Hypoglycaemia in screening oral glucose tolerance test in pregnancy with low birth weight fetus

Maternal hypoglycemia,a condition characterized by lower than normal blood glucose levels in pregnant women,has been increasingly associated with adverse pregnancy outcomes,including low birth weight(LBW)in neonates.LBW,defined as a birth weight of less than 2500 g,can result from various factors,including maternal nutrition,health status,and metabolic conditions like hypoglycemia.Maternal hypoglycemia may affect fetal growth by altering the supply of essential nutrients and oxygen to the fetus,leading to restricted fetal development and growth.This condition poses significant risks not only during pregnancy but also for the long-term health of the child,increasing the likelihood of developmental delays,health issues,and chronic conditions later in life.Research in this area has focused on understanding the mechanisms through which maternal hypoglycemia influences fetal development,with studies suggesting that alterations in placental blood flow and nutrient transport,as well as direct effects on fetal insulin levels and metabolism,may play a role.Given the potential impact of maternal hypoglycemia on neonatal health outcomes,early detection and management are crucial to minimize risks for LBW and its associated complications.Further investigations are needed to fully elucidate the complex interactions between maternal glucose levels and fetal growth,as well as to develop targeted interventions to support the health of both mother and child.Understanding these relationships is vital for improving prenatal care and outcomes for pregnancies complicated by hypoglycemia.

Evaluation of HPV Molecular Tests in Primary Screening for Cervical Cancer in Brazil

Background: Incorporation of HPV tests into cervical cancer screening programs may be advantageous over conventional cytology, especially in developing nations, where the largest burden of cervical cancer is observed. Objectives: To conduct an evaluation of commercially available molecular HPV tests in Brazilian women. Study design: Two groups were recruited: group A was composed of 511 women referred to the clinics because of a previous abnormal Pap test while group B consisted of 2464 subjects under routine screening. Cervical samples were collected using SurePath liquid cytology (LBC) device, and split into aliquots which were submitted to molecular testing by Hybrid Capture and cobas HPV. Colposcopy and biopsies were made according to the standard guidelines, directed by cytological diagnosis. Results: Prevalence of HSIL was 5.97% and 0.7% in Group A and B respectively. High-Risk HPV DNA was found in about 9% of group B women, while in group A this frequency was 24%. Having CIN3+ as the study end-point, the negative predictive values for molecular methods were above 99.8%. All “in-situ” and invasive cervical carcinomas were detected by both HPV nucleic acid assays. Conclusion: Use of HPV DNA testing was feasible and highly sensitive in cancer screening settings of Brazil.

Colorectal cancer screening: Modalities and adherence

In the last decade,several studies have explored various modalities and strategies for colorectal cancer(CRC)screening,taking into account epidemiological data,individual characteristics,and socioeconomic factors.In this editorial,we comment further on a retrospective study by Agatsuma et al published in the recent issue of the World Journal of Gastroenterology.Our focus is on screening trends,particularly in relation to efforts to improve the currently suboptimal uptake among the general population worldwide,aiming to enhance early diagnosis rates of CRC.There is a need to raise awareness through health edu-cation programs and to consider the use of readily available,non-invasive screening methods.These strategies are crucial for attracting screen-eligible populations to participate in first-line screening,especially those in high-or average-risk groups and in regions with limited resources.Liquid biopsies and biomarkers represent rapidly evolving trends in screening and diagnosis;however,their clinical relevance has yet to be standardized.

Smoking and genital human papilloma virus infection in women attending cervical cancer screening in Greece

AIM: To investigate whether smoking is associated with human papilloma virus(HPV) infection. METHODS: HPV infection is considered to be a neces-sary condition for cervical cancer development. The study population included 1291 women, aged 25-55 years, attending cervical cancer screening. All women had a Papanicolaou(Pap) test, with liquid-based cytology(Thinprep), an HPV-DNA test and an evaluation of smoking habits. The COBAS 4800 system was used for HPV-DNA testing, enabling identifi cation of the following high-risk HPV(hr HPV)-types: each of HPVs 16 and 18 separately, and HPVs 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68 as a cocktail. The evaluation of smoking habits was assessed using the smoking intensity index(SII), a variable formed as the product of cigarettes consumed per day by the days(years × 365) that a woman was a smoker, divided by 1000. RESULTS: There were 136 smokers among 238 women tested positive for hr HPV-types(HPVs 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and/or 68), and 463 smokers among 1053 hr HPV-negative women(OR = 1.7, P < 0.001). This association was attributed to the youngest age group of women, aged 25-34 years(OR = 2.3, P < 0.001), while there was no association in other age groups. The intensity of smoking(increasing SII) showed no statistically signifi cant association with hr HPV infection. Cervical infection with HPV 16 and/or HPV 18 was also not associated with age or smoking habits. Finally, no association was found between Pap test status and smoking habits or smoking intensity. CONCLUSION: Smoking appears to be associated with hr HPV infection of the uterine cervix, particularly in younger women. Further studies should investigate whether this association is based on causality and evaluate the role of other possible co-factors.

Screening for colorectal cancer in Tianhe,Guangzhou:results of combining fecal immunochemical tests and risk factors for selecting patients requiring colonoscopy

Objective:To explore the performance of a protocol combining fecal immunochemical test(FIT)and a high-risk factor questionnaire(HRFQ)for selecting patients requiring colonoscopy as part of a population-based colorectal cancer(CRC)screening program in China.Methods:From 2015 to 2016,we conducted a CRC screening program for all residents aged 45 years or older in Tianhe District,Guangzhou City,China.Participants underwent an FIT and received an HRFQ as part of primary screening.Those with positive FIT and/or HRFQ results were considered to be at high risk and were recommended to undergo colonoscopy.Results:A total of 10074 subjects were recruited and enrolled in the screening program.In the enrolled population,17.5%had positive FIT results and 19.4%had positive HRFQ results.Of those recommended to undergo diagnostic colonoscopy,773 did so.The screening method’s overall positive predictive value(PPV)was 4.9%for non-adenomatous polyps,11.4%for low-risk adenomas(LRAs),15.9%for high-risk adenomas(HRAs)and 1.6%for CRC.The PPVs of positive FIT results for nonadenomatous polyps,LRAs,HRAs and CRC were 5.2%,15.9%,22.5%and 2.5%,respectively.The PPVs of positive HRFQ results for non-adenomatous polyps,LRA,HRA and CRC were 4.1%,10.2%,14.3%and 1.4%,respectively.The PPVs associated with combined positive FIT and HRFQ results for non-adenomatous polyps,LRAs,HRAs and CRC were 4.5%,16.4%,23.7%and 2.8%,respectively.Conclusion:Our results suggest that this two-step CRC screening strategy,involving a combination of FIT and HRFQ followed by colonoscopy,is useful to identify early-stage CRC.The high detection rates and PPVs for CRC and adenomas encourage this strategy’s use in ongoing screening programs.