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At least 1,117 records · Page 62Linked to original sources
PubMed2006

Determination of HPV type 16 and 18 viral load in cervical smears of women referred to colposcopy.

It has been recognized that human papillomavirus infection is the major causal factor for high-grade cervical lesions. The aim of the study was to evaluate the relationship between HPV 16 and 18 viral loads and cervical status in different age strata. A duplex real time PCR method was devised to determine HPV 16 and 18 viral load per million of human cells using an in house plasmidic construct as a standard of quantification. The 151 cervical scrapes were collected before colposcopic examination from either abnormal cervico-vaginal smear (group 1, 97 patients) or from post treatment clinical follow-up (group 2, 54 patients). In women aged 30-40, the HPV16 viral loads were significantly higher in high-grade squamous intraepithelial lesion than in low-grade squamous intraepithelial lesion in both groups and HPV18 in group 1. In women aged 20-30 of group 1, high HPV viral load was associated in few cases with high-grade squamous intraepithelial lesion or low-grade squamous intraepithelial lesion, and surprisingly in some patients with normal cervix. HPV 16 and 18 viral loads are related to the severity of cervical lesion, and may be useful in the clinical management of cervical lesions. A specific follow-up may be useful for those with high viral load despite normal cervix.

Adolescent↗
PubMed2004

Imaging of an enterovaginal fistula with flexible colposcopy, an endoscopic retrograde cholangiopancreatography cannula and radiographic screening.

The diagnosis of a rectovaginal or enterovaginal fistula is mostly made by a careful historical of a faecal vaginal discharge. When a rectovaginal fistula is low, an examination will demonstrate it with ease. However, when there is a high and small fistula into the vault or the fornix of the vagina, traditional methods of small bowel enema and barium enema may not demonstrate the fistula. Ultrasound and magnetic resonance imaging may demonstrate a fistula but not the nature of the bowel involved. Vaginography has been the most successful imaging method to date. Demonstrating an enterovaginal fistula and substantiating whether or not the rectum, the small bowel alone or both are implicated are important for operation planning; a fistulogram through the vagina by endoscopic method is a simple and useful adjunct to the available methods of imaging enterovaginal fistulas. We report a case and discuss a technique of endoscopic fistulography through a small fistulous opening high in the vagina. We believe that this technique is accurate, simple and complementary to vaginography in demonstrating an enterovaginal fistula.

Adult↗
PubMed2004

Women with low-grade abnormalities on Pap smear should be referred for colposcopy.

AIM: To assess cytological, colposcopic and histological outcomes in women referred to a teaching hospital dysplasia clinic with low-grade changes on screening Pap smear. METHODS: Analysis of a computerised database. RESULTS: Repeating the Pap test was of little value. Fifteen percent of women with low-grade changes on the referral smear had biopsy proven high-grade change. There was little difference in biopsy proven high-grade change in women referred with an 'abnormal smear of uncertain significance' (23%) or 'an abnormal smear of uncertain significance-possible high-grade change' (24%). CONCLUSIONS: Given these findings and the current medico-legal climate, immediate referral of women with low-grade changes on routine cytology is indicated, and seems a safer option than the more conservative approach of a repeat smear in 6 or 12 months. Further study of the usefulness of separating smears of uncertain significance into high-grade and low-grade categories is warranted. Consumer input into recommendations for management of Pap smear abnormalities is required.

Biopsy↗