目的:系统评价绝经期妇女激素替代治疗与宫颈癌发病风险的相关性。方法:检索Pub Med、Em Base、Web of Science、CNKI、维普及万方数据库,搜集有关绝经期妇女激素替代治疗和宫颈癌发病风险相关的研究,检索时间截至2017年11月1日。由2位...目的:系统评价绝经期妇女激素替代治疗与宫颈癌发病风险的相关性。方法:检索Pub Med、Em Base、Web of Science、CNKI、维普及万方数据库,搜集有关绝经期妇女激素替代治疗和宫颈癌发病风险相关的研究,检索时间截至2017年11月1日。由2位研究者独立筛选并纳入相关文献,提取文献数据。采用STATA12.0统计软件进行Meta分析,以比值比(OR)及95%置信区间(95%CI)作为效应量,异质性检验评估使用统计量I2;敏感性分析判定结果的稳定性;发表偏倚使用漏斗图、Begg秩相关和Egger线性回归法。结果:最终纳入10篇研究,样本量680235例,其中病例组4312例,对照组675923例。Meta分析结果显示,绝经妇女激素替代治疗与宫颈癌的发病无相关性(OR=0.85,95%CI为0.55~1.31,P=0.467)。根据文献研究类型、种族和激素替代治疗方案的不同进行亚组分析,结果显示:在队列研究、病例对照研究和随机对照研究中发现激素替代治疗与宫颈癌的发病无相关性(OR分别为0.35、0.71、1.48,P=0.41、0.07、0.36);分别对欧洲、亚洲和北美洲人群进行分析发现激素替代治疗与宫颈癌的发病风险无相关性(OR分别为0.59、0.90、1.29,P=0.16、0.80、0.33);绝经妇女不论是使用雌激素还是雌孕激素联合治疗均未发现激素替代治疗会增加宫颈癌的发病风险(OR分别为0.81、0.83,P=0.59、0.39)。结论:绝经妇女使用激素替代治疗不增加宫颈癌的发病风险,结果不受研究类型、种族和激素替代治疗方案的不同而变化。展开更多
The population plagued with the HIV/AIDS pandemic in Cameroon is young, a generation that may desire or control fertility. For those who may become pregnant, the desire to have children may not be there. We carried ou...The population plagued with the HIV/AIDS pandemic in Cameroon is young, a generation that may desire or control fertility. For those who may become pregnant, the desire to have children may not be there. We carried out this study to look at the picture of the reproductive health needs of women living with HIV/AIDS in our setting. In this cross-sectional non-analytic design that lasted for three years, we employed both qualitative and quantitative methods to collect data from them after receiving ethical clearance (N221/CM/2009) from the National Ethics Committee. Consenting HIV infected women who were attending the “HIV Day Care” clinics and those who delivered and were in the post partum wards in four of our major hospitals in Yaounde were enrolled. Interviews were individualized. We used both CSPro version 4.1 and Statistical Package for Social Sciences (SPSS) version 19.0 softwares for data analysis. Four hundred and fifteen (415) women were enrolled;the mean age was 29 ± 7.8 years;the most represented age group was 24 -29 years. They were single (36.14%), well educated (5 out of 10 had attained university level of education), 61.20% revealed that their partners knew their HIV status, 82.4% believed that screening for cancer of the cervix was necessary for their status and 47.70% would want to be screened for some or all STIs. About 36.86% had the desire to have children, 57.1% of those who delivered did not plan to have the pregnancies out of which 82% would have wanted a modern method of contraception but did not have (82% unmet needs). Modern contraceptive use was associated with age and individual characteristics such as level of education. It was 64.34% among women who had secondary level of education and below as against 35.66% among those who had high school level of education and above. Contraceptive use was also high among women who were unmarried as against those who were married (89.64% vs 10.36%). The desire to have children decreased as age increased (43.85% vs 18.79%) and was lower among mar展开更多
Introduction: cervical cancer is common with high mortality. It is diagnosed late in developing countries. Reducing mortality requires better knowledge and screening for cervical cancer. Objective: To study the knowle...Introduction: cervical cancer is common with high mortality. It is diagnosed late in developing countries. Reducing mortality requires better knowledge and screening for cervical cancer. Objective: To study the knowledge, attitudes and practices of midwives in the Kara region of cervical cancer screening. Methods: Cross-sectional, descriptive study from January 2020 to June 2020 conducted with midwives from the Kara region. Results: Fifty midwives participated in the study. The average age was 32.46 years and the majority (92%) had less than 10 years work experience. Thirty seven (74%) said that cervical cancer was due to human papillomavirus oncogenes and 32% to know the two commonly used screening methods (cervical cytology and VIA/VILI). Only 30% and 8% respectively know the pace and target of screening. They had all expressed the desire to be trained and to carry out routine screening. All of the respondents had never practiced a cervical cytology, and only 01 had once practiced VIA/VILI. Conclusion: Midwives have little knowledge of uterine cancer screening and do not practice it. They express the need to be trained in order to popularize the practice.展开更多
Radiotherapy plays a major role in the treatment of cervical cancer. A successful radiotherapy program integrates both external beam and brachytherapy components. The principles of radiotherapy are strongly based on t...Radiotherapy plays a major role in the treatment of cervical cancer. A successful radiotherapy program integrates both external beam and brachytherapy components. The principles of radiotherapy are strongly based on the anatomy of the organ and patterns of local and nodal spread. However, in patients with distorted anatomy, several practical issues arise in the delivery of optimal radiotherapy, especially with brachytherapy. Müllerian duct anomalies result in congenital malformations of the female genital tract. Though being very commonly studied for their deleterious effects on fertility and pregnancy, they have not been recognized for their potential to interfere with the delivery of radiotherapy among patients with cervical cancer. Here, we discuss the management of cervical cancer among patients with Müllerian duct anomalies and review the very sparse amount of published literature on this topic.展开更多
文摘目的:系统评价绝经期妇女激素替代治疗与宫颈癌发病风险的相关性。方法:检索Pub Med、Em Base、Web of Science、CNKI、维普及万方数据库,搜集有关绝经期妇女激素替代治疗和宫颈癌发病风险相关的研究,检索时间截至2017年11月1日。由2位研究者独立筛选并纳入相关文献,提取文献数据。采用STATA12.0统计软件进行Meta分析,以比值比(OR)及95%置信区间(95%CI)作为效应量,异质性检验评估使用统计量I2;敏感性分析判定结果的稳定性;发表偏倚使用漏斗图、Begg秩相关和Egger线性回归法。结果:最终纳入10篇研究,样本量680235例,其中病例组4312例,对照组675923例。Meta分析结果显示,绝经妇女激素替代治疗与宫颈癌的发病无相关性(OR=0.85,95%CI为0.55~1.31,P=0.467)。根据文献研究类型、种族和激素替代治疗方案的不同进行亚组分析,结果显示:在队列研究、病例对照研究和随机对照研究中发现激素替代治疗与宫颈癌的发病无相关性(OR分别为0.35、0.71、1.48,P=0.41、0.07、0.36);分别对欧洲、亚洲和北美洲人群进行分析发现激素替代治疗与宫颈癌的发病风险无相关性(OR分别为0.59、0.90、1.29,P=0.16、0.80、0.33);绝经妇女不论是使用雌激素还是雌孕激素联合治疗均未发现激素替代治疗会增加宫颈癌的发病风险(OR分别为0.81、0.83,P=0.59、0.39)。结论:绝经妇女使用激素替代治疗不增加宫颈癌的发病风险,结果不受研究类型、种族和激素替代治疗方案的不同而变化。
文摘The population plagued with the HIV/AIDS pandemic in Cameroon is young, a generation that may desire or control fertility. For those who may become pregnant, the desire to have children may not be there. We carried out this study to look at the picture of the reproductive health needs of women living with HIV/AIDS in our setting. In this cross-sectional non-analytic design that lasted for three years, we employed both qualitative and quantitative methods to collect data from them after receiving ethical clearance (N221/CM/2009) from the National Ethics Committee. Consenting HIV infected women who were attending the “HIV Day Care” clinics and those who delivered and were in the post partum wards in four of our major hospitals in Yaounde were enrolled. Interviews were individualized. We used both CSPro version 4.1 and Statistical Package for Social Sciences (SPSS) version 19.0 softwares for data analysis. Four hundred and fifteen (415) women were enrolled;the mean age was 29 ± 7.8 years;the most represented age group was 24 -29 years. They were single (36.14%), well educated (5 out of 10 had attained university level of education), 61.20% revealed that their partners knew their HIV status, 82.4% believed that screening for cancer of the cervix was necessary for their status and 47.70% would want to be screened for some or all STIs. About 36.86% had the desire to have children, 57.1% of those who delivered did not plan to have the pregnancies out of which 82% would have wanted a modern method of contraception but did not have (82% unmet needs). Modern contraceptive use was associated with age and individual characteristics such as level of education. It was 64.34% among women who had secondary level of education and below as against 35.66% among those who had high school level of education and above. Contraceptive use was also high among women who were unmarried as against those who were married (89.64% vs 10.36%). The desire to have children decreased as age increased (43.85% vs 18.79%) and was lower among mar
文摘Introduction: cervical cancer is common with high mortality. It is diagnosed late in developing countries. Reducing mortality requires better knowledge and screening for cervical cancer. Objective: To study the knowledge, attitudes and practices of midwives in the Kara region of cervical cancer screening. Methods: Cross-sectional, descriptive study from January 2020 to June 2020 conducted with midwives from the Kara region. Results: Fifty midwives participated in the study. The average age was 32.46 years and the majority (92%) had less than 10 years work experience. Thirty seven (74%) said that cervical cancer was due to human papillomavirus oncogenes and 32% to know the two commonly used screening methods (cervical cytology and VIA/VILI). Only 30% and 8% respectively know the pace and target of screening. They had all expressed the desire to be trained and to carry out routine screening. All of the respondents had never practiced a cervical cytology, and only 01 had once practiced VIA/VILI. Conclusion: Midwives have little knowledge of uterine cancer screening and do not practice it. They express the need to be trained in order to popularize the practice.
文摘Radiotherapy plays a major role in the treatment of cervical cancer. A successful radiotherapy program integrates both external beam and brachytherapy components. The principles of radiotherapy are strongly based on the anatomy of the organ and patterns of local and nodal spread. However, in patients with distorted anatomy, several practical issues arise in the delivery of optimal radiotherapy, especially with brachytherapy. Müllerian duct anomalies result in congenital malformations of the female genital tract. Though being very commonly studied for their deleterious effects on fertility and pregnancy, they have not been recognized for their potential to interfere with the delivery of radiotherapy among patients with cervical cancer. Here, we discuss the management of cervical cancer among patients with Müllerian duct anomalies and review the very sparse amount of published literature on this topic.
