Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2003. 104 leaves / Whiplash injuries are thought to occur in as many as one-fifth of all MVA’s in the United States and Canada. South Africa may have a higher incidence of whiplash injuries due to the exceptionally high road accident rate when compared with international norms (Burger 1996:478). The incidence rate is higher among female subjects and people aged 20-24 years (Teasell and Shapiro 1998: 72, Spitzer et al. 1995). Whiplash injuries or whiplash-associated disorders (WAD) often result in chronic pain with a poor response to conventional therapeutics. Manipulation, exercise and anti-inflammatories have been identified as the options with scientifically established validity in the management of WAD (Spitzer et al. 1995) Patients with WAD have a distortion of the posture control system as a result of disorganised neck proprioceptive activity. It would therefore appear that proprioceptive rehabilitative exercises would benefit WAD sufferers (Revel et al. 1994, Gimse et al. 1996). Spinal manipulation has also been shown to have a significant effect on proprioceptive-dependent abilities in subjects with chronic neck pain (Rogers 1997). This suggests that a combination of manipulation and proprioceptive rehabilitation may offer an improved treatment protocol for WAD (Fitz-Ritson 1995). The purpose of this investigation is to evaluate the relative effectiveness of proprioceptive exercises and cervical spine manipulation compared to manipulation alone, in terms of subjective and objective measures, in the treatment of whiplash-associated disorders.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Department of Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Background Literature has shown that clinical and radiological diagnoses do not always correlate in patients with neck pain (Ferrari and Russel, 2003; Peterson and Hsu, 2004). It is not known if this applies to the Chiropractic Day Clinic (CDC) at the Durban University of Technology (DUT) and if the radiological diagnosis leads to a change in the patient’s initial management plan. The impact of cervical spine plain film radiographs will therefore be investigated in the diagnosis and management of patients that presented with neck pain to the CDC at the DUT. It is also not known whether the reason for referral for cervical spine plain film radiographs is always indicated as per the indications in the clinic handbook and radiological referral guidelines. Objectives Objectives were: (1) To determine the suspected pre-radiographic clinical diagnosis and management of the selected clinical records prior to referral for cervical spine plain film radiography; (2) To record the reasoning to send for cervical spine plain film radiographic imaging and to establish whether these are in line with proposed guidelines for referral as found in the literature; (3) To determine the relationship between the suspected pre-radiographic clinical and the radiological diagnoses of patients with neck pain; (4) To determine the number of incidental findings in the selected patients’ plain film radiographs; (5) To determine any change in the pre-radiographic clinical diagnoses and management following radiological reporting of the selected patient’s plain film radiographs. Method This was a quantitative, retrospective, clinical study. The archives at the CDC at the DUT were searched for cervical spine plain film radiographs between 1 January 1997 to 31 December 2013 and these were matched with the corresponding clinical records. After applying the inclusion and exclusion criteria, 73 records were included in the study. The patient’s personal information was coded to ensure confidentiality (Appendix A) and specific clinical and radiological information was recorded (Appendix B). Statistical analysis included the use of frequency counts, percentages, mean, standard deviation and range for the descriptive objectives. Results A total of 73 clinical files and corresponding plain film radiographs were assessed. The mean age of the patients was 44 years. The gender distribution was 64.4% (n=47) females and 35.6% (n=26) males. The most frequent primary radiological diagnosis was loss of lordosis at 41.1% (n=30) followed by cervical spondylosis at 35.6% (n=26) and old cervical spinal trauma at 12.3% (n=9). Sixty four percent (n=47) of patients in this study were sent for cervical spine plain film radiographs after their initial clinical consultation. Reasons that are not considered relevant indications for plain film radiographic referral were present in 46.2% (n=34) of cases; these described non-specific mechanical disorders. The most common reason for plain film radiographic referral was due to positive orthopaedic tests 57.5% (n=42). A total of 27.4% (n=20) of clinical files reviewed had a change in their initial clinical diagnosis and 72.6% (n=53) of these patients had no change in diagnosis. All of the post-radiographic clinical diagnoses were non-specific mechanical conditions. Numerous treatment modalities were utilized by the students with the most common pre-radiographic treatment being soft tissue therapy at 63.0% (n=46). A total of 75% (n=55) of patients had a change of treatment after plain film radiographs were performed and spinal manipulative therapy (SMT) was the main treatment added in 41% of cases. Conclusion Cervical spine plain film radiographs have little impact on the diagnosis of patients with non-specific mechanical neck pain without red flags. It was however found that plain film radiographs had an impact on the management in the majority of cases, especially with an increase in SMT use after plain film radiographs. / M

No description available.

Gimdos kaklelio vėžys pasaulyje yra antroji, o Lietuvoje ketvirtoji pagal dažnumą moterų onkologinė liga. Pagrindinė gimdos kaklelio vėžio priežastis yra žmogaus papilomos viruso (ŽPV) infekcija gimdos kaklelyje. Vakarų šalyse ikivėžiniams pokyčiams ar vėžinėms ląstelės nustatyti yra naudojamas citologija paremtas Papanicolaou testas (Pap) ir ŽPV DNR testas. Šiuo metu naudojami ŽPV diagnostiniai testai remiasi molekulinės biologijos tyrimo metodais. Tyrimui buvo pasirinktas polimerazės grandininės reakcijos (PGR) metodas, o ne plačiai naudojamas JAV bei Europos kokybės sertifikatus turintis Hybrid Capture 2 (HC2) metodas. PGR yra ypač jautrus, greitas, komerciškai prieinamas metodas, kuriam reikalingas nedidelis tiriamosios medžiagos kiekis, ir kuriuo galima tiksliai identifikuoti ŽPV tipus. HC2 metodas nenustato ŽPV genotipų, galimi klaidingai neigiami rezultatai, nes nėra vidinės kontrolės, o dėl kryžminių reakcijų galimi klaidingai teigiami rezultatai. Naujausi literatūros šaltiniai teigia, kad PGR turi daug perspektyvų ateityje ir manoma, kad ŽPV nustatymo standartas bus 14 DR-ŽPV tyrimas sujungtas su ŽPV-16 ir ŽPV-18 tipų nustatymu. Todėl siekiant ŽPV tyrimams pasirinkti optimaliausią iš Lietuvoje siūlomų komercinių rinkinių Valstybiniame patologijos centre buvo atliekamas šis tyrimas. Įvertinus tyrimų rezultatus, tolesniems tyrimams pasirinktas „Seeplex® HPV4A ACE Screening“ ŽPV nustatymo rinkinys. / Cervical cancer is the second oncological disease in women in the world, and the fourth one in Lithuania. The main cause of the cervical cancer is Human papillomavirus (HPV) infection in the cervix uteri. In order to detect precancerous changes or cancer cells, a Papanicolaou (Pap) test based on cytology and HPV DNA test are used in the Western world. Currently used HPV diagnostic tests are based on molecular biology testing methods. The polymerase chain reaction (PCR) method, not the extensively used Hybrid Capture 2 (HC2) method awarded the certificate of quality by both the USA and Europe, was chosen. PCR is a particularly sensitive, fast, and commercially available method that needs a small quantity of research material and can identify the types of HPV. HC2 method does not detect HPV genotypes, false-negative results are possible because there is no internal control, and due to cross reactions, false-positive results are possible. The newest written sources state that PCR will have much potential in the future and it is thought that HPV detection standard will become 14 HR-HPV test combined with the detection of the types of HPV-16 and HPV-18. Therefore, in order to chose the optimum one for HPV tests from the commercial kits offered in Lithuania, this investigation was carried out in the National Centre of Pathology. Four different HPV diagnostic kits were used for the research. Having evaluated the research results, „Seeplex® HPV4A ACE Screening“ HPV diagnostic kit was... [to full text]

Cervical cancer is the third most common cancer among women worldwide, and the fourth leading cause of cancer mortality. Despite significant declines in the incidence and mortality rates of cervical cancer in Canada, it remains the 4th most common cancer in women aged 20-29 years. In order to gain novel insights into cervical cancer tumourigenesis and clinical outcome, we investigated and characterized the alterations in microRNA (miRNA) expression in this disease. Firstly, we performed global miRNA expression profiling of cervical cancer cell lines (n=3), and patient specimens (n=79). From this analysis, we identified miR-196b to be significantly down-regulated in cervical cancer, and characterized its role in regulating the HOXB7~VEGF axis. The global miRNA expression data also led to the development of a candidate 9-miRNA signature that was prognostic for disease-free survival in patients with cervical cancer, although we were unable to validate this signature in an independent cohort. This report describes important considerations concerning the development and validation of microRNA signatures for cervical cancer. Our investigations also led us to a comparison of three methods for measuring miRNA abundance: the TaqMan Low Density Array, the NanoString nCounter assay, and single-well quantitative real-time PCR. Our findings demonstrated limited concordance between the TLDA and NanoString platforms, although each platform correlated well with PCR, which is considered the gold standard for nucleic acid quantification. Furthermore, we examined biases created by amplification protocols for microarray studies. Our analysis demonstrated that performing a correction using the LTR-method (linear transformation of replicates) could help mitigate, but not completely eliminate such biases. Overall, this report presents insights into the role of miRNAs in cervical cancer, as well as an evaluation of technical considerations concerning miRNA and mRNA expression profiling studies.

No description available.

Background: Cervical cancer is the third most common reproductive cancer in the U.S. To date, one report concluded that U.S. Vietnamese women had the highest incidence rate (43.0/100,000). The current study examines whether U.S. Vietnamese women are more likely to have cervical cancer in comparison to Whites, Blacks, Hispanics, American Indians, and other Asian subgroups. Methods: SEER data of cervical cancers diagnosed from 1993-1995 (n = 37,790) was utilized. Using SPSS, chi-square statistics assessed whether Vietnamese women were older and more likely to be married or diagnosed at a later stage. Logistic regression assessed the amount of risk race/ethnicity contributes to stage of diagnosis adjusting for age and martial status. SEER*Stat and U.S. Census data were used to compute age-adjusted incidence and prevalence rates per 100,000 woman-years for cervical cancer. Results: After adjustment, Vietnamese women were more likely to have carcinoma in situ (OR=1.44, p = 0.0 14) compared to white women. The odds of distant stage diagnosis for Vietnamese women was 3.35 times that of whites (p = 0.093). Vietnamese women had greater odds of distant stage diagnosis than other Asian subgroups (OR = 1.43, p = 0.092). The overall age-adjusted incidence rate for invasive cervical cancer for Asian-Pacific Islanders is 6.71100,000 (including Vietnamese) compared to 5.0/100,000 for whites. However, the overall incidence rate for Vietnamese women is 21.4/100,000 compared to 10.4/100,000 for whites. Conclusions: Vietnamese race/ethnicity is associated with cervical cancer diagnosis. Asian subgroups are at varying risk of cervical cancer and should be assessed separately as to not obscure differences.

Vietnamese women experience cancer screening disparities and inconsistent adherence to screening guidelines. The goal of this study was to implement and evaluate a breast and cervical cancer screening intervention to promote cancer screening knowledge, attitudes, self-efficacy, intention, and behavior for Vietnamese women. Secondary objectives of the study included examining the relationships between cultural variables (e.g., acculturation, ethnic identity, religiosity, and collectivism) and cancer screening variables. The study enrolled 102 women from the greater Richmond metropolitan area. Participants were assigned to an intervention group or a print material control group. In the intervention session, participants were exposed to information on female cancers and were taught how and where to access Pap tests and clinical breast exams (CBE). Follow-up data were collected six months after the intervention to determine whether or not there were longer-term program effects. Intervention participants also took part in focus groups that examined their reactions, thoughts, feelings, and experiences in regards to the intervention. In addition, focus groups explored participants’ sources of motivation for cancer screening and whether they shared information obtained in the sessions with other individuals. The intervention was effective in promoting immediate and longer-term gains in breast and cervical cancer knowledge, attitudes towards screening, self-efficacy for screening, and actual screening behaviors. The study’s findings indicated that acculturation was linked to higher levels of self-efficacy and screening behavior and less positive attitudes towards screening. Personal and social extrinsic religiosity were associated with more positive attitudes towards screening. Social extrinsic religiosity was also associated with more self-efficacy for screening and screening behavior. Intrinsic religiosity was linked to lower levels of self-efficacy for screening. Focus group discussions revealed that the women shared cancer-related information with friends, female family members, and husbands. Focus group discussions also revealed that emphasis on caretaking roles may help increase women’s adherence to screening guidelines. This study provides evidence for the effectiveness of culturally-tailored strategies in developing cancer screening interventions for the Vietnamese population. This study also demonstrates how health information is transmitted across informal channels within faith-based communities.

Title: Effect of forward head posture on postural stabilization measured by postural somatooscillography. Objectives: The aim of this thesis was to assess the influence of the forward head posture on the overall ability of postural stabilization using postural somatooscillography method. Methods: This thesis was prepared using analytical - comparative study. It compared two groups of fifteen subjects using the challenge test "3 steps - standing on one leg" in standart conditions. The measurement was recorded to the Microswing 6.0 and collected data was evaluated by Posturomed Commander. Results: The research did not achieve clear results at all, but in the overall assessment, we could say, that people with forward head posture have different, maybe slightly worse ability of postural stabilization. Keywords: postural stability, forward head posture, Posturomed, cervical spine

Le cancer du col de l’utérus est la première cause de cancer chez la femme en Afrique de l’Ouest, une région du monde où le virus de l’immunodéficience humaine (VIH) sévit de manière endémique. Ce travail s’inscrit dans le cadre de l’étude du lien entre ces deux pathologies ainsi que des spécificités du dépistage du cancer du col dans le contexte de l’infection à VIH.Notre travail de recherche a été conduit en plusieurs étapes. Une enquête hospitalière a tout d’abord comparée la fréquence du VIH chez des femmes atteintes de cancer du col et chez des femmes atteintes d’autres cancers. Nous avons ensuite mis en place un programme de dépistage des cancers du col par inspection visuelle au sein de trois cliniques VIH à Abidjan offrant cette intervention pendant une période de plusieurs mois. Un échantillon de ces femmes dépistées a enfin été prélevé pour la recherche de papillomavirus humains (PVH). Sur les 152 cas de cancer du col inclus dans la première enquête, 25% étaient VIH-positifs contre 4,7% chez les 257 patientes du groupe de comparaison, donnant un Rapport de Côte (RC) ajusté de 7,6 (3,6 – 16,2) pour l’association entre ces deux morbidités sévères. Un total de 4 046 femmes a été dépisté par inspection visuelle. La fréquence d’un test positif était de 9,0% (8,0 – 10,0) chez les 2 998 femmes VIH-positives et 3,9% (2,7 – 5,1) chez les 1 048 femmes VIH-négatives. La prévalence de l’infection à PVH oncogène était de 33,0% chez les 191 femmes VIH-négatives et de 52,8% chez les 254 femmes VIH-positives ayant pu être testé par PCR. Un taux de CD4<200 cellules/mm3 était associé à la présence d’un PVH oncogène (RC= 2,8 [1,1 – 8,3] Ref. CD4 ≥500). L’infection à VIH est fortement associée au risque de cancer du col ainsi qu’à la présence de ses précurseurs que sont les PVH. La mise en place de programmes de dépistage associé à une bonne reconstitution immunitaire semble être des mesures essentielles pour réduire le fardeau de ce cancer chez les femmes VIH-positives en Afrique de l’Ouest à l’ère de l’accès élargi aux antirétroviraux. / Cervical cancer is the leading cause of cancer among women in West Africa, where infection with the Human Immunodeficiency Virus (HIV) is endemic. This work study the link between these two pathologies as well as the specificities linked to cervical cancer screening in the context of HIV infection. Our research project was conducted in several stages. A first hospital-based study compared the prevalence of HIV in women with cervical cancer and in women with other cancers. We then implement a cervical cancer screening program with visual inspection methods in three HIV clinics in Abidjan during several months. A sample of women screened was finally selected and collected for human papillomavirus (HPV) identification. Of the 152 cases of cervical cancer included during the first study, 25% were HIV-positive compared to 4.7% among the 257 patients of the comparison group, giving an adjusted odd ratio (OR) of 7.6 (3.6 - 16.2). A total of 4,046 women were screened by visual inspection. The frequency of a positive test was 9.0% (8.0 - 10.0) in the 2,998 HIV-positive women and 3.9% (2.7 - 5.1) in the 1,048 HIV-negative women. The prevalence of oncogenic HPV was 33.0% in the 191 HIV-negative women and 52.8% in the 254 HIV-positive women that underwent PCR testing. A CD4 count <200 cells/mm3 was associated with the presence of oncogenic HPV (OR = 2.8 [1.1 - 8.3] Ref. CD4≥500). HIV infection is strongly associated with cervical cancer and the presence of its precursors, oncogenic HPV. The implementation of adapted screening programs combined with good immune reconstitution seems to be key measures to reduce the burden of cervical cancer in HIV-positive women in West Africa in the era of expanded access to antiretroviral drugs.