[Current developments in uterine cervical carcinoma prevention and screening]. / Actualités sur le dépistage et la prévention des infections à VPH dans le cadre des cancers du col utérin.

The causality between the HPV infection and the carcinoma of the uterine cervix is demonstrated. The benefits of the prophylactic HPV vaccine are emerging in the general population. This vaccine has no evident general side effect. So it is proposed for young women and young men. The commercialization of a nonavalent vaccine will increase its preventive activity. Already, international societies recommend using the HPV test for cervical carcinoma screening in replacement of the cytology in women more than 30-35 years old. In case of negative test, the interval between screenings can be increase until 5 years. In case of positive test, the cervical cytology is used for the triage, but other tests are under development. Due to the vaccine efficacy, the future modalities and the cost/benefits ratio of the screening should be questioned.

[New guidelines for cervical cancer screening in young patients: what impact? ]. / Nouvelles recommandations dans le dépistage du cancer du cot chez les jeunes patientes: quel impact?

The publication in 2009 of the new recom- mandations by the American College of Obstetricians and Gynaecologists (ACOG) about the screening of cervical cancer enabled us to optimize the treatment, especially in young patients. The aim of these modifications is to decrease overtreatment of low grade lesions and thereby the risk of obstetrical complica- tions. The objective of our article is to briefly recall these new guidelines together with a study conducted in our Department of Obstetrics and Gynaecology which aim is to confirm that our practice follows these instructions and to check that these procedures are safe for the future of these young patients.

When obstetrics-gynecology specialists need to call an ophthalmologist urgently: a case report.

BACKGROUND: We report here a case of a healthy 23-year-old female patient who was assessed at the gynecology emergency department for genital ulcers, fever, and blurred vision. After suspicion of herpes simplex virus-2 lesions, the diagnosis of Behçet's disease was made. We report this case with the aim of including Behçet's disease in the differential diagnosis of genital ulcers, and emphasize the emergency of the vision loss that can be irreversible. CASE PRESENTATION: A healthy 23-year-old European female patient was assessed by gynecology in the emergency department for genital lesions associated with fever and blurred vision. At first, these lesions were suspected to be primary herpes simplex virus-2 infection One day later, she experienced decreased visual acuity in both eyes. After 4 days of worsening genital ulcers and persistent blurred vision, the patient was referred to the ophthalmology department. Fundoscopic examination showed retinal hemorrhages that were consistent with the first presentation of Behçet's disease. CONCLUSIONS: This case demonstrates that genital ulcers can be the very initial symptom of this ophthalmologic emergency. The differential diagnosis of genital ulcers is challenging. Behçet's disease should be included, especially when associated with systemic or ocular manifestations, and should be considered an emergency for the gynecologist to prevent long-term vision loss.

[Menstrual disorders in adolescents: commonplace or worrisome?]. / Troubles du cycle à l'adolescence: une banalité?

The first menstrual cycles following menarche are often caracterized by irregular and/or heavy bleeding. The adolescent patient may be worried by these episodes of bleeding. In 50-80% of cases these are anovulatory bleeding due to the immaturity of the gonadotrophic axis. Nevertheless pathologies such as von Willebrand disease, genital infection, polycystic ovary syndrom, eating disorders, a tumor or a pregnancy may be diagnosed by bleeding abnormalities. The challenge for the physician is to distinguish between bleeding abnormalities secondary to anovulation and pathologies where investigations and specific follow-up is mandatory. Adolescents who experience abnormal bleeding must be counceled according to their perceptions and expectations.

[Role of the PAP smear in adolescence]. / Place du frottis cytologique à l'adolescence.

The publication of the 2006 directives concerning the management of PAP smears has incited us to update our internal protocols at the CHUV, which are described in this article. A new addition to these directives is the specific management of adolescent PAP smears, who present both a high HPV carriage rate and increased incidence of cytological abnormalities with a favorable outcome in most cases. Our goal is to avoid over-treating dysplasias in this type of patient in order to avoid long-term complications. Emphasis is placed on the first gynecological consultation where a listening ear and clear and targeted information remain essential in the proper management of a young patient.

Nabothian cyst content: A potential pitfall for the diagnosis of invasive cancer on Pap test cytology.

Nabothian cysts are common, benign findings of the squamocolumnar junction of the adult cervix. These cysts are filled with mucus and can also contain proteinaceous material, neutrophils, or neutrophil debris. Nabothian cysts can be broken by the spatula during smear taking, may stick to the brush and be smeared onto slides in conventional cytology or dissolved in the preserving solution for liquid-based cytology (LBC) preparations. The granular content of Nabothian cysts may be mistaken for the tumor diathesis (TD) pattern associated with invasive carcinoma. In the case described, the patient presented a high-grade squamous intraepithelial lesion associated with granular material (Nabothian cyst content) that we considered erroneously on LBC to be TD-like material, thus, raising the suspicion of invasive carcinoma. To the best of our knowledge, this is the first report showing that Nabothian cyst content may present a potential pitfall in the diagnosis of invasive carcinoma on LBC.