Prevalence of human papillomavirus types 16, 18, and 45 in women with cervical intraepithelial changes: associations with colposcopic and histological findings.

The aim of the study was to determine the prevalence of human papillomavirus (HPV) types 16, 18, and 45 in women with cervical intraepithelial changes caused by high-risk HPV in relation to colposcopic and histological findings. MATERIAL AND METHODS. A prospective study of 393 women with cervical cytologic changes confirmed by the Papanicolaou test was undertaken from April 3, 2006, to April 3, 2007. The Hybrid Capture 2 assay was performed. HPV-positive women underwent genotyping for types 16, 18, and 45. Colposcopy and biopsy were performed in 317 (80.7%) and 249 women (63.4%), respectively. The results were analyzed by age groups. RESULTS. Of all the women with cervical intraepithelial changes, 59% were positive for HR HPV, and 62% were positive for HPV types 16, 18, and 45. HPV types 16, 18, and 45 were detected in 54.8% of women with ASC-US/AGUS/ASC-H, 50.0% of women with LSIL, and 75.6% of women with HSIL. After confirmation of any histological and colposcopic changes, HPV types 16, 18, and 45 were detected in 68.0% and 69.0% of women, respectively. Moreover, 84.2% of the women with HSIL and high-grade colposcopic changes, and 78.5% of the women with HSIL and CIN 2/CIN 2-3/CIN 3/carcinoma in situ were positive for HPV types 16, 18, and 45. The sensitivity of the Papanicolaou test together with the Hybrid Capture 2 test compared with the Papanicolaou test together with the HPV 16/18/45 test diagnosing CIN 2+ changes did not differ (96.7% vs. 97.1%), but the specificity was higher (40.3% vs. 8.0%). CONCLUSIONS. The majority of the cytologic, colposcopic, and histological changes were caused by HPV types 16, 18, and 45. Despite the high prevalence of HPV types 16, 18, and 45, testing for these genotypes together with the Papanicolaou test did not improve the diagnosis of high-grade cervical intraepithelial lesions.

The Diagnostic Properties of Medical History in the Diagnosis of Tubal Pathology among Subfertile Patients.

Objectives. To evaluate the diagnostic performance of medical history in the diagnosis of tubal pathology among subfertile patients. Patients and Methods. Prospective cross-sectional study was performed. Prior to tubal evaluation, medical history data were collected. Sensitivity, specificity, and likelihood ratios (LRs) for predicting tubal pathology as determined by laparoscopy and dye test were calculated for each issue of medical history. Results. 39.6 % (59/149) were diagnosed with tubal pathology. The sensitivity for the different issues ranged between 1.7 and 54.2% and the specificity between 75.6 and 97.8%. The estimated highest value of positive LR is attributed to the history of ectopic pregnancy and lowest of negative LR to pelvic inflammatory disease (PID) and abdominal surgery. Conclusion. The positive history of PID, sexually transmitted diseases (STDs), abdominal and laparoscopic surgery, and ectopic pregnancy are satisfactory screening tests for ruling the tubal pathology in. The negative history of evaluated issues is inappropriate for ruling the tubal damage out.

[The evaluation of clinical signs and hormonal changes in women who complained of excessive body hair growth]. / Moteru, kurios skundesi padidejusiu kuno plaukuotumu, klinikiniu pozymiu ir hormonu pokyciu ivertinimas.

OBJECTIVE: To evaluate the clinical signs and hormonal changes in women who complained of increased hair growth. MATERIAL AND METHODS: We studied 122 female residents of Lithuania aged 18-35 years who were referred to the Clinic of Endocrinology of Kaunas University of Medicine Hospital in 2002-2003 for excessive body hair growth. Increased body hair was graded using the Ferriman-Gallwey (F-G) method. Hirsutism was defined when the F-G score was > or =8. RESULTS: Hirsutism was present in 74 (60.66 %) females and in 48 (39.34 %) no hirsutism was noted. The females with hirsutism complained more frequently of infertility (p<0.05), increased greasiness of skin (p<0.05) and noted the progressing increase of hair growth (p<0.05). No differences in frequency of menstrual disorders and acne were found. The females with hirsutism had significantly higher body mass index, systolic and diastolic blood pressure, larger waist and hip circumference (p<0.001) and higher waist/hip ratio (p<0.01). The significantly higher levels of testosterone and dehydroepiandrosterone sulfate (p<0.05), higher values of free androgen index (p<0.001) and significantly lower levels of sex hormone-binding globulin (p<0.01) were found in females with hirsutism. Women were prone to overestimate the increased hair growth, when compared with the physician's assessment (p<0.05). No significant difference was found (p>0.05) comparing the mean values of testosterone, sex hormone-binding globulin, free androgen index and dehydroepiandrosterone sulfate between two groups divided according to the subjective evaluation of excessive hair growth by females. CONCLUSIONS: Women are prone to overestimate the increased hair growth. The significantly higher levels of testosterone and dehydroepiandrosterone sulfate, higher values of free androgen index and lower levels of sex hormone binding globulin (p<0.01) were found in females with hirsutism. The females with hirsutism complained more frequently of infertility, increased greasiness of skin, had higher body mass index, systolic and diastolic blood pressure, larger waist and hip circumference and higher waist/hip ratio.