Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.7.10.2 (focal adhesion kinase)
 44,029 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective study of the results of cervical cytological screening of HIV-infected women attending an inner city ambulatory HIV clinic over a 6-year period between 1987 and 1992 was carried out. During this time a total of 165 HIV-infected women attended for management of their HIV disease. The results of cervical cytological specimens (smears) were available in 136 (82.4%) women. The risk categories for HIV infection of these 136 women were intravenous drug use 110 (80.9%), heterosexual sex 24 (17.6%) and undetermined 2 (1.5%). Eighty-five (62.5%) of the 136 women were classified CDC group 2, 30 (22%) CDC group 3, and 21 (15.5%) CDC group 4 at the time of initial cytological screening. Forty-one (30.1%) women had mild dysplasia/CIN 1, 21 (15.4%) had moderate dysplasia/CIN 2 and 17 (12.5%) had severe dysplasia/CIN 3. The overall prevalence of dysplasia/CIN was 58.1%. Twenty-seven (34.2%) of the women with dysplasia/CIN had cytological evidence of human papillomavirus infection. No association between the clinical stage of HIV disease and the presence or degree of dysplasia/CIN was demonstrated. Women with cytological evidence of CIN were significantly more likely to have had genital warts than those with no evidence of CIN (OR 3.1, CI 1.1-10). In those women with cervical dysplasia who underwent colposcopic examination, CIN was confirmed in a high proportion of cases. The default rate from colposcopy, however, was high (35.4%).
Int J STD AIDS
PMID:Cervical cytological screening in HIV-infected women in Dublin--a six-year review. 754 89

An audit of the use of colposcopy in women with anogenital warts was performed. Fifty women attending a clinic for sexually transmitted diseases in a District General Hospital with anogenital warts were examined by cervical cytology and colposcopy for cervical infection by human papillomavirus (HPV) or epithelial abnormality indicating cervical intraepithelial neoplasia (CIN) or both. Collated results showed a high prevalence of both conditions in these 50 women; 20 (40%) had evidence of cervical infection by HPV and 11 (22%) epithelial abnormalities consistent with CIN 1 or 2. However, neither CIN 3 nor invasive disease was detected. Colposcopy in this setting was shown to be a specific but insensitive tool and its role in the routine management of women with anogenital warts at our institution is not warranted.
Int J STD AIDS
PMID:Screening for cervical abnormalities in women with anogenital warts in an STD clinic: an inappropriate use of colposcopy. 784 24

'See and treat' colposcopy using an excisional technique (usually LLETZ) is very attractive to patients and practitioners. It is therapeutically effective, efficient and cost-effective within the context of the screening programme. It is, of course, inappropriate to excise the transformation zone of any woman who attends the clinic with an abnormal smear. The question should however be, 'Is there a reason why I should not see and treat', rather than 'why should I see and treat'. Reasons for avoiding 'see and treat' comprise patients' preference and young age coupled with minor cytological or histological abnormalities (i.e. mild dyskaryosis or less and CIN 1 or less). This is because many minor problems will resolve without therapy and because long-term data collection may show effects about which we know nothing. I would argue that for patients with mild abnormalities who are older or their fertility is not an issue, 'see and treat' is appropriate because the treatment morbidity is so low and they are at higher risk of having significant lesions than young women. Finally, for patients with more severe abnormalities, the timing of the treatment is irrelevant, and the only argument against 'see and treat' is patient preference.
Int J STD AIDS
PMID:The case for early intervention ('see and treat') in patients with dyskaryosis on routine cervical screening. 911 75

The aim of the study was to compare the frequency of Chlamydia trachomatis infection in patients with cervical intraepithelial neoplasia (CIN) and in women without cervical pathology. In a study group of 423 patients with histologically proven CIN and in 108 controls with normal cervical smear, cytological material for direct immunofluorescence analysis was obtained. Among 423 patients, 24 (5.7%) had CIN 1, 108 (25.5%) CIN 2 and 291 (68.8%) CIN 3. Among all patients with CIN, 27 (6.4%) were C. trachomatis positive and 396 (93.6%) C. trachomatis negative. In the control group 6 (5.6%) were C. trachomatis positive and 102 (94.4%) C. trachomatis negative. The difference between C. trachomatis infection incidence in patients with CIN and in women without cervical pathology was not significant (chi2=0.29; P>0.05). In this study, no difference in C. trachomatis infection incidence was detected between patients with CIN and women with normal cervical smears. The impact of C. trachomatis infection seems not to interfere with the development or even the promotion of CIN.
Int J STD AIDS 1999 May
PMID:Chlamydia trachomatis infection in women with and without cervical intraepithelial neoplasia. 1066 5

The prevalence of cervical intraepithelial neoplasia (CIN) is high among HIV-infected women. Decreased CD4 lymphocytes, high human immunodeficiency viral load (HIVL) and human papillomavirus (HPV) infection are risk factors for CIN. We characterized the prevalence, risk factors and prognosis of histologically-verified CIN among systematically followed HIV-infected women enrolled from a low HIV-prevalence population. The study population comprised 153 HIV-infected women followed between 1989 and 2006. The mean +/- SD duration of follow-up was 5.6 +/- 3.8 years. Demographic as well as treatment-related data were derived from medical reports. During the follow-up, 51 subjects (33%) displayed CIN (16% CIN 1 and 18% CIN 2 +), whereas 102 subjects had Pap smear results of normal cells, atypical squamous cells of uncertain significance, or signs of low-grade squamous intraepithelial lesion (LSIL) but no CIN in histological specimens from the cervix. Only one case of cancer of the uterine cervix was detected. Pap smears were reliable in screening for CIN; 75% of patients with CIN had high-grade squamous intraepithelial lesion (HSIL) or LSIL in Pap smears taken at the time of dysplasia. The incidence of CIN decreased from 12.7 to 3.5 (per 100 subjects) between 2000 and 2005 (P = 0.07). The risk of CIN was not associated with decreased levels of CD4 lymphocytes, duration of HIV infection, use of antiretroviral medication or plasma HIVL. In univariate analysis, bacterial vaginosis (BV) was associated with a significantly increased risk of CIN, whereas parity was associated with lower risk of CIN. Each delivery lowered the risk of CIN by 30% (P = 0.02). The significantly lower risk of CIN among parous women (P = 0.04) persisted in multivariate analysis. CIN was treated by means of loop electrosurgical excision procedure (LEEP), (n = 34). The recurrence rate was low; seven subjects (14%) had a recurrence of CIN during follow-up. The nadir of CD4 lymphocytes was lower (P = 0.04) and the HIVL higher (P = 0.03) among subjects with recurrence of CIN. Duration of HIV infection, use of antiretroviral medication and positive margins in LEEP specimens were indistinguishable among subjects with vs. without recurrence of CIN. The prevalence of CIN is high among systematically managed HIV-infected women. However, the incidence of CIN decreased during the 21st century. BV was associated with an increased risk of CIN whereas parous women had lower risk of CIN. However, the patients with and without CIN could not be distinguished on the basis of previously described risk factors. Regular follow-up by means of Pap smears is warranted in all HIV-infected women.
Int J STD AIDS 2008 Jan
PMID:Risk factors, diagnosis and prognosis of cervical intraepithelial neoplasia among HIV-infected women. 1827 45