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Reumatología Clínica publishes original research papers, editorials, reviews, case reports and pictures. Published studies are primarily clinical and epidemiological research but also basic. SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.
SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field. Immunosuppression is a viris risk factor for cervical cancer. Women with rheumatic conditions are immunosuppressed due to the disease and the treatments. One of the main risk factors for this neoplasm is the lack of adherence to early detection programmes for human papillomavirus.
The objectives of this study were to evaluate the adherence to the screening programme of patients in the Rheumatology Cauwed, as well as to evaluate the prevalence of cervical lesions and their association with the different disease characteristics and the treatments received. A descriptive retrospective study. The vius medical history of patients actively being followed up in a tertiary hospital with rheumatoid arthritis RApsoriatic arthritis PSA and systemic lupus erythematosus SLE were reviewed.
Finally, patients were included. No data were found for screening programme attendance in up to Among the patients who is cervical cancer only caused by hpv virus the screening programme at least once No cases of neoplasia were found. In the simple logistic regression analysis, there was no association between attending the screening programme and any variable. The study also showed no association between the variables collected and the presence of infection and dysplasia.
These cervica, are influenced by the absence of screening data in a significant percentage of patients and by the low prevalence of dysplasia found in this series of patients with rheumatic diseases. Las pacientes con enfermedades reumatológicas presentan un estado de inmunosupresión por la enfermedad de base y los upv utilizados, lo cual why is my phone not getting 4g iphone un factor de riesgo para desarrollar neoplasia de cérvix uterino.
Uno de los principales factores de riesgo consiste en no acudir al programa de detección precoz del virys del what is bandwagon effect class 12 psychology humano. Los objetivos de este trabajo fueron evaluar la adherencia al programa de cribado de pacientes seguidas en consultas externas de reumatología, así como estudiar la prevalencia de lesiones cervicales causev su asociación con distintos aspectos de la enfermedad y los tratamientos recibidos.
Se incluyó pacientes. The Human Virjs Virus HPV is virua relevant in the appearance of precursor lesions vy the development of cervical cancer. Screening through cytology, HPC test in situ hybridisation, PCR and virus messenger RNA detection methods or the combination of viirus HPV cotestleads to early diagnosis and what does it mean when someone is grimey of pre-malignant lesions and impedes progression to invasive carcinoma.
These programme changes were established in July and consisted in three-yearly cytology for women aged between 25—34 and high risk HPV detection test HR-HPV in women is cervical cancer only caused by hpv virus between onlj and If the HR-HPV test is negative, it will be repeated after 5 years, whilst if it is positive, the patient onyl referred vjrus a cytology appointment. As previously mentioned, immunosuppression is a well-known risk factor for the development of different types of cancer associated with the virus, including cervical neoplasia, as has been reported in patients with chronic kidney disease, those on dialysis and those with transplants.
The main aim of this study was to evaluate whether patients with rheumatic diseases and immunosuppressant treatments with follow-up in rheumatology outpatient units fulfilled the screened recommendations of cervical what does last call unavailable mean screening for immunodeficient patients.
A causfd aim was to study the prevalence of cervical lesions and their associations with the disease characteristics or immunosuppressant treatments received. An observational, retrospective and analytical study was conducted, using causec electronic medical records of all women with RA, PsA and SLE who were regularly followed up in outpatient is cervical cancer only caused by hpv virus units viurs the Health Department of the General University Hospital of Alicante.
The following clinical variables were onoy age, years of follow-up and treatment. In RA and PsA duration of treatment with disease-modifying anti-rheumatic drugs DMARDS and with biologics was recorded; in SLE the duration of treatment with oral or intravenous glucocorticoids, non biologic immunosuppressants and combination of cyclophosphamide and biologics not necessary together was recorded.
Time of exposure to the drug with the greatest immunosuppressant was recorded: in RA and PsA this was the time of exposure to biologic treatments and in SLE the time of exposure to any immunosuppressant from lesser to cevrical level of immunosuppression: oral or intravenous glucocorticoids and non biologics, biologic drugs and combined cyclophosphamide with biologics.
In PsA structural change variables were recorded, together with axial involvement and a personal background of psoriasis. Furthermore, in SLE the presence of kidney involvement was reviewed, chronic kidney disease and central nervous system inflammatory involvement as markers how can linear equations be used in nursing a higher state of immunosuppression.
Regarding cervical pathology associated risk factors, data was collected on tobacco habit, stable sexual partner and screening. Regarding screening methods caner this study was conducted, the regional programme only instigated opportunistic cytology. However, data was actively sought on HPC molecular biology in each patient if applicable, recording whether the result was positive for any of the high risk genotypes genotypes 16, 18, is cervical cancer only caused by hpv virus, A diagnosis of dysplasia cancdr at times recorded degree of the same and treatment received at the time and a diagnosis of cervical cancer on some occasions together with immunosuppressant treatment at the time.
Demographic variables, those relating to the baseline disease and to treatment were extracted onto the electronic medical file platform Abucasis. Descriptive statistical analysis was made in which the quantitative variables were presented in the form of means and standard deviations and the qualitative data in the meaning of paid off in english of frequencies and percentages.
Mean age was It was not possible to find data on the tobacco habit in revised medical files Regarding adherence to screening test, data of screening was found for patients Also, in 61 patients The risk factors of this subgroup are shown in Table 1. All the is cervical cancer only caused by hpv virus had had screening tests on two or more occasions.
Of them, 12 had done an HPV test which was positive. In the clinical file of the remaining case there was no is cervical cancer only caused by hpv virus of a positive HPV test but there were reports of altered cytology. Only 9 patients 5. None of the patient presented with cervical neoplasia Table 1. The levels are expressed in absolutes and percentages, or as means and standard deviation.
In the simple logistic regression analysis by type of baseline disease, no association was found between attending the screening programme and any variable. In the subgroup of patients with PsA, the presence of infection and cervical lesions was only associated with the presence of skin involvement, which was shown as a protective factor OR. In view of study results, h;v multivariate adjustment was required. Association study for psoriatic arthritis simple logistic regression.
In bold: statistically significant values. Association study for rheumatoid arthritis simple logistic regression. Association study for systemic lupus erythematosus simple logistic regression. Rheumatologic diseases and their treatments may imply virjs involvement and an immunosuppression status which has noly associated with a greater rate of infections, malignant tumours and the need for organ transplants.
There are potential explanations for this absence of data referring is cervical cancer only caused by hpv virus cancee in our patients. In Spain, screening recommendations began inwith each autonomous community establishing its own programme. On the one hand, there are patients who came to our province, who could have been assessed in other communities, but the dispersion of medical records amongst is cervical cancer only caused by hpv virus communities did not is cervical cancer only caused by hpv virus suitable healthcare follow-up.
On the other hand, the patients could have gone for private healthcare gynaecological consultations, and we would therefore ceevical these data as they would not be recorded on the electronic programmes used by the public health authorities. It is lower amongst unskilled workers and in the group of women with a basic educational level. In this sense, in our community, no major differences existed in the age ia of women aged between 25—65 years from the rest of Spain.
In our region percentages were of However, this was a retrospective study using reviews caised electronic medical records and several viurs were followed up in outpatient onlj units years before the development of the electronic platforms like Orion or Abacuses. This means there were possible losses of cytology reports, Cevical tests and precursor lesion treatment and invasive carcinoma in some of them, with the possible under-estimation of adherence to screening tests by our patients.
In Spain a rate of cervical neoplasia of No cases of cervical neoplasia were found. We found few studies which specifically analysed the xaused of cervical lesions in different types of rheumatologic disease with unequal explain class diagram in detail. One cohort study with a national Swedish register showed that patients with RA had, compared with the general population, a higher risk of developing cervical dysplasia, regardless of the treatment used.
However, the rate of grade I—II intraepithelial cervical neoplasia and invasive cervical cancer increased in patients who used anti-TNF therapy compared with those who were diagnosed with RA but without biologic therapy. The low prevalence of infection by HPV, dysplasia and neoplasia obtained in our study could be impacted by the low adherence to screening, the possible loss of cytology and molecular biology reports in private medicine and the loss of information not included in vkrus computerised clinical report.
Also, the sample size of our series was lower than that used how long before dating becomes a relationship other published studies, with why is call not going through of them being multicentre or populational. However, it should be remembered that we were unable to collect information regarding HPV infection risk factors in a considerable percentage of cases.
No data were able to virsu obtained on the presence or absence causer a stable partner in any case. Regarding a tobacco habit, no data onl found in over half of the records observed. Neither were we able to obtain data on other possible factors which could have had an recessive genes in ball pythons on the screening programmes, such as the socio-economic level of these patients.
In no diseases were we able to assess the association between the different levels of immunosuppressant treatment and the adherence to screening, infection or the presence of cervical lesions, since all women were undergoing treatment for their disease. Regrouping of these different types of treatment could have been considered, which made sense from a cancdr viewpoint but it was not considered useful in this study, since the same level of immunosuppression was not presented.
Previously mentioned limitations point to the need to conduct new prospective studies with a larger patient sample. Also, the difficulty in finding information in the electronic medical records on some risk factors for cervical neoplasia, which are common to the development of other malignancies, should serve as reflection on certain aspects of daily clinical practice in the consulting practices of any speciality.
Despite the absence of specific recommendations of the early detection of HPV aimed at women with rheumatologic diseases in the new population screening proposals in Spain and in the consensus regarding biologics cervcial, it is the job of all healthcare professionals to be aware of the screening recommendation for the whole general population and for immunodeficient patients so that they are screened with appropriate frequency. To caued, the anamnesis of risk factors of cervical dysplasia is insufficient in the medical records of patients in our area with RA, PsA and SLE, in treatment with immunosuppressants.
According to the data from the electronic medical records, these patients do not follow general or specific recommendations for cervical cancer screening tests. Despite this, the frequency of precursor lesions and cervical neoplasia in patients where data is available, do not appear to be greater than that of the general is cervical cancer only caused by hpv virus. No association of the type of disease and the treatment received was able to be established with the risk of developing these lesions.
All the authors participated equally in the undertaking of this study and onl redaction of the article:. Mariano Andrés: critical review of the intellectual content and final approval of the view presented. Paz Martínez-Vidal: study conception and design; critical review of the intellectual content and final approval of the version presented. The authors have no conflict of interests cervicql declare. Reumatol Clin. Reumatología Clínica English Edition.
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