Atraumatic Sacral Fracture in Late Pregnancy: A Case Report.

Study Design Case report. Objective Sacral fractures, traumatic or atraumatic, are a rather rare cause of low back pain. The majority of the cases of pregnancy-related sacral fractures are reported as a postpartum complication, and only few cases of sacral atraumatic fractures have been reported in the last trimester of the pregnancy. The aim of this study is to report a rare case of atraumatic sacral fracture in the third trimester of pregnancy. Methods We report the case of a 30-year-old Caucasian European woman during her 37th week (36 weeks and 4 days) of gestation, who complained during her scheduled obstetric examination of continuous low back pain with no associated history of trauma. The patient performed activities of daily living with a normal level of fatigue and reported no running or walking long distances. She was examined in our department, and a magnetic resonance imaging scan was performed that showed a vertical nondisplaced fracture in her left sacrum. Results The patient was treated conservatively, and analgesics were administrated according to the consensus of the orthopedic and the anesthesiology departments. No further complications were recognized in the remaining period of her pregnancy, and a healthy child was born by caesarean section. Conclusions Atraumatic fractures of the sacrum should be included in the differentiated diagnosis of pregnant patients with low back pain.

An update review on HPV testing methods for cervical neoplasia.

BACKGROUND: Human papillomavirus (HPV) infection has a strong causal relationship with cervical cancer. Previous prevention strategies were based on cytology and colposcopy, and were limited by their low sensitivity. METHODS for HPV DNA or RNA detection have been developed that are expected to improve cervical cancer screening protocols. OBJECTIVE: The aim of this paper was to review the HPV testing methods that are used and their clinical applications. METHODS: A MEDLINE search was performed and the references of the retrieved articles were hand-searched for any missed studies. RESULTS/CONCLUSIONS: The main HPV testing methods that have well-defined clinical applications at present are polymerase chain reaction (PCR) and Hybrid Capture II. Real-time PCR and mRNA testing are techniques of growing interest. The main clinical applications are in the triage of borderline Pap smears and in the follow-up after treatment for cervical pre-malignant lesions. Other applications such as use in primary screening are under consideration.