How the Cervical Microbiota Contributes to Cervical Cancer Risk in Sub-Saharan Africa

Despite ongoing efforts, sub-Saharan Africa faces a higher cervical cancer burden than anywhere else in the world. Besides HPV infection, definitive factors of cervical cancer are still unclear. Particular states of the cervicovaginal microbiota and viral infections are associated with increased cervical cancer risk. Notably, HIV infection, which is prevalent in sub-Saharan Africa, greatly increases risk of cervicovaginal dysbiosis and cervical cancer. To better understand and address cervical cancer in sub-Saharan Africa, a better knowledge of the regional cervicovaginal microbiome is required This review establishes current knowledge of HPV, HIV, cervicovaginal infections, and the cervicovaginal microbiota in sub-Saharan Africa. Because population statistics are not available for the region, estimates are derived from smaller cohort studies. Microbiota associated with cervical inflammation have been found to be especially prevalent in sub-Saharan Africa, and to associate with increased cervical cancer risk. In addition to high prevalence and diversity of HIV and HPV, intracellular bacterial infections such as Chlamydia, Gonorrhea, and Mycoplasma hominis are much more common than in regions with a low burden of cervical cancer. This suggests the prevalence of cervical cancer in sub-Saharan Africa may be partially attributed to increased cervical inflammation resulting from higher likelihood of cervical infection and/or microbial dysbiosis

Cervical plate fracture: a rare complication

In traumatic and degenerative diseases cervical fusion with anterior cervical plate are commonly used. The increase in the use of cervical plate segment level is also increased risk of developing complications. This case report shows that the increase in the use of cervical plate segment level and also the complications in cervical spinal instrumentation, short-segment cervical plate rare case reported to be broken

Choice, morality and vulnerability : young women's discourses of cervical screening : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology (endorsement in Health Psychology) at Massey University, Albany, New Zealand

Cervical screening is a health surveillance tool used to prevent cervical cancer. In New Zealand, research into cervical screening has largely focused on barriers to participation. This type of research implicitly assumes that cervical screening is a desirable health behaviour for women to engage in, and does not explore how social and political factors are implicated in cervical screening behaviour. This research sought to explore women’s understandings and experiences of cervical screening. Ten women aged 20 to 30 were interviewed, their responses recorded and transcribed, and an interpretive analysis conducted. From the analysis, three broad webs of discourse surrounding cervical screening – choice, morality and vulnerability – were identified and discussed. Each web of discourse was used to construct cervical screening in different ways. For choice, participants constructed cervical screening as an autonomous choice, routine, or an obligation. Morality was drawn upon for its role in cervical screening around ideas of individual and social responsibility, and sexual activity. Finally, vulnerability was explored through the fear of getting cervical cancer, the vulnerability experienced as part of screening, and the protection it was seen to offer. Choice, morality and vulnerability worked together to limit the available ways of experiencing and acting in relation to cervical screening, constructing compliance as the only option for women. Those who do not comply are positioned as problematic, irresponsible and immoral by women, their friends and families, and health professionals. This research highlighted the ways in which discourses produce realities which create and maintain power imbalances which govern and control women’s bodies. Rather than viewing cervical screening as a desirable yet morally neutral act which all women ought to participate in, it is a site where women may choose to comply or resist dominant discourses which exert power over women’s bodies

Clinical Correlates of High Cervical Fractional Anisotropy in Acute Cervical Spinal Cord Injury

Objective: Fractional anisotropy (FA) of the high cervical cord (C1-C2), rostral to the injury site, correlates with upper limb function in patients with chronic cervical spinal cord injury (SCI). In acute cervical SCI, this relationship has not been investigated. The objective of this study was to identify functional correlates of FA of the high cervical cord in a series of patients with acute cervical SCI. Methods: Traumatic cervical SCI patients who underwent presurgical cervical spine diffusion tensor imaging at our institution were reviewed for this study. FA of the whole cord as well as the lateralcorticospinal tracts (CSTs) was calculated on axial images from C1-C2. Upper limb motor (C5-T1) and sensory (C2-T1) function scores were extracted from the admission American Spinal Injury Association (ASIA) examinations. Correlation analysis for FA with ASIA examinations was performed using a Pearson correlation. Results: Twelve subjects (9 men, 3 women; mean age 54.7 ± 4.0 years) underwent cervical spine diffusion tensor imaging at a mean duration of 3.6 ± 0.9 days postinjury. No patient had cord compression or intramedullary T2-weighted hyperintensities within the C1-C2 segments. FA correlated with upper limb motor score (whole cord: r = 0.59, P = .04; CST: 0.67, P = .01) and the ASIA grade (whole cord: r = 0.61, P = .03; CST: r = 0.71, P = .009). No correlation was found between FA and sensory scores. Conclusions: FA of the whole cervical cord as well as the CST, rostral to the injury site, is associated with preserved upper limb motor function as well as superior ASIA grades after acute cervical SCI. FA of the high cervical cord is a potential biomarker of neural injury after acute cervical SCI

Conservative surgical treatment in cervical dysplastic lesions associated with cystorectocele

The treatment of cervical intraepithelial neoplasia aims at removing the squamocolumnar junction area, including abnormal tissues, up to the healthy tissue. Old postpartum perineal tears associated with cystorectocele, hypertrophic cervical elongation, and first and second degree uterine prolapse are pelvic static disorders. Particular aspects of pelvic-genital static disorder are related to the vulnerability of the pelvic-perineal floor during birth. On the occasion of birth, especially when there are different forms of dystocia during labor, the degradation of soft pelvic, genital, and vaginal-perineal tissues can occur. The objective of this study was to re-evaluate the conservative treatment of cervical dysplasia, depending on the degree of cervical lesions, the surface extension, the age of the patients, and the pathology associated with cervical lesions – colpocele, cystorectocele, and urinary incontinence in the old postpartum perineal tears. In order to solve the three types of concomitant lesions, we used the Manchester operation: the anterior colporrhaphy with the recalibration of the urethra and the suspension of the cystocele, the minimal colpectomy, the lesional cervical amputation with the anterior fixation of the parameters, and the posterior colpoperineorrhaphy with high myorrhaphy of the levator ani muscles. The decision on the management of cervical dysplasia has taken into account the degree of cervical lesions, the extension on the surface, the patients’ age and the pregnancy planning, and the pathology associated with cervical lesions. The Manchester operation is a conservative surgical procedure, effective in women under 45 years old, multiparous, with present genital activity, with dysplastic cervical lesions and cystorectocele. It also solves cystorectocele, cervical dysplasia, hypertrophic cervical elongation, and first and second degree uterine prolapse

In vivo characterization of connective tissue remodeling using infrared photoacoustic spectra

Premature cervical remodeling is a critical precursor of spontaneous preterm birth, and the remodeling process is characterized by an increase in tissue hydration. Nevertheless, current clinical measurements of cervical remodeling are subjective and detect only late events, such as cervical effacement and dilation. Here, we present a photoacoustic endoscope that can quantify tissue hydration by measuring near-infrared cervical spectra. We quantify the water contents of tissue-mimicking hydrogel phantoms as an analog of cervical connective tissue. Applying this method to pregnant women in vivo, we observed an increase in the water content of the cervix throughout pregnancy. The application of this technique in maternal healthcare may advance our understanding of cervical remodeling and provide a sensitive method for predicting preterm birth

Assessing the cervical range of motion in infants with positional plagiocephaly

Purpose: To determine if infants with positional plagiocephaly have limitations of active and passive cervical range of motion measured with simple and reliable methods. Methods: The examiners assessed bilateral active and passive cervical rotations and passive cervical lateral flexion. Cervical assessment was performed twice by 2 different physicians to assess intertester reliability. To assess intratester reliability the first investigator performed a second examination 48 hours after the first one. Results: One-hundred nine subjects were analyzed; 70.7% of the sample had head positional preference on the right, while 29.3% had head positional preference on the left (x2 35.52, P <0.001). Cervical rotations and lateral flexion showed reliable levels of agreement for intra and intertester reliability. Conclusions: The most limited range of motion in infants with positional plagiocephaly was cervical active rotation which affected more than 90% of patients. Passive cervical rotations and lateral flexion were limited in more than 60% of patient

Barriers to cervical screening participation in high-risk women

Aim Women aged 25–35 years, for whom cervical cancer is most problematic, are least likely to participate in the cervical screening programme. Therefore, identifying barriers to screening participation in this high-risk group is essential. Subject and methods A sample of 430 women completed an electronic survey of their cervical screening history and answered questions on sociodemographic, behavioural, attitudinal and informational barriers to cervical screening uptake. Logistic regression was used to predict cervical screening non attendance. Results Women with more than 10 sexual partners in their lifetime were more likely, but women from ethnic minorities, less likely to participate in the cervical screening programme. Women unaware of the recommended screening interval were also less likely to be screened, as were women who believed that screening is a test for cancer. Screening was also less likely among women who endorsed the belief that screening in the absence of symptoms is unnecessary. Conclusion These data highlight poor knowledge of the recommended screening interval and purpose of cervical cancer screening in this high-risk group. As such, interventions that target these informational barriers might be most effective for increasing cervical screening uptake in this high-risk group

Active adjustment of the cervical spine during pitch production compensates for shape: The ArtiVarK study

The anterior lordosis of the cervical spine is thought to contribute to pitch (fo) production by influencing cricoid rotation as a function of larynx height. This study examines the matter of inter-individual variation in cervical spine shape and whether this has an influence on how fo is produced along increasing or decreasing scales, using the ArtiVarK dataset, which contains real-time MRI pitch production data. We find that the cervical spine actively participates in fo production, but the amount of displacement depends on individual shape. In general, anterior spine motion (tending toward cervical lordosis) occurs for low fo, while posterior movement (tending towards cervical kyphosis) occurs for high fo

Vietnamese American women’s beliefs and perceptions on cervical cancer, cervical cancer screening, and cancer prevention vaccines: A community-based participatory study

Cervical cancer remains commonly diagnosed in Vietnamese American women. Despite efforts to increase cervical cancer screening among Vietnamese American women, participation rates are persistently lower than the national goal. The objective of this study is to explore beliefs of Vietnamese American women about cervical cancer, cervical cancer screening, and cancer prevention vaccines. A qualitative descriptive investigation captured group perceptions about meaning and beliefs of cervical cancer, screening, and cancer prevention vaccines, and participants’ stories using a community-based participatory research approach. Forty Vietnamese American women were recruited from the Portland, Oregon metropolitan area into four focus groups. Using a process of directed content analysis, focus group transcripts were coded for themes. We found that cervical cancer continues to be a difficult topic to discuss, and Vietnamese American women may not bring the topic up themselves to their health care providers. Some women experienced intense emotions of fear or shame of having their cervix examined. Women delayed seeking cervical cancer screening and needed to have early warning signs, which guided them as to when to seek health care. Women focused on cleanliness through vaginal and/or perineal washing as primary prevention for cervical cancer. There were limited awareness and knowledge about cancer prevention vaccines, specifically the human papillomavirus. Some women relied heavily on their informal social networks of family, friends, or community for health knowledge. Fear and misunderstanding dominated the beliefs of Vietnamese American women about cervical cancer screening and prevention. These findings underscored the importance of having culturally-specific findings, which will inform a multicomponent intervention to promote cervical cancer screening and cancer prevention vaccine uptake within this population