Primary Screening for Breast Diseases among 17618 Women in Wufeng Area, a Region with High Incidence of Cervical Cancer in China

In this study, the current status for breast diseases in a region with high-incidence of cervical cancer were epidemiologically investigated. From March to August, 2009, 17618 women, from Wufeng area of Hubei province, China, were recruited to screen breast diseases by using breast infrared diagnostic apparatus. Other diagnostic methods, such as B-mode ultrasound, X-ray mammography, needle biopsy and pathological examination were, if necessary, used to further confirm the diagnosis. The screening showed that 5990 of 17618 cases (34.00%) had breast diseases, 5843 (33.16%) had mammary gland hyperplasia, 48 (0.27%) had breast fibroadenoma, 11 (0.06%) had breast carcinoma, and 88 (0.50%) had other breast diseases. The peak morbidity of breast cancer was found in the women aged 50–60 ages. The morbidity of breast cancer was significantly increased in women elder than or equal to 50 years old (n=8, 0.157%) in comparison with that in the subjects younger than 50 years old (n=3, 0.024%) (u=2.327, P<0.05). It was shown that the occurrence of breast diseases was concentrated in women aged 20–40 years, while the total morbidity reached its peak at the age of 30 years and then decreased sharply after age of 40. Compared with the patients elder than or equal to 40 years old (n=3289, 27.46%), the morbidity rate of breast diseases was significantly increased in women less than 40 years old (2648 cases, 47.18%; P<0.001). However, there was no significant difference in the morbidity of breast diseases between the age group of 20–29 years and that of 30–39 years (P=0.453), and both of them were high. There was no significant association between the morbidity of breast diseases and cervical cancer. Since the morbidity of breast diseases was higher among young women, more attention should be paid to the screening of breast diseases among young women for early diagnosis.

Adherence to Radiation Therapy among Cervical Cancer Patients at Cancer Diseases Hospital in Lusaka, Zambia

Background: Radiation therapy has the potential to improve cure rates and provide palliative relief for cervical cancer patients. Despite adherence to radiation therapy being a key treatment modality, patients rarely follow prescriptions. Poor adherence to radiation therapy is associated with low survival and high mortality rates. This study therefore sought to investigate the levels of adherence and factors influencing adherence to radiation therapy among cervical cancer patients being treated at Cancer Diseases Hospital. Methods: A cross-sectional analytical study design was used, 142 patients were selected from the outpatient department using a fishbowl sampling method. A structured interview schedule was used to collect data. Data was entered and analyzed using SPSS, the binary logistic regression analysis was used to predict levels of adherence to treatment and to identify factors associated with adherence to RT among cervical cancer patients. Results: The findings showed that 93% of the participants adhered to radiation therapy while 7% did not adhere to treatment. Majority of the patients 77.1% had experienced side effects of radiation therapy. About 28% of patients had severe psychological distress. By using binary logistic regression, there was a statistically significant association between adherence and perceived quality of health care services (p = 0.001). The analysis showed that patients who perceived poor quality of health care services were 0.005 (99.5%) times less likely to adhere to radiation therapy. The other independent variables were not statistically significant despite being associated with adherence among cervical cancer patients. Conclusions and Recommendations: The findings showed that patients who perceived good quality of health care services had higher chances of adherence compared to those who perceived poor quality of health care services. There is therefore a need for quality service provision which could include good maintenance of radiation machines. Furthermore, there is a need to develop guidelines for follow-up in case of any disease outbreak to avoid interference with patients’ treatment schedules and appointments for reviews.

Cervical Diseases Prediction Using LHVR Techniques

The stabilizing mechanisms of cervical spine spondylosis are involved in the degenerating segmentation vertebra,which often causes pain.Health of the individual is affected,both physically and mentally.Due to depression,nervous-ness,and psychological damages occur thereby losing their human activity func-tions.The nucleus pulposus of spinal disc herniation is prolapsed through a deficiency of annulusfibrosus.A jelly-like core part of the disc contains proteins that cause the tissues to become swollen when it touches the nucleus pulposus.The proposed Gradient Linear Classification(GLC)algorithm is used for the effi-cient automatic classification of disc degeneration herniation of Inter vertebral/vertebra in a cervical disc.Distance between the disc degeneration is classified through gradient operator and is estimated using the rotation of angles between the correlations.Specialists of the orthopedic spine are searching for high-preci-sion algorithms,which are achieved using proposed Linear Hybrid Vertebra Regression(LHVR)diagnostic techniques to identify the degree of cervical disc degeneration using an accurate location.Our experimental results have been used to determine a high range of classification in predicting the spinal cord which saves handling time and accomplishes high accuracy in detection.

The application of C1-C2 pedicle screw internal fixation on the upper cervical diseases of children

Objective To report five cases of puerile (【9 years) atlantoaxial instability which underwent C1-C2 pedicle screw internal fixation by posterior approach,and to introduce the surgical technique and the key point

Follow-up Study on the Motion Range after Treatment of Degenerative Disc Disease with the Bryan Cervical Disc Prosthesis

This study examined effect of a new intervertebral cervical disc prosthesis in relieving the neurological symptoms and signs, improving the patients＇ ability to perform daily activities, reducing pain, and maintaining the stability and segmental motion. From December 2003 to October 2004, 12 patients, who had received 14 replacements of cervical artificial discs, were followed-up for 2 to 8 months （with a mean of 5.2 months）. Of them 5 had cervical spondylotic myelopathy and 7 had cervical disc herniation. The patients included 7 males and 5 females, with their age ranging from 35 to 62 y and a mean of 50.3 y. Single-level replacements were performed in 10 cases and 2 cases received two-level replacement. Operation time of the single-level surgery averaged 130±50 rain and the time of two-level surgery was 165±53 min on average （from skin incision to skin suturing）. Neurological or vascular complications during or after surgery was not observed. Japanese Orthopedic Association scores （JOA scores） increased from 8.6 to 15.8 on average. There was no prothesis subsidence or excursion. Replaced segments were stable and the range of motion was partially restored, being 4.68° （3.6°-6.1°） in flexion and extension position and 3.51 ° （2.5°-4.6°）, 3.42° （2.6°-4.3°） in left and right bending position. No obvious loss of physiological curvature was noted. CT or MRI follow-up showed that excursion was less than 1.5 mm） in 2 of 14 levels and between 1.5 mm and 3 mm） in 1 of 14 levels. No ossification in the replaced levels was observed. It is concluded that satisfactory short-term results were achieved in the 12 cases of artificial disc replacements. Different from anterior cervical discectomy and fusion, the replacement could achieve quick functional recovery and did not lead to the movement limitation of cervical vertebrae. At least a 5-years follow-up was needed to assess the long-term effect of the prosthesis on its neighboring segments.

Acupuncture for cervical dystonia associated with anxiety and depression: A case report

BACKGROUND Cervical dystonia(CD)is a type of muscle tone disorder that usually occurs in the neck muscles.Due to the intermittent or continuous involuntary contraction of the neck muscles,the head and neck are twisted and skewed and some postural abnormalities occur.Long-term abnormal posture or pain can cause negative emotions in patients,which can affect their quality of life.CASE SUMMARY This case report included a 37-year-old woman who was diagnosed with CD associated with anxiety and depression;the accompanying symptoms were head and neck tilt of approximately 90°to the right and mental abnormality.After two courses of acupuncture treatment,the patient’s head and neck can be maintained in a normal position,and the negative emotions can be relieved.CONCLUSION This case indicates that acupuncture can effectively improve CD and the emotional state and quality of life of patients,making it an effective alternative treatment for the condition.

Status Quo of Acceptance of Illness among Reproductive Age Cervical Cancer Patients and Its Influencing Factors

Objective: To explore the status quo of acceptance of illness among reproductive-age cervical cancer patients and its influencing factors, to provide a theoretical basis for the implementation of targeted interventions. Methods: The convenience sampling method was used to investigate 256 reproductive-age cervical cancer patients using the general information questionnaire, Acceptance of Illness Scale, Reproductive Concerns After Cancer Scale, and Medical Coping Style Scale. Results: The total score of the acceptance of illness was (18.03 ± 3.24), and reproductive concerns were (57.02 ± 6.30), among reproductive-age cervical cancer patients. Multivariate analysis showed that age, number of children, income level, treatment method, level of reproductive concerns, and the yield and avoidance dimensions of medical coping style were the main influencing factors on patients’ level of illness acceptance (all P Conclusion: The acceptance of illness levels in reproductive-age cervical cancer patients was low to intermediate, and medical staff should timely identify high-risk groups and take preventive management measures based on influencing factors.

Outcomes of cervical degenerative disc disease treated by anterior cervical discectomy and fusion with self-locking fusion cage

BACKGROUND Cervical degenerative disc(CDD)disease is a common type of spondylosis.Although anterior cervical discectomy and fusion(ACDF)is the preferred treatment for CDD disease,internal fixation with a titanium plate may cause various complications.The invention of the ACDF with a self-locking fusion cage(ROI-C)has effectively decreased the incidence of postoperative complications.AIM To observe the outcomes of CDD disease treated by ACDF with a ROI-C.METHODS Ninety patients with CDD disease treated at our hospital from March 2019 to March 2021 were included.They were divided into two groups(control group and observation group,n=45 in each)using a random number table.Patients in the control group received ACDF plus internal fixation with a titanium plate.Those in the observation group received ACDF+ROI-C placement.The two groups of patients were compared in terms of surgical parameters,pain,cervical spine function,range of motion,and complications.RESULTS The two groups of patients showed no significant differences in surgical time,blood loss,drainage volume,and length of hospital stay(P>0.05).No significant differences in the visual analogue scale(VAS),Japanese Orthopedic Association(JOA),and neck disability index(NDI)scores were observed between the two groups before surgery(P>0.05).The VAS and NDI scores in the observation group were considerably lower than those in the control group after surgery;however,the JOA scores in the observation group were significantly higher than those in the control group(P<0.05).No significant differences were observed in cervical disc height and the range of motion of the superior or inferior adjacent vertebrae between the two groups before surgery(P>0.05).The disc height in the observation group was larger than that in the control group after surgery.The range of motion of both the superior and inferior adjacent vertebrae was significantly smaller in the observation group than in the control group(P<0.05).The incidence of complications was only 2.22% in the observation group compared to 15.56% in the control group,and the difference was statistically significant(P<0.05).CONCLUSION Cervical spine function restoration was better with ROI-C with internal fixation in ACDF than with conventional titanium plates in ACDF for CDD disease.

Clinical features and surgical treatment of the coexistence of cervical,thoracic and lumber degenerative disease

Objective To discuss clinical features and surgical treatment of the coexistence of cervical,thoracic and lumber degenerative disease. Methods From January 2004 to December 2008,79 cases with the coexistence of cervical,thoracic

Adjuvant chemotherapy for early-stage cervical cancer

The aim of this review is to address the current status of adjuvant chemotherapy alone in early-stage cervical cancer treatments in the literature. At present, the therapeutic effect of adjuvant chemotherapy alone after radical surgery （RS） has not yet been established, and radiation therapy （RT） or concurrent chemoradiotherapy （CCRT） is recommended as the standard adjuvant therapy after RS for early-stage cervical cancer in various guidelines. The main purpose of adjuvant therapy after RS, however, should be to reduce extrapelvic recurrence rather than local recurrence, although adjuvant RT or CCRT has survival benefits for patients with intermediate- or high-risk factors for recurrence. Moreover, several studies reported that adjuvant therapies including RT were associated with a higher incidence of complications, such as lymphedema, bowel obstruction and urinary disturbance, and a lower grade of long-term quality of life （QOL） or sexual functioning than adjuvant chemotherapy alone. The effect of adjuvant chemotherapy alone for early-stage cervical cancer with intermediate- or high-risk factors for recurrence were not fully investigated in prospective studies, but several retrospective studies suggest that the adjuvant effects of chemotherapy alone are at least similar to that of RT or CCRT in terms of recurrence rate, disease-free survival, or overall survival （OS） with lower incidence of complications. Whereas cisplatin based combination regimens were used in these studies, paclitaxel/cisplatin （TP） regimen, which is currently recognized as a standard chemotherapy regimen for patients with metastatic, recurrent or persistent cervical cancer by Gynecologic Oncology Group （GOG）, had also survival benefit as an adjuvant therapy. Therefore, it may be worth considering a prospective randomized controlled trial （RCT） of adjuvant chemotherapy alone using TP regimen versus adjuvant RT as an alternative adjuvant therapy. Because early-stage cervical cancer is a curable condition, it is necessary that the therapeutic strategies should be improved with considering adverse events and QOL for long-term survivors.

Establishment and verification of a surgical prognostic model for cervical spinal cord injury without radiological abnormality

Some studies have suggested that early surgical treatment can effectively improve the prognosis of cervical spinal cord injury without radiological abnormality, but no research has focused on the development of a prognostic model of cervical spinal cord injury without radiological abnormality. This retrospective analysis included 43 patients with cervical spinal cord injury without radiological abnormality. Seven potential factors were assessed: age, sex, external force strength causing damage, duration of disease, degree of cervical spinal stenosis, Japanese Orthopaedic Association score, and physiological cervical curvature. A model was established using multiple binary logistic regression analysis. The model was evaluated by concordant profiling and the area under the receiver operating characteristic curve. Bootstrapping was used for internal validation. The prognostic model was as follows: logit(P) =-25.4545 + 21.2576 VALUE + 1.2160SCORE-3.4224 TIME, where VALUE refers to the Pavlov ratio indicating the extent of cervical spinal stenosis, SCORE refers to the Japanese Orthopaedic Association score(0–17) after the operation, and TIME refers to the disease duration(from injury to operation). The area under the receiver operating characteristic curve for all patients was 0.8941(95% confidence interval, 0.7930–0.9952). Three factors assessed in the predictive model were associated with patient outcomes: a great extent of cervical stenosis, a poor preoperative neurological status, and a long disease duration. These three factors could worsen patient outcomes. Moreover, the disease prognosis was considered good when logit(P) ≥-2.5105. Overall, the model displayed a certain clinical value. This study was approved by the Biomedical Ethics Committee of the Second Affiliated Hospital of Xi'an Jiaotong University, China(approval number: 2018063) on May 8, 2018.

Tenosynovial giant cell tumor involving the cervical spine: A case report

BACKGROUND Tenosynovial giant cell tumors(TGCTs)are a frequent benign proliferative disease originating from the synovial membrane.However,TGCTs rarely occur in the spine.The purpose of this paper is to report a case of TGCT occurring in the cervical spine.Although the disease is rare,it is essential to consider the possibility of TGCT in axial skeletal lesions.Awareness of spinal TGCTs is important because their characteristics are similar to common spinal tumor lesions.CASE SUMMARY A 49-year-old man with a 2-year history of neck pain and weakness in both lower extremities was referred to our ward.Imaging revealed a mass extending from the left epidural space to the C4-5 paravertebral muscles with uneven enhancement.The tumor originated in the synovium of the C4-5 lesser joint and eroded mainly the C4-5 vertebral arch and spine.Puncture biopsy was suggestive of a giant cellrich lesion.The patient had pulmonary tuberculosis,and we first administered anti-tuberculosis treatment.After the preoperative requirements of the antituberculosis treatment were met,we used a posterior cervical approach to completely remove the mass after fixation with eight pedicle screws.The mass was identified as a TGCT by postoperative immunohistochemical analysis.Recurrence was not detected after 1 year of follow-up.CONCLUSION Spinal TGCTs are often misdiagnosed.The radiological changes are not specific.The ideal treatment comprises complete excision with proper internal fixation,which can significantly reduce postoperative recurrence.

Anterior and Posterior Approach Results for Treatment of Cervical Myelopathy in the Elderly: A 10-Year Experience in a Mexican Institution

Introduction: Degeneration of the cervical spine (CDSD) prevalence is nearly 90% by the 7th decade. This is the first research that compares the outcomes between the Anterior Approach (AA) and Posterior Approach (PA) to cervical myelopathy (CM) in the elderly. Materials and Methods: A retrospective observational study of electronic health records at the Hospital Central Sur de Alta Especialidad (HCSAE), PEMEX from January 2010 to May 2020 with patients older than 60 years submitted to cervical surgery. For the analysis we elaborated two groups according to the surgical approach: AA vs PA;we analyzed the trans-operative behavior, the immediate outcome, and after 3 months, 6 months, and 1 year. Results: As a total of 145 patients, the prevalence of CM in elderly was the 63.8% with a median age of 69 (64 - 75) years. We found statistical differences in strength outcome only in the P3m (p = 0.011), for sensitivity we found major prevalence of affection in the PA group. We didn’t report a significant difference in the Neck Disability Index (NDI) at all measures, but the PA presented a major incapacity. The Nurick scale results were significant in all stages (p < 0.05);and presented improvement compared with presurgical period (p < 0.001). Discussion: Patients show significant improvements in outcome measures with either anterior or posterior surgery. Both approaches are highly efficacious in preventing neurologic deterioration and in most cases improve neurological function with appropriate postoperative management like rehabilitation, pain management, and psychological support. Conclusion: The patients submitted to surgical medullary decompression presented a favorable outcome despite the age and the higher prevalence of comorbidities;whereby we favor the surgical treatment in all patients in a case-to-case selection to generate a positive impact on functional outcomes.

Evaluation of Therapeutic Effect of Maneuver-Dominated Method in 30 Cases of Cervical Spondylotic Myelopathy

Thirty cases of cervical spondylotic myelopathy (CSM) were treated by a maneuver-dominated non-surgical therapy. Eighteen cases were recovered to grade E according to the criteria set by the American Spinal Injury Association. The effect was definite. Indications and contraindications of the maneuver were proposed on the basis of the pathogenesis of CSM and the principles of this manual method.

Neck pain and absence of cranial nerve symptom are clues of cervical myelopathy mimicking stroke:Two case reports

BACKGROUND Cervical myelopathy is a potential stroke imitator,for which intravenous thrombolysis would be catastrophic.CASE SUMMARY We herein present two cases of cervical myelopathy.The first patient presented with acute onset of right hemiparesis and urinary incontinence,and the second patient presented with sudden-onset right leg monoplegia.The initial diagnoses for both of them were ischemic stroke.However,both of them lacked cranial nerve symptom and suffered neck pain at the beginning of onset.Their cervical spinal cord lesions were finally confirmed by cervical computed tomography.A literature review showed that neck pain and absence of cranial nerve symptom are clues of cervical myelopathy.CONCLUSION The current report and the review remind us to pay more attention to these two clues in suspected stroke patients,especially those within the thrombolytic time window.

儿童颈椎神经弓中心软骨联合形态发育的数字解剖学特征

背景:随着国内外学者对儿童颈椎相关疾病重视程度的提升,探知不同年龄儿童颈椎形态发育解剖学指标及变化规律的需求不断提高。目的:通过测量1-6岁儿童C_(2)-C_(7)神经弓中心软骨联合解剖学位置指标,探讨及分析儿童不同年龄和椎序间形态发育的变化规律。方法:回顾性收集了省级三甲医院1-6岁儿童正常颈椎CT影像资料160例,按照1周岁为一个年龄组分6组,将连续扫描的颈椎断层影像原始数据导入Mimics 16.0软件中,在二维图像窗口下,选择Measurements测量工具分别在冠状面及横断面上对颈椎C_(2)-C_(7)节段神经弓中心软骨联合的解剖学位置指标进行测量和分析。结果与结论:①C_(2)-C_(7)神经弓中心软骨联合两侧间距离、神经弓中心软骨联合左右侧与横突的距离均随着年龄增长逐渐增大,各颈椎节段椎骨整体发育较神经弓中心软骨联合骨化速度快;②C_(2)-C_(7)神经弓中心软骨联合两侧横断面夹角随年龄增长逐渐增大、神经弓中心软骨联合左右侧与椎体前后缘的夹角均逐渐减小,颈椎节段神经弓中心软骨联合两侧趋于向椎弓部位生长,主要促进椎弓的生长发育;③除C_(7)以外,其他椎段随着颈椎下行神经弓中心软骨联合两侧冠状面夹角变化较小,颈椎的神经弓中心软骨联合更偏向于纵向生长与骨化;④C_(7)的神经弓中心软骨联合位置变化与其余颈椎节段有明显差异;⑤儿童C_(2)-C_(7)神经弓中心软骨联合位置解剖学指标在不同年龄段和不同椎体之间有明显发育规律,且这些规律有助于儿童颈椎疾病的临床诊断与治疗。

九十一种炎症蛋白与颈椎间盘退变的因果关系

背景:颈椎间盘退变是一种常见的退行性疾病,而炎症蛋白在颈椎间盘退变中起到重要作用,但其中的具体机制仍有待深入研究。目的:采用孟德尔随机化方法来评估91种炎症蛋白与颈椎间盘退变之间的潜在因果关系。方法:获取91种炎症蛋白的全基因组关联分析统计数据(从GCST90274758到GCST90274848)和芬兰数据库中颈椎间盘退变的全基因组关联分析数据(finngen_R10_M13_CERVICDISCV)。采用逆方差加权法、MR-Egger回归法、加权中位数法、加权模型法和简单模型法来研究炎症蛋白与颈椎间盘退变之间的因果关系。敏感性分析检验孟德尔随机化分析结果是否可靠,然后以同样方法进行反向孟德尔随机化分析。结果与结论:①正向分析结果表明,共有6种炎症蛋白与颈椎间盘退变有显著的因果关系,其中胶质细胞系源性神经营养因子水平(OR=1.095,95%CI:1.012-1.184,P=0.023)、白细胞介素4水平(OR=1.094,95%CI:1.002-1.194,P=0.045)和单核细胞趋化蛋白1水平(OR=1.062,95%CI:1.001-1.127,P=0.048)与颈椎间盘退变风险呈直接的正向因果关联;白细胞介素17 C水平(OR=0.906,95%CI:0.839-0.979,P=0.013)、白细胞介素18水平(OR=0.924,95%CI:0.866-0.986,P=0.017)和白细胞介素2水平(OR=0.894,95%CI:0.821-0.973,P=0.010)与颈椎间盘退变风险呈直接的负向因果关联。②反向分析结果表明,当颈椎间盘退变作为暴露数据时,与91种炎症蛋白均不具有显著因果关系。③敏感性分析结果显示:双向孟德尔随机化的Cochran’s Q检验、MR-Egger回归法和MR-PRESSO结果P值均大于0.05,表明炎症蛋白与颈椎间盘退变之间的因果效应分析不存在显著的异质性和多效性。④上述结果证实,胶质细胞系源性神经营养因子水平、白细胞介素4水平、单核细胞趋化蛋白1水平、白细胞介素17C水平、白细胞介素18水平和白细胞介素2水平与颈椎间盘退变之间可能具有较为显著的潜在因果关系,这为研究颈椎间盘退变潜在的机制、探索颈椎间盘退变的早期防治以及相关的药物治疗提供了有价值的线索。

Etiology for Degenerative Disc Disease

Degenerative disc disease is a multifaceted progressive irreversible condition and an inevitable part of aging,which has been found to be a contributing factor for low back pain and might cause radiculopathy,myelopathy,spinal stenosis,degenerative spondylolisthesis,and herniations.Its etiology is complex and multifactorial.Although genetics influence more dominant,the occupational and mechanical influences still persist as a major risk factor.This review emphasizes up-to-date knowledge regarding etiology of disc degeneration with special consideration on occupational,lifestyle factors,and genetic polymorphisms.

Abnormalities of uterine cervix in women with inflammatory bowel disease

AIM： To evaluate the prevalence of abnormalities of the uterine cervix in women with inflammatory bowel disease （IBD） when compared to healthy controls. METHODS： One hundred and sixteen patients with IBD [64 with Crohn＇s disease （CD） and 52 with ulcerative colitis （UC）] were matched to 116 healthy controls by age （＋/- 2 years） at the time of most recent papanicolaou （Pap） smear. Data collected consisted of age, race, marital status, number of pregnancies, abortions/miscarriages, duration and severity of IBD, Pap smear results within five years of enrollment, and treatment with immunosuppressive drugs. Pap smear results were categorized as normal or abnormal including atypical squamous cells of undetermined significance （ASCUS）, low-grade squamous intraepithelial lesion （LGSIL）, and high-grade squamous intraepithelial lesion （HGSIL）. RESULTS： The median age at the time of Pap smear was 46 （range： 17-74） years for the IBD group and matched controls （range： 19-72 years）. There were more Caucasian subjects than other ethnicities in the IBD patient group （P = 0.025）, as well as fewer abortions （P = 0.008）, but there was no significant difference regarding marital status. Eighteen percent of IBD patients had abnormal Pap smears compared to 5% of controls （P = 0.004）. Subgroup analysis of the IBD patients revealed no significant differences between CD and UC patients in age, ethnicity, marital status, number of abortions, disease severity, family history of IBD, or disease duration. No significant difference was observed in the number of abnormal Pap smears or the use of immunosuppressive medications between CD and UC patients CP = 0.793）. No definitive observation could be made regarding HPV status, as this was not routinely investigated during the timeframe of our study. CONCLUSION： Diagnosis of IBD in women is related to an increased risk of abnormal Pap smear, while type of IBD and exposure to immunosuppressive medications are not. This has significant implications for women with IBD in that Pap smear screening protocols should be conscientiously followed, with appropriate investigation of abnormal results.

Kikuchi-Fujimoto disease:A comprehensive review

Kikuchi-Fujimoto disease,a rare form of necrotizing lymphadenitis,is an uncommon,benign,self-limiting disorder of obscure etiology.It affects mostly young adults of both genders.Clinically,it presents with fever and lymphadenopathy of a firm to rubbery consistency frequently involving cervical lymph nodes while weight loss,splenomegaly,leucopenia,and elevated erythrocyte sedimentation rate feature in severely affected patients.Cutaneous involvement occurs in about 30%-40%of cases as facial erythema and nonspecific erythematous papules,plaques,acneiform or morbilliform lesions of great histologic heterogeneity.Both Kikuchi-Fujimoto disease and systemic lupus erythematosus share an obscure and complex relationship as systemic lupus erythematosus may occasionally precede,develop subsequently,or sometimes be associated concurrently with Kikuchi-Fujimoto disease.It is often mistaken for non-Hodgkin lymphoma while lupus lymphadenitis,cat-scratch disease,Sweet’s syndrome,Still’s disease,drug eruptions,infectious mononucleosis,and viral or tubercular lymphadenitis are other common differentials.Fine needle aspiration cytology mostly has features of nonspecific reactive lymphadenitis and immunohistochemistry studies usually show variable features of uncertain diagnostic value.Since its diagnosis is exclusively from histopathology,it needs to be evaluated more carefully;an early lymph node biopsy will obviate the need for unnecessary investigations and therapeutic trials.Its treatment with systemic corticosteroids,hydroxychloroquine,or antimicrobial agents mostly remains empirical.The article reviews clinicoepidemiological,diagnostic,and management aspects of KFD from the perspective of practicing clinicians.