Cervical cancer is a malignant neoplasm arising from cells that originate in the cervix uteri. It is the second most prevalent cancer among women. It can have several causes; an infection with some type of human papillomavirus (HPV) is the greatest risk factor for cervical cancer. Over 100 types of HPVs have been identified, and more than 40 types of HPVs are typically transmitted through sexual contact and infect the anogenital region. Among these, a number of HPVs types, containing types 16 and 18, are classified as "high-risk" HPVs that can cause cervical cancer. The HPVs vaccine prevents infection with certain species of HPVs associated with the development of cervical cancer, genital warts, and some less common cancers. Two HPVs vaccines are currently on the global market: quadrivalent HPVs vaccine and bivalent HPV vaccine that use virus-like particles as a vaccine antigen. This review discusses the current status of HPVs vaccines on the global market, clinical trials, and the future of HPVs vaccine development.
Cervix Uteri ; Condylomata Acuminata ; Female ; Humans ; Papillomavirus Vaccines* ; Risk Factors ; Uterine Cervical Neoplasms ; Vaccines ; Vaccines, Virus-Like Particle

Background: The increasing prevalence of cementless total knee arthroplasty (TKA) necessitates a reliable assessment of bone quality. Central bone mineral density (BMD), measured by dual-energy x-ray absorptiometry (DEXA) in the lumbar spine and hip, is conventionally used to estimate bone quality. However, its effectiveness in predicting the actual bone strength at the knee, which is crucial for cementless TKA, is under scrutiny. This study investigated the relationship between central BMD and actual bone strength at the knee. Methods: This prospective study included 191 knees undergoing standard posterior-stabilized TKA between November 2021 and March 2023. Central BMD was assessed 3 months before TKA, and the failure load of bone fragments collected during box preparation was directly measured using an indentation test. Relationships between central BMD and failure load as a measure of the actual bone strength at the knee were analyzed. Results: Linear regression analysis revealed a weak correlation between central BMD and the actual bone strength at the knee (R 2= 0.146 in all patients; < 0.001 in osteoporosis group; 0.126 in non-osteoporosis group). The correlation suggested by the regression models was particularly insignificant in the osteoporosis subgroup, showing that central BMD is not a reliable predictor of bone strength for cementless TKA. Conclusions Central BMD measurements have limited utility in accurately predicting the real bone strength at the knee for cementless TKA. This study highlights the need for more specific and direct methods of assessing bone quality at the knee to ensure the success of cementless TKA.

Background: The increasing prevalence of cementless total knee arthroplasty (TKA) necessitates a reliable assessment of bone quality. Central bone mineral density (BMD), measured by dual-energy x-ray absorptiometry (DEXA) in the lumbar spine and hip, is conventionally used to estimate bone quality. However, its effectiveness in predicting the actual bone strength at the knee, which is crucial for cementless TKA, is under scrutiny. This study investigated the relationship between central BMD and actual bone strength at the knee. Methods: This prospective study included 191 knees undergoing standard posterior-stabilized TKA between November 2021 and March 2023. Central BMD was assessed 3 months before TKA, and the failure load of bone fragments collected during box preparation was directly measured using an indentation test. Relationships between central BMD and failure load as a measure of the actual bone strength at the knee were analyzed. Results: Linear regression analysis revealed a weak correlation between central BMD and the actual bone strength at the knee (R 2= 0.146 in all patients; < 0.001 in osteoporosis group; 0.126 in non-osteoporosis group). The correlation suggested by the regression models was particularly insignificant in the osteoporosis subgroup, showing that central BMD is not a reliable predictor of bone strength for cementless TKA. Conclusions Central BMD measurements have limited utility in accurately predicting the real bone strength at the knee for cementless TKA. This study highlights the need for more specific and direct methods of assessing bone quality at the knee to ensure the success of cementless TKA.

Background: The increasing prevalence of cementless total knee arthroplasty (TKA) necessitates a reliable assessment of bone quality. Central bone mineral density (BMD), measured by dual-energy x-ray absorptiometry (DEXA) in the lumbar spine and hip, is conventionally used to estimate bone quality. However, its effectiveness in predicting the actual bone strength at the knee, which is crucial for cementless TKA, is under scrutiny. This study investigated the relationship between central BMD and actual bone strength at the knee. Methods: This prospective study included 191 knees undergoing standard posterior-stabilized TKA between November 2021 and March 2023. Central BMD was assessed 3 months before TKA, and the failure load of bone fragments collected during box preparation was directly measured using an indentation test. Relationships between central BMD and failure load as a measure of the actual bone strength at the knee were analyzed. Results: Linear regression analysis revealed a weak correlation between central BMD and the actual bone strength at the knee (R 2= 0.146 in all patients; < 0.001 in osteoporosis group; 0.126 in non-osteoporosis group). The correlation suggested by the regression models was particularly insignificant in the osteoporosis subgroup, showing that central BMD is not a reliable predictor of bone strength for cementless TKA. Conclusions Central BMD measurements have limited utility in accurately predicting the real bone strength at the knee for cementless TKA. This study highlights the need for more specific and direct methods of assessing bone quality at the knee to ensure the success of cementless TKA.

Background: The increasing prevalence of cementless total knee arthroplasty (TKA) necessitates a reliable assessment of bone quality. Central bone mineral density (BMD), measured by dual-energy x-ray absorptiometry (DEXA) in the lumbar spine and hip, is conventionally used to estimate bone quality. However, its effectiveness in predicting the actual bone strength at the knee, which is crucial for cementless TKA, is under scrutiny. This study investigated the relationship between central BMD and actual bone strength at the knee. Methods: This prospective study included 191 knees undergoing standard posterior-stabilized TKA between November 2021 and March 2023. Central BMD was assessed 3 months before TKA, and the failure load of bone fragments collected during box preparation was directly measured using an indentation test. Relationships between central BMD and failure load as a measure of the actual bone strength at the knee were analyzed. Results: Linear regression analysis revealed a weak correlation between central BMD and the actual bone strength at the knee (R 2= 0.146 in all patients; < 0.001 in osteoporosis group; 0.126 in non-osteoporosis group). The correlation suggested by the regression models was particularly insignificant in the osteoporosis subgroup, showing that central BMD is not a reliable predictor of bone strength for cementless TKA. Conclusions Central BMD measurements have limited utility in accurately predicting the real bone strength at the knee for cementless TKA. This study highlights the need for more specific and direct methods of assessing bone quality at the knee to ensure the success of cementless TKA.

Background: As the prevalence of hypertension increases with age and the proportion of the older population is also on the rise, research on the characteristics of older hypertensive patients and the importance of frailty is necessary. This study aimed to identify clinical characteristics of older hypertension in Korea and to investigate these characteristics based on frailty status. Methods: The HOW to Optimize eLDerly systolic BP (HOWOLD-BP) is a prospective, multicenter, open-label, randomized clinical trial that aims to compare intensive (target systolic blood pressure [SBP] ≤ 130 mmHg) with standard (target SBP ≤ 140 mmHg) treatment to reduce cardiovascular events in older hypertensive Korean patients aged ≥ 65 years. Data were analyzed through a screening assessment of 2,085 patients recruited from 11 university hospitals. Demographic, functional (physical and cognitive), medical history, laboratory data, quality of life, and medication history of antihypertensive drugs were assessed. Results: The mean age was 73.2 years (standard deviation ± 5.60), and 48.0% (n = 1,001) were male. Prevalent conditions included dyslipidemia (66.5%), obesity (body mass index ≥ 25 kg/m 2 , 53.6%), and diabetes (28.9%). Dizziness and orthostatic hypotension were self-reported by 1.6% (n = 33) and 1.2% (n = 24), respectively. The majority of patients were on two antihypertensive drugs (48.4%), while 27.5% (n = 574) and 20.8% (n = 433) were on 1 and 3 antihypertensive medications, respectively. Frail to pre-frail patients were older and also tended to have dependent instrumental activities of daily living, slower gait speed, weaker grip strength, lower quality of life, and lower cognitive function. The frail to pre-frail group reported more dizziness (2.6% vs. 1.2%, P < 0.001) and had concerning clinical factors, including lower glomerular filtration rate, more comorbidities such as diabetes, stroke, and a history of admission. Frail to pre-frail older hypertensive patients used slightly more antihypertensive medications than robust older hypertensive patients (1.95 vs. 2.06, P = 0.003). Pre-frail to frail patients often chose beta-blockers as a third medication over diuretics. Conclusion This study described the general clinical characteristics of older hypertensive patients in Korea. Frail hypertensive patients face challenges in achieving positive clinical outcomes because of multifactorial causes: they are older, have more morbidities, decreased function, lower quality of life and cognitive function, and take more antihypertensive medications. Therefore, it is essential to comprehensively evaluate and monitor diseaserelated or drug-related adverse events more frequently during regular check-ups, which is necessary for pre-frail to frail older patients with hypertension.