Results of a Survey Concerning Cervical Cancer Risk Factors among Women in Western Kazakhstan

During 2014–2017, a survey concerning risk factors for cervical cancer involving 1166 clinically healthy women and 65 having CaCx was conducted in Western Kazakhstan. Only 34.7% of interviewees constantly participated in state-sponsored screening program, while 37.3% ignored screening in free state-sponsored clinics. Favorable attitude toward vaccination stated 22.9% of the respondents, whereas 38.8% knew nothing, and 33.6% could not clarify their position in this issue. Education is a key factor for better perception of preventive measures—69.2% of the respondents with higher education are aware of vaccination (p ≤ 0.00001, Cramer’s V 0.18, χ2–23.1). Social profiles of HPV-infected and CaCx-diseased women differ significantly and, mainly, by standard of living and occupational status. The likelihood of the CaCx onset in Western Kazakhstan decreased by 14 times at relatively high standard of living (OR 0.0713, p = 0.024) and by 3.3 times provided at least irregular participation in screening (OR 0.3384, p = 0.0304). Overall, the findings are quite able to contribute to an understanding why women become affected by CaCx. Low standard of living due to lack of education, low attendance of screening, and low awareness on preventive measures‑all these reasons are interacted and constitute a set of universal triggers for vulnerability toward CaCx

Heparin-Conjugated Fibrin Hydrogel with Chondroinductive Growth Factors and Human Synovium-Derived Mesenchymal Stem Cells for the Treatment of Articular Cartilage Defects: Evaluation of Clinical Safety

The purpose of this study was to evaluate the safety of an injectable heparin-conjugated fibrin (HCF) hydrogel containing human synovium-derived mesenchymal stem cells (SDMSCs), TGF-β1, and BMP-4 after implantation into articular cartilage defect in patients with osteoarthritis (OA). The study included 15 OA patients with a mean age of 44.2±18.0 years. The median articular cartilage defect size was 4.9±2.0 cm. HCF hydrogel, containing SDMSCs and growth factors (TGF-β1 and BMP-4), was implanted into the cartilage defect using DUPLOJECT two-syringe device connected with the DUPLOTIP dual lumen cannula. Clinical and radiological outcomes were evaluated with VAS, WOMAC, KOOS, and MOCART. The clinical study results showed that implantation of HCF hydrogel with autologous SDMSCs, TGF-β1, and BMP-4 appeared to be safe and did not show severe adverse events in OA patients. The assessment of clinical outcomes after 6 months showed improvement in VAS, WOMAC, and KOOS scores in all patients. The MOCART evaluation demonstrated an enhancement of cartilage tissue repair in 73.3% of OA patients at 6 months after surgery. Thus, implantation of HCF hydrogel with SDMSCs, TGF-β1, and BMP-4 was safe and demonstrated signs of improvement in articular cartilage repair. The evaluation of the long-term safety and therapeutic efficacy of HCF hydrogel is required in a further clinical study using a larger number of OA patients

Cervical screening in Western Kazakhstan: Liquid-based cytology 'Cell Scan' versus azur-eosin staining

Abstract Objective: To assess the effectiveness of the current cervical cancer screening tools in Western Kazakhstan. Methods: Smears taken through (i) conventional cytology using azur-eosin staining and (ii) liquid-based cytology (LBC) ‘Cell Scan’ in the general female population and in women first diagnosed with cervical cancer were collected throughout the region. ROC-analysis with curve construction and weighted Cohen’s j calculation were applied. A total of 494 cytological pairs were collected, including 94 sets with histology findings. Results: The conventional (azur-eosin staining) technique contained 0.2% non-informative material and LBC ‘Cell Scan’ had 5.9%. Area under the curve was 0.95 for the conventional technique and 0.92 for ‘Cell Scan’ (p>0.05). The conventional smears showed j 0.62, sensitivity 90.4% at specificity 90.0% for CIN2þ, while LBC ‘Cell Scan’smears showed j 0.47, sensitivity 83.3% at specificity 92.5%. Conclusions: In this analysis it was not possible to prove that the LBC ‘Cell Scan’ technique was superior to its predecessor, azur-eosin staining. These findings highlight the need to modify the current screening programme according to updated international scientific evidence on effective screening design, such as the use of HPV DNA testing with Pap smear triage in women aged 30 or older. Further research, and a Health Technology Assessment, are necessary if we wish to establish a national standardized screening programme using the available technology appropriately

Human Papillomavirus related issues in western Kazakhstan: protocol for a comprehensive study

This article describes a Protocol for a study to determine a scope of Human Papillomavirus (HPV) infection and evaluate cervical cancer prevention measures in the western Kazakhstan. Introduction — ICO (Institut Catala d’Oncologia) working group in 2015 informed that cervical cancer in Kazakhstan ranked as the 1st most frequent cancer among 15-44 aged women. Aim — comprehensive analysis of the HPV infection across the female population to predict further trends in the cervical cancer morbidity and outline the circle of urgent preventive measures. The most important tasks are the following: to analyze a set of clinical, laboratory and socio-demographic data for identification the region-specific risk factors of the disease; to present a comparative analysis of diagnostic screening tools practiced in the region for the development corrective recommendations for existing screening strategy. Methods — This study constitutes a mix of three different types: interview+cross-sectional study for general female population and interview+case-control study for women with the first time diagnosed cervical cancer, where women of the general sample of the same age with detected HPV infection but not affected by the disease serve as a control for those with the disease. Anticipated Results — A high feasibility and pithiness of this study is expected. Obtaining a wide body of information relatively HPV scope and a quality of the screening process during a patient’s single visit is the main strength of the research. Conclusion — Successful implementation of challenges announced in the research can lead to changing a general vector or/and constituent parts of the existing screening program