Developing countries suffer the highest burden of cervical cancers but have the lowest resources. Effective cervical cytology screening programme, along with a network of diagnostic and therapeutic colposcopy centres,...Developing countries suffer the highest burden of cervical cancers but have the lowest resources. Effective cervical cytology screening programme, along with a network of diagnostic and therapeutic colposcopy centres, like developed countries, is almost impossible to be reproduced in developing countries. Visual inspection methods [e.g., Visual inspection with Lugol's iodine(VILI) and Visual Inspection with Acetic Acid(VIA)] which are cheaper, require less expertise and have the advantage of possible treatment in one setting have been shown to be effective alternatives. The sensitivity to detect CIN2+, by VIA and VILI, have been shown to be 80% and 91% respectively, with a specificity rate of 92% and 85% respectively. Screening by human papillomavirus(HPV) testing has high sensitivity(96.4%) but low specificity(94.1%) to detect CIN2+, when compared to Pap Smear(sensitivity, 55.4% and specificity, 96.8%). A single lifetime HPV testing in a large unscreened population has been shown to significantlyreduce cervical cancer incidence and mortality when compared to cervical cytology, VIA or no screening. HPV testing of self-collected vaginal specimens also helps to overcome religious and socio-cultural barriers towards pelvic examination amongst women in developing countries. Current HPV testing methods are expensive, skill/infrastructure demanding and takes time to produce results. A cheaper HPV test, called careH PV?, which is able to provide results within 2.5 h and requires minimal skill/infrastructure to operate, was designed for use in developing countries. One stop screen and treat facilities using VIA or rapid HPV testing, and cryotherapy, can overcome non-compliance to follow-up which is a major issue in developing countries. Cure rates of 81.4% for CIN1, 71.4% for CIN2 and 68.0% for CIN3 at 6 mo after treatment have been reported. Incorporating telemedicine with cervicography of VIA or VILI or even telecolposcopy, has great potential in cervical cancer screening, especially in countries with vast geographical areas.展开更多
目的探讨维生素C注射液(VCS)脱碘对内镜下食管碘染色的老年病人舒适度及护理满意度的影响。方法利用随机数表法将2019年3~4月南京医科大学第一附属医院52例内镜下食管碘染色后脱碘处理的老年病人(>60岁),随机分为VCS组和生理盐水(NS)...目的探讨维生素C注射液(VCS)脱碘对内镜下食管碘染色的老年病人舒适度及护理满意度的影响。方法利用随机数表法将2019年3~4月南京医科大学第一附属医院52例内镜下食管碘染色后脱碘处理的老年病人(>60岁),随机分为VCS组和生理盐水(NS)组,每组26例。根据Bruggrmann舒适度评分制定舒适度评分表及简易护理满意度量表,对检查结束时和检查后30 min 2组病人的舒适度和护理满意度进行评分和比较分析。结果碘染后急性症状主要为胸骨后不适,迟发反应以上腹部不适为主。检查结束时VCS组的胸骨后不适发生率明显低于NS组(P=0.02);检查后30 min VCS组咽喉不适较NS组明显缓解(P=0.02)。VCS组护理满意度总评分、沟通与解释和专业水平评分均高于NS组(均P<0.05)。结论VCS脱碘能显著改善老年病人碘染后的胸骨后不适和咽喉部不适,提高护理满意度。展开更多
基金Supported by fellowships from the Prime Minister of AustraliaAsia Endeavour Award,Ministry of Higher Education,Malaysiaand University Technologi MARA,Malaysia
文摘Developing countries suffer the highest burden of cervical cancers but have the lowest resources. Effective cervical cytology screening programme, along with a network of diagnostic and therapeutic colposcopy centres, like developed countries, is almost impossible to be reproduced in developing countries. Visual inspection methods [e.g., Visual inspection with Lugol's iodine(VILI) and Visual Inspection with Acetic Acid(VIA)] which are cheaper, require less expertise and have the advantage of possible treatment in one setting have been shown to be effective alternatives. The sensitivity to detect CIN2+, by VIA and VILI, have been shown to be 80% and 91% respectively, with a specificity rate of 92% and 85% respectively. Screening by human papillomavirus(HPV) testing has high sensitivity(96.4%) but low specificity(94.1%) to detect CIN2+, when compared to Pap Smear(sensitivity, 55.4% and specificity, 96.8%). A single lifetime HPV testing in a large unscreened population has been shown to significantlyreduce cervical cancer incidence and mortality when compared to cervical cytology, VIA or no screening. HPV testing of self-collected vaginal specimens also helps to overcome religious and socio-cultural barriers towards pelvic examination amongst women in developing countries. Current HPV testing methods are expensive, skill/infrastructure demanding and takes time to produce results. A cheaper HPV test, called careH PV?, which is able to provide results within 2.5 h and requires minimal skill/infrastructure to operate, was designed for use in developing countries. One stop screen and treat facilities using VIA or rapid HPV testing, and cryotherapy, can overcome non-compliance to follow-up which is a major issue in developing countries. Cure rates of 81.4% for CIN1, 71.4% for CIN2 and 68.0% for CIN3 at 6 mo after treatment have been reported. Incorporating telemedicine with cervicography of VIA or VILI or even telecolposcopy, has great potential in cervical cancer screening, especially in countries with vast geographical areas.
文摘目的探讨维生素C注射液(VCS)脱碘对内镜下食管碘染色的老年病人舒适度及护理满意度的影响。方法利用随机数表法将2019年3~4月南京医科大学第一附属医院52例内镜下食管碘染色后脱碘处理的老年病人(>60岁),随机分为VCS组和生理盐水(NS)组,每组26例。根据Bruggrmann舒适度评分制定舒适度评分表及简易护理满意度量表,对检查结束时和检查后30 min 2组病人的舒适度和护理满意度进行评分和比较分析。结果碘染后急性症状主要为胸骨后不适,迟发反应以上腹部不适为主。检查结束时VCS组的胸骨后不适发生率明显低于NS组(P=0.02);检查后30 min VCS组咽喉不适较NS组明显缓解(P=0.02)。VCS组护理满意度总评分、沟通与解释和专业水平评分均高于NS组(均P<0.05)。结论VCS脱碘能显著改善老年病人碘染后的胸骨后不适和咽喉部不适,提高护理满意度。
