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This book provides a comprehensive analysis of how the HPV industry has invaded and eroded the women's health care system in the field of cervical cancer prevention. The analysis based on currently available science and public records provides the readers interested in cervical cytopathology, HPV molecular diagnostics and HPV vaccination with a clear understanding of issues and solutions to cervical cancer prevention. Pap smear screening in the United States was first implemented as an annual test in the late 1940s. Its widespread use for early detection of precancerous cells destined to proceed to invasive carcinoma for timely ablative treatment markedly reduced the morbidity and mortality rates of cervical cancer. No one should die of cervical cancer if every woman continued receiving proper annual Pap smear screening carried out by a team of cytology technologist, pathologist and gynecologist. However, this teamwork broke down when cytology samples were sent to geographically distant centralized commercial laboratories for screening. Under such business atmosphere, cytology screeners, pathologists and gynecologists hardly speak to one another to discuss any potential diagnostic problems. Overwhelming numbers of unnecessary colposcopic biopsies have been performed on essentially healthy women when "false positive" cytology reports are sent to their gynecologists. However, it is the false-negative results which draw public attention while stories about Pap smear litigation cases are circulated around social media sites when follow-up tests unexpectedly reveal an invasive cancer during the patient's annual screening. Further chaos was created after human papillomavirus (HPV) infections were discovered by Dr. Harald zur Hausen to be one of the most important risk factors for developing cervical cancer. A handful of opportunists successfully persuaded the Food and Drug Administration to regulate their HPV assays as cancer tests and anti-HPV vaccines as cancer vaccines so that they can market these products by tapping into the public's fear of cancer. Commercial HPV tests detect many reversible cytopathology changes with high viral loads per cell, but are not sensitive enough to detect high-grade precancerous cells with low viral loads per cell. Without performing DNA sequencing, none of these test kits can provide an accurate genotyping for follow-up of persistent HPV infections, a true cancer risk. This book points out there is no factual evidence that HPV vaccination has prevented a single case of cervical cancer. Using reversible precancerous histologic changes as surrogate endpoints in clinical trials to support the claim of efficacy of HPV vaccination in prevention of cervical cancer is flawed. Since the HPV vaccine Gardasil relies on using residual HPV L1 gene DNA fragments bound to aluminum salt as the toll-like receptor 9 agonist to boost innate immune response, high levels of pro-inflammatory cytokines are generated in the vaccinees. These pro-inflammatory cytokines may cause serious adverse events in genetically and physically predisposed individuals. Women consumers are advised to read this book before choosing the modalities for cervical cancer prevention to protect their own health and lives as well as those of their loved ones.
The seventh edition of the Canadian Immunization Guide was developed by the National Advisory Committee on Immunization (NACI), with the support ofthe Immunization and Respiratory Infections Division, Public Health Agency of Canada, to provide updated information and recommendations on the use of vaccines in Canada. The Public Health Agency of Canada conducted a survey in 2004, which confi rmed that the Canadian Immunization Guide is a very useful and reliable resource of information on immunization.
This book offers clear, up-to-date guidance on how to report cytologic findings in cervical, vaginal and anal samples in accordance with the 2014 Bethesda System Update. The new edition has been expanded and revised to take into account the advances and experience of the past decade. A new chapter has been added, the terminology and text have been updated, and various terminological and morphologic questions have been clarified. In addition, new images are included that reflect the experience gained with liquid-based cytology since the publication of the last edition in 2004. Among more than 300 images, some represent classic examples of an entity while others illustrate interpretative dilemmas, borderline cytomorphologic features or mimics of epithelial abnormalities. The Bethesda System for Reporting Cervical Cytology, with its user-friendly format, is a “must have” for pathologists, cytopathologists, pathology residents, cytotechnologists, and clinicians.
Most women who die from cervical cancer, particularly in developing countries, are in the prime of their life. They may be raising children, caring for their family, and contributing to the social and economic life of their town or village. Their death is both a personal tragedy, and a sad and unnecessary loss to their family and their community. Unnecessary, because there is compelling evidence, as this Guide makes clear, that cervical cancer is one of the most preventable and treatable forms of cancer, as long as it is detected early and managed effectively. Unfortunately, the majority of women in developing countries still do not have access to cervical cancer prevention programmes. The consequence is that, often, cervical cancer is not detected until it is too late to be cured. An urgent effort is required if this situation is to be corrected. This Guide is intended to help those responsible for providing services aimed at reducing the burden posed by cervical cancer for women, communities and health systems. It focuses on the knowledge and skills needed by health care providers, at different levels of care.
“HPV and Cancer” is a concise read that covers all aspects of the Human Papilloma Virus as it relates to human cancers. While written by professionals, it design to be understandable by those that are not in the field, yet it has the technical details that professionals want to stay abreast of this changing field. The book starts out the history of HPV and progresses into the molecular biology of the virus and our current understand of the structure and functions of the proteins and genes it encodes. We then look at the dynamic trends of this infectious agent in the human population, how it interacts with human cells, and the role it plays with other organisms to produce both benign and malignant tumors. Lastly, there is a discussion about a new vaccine for HPV and the hopes that are held by many to change the trends with this virus and the associated cancers it produces.
Written with the busy practice in mind, this book delivers clinically focused, evidence-based gynecology guidance in a quick-reference format. It explores etiology, screening, tests, diagnosis, and treatment for a full range of gynecologic health issues. The coverage includes the full range of gynecologic malignancies, reproductive endocrinology and infertility, infectious diseases, urogynecologic problems, gynecologic concerns in children and adolescents, and surgical interventions including minimally invasive surgical procedures. Information is easy to find and absorb owing to the extensive use of full-color diagrams, algorithms, and illustrations. The new edition has been expanded to include aspects of gynecology important in international and resource-poor settings.
Despite the common perception that medicine is becoming specialty driven, there are many reasons for primary care providers to offer women’s health procedures in an office setting. Women feel more comfortable having procedures done by prov- ers whom they already know and trust. Continuity of care is still valued by patients, who trust their primary care providers to work with them as collaborators in the decision-making process. Women have found that their options for care have become limited, not by their own decision, but by the lack of training of their p- vider. In rural areas, the barriers of time, expense, and travel often prevent many women from obtaining necessary care; yet many of the procedures that these women are requesting are relatively easy to learn. Positive experiences are shared by women who then refer friends and family by word of mouth. This book has been designed to assist not only the clinician performing the pro- dures covered, but also the office staff with setting up the equipment tray prior to p- forming the procedure and with preparing office documents and coding information needed to complete the procedure. Most procedures covered can be done with a mi- mum investment in equipment and require minimal training.
"The AAP's authoritative guide to the manifestations, etiology, epidemiology, diagnosis, and treatment of more than 200 childhood conditions." -- Provided by publisher.
Recoge: 1. Epidemiological guidelines for quality assurance in cervical cancer screening - 2. Methods for screening and diagnosis - 3. Laboratory guidelines and quality assurance practices for cytology - 4. Techniques and quality assurance guidelines for histopathology - 5. Management of abnormal cervical cytology - 6. Key performance indicators - 7. Annexes.