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Barriga J, Mathews C, Marino C, Tombazzi C. 71 HEMOBILIA AFTER LAPAROSCOPIC CHOLECYSTECTOMY: CASE REPORT. J Investig Med 2016. [DOI: 10.2310/6650.2005.x0008.70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Lokich E, Quddus M, Raker C, Mathews C. Molecular markers in uterine papillary serous carcinoma: Correlation between endometrial biopsy and hysterectomy specimens. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lokich E, Palisoul M, Romano N, Craig Miller M, Robison K, Stuckey A, DiSilvestro P, Mathews C, Granai CO, Lambert-Messerlian G, Moore RG. Assessing the risk of ovarian malignancy algorithm for the conservative management of women with a pelvic mass. Gynecol Oncol 2015; 139:248-52. [PMID: 26364809 DOI: 10.1016/j.ygyno.2015.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 09/05/2015] [Accepted: 09/08/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To evaluate the use of as an aid in the identification of women who can safely undergo conservative, non-surgical management. METHODS All patients referred to the Program in Women's Oncology for surgery with a pelvic mass are evaluated at a prospective multidisciplinary tumor board (TB) where ROMA and imaging are used for management recommendations. This study evaluated women presented to TB with a pelvic mass between 2009 and 2013 who had either surgical or conservative management. RESULTS Of the 498 patients assessed, 392 (79%) had benign disease, 22 (4%) had LMP tumors, 28 (6%) had stage I-II epithelial ovarian cancer (EOC), 36 (7%) had stage III-IV EOC and 20 (4%) had non-EOC. Using clinical assessment in conjunction with ROMA, the TB recommended observation in 188 (37.8%) women. All patients diagnosed with an invasive malignancy were recommended for surgery by the TB. In the 315 patients managed surgically, 212 were found to have benign disease and 84 women were diagnosed with an invasive malignancy. The sensitivity for the initial TB recommendations using ROMA in conjunction with clinical judgment for detecting malignancy was 100% with a specificity of 47.7% and a NPV of 100%. When including low malignant potential tumors the sensitivity was 99.1%. For stage I-IV EOC ROMA alone had a sensitivity of 95.3%. CONCLUSIONS ROMA in conjunction with clinical assessment can safely identify women for conservative management.
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Murphy K, Steyn K, Mathews C. The midwife's role in providing smoking cessation interventions for pregnant women: The views of midwives working with high risk, disadvantaged women in public sector antenatal services in South Africa. Int J Nurs Stud 2015; 53:228-37. [PMID: 26302658 DOI: 10.1016/j.ijnurstu.2015.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 08/04/2015] [Accepted: 08/04/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the knowledge, attitudes, beliefs and current practices of South Africa midwives in relation to providing smoking cessation education or counselling to pregnant women. This was with a view to involving them in a potential smoking cessation intervention, targeting a sub-group of South African women who are at particularly high risk of the adverse pregnancy outcomes associated with smoking. DESIGN A cross-sectional survey of midwives, supplemented by individual, in depth, qualitative interviews. SETTING Public sector antenatal clinics serving this particular community of women in five of the major urban centres of South Africa. PARTICIPANTS A total of 102 midwives were surveyed across 29 antenatal clinics and 24 were interviewed. MEASUREMENTS Self-administered survey and semi-structured, individual interviews describing constructs from the Theory of Planned Behaviour with respect to the provision of smoking cessation education/counselling, including: knowledge, attitudes, subjective norms and perceived behavioural control. FINDINGS The majority of midwives accepted that providing smoking cessation advice was a part of their remit, perceived prevailing social norms to be supportive and were, overall, positively predisposed to participating in a smoking cessation intervention in antenatal clinics. However, the study identified a number of constraints to midwives fulfilling this role, which affected their perceived behavioural control. These included stressful working conditions, too little time, a dearth of educational resources and a lack of knowledge of best practice intervention methods and counselling skills. Perceived patient resistance to quitting was a further obstacle. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE For the intervention to be accepted and adopted by midwives, it would need to offer them an opportunity to enhance their professional knowledge and expertise, provide them with attractive educational aids and take into account the very limited time they have for smoking education. Patient-centred, best practice methods for cessation counselling may help midwives overcome the problem of patient resistance and to engage smokers in constructive discussions about smoking with a greater prospect of success.
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Lokich E, Palisoul M, Romano N, Stuckey A, Robison K, DiSilvestro P, Mathews C, Miller M, Granai C, Moore R. ROMA guided conservative management for women diagnosed with an ovarian cyst or pelvic mass. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Urh A, Robison K, Raker C, Steinhoff M, DiSilvestro P, McCourt C, Mathews C, Stuckey A, Granai C, Moore RG. Evaluation of reliability and the predictive value of ICG directed SLN dissection in women with endometrial and cervical cancer. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2014.11.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Wentzensen N, Walker JL, Gold MA, Smith KM, Zuna RE, Mathews C, Dunn ST, Zhang R, Moxley K, Bishop E, Tenney M, Nugent E, Graubard BI, Wacholder S, Schiffman M. Multiple biopsies and detection of cervical cancer precursors at colposcopy. J Clin Oncol 2014; 33:83-9. [PMID: 25422481 DOI: 10.1200/jco.2014.55.9948] [Citation(s) in RCA: 140] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Women with abnormal cervical cancer screening results are referred to colposcopy and biopsy for diagnosis of cervical cancer precursors (high-grade squamous intraepithelial lesions [HSILs]). Colposcopy with a single biopsy can miss identification of HSILs. No systematic study has quantified the improved detection of HSIL by taking multiple lesion-directed biopsies. METHODS The Biopsy Study was an observational study of 690 women referred to colposcopy after abnormal cervical cancer screening results. Up to four directed biopsies were taken from distinct acetowhite lesions and ranked by colposcopic impression. A nondirected biopsy of a normal-appearing area was added if fewer than four directed biopsies were taken. HSIL identified by any biopsy was the reference standard of disease used to evaluate the incremental yield and sensitivity of multiple biopsies. RESULTS In the overall population, sensitivities for detecting HSIL increased from 60.6% (95% CI, 54.8% to 66.6%) from a single biopsy to 85.6% (95% CI, 80.3% to 90.2%) after two biopsies and to 95.6% (95% CI, 91.3% to 99.2%) after three biopsies. A significant increase in sensitivity of multiple biopsies was observed in all subgroups. The highest increase in yield of HSIL was observed for women with a high-grade colposcopic impression, HSIL cytology, and human papillomavirus (HPV) type 16 positivity. Only 2% of all HSILs diagnosed in the participants were detected by biopsies of normal-appearing transformation zone. CONCLUSION Collection of additional lesion-directed biopsies during colposcopy increased detection of histologic HSIL, regardless of patient characteristics. Taking additional biopsies when multiple lesions are present should become the standard practice of colposcopic biopsy.
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Cachay E, Agmas W, Mathews C. Five-year cumulative incidence of invasive anal cancer among HIV-infected patients according to baseline anal cytology results: an inception cohort analysis. HIV Med 2014; 16:191-5. [PMID: 25197003 DOI: 10.1111/hiv.12190] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2014] [Indexed: 01/15/2023]
Abstract
OBJECTIVES The aim of the study was to estimate the cumulative incidence of, and rates of progression to, invasive anal cancer (IAC) according to baseline anal cytology screening category in an unselected HIV clinical care cohort in the antiretroviral era. METHODS A retrospective cohort analysis of HIV-infected patients under care at the University of California at San Diego Owen Clinic was carried out. Patients were eligible for this analysis if they had at least two anal cytohistological results available for longitudinal analysis. Kaplan-Meier analysis was used to estimate the cumulative incidence of IAC over time according to baseline cytology category [less than high-grade intraepithelial lesion (HSIL) versus HSIL]. Cox regression analysis was used to adjust for the following covariates: antiretroviral use, level of HIV viraemia, smoking status and infrared photocoagulation (IRC) ablation therapy. RESULTS Between 2000 and 2012, we followed 2804 HIV-infected patients for a median of 4 years under a clinic protocol requiring baseline anal cytology screening. Incident IAC was diagnosed in 23 patients. Patients with a baseline HSIL anal cytology had an estimated 5-year probability of progression to IAC of 1.7% and an estimated annual progression risk of 1 in 263. None of the examined covariates was significantly associated with IAC incidence when examined in separate unadjusted Cox models. CONCLUSIONS HIV-infected patients with a baseline HSIL anal cytology had a 5-year cumulative incidence of IAC of 1.65%, with an upper 95% confidence bound of 4.5%. This population-based study provides quantitative risk estimates that may be used for counselling patients regarding management options for abnormal cytology results.
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Mathews C, Aarø LE, Grimsrud A, Flisher AJ, Kaaya S, Onya H, Schaalma H, Wubs A, Mukoma W, Klepp KI. Effects of the SATZ teacher-led school HIV prevention programmes on adolescent sexual behaviour: cluster randomised controlled trials in three sub-Saharan African sites. Int Health 2013; 4:111-22. [PMID: 24029149 DOI: 10.1016/j.inhe.2012.02.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
In this study, the effects on young adolescent sexual risk behaviour of teacher-led school HIV prevention programmes were examined in two sites in South Africa (Cape Town and Mankweng) and one site in Tanzania (Dar es Salaam). In Cape Town, Dar es Salaam and Mankweng, 26, 24 and 30 schools, respectively, were randomly allocated to intervention or comparison groups. Primary outcomes were delayed sexual debut and condom use among adolescents aged 12-14 years (grade 8 in South Africa and grades 5 and 6 in Tanzania). In total, 5352, 4197 and 2590 students participated at baseline in 2004 in Cape Town, Dar es Salaam and Mankweng, respectively, and 73% (n = 3926), 88% (n = 3693) and 83% (n = 2142) were retained 12-15 months later. At baseline, 13% (n = 224), 5% (n = 100) and 17% (n = 164) had had their sexual debut, and 44% (n = 122), 20% (n = 17) and 37% (n = 57) of these used a condom at last sex, respectively. In Dar es Salaam, students in the intervention were less likely to have their sexual debut during the study (OR 0.65, 95% CI 0.48-0.87). In Cape Town and Mankweng, the intervention had no impact. The current interventions were effective at delaying sexual debut in Dar es Salaam but not in South Africa, where they need to be supplemented with programmes to change the environment in which adolescents make decisions about sexual behaviour.
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Thomas E, Nugent E, McMeekin D, Walker J, Landrum L, Moxley K, Bishop E, Mathews C, Moore K. Effectiveness of cyanoacrylate microbial sealant (CMS) in the reduction of surgical site infection in gynecologic oncology procedures: A single-center randomized study: Interim analysis. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bastien S, Mason-Jones AJ, De Koker P, Mmbaga EJ, Ross DA, Mathews C. Herpes simplex virus type 2 infection as a biomarker for sexual debut among young people in sub-Saharan Africa: a literature review. Int J STD AIDS 2013; 23:761-6. [PMID: 23155093 DOI: 10.1258/ijsa.2012.011433] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Biological markers are needed in order to provide objective measures to validate self-reported sexual behaviour and interpret prevention trial data. In this review, we evaluated herpes simplex type 2 virus (HSV-2), one of the most prevalent sexually transmitted infections in sub-Saharan Africa as a biological marker of sexual debut. Based on our findings, we do not recommend using HSV-2 as a biomarker for sexual debut due to its low transmission probabilities and the fact that HSV-2 prevalence is not 100% among potential sexual partners. We recommend that the validation of alternative biological measures should be prioritized, and included in future studies and trials of interventions to reduce sexual health risk.
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Dewing S, Mathews C, Schaay N, Cloete A, Louw J, Simbayi L. "It's important to take your medication everyday okay?" An evaluation of counselling by lay counsellors for ARV adherence support in the Western Cape, South Africa. AIDS Behav 2013; 17:203-12. [PMID: 22610373 DOI: 10.1007/s10461-012-0211-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
There is growing interest in standard care programmes for antiretroviral (ARV) adherence support. In South Africa, individual counselling following ARV initiation is a main strategy for supporting adherence in the public sector. Egan's client-centred "Skilled Helper" counselling model is the predominant model used in HIV counselling in this context. This study evaluated counselling delivered by lay ARV adherence counsellors in Cape Town in terms of adherence to Egan's model. Thirty-eight transcripts of counselling sessions with non-adherent patients were analysed based on the methods of content analysis. These sessions were conducted by 30 counsellors. Generally counsellors' practice adhered neither to Egan's model nor a client-centred approach. Inconsistent with evidence-based approaches to counselling for ARV adherence support, counsellors mainly used information-giving and advice as strategies for addressing clients' non-adherence. Recommendations for improving practice are made. The question as to how appropriate strategies from developed countries are for this setting is also raised.
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Bishop E, Nugent E, Mathews C, Farrell R, Landrum L, McMeekin D. Prognostic factors in stage 2B–3B cervical cancer in an era of chemoradiation. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nugent E, Long A, Mathews C, Bishop E, Moxley K, Benbrook D, Wild R, McMeekin D. Biomarkers associated with metabolic syndrome, endometrioid adenocarcinoma (EC) of the uterus, and disease prognosis. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Farrell R, Nugent E, Mathews C, Bishop E, Perry L, Landrum L, Lee S, Kim Y, Nam J, Kim Y, McMeekin D. Outcomes and disease progression after cervical excisional procedures (EPS), loop electroexcisional procedure (LEEP) or cone biopsy specimens (CKC), and radical hysterectomy (RH) for early stage invasive cervical cancer. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.07.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Nugent E, Bishop E, Mathews C, Perry L, Farrell R, Landrum L, Moxley K. The prognostic impact of isolated pelvic lymph node metastasis in a contemporary population of early stage and loco-regionally advanced carcinoma of the uterine cervix. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.07.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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67
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Perry L, Mathews C, Nugent E, Farrell R, Moore K. Para-aortic nodal metastases in the modern era: still a dismal prognosis. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.07.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Dewing S, Mathews C, Schaay N, Cloete A, Louw J, Simbayi L. Behaviour change counselling for ARV adherence support within primary health care facilities in the Western Cape, South Africa. AIDS Behav 2012; 16:1286-94. [PMID: 21983698 DOI: 10.1007/s10461-011-0059-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Health care systems have been described as ideal settings for behaviour change counselling interventions. There is little research evaluating the feasibility of implementing such interventions in routine practice in primary care facilities. We implemented an intervention called Options for Health within routine adherence counselling practice in 20 antiretroviral facilities in Cape Town, South Africa. Lay counsellors were trained to use Options to help clients to optimise ARV adherence and reduce sexual risk behaviour. Counsellors delivered the intervention to 9% of eligible patients over 12 months. Interviews with counsellors revealed barriers to implementation including a lack of counselling space, time pressure and patient resistance to counselling. Counsellors felt that Options was not appropriate for use with all patients and adherence problems, and used parts of the intervention as it suited their needs. Findings revealed weaknesses in the current adherence counselling system that have implications for the feasibility of behaviour change counselling within this context.
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Wentzensen N, Schwartz L, Zuna RE, Smith K, Mathews C, Gold MA, Allen RA, Zhang R, Dunn ST, Walker JL, Schiffman M. Performance of p16/Ki-67 immunostaining to detect cervical cancer precursors in a colposcopy referral population. Clin Cancer Res 2012; 18:4154-62. [PMID: 22675168 DOI: 10.1158/1078-0432.ccr-12-0270] [Citation(s) in RCA: 162] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE Cytology-based screening has limited sensitivity to detect prevalent cervical precancers. Human papilloma virus (HPV) DNA testing is highly sensitive and provides a high, long-term reassurance of low risk of cervical cancer. However, the specificity of HPV DNA testing is limited, requiring additional, more disease-specific markers for efficient screening approaches. EXPERIMENTAL DESIGN Liquid-based cytology samples were collected from 625 women referred to colposcopy. A slide was stained using the CINtec plus cytology assay. Pap cytology and HPV genotyping were conducted from the same vial. Clinical performance characteristics were calculated for all women, stratified by age, and for women referred with a low-grade squamous intraepithelial lesion (LSIL) Pap. RESULTS p16/Ki-67 positivity increased with histologic severity, from 26.8% in normal histology, 46.5% in CIN1, 82.8% in CIN2 to 92.8% in CIN3. Among women with CIN3, p16/Ki-67 positivity increased from 77.8% for women younger than 30 years without HPV16 to 100% for women 30 years and older with HPV16. The sensitivity and specificity to detect CIN3+ were 93.2% and 46.1%, respectively, and increased to 97.2% and 60.0% among women 30 years and older. In women with high-risk (HR)-HPV-positive atypical squamous cells of undetermined significance (ASC-US) and LSIL, sensitivity and specificity for detection of CIN3 were 90.6% and 48.6%, respectively. CONCLUSIONS p16/Ki-67 testing could reduce referral to colposcopy by almost half while detecting the most severe cases of CIN3. The high sensitivity of p16/Ki-67 with significantly improved specificity compared with HPV testing makes p16/Ki-67 a viable option for LSIL triage. Further studies are required to evaluate p16/Ki-67 as triage marker in HPV-based screening strategies.
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Scharf J, Yu D, Mathews C, Neale B, Stewart E, Fagerness J, Evans P, Gamazon E, Service S, Osiecki L, Illmann C, Cath D, King R, Dion Y, Sandor P, Barr C, Budman C, Lyon G, Grados M, Singer H, Jankovic J, Gilbert D, Hoekstra P, Heiman G, Tischfield J, State M, Robertson M, Kurlan R, Ophoff R, Gibbs JR, Cookson M, Hardy J, Singleton A, Ruiz-Linares A, Rouleau G, Heutink P, Oostra B, McMahon W, Freimer N, COX N, Pauls D. Genome-Wide Association Study of Gilles de la Tourette Syndrome (IN10-1.002). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.in10-1.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Scharf J, Yu D, Mathews C, Neale B, Stewart E, Fagerness J, Evans P, Gamazon E, Service S, Osiecki L, Illmann C, Cath D, King R, Dion Y, Sandor P, Barr C, Budman C, Lyon G, Grados M, Singer H, Jankovic J, Gilbert D, Hoekstra P, Heiman G, Tischfield J, State M, Robertson M, Kurlan R, Ophoff R, Gibbs JR, Cookson M, Hardy J, Singleton A, Ruiz-Linares A, Rouleau G, Heutink P, Oostra B, McMahon W, Freimer N, COX N, Pauls D. Genome-Wide Association Study of Gilles de la Tourette Syndrome (S32.006). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s32.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Mathews C, Lee S, Nugent E, Landrum L, Bishop E, Kim Y, Nam J, Kim Y, McMeekin D. A re-evaluation of contemporary risk models for early stage cervical cancer. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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73
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Farrell R, Mathews C, Walker J, Landrum L. Cervical adenocarcinoma in the elderly. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2011.07.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Mathews C, Nugent E, Moxley K, Bishop E, McMeekin D. Endometrial cancer risk stratification criteria applied in a unique population. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2011.07.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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75
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Zuna RE, Tuller E, Wentzensen N, Mathews C, Allen RA, Shanesmith R, Dunn ST, Gold MA, Wang SS, Walker J, Schiffman M. HPV16 variant lineage, clinical stage, and survival in women with invasive cervical cancer. Infect Agent Cancer 2011; 6:19. [PMID: 22035468 PMCID: PMC3226431 DOI: 10.1186/1750-9378-6-19] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Accepted: 10/28/2011] [Indexed: 11/18/2022] Open
Abstract
Background HPV16 variants are associated with different risks for development of CIN3 and invasive cancer, although all are carcinogenic. The relationship of HPV 16 variants to cancer survival has not been studied. Methods 155 HPV16-positive cervical cancers were categorized according to European and non-European variant patterns by DNA sequencing of the E6 open reading frame. Clinico-pathologic parameters and clinical outcome were collected by chart review and death registry data. Results Of the 155 women (mean age 44.7 years; median follow-up 26.7 months), 85.2% harbored European variants while 14.8% had non-European sequences. HPV16 variants differed by histologic cell type (p = 0.03) and stage (1 vs. 2+; p = 0.03). Overall, 107 women (68.0%) were alive with no evidence of cancer, 42 (27.1%) died from cervical cancer, 2 (1.3%) were alive with cervical cancer, and 4 (2.6%) died of other causes. Death due to cervical cancer was associated with European variant status (p < 0.01). While 31% of women harboring tumors with European variants died from cervical cancer during follow-up, only 1 of 23 (4.4%) non-European cases died of cancer. The better survival for non-European cases was partly mediated by lower stage at diagnosis. Conclusions Overall, invasive cervical cancers with non-European variants showed a less aggressive behavior than those with European variants. These findings should be replicated in a population with more non-European cases.
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