Risk of cervical high-grade squamous intraepithelial neoplasia in cytologic negative and persistently high-risk human papillomavirus positive patients according to genotypes: a retrospective single center analysis.

In January 2020, a different cervical cancer screening program started in Germany. Women above the age of 35 are recommended to have a combined HPV and cytology swab every three years. Showing persistent high-risk human papillomavirus (hrHPV), cytologic negative cervical samples at baseline and after 12 months, patients are referred to colposcopy. Entailing considerable additional workload due to the required colposcopies, we analyzed the risk of high-grade cervical intraepithelial neoplasia (CIN 3) in cytologic negative and persistent hrHPV women according to their hrHPV genotypes.Methods In this single center retrospective study, patients with persistent hrHPV, cytology negative cervical samples from our certified Colposcopy Unit in 2020 and 2021 were analyzed. Patient demographics, hrHPV types, biopsy rates and histological reports were collected.Results During the study, 69 patients were enrolled. Most frequent hrHPV genotypes were: hrHPV other 72.5%; HPV 16, 20.3% and HPV 18, 7.2%. Colposcopy showed no or minor changes in 92.7% and major changes in 7.2%. CIN 3 was found in 7 patients (10.1%). Prevalence of CIN 3 by hrHPV genotypes was 27.3% for HPV16, 20.0% for HPV18 and 7.1% for HPVO. A statistically significant dependency between hrHPV and cervical intraepithelial neoplasia was demonstrated (p = 0.048).Conclusion Within this single center study of persistent hrHPV, cytologic negative samples, patients with HPV 16 were more likely to have high-grade disease compared to other hrHPV subtypes. Larger prospective randomized trials are needed to substantiate our results and obtain adjusted cervical cancer screening time intervals according to the hrHPV genotypes.

Lower Limb Lymphedema Awareness among Gynecological Cancer Patients: An International Survey Supported by the European Network of Gynecological Cancer Advocacy Groups (ENGAGe) Group.

INTRODUCTION: Patient awareness of postoperative lymphedema in the field of gynecologic oncology has been poorly documented in the international literature. We wished to capture and document the awareness among gynecological cancer survivors about postoperative lymphedema, including aspects such as the adequacy of perioperative counseling, management, and quality of life. METHODS: A web-based survey comprising 25 multiple-choice questions was distributed to gynecological cancer advocacy groups within the European Network of Gynecological Cancer Advocacy Groups (ENGAGe) group. The survey was validated in a pilot group of gynecological patients prior to distribution. RESULTS: Overall, 386 women from 20 countries completed the questionnaire. Only half of the patients (n = 211) knew what lymphedema is, whereas 52% of the respondents stated that they were never informed at their pre-operative assessment about the potential risk of developing lymphedema. Fifty-three percent of those women who were informed about the risk and management of lymphedema received information through self-initiative, connecting mainly with patient groups or online. Approximately 84% of patients with lymphedema reported that they informed their doctor about their symptoms. Ninety-four patients (55.3%, which is not 55% of the 386) were treated for lymphedema. Forty-five women out of 136 reported that lymphedema significantly affected their everyday lives. DISCUSSION: We report a large lack of awareness and a significant gap of knowledge about the risks and treatment options related to postoperative lymphedema among gynecological cancer survivors. Institutional practice routines and awareness among professionals need to be urgently recalled and adapted to adequately inform and support gynecological cancer patients.

Physiological status of broiler chickens with diets supplemented with milk thistle extract.

BACKGROUND AND AIM: In recent decades, the use of various feed supplements is the current trend in poultry farming, among which phytogenics serve as alternatives to feed antibiotics. This study aimed to examine the effect of feeding various doses of milk thistle extract (Silybum marianum) on the morphological and biochemical parameters of the blood in broiler chickens. MATERIALS AND METHODS: Experiments were carried out in an industrial poultry farm on broiler chickens of the Hubbard ISA F15 cross for 40 days. One control group and five experimental groups of day-old chickens were formed. The number of birds in each group was 50. Broilers of all groups received complete feed, and the experimental groups received an additional milk thistle extract at doses of 0.1, 0.5, 1.0, 1.5, and 2.0 mg/kg of body weight. Milk thistle medicinal plant extract was obtained using water-ethanol extraction followed by low-temperature vacuum drying. For the assessment of blood analyses, samples were collected from the wing vein of six chickens per group. Using unified methods recommended by the International Federation of Clinical Chemistry, the content of red blood cells, hemoglobin, white blood cells, total protein, protein fractions, triglycerides, glucose, calcium, phosphorus, and the concentration of alanine aminotransferase and aspartate aminotransferase in the blood serum were determined. RESULTS: It was found that the introduction of milk thistle extract into the diet of broiler chickens with the aforementioned doses increased the number of red blood cells, hemoglobin, white blood cells in the blood, as well as a decrease in the level of albumin and an increase in the content of γ-globulins in its serum. CONCLUSION: The authors assume that the introduction of milk thistle extract into a complete feed for broiler chickens increased the anabolic processes in their bodies, accompanied by increased use of proteins of the albumin fraction as the main material for organogenesis.