factors associated with self-collection for HPV testing, psychometrically test Diffusion of Innovations (DOI) instruments, and identify preferences for self-collection for HPV testing. Three distinct aims were developed: 1) factors (sociodemographic, health-related, and theoretical variables) associated with mailed return of vaginal self-collection for HPV testing, 2) psychometric examination of DOI ÷instruments (relative advantages and complexity), and 3) dimensions of self-collection and characteristic preferences to self-collection for HPV testing stratified by age cohorts. This dissertation involved two cross-sectional studies. In Chapters 2-3, data were collected from women (n=168) at food pantries and online. Women were eligible if they were: 1) female, 2) between the ages of 30-65, 3) could read and speak English, and 4) at 2019 federal poverty guidelines for income and family size as defined by the Department of Health and Human Services. Women were not eligible if they had a history of hysterectomy or were adherent to cervical cancer screening guidelines. Logistic regression analyses, item analysis, Cronbach’s alpha, exploratory factor analysis, and tests were used to analyze data. Chapter 4 involved collection of data from an online survey with a sample (n=878) provided by Dynata. Participants evaluated 9 scenarios that varied along 4 attributes: HPV self-collection kit type (vaginal swab or urine collection), HPV self-collection kit delivery (mail, pharmacy pick-up, or clinic pick-up), HPV self-collection kit return (mail, pharmacy drop-off, or clinic drop-off), and HPV test result communication (mail, phone call, or text message). Ratings-based conjoint analysis (RBCA) determined how each attribute influenced the ratings of each scenario.

A dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfilment of the requirements for the degree of Master of Pharmacy / Cervical Intraepithelial Neoplasia (CIN) or Human Papilloma Virus (HPV) is known as the precancerous stages of cervical cancer and may be treated with antineoplastic agents Current treatment includes intravenous administration of Gemcitabine and 5-Fluorouracil however, these drugs have an undesirable side effect profile. This may be overcome by local administration of chemotherapeutic drugs to the site of the cancer. The purpose of this study was to design a drug delivery system that can be locally administered to the site of the cervical cancer and possess thermosonic properties. Designs of three Thermosonic Injectable Organogels (TIO’s) were undertaken using ring opening polymerization (open ring reaction) to formulate three different gels to test the response ability of the gels against thermal and ultrasound exposure. The times taken for these gels to form were recorded at below 15 minutes. All three TIO’s responded differently to thermal and ultrasound stimuli. Physical changes in the gels were noted and further studies were undertaken to confirm their responsiveness towards the dual-stimuli. All three TIO’s showed a dense microstructure containing pores catering for the incorporation of drugs or drug-loaded carriers. Rheological studies showed that there was an increase in viscosity of the gels under increasing heat even though the response differed between TIO formulations. The gels were non-cytotoxic at distinct concentrations ranging between 6.1mg/ml-7.8mg/ml. Solid Lipid Nanospheres (SLN’s) were then designed which encapsulated the mode antineoplastic drug 5-Fluorouracil. The SLN’s were spherical in shape and had an acceptable poly dispersion index (PDI) which was below 0.7 after ultrasonication and filtration of prepared samples. The SLN’s were then incorporated by direct additition and dispersion into the TIO formulations before undertaking the open ring reaction to form Thermosonic Injectable Nano-Organogels (TINO’s). The TINO’s were analysed for its swelling and erosive properties. Results showed that the TINO’s posesses both swelling and erosive properties. Furthermore, the TINO’s underwent dissolution studies that involved thermal and thermal with ultrasound stimuli to test the drug release rate and the stimuli responsiveness of the TINO. Results of the SLN’s showed a very slow release rate whether exposed to a single (thermal) or both thermal and ultrasound stimuli, indicating that the addition of ultrasound stimuli did not alter the drug release from the SLN’s. However, the incorporation of the SLN’s into the TIO’s prolonged the release rate. Hence increasing the SLN concentration in the TIO’s reduced the response towards ultrasound stimuli. Therefore lower ratios of SLN:TIO provided superior responsiveness compared to higher concentrations of SLN:TIO. TIO 1 and TINO 2 released drug with thermal stimuli and higher drug release occurred with exposure to both thermal and ultrasound stimuli. These TINO’s in conjunction with ultrasound responsiveness may be used as a potential platform for the delivery of antineoplastics in treating cervical cancer. / MT2017

A research report submitted to the Faculty of Health Sciences, University of the Witwaters-rand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Med-icine in Obstetrics and Gynaecology. Johannesburg 2019 / Background and objectives Cervical cancer can be prevented by screening and treatment of cervical cancer precursor lesions. Women with an abnormal Pap smear are referred to colposcopy for diagnosis and are then treated immediately in many South African colposcopy clinics. Hence accurate colposcopic diagnosis is important. The aim of this study was to determine the accuracy of diagnosing cervical intraepithelial neoplasia with either the Reid Colposcopic Index or the Swede score in HIV infected women. The components of the Reid colposcopic index are acetowhiteness, margins, vascular patterns and iodine staining. The Swede score has all the components of the Reid score with the addition of lesion size as a fifth compo-nent. Methods This was a secondary data analysis of the South African arm of the “HPV in Africa Research Partnership (HARP) study” comparing different screening tests in the prevention of cervical cancer in HIV infected women. Women were recruited from primary health care clinics and HIV treatment centres in Hillbrow, Johannesburg. All women had a Pap smear, Human papil-lomavirus testing, and visual inspection with lugol’s iodine and with acetic acid. All women with any positive screening test were referred to colposcopy. At colposcopy a four-quadrant biopsy and directed biopsies of any visible lesions were performed. The colposcopist rec-orded the colposcopy findings using the Swede score. For this study, the information from the Swede score was used to determine the Reid colposcopy index. Data was extracted from the HARP study database. Results A total of 624 women were eligible for the study in the South African arm, only 577 women were included for this study. The mean age was 34 years (SD±5.89). Antiretroviral therapy was used by 370 (64%) women. Abnormal Pap smears were found in 484 (88%) women, VIA was positive in 162 (28%), VILI was positive in 219 (37%) and HR HPV DNA was found in 374 (65%) women re-spectively. Histological findings showed that 263 (46%) of the women had no CIN, 185 (32%) had CIN 1, 76 (13%) had CIN 2 and 53 (9%) had CIN 3. The Swede score of 5 had a sensitivity of 72.9%, specificity of 71.9%, PPV of 42.7%and NPV of 90.2% respectively. A Reid score of 4 had a sensitivity of 72.9%, specificity of 69.4%, PPV of 40.7% and NPV of 89.9%. In comparison, the Area under the curve was higher for the Swede score compared to the Reid and this differ-ence was statistically significant. Conclusion This study shows that the Swede score when compared to the Reid score performs better in terms of accuracy for predicting CIN≥2 lesions. The addition of the lesion size has been shown to have an added advantage in the performance of the scoring. Both scores also demonstrated flexibility. There is a higher likelihood of HIV infected women to be referred for colposcopy as they have a higher incidence of cervical cancer precursor lesions. There was no difference in the performance of the Swede or Reid score by antecedent Pap smear and there was no difference in colposcopy findings on women with the presence of HR-HPV or no HR-HPV. / E.K. 2019

Thesis (M.S.)--Boston University, 1956 / This thesis represents one part of a group study conducted jointly by four Boston University social work students. The purpose of this group study is to examine first same of the social and emotional factors that affect the rehabilitation of cancer patients, and second, the role of social service in this rehabilitation. The study is based on the cases comprising the Harvard Medical School project.

No description available.

Head and neck injuries are common in contact sports. Proper function of the cervical spine sensorimotor system is important in limiting these injuries. Repetitive stress incurred during contact sport participation may negatively affect this system and increase injury risk. Currently, there is a paucity of research examining contact sport exposure and cervical spine sensorimotor function. The purpose of this study was to examine the effect of contact sport participation on cervical sensorimotor function. The independent variables were group (rugby, non-contact), sex (male, female), and time (pre-season, post-season). The primary dependent variable was neck position sense error as measured by total neck reposition (TNRE) error and maximum neck reposition error (MaxNRE). Secondary dependent variables included neck disability index, signs and symptom (S/S) number, symptom severity, concussion history, cervical range of motion, and isometric neck strength. This prospective observational study included forty-nine participants (15 male rugby, 11 female rugby, 11 non-contact male control, 12 non-contact female control) from Temple University campus recreation club sport teams. Athletes participated in two testing sessions, one prior to the season (i.e., pre-season) and one following the season. Data were analyzed using descriptive and inferential statistics. Independent-sample t-tests with Bonferroni corrections were used to assess statistically significant differences in dependent variables at pre-season between groups (Aim 1) and sex (Aim 2). Independent-samples t-tests with Bonferroni correction were also used to explore statistically significant differences in dependent variables change scores from pre-season to post-season between groups (Aim 1). Pearson correlations (r > .60) were used to assess potential covariates but none were identified. Pearson correlations were also used to evaluate the relationship between pre-season maximum and total neck reposition sense error and the following dependent variables: years of contact sport participation, concussion S/S number and severity score, global cervical range of motion and global cervical isometric strength (Aim 3). For Aim 1, between group differences were identified for global cervical isometric strength, t (1, 45) = 2.98, p = .005, and total joint reposition error t (1, 45) = 2.78, p = .008, only. There were no significant change score differences between groups across time. For Aim 2, sex differences were identified in years of contact sport exposure (p = .004), height (p < .001) and global isometric strength (p <.001), only. For Aim 3, preseason concussion S/S number and severity scores were significantly correlated (p < .05) with total joint reposition error (r = .352) and maximum joint reposition error (r = .476). The present study findings indicate a difference in cervical spine sensorimotor function between collegiate club rugby athletes and controls. Specifically, rugby athletes exhibited significantly greater neck reposition sense error than controls. Additionally, concussion S/S scores were related to reposition sense error. Differences in position sense error were not identified between males and females, however females did exhibit less neck strength mirroring previous reports. These findings suggest that exposure to contact sport-related impacts may lead to changes in cervical spine sensorimotor function. These changes are important as they could represent an increased risk of injury and can be modified proactively. A comprehensive cervical spine pre-season examination including concussion S/S and position sense assessments could identify individuals needing preventative intervention. Future research should explore the risk associated with these proprioceptive deficits and the benefits of proactive therapeutic intervention designed to mitigate sensorimotor deficits in contact sport athletes. / Kinesiology

BACKGROUND: Cervical cancer is one of the most common forms of gynecologic malignancies worldwide with increased incidence in lower income countries. Bolivia, a lower-income country, experiences high rates of morbidity and mortality related to cervical cancer. The increased incidence is a multifactorial issue that includes low cervical cancer literacy, barriers to healthcare access, and poor follow-up rates. LITERATURE REVIEW FINDINGS: The current research finds that Bolivia's fragmented healthcare system has significantly influenced the country’s high cervical cancer burden. Women often receive inadequate sexual and reproductive health services that has led to a higher incidence of preventable morbidity and mortality. Previous research, however, has shown that the implementation of HPV self-screening and use of point of care testing are effective interventions in rural areas of Bolivia to increase screening. In addition, studies have shown that vaccination of school aged children utilizing a school-based model is another promising intervention in hopes of lowering the country’s burden of disease. Lack of cervical health knowledge in rural areas of Bolivia is another finding. Previous research has proposed that community education and optimization of cervical cancer knowledge can have a great impact on screening. METHODS: The study proposes to conduct an interventional study. The study will initially seek to implement an education intervention to improve the knowledge and understanding of cervical health for school aged and adult women in a single school district of rural Cochabamba, Bolivia. Phase I and II of the study will then aim to implement a vaccination campaign and an HPV self-screening program with point of care testing in the same school district. CONCLUSION: This study will seek to implement an HPV- self screening program and a vaccination campaign in rural Cochabamba, Bolivia through a multidisciplinary approach which involves vaccination, screening, and community education. Limitations of the proposed study includes lack of generalizability, time constraints, and financial constraints. SIGNIFICANCE: Cervical cancer is highly preventable through adequate screening and prophylaxis with vaccination. The goals of the study will seek to implement affordable and easily accessible screening methods and vaccination for a population in rural Bolivia to ultimately improve screening rates and follow up care. Efforts to increase screening in this population can lead to decreased rates of mortality and morbidity from cervical cancer in vulnerable, resource limited countries.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic Faculty: Health Sciences, Durban University of Technology, 2009 / Aim To determine the profile of traumatic cervical spine fractures with respect to the epidemiology, clinical presentation, types of fractures, conservative and surgical intervention, short-term post-intervention (i.e. post-conservative and post-surgical) complications and short-term post-surgical rehabilitation of patients presenting at the Spinal Unit of King George V Hospital over a 12-week period. Methods Patients who presented to the King George V Hospital Spinal Unit from surrounding hospitals with traumatic cervical spine fractures were evaluated by the medical staff. Data concerning the epidemiology, clinical presentation, types of fractures, conservative and surgical intervention, short-term post-intervention (i.e. post-conservative and postsurgical) complications and short-term post-surgical rehabilitation data were recorded by the researcher. A p-value of <0.05 was considered as statistically significant. Appropriate statistical tests were applied to the hypothesis-testing objectives. These involved the Pearson’s Chi Square Tests for categorical variables or Fisher’s Exact Tests as appropriate where sample sizes were small. Paired t-tests were done to compare preand- post-surgical Frankel grading and Norton Pressure Sore Assessment scores. Results The number of patients who presented to the Spinal Unit over a 12-week period was 20, of this number 17 were males, three were females and all were black. Eleven patients were treated surgically while nine patients were treated conservatively. The most frequent aetiology of cervical spine fractures was motor vehicle accidents (n = 10) followed by falls (n = 9). The most common co-existing medical conditions were smoking (n = 7), HIV (n = 5), alcohol abuse (n = 3) and obesity (n = 3). The most frequent locations of cervical spine fractures were C2 (n = 6), C1 (n = 4) and the posterior column of C6 (n = 3), while dislocations occurred primarily at the C5-C6 levels (n = 5) of the lower cervical spine. Odontoid fractures (n = 6), Jefferson’s fractures (n = 4) and unilateral facet dislocations (n = 6) were the most common fractures and dislocations v observed. Head injuries (n = 4) and lower limb fractures (n = 3) were the most common extra-spinal fractures. All subjects who sustained head injuries also had associated C1 or C2 fractures. Neurological complications most frequently involved the upper limb where loss of motor function (n = 8) and weakness (n = 4) were observed. The majority of the patients (n = 8) reported a Frankel Grading of E. There were no significant associations between types of fracture and gender with the exception of fracture/dislocation observed in two females. There was a statistically significant difference in the NPSA score (p = 0.004). Conservative care utilized included soft collar (n = 6), cones calipers (n = 6), physiotherapy (n = 4), Minerva jacket (n = 4) and SOMI (sterno-occipital mandibular immobilization) brace (n = 1) while surgical intervention included anterior decompression (n = 8), anterior fusion (n = 8), allograft strut (n = 8), discectomy (n = 8), anterior cervical plating (n = 8), anterior screw fixation (n = 2), a transoral approach (n = 1) and a corpectomy (n = 1). The short-term post-conservative care complications observed in this study were an occipital pressure sore (n = 1), severe discomfort (n = 1) as well as severe neck pain (n = 1), while the short-term post-surgical complications were severe neck pain (n = 2), oral thrush (n = 1), pneumonia (n = 1), odynophagia (n = 1) and hoarseness (n = 1). Of the 11 patients who underwent cervical spine surgery, ten were sent for physiotherapy and one for occupational therapy. No significant associations were seen between the type of cervical spine fracture and the age of the subject. There was a significant association between fracture/dislocation and the female gender (p = 0.016). There was significant negative association between odontoid fracture and: anterior decompression, anterior fusion, allograft strut, discectomy and anterior cervical plating (p = 0.006). Conclusion The results of this study reflect the presentation and management of cervical spine fractures at a referral spinal unit of a public hospital in KwaZulu Natal. The impact of HIV and other co-existing medical conditions were not determined due to the small sample size in this study. Further epidemiological studies are required to be conducted in the Spinal Units of all South African public hospitals in order to confirm or refute the observation of this study. / National Research Foundation (NRF)