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Kurt G, Ozcan NK. The Effect of Virtual Reality On Pain and Anxiety Management During Pelvic Examination: A Randomized Controlled Trial. J Midwifery Womens Health 2024. [PMID: 38178322 DOI: 10.1111/jmwh.13587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/15/2023] [Indexed: 01/06/2024]
Abstract
INTRODUCTION It is important for health care professionals to address women's pain and anxiety during pelvic examinations. This study aimed to evaluate the impact of virtual reality (VR) on pain and anxiety management during pelvic examinations. METHODS The study was a randomized controlled clinical trial reported in according to the Consolidated Standards of Reporting Trials 2010 Guidelines. The research was conducted with 128 women (64 intervention, 64 control) who received care at a tertiary hospital outpatient clinic between November 2021 and February 2022. The intervention group received VR application via virtual glasses during pelvic examination, while the control group received routine care. Anxiety was measured using the State-Trait Anxiety Inventory before and after the pelvic examination, and the Visual Analog Scale was used to assess pain after the pelvic examination. The study was registered at ClinicalTrials.gov (NCT05545488). RESULTS The mean anxiety scores of the women in the intervention and control groups were similar pretest (59.00 and 57.77). The mean anxiety score decreased after the pelvic examination to 36.53 in the intervention group and 47.55 in the control group. Results indicated a significant main effect for group assignment (F9.56 ; η2 = .071; P = .002), a significant main effect for time (F384.14 ; η2 = .753; P < .001), and a significant interaction between group and time (F53.95 ; η2 = .300; P < .001). Pain scores after the pelvic examination were lower in the intervention group (4.25) than in the control group (6.41; P < .001). CONCLUSION VR was effective in the management of pain and anxiety during pelvic examination. Future studies should compare the effectiveness of VR with other methods in reducing pain and anxiety during a pelvic examination.
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Affiliation(s)
- Gülay Kurt
- Department of Midwifery, Institute of Graduate Studies, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Neslihan Keser Ozcan
- Department of Midwifery, Faculty of Health Science, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Rad A, Sørbye SW, Brenn T, Tiwari S, Løchen ML, Skjeldestad FE. 13-Type HPV DNA Test versus 5-Type HPV mRNA Test in Triage of Women Aged 25-33 Years with Minor Cytological Abnormalities-6 Years of Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4119. [PMID: 36901129 PMCID: PMC10002392 DOI: 10.3390/ijerph20054119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND A specific, cost-effective triage test for minor cytological abnormalities is essential for cervical cancer screening among younger women to reduce overmanagement and unnecessary healthcare utilization. We compared the triage performance of one 13-type human papillomavirus (HPV) DNA test and one 5-type HPV mRNA test. METHODS We included 4115 women aged 25-33 years with a screening result of atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSIL) recorded in the Norwegian Cancer Registry during 2005-2010. According to Norwegian guidelines, these women went to triage (HPV testing and repeat cytology: 2556 were tested with the Hybrid Capture 2 HPV DNA test, which detects the HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68; and 1559 were tested with the PreTect HPV-Proofer HPV mRNA test, which detects HPV types 16, 18, 31, 33, and 45). Women were followed through December 2013. RESULTS HPV positivity rates at triage were 52.8% and 23.3% among DNA- and mRNA-tested women (p < 0.001), respectively. Referral rates for colposcopy and biopsy and repeat testing (HPV + cytology) after triage were significantly higher among DNA-tested (24.9% and 27.9%) compared to mRNA-tested women (18.3% and 5.1%), as were cervical intraepithelial neoplasia grade 3 or worse (CIN3+) detection rates (13.1% vs. 8.3%; p < 0.001). Ten cancer cases were diagnosed during follow-up; eight were in DNA-tested women. CONCLUSION We observed significantly higher referral rates and CIN3+ detection rates in young women with ASC-US/LSIL when the HPV DNA test was used at triage. The mRNA test was as functional in cancer prevention, with considerably less healthcare utilization.
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Affiliation(s)
- Amir Rad
- Department of Community Medicine & Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | | | - Tormod Brenn
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Sweta Tiwari
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine & Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Finn Egil Skjeldestad
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
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Shami S, Coombs J. Cervical cancer screening guidelines: An update. JAAPA 2021; 34:21-24. [PMID: 34448772 DOI: 10.1097/01.jaa.0000769656.60157.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
ABSTRACT Cervical cancer screening practices in the United States have been inefficient, with variable screening rates. Some women are screened too frequently, overmanaged, lost to follow-up, or are at risk and should be screened but are not. Timely screening, identification, and management of abnormal cervical cells is vital in order to prevent progression to cervical cancer. Educating, counseling, screening, and offering the human papillomavirus vaccine continue to be the primary methods of cervical cancer prevention practices. Guidelines and primary screening methods have been updated because of supporting evidence, and clinicians must stay up-to-date in order to provide effective patient care.
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Affiliation(s)
- Sarah Shami
- Sarah Shami is an assistant professor and clinical coordinator in the PA program at CUNY York College in Jamaica, N.Y. Jennifer Coombs is an associate professor in the PA program at the University of Utah in Salt Lake City. The authors have disclosed no potential conflicts of interest, financial or otherwise
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O'Laughlin DJ, Strelow B, Fellows N, Kelsey E, Peters S, Stevens J, Tweedy J. Addressing Anxiety and Fear during the Female Pelvic Examination. J Prim Care Community Health 2021; 12:2150132721992195. [PMID: 33525968 PMCID: PMC7970676 DOI: 10.1177/2150132721992195] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
To review the anxiety and fear risk factors, pathophysiology, symptoms, screening and diagnosis while highlighting treatment considerations for women undergoing a pelvic examination.
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Affiliation(s)
- Danielle J O'Laughlin
- Mayo Clinic Rochester - Community Internal Medicine.,Assistant professor in medicine, Mayo Clinic in Rochester, Rochester, MN, USA
| | - Brittany Strelow
- Mayo Clinic Rochester - Community Internal Medicine.,Assistant professor in medicine, Mayo Clinic in Rochester, Rochester, MN, USA
| | - Nicole Fellows
- Mayo Clinic Rochester - Community Internal Medicine.,Instructor in surgery and medicine, Mayo Clinic in Rochester, Rochester, MN, USA
| | - Elizabeth Kelsey
- Mayo Clinic Rochester - Community Internal Medicine.,Instructor in medicine, Mayo Clinic in Rochester, Rochester, MN, USA
| | - Sonya Peters
- Mayo Clinic Rochester - Community Internal Medicine.,Instructor in medicine, Mayo Clinic in Rochester, Rochester, MN, USA
| | - Joy Stevens
- Mayo Clinic Rochester - Community Internal Medicine.,Instructor in medicine, Mayo Clinic in Rochester, Rochester, MN, USA
| | - Johanna Tweedy
- Mayo Clinic Rochester - Community Internal Medicine.,Instructor in medicine, Mayo Clinic in Rochester, Rochester, MN, USA
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Mazaheri Moghaddam M, Mazaheri Moghaddam M, Hamzeiy H, Baghbanzadeh A, Pashazadeh F, Sakhinia E. Genetic basis of acephalic spermatozoa syndrome, and intracytoplasmic sperm injection outcomes in infertile men: a systematic scoping review. J Assist Reprod Genet 2021; 38:573-586. [PMID: 33452591 DOI: 10.1007/s10815-020-02008-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/08/2020] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Acephalic spermatozoa syndrome (ASS) is known as a severe type of teratozoospermia, defined as semen composed of mostly headless spermatozoa that affect male fertility. In this regard, this systematic review aimed to discuss gene variants associated with acephalic spermatozoa phenotype as well as the clinical outcomes of intracytoplasmic sperm injection (ICSI) treatment for the acephalic spermatozoa-associated male infertility. METHODS A systematic search was performed on PubMed, Embase, Scopus, and Ovid databases until May 17, 2020. This systematic scoping review was reported in terms of the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) statement. RESULTS Twenty articles were included in this systematic review. Whole-exome and Sanger sequencing have helped in the identification of variants in SUN5, PMFBP1, BRDT, TSGA10, DNAH6, HOOK1, and CEP112 genes as possible causes of this phenotype in humans. The results of the ICSI are conflicting due to both positive and negative reports of ICSI outcomes. CONCLUSION ASS has a genetic origin, and several genetic alterations related to the pathogenesis of this anomaly have been recently identified. Notably, only SUN5 and PMFBP1 mutations are well-known to be implicated in ASS. Accordingly, more functional studies are needed to confirm the pathogenicity of other variants. ICSI could provide a promising treatment for acephalic spermatozoa-associated male infertility. Besides the importance of sperm head-tail junction integrity, some other factors, whether within the sperm cell or female factors, may be involved in the ICSI outcome.
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Affiliation(s)
- Marziyeh Mazaheri Moghaddam
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Madiheh Mazaheri Moghaddam
- Department of Genetics and Molecular Medicine, School of Medicine, Zanjan University of Medical Sciences (ZUMS), Zanjan, Iran
| | - Hamid Hamzeiy
- Tabriz Genetic Analysis Centre (TGAC), Tabriz University of Medical Sciences, Tabriz, Iran.,Genomize Inc., Istanbul, Turkey
| | - Amir Baghbanzadeh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariba Pashazadeh
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ebrahim Sakhinia
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. .,Tabriz Genetic Analysis Centre (TGAC), Tabriz University of Medical Sciences, Tabriz, Iran.
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Abstract
Through the implementation of systematic cervical cancer screening in the mid-20th century, the United States and other developed countries have seen death rates from cervical cancer decreased by ≥70%.The purpose of this article is to address several of the most controversial issues associated with cervical cancer screening recommendations in light of historical and evolving data. In this article, we will explore the controversies around the age at which to initiate and exit screening, human papilloma virus testing alone as a primary screening approach, and the impact of human papilloma virus vaccination on cervical cancer rates.
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Díaz Del Arco C, Jiménez Ayala B, García D, Sanabria C, Fernández Aceñero MJ. Distribution of cervical lesions in young and older women. Diagn Cytopathol 2019; 47:659-664. [PMID: 31184808 DOI: 10.1002/dc.24163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/11/2019] [Accepted: 02/15/2019] [Indexed: 10/27/2023]
Abstract
INTRODUCTION Age range for cervical screening varies widely between countries. In addition, sexual behavior has changed, life expectancy is increasing, and new insights have been gained into the pathogenesis of HPV infection. Our aim is to evaluate the distribution of cervical lesions in young and older patients. METHODS Review of all cervical smears diagnosed in a public institution (2010-2017) and a private institution (2016-2017) in Madrid, Spain. We have included all women aged younger than 30 and older than 65 years with atypical smears (n = 1573). RESULTS Women younger than 30 years were diagnosed with ASCUS, ASC-H, LSIL, and HSIL in 47%, 5.3%, 45.17%, and 2.6% of atypical cases, respectively. Women older than 65 years were diagnosed with ASCUS, ASC-H, LSIL, HSIL, and SCC in 38%, 12.39%, 16.8%, 13.27%, and 19.5% of atypical cases, respectively. Medical records of patients from the public institution were reviewed. Of note, 76.3% of young women showed negative smears at follow-up and 14.1% showed high-grade dysplasia (HGD). Mean ages for low-grade and HGD were 24.7 and 25.7 years, respectively. HGD was found in 37.9% of women with histological examination (33.5%). As for older patients, 25% of them had no Pap smears performed before age 65, and in 60% of the previously screened women, the screening program had not been used adequately. Mean age of first smear was 69.5 years. Carcinoma was subsequently detected in 20.7% of patients. CONCLUSIONS Current guidelines seem to be adequately preventing carcinoma in young women. However, screening adherence should be encouraged to detect important lesions in both age groups, especially among older women.
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Affiliation(s)
- Cristina Díaz Del Arco
- Department of Surgical Pathology, Hospital Clínico San Carlos, Madrid, Spain
- Complutense University of Madrid, Madrid, Spain
| | | | - Dolores García
- Department of Surgical Pathology, Hospital Clínico San Carlos, Madrid, Spain
| | - Carmen Sanabria
- Department of Surgical Pathology, Hospital Clínico San Carlos, Madrid, Spain
| | - Mª Jesús Fernández Aceñero
- Department of Surgical Pathology, Hospital Clínico San Carlos, Madrid, Spain
- Complutense University of Madrid, Madrid, Spain
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Shamsunder S, Pannu D, Khanna G, Banerjee A, Zutshi V, Malik S. Comparison of cervical cancer screening by visual inspection with acetic acid versus cervical-cytology in pregnancy. Indian J Med Paediatr Oncol 2019. [DOI: 10.4103/ijmpo.ijmpo_40_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Aims: The aim of this study was to compare visual inspection with acetic acid (VIA) with cervical cytology for cervical cancer screening in pregnant women. Settings and Design: A prospective cohort study was conducted after institutional ethical committee approval in a tertiary care hospital in Northern India. Pregnant women of gestational age <28 weeks were randomly recruited from the antenatal clinic. Subjects and Methods: All eligible women had a Pap smear followed by VIA; colposcopy was performed if either test was positive. Swede score was used for grading of the acetowhite lesion; biopsy was planned if Swede score was ≥8. Statistical Analysis Used: The sensitivity, specificity, and predictive values for both screening methods were compared with colposcopy as the reference standard. Results: There were 370 low-risk pregnant women in the age group of 20–36 years in the study with a mean parity was 2.1, and the median period of gestation of 14.6 weeks. Abnormal Pap cytology was seen in 5.9% (n = 22) of patients; the abnormalities were ASCUS in 13 (59%), LSIL in 4 (18.2%), and AGC-NOS in 5 (22.7%) patients. VIA positivity was found in 8.4% (n = 31). The positive predictive value was 31.8% for cervical cytology and 48.4% for VIA (P = 0.001). No invasive lesion was detected. Positive predictive value of VIA was significantly higher than Pap cytology for detection of abnormal lesions. Conclusions: VIA is a cost-effective method with better predictive value than Pap smear for cervical cancer screening in pregnant women.
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Affiliation(s)
- Saritha Shamsunder
- Department of Obstetrics and Gynaecology, Vardhmaan Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Deepika Pannu
- Department of Obstetrics and Gynaecology, Vardhmaan Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Geetika Khanna
- Department of Pathology, Vardhmaan Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Ananya Banerjee
- Department of Obstetrics and Gynaecology, Vardhmaan Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Vijay Zutshi
- Department of Obstetrics and Gynaecology, Vardhmaan Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Sunita Malik
- Department of Obstetrics and Gynaecology, Vardhmaan Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Cooper CP, Saraiya M. Primary HPV testing recommendations of US providers, 2015. Prev Med 2017; 105:372-377. [PMID: 29056319 PMCID: PMC5809311 DOI: 10.1016/j.ypmed.2017.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 08/10/2017] [Accepted: 08/13/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To investigate the HPV testing recommendations of US physicians who perform cervical cancer screening. METHODS Data from the 2015 DocStyles survey of U.S. health care providers were analyzed using multivariate logistic regression to identify provider characteristics associated with routine recommendation of primary HPV testing for average-risk, asymptomatic women ≥30years old. The analysis was limited to primary care physicians and obstetrician-gynecologists who performed cervical cancer screening (N=843). RESULTS Primary HPV testing for average-risk, asymptomatic women ≥30years old was recommended by 40.8% of physicians who performed cervical cancer screening, and 90.1% of these providers recommended primary HPV testing for women of all ages. The screening intervals most commonly recommended for primary HPV testing with average-risk, asymptomatic women ≥30years old were every 3years (35.5%) and annually (30.2%). Physicians who reported that patient HPV vaccination status influenced their cervical cancer screening practices were almost four times more likely to recommend primary HPV testing for average-risk, asymptomatic women ≥30years old than other providers (Adj OR=3.96, 95% CI=2.82-5.57). CONCLUSION Many US physicians recommended primary HPV testing for women of all ages, contrary to guidelines which limit this screening approach to women ≥25years old. The association between provider recommendation of primary HPV testing and patient HPV vaccination status may be due to anticipated reductions in the most oncogenic HPV types among vaccinated women.
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Affiliation(s)
| | - Mona Saraiya
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, United States.
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