PubMed · 15397631
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D COULTON. 1949. Cervicitis.. https://pubmed.ncbi.nlm.nih.gov/15397631/
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OBJECTIVE: To review the most recent and relevant issues concerning paracervical block in obstetrics since 1975 when Jägerhorn described the superficial technique that has become a standard. DATA SOURCES: Extraction from Pubmed database of articles issued from 1975 to 2005. DATA SELECTION: The collected articles were selected on the basis of the use of the superficial injection method. The more recent data were selected. The keywords were: paracervical, labour, childbirth, and neonate. DATA SYNTHESIS: Paracervical block (PCB) is routinely used over the world despite the risk of foetal bradycardia. Bradycardia occurring immediately after the performance of block is short lasting. The reports of few cases of foetal or neonatal deaths have caused many physicians to question its safety. The incidence of bradycardia has dramatically decreased (less than 10%) due to the Jägerhorn superficial injection method. In case of healthy neonate the occurrence of bradycardia is harmless but its mechanism is still imprecise. The intensity an duration of analgesia is poor in comparison with epidural anaesthesia. PCB is a viable alternative to epidural in selected cases.
Human papillomavirus (HPV) is an etiologic agent for both oropharyngeal and cervical cancers, yet little is known about the interrelationship between oral and cervical HPV infections. Therefore, we compared the prevalences and type distributions of oral and cervical HPV infections and evaluated infection concordance in a cross-sectional study within the Women's Interagency HIV Study cohort. Oral rinse and cervical-vaginal lavage samples were concurrently collected from a convenience sample of 172 human immunodeficiency virus (HIV)-positive and 86 HIV-negative women. HPV genomic DNA was detected by PGMY09/11 L1 consensus primer PCR and type specified by reverse line blot hybridization for 37 HPV types and beta-globin. Only 26 of the 35 HPV types found to infect the cervix were also found within the oral cavity, and the type distribution for oral HPV infections appeared distinct from that for cervical infections (P<0.001). Oral HPV infections were less common than cervical infections for both HIV-positive (25.2% versus 76.9%, P<0.001) and HIV-negative (9.0% versus 44.9%, P<0.001) women. Oral HPV infections were more common among women with a cervical HPV infection than those without a cervical HPV infection (25.5% versus 7.9%, P=0.002). The majority of women (207; 93.7%) did not have simultaneous oral and cervical infections by the same HPV type; however, the number of women who did (14; 6.3%) was significantly greater than would be expected by chance (P=0.0002). Therefore, the oral and cervical reservoirs for HPV infection are likely not entirely independent of one another.
The majority of existing human papillomavirus (HPV) genotyping assays are based on multiplex PCR using consensus or degenerate primers. We developed a Templex HPV assay that simultaneously detects and identifies 25 common HPV genotypes in a single-tube reaction using type-specific primers for the HPV-specific E6 and E7 genes. The analytical sensitivities of the Templex assay for HPV type 16 (HPV-16), -18, and -56 were 20, 100, and 20 copies per reaction mixture, respectively. The Templex assay provides semiquantitative information on each type when multiple HPV types coexist in one reaction. We tested 109 clinical cervical specimens previously evaluated with the Digene HC2 high-risk HPV DNA test and found 95.4% concordance between the assay results. The Templex assay provided type-specific results and found multiple types in 29.2% (14 of 48) of high-risk HPV-positive samples. The entire Templex procedure, including DNA extraction, can be completed within 5 hours, providing a rapid and reliable diagnostic tool for HPV detection and typing that is amenable to automation.