Perspectives, fears and expectations of patients with gynaecological cancers during the COVID-19 pandemic: A Pan-European study of the European Network of Gynaecological Cancer Advocacy Groups (ENGAGe)

"Artículo escrito por un elevado número de autores, solo se referencian el que aparece en primer lugar, el nombre del grupo de colaboración, si le hubiere, y los autores pertenecientes a la UAM".Background: The impact of the COVID-19 pandemic on European gynaecological cancer patients under active treatment or follow-up has not been documented. We sought to capture the patient perceptions of the COVID-19 implications and the worldwide imposed treatment modifications. Methods: A patient survey was conducted in 16 European countries, using a new COVID-19-related questionnaire, developed by ENGAGe and the Hospital Anxiety & Depression Scale questionnaire (HADS). The survey was promoted by national patient advocacy groups and charitable organisations. Findings: We collected 1388 forms; 592 online and 796 hard-copy (May, 2020). We excluded 137 due to missing data. Median patients’ age was 55 years (range: 18–89), 54.7% had ovarian cancer and 15.5% were preoperative. Even though 73.2% of patients named cancer as a risk factor for COVID-19, only 17.5% were more afraid of COVID-19 than their cancer condition, with advanced age (>70 years) as the only significant risk factor for that. Overall, 71% were concerned about cancer progression if their treatment/follow-up was cancelled/postponed. Most patients (64%) had their care continued as planned, but 72.3% (n = 892) said that they received no information around overall COVID-19 infection rates of patients and staff, testing or measures taken in their treating hospital. Mean HADS Anxiety and Depression Scores were 8.8 (range: 5.3–12) and 8.1 (range: 3.8–13.4), respectively. Multivariate analysis identified high HADS-depression scores, having experienced modifications of care due to the pandemic and concern about not being able to visit their doctor as independent predictors of patients’ anxiety. Interpretation: Gynaecological cancer patients expressed significant anxiety about progression of their disease due to modifications of care related to the COVID-19 pandemic and wished to pursue their treatment as planned despite the associated risks. Healthcare professionals should take this into consideration when making decisions that impact patients care in times of crisis and to develop initiatives to improve patients’ communication and education

Relationship between Teacher Efficacy and Information and Communication Technology Competencies of Pre-Service Teachers

The main purpose of this study was to determine the relationship between teacher efficacy levels, information and communication technology competencies, and demographic variables of pre-service teachers. In addition to the main problem, teacher efficacy levels and the technological competencies were also reviewed in terms of variables such as gender, grade, the status of choosing the teaching profession willingly, and if they were given the opportunity to select the teaching profession again. The study was designed in a correlational screening model, and the sample of the study consisted of pre-service teachers. Ohio State Teacher Efficacy Scale (OSTES) and Information and Communication Technology Competencies Scale (ICTCS) were used as the data collection tools. Multiple linear regression analysis was conducted to reveal how the variables of teacher efficacy, gender, grade level, willingly choosing to become a teacher, and re-choosing to become a teacher if having a chance predict ICTCS. As a result of correlational and regression significance tests, it was determined that only the teacher efficacy variable predicted ICTCS to a large extent in the established regression model. Additionally, it was found that the teacher efficacy and the information communication technology competencies of pre-service teachers showed differences in terms of grade and the status of choosing the teaching profession willingly variables, while they did not differ in terms of gender and if they were given the opportunity to select the teaching profession again. Recent studies show that the most important conditions for attaining these skills are that teachers have general competencies for using information and communication technologies in their lessons. So, this study can contribute to the field by determining the positive relationship between teaching efficacy levels and information and communication technologies competencies of pre-service teachers, as well as presenting the results of some specific variables

Aflatoksikoza u rotvajlera nakon uzimanja pljesnive hrane: kliničkopatološki nalazi i učinkovita terapija tetrasulfatom.

The purpose of this study was to describe the clinical, hematologic, gross, histopathologic and toxicologic findings and to report effective therapy application for aflatoxicosis in dogs, ascribed to the ingestion of moldy wet bread contaminated with aflatoxin. A prospective case series of 10 client-owned dogs from the same household developed toxicological signs after eating moldy bread treated with water that had been stored for an undetermined period, fully covered with a grey-green mold. All dogs exhibited vomiting followed by excessive salivation and hyperaesthesia. Among the surviving dogs (n = 7), three of them presented with diarrhea, depression, abdominal pain and two others showed icterus. One of the dead dogs was found on the initial referral. Two others were dead following initial diagnosis and prior to therapy application. The most common gross findings in the dogs were generalized icterus, mucosal or submucosal edema and petechial, to ecchymotic hemorrhages in the organs. Histopathological findings included focal necrotic areas extending from the periacinar to centroacinar regions in the liver, biliary hyperplasia, cholestasis and multifocal hemorrhages in the kidneys and lungs. Due to the sudden onset of clinical signs, the lack of exposure to other toxins, and the confirmed evidence of ingestion of moldy bread, the results of analysis of liver samples and the histopathological signs, the definitive diagnosis was mycotoxicosis. Therapeutic applications included tetrasulphate (an antidote) given orally, and supportive treatment with balanced electrolyte solutions, antiemetics and H2 receptor antagonist. All treated dogs (7/7) made a full recovery over 18-24 hours. The results of the present study reported here describe the clinicopathological features of aflatoxicosis in Rottweilers, suggesting that the use of tetrasulphate solution as an inexpensive and available therapy may have helped the survival of the dogs and might reverse the adverse health effects of mycotoxins.Svrha je ovog rada iznijeti kliničke, hematološke, patoanatomske, patohistološke i toksikološke nalaze te izvijestiti o uspješnom liječenju pasa koji su jeli pljesnivu i vlažnu hranu što je sadržavala aflatoksin. U 10 pasa jednog vlasnika primijećeni su znakovi otrovanja nakon što su jeli pljesniv kruh namočen u vodu koji je prethodno bio čuvan neodređeno vrijeme, a u potpunosti je bio prekriven sivo-zelenom plijesni. Svi su psi povraćali uz obilno slinjenje i hiperesteziju. Od sedam preživjelih pasa, tri su imala proljev, bili su potišteni te su pokazivali bol u trbuhu, a dva su imala i žuticu. Jedan od uginulih pasa na početku je upućivao na toksikozu. Dva su uginula nakon postavljene dijagnoze, a prije početka liječenja. Patoanatomski je ustanovljena generalizirana žutica, edem sluznice ili submukoze te petehijalna do ekhimotična krvarenja po organima. Patohistološki su ustanovljena nekrotična žarišna područja pružajući se od periacinarnih do centroacinarnih područja u jetri, zatim bilijarna hiperplazija, kolestaza i multifokalna krvarenja po bubrezima i plućima. Na osnovi nagle pojave kliničkih znakova, nedostatka dokaza izloženosti drugim toksinima, potvrđenog dokaza uzimanja pljesnivog kruha, rezultata analize uzoraka jetre i patohistoloških nalaza postavljena je konačna dijagnoza mikotoksikoze. Za liječenje je peroralno bio primijenjen tetrasulfat(antidot) i uravnotežena otopina elektrolita, zatim antiemetici i antagonisti H 2 receptora. Svi liječeni psi (7/7) u potpunosti su se oporavili za 18 do 24 sata. Prikazani rezultati opisuju kliničke i patološke značajke aflatoksikoze u rotvajlera i upućuju na zaključak da se ona može liječiti otopinom tetrasulfata kao jeftinim i pristupačnim lijekom koji može pomoći u preživljavanju pasa te smanjiti štetne učinke mikotoksina na zdravlj

Tackling cervical cancer in Europe amidst the COVID-19 pandemic

According to estimates for 2018, approximately 33 000 cases of cervical cancer occurred and 15 000 people died from the disease in Europe (see map in appendix). Human papillomavirus (HPV) vaccine coverage is relatively low in countries with the highest incidence and screening performance is heterogeneous among European countries. Cytological screening followed by treatment of screen-detected cervical lesions has resulted in substantial decreases in the burden of cervical cancer in western and northern Europe; but in eastern Europe, cervical cancer incidence and mortality remain comparatively&nbsp;high. Today, new powerful tools are available for primary and secondary prevention of cervical cancer, among which prophylactic HPV vaccines, and screening using validated HPV tests for women—including some tests that can be applied on self-collected samples, a strategy that might be used to reach underscreened&nbsp;populations. In May, 2018, the WHO Director General launched a call to eliminate cervical cancer by vaccinating at least 90% of girls by age 15 years, by offering screening at least twice in a lifetime to 70% or more of the target age populations and treat more than 90% of women with screen-detected&nbsp;lesions. Recently, a large group of experts from diverse professional societies and cancer organisations supporting WHO’s call to eliminate cervical cancer, proposed a series of concerted actions to implement organised integrated HPV vaccination and HPV-based screening, and requested European health authorities to endorse the principles of the WHO elimination initiative, mobilise resources to update evidence-based guidelines, and translate them into quantified and monitored preventive&nbsp;activities. However, in the first half of 2020, due to the dramatic COVID-19 pandemic, cervical cancer prevention activities have been disrupted in many European countries. We are concerned and urge the public health community to maintain sufficient resources to sustain HPV vaccination and cancer screening in the&nbsp;future. Importantly, the COVID-19 pandemic might also generate opportunities for more efficient prevention, by promoting more cost-effective, evidence-based protocols, by focusing on women who are at high-risk, extending HPV testing on self-collected samples, and discouraging inefficient policies, such as screening with two tests. We welcome the unprecedented collaborations between the cancer and infectious disease communities, who have been working jointly to tackle the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by applying the experience of HPV test evaluation to protocols for comparing and validating SARS-CoV-2 assays and by bringing modellers together in the COVID-19 and Cancer Taskforce Global Modelling&nbsp;Consortium.</p

Endocervical polyps in high risk human papillomavirus infections

Objectives: Human papillomavirus (HPV) positive patients with and without endocervical polyps is compared with respect to HPV genotypes and presence of pre-invasive diseases. To our knowledge, this is the first and largest report in the literature examining the endocervical polyps in HPV positive cases. Material and methods: Clinicopathological data for the first one million screening patients (n = 1 060 992) from around the entire country during 2015 and 2016 were targeted for this research. Colposcopy, colposcopic surgical diagnostic procedures and final pathology results of 3499 patients with high-risk (HR) HPV-positive were obtained from reference colposcopy centers. Patients with endocervical polyps (n = 243 [6.9 %]) were accepted as experimental arm while patients without any endocervical polyp (n = 3256 [93.1%]) were regarded as the control group. Age, HPV genotype, Pap smear abnormality, and final pathological results were compared between two groups using Student’s t-test and cross-tabulation chi-square test. Results: The incidence of endocervical polyp was found to be 6.9 % in HR HPV-positive women. The most common HPV genotypes observed in both groups were HPV 16 or 18. Abnormal cytology reports (≥ ASC-US) were not significantly different between both groups. However, with respect to final pathological diagnosis, patients with endocervical polyp had significantly lower numbers of pre-invasive diseases (31.3% vs 44.2%; p &lt; 0.10). Conclusions: Endocervical polyps may be more common in patients with HR HPV infections. HPV 18 is observed significantly more, in the HR HPV positive endocervical polyp group. Patients with endocervical polyps do not have increased risk for preinvasive cervical diseases

The Level of Knowledge of Parkinson’s Disease among Nonprofessional Caregivers in a Movement Disorders Center in Turkey

Introduction. Only a few studies have been conducted to determine the level of knowledge among caregivers about Parkinson’s disease (PD). The aim of the current study was to determine the knowledge of PD among caregivers at a movement disorder clinic in Turkey. Methods. We conducted a questionnaire based interview with the subjects in a tertiary care neurology facility in Turkey. The questions were divided into two parts covering the symptomatology and treatment of PD. A questionnaire consisting of 10 questions was applied to the subjects who had to mark the correct option in a stipulated time. Results. Eighty caregivers were included in the study. The caregivers’ mean age was 47.94 years (SD = 12.40). There were 47 female caregivers (58.8%). The most well-known question was that the number of drugs given to the patient may vary with time (76.3%), whereas “the benefit noted in the patient’s treatment decreases over time” was the least known question (11.3%). Discussion. This study is the first in our country and shows the necessity to increase the knowledge of PD among caregivers and the public. Education programs may have a positive role in imparting knowledge to the caregivers of PD patients

The European response to the WHO call to eliminate cervical cancer as a public health problem

The age-standardised incidence of cervical cancer in Europe varies widely by country (between 3 and 25/100000 women-years) in 2018. Human papillomavirus (HPV) vaccine coverage is low in countries with the highest incidence and screening performance is heterogeneous among European countries. A broad group of delegates of scientific professional societies and cancer organisations endorse the principles of the WHO call to eliminate cervical cancer as a public health problem, also in Europe. All European nations should, by 2030, reach at least 90% HPV vaccine coverage among girls by the age of 15 years and also boys, if cost-effective; they should introduce organised population-based HPV-based screening and achieve 70% of screening coverage in the target age group, providing also HPV testing on self-samples for nonscreened or underscreened women; and to manage 90% of screen-positive women. To guide member states, a group of scientific professional societies and cancer organisations engage to assist in the rollout of a series of concerted evidence-based actions. European health authorities are requested to mandate a group of experts to develop the third edition of European Guidelines for Quality Assurance of Cervical Cancer prevention based on integrated HPV vaccination and screening and to monitor the progress towards the elimination goal. The occurrence of the COVID-19 pandemic, having interrupted prevention activities temporarily, should not deviate stakeholders from this ambition. In the immediate postepidemic phase, health professionals should focus on high-risk women and adhere to cost-effective policies including self-sampling.Peer reviewe

The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) Consensus Statement on the Management of Vaginal Intraepithelial Neoplasia

Copyright © 2023 ESGO, ISSVD, EFC, ECSVD. Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP.Peer reviewedPublisher PD

The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) consensus statement on the management of vaginal intraepithelial neoplasia

© ESGO, ISSVD, EFC, ECSVD 2023. Re-use permitted under CC BY. Published by BMJ.Peer reviewedPublisher PD