POPULARITY
3 episodes with Colposcopy
2 episodes with Colposcopy
2 episodes with Colposcopy
2 episodes with Colposcopy
2 episodes with Colposcopy
A safe alternative to clinician-administered tests, the self-test for HPV can help prevent cervical cancer. Synopsis: Every first Wednesday of the month, The Straits Times helps you make sense of health matters that affect you. HPV or the human papillomavirus is a common virus that is sexually transmitted, and while most HPV infections clear on their own, persistent infections with high-risk types can lead to cervical cancer. In March 2025, the Society for Colposcopy & Cervical Pathology of Singapore (SCCPS) published an updated set of national cervical cancer screening guidelines. The guidelines now recommend HPV self-sampling as an option to traditional cervical cancer screening methods. In Singapore, cervical cancer is currently the 11th most common cancer in women, with 309 new cases and 172 deaths in 2023, according to data from the Catalan Institute of Oncology (ICO) and the International Agency for Research on Cancer (IARC) Information Centre on HPV and Cancer. However, cervical cancer is one of the most preventable and treatable forms of cancer, as long as it is detected early and managed effectively, said the World Health Organisation (WHO). It aims to eliminate cervical cancer as a public health problem by 2030, with the following strategy: Vaccinate 90 per cent of girls with preventive HPV vaccines by age 15; Screen 70 per cent of women with a high-performance test like HPV DNA screening by age 35, and again by age 45; Treat 90 per cent of women who have precancerous cells in the cervix or cervical cancer. In this episode, senior health correspondent Joyce Teo speaks to Dr Felicia Chin, an obstetrician and gynaecological oncologist at Gynae Onco Partners about HPV DNA self-testing, what it entails, and who should screen for cervical cancer. Until late last year, Dr Chin was a senior consultant at KK Women’s and Children’s Hospital. She sits on the SCCPS committee. Highlights (click/tap above) 1:54 Explaining the various tests for cervical cancers 3:14 Guidelines for cervical cancer screening in Singapore 4:32 How does HPV self-sampling work? 5:23 Difference between a self-test and a pap smear 13:42 Cervical cancer symptoms Read Joyce Teo's stories: https://str.sg/JbxN Host: Joyce Teo (joyceteo@sph.com.sg) Produced and edited by: Amirul Karim & Eden Soh Executive producers: Ernest Luis and Lynda Hong Follow Health Check Podcast here and get notified for new episode drops: Channel: https://str.sg/JWaN Apple Podcasts: https://str.sg/JWRX Spotify: https://str.sg/JWaQ Feedback to: podcast@sph.com.sg --- Follow more ST podcast channels: All-in-one ST Podcasts channel: https://str.sg/wvz7 ST Podcasts website: http://str.sg/stpodcasts ST Podcasts YouTube: https://str.sg/4Vwsa --- Get The Straits Times app, which has a dedicated podcast player section: The App Store: https://str.sg/icyB Google Play: https://str.sg/icyX --- #healthcheckSee omnystudio.com/listener for privacy information.
A safe alternative to clinician-administered tests, the self-test for HPV can help prevent cervical cancer. Synopsis: Every first Wednesday of the month, The Straits Times helps you make sense of health matters that affect you. HPV or the human papillomavirus is a common virus that is sexually transmitted, and while most HPV infections clear on their own, persistent infections with high-risk types can lead to cervical cancer. In March 2025, the Society for Colposcopy & Cervical Pathology of Singapore (SCCPS) published an updated set of national cervical cancer screening guidelines. The guidelines now recommend HPV self-sampling as an option to traditional cervical cancer screening methods. In Singapore, cervical cancer is currently the 11th most common cancer in women, with 309 new cases and 172 deaths in 2023, according to data from the Catalan Institute of Oncology (ICO) and the International Agency for Research on Cancer (IARC) Information Centre on HPV and Cancer. However, cervical cancer is one of the most preventable and treatable forms of cancer, as long as it is detected early and managed effectively, said the World Health Organisation (WHO). It aims to eliminate cervical cancer as a public health problem by 2030, with the following strategy: Vaccinate 90 per cent of girls with preventive HPV vaccines by age 15; Screen 70 per cent of women with a high-performance test like HPV DNA screening by age 35, and again by age 45; Treat 90 per cent of women who have precancerous cells in the cervix or cervical cancer. In this episode, senior health correspondent Joyce Teo speaks to Dr Felicia Chin, an obstetrician and gynaecological oncologist at Gynae Onco Partners about HPV DNA self-testing, what it entails, and who should screen for cervical cancer. Until late last year, Dr Chin was a senior consultant at KK Women’s and Children’s Hospital. She sits on the SCCPS committee. Highlights (click/tap above) 1:54 Explaining the various tests for cervical cancers 3:14 Guidelines for cervical cancer screening in Singapore 4:32 How does HPV self-sampling work? 5:23 Difference between a self-test and a pap smear 13:42 Cervical cancer symptoms Read Joyce Teo's stories: https://str.sg/JbxN Host: Joyce Teo (joyceteo@sph.com.sg) Produced and edited by: Amirul Karim & Eden Soh Executive producers: Ernest Luis and Lynda Hong Follow Health Check Podcast here and get notified for new episode drops: Channel: https://str.sg/JWaN Apple Podcasts: https://str.sg/JWRX Spotify: https://str.sg/JWaQ Feedback to: podcast@sph.com.sg --- Follow more ST podcast channels: All-in-one ST Podcasts channel: https://str.sg/wvz7 ST Podcasts website: http://str.sg/stpodcasts ST Podcasts YouTube: https://str.sg/4Vwsa --- Get The Straits Times app, which has a dedicated podcast player section: The App Store: https://str.sg/icyB Google Play: https://str.sg/icyX --- #healthcheckSee omnystudio.com/listener for privacy information.
Following months of extensive refurbishment, the Vieux Fort Wellness Centre has reopened, offering residents of Vieux Fort and surrounding communities access to upgraded healthcare services in a safer and improved facility. The Centre resumed operations on January 20, 2025, after its closure in October 2024 due to air quality concerns caused by mold infestation and underlying maintenance issues. Jenny Daniel, Permanent Secretary in the Ministry of Health, Wellness, and Elderly Affairs, highlighted the necessity of these interventions. The Men's Health Clinic focuses on preventive care and chronic disease management, particularly prostate health and overall wellness. Meanwhile, the Colposcopy Clinic provides specialized evaluation and management of cervical health concerns for women. Residents are encouraged to utilize the expanded services available at the Vieux Fort Wellness Centre. Operating hours are Monday to Friday, 8:00 AM to 4:30 PM, and Saturdays, 8:00 AM to 12:30PM.
CC395: On this month's bonus episode... Lindsie and Kail ask their children to do as they say, and not as they do. Kail talks about new tax breaks and her stance on them as someone who came from poverty. Lindsie goes through her recent Instagram stories that had Kail and Elijah laughing in their beds the night before. Kail explains to Lindsie a new term, but not a new concept, called future faking. Listeners ask, how long should an engagement should last? And today's Foul Play teaches us about Colposcopy.. Thank you to our sponsor! Branch Basics: Get 15% off Branch Basics with the code coffee at branchbasics.com/coffee #branchbasicspod CookUnity: Go to cookunity.com/coffeeconvos or enter code COFFEECONVOS before checkout for 50% off your first week. DraftKings: Download the DraftKings Casino app and sign up with promo code COFFEE Thrive Causemetics: Get an exclusive 20% off your first order when you visit thrivecausemetics.com/COFFEE
Episode 182: HPV VaxFuture Dr. Zuaiter and Dr. Arreaza briefly discuss HPV infection but pocus on the prevention of the infection with the vaccine. Dr. Arreaza mentions that HPV vaccine is also recommended by ASCCP to medical professionals. Written by Amanda Zuaiter, MS4, Ross University School of Medicine. Edits and comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Human Papilloma Virus (HPV).According to the World Health Organization, cervical cancer is the 4th most common cancer affecting women globally. Annually, there are over 600,00 new cases and more than 300,000 deaths. The leading cause of cervical cancer is HPV. HPV, or human papillomavirus, is a prevalent virus that is spread through close skin-to-skin contact, mainly by sexual intercourse. It is the most common sexually transmitted disease in the United States. The term STI and STD are used indistinctively, but some people make a difference, such as Dr. Cornelius Reitmeijer. STI refers to sexually transmitted infection, which can be asymptomatic, and STD stands for sexually transmitted disease, which are the signs and symptoms caused by the multiplication of the infectious agent and disruption of bodily functions. STI is the preferred term, as recommended by experts during the last few years. Low risk vs High risk HPV.There are over 200 strains of HPV which fall into two categories: low risk and high risk. The low-risk types, HPV 6 and 11, cause warts around the genitals, anus, mouth or throat. The high-risk types, HPV 16 and 18, are linked to cervical, vaginal, anal, and other cancers. Persistent infection with high-risk HPV types is the primary cause of cervical cancer, accounting for 70% of cervical cancer cases. While often asymptomatic, persistent HPV infections can develop into papular lesions which can cause bleeding and pain or cause sore throat and hoarseness if warts develop in the throat.Not all warts will turn into cancer, but the risk of a wart turning into cancer is higher than normal skin or mucosa that has not been infected by HPV.Even though cervical cancer is the most well-known condition linked to HPV, it's important to note that HPV isn't just a women's health issue. It can also cause cancers in men, such as throat, penile and anal cancers. Men, however, are not screened for HPV if they have no signs or symptoms of infection.HPV Prevention: General measures that can be taken are maintaining a healthy immune system by exercising regularly and a balanced diet and quitting smoking.Male circumcision has been shown to reduce the risk of penile cancer in men and their sexual partners may have a lower risk of cervical cancer. Screening: Women should undergo regular pap smears with HPV screening. Pap smear screening begins at the age of 21 and is recommended every 3 years. From ages 30-65, co-testing should be done every 5 years, according to the guidelines by the American College of Obstetrics and Gynecology. Also, HPV test self-collection is now available in the US since May 2024, and it is useful especially in rural areas.The most effective ways to prevent the transmission of HPV is to practice safe sex, using condoms, and getting vaccinated. HPV vaccine. For medical providers: It was announced only to ASCP (American Society for Colposcopy and Cervical Pathology) members in the middle of the pandemic. On February 19, 2020, ASCCP recommended HPV vaccination for clinicians routinely exposed to the virus.This recommendation encompasses the complete health care team, including but not limited to, physicians, nurse practitioners, nurses, residents, and fellows, as well as office and operating room staff in the fields of obstetrics and gynecology, family practice, gynecologic oncology, and dermatology. Let's remember that in 2018, the FDA a supplemental application for Gardasil 9 to include persons aged 27 to 45 years old. The ASCCP letter states “While there is limited data on occupational HPV exposure, ASCCP, as well as other medical societies, recommend that members actively protect themselves against the risks” among medical providers. For patients: The vaccine is given to prevent the types of HPV that are most likely to cause cancer and other health problems. It works by training the immune system to recognize and fight HPV before an infection can take hold. Gardasil-9® is the brand name that is offered in the US. The 9 means it targets 9 strains of the virus (6, 11, 16, 18, 31, 33, 45, 52, and 58). It's important to note that the vaccine is preventative, and it is not considered a treatment. This means it's most effective when given BEFORE any exposure to HPV, ideally during adolescence. The HPV vaccine is recommended for boys and girls ages 11-12 but can be started as early as the age of 9. We need to be prepared to manage vaccine hesitancy because some parents may be concerned when you explain the vaccine to them. A study done in Scotland found that there were NO cases of invasive cervical cancer in adults who received any doses of the HPV vaccine at 12 to 13 years of age. To get to that conclusion, they reviewed the cancer data of 447,845 women who were born between 1988 and 1996. The data demonstrated that the HPV vaccine prevents invasive cervical cancer, especially when given between 12 to 13 years of age. When the vaccine is given later in life, it tends to be less effective. AmandaHow is HPV vaccine given?The vaccine schedule is as follows: -For ages 9-14, two shots are given with the second dose 6-12 months after the first. -For those ages 15-26, three shots are given. After the first shot, the second is given after 1-2 months, and the third shot 6 months after the first. This is the same schedule for immunocompromised people regardless of their age. -People over the age of 26 can still receive the vaccine, as the FDA has approved the vaccine for individuals up to the age of 45. With that being said, those over the age of 26 may not fully benefit from the vaccine due to the fact they may have already been exposed to HPV. Still, vaccination can provide protection against other strains of the virus.Other HPV Vaccine considerations:Is HPV vaccine effective?-Studies have shown that the HPV vaccine is nearly 100% effective at preventing cervical pre-cancers caused by HPV 16 and 18.Are boosters needed?-The vaccine provides protection for at least 10 years and boosters are not required. The vaccine is recommended for boys too, as they are also at risk for HPV causing cancers, and administration of the vaccine helps to reduce the spread of the virus. It is safe to administer the HPV vaccine with all other age-appropriate vaccinations. What if my patient misses a dose?-If a dose is missed, it can be resumed at any time without restarting the series. There are no known severe side effects or reactions to the vaccine. The vaccine can be given even if the person has already been exposed to HPV as it can protect against the other types of HPV.Conclusion: HPV is a common cause of cervical cancer, and the benefits of the HPV vaccine are profound. Countries with high vaccination rates have already seen significant drops in HPV infections, genital warts, and cervical pre-cancers. Vaccination protects individuals and helps achieve herd immunity, benefiting entire communities.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Sabour, Jennifer, “The Difference Between STD and STI,” Verywell Health, August 22, 2024, https://www.verywellhealth.com/std-vs-sti-5214421. ASCCP Letter, February 19, 2020, https://www.asccp.org/hpv-vaccinationBarry HC. Scottish Screening: No Cases of Invasive Cervical Cancer in Women Who Received At least One Dose of Bivalent HPV Vaccine at 12 or 13 Years of Age. Am Fam Physician. 2024 Aug;110(2):201-202. PMID: 39172683. https://pubmed.ncbi.nlm.nih.gov/39172683/World Health Organization. “Cervical Cancer,” March 5, 2024, www.who.int/news-room/fact-sheets/detail/cervical-cancerACOG, “Cervical Cancer Screening FAQ,” www.acog.org/womens-health/faqs/cervical-cancer-screening. Accessed January 9, 2025.ACOG, “HPV Vaccination FAQ,” www.acog.org/womens-health/faqs/hpv-vaccination. Accessed January 9, 2025.Cox, J. Thomas and Joel M Palefsky, UpToDate, www.uptodate.com/contents/human-papillomavirus-vaccination, accessed January 9, 2025.National Cancer Institute. “HPV and Cancer.” National Cancer Institute, 18 Oct. 2023, www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer .Theme song, Works All the Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.
Episode 176: Self-sampling for HPV screeningFuture Dr. Markarian explains the importance of HPV screening for the prevention of cervical cancer. Dr. Arreaza adds some insight about cervical cancer.Written by Chantal Markarian, MSIV, American University of the Caribbean. Editing and comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Insights into Cervical Cancer.Chantal: Cervical cancer stands as the most prevalent form of cancer in women globally costing the lives of approximately 350,000 women annually. About 4,000 women die of cervical cancer a year in the US. Cervical cancer is initially asymptomatic, allowing it to advance to a more severe stage if not detected early. The positive news is that cervical cancer is highly preventable through screening for precancerous lesions or the presence of HPV —the primary culprit behind most cases.The role of HPV: Human Papilloma Virus, according to the World Health Organization, caused an estimated 620,000 cancer cases in women and 70,000 cancer cases in men.Cervical cancer is more prevalent in certain regions. In regions with established screening initiatives, the incidence rate and mortality rate of cancer are lower than in resource-limited areas. This highlights that resource-constrained countries continue to bear a burden of this disease. In nations like the United States, access to the HPV vaccine along with routine screenings, like Pap smears and HPV tests has significantly decreased the prevalence of cervical cancer.Screening recommendations from the US Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS).The U.S Preventive Services Task Force advises that women aged 21 to 29 undergo a Pap test every three years while those aged 30 to 65 should opt for co-testing (Pap and HPV tests) every five years. These examinations are usually conducted in outpatient facilities, where a medical professional collects a sample of cervical cells that are later examined under a microscope.A normal result states that the sample was adequate for evaluation, in other words, that endocervical/transformation zone components are present, and that the patient is “Negative for intraepithelial lesion or malignancy.” ACS recommends cervical cancer screening begin at age 25 for women and people with a cervix. Those aged 25 to 65 should have a primary HPV test every 5 years. (A primary HPV test means the HPV test is done without cytology; follow-up screening can be done with a Papanicolaou (Pap) test if needed.) If primary HPV testing is not available, screening may be done with either a co-test every 5 years, which combines an HPV test with a Papanicolaou (Pap) test, or a Pap test alone every 3 years. How is Cervical Cancer Classified?Two systems categorize lesions: the Cervical Intraepithelial Neoplasia (CIN) scale and the Bethesda system.The CIN scale categorizes lesions based on the degree of involvement of the cervical lining ranging from mild (CIN I) to moderate (CIN II) to severe dysplasia (CIN III).The Bethesda system emphasizes cytological findings organizing results into categories such as atypical squamous cells, low-grade lesions (LSIL), and high-grade lesions (HSIL).ASCUS (Atypical Squamous Cells of Undetermined Significance) is the most common abnormality seen in pap smears. It may or may not indicate a problem, you have to make a decision based on the patient. Cervical cancer is largely linked to high-risk HPV (hrHPV), mostly HPV 16 and 18, and scientists are investigating tests that identify hrHPV DNA or RNA. These tests may provide a more accurate evaluation of cancer risk compared to traditional cytology. Examples include DNA amplification tests like Cobas test and the Xpert HPV test.Obstacles to Screening.Despite the efficacy of cervical cancer screening, many women face many obstacles to testing. In regions with limited resources, fear, embarrassment, lack of awareness, and restricted healthcare access pose challenges to screening.In Nigeria, a study revealed that women often avoid Pap smears due to a lack of awareness. Similarly, healthcare providers in Ecuador highlighted issues like the absence of screening programs and inadequate health promotion efforts. Women in Peru face obstacles such as long waiting times preferences for female healthcare providers and limited access to health facilities. In 2022, 31% of minority women in the US did not undergo Pap smears in the past three years; many of these women were uninsured, unemployed, or low-income. These challenges contribute to higher rates of cervical cancer among women who do not follow recommended screening guidelines.We must mention the cultural obstacle as well. Some cultures do not allow any kind of pelvic exams before marriage. They put a major emphasis on being a “virgin,” and placing a speculum in the vagina may be considered culturally unacceptable. In those cases, the doctor has to use their best persuasion skills to accomplish the goals of care. For example, they may suggest having the mother in the room during the pap smear, using the smallest speculum possible, or other techniques.Self-sampling.In 2020, the World Health Organization (WHO) introduced a global initiative to combat cervical cancer worldwide. The initiative aims to:Vaccinate 90% of girls by age 15.Screen 70% of women by age 35.Treat 90% of women with lesions and invasive cancer by 2030.To achieve these goals, self-sampling for HPV testing has been introduced as a viable option for cervical cancer screening. Self-sampling for HPV testing is seen as an alternative for cervical cancer screening that addresses barriers associated with traditional methods. This approach enables women to take samples themselves using swabs or brushes removing the necessity for a pelvic examination. The option to mail in samples and receive results within two weeks enhances the convenience, privacy, and accessibility of the process giving individuals control over their health.While self-sampling for hrHPV detection is not currently standard practice in the United States, it has been successfully implemented in countries across Europe, Africa, and South America. Pilot studies are ongoing in nations like Canada and New Zealand to assess its effectiveness offering promise for its impact.In May 2024, the Food and Drug Administration (FDA) approved primary HPV self-collection for cervical cancer screening in a health-care setting. That means, the patient still has to go to a clinic to self-collect her sample. How Effective is HPV Self-Sampling?Research supports the accuracy of HPV self-sampling. A study conducted by Polman et al., which involved a randomized controlled trial, demonstrated that HPV tests on self-collected samples were just as precise as those done on samples collected by clinicians in detecting high-grade lesions (CIN II and CIN III). Similarly, a meta-analysis conducted by Arbyn et al. showed no difference in sensitivity or specificity between self-sampled and clinician-sampled tests for detecting CIN grade II or higher.These results indicate that self-sampling could be an adequate screening method for cervical cancer. This reassurance may motivate women to partake in screenings knowing they have a convenient and effective option. Ok, let's say a patient has collected her sample or the sample was collected by a clinician, what is next?Management of Cervical Cancer Screening Results.The process of managing cervical cancer screening results involves evaluating a patient's immediate and five-year risk of developing cervical abnormalities (CIN 3+) following guidelines from the American Society for Colposcopy and Cervical Pathology (ASCCP).The ASCCP app is the best investment you can make in primary care. It is only $9.99, but it can save you a lot of time in clinic. Estimating risk is a process that considers factors such as current HPV test results, past screening outcomes, the patients' age, and whether they've had a hysterectomy or not. When Risk is Elevated, Prompt Action.If a patient's immediate risk of developing CIN 3 exceeds 4%, expedited treatment is typically recommended. This treatment may entail one of several procedures aimed at removing abnormal cervical tissue.Loop Electrosurgical Excision Procedure (LEEP): A common method that removes tissue using an electric wire loop. Cold Knife Conization: In this procedure, a scalpel removes a cone-shaped section of the cervix.Laser Cone Biopsy: This technique involves removing a cone-shaped section of tissue using a laser.Alternatively, healthcare providers may opt for treatment methods such, as cryotherapy, thermos-ablation, and laser ablation to eliminate abnormal tissue.And those procedures are typically out of the scope of family medicine, but many family doctors may perform them with the proper training and experience.When the risk is deemed low, Surveillance.Patients with a risk of CIN 3 below 4% are typically advised to undergo surveillance with HPV testing every 1-5 years. If HPV testing is not available cytology alone (Pap test) is considered acceptable.Special considerations for women.For women under 25, a cautious approach is taken. If a low-grade lesion (LSIL) is identified through cytology, it is recommended to repeat the test annually for two years. If two consecutive tests show normal results the patient can resume screening intervals based on age. However, if a high-grade lesion (HSIL) is detected, a colposcopy and biopsy are recommended. It should be noted that expedited treatment is generally not advised for this age group since many high-grade lesions may resolve spontaneously.For women over 25, the presence of low-grade lesions or persistent high-risk HPV often leads to recommendations for colposcopy and cervical biopsy.When a cervical biopsy shows adenocarcinoma in situ it is suggested to perform an excisional procedure to rule out invasive cancer. The next steps depend on the margins of the excised tissue; If the margins show positive results (indicating abnormal tissue remains) further excision is necessary to ensure clear margins. This may be followed by a hysterectomy due to the risk of residual disease. For individuals who have been treated for high-grade lesions there is still a risk of developing cervical cancer. Therefore, long-term surveillance is essential. Women over 25 should undergo HPV testing six months after treatment, then annually until three consecutive negative tests are obtained. Subsequently testing every three years is advised for 25 years. As for women under 25, cervical cytology should be done six months post-treatment. Then at six-month intervals until three consecutive negative results are achieved. Once they reach 25 years old, they should switch to HPV testing.As summary, HPV is the most common cause of cervical cancer, and screening must be implemented no matter what your zip code is because adequate screening can lead to a lower mortality. Remember that self-collection is an alternative for your patients, and it is FDA-approved if it is done in a healthcare setting. The ASCCP guidelines are very useful but difficult to memorize, so you can invest in the ASCCP phone app to provide accurate care for your patients. Thanks!References: 1. World Health Organization. HPV and Cervical Cancer Fact Sheet. 2024. Available online: https://www.who.int/en/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer (accessed on 10 August 2024).2. Arbyn M, Weiderpass E, Bruni L, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 2020;8(2):e191-e203.3. Serrano B, Ibáñez R, Robles C, Peremiquel-Trillas P, de Sanjosé S, Bruni L. Worldwide use of HPV self-sampling for cervical cancer screening. Preventive Medicine. 2022;154:106900.4. Gupta S, Palmer C, Bik EM, et al. Self-sampling for human papillomavirus testing: increased cervical cancer screening participation and incorporation in international screening programs. Front Public Health. 2018;6:345033.5. Ubah C, Nwaneri AC, Anarado AN, Iheanacho PN, Odikpo LC. Perceived barriers to cervical cancer screening uptake among women of an urban community in South-eastern Nigeria. Asian Pac J Cancer Prev. 2022;23(6):1959-1965.6. Vega Crespo, B., Neira, V.A., Ortíz Segarra, J. et al.Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals. BMC Public Health 22, 2144 (2022). https://doi.org/10.1186/s12889-022-14601-y7.Olaza-Maguiña AF, De la Cruz-Ramirez YM. Barriers to the non-acceptance of cervical cancer screenings (Pap smear test) in women of childbearing age in a rural area of Peru. Ecancermedicalscience. 2019;13:901.8. Sharma M, Batra K, Johansen C, Raich S. Explaining correlates of cervical cancer screening among minority women in the United States. Pharmacy. 2022 Feb 15;10(1):30.9. Polman NJ, Ebisch RMF, Heideman DAM, et al. Performance of human papillomavirus testing on self-collected versus clinician-collected samples for the detection of cervical intraepithelial neoplasia of grade 2 or worse: a randomised, paired screen-positive, non-inferiority trial. The Lancet Oncology. 2019;20(2):229-238.10. Costa S, Verberckmoes B, Castle PE, Arbyn M. Offering HPV self-sampling kits: an updated meta-analysis of the effectiveness of strategies to increase participation in cervical cancer screening. British Journal of Cancer. 2023 Mar 23;128(5):805-13.11. Perkins RB, Guido RS, Castle PE, et al. 2019 ASCCP risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis. 2020;24(2):102-131.12. Straughn, Jr, J Michael, and Catheryn Yashar. “Management of Early-Stage Cervical Cancer.” Www.uptodate.com, 2 Aug. 2024, https://www.uptodate.com/contents/management-of-early-stage-cervical-cancer. Accessed 13 Aug. 2024.13. AMBOSS GmbH.Cervical cancer screening. https://amboss.com/. Accessed August 18, 2024.14. Royalty-free music used for this episode: Lofi-Chilly by Gushito, downloaded on Nov 06, 2023, from https://www.videvo.net
Brittany Chaffee talks about navigating cervical health testing, and recounts the moment she received an alarming call from her doctor, leading to years of anxiety, biopsies, and eventually, a harrowing LEEP procedure. Brittany emphasizes the importance of talking publicly about women's health to combat shame and isolation. Show notes:‘The powerful act of sharing our stories about women's health.' What is a LEEP procedure?What is a colposcopy?More information on cervical cancer screening We're building a community around women's health so that no one is overlooked. You can support the show by:-Subscribing to the Overlooked newsletter on the website: www.overlookedpod.com-Leaving us a review on Apple Podcasts, Spotify, or wherever you listen. -Sharing this episode with someone who will find it useful and relevant.-Write to us and tell us your story: hello@overlookedpod.com
This episode is sponsored by HCA Midwest Health. One of the first of many decisions you'll have to make once you find out you're having a baby is choosing a healthcare practitioner. Some women choose an obstetrician, while others opt for a midwife. Today we are chatting with Kim Boote, a Certified Nurse Midwife with Kansas City Women's Clinic, part of HCA Midwest Health, to learn about the benefits of choosing a midwife. Meet Kim Boote Kim Boote, CNM, MSN, C-EFM is a Certified Nurse Midwife with Kansas City Women's Clinic seeing patients in Kansas City, Olathe, and Lansing, KS. She is affiliated with Overland Park Regional Medical Center. Kim is a member of the American College of Nurse-Midwives (ACNM), the American College of Obstetricians and Gynecologists (ACOG), and the American Society for Colposcopy and Cervical Pathology (ASCCP). She received her Bachelor of Science in Nursing (BSN) from the University of Iowa, her Master of Science in Nursing (MSN) from Case Western Reserve University, and her Nurse-Midwifery certificate from Frontier Nursing University. Kim and her family enjoy vacationing in warm climates where they can hike, snorkel, or just enjoy the ocean. She loves learning where all her patients have traveled to update her bucket list for new destinations. Kim has four kids that keep her busy! Connect with Megan and Sarah We would love to hear from you! Send us an e-mail or find us on Instagram or Facebook!
Relocation of Services from the Castries Wellness Centre The Ministry of Health, Wellness and Elderly Affairs informs the public of the continued closure of Castries Wellness Centre from Tuesday 19 December, 2023. This closure is necessary as the Ministry seeks to ensure a healthy environment for clients and staff. In an effort to ensure that quality healthcare services remain available to the public, services which were offered at the Castries Wellness Centre have been redirected as follows: Medical Clinics and all Primary Health Care Clinics including Antenatal and Child Health clinics, dressings and pap smears, among others, have been redirected to the La Clery Wellness Centre. Clinic days remain the same as were previously conducted at the Castries Wellness Centre, that is from 8:00 a.m. - 4:30 p.m. Monday to Friday. In addition, the Medical Clinic is available on Saturday from 8:00 am – 12:00 p.m. The Dermatology Clinic has been redirected to the Gros Islet Polyclinic. The Podiatry Clinic, Obstetrics/Gynecology Clinic and Phlebotomy Service can be accessed at the Entrepot Wellness Centre. The Medical Internist Clinic will be available at the Grande Riviere Wellness Centre, Monchy Wellness Centre and the Gros Islet Polyclinic. The Diabetic Retinopathy Clinic and Colposcopy services will remain unavailable at this time, and the Ministry will inform the public of the resumption of these services in a subsequent communication. Clients are urged to visit the appropriate Wellness Centre for healthcare services, and to utilize their nearest community Wellness Centre for care in order to preserve or improve their health. The Ministry of Health, Wellness and Elderly Affairs apologizes for any inconvenience that these changes may cause, and thanks the public for its cooperation as we strive to resolve the situation. For further information, please contact the Community Health Services Unit at telephone number 468-5321, 468-5381 or 4685383. SERVICE NEW LOCATION SCHEDULED DAYS Medical Clinic La Clery Wellness Centre Monday to Friday, from 8:00 a.m. to 4:30 p.m. Saturday, from 8:00 a.m. to 12 noon. Primary Health services including: · Antenatal clinic · Child Health clinic · Family Planning · Dressings · Pap Smear La Clery Wellness Centre Monday to Friday, from 8:00 a.m. to 4:30 p.m. Saturday, from 8:00 a.m. to 12 noon. Sexual and Reproductive Health Services Ciceron Wellness Centre Monday to Friday, from 8:00 a.m. to 4:30 p.m. Dermatology Clinic Gros Islet Polyclinic Wednesdays, except the 3rd Wednesday each month. Podiatry Clinic Entrepot Wellness Centre 3rd Wednesday and 4th Friday each month Obstetrics and Gynecology Clinic Entrepot Wellness Centre 4th Monday and 3rd Friday each month Phlebotomy Services Entrepot Wellness Centre Wednesday and Thursday, except the 3rd Wednesday each month Medical Internist Clinic Gros Islet Polyclinic 2nd and 4th Monday each month Medical Internist Clinic Grand Riviere Wellness Centre 1st Friday each month Medical Internist Clinic Monchy Wellness Centre 1st Tuesday each month Pharmacy Services La Clery Wellness Centre Monday to Friday, from 8:00 a.m. to 4:30 p.m. and Saturday from 8:00 a.m. to 12:00 p.m.
For more episodes of MedStar Health DocTalk, go to medstarhealth.org/doctalk.
Welcome and thank you for listening! We are starting a new series: ‘Let's talk about it' addressing the topics we rather don't want to talk about, especially topics that are related to sexual and reproductive health as it is subject to stigma. We are kicking the series off by talking to Sebabatso Tsaoane about Cervical Cancer, what it is, how it can be prevented and treated. Sebabatso is a Multi-award winning Registered Nurse Midwife as an agent of change she constantly goes beyond the call of duty to manifest her vision of healing the nation by healing women. She is the founder and CEO of Black Woman Arise Women's Health Foundation; A non-profit organization aimed at promoting women's sexual reproductive health through de-stigmatization, education and bridging the gap between women in the community and healthcare professionals. Through this NPO, Sebabatso is working on a project to decrease cervical cancer related morbidity and mortality amongst Mangaung Metro women. This is done through taking cervical cancer screening services to disadvantaged and hard to reach areas in the Mangaung Metro Municipality on a mobile clinic in order to raise awareness and promote early detection. Furthermore, she provides training for Nurses in order to improve capacity to provide cervical cancer education and screening. Through partnership with the Department of Health, Sebabatso is working on opening a Colposcopy and LLETZ clinic in one of the District hospitals in order to decentralize precancer treatment and reduce long waiting periods for the women with positive pap smear results. Additionally, Sebabatso provides training for traditional and faith based leaders in order to empower them to better support their congregants and promote screening behaviour. You can find out more about Sebabatso and her work on her website: http://www.bwawhf.co.za/ or follow her on Social Media: Instagram: @sebabatso_tsaoane @blackwoman_health_ @bwa_womens_clinic Facebook: Sebabatso Connie Tsaoane Black Woman Arise Women's Health Foundation Black Woman Arise Clinic If you found this episode helpful please leave us a review or give us a rating as that helps us get the show out to more people. And don't forget to subscribe! We'd love to stay in touch and keep you updated with all our latest content & resources to equip & empower you. So if you're a midwife or any type of birth and baby worker go to sensitivemidwifery.co.za/freegift If you're a mom, visit sisterlilian.co.za/freegift for more training and resources. That way we can keep you up to date when we release new episodes like this plus a few other bonuses. Remember you're making a big difference because you're shaping the future of humankind. Thanks for listening and I look forward to journeying with you.
In today's episode, Julia talks about how she manifested her 2-bedroom apartment in Nicaragua and a negative test result for her colposcopy, and how you can apply this story to your eczema healing. She covers: What happened with Julia's medical exam with her Gynocologist How she started manifesting a negative result despite her exam being “high risk” How she manifested her 2-bedroom apartment in Nicaragua BONUS: How Julia manifested the best seats on her flight to Nicaragua Biggest tip for manifesting anything in life And so much more! If you enjoyed this episode, make sure you subscribe, rate and leave us a review!!! Want to get a FREE eczema healing visualization? Leave a review on Apple iTunes and send a screenshot of your review to hello@juliachien.ca. We will send you the visualization to your inbox! Want to work with Julia? Apply for her signature program, Clear Your Eczema to learn how to heal your skin naturally so you can finally achieve your dream life!
On this week's episode of the CWC podcast I dive into how important hormone function is, especially if you are trying to lose weight or even just function in a normal capacity as a human. I also talk in depth about autoimmune disorders and why you should eat more and avoid certain types of exercises if you have one. Lastly I go off on a fun little rant about feminism and how our medical system has completely failed women, including my experience with postpartum depression and how I didn't even know I had it until years later. As always, please reach out to me if you have questions about ANYTHING at all. My dm's are open daily if you are suffering and cannot find answers. https://linktr.ee/carolinemathias
Catherine Dezynski is a licensed certified nurse midwife and women's health nurse practitioner. Her clinical areas of expertise include family planning, colposcopy, office-based gynecology, and labor management. Catherine is a member of the American College of Obstetricians and Gynecologists (ACOG), Nurse Practitioners in Women's Health (NPWH), and the American Society for Colposcopy and Cervical Pathology (ASCCP). Catherine is also a medical science liaison for BD, a global medical technology company and the creator of advanced cervical cancer screening tests. In this episode, we talk about why cervical cancer is underdiagnosed, shocking statistics on the rates of diagnosis and death, how the testing innovations at BD help women prevent cervical cancer before it starts, why HPV testing is recommended alongside Pap smears, what you need to know about the HPV vaccine, and so much more! To learn more, visit https://nicolejardim.com/podcasts/advanced-cervical-cancer-testing-that-could-save-your-life-catherine-dezynski/. This episode is brought to you by Knix. Visit Knix.com to shop for period underwear and more. Podcast Production Support: Amazing Gains | https://listenerstoclients.com
SURVEY LINK: https://bit.ly/feedback_UltraSounds SUMMARY: Brittany and Jourdan discuss five clinical vignettes regarding cervical cancer screening with Dr. Elizabeth Campbell, MD. TIMESTAMPS: 00:30: Intro 00:43: Dr. Campbell Bio 01:09: Case 1: 27 year old with LSIL 03:52: Case 2: 34 year old with a history of atypical squamous cells of unknown significance 06:14: Case 3: 44 year old presenting with post-coital vaginal bleeding 09:12: Case 4: 67 year old with considerations for screening 12:21: Case 5: 16 year old unvaccinated against HPV 16:23: Wrap-up LINKS: Recommendation: Cervical Cancer: Screening. US Preventive Services Taskforce, 21 Aug. 2018. HPV Vaccination. American College of Obstetricians & Gynecologists Abnormal Cervical Cancer Screening Test Results. American College of Obstetricians & Gynecologists American College of Obstetricians and Gynecologists. Updated guidelines for management of cervical cancer screening abnormalities. Practice Advisory. Washington, DC: American College of Obstetricians and Gynecologists; 2021. Fontham, Elizabeth T., et al. “Cervical Cancer Screening for Individuals at Average Risk: 2020 Guideline Update from the American Cancer Society.” Khan, Michelle J. et al. “ASCCP Colposcopy Standards: Role of Colposcopy, Benefits, Potential Harms, and Terminology for Colposcopic Practice.” Cervical Intraepithelial Neoplasia Management, Up to Date Colposcopy, Up to Date Cervical Cancer Screening Management, Up to Date HPV Vaccination Recommendations. Centers for Disease Control and Prevention TRANSCRIPT: https://bit.ly/ultrasounds_CervicalCancerScreen DISCLOSURES/DISCLAIMERS: The OBGYN Delivered student team has no relevant financial disclosures. The Ultrasounds podcast is for educational and informational purposes only and should not be considered medical advice. Please do not use any of the information presented to treat, diagnose, or prevent real life medical concerns. The statements made on this podcast are solely those of the OB/GYN Delivered hosts and guests and do not reflect the views of any specific institution.
Molly Broache serves as Associate Director, US Region, Medical Affairs for BD Integrated Diagnostic Solutions (IDS) and is also licensed as a women's health nurse practitioner in both Maryland and Virginia. Molly manages a team of medical science liaisons responsible for specimen management, microbiology, and women's health & cancer. Molly's clinical areas of expertise include women's healthcare, gynecology, infectious disease diagnostic tests, and women's health screening guidelines. Molly is a member of the American College of Obstetricians and Gynecologists (ACOG), Nurse Practitioners in Women's Health (NPWH), American Society for Colposcopy and Cervical Pathology (ASCCP), and the Medical Science Liaison Society (MSLS). She serves on the membership committee for ASCCP and the Cervical Cancer Screening Initiative – Provider Workgroup for the American Cancer Society. Molly holds two Bachelor's degrees from Johns Hopkins University, in both molecular biology and nursing. She also holds a master's degree in nursing from Georgetown University, where she received her training as a nurse practitioner. Molly is currently completing her Doctor of Nursing Practice degree at the University of Maryland, Baltimore.BD is one of the largest global medical technology companies in the world and is advancing the world of health by improving medical discovery, diagnostics and the delivery of care. The company supports the heroes on the frontlines of health care by developing innovative technology, services and solutions that help advance both clinical therapy for patients and clinical process for health care providers. BD and its 75,000 employees have a passion and commitment to help enhance the safety and efficiency of clinicians' care delivery process, enable laboratory scientists to accurately detect disease and advance researchers' capabilities to develop the next generation of diagnostics and therapeutics. BD has a presence in virtually every country and partners with organizations around the world to address some of the most challenging global health issues. By working in close collaboration with customers, BD can help enhance outcomes, lower costs, increase efficiencies, improve safety and expand access to health care.LinkedIn: www.linkedin.com/company/bd1/ | Twitter @BDandCo | Instagram: @becton_dickinson
In this episode, Blyss and Dr. Stu discuss the difference between a Colposcopy, LEEP and Cone Biopsy. They also share a variety of letters from listeners–many who were left without answers or dealt with health care professionals that lack awareness of social cues. Today's show is yet another reminder of the unfortunate fact that the fear of the birth person or team you hire is sometimes the catalyst for the resistance to the birth you deserve and desire.In this episode of Birthing Instincts:Pondering what is and is not a “waste of time”What is ectropion of the cervix? The difference between a colposcopy, LEEP & cone biopsyWhat to do when you're studying under someone with different valuesA letter from a listener about the Vitamin K shotStories of fear mongering by doctorsThis show is supported by:Bamboobies | Go to INSTINCTS to get 25% off your first order!LMNT | Go to drinklmnt.com/birthinginstincts to get a free sample pack!Connect with Dr. Stu:Instagram: @birthinginstinctsWebsite: birthinginstincts.comConnect with Blyss:Instagram: @birthingblyssWebsite: birthingblyss.comThis show is produced by Soulfire Productions
Cervical screening tests (Pap smears) are an important part of looking after your health. Now every 5 years from age 25 to 74 , the test screens for the human papilloma virus (HPV) and pre-cancerous changes. In today's episode Dr Dominique Baume and Dr Preetam Ganu discuss what this means for women and further treatment steps.
Host: Hector O. Chapa, MD, FACOG Guest: Linda Ahn, MD, FACOG Amid growing evidence that infection with high-risk HPV can increase the risk of cervical cancer, the American College of Obstetricians and Gynecologists, the American Society for Colposcopy and Cervical Pathology, and the American Cancer Society have all updated their guidelines to help identify patients at risk while reducing unnecessary invasive procedures and over-testing. Joining Dr. Hector Chapa to walk us through these guidelines is board-certified obstetrician/gynecologist Dr. Linda Ahn.
Dr. Bradley Monk is a member of Arizona Oncology and part of the US Oncology Network and continues to practice in Phoenix. Most recently, he has been appointed the US Oncology Medical Director of Gynecologic Oncology Research. Dr. Monk is also a Professor on the Clinical Scholar Track at the University of Arizona College of Medicine – Phoenix and works at Arizona Oncology (US Oncology Network). Dr. Monk's research interests include the prevention and treatment of gynecologic cancers. Dr. Monk is a fellow of the American College of Surgeons, the American College of Obstetricians and Gynecologists) and the American Society for Colposcopy and Cervical Pathology, as well as being an active member of the Society of Gynecologic Oncology, International Gynecologic Cancer Society, and American Society of Clinical Oncology. He has authored more than 330 peer-reviewed articles along with more than 30 book chapters dealing predominantly with the prevention and chemotherapy of gynecologic malignancies and patient quality of life.
Sinéad opened up to listeners about her experience of needing to get a colposcopy done as she had irregular bleeding in the cervix. The experience was a nerve wrecking one as HPV is present and a biopsy was taken, however HPV is more common than we think and in fact most people will have this at some stage and it does no harm. Sinéad highlighted the importance of cervical screening and the need for more education and open discussion around HPV, smears and women's health. See acast.com/privacy for privacy and opt-out information.
CME credits: 0.25 Valid until: 14-07-2022 Claim your CME credit at https://reachmd.com/programs/cme/riding-wave-change-cervical-cancer-screening-managing-patients-light-risk-using-extended-genotyping/12697/ Updated cervical cancer screening guidelines were published by both the American Society for Colposcopy and Cervical Pathology (ASCCP) and the American Cancer Society (ACS). Dr. Lee Shulman leads a discussion with Dr. Anna-Barbara Moscicki on the recent guidelines, the range of cervical cancer screening tests, and the impact on risk stratification and patient management.
CME credits: 0.25 Valid until: 14-07-2022 Claim your CME credit at https://reachmd.com/programs/cme/riding-wave-change-cervical-cancer-screening-managing-patients-light-risk-using-extended-genotyping/12697/ Updated cervical cancer screening guidelines were published by both the American Society for Colposcopy and Cervical Pathology (ASCCP) and the American Cancer Society (ACS). Dr. Lee Shulman leads a discussion with Dr. Anna-Barbara Moscicki on the recent guidelines, the range of cervical cancer screening tests, and the impact on risk stratification and patient management.
Host: Lee P. Shulman, MD, FACMG, FACOG Guest: Anna-Barbara Moscicki, MD Updated cervical cancer screening guidelines were published by both the American Society for Colposcopy and Cervical Pathology (ASCCP) and the American Cancer Society (ACS). Dr. Lee Shulman leads a discussion with Dr. Anna-Barbara Moscicki on the recent guidelines, the range of cervical cancer screening tests, and the impact on risk stratification and patient management.
Local GP Camilla Janssen talks to Ian Simpson, a consultant Gynaecologist in Basingstoke, who runs the colposcopy service. They explore the recent changes to the cervical screening programme and the impact that these changes have on secondary and primary care. They also discuss the appropriate referral criteria for colposcopy and highlight conditions that would be better served by a referral to general gynaecology instead. They discuss HPV and how to explain this to patients.
Why they are important, what happens and what the results mean.
In this episode Tynee Talks to Board Certified OB/GYN Dr. Sierra Cuthpert & Hip Hop Writer Tia Scott (The the Writer) about Black women's vaginal health, health disparities, and the importance of papsmears and yearly wellness checks. Together they tackle why asking the right questions, and seeing a health care provider that has your best interest at hand can be life saving. Tia and Tynee also expound on their Cervical Cancer Scare, and how women of color, health care providers saved their lives. This Talk touches on HPV, Colposcopy's, and Leep procedures, so that you are well informed next time you go for your wellness check! #tyneetalks #blackwomenshealth #cervicalcancer Guest Links: Dr. Sierra Cuthpert: Instagram: Instagram.com/Dr_itsme Tia Scott (Tia the Writer) Instagram.com/tia_the_writer https://linktr.ee/tia_the_writer ** Host (Tynee Talks) Links: Host Links: Facebook: www.facebook.com/tyneetalks/ Instagram: @tyneetalks Twitter: @tyneetune Shop: Tynee Talks Merchandise shop.spreadshirt.com/tynee-talks shoptyneetalks.bigcartel.com Made In Flint Shirt: www.myeightonezero.com Hoops Provided by Hoop Mobb: www.hoopmobb.com Find out more at https://tynee-talks.pinecast.co This podcast is powered by Pinecast.
Gynecologist Medical Lectures Gynecology हिंदी प्रेग्नेंसी वोमेन्स हेल्
Colposcopy,is it painful,how much Time
Episode 18: Cervical PolypsThe sun rises over the San Joaquin Valley, California, today is June 26, 2020.As our nation continues to battle the OPIOID epidemic (along with other epidemics), our good, old-fashioned aspirin at high doses (900 to 1300 mg) was found to be effective and safe to treat acute migraine headaches. Further research is needed to recommend aspirin as a prophylactic therapy, but it’s promising. Findings of this research were published in November 2019 by Dr Biglione and collaborators in The American Journal of Medicine (1,2). Aspirin keeps giving us surprises after more than 120 years on the market! Also, the Food and Drug Administration has approved the first over-the-counter ibuprofen and acetaminophen combination drug for the U.S. It’s called Advil Dual Action which contains 250 mg of ibuprofen and 500 mg of acetaminophen. It will be available later in 2020 (3).Talking about epidemics, have you heard that diabetes is a surgical disease? Some experts support the cure of diabetes with bariatric surgery, and yes, it may not be the first choice, but it is effective when used appropriately. However, according to a research presented during Endo Online 2020, Dr Yingying Luo, stated that having bariatric surgery BEFORE developing type 2 diabetes results in a greater weight loss, especially within the first 3 years after surgery. The probability of achieving BMI less than 30, and the chance of reaching excess weight loss of more than 50%, is higher in patients WITHOUT diabetes before surgery(4). Diabetes prevention is another good reason to send your patients to bariatric surgery in a timely manner when they meet criteria. Welcome to Rio Bravo qWeek, the podcast of the Rio Bravo Family Medicine Residency Program, recorded weekly from Bakersfield, California, the land where growing is happening everywhere.The Rio Bravo Family Medicine Residency Program trains residents and students to prevent illnesses and bring health and hope to our community. Our mission: To Seek, Teach and Serve. Sponsored by Clinica Sierra Vista, Providing compassionate and affordable care to patients throughout Kern and Fresno counties since 1971. “A good head and good heart are always a formidable combination. But when you add to that a literate tongue or pen, then you have something very special.” ― Nelson MandelaI always thought that having a good brain and a good heart were enough to be wise, but Mr Mandela taught me that having a good tongue or pen makes than person even more special. Do you get it? Being wise and compassionate, and being able to communicate that information to others is very important. That’s why we have this exercise called Rio Bravo qWeek– to learn how to transfer information from our head and our hearts to our co-residents and patients. I hope we can become better communicators every day. Before I introduce our guest today, I want to take a minute to correct myself. In episode 15, I said “more higher”, I noticed my mistake, and I correct it now: It is not “more higher”, it’s just “higher”. Also, I hope you heard the beautiful quote we used at the end of our episode 17. I want to clarify that we do not have any political affiliation, but we have the same values and principles we shared with the good people of America, including politicians, artists, NGOs, religions, and other groups. I encouraged you to “examine what is said, not him who speaks” (Arab proverb), especially in this podcast. We have a very pleasant and clever resident who has some things to say today. Welcome, Dr Yodaisy Rodriguez.Question Number 1: Who are you?My name is Yodaisy Rodriguez Acosta. I graduated from medical school in Cuba. Before moving to the US, I worked in Honduras and in Venezuela as part of Medical collaboration programs. I love outdoor activities, gardening, crafting, movies, and dogs. My perfect day is having a picnic with my family.Question number 2: What did you learn this week? I learned about cervical polyps this week. Clinicians may encounter normal variants and benign neoplasms of the cervix on pelvic examination. It is important, as family medicine doctors, to become familiar with a normal cervix, so we can identify what looks ABNORMAL.Cervical polyp definition-A cervical polyp is a growth or tumor found in the cervical canal. It is a lobular or tear-shape growth, red or purple, it can also be very vascularized. After you see a couple of them you learn to recognize them. -They present more commonly in post-menarche and pre-menopausal women who have been pregnant. - It is included in the Cervical Noncystic lesions.-The etiology is unknown. Chronic inflammation of the cervical canal may be the cause. Hormonal factors may also play a role, since endometrial hyperplasia and cervical polyps coexist. -Differential diagnosis includes an endometrial polyp or prolapsed leiomyoma.-Malignancy in polyps is uncommon.What to do when you see a cervical polypPolyps should always be removed if they are symptomatic (eg, bleeding, excessive discharge), large (≥3 cm), or appear atypical. Polypectomy is usually a small procedure done in the office. Malignancy is rarely found in a cervical polyp, however, polyps that are removed should be submitted to the laboratory for histological study.Question number 3: Why is that knowledge important for you and your patients?Because cervical cancer is very common. Every year, nearly 13,000 cases of cervical cancer are diagnosed, with more than 4,000 deaths. Cervical cancer is typically asymptomatic. We should become familiar with the screening and management of cervical diseases. Having the right information will help us answer our patient’s concerns. Question number 4: How did you get that knowledge?I learned because I had a patient with a cervical polyp. When you receive an abnormal pap result, you normally look up the next step by using the ASCCP app, but what do you do when the cervix looks abnormal during the physical exam? How do you perform a polyp removal? Thanks to my OBGYN attendings, and thanks to my gynecology rotations, I have improved my knowledge and abilities in managing abnormal cervix. I learned that if a patient has a grossly visible cervical lesion, biopsy should be performed. If biopsy cannot be performed at that visit, cervical cytology should be collected, and the patient should have a biopsy as soon as possible. Comment: We had a patient recently with an abnormal cervical exam. It was described as a “cavity” between 3 and 6 o’clock. The resident explained to me that “he has never seen any cervix like that”. Our patient had weight loss and abdominal pain, along with bilateral hydronephrosis. The cervical biopsy was done at the time of the placement of bilateral ureter stents in the OR. The biopsy resulted in squamous cell carcinoma of the cervix. So, I agree with you, grossly abnormal cervix should prompt us to perform a biopsy in a timely manner.Cervical cytology became the standard screening with the introduction of the Papanicolaou (Pap) smear in 1941. Now we start screening for cervical cancer at age 21 regardless of sexual activity. Cultural concerns should be addressed and respected when possible. A patient at age 21 may decline pelvic exam, you have to be culturally sensitive and discuss the matter with the patient and encourage pap smear with tact, but respect patient’s preferences.Question number 5: Where did that knowledge come from? 1) Up To Date. 2) Cervical Cancer: Evaluation and Management by Jennifer Wipperman and collaborators, published in the American Family Physician in 2018.3) FP notebook app 4) American Society for Colposcopy and Cervical Pathology (ASCCP) app ____________________________Speaking Medical: Pioikilothermiaby Edvard Davtyan, MS4Good afternoon, my name is Edvard Davtyan, I am a 4th year medical student. I will be presenting the word of the week, Poikilothermia. This may sound like a phrase used in the world of thermodynamics. However, this phrase is more commonly used in the realm of Biology and Medicine. The term poikilothermia means “cool extremity”. It is originated from the word poikilothermwhich is used to describe animals or organisms whose internal temperature varies considerably with the temperature of its surroundings. These animals are also referenced by the common vernacular “cold-blooded.” The term is derived from Greek poikilos,meaning “varied”, and thermos, meaning “heat.”In Medicine, the loss of thermoregulation in humans is referred to as poikilothermia. This is seen in states of sedation (esp. REM sleep), effects of hypnotic drugs and acute limb ischemia. Poikilothermia is 1 of the 6 P’s in clinical presentation of acute limb ischemia: Pain, Pallor, Paresthesia, Pulselessness, Poikilothermia, and Paralysis. Hope this has been interesting for you, remember, if your patient has poikilothermia, it doesn’t mean they are cold-blooded, it just means you should probably check their ankle-brachial index (ABI).____________________________Espanish Por Favor: Chorroby Dr Claudia Carranza(Recorded Previously on 6/10/2020)Hi this is Dr Carranza on our section Espanish Por Favor. This week’s word is chorro. Chorro means jet or stream; some patients use this word to describe their bowel movement. Patients can come to you with the complaint: “Doctor, tengo chorro”, which means “Doctor, I have the runs” or in other words, “I’m having diarrhea”. This is more common in the Spanish-speakers coming from Mexico. You can then continue the interview and ask about how often, for how many days and if it’s bloody or melanotic, etc. Chorro can also mean a ton or lots; so, a patient might say “Doctor, tengo un chorro de problemas” which means “Doctor, I have a ton of problems”. Now you know the Spanish word of the week, “CHORRO”.____________________________For your Sanity (Medical Joke of the Week): ***by Dr Steven Saito and Dr Lisa ManzanaresA cosmetic surgeon sign says: “If life gives you lemons, a simple surgery will give you melons”.____________________________Now we conclude our episode number 18 “Cervical Polyps”. Dr Rodriguez recommended us to get used to a normal cervix. If a cervix looks odd, do not hesitate to or perform a biopsy schedule patient for biopsy. If you see a cervical polyp, a polypectomy can be easily performed in the office. Remember to send that sample to pathology. Edvard explained that Poikilothermia refers to cold-blooded animals, but it also refers to a “cold limb” as a sign of acute limb ischemia. Chorro was explained by Dr Carranza as a “less elegant” way to say diarrhea in Spanish. This is the end of Rio Bravo qWeek. We say good bye from Bakersfield, a special place in the beautiful Central Valley of California, United States, a land where growing is happening everywhere.If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. Our podcast team is Hector Arreaza, Yodaisy Rodriguez, Claudia Carranza, Edvard Davtyan, Lisa Manzanares, and Steven Saito. Audio edition: Suraj Amrutia. See you soon! _____________________References:The American Journal of Managed Care, https://www.ajmc.com/newsroom/aspirin-effective-in-treating-acute-migraine-preventing-recurrent-migraine-review-finds.Biglione B, Gitin A, Gorelick PB, et al. Aspirin in the treatment and prevention of migraine headaches: possible additional clinical options for primary healthcare providers [published online November 8, 2019]. Am J Med. doi: 10.1016/j.amjmed.2019.10.023.“FDA approves combination ibuprofen-acetaminophen drug for U.S.”, ADA News, March 02, 2020, https://www.ada.org/en/publications/ada-news/2020-archive/march/fda-approves-combination-ibuprofen-acetaminophen-drug-for-us“Bariatric surgery may be less beneficial in diabetes”, Family Practice News, Vol 50, No. 4, April 2020, page 11. “Benign cervical lesions and congenital anomalies of the cervix” by Marc R Laufer, MD, UptoDate, Last updated on May 28, 2020. https://www.uptodate.com/contents/benign-cervical-lesions-and-congenital-anomalies-of-the-cervix?search=cervical%20polyp§ionRank=1&usage_type=default&anchor=H16&source=machineLearning&selectedTitle=1~28&display_rank=1#H16, accessed on June 22, 2020.“Cervical Cancer: Evaluation and Management” by Jennifer Wipperman, MD, MPH; Tara Neil, , MD; and Tracy Williams, MD, Am Fam Physician. 2018 Apr 1;97(7):449-454. https://www.aafp.org/afp/2018/0401/p449.html American Society for Colposcopy and Cervical Pathology (ASCCP), App.
Episode 7 - Suboxone: One Film at a TimeThe sun rises over the San Joaquin Valley, California. Today is April 15, 2020. Viral diseases anyone? The American Society for Colposcopy and Cervical Pathology (ASCCP) recommended HPV vaccination for clinicians routinely exposed to HPV. This recommendation encompasses the complete provider team, including physicians, nurse practitioners, nurses, residents, and fellows, and others in the fields of OB/GYN, family practice, gyn-onc, and dermatology. While there is limited data on occupational HPV exposure, ASCCP, recommends that members actively protect themselves against the risks(1). This recommendation on HPV vaccination for health care workers was published on February 19, 2020. We thought it would be pertinent to remind you about the viral infections that we CAN prevent, since there are some viruses for which we do NOT have a vaccine yet. Welcome to Rio Bravo qWeek, the podcast of the Rio Bravo Family Medicine Residency Program, recorded weekly from Bakersfield, California, the land where growing never stopsThe Rio Bravo Family Medicine Residency Program trains residents and students to prevent illnesses and bring health and hope to our community. Our mission: To Seek, Teach and Serve. Sponsored by Clinica Sierra Vista, Providing compassionate and affordable care to patients throughout Kern and Fresno counties since 1971. Quote: “Improvement begins with I.” – Arnold H. GlasowImprovement is a never-ending process, and we must remind ourselves who needs to improve first? It’s normally us. That’s why “improvement begins with I”, I think that was a brilliant quote. Today our guest is Golriz Asefi. She is a smart, compassionate, dynamic PGY1 who is excited to talk to us after her community medicine rotation. She told me she enjoyed a lot working with Dr Beare, our street medicine doctor, whom I hope can be our guest in this podcast one day. Welcome, Dr Asefi. As you know we will ask you 5 questions. Let’s start with our first question number 1. 1. Who are you?I’m Dr Golriz Asefi, I’m a PGY1 here at Rio Bravo family medicine residency program. I grew up in the Bay Area (California). I went to UC Berkeley and then to Ross University School of Medicine. I picked our residency program because I was very interested in community medicine and helping the underserved. On my “spare time” I like to take long walks by the beach and go hiking with my friends. I also have a newly found love for yoga and barr method. 2. What did you learn this week?This week I learned about suboxone. Suboxone is a combination of buprenorphine (a partial opioid agonist) and naloxone (an opioid antagonist). It is used in the treatment of opioid use disorder along with counseling and other behavioral therapy. Suboxone is a class III controlled substance in the form of sublingual pill, sublingual film or buccal film.Comment: Suboxone is part of the Medication-Assisted Treatment (MAT) of opioids. It is the use of medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders. These medications operate to normalize brain chemistry, block the euphoric effects of opioids, relieve physiological cravings, and normalize body functions without the negative effects of the abused drug.Suboxone is a combined medication. Why do we have both an agonist and antagonist in the same dose you might ask? Well it’s to prevent abuse, you see naloxone when taken sublingually as directed is minimally absorbed, whereas when injected, it is a strong blocker of the opioid receptor. So, you can get the antagonistic effect of naloxone. When taken sublingually naloxone is poorly absorbed, therefore patients experience less withdrawal symptoms. The “Ceiling effect”Buprenorphine exhibits what’s called a “ceiling effect”, which occurs because suboxone partially stimulates opioid receptors even when saturated. Even exponentially increasing the dose only achieves limited additional effect– similar to approaching an asymptote - remember those hyperbolas and parabola in high school geometry? Basically, never reach full effect. Therefore, it has a lower chance of abuse and accidental overdose. Suboxone vs MethadoneMethadone is full opioid agonist. It is a PO liquid administered through methadone clinics to which patients must go to everyday, and get the medication. Take-home privileges can be eventually earned for methadone. Suboxone has lower chances of overdose because it is a partial agonist, however, dropout rates are higher. Suboxone can be prescribed to be taken at home, so it is more convenient(2).Candidates for suboxone Opiate users who are motivated for treatment and are willing to adhere to scheduled visits and treatment. They should understand the indications, risks, benefits, and alternatives. Ideally, they should not be on other CNS depressants, such as alcohol and benzos, however, suboxone is preferable over methadone for people who use CNS depressants or are at higher risk of respiratory failure. Suboxone can also be used during pregnancy.Contraindications to suboxone:-Severe liver impairment.-Conditions that already increases risk of respiratory depression such as head injuries or taking CNS depressants such as benzodiazepines or alcohol. Mixing large amounts of other medications with buprenorphine can lead to overdose or death(2).Required Training to Prescribe SuboxonePrescription is regulated by the DATA (Drug Addiction Treatment Act of 2000), you need to complete a MAT (medication assisted treatment) training which is currently available free of cost. To qualify as an MD, you need to have an active medical license and DEA license. The training takes about 8 hrs for MDs, 24hrs for NPs, CNMs, and PAs. You can take the training at anytime, even as a resident, and save the certificate until you receive your MD license and DEA license. The training is 100% online, you can print your certificate and apply for an X-license to prescribe suboxone. The information is found online at PCSSNOW.ORG (Providers Clinical Support System)(3)3. Why is this knowledge important for you and your patients?Suboxone is underutilized by primary care providers. Opioid use disorder leads to a lot of socioeconomic problems, such as increased rates of suicide, accidental overdose, HIV, HepC, marital problems, and unemployment. About 46,000 people died of opiate related deaths in 2018, steadily rising from 21,000 in 2010. Of that, 18,000 was due to prescription opioids(4). Luckily, treatment of the disorder decreases all of the above. MAT has shown to improve mortality due to opioid overdose, increase retention in treatment, decrease illicit opiate use and other criminal activity, increase patient’s ability to gain and maintain employment, improve birth outcomes in pregnant women with substance use disorder, lower risk of contracting HIV and HepC. You can see, Dr Arreaza, you can make a big impact in your patients if you get this training, you will change lives and whole communities by providing this life-changing treatment. Comment: This is something I learned recently. Having a substance use disorder reprograms your brain, it is like being thirsty and not finding water to drink. So when we tell our patients, “Just stop taking Norco”, it is similar to tell them, “Just stop drinking water.” We have to develop empathy to some of the most neglected patients in our society. Not many people are helping these patients! And many of them also have mental illness, as many as 30-60%, depending on the source you read. So, it’s a good idea to get trained to help this vulnerable population.4. How did you get this knowledge?I was working with Dr. Beare during my community medicine rotation. I really enjoyed learning about suboxone and seeing how rewarding this experience was between him and his patients. This made me want to do more research and present this topic to my colleagues. As Dr. Beare likes to say: “Treating addiction is like treating any other complex chronic disease. There is no such thing as quick fix.” We as physicians need to listen to our patients, to care and to treat this difficult condition.5. Where did this knowledge come from?-SAMHSA – substance abuse and medical health service administration, The National Institutes of Health, an Up to Date article, and other articles. See details below.______________________Speaking Medicalby Lisa Manzanares The medical word of the day is leukorrhea. It is the flow of whitish, yellowish, or greenish discharge from the vagina. Leukorrhea can be normal, or it can be a sign of infection. Leukorrhea commonly occurs during pregnancy, and is normal if the discharge is thin, white, and odorless. Physiologic leukorrhea is a normal condition occurring within several months to 1 year of onset of menses in adolescent girls. Leukorrhea that is not normal can be caused by bacteria: bacterial vaginosis, chlamydia, gonorrhea, or postpartum endometritis. Fungal causes include candida species. Parasites can cause it, too: specifically, Trichomonas vaginalis.So, when your patient complains of vaginal discharge, be sure to sound smart in your notes and document that the patient has leukorrhea._________________________Espanish Por Favor (Spanish Word of the Day) by Claudia CarranzaHi this is Dr Carranza on our section Espanish por favor. The Spanish word for this week is rodilla. What comes to your mind when you hear the word rodilla? Does it sound to you like a popular Mexican food? Well, rodilla has nothing to do with quesadilla. Rodilla is a large joint in our body that may wear off over time and gets injured easily. Yes, you guessed it, rodilla means knee. This word comes from the Latin root “rota” or “rueda” which means round or wheel. Patients may come to you with the complaint: “Doctor, me duelen las rodillas” or “Doctor, tengo la rodilla hinchada” which means: “Doctor, my knees hurt” or “Doctor, my knee is swollen”. Most likely the patient will point at one or both of their knees which will guide your assessment. Now you know the Spanish word of the day, rodilla. Have a great week and take care! __________________________________________For your Sanity (Medical joke of the day)by Golriz Asefi and Lisa ManzanaresThe Expensive DentistPatient: Doctor, how much to have this tooth pulled?Dentist: $100.00. Patient: What? $100.00 for just a few minutes of work? Dentist: Well, I can extract it very slowly if you like.The Invisible PatientClerk: Doctor, there's a man on line 1 who thinks he's invisible.Doctor: Well, tell him we can't see him right now.__________________________________________Conclusion: During this episode, we had a glimpse of the Medication Assisted Treatment for Opioid Use Disorder. Suboxone can be the answer to many patients who are desperately looking for help to overcome their addictions. Suboxone can make a difference, one film at a time. We also were reminded of another way to say vaginal discharge, leukorrhea; and learned how to say knee in Spanish, rodilla. May you continue to enjoy your training and stay safe. See you next week! This is the end of Rio Bravo qWeek. We say good bye from Bakersfield, a special place in the beautiful Central Valley of California, United States, a land where growing is happening everywhere.If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or by visiting our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. Our podcast team is Hector Arreaza, Lisa Manzanares, Claudia Carranza, and Golriz Asefi. Audio edition: Suraj Amrutia. ________________________________References“ASCCP: Clinicians Routinely Exposed to HPV Should Receive Vaccine”, OBG Project Alert, https://www.obgproject.com/2020/03/03/asccp-clinicians-routinely-exposed-to-hpv-should-receive-vaccine/, accessed on April 13, 2020.Buprenorphine, SAMHSA, https://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine , accessed on Apr 13, 2020.Waiver Training for Physicians, Providers Clinical Support System, https://pcssnow.org/medication-assisted-treatment/waiver-training-for-physicians/ Overdose Death Rates, National Institute on Drug Abuse, https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-ratesStrain, Eric, MD, “Pharmacotherapy for opioid use disorder”, https://www.uptodate.com/contents/pharmacotherapy-for-opioid-use-disorder?search=suboxone&source=search_result&selectedTitle=2~19&usage_type=default&display_rank=1, accessed on March 23, 2020. Velander JR. “Suboxone: Rationale, Science, Misconceptions”, Ochsner J. 2018;18(1):23–29. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/ , accessed on March 23, 2020.Srivastava, Anita; Kahan, Meldon; Nader, Maya (March 2017), "Primary care management of opioid use disorders: Abstinence, methadone, or buprenorphine-naloxone?". Canadian Family Physician. 63(3): 200–205. ISSN1715-5258. PMC5349718. PMID28292795.
Join us as we explore the importance of pap tests, what really causes cervical cancer and how you can protect yourself. We'll be discussing the latest guidelines in Canada so you know when your pap is due, how your immune system can fight cervical cancer, what you can expect if you have an abnormal pap, and more! Featuring Dr. Schepansky a Gynecologic Oncologist in the Department of Obstetrics and Gynecology at the University of Alberta. Her practice is based at the Cross Cancer Institute and the Royal Alexandra Hospital in Edmonton. She has done work as the Chair of Colposcopy Quality Improvement Committee for the Alberta Cervical Cancer Screening Program. Resources: (1) Screening For Life (includes info on cervical cancer and a risk assessment tool): http://screeningforlife.ca/cervical-cancer-at-a-glance/ (2) Choosing Wisely: https://choosingwiselycanada.org/pap-tests/ (3) Canadian Cancer Society: https://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/tests-and-procedures/pap-test/?region=on (4) My Health Alberta: https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=tw9600 (5) Alberta Health Services - A Patient's Guide to Colposcopy: https://www.youtube.com/watch?v=57EXw9oU9TA&feature=youtu.be Summary Sheet: CervicalCancerandPapTests.html
In this quickie bonus, Dr. Tabatha will answer the Question of the Week: What's a Colposcopy and Why Do I Need to Have That Done?She explains why you might need to have it done, and what a colposcopy entails. A pap smear is a screening test to see if your cells are normal or abnormal. The colposcopy is a diagnostic test to determine whether your abnormal pap smear is anything that has to be treated or followed. Listen to this quick episode to find out what to expect. SEND DR. TABATHA YOUR QUESTION OF THE WEEK!On Instagram: https://www.instagram.com/dr_tabatha/on Facebook: https://www.facebook.com/DrTabathaand check out her website: https://www.drtabatha.com/
Dr. Ramirez is a board certified OB-GYN specializing in minimally invasive robotic surgery, uro-gynecology, and hormone therapy. He completed his residency at Texas Tech University, at which time he became an associate professor with Texas Tech training residents in minimally invasive surgery. He has been practicing in Ardmore, OK. going on 7 years; during this time he has developed the Robotic Surgery Department at Mercy Hospital and has become the chair of the department. As a robotic surgery proctor, Dr. Ramirez actively trains other physicians in using the Di Vinci robot for a number of different surgeries. During residency Dr. Ramirez experienced extended training in uro-gyn including treating urinary incontinence and vaginal prolapse. Dr, Ramirez created Femtite - non surgical radio frequency vaginal rejuvenation. He also serves as an adjunct clinical assistant professor of obgyn at OSU. Dr. Ramirez stays up to date in the development of obstetric care. Through further training, Dr. Ramirez is proficient in replacing both male and female hormones. Dr. Ramirez’s professional affiliations include: Member of American Board of Obstetrics and Gynecology, Member of American Medical Association, Member of Minimally Invasive Surgery Association, Member of American Society for Colposcopy and Cervical Pathology, Mercy Medical Board of Directors, and Mercy Board of Quality Assurance. He also serves as an adjunct clinical assistant for Oklahoma State University medical students and residents.
The Renewed Cervical Screening program has brought changes to clinical practice in Australia. In this podcast interview, A/Prof Annabelle Farnsworth, President of the Australian Society for Colposcopy & Cervical Pathology, and Medical Director at Douglass Hanly Moir, talks to RACGP President Dr Harry Nespolon about HPV, the latest vaccines, self-collection, and how the renewed program could potentially eliminate cervical cancer by 2035.
Today I'm talking about cervical cancer and the most common STD, HPV. I'm also going to talk about screening, its importance, and why! Also today, I'll tell you about the HPV vaccine and when and why to get it or give it to your children!Let me know if you have questions! I have a new email, kelly@readbetweenlegs.comOr ask me via social media or my website, www.readbetweenlegs.comReferences:Cervical Cancer Statistics | CDC. (2018, May). Retrieved from https://www.cdc.gov/cancer/cervical/statistics/index.htmSaslow, D., Solomon, D., Lawson, H. W., Killackey, M., Kulasingam, S. L., Cain, J., … Myers, E. R. (2012). American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA: A Cancer Journal for Clinicians, 62(3), 147–172. doi: 10.3322/caac.21139Schuiling, K. (2011). Womens gynecological health. Sudbury: Jones & Bartlett Learning.Simon & Schuster. (2011). Our bodies, ourselves. New York.
We dive deep into the relationship between HPV and cervical cancer and identify when and how to screen women with tips from Dr. Karen Smith-McCune (UCSF), Professor in the Department of Obstetrics and Gynecology! We review common cytology findings, screening guidelines, and basic indications for HPV vaccination. Full show notes at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Producer: Molly Heublein MD Writer: Elena Gibson MD and Molly Heublein MD Infographic: Beth Garbitelli MS2 Cover Art: Kate Grant MBChB DipGUMed Hosts: Molly Heublein MD; Matthew Watto MD, FACP Editor: Emi Okamoto MD; Matthew Watto MD, FACP Guest: Karen K. Smith-McCune MD, PhD Sponsors Win a prize! Help ACP Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud. Tell us why you are I.M. Proud and enter the contest by visiting acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019! What makes you proud to practice internal medicine or one of the I.M. subspecialties? What recent patient experience made you proud to be an internist or subspecialist? How is internal medicine unique from other subspecialties? See us at the CHEST 2019 Annual Meeting in New Orleans! We’ll be doing two live interviews on stage, plus recording two recap episodes to bring you high yield clinical pearls from the conference. Look out for us in our red Curbsiders shirts and say hello. Take a picture with Stuart! Give Paul a hug! Register today https://chestmeeting.chestnet.org/ !!!! Time Stamps 00:00 Sponsor: I.M. Proud National Internal Medicine Day Story Contest 01:00 Reminder: We’ll be at CHEST 2019 in NOLA! 01:33 Intro, guest bio 04:35 Guest one-liner; Check out our classic Curbsiders’ Top Picks 08:00 Sponsor: I.M. Proud National Internal Medicine Day Story Contest 09:49 Case of HPV; Background; Is HPV an STI? 13:47 Frequency of screening; Discussion of testing types & pitfalls 18:11 Summary of testing for cervical cancer 20:20 Is co-testing every helpful? 24:05 Choosing a testing interval 24:40 Colposcopy; Risks 32:19 Screening women under 30 years old? Under 21 years old? 33:22 Interpreting a PAP (cytology) result; Algorithm for cervical cancer screening 42:08 Women over 65 years old; When to stop screening 46:02 Will Vaginal swabs replace traditional cervical screening 48:40 Screening after Hysterectomy or “Partial” hysterectomy 50:25 HPV vaccine in older adults and shared decision making 54:21 HPV vaccine in children, young adults 58:12 Take home points 59:40 Outro Disclosures Dr. Smith-McCune reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. Citation Smith-McCune K, Heublein M, Gibson E, Garbitelli B, Okamoto M, Watto MF. “#175 Cervical Cancer Screening and HPV”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. September 30, 2019.
Associate Professor Annabelle Farnsworth, President of the Australian Society for Colposcopy & Cervical Pathology, provides an update on the Renewed Cervical Screening program, including areas of confusion that have arisen in clinical practice, and case presentations that include the management of under screened women, women with abnormal bleeding, and older women who are HPV positive.
Why: ASCCP guidelines (there is an app! Or PDF) Cervical dysplasia — caused by HPV CIN I–CIN3 is a progression Risk factors: Smoking, other STIs including HIV, immunodeficiency Histology: Increased Nuclear: cytoplasmic ratio when abnormal Acetic Acid: exact mechanism unknown, the higher N:C ratio cells (aka abnormal cells) reflect more light and appear white. […]
Why: ASCCP guidelines (there is an app! Or PDF) Cervical dysplasia — caused by HPV CIN I–CIN3 is a progression Risk factors: Smoking, other STIs including HIV, immunodeficiency Histology: Increased Nuclear: cytoplasmic ratio when abnormal Acetic Acid: exact mechanism unknown, the higher N:C ratio cells (aka abnormal cells) reflect more light and appear white. […]
In the final installment of the pap series we delve into what happens after you have an abnormal result including the guidelines your doctor follows and the testing that may be done.
Host: Stephen Cohen, MD Standards in cervical cancer detection methods have come a long way in the past 30 years, from cervical cytology to HPV co-testing and HPV primary screening. How did the OB/GYN community get here, and is the direction of current practice standards in sync with clinical preferences nationwide? Joining Dr. Stephen Cohen to discuss these and other questions at the Women's Health Annual Visit in Houston, TX is Dr. Thomas Cox, former Director of Gynecology and Colposcopy at the University of California-Santa Barbara Health Services Center and Past-President of the American Society of Colposcopy and Cervical Pathology.
Host: Stephen Cohen, MD Standards in cervical cancer detection methods have come a long way in the past 30 years, from cervical cytology to HPV co-testing and HPV primary screening. How did the OB/GYN community get here, and is the direction of current practice standards in sync with clinical preferences nationwide? Joining Dr. Stephen Cohen to discuss these and other questions at the Women's Health Annual Visit in Houston, TX is Dr. Thomas Cox, former Director of Gynecology and Colposcopy at the University of California-Santa Barbara Health Services Center and Past-President of the American Society of Colposcopy and Cervical Pathology.
This podcast is a review of the submitted article by Dr. Wentzensen and colleagues regarding multiple cervical biopsies at the time of colposcopy and the implications for the management of cervical dysplasia.
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