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Objective Methods Results Conclusion This study aimed to investigate the obstetric outcomes of transabdominal cerclage (TAC) in Japan.Questionnaires on TAC were sent to 183 institutions performing high‐quality perinatal management in Japan. As a first‐step questionnaire, we asked whether TAC was performed between January 1, 2011, and December 31, 2022. In the second step of the questionnaire, the characteristics of all cases were asked from all institutions in which TAC was performed.The response rate for the first survey was 59% (108/183). Of the 108 institutions, 27 performed TAC (25%) in 133 pregnancies. Of these 27 institutions, 19 responded to the second survey. One hundred twenty‐five pregnancies were included in this study, five of which were aborted (gestational weeks <22 weeks), and 69 babies were born after 37 gestational weeks (55%). Eighty‐two open abdominal cerclages were performed at 17 institutions and 43 laparoscopic TACs at three institutions. There were no differences in the age at TAC, gestational weeks at TAC, operative time of TAC, gestational weeks at delivery, incidence rate of second‐trimester loss, or preterm delivery (before 37 gestational weeks) rate between the two groups. However, blood loss during open TAC was greater than that during laparoscopic TAC.TAC is a rare surgery for cervical insufficiency in Japan. TAC may be a safe and useful method for preventing second‐trimester loss and preterm delivery in high‐risk patients. TAC may also be a key option in Japan to improve perinatal outcomes in patients with cervical insufficiency. [ABSTRACT FROM AUTHOR]

Background: Equitable access to colposcopy services is required if we are to realise the benefit of the introduction of human papilloma virus (HPV) screening in Aotearoa New Zealand. We piloted a community colposcopy clinic, co‐located at an urban marae health clinic. Aim: To describe the experiences of wāhine (women) attending the marae‐based colposcopy clinic. Methods: An in‐depth reflexive thematic analysis from 34 people's accounts was undertaken. Results: Five themes were identified from the experiences of wāhine attending the clinic. Three themes related to how having a local clinic supported access: everyone was welcoming and friendly, the environment was familiar and non‐clinical and the clinic was accessible. The fourth theme related to how this contributed to agency. A fifth theme relates to wāhine views about informing the ongoing provision of colposcopy services. The experiences reflected the principles and values practised at the marae health clinic. Wāhine described feeling cared for as soon as they entered the clinic. As the clinic was local, and for some based at their marae, it was a known space where they knew the experience would be safe. Whānau were welcome with spaces for children to play. Being local meant there were fewer logistics to manage, all of which supported access. Discussion: Prioritising wāhine through the provision of culturally safe and accessible colposcopy is feasible. It has the potential to contribute to the elimination of cervical cancer in Aotearoa, New Zealand. [ABSTRACT FROM AUTHOR]

Background: In mid-2022 Australia's National Cervical Screening Program made self-collection of a vaginal sample an option for screening for young women or people with a cervix aged 25 to 29 years for the first time. This study explored what young women thought about, and wanted to know about, self-collection, and what their future screening preferences are. Methods: Young women (n = 21), aged 24–29 years, were recruited through social media. Semi-structured interviews explored screening history, screening preferences and thoughts about self-collection. Data were analysed using an a priori coding framework informed by the Theoretical Framework of Acceptability. Results: Young women valued the addition of self-collection to the national cervical screening program, believing it to be less invasive and more convenient. However, they also valued the choice to opt for a clinician-collected specimen if preferred. Conclusions: Self-collection is a valuable addition to the National Cervical Screening Program. This study suggests that continued efforts are needed to raise awareness of its availability, and improve understanding about its accuracy, the ease of collection, that you still need to engage with a primary healthcare service to access it and that you can still opt for a clinician-collected test. Now available for the first time to young women and people with a cervix (aged 25–29 years), self-collection cervical screening is a safe, accurate and easy method to complete regular cervical screening without the use of a speculum. However, the best ways to communicate and promote self-collection to this age group has not been researched. This is important, because self-collection creates a positive screening experience, and will encourage young people to continue screening throughout their life, ultimately preventing cervical cancer. [ABSTRACT FROM AUTHOR]

Gynaecological cancers encompass a spectrum of malignancies affecting the female reproductive system, comprising the cervix, uterus, ovaries, vulva, vagina, and fallopian tubes. The significant health threat posed by these cancers worldwide highlight the crucial need for techniques for early detection and prediction of gynaecological cancers. Preferred reporting items for systematic reviews and Meta-Analysis guidelines are used to select the articles published from 2013 up to 2023 on the Web of Science, Scopus, Google Scholar, PubMed, Excerpta Medical Database, and encompass AI technique for the early detection and prediction of gynaecological cancers. Based on the study of different articles on gynaecological cancer, the results are also compared using various quality parameters such as prediction rate, accuracy, sensitivity, specificity, the area under curve precision, recall, and F1-score. This work highlights the impact of gynaecological cancer on women belonging to different age groups and regions of the world. A detailed categorization of the traditional techniques like physical-radiological, bio-physical and bio-chemical used to detect gynaecological cancer by health organizations is also presented in the study. Besides, this work also explores the methodology used by different researchers in which AI plays a crucial role in identifying cancer symptoms at earlier stages. The paper also investigates the pivotal study years, highlighting the periods when the highest number of research articles on gynaecological cancer are published. The challenges faced by researchers while performing AI-based research on gynaecological cancers are also highlighted in this work. The features and representations such as Magnetic Resonance Imaging (MRI), ultrasound, pap smear, pathological, etc., which proficient the AI algorithms in early detection of gynaecological cancer are also explored. This comprehensive review contributes to the understanding of the role of AI in improving the detection and prognosis of gynaecological cancers, and provides insights for future research directions and clinical applications. AI has the potential to substantially reduce mortality rates linked to gynaecological cancer in the future by enabling earlier identification, individualised risk assessment, and improved treatment techniques. This would ultimately improve patient outcomes and raise the standard of healthcare for all individuals. [ABSTRACT FROM AUTHOR]

Background: The uterus undergoes dynamic changes throughout the menstrual cycle. Diffusion kurtosis imaging (DKI) is based on the non‐Gaussian distribution of water molecules and can perhaps represent the changes of uterine microstructure. Purpose: To investigate the temporal changes in DKI‐parameters of the normal uterine corpus and cervix during the menstrual cycle. Study Type: Prospective. Population: 21 healthy female volunteers (26.64 ± 4.72 years) with regular menstrual cycles (28 ± 7 days). Field Strength/Sequence: Readout segmentation of long variable echo‐trains (RESOLVE)‐based DKI and fast spin‐echo T2‐weighted sequences at 3.0T. Assessment: Each volunteer was scanned during the menstrual phase, ovulatory phase, and luteal phase. Regions of interest (ROI) were manually delineated in the endometrium, junctional zone, and myometrium of the uterine body, and in the mucosal layer, fibrous stroma layer, and loose stroma layer of the cervix. The mean Kapp (diffusion kurtosis coefficient), Dapp (diffusion coefficient), and ADC (apparent diffusion coefficient) values were measured in the ROI. Statistical Tests: ANOVA with Bonferroni or Tamhane correction. Intraclass correlation coefficient (ICC) for assessing agreement. P < 0.05 was considered statistically significant. Results: During the menstrual cycle, the highest Kapp (0.848 ± 0.184) and lowest Dapp (1.263 ± 0.283 *10−3 mm2/sec) values were found in the endometrium during the menstrual phase. The Dapp values for the myometrium were significantly higher than those of the endometrium and the junctional zone in every phase. Meanwhile, the Dapp values for the three zonal structures of the cervix during ovulation were significantly higher than those during the luteal phase. However, there was no significant difference in the ADC values of the loose stroma between ovulation and the luteal phase (P = 0.568). The reproducibility of DKI parameters was good (ICC, 0.857–0.944). Data Conclusion: DKI can show dynamic changes of the normal uterus during the menstrual cycle. Level of Evidence: 2 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

In this work, we present a novel preclinical device utilizing Torsional Wave Elastography (TWE). It comprises a rotational actuator element and a piezoceramic receiver ring circumferentially aligned. Both allow the transmission of shear waves that interact with the tissue before being received. Our main objective is to demonstrate and characterize the reliability, robustness, and accuracy of the device for characterizing the stiffness of elastic materials and soft tissues. Experimental tests are performed using two sets of tissue mimicking phantoms. The first set consists of calibrated CIRS gels with known stiffness value, while the second test uses non-calibrated manufactured phantoms. Our experimental observations show that the proposed device consistently and repeatably quantifies the stiffness of elastic materials with high accuracy. Furthermore, comparison with established techniques demonstrates a very high correlation (> 95%), supporting the potential medical application of this technology. The results obtained pave the way for a cross-sectional study aiming to investigate the correlation between gestational age and cervical elastic properties during pregnancy. [ABSTRACT FROM AUTHOR]

In the last two decades or so, a spectrum of benign, premalignant and malignant cervical glandular lesions exhibiting gastric differentiation has been described, with gastric‐type adenocarcinoma representing the most common human papillomavirus (HPV)‐independent cervical adenocarcinoma. More recently, limited literature has reported a variety of gastric‐type glandular lesions at other sites within the female genital tract and, as in the cervix (the most common site for these lesions), a spectrum of benign, premalignant and malignant lesions has been proposed. We provide an update and review of the emerging spectrum of gastric‐type glandular lesions at female genital tract sites other than the cervix. In the endometrium, putative gastric‐type glandular lesions include mucinous metaplasia of gastric‐type, atypical mucinous proliferation of gastric‐type and gastric‐type adenocarcinoma. Similarly in the vagina, gastric‐type adenosis, atypical adenosis and adenocarcinoma have been described. There have also been occasional reports of gastric‐type lesions involving the ovary and fallopian tube. We provide guidance on how to recognise gastric‐type lesions morphologically and immunophenotypically and stress that sometimes these lesions occur at more than one site within the female genital tract (synchronous/multifocal gastric‐type lesions of the female genital tract), sometimes in association with Peutz–Jeghers syndrome. [ABSTRACT FROM AUTHOR]

Concurrent chemo-radiation followed by high dose rate brachytherapy is the standard of care for locally advanced cervical cancer. The proximity of the ureters to the tumor volume risks ureteric stenosis. Here we outline the current understanding of radiotherapy induced ureteric stenosis in patients treated for cervical cancer, focusing on the incidence, risk factors, clinical consequences, and management. Searches on EMBASE, PubMed, Science Direct, and Google Scholar were performed for publications reporting on radiotherapy, cervix cancer and ureteric stenosis. Multi and single center, prospective/retrospective, cohort, and cross-sectional studies were included. This narrative review identified key issues relevant to radiation induced ureteric stenosis in cervical cancer in the literature. Thirteen studies were evaluated, identifying crude and actuarial rates of ureteric stenosis of 0.3–13.5% and 1.5–4.4% (at 5 years) respectively. The risk of ureteric stenosis is highest in the first 5 years after radiotherapy but continues to occur at a rate of 0.15% per year. Risk factors including advanced FIGO stage, tumor size >5 cm and baseline hydronephrosis increase the incidence of ureteric stenosis. EQD2 doses of ≥ 77Gy were significantly associated with ≥grade 3 ureteric morbidity. The majority of patients were managed with nephrostomy +/- ureteric stent insertion, with some requiring ureteral reimplantation, urinary diversion or nephrectomy. This review has identified multiple considerations, highlighting the need to identify patients highest at risk of ureteric stenosis. There is also a need to recognize ureters as organs at risk, record dose exposure, and apply dose constraints, all of which set the landscape for allowing dose optimization. [ABSTRACT FROM AUTHOR]

Simple Summary: This study explored the different types of bacteria found in the reproductive tract of healthy maiden mares during their estrus cycle. Vaginal, uterine, clitoral fossa, and perineal skin swabs were collected from 12 mares, and the bacterial communities were characterized using a high-throughput sequencing methodology. The types and number of bacteria detected in the uterus and vagina were similar to each other but different from those in the clitoral area and skin. Specific bacteria, such as those from the families Streptococcaceae and Staphylococcaceae, were common in the uterus and vagina, but Lactobacillaceae were rare. Some bacteria associated with reproductive diseases were also found in these healthy mares, suggesting that these bacteria are naturally present even in healthy animals. This descriptive cross-sectional study compared the microbiota of the uterus, vagina, clitoral fossa (CF), and perineal skin in healthy maiden mares during estrus. Twelve synchronized, healthy maiden mares (3–4 years old) from one single recipient mare herd were included. Microbial communities were characterized by amplifying the V3–V4 region of the 16S rRNA gene using the Illumina MiSeq platform. The uterine and vaginal microbiota had significantly lower richness (Chao-1) than the skin (p < 0.05). The uterine and vagina bacterial composition was similar in presence and abundance and could be differentiated from that of the CF and perineal skin. The microbial composition (Jaccard and Bray–Curtis distances) significantly differed across body-site locations (p < 0.05), which explained approximately 14% and 19% of the variation in microbial composition for Jaccard and Bray–Curtis distances, respectively. Firmicutes, Actinobacteria, Proteobacteria, and Bacteroidetes were the dominant taxa in the uterus and vagina, with higher proportions of Proteobacteria in the vaginal samples compared to the uterine samples. Streptococcaceae and Staphylococcaceae were present in high abundance in the uterine and vaginal samples, while Lactobacillaceae were not (<10%). We demonstrate that the uterine and vaginal microbiota of healthy maiden mares during estrus is similar but both distinct from that of the CF and perineal skin. [ABSTRACT FROM AUTHOR]

Background/Aim: In the past, the standard of care for women with abnormal cervical cytology has been the performance of colposcopically guided biopsy, followed by conization or large loop excision of the transition zone (LLETZ) where biopsy revealed pre-cancerous or cancerous areas. More straightforward protocols are emerging which advocate performing LLETZ in all women with highly suspicious cytology, suspicious colposcopic impression, or the presence of high-risk oncogenic human papilloma virus (HPV) strains in their cervical swabs. This, theoretically, would reduce the rate of false-negative diagnoses, but at the price of overtreating a significant number of healthy women. Patients and Methods: We retrospectively analyzed cervical cancer screening protocols in two large cohorts of women with high-risk HPV. The study compared outcomes between patients undergoing a colposcopically directed biopsy before LLETZ (n=683) and those proceeding directly to LLETZ without a biopsy (n=136). The primary focus was to assess whether intervening biopsies would reduce unnecessary ablative procedures without compromising the detection of high-grade lesions. Results: The biopsy group had a high false-negative rate, with several high-grade lesions (CIN3) and a case of invasive cancer initially underdiagnosed. Conversely, the direct-to-LLETZ approach, while ensuring no high-grade lesions were missed, led to overtreatment of lower grade lesions. Conclusion: These findings raise concern about the reliance on biopsy results for treatment decisions. Neither protocol was entirely satisfactory, although the more aggressive one avoided the potentially life-threatening consequence of false-negative results. Further research is mandatory to accurately diagnose all cases requiring aggressive treatment, without subjecting healthy women to ablative treatments they do not need. [ABSTRACT FROM AUTHOR]

Background/Aim: Distinguishing ovarian metastasis of usual-type endocervical adenocarcinoma (UEA) from primary ovarian tumors is often challenging because of several overlapping features. This study aimed to investigate the clinicopathological characteristics and outcomes of patients with metastatic ovarian UEA. Patients and Methods: Clinicopathological information was collected from eight patients with metastatic ovarian UEA. Immunostaining was also performed. Results: Most patients presented with adnexal masses that were suspected to be primary ovarian tumors. All examined cases showed block p16 positivity in paired primary and metastatic tumors. Five patients who completed post-operative chemotherapy or concurrent chemoradiotherapy (CCRT) did not experience recurrence. In contrast, one patient who refused further treatment after the first CCRT cycle experienced ovarian and peritoneal metastases. One patient with isolated ovarian metastasis left untreated and developed peritoneal metastasis during follow-up. Conclusion: Patients with UEA who received proper management for ovarian metastases showed favorable outcomes. Given that ovarian metastatic UEA can mimic primary ovarian borderline tumor or carcinoma of the mucinous or endometrioid type, pathologists should be aware of this unusual but distinctive morphology to avoid misdiagnosis and inappropriate treatment. [ABSTRACT FROM AUTHOR]

Approximately 95% of cervical squamous cell carcinomas are associated with high-risk HPV, with a small number of HPV-independent tumors. However, low-risk HPV types have also been detected in rare cervical squamous cell carcinomas. Low-grade squamous intraepithelial lesion-related changes are a rare morphologic finding in cervical squamous cell carcinoma. We present the case of a 30-yr-old woman who presented with pelvic pain and foul-smelling vaginal discharge showing an exophytic lesion protruding from the cervix. Repeated superficial biopsies showed a low-grade squamous intraepithelial lesion (LSIL) characterized by binucleation and koilocytosis. Chromogenic in-situ hybridization revealed the presence of HPV6/11. The absence of high-risk HPV was confirmed by PCR. After following the patient for nine months without intervention, type III hysterectomy and bilateral pelvic paraaortic lymphadenectomy were performed. Microscopic examination showed well-differentiated squamous cell carcinoma with solid epithelial islands and extensive eosinophilic cytoplasm without pleomorphism. HPV 6 and 11 were also detected with chromogenic in-situ hybridization. Neoplasm invaded the full-thickness of the cervical wall and infiltrated the vagina, parametrium, the proximal ureter and bladder. The patient who received chemoradiotherapy is disease-free at 36 months follow-up. Low-risk HPV-related well-differentiated invasive squamous lesions exist, and such lesions could be a diagnostic pitfall for gynecologists and pathologists; in these cases, radiologic-pathologic correlation and radiologic guided biopsy are mandatory.

Introduction: Cervical invasive carcinoma is one of the most frequent cancers in the world, and it can be prevented with screening. The papanicolaou (Pap) smear is the most common screening procedure. Pap staining, as it is now done, is costly, requires a large amount of alcohol, and takes a long time. Materials and Methods: A total of 170 patients were recruited. One hundred and sixty-six patients, considering eligibility criteria, undergoing Pap smear test. Eligibility criteria: Age: 18–49 years females, who did not have a total hysterectomy done, who consented to participate in the study. Each patient had two smears taken on glass slides. Standard Pap smears were fixed for at least 15 min in 95% ethanol. The other smear was air-dried before being fixed with alcohol formalin and stained with modified ultrafast Pap (MUFP) stain. A comparison of two different techniques was made on the basis of cytomorphological features. Results: In studied smears, a clean background was seen in 18.24% and 14.12% of the cases in Pap stain and MUFP, respectively. Kappa analysis found a good correlation between Pap stain and MUFP (kappa: 0.81, P < 0.01). Crisp chromatin was seen in 89.41% and 67.65% of MUFP and Pap staining, respectively. About 88.82% of MUFP stains showed optimal cytoplasmic details and the same was revealed by 81.18% of Pap stains. MUFP has a better quality index (QI) as compared to Pap staining as no case in MUFP had QI of < 0.80 with a statistically significant difference as P < 0.05. Conclusion: MUFP is a simple, user-friendly, affordable, and less time-consuming alternative in low-resource areas in comparison to the traditional technique for mass cervical cancer screening.

Abstract In this work, we present a novel preclinical device utilizing Torsional Wave Elastography (TWE). It comprises a rotational actuator element and a piezoceramic receiver ring circumferentially aligned. Both allow the transmission of shear waves that interact with the tissue before being received. Our main objective is to demonstrate and characterize the reliability, robustness, and accuracy of the device for characterizing the stiffness of elastic materials and soft tissues. Experimental tests are performed using two sets of tissue mimicking phantoms. The first set consists of calibrated CIRS gels with known stiffness value, while the second test uses non-calibrated manufactured phantoms. Our experimental observations show that the proposed device consistently and repeatably quantifies the stiffness of elastic materials with high accuracy. Furthermore, comparison with established techniques demonstrates a very high correlation (> 95%), supporting the potential medical application of this technology. The results obtained pave the way for a cross-sectional study aiming to investigate the correlation between gestational age and cervical elastic properties during pregnancy.

Background: Uterine and Cervical cancer survivors face challenges like the disruption of emotional and sexual relationships, struggle to maintain sexual life and intimacy, and the possibility of divorce. The study aimed to determine the effect of group counseling based on couples’ constructive communication on perceived spousal support in uterine and cervical cancer survivors.Methods: A randomized controlled trial on 40 women who survived uterine and cervical cancer were recruited using convenience sampling and then randomly allocated to a couple-based constructive communication intervention group and a routine cancer center care control group from June 2019 to March 2020 in Motahhari and Imam Khomeini hospitals in Urmia. The intervention group was involved in a group counseling session weekly for 5 weeks, regarding constructive couple communication skills. Perceived spouse support was assessed using the sources of social support scale which has 4 subscales informational, instrumental, emotional, and negative support before and one week after the end of the intervention in both groups. Data analysis was performed using SPSS version 24 through Independent and paired t-tests, Mann-Whitney U test, Wilcoxon, chi-square, and ANCOVA. P value

Pyometra is a life-threatening disease, the severity of which depends on cervical patency status. This study investigated cervical inflammation status as well as the expression patterns and localization of aquaporin (AQP1, AQP2, AQP3, AQP5, and AQP9), and hormone receptors in cervical tissue that influences canine pyometra. Of the 36 animals enrolled in the study, 24 were diagnosed with pyometra and separated into two groups: open cervix pyometra and close cervix pyometra, while 12 healthy animals presented for elective ovariohysterectomies were allocated into the control group. Surgical treatment was performed for treatment of pyometra. After each operation, cervix samples were collected and analyzed for AQP and hormone receptor expression patterns determined by qPCR and protein expression by means of immunohistochemistry. Blood samples were also collected to determine serum progesterone concentrations. AQP9 expression was downregulated approximately 3-fold while and PGR expression was downregulated more than 2 fold in both pyometra groups compared to the control group. AQP3 and AQP5 gene expression levels were upregulated more than 3 fold in the open-cervix pyometra group than the closed-cervix pyometra group (P < 0.05). This is the first study to describe the expression patterns and immunolocalization of AQPs in canine cervical tissue based on pyometra patency status and to report AQP3 and AQP5 expression in cervical tissue linked to cervical patency. • The cervical AQP gene expression was conducted for the first time in bitches with pyometra. • AQP9 and PGR expression upregulated healthy cervix tissue. • Cervical AQP3 and AQP5 expression upregulated in open cervix pyometra compared to closed cervix. • Cervical tissues were positive for inflammation in open cervix group. [ABSTRACT FROM AUTHOR]

Abstract Background Cervical cancer is one of the leading causes of death in women worldwide. The majority of the cases are found in developing countries. The increasing risk of cervical cancer prevalence and growing danger of death from cervical cancer and the high occurrence of human papillomavirus (HPV) infection in women who are HIV positive give us the ground to study the prevalence and associated risk factors. Objective The study aims to assess the prevalence of cervical cancer screening and associated risk factors among HIV-positive women attending the Adult ART clinic at the University of Gondar Hospital. Methods An institution-based cross-sectional study was conducted from March to August 2021, on adult HIV-positive women attending the Adult ART clinic at Gondar University Referral Hospital by phone calling patients per week for six months to complete a total of 2744 HIV-positive patients who were not screened for cervical cancer before. The data were collected using an interviewer-administered questionnaire. Bivariate and multivariable logistic regression analyses were used to determine the presence and the degree of association between dependent and independent variables. In the multivariable logistic analysis, a P-value of

Objective To compare attitudes toward self-sampling for human papillomavirus (HPV) testing before and after specimen collection in women undergoing colposcopy. The factors associated with the pre-sampling attitude were also studied. Methods This prospective study enrolled women with abnormal cervical cytology and/or positive high-risk HPV who attended colposcopy clinics at 10 cancer centers in Thailand between October 2021 and May 2022. Prior to colposcopy, the attitudes of the women toward self-sampling were surveyed through a questionnaire. Written and verbal instructions for self-sampling were provided before the process and subsequent colposcopy. The attitudes toward self-sampling were reassessed after the actual self-sampling. Factors associated with the attitudes were analyzed. Results A total of 499 women were included in this study. The mean age was 39.28±11.36 years. A total of 85.3% were premenopause, and 98.8% had sexual experience. With the full score of 45, the attitude score after self-sampling was significantly higher than the attitude score before self-sampling (39.69±5.16 vs. 37.76±5.71; P

Aim and Objectives: The present study was done to compare the visual inspection methods with Pap smear as a screening test for premalignant lesions of the cervix. Materials and Methods: The present observational prospective study was done at the Department of Obstetrics and Gynecology at Teerthanker Mahaveer Medical College and Research Center for 18 months. All study subjects were subjected to Papanicolaou smear, VIA, and VILI examination. If any of these tests were found positive, then a colposcopy and cervical biopsy were done. Results: The sensitivity of Pap, VIA, VILI, and colposcopy was 52.63%, 84.21%, 73.68%, and 84.21%, respectively. The specificity of Pap, VIA, VILI, and colposcopy was 60.0%, 80.0%, 60.0%, and 80.0%, respectively. The accuracy of Pap, VIA, VILI, and colposcopy was 54.17%, 83.33%, 70.83%, and 83.33%, respectively. Conclusion: It is well known that VIA and VILI are very easy to carry out and apply. Even technically they do not cost much, consume less tax and can be applied to all the patients. Even the results are calculated in a faster manner which helps in chalking out the plan in an easy way.

Purpose: The aim of this study was to investigate the prevalence and age distribution of high risk human papilloma virus (hrHPV) infection from Turkish women with normal cytology. Materials and Methods: Our study population consisted of 4212 women with normal cytology and adequate hrHPV molecular testing. The cases were divided into 5 groups according to their age ranges as 21-25 years old, 25-29 years old, 30-44 years old, 45-54, and 55-65 years old. Groups were compared with hrHPV positivity and type 16/18 positivity. Results: Hr HPV was detected in 494 (11.73 %) of 4212 cases. The positivity of hr HPV were 31.97% in group 1 (21-24 years), 18.34% in group 2 (25-29 years), 11.29% in group 3 (30-44 years), 8.73% in group 4 (45-54 years), and 10.18% in group 5 (55-65 years) . There was statistically significant difference in the rates of hrHPV between group 1 and the other groups (p

Introduction. Inflammatory diseases of the pelvic organs (IDPO) remain the most relevant issue in contemporary gynecology. In modern diagnostics of reproductive organ pathologies, a highly effective and accessible method is ultrasound examination. Recent studies in this field, conducted using high-frequency digital transvaginal echography, have significantly contributed to reevaluating the potential of ultrasonographic diagnosis of the cervix; however, further research is warranted. The aim of this research is to enhance the diagnosis of cervical changes in cervicitis. Materials and methods. The study included 68 women with chronic cervicitis. The diagnosis was established based on clinical, colposcopy, and bacterioscopist examinations. During transvaginal ultrasound examinations, the cervix was visualized in both longitudinal and transverse projections for all patients. The patients with chronic cervicitis were divided into two groups: Group I consisted of 37 patients with visual changes in the cervix, while Group II comprised 31 women without any changes. A comparison group included 35 healthy women. Results. Chronic cervicitis is characterized by an increase in the thickness and volume of the cervix, as well as the heterogeneity of the stroma due to cystic cavities, with elevated ratios of cervix thickness to length and endocervix thickness to cervix thickness. Significant sonographic signs of the inflammatory process in the endocervix also include certain structural features, such as indistinct contours, increased echogenicity, small cysts, and multiple microcalcifications in the endocervix, uneven dilation of the cervical canal, and an area of reduced echogenicity. Conclusions. Therefore, a thorough ultrasound examination to determine the condition of the cervix, thickness, and structure of the endocervix can be a valuable adjunct non-invasive tool in the diagnosis of chronic cervicitis and can assist clinicians in diagnosing this pathology even in cases where there are no visual changes in the cervix during an examination.

Daifeng Hu,1,&ast; Mengyue Miao,1,&ast; Hui Zhou,1 Xia Gu,1,2 Xuedan Wang,3 Alexander Tobias Teichmann,1 Qin Wang,1 Youzhe Yang1,2 1Sichuan Provincial Center for Gynaecology and Breast Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People’s Republic of China; 2Academician (Expert) Workstation of Sichuan Province, Luzhou, 646000, People’s Republic of China; 3Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qin Wang; Youzhe Yang, The Affiliated Hospital of Southwest Medical University, NO. 25 Taiping Street, Jiangyang District, Luzhou, 646000, People’s Republic of China, Email wangq@swmu.edu.cn; yangyouzhe@swmu.edu.cnAbstract: Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal tumors originating from perivascular epithelioid cells. In gynecological system, the uterus is one of the most common sites affected by PEComas. Most PEComas are benign, and patients usually have a good prognosis. However, malignant uterus PEComa is rare, and better comprehensive epidemiological investigations are needed. To date, there are a few reported cases of uterus PEComa. We herein report a rare case of malignant PEComa occurred in the uterine corpus and cervix, possibly accompanied by pulmonary lymphangioleiomyomatosis (PLAM). In addition, 55 cases of malignant uterus PEComa were picked out and collected in the data base of PubMed and Medline. On the one hand, the age of onset, population distribution, clinical manifestations, metastatic sites and routes of metastasis were analysed. On the other hand, a summary of the epidemiology, pathogenesis, diagnosis, and treatments of uterus PEComa was given.Keywords: perivascular epithelioid cell tumors, uterus, malignant, rare case, cervix

Background: Cervical cancer is one of the leading causes of death in women worldwide. The majority of the cases are found in developing countries. The increasing risk of cervical cancer prevalence and growing danger of death from cervical cancer and the high occurrence of human papillomavirus (HPV) infection in women who are HIV positive give us the ground to study the prevalence and associated risk factors. Objective: The study aims to assess the prevalence of cervical cancer screening and associated risk factors among HIV-positive women attending the Adult ART clinic at the University of Gondar Hospital. Methods: An institution-based cross-sectional study was conducted from March to August 2021, on adult HIV-positive women attending the Adult ART clinic at Gondar University Referral Hospital by phone calling patients per week for six months to complete a total of 2744 HIV-positive patients who were not screened for cervical cancer before. The data were collected using an interviewer-administered questionnaire. Bivariate and multivariable logistic regression analyses were used to determine the presence and the degree of association between dependent and independent variables. In the multivariable logistic analysis, a P-value of < 0.05 and odds ratio with a 95% confidence interval were considered to determine independent predictors for the prevalence of premalignant or malignant cervical lesions among HIV-positive patients. Result: This study assessed 915 HIV Positive women who were screened for cervical cancer via visual inspection with acetic acid (VIA) as the primary screening tool and found that 24.48% had positive VIA results. Those with VIA-positive cases pathology examination showed 72.4% had abnormal pathology reports (CIN 1/2/3–51.25%, 17.23% cancer & 3.9% CIS), strengthening the finding in many studies that suggest HIV-positive women have a high rate of premalignant lesions. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy and safety of transdermal glycerol trinitrate skin patches as an additive and effective agent for facilitating cervical ripening for labour induction. Methods: This was a double-blinded prospective randomised clinical trial carried out in a major obstetric unit in India. Women who planned for labour induction were randomly allocated for induction either by combined application of glycerol trinitrate skin patches [GTN patch] and intracervical dinoprostone gel or by the gel only. Sample randomisation was done using a stratified block randomisation technique with a sealed envelope. The numbers designating the group allocation sequence were concealed from doctors, research staff, and investigators. Six hourly improvements were assessed in the modified Bishop's score, induction-delivery time interval, the need for oxytocin, maternal side effects and foetal outcomes. Data were analysed using SPSS software. Results and discussion: Recruitment Bishop scores, parity and gestational age were matched in both cases and the control group. The modified Bishop's score was statistically improved in study groups, as evidenced compositely and irrespective of parity. The two groups appeared to have no significant differences regarding other outcomes. The additional application of the GTN patch seems helpful to accelerate the progress of labour but could not yield any favourable labour outcome. The GTN patch does not impose additional feto-maternal adverse effects apart from increased incidences of headaches. [ABSTRACT FROM AUTHOR]

In eutocic labor, the autonomic nervous system is dominated by the parasympathetic system, which ensures optimal blood flow to the uterus and placenta. This study is focused on the detection of the quantitative presence of catecholamine (C) neurofibers in the internal uterine orifice (IUO) and in the lower uterine segment (LUS) of the pregnant uterus, which could play a role in labor and delivery. A total of 102 women were enrolled before their submission to a scheduled cesarean section (CS); patients showed a singleton fetus in a cephalic presentation outside labor. During CS, surgeons sampled two serial consecutive full-thickness sections 5 mm in depth (including the myometrial layer) on the LUS and two randomly selected samples of 5 mm depth from the IUO of the cervix. All histological samples were studied to quantify the distribution of A nerve fibers. The authors demonstrated a significant and notably higher concentration of A fibers in the IUO (46 ± 4.8) than in the LUS (21 ± 2.6), showing that the pregnant cervix has a greater concentration of A neurofibers than the at-term LUS. Pregnant women's mechanosensitive pacemakers can operate normally when the body is in a physiological state, which permits normal uterine contractions and eutocic delivery. The increased frequency of C neurofibers in the cervix may influence the smooth muscle cell bundles' activation, which could cause an aberrant mechano-sensitive pacemaker activation–deactivation cycle. Stressful circumstances (anxiety, tension, fetal head position) cause the sympathetic nervous system to become more active, working through these nerve fibers in the gravid cervix. They might interfere with the mechano-sensitive pacemakers, slowing down the uterine contractions and cervix ripening, which could result in dystocic labor. [ABSTRACT FROM AUTHOR]

Objective: To evaluate longitudinal changes in cervical length (CL) and mean cervical shear wave elastography (CSWE) score in women with a singleton or twin pregnancy who undergo spontaneous preterm birth (sPTB) compared with those who deliver at term. Methods: This was a prospective longitudinal study of unselected women with a singleton or twin pregnancy attending a dedicated research clinic for screening for sPTB at four timepoints during pregnancy: 11 + 0 to 15 + 6 weeks, 16 + 0 to 20 + 6 weeks, 21 + 0 to 24 + 6 weeks and 28 + 0 to 32 + 6 weeks. At each visit, a transvaginal ultrasound scan was conducted to measure the CL and the CSWE scores in six regions of interest (ROI) (inner, middle and external parts of anterior and posterior cervical lips). The mean CSWE score from the six ROIs was calculated for analysis. Log10 transformation was applied to data to produce a Gaussian distribution prior to statistical analysis. A multilevel mixed‐effects analysis was performed to compare longitudinally CL and CSWE between the sPTB and term‐delivery groups. Results: The final cohort consisted of 1264 women, including 1143 singleton pregnancies, of which 57 (5.0%) were complicated by sPTB, and 121 twin pregnancies, of which 33 (27.3%) were complicated by sPTB. Compared to those who delivered at term, women with sPTB had a lower CL across gestation when controlling for history of cervical surgery, number of fetuses, gestational age (GA) at cervical assessment and the interaction between GA at cervical assessment and sPTB (P < 0.001). Specifically, CL in the sPTB group was significantly lower at 21 + 0 to 24 + 6 weeks (P = 0.039) and 28 + 0 to 32 + 6 weeks (P < 0.001). Twin pregnancies had significantly greater CL throughout pregnancy compared with singleton pregnancies (regression coefficient, 0.01864; P < 0.001). After adjusting for maternal age, weight, height, body mass index and GA at cervical assessment, CSWE score in the sPTB group was significantly lower compared with that in the term‐delivery group across gestation (P = 0.013). However, on analysis of individual visits, CSWE score in the sPTB group was significantly lower than that in the term‐delivery group only at 11 + 0 to 15 + 6 weeks (P = 0.036). There was no difference in CSWE score between singleton and twin pregnancies throughout gestation (regression coefficient, –0.00128; P = 0.937). Conclusions: Women with sPTB have a shorter and softer cervix across gestation compared with those who deliver at term. A shorter cervix in the sPTB group is observed from the late second trimester onwards, while lower cervical stiffness in the sPTB group is observed primarily in the first trimester. CL is significantly lower in singleton pregnancies compared with twin pregnancies, while cervical stiffness does not differ between the two. Our findings indicate that the cervix tends to undergo a softening process prior to shortening in sPTB cases. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Strain elastography allows the evaluation of tissue elasticity. Background/Objectives: Tissue elasticity depends on the content and distribution of collagen fibers and is shaped by the applied tensile forces that may differ in uteri with a different angle of flexion of the corpus on the cervix. The objective was to investigate whether the angle of uterine flexion is related to cervical tissue elasticity. Methods: The anterior angle between the longitudinal axis of the uterus corpus and that of the cervix was measured in 275 non-pregnant young women by transvaginal ultrasonography and considered both as an absolute value or categorized as ≤150°, between >150° and ≤210°, and >210°. Strain elastography was used to assess tissue elasticity by placing the probe in the anterior vaginal fornix. Tissue elasticity was evaluated in the middle of the anterior cervical compartment (ACC), in the middle of the posterior cervical compartment (PCC), in the middle portion of the cervical canal (MCC), and at the internal cervical os (ICO). In a sagittal plane MCC was evaluated across the cervical canal, and ACC and PCC at a distance equal between the cervical canal and the outer anterior or posterior part of the cervix. MCC, ACC and PCC were evaluated at equal distance between the ICO and the external cervical os. Elasticity was expressed as a color score ranging from 0.1 (low elasticity) to 3 (high elasticity). Results: The angle of uterine flexion show a negative linear relation with the elasticity of the ACC (p = 0.001) and MCC (p = 0.002) and a positive relation with the elasticity of the PCC (p = 0.054). In comparison to uteri with an angle of flexion of <150°, those with an angle of flexion of >210° had lower elasticity of the ACC (p = 0.001) and MCC (p = 0.001) and higher elasticity of the PCC (p = 0.004). The ACC/PCC and PCC/MCC elasticity ratios were also significantly different (p = 0.001). Conclusions: The angle of uterine flexion is associated with changes in cervix elasticity. Retroflexion is associated with stiffer ACC and MCC and a more elastic PCC. Differences in tissue elasticity suggest structural changes of the cervix that may have implication in variate obstetric and gynecological conditions. [ABSTRACT FROM AUTHOR]

Background: Ewing’s sarcoma (ES) is an aggressive cancer of bone and soft tissue, most of which tend to occur in the bone. Extraosseous Ewing’s sarcoma (EES) of the cervix is extremely rare. Case presentation: In the present work, we reported a 39-year-old cervical EES patient with a 2.5*2.1*1.8 cm tumor mass. According to previous literatures, our case is the smallest tumor found in primary cervical ES ever. The patient initially came to our hospital due to vaginal bleeding, and then the gynecological examination found a neoplasm between the cervical canal and partially in the external cervical orifice. The diagnosis of EES was confirmed below: Hematoxylin & Eosin staining (H&E) revealed small round blue malignant cells in biopsy specimens. Immunohistochemistry (IHC) showed the positive staining for CD99, NKX2.2, and FLI1. Disruption of EWSR1 gene was found by fluorescence in situ hybridization (FISH), and the EWSR1–FLI1 gene fusion was determined by next-generation sequencing (NGS). The patient received laparoscopic wide hysterectomy, bilateral adnexectomy, pelvic lymphadenectomy, and postoperative adjuvant chemotherapy and remained disease free with regular follow-up for 1 year. Conclusions: Through a systematic review of previously reported cervical ES and this case, we highlighted the importance of FISH and NGS for the accuracy of ESS diagnosis, which could assist on the optimal treatment strategy. However, due to the rarity of the disease, there is no standard treatment schemes. Investigation on molecular pathological diagnosis and standardization of treatment regimens for cervical ES are critical to patients’ prognosis. [ABSTRACT FROM AUTHOR]

Issue Addressed: Cervical screening rates for young women aged between 25 and 35 are lower than older Australian women, however, little research has been conducted to understand why. This study aimed to identify and explore the barriers and enablers faced by young Victorians with a cervix to regular cervical screening. Methods: This study used a mixed method exploratory design consisting of qualitative focus groups and a quantitative online survey. Four focus groups were conducted with 24 Victorians with a cervix aged between 25 and 35. Barriers, enablers and knowledge of cervical screening were explored. Focus groups were recorded and transcribed for thematic analysis of common themes. A supporting online survey was completed by 98 respondents. Summary statistics were analysed for differences in age. Results: Focus groups and the online survey revealed four main factors that influence young people's cervical screening behaviour. These include past negative screening experiences, practitioner factors, priority placed on cervical screening, and cervical screening knowledge. These factors differ to the opinions of people older than 35, with young people focusing more on the psychological elements of cervical screening compared with practical factors. Conclusions: This research provides a unique insight into cervical screening barriers faced by women and people with a cervix aged between 25 and 35 as well as what factors motivate them to screen. So What?: These findings should be utilised to inform the design of public health campaign messaging targeting this age demographic. Findings can also assist practitioners to improve how they communicate with young people in a clinical setting. [ABSTRACT FROM AUTHOR]

Previously studied classes of pesticides, including organochlorines, organophosphates and pyrethroids disturb the mechanism that causes bovine myometrial contractions. Hence, the aim of this study was to investigate the effects of carbaryl and thiram, which are representative carbamate pesticides commonly used in global agriculture, on the motor and secretory functions of bovine cervixes. Additionally, the impacts of these pesticides on intra- and intercellular signaling in vitro were estimated. In this study, cervical cells or strips were obtained from cows at days 18–20 of the estrous cycle and were treated with carbaryl or thiram. Neither carbamate (10 or 100 ng/ml) exerted cytotoxic effects. Carbaryl increased the level of mRNA (at a dose of 0.1 ng/ml) and protein (at both doses, 1 and 10 ng/ml) expression for the oxytocin receptor (OXTR), while thiram (at 0.1 and 10 ng/ml or 0.1–10 ng/ml, respectively) caused the opposite effects. Moreover, the level of the second messenger inositol-trisphosphate (IP3) was decreased by carbaryl (10 ng/ml) but increased by thiram (10 ng/ml). Only thiram decreased prostaglandin-endoperoxide synthase 2 (PTGS2 ; 0.1 ng/ml) and aldo-keto reductase family 1 , member B1 (AKR1B1; 0.1 ng/ml), and prostaglandin E synthase 2 (PTGES2; 0.1–10 ng/ml) mRNA expression, while thiram (0.1–10 ng/ml) and carbaryl (0.1 and 10 ng/ml) both decreased the release of PGF2α. Carbaryl (10 ng/ml) and thiram (10 ng/ml) also decreased the level of a gap junction protein (GAP). Moreover, carbaryl (10 ng/ml) decreased the level of myosin light chain kinase (MLCK). However, the strength of cervical contractions was increased by thiram (1 and 10 ng/ml) but decreased by carbaryl (1 and 10 ng/ml). Carbaryl increased the receptivity of cervical cells to oxytocin (OXT), but inhibited further transduction (IP3) of this signal. Hence, direct inhibition of cervical strip contraction may occur. In contrast, thiram mostly decreased the receptivity of cervical cells to OXT, while it stimulated the contraction of cervical strips. Moreover, compared to carbaryl, thiram more greatly affected the synthesis and release of prostaglandins. These results suggest that carbaryl and thiram disturb OXT signaling, PG secretion and cervical contraction in vitro. • Carbaryl increased OT receptivity of cervix, while thiram decreased it. • Carbaryl and thiram disturbed intra- and intercellular transduction of OT signals. • Carbaryl and thiram decreased PGF2α secretion from cervical cells. • Thiram increased cervical contraction in cows, while carbaryl decreased it. [ABSTRACT FROM AUTHOR]

Cervical cancer, as the fourth most common cancer in women, poses a significant threat to women's health. Vaginal colposcopy examination, as the most cost-effective step in cervical cancer screening, can effectively detect precancerous lesions and prevent their progression into cancer. The size of the lesion areas in the colposcopic images varies, and the characteristics of the lesions are complex and difficult to discern, thus heavily relying on the expertise of the medical professionals. To address these issues, this paper constructs a vaginal colposcopy image dataset, ACIN-3, and proposes a Fusion Multi-scale Attention Network for the detection of cervical precancerous lesions. First, we propose a heterogeneous receptive field convolution module to construct the backbone network, which utilizes combinations of convolutions with different structures to extract multi-scale features from multiple receptive fields and capture features from different-sized regions of the cervix at different levels. Second, we propose an attention fusion module to construct a branch network, which integrates multi-scale features and establishes connections in both the spatial and channel dimensions. Finally, we design a dual-threshold loss function and introduce positive and negative thresholds to improve sample weights and address the issue of data imbalance in the dataset. Multiple experiments are conducted on the ACIN-3 dataset to demonstrate the superior performance of our approach compared to some classical and recent advanced methods. Our method achieves an accuracy of 92.2% in grading and 94.7% in detection, with average AUCs of 0.9862 and 0.9878. Our heatmap illustrates the accuracy of our approach in focusing on the locations of lesions. [ABSTRACT FROM AUTHOR]

To provide insight into the biological characteristics of the healthy cervix by defining intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters across the menstrual cycle. Forty-three females of reproductive age (18–45 years old) were included in this prospective study. Conventional magnetic resonance imaging (MRI) and IVIM-DWI scans were performed at multiple time-points across the menstrual cycle: T 1 (menses), T 2 (follicular phase), T 3 (luteal phase). Intra- and interobserver repeatability of the IVIM-DWI values were evaluated with intraclass correlation coefficients (ICC), and D* was excluded from the analyses due to poor repeatability. Differences in each IVIM-DWI parameter among T 1 , T 2 , and T 3 were explored. Subjects were stratified by age and parity for subgroup analyses (younger [18 - < 30 years] vs. older [≥30–45 years]; parity 0 vs. parity 1 and 2). Correlations between subject age and IVIM-DWI parameters were assessed. The overlap for each IVIM-DWI parameter among T 1 , T 2 , and T 3 was evaluated. ADC and D values of the cervix were significantly lower at T 3 compared with T 1 (p = 0.02 and 0.03) or T 2 (p < 0.01 and < 0.01). In younger subjects (n = 26), ADC and D values were significantly lower at T 3 compared with T 1 (p < 0.01 and p = 0.02) or T 2 (p = 0.03 and p = 0.04). In older subjects (n = 17), ADC values were significantly higher at T 2 compared with T 1 (p = 0.01) or T 3 (p = 0.01). There were significant differences in ADC values at T 1 in subgroup analyses stratified by age and parity (both p < 0.01). There was a moderate correlation between age and ADC values at T 1. Overlap for IVIM-DWI parameters across the menstrual cycle was >50%. ADC and D values of the heathy cervix differed across the menstrual cycle. Age and parity may influence the ADC value. • There were statistical differences in IVIM-DWI of the healthy cervix. • Studies of IVIM-DWI and cervix should scan in the same stage of menstrual cycle. • IVIM-DWI held potential as a method for studying the cervical physiological cycle. • ADC values decrease progressively with age. • Subgroup analysis may be necessary if study involved childbearing age & cervix. [ABSTRACT FROM AUTHOR]

Nabothian cysts are non-malignant lesions that occur on the cervix and affect a large percentage of reproductive aged women. They usually occur because of childbirth or minor trauma; most of the time, they are small and asymptomatic and require no treatment. However, large Nabothian cysts may vary in appearance and even resemble malignant tumors. Consequently, to rule out malignancy, a biopsy is advised. The greatest valuable imaging modalities for cervical cystic lesions are MRI and transvaginal ultrasonography. Nabothian cysts usually don't need any treatment, but if the lesion's nature is unclear and it hurts, surgery may be necessary. In this case study, chronic pelvic pain is described, and abnormal uterine bleeding needed surgical intervention because of chronic cystic cervicitis and multiple Nabothian cysts accompanied with Leiomyoma accompanied with adenomyosis and endometrial hyperplasia without atypia. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BackgroundAge-specific data on anal, and corresponding cervical, human papillomavirus (HPV) infection are needed to inform female anal cancer prevention.MethodsWe centrally reanalyzed individual-level data from 26 studies reporting HPV prevalence in paired anal and cervical samples by human immunodeficiency virus (HIV) status and age. For women with HIV (WWH) with anal high-grade squamous intraepithelial lesions or worse (HSIL+), we also investigated concurrent cervical cytopathology.ResultsIn HIV-negative women, HPV16 prevalence decreased significantly with age, both at anus (4.3% at 15-24 years to 1.0% at ≥55 years; ptrend = 0.0026) and cervix (7.4% to 1.7%; ptrend < 0.0001). In WWH, HPV16 prevalence decreased with age at cervix (18.3% to 7.2%; ptrend = 0.0035) but not anus (11.5% to 13.9%; ptrend = 0.5412). Given anal HPV16 positivity, concurrent cervical HPV16 positivity also decreased with age, both in HIV-negative women (ptrend = 0.0005) and WWH (ptrend = 0.0166). Among 48 WWH with HPV16-positive anal HSIL+, 27 (56%) were cervical high-risk HPV-positive, including 8 with cervical HPV16, and 5 were cervical HSIL+.ConclusionsAge-specific shifts in HPV16 prevalence from cervix to anus suggest that HPV infections in the anus persist longer, or occur later in life, than in the cervix, particularly in WWH. This is an important consideration when assessing the utility of cervical screening results to stratify anal cancer risk.

Cervical cancer remains one of the most common malignancies diagnosed in women as well as a leading cause of cancer related deaths in women worldwide. Cutaneous metastasis associated with cervical malignancy is a remarkably rare phenomenon. We present a patient whose cutaneous signs led to the diagnosis of metastatic adenocarcinoma of the cervix.

Introduction: Continuation of the disease after cervical conization is probable. Knowing the risk factors involved can facilitate the selection of treatment methods and appropriate follow-up; therefore, this study was conducted with aim to determine the factors related to the remaining positive margin after cervical conization.Methods: In this retrospective cross-sectional analytical study, the clinical records of all women ≥ 18 years with intra-epithelial neoplasia (CIN) type 3 who underwent cervical conization in Imam Hossein (A) Hospital of Tehran (2017-2022) were selected by total population sampling and effective factors on the condition of the internal margin after cervical conization were investigated. The data was analyzed by SPSS software (version 23) and t and Mann-Whitney statistical tests. P

Objective To explore the effect of group cognitive behavioral therapy (CBT) on the clinical outcome of patients with persistent high-risk human papillomavirus (HR-HPV) infection, and to construct a systematic psychological intervention treatment program for persistent HR-HPV infection patients with emotional disorders. Methods A total of 96 patients with persistent HR-HPV infection complicated with emotional disorder admitted in our hospital from September 2021 to March 2022 were recruited, and then randomly divided into an intervention group (n=44) and a control group (n=45) after 5 of them were excluded due to personal reason. The control group received health education and follow-up monitoring, and the intervention group received group CBT intervention additionally. Their clinical outcomes and psychological scale scores were compared between the 2 groups. Results In a follow-up for 6 and 12 months, the regression rate of HR-HPV infection was higher, and the sustained infection rate and progression rate of HR-HPV in the intervention group than the control group (P < 0.05). The intervention group also obtained lower scores of Nine-Item Patient Health Questionnaire (PHQ-9) and generalized anxiety scale (GAD-7) immediately after the intervention, and 6 and 12 months in follow-up for when compared with the control group (P < 0.05). And the scores at above time points were statistically lower than those before intervention in the intervention group (P < 0.05), but no such differences were observed in the control group (P>0.05). Conclusion Systematic psychological intervention treatment is beneficial to HR-HPV infection subside for patients with persistent HR-HPV infection. [Key words] human papillomavirus , cognitive behavioral therapy , cervix, reversion ,

Yuelin Song,1,2,&ast; Ruizhe Li,1,2,&ast; Lifei Wang,3 Hongjing Wang1,2 1Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, People’s Republic of China; 2Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People’s Republic of China; 3Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hongjing Wang, West China Second University Hospital of Sichuan University, No. 20, Section 3, Renmin South Road, Wuhou District, Chengdu, Sichuan Province, 610041, People’s Republic of China, Tel +86 181 8060 9060, Email whjscdx@163.comAbstract: Primary angiosarcomas are a rare type of soft-tissue sarcomas that originate from endothelial cells. These sarcomas can develop in any part of the body and have a poor prognosis. However, they are commonly found in the skin of elderly white men, particularly on the scalp and head region. Primary angiosarcoma of the cervix is exceptionally rare. To date, only two cases of this disease have been reported worldwide. The diagnosis of the disease is difficult microscopically, requiring immunohistochemistry and genetic testing to distinguish. We report a recent case, in which the lesion was preoperatively considered a high-grade endometrial stromal sarcoma. A 35-year-old woman presented with vaginal bleeding and cervical erosions. A high-grade endometrial stromal sarcoma involving the cervix was considered and a modified radical hysterectomy was performed with bilateral salpingo-oophorectomy and sentinel lymph nodes resection. The gene diagnosis performed by fluorescence in situ hybridization for YWHAE translocation fusion was negative excluding a YWHAE-translocated high-grade endometrial stromal sarcoma. A primary angiosarcoma of the cervix was finally diagnosed. Primary angiosarcoma of the cervix is rare, and gynecologic pathologists do not know it well, so it is easy to be wrongly considered. Immunohistochemistry and genetic testing help confirm the diagnosis.Keywords: angiosarcoma, case report, cervix, genetic testing, immunohistochemistry

Screening for cervical abnormalities is crucial to reduce the risk of developing abnormal cells in the cervix. Several pathological methods have been proposed to date, however, they require exhaustive histological examination and time. In this paper, we proposed a method to localize the abnormality by using reconstruction images. The weighted frequency-difference Electrical Impedance Tomography (WfdEIT) method was implemented on three cervical specimens: one normal, one with Cervical intraepithelial neoplasia (CIN) grade 2, and one cancer specimen. A 16-electrode probe was developed to work with an EIT system operated at 2-125 kHz excitation frequencies. Experimental results have shown that the abnormalities in the specimens could be identified in most cases, represented by the positive conductivity changes. The localization of the CIN2 specimen was more accurate than that of the cancer specimen. The conductivities of the transformation zone (TZ) part and the cancer region of the specimens were significantly higher than those of the ectocervical part by 1.5-2.2 times. Interestingly, the tissue in the TZ part had a similar frequency spectrum of conductivity to the tissue with cancer and this caused difficulty to distinguish between them. The TZ region of the specimens in the reconstruction images was always positive in conductivity change in a similar manner to cancer. The abnormality imaging for identifying cancer in the TZ region is then still challenging.

Abstract Background In Sub-Saharan Africa, the prevalence of dyslipidemia is on the rise, with studies showing dyslipidemia as a contributing factor to the progression of premalignant lesions to cervical cancer. In Uganda, cervical cancer and dyslipidemia are common health concerns, considering the increasing trends of dyslipidemia in the general population and inadequate information regarding dyslipidemia and cervical lesions. This study aimed to determine the prevalence of dyslipidemia and its association with precancerous and cancerous lesions of the cervix among women attending a cervical cancer clinic at the Uganda Cancer Institute. Methods This cross-sectional study was conducted from February to April 2022 among women with premalignant and malignant lesions of the cervix. Data on social demographics and health-seeking behaviours were collected using a pretested structured questionnaire after written informed consent had been obtained. Pap smear collection preceded visual inspection with acetic acid; cervical biopsies were collected appropriately from eligible participants; and cervical lesions were classified using the Bethesda system 2014. Serum lipids, total cholesterol (T.C.), high-density lipoprotein (HDLc), low-density lipoprotein (LDLc), and triglycerides (T.G.s) were analysed using the COBAS™ 6000 Clinical Chemistry Analyser. The associations were assessed using the chi-square test, and P ≤ 0.05 was considered statistically significant. Results The overall prevalence of dyslipidemia among women with cervical lesions was 118/159 (74%), and low HDLc was the most prevalent at 64.6% (95% CI 39.0–54.3). High T.C. (P = 0.05), high T.G.s (P = 0.011), and low HDL-c (P = 0.05) showed a significant association with precancerous lesions. High LDL-c (P = 0.019), high T.G.s (P = 0.02), and high T.G.s (P

Background: Cervical cancer is the fourth most common cancer in women with an estimated. 6,04,000 new cases in 2020 representing 66% of all female cancers. It is the leading cause of cancer-related death among women. Objectives: To assess the awareness about risk factors of cancer cervix and factors associated with it. Subjects and Methods: This is a community-based cross-sectional study done in rural field practice area of a Medical College, Hyderabad, Telangana from March to June, among all consenting women in reproductive age group. Data were collected using a predesigned semi-structured questionnaire which contains questions on sociodemographic factors, reproductive risk factors such as age at marriage, prolong use of OCPs, and multiple births. Results: Out of the 270 females, respondents belonged majorly to 25 − 34 years age group. About 76.2% of the respondents (206/270) had heard about cervical cancer, of the 76.2% of the study subjects who had heard about cancer cervix, none of them were aware about pap test and vaccination for human papilloma virus (HPV) which is meant to prevent cancer cervix. Conclusion: The study showed that women had a fair knowledge about risk factors and symptoms of cancer cervix. Awareness on screening tests, i.e., pap test, HPV vaccinations was poor.

BACKGROUND: Hormonal changes during the menstrual cycle play a key role in shaping immunity in the cervicovaginal tract. Cervicovaginal fluid contains cytokines, chemokines, immunoglobulins, and other immune mediators. Many studies have shown that the concentrations of these immune mediators change throughout the menstrual cycle, but the studies have often shown inconsistent results. Our understanding of immunological correlates of the menstrual cycle remains limited and could be improved by meta-analysis of the available evidence. METHODS: We performed a systematic review and meta-analysis of cervicovaginal immune mediator concentrations throughout the menstrual cycle using individual participant data. Study eligibility included strict definitions of the cycle phase (by progesterone or days since the last menstrual period) and no use of hormonal contraception or intrauterine devices. We performed random-effects meta-analyses using inverse-variance pooling to estimate concentration differences between the follicular and luteal phases. In addition, we performed a new laboratory study, measuring select immune mediators in cervicovaginal lavage samples. RESULTS: We screened 1570 abstracts and identified 71 eligible studies. We analyzed data from 31 studies, encompassing 39,589 concentration measurements of 77 immune mediators made on 2112 samples from 871 participants. Meta-analyses were performed on 53 immune mediators. Antibodies, CC-type chemokines, MMPs, IL-6, IL-16, IL-1RA, G-CSF, GNLY, and ICAM1 were lower in the luteal phase than the follicular phase. Only IL-1α, HBD-2, and HBD-3 were elevated in the luteal phase. There was minimal change between the phases for CXCL8, 9, and 10, interferons, TNF, SLPI, elafin, lysozyme, lactoferrin, and interleukins 1β, 2, 10, 12, 13, and 17A. The GRADE strength of evidence was moderate to high for all immune mediators listed here. CONCLUSIONS: Despite the variability of cervicovaginal immune mediator measurements, our meta-analyses show clear and consistent changes during the menstrual cycle. Many immune mediators were lower in the luteal phase, including chemokines, antibodies, matrix metalloproteinases, and several interleukins. Only interleukin-1α and beta-defensins were higher in the luteal phase. These cyclical differences may have consequences for immunity, susceptibility to infection, and fertility. Our study emphasizes the need to control for the effect of the menstrual cycle on immune mediators in future studies.