Evaluation of SHOX copy number variations in patients with Mullerian aplasia

Peer reviewe

Pregnancy incidence and outcome before and after cervical intraepithelial neoplasia: a retrospective cohort study,”

Abstract We performed a retrospective cohort study of 3530 women treated for cervical intraepithelial neoplasia (CIN) in Helsinki University Central Hospital, Finland, to investigate whether CIN treatment itself affects pregnancy incidence and outcome. We estimated the incidence of live births, miscarriages, extrauterine pregnancies, molar pregnancies, and termination of pregnancies (TOPs) before and after CIN treatment using nationwide registers. Women were followed up until death, emigration, sterilization, or the end of 2004. The comparison of incidence of pregnancy outcomes before and after the treatment was estimated by calculating hazard ratios (HRs) with conditional Poisson regression. After 76,162 woman-years of follow-up, the incidence of any pregnancy remained constant over CIN-treatment, HR 1.02 and 95% confidence interval (CI) 0.97-1.08, but the incidence of the first pregnancy was significantly elevated after treatment, HR 1.13, and 95% CI 1.03-1.23. The incidence of live births was significantly elevated after treatment, HR 1.08 and 95% CI 1.01-1.15. Incidence of miscarriages, TOPs, extrauterine pregnancies, and molar pregnancies was not elevated. TOPs was significantly increased in the first pregnancy, HR 1.40, 95% CI 1.15-1.72 and after treatment by the loop electrosurgical excision procedure (LEEP), HR 1.36, 95% CI 1.15-1.60. CIN treatment did not reduce pregnancy incidence and women had more live births after than before CIN treatment. TOPs was more common in the first pregnancy or after treatment by LEEP. We encourage research on the psychosocial consequences of CIN treatment also in other countries and settings

Family history influences the tumor characteristics and prognosis of breast cancers developing during postmenopausal hormone therapy

Long term use of postmenopausal hormone therapy (HT) has been reported to increase breast cancer risk. On the other hand, observational studies suggest that breast cancers diagnosed during HT may have a more favorable prognosis. While family history is a risk factor for breast cancer, and genetic factors also influence prognosis, the role of family history in combination with HT use has been little studied. We investigated the relationship between HT, family history, and prognosis in 584 (267 exposed) familial and 952 (460 exposed) non-familial breast cancer cases, using three survival end points: death from breast cancer (BCS), distant disease free survival (DDFS), and local recurrence free survival (LRFS). Among non-familial cases, HT was associated with better BCS (HR 0.63, 95% CI 0.41-0.94; p = 0.025), and DDFS (HR 0.58, 95% CI 0.40-0.85; p = 0.005), with a consistent but not statistically significant effect in LRFS. This effect was not seen in familial cases (HR > 1.0), and family history was found to interact with HT in BCS (p((interaction)) = 0.0067) (BC-death) and DDFS (p((interaction)) = 0.0070). There was phenotypic heterogeneity between HT-associated tumors in familial and non-familial cases, particularly on estrogen receptor (ER) status, although the interaction between HT and family history appears to be at least partially independent of these markers (p = 0.0370 after adjustment for standard prognostic factors). If confirmed by further studies, our results suggest that family history should be taken into consideration in clinical counseling before beginning a HT regimen.Peer reviewe

Fostering Prevention of Cervical Cancer by a Correct Diagnosis of Precursors : A Structured Case-Based Colposcopy Course in Finland, Norway and UK

High-quality colposcopy is essential in cervical cancer prevention. We performed a multicentre prospective interventional pilot-study, evaluating the effect of a six-hour case-based colposcopy course on short- and long-term learning of colposcopy-related knowledge, diagnostic accuracy levels and confidence. We recruited 213 colposcopists participating in three European Federation of Colposcopy (EFC) basic colposcopy courses (Finland, Norway, UK). The study consisted of three tests with identical content performed before, after and 2 months after the course, including ten colposcopic images, ten patient cases and scales for marking confidence in the answers. Outcome measures where mean scores in correct case-management, diagnosis (including high-grade lesion recognition), transformation-zone recognition and confidence in answers. Results were compared between the three tests and stratified according to experience. Mean test scores improved after the course for all participants. The increase was highest for beginners. Confidence in answers improved and the number of colposcopists showing high confidence with low scores decreased. A structured case-based course improves skills and confidence especially for inexperienced colposcopists; however, trainers should be aware of the risk of overconfidence. To complement theoretical training, further hands-on training including high-quality feedback is recommended. Conclusions drawn from long-term learning are limited due to the low participation in the follow-up test

Evaluasi Pengetahuan Sebelum dan Sesudah Penyuluhan Tentang Kanker Payudara dan Praktek Sadari di Madrasah Aliyah Hidayatul Muslimin 2 Kecamatan Sungai Raya Kabupaten Kubu Raya Tahun 2017

Pengetahuan merupakan hasil dari tahu dan ini terjadi setelah orang melakukan pengindraan terhadap suatu objek tertentu. Kanker payudara adalah suatu penyakit dimana terjadi pertumbuhan berlebihan atau perkembangan tidak terkontrol dari sel-sel (jaringan) payudara. Diperkirakan bahwa di seluruh dunia lebih dari 508 000 wanita meninggal pada tahun 2011 karena kanker payudara. prevalensi kanker payudara di Indonesia mencapai 0,5 per 1000 perempuan. Pada tahun 2003 berjumlah 221 orang, mengalami kenaikan tiga kali lipat pada tahun 2012. Tujuan umum dari penelitian ini adalah untuk mengevaluasi pengetahuan sebelum dan sesudah penyuluhan tentang kanker payudara dan praktek SADARI di Madrasah Aliyah Hidayatul Muslimin 2 Kecamatan Sungai Raya Kabupaten Kubu Raya tahun 2017. Desain penelitian ini adalah Quasi Eksperimen. Dengan rancangan penelitian One Group Pre- Post test. Dengan menggunakan alat ukur kuesioner dan lembar checklist. Dari hasil penelitian Sebelum penyuluhan dan praktek didapatkan sebagian dari responden dengan pengetahuan baik yaitu 41 responden (56,9%) dan sebagian dari responden dengan praktek baik yaitu 33 responden (45,8%). Dan sesudah penyuluhan dan praktek sebagian dari responden dengan pengetahuan baik yaitu 38 responden (52,8%) dan sebagian besar responden dengan praktek baik yaitu 47 responden (65,3%), diketahui hasil uji statistik T-Test pengetahuan -4, 947 dan T-Test praktek yaitu -14,761 didapatkan nilai P-Value 0,0001 < 0,05 yang berarti Ha diterima yaitu ada perbedaan pengetahuan sebelum dan sesudah diberikan penyuluhan,dan.praktek. Kesimpulan hasil penelitian ini sebaiknya siswi rutin melakukan SADARI setiap bulan pada hari ke 5-10 menstruasi sehingga dapat mendeteksi dini adanya kelainan pada payudara

Fostering Prevention of Cervical Cancer by a Correct Diagnosis of Precursors: A Structured Case-Based Colposcopy Course in Finland, Norway and UK

Simple Summary Cervical cancer prevention is presently undergoing a thorough reformation due to introduction of human papillomavirus (HPV)-testing and vaccines in primary prevention. The screening program, however, is more than a single test or preventive intervention-the possible lesion has to be found, located and treated. Colposcopy plays a major role in this management. Literature dealing with training and learning, especially with colposcopy, is extremely scarce. The aim of the European Federation of Colposcopy, EFC, is to improve the education and training in colposcopy, e.g., by organizing colposcopy courses. The aim of our prospective interventional study was to pilot this intensive participant activating EFC Basic Colposcopy Course on the short- and long-term learning of colposcopy-related knowledge, image recognition and the diagnostic confidence. High-quality colposcopy is essential in cervical cancer prevention. We performed a multicentre prospective interventional pilot-study, evaluating the effect of a six-hour case-based colposcopy course on short- and long-term learning of colposcopy-related knowledge, diagnostic accuracy levels and confidence. We recruited 213 colposcopists participating in three European Federation of Colposcopy (EFC) basic colposcopy courses (Finland, Norway, UK). The study consisted of three tests with identical content performed before, after and 2 months after the course, including ten colposcopic images, ten patient cases and scales for marking confidence in the answers. Outcome measures where mean scores in correct case-management, diagnosis (including high-grade lesion recognition), transformation-zone recognition and confidence in answers. Results were compared between the three tests and stratified according to experience. Mean test scores improved after the course for all participants. The increase was highest for beginners. Confidence in answers improved and the number of colposcopists showing high confidence with low scores decreased. A structured case-based course improves skills and confidence especially for inexperienced colposcopists; however, trainers should be aware of the risk of overconfidence. To complement theoretical training, further hands-on training including high-quality feedback is recommended. Conclusions drawn from long-term learning are limited due to the low participation in the follow-up test.Peer reviewe

Emättimen mikrobiomi terveyden ylläpitäjänä

English summaryPeer reviewe

TBX6, LHX1 and copy number variations in the complex genetics of Mullerian aplasia

Peer reviewe

Hedelmällisyysneuvontaa ja poliittisia päätöksiä lääkkeeksi vauvakuumekatoon

Non peer reviewe