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Longatto-Filho A, Roteli-Martins C, Hammes L, Etlinger D, Pereira SMM, Erzen M, Branca M, Naud P, Derchain SFM, Sarian LO, Matos J, Gontijo R, Lima T, Maeda MYS, Tatti S, Syrjänen S, Syrjänen K. Self-sampling for human papillomavirus (HPV) testing as cervical cancer screening option. Experience from the LAMS study. EUR J GYNAECOL ONCOL 2008; 29:327-332. [PMID: 18714563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE To compare Hybrid Capture II (HC2) in detecting high-risk (HR) HPV in patient-collected vaginal samples with those obtained using gynaecologist collected samples. METHODS Patients were submitted to Pap smears, visual inspection with acetic acid (VIA) and HC2 for hr-HPV. RESULTS A total of 1,081 HC2 tests for HR-HPV were performed: 770 (71.2%) samples were collected by a physician and 311 (28.8%) were self-collected by the patients. In detecting any cervical lesion, the sensitivity of HC2 collected by a physician was higher (92.86%) than that (37.5%) in the self-sampling group. Negative predictive value (NPV) was high for both, 99.69% and 93.75%, respectively. Using the CIN2 cutoff, performance of HC2 was significantly improved: 92.9% and 62.5%, respectively. HC2 specificity for any cervical lesion and for CIN2 or higher were close to 90% in both groups. CONCLUSIONS Self-sampled HPV testing is a powerful option to increase the detection of cervical lesions in women segregated from prevention programs.
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Schmidt NK, Else-Quest NM, Hammes L, Eickhoff J, Hyde J, Schiller JH. Evaluation of guilt, shame and depression in non-small cell lung cancer (NSCLC) relative to breast (BC) and prostate cancer (PC). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7158 Background: Most NSCLC is related to smoking, and thus is potentially avoidable. Prior qualitative studies suggest that stigma from a self-induced illness results in feelings of guilt and shame in NSCLC patients (pts). This study is a prospective quantative study of guilt, shame and depression in NSCLC pts relative to BC and PC pts. Methods: Stage IV NSCLC, BC, and PC pts completed 3 surveys over 6 months (T1–3). The survey was a 20 minute questionnaire, including standardized tests of shame, guilt, and depression, as well as several investigator designed questions (IDQ) and demographic data. Goal enrollment is 94 NSCLC pts, 47 BC pts and 47 PC pts, with 80% power to detect a 0.75 point difference in the State Shame and Guilt Scale (SSGS, scores 1 to 5). Data for the first 159 pts with T1 and T2 data are presented. Means of the pooled results for the SSGS and IDQ were compared via analysis of variance; impact of cancer (CA) and gender were performed via regression analyses. Results: 92 NSCLC, 41 PC, and 26 BC patients have been enrolled. 55% of participants are male, mean age is 66 years (35–87), and 67% are married. There is a diverse range of incomes and education. IDQ were combined into a composite score, “self-blame” (reliable, internal consistency score 0.76). Results at T2 are presented in the table. Multiple regression analysis performed on women found that type of CA predicted depression, mediated by shame and guilt. Conclusions: NSCLC is associated with increased levels of guilt and shame leading to depression, relative to BC and PC. This disparity is particularly striking amongst women with NSCLC. Guilt, shame and depression may hamper a pt’s ability to advocate for themselves and may affect treatment outcomes. Further investigation is warranted as to whether a targeted intervention may improve levels of stigma amongst NSCLC pts. Funding provided by an American Medical Association Seed Grant. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
| | | | - L. Hammes
- University of Wisconsin, Madison, WI
| | | | - J. Hyde
- University of Wisconsin, Madison, WI
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Longatto-Filho A, Erzen M, Branca M, Roteli-Martins C, Naud P, Derchain SFM, Hammes L, Sarian LO, Bragança JF, Matos J, Gontijo R, Lima T, Maeda MYS, Tatti S, Syrjänen S, Dores G, Lörincz A, Syrjänen K. Human papillomavirus testing as an optional screening tool in low-resource settings of Latin America: experience from the Latin American Screening study. Int J Gynecol Cancer 2006; 16:955-62. [PMID: 16803469 DOI: 10.1111/j.1525-1438.2006.00582.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Hybrid capture II (HC II) test for oncogenic human papillomaviruses (HPV) was carried out in a cohort of 4284 women at their first clinical visit. Overall prevalence of HPV was 17.1%, decreasing with age from 33.9% among women below 20 years to only 11.0% among those older than 41 years. HPV prevalence was significantly higher among current smokers (odds ratio [OR] = 1.31; 95% CI 1.1-1.6), in women with two or more lifetime sexual partners (OR = 1.9; 95% CI 1.6-2.4), and those women with two or more sexual partners during the past 12 months prior to examination (OR = 1.6; 95% CI 1.2-2.2). HPV detection increased in parallel with increasing cytologic abnormality, being highest in women with high-grade squamous intraepithelial lesion (P= 0.001). Specificity of the HPV test in detecting histologically confirmed cervical disease was 85% (95% CI 83.9-86.1). Sensitivity of the HPV test in detecting histologic abnormalities increased in parallel with disease severity, ranging from 51.5% for cervical intraepithelial neoplasia (CIN) 1 to 96.5% for CIN 3 and 100.0% for cancer, with respective decline of positive predictive value. These data suggest that HPV testing with HC II assay might be a viable screening tool among this population with relatively high prevalence of cervical disease.
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Longatto-Filho A, Eržen M, Branca M, Roteli-Martins C, Naud P, Derchain SF, Hammes L, Sarian LO, Bragança JF, Matos J, Gontijo R, Lima T, Maeda MY, Tatti S, Syrjänen S, Dores G, LÖRINCZ A, Syrjänen K. Human papillomavirus testing as an optional screening tool in low-resource settings of Latin America: experience from the Latin American Screening study. Int J Gynecol Cancer 2006. [DOI: 10.1136/ijgc-00009577-200605000-00001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Hybrid capture II (HC II) test for oncogenic human papillomaviruses (HPV) was carried out in a cohort of 4284 women at their first clinical visit. Overall prevalence of HPV was 17.1%, decreasing with age from 33.9% among women below 20 years to only 11.0% among those older than 41 years. HPV prevalence was significantly higher among current smokers (odds ratio [OR] = 1.31; 95% CI 1.1–1.6), in women with two or more lifetime sexual partners (OR = 1.9; 95% CI 1.6–2.4), and those women with two or more sexual partners during the past 12 months prior to examination (OR = 1.6; 95% CI 1.2–2.2). HPV detection increased in parallel with increasing cytologic abnormality, being highest in women with high-grade squamous intraepithelial lesion (P = 0.001). Specificity of the HPV test in detecting histologically confirmed cervical disease was 85% (95% CI 83.9–86.1). Sensitivity of the HPV test in detecting histologic abnormalities increased in parallel with disease severity, ranging from 51.5% for cervical intraepithelial neoplasia (CIN) 1 to 96.5% for CIN 3 and 100.0% for cancer, with respective decline of positive predictive value. These data suggest that HPV testing with HC II assay might be a viable screening tool among this population with relatively high prevalence of cervical disease.
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Naud P, Matos J, Hammes L, Stuckzynski J, Brouwers K, Magno V, Dias E, Crusius P, d'Avila A, Campos C, Costa M, Höblik M, Marc C, Marroni R, Syrjänen K. Factors predicting intermediate endpoints of cervical cancer and exposure to human papillomavirus (HPV) infections in young women screened as potential targets for prophylactic HPV vaccination in south of Brazil. Eur J Obstet Gynecol Reprod Biol 2006; 124:110-8. [PMID: 16386655 DOI: 10.1016/j.ejogrb.2005.02.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2004] [Revised: 11/21/2004] [Accepted: 02/09/2005] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To explore the predictors of intermediate endpoints of cervical cancer in 500 women living in Porto Alegre. STUDY DESIGN Five hundred randomly selected women (mean age 20.3 years, range 15-25) were screened using PCR detecting 25 HPV types (HPV6, 11, 16, 18, 31, 33, 34, 35, 39, 40, 42, 43, 44, 45, 51, 52, 53, 54, 56, 58, 59, 66, 68, 70, and 74). Women were interviewed and serum samples were analysed for antibodies to HPV16 and HPV18 VLPs. Regression models were constructed to analyse predictive factors for (a) HPV PCR status, (b) HPV16-seropositivity, (c) HPV18-seropositivity, and (d) SIL in the PAP smear, used as intermediate endpoints of cervical cancer. RESULTS Specific HPV types were identified in 137 (27.4%) of the 157 (31.4%) PCR-positive women. PAP test result was the most powerful independent predictor of HPV status in PCR (p = 0.0001), followed by the sexual activity started (p = 0.001) (adjusted OR 34.075, 95% CI: 4.650-249.715). PAP test SIL was independently predicted only by the HPV PCR status (p = 0.0001) (OR 7.561, 95% CI: 2.787-20.514). HPV16 and HPV18 serostatus were the most significant predictors of each other (p=0.0001), and the life-time number of sexual partners was more significant (p=0.001) predictor of HPV16 than HPV18 serostatus (p = 0.049). CONCLUSION These data are useful in evaluating the exposure status of the women to the risk factors of cervical cancer in south of Brazil.
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Affiliation(s)
- P Naud
- Hospital de Clinicas de Porto Alegre, Department of Obstetrics and Gynaecology, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Nova York, 117/23 Auxiliadora, ZIP 90550-070 Porto Alegre, RS, Brazil
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Naud P, Matos J, Hammes L, Prolla J, Schwartsmann G, Vetorazzi J, Quadros C, Gomes T, Lemos A, Manfrói AD, Marc C, Berti C, Born C, Vettori D, Santos D, Dias E, Cislaghi G, Costa M, Santos R, Marroni R, Magno V, Syrjänen K. Cervical Cancer Screening in Porto Alegre, Brazil: Alternative Methods for Detecting Cancer Precursors in a Developing Country. J Low Genit Tract Dis 2001; 5:24-8. [PMID: 17043558 DOI: 10.1046/j.1526-0976.2001.51005.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This study was conducted to test the performance characteristics of cervical cancer screening by visual inspection of the cervix with acetic acid and iodine solution. METHODS A total of 100 women were screened for cervical cancer by Pap smear and naked eye inspection of the cervix after application of acetic acid and iodine solution. RESULTS Comparing visual inspection to the Pap test, a sensitivity of 85.7%, specificity of 78.5%, and concordance of 79% (p < .0011) was established. Comparing the Pap test with colposcopy, the corresponding figures were 42.9%, 92.3%, and 66.6% (p < .077), respectively. Visual inspection compared to colposcopy showed corresponding figures of 100%, 7.7%, and 55.5% (p = .48), respectively. Colposcopy and biopsy had an agreement of 100%. CONCLUSIONS Visual inspection with acetic acid and iodine solution proved to be a reasonable method of screening for cervical cancer precursors.
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Affiliation(s)
- P Naud
- Department of Gynecology and Obstetrics, Federal University of Rio Grande do Sul, Brazil
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Berger PB, Bell MR, Rihal CS, Ting H, Barsness G, Garratt K, Bellot V, Mathew V, Melby S, Hammes L, Grill D, Holmes DR. Clopidogrel versus ticlopidine after intracoronary stent placement. J Am Coll Cardiol 1999; 34:1891-4. [PMID: 10588199 DOI: 10.1016/s0735-1097(99)00442-8] [Citation(s) in RCA: 120] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The study compared the safety and efficacy of ticlopidine with clopidogrel in patients receiving coronary stents. BACKGROUND Stent thrombosis is reduced when ticlopidine is administered with aspirin. Clopidogrel is similar to ticlopidine in chemical structure and function but has fewer side effects; few data are available about its use in stent patients. METHODS We compared 30-day event rates in 500 consecutive coronary stent patients treated with aspirin and clopidogrel (300 mg loading dose immediately prior to stent placement, and 75 mg/day for 14 days) to 827 consecutive stent patients treated with aspirin and ticlopidine (500 mg loading dose and 250 mg twice daily for 14 days). RESULTS Patients treated with clopidogrel had more adverse clinical characteristics including older age, more severe angina, and more frequent infarction within the prior 24 h. Nonetheless, mortality was 0.4% in clopidogrel patients versus 1.1% in ticlopidine patients; nonfatal myocardial infarction occurred in 0% versus 0.5%, stent thrombosis in 0.2% versus 0.7%, bypass surgery or repeat angioplasty in 0.4% versus 0.5%, and any event occurred in 0.8% versus 1.6% of patients, respectively (p = NS). Based on the observed 30-day event rate of 1.6% with ticlopidine, the statistical power of the study was 43% to detect an even rate of 0.5% with clopidogrel, and 75% to detect an event rate with of 4% with clopidogrel, with a p value of 0.05. CONCLUSIONS These data indicate that clopidogrel can be safely substituted for ticlopidine in patients receiving coronary stents.
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Affiliation(s)
- P B Berger
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, USA
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Berger PB, Bell MR, Holmes DR, Hammes L, Kosanke JL, Bresee SJ. Effect of restenosis after an earlier angioplasty at another coronary site on the frequency of restenosis after a subsequent coronary angioplasty. Am J Cardiol 1992; 69:1086-9. [PMID: 1561984 DOI: 10.1016/0002-9149(92)90869-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- P B Berger
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905
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Maynard JE, Dull HB, Hanson ML, Feltz ET, Berger R, Hammes L. Evaluation of monovalent and polyvalent influenza vaccines during an epidemic of type A2 and B influenza. Am J Epidemiol 1968; 87:148-57. [PMID: 5637865 DOI: 10.1093/oxfordjournals.aje.a120795] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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