Presence of 20% or more clue cells: an accurate criterion for the diagnosis of bacterial vaginosis in Papanicolaou cervical smears

A study was carried out in 135 women of reproductive age to evaluate the role of the Papanicolaou smear performed in cervical and vaginal samples for the diagnosis of bacterial vaginosis (BV), to validate the method for this diagnosis and to evaluate the reproducibility of the criterion used. The cervical and vaginal smears were stained using the Papanicolaou method and evaluated by two separate observers. The finding of 20% or more clue cells was considered positive for the presence of BV. This diagnostic criterion presented a sensitivity of 87%, specificity of 94%, a positive predictive value of 81%, and a negative predictive value of 96%, both in cervical and vaginal samples. There was excellent agreement in the diagnosis of BV between the two observers (kappa, 0.87) and between cervical and vaginal samples (kappa, 0.92). Therefore, the presence of 20% or more clue cells in the Papanicolaou smear is an accurate and reproducible criterion for the diagnosis of BV and may be used in screening for this infection, eliminating the need for further vaginal sample collection.     

Body mass index and incidence of localized and advanced prostate cancer--a dose-response meta-analysis of prospective studies

BackgroundThe relationship between obesity and risk of prostate cancer (PCa) is unclear; however, etiologic heterogeneity by subtype of PCa (localized, advanced) related to obesity was suggested. Therefore, we conducted a dose–response meta-analysis of prospective studies to assess the association between body mass index (BMI) and risk of localized and advanced PCa.Materials and methodsRelevant prospective studies were identified by a search of Medline and Embase databases to 03 October 2011. Twelve studies on localized PCa (1 033 009 men, 19 130 cases) and 13 on advanced PCa (1 080 790 men, 7067 cases) were identified. We carried out a dose–response meta-analysis using random-effects model.ResultsFor localized PCa, we observed an inverse linear relationship with BMI [P_trend < 0.001, relative risk (RR): 0.94 (95% confidence interval, 95% CI, 0.91–0.97) for every 5 kg/m² increase]; there was no evidence of heterogeneity (P_{heterogeneity} = 0.27). For advanced PCa, we observed a linear direct relationship with BMI (P_trend = 0.001, RR: 1.09 (95% CI 1.02–1.16) for every 5 kg/m² increase); there was weak evidence of heterogeneity (P_{heterogeneity} = 0.08). Omitting one study that contributed substantially to the heterogeneity yielded a pooled RR of 1.07 (95% CI 1.01–1.13) for every 5 kg/m² increase (P_{heterogeneity} = 0.26).ConclusionsThe quantitative summary of the accumulated evidence indicates that obesity may have a dual effect on PCa—a decreased risk for localized PCa and an increased risk for advanced PCa.     

Is bacterial vaginosis associated with squamous intraepithelial lesion of the uterine cervix?

The objective of this study was to analyze the association between bacterial vaginosis (BV) and squamous intraepithelial lesion (SIL). Pap smears were analyzed to verify the presence of BV and SIL. One hundred and ten women with SIL comprised the study group, while 110 women with no cytological abnormalities served as controls. BV was similarly present in women of both groups: 18% of women with SIL and 12% of women without SIL. Results were also similar when the grade of SIL was taken into consideration. BV was detected in 16% of women with low-grade SIL and in 12% of women in the control group, while a higher rate of BV (33%) was found among women with high-grade SIL in comparison to the controls (12%). This difference, however, was not statistically significant. BV tended to be more common among women with high-grade SIL than in women with no cytological abnormalities.     

Cytological evaluation and investigation of the vaginal flora of long-term users of the levonorgestrel-releasing intrauterine system (LNG-IUS)

Background

The study was conducted to evaluate the cytopathological findings and vaginal flora in cervical smear samples from women using the levonorgestrel-releasing intrauterine system (LNG-IUS) for a period of up to 7 years.

Study Design

Postinsertion cytology examinations were conducted on 187 women who had an LNG-IUS inserted between April and September 1998 in the family planning clinic of the Universidade Estadual de Campinas.

Results

During the 7 years of follow-up, a high frequency of candidiasis was found from the fourth through the seventh year of use in comparison to the first year of use. No significant results were found with respect to cytopathological abnormalities or other microbiological alterations following insertion of the LNG-IUS.

Conclusion

Use of the LNG-IUS had no effect on cervical smears over the 7-year follow-up period; however, an increase occurred in the frequency of candidiasis.     

Idiopathic bone cavity: case series involving children and adolescents

Aim: This study aimed at reviewing a series of clinical cases of children and adolescents treated for idiopathic bone cavity (IBC). Methods: Ten lesions diagnosed as IBC in nine patients treated between February 2000 and December 2008 were reviewed, focusing on clinical and radiographic aspects, as well the therapeutic approach. Results: Most of the patients were Caucasian with no sex predilection (55.5% males and 45.5% females), and all were in the second decade of life at the time of IBC diagnosis. The lesions were asymptomatic and detected during routine radiographic examinations. All the lesions were located in the mandible, and the anterior region was the most affected. The most adopted therapeutic approach was simple curettage of the bone cavity, and all surgically‐treated patients presented complete bone healing after 6 months, postoperatively. Conclusions: Clinical and radiographic diagnoses associated with surgical exploration are the most important treatment options in order to avoid radical surgery or unnecessary endodontic treatment, mainly when idiopathic bone cavities are detected in children and adolescents. Further studies aimed at elucidating the etiopathogenesis of this condition and defining the most appropriate treatment should be conducted.