Vaginal Smears: Collection of pooled secretions of the posterior vaginal fornix for cytologic examination.Vagina: The genital canal in the female, extending from the UTERUS to the VULVA. (Stedman, 25th ed)Vaginosis, Bacterial: Polymicrobial, nonspecific vaginitis associated with positive cultures of Gardnerella vaginalis and other anaerobic organisms and a decrease in lactobacilli. It remains unclear whether the initial pathogenic event is caused by the growth of anaerobes or a primary decrease in lactobacilli.Estrus: The period in the ESTROUS CYCLE associated with maximum sexual receptivity and fertility in non-primate female mammals.Diestrus: A phase of the ESTROUS CYCLES that follows METESTRUS. Diestrus is a period of sexual quiescence separating phases of ESTRUS in polyestrous animals.Estrous Cycle: The period of cyclic physiological and behavior changes in non-primate female mammals that exhibit ESTRUS. The estrous cycle generally consists of 4 or 5 distinct periods corresponding to the endocrine status (PROESTRUS; ESTRUS; METESTRUS; DIESTRUS; and ANESTRUS).Gardnerella vaginalis: A species in the genus GARDNERELLA previously classified as Haemophilus vaginalis. This bacterium, also isolated from the female genital tract of healthy women, is implicated in the cause of bacterial vaginosis (VAGINOSIS, BACTERIAL).Gentian Violet: A dye that is a mixture of violet rosanilinis with antibacterial, antifungal, and anthelmintic properties.Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge.Proestrus: A phase of the ESTROUS CYCLE that precedes ESTRUS. During proestrus, the Graafian follicles undergo maturation.Ovary: The reproductive organ (GONADS) in female animals. In vertebrates, the ovary contains two functional parts: the OVARIAN FOLLICLE for the production of female germ cells (OOGENESIS); and the endocrine cells (GRANULOSA CELLS; THECA CELLS; and LUTEAL CELLS) for the production of ESTROGENS and PROGESTERONE.PhenazinesProgesterone: The major progestational steroid that is secreted primarily by the CORPUS LUTEUM and the PLACENTA. Progesterone acts on the UTERUS, the MAMMARY GLANDS and the BRAIN. It is required in EMBRYO IMPLANTATION; PREGNANCY maintenance, and the development of mammary tissue for MILK production. Progesterone, converted from PREGNENOLONE, also serves as an intermediate in the biosynthesis of GONADAL STEROID HORMONES and adrenal CORTICOSTEROIDS.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Uterus: The hollow thick-walled muscular organ in the female PELVIS. It consists of the fundus (the body) which is the site of EMBRYO IMPLANTATION and FETAL DEVELOPMENT. Beyond the isthmus at the perineal end of fundus, is CERVIX UTERI (the neck) opening into VAGINA. Beyond the isthmi at the upper abdominal end of fundus, are the FALLOPIAN TUBES.Castration: Surgical removal or artificial destruction of gonads.Ovulation: The discharge of an OVUM from a rupturing follicle in the OVARY.Estradiol: The 17-beta-isomer of estradiol, an aromatized C18 steroid with hydroxyl group at 3-beta- and 17-beta-position. Estradiol-17-beta is the most potent form of mammalian estrogenic steroids.Papanicolaou Test: Cytological preparation of cells collected from a mucosal surface and stained with Papanicolaou stain.Luteinizing Hormone: A major gonadotropin secreted by the adenohypophysis (PITUITARY GLAND, ANTERIOR). Luteinizing hormone regulates steroid production by the interstitial cells of the TESTIS and the OVARY. The preovulatory LUTEINIZING HORMONE surge in females induces OVULATION, and subsequent LUTEINIZATION of the follicle. LUTEINIZING HORMONE consists of two noncovalently linked subunits, alpha and beta. Within a species, the alpha subunit is common in the three pituitary glycoprotein hormones (TSH, LH and FSH), but the beta subunit is unique and confers its biological specificity.Ovarian Follicle: An OOCYTE-containing structure in the cortex of the OVARY. The oocyte is enclosed by a layer of GRANULOSA CELLS providing a nourishing microenvironment (FOLLICULAR FLUID). The number and size of follicles vary depending on the age and reproductive state of the female. The growing follicles are divided into five stages: primary, secondary, tertiary, Graafian, and atretic. Follicular growth and steroidogenesis depend on the presence of GONADOTROPINS.Organ Size: The measurement of an organ in volume, mass, or heaviness.Rats, Wistar: A strain of albino rat developed at the Wistar Institute that has spread widely at other institutions. This has markedly diluted the original strain.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Sputum: Material coughed up from the lungs and expectorated via the mouth. It contains MUCUS, cellular debris, and microorganisms. It may also contain blood or pus.Tuberculosis, Pulmonary: MYCOBACTERIUM infections of the lung.Cervix Uteri: The neck portion of the UTERUS between the lower isthmus and the VAGINA forming the cervical canal.Microscopy: The use of instrumentation and techniques for visualizing material and details that cannot be seen by the unaided eye. It is usually done by enlarging images, transmitted by light or electron beams, with optical or magnetic lenses that magnify the entire image field. With scanning microscopy, images are generated by collecting output from the specimen in a point-by-point fashion, on a magnified scale, as it is scanned by a narrow beam of light or electrons, a laser, a conductive probe, or a topographical probe.Cervical Intraepithelial Neoplasia: A malignancy arising in uterine cervical epithelium and confined thereto, representing a continuum of histological changes ranging from well-differentiated CIN 1 (formerly, mild dysplasia) to severe dysplasia/carcinoma in situ, CIN 3. The lesion arises at the squamocolumnar cell junction at the transformation zone of the endocervical canal, with a variable tendency to develop invasive epidermoid carcinoma, a tendency that is enhanced by concomitant human papillomaviral infection. (Segen, Dictionary of Modern Medicine, 1992)Benzophenoneidum: An aniline dye used as a disinfectant and an antiseptic agent. It is weakly fluorescing and binds specifically to certain proteins.Uterine Cervical Dysplasia: Abnormal development of immature squamous EPITHELIAL CELLS of the UTERINE CERVIX, a term used to describe premalignant cytological changes in the cervical EPITHELIUM. These atypical cells do not penetrate the epithelial BASEMENT MEMBRANE.Cytodiagnosis: Diagnosis of the type and, when feasible, the cause of a pathologic process by means of microscopic study of cells in an exudate or other form of body fluid. (Stedman, 26th ed)Colposcopy: The examination, therapy or surgery of the cervix and vagina by means of a specially designed endoscope introduced vaginally.Specimen Handling: Procedures for collecting, preserving, and transporting of specimens sufficiently stable to provide accurate and precise results suitable for clinical interpretation.Azure Stains: PHENOTHIAZINES with an amino group at the 3-position that are green crystals or powder. They are used as biological stains.Mass Screening: Organized periodic procedures performed on large groups of people for the purpose of detecting disease.Sensitivity and Specificity: Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)Staining and Labeling: The marking of biological material with a dye or other reagent for the purpose of identifying and quantitating components of tissues, cells or their extracts.Bacteriological Techniques: Techniques used in studying bacteria.Mycobacterium tuberculosis: A species of gram-positive, aerobic bacteria that produces TUBERCULOSIS in humans, other primates, CATTLE; DOGS; and some other animals which have contact with humans. Growth tends to be in serpentine, cordlike masses in which the bacilli show a parallel orientation.False Negative Reactions: Negative test results in subjects who possess the attribute for which the test is conducted. The labeling of diseased persons as healthy when screening in the detection of disease. (Last, A Dictionary of Epidemiology, 2d ed)Trichomonas vaginalis: A species of TRICHOMONAS that produces a refractory vaginal discharge in females, as well as bladder and urethral infections in males.Trichomonas Vaginitis: Inflammation of the vagina, marked by a purulent discharge. This disease is caused by the protozoan TRICHOMONAS VAGINALIS.Trichomonas Infections: Infections in birds and mammals produced by various species of Trichomonas.Candida: A genus of yeast-like mitosporic Saccharomycetales fungi characterized by producing yeast cells, mycelia, pseudomycelia, and blastophores. It is commonly part of the normal flora of the skin, mouth, intestinal tract, and vagina, but can cause a variety of infections, including CANDIDIASIS; ONYCHOMYCOSIS; vulvovaginal candidiasis (CANDIDIASIS, VULVOVAGINAL), and thrush (see CANDIDIASIS, ORAL). (From Dorland, 28th ed)Vaginal Discharge: A common gynecologic disorder characterized by an abnormal, nonbloody discharge from the genital tract.Leukorrhea: A clear or white discharge from the VAGINA, consisting mainly of MUCUS.Uterine Cervical Neoplasms: Tumors or cancer of the UTERINE CERVIX.Speech: Communication through a system of conventional vocal symbols.Moraxella: A genus of gram-negative, aerobic bacteria occurring as rods (subgenus Moraxella) or cocci (subgenus Branhamella). Its organisms are parasitic on the mucous membranes of humans and other warm-blooded animals.Anxiety: Feeling or emotion of dread, apprehension, and impending disaster but not disabling as with ANXIETY DISORDERS.

Screening for cervical cancer: a review of women's attitudes, knowledge, and behaviour. (1/2075)

The United Kingdom (UK) cervical screening programme has been successful in securing participation of a high proportion of targeted women, and has seen a fall in mortality rates of those suffering from cervical cancer. There remains, however, a significant proportion of unscreened women and, of women in whom an abnormality is detected, many will not attend for colposcopy. The present work reviews the psychological consequences of receiving an abnormal cervical smear result and of secondary screening and treatment, and examines reasons for women's non-participation in the screening programme. Psychological theories of screening behavior are used to elucidate women's reactions and to suggest methods of increasing participation, of improving the quality of the service, and of reducing women's anxiety. A literature search identified studies that examine factors influencing women's participation in the screening programme, their psychological reaction to the receipt of an abnormal cervical smear result, and experiences of colposcopy. Reasons for non-participation include administrative failures, unavailability of a female screener, inconvenient clinic times, lack of awareness of the test's indications and benefits, considering oneself not to be at risk of developing cervical cancer, and fear of embarrassment, pain, or the detection of cancer. The receipt of an abnormal result and referral for colposcopy cause high levels of distress owing to limited understanding of the meaning of the smear test; many women believe the test aims to detect existing cervical cancer. The quality of the cervical screening service can be enhanced by the provision of additional information, by improved quality of communication, and by consideration of women's health beliefs. This may result in increased participation in, and satisfaction with, the service.  (+info)

Natural history of dysplasia of the uterine cervix. (2/2075)

BACKGROUND: A historical cohort of Toronto (Ontario, Canada) women whose Pap smear histories were recorded at a major cytopathology laboratory provided the opportunity to study progression and regression of cervical dysplasia in an era (1962-1980) during which cervical squamous lesions were managed conservatively. METHODS: Actuarial and Cox's survival analyses were used to estimate the rates and relative risks of progression and regression of mild (cervical intraepithelial neoplasia 1 [CIN1]) and moderate (CIN2) dysplasias. In addition, more than 17,000 women with a history of Pap smears between 1970 and 1980 inclusive and who were diagnosed as having mild, moderate, or severe dysplasia were linked to the Ontario Cancer Registry for the outcome of any subsequent cervical cancers occurring through 1989. RESULTS: Both mild and moderate dysplasias were more likely to regress than to progress. The risk of progression from mild to severe dysplasia or worse was only 1% per year, but the risk of progression from moderate dysplasia was 16% within 2 years and 25% within 5 years. Most of the excess risk of cervical cancer for severe and moderate dysplasias occurred within 2 years of the initial dysplastic smear. After 2 years, in comparison with mild dysplasia, the relative risks for progression from severe or moderate dysplasia to cervical cancer in situ or worse was 4.2 (95% confidence interval [CI] = 3.0-5.7) and 2.5 (95% CI = 2.2-3.0), respectively. CONCLUSION: The risk of progression for moderate dysplasia was intermediate between the risks for mild and severe dysplasia; thus, the moderate category may represent a clinically useful distinction. The majority of untreated mild dysplasias were recorded as regressing to yield a normal smear within 2 years.  (+info)

Pap screening clinics with native women in Skidegate, Haida Gwaii. Need for innovation. (3/2075)

PROBLEM ADDRESSED: First Nations women in British Columbia, especially elders, are underscreened for cancer of the cervix compared with the general population and are much more likely to die of the disease than other women. OBJECTIVE OF PROGRAM: To develop a pilot program, in consultation with community representatives, to address the Pap screening needs of First Nations women 40 years and older on a rural reserve. MAIN COMPONENTS OF PROGRAM: Identification of key links to the population; consultation with the community to design an outreach process; identification of underscreened women; implementation of community Pap screening clinics; evaluation of the pilot program. CONCLUSIONS: We developed a Pap screening outreach program that marked a departure from the usual screening approach in the community. First Nations community health representatives were key links for the process that involved family physicians and office staff at a local clinic on a rural reserve. Participation rate for the pilot program was 48%, resulting in an increase of 15% over the previously recorded screening rate for this population. More screening clinics of this type and evaluation for sustainability are proposed.  (+info)

Mildly dyskaryotic smear results: does it matter what women know? (4/2075)

BACKGROUND: As of 1992, all women in the UK who have a first mildly dyskaryotic cervical smear are placed under surveillance for 6 months rather than being referred for immediate colposcopy. OBJECTIVES: We aimed to explore the relationship between anxiety and understanding about mild dyskaryotic, and to propose and discuss a method of analysing free text comments written by participants in studies based on structured questionnaires. METHODS: The freely scripted text of 236 women who had completed a questionnaire as part of a randomized controlled trial to assess the impact of an educational package was analysed. Randomization group status was concealed. Texts expressing similar views were grouped together and categorized. A matrix was drawn up to encompass the categories, and the comments were reallocated accordingly. RESULTS: Examination of the free text revealed two dimensions, concern and knowledge. There were no differences with respect to the apparent level of concern between the two randomization groups. However, comments from the intervention group were significantly more likely to have been classified as expressing good or vague knowledge than those from women in the control group. CONCLUSION: Although the educational intervention improved women's knowledge about the meaning of an abnormal smear result, this better knowledge was not correlated with less anxiety about the result. The free text analysis was a useful supplement to the main trial questionnaires. It demonstrated the existence of a range of understanding about cervical dyskaryosis, of anxieties relating to the receipt of such a result and the degree of interest women showed in acquiring further information.  (+info)

A mobile unit: an effective service for cervical cancer screening among rural Thai women. (5/2075)

BACKGROUND: We carried out a systematic screening programme using a mobile unit with the purpose of increasing use of Papanicolaou (Pap) smear screening among rural Thai women. The mobile unit campaign was carried out initially between January and February 1993 and then in 1996 in all the 54 rural villages in Mae Sot District, Tak Province, northern Thailand. METHODS: To evaluate the effect of the programme on changes in knowledge and use of screening, we compared the results of three interview surveys of women, 18-65 years old, in villages selected by systematic sampling for each survey; first in 1991 (before the operation of the programme), secondly in 1994 (one year after the first screening campaign), and last in 1997 (one year after the second campaign). This report also compares data on Pap smears taken by the mobile unit with other existing screening services in the study area. RESULTS: A total of 1603, 1369, and 1576 women respectively, participated in each survey. The proportion of women reported knowing of the Pap smear test increased from 20.8% in 1991 to 57.3% in 1994 and to 75.5% in 1997. The proportion of women who had ever had a Pap smear increased from 19.9% in 1991 to 58.1% in 1994 and to 70.1% by 1997. Screening by the mobile unit accounted for 85.2% of all cervical intraepithelial neoplasia (CIN) III and all invasive cancers identified among the Pap smears taken by screening services in the area between 1992 and 1996. The rate of CIN III was 3.5/1000 smears in this screening programme, which was 5.2 and 2.0 times higher than the rates in the maternal and child health/family planning clinic and the annual one-week mass screening campaign respectively. CONCLUSIONS: The use of a mobile unit may be an effective screening programme in rural areas where existing screening activities cannot effectively reach the female population at risk.  (+info)

Comparison between virus isolation method, Papanicolaou stain, immunoperoxidase stain and polymerase chain reaction in the diagnosis of genital herpes. (6/2075)

Papanicolaou (Pap) stain, immunoperoxidase (IP) stain and polymerase chain reaction (PCR) were evaluated against the virus isolation method for their sensitivity and specificity in the diagnosis of herpes simplex virus (HSV) infection in 96 women who were suspected of genital herpes. The result showed that the sensitivity of PCR, IP and Pap stain was 100, 92.0 and 62.7%, respectively, while the specificity was 76.2, 66.7 and 81.0%, respectively. PCR was even more sensitive than the virus isolation technique. As Pap stain is the technique routinely performed for diagnosing genital herpes in most of the hospitals in Thailand, its low sensitivity should be taken into consideration. Based on the investigation by all four techniques together, HSV infection was diagnosed in 91.6% of the cases suspected of genital herpes which reflected higher precision of the clinical diagnosis over Pap stain.  (+info)

Association of human papillomavirus infection and disease with magnitude of human immunodeficiency virus type 1 (HIV-1) RNA plasma level among women with HIV-1 infection. (7/2075)

Ninety-three women with human immunodeficiency virus type 1 (HIV-1) infection were enrolled in a cross-sectional study to evaluate the relationship between plasma HIV-1 RNA levels and coincident cervical infection and disease caused by human papillomaviruses (HPVs). HIV-1 RNA plasma levels of >10,000 copies/mL were highly associated with the presence in cervical specimens of HPV DNA of oncogenic (high risk) virus genotypes (P=.006; relative risk, 2.57). In addition, similar HIV-1 RNA plasma levels were associated with abnormal Pap smears (P=.01; relative risk, 2.11). In this study, 81% of women with high-risk HPV cervical infection had abnormal Pap smears. Measurement of HIV-1 RNA plasma levels may help to identify a subgroup of HIV-1-infected women at increased risk for cervical HPV infection and disease.  (+info)

Nonisotopic detection and typing of human papillomavirus DNA in genital samples by the line blot assay. The Canadian Women's HIV study group. (8/2075)

The line blot assay, a gene amplification method that combines PCR with nonisotopic detection of amplified DNA, was evaluated for its ability to detect human papillomavirus (HPV) DNA in genital specimens. Processed samples were amplified with biotin-labeled primers for HPV detection (primers MY09, MY11, and HMB01) and for beta-globin detection (primers PC03 and PC04). Amplified DNA products were hybridized by a reverse blot method with oligonucleotide probe mixtures fixed on a strip that allowed the identification of 27 HPV genotypes. The line blot assay was compared to a standard consensus PCR test in which HPV amplicons were detected with radiolabeled probes in a dot blot assay. Two hundred fifty-five cervicovaginal lavage specimens and cervical scrapings were tested in parallel by both PCR tests. The line blot assay consistently detected 25 copies of HPV type 18 per run. The overall positivity for the DNA of HPV types detectable by both methods was 37.7% (96 of 255 samples) by the line blot assay, whereas it was 43. 5% (111 of 255 samples) by the standard consensus PCR assay. The sensitivity and specificity of the line blot assay reached 84.7% (94 of 111 samples) and 98.6% (142 of 144 samples), respectively. The agreement for HPV typing between the two PCR assays reached 83.9% (214 of 255 samples). Of the 37 samples with discrepant results, 33 (89%) were resolved by avoiding coamplification of beta-globin and modifying the amplification parameters. With these modifications, the line blot assay compared favorably to an assay that used radiolabeled probes. Its convenience allows the faster analysis of samples for large-scale epidemiological studies. Also, the increased probe spectrum in this single hybridization assay permits more complete type discrimination.  (+info)

  • There really is not much that goes into preparing for a Pap smear, though it is advised to avoid scheduling your test during your menstrual cycle, in addition to avoiding having intercourse or using any substances that may enter the vagina (jellies, douches, etc. (
  • Some women say that they bleed a tiny bit from the Pap smear after the exam, so they like to put a pantiliner in their underwear as they get dressed. (
  • For younger women ages 21 to 30, the recommendations call only for Pap smears every three years. (
  • HPV is also associated with vaginal and vulvar cancer in women and can lead to penile cancer in men. (
  • PAP smears should be started as soon as women turn 21 years old or 3 years after being sexually active, whichever comes first. (
  • It is recommended that woman aged 25 to 49 should go for a pap smear every three years and for women aged 50 to 64 should go every five years. (
  • Whether done as part of scheduled visits to an OBGYN or due to a suspected health issue, a Pap smear is an important tool to keep women healthy. (
  • Some women also prefer to complete Pap smears more often than every 3 years for reassurance regarding their health, though this is not necessary. (
  • Women within this older age range are usually exempt from Pap smears if they have received them regularly throughout their lifetime and have never had one of these tests come back with positive results for cancer. (
  • The primary goal of having an OBGYN perform a Pap smear is to determine if the cells are normal, precancerous or cancerous. (