ABSTRACT
BackgroundPatients recovering from COVID-19 often suffer long-term Long-COVID (e.g., depression, poor concentration, anxiety, sleep disturbances, and fatigue). Similar symptoms also rarely seem to occur after COVID-19 vaccination. There is still no effective treatment for these symptoms. We have had a clinical experience that patients presenting with psychiatric/physical symptoms due to COVID-19 or COVID-19 vaccination (defined as Long-COVID and Post-Vaccine patients) often recover after transcranial magnetic stimulation (TMS) and that TMS poorly heals depression in strongly fatigued patients. Aims1. Determine whether there are differences in background characteristics and symptoms between Long-COVID and Post-Vaccine patients; 2. Examine whether TMS led to an improvement in their symptoms; 3. Test the involvement of fatigue in the recovery of depression of Long-COVID and Post-Vaccine patients with TMS. MethodsWe conducted a retrospective analysis using the medical records of the outpatient clinic of Tokyo TMS Clinic. Results1. We found no differences in initial symptoms and courses of treatment between Long-COVID and Post-Vaccine patients. 2. All psychiatric/physical symptom scores after 10 TMS treatments were significantly better than before. Though these results are of before-and-after studies, numerous reports have suggested that TMS effectively improves depression, insomnia, anxiety, and related neuropsychiatric symptoms, which were also primary complaints of patients in this study. We thus attributed the improvement in QIDS, PHQ9 (Both indices of depression), and GAD7 (anxiety indicator) to TMS. 3. The recovery rate of depression in Long-Covid and Post-Vaccine patients with TMS decreased with the severity of fatigue. ConclusionsThis is the first report to elucidate the efficacy of TMS and the factors affecting it for psychiatric symptoms after COVID-19 and COVID-19 vaccination. Our study may lead to further validation of the effectiveness and mechanisms of TMS in patients suffering from Long-COVID and COVID-19 vaccine long-term adverse reactions.
ABSTRACT
This study sought to demonstrate the benefits of conducting cervical cytology and human papillomavirus (HPV) testing in our cervical cancer screening program and was conducted between April 2012 and March 2017 in the Yuri-Honjo district of Akita Prefecture. A total of 3581 women aged 20-49 years underwent this combined screening for 5 years. Of these, 10.3% (369/3581) tested positive for HPV, and 433 women were initially diagnosed as positive for atypical squamous cells of undetermined significance and/or positive for HPV. Of those, 342 women (79.0%) underwent cervical biopsy, among whom 62 (18.1%) were diagnosed as positive for cervical intraepithelial neoplasia (CIN)2+. Of 204 women who were positive for HPV but showed no abnormalities in cytology, 24 women (11.8%) were positive for CIN2+ and 6 women were positive for CIN3+. Conventional cytology (Pap test) detected only 0.58% of the examinees positive for CIN2+ in Akita Prefecture, whereas our combined screening involving a Pap test and HPV testing detected 1.73% of the examinees (P<0.0001). We recommend HPV testing be used in combination with the Pap test to improve cervical cancer screening and accurately identify CIN2/3 disease.
