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1.
Altern Ther Health Med ; 30(9): 90-94, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38581329

RESUMO

Objective: The objective of this study was to assess the prevalence of high-risk HPV infection in married women in Longgang District, Shenzhen, and to analyze the distribution of HPV subtypes across different age groups while identifying risk factors associated with HPV infection. Methods: 1. From January 2018 to December 2020, 209,627 married women in Longgang District were selected as study subjects, using high-risk HPV testing as the primary screening means. HPV 16 or 18 positive directly referred to colposcopy, other types positive continued liquid-based thin-layer cytology (TCT) examination, if ≥ ASCUS, referred to colposcopy, and biopsy if necessary. 2. 210 female patients who came to our hospital for HPV testing from January 2018 to December 2020 were used for the study, including 130 HPV-positive patients and 80 HPV-negative patients. The risk factors of HPV infection were studied by questionnaire. Results: The HPV infection rate in 2018 was 13.17%, including LSIL 6.87%, HSIL 3.57%, the single type infection rate was 79.83%, top5 monotypes were 52, 53, 16, 58, 81, multiple types infection rate was 20.17%, top5 multiple types were 52/ 53, 52/68, 16/52 52/58, 52/81; 2019 HPV positivity rate was 10.23%, including LSIL 5.98%, HSIL 5.81%, the monotypic infection rate was 82.5%, top5 monotypic were: 52, 16, 58, 51, 53, multi heavy sex infection rate was 17.5%, top5 multi typic were: 52/53, 52/58, 52/68, 16/52, 51/52; HPV positive rate in 2020 was 11.28%, including LSIL 6 %, HSIL 4.84%, monotypic infection rate was 79.89%, top5 monotypic were: 52, 16, 53, 58, 51, multiheavy category infection rate was 20.11%, top5 multitypic were: 52/58, 16/52, 52/68, 52/53, 51/52. 30-50 years old is the high prevalence age of HPV susceptibility, followed by 50-60 years old, and HPV52 is the most common type. 2. 210 female patients were surveyed by filling out questionnaires: Smoking history, age at first sex, age at first pregnancy, abortion, number of sexual partners, contraceptive method, bleeding during intercourse, cervicitis, vaginitis, sleeping habits, and mental status totaling 11 factors were significant between infected and control (P < .05). Dichotomous logistic regression analysis with these 11 factors as independent variables and HPV infection as dependent variable revealed that abortion (OR=2.117, 95% CI: 1.337-3.354), number of sexual partners (OR=2.562, 95% CI: 1.222-5.373), cervicitis (OR=2.873, 95% CI: 1.407-5.868), vaginitis (OR=2.413, 95% CI: 1.158-5.026) staying up late (OR=2.408, 95% CI: 1.134-5.115) and mental status (OR=3.139, 95% CI: 1.470-6.703) were six factors that were risk factors for HPV infection. Conclusion: The common HPV infection types among women in Longgang district were mainly 52, 16, 58, 53, and 51, with a predominance of a single type of infection. The positive rate and pathogenicity of HPV 52 were higher than HPV 16. Women aged 30-60 years should be included in priority screening for cervical lesions. The six factors of miscarriage, number of sexual partners, cervicitis, vaginitis, staying up late, and mental status were risk factors for HPV infection occurrence.


Assuntos
Infecções por Papillomavirus , Humanos , Feminino , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , China/epidemiologia , Adulto , Fatores de Risco , Pessoa de Meia-Idade , Prevalência , Adulto Jovem , Papillomaviridae/isolamento & purificação , Inquéritos e Questionários , Idoso , Adolescente , Papillomavirus Humano
2.
Patient Educ Couns ; 123: 108200, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38368784

RESUMO

OBJECTIVE: To develop theory-informed human papillomavirus (HPV) vaccine education materials that appeal to 18-26-year-olds. METHODS: First, draft materials informed by Theory of Planned Behavior (TPB) and Health Belief Model (HBM) were developed. Next, an initial set of Consolidated Framework for Implementation Research (CFIR)-guided interviews were conducted with 18-26-year-old participants to receive feedback about content, format, appeal, implementation facilitators and barriers, and potential delivery modalities. Then, interviews were transcribed, coded, and analyzed using thematic analysis. Next, materials were modified based upon feedback. Finally, another set of interviews was conducted. RESULTS: Most participants (n = 15) were female (93%), White (60%), and non-Hispanic (93%). All (100%) had heard of HPV and the HPV vaccine, and 80% reported having received the vaccine. Participant feedback on materials included emphasizing vaccine benefits and efficacy, rewording to enhance comprehension, and adding images represent diversity beyond race/ethnicity and sexual orientation. Suggested delivery methods included social media, print materials, and posters. CONCLUSION: Qualitative interviews with young adults suggest that HPV education materials targeted to 18-26-year-olds should include health behavior theory-aligned messaging, inclusive imagery, and be disseminated through multiple modalities. PRACTICE IMPLICATIONS: Providers should consider utilizing theory-based education materials that are relevant and appealing to young adults.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Humanos , Masculino , Feminino , Adulto Jovem , Adolescente , Adulto , Infecções por Papillomavirus/prevenção & controle , Comportamentos Relacionados com a Saúde , Vacinação , Papillomavirus Humano , Conhecimentos, Atitudes e Prática em Saúde , Aceitação pelo Paciente de Cuidados de Saúde
3.
BMC Public Health ; 24(1): 211, 2024 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-38233805

RESUMO

BACKGROUND: Cervical cancer is a global disease and it is well established that cervical cancer is caused by human papillomavirus (HPV). In Sweden self-sampling for HPV is now used as a complement to sampling performed by a midwife. However, there is a lack of knowledge on how older women perceive the self-sampling compared to the sampling performed by a midwife. Therefore, the aim of the study was to describe how women, aged 64 years and older, perceived the process of self-sampling and sampling performed by a midwife for HPV-testing. METHODS: Eighteen women were included in a qualitative interview study, and a phenomenographic approach was used for the analysis of the interviews. RESULTS: Three descriptive categories emerged: Confidence in sampling, Facilitating participation and Being informed. Within the categories, eight conceptions emerged describing the variation relating to how the women perceived the process of self-sampling and sampling performed by a midwife. CONCLUSIONS: Women in this study describe confidence in self-sampling for HPV-testing and that the self-sampling was saving time and money, both for themselves and for society. Information in relation to an HPV-positive test result is of importance and it must be kept in mind that women affected by HPV may feel guilt and shame, which health care professionals should pay attention to. This knowledge can be used in education of health care staff. TRIAL REGISTRATION: https://researchweb.org/is/fourol/project/228071 . Reg. no 228,071.


Assuntos
Tocologia , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Feminino , Humanos , Gravidez , Idoso , Papillomavirus Humano , Neoplasias do Colo do Útero/diagnóstico , Infecções por Papillomavirus/diagnóstico , Papillomaviridae , Manejo de Espécimes , Detecção Precoce de Câncer , Programas de Rastreamento , Autocuidado
4.
J Ethnopharmacol ; 319(Pt 3): 117225, 2024 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-37797877

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Cervical cancer is one of the most common malignancies in women that continues to be a public health problem worldwide. Human papillomavirus (HPV) infection is closely related as the causative agent of almost all cases of cervical cancer. Currently, there is no effective treatment for the persistence of HPV. Although vaccines have shown promising results in recent years, they are still a costly strategy for developing countries and have no therapeutic effect on existing infections, which is why the need arises to search for new strategies that can be used in treatment, suppressing oncogenic HPV and disease progression. Extracts of Schisandra Chinensis and Pueraria lobata have been used in traditional medicine, and it has been shown in recent years that some of their bioactive compounds have pharmacological, antioxidant, antitumor, apoptotic, and proliferation effects in HPV-positive cells. However, its mechanism of action has yet to be fully explored. AIM OF THE STUDY: The following study aimed to determine the chemical composition, antioxidant activity, and potential antiproliferative and viral oncogene effects of natural extracts of S. chinensis and P. lobata on HPV-18 positive cervical cancer cells. MATERIALS AND METHODS: The HPV-18-positive HeLa cells were treated for 24 and 48 h with the ethanolic extracts of S chinensis and P. lobata. Subsequently, cell viability was evaluated using the resazurin method, the effect on the cell cycle of the extracts (1.0, 10, and 100 µg/mL) was measured by flow cytometry, the gene of expression of the E6/E7, P53, BCL-2, and E2F-1 were determined by RT-PCR and the protein expression of p53, Ki-67, x|and Bcl-2 by immunohistochemistry. Additionally, the chemical characterization of the two extracts was carried out using LC-MS, and the total phenolics content (TPC), Total flavonoid content (TFC), and DPPH radical scavenging capacity were determined. Data were analyzed using the Mann-Whitney and Kruskal Wallis U test with GraphPad Prism 6 software. RESULTS: The natural extracts of Schisandra chinensis and Pueraria lobata induced down-regulation of E6 HPV oncogene (p<0.05) and a strong up-regulation of P53 (p<0.05), E2F-1 (p<0.05), and Bcl-2 (p<0.05) gene expression. Simultaneously, the natural extracts tend to increase the p53 protein levels and arrest the cell cycle of HeLa in the G1/S phase (p<0.05). Investigated extracts were characterized by the occurrence of bioactive lignans and isoflavones in S. chinensis and P. lobata, respectively. CONCLUSION: The extracts of S. chinensis and P. lobata within their chemical characterization mainly present lignan and isoflavone-type compounds, which are probably responsible for inhibiting the expression of the HPV E6 oncogene and inducing an increase in the expression of p53, Bcl -2 and E2F-1 producing cell cycle detection in S phase in HeLa cells. Therefore, these extracts are good candidates to continue studying their antiviral and antiproliferative potential in cells transformed by HPV.


Assuntos
Infecções por Papillomavirus , Pueraria , Schisandra , Neoplasias do Colo do Útero , Humanos , Feminino , Células HeLa , Papillomavirus Humano , Proteína Supressora de Tumor p53/genética , Neoplasias do Colo do Útero/tratamento farmacológico , Regulação para Baixo , Infecções por Papillomavirus/tratamento farmacológico , Oncogenes , Proteínas Proto-Oncogênicas c-bcl-2 , Antioxidantes
5.
JAMA ; 330(20): 1971-1981, 2023 11 28.
Artigo em Inglês | MEDLINE | ID: mdl-38015219

RESUMO

Importance: Optimal strategies for increasing cervical cancer screening may differ by patient screening history and health care setting. Mailing human papillomavirus (HPV) self-sampling kits to individuals who are overdue for screening increases adherence; however, offering self-sampling kits to screening-adherent individuals has not been evaluated in the US. Objective: To evaluate the effectiveness of direct-mail and opt-in approaches for offering HPV self-sampling kits to individuals by cervical cancer screening history (screening-adherent and currently due, overdue, or unknown). Design, Setting, and Participants: Randomized clinical trial conducted in Kaiser Permanente Washington, a US integrated health care delivery system. Individuals aged 30 to 64 years with female sex, a primary care clinician, and no hysterectomy were identified through electronic health records (EHRs) and enrolled between November 20, 2020, and January 28, 2022, with follow-up through July 29, 2022. Interventions: Individuals stratified as due (eg, at the time of randomization, these individuals have been previously screened and are due for their next screening in ≤3 months) were randomized to receive usual care (patient reminders and clinician EHR alerts [n = 3671]), education (usual care plus educational materials about screening [n = 3960]), direct mail (usual care plus educational materials and a mailed self-sampling kit [n = 1482]), or to opt in (usual care plus educational materials and the option to request a kit [n = 3956]). Individuals who were overdue for screening were randomized to receive usual care (n = 5488), education (n = 1408), or direct mail (n = 1415). Individuals with unknown history for screening were randomized to receive usual care (n = 2983), education (n = 3486), or to opt in (n = 3506). Main Outcomes and Measures: The primary outcome was screening completion within 6 months. Primary analyses compared direct-mail or opt-in participants with individuals randomized to the education group. Results: The intention-to-treat analyses included 31 355 randomized individuals (mean [SD] age, 45.9 [10.4] years). Among those who were due for screening, compared with receiving education alone (1885 [47.6%]), screening completion was 14.1% (95% CI, 11.2%-16.9%) higher in the direct-mail group (914 [61.7%]) and 3.5% (95% CI, 1.2%-5.7%) higher in the opt-in group (2020 [51.1%]). Among individuals who were overdue, screening completion was 16.9% (95% CI, 13.8%-20.0%) higher in the direct-mail group (505 [35.7%]) compared with education alone (264 [18.8%]). Among those with unknown history, screening was 2.2% (95% CI, 0.5%-3.9%) higher in the opt-in group (634 [18.1%]) compared with education alone (555 [15.9%]). Conclusions and Relevance: Within a US health care system, direct-mail self-sampling increased cervical cancer screening by more than 14% in individuals who were due or overdue for cervical cancer screening. The opt-in approach minimally increased screening. To increase screening adherence, systems implementing HPV self-sampling should prioritize direct-mail outreach for individuals who are due or overdue for screening. For individuals with unknown screening history, testing alternative outreach approaches and additional efforts to document screening history are warranted. Trial Registration: ClinicalTrials.gov Identifier: NCT04679675.


Assuntos
Detecção Precoce de Câncer , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Feminino , Humanos , Pessoa de Meia-Idade , Detecção Precoce de Câncer/métodos , Escolaridade , Papillomavirus Humano/isolamento & purificação , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/etiologia , Autoavaliação Diagnóstica , Estados Unidos/epidemiologia , Adulto , Serviços Postais
6.
Afr J Reprod Health ; 27(6): 101-109, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37715679

RESUMO

HPV infection can lead to various diseases, from benign lesions to cancer, both in men and women. Health professionals with a high level of HPV knowledge will be effective in raising public awareness. This study aims to investigate the HPV knowledge level of midwifery and nursing students, who are future healthcare professionals. This study was carried out cross-sectionally. The data were collected between September and October 2022. The study was completed by 565 students. The form used is the 'Human Papilloma Virus Knowledge Scale (HPV-KS)'. The scale consists of 33 items and 4 sub-dimensions. The highest score to be obtained from the scale is 33 and the lowest score is 0. A high score indicates a high level of knowledge about HPV. In this study, it was found that nursing and midwifery students had low knowledge about HPV (11.45±6.79). The HPV knowledge level of midwifery students was found higher than nursing students (p=0.000). Female students scored significantly higher than males in the HPV testing knowledge questions (p=0.045) and HPV vaccine knowledge questions (p=0.022) sub-dimensions. The HPV knowledge score of the students who stated that they had sufficient knowledge about sexually transmitted diseases was also high (p=0.000). Awareness of HPV should be developed in nursing and midwifery students. It is important for nursing and midwifery students, who will provide health services after graduation, to have a high level of HPV knowledge in order to protect their own and society's health.


Assuntos
Tocologia , Infecções por Papillomavirus , Estudantes de Enfermagem , Masculino , Gravidez , Feminino , Humanos , Infecções por Papillomavirus/prevenção & controle , Estudos Transversais , Turquia , Papillomavirus Humano
7.
Altern Ther Health Med ; 29(6): 425-429, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37442188

RESUMO

Objective: This study aims to understand the clinical characteristics of male HPV infection and provide data and information for the prevention and health of the male and female reproductive tracts in the region. Methods: A total of 390 male patients who underwent HPV examinations in outpatient clinics and physical examinations in 363 hospitals from December 2017 to May 2022 were selected. Samples were collected, and HPV genotyping was performed using multiplex fluorescent PCR. The HPV infection rate, genotype distribution, age distribution, and clinical symptom distribution were analyzed. Results: Out of 3,816 samples, the total HPV infection rate was 47.44% (185/390). The HPV infection rate in the symptomatic group was 57.09% (141/247), significantly higher than that in the asymptomatic group (P < .01). Among the subtypes, HPV6 accounted for the highest proportion (31.03%, 90/290), followed by HPV11 (14.14%, 41/290) and HPV52 (8.62%, 25/290). Types 6 and 11 were mainly concentrated in the symptomatic group (91.11%, 85.37%). The highest positive rate was observed in the 17-30-year-old group (45.41%, 85/185), followed by the 31-40-year-old group (28.11%, 52/185). The proportion of HPV infections with clinical symptoms of abnormal growth was 84.40% (119/141). HPV6 or/and HPV11 infections were mainly concentrated in the abnormal growth group, accounting for 90.76% (108/113). Conclusions: The rates of male HPV infection are high, particularly among individuals aged 17-40. Low-risk infections (types 6 and 11) cause male reproductive tract symptoms, including abnormal growth. High-risk infection (HPV52) correlates with local women's HPV subtype distribution and potential transmission. Therefore, screening for male HPV infection is crucial in preventing cervical cancer. Authorities should promote the development and early use of male HPV vaccines.


Assuntos
Infecções por Papillomavirus , Neoplasias do Colo do Útero , Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Papillomavirus Humano , Neoplasias do Colo do Útero/prevenção & controle , Papillomavirus Humano 11/genética , Papillomaviridae/genética , Genitália Masculina , Prevalência
8.
Adv Healthc Mater ; 12(22): e2203326, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37285852

RESUMO

In this work, fluorogenic probes based on oligonucleotide capped nanoporous anodic alumina films are developed for specific and sensitive detection of human papilloma virus (HPV) DNA. The probe consists of anodic alumina nanoporous films loaded with the fluorophore rhodamine B (RhB) and capped with oligonucleotides bearing specific base sequences complementary to genetic material of different high-risk (hr) HPV types. Synthesis protocol is optimized for scale up production of sensors with high reproducibility. The sensors' surfaces are characterized by scanning electron microscopy (HR-FESEM) and atomic force microscopy (AFM) and their atomic composition is determined by energy dispersive X-ray spectroscopy (EDXS). Oligonucleotide molecules onto nanoporous films block the pores and avoid diffusion of RhB to the liquid phase. Pore opening is produced when specific DNA of HPV is present in the medium, resulting in RhB delivery, that is detected by fluorescence measurements. The sensing assay is optimized for reliable fluorescence signal reading. Nine different sensors are synthesized for specific detection of 14 different hr-HPV types in clinical samples with very high sensitivity (100%) and high selectivity (93-100%), allowing rapid screening of virus infections with very high negative predictive values (100%).


Assuntos
Nanoporos , Infecções por Papillomavirus , Humanos , Óxido de Alumínio/química , Oligonucleotídeos , Papillomavirus Humano , Reprodutibilidade dos Testes , DNA
9.
Perm J ; 27(2): 31-36, 2023 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-37221889

RESUMO

INTRODUCTION Immunization rates against the human papillomavirus (HPV) remain suboptimal in the young adult population. Little is known about the most effective means for encouraging vaccination in this population. METHODS The authors conducted a clinical trial of 3 methods to encourage HPV vaccination in a large Northern California integrated Health Plan. Young adults aged 18-26 with evidence of insufficient HPV vaccination were sent a bulk secure message from the Health Plan (standard outreach); those who did not respond were randomized to no further outreach, a second, personalized secure message from a specific practitioner, or a letter mailed to their home. The primary outcome was receipt of at least 1 HPV vaccine within 3 months following the initial bulk secure message. RESULTS In total, 7718 young adults were randomized. After 3 months, 86 patients (3.5%) who received no additional outreach obtained an immunization, compared with 114 (4.6%) who received the second secure message (p = 0.05) and 126 (5.1%) who received the mailed letter (p = 0.006). DISCUSSION Supplemental mailed or personalized electronic messages increased vaccination beyond no additional intervention, although gains were not clinically meaningful. These findings highlight the need for more successful alternatives to encourage uptake of such preventive health interventions among young adults. The successful conduct of this rapid-cycle, randomized trial showed that such evaluations are feasible, providing actionable data to inform implementation strategies. CONCLUSIONS Further study is needed to identify effective strategies for improving preventive health uptake in this important and underserved population. Rapid-cycle randomized evaluation strategies can provide critical information to focus efforts for achieving this goal.


Assuntos
Sistema de Aprendizagem em Saúde , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Humanos , Adulto Jovem , Papillomavirus Humano , Infecções por Papillomavirus/prevenção & controle , Vacinação , Imunização/métodos , Vacinas contra Papillomavirus/uso terapêutico
10.
EBioMedicine ; 91: 104577, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37068348

RESUMO

BACKGROUND: Hyperthermia is a well-accepted cancer therapy. Microwaves provide a very precise, targeted means of hyperthermia and are currently used to treat plantar warts caused by cutaneous-infective human papillomaviruses (HPVs). Other HPV genotypes infecting the anogenital mucosa cause genital warts or preneoplastic lesions or cervical cancer. Effective, non-ablative therapies for these morbid HPV-associated lesions are lacking. METHODS: The molecular consequences of microwave treatment were investigated in in vitro cultured three-dimensional HPV-positive cervical tumour tissues, and tissues formed from HPV-infected normal immortalised keratinocytes. Microwave energy delivery to tissues was quantified. Quantitative reverse transcriptase PCR was used to quantify mRNA expression. Immunohistochemistry and fluorescence immunostaining was used to assess protein expression. FINDINGS: Microwave energy deposition induced sustained, localised cell death at the treatment site. There was a downregulation in levels of HPV oncoproteins E6 and E7 alongside a reduction in cellular growth/proliferation and induction of apoptosis/autophagy. HSP70 expression confirmed hyperthermia, concomitant with induction of translational stress. INTERPRETATION: The data suggest that microwave treatment inhibits tumour cell proliferation and allows the natural apoptosis of HPV-infected cells to resume. Precision microwave delivery presents a potential new treatment for treating HPV-positive anogenital precancerous lesions and cancers. FUNDING: Funding was through an Innovate UK Biomedical Catalyst grant (ID# 92138-556187), a Chief Scientist Office grant (TCS/19/11) and core support from Medical Research Council (MC_ UU_12014) core funding for the MRC-University of Glasgow Centre for Virus Research.


Assuntos
Hipertermia Induzida , Proteínas Oncogênicas Virais , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Feminino , Humanos , Papillomavirus Humano , Micro-Ondas , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/terapia , Proteínas Oncogênicas Virais/genética , Proteínas Oncogênicas Virais/metabolismo , Neoplasias do Colo do Útero/terapia , Neoplasias do Colo do Útero/genética , Morte Celular , Proteínas E7 de Papillomavirus/genética
11.
JAMA Netw Open ; 6(3): e234052, 2023 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-36947040

RESUMO

Importance: Human papillomavirus (HPV) self-sampling addresses barriers to cervical cancer screening, and mailed self-sampling kits have been reported to increase screening uptake. International research suggests mailed kits are cost-effective in certain settings. However, the cost-effectiveness of mailing HPV self-sampling kits for increasing screening uptake has not been evaluated in the US. Objective: To conduct an economic evaluation of a mailed HPV self-sampling intervention among underscreened women enrolled in an integrated US health care system. Design, Setting, and Participants: This economic evaluation involved a cost-effectiveness analysis of results from a randomized clinical trial of 19 851 women aged 30 to 64 years enrolled in a health plan from Kaiser Permanente Washington (KPWA), a US-based integrated health care system. Women were identified through electronic medical records, and eligible participants were enrolled in a health plan for at least 3 years and 5 months, had a primary care clinician, had not received a Papanicolaou test for at least 3 years and 5 months, and had not received a hysterectomy. Enrollment occurred from February 25, 2014, to August 29, 2016, with follow-up through February 25, 2018. The current economic evaluation was conducted between August 2, 2021, and July 30, 2022. Intervention delivery costs were calculated from both the KPWA and Medicare perspectives and were based on either wellness visit or Papanicolaou test-only visit costs. Intervention: Participants in the control group received usual care, which comprised patient reminders and ad hoc outreach for screening. Participants in the intervention group received usual care plus a mailed HPV self-sampling kit. Main Outcome and Measures: The primary economic outcome was the incremental cost-effectiveness ratio (ICER) for increased screening uptake, defined as the incremental difference in cost (intervention group minus control group) divided by the difference in the number of participants completing screening (intervention group minus control group) within 6 months of randomization. Results: Among 19 851 women (mean [SD] age, 50.1 [9.5] years; 76.7% White), 9960 were randomized to the intervention group, and 9891 were randomized to the control group. Baseline ICERs ranged from $85.84 (95% CI, $85.68-$85.99) using KPWA wellness visits as the cost basis to $146.29 (95% CI, $146.20-$146.38) using Medicare Papanicolaou test-only visits as the cost source. Subgroups of participants aged 50 to 64 years and participants most recently overdue for screening achieved cost-effectiveness at lower levels of willingness to pay for an additional completed screening than other subgroups. Conclusions and Relevance: In this economic evaluation, mailing HPV self-sampling kits to women overdue for cervical cancer screening was cost-effective for increased screening uptake relative to usual care. These results support mailing HPV kits as an efficient outreach strategy for increasing screening rates among eligible women in US health care systems.


Assuntos
Infecções por Papillomavirus , Neoplasias do Colo do Útero , Idoso , Feminino , Estados Unidos , Humanos , Pessoa de Meia-Idade , Papillomavirus Humano , Análise Custo-Benefício , Detecção Precoce de Câncer/métodos , Infecções por Papillomavirus/diagnóstico , Papillomaviridae , Medicare
12.
PLoS One ; 18(1): e0280287, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36630459

RESUMO

Human papillomavirus (HPV) vaccination is a well-established and successful tool for preventing HPV-related cancers. However, vaccine uptake remains low, influenced by patient hesitancy around safety concerns and little opportunity to discuss the vaccine with trusted healthcare providers. We conducted a national, cross-sectional study of allopathic and osteopathic medical students regarding knowledge of HPV vaccination guidelines March-April 2021. Analysis sought to identify gaps in knowledge as well as demographic and academic correlates of knowledge. A total of 718 students participated (response rate = 50.8%). While 92.8% of participants identified the connection between HPV and cervical cancer, lower percentages associated HPV with vaginal/vulvar (67.7%), anal (63.3%), and penile (53.9%) cancers. Low percentages of participants correctly identified age of HPV vaccine eligibility (33.3%) and how many doses are needed for full protection (48.1%). This study identifies specific knowledge gaps in medical students' training on HPV-related cancers and HPV vaccination guidelines. Through addressing these gaps, we may improve HPV vaccine uptake and decrease the incidence of HPV-related cancers.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Estudantes de Medicina , Neoplasias do Colo do Útero , Feminino , Humanos , Estudos Transversais , Infecções por Papillomavirus/prevenção & controle , Papillomavirus Humano , Inquéritos e Questionários , Vacinação , Aceitação pelo Paciente de Cuidados de Saúde , Neoplasias do Colo do Útero/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde
13.
J Cancer Educ ; 38(4): 1208-1214, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-36526919

RESUMO

We investigated what is being taught about HPV in US medical schools and evaluated a digital health intervention for medical students to increase their intention to provide a high-quality HPV vaccine recommendation. An online survey was emailed to Academic Deans at the 124 accredited US Schools of Medicine and Osteopathic Medicine between February and April 2018. A digital educational module was emailed to medical students in June 2020. A single-subject longitudinal study design was employed. Pre- post-survey administration measured change in knowledge, attitudes, subjective norms, perceived behavioral control, and intention to recommend HPV vaccine. Gaps in medical school curricula were found. Very few schools (~ 9%) reported teaching content on HPV prevention strategies or patient education. For the digital intervention, independent and dependent variables increased positively. Perceived behavioral control improved at significant levels as participants felt more confident addressing parents' concerns about the vaccine (p < 0.001) and more confident recommending the vaccine for patients (p < 0.05) post module. On the pre-survey, only 6% of the sample knew the most effective HPV vaccine communication style and on the post-survey 81% correctly identified it (p < 0.001). The intervention increased HPV and HPV vaccine knowledge, self-efficacy, and intention to provide a high-quality HPV vaccine recommendation to patients.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Estudantes de Medicina , Humanos , Papillomavirus Humano , Infecções por Papillomavirus/prevenção & controle , Vacinação , Vacinas contra Papillomavirus/uso terapêutico , Estudos Longitudinais , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos e Questionários , Aceitação pelo Paciente de Cuidados de Saúde , Faculdades de Medicina
15.
J Cosmet Dermatol ; 22(3): 913-915, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36374623

RESUMO

BACKGROUND: Verruca plana is a benign proliferation of the skin caused by human papilloma virus (HPV) infection. Fresh garlic can serve as an alternative therapy, and it has shown considerable effectiveness as a topical treatment for verruca plana. However, topical garlic treatment for verruca plana triggered Koebner phenomenon (KP), which has not been previously reported. AIM: The aim of our report is to explore the possible causes of this adverse reaction. METHOD: We here describe a 20-year-old female patient who developed a beaded rash after garlic treatment for facial wart plana, known as autoinoculation or KP. RESULTS: Garlic may have caused damage to the surrounding normal skin through primary irritation or allergic reactions. Then, the HPV virus on the primary verruca plana took the opportunity to spread to the surrounding skin injured by garlic stimulation, triggering the KP. CONCLUSION: When using garlic to treat verruca plana, the operator needs to precisely apply the mashed garlic to the warts, and this treatment is strictly prohibited for patients who are allergic to garlic. Avoid such adverse reactions.


Assuntos
Alho , Infecções por Papillomavirus , Verrugas , Feminino , Humanos , Adulto Jovem , Adulto , Infecções por Papillomavirus/complicações , Verrugas/tratamento farmacológico , Papillomavirus Humano , Administração Tópica
16.
Biol Trace Elem Res ; 201(3): 1026-1050, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35467267

RESUMO

Cervical cancer is an aggressive type of cancer affecting women worldwide. Many affected individuals rely on smear tests for the diagnosis, surgery, chemotherapy, or radiation for their treatment. However, due to a broad set of undesired results and side-effects associated with the existing protocols, the search for better diagnostic and therapeutic interventions is a never-ending pursuit. In the purview, the bio-concentration of trace elements (copper, selenium, zinc, iron, arsenic, manganese, and cadmium) is seen to fluctuate during the occurrence of cervical cancer and its progression from pre-cancerous to metastatic nature. Thus, during the occurrence of cervical cancer, the detection of trace elements and their supplementation will prove to be highly advantageous in developing diagnostic tools and therapeutics, respectively. This review provides a detailed overview of cervical cancer, its encouragement by human papillomavirus infections, the mechanism of pathology, and resistance. Majorly, the review emphasizes the less explored role of trace elements, their contribution to the growth and inhibition of cervical cancer. Numerous clinical trials have been listed, thereby providing a comprehensive reference to the exploration of trace elements in the management of cervical cancer.


Assuntos
Infecções por Papillomavirus , Selênio , Oligoelementos , Neoplasias do Colo do Útero , Feminino , Humanos , Papillomavirus Humano , Manganês , Zinco , Cobre
17.
Afr Health Sci ; 23(2): 179-185, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38223622

RESUMO

Background: To analyse the correlation between vaginal flora and cervical immune function of HPV-infected patients with cervical cancer. Methods: Six hundred females with genital tract infections treated in Xuzhou Hospital of Traditional Chinese Medicine from January 2014 to December 2016 were selected and divided into a high-risk HPV group (n=246) and a control group (n=354). The vaginal flora and human T lymphocyte subsets (CD3+, CD4+, CD8+) were detected. Multivariate logistic regression analysis was performed to explore the risk factors for HPV infection. Results: The numbers of CD4+ and CD4+/CD8+ T cells of the high-risk HPV group were significantly lower than those of the control group (P<0.05). The two groups had similar numbers of CD3+ and CD8+ T cells. In the high-risk HPV group, the positive rates of Lactobacillus, Chlamydia trachomatis, Mycoplasma hominis, mycetes, Ureaplasma urealyticum and bacterial vaginosis were significantly higher than those of the control group (P<0.05). There was no significant difference in the positive rates of trichomonads between the two groups. Multivariate logistic regression analysis revealed that C. trachomatis and U. urealyticum were independent risk factors for high-risk HPV infection (P<0.05). Conclusion: High-risk HPV infection in patients with cervical cancer was associated with vaginal flora and immune function. C. trachomatis and U. urealyticum were independent risk factors for high-risk HPV infection.


Assuntos
Infecções por Chlamydia , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Feminino , Humanos , Neoplasias do Colo do Útero/complicações , Infecções por Papillomavirus/complicações , Papillomavirus Humano , Infecções por Chlamydia/complicações , Infecções por Chlamydia/microbiologia , Imunidade , Chlamydia trachomatis
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