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At least 1,387 records · Page 77Linked to original sources
PubMed1986

Control of cancer of the cervix uteri. A WHO meeting.

Cancer of the uterine cervix is a global problem. It is the most common cancer in women in developing countries and is the second most common cancer in women worldwide, with approximately half a million new cases each year. It is strongly linked with an early onset of sexual activity and multiple sexual partners; recent evidence points to a causal link between some of the precursor lesions of this cancer and specific papillomavirus infections. Cervical cancer has significant morbidity and mortality if it is not detected before it reaches an advanced stage with symptoms. If the disease is detected in an early asymptomatic stage it is nearly always curable by surgery or radiotherapy. Therefore today, cytological screening is the mainstay for control of cervical cancer.In some developed countries, screening programmes for cervical carcinoma have been in operation for many years. In places where large well-organized programmes have been functioning, significant decreases in mortality, in the range of 50-60%, have been observed. The favourable effects result primarily from the removal of intraepithelial lesions preventing the occurrence of invasive tumours.In countries where resources are limited, the aim should be to screen every woman once in her lifetime between 35 and 40 years of age. When more resources are available the frequency of screening should be increased to once every ten or five years for the age groups 35 to 55 years and, ideally, once every three years for women aged between 25 and 60 years.

Africa↗
PubMedDate not supplied

The prevalence of Chlamydia trachomatis in a young, sexually-active population.

A prospective study was carried out to determine the prevalence of Chlamydia trachomatis among 1000 sexually-active women at the Family Planning Association Clinic in Melbourne. This organism was isolated from the cervices of 5.1% of screened women. The women were surveyed about their sexual and gynaecological history, and symptoms of discharge or pain. It was found that women who gave positive results for the presence of Chlamydia were younger, and had commenced intercourse at an earlier age. Risk factors of multiple sexual partners, cervical ectopy and symptoms of urethritis were identified. We recommend that women who have more than one sexual partner should ask their partners to use condoms or, failing this, undergo annual screening for Chlamydia by immunofluorescent staining.

Adult↗
PubMed1987

The Cape Town Teenage Clinic.

Over a 6-month period 265 white females aged under 24 years attending the Teenage Clinic of the Western Cape Region of the Family Planning Association were interviewed at their first visit; 81% were sexually active. The age of menarche and the parents' marital status were important parameters of socio-sexual behaviour. The earlier the menarche, the higher the prevalence of coitus at a younger age, and the shorter the interval between menarche and the first coitus. Young age at first coitus, in turn, was associated with a higher prevalence of multiple sexual partners and smoking, and a longer period of unprotected intercourse before attending the clinic than among those who first attempted intercourse at a later age. Of those who had first experienced coitus at under 17 years, 37% came from single-parent families, compared with 12% of those in whom coitus was delayed until over 19 years of age. The important health and educational implications are discussed.

Adolescent↗
PubMed1987

Epidemiology of cervical cancer by cell type.

A multicenter case-control study of 481 invasive cervical cancer patients and 801 population controls enabled comparison of risk factors for squamous cell tumors (n = 418), adenosquamous cancers (n = 23), and adenocarcinomas (n = 40). The epidemiology of the squamous cell tumors resembled that found in other studies, with the major risk factors being absence of Pap smear screening (relative risk = 3.6 to 4.8 for those not screened within 5 yr), multiple sexual partners (relative risk = 2.9 for over ten partners), and history of genital infections or sores (relative risk = 2.3). Although based on small numbers, adenosquamous tumors appeared to share some of these risk factors, notably number of sexual partners, years since last Pap smear, and level of education. Adenocarcinomas were not similarly affected, although sexual practices were marginally predictive. Obesity increased the risk of adenocarcinoma, but no other similarities to endometrial adenocarcinoma were observed. Smoking was a significant predictor of squamous cell tumors but did not affect adenocarcinomas. Extended use of oral contraceptives was a risk factor for all tumor types, especially adenocarcinoma, and a familial tendency to cervical cancer was also observed for all cell types.

Adenocarcinoma↗
PubMed1976

In vivo and in vitro "markers" of human cervical intraepithelial neoplasia.

The human uterine cervix offers a unique opportunity to study the early lesions of squamous cell carcinoma, i.e., carcinoma in situ and dysplasia [combined as cervical intraepithelial neoplasia (CIN)]. In vivo, the patients with CIN have the epidemiological common denominators or "markers" of early onset of coitus, multiple sexual partners, 1st delivery before age 20, and antibodies to herpes simplex virus type 2 more frequently than do controls. The lesions themselves have specific epithelial and vascular changes observable with the colposcope in addition to the usual histological markers from biopsy specimens. The chromosomes and DNA content of cells in these lesions are abnormal. In vitro, the cells from CIN have characteristics somewhat between normal and invasive carcinoma. They lack contact inhibition and may be transferred for several generations, in contrast to normal cervical epithelial cells. The fibroblasts from areas adjacent to DIN are different from normal fibroblasts. The mitotic mechanism in cells cultured from CIN has a significantly prolonged prophase and telophase when compared to similar normal cells. The surface of CIN cells, unlike normal cells, has numerous microvilli when examined by scanning electron microscopy and has characteristic differences from normal cells with numerous elongated, irregular microvilli. With the transmission electron microscope, an increase in microvilli and a decrease in desmosomes and tonofibrils are seen in CIN cells. Some of these markers are being used clinically to manage patients with CIN. Other markers are the basis for further investigation of human carcinogenesis.

Antibodies, Viral↗
PubMedDate not supplied

Intravenous drug users and the acquired immune deficiency syndrome.

Acquired immune deficiency syndrome (AIDS), a new epidemic disease characterized by dysfunction of cellular immunity, is most common among homosexual and bisexual males with multiple sexual partners and users of intravenous drugs. AIDS appears to be spread by contact with blood products and body fluids. Not only is the heroin user at increased risk of contracting AIDS, but also the occasional recreational drug user who shares a needle and syringe when he or she self-administers cocaine or amphetamines at a party on a weekend. Although precise figures are not available, there may be as many as several million recreational and regular users of cocaine and heroin. Data from a national sample of drug abuse treatment programs indicates that more than 80 percent of all clients seeking treatment, whatever their primary drug of abuse at the time of admission to treatment, have administered drugs to themselves intravenously during the year before treatment. Several hundred thousand treatment episodes occur each year. Data from surveys indicate that drug users entering treatment are well aware of the increased risks associated with AIDS. It is not surprising that treatment staff, also, have expressed concerns about their own susceptibility to the disease. Special education programs for these health workers have been instituted in New York City and have met with success. These programs have provided information and reassurance to treatment providers. At present, no health worker providing direct treatment service to drug abusers with a history of intravenous drug use has contracted AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1984

[Prevention of Chlamydia trachomatis infections in women].

Over the past several years, the incidence of chronic salpingitis has increased relentlessly, with its accompanying pelvic pain, ectopic pregnancies, and tubal sterility. Chlamydia are a frequent etiologic agent. Preventing these infections is difficult, nevertheless proper care will be given by recalling four key words: avoidance, diagnosis, education, and treatment. It is important to discourage early sexual activity and multiple sexual partners, to encourage the use of condoms, and avoid the use of an intrauterine device in adolescents. Atypical presentations of salpingitis must be recognized and treated effectively, thus preventing the spread of infection. Education on venereal diseases should be presented in secondary schools, during military service, and other similar groups, but especially during physician visits for contraception.

Adolescent↗
PubMed1984

The significance of finding curved rods in the vaginal secretions of patients attending a genito-urinary medical clinic.

Curved rods were found in 108 (21.6%) of 500 women consecutively attending a genito-urinary medical clinic. A positive association was elicited with the wearing of an intra-uterine contraceptive device (p less than 0.001), intercourse with a casual or multiple sexual partners within the preceding 3 months (p less than 0.001) and concurrent chlamydial infection of the uterine cervix (p less than 0.025). There was no apparent relationship with contact with non-candidal balanitis, but an increased rate (31.3%) was noted in contacts of non-gonococcal urethritis indicating a need for further research into a possible aetiological role.

Bacteria, Anaerobic↗
PubMed1983

Alternative causes of pelvic inflammatory disease.

Seminal fluid from asymptomatic men reveals a wide variety of aerobic and anaerobic bacteria. The number of bacteria tends to correlate with the sexual experience of the individual. Experimental evidence has shown that these bacteria can attach themselves to moving spermatozoa and travel through ovulatory-phase cervical mucus. Exogenously added bacteria also exhibit the same potential. These experimental results suggest a rational explanation for the development of pelvic inflammatory disease in promiscuous women with multiple sexual partners. In addition, the findings help to explain the marked difference observed in the rate of pelvic inflammatory disease among patients using barrier-type birth control and oral contraceptives as compared with the rate among women who use intrauterine devices, with which the ovulatory-phase cervical mucus is unprotected.

Adolescent↗
PubMed1982

Review of the epidemiology of cervical cancer in the Pacific Basin.

Cervical cancer, despite its declining incidence in the developed countries, is still an important cancer in the less-developed world. The mortality and incidence trends for some of the countries in the Pacific Basin are presented. Among the high-risk communities and populations are Colombia (Cali), New Zealand (Maoris), El Paso, Texas (Latin Americans), California (blacks), Hawaii (Hawaiians), Singapore (Chinese and Indians), Hong Kong, Philippines (Manila), New Caledonia (Melanesians), Alaska (American Indians), Fiji. The major risk factors are summarized, with age at first coitus as the key factor; some doubts are expressed about the validity of multiple sexual partners and circumcision of male partners as risk factors. The likely role of herpesvirus is still being studied, and the possible increase in incidence of cervical cancer among younger women could be attributed to greater sexual promiscuity in that group. Some suggestions for future research are made.

Asia, Southeastern↗
PubMed1995

Expression of the proto-oncogene rhombotin-2 is identical to the acute phase response protein metallothionein, suggesting multiple functions.

Rhombotin-2 (RBTN-2) is a LIM domain protein that, with the exception of thymocytes, is widely expressed during fetal development. Although RBTN-2 is crucial for normal erythropoiesis, the ectopic expression of RBTN-2 in T lymphocytes results in T-cell proliferation and leukemogenesis. Thus, while a proliferative function for RBTN-2 has been established in T-cells, neither its role in erythropoiesis nor its function(s) in other tissues are known. We have examined the expression and location of RBTN-2 in normal and malignant cells. Similar to fetal development, RBTN-2 RNA was detected in all normal adult tissues tested with the exception of colon and thymocytes. RBTN-2 RNA was not detected in all primary tumors and tumor cell lines, indicating RBTN-2 expression is not ubiquitous in proliferating cells. Using polyclonal antisera, RBTN-2 was detected predominantly in the nucleus of human hematopoietic cells. Significantly, human leukemic T cells with disruption of the RBTN-2 locus and thymocytes from transgenic mice with enforced expression of RBTN-2 showed similar nuclear location of RBTN-2 protein, consistent with the notion that RBTN-2 acts as a transcriptional regulator in T-cell proliferation. Surprisingly, in normal tissues, RBTN-2 showed a strikingly similar distribution to that of metallothionein-1, having both nuclear and cytoplasmic localization that suggested that RBTN-2 may be involved in the acute phase response. Indeed, similar to metallothionein-1, RBTN-2 mRNA was induced in thymocytes of mice exposed to zinc and in human thymocytes treated with the phorbol ester 12-O-tetradecanoylphorbol-13-acetate. Since the LIM domain permits binding of multiple protein partners, the specific function of RBTN-2 may depend upon subcellular sequestration through interaction with different cofactors. Thus, in addition to its roles in erythropoiesis and T-cell leukemia, RBTN-2 may also be involved in the acute phase response.

Acute-Phase Proteins↗
PubMed1994

AIDS knowledge, attitude and behaviour patterns among university students in Ibadan, Nigeria.

This study investigated the knowledge, attitudes and personal behaviours of University students on AIDS. Two hundred and fifty students from the University of Ibadan randomly selected from eight faculties were surveyed. Results indicated that 58.7% of the subjects knew that AIDS is caused by a virus but 72.6% thought the disease could be spread through kissing, hugging or shaking hands and 48.0% believe they cannot have AIDS. Most students showed a high degree of aversion to AIDS victims while about a quarter reported having multiple sexual partners in the last five years. The results suggest that well organised, specifically targeted educational programmes are needed for University students.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Acquired immunodeficiency syndrome-related Kaposi's sarcoma.

OBJECTIVE: To describe Kaposi's sarcoma (KS) associated with the acquired immunodeficiency syndrome (AIDS). DESIGN: A review of AIDS-related KS (AIDS-KS), with its associated epidemiologic and etiologic characteristics, pathogenesis, clinical manifestations, histopathologic features, prognosis, and treatment, is presented. RESULTS: KS is the most frequent malignant lesion in patients with AIDS. The incidence of AIDS-KS is high in homosexual and bisexual men who have multiple sexual partners and in children and women with the human immunodeficiency virus (HIV) infection. Anal-oral contact is one of the main routes of the sexually transmitted agents of AIDS-KS. The major pathogenic factors that may possibly induce AIDS-KS are HIV itself or other sexually transmitted agents, HIV tat gene, some oncogenes and cytokines such as interleukin 6, basic fibroblast growth factor, transforming growth factor-beta, oncostatin M, and platelet-derived growth factor. Treatment includes local therapy, radiotherapy, systemic chemotherapy, zidovudine, interferon, granulocyte-macrophage colony-stimulating factor, and other agents. CONCLUSION: KS may be an early manifestation of AIDS and the most frequent neoplastic complication of AIDS. Growth factors, cytokines, immunosuppression, and interaction with infectious agents seem to have a role in the development of this enigmatic disorder. Treatment of KS should be individualized. Further investigation of the agents and factors of AIDS-KS may help facilitate the treatment and prevention of this neoplasm.

Acquired Immunodeficiency Syndrome↗
PubMed1994

[Social characteristics of a HIV-positive patient group].

OBJECTIVE: To discover the social, economic and cultural characteristics of the HIV+ population within our health area and any consequent implications for the spread of the disease. DESIGN: A descriptive study by means of a direct questionnaire. SETTING: The Macarena area in Sevilla. PATIENTS: 110 HIV+ patients. MEASUREMENTS AND MAIN RESULTS: A questionnaire, which included items concerning work situation, cultural and economic status, drug habits, sexual behaviour and social situation, was administered to 110 people. The determinant social profile of those patients studied was: male, PVDU, between 25 and 34, heterosexual, with multiple sexual partners, resident in the urban area, economically dependent on their parents with whom they live, and having a low education level. Homosexual patients had a higher education level. CONCLUSIONS: 1. The social conditions of marginal groups must be changed, in order to lessen drug consumption and so cut the epidemiological transmission chain. 2. High-risk behaviour, rather than high-risk groups, should be referred to, given that (albeit to a lesser degree) this infection can affect people at any social level, who engage in high-risk activities.

Adolescent↗
PubMed1993

[ALAT and viral RNA as risk factors in 68 blood donors with anti-hepatitis C antibodies].

AIM: Determine the risk factors in blood donors with anti hepatitis C antibodies (anti-HCV ab) possible liver involvement and evaluation of their infectious potential by a search for viral RNA in blood. METHODS: Between July 1990 and October 1991, 19,632 blood donors were screened for hepatitis C. Antibodies to HCV were detected in 74 donors (2nd generation ELISA, Abbott). We evaluated the risk factors, determined ALAT levels and looked for circulating RNA virus by amplification of the non-coding region of the viral genome (RTPCR) in 68 of these 74 donors screened. A control was chosen arbitrarily from 103 donors with high ALAT levels, but with no antibodies to HCV nor detectable circulating viral DNA. RESULTS: The prevalence of anti-HCV ab in blood donors in 0.37%. No risk factor was found in 29 donors (43%). Parenteral exposure (former i.v. drug addiction and history of transfusions) was found to be the mode of transmission of hepatitis C in 23 donors (34%). History of NANB jaundice (non-post transfusion) was reported in 1 donor (1%). The remaining 15 donors (22%) were found to have minor risk factors - either isolated or in combination (exposure, tatoos, multiple sexual partners). Former i.v. drug addiction (p = 0.0000006) as well as a history of transfusions (p = 0.0071) are significantly more frequent in the group of donors with antibodies to HCV. None of the 35 sexual partners of the tested donors proved to be positive. 21 donors (30%) had high ALAT (+2 SD). Viral RNA was detected in blood of 26 donors (38%). The proportion of cases with positive viral RNA was 61% if only those donors with high ALAT levels were taken into consideration (13 positive of 21). CONCLUSIONS: Risk factors were found in 39 donors (57%) with antibodies to HCV. History of parenteral exposure was found to be significantly more frequent than in the control group (p = 0.0000054). Sexual transmission within couples was not demonstrated in the population tested. A positive PCR test is a probable indicator of a continuous viral replication and reflects a possible chronic hepatic involvement as well as a potential infectivity. This test is positive in at least 38% of donors with antibodies to HCV and in more than 60% of those who, in addition, have high ALAT levels.

Alanine Transaminase↗