Most Read Articles
07 Aug 2016
Pravastatin supplementation is associated with improved pregnancy outcomes among women with refractory obstetric antiphospholipid syndrome (APS) who developed preeclampsia (PE) or intrauterine growth restriction (IUGR) during standard antithrombotic therapy, according to a study.
Roshini Claire Anthony, 07 Sep 2016

Estrogen receptor α (ESR1) mutations Y537S and D538G are associated with reduced overall survival (OS) in patients with human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer, according to findings of a secondary analysis of the BOLERO-2* clinical trial.

Christina Leung, Robert Chin, 19 Sep 2017
This review article outlines the prevalence of nausea and vomiting of pregnancy (NVP) and hyperemesis gravidarum (HG), definition of NVP and HG, aetiology, risk factors, complications of HG, recommended investigations, primary care management, hospital and ambulatory daycare, therapeutic management of HG supported by good clinical evidence, discharge planning, and importance of the multidisciplinary team to provide high quality care in patients with NVP and HG.

HPV genotyping with LBC trumps cytology for cervical screening in SG

23 Aug 2017
Singling out the DNA of HPV as a routine test proven to significantly locate pre-cancerous lesions

Human papillomavirus (HPV)+16/18 genotyping with reflex liquid-based cytology, compared to cytology, detects more cervical intraepithelial neoplasia grade 3 or worse (≥CIN3) and is cost-effective for cervical screening in Singapore, suggests a recent study.

A total of 1,866 women were included in the study; of these, 167 (8.9 percent) had abnormal cytology (≥ASCUS [atypical squamous cells of undetermined significance]) and 171 (9.2 percent) tested positive for high-risk HPV.

There were 23 CIN detected. Of the 10 ≥CIN3 cases, three had negative cytology but positive HPV-16.

Compared to cytology, HPV genotyping detected more ≥CIN3 (odds ratio, 1.43). Furthermore, HPV+16/18 genotyping with reflex LBC was superior to LBC with reflex HPV in terms of cost-effectiveness, both for disease detection rate and cost per case of ≥CIN2 detected.

Researchers retrospectively analysed women who were ≥25 years old and undertook cotesting with LBC and HPV-genotyping for HPV-16, HPV-18 and 12 high-risk HPV types in a single institution. A single cervical smear in ThinPrep PreservCyt solution was separated for tests in independent cytology and molecular pathology laboratories.

A designated gynaecologist reviewed the results based on institutional clinical management protocols. Those who tested positive for HPV-16 and/or HPV-18 (regardless of cytology results), cytology showing low-grade squamous intraepithelial lesions (SIL) or high-grade SIL, or ASCUS with positive 12 high-risk HPV types were referred for colposcopy.

A colposcopist determined cervical biopsy, either directed punch biopsies or excisional biopsy, and a gynaecologic pathologist reviewed the ≥CIN3 diagnosis.

Epidemiological, clinical and financial input data form Singapore were used to analyse the cost-effectiveness of HPV-based screening in terms of disease and financial burden.

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Most Read Articles
07 Aug 2016
Pravastatin supplementation is associated with improved pregnancy outcomes among women with refractory obstetric antiphospholipid syndrome (APS) who developed preeclampsia (PE) or intrauterine growth restriction (IUGR) during standard antithrombotic therapy, according to a study.
Roshini Claire Anthony, 07 Sep 2016

Estrogen receptor α (ESR1) mutations Y537S and D538G are associated with reduced overall survival (OS) in patients with human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer, according to findings of a secondary analysis of the BOLERO-2* clinical trial.

Christina Leung, Robert Chin, 19 Sep 2017
This review article outlines the prevalence of nausea and vomiting of pregnancy (NVP) and hyperemesis gravidarum (HG), definition of NVP and HG, aetiology, risk factors, complications of HG, recommended investigations, primary care management, hospital and ambulatory daycare, therapeutic management of HG supported by good clinical evidence, discharge planning, and importance of the multidisciplinary team to provide high quality care in patients with NVP and HG.