Self-sampling is a method by which the subject collects the own specimens for disease detection. It has the advantages of strong privacy, convenient and simple operation, free time and place, etc. It can improve the compliance of people in remote areas, affected by traditional concepts, limited by working hours and underdeveloped transportation and medical treatment to participate in disease detection and screening. With the development of "Internet+health care" and "Internet+nursing service", home-based self-sampling testing will become a developing situation for disease detection and screening. Human immunodeficiency virus and Human papillomavirus infection bring a heavy burden to individuals and society. In the absence of effective and widespread primary prevention, secondary prevention, namely "early detection, early diagnosis and early treatment" is an effective measure to control the adverse consequences. At present, there are many researches on HPV and HIV self-sampling test, whose test results are highly reliable and highly accepted in the population, and is of great significance for improving the coverage rate of cervical cancer screening and the diagnosis rate of HIV carriers.
Female ; Humans ; Papillomaviridae ; Early Detection of Cancer/methods* ; Uterine Cervical Neoplasms/prevention & control* ; Alphapapillomavirus ; Self Care/methods* ; Papillomavirus Infections/prevention & control* ; Specimen Handling/methods* ; Mass Screening/methods* ; HIV Infections/diagnosis* ; HIV ; Vaginal Smears/methods*

OBJECTIVE: To analyze the characteristics of cervical microecology in late reproductive-age women with cervical lesions and explore new methods for preventing cervical lesions. METHODS: Cervical smears were obtained from a total of 147 women of late reproductive age, including 24 with high-risk HPV infection (HR-HPV), 27 with low-grade squamous intra-epithelial lesions (LSIL), 36 with high-grade squamous intra-epithelial lesions (HSIL), 35 with cervical cancer (CC) and 25 healthy women. llumina MiSeq sequencing of V3-V4 region of the 16S rRNA gene amplicons was used to characterize the vaginal microbiota of the women. OTUs analysis of the valid data was performed, and the α-diversity (Chao1, Simpson's Index and Shannon Index) and β-diversity (T-test, weighted UniFrac β diversity, and MetaStat analysis) were evaluated. RESULTS: Dilution curve and species accumulation boxplot validated the quality of the samples. OTUs analysis of the 5 groups demonstrated that cervical bacterial genus consisted primarily of CONCLUSIONS The abundance of
Female ; Humans ; Microbiota ; Papillomaviridae ; Papillomavirus Infections ; RNA, Ribosomal, 16S/genetics* ; Uterine Cervical Neoplasms ; Vaginal Smears

vaginal cytology are used to interpret the changes in hormonal levels and modifications in estrous cycle. The aim of this study is to compare the pattern of vaginal cytology and body mass among PCOS rats which are treated with metformin and Cynodon dactylon. Twenty-four Wistar rats were selected and divided into four groups: control, induced, treatment, and referral. PCOS was induced in all groups except controls by giving letrozole through oral gavage for 21 days. After inducing PCOS, the referral and treatment group were treated for PCOS with metformin and C. dactylon respectively for next 21 days. Vaginal smear of all the groups were taken every day from day one and screened for estrous cycle. The body mass of the animals was measured on days 1, 21, and 42. Animals were sacrificed after 24 hours of the last dose and the reproductive organs were dissected out and weighed. Results of the study show the estrous cycle begins to revert after 1-week administration of C. dactylon; while the changes were slower in referral group. There was a rapid decrease in the body mass as well as reproductive organs among the treatment and referral group compared to that of induced and control. Finding of this study suggests that C. dactylon treats PCOS better than metformin.]]>
Animals ; Cynodon ; Estrous Cycle ; Female ; Follicle Stimulating Hormone ; Gonadotropin-Releasing Hormone ; Hypothalamus ; Luteinizing Hormone ; Menstrual Cycle ; Metformin ; Polycystic Ovary Syndrome ; Rats ; Rats, Wistar ; Referral and Consultation ; Vaginal Smears

OBJECTIVE: Human papillomaviruses (HPVs) are among the agents responsible for infection and cancer of the skin and mucous membranes in the human body. The aim of this study was to investigate the frequency and type distribution of HPVs in married female patients with gynecological complaints, who had visited the Maternity Hospital in Erzurum, Turkey. METHODS: In this study, 263 cervical swab samples were taken from married women using the Pap smear method and were investigated for positive reactivity against HPV. The L1 gene region of HPV was investigated using molecular methods. For this purpose, polymerase chain reaction (PCR) assays and sequence analysis of positive samples were performed. Phylogenetic analyses were performed using a bioinformatics approach after sequencing. RESULTS: HPV-DNA was detected in 17 (6.5%) samples. Highest positive reactivity to HPV-DNA was found in the 35–44 age group at 9.2%. Fourteen out of seventeen positive samples were included in the phylogenetic analysis. All isolates clustered in the Alphapapillomavirus genus. Six samples were found to be HPV 70 positive, four were HPV 16 positive, and the rest were HPV 54, 72, 81, and 114 positive. When genotyping data were evaluated according to the risk group, we found that 28.6% of the 14 samples were found to be high risk-HPV, and 71.4% were low risk-HPV. CONCLUSIONS: As per our knowledge, this is the first report on the phylogenetic analysis of HPV genotypes isolated from women in Turkey. The prevalence of low- and-high risk HPV was determined in married women in Erzurum, and these results contribute to the epidemiological data on the distribution of HPV types for this region.
Alphapapillomavirus ; Computational Biology ; Female ; Genotype ; Hospitals, Maternity ; Human Body ; Human papillomavirus 16 ; Humans ; Methods ; Mucous Membrane ; Papanicolaou Test ; Papillomavirus Infections ; Polymerase Chain Reaction ; Prevalence ; Sequence Analysis ; Skin Neoplasms ; Turkey ; Vaginal Smears

Objective: Cervical cancer screening can reduce both the incidence and mortality rates of the disease. This study aimed to assess the diagnostic accuracy of conventional cytology, liquid based cytology and visual inspection with acetic acid in detecting pre-malignant and malignant cervical lesions. Methods: There were 249 patients who participated in the study. Of these, 6/249 (2.4%) turned out positive in papsmear, 7/249 (2.8%) turned out positive in liquid based cytology while 23/249 (9.2%) turned out positive in visual inspection with acetic acid. Colposcopic guided cervical biopsy was done on all 249 patients to confirm the results. Results: Fourteen turned out positive for cervical intraepthelial neoplasia, 1 patient had carcinoma in situ and 1 was positive for squamous cell carcinoma. Conclusion Among the three screening tests, VIA appears to be the most accurate, followed by liquid based cytology as compared to the conventional papsmear.
Vaginal Smears ; Cytology ; Cytodiagnosis

OBJECTIVE: Human papillomavirus (HPV) testing is widely incorporated into cervical cancer screening strategies. Current screening requires pelvic examination for cervical sampling, which may compromise participation. The acceptance could be raised by introducing testing on vaginal swabs. We explored the interchangeability of vaginal swabs and cervical smears for HPV testing, by means of a prospective study conducted in female sex workers (FSWs). Besides, we report on the occurrence of 32 different HPV genotypes in FSW with low-grade squamous intraepithelial lesion (LSIL) or high-grade squamous intraepithelial lesion (HSIL). METHODS: Paired physician-collected vaginal swabs and cervical smears from 303 FSW were tested for HPV using the Abbott RealTime High-Risk HPV assay. Cervical cytology was examined on cervical smears. In case of HSIL/LSIL cytological classification (n=52), both samples were genotyped using INNO-LiPa HPV Genotyping Extra II. RESULTS: The overall prevalence of high-risk (HR)-HPV was 51%. In FSW with HSIL/LSIL cervical cytology, the sensitivity and specificity of vaginal samples for the detection of HR-HPV was 100% and 70% and for probable HR-HPV 100% and 91%. The mean number of genotypes identified in vaginal samples (mean=3.5; 95% confidence interval [CI]=2.8–4.2) was significantly higher than in cervical smear samples (mean=2.6; 95% CI=2.1–3.0) (p=0.001). The most frequently encountered HR-HPV genotypes were HPV16, 31, 51, and 52. CONCLUSION: As our study shows that vaginal swabs are equivalent to cervical smears for the detection of (probable) HR-HPV, vaginal swabs can be used for HPV testing in cervical cancer screening strategies. Given the acceptance of vaginal sampling, this finding offers an opportunity to boost screening coverage.
Chlamydia trachomatis ; Classification ; DNA ; Female ; Genotype ; Gynecological Examination ; Humans ; Mass Screening ; Mycoplasma genitalium ; Neisseria gonorrhoeae ; Papillomaviridae ; Prevalence ; Prospective Studies ; Sensitivity and Specificity ; Sex Workers ; Sexually Transmitted Diseases ; Squamous Intraepithelial Lesions of the Cervix ; Trichomonas vaginalis ; Uterine Cervical Neoplasms ; Vaginal Smears

OBJECTIVE: To investigate the progression risk of atypical squamous cells of undetermined significance (ASCUS) with different clinical managements. METHODS: Women with their first diagnosis of ASCUS cytology were retrieved from the national cervical cancer screening database and linked to the national health insurance research database to identify the management of these women. The incidences of developing cervical intraepithelial neoplasia grade 3 and invasive cervical cancer (CIN3+) were calculated, and the hazard ratios (HRs) were estimated using a Cox proportional hazards model. This study was approved by the Research Ethics Committee of the National Taiwan University Hospital and is registered at ClinicalTrials.gov (Identifier: NCT02063152). RESULTS: There were total 69,741 women included. Various management strategies including colposcopy, cervical biopsies and/or endocervical curettage, and cryotherapy, failed to reduce the risk of subsequent CIN3+ compared with repeat cervical smears. Loop electrosurgical excision procedure/conization significantly decreased risk of subsequent CIN3+ lesions (HR=0.22; 95% confidence interval [CI]=0.07–0.68; p=0.010). Women in their 40s–50s had an approximately 30% risk reduction compared to other age groups. Women with a previous screening history >5 years from the present ASCUS diagnosis were at increased risk for CIN3+ (HR=1.24; 95% CI=1.03–1.49; p=0.020). CONCLUSION: In women of first-time ASCUS cytology, a program of repeat cytology can be an acceptable clinical option in low-resource settings. Caution should be taken especially in women with remote cervical screening history more than 5 years.
Atypical Squamous Cells of the Cervix* ; Biopsy ; Cervical Intraepithelial Neoplasia* ; Cohort Studies* ; Colposcopy ; Cryotherapy ; Curettage ; Diagnosis ; Ethics Committees, Research ; Female ; Humans ; Incidence ; Mass Screening ; National Health Programs ; Proportional Hazards Models ; Risk Reduction Behavior ; Taiwan ; Uterine Cervical Neoplasms ; Vaginal Smears

Two young dogs were referred to the Veterinary Medical Teaching Hospital of Konkuk University, one for examination of vaginal discharge and the other after being hit by a car. Dog 1 exhibited a high neutrophil count on Gram-stained vaginal smears, marked leukocytosis on a complete blood count, and uterine enlargement on ultrasonography. In dog 2, a markedly enlarged right uterine horn containing echogenic debris was found incidentally on ultrasonography. A tentative diagnosis of pyometra was made in both cases and ovariohysterectomy was performed. Purulent material was collected from each uterine horn and submitted separately for aerobic and anaerobic bacterial culture; all culture results were negative. The white blood cell count revealed normal limits 2 days post operation in dog 1 and 4 days post operation in dog 2. Positive bacterial cultures are usually obtained from dogs with pyometra, and antibiotic selection is based on the results of culture and sensitivity testing in the event of failure of empiric antibiotic therapy. However, in the cases reported here, no bacterial growth was identified from the uterine samples despite the presence of purulent material. A short course of empiric antibiotic therapy was administered. This is the first known report describing sterile pyometra in dogs.
Animals ; Blood Cell Count ; Diagnosis ; Dogs* ; Horns ; Hospitals, Teaching ; Leukocyte Count ; Leukocytosis ; Neutrophils ; Pyometra* ; Ultrasonography ; Vaginal Discharge ; Vaginal Smears

This study explored epidemiological trends in trichomoniasis in Daegu, South Korea. Wet mount microscopy, PCR, and multiplex PCR were used to test for Trichomonas vaginalis in vaginal swab samples obtained from 621 women visiting 2 clinics in Daegu. Of the 621 women tested, microscopy detected T. vaginalis in 4 (0.6%) patients, PCR detected T. vaginalis in 19 (3.0%) patients, and multiplex PCR detected T. vaginalis in 12 (1.9%) patients. Testing via PCR demonstrated high sensitivity and high negative predictive value for T. vaginalis. Among the 19 women who tested positive for T. vaginalis according to PCR, 94.7% (18/19) reported vaginal signs and symptoms. Notably, more than 50% of T. vaginalis infections occurred in females younger than 30 years old, and 58% were unmarried. Multiplex PCR, which simultaneously detects pathogens from various sexually transmitted infections, revealed that 91.7% (11/12) of patients were infected with 2 or more pathogens. Mycoplasma hominis was the most prevalent co-infection pathogen with T. vaginalis, followed by Ureaplasma urealyticum and Chlamydia trachomatis. Our results indicate that PCR and multiplex PCR are the most sensitive tools for T. vaginalis diagnosis, rather than microscopy which has been routinely used to detect T. vaginalis infections in South Korea. Therefore, clinicians should take note of the high prevalence of T. vaginalis infections among adolescent and young women in order to prevent persistent infection and transmission of this disease.
Adolescent ; Adult ; Ambulatory Care Facilities/statistics & numerical data ; Female ; Humans ; Microscopy/standards ; Middle Aged ; Multiplex Polymerase Chain Reaction/standards ; Polymerase Chain Reaction/standards ; Predictive Value of Tests ; Prevalence ; Republic of Korea/epidemiology ; Sensitivity and Specificity ; Trichomonas Infections/*epidemiology/prevention & control ; Trichomonas vaginalis/physiology ; Vaginal Smears/standards ; Young Adult

OBJECTIVE: This study aimed to examine the meaning and usefulness of sexually transmitted infection (STI) test when caring for patients who have abnormal cervical cytology and/or positive high-risk human papillomavirus (HPV) DNA test results. METHODS: Among patients who underwent liquid-based cervical cytology and HPV DNA tests at the Obstetrics and Gynecology outpatient clinic, 800 patients who showed abnormal cervical cytology were compared with 200 patients in the control group. Both groups were simultaneously tested via multiplex real-time polymerase chain reaction for seven types of STI-causative microorganisms. RESULTS: The positive rate of high-risk HPV infection in total STIs positive group was 1.47 times higher than that of total STIs negative group. The probability of a cytological diagnosis of a grade equal to or higher than atypical squamous cells-cannot exclude high grade squamous intraepithelial lesion (ASC-H) was significantly higher in patients testing positive for total STIs (1.46 times), Chlamydia trachomatis (3.21 times), or Mycoplasma genitalicum (3.58 times) than in those testing negative. The total STIs positive rate was significantly higher for those having a cytological diagnosis of a grade equal to or higher than atypical squamous cells of undetermined significance (ASC-US) when high-risk HPV test result was negative. CONCLUSION: Correlations were present not only between STIs and high-risk HPV infection but also between abnormal cervical cytology and STIs. Therefore, additional evaluation of STIs will be helpful to appropriately diagnose and treat patients with abnormal cervical cytology, positive results on high-risk HPV DNA test, or a cytological diagnosis of ASC-US despite negative high-risk HPV DNA test result.
Adult ; Aged ; Female ; Humans ; Middle Aged ; Outpatients ; Papillomavirus Infections/*pathology ; Risk ; Sexually Transmitted Diseases/*pathology ; *Vaginal Smears