Impact of an HPV diagnosis on the quality of life in young women.

OBJECTIVE: To evaluate the impact of the communication of an HPV diagnosis on the cognitive-behavioural aspect, emotional experiences, psychic-physical well-being, and psychosexual sphere in young women between the ages of 20 and 45. METHOD: During the period between February 2006 and March 2007, at the U.O. Department of Obstetrics and Gynecology of the ULSS 13 of Mirano (VE), we distributed three self-evaluating questionnaires (the CBA-20, the SAT-P, and the BISF-W) to 36 women who had been diagnosed with an HPV infection and 36 women who had never been diagnosed with HPV. RESULTS: 36% of the experimental group reacted to the diagnosis with fear and 29% reacted with anxiety, while in only 3% of the cases did the women react with anger. Significant differences emerged in two samples regarding state anxiety and obsessive and compulsive aspects, while there were no significant differences between the two groups regarding the subjective satisfaction with life quality and sexual function. A significant positive correlation was found between the sum of anxiety and fear expressed at the time of the diagnosis and the trait anxiety reported in the Cognitive Behavioural Assessment 2.0. CONCLUSIONS: The results indicate that the prevalent emotions felt at the time of the diagnosis are fear and anxiety. The persons who were diagnosed with an HPV infection resulted as having higher levels of trait anxiety, obsessions, compulsions, and above all, behaviours and worries related to hygiene and improbable infections.

Patterns of recurrence in patients with squamous cell carcinoma of the vulva. A multicenter CTF Study.

BACKGROUND: Invasive vulvar carcinoma is a rare disease with an incidence rate of 3-5% of all female genital neoplasms. The current study discusses the limited number of articles in the literature regarding the patterns of recurrence as well as the clinical outcome of patients with recurrent disease based on a consistent and consecutive series of cases. METHODS: A common clinical chart focusing on the study of patterns of recurrence was used in five Italian gynecologic institutions with uniform criteria of surgical nomenclature, pathologic variables, and sites of recurrence. Between 1980-1994, 502 cases of primary invasive squamous carcinoma of the vulva were registered consecutively, treated, and considered for this multicentered study. RESULTS: Of 502 patients, 187 (37.3%) developed a recurrence. Distribution of the recurrences by site was as follows: perineal, 53.4%; inguinal, 18.7%; pelvic, 5.7%; distant, 7.9%; and multiple, 14.2%. In a multivariate analysis, 3 characteristics appeared to be statistically correlated with the risk of recurrence: International Federation of Gynecology and Obstetrics Stage > II (P = 0.029), positive lymph nodes (P = 0.009), and vascular space invasion (P = 0.004). The 5-year survival rate was 60% for perineal recurrences, 27% for inguinal and pelvic recurrences, 15% for distant recurrences, and 14% for multiple recurrences. CONCLUSIONS: In the current study the prognostic factors found to have statistical significance as prognostic factors for risk of recurrence were tumor dimension, lymph node involvement, and stromal and vascular space invasion. The presence of inguinal lymph node metastases was predictive of multiple and distant recurrences with a low rate of incidence of isolated perineal recurrence (27%) compared with negative lymph node cases (57.5%). Survival analysis of recurrent disease showed that the surgical resection of local recurrences may provide acceptable results (51% at 5 years). This observation may justify a follow-up program aimed at identifying those patients with early local recurrence suitable for radical resection.

[Anomalies of the trunk. An analysis of their prevalence in young athletes]. / Anomalie del tronco. Analisi della prevalenza nel giovane sportivo.

BACKGROUND: To evaluate the influence of some sports (swimming, tennis, soccer, artistic gym, classical dance, basket, volley) on the development of the musculoskeletal system in prepuberal children. METHODS: From January 1994 to December 1997, 3,765 students of the 4th and 6th class of primary schools in the area of the health district of Cremona, underwent orthopaedic screening. The prevalence of kyphosis, hyperlordosis and back asymmetry in children playing and not playing sports were compared. Statistical analysis was performed using X2-test. RESULTS: The incidence of hyperlordosis was significantly lower in boys playing soccer while the incidence of back asymmetry was higher in girls playing basketball. Tennis was found not to be a suitable sport for either male or female prepuberal children. Swimming was the best sport for females whereas males who swan registered a higher incidence of hyperphosis compared to the control group. In females the incidence of hyperlordosis did not correlate with any of the sports considered whereas the incidence in boys playing soccer and swimming showed a decrease. Hyperkyphosis in females can be reduced by swimming and volleyball, in males by playing basketball. CONCLUSIONS: The results obtained suggest the importance of an orthopaedic evaluation of children who want to take up sports.