HPV-DNA -positiivisuuden vaikutus nuorten naisten elämänlaatuun

Kohdunkaulansyövän välttämättömän syyn, ihmisen papilloomaviruksen (HPV) -DNA -seulonta on lähitulevaisuudessa korvaamassa irtosolu- (papa-) näyteseulonnat Suomessa. Tämän tutkielman tarkoituksena on selvittää, miten seulonnan tuloksena saatu tieto positiivisesta HPV-DNA:sta ja sen mahdollisista vaikutuksista vaikuttaa nuorten naisten elämänlaatuun. Tutkittavat rekrytoitiin vuonna 2004–2005 HPV-rokotetutkimukseen (HPV tai Hepatiitti A-rokote). Viimeisellä tutkimuskäynnillä ne, joilla todettiin positiivinen HPV-DNA, ohjattiin seurantaan. Seurantavaiheessa HPV-DNA- ja irtosolunäytteitä otettiin vuosittain. Terveyteen liittyvää elämänlaatua tutkittiin kahden puolentoista vuoden välein (toukokuussa 2010 ja marraskuussa 2011) postitettujen elämänlaatua kartoittavien kyselyiden avulla. Kyselyihin (RAND-36, EQ-5D VAS -osuus ja CECA-10) vastanneet 160 tutkittavaa jaettiin heille kerrotun HPV-DNA testin tuloksen mukaisesti ensimmäisen kyselyn vastaamisen hetkellä: positiivisiin ja -negatiivisiin ja toisen kyselyn kohdalla kolmeen ryhmään: positiivinen -> positiivinen, positiivinen -> negatiivinen, negatiivinen -> negatiivinen. Elämänlaadun muutosta arvioitiin kvantitatiivisin menetelmin ensimmäisen ja toisen kyselyn vastausten perusteella, eri ryhmien välisiä vastauksia verrattiin keskenään ja niitä verrattiin myös samanikäisten suomalaisten arvoihin. Tietoisuus todetusta kohdunkaulan syöpäriskiä lisäävästä positiivisesta HPV-DNA:sta heikensi terveyteen liittyvää elämänlaatua fyysisen toimintakyvyn, kivuttomuuden ja koetun terveyden ulottuvuuksilla verrattuna samanikäiseen suomalaiseen verrokkiväestöön. HPV-DNA -positiivisuuden jatkuessa puolitoista vuotta terveys koettiin edelleen samanikäistä verrokkiväestöä huonommaksi. Todettu HPV-DNA -positiivisuus aiheutti alkuvaiheessa huolta ja pelkoa tilanteen pahenemisesta verrattuna niihin, joilla HPV-DNA oli muuttunut negatiiviseksi. Huoli ei heijastunut muihin mitattuihin elämänlaadun ulottuvuuksiin. Toistetussa mittauksessa, kun HPV-DNA -positiivisuutta seurattiin pidempään, huoli heikkeni. HPV-DNA -positiivisten HPV-rokotettujen ja Hepatiitti A -rokotettujen elämänlaadussa ei ollut eroavaisuutta. Tutkimuksen perustella voidaan päätellä, että siirryttäessä laajempaan HPV-DNA -seulontaan on annettava riittävästi tietoa ja ohjausta HPV-infektioiden luonteesta, HPV-DNA - testauksesta ja sen tuloksista, jotta seulonta ei vaikuta heikentävästi elämänlaatuun

The Prevalence of HSV, HHV-6, HPV and Mycoplasma genitalium in Chlamydia trachomatis positive and Chlamydia trachomatis Negative Urogenital Samples among Young Women in Finland

Chlamydia trachomatis, Mycoplasma genitalium, herpes simplex virus (HSV) and human papillomavirus (HPV) cause sexually transmitted infections. In addition, human herpesvirus 6 (HHV-6) may be a genital co-pathogen. The prevalence rates of HSV, HHV-6, HPV, M. genitalium, and the C. trachomatis ompA genotypes were investigated by PCR in urogenital samples of the C. trachomatis nucleic acid amplification test positive (n = 157) and age-, community- and time-matched negative (n = 157) women. The prevalence of HPV DNA was significantly higher among the C. trachomatis positives than the C. trachomatis negatives (66% vs. 25%, p < 0.001). The prevalence of HSV (1.9% vs. 0%), HHV-6 (11% vs. 14%), and M. genitalium DNA (4.5% vs. 1.9%) was not significantly different between the C. trachomatis-positive and -negative women. Thirteen per cent of test-of-cure specimens tested positive for C. trachomatis. The prevalence of HSV, HHV-6, HPV, M. genitalium, and the C. trachomatis ompA genotypes did not significantly differ between those who cleared the C. trachomatis infection (n = 105) and those who did not (n = 16). The higher prevalence of HPV DNA among the C. trachomatis positives suggests greater sexual activity and increased risk for sexually transmitted pathogens

The Prevalence of HSV, HHV-6, HPV and Mycoplasma genitalium in Chlamydia trachomatis positive and Chlamydia trachomatis Negative Urogenital Samples among Young Women in Finland

Chlamydia trachomatis, Mycoplasma genitalium, herpes simplex virus (HSV) and human papillomavirus (HPV) cause sexually transmitted infections. In addition, human herpesvirus 6 (HHV-6) may be a genital co-pathogen. The prevalence rates of HSV, HHV-6, HPV, M. genitalium, and the C. trachomatis ompA genotypes were investigated by PCR in urogenital samples of the C. trachomatis nucleic acid amplification test positive (n = 157) and age-, community- and time-matched negative (n = 157) women. The prevalence of HPV DNA was significantly higher among the C. trachomatis positives than the C. trachomatis negatives (66% vs. 25%, p <0.001). The prevalence of HSV (1.9% vs. 0%), HHV-6 (11% vs. 14%), and M. genitalium DNA (4.5% vs. 1.9%) was not significantly different between the C. trachomatis-positive and -negative women. Thirteen per cent of test-of-cure specimens tested positive for C. trachomatis. The prevalence of HSV, HHV-6, HPV, M. genitalium, and the C. trachomatis ompA genotypes did not significantly differ between those who cleared the C. trachomatis infection (n = 105) and those who did not (n = 16). The higher prevalence of HPV DNA among the C. trachomatis positives suggests greater sexual activity and increased risk for sexually transmitted pathogens.Peer reviewe

The Prevalence of HSV, HHV-6, HPV and Mycoplasma genitalium in Chlamydia trachomatis positive and Chlamydia trachomatis Negative Urogenital Samples among Young Women in Finland

Chlamydia trachomatis, Mycoplasma genitalium, herpes simplex virus (HSV) and human papillomavirus (HPV) cause sexually transmitted infections. In addition, human herpesvirus 6 (HHV-6) may be a genital co-pathogen. The prevalence rates of HSV, HHV-6, HPV, M. genitalium, and the C. trachomatis ompA genotypes were investigated by PCR in urogenital samples of the C. trachomatis nucleic acid amplification test positive (n = 157) and age-, community- and time-matched negative (n = 157) women. The prevalence of HPV DNA was significantly higher among the C. trachomatis positives than the C. trachomatis negatives (66% vs. 25%, p < 0.001). The prevalence of HSV (1.9% vs. 0%), HHV-6 (11% vs. 14%), and M. genitalium DNA (4.5% vs. 1.9%) was not significantly different between the C. trachomatis-positive and -negative women. Thirteen per cent of test-of-cure specimens tested positive for C. trachomatis. The prevalence of HSV, HHV-6, HPV, M. genitalium, and the C. trachomatis ompA genotypes did not significantly differ between those who cleared the C. trachomatis infection (n = 105) and those who did not (n = 16). The higher prevalence of HPV DNA among the C. trachomatis positives suggests greater sexual activity and increased risk for sexually transmitted pathogens

Prolyl 4-hydroxylase subunit alpha 1 (P4HA1) is a biomarker of poor prognosis in primary melanomas and its depletion inhibits melanoma cell invasion and disrupts tumor blood vessel walls

Abstract Melanoma is an unpredictable, highly metastatic malignancy, and treatment of advanced melanoma remains challenging. Novel molecular markers based on the alterations in gene expression and the molecular pathways activated or deactivated during melanoma progression are needed for predicting the course of the disease already in primary tumors and for providing new targets for therapy. Here, we sought to identify genes whose expression in primary melanomas correlate with patient disease-specific survival using global gene expression profiling. Many of the identified potential markers of poor prognosis were associated with the epithelial-mesenchymal transition, extracellular matrix formation, and angiogenesis. We studied further the significance of one of the genes, prolyl 4-hydroxylase subunit alpha 1 (P4HA1), in melanoma progression. P4HA1 depletion in melanoma cells reduced cell adhesion, invasion, and viability in vitro. In melanoma xenograft assays, we found that P4HA1 knockdown reduced melanoma tumor invasion as well as the deposition of collagens, particularly type IV collagen, in the interstitial extracellular matrix and in the basement membranes of tumor blood vessels, leading to vessel wall rupture and hemorrhages. Further, P4HA1 knockdown reduced the secretion of collagen triple helix repeat containing 1 (CTHRC1), an important mediator of melanoma cell migration and invasion, in vitro and its deposition around tumor blood vessels in vivo. Taken together, P4HA1 is an interesting potential prognostic marker and therapeutic target in primary melanomas, influencing many aspects of melanoma tumor progression.Peer reviewe

Association of Chlamydia trachomatis infection with cervical atypia in adolescent women with short-term or long-term use of oral contraceptives : a longitudinal study in HPV vaccinated women

Objective We assessed the relationship between Chlamydia trachomatis infection, duration of oral contraceptive (OC) use and cervical atypia among young adult Finnish women. Design A longitudinal study. Setting and participants Women who were included in this study participated in a community-randomised trial on the effectiveness of human papillomavirus (HPV) vaccination and C. trachomatis screening at ages 18.5 and 22 years in Finland. They completed questionnaires on both visits about sexual behaviours. The cytology test results at age 18.5 and 22 years were also available for those women. The total number of participants in this study at 18.5 years of age were 11 701 and at 22 years of age were 6618. Main outcome measure ORs with 95% CIs using univariable and multivariable logistic regression were used to assess the association between C. trachomatis infection, duration of OC and squamous intraepithelial lesions (SIL). Results There were 940 cytological SIL cases at the first screening visit and 129 cytological SIL cases at the second screening visit. Among the 22 years old, more than fourfold adjusted risk of SIL was associated with C. trachomatis positivity. The HPV16/18, condom use, smoking and number of sexual partners adjusted joint effect of prolonged OC use and C. trachomatis was significantly increased (OR 4.7, 95% CI 1.7 to 12.8) in the 22-year-old women. This observed joint effect was 1.6 times higher than expected on a multiplicative scale. On additive scale, the observed relative excess risk from interaction was 1.8. Conclusion The risk of SIL in HPV vaccinated women is significantly increased if they are C. trachomatis positive and have used OC for 5 or more years. The biological basis may be lack of condom facilitated protection against sexually transmitted diseases.Peer reviewe

Three factor eating questionnaire-R18 as a measure of cognitive restraint, uncontrolled eating and emotional eating in a sample of young Finnish females

<p>Abstract</p> <p>Background</p> <p>The aim of the study was to examine the construct validity of the Three-Factor Eating Questionnaire -R18 (TFEQ-R18), a measure of eating behaviour, and to evaluate cognitive restraint, uncontrolled eating and emotional eating in a sample of adolescent and young adult females of different weights.</p> <p>Methods</p> <p>Subjects were 2 997 females, aged 17 to 20 years, who participated in a phase III human papillomavirus vaccination trial in Finland in 2004 – 2009.</p> <p>Self-administered questionnaires and weight and height measurements were used. The factor structure of the TFEQ-R18 was verified by factor analysis. Connections between measured eating behaviour and Body Mass Index (BMI) were tested using analysis of variance.</p> <p>Results</p> <p>The original factor structure of the TFEQ-R18 was replicated: six of the eighteen items measured cognitive restraint, nine measured uncontrolled eating, and three measured emotional eating. On average, higher BMI was associated with higher levels of cognitive restraint (p < 0.001) and emotional eating (p < 0.001), but not with uncontrolled eating.</p> <p>Conclusion</p> <p>Structural validity of the TFEQ-R18 was good in this sample of young Finnish females with a varying range of body weights. Use of the instrument as a measure of eating behaviour was thus corroborated. Connections of restrained and emotional eating with BMI were in accordance with previous findings from young females.</p

Effects of a fibre-enriched milk drink on insulin and glucose levels in healthy subjects

<p>Abstract</p> <p>Background</p> <p>The glycaemic response to foods is dependent on the quality and content of carbohydrates. Carbohydrates in the form of dietary fibre have favourable effects on insulin and glucose metabolism and may help to control energy intake. Dairy products have a relatively low carbohydrate content, and most of the carbohydrate is in the form of lactose which causes gastrointestinal symptoms in part of the population. In order to avoid these symptoms, dairy products can be replaced with lactose-free dairy products which are on the market in many parts of the world. However, the effects of lactose-free products on insulin and glucose metabolism have not been studied.</p> <p>Methods</p> <p>In the present study, we investigated the effects of 1) a lactose-free milk drink, 2) a novel fibre-enriched, fat- and lactose-free milk drink and 3) normal fat-free milk on serum glucose and insulin levels and satiety using a randomized block design. Following an overnight fast, 26 healthy volunteers ingested 200 ml of one of these drinks on three non-consecutive days. Insulin and glucose levels and subjective satiety ratings were measured before the ingestion of the milk product and 20, 40, 60, 120 and 180 minutes after ingestion. The responses were calculated as the area under the curve subtracted by the baseline value (AUC minus baseline).</p> <p>Results</p> <p>The insulin response was significantly lower for the fibre-enriched milk drink than it was for the other milk products (AUC, <it>P </it>= 0.007). There were no differences in the response for glucose or in the AUC for the subjective satiety ratings between the studied milk products.</p> <p>Conclusion</p> <p>The present results suggest that this novel milk drink could have positive effects on insulin response.</p