Sexual Reproductive Health and Rights Repository (Aga Khan University)
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Establishment, authenticity, and characterization of cervical cancer cell lines
Get PDFCell lines have been considered excellent research models in many areas of biomedicine and, specifically, in the study of carcinogenesis. However, they cease to be effective models if their behavior changes. Although studies on the cross-contamination of cell lines originating from different tissues have been performed, little is known about cell lines derived from cervical neoplasia. We know that high-risk HPV (HR-HPV) is associated with the development of this type of cancer. This link between HPV infection and cancer was first established over 35 years ago when HPV16 DNA was found to be present in a large proportion of cervical cancer biopsies. The present review paper aims to report the status of the establishment, authenticity, and characterization of cervical cancer (CC) cell lines. This is a systematic review of articles on the establishment, authenticity, and characterization of CC cell lines, published from 1960 to date in the databases and in cell repository databases. 52 cell lines were identified in the literature. Only 25 cell lines were derived from cervical neoplasia, of which only 45.8% have a reported identity test (genomic fingerprint). Despite the increase in the establishment of cell lines of cervical neoplasia and the standards for the regulation of these study models, the criteria for their characterization continue to be diverse
Management and care of patients with invasive cervical cancer: ASCO resource-stratified guideline rapid recommendation update
Get PDFASCO Rapid Recommendations Updates highlight revisions to select ASCO guideline recommendations as a response to the emergence of new and practice-changing data. The rapid updates are supported by an evidence review and follow the guideline development processes outlined in the ASCO Guideline Methodology Manual. The goal of these articles is to disseminate updated recommendations, in a timely manner, to better inform health practitioners and the public on the best available cancer care options
Correlates of cervical cancer screening participation, intention and self-efficacy among Muslim women in southern Ghana
Get PDFBackground:
The World Health Organisation’s efforts to eliminate cervical cancer by 2030 with a target of 70% screening coverage using a high-performance test demand that women increase participation in screening. Factors that impact uptake of screening must therefore be identified and bottlenecks addressed, especially in lower- and middle-income countries where cervical cancer incidence remains high. This study investigated Muslim women, participation in, intention to engage in and self-efficacy about cervical cancer screening.
Methods:
An analytical cross-sectional study was conducted among Muslim women aged 18 years and above in the Cape Coast Metropolis of Ghana using an interviewer-administered questionnaire. Data were analysed using appropriate descriptive statistics, Chi-square test, point biserial correlation and binary logistic regression analysis.
Results:
The mean age of participants was approximately 31 years (M = 30.9, SD = 10.4). Out of the 431 women, 21 (4.9%) had ever participated in cervical cancer screening. Participants demonstrated very low knowledge about cervical cancer and screening, with a mean knowledge score of 3.68 out of 15. Knowledge about cervical cancer was associated with increased odds of participating in cervical cancer screening (aOR = 1.32, 95%CI 1.11, 1.56). Concerns about similarity with health provider in terms of gender and faith was associated with decreased odds of cervical cancer screening self-efficacy (aOR = 0.81, 95% CI 0.67). Islamic modesty (aOR = 0.88, 95%CI 0.81, 0.96) was associated with decreased self-efficacy about seeking cervical cancer screening, whereas attitude (aOR = 1.32, 95%CI 1.14, 1.53) was significantly associated with increased self-efficacy about seeking cervical cancer screening. Again, Islamic modesty (aOR = 0.88, 95%CI 0.80, 0.97) was associated with decreased intention to participate in screening, whereas attitude (aOR = 1.42, 95%CI 1.20, 1.68) was associated with increased intention to participate in screening.
Conclusions:
There are gaps in knowledge of cervical cancer among Muslim women in this study as less than 5% had participated in screening. A positive attitude was found to influence intention to screen and actual participation in screening programmes. Islamic modesty and commitment to the Islamic faith decreased intention and self-efficacy regarding screening. Therefore, comprehensive and appropriate socio-cultural and religion-specific interventions aimed at addressing the barriers to screening are important in improving uptake among Muslim women
Antenatal depression: Efficacy of a pre-post therapy study and repercussions in motor development of children during the first 18 months postpartum. Study: “Pregnancy care, healthy baby”
Get PDFAims:
To evaluate the efficacy of brief psychotherapeutic interventions of cognitive behavioral therapy to treat antenatal depression and verify the association between interventions and motor development of infants at 3 and 18 months of age.
Methods:
Pre-post-intervention study nested a randomized clinical trial, both of which are extracts from a population-based cohort study of a southern Brazilian city. The major depressive episode was measured through Mini Plus, the severity of depressive symptoms by BDI-II and motor development using Bayley-III and AIMS. The follow-ups occurred during the gestational period (T2) and at 3 (T3) and 18 months (T4) after delivery.
Results:
Data were analyzed from 336 women in the control group (not intervened) and 108 from the group of depressed women who received intervention for antenatal depression. The effectiveness of the interventions for a major depressive episode was around 80% for both models in the two follow-up stages (3 and 18 months postpartum). In addition, the children whose mothers received intervention presented 3.7 (95% CI 0.7–6.6) points higher in Bayley-III at 3 months old when compared to the children in the control group (p = 0.01). There was no difference between the two psychotherapy models tested, both being equally effective (p > 0.05).
Conclusions:
We found that the brief psychotherapeutic interventions of cognitive behavioral therapy for gestational depression were effective in causing remission of the condition both in the short and long term, besides indirectly causing benefits also to the children, with regard to their motor development
circ_ZFR is linked to paclitaxel resistance in cervical cancer via mir-944 sponging and IL-10 upregulation
Get PDFObjective:
Cervical cancer (CC) has an elevated rate of invasion and death despite surgical treatment, radiotherapy, and chemotherapy. Several studies revealed that circRNAs have a key contribution to the resistance of drugs against different types of carcinomas. The goal of the existing study was to figure out what role circ_ZFR plays in paclitaxel (PTX) resistance in cervical cancer (CC) patients.
Materials and Methods:
Herein, two types of CC cells (SiHa/PTX and Hela/PTX) were utilized. The levels of IL-10 mRNA, miR-944, and circ_ZFR were measured using qRT-PCR analyses. The CCK-8 assay was used to determine PTX resistance. The IL-10 expression was measured via the ELISA technique. The combination of miR-944 and circ_ZFR or IL-10 was validated using a dual-luciferase reporter (DLR) assay.
Results:
The amount of circ_ZFR was increased in PTX-resistant CC cells and tissues. In PTX-resistant CC cells, knocking down circ_ZFR expression decreased PTX resistance. circ_ZFR knockdown significantly reduced IL-10 expression via sponging miR-944, increasing PTX sensitivity in PTX-resistant CC cells.
Conclusion:
circ_ZFR knockdown has a considerable role in overwhelming CC-associated PTX resistance by modifying the axis of miR-944/IL-10 axis, suggesting that developing a circRNA target-based treatment could be considered prevent CC progression
Shackling and pregnancy care policies in US prisons and jails
Get PDFThis article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.Objectives:
The number of incarcerated women in the United States has risen exponentially. Many are of childbearing age with 3-4% being pregnant at intake. Despite the need for comprehensive pregnancy-related health care in prisons and jails, there is no oversight that requires adherence to the established standards. The objective of this study was to assess prison and jail pregnancy policies and practices with an emphasis on restraint use and compliance with anti-shackling legislation.
Methods:
We conducted a survey of 22 state prisons and six jails, including the five largest jails, from 2016–2017 regarding pregnancy policies and practices including restraint use, prenatal care, delivery and birth, and other pregnancy accommodations. We compared reported restraint policies to state legislation at the time of the survey.
Results:
Data indicate that pregnancy policies and services in prisons and jails vary and compliance inconsistencies with anti-shackling legislation exist. A third of the prisons and half of the jails did not have accredited health care services. All study facilities provided prenatal vitamins and most provided supplemental snacks. Most facilities stationed an officer inside the hospital room during labor and delivery, but nearly one-third of facilities did not require a female-identifying officer.
Conclusions for practice:
Limited oversight and standardization of carceral health care and accommodations for pregnant people lead to variability in prisons and jails. Prisons and jails should adopt and implement standards of care guidelines to ensure the safety and well-being of pregnant people who have unique healthcare needs. Incarcerated pregnant people should be viewed as expectant parents in need of comprehensive health care, rather than as criminals who forfeited their right to a safe, respectful, and humane childbirth
Assessment of online self-testing and self-sampling service providers for sexually transmitted infections against national standards in the UK in 2020
Get PDFObjectives:
Online testing for STIs may help overcome barriers of traditional face-to-face testing, such as stigma and inconvenience. However, regulation of these online tests is lacking, and the quality of services is variable, with potential short-term and long-term personal, clinical and public health implications. This study aimed to evaluate online self-testing and self-sampling service providers in the UK against national standards.
Methods:
Providers of online STI tests (self-sampling and self-testing) in the UK were identified by an internet search of Google and Amazon (June 2020). Website information on tests and associated services was collected and further information was requested from providers via an online survey, sent twice (July 2020, April 2021). The information obtained was compared with British Association for Sexual Health and HIV and Faculty of Sexual and Reproductive Healthcare guidelines and standards for diagnostics and STI management.
Results:
31 providers were identified: 13 self-test, 18 self-sample and 2 laboratories that serviced multiple providers. Seven responded to the online survey. Many conflicts with national guidelines were identified, including: lack of health promotion information, lack of sexual history taking, use of tests licensed for professional-use only marketed for self-testing, inappropriate infections tested for, incorrect specimen type used and lack of advice for postdiagnosis management.
Conclusions:
Very few online providers met the national STI management standards assessed, and there is concern that this will also be the case for service provision aspects that were not covered by this study. For-profit providers were the least compliant, with concerning implications for patient care and public health. Regulatory change is urgently needed to ensure that all online providers are compliant with national guidelines to ensure high-quality patient care, and providers are held to account if non-compliant
Association of red cell distribution width/albumin ratio with intraoperative blood transfusion in cervical cancer patients
Get PDFBackground:
Although minimally invasive surgical techniques have reduced intraoperative bleeding, the risk of transfusion exists. However, few studies have evaluated risk factors for transfusion in radical hysterectomy. We aimed to evaluate the association between preoperative red cell distribution width/albumin ratio (RDW/albumin) and transfusion in cervical cancer patients.
Methods:
We analyzed 907 patients who underwent radical hysterectomy between June 2006 and February 2015. Logistic regression and Cox regression analyses were performed to determine the risk factors for transfusion and mortality at 5-year and overall. Net reclassification improvement (NRI) and integrated identification improvement (IDI) analyses were performed to verify the improvement of the intraoperative transfusion model upon the addition of RDW/albumin.
Results:
RDW/albumin was an independent risk factor for transfusion (odds ratio [OR]: 1.34, 95% confidence interval [CI]: 1.02–1.77, p = 0.035). Additionally, body mass index, operation time, laparoscopic surgery, total fluids, and synthetic colloid were risk factors for transfusion. RDW/albumin was an independent risk factor for 5-year mortality (hazard ratio [HR]: 1.51, 95% CI: 1.07–2.14, p = 0.020), and overall mortality (HR: 1.48, 95% CI: 1.06–2.07, p = 0.021). NRI and IDI analyses showed the discriminatory power of RDW/albumin for transfusion (p<0.001 and p = 0.046, respectively).
Conclusions:
RDW/albumin might be a significant factor in transfusion and mortality in cervical cancer patients
Health care provider's experience and perspective of cervical cancer screening in Singapore: a qualitative study
Get PDFBackground:
In Singapore, the current cervical cancer screening (CCS) coverage rate of 48% falls below the national target of 70%. Health care providers (HCPs) play a critical role in promoting CCS uptake. However, there is limited understanding of the perspectives of HCPs regarding CCS. Hence, we aimed to understand the challenges encountered by HCPs delivering CCS in different care settings in the Singapore health system. We also aimed to explore perspectives on newer features of CCS such as self-sampling and HPV genotyping.
Methods:
Physicians, nurses, program administrators and laboratory technicians involved with CCS were invited for a one-on-one semi-structured interview conducted over Zoom between May to August 2021. The interviews were transcribed and analyzed using thematic analysis.
Results:
Eighteen HCPs from 12 institutions were interviewed. Most participants were women (61.1%) and worked in public health institutions (72.2%). For factors influencing CCS, nine key themes were identified and organized into four categories: (1) patient factors, (2) HCP factors, (3) health system factors and (4) health promotion factors. Key themes commonly highlighted by study participants were related to patients' preferences and acceptance for screening, the processes of delivering CCS, the national priority for cervical cancer and the effectiveness of existing health promotion efforts. Five key themes were identified for CCS innovations. Self-sampling was viewed favorably to increase CCS uptake, while primary HPV screening with HPV partial genotyping had higher sensitivities to detect pre-cancers and cancers compared to cytology. Extended HPV genotyping beyond HPV16/18 could play an important role in CCS with increasing HPV vaccination coverage, as well as in the management of persistent HPV infection.
Conclusion:
In Singapore, HCPs face multiple challenges for CCS in practice. Insights from this study are directly relevant to, and useful for developing policies around national CCS programs and treatment guidelines
Covid-19-associated mental health impact on menstrual function aspects: dysmenorrhea and premenstrual syndrome, and genitourinary tract health: a cross sectional study among Jordanian medical students
Get PDFThe physiology of reproduction is affected by psychological distress through neuroendocrine pathways. Historically, COVID-19 is one of the most stressful events with devastating consequences. This research aims to investigate the relationship between dysmenorrhea, PMS, and reproductive tract health on one hand, and COVID-19-related anxiety, depression, and stress on the other among medical students in Jordan. Medical students were invited through teaching platforms and social media to complete an online survey. SPSS software was used to analyze data. A total of 385 medical students participated in this research. Hence, 49.9% of the study population reported severe dysmenorrhea during COVID-19 compared to 36.9% before COVID-19 (p = 0.000). Dysmenorrhea was significantly associated with disruptions of sport and daily activities during COVID-19 (p = 0.015 and p = 0.002, respectively). The prevalence of PMS components, e.g., mastalgia, fatigue, headache, palpitation, and emotional and sleep disturbances, was raised during COVID-19 compared with before (p < 0.05). Symptoms of genitourinary tract infections, such as lower abdominal pain, vaginal discharge, genitalia rash/ulcers and itching, and urgency, were significantly increased after COVID-19 (p < 0.05). Positive Pearson correlations between COVID-19-associated mental health disorders and dysmenorrhea severity, PMS, and genital tract health abnormalities were observed (p < 0.05). The multiple linear regression model revealed that dysmenorrhea severity, PMS symptoms like palpitation, and genitourinary symptoms like lower abdominal pain and urgency were associated with worsening of depression, while dysuria was associated with a protective effect against depression. Moreover, it was observed that dysmenorrhea severity, PMS symptoms, such as headache and palpitation, and urinary urgency were associated with aggravation of anxiety. However, food craving and dysuria were protective against anxiety. Finally, dysmenorrhea severity, PMS symptoms of headache and palpitation, lower abdominal pain, and urgency were related to worsening of stress, whereas the premenstrual symptom of breast pain was a protective factor against stress. This work showed that COVID-19 pandemic-related psychological distress and menstrual, premenstrual, and genitourinary symptoms are closely related. Further future work is required to evaluate the long lasting-effects of the pandemic on mental health and the physiology of reproduction