The Diagnostic Properties of Medical History in the Diagnosis of Tubal Pathology among Subfertile Patients

Objectives. To evaluate the diagnostic performance of medical history in the diagnosis of tubal pathology among subfertile patients. Patients and Methods. Prospective cross-sectional study was performed. Prior to tubal evaluation, medical history data were collected. Sensitivity, specificity, and likelihood ratios (LRs) for predicting tubal pathology as determined by laparoscopy and dye test were calculated for each issue of medical history. Results. 39.6 % (59/149) were diagnosed with tubal pathology. The sensitivity for the different issues ranged between 1.7 and 54.2% and the specificity between 75.6 and 97.8%. The estimated highest value of positive LR is attributed to the history of ectopic pregnancy and lowest of negative LR to pelvic inflammatory disease (PID) and abdominal surgery. Conclusion. The positive history of PID, sexually transmitted diseases (STDs), abdominal and laparoscopic surgery, and ectopic pregnancy are satisfactory screening tests for ruling the tubal pathology in. The negative history of evaluated issues is inappropriate for ruling the tubal damage out

Prevalence of Human Papillomavirus Types 16, 18, and 45 in Women With Cervical Intraepithelial Changes: Associations With Colposcopic and Histological Findings

The aim of the study was to determine the prevalence of human papillomavirus (HPV) types 16, 18, and 45 in women with cervical intraepithelial changes caused by high-risk HPV in relation to colposcopic and histological findings. Material and Methods. A prospective study of 393 women with cervical cytologic changes confirmed by the Papanicolaou test was undertaken from April 3, 2006, to April 3, 2007. The Hybrid Capture 2 assay was performed. HPV-positive women underwent genotyping for types 16, 18, and 45. Colposcopy and biopsy were performed in 317 (80.7%) and 249 women (63.4%), respectively. The results were analyzed by age groups. Results. Of all the women with cervical intraepithelial changes, 59% were positive for HR HPV, and 62% were positive for HPV types 16, 18, and 45. HPV types 16, 18, and 45 were detected in 54.8% of women with ASC-US/AGUS/ASC-H, 50.0% of women with LSIL, and 75.6% of women with HSIL. After confirmation of any histological and colposcopic changes, HPV types 16, 18, and 45 were detected in 68.0% and 69.0% of women, respectively. Moreover, 84.2% of the women with HSIL and high-grade colposcopic changes, and 78.5% of the women with HSIL and CIN 2/ CIN 2-3/CIN 3/carcinoma in situ were positive for HPV types 16, 18, and 45. The sensitivity of the Papanicolaou test together with the Hybrid Capture 2 test compared with the Papanicolaou test together with the HPV 16/18/45 test diagnosing CIN 2+ changes did not differ (96.7% vs. 97.1%), but the specificity was higher (40.3% vs. 8.0%). Conclusions. The majority of the cytologic, colposcopic, and histological changes were caused by HPV types 16, 18, and 45. Despite the high prevalence of HPV types 16, 18, and 45, testing for these genotypes together with the Papanicolaou test did not improve the diagnosis of high-grade cervical intraepithelial lesions