Comparison of urine and cervical samples for detecting human papillomavirus (HPV) with the Cobas 4800 HPV test.

BACKGROUND: Human papillomavirus (HPV) is the main cause of cervical cancer. The development of non-invasive self-sample collection methods would have the potential advantage of increasing the acceptance of the screening procedures. OBJECTIVES: To compare human papillomavirus (HPV) DNA detection and genotyping with the Cobas 4800 HPV test (Roche Diagnostic, Spain) on paired cervical and first voided urine. STUDY DESIGN: Paired urine and cervical samples were collected from 125 women referred for evaluation of abnormal Pap smear results. RESULTS: The overall percent agreement between HPV detection in urine and cervical samples was 88%. A substantial concordance rate of HPV DNA detection in both samples was observed (κ=0.76; 95% IC: 64-87). In this high prevalence population the sensitivity, specificity, NPV and PPV for detection of HPV DNA from urine versus cervical samples were 90.5% (95% IC: 80-95%), 85%, (95% IC: 74-92%), 89.8% (95% IC: 79.5-95.3) and 86.4% (95% IC: 76.1-92.7) respectively. Compared to histologically confirmed CIN 2/3 disease, the clinical sensitivity and specificity for the detection of high-risk HPV in urine samples were 95% (95% IC: 76-97%) and 52.4% (95% IC: 40-64%) respectively. CONCLUSIONS: These results suggest that urine samples processed with Cobas 4800 HPV test may be useful for clinical management of HPV infection.

Bayesian estimation of the prevalence of suicide risk in institutionalized older people.

The assessment of suicide risk in institutionalized older people has received less attention in comparison with those not institutionalized. The studies carried out show contradictory data on the prevalence of risk in this population group. The current work estimates the prevalence of suicide risk through a Bayesian analysis and studies the risk factors of this behavior in a group of 110 institutionalized older people. A prevalence of 38.4% is obtained, and an association between suicide risk and the factors depression and perception of health. The results indicate to us the necessity for actions directed at decreasing the suicide rate in geriatric homes.