228 results on '"D'ANNA, BARBARA"'
Search Results
2. Inconsistent Sexual Behavior Reporting Among Youth Affected by Perinatal HIV Exposure in the United States
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Paige L. Williams, Molly F. Franke, Anna-Barbara Moscicki, Georg R. Seage, Katherine Tassiopoulos, and Krystal Cantos
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Male ,Safe Sex ,medicine.medical_specialty ,Adolescent ,Social Psychology ,Sexual Behavior ,HIV Infections ,Article ,law.invention ,Cohort Studies ,Condoms ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Condom ,law ,Humans ,Medicine ,030212 general & internal medicine ,Young adult ,Child ,030505 public health ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,Virginity test ,Cognition ,medicine.disease ,United States ,Health psychology ,Infectious Diseases ,Female ,0305 other medical science ,business ,Demography ,Cohort study - Abstract
We examined reporting agreement of oral, vaginal, and anal sex in adolescents and young adults living with perinatally-acquired HIV and those perinatally HIV-exposed and uninfected in the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol (AMP) and AMP Up studies. Agreement between fixed constructs (e.g., age at first sex) and prevalence of logical inconsistencies (e.g., reclaimed virginity status) over time were assessed. Internal consistency was also examined using an attention check question and questions regarding condom use in the prior three months. Those who reported having anal sex in adolescence had a higher proportion of inconsistent responses compared to vaginal and oral sex measures. At their most recent survey, 84% of young adults correctly answered an attention check question and 74% agreed within the survey on condom use in the prior three months. In bivariate analyses, HIV status was not associated with responding inconsistently. Increased time between surveys, male sex, and younger age at first survey were associated with multiple measures of inconsistency over time, while lower cognitive scores, having less than a high school diploma, and negatively answering post-survey acceptability questions were associated with incorrectly answering an attention check question.
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- 2021
3. Human Spheroids from Adipose-Derived Stem Cells Induce Calvarial Bone Production in a Xenogeneic Rabbit Model
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Francesco Moschella, Cesare Gagliardo, Angelo A. Leto Barone, Ada Maria Florena, Giuseppa Bilello, Anna Barbara Di Stefano, Francesca Toia, Luigi Montesano, Adriana Cordova, Alessandro Gulino, Beatrice Belmonte, Di Stefano, Anna Barbara, Montesano, Luigi, Belmonte, Beatrice, Gulino, Alessandro, Gagliardo, Cesare, Florena, Ada Maria, Bilello, Giuseppa, Moschella, Francesco, Cordova, Adriana, Leto Barone, Angelo A, and Toia, Francesca
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Bone Regeneration ,Cellular differentiation ,Adipose tissue ,Bone healing ,030230 surgery ,Settore MED/08 - Anatomia Patologica ,03 medical and health sciences ,0302 clinical medicine ,Tissue engineering ,Osteogenesis ,Adipocytes ,Animals ,Humans ,Medicine ,spheroids ,Bone regeneration ,Cells, Cultured ,adipose-derived stem cell ,business.industry ,Ossification ,Stem Cells ,Regeneration (biology) ,Skull ,Cell Differentiation ,Cell biology ,Adipose Tissue ,030220 oncology & carcinogenesis ,Surgery ,Rabbits ,medicine.symptom ,Stem cell ,business - Abstract
Calvarial defects can result from several causes. Tissue engineering hold the potential to restore native form and protective function. We have recently shown that stemness and differentiation ability of spheroids from adipose-derived stem cells (S-ASCs) promotes osteoblasts growth within Integra in a small vertebral lesion. In our study, we aimed to test osteogenic potential of S-ASCs in aiding regeneration of a calvarial defect. Groups containing Integra showed increased bone regeneration at the calvarial defect-Integra interface compared with the control group. In particular, S-ASC-derived osteoblasts group showed a superior calvarial remodeling than undifferentiated S-ASCs group. Clusters of ossification were observed in these both groups with enhanced microvasculature density and fibrosis. In conclusion, seeding of S-ASCs in dermal regeneration templates enhanced bone healing in a rabbit calvarial defect model. These findings could prompt the elective use of S-ASCs with enhanced multilineage differentiation potential for tissue engineering purposes.
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- 2021
4. Negative pressure wound treatment in a neonate with epidermolysis bullosa simplex severe generalized: A case report
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Clemens Schiestl, Anna-Barbara Schlueer, Lisa Weibel, Martin Theiler, Kathrin Neuhaus, Agnes Schwieger-Briel, University of Zurich, and Schlueer, Anna-Barbara
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medicine.medical_specialty ,medicine.medical_treatment ,610 Medicine & health ,Dermatology ,2708 Dermatology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Epidermolysis bullosa simplex ,0302 clinical medicine ,Skin fragility ,medicine ,Humans ,In patient ,10220 Clinic for Surgery ,2735 Pediatrics, Perinatology and Child Health ,Wound treatment ,Skin ,integumentary system ,EB simplex ,business.industry ,Infant, Newborn ,Skin Transplantation ,medicine.disease ,Bandages ,Epidermolysis Bullosa Simplex ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,Skin grafting ,Epidermolysis bullosa ,Epidermolysis Bullosa ,business ,Rare disease - Abstract
Negative pressure wound treatment (NPWT) is very useful for the treatment of chronic or deep wounds and in the setting of skin grafting. Due to the need for adhesive dressings, this treatment is rarely attempted in patients with skin fragility secondary to hereditary epidermolysis bullosa (EB). We present a neonate with EB simplex, severe generalized in a critical clinical state where NPWT was successfully applied and describe the measures taken to avoid any further skin damage. This case is of clinical importance to physicians and health care staff treating patients with this rare disease where additional therapeutic measures for the treatment of chronic wounds are scarce.
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- 2020
5. Cognitive impairment in the HTLV-1 infection: a comparative study associated with functional performance
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Rodrigo Nicolato, Marco Aurélio Romano-Silva, Luiz Cláudio Ferreira Romanelli, Débora Marques de Miranda, Renata Caetano Vieira de Faria, Leandro Fernandes Malloy-Diniz, Anna Barbara de Freitas Carneiro Proietti, and Jonas Jardim de Paula
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0301 basic medicine ,Activities of daily living ,Population ,Asymptomatic ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,immune system diseases ,hemic and lymphatic diseases ,Virology ,Activities of Daily Living ,Tropical spastic paraparesis ,Humans ,Medicine ,Cognitive Dysfunction ,education ,Episodic memory ,Human T-lymphotropic virus 1 ,education.field_of_study ,Recall ,business.industry ,Neuropsychology ,virus diseases ,Physical Functional Performance ,Executive functions ,medicine.disease ,HTLV-I Infections ,Paraparesis, Tropical Spastic ,030104 developmental biology ,Neurology ,Case-Control Studies ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Human T cell leukemia virus type-I (HTLV-1) infection courses with a myelopathy, the tropical spastic paraparesis (HAM/TSP). In a case-control study, we compared the neuropsychological profile and functional characteristics in two case HTLV-1-infected groups (asymptomatic and with HAM/TSP) with a control group negative for HTLV-1. Subjects were paired for age, sex, and educational features. The case group differed from control group in neuropsychological measures such as in episodic memory recall, executive functions, and fine motor dexterity measure. Individuals with HAM/TSP have more depressive symptoms and worst performance in activities of daily living (ADL) presenting a less functionality. In multivariate models, the fine motor performance, the executive functioning, the recognition memory, and the depressive symptoms explained part of the variance in functionality. Those findings may contribute to understand of everyday life impairments and limitations of HTLV-1-infected population and to organize the rehabilitation. Once more, based in neuropsychological and functional data, we can reaffirm that HTLV-1 is never a benign condition, but sometimes it is only in a stage coursing with less symptoms.
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- 2020
6. 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors
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Jane J. Kim, Richard S. Guido, David Chelmow, Ritu Nayar, Mark H. Einstein, Mark Schiffman, Nicolas Wentzensen, Philip E. Castle, Warner K. Huh, Rebecca B. Perkins, Anna-Barbara Moscicki, Francisco A.R. Garcia, George F. Sawaya, and Mona Saraiya
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Colposcopy ,medicine.medical_specialty ,medicine.diagnostic_test ,Obstetrics ,business.industry ,Medical record ,HPV infection ,Obstetrics and Gynecology ,General Medicine ,Guideline ,medicine.disease ,Squamous intraepithelial lesion ,Risk Estimate ,Colposcopic Biopsy ,medicine ,business ,Risk assessment - Abstract
This is the fourth American Society of Colposcopy and Cervical Pathology (ASCCP)-sponsored consensus guidelines for management of cervical cancer screening abnormalities, after the original consensus conferences in 20011 and subsequent updates in 20062 and 2012.3 An interim guidance publication providing management recommendations for primary HPV screening was released in 2015.4 This document updates and replaces all previous guidance. The key difference between 2019 guidelines and previous versions is the change from primarily test results–based algorithms (e.g., “Colposcopy is recommended for patients with HPV-positive atypical squamous cells of undetermined significance [ASC-US], low-grade squamous intraepithelial lesion [LSIL],” etc.) to primarily “risk-based” guidelines (e.g., “Colposcopy is recommended for any combination of history and current test results yielding a 4.0% or greater probability of finding CIN 3+,” etc.). See Box 1 for essential changes. Tables of risk estimates for possible combinations of current screening test results and screening history (including unknown history) have been generated from a prospective longitudinal cohort of more than 1.5 million patients followed for more than a decade at Kaiser Permanente Northern California (KPNC). All KPNC estimates of risk underlying guideline decisions are detailed in the accompanying article by Egemen et al.5 The applicability of these risk estimates to other United States regions and populations has been confirmed in other data sets from screening programs and clinical trials.6 Many patients, especially those with minor abnormalities, can be managed by identifying their risk level using Tables 1A to 5B in Egemen et al5 and linking it to a recommended clinical action (return to routine screening, surveillance with repeat testing at 1- or 3-year intervals, colposcopy, or treatment). To facilitate use of these tables, the same information will be accessible via smartphone app (for purchase) and web (no cost) through http://www.asccp.org. Decision aids may facilitate use of the tables.7 Common abnormalities are managed using risk estimates outlined in Section E, and rare abnormalities are managed via the result-specific consensus recommendations outlined in Sections G-K. Box 1. Essential Changes From Prior Management Guidelines 1) Recommendations are based on risk, not results. Recommendations of colposcopy, treatment, or surveillance will be based on a patient's risk of CIN 3+ determined by a combination of current results and history (including unknown history). The same current test results may yield different management recommendations depending on the history of recent past test results. 2) Colposcopy can be deferred for certain patients. Repeat HPV testing or cotesting at 1 year is recommended for patients with minor screening abnormalities indicating HPV infection with low risk of underlying CIN 3+ (e.g., low-grade cytologic abnormalities after a documented negative screening HPV test or cotest). At the 1-year follow-up test, referral to colposcopy is recommended if results remain abnormal. 3) Guidance for expedited treatment is expanded (i.e., treatment without colposcopic biopsy). Expedited treatment was an option for patients with HSIL cytology in the 2012 guidelines; this guidance is now better defined. For nonpregnant patients 25 years or older, expedited treatment, defined as treatment without preceding colposcopic biopsy demonstrating CIN 2+, is preferred when the immediate risk of CIN 3+ is ≥60%, and is acceptable for those with risks between 25% and 60%. Expedited treatment is preferred for nonpregnant patients 25 years or older with high-grade squamous intraepithelial lesion (HSIL) cytology and concurrent positive testing for HPV genotype 16 (HPV 16) (i.e., HPV 16–positive HSIL cytology) and never or rarely screened patients with HPV-positive HSIL regardless of HPV genotype. Shared decision-making should be used when considering expedited treatment, especially for patients with concerns about the potential impact of treatment on pregnancy outcomes. 4) Excisional treatment is preferred to ablative treatment for histologic HSIL (CIN 2 or CIN 3) in the United States. Excision is recommended for adenocarcinoma in situ (AIS). 5) Observation is preferred to treatment for CIN 1. Treatment remains acceptable for patients with repeat diagnoses of CIN 1 persisting 2 years or more. 6) Histopathology reports based on Lower Anogenital Squamous Terminology (LAST)/World Health Organization (WHO) recommendations for reporting histologic HSIL should include CIN 2 or CIN 3 qualifiers, i.e., HSIL(CIN 2) and HSIL (CIN 3). 7) All positive HPV tests, regardless of genotype, should have additional reflex triage testing performed from the same laboratory specimen (e.g., reflex cytology). Additional testing from the same laboratory specimen is recommended because the findings may inform colposcopy practice. For example, those with HSIL cytology and concurrent positive testing for HPV genotype 16 qualify for expedited treatment. HPV 16 or 18 infections have the highest risk for CIN 3 and occult cancer, so additional evaluation (e.g., colposcopy with biopsy) is necessary even when cytology results are negative. If HPV 16 and 18 testing is positive, and additional laboratory testing of the same sample is not feasible, the patient should proceed directly to colposcopy. 8) Continued surveillance with HPV testing or cotesting at 3-year intervals for at least 25 years is recommended after treatment of histologic HSIL, CIN 2, CIN 3, or AIS. Continued surveillance at 3-year intervals beyond 25 years is acceptable for as long as the patient's life expectancy and ability to be screened are not significantly compromised by serious health issues. The 2012 guidelines recommended return to 5-year screening intervals and did not specify when screening should cease. New evidence indicates that risk remains elevated for at least 25 years, with no evidence that treated patients ever return to risk levels compatible with 5-year intervals. Surveillance with cytology alone is acceptable only if testing with HPV or cotesting is not feasible. Cytology is less sensitive than HPV testing for detection of precancer and is therefore recommended more often. Cytology is recommended at 6-month intervals when HPV testing or cotesting is recommended annually. Cytology is recommended annually when 3-year intervals are recommended for HPV or cotesting. 9) Human papilloma virus assays that are Food and Drug Administration (FDA)-approved for screening should be used for management according to their regulatory approval in the United States. (Note: all HPV testing in this document refers to testing for high-risk HPV types only). For all management indications, HPV mRNA and HPV DNA tests without FDA approval for primary screening alone should only be used as a cotest with cytology, unless sufficient, exceptionally rigorous data are available to support primary HPV testing in management. The minimum amount of data required to generate a recommendation will include the patient's age and current test results, as we recognize that previous screening history is often not known. Increased precision of management guidance will be possible if information is available on test results within the past 5 years and previous precancer treatment within the past 25 years.3 Current results and past history are designed to generate the patient's risk estimate from data tables.5 Risk estimates are available for the following clinical situations: abnormal screening test results with unknown history, abnormal screening test results with medical record documentation of a preceding negative HPV test or cotest, surveillance of previous abnormal screening test results that did not require immediate colposcopic referral (e.g., follow-up after an HPV-positive cytology negative result), colposcopy/biopsy results, and follow-up surveillance tests after colposcopy or after treatment for, or resolution of, high-grade abnormalities (e.g., CIN 2+). The recognition that persistent HPV infection is necessary for developing precancer and cancer (defined as CIN 3+, which includes diagnoses of CIN 3, AIS, and cancer) underlies the 2019 guideline update. Prospective longitudinal data indicate that when a new abnormal screening test result follows a negative HPV test or cotest within the past 5 years, the estimated risk of CIN 3+ is reduced by approximately 50%.8 A negative cytology result within 3 years of a new abnormal screening test, however, does not confer a similar reduction in risk.9 The 2019 guidelines also recognize that a colposcopic examination performed according to accepted standards (e.g., using the KPNC colposcopy protocol or the ASCCP Colposcopy Standards10) confirming low-grade or normal histology reduces a patient's estimated risk of having precancer/cancer in the next 2 years.11 This allows patients with an HPV-positive ASC-US or LSIL result at their 1-year follow-up visit after a colposcopy confirming normal- or low-grade histology to return for repeat HPV or cotesting in 1 more year, rather than immediately return to colposcopy. Thus, incorporating a patient's history of previous HPV tests and colposcopy/biopsy results will permit detection and treatment of CIN 3+ while avoiding unnecessary interventions for patients with new HPV infections who are at lower risk.12
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- 2020
7. MicroRNAs in solid organ and vascularized composite allotransplantation: Potential biomarkers for diagnosis and therapeutic use
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Francesco Moschella, Anna Barbara Di Stefano, Francesca Toia, Marco Pappalardo, Adriana Cordova, and Anna Barbara Di Stefano, Marco Pappalardo, Francesco Moschella, Adriana Cordova, Francesca Toia
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Graft Rejection ,medicine.medical_specialty ,Immune rejection ,medicine.medical_treatment ,Bioinformatics ,Vascularized Composite Allotransplantation ,Organ transplantation ,RNA interference ,microRNA ,Biomarker ,Micro-RNAs ,Tolerance ,Vascularized composite allotransplantations ,medicine ,Humans ,Biomarker discovery ,Immunosuppression Therapy ,Transplantation ,business.industry ,Immunosuppression ,Biomarker (cell) ,MicroRNAs ,Vascularized composite allotransplantations, Micro-RNAs, Biomarker, Immune rejection, Organ transplantation, Tolerance ,business ,Biomarkers ,Allotransplantation - Abstract
Nowadays, solid organ transplantation (SOT) is an established treatment for patients with end-organ dysfunction, which dramatically improves the quality-of-life. Vascularized composite allotransplants (VCAs) including hand and face have been reported worldwide over the last 20 years. However, VCAs, differently to SOT, are life-enhancing instead of life-saving and are not routinely performed due to the risk of immune rejection and the adverse effects of immunosuppression. Over the past decade, although considerable improvements in short-term outcomes after allotransplantation have been registered, these results have not been translated into major progress in long-term allograft acceptance and patient survival. Recently active researches in the field of biomarker discovery have been conducted to develop individualized therapies for allograft recipients. MicroRNAs (miRNAs) are a small noncoding RNAs functioning as critical regulators of gene and protein expression by RNA interference. They have been connected in numerous biological processes and diseases. Due to their immunomodulatory functions, miRNAs have been amended as potential diagnostic and prognostic biomarker for the detection of rejection in allotransplantation. Due to their specific circulating expression profile, they could act as noninvasive predictive tools for rejection that may help clinicians in an early adjustment of the immunosuppression protocol during acute rejections episodes. Indeed, specific anti-sense oligonucleotides suppressing miRNAs expressed in rejection could reduce the rejection rate in allografts and decrease the use of immunosuppressants. We present a literature review of the immunomodulatory properties and characteristics of miRNAs. We will summarize the current knowledge on miRNAs as potential biomarkers for allograft rejection and possible application in allotransplantation monitoring. Finally, we will discuss the advances in preclinical miRNA-based therapies for immunosuppression.
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- 2020
8. Impact of an Educational Tool on Young Women’s Knowledge of Cervical Cancer Screening Recommendations
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Sitaram Vangala, Heike Thiel de Bocanegra, Anna-Barbara Moscicki, Christine Dehlendorf, and Miriam Kuppermann
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Cancer Research ,Health Knowledge, Attitudes, Practice ,medicine.medical_specialty ,Epidemiology ,Clinical Trials and Supportive Activities ,Oncology and Carcinogenesis ,Uterine Cervical Neoplasms ,Cervical Cancer ,Cervical cancer screening ,Cancer prevention ,Cervical cytology testing ,Clinical Research ,Surveys and Questionnaires ,medicine ,Humans ,Mass Screening ,Online patient education ,Papillomaviridae ,Early Detection of Cancer ,HPV vaccine ,Cancer ,Vaginal Smears ,Practice ,business.industry ,Health Knowledge ,Prevention ,Papillomavirus Infections ,Health Services ,Quality Education ,Infectious Diseases ,Cross-Sectional Studies ,Oncology ,Attitudes ,Family medicine ,Public Health and Health Services ,Sexually Transmitted Infections ,Female ,Patient Safety ,business ,Papanicolaou Test - Abstract
Purpose Current cervical cancer screening guidelines recommend 3-year screening intervals, in contrast to the previous recommendation of annual screening, to prevent over screening and overtreatment. We evaluated the impact of viewing a tablet-based educational tool prior to seeing a clinician on young women’s knowledge and understanding of cervical cancer screening, HPV vaccination follow-up of abnormal pap smears, and comfort in communicating with their providers. Methods This cross-sectional study was part of a cluster-randomized study of fourteen primary care clinics from January 2015 to December 2016. We developed the cervical cancer education tool in English and Spanish using a community-based approach that included formative work and cognitive interviewing. Clinics were randomized to use the intervention (tablet-based patient education tool) or to participate as a control group. We administered surveys to a convenience sample of 229 English- or Spanish-speaking women aged 19 to 35 years in these clinics. We used descriptive analyses and logistic regression models with cluster-robust standard errors to compare differences among the two groups. Results Compared to women seen in control clinics, women seen in intervention clinics demonstrated greater knowledge regarding human papilloma virus (HPV (p = 0.004) and understanding (p p = 0.053). Women in the intervention group felt that the tool helped them understand that an abnormal Pap smear does not require immediate treatment (61.5%). Conclusion Innovative online patient education that is offered prior to patients’ interaction with their clinicians can improve their knowledge about cervical cancer prevention and treatment.
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- 2021
9. Natural History of HPV Infection Latency and Clearance
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Anna-Barbara Moscicki
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Cervical cancer ,business.industry ,Transmission (medicine) ,HPV infection ,Obstetrics and Gynecology ,Anus ,medicine.disease ,Natural history ,medicine.anatomical_structure ,Oncology ,Surgical oncology ,Immunology ,medicine ,Vagina ,Latency (engineering) ,business - Abstract
The majority of redetection of the same HPV type is likely due to sexual exposure. Other possible reasons are exposure to reservoirs in the partner or self and reactivation of a latent infection. Any prevalent infection is higher risk of cancer development than incident infection. Discussion should include the possibility of new infection, reactivation or transmission for another reservoir (e.g., partner, vagina, anus). But the importance is that a “new” infection preceded by a previously negative infection has little to no risk of cervical cancer and low risk of a significant precancer (ASCCP). However, the risk is not zero so follow-up is needed.
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- 2021
10. Effect of 2 Interventions on Cervical Cancer Screening Guideline Adherence
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Anna-Barbara Moscicki, Sandy K. Navarro, Miriam Kuppermann, David Elashoff, Xinkai Zhou, Christine Dehlendorf, Charlene Chang, Ysabel Duron, Fred L. Wyand, Heike Thiel de Bocanegra, George F. Sawaya, and Sitaram Vangala
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medicine.medical_specialty ,Epidemiology ,Clinical Trials and Supportive Activities ,Psychological intervention ,Uterine Cervical Neoplasms ,Cervical cancer screening ,Cervical Cancer ,01 natural sciences ,Medical and Health Sciences ,Education ,03 medical and health sciences ,0302 clinical medicine ,7.1 Individual care needs ,Clinical Research ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,0101 mathematics ,Prospective cohort study ,Trial registration ,Early Detection of Cancer ,Cancer ,Colposcopy ,medicine.diagnostic_test ,business.industry ,Guideline adherence ,Prevention ,010102 general mathematics ,Public Health, Environmental and Occupational Health ,Health Services ,Good Health and Well Being ,Mobile phone ,Family planning ,Physical therapy ,Female ,Guideline Adherence ,Patient Safety ,Management of diseases and conditions ,Public Health ,business ,Digestive Diseases ,Cell Phone - Abstract
Introduction This study sought to determine whether a provider mobile phone application, used with or without a patient educational tool accessed on a computer tablet, would promote adherence to guidelines for cervical cancer screening and management of abnormal cytology in young women. Methods The study was conducted as a prospective cohort study in which 14 Family Planning, Access, Care, and Treatment provider clinics were randomized to 1 of 2 arms: (1) provider mobile phone application only or (2) provider mobile phone application plus patient educational tool. The provider mobile phone application gave information to providers regarding cervical cancer screening and management of abnormal cytology. The patient educational tool accessed on a computer tablet was a patient-centered educational tool. Each arm was compared with clinic control groups (no intervention) in a 2:1 ratio (control:intervention). Claims data were used to calculate and compare 18-month cytology (Pap) and colposcopy rates before the intervention and during the 18 months using the Poisson mixed-effect regression model. A sensitivity analysis examined the differences in the rate of change between each arm and controls. The study took place between July 2015 and December 2016, and analysis was performed in 2019. Results The clinics randomized to the provider mobile phone application plus patient educational tool arm and their control group achieved similar 18-month Pap rates (0.52, 95% CI=0.37, 0.74 and 0.68, 95% CI=0.53, 0.86, respectively) as well as the provider mobile phone application arm and their control group (0.44, 95% CI=0.33, 0.58 and 0.41, 95% CI=0.34, 0.51; p-values >0.1). In the sensitivity analysis, the difference in the rate of change in Pap rates for the provider mobile phone application plus patient educational tool arm and their control group before and during the intervention was −0.22 and −0.09, respectively (p=0.02), but no differences were seen between the provider mobile phone application arm and their control group. No significant changes were observed for colposcopy rates. Conclusions Providing clinicians and patients with information on guidelines had no demonstrable effect on 18-month Pap and colposcopy rates in the regression model; however, results from the sensitivity analysis for the patient educational tool were encouraging. Trial registration This study is registered at www.clinicaltrials.gov NCT02270021.
- Published
- 2021
11. Higher-Calorie Refeeding in Anorexia Nervosa: 1-Year Outcomes From a Randomized Controlled Trial
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Neville H. Golden, Sara M. Buckelew, Anna Kreiter, Erin C. Accurso, Vanessa I. Machen, Sally H. Adams, Allyson F. Sy, Leslie Wilson, Daniel Le Grange, Jing Cheng, Andrea K. Garber, Cynthia J. Kapphahn, and Anna-Barbara Moscicki
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Male ,medicine.medical_specialty ,Calorie ,Anorexia Nervosa ,Adolescent ,Eating Disorders ,Decision Making ,Clinical Trials and Supportive Activities ,Clinical nutrition ,Refeeding syndrome ,Tertiary care ,Patient Readmission ,Medical and Health Sciences ,Pediatrics ,law.invention ,Feeding and Eating Disorders ,Randomized controlled trial ,law ,Recurrence ,Clinical Research ,Internal medicine ,Outcome Assessment, Health Care ,medicine ,Humans ,Nutrition ,business.industry ,Remission Induction ,Rehabilitation ,Psychology and Cognitive Sciences ,Evaluation of treatments and therapeutic interventions ,Articles ,medicine.disease ,Anorexia ,Brain Disorders ,Eating disorders ,Mental Health ,Anorexia nervosa (differential diagnoses) ,6.1 Pharmaceuticals ,Pediatrics, Perinatology and Child Health ,Female ,medicine.symptom ,business ,Energy Intake ,Weight gain ,Follow-Up Studies - Abstract
BACKGROUND AND OBJECTIVES:We recently reported the short-term results of this trial revealing that higher-calorie refeeding (HCR) restored medical stability earlier, with no increase in safety events and significant savings associated with shorter length of stay, in comparison with lower-calorie refeeding (LCR) in hospitalized adolescents with anorexia nervosa. Here, we report the 1-year outcomes, including rates of clinical remission and rehospitalizations.METHODS:In this multicenter, randomized controlled trial, eligible patients admitted for medical instability to 2 tertiary care eating disorder programs were randomly assigned to HCR (2000 kcals per day, increasing by 200 kcals per day) or LCR (1400 kcals per day, increasing by 200 kcals every other day) within 24 hours of admission and followed-up at 10 days and 1, 3, 6, and 12 months post discharge. Clinical remission at 12 months post discharge was defined as weight restoration (≥95% median BMI) plus psychological recovery. With generalized linear mixed effect models, we examined differences in clinical remission over time.RESULTS:Of 120 enrollees, 111 were included in modified intent-to-treat analyses, 60 received HCR, and 51 received LCR. Clinical remission rates changed over time in both groups, with no evidence of significant group differences (P = .42). Medical rehospitalization rates within 1-year post discharge (32.8% [19 of 58] vs 35.4% [17 of 48], P = .84), number of rehospitalizations (2.4 [SD: 2.2] vs 2.0 [SD: 1.6]; P = .52), and total number of days rehospitalized (6.0 [SD: 14.8] vs 5.1 [SD: 10.3] days; P = .81) did not differ by HCR versus LCR.CONCLUSIONS:The finding that clinical remission and medical rehospitalization did not differ over 1-year, in conjunction with the end-of-treatment outcomes, support the superior efficacy of HCR as compared with LCR.
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- 2021
12. An international consensus on device-related pressure ulcers
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Holly Kirkland-Kyhn, Nils Lahmann, Catherine T Milne, Karen Ousey, G. Ciprandi, Amit Gefen, Fiona Coyer, Nicola Waters, Joyce M. Black, Michelle Barakat-Johnson, Norihiko Ohura, Paulo Alves, Dimitri Beeckman, Jacqui Fletcher, Peter Worsley, Zena Moore, Yohan Payan, and Anna-Barbara Schlüer
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Pressure Ulcer ,medicine.medical_specialty ,Consensus ,Equipment and Supplies ,Risk Factors ,business.industry ,medicine ,MEDLINE ,Humans ,Nursing ,Intensive care medicine ,business ,General Nursing - Abstract
Catherine Milne and colleagues present the findings of their review, ccna2@juno.com
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- 2020
13. A prospective, single-arm, open-label, non-randomized, phase IIa trial of a nonavalent prophylactic HPV vaccine to assess immunogenicity of a prime and deferred-booster dosing schedule among 9–11 year-old girls and boys – clinical protocol
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Eva Szabo, Heide Woo, Eileen Dimond, Yi Zeng, Susan Vanzzini, Francisco A.R. Garcia, Chiu Hsieh Hsu, Vikrant V. Sahasrabuddhe, Anna-Barbara Moscicki, H.-H. Sherry Chow, Hillary DeRose, Angelica Mondragon, and Valerie D. Butler
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Male ,0301 basic medicine ,Cancer Research ,Pediatrics ,medicine.medical_specialty ,Human papillomavirus ,Serologic geometric mean titer ,Booster dose ,Antibodies, Viral ,Nonavalent HPV vaccine ,lcsh:RC254-282 ,Genital warts ,Study Protocol ,03 medical and health sciences ,Immunogenicity, Vaccine ,0302 clinical medicine ,Genetics ,medicine ,Humans ,Papillomavirus Vaccines ,Prospective Studies ,Child ,Immunization Schedule ,HPV vaccine ,Cervical cancer ,Reactogenicity ,business.industry ,Immunogenicity ,Papillomavirus Infections ,Antibody titer ,Gardasil 9 ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,3. Good health ,Regimen ,Titer ,Treatment Outcome ,030104 developmental biology ,Oncology ,030220 oncology & carcinogenesis ,Female ,business - Abstract
Background Human papillomavirus (HPV) vaccines are indicated for the prevention of cancers and genital warts caused by vaccine-covered HPV types. Although the standard regimen requires a two or three-dose vaccine series, there is emerging data suggesting that a single dose of the bivalent or quadrivalent HPV vaccine generates persistently positive antibody titers. No similar data is yet available for the nonavalent HPV vaccine, currently the only HPV vaccine available in the United States. The overall objective of our study is to assess the stability and kinetics of antibody titers for 24 months following a single dose of the nonavalent HPV vaccine among preteen girls and boys. Methods This is a prospective, single-arm, open-label, non-randomized, Phase IIa trial among 9–11 year-old girls and boys to determine the immunogenicity after a single dose of the nonavalent HPV vaccine (GARDASIL® 9) over 24 months, with a deferred booster dose at 24 months and an optional booster at 30 months after the first dose. Participants provide blood specimens at 6, 12, 18, 24, and 30 months after the first dose. Serologic geometric mean titers (GMT) of the nine vaccine types (HPV 16/18/ 6/11/31/33/45/52/58) will be measured at each time point. The primary objective is to determine the stability of type-specific serologic GMT of HPV16 and HPV18 between the 6- vs. 12-month, 12- vs. 18-month, and 18- vs. 24-month visits. Secondary objectives are to determine the stability of type-specific serologic GMT of the other HPV types (HPV 6/11/31/33/45/52/58) between the visits and to assess safety and reactogenicity after each vaccine dose. Discussion Single dose HPV vaccination could simplify the logistics and reduce costs of HPV vaccination in the US and across the world. This study will contribute important immunogenicity data on the stability and kinetics of type-specific antibody titers and inform feasibility of the single dose HPV vaccination paradigm. Trial registration ClinicalTrials.gov Identifier: NCT02568566. Registered on October 6, 2015. Electronic supplementary material The online version of this article (10.1186/s12885-019-5444-4) contains supplementary material, which is available to authorized users.
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- 2019
14. The association between oral disease and type of antiretroviral therapy among perinatally HIV-infected youth
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George R. Seage, Tzy-Jyun Yao, Jonathan S Russell, Mark I. Ryder, Anna-Barbara Moscicki, Caroline H. Shiboski, and Russell B. Van Dyke
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Male ,Cart ,medicine.medical_specialty ,Adolescent ,Cross-sectional study ,Immunology ,Bleeding on probing ,Integrase inhibitor ,HIV Infections ,Article ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Antiretroviral Therapy, Highly Active ,Internal medicine ,medicine ,Humans ,Immunology and Allergy ,030212 general & internal medicine ,Young adult ,Periodontal Diseases ,business.industry ,Stomatognathic Diseases ,030206 dentistry ,Viral Load ,medicine.disease ,CD4 Lymphocyte Count ,stomatognathic diseases ,Cross-Sectional Studies ,Infectious Diseases ,Anti-Retroviral Agents ,Female ,medicine.symptom ,business ,Viral load ,Cohort study - Abstract
Objectives This study explores the association between combination antiretroviral therapy (cART) and oral health outcomes (dental and periodontal) among perinatally HIV-infected (PHIV) youth. Methods We conducted a cross-sectional study of oral health among PHIV youth participating in the Oral Health substudy of the Pediatric HIV/AIDS Cohort Study (PHACS). Dentists at research sites were trained/calibrated on how to perform a standardized oral mucosal, dental and periodontal examination. They assessed the decayed-missing-filled-surfaces and teeth index (DMFS/T). The number of decayed surfaces and teeth and the number of teeth with gingival bleeding on probing for each participant were derived from the examination. Data for analysis included lifetime measurements of CD4 cell count and viral load, sociodemographic information and current/past history of ART. Results Among 209 PHIV youth, 95% were on ART at the time of enrolment. Among 143 PHIV youth on the same cART for at least 1 year, we found that the mean decayed teeth score of those receiving cART containing an integrase inhibitor was 86% higher than that of those on cART without an integrase inhibitor after adjusting for age, lifetime proportion of unsuppressed viral load and CD4 cell count nadir. Initiating protease inhibitors before age 6 years was associated with a significantly lower DMFT score than participants who initiated at age 6 years and older. Conclusion Our study revealed that PHIV youth who received cART containing an integrase inhibitor had a significantly higher number of untreated active caries than those on cART without an integrase inhibitor. This may warrant closer dental surveillance of those receiving an integrase inhibitor.
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- 2018
15. Toll-like receptors: Important immune checkpoints in the regression of cervical intra-epithelial neoplasia 2
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Mark E. Scott, Sepideh Farhat, Teresa M. Darragh, Anna-Barbara Moscicki, and Gordana Halec
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0301 basic medicine ,Oncology ,Cervical cancer ,Cancer Research ,medicine.medical_specialty ,Innate immune system ,business.industry ,virus diseases ,TLR9 ,medicine.disease ,female genital diseases and pregnancy complications ,Lesion ,03 medical and health sciences ,TLR2 ,030104 developmental biology ,0302 clinical medicine ,Immune system ,030220 oncology & carcinogenesis ,Internal medicine ,TLR3 ,medicine ,medicine.symptom ,Receptor ,business - Abstract
Toll-like receptors (TLRs) are innate immune defenders thought to be critical for the clearance of human papillomavirus (HPV) infections hence preventing the development of HPV-associated high-grade cervical intra-epithelial neoplasia (CIN2 or 3), a potential cervical cancer precursor. However, the role of TLRs in the regression of established cervical lesions, such as CIN2, is hindered by a lack of prospective design studies. Using SYBR green real-time PCR assays, we have examined the gene expression of TLR2, TLR3, TLR7, TLR8 and TLR9, in cytobrush collected endocervical cells of 63 women diagnosed with CIN2 at study entry (baseline) and followed over a 3-year period. Wilcoxon rank-sum test was used to examine the association between TLR expression levels, measured at baseline, and CIN2 outcome (regression vs. persistence/progression) over time. HPV genotyping was performed using Roche Linear Array Assay detecting 37 HPV types. Women with CIN2 regression showed significantly higher baseline levels of TLR2 (p = 0.006) and TLR7 (p = 0.007), as well as a non-significant trend for a higher TLR8 expression (p = 0.053) compared to women with CIN2 persistence/progression. Six women with CIN2 regression, who presented with an HR-HPV DNA-negative CIN2 lesion at study entry, had significantly higher baseline levels of TLR2 (p = 0.005), TLR7 (p = 0.013) and TLR8 (p = 0.012), compared to women with CIN2 persistence/progression, suggesting their role in clearance of HPV prior to clearance of the lesion. Our results confirm a key role of TLRs in regression of CIN2 and support the potential use of TLR-agonists for treatment of these lesions.
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- 2018
16. Should Cervical Cancer Screening be Performed Before the Age of 25 Years?
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Rebecca B. Perkins, Anna-Barbara Moscicki, Marion Saville, and Julia M.L. Brotherton
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Adult ,medicine.medical_specialty ,MEDLINE ,Uterine Cervical Neoplasms ,Cervical cancer screening ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Health care ,medicine ,Health insurance ,Humans ,030212 general & internal medicine ,Young adult ,Early Detection of Cancer ,Cervical cancer ,Intraepithelial neoplasia ,Forum ,business.industry ,Obstetrics ,Age Factors ,Obstetrics and Gynecology ,General Medicine ,medicine.disease ,United States ,Vaccination ,030220 oncology & carcinogenesis ,Female ,business ,Facilities and Services Utilization - Abstract
When should young women begin cervical cancer screening? Dr. Moscicki states that we should continue to initiate screening before the age of 25 years in the US. The reasons include a lower rate of HPV vaccination among the current generation of young adult women and increases in invasive cervical cancer cases in countries that have raised the screening age to 25 years. She further cites specific shortcomings of the US healthcare system that can contribute to underscreening among young women, including fragmented healthcare, lack of health insurance, and a rapidly declining rate of pelvic examinations for cervical cancer screening among this age group, despite current guidelines that continue to recommend screening. She posits that although cervical cancer is rare among women aged 21 to 24 years, promoting screening in this age group acts as a safety net to prevent cancers among women aged 25 to 29 years.
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- 2018
17. Novel modified Peyton's approach for knowledge retention on newborn life support training in medical students
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Erol Tutdibi, Anna-Barbara Hilleke, Gudrun Wagenpfeil, Nasenien Nourkami-Tutdibi, and Michael Zemlin
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medicine.medical_specialty ,Students, Medical ,undergraduate medical education ,Resuscitation ,Significant group ,instructional approach ,Intervention group ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,medicine ,Humans ,030212 general & internal medicine ,business.industry ,Infant, Newborn ,General Medicine ,Knowledge acquisition ,Knowledge retention ,clinical skills ,Life Support Care ,Life support ,Pediatrics, Perinatology and Child Health ,Physical therapy ,Clinical Competence ,Curriculum ,newborn life support ,Peyton ,business ,Neonatal resuscitation ,Clinical skills ,Education, Medical, Undergraduate - Abstract
Aim We sought to improve retention of neonatal resuscitation skills by modifying step 3 through additional functional verbalisation in Peyton's four-step approach (P4S). Methods Newborn life support (NLS) training was performed in a simulation-based setting. In contrast to the traditional approach, students taught with the modified approach were requested to explain every step of their performance in Peyton's step 3. A total of 123 students were allocated into both experimental groups. Students were then assessed by megacode on day four (initial assessment) and 6 months (follow-up assessment). Results Both groups showed similar scorings in the initial, follow-up assessment and in mean change. On initial megacode, time to start with initial inflation and post-resuscitation care was significantly faster in the control group. All showed a significant loss of performance irrespective of modification in step 3 in the follow-up assessment. Only time until start with post-resuscitation care shows a significant group difference in mean change between initial and follow-up with increasing time in the control and decreasing time span in intervention group. Conclusion Both methods showed equal levels of knowledge acquisition and long-term decline in NLS performances. Verbalisation in step 3 influenced speed of applied NLS performance.
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- 2021
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18. The Role of Behavioral and Neurocognitive Functioning in Substance Use Among Youth with Perinatally Acquired HIV Infection and Perinatal HIV Exposure Without Infection
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Kendall J. Bryant, Sean S Brummel, Anai Cuadra, Claude A. Mellins, Renee Smith, Katherine Tassiopoulos, Cheryl Anne Boyce, Kathleen Malee, Anna-Barbara Moscicki, and Sharon Nichols
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medicine.medical_specialty ,Social Psychology ,Adolescent ,Substance-Related Disorders ,Psychological intervention ,HIV Infections ,Neuropsychological Tests ,Article ,Cognition ,Pregnancy ,Medicine ,Humans ,Cognitive skill ,business.industry ,Proportional hazards model ,Public health ,Public Health, Environmental and Occupational Health ,Infectious Disease Transmission, Vertical ,Cognitive test ,Health psychology ,Infectious Diseases ,Female ,business ,Neurocognitive ,Clinical psychology - Abstract
This study examined associations of self-regulatory behavior and cognitive functioning with substance use (SU) to inform interventions for youth with perinatal HIV infection (YPHIV) or exposure but uninfected (YPHEU). Youth aged 7-15 years (YPHIV, n = 390; YPHEU, n = 211) were followed longitudinally with cognitive testing and behavioral questionnaires including self-report of alcohol, marijuana, tobacco, and other SU. Cox proportional hazards analyses were used to examine correlates of initiating each substance for those without prior use at baseline and generalized estimating equation analyses were used to address associations of cognitive/behavioral measurements with SU prevalence for the entire sample. Lower self-reported self-regulation skills, but higher cognitive functioning abilities, were associated with initiation and prevalent use of alcohol and marijuana regardless of HIV status. Our findings suggest SU screening tools and self-regulation interventions developed for general adolescent populations should be implemented for those with PHIV, who may be at heightened risk for SU-related health consequences.En este estudio se examina el vínculo del comportamiento autorregulado y la función cognoscitiva con el consumo de sustancias para argumentar intervenciones para los jóvenes con infección perinatal por el VIH (JIPVIH) y los jóvenes con exposición perinatal sin infección por el VIH (JEPSIVIH). Se hizo un seguimiento longitudinal de jóvenes de 7 a 15 años de edad (JIPVIH, n = 390; JEPSIVIH, n = 211) por medio de pruebas cognoscitivas y cuestionarios sobre el comportamiento, incluyendo el autoinforme de consumo de alcohol, marihuana, tabaco y otras sustancias. Se usaron los análisis Cox de riesgos proporcionales para examinar factores correlacionados con el inicio del consumo de cada sustancia por personas no consumidoras en el punto de referencia inicial. Asimismo, se usaron análisis de ecuaciones de estimación generalizadas para examinar la asociación entre la prevalencia del consumo de sustancias y las medidas cognoscitivas y las medidas conductuales para toda la muestra. Habilidades de autorregulación disminuidas, según autoinforme, pero capacidades superiores de función cognoscitiva, fueron vinculadas con el inicio y consumo frecuente de alcohol y marihuana, independientemente de la condición de VIH. Nuestros hallazgos sugieren que herramientas para detectar el consumo de sustancias e intervenciones de autorregulación creadas para la población general de adolescentes se deberían implementar para los JIPVIH que podrían correr mayores riesgos de sufrir consecuencias en la salud relacionadas con el consumo de sustancias.
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- 2021
19. Mining Engineer Competencies for an Innovative Economy
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Anna Barbara and Peter Tauš
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business.industry ,0211 other engineering and technologies ,Context (language use) ,02 engineering and technology ,010501 environmental sciences ,01 natural sciences ,Field (computer science) ,Maximum efficiency ,Competition (economics) ,Environmental sciences ,Mining engineering ,Work (electrical) ,Key (cryptography) ,GE1-350 ,021108 energy ,Human resources ,business ,Productivity ,0105 earth and related environmental sciences - Abstract
One of the features of modern mining is its focus on the development of human resources. The high level of labor productivity, as the main factor in the efficiency of mining enterprises in the context of heightened competition in the mineral resources market, brings to the fore the assessment of the state of human potential and its use with maximum efficiency. Consequently, the successful operations of a mining enterprise largely depend on how effectively its human potential is used. To achieve high results of work, a competently built personnel policy is required, one of the key tasks of which is the selection and placement of personnel. As practice shows, the shortage of qualified mining engineers and the growth of their cost in the labor market can become one of the key factors hindering the development of business in the field of mining.
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- 2021
20. Environmental Economic Security Management of a Coal Mining Enterprise
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Anna Barbara, Alexander Pimonov, Juraj Janocko, Yana Mikhailova, and V G Mikhailov
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Structure (mathematical logic) ,021110 strategic, defence & security studies ,Cost estimate ,Process (engineering) ,business.industry ,05 social sciences ,0211 other engineering and technologies ,Coal mining ,02 engineering and technology ,Environmental economics ,Environmental sciences ,Work (electrical) ,Order (exchange) ,0502 economics and business ,Economic security ,Key (cryptography) ,GE1-350 ,050207 economics ,business - Abstract
The structure of the mining environmental economic system, where the key role is played by a coal mining enterprise or a set of enterprises, combined, among other things, with a coal-processing infrastructure, is studied in the article. Known approaches to the definition and the features of assessing the regional environmental economic security of a coal mining enterprise are analyzed. The structure of environmental economic security management of an industrial enterprise operating in an industrialized region is considered and a method for achieving the required level of environmental economic security, expressed in the form of a cost estimate of this process, is proposed. The work performed is of practical importance for environmental surveillance of various levels and large industrial enterprises, especially those related to coal mining and processing, in order to predict the required level of environmental economic security.
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- 2021
21. Sources of Stress, Family Functioning, and Needs of Families With a Chronic Critically Ill Child: A Qualitative Study
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Chantal Grandjean, Pascale Ullmann, Mark Marston, Marie-Christine Maitre, Marie-Hélène Perez, Anne-Sylvie Ramelet, The OCToPuS Consortium, Anne-Laure Lauria, Angelo Polito, Nathalie Bochaton, Daniel Trachsel, Silvia Schnidrig, Tilman Humpl, Bjarte Rogdo, Ellen Wild, Thomas Neuhaus, Sandra Stalder, Barbara Brotschi, Franziska von Arx, Anna-Barbara Schlüer, Thomas Riedel, Pascale Van Kleef, University of Zurich, OCToPuS Consortium, Lauria, A.L., Polito, A., Bochaton, N., Trachsel, D., Schnidrig, S., Humpl, T., Rogdo, B., Wild, E., Neuhaus, T., Stalder, S., Brotschi, B., von Arx, F., Schlüer, A.B., Riedel, T., and Van Kleef, P.
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chronic critical illness (CCI) ,chronic disease ,family ,family functioning ,family needs ,family nursing ,family stress ,pediatric intensive care unit ,media_common.quotation_subject ,610 Medicine & health ,Affect (psychology) ,Pediatrics ,RJ1-570 ,German ,Intensive care ,Medicine ,Empowerment ,Original Research ,media_common ,Pediatric intensive care unit ,business.industry ,Critically ill ,language.human_language ,Family nursing ,10036 Medical Clinic ,Pediatrics, Perinatology and Child Health ,language ,business ,Clinical psychology ,Qualitative research - Abstract
PICU hospitalization is particularly stressful for families. When it is prolonged and the prognostic is uncertain, it can significantly and negatively affect the whole family. To date, little is known on how families with a chronic critically ill (CCI) child are affected. This national study explored the specific PICU-related sources of stress, family functioning and needs of families of CCI patients during a PICU hospitalization. This descriptive qualitative study was conducted in the eight pediatric intensive care units in Switzerland. Thirty-one families with a child meeting the CCI criteria participated in semi-structured interviews. Interviews, including mothers only (n = 12), fathers only (n = 8), or mother and father dyads (n = 11), were conducted in German, French, or English by two trained researchers/clinical nurses specialists. Interviews were recorded, transcribed verbatim, and analyzed using deductive and inductive content analyses. Five overarching themes emerged: (1) high emotional intensity, (2) PICU-related sources of stress, (3) evolving family needs, (4) multi-faceted family functioning, and (5) implemented coping strategies. Our study highlighted the importance of caring for families with CCI children. Parents reported high negative emotional responses that affect their family functioning. Families experience was highly dependent on how HCPs were able to meet the parental needs, provide emotional support, reinforce parental empowerment, and allow high quality of care coordination.
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- 2021
22. From Coverage Path Planning to parking lot exploration
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Anna Barbara Adam, Emese Gincsaine Szadeczky-Kardoss, and Laszlo Kocsany
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Computer science ,business.industry ,ComputingMilieux_LEGALASPECTSOFCOMPUTING ,Mobile robot ,Free space ,GeneralLiterature_MISCELLANEOUS ,Task (project management) ,Transport engineering ,Order (business) ,Path (graph theory) ,Parking lot ,Motion planning ,Internet of Things ,business - Abstract
Nowadays, it is getting really difficult to find an adequate free parking space, as there are more and more vehicles travelling on the roads. It is especially a difficult task to find a free parking place in huge parking garages and shopping malls, because the area of the parking zone is big, and there are a lot of cars searching for a free space. In some parking lots, a parking system is installed. These parking systems contain sensors at every parking space in order to perceive and indicate the occupancy of the given parking space. Using the signals of these systems, the vehicles can be navigated directly to the given parking space, for example using an IoT system. However, most of the parking lots are not equipped with these parking systems, so the driver must circumnavigate them, in order to be able to detect the free parking spaces. For an autonomous vehicle, a path should be planned, which drives along all the possible free parking spaces, so that the sensors of the vehicle could detect them. The parking lot exploration is very similar to the coverage path planning (CPP) problems. This paper presents CPP algorithm based parking lot exploration methods, in which personal preferences can be taken into account, too.
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- 2020
23. Characterization of γδ T cells in intestinal mucosa from patients with early onset or long standing inflammatory bowel disease and their correlation with clinical status
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Filippo Mocciaro, Elena Lo Presti, Anna Barbara Di Stefano, Francesco Dieli, Elettra Unti, Nunzia Scibetta, Roberto Di Mitri, G.M. Pecoraro, E. Conte, Giuseppe Cicero, Serena Meraviglia, Lo Presti, Elena, Di Mitri, Roberto, Mocciaro, Filippo, Di Stefano, Anna Barbara, Scibetta, Nunzia, Unti, Elettra, Cicero, Giuseppe, Pecoraro, Giulia, Conte, Elisabetta, Dieli, Francesco, and Meraviglia, Serena
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Adult ,Male ,0301 basic medicine ,Necrosis ,Adolescent ,Biopsy ,T-Lymphocytes ,Inflammatory bowel disease ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Intestinal mucosa ,inflammatory bowel disease ,medicine ,Humans ,gamma delta T cells ,Intestinal Mucosa ,Aged ,Aged, 80 and over ,Innate immune system ,business.industry ,Gastroenterology ,General Medicine ,Middle Aged ,Flow Cytometry ,Inflammatory Bowel Diseases ,medicine.disease ,Ulcerative colitis ,Phenotype ,030104 developmental biology ,Immunology ,Female ,Tumor necrosis factor alpha ,Interleukin 17 ,medicine.symptom ,business ,Biomarkers ,030215 immunology - Abstract
Background and Aims Inflammatory bowel disease [IBD] is a complex chronic inflammatory disease of the human gut with no clear aetiology. Traditionally, dysregulated adaptive immune responses play an important role even though accumulating evidence suggests a role also for innate immunity. Because of the well-known plasticity of γδ T cells, we investigated their percentage occurrence, phenotypic features and effector functions in the intestinal mucosa of early-onset and long-standing IBD patients, as compared to healthy subjects. Methods Fresh biopsies from 30 Crohn’s disease and ulcerative colitis patients were obtained and digested, and cells were analysed by flow cytometry. Results We found a reduced frequency of Vδ1 T cells in tissue from early and late IBD patients (2.24% and 1.95%, respectively, vs 5.44% in healthy tissue) but an increased frequency of Vδ2 T cells in the gut of late IBD patients (3.19% in late patients vs 1.5% in early patients and 1.65% in healthy tissue). The infiltrating Vδ2 T cells had predominant effector memory and terminally differentiated phenotypes and produced elevated levels of tumour necrosis factor-α [TNF-α] and interleukin-17 [IL-17]. The frequency of tissue Vδ2 T cells correlated with the extent of the inflammatory response and the severity of IBD. Conclusion Our study shows that tissue Vδ1 T cells are decreased in IBD patients while Vδ2 T cells are increased in the gut of IBD patients and contribute to TNF-α production. Moreover, we identify an as yet unappreciated role of Vδ2 T cells in IL-17 production in the gut of long-standing IBD patients, suggesting that they also participate in the chronic inflammatory process.
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- 2019
24. Immunomodulation in vascularized composite allotransplantation: What is the role for adipose-derived stem cells?
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Marco Pappalardo, Serena Meraviglia, Luigi Montesano, Francesco Moschella, Angelo A. Leto Barone, Anna Barbara Di Stefano, Francesco Dieli, Francesca Toia, Antonio Russo, Sara Di Lorenzo, Pappalardo Marco, Montesano Luigi, Toia Francesca, Russo Antonio, Di Lorenzo Sara, Dieli Francesco, Moschella Francesco, Leto Barone,Angelo A., Meraviglia Serena, and Di Stefano Anna Barbara
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Pathology ,medicine.medical_specialty ,medicine.medical_treatment ,Uterus ,Adipose tissue ,030230 surgery ,Vascularized Composite Allotransplantation ,Abdominal wall ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Animals ,Humans ,Immunologic Factors ,cell-based therapie ,adipose-derived stem cell ,business.industry ,Graft Survival ,face transplantation ,vascularized composite allotransplantation ,medicine.anatomical_structure ,Adipose Tissue ,030220 oncology & carcinogenesis ,Transplantation Tolerance ,Surgery ,business ,Hand transplantation ,Allotransplantation ,hand transplantation - Abstract
Hand and face transplants are becoming increasingly common, recording progressively more penile, uterus, abdominal wall, and allotransplantation cases reported worldwide. Despite current protocols allow long-term survival of the allografts, the ultimate goal of donor-specific tolerance has not been achieved yet. In fact, the harmful adverse effects related to the lifelong administration of immunosuppressive agents are the main drawbacks for vascularized composite allotransplantations. Research is very active in investigating alternative methods to induce greater tolerance while minimizing toxicity. Adipose-derived stem cells (ASCs) represent promising cell therapies for immunomodulation in preclinical and clinical settings. Their clinical appeal is due to their easy harvest in large quantities through a noninvasive and well-accepted approach; they may well promote donor-specific tolerance and potentially reduce immunosuppression. Several experimental studies exist, but lacking review articles reporting current evidence. This work proposes a literature review on the immunomodulatory role of ASCs in vascularized composite allotransplantations. In vitro and in vivo evidence will be summarized. The role that cell passaging and upstream progenitors - the so-called spheroid ASCs - may play in modulating the immune response will also be discussed. Finally, this article will summarize current knowledge on biodistribution, migration, and homing of injected stem cells. This review may well provide useful information for preclinical and clinical studies, aiming at a breakthrough for donor-specific tolerance.
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- 2019
25. The Vaginal Microbiota and Innate Immunity After Local Excisional Treatment for Cervical Intraepithelial Neoplasia
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Maria Paraskevaidi, David A. MacIntyre, Anna-Barbara Moscicki, Yun S. Lee, Phillip R. Bennett, Deirdre Lyons, Vishakha Mahajan, Anita Mitra, Julian Marchesi, Evangelos Paraskevaidis, Ann Smith, Maria Kyrgiou, and Imperial College Healthcare Charity
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medicine.medical_treatment ,ved/biology.organism_classification_rank.species ,Prevotella ,Uterine Cervical Neoplasms ,QH426-470 ,Gastroenterology ,Mucosal immunity ,Lactobacillus ,RNA, Ribosomal, 16S ,Genetics (clinical) ,Genetics & Heredity ,IFN-GAMMA ,biology ,Lactobacillus crispatus ,Microbiota ,WOMEN ,ASSOCIATION ,Cytokine ,BACTERIAL VAGINOSIS ,Vagina ,Disease Progression ,Medicine ,Molecular Medicine ,Female ,Vaginal microbiota ,Life Sciences & Biomedicine ,Antimicrobial Peptides ,medicine.medical_specialty ,Genotype ,LEUKOCYTE PROTEASE INHIBITOR ,LARGE LOOP EXCISION ,Cervical intraepithelial neoplasia ,Prevotella bivia ,Proinflammatory cytokine ,Immune system ,Internal medicine ,INCOMPLETE EXCISION ,Genetics ,medicine ,Humans ,TRANSFORMATION ZONE ,Molecular Biology ,ANTIMICROBIAL PEPTIDE ,0604 Genetics ,Science & Technology ,Innate immune system ,ved/biology ,business.industry ,Research ,Metataxonomics ,1103 Clinical Sciences ,HUMAN-PAPILLOMAVIRUS INFECTION ,medicine.disease ,biology.organism_classification ,Uterine Cervical Dysplasia ,Immunity, Innate ,business - Abstract
Background Vaginal microbiota (VMB) composition is altered in women with cervical intra-epithelial neoplasia (CIN) compared to healthy controls and is associated with disease progression. However, the impact of CIN excision on the VMB and innate immunity is not known. This observational study aims to explore the impact of CIN excision on the VMB, antimicrobial peptides (AMP) and proinflammatory cytokines. Methods We sampled 103 non-pregnant, premenopausal women at the time of excisional treatment for CIN and at their 6-month follow-up visit. A further 39 untreated controls with normal cytology were also sampled. We used metataxonomics to group vaginal swab samples into community state types (CSTs) and ELISA to quantify cytokine and AMP levels in matched vaginal secretions. Analyses were performed to compare the bacterial composition and immune analyte levels before and after CIN excision and in healthy controls. Results Women with CIN had significantly higher rates of Lactobacillus species depletion pre-treatment compared to healthy controls (CST IV 21/103, 20% vs 1/39, 3%, p = 0.0081). Excision did not change the VMB composition, with CST IV remaining significantly more prevalent after excision compared to untreated, healthy controls (CST IV 19/103, 20% vs 1/39, 3%, p = 0.0142). Prevotella bivia and Sneathia amnii were significantly higher in samples before treatment compared to untreated controls, and Prevotella bivia remained significantly higher amongst the treated, with less Lactobacillus crispatus compared to untreated controls. IL-1β and IL-8 remained significantly elevated pre- (p < 0.0001 and p = 0.0014, respectively) and post-treatment (p < 0.0001 and p = 0.0035, respectively) compared to untreated controls. Levels of human beta-defensin-1 and secretory leukocyte protease inhibitor were both significantly reduced following CIN excision (p < 0.0001); however, their levels remained lower than controls post-treatment. Conclusions Women with CIN have an increased prevalence of Lactobacillus sp. depletion, high-diversity VMB composition, and higher levels of proinflammatory cytokines and AMPs compared to normal controls. Surgical excision of the disease reduces levels of vaginal AMPs but does not alter VMB composition or cytokine levels. These findings suggest that women with CIN have an inherent predisposition to a high-diversity proinflammatory environment that is not corrected by disease excision. The failure to re-establish a Lactobacillus-enriched CST may explain why women remain at high risk of pre-invasive and invasive disease recurrence.
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- 2020
26. Cervical-Vaginal Microbiome and Associated Cytokine Profiles in a Prospective Study of HPV 16 Acquisition, Persistence, and Clearance
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Baochen Shi, Anna-Barbara Moscicki, Hazel Huang, Emma Barnard, and Huiying Li
- Subjects
0301 basic medicine ,Microbiology (medical) ,medicine.medical_treatment ,030106 microbiology ,Immunology ,lcsh:QR1-502 ,microbiome ,Inflammation ,Cervix Uteri ,medicine.disease_cause ,Microbiology ,lcsh:Microbiology ,Proinflammatory cytokine ,03 medical and health sciences ,Immune system ,Cellular and Infection Microbiology ,cervix ,medicine ,Gardnerella vaginalis ,Humans ,Microbiome ,Prospective Studies ,human papillomavirus ,Cervix ,Original Research ,Human papillomavirus 16 ,business.industry ,Microbiota ,HPV infection ,virus diseases ,medicine.disease ,female genital diseases and pregnancy complications ,cytokines ,030104 developmental biology ,Infectious Diseases ,medicine.anatomical_structure ,Cytokine ,inflammation ,Female ,medicine.symptom ,business - Abstract
Persistent human papillomavirus (HPV) infections is necessary for the development of cervical cancers. Consequently, understanding the biologic mechanisms resulting in clearance is key in cancer prevention. Similar to other mucosal sites, it is expected that the local microbiome plays a significant role in shaping the immune response responsible for HPV clearance. Using cervical wash repository samples from a prospective study of HPV in women, this study investigates the microbiome and its associated inflammatory milieu during HPV 16 pre-acquisition, persistence and clearance states. For comparison, samples from women with no history of HPV ever during the study period were selected. We showed that 9 of 13 inflammatory cytokines were found to be significantly increased in the immediate post-clearance visit compared to the pre-acquisition or infection visits. Gardnerella vaginalis was associated with higher levels of inflammatory cytokines. Women with no history of HPV infection had similar cytokine profiles as those with HPV 16 post-clearance. This in vivo study documented an immune response shortly after HPV 16 clearance. G. vaginalis appeared to be involved in shaping this immune response. The appearance of G. vaginalis may have resulted from a shift from anti-microbial to anti-viral immune response with loss of bacterial control. The similar high levels of cytokines seen in women with no history of HPV suggest that a certain level of inflammatory surveillance is required to maintain an HPV negative state. This data may inform therapies such as probiotics or pro-inflammatory agents for treatment of persistent HPV.
- Published
- 2020
27. Determining Whether a Mobile App and Website Improve Appropriate Pap Test Screening for Cervical Cancer
- Author
-
Sandy K. Navarro, Sitaram Vangala, Dick Guido, Miriam Kuppermann, Anna-Barbara Moscicki, Xinkai Zhou, Heike Thiel de Bocanegra, George F. Sawaya, Christine Dehlendorf, Ysabel Duron, Fred L. Wyand, Charlene Chang, and David Elashoff
- Subjects
Oncology ,Cervical cancer ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Internal medicine ,Mobile apps ,Medicine ,Pap test ,business ,medicine.disease - Published
- 2020
28. COVID-19 bei Neugeborenen, Kindern und Jugendlichen: Fakten, Zahlen und Risiken
- Author
-
Anna-Barbara Schlüer
- Subjects
Risk ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Adolescent ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pneumonia, Viral ,Betacoronavirus ,Pandemic ,Medicine ,Humans ,Child ,Pandemics ,General Nursing ,biology ,business.industry ,SARS-CoV-2 ,Infant, Newborn ,COVID-19 ,Infant ,General Medicine ,biology.organism_classification ,Infant newborn ,Virology ,Child, Preschool ,business ,Coronavirus Infections - Published
- 2020
29. The vaginal microbiota associates with the regression of untreated cervical intraepithelial neoplasia 2 lesions
- Author
-
David A. MacIntyre, Anna-Barbara Moscicki, Maria Kyrgiou, Phillip R. Bennett, Konstantinos K. Tsilidis, Ann Smith, George Ntritsos, Anita Mitra, Julian R. Marchesi, Imperial College Healthcare Charity, and Medical Research Council (MRC)
- Subjects
0301 basic medicine ,Prevotella ,Physiology ,Uterine Cervical Neoplasms ,General Physics and Astronomy ,Cervix Uteri ,medicine.disease_cause ,Cancer prevention ,Cohort Studies ,0302 clinical medicine ,Risk Factors ,RNA, Ribosomal, 16S ,ADOLESCENTS ,Medicine ,Gardnerella vaginalis ,Papillomaviridae ,lcsh:Science ,RISK ,Multidisciplinary ,biology ,Microbiota ,WOMEN ,CANCER ,female genital diseases and pregnancy complications ,Multidisciplinary Sciences ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,BACTERIAL VAGINOSIS ,Vagina ,Biomarker (medicine) ,Science & Technology - Other Topics ,Female ,Bacterial vaginosis ,Adult ,DNA, Bacterial ,Adolescent ,Science ,Genetics and Molecular Biology ,Cervical intraepithelial neoplasia ,General Biochemistry, Genetics and Molecular Biology ,Article ,03 medical and health sciences ,Young Adult ,Humans ,Microbiome ,Cervical Intraepithelial Neoplasia ,METAANALYSIS ,Neoplasm Staging ,Science & Technology ,SEQUENCES ,business.industry ,HUMAN-PAPILLOMAVIRUS ,Papillomavirus Infections ,General Chemistry ,biology.organism_classification ,medicine.disease ,Uterine Cervical Dysplasia ,TRANSFORMATION ,Lactobacillus ,030104 developmental biology ,CELLS ,General Biochemistry ,Cervical cancer ,lcsh:Q ,business ,Follow-Up Studies - Abstract
Emerging evidence suggests associations between the vaginal microbiota (VMB) composition, human papillomavirus (HPV) infection, and cervical intraepithelial neoplasia (CIN); however, causal inference remains uncertain. Here, we use bacterial DNA sequencing from serially collected vaginal samples from a cohort of 87 adolescent and young women aged 16–26 years with histologically confirmed, untreated CIN2 lesions to determine whether VMB composition affects rates of regression over 24 months. We show that women with a Lactobacillus-dominant microbiome at baseline are more likely to have regressive disease at 12 months. Lactobacillus spp. depletion and presence of specific anaerobic taxa including Megasphaera, Prevotella timonensis and Gardnerella vaginalis are associated with CIN2 persistence and slower regression. These findings suggest that VMB composition may be a future useful biomarker in predicting disease outcome and tailoring surveillance, whilst it may offer rational targets for the development of new prevention and treatment strategies., Persistent infection with human papillomavirus can lead to cervical intraepithelial neoplasia (CIN). Here, the authors profile the vaginal microbiota in a cohort of non-pregnant young women diagnosed with CIN2 and find that absence of Lactobacillusspp. and presence of a diverse population of strict anaerobes associates with a decreased regression of untreated CIN2 lesions.
- Published
- 2020
30. IPVS statement on 'Temporary HPV vaccine shortage: Implications globally to achieve equity'
- Author
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Julia M.L. Brotherton, Andreas M. Kaufmann, Margaret Stanley, Yin Ling Woo, Anna R Giuliano, Anna-Barbara Moscicki, Neerja Bhatla, Karen Chan, Joel M. Palefsky, and Suzanne M. Garland
- Subjects
Actuarial science ,Equity (economics) ,Health Equity ,business.industry ,Papillomavirus Infections ,MEDLINE ,Uterine Cervical Neoplasms ,Global Health ,World Health Organization ,Article ,lcsh:Infectious and parasitic diseases ,Infectious Diseases ,Virology ,Global health ,Vaccine shortage ,Medicine ,Humans ,lcsh:RC109-216 ,Female ,Papillomavirus Vaccines ,Disease Eradication ,business - Published
- 2020
31. Current trends and new developments in HIV research and periodontal diseases
- Author
-
Tzy-Jyun Yao, Anna-Barbara Moscicki, Caroline H. Shiboski, and Mark I. Ryder
- Subjects
0301 basic medicine ,Adult ,Chronic condition ,medicine.medical_specialty ,Aging ,Pediatric AIDS ,Osteoporosis ,Clinical Trials and Supportive Activities ,HIV Infections ,Disease ,Article ,Oral and gastrointestinal ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,Clinical Research ,mental disorders ,Epidemiology ,medicine ,Dementia ,Humans ,2.1 Biological and endogenous factors ,Microbiome ,Dental/Oral and Craniofacial Disease ,Aetiology ,Intensive care medicine ,Child ,Periodontal Diseases ,Pediatric ,business.industry ,Incidence (epidemiology) ,virus diseases ,Evaluation of treatments and therapeutic interventions ,030206 dentistry ,medicine.disease ,030104 developmental biology ,Infectious Diseases ,Good Health and Well Being ,6.1 Pharmaceuticals ,Dentistry ,Chronic Disease ,Disease Progression ,Periodontics ,HIV/AIDS ,business ,Infection - Abstract
With the advent of combined antiretroviral therapies, the face of HIV infection has changed dramatically from a disease with almost certain mortality from serious comorbidities, to a manageable chronic condition with an extended lifespan. In this paper we present the more recent investigations into the epidemiology, microbiology, and pathogenesis of periodontal diseases in patients with HIV, and the effects of combined antiretroviral therapies on the incidence and progression of these diseases both in adults and perinatally infected children. In addition, comparisons and potential interactions between the HIV-associated microbiome, host responses, and pathogenesis in the oral cavity with the gastrointestinal tract and other areas of the body are presented. Also, the effects of HIV and combined antiretroviral therapies on comorbidities such as hyposalivation, dementia, and osteoporosis on periodontal disease progression are discussed.
- Published
- 2020
32. Salivary metabolite levels in perinatally HIV-infected youth with periodontal disease
- Author
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George R. Seage, Tzy-Jyun Yao, Markus Hardt, Oliver D. King, Fabian Schulte, Bruce J. Paster, Anna-Barbara Moscicki, Russell B. Van Dyke, Caroline H. Shiboski, and Mark I. Ryder
- Subjects
Male ,Adolescent ,Endocrinology, Diabetes and Metabolism ,Metabolite ,Clinical Biochemistry ,Context (language use) ,HIV Infections ,Oral Health ,01 natural sciences ,Biochemistry ,Article ,Cohort Studies ,03 medical and health sciences ,chemistry.chemical_compound ,Young Adult ,Acquired immunodeficiency syndrome (AIDS) ,Periodontal disease ,Tandem Mass Spectrometry ,medicine ,Metabolome ,Humans ,Metabolomics ,Child ,Saliva ,Periodontal Diseases ,030304 developmental biology ,Periodontitis ,0303 health sciences ,Bacteria ,business.industry ,010401 analytical chemistry ,medicine.disease ,Molecular medicine ,0104 chemical sciences ,Cross-Sectional Studies ,chemistry ,Immunology ,Female ,business ,Cohort study ,Chromatography, Liquid - Abstract
INTRODUCTION. Salivary metabolite profiles are altered in adults with HIV compared to their uninfected counterparts. Less is known about youth with HIV and how oral disorders that commonly accompany HIV infection impact salivary metabolite levels. OBJECTIVE: As part of the Adolescent Master Protocol multi-site cohort study of the Pediatric HIV/AIDS Cohort Study (PHACS) network we compared the salivary metabolome of youth with perinatally-acquired HIV (PHIV) and youth HIV-exposed, but uninfected (PHEU) and determined whether metabolites differ in PHIV vs. PHEU. METHODS: We used three complementary targeted and discovery-based liquid chromatography-tandem mass spectrometry (LC-MS/MS) workflows to characterize salivary metabolite levels in 20 PHIV and 20 PHEU youth with and without moderate periodontitis. We examined main effects associated with PHIV and periodontal disease, and the interaction between them. RESULTS: We did not identify differences in salivary metabolite profiles that remained significant under stringent control for both multiple between-group comparisons and multiple metabolites. Levels of cadaverine, a known periodontitis-associated metabolite, were more abundant in individuals with periodontal disease with the difference being more pronounced in PHEU than PHIV. In the discovery-based dataset, we identified a total of 564 endogenous peptides in the metabolite extracts, showing that proteolytic processing and amino acid metabolism are important to consider in the context of HIV infection. CONCLUSION. The salivary metabolite profiles of PHIV and PHEU youth were overall very similar. Individuals with periodontitis particularly among the PHEU youth had higher levels of cadaverine, suggesting that HIV infection, or its treatment, may influence the metabolism of oral bacteria.
- Published
- 2020
33. The Natural History of Human Papillomavirus Infection in Relation to Cervical Cancer
- Author
-
Anna-Barbara Moscicki, Mark Schiffman, and Silva Franceschi
- Subjects
Oncology ,Cervical cancer ,medicine.medical_specialty ,Chlamydia ,business.industry ,virus diseases ,medicine.disease ,Cervical intraepithelial neoplasia ,female genital diseases and pregnancy complications ,Hpv persistence ,Natural history ,Contraceptive use ,High risk hpv ,Internal medicine ,medicine ,Human papillomavirus ,business - Abstract
Over the last two decades studies of the natural history of human papillomavirus (HPV) have elucidated the transient nature of most HPV infections and underscored the importance of HPV persistence in the development of invasive cancers associated with HPV. Studies also demonstrated the benign nature of cervical intraepithelial neoplasia (CIN 1) and the importance of CIN 3 as the critical precancerous lesion requiring detection and treatment in order to prevent progression to invasive cancers. Cofactors associated with cervical cancer include smoking cigarettes, prolonged oral contraceptive use, chlamydia infections, and multiparity. However, these contributions of these cofactors remain miniscule compared to the role of high risk HPV persistence.
- Published
- 2020
34. Storytelling als innovative Methode zur videobasierten Edukation für Eltern von Kindern mit atopischer Dermatitis
- Author
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Anna-Barbara Schlüer, Corinne Brunner, Martin Theiler, Lisa Weibel, University of Zurich, and Brunner, Corinne
- Subjects
Parents ,Sleep Wake Disorders ,medicine.medical_specialty ,Video Recording ,610 Medicine & health ,Dermatitis, Atopic ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Patient Education as Topic ,medicine ,Humans ,030212 general & internal medicine ,10220 Clinic for Surgery ,Child ,2900 General Nursing ,Video based ,General Nursing ,business.industry ,Infant, Newborn ,Infant ,General Medicine ,Atopic dermatitis ,medicine.disease ,Dermatology ,Child, Preschool ,Chronic Disease ,Quality of Life ,business - Abstract
Zusammenfassung. Hintergrund: Die atopische Dermatitis (AD) ist eine chronische, rezidivierende Hauterkrankung. Jedes fünfte bis sechste Kind ist in der westlichen Zivilisation davon betroffen. Die Folgen der Erkrankung können gravierend sein: Chronische Entzündung der Haut und plagender Juckreiz verbunden mit Schlafstörungen. Für den Erfolg der Therapie ist die Edukation der Eltern von betroffenen Kindern zentral. Ziel: Entwicklung und Evaluation von evidenzbasierten Edukationsvideos für Eltern von einem Kleinkind mit AD. Methode: In den Videos wurde die Methode Storytelling eingesetzt. Ziel von Storytelling ist, Informationen durch den Einsatz von Geschichten einfach zu vermitteln. Anschließend an die Entwicklung wurden die Videos hinsichtlich der Verständlichkeit, der Wichtigkeit sowie der Nützlichkeit der Inhalte von einem multi-professionellem Team sowie von Familien mit betroffenen Kindern evaluiert. Ergebnisse: Es entstanden insgesamt sechs Videos, welche Themen wie Ursachen der AD, Symptome, Hautpflege, Behandlung sowie Leben mit AD beinhalteten. Storytelling wurde umgesetzt indem zwei Familien mit betroffenen Kindern von ihren Erfahrungen mit der Erkrankung erzählten. Fachinformationen wurden durch Spezialistinnen vermittelt. Die Evaluation ergab, dass die Informationen in den Videos einfach verständlich und relevant sind. Schlussfolgerungen: Mit evidenzbasierten Videos kann die Edukation auf innovative, kreative und moderne Art und Weise gefördert werden. Storytelling ist eine nutzerfreundliche Methode um komplexe Informationen einfach und verständlich zu vermitteln.
- Published
- 2020
35. Towards sustainable mining in the didactic process - MEITIM project as an opportunity to increase the attractiveness of mining courses (case study of Poland)
- Author
-
Anna Barbara Gogolewska, Danuta Szyszka, Justyna Górniak-Zimroz, Justyna Woźniak, Joanna Krupa-Kurzynowska, Gabriela Paszkowska, Arturo Hidalgo, Ritva Tuunila, Juan Herrera Herbert, Maria A. Mamelkina, Barbara Kiełczawa, Karolina Adach-Pawelus, Matti Lampinen, and Magdalena Worsa-Kozak
- Subjects
Entrepreneurship ,Knowledge management ,Higher education ,Process (engineering) ,020209 energy ,media_common.quotation_subject ,Educación ,Geography, Planning and Development ,TJ807-830 ,02 engineering and technology ,010501 environmental sciences ,Management, Monitoring, Policy and Law ,mining ,TD194-195 ,01 natural sciences ,Renewable energy sources ,Field (computer science) ,statistics of mining faculties ,0202 electrical engineering, electronic engineering, information engineering ,Technology integration ,GE1-350 ,European Green Deal ,Curriculum ,0105 earth and related environmental sciences ,media_common ,Sustainable development ,Environmental effects of industries and plants ,Renewable Energy, Sustainability and the Environment ,business.industry ,Environmental sciences ,higher education ,raw materials ,Minería ,business ,Reputation - Abstract
Mining has been embedded in the public consciousness as a dirty, non-innovative, outdated and environmentally harmful industry. Proper education, especially the academic one, becomes crucial to successfully change this image. This article depicts the initial assumptions of the international project Master in Entrepreneurship, Innovation and Technology Integration in Mining (MEITIM), co-financed by EIT Raw Materials, that aims to diagnose the current state of Polish higher education in the field of mining at, among others, the Wroclaw University of Science and Technology (WUST), concerning the experience of the Technical University of Madrid (UPM) and Lappeenranta University of Technology (LUT). The MEITIM project allowed identifying the directions of necessary changes in the didactic process as an indispensable set of skills and knowledge for a future mining graduate. Such activities are dictated by many guidelines and arrangements, among others, at the level of the European Commission or key industry institutions such as the International Council on Mining and Metals. These are key competencies that require significant changes in university curricula supporting sustainable development goals in innovative mining. The authors show that there is a link between the condition of the mining industry in Poland, its reputation, and the number of people who want to study mining.
- Published
- 2020
36. Weight Loss and Illness Severity in Adolescents With Atypical Anorexia Nervosa
- Author
-
Jing Cheng, Sara M. Buckelew, Erin C. Accurso, Sally H. Adams, Neville H. Golden, Allyson F. Sy, Daniel Le Grange, Leslie Wilson, Andrea K. Garber, Vanessa I. Machen, Kristina Saffran, Anna Kreiter, Anna-Barbara Moscicki, and Cynthia J. Kapphahn
- Subjects
Male ,medicine.medical_specialty ,Anorexia Nervosa ,Adolescent ,Eating Disorders ,Anorexia nervosa ,Severity of Illness Index ,Medical and Health Sciences ,Pediatrics ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Thinness ,Clinical Research ,Weight loss ,030225 pediatrics ,Internal medicine ,Severity of illness ,Heart rate ,Weight Loss ,medicine ,Humans ,Young adult ,Child ,Nutrition ,business.industry ,Body Weight ,Psychology and Cognitive Sciences ,Articles ,Stepwise regression ,medicine.disease ,Confidence interval ,Anorexia ,Mental Health ,Pediatrics, Perinatology and Child Health ,Zero Hunger ,Amenorrhea ,Female ,medicine.symptom ,business - Abstract
BACKGROUND: Lower weight has historically been equated with more severe illness in anorexia nervosa (AN). Reliance on admission weight to guide clinical concern is challenged by the rise in patients with atypical anorexia nervosa (AAN) requiring hospitalization at normal weight. METHODS: We examined weight history and illness severity in 12- to 24-year-olds with AN (n = 66) and AAN (n = 50) in a randomized clinical trial, the Study of Refeeding to Optimize Inpatient Gains (www.clinicaltrials.gov; NCT02488109). Amount of weight loss was the difference between the highest historical percentage median BMI and admission; rate was the amount divided by duration (months). Unpaired t tests compared AAN and AN; multiple variable regressions examined associations between weight history variables and markers of illness severity at admission. Stepwise regression examined the explanatory value of weight and menstrual history on selected markers. RESULTS: Participants were 16.5 ± 2.6 years old, and 91% were of female sex. Groups did not differ by weight history or admission heart rate (HR). Eating Disorder Examination Questionnaire global scores were higher in AAN (mean 3.80 [SD 1.66] vs mean 3.00 [SD 1.66]; P = .02). Independent of admission weight, lower HR (β = −0.492 [confidence interval (CI) −0.883 to −0.100]; P = .01) was associated with faster loss; lower serum phosphorus was associated with a greater amount (β = −0.005 [CI −0.010 to 0.000]; P = .04) and longer duration (β = −0.011 [CI −0.017 to 0.005]; P = .001). Weight and menstrual history explained 28% of the variance in HR and 36% of the variance in serum phosphorus. CONCLUSIONS: Weight history was independently associated with markers of malnutrition in inpatients with restrictive eating disorders across a range of body weights and should be considered when assessing illness severity on hospital admission.
- Published
- 2019
37. Agricultural tax as a source of income for rural communes
- Author
-
Aneta Zakrzewska and Anna Barbara Kobiałka
- Subjects
agricultural tax ,rural communes ,Ecology ,Agriculture ,business.industry ,Agriculture (General) ,Automotive Engineering ,own income ,Business ,Agricultural economics ,QH540-549.5 ,S1-972 - Abstract
The revenues from the agricultural tax only to a small extent contribute to the budgets of communes, and they often constitute the basic source of tax revenues in rural communes. This is the main reason for the worse income situation of rural communes in Poland. Rural communes in Poland are the least independent units and such situation requires the search for effective sources of income for local government units. For many years, there has also been a discussion on the possibility of real taxation of income from agricultural activities. Considering the above, the purpose of this study was to analyze the income equipment of rural communes in the field of agricultural tax in 2011–2017. The analysis of the income structure confirms that in rural communes, the share of agricultural tax in total income is twice as high as the average in Polish communes. However, this is not a factor that makes it possible to increase the financial independence of rural communes.
- Published
- 2019
38. 'Allein mit dem Tabu' – Wie Frauen mit vulvären Neoplasien die Unterstützung durch ihr soziales Umfeld beschreiben – Eine qualitative Studie
- Author
-
Rebecca Spirig, Beate Senn, and Anna Barbara Rüegsegger
- Subjects
Vulvar neoplasm ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,business.industry ,Sick role ,media_common.quotation_subject ,Taboo ,General Medicine ,03 medical and health sciences ,Social support ,0302 clinical medicine ,Quality of life (healthcare) ,030220 oncology & carcinogenesis ,Family medicine ,Medicine ,business ,General Nursing ,media_common ,Qualitative research - Abstract
Zusammenfassung. Hintergrund: Vulväre Neoplasien sind gynäkologische Erkrankungen mit zum Teil einschneidenden Folgen für die Betroffenen. Neben physischen Komplikationen leiden die Frauen häufig unter psychischen Problemen. Die mit Scham besetzte Krankheit führt zu einer Verminderung der Lebensqualität und beeinträchtigt das Sozialleben. Es ist wenig bekannt darüber, was diese Frauen an sozialer Unterstützung erhalten. Ziel: Das Ziel dieser qualitativen Studie war, zu beschreiben, wie betroffene Frauen die Unterstützung durch das soziale Umfeld in der Zeit von der Diagnose bis sechs Monate postoperativ erleben bzw. vermissen. Methode: In der vorliegenden Sekundäranalyse wurde ein qualitatives Design gewählt. Es wurden 20 transkribierte Interviews aus der WOMAN-PRO-Studie mittels qualitativer Inhaltsanalyse nach Mayring ausgewertet. Ergebnisse: Die Analyse ergab vier Hauptkategorien: Eine schlimme Krankheit haben zeigt, wie die Frauen die Diagnose als Schock erlebten, mit welchen Tabuthemen sowie Schuldfragen sie sich auseinandersetzen mussten. Stark ausgeprägt war die Kategorie Sich allein fühlen, bedingt durch Nicht-Sprechen, Nicht-Hinschauen und Nicht-Handeln. In Selber anpacken wird beschrieben, welche Strategien den Frauen halfen, aus dem Alleinsein herauszufinden. In Hilfe erfahren wird deutlich, dass diejenigen Frauen, die von sich aus mit dem sozialen Umfeld in Kontakt traten, in der Regel soziale Unterstützung erhielten. Schlussfolgerungen: Diese Patientinnen haben einen hohen Bedarf an umfassenden Informationen sowie an emotionaler und praktischer Unterstützung durch das private Umfeld und besonders auch durch die Gesundheitsfachleute. Eine definierte Bezugs- und Vertrauensperson während des ganzen Behandlungsprozesses ist zu empfehlen.
- Published
- 2018
39. Risk of human papillomavirus infection in women with rheumatic disease: cervical cancer screening and prevention
- Author
-
Seoyoung C. Kim, Anna-Barbara Moscicki, and Sarah Feldman
- Subjects
medicine.medical_specialty ,Population ,Human Papilloma Virus Vaccine ,Uterine Cervical Neoplasms ,Reviews ,Immunocompromised Host ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Risk Factors ,Rheumatic Diseases ,Internal medicine ,medicine ,Humans ,Mass Screening ,Pharmacology (medical) ,Papillomavirus Vaccines ,030212 general & internal medicine ,Pap test ,Papillomaviridae ,education ,Contraindication ,Early Detection of Cancer ,030203 arthritis & rheumatology ,Cervical cancer ,education.field_of_study ,biology ,medicine.diagnostic_test ,business.industry ,Papillomavirus Infections ,HPV infection ,virus diseases ,medicine.disease ,biology.organism_classification ,female genital diseases and pregnancy complications ,Vaccination ,Female ,business - Abstract
Human Papillomavirus (HPV) is the most common sexually transmitted infection in the USA, with over 14 million people acquiring HPV each year. HPV is also the cause of most anogenital cancers. About 90% of HPV infections spontaneously resolve over 3 years. However, about 10% remain as persistent infection defined as repeatedly detected in cervical samples. As HPV is controlled by local and systemic immune responses, individuals with immunosuppression are at risk for cervical cancer. It is hypothesized that immunosuppressed individuals are more likely to have HPV persistence, which is necessary for malignant transformation. Accordingly, women with rheumatic diseases such as SLE and RA are likely vulnerable to HPV infection and the progression of cervical disease. The HPV vaccine, given as a series of vaccinations, is safe and effective that can prevent HPV infection and cervical cancer. There is no contraindication to HPV vaccination for women to age 26 with rheumatic disease, as it is not live. As in the general population, timing is key for the efficacy of the HPV vaccine as the goal is to vaccinate prior to sexual debut and exposure to HPV. There are no formal recommendations for cervical cancer screening in women with rheumatic disease but recommendations for the HIV-positive population can be adopted, meaning to screen with a Pap test annually for three consecutive years and if all normal, to extend the interval to every 3 years with the option of co-testing with HPV at 30 years and older.
- Published
- 2018
40. Hand Hygiene Evaluation Using Two Different Evaluation Tools and Hand Contamination of Veterinary Healthcare Workers in a Swiss Companion Animal Clinic
- Author
-
Anna Barbara Emilia Zimmermann, Barbara Willi, Kira Schmitt, Roger Stephan, University of Zurich, and Willi, Barbara
- Subjects
medicine.medical_specialty ,10253 Department of Small Animals ,antibiotic resistance ,3400 General Veterinary ,Veterinary medicine ,media_common.quotation_subject ,Companion animal ,610 Medicine & health ,Article ,hygiene ,Hygiene ,Internal medicine ,hand ,infection prevention control ,hospital ,SF600-1100 ,Health care ,Medicine ,10082 Institute of Food Safety and Hygiene ,media_common ,General Veterinary ,business.industry ,Patient contact ,Confidence interval ,570 Life sciences ,biology ,business - Abstract
Hand hygiene (HH) is the most important measure to prevent nosocomial infections. HH compliance in companion animal clinics has been reported to be poor. The present study compared an online application with the WHO evaluation form to assess the WHO five moments of HH in a Swiss companion animal clinic. In 202 hand swabs from 87 staff members, total viable count (TVC) before and after patient contact was evaluated and the swabs were tested for selected antimicrobial resistant microorganisms of public health importance. HH compliance (95% confidence interval) was 36.6% (33.8–39.5%) and was similar when assessed with the two evaluation tools. HH differed between hospital areas (p = 0.0035) and HH indications (p < 0.0001). Gloves were worn in 22.0% (18.0–26.6%) of HH observations and were indicated in 37.2% (27.3–48.3%) of these observations. Mean TVC before patient contact was lower (0.52 log CFU/cm2) than after patient contact (1.02 log CFU/cm2) but was similar before patient contact on gloved and ungloved hands. Three hand swabs (1.5% (0.4–4.3%)) were positive for methicillin-resistant Staphylococcus aureus. Gloving should not be regarded as a substitute for HH. Overall, HH in companion animal medicine should urgently be fostered.
- Published
- 2021
41. Evidence-Based Consensus Recommendations for Colposcopy Practice for Cervical Cancer Prevention in the United States
- Author
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Mark Schiffman, Cara Mathews, Martha M. Mitchell, Warner K. Huh, Rebecca B. Perkins, Christine Conageski, Kim Choma, Michelle J. Khan, Elizabeth A. Stier, Mark H. Einstein, Theognosia Papasozomenos, Angela Liu, Edward J. Mayeaux, Richard S. Guido, Michael A. Gold, Akiva P. Novetsky, Barbara S. Apgar, Alan G. Waxman, Michelle I. Silver, Candice A. Tedeschi, Nicolas Wentzensen, Claudia L. Werner, Anna-Barbara Moscicki, L. Stewart Massad, Francisco A.R. Garcia, Julia C. Gage, Jose Jeronimo, David Chelmow, Teresa M. Darragh, and Katie M. Smith
- Subjects
medicine.medical_specialty ,Evidence-based practice ,cervical cancer ,Clinical Sciences ,MEDLINE ,Uterine Cervical Neoplasms ,Cervical cancer screening ,evidence based ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,biopsy ,Obstetrics & Reproductive Medicine ,Early Detection of Cancer ,Colposcopy ,Cervical cancer ,Cervical pathology ,Gynecology ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,business.industry ,screening ,colposcopy ,Obstetrics and Gynecology ,General Medicine ,medicine.disease ,United States ,030220 oncology & carcinogenesis ,Family medicine ,recommendations ,Cervical cancer prevention ,Female ,business - Abstract
The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of colposcopy and directed biopsy for cervical cancer prevention in the United States (US). The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. An extensive literature review was conducted and supplemented by a systematic review and meta-analysis of unpublished data. In addition, a survey of practicing colposcopists was conducted to assess current colposcopy practice in the US. Recommendations were approved by the working group members, and the final revisions were made based on comments received from the public. The recommendations cover terminology, risk-based colposcopy, colposcopy procedures, and colposcopy adjuncts. The ASCCP Colposcopy Standards recommendations are an important step toward raising the standard of colposcopy services delivered to women in the US. Because cervical cancer screening programs are currently undergoing important changes that may affect colposcopy performance, updates to some of the current recommendations may be necessary in the future.
- Published
- 2017
42. HPV vaccination of immunocompromised hosts
- Author
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Anna-Barbara Moscicki, S. de Sanjose, Joel M. Palefsky, R. Sankaranarayanan, Margaret Stanley, Andreas M. Kaufmann, Julia M.L. Brotherton, Suzanne M. Garland, and Neerja Bhatla
- Subjects
Papillomavirus vaccines ,HPV related cancers ,Adolescent ,Vacuna del papil·lomavirus ,Immunocompromised hosts ,Guidelines as Topic ,HPV vaccines ,Disease ,Article ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,Papillomavirus Vaccines ,Immunocompromised Host ,0302 clinical medicine ,Immunogenicity, Vaccine ,Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 ,Virology ,medicine ,Humans ,lcsh:RC109-216 ,030212 general & internal medicine ,Child ,Cervical cancer ,Human papillomavirus (HPV) ,business.industry ,Vaccination ,Papillomavirus Infections ,virus diseases ,HPV Guidelines ,medicine.disease ,female genital diseases and pregnancy complications ,Regimen ,Infectious Diseases ,Increased risk ,Immunization ,030220 oncology & carcinogenesis ,Immunology ,Female ,business - Abstract
It is well-established that immunocompromised people are at increased risk of HPV-related disease compared with those who are immunocompetent. Prophylactic HPV sub-unit vaccines are safe and immunogenic in immunocompromised people and it is strongly recommended that vaccination occur according to national guidelines. When delivered to immunocompromised populations, HPV vaccines should be given as a 3-dose regimen. Keywords: Human papillomavirus (HPV), Vaccination, Immunocompromised hosts, HPV related cancers, HPV Guidelines
- Published
- 2017
43. Preparing for the Next Round of ASCCP-Sponsored Cervical Screening and Management Guidelines
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Warner K. Huh, Philip E. Castle, David Chelmow, Nicolas Wentzensen, Richard S. Guido, Mark Schiffman, Michelle J. Khan, Teresa M. Darragh, Colleen K. Stockdale, Michelle I. Silver, and Anna-Barbara Moscicki
- Subjects
Societies, Scientific ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Cervical screening ,business.industry ,Alternative medicine ,MEDLINE ,Disease Management ,Uterine Cervical Neoplasms ,Obstetrics and Gynecology ,General Medicine ,Article ,National Cancer Institute (U.S.) ,United States ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Family medicine ,Practice Guidelines as Topic ,medicine ,Humans ,Female ,Disease management (health) ,business ,Early Detection of Cancer - Published
- 2017
44. Four-year persistence of type-specific immunity after quadrivalent human papillomavirus vaccination in HIV-infected children: Effect of a fourth dose of vaccine
- Author
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Jennifer S. Read, Adriana Weinberg, William A. Meyer, Myron J. Levin, Alfred J. Saah, Anna-Barbara Moscicki, Sharon Huang, Kelly Richardson, and Lin-Ye Song
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Male ,0301 basic medicine ,Time Factors ,030106 microbiology ,Immunization, Secondary ,HIV Infections ,Antibodies, Viral ,Placebo ,Article ,Persistence (computer science) ,Placebos ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 ,Immunity ,Humans ,Medicine ,030212 general & internal medicine ,Child ,Immunoassay ,General Veterinary ,General Immunology and Microbiology ,biology ,medicine.diagnostic_test ,business.industry ,Papillomavirus Infections ,Public Health, Environmental and Occupational Health ,Antibody titer ,Vaccination ,Infectious Diseases ,Immunology ,biology.protein ,Molecular Medicine ,Female ,Antibody ,business ,Follow-Up Studies - Abstract
Objective Although HIV-infected children are recommended to receive quadrivalent human papillomavirus vaccine (QHPV) there is limited information on their response to QHPV. This study in HIV-infected children, evaluated the magnitude and duration of immune responses to QHPV. This report describes type-specific serum antibody responses over a 4-to-5 year period after either 3 or 4 doses of QHPV. Design/methods HIV-infected children, ages 7-to-11 years, received 3 doses of QHPV (n = 96) or placebo (n = 30). At 72 weeks QHPV recipients received a fourth dose (n = 84), while placebo recipients began the 3-dose QHPV schedule (n = 27). HPV serotype-specific antibody was determined, by competitive Luminex immunoassay (cLIA) and IgG Luminex immunoassay, at 2, 3.5, and 4-to-5 years after the last dose of QHPV in each treatment arm. Results At 4-to-5 years after the last dose of QHPV, antibody titers were significantly higher in 4-dose than in 3-dose group. However, the proportion of vaccinees with a seroresponse in the cLIA assay was not different between the two groups (86–93% for HPV types 6, 11, and 16, and 64% for HPV type 18). These results were very similar to the seroresponse rate in these HIV-infected children at 1 month after completing vaccination. Conclusions Children with well-controlled HIV infection who receive 3 doses of the QHPV vaccine maintain seropositivity and antibody levels that are generally similar to children of the same age who are not HIV-infected. Antibody titer correlated strongly with low log HIV RNA, low CD8%, and high CD4%. Additionally, a fourth dose of vaccine in HIV-infected children produces a marked rise in antibody characteristic of an anamnestic response and persistence of high antibody levels. Study identification: IMPAACT P1085 (V501-021). CLINICALTRIALS.GOV identifier: NCT01206556 .
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- 2017
45. Prevalence of periodontal diseases in a multicenter cohort of perinatally HIV-infected and HIV-exposed and uninfected youth
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Mark I, Ryder, Tzy-Jyun, Yao, Jonathan S, Russell, Anna-Barbara, Moscicki, Caroline H, Shiboski, and Susan, Adubato
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Male ,medicine.medical_specialty ,Longitudinal study ,Adolescent ,Bleeding on probing ,Human immunodeficiency virus (HIV) ,Dentistry ,HIV Infections ,medicine.disease_cause ,Severity of Illness Index ,Article ,Young Adult ,03 medical and health sciences ,Gingivitis ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Risk Factors ,Internal medicine ,Prevalence ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Child ,Periodontal Diseases ,Periodontitis ,business.industry ,030206 dentistry ,medicine.disease ,Infectious Disease Transmission, Vertical ,Cohort ,Periodontics ,Female ,medicine.symptom ,business ,Cohort study - Abstract
Aims To compare the prevalence and severity of periodontal diseases between 180 perinatally HIV-infected (PHIV) and 118 perinatally HIV-exposed and uninfected (PHEU) youth in a cross-sectional study conducted at 11 clinical sites in the United States and Puerto Rico from the Adolescent Master Protocol (AMP) study of the Pediatric HIV/AIDS cohort study (PHACS) network. Methods Several analyses were conducted, employing the current CDC/AAP classification for periodontitis and incorporating a definition of gingivitis based on a bleeding on probing threshold, and analyses based on more detailed whole mouth, intraoral regionally, site-based, and tooth-based criteria of bleeding on probing, plaque levels, pockets depths and clinical attachment levels. Results After adjusting for plaque control habits, and behavioral and sociodemographic factors, there were no significant differences in periodontal diseases between the PHIV and PHEU youth using any of these criteria. For PHIV youth, there was no significant association between parameters of periodontal disease and current HIV status. Conclusions While no significant differences in periodontal parameters were noted between the PHIV and PHEU youth, the influence of antiretroviral therapy on merits further exploration in this cohort in a longitudinal study. This article is protected by copyright. All rights reserved.
- Published
- 2016
46. Determinants of Acquisition and Clearance of Human Papillomavirus Infection in Previously Unexposed Young Women
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Diane M. Harper, Paulo Naud, Anna-Barbara Moscicki, Newton Sérgio de Carvalho, Agnihotram V. Ramanakumar, Paola Colares de Borba, Cecilia Roteli-Martins, Gary Dubin, Eduardo L. Franco, Mariam El-Zein, Julio Cesar Teixeira, Stephen K. Tyring, and Brian Ramjattan
- Subjects
Microbiology (medical) ,Adult ,medicine.medical_specialty ,Canada ,Adolescent ,Genotype ,Sexual Behavior ,Prevalence ,Physiology ,Dermatology ,Cervix Uteri ,Original Studies ,Cohort Studies ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Double-Blind Method ,Risk Factors ,Epidemiology ,medicine ,Humans ,030212 general & internal medicine ,Young adult ,Cervix ,Papillomaviridae ,Cervical cancer ,030505 public health ,business.industry ,Incidence (epidemiology) ,Incidence ,Papillomavirus Infections ,Public Health, Environmental and Occupational Health ,HPV infection ,virus diseases ,medicine.disease ,female genital diseases and pregnancy complications ,United States ,Infectious Diseases ,medicine.anatomical_structure ,Sexual Partners ,Female ,0305 other medical science ,business ,Brazil ,Cohort study - Abstract
Lifetime number of sex partners, marital status, and history of sexually transmitted disease were associated with human papillomavirus (HPV) acquisition among women without prior exposure to HPV infection, with no observed differences in risk determinants patterns for HPV infections by length of follow-up. Supplemental digital content is available in the text., Background Global variation in human papillomavirus (HPV) prevalence and persistence may be explained by differences in risk factors, such as sexual activity, oral contraceptive use, and behavioral factors. We evaluated determinants of acquisition and clearance of HPV infection among young women previously unexposed to HPV. Methods Five hundred thirty-four women aged 15 to 25 years who were cytology and HPV DNA negative, and seronegative for anti-HPV-16/18 antibodies, were recruited (July 2000–September 2001) from study centers in Brazil, the United States, and Canada (NCT00689741/NCT00120848). They were followed up for 76 months. Cervical samples were HPV genotyped via polymerase chain reaction. We used multivariable (forward stepwise, P = 0.15) Cox proportional hazards regression to estimate rate ratios (RR) and 95% confidence intervals (CI), separately according to length of follow-up time. Results On short-term follow-up (0–27 months), 257 (48%; 8535.80 person-months; incidence rate = 30.11; 95% CI, 26.64–34.02) incident HPV infections were detected. Marital status, lifetime number of sex partners, history of any sexually transmitted disease, and occasional use of oral contraceptives were strongly associated with acquisition of any HPV. Having 2 or more lifetime sex partners (RR, 2.03; 95% CI, 1.37–3.02) and a history of any sexually transmitted disease (RR, 1.98; 95% CI, 1.19–3.29) were the most important determinants of high-risk HPV (hrHPV) incidence. During the entire follow-up (0–76 months), an increased hrHPV clearance was found among women in North America (RR, 1.38; 95% CI, 1.08–1.78) and black women (RR, 1.64; 95% CI, 1.04–2.60). Greater number of lifetime partners was associated with reduced clearance rates for any HPV (RR, 0.65; 95% CI, 0.43–0.98). Conclusions We identified variation in risk of HPV acquisition and clearance among women unexposed to HPV at baseline.
- Published
- 2019
47. Interstitial Lung Disease Frequently Precedes CVID Diagnosis
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Carmen Scheibenbogen, Anna-Barbara Stittrich, Kirsten Wittke, Leif G. Hanitsch, and Hans-Dieter Volk
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Adult ,Aged, 80 and over ,Male ,Pathology ,medicine.medical_specialty ,Delayed Diagnosis ,Adolescent ,business.industry ,Immunology ,Interstitial lung disease ,Middle Aged ,medicine.disease ,Young Adult ,Medical microbiology ,Common Variable Immunodeficiency ,Cross-Sectional Studies ,Immunology and Allergy ,Medicine ,Humans ,Female ,business ,Lung Diseases, Interstitial ,Aged - Published
- 2019
48. Trends in post-partum viral load among women living with perinatal HIV infection in the USA: a prospective cohort study
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Anna-Barbara Moscicki, Hiv, Deborah Kacanek, Brad Karalius, Claire A Berman, Kathleen M. Powis, Mary E. Paul, Katherine Tassiopoulos, George R. Seage, and Kunjal Patel
- Subjects
0301 basic medicine ,Adult ,medicine.medical_specialty ,Adolescent ,Epidemiology ,Immunology ,Population ,Psychological intervention ,HIV Infections ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Pregnancy ,Virology ,Medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Young adult ,Pregnancy Complications, Infectious ,Prospective cohort study ,education ,education.field_of_study ,business.industry ,Obstetrics ,Postpartum Period ,virus diseases ,Viral Load ,medicine.disease ,030112 virology ,United States ,Infectious Diseases ,Cohort ,HIV-1 ,Female ,business ,Viral load - Abstract
Summary Background Small studies reported poor post-partum outcomes among young women living with perinatal HIV infection who are now ageing into adulthood and becoming pregnant. For targeted clinical intervention, we sought to identify women in this population at risk of poor post-partum virological control. Methods We abstracted data on pregnancy history for women living with perinatal HIV infection in the Pediatric HIV/AIDS Cohort Study-AMP Up protocol, a prospective study of young adults living with perinatal HIV from 14 sites in the USA. Linear models with generalised estimating equations described trends in HIV viral load through 1 year post-pregnancy by pregnancy outcome. We used group-based trajectory modelling to identify viral load trajectory groups in the first post-partum year after livebirths. We then compared sociodemographic and clinical factors across identified groups. We defined viraemia as 400 copies per mL or more. Findings Between April 15, 2014, and Oct 1, 2017, we enrolled 323 women, of whom 234 had perinatal HIV infection, and reported age at sexual debut and history of heterosexual vaginal intercourse. Of the 172 pregnancies recorded in these women, 147 (85%, 104 livebirths and 43 spontaneous or elective abortions) were eligible for post-pregnancy viral load trajectory analyses (ie, had at least two viral loads in the year after end of pregnancy). Viral load increased by 0·7 log10 copies per mL (95% CI 0·5 to 1·0) in the first 12 weeks post partum after 104 livebirths, and subsequently stabilised from 13 weeks to 1 year post partum (slope −0·01 log10 copies per mL, 95% CI −0·3 to 0·3). By comparison, the average viral load trajectory after 43 spontaneous or elective abortions remained at less than 400 copies per mL. We identified three distinct groups of viral load trajectories after 104 livebirths, classified as reflecting sustained suppression (31 [30%]), rebound viraemia (55 [53%]), and persistent viraemia (18 [17%]). Women with sustained post-partum suppression were older at conception (22·9 years, IQR 19·4–25·9) than those with rebound viraemia (20·4 years, 18·8–22·2), or persistent post-partum viraemia (19·0 years, 17·7–20·5). Pre-conception viraemia and immune suppression were also strong risk factors for post-partum viraemia. Interpretation Despite success achieving viral load suppression during pregnancy, women living with perinatal HIV infection have a high risk of post-partum viraemia. Younger age at conception, pre-conception viraemia, and pre-conception immune suppression could identify women in this population most likely to benefit from post-partum adherence interventions. Funding National Institutes of Health.
- Published
- 2019
49. Use of an automated pyrosequencing technique for confirmation of Sickle Cell Disease
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Camila Cruz de Martino, Cecilia Salete Alencar, Paula Loureiro, Anna Barbara de Freitas Carneiro-Proietti, Claudia de Alvarenga Máximo, Rosimere Afonso Mota, Daniela Oliveira Werneck Rodrigues, Nelson Gaburo Junior, Shannon Kelly, Ester Cerdeira Sabino, and International Component of the NHLBI Recipient Epidemiology and Donor Evaluation Study (REDS-III)
- Subjects
Molecular biology ,Thalassemia ,Hemoglobin, Sickle ,Artificial Gene Amplification and Extension ,Biochemistry ,Polymerase Chain Reaction ,Geographical locations ,Cohort Studies ,0302 clinical medicine ,Sequencing techniques ,hemic and lymphatic diseases ,Genotype ,Medicine and Health Sciences ,DNA sequencing ,Liquid Chromatography ,Sanger sequencing ,Multidisciplinary ,Chromatographic Techniques ,High-Throughput Nucleotide Sequencing ,Hemoglobin variants ,Beta thalassemia ,Hematology ,Hemoglobin C ,Genetic Diseases ,030220 oncology & carcinogenesis ,symbols ,Medicine ,Brazil ,Research Article ,congenital, hereditary, and neonatal diseases and abnormalities ,Beta-Thalassemia ,Science ,Anemia, Sickle Cell ,Research and Analysis Methods ,03 medical and health sciences ,symbols.namesake ,Autosomal Recessive Diseases ,medicine ,Humans ,Hemoglobin ,Clinical Genetics ,Sickle Cell Disease ,Newborn screening ,business.industry ,Dideoxy DNA sequencing ,Biology and Life Sciences ,Proteins ,South America ,medicine.disease ,High Performance Liquid Chromatography ,Hemoglobinopathies ,Molecular biology techniques ,Mutation ,People and places ,business ,030215 immunology - Abstract
BackgroundThe diagnosis of sickle cell disease (SCD) is made by hemoglobin assays such as high-performance liquid chromatography (HPLC), isoelectric focusing and cellulose acetate or citrate agar electrophoresis. These assays are easy to perform and used in large-scale newborn screening in many countries. These tests however may not easily differentiate Sβ0 thalassemia from SS or identify other hemoglobin variants, and in this case, hemoglobin (HBB) gene sequencing may be necessary.ObjectivesTo develop a high throughput DNA based confirmatory assay for SCD and to detect mutations in the HBB gene.MethodsWe developed an automated pyrosequencing technique (PyS) based on QIAGEN technology (Hilden, Germany) to detect homozygous or heterozygous hemoglobin S mutations as well as hemoglobin C mutations. The technique was tested on 2,748 samples from patients enrolled in a multi-center SCD cohort in Brazil. Patients were previously tested using HPLC to diagnose SCD as part of routine clinical care. Any subjects with discrepant results between HPLC and PyS or with heterozygous hemoglobin S detected had Sanger sequencing of the HBB gene.ResultsWe identified 168 samples with discrepant results between HPLC and PyS and 100 with concordant HPLC and PyS= heterozygous S, which would suggest Sβ-thalassemia or other hemoglobin S variants. The PyS assay correctly identified 1906 (98.7%) of the 1930 HbSS and 628 (98.7%) of the 636 HbSC samples. Of the 179 remaining samples, PyS correctly indicated S heterozygosis in 165 (92.2%). Of the 165 heterozygous S samples confirmed by Sanger as consistent with Sβ thalassemia genotype, 84 samples were classified as Sβ0 thalassemia and 81 as Sβ+ thalassemia. The most frequent beta thalassemia mutations of Sβ0 and Sβ+ were HBB: c.118C>T (Gln40Stop) and HBB c.92 + 6T> C, respectively.DiscussionThe PyS proved to be satisfactory for large-scale confirmatory testing of hemoglobin mutation. Moreover, with this study we were able to describe the most common β+ and β0 mutations in SCD patients with Sβ-thalassemia in a large multi-institutional SCD cohort in Brazil.
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- 2019
50. Guidelines for Cervical Cancer Screening in Immunosuppressed Women Without HIV Infection
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Lisa Beth Spiryda, Lisa Flowers, Anna-Barbara Moscicki, Kathy L. MacLaughlin, Michael A. Gold, Jeanne Murphy, Margaret E. Long, and Megan J. Huchko
- Subjects
Adult ,Pediatrics ,medicine.medical_specialty ,MEDLINE ,Human immunodeficiency virus (HIV) ,Organ function ,Uterine Cervical Neoplasms ,Cervical cancer screening ,medicine.disease_cause ,Immunocompromised Host ,Young Adult ,Quality of life (healthcare) ,medicine ,Humans ,Mass Screening ,Young adult ,Aged ,Cervical cancer ,Aged, 80 and over ,business.industry ,Papillomavirus Infections ,Obstetrics and Gynecology ,General Medicine ,Middle Aged ,medicine.disease ,Practice Guidelines as Topic ,Life expectancy ,Female ,Squamous Intraepithelial Lesions of the Cervix ,business - Abstract
The risk of cervical cancer (CC) among women immunosuppressed for a variety of reasons is well documented in the literature. Although there is improved organ function, quality of life and life expectancy gained through use of immunosuppressant therapy, there may be increased long-term risk of cervical neoplasia and cancer and the need for more intense screening, surveillance, and management. Although guidance for CC screening among HIV-infected women (see Table 1) has been supported by evidence from retrospective and prospective studies, recommendations for CC screening among non-HIV immunosuppressed women remains limited because quality evidence is lacking. Moreover, CC screening guidelines for HIV-infected women have changed because better treatments evolved and resulted in longer life expectancy.The objective of this report was to summarize current knowledge of CC, squamous intraepithelial lesions, and human papillomavirus (HPV) infection in non-HIV immunocompromised women to determine best practices for CC surveillance in this population and provide recommendations for screening. We evaluated those with solid organ transplant, hematopoietic stem cell transplant, and a number of autoimmune diseases.A panel of health care professionals involved in CC research and care was assembled to review and discuss existing literature on the subject and come to conclusions about screening based on available evidence and expert opinion. Literature searches were performed using key words such as CC, cervical dysplasia/squamous intraepithelial lesion, HPV, and type of immunosuppression resulting in an initial group of 346 articles. Additional publications were identified from review of citations in these articles. All generated abstracts were reviewed to identify relevant articles. Articles published within 10 years were considered priority for review. Reviews of the literature were summarized with relevant statistical comparisons. Recommendations for screening generated from each group were largely based on expert opinion. Adherence to screening, health benefits and risks, and available clinical expertise were all considered in formulating the recommendations to the degree that information was available.Solid Organ Transplant: Evidence specific for renal, heart/lung, liver, and pancreas transplants show a consistent increase in risk of cervical neoplasia and invasive CC, demonstrating the importance of long-term surveillance and treatment. Reports demonstrate continued risk long after transplantation, emphasizing the need for screening throughout a woman's lifetime.Hematopoietic Stem Cell Transplant: Although there is some evidence for an increase in CC in large cohort studies of these patients, conflicting results may reflect that many patients did not survive long enough to evaluate the incidence of slow-growing or delayed-onset cancers. Furthermore, history of cervical screening or previous hysterectomy was not included in registry study analysis, possibly leading to underestimation of CC incidence rates.Genital or chronic graft versus host disease is associated with an increase in high-grade cervical neoplasia and posttransplant HPV positivity.Inflammatory Bowel Disease: There is no strong evidence to support that inflammatory bowel disease alone increases cervical neoplasia or cancer risk. In contrast, immunosuppressant therapy does seem to increase the risk, although results of observational studies are conflicting regarding which type of immunosuppressant medication increases risk. Moreover, misclassification of cases may underestimate CC risk in this population. Recently published preventive care guidelines for women with inflammatory bowel disease taking immunosuppressive therapy recommend a need for continued long-term CC screening.Systemic Lupus Erythematosus and Rheumatoid Arthritis: The risk of cervical high-grade neoplasia and cancer was higher among women with systemic lupus erythematosus than those with rheumatoid arthritis (RA), although studies were limited by size, inclusion of women with low-grade neoplasia in main outcomes, and variability of disease severity or exposure to immunosuppressants. In studies designed to look specifically at immunosuppressant use, however, there did seem to be an increase in risk, identified mostly in women with RA. Although the strength of the evidence is limited, the increase in risk is consistent across studies.Type 1 DM: There is a paucity of evidence-based reports associating type 1 DM with an increased risk of cervical neoplasia and cancer.The panel proposed that CC screening guidelines for non-HIV immunocompromised women follow either the (1) guidelines for the general population or (2) current center for disease control guidelines for HIV-infected women. The following are the summaries for each group reviewed, and more details are noted in accompanying table:Solid Organ Transplant: The transplant population reflects a greater risk of CC than the general population and guidelines for HIV-infected women are a reasonable approach for screening and surveillance.Hematopoietic Stem Cell Transplant: These women have a greater risk of CC than the general population and guidelines for HIV-infected women are a reasonable approach for screening. A new diagnosis of genital or chronic graft versus host disease in a woman post-stem cell transplant results in a greater risk of CC than in the general population and should result in more intensive screening and surveillance.Inflammatory Bowel Disease: Women with inflammatory bowel disease being treated with immunosuppressive drugs are at greater risk of cervical neoplasia and cancer than the general population and guidelines for HIV-infected women are a reasonable approach for screening and surveillance. Those women with inflammatory bowel disease not on immunosuppressive therapy are not at an increased risk and should follow screening guidelines for the general population.Systemic Lupus Erythematosus and Rheumatoid Arthritis: All women with systemic lupus erythematosus, whether on immunosuppressant therapy or not and those women with RA on immunosuppressant therapy have a greater risk of cervical neoplasia and cancer than the general population and should follow CC screening guidelines for HIV-infected women. Women with RA not on immunosuppressant therapy should follow CC screening guidelines for the general population.Type 1 Diabetes Mellitus: Because of a lack of evidence of increased risk of cervical neoplasia and cancer among women with type 1 DM, these women should follow the screening guidelines for the general population.
- Published
- 2019
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