Aim of this study was to compare the 5‐year risk of cervical intraepithelial neoplasia grade 2+ (CIN2+)/CIN3+ and the performance parameters at 3‐year rescreening of a negative E6/E7 mRNA‐human ...papillomavirus (HPV) test with those of a HPV‐DNA‐negative test. We studied a cohort of HPV‐negative women tested with the Aptima HPV‐mRNA Assay (“HPV‐mRNA cohort”) versus a cohort of HPV negatives tested with the Hybrid Capture 2 (HC2) DNA test living in neighboring areas. Both cohorts were rescreened after 3 years by a HPV‐DNA test (HC2 or Cobas 4800 HPV test). HPV test positivity, referral to colposcopy and detection of CIN2+ at 3‐year rescreening were computed. The Veneto Cancer Registry was checked to search for invasive cancers and CIN3 diagnosed up to 5 years from the negative baseline test. Some 22,338 HPV‐mRNA and 68,695 HPV‐DNA‐negative women were invited to 3‐year rescreening, and, respectively, 16,641 (74.5%) and 54,630 (79.6%) complied with the invitation. The proportion of HPV‐positive tests, referral to colposcopy and detection of CIN2+ in the HPV‐mRNA and HPV‐DNA cohorts were, respectively. 4.0 and 3.9% (ratio 1.08; 95% confidence interval CI 0.99–1.17), 2.6 and 2.5% (ratio 1.06, 95% CI 0.95–1.18) and 1.4 and 1.7‰ (ratio 0.85, 95% CI 0.54–1.33). The relative 5‐year cumulative risk of cancer and of CIN2+ in the HPV‐mRNA and HPV‐DNA cohorts were 4.5 and 8.7/100,000 (ratio 0.51; 95%CI 0.01–4.22) and 1.1 and 1.5/1,000 (ratio 0.74; 95%CI 0.45–1.16), respectively. A negative HPV‐mRNA test confers a risk of invasive cervical carcinoma and of CIN2+ at 5 years comparable to that of a negative HPV‐DNA test.
What's new?
HPV‐DNA tests are more sensitive and less specific than Pap tests. One way to cut down on false positives while maintaining high sensitivity is to look for overexpression of the HPV oncogene E6/E7 by mRNA testing. Here, the authors evaluated how well HPV‐mRNA testing compared with HPV‐DNA testing. They found that the 5‐year CIN2+, CIN3+, and invasive cervical cancer risks were comparable between women who tested negative for either test. Indeed, re‐screening with a HPV‐DNA test after 3 years returned similar rates of CIN2+ and CIN3+ regardless of which method had been used for the first screening.
HPV DNA-based screening is more effective than a Pap test in preventing cervical cancer, but the test is less specific. New HPV tests have been proposed for primary screening. The HPV mRNA test ...showed a similar or slightly lower sensitivity than the HPV DNA tests but with a higher specificity. We report the results of an organised HPV mRNA-based screening pilot program in Venice, Italy.
From October 2011 to May 2014, women aged 25-64 years were invited to undergo a HPV mRNA test (Aptima). Those testing positive underwent cytological triage. Women with positive cytology were referred to colposcopy, whereas those with negative cytology were referred to repeat the HPV mRNA test 1 year later. The results of the HPV mRNA test program were compared with both the local historical cytology-based program and with four neighbouring DNA HPV-based pilot projects.
Overall, 23 211 women underwent a HPV mRNA test. The age-standardised positivity rate was 7.0%, higher than in HPV DNA programs (6.8%; relative rate (RR) 1.11, 95% confidence interval (CI) 1.05-1.17). The total colposcopy referral was 5.1%, double than with cytology (2.6%; RR 2.02, 95% CI 1.82-2.25) but similar to the HPV DNA programs (4.8%; RR 1.02; 95% CI 0.96-1.08). The cervical intraepithelial neoplasia grade 2+ detection rate with HPV mRNA was greater than in the HPV DNA programs at baseline (RR 1.50; 95% CI 1.19-1.88) and not significantly lower at the 1-year repeat (RR 0.70; 95% CI 0.40-1.16). The overall RR was 1.29 (95% CI 1.05-1.59), which was much higher than with cytology (detection rate 5.5‰ vs 2.1‰; RR 2.50, 95% CI 1.76-3.62).
A screening programme based on the HPV mRNA obtained results similar to those observed with the HPV DNA test. In routine screening programmes, even a limited increase in HPV prevalence may conceal the advantage represented by the higher specificity of HPV mRNA.
The diagnosis and follow-up of bladder cancer are mainly based on cystoscopy, an invasive method which could be negative in case of flat malignancies such as carcinoma in situ. Other noninvasive ...diagnostic methods have not yet given satisfactory results. There is a need for a reliable yet noninvasive method for the detection of bladder cancer. Our aim was to investigate whether cell-free DNA quantified in urine (ucf-DNA) could be a useful marker for the diagnosis of bladder cancer. A standard urine test was performed in 150 naturally voided morning urine samples that were processed to obtain a quantitative evaluation of ucf-DNA. Leukocyturia and/or bacteriuria were found in 18 subjects, who were excluded from the study. Statistical analysis was performed on 45 bladder cancer patients and 87 healthy subjects. Ucf-DNA was extracted from urine samples by a spin column-based method and quantified using four different methods: GeneQuant Pro (Amersham Biosciences, Pittsburg, PA, USA), Quant-iT DNA high-sensitivity assay kit (Invitrogen, Carlsbad, CA, USA), Real-Time PCR (Applied Biosystems, Foster City, CA, USA), and NanoDrop 1000 (NanoDrop Technologies, Houston, TX, USA). Median free DNA quantification did not differ statistically between bladder cancer patients and healthy subjects. A receiver-operating characteristic (ROC) curve was developed to evaluate the diagnostic performance of ucf-DNA quantification for each method. The area under the ROC curve was 0.578 for GeneQuant Pro, 0.573 for the Quant-iT DNA high-sensitivity assay kit, 0.507 for Real-Time PCR, and 0.551 for NanoDrop 1000, which indicated that ucf-DNA quantification by these methods is not able to discriminate between the presence and absence of bladder cancer. No association was found between ucf-DNA quantification and tumor size or tumor focality. In conclusion, ucf-DNA isolated by a spin column-based method and quantified by GeneQuant Pro, Quant-iT DNA high-sensitivity assay kit, Real-Time PCR or NanoDrop 1000 does not seem to be a reliable marker for the diagnosis of bladder cancer.
We report a case of dermoid cyst of the head of the pancreas area in a 26-yr-old woman radically treated with pancreatoduodenectomy and alive with no recurrence at 6-yr follow-up. The diagnostic and ...surgical procedures are described, and the literature is reviewed.
This paper provides a synthesis and comparison of methodologies and results obtained in several studies devoted to the impact of climate change on hydropower. By putting into perspective various case ...studies, we provide a broader context and improved understanding of climate changes on energy production. We also underline the strengths and weaknesses of the approaches used as far as technical, physical and economical aspects are concerned. Although the catchments under investigation are located close to each other in geographic terms (Swiss and Italian Alps), they represent a wide variety of situations which may be affected by differing evolutions for instance in terms of annual runoff. In this study, we also differentiate between run-of-river, storage and pumping-storage power plants. By integrating and comparing various analyses carried out in the framework of the EU-FP7 ACQWA project, this paper discusses the complexity as well as current and future issues of hydropower management in the entire Alpine region.
•Impact of climate change on hydropower in the Italian and Swiss alpine regions•Influence of the wholesale electricity prices in the water reservoirs' management•Combination of hydrologic and economic models•Integration of several case studies carried out by different research groups•Each case is a special case although they are located close to each other.
Healthcare settings have recently increased the use of companion animals in the workplace to provide emotional support to people with disabilities, but there is limited empirical research on the ...effects of these programs on healthcare workers. However, it is reasonable to speculate that Animal-Assisted Interventions (AAIs) may have positive effects on health care workers (HCWs) by buffering the negative effects of work-related stress and other occupational psychosocial risk factors. The aim of this review was to examine the beneficial effects of AAIs on the psychological well-being of HCWs. A systematic review was conducted in December 2021 to gain insight into the positive effects of pets on HCWs in the workplace. Searches were conducted in the following databases: Scopus, PubMed/Medline, Web of Science, and Google Scholar, including studies between 2001 and December 2021, and 12 articles were included in the review. The results indicate that implementing the AAI program in a busy clinic is feasible and that the program is accepted by medical professionals because of the immense psychological benefits it provides. However, the healthcare professionals disliked the experimental design that forced them to leave their workplaces at a certain time.
ObjectivesThis study aims to analyse, from a descriptive and qualitative point of view, the episodes of violence reported by healthcare workers (HCWs) in a large public Italian hospital. Qualitative ...analysis permits us to collect the victims’ words used to describe the event and the ways in which they dealt with it. A comparison between genders was performed to better understand what type of different strategies could be used to improve the prevention of workplace violence for HCWs.Design and settingThe retrospective observational study was carried out in ‘Città della Salute e della Scienza’, a complex of four interconnected hospitals situated in Northern Italy. This study analysed aggression data from the 4-year period of 2015–2018 that included all HCW categories. The data were obtained from the aggression reporting form.ParticipantsThe analysed records were supplied by 396 HCWs (3.6% of all HCWs in the hospital).ResultsMale HCWs aged <30 years did not report violent episodes that occurred in the workplace, while male HCWs with 6–15 years of work experience reported more violent episodes than their female counterparts. Among the HCW professions, nursing was the profession, in which HCWs were more prone to experience a violent episode, while male medical doctors were more prone to report violent episodes than female medical doctors. Moreover, female HCWs experienced more verbal violence (insults) than male HCWs did, while male HCWs experienced more physical violence (bodily contact) than female HCWs did.ConclusionsThe findings from this explorative study suggest that there is a gender difference in the characteristics of workplace violence perpetrated by patients, patients’ relatives and visitors and in the way in which these episodes are described. Consequently, it is important for informative and preventive courses to consider gender differences in experiencing a violent episode.
The aim of this study was to analyze the well-being and coping strategies of nurses working in an organizational setting perceived as characterized by workplace bullying. The innovative aspect of ...this study is that we considered only those who perceive to work in an organizational environment characterized by workplace bullying, and not those who see themselves as victims and those who perceive they work in an organizational environment not characterized by workplace bullying.
A questionnaire with the NAQ-R, PGWBI, Val.Mob. and Brief COPE scales was administered to nurses. To better understand this phenomenon, a comparison was made between 331 nurses and 166 workers in other professions who also work in an organizational environment perceived to be characterized by workplace bullying.
In both groups (nurses and workers), the results were approximately the same in terms of personal bullying and workplace bullying episodes and the number of physical and emotive symptoms. The PGWBI score was lower for nurses than for workers in other fields. Among the individual symptoms, nurses and registered nurses were more likely to report gastritis, insomnia and heartburn than workers in other contexts. Workers in other contexts were more likely than nurses to report symptoms of anxiety, fear, feelings of insecurity, inferiority and guilt. In terms of coping strategies, nurses were more likely than other workers to report distraction, substance use, emotional support, disengagement, venting, positive reframing, humor, and religion. Workers in other professional context were more likely than nurses to report active coping, denial, instrumental support, planning, acceptance, and self-blame.
Results suggest that the consequences of working in a perceived organizational environment characterized by workplace bullying are similar for both groups of workers, with nonstatistical differences in perceived workplace bullying episodes and sum of physical and emotive symptoms.
Overall, findings suggest that workplace bullying prevention is a fundamental element in training workers in all types of workplaces and should be an integral part of curriculum activities.
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