Cervical Anomalies Research Articles

Automatic Classification of Cervical Cells Using Deep Learning Methods

Cervical cancer, second only to breast cancer, is one of the cancers leading to cause death among women. Cervical cancer is a cancer that forms in the cells of the cervix, which is the lower section of the uterus that connects the uterus to the pelvis to the vaginal area. Various forms of the papilloma virus (HPV), a sexually transmitted infection that plays a role in cervical cancer and plays a critical part in most cases. The risk of cervical cancer developing can be reduced by undergoing screenings and receiving a vaccination that protects against HPV infection Cancer prevention is important. Most of the time, this is accomplished by checking the transformation zones. Cervical pre-cancerous stages can be observed in three different types, and all can transfigure into cancer. As a result, it's crucial to screen cervical anomalies sensibly and have a reliable process to determine if a cervix is normal (healthy) or pre-cancerous. Presently, the test being carried is a Pap smear test, commonly referred as a Pap test, which is a cervical screening procedure. It examines the cervix for the presence of pre - cancerous or cancerous cells. At present times deep learning is becoming more important alternative for cancer screening. A cervical cancer detection and classification system based on CNN has been proposed. Deep-learned features are acquired using the CNNs mode

Lightweight Low-Rank Adaptation Vision Transformer Framework for Cervical Cancer Detection and Cervix Type Classification.

Cervical cancer is a major health concern worldwide, highlighting the urgent need for better early detection methods to improve outcomes for patients. In this study, we present a novel digital pathology classification approach that combines Low-Rank Adaptation (LoRA) with the Vision Transformer (ViT) model. This method is aimed at making cervix type classification more efficient through a deep learning classifier that does not require as much data. The key innovation is the use of LoRA, which allows for the effective training of the model with smaller datasets, making the most of the ability of ViT to represent visual information. This approach performs better than traditional Convolutional Neural Network (CNN) models, including Residual Networks (ResNets), especially when it comes to performance and the ability to generalize in situations where data are limited. Through thorough experiments and analysis on various dataset sizes, we found that our more streamlined classifier is highly accurate in spotting various cervical anomalies across several cases. This work advances the development of sophisticated computer-aided diagnostic systems, facilitating more rapid and accurate detection of cervical cancer, thereby significantly enhancing patient care outcomes.

Biochemical and immunomodulatory insights of extracellular matrix from decellularized human whole cervix: recellularization and in vivo ECM remodeling interplay

Extracellular matrix (ECM) rich whole organ bio-scaffolds, preserving structural integrity and essential growth factors, has potential towards regeneration and reconstruction. Women with cervical anomalies or trauma can benefit from clinical cervicovaginal repair using constructs rich in site specific ECM. In this study, complete human cervix decellularization was achieved using a modified perfusion-based stir bench top decellularization method. This was followed by physico-chemical processes including perfusion of ionic agents, enzymatic treatment and washing using detergent solutions for a duration of 10–12 d. Histopathological analysis, as well as DNA quantification confirmed the efficacy of the decellularization process. Tissue ultrastructure integrity was preserved and the same was validated via scanning electron microscopy and transmission electron microscopy studies. Biochemical analysis and structural characterizations like Fourier transform infrared, Raman spectroscopy of decellularized tissues demonstrated preservation of important proteins, crucial growth factors, collagen, and glycosaminoglycans. In vitro studies, using THP-1 and human umbilical vein endothelial cell (HUVEC) cells, demonstrated macrophage polarization from M1 to M2 and vascular functional genes enhancement, respectively, when treated with decellularized human cervical matrix (DHCp). Crosslinked DHC scaffolds were recellularized with site specific human cervical epithelial cells and HUVEC, showing non-cytotoxic cell viability and enhanced proliferation. Furthermore, DHC scaffolds showed immunomodulatory effects in vivo on small rodent model via upregulation of M2 macrophage genes as compared to decellularized rat cervix matrix scaffolds (DRC). DHC scaffolds underwent neo-vascularization followed by ECM remodeling with enhanced tissue integration.

The Outcome of Treatment for Thyroglossal Tract Anomalies.

Background Thyroglossal tract anomalies are the most common cause of midline neck swelling. Thyroglossal cysts present between the base of the tongue and cricoid cartilage as painless, midline swelling that moves on deglutition and protrusion of the tongue. If the thyroglossal cyst gets infected or is violated surgically, it can result in a thyroglossal sinus or fistula. Investigations in patients with suspected thyroglossal cysts include a thyroid function test, ultrasonography of the neck, and fine needle aspiration cytology (FNAC). Computed tomography (CT) or magnetic resonance imaging (MRI) can be done for larger cysts or suspected malignancies. The gold standard treatment is Sistrunk surgery. Recurrence rates with Sistrunk surgery are lower when the surgery is performed accurately. This study was conducted to document the clinical presentation and treatment outcome in patients treated for thyroglossal tract anomalies. Methods This is a retrospective analysis of 46 medical case records of patients operated on for thyroglossal tract anomalies at a rural tertiary care hospital from April 1995 to April 2021. Patients fulfilling the inclusion and exclusion criteria were evaluated with a detailed history, various clinical presentations, location, extent of anomalies, and thyroid function test results documented. Ultrasound images were reviewed, and the findings were documented. All patients have consent, and they underwent Sistrunk surgery. Patients in whom the normal thyroid gland was found to be absent were started on replacement thyroxine after surgery. The specimen was subjected to histopathological examination by a senior pathologist. The outcome regarding complications, recurrence, and further treatment were reviewed. The outcome of the thyroglossal fistula was compared with that of thyroglossal cysts, and the outcome of infrahyoid thyroglossal tract anomalies was compared with that of suprahyoid thyroglossal tract anomalies. Results In this study, among the 46 patients, 24 (52.2%) were female and 22 (47.8%) were male. The minimum age was three years, the maximum was 58, and the mean was 20.6 years. In this study, 71.7% of the patients were diagnosed with thyroglossal cysts, 10.9% had thyroglossal fistulas, and two had lingual thyroids. The most common location of the cyst was infrahyoid (73.9%). 44 patients underwent Sistrunk surgery, and two patients diagnosed with lingual thyroid underwent excision. Three patients had complications (two pharyngo-cutaneous fistulas, one wound dehiscence), and all were managed conservatively. There were no recurrences in our study. Conclusion Thyroglossal tract anomalies are the most common congenital cervical anomalies. A complete Sistrunk procedure includes the removal of the entire thyroglossal tract, inclusive of the body of the hyoid bone along with the cuff of base tongue tissue, and gives the best result for thyroglossal tract anomalies.

Step-by-Step Hysteroscopic Treatment of Complete Uterine Septum Associated or Not with Cervical Anomalies

To demonstrate our hysteroscopic technique using the mini-resectoscope for the treatment of complete uterine septum with or without cervical anomalies. A step-by-step video demonstration of the technique with the use of an educational video. We present 3 patients diagnosed as having complete uterine septum (U2b according to the ESHRE/ESGE classification) with or without cervical anomalies (C0, normal cervix; C1, septate cervix; C2, double "normal" cervix"), 2 of them with a longitudinal vaginal septum (V1). The first case is a 33-year-old woman with history of primary infertility diagnosed as having a complete uterine septum with normal cervix (class U2bC0V0 according to the ESHRE/ESGE classification). Case 2 is a 34-year-old woman with infertility and abnormal uterine bleeding, diagnosed as having complete uterine and cervical septum and a partial nonobstructive vaginal septum (class U2bC1V1). Case 3 is a 28-year-old woman with infertility and dyspareunia, diagnosed as having a complete uterine septum, double "normal" cervix, and nonobstructive longitudinal vaginal septum (class U2bC2V1) Still 3. The procedures were performed in a tertiary care university hospital. The 3 procedures were performed in the operative room using a 15 Fr continuous flow mini-resectoscope and bipolar energy with the patient under general anesthesia Still 1 and Still 2. No complications were encountered in any of the 3 cases. After all procedures, a gel based on hyaluronic acid was applied to minimize postoperative adhesion formation. Patients were discharged home the same day of the procedure after a short period of observation. Hysteroscopic treatment of patients with uterine septa associated or not with cervical anomalies using miniaturized instruments is a feasible and effective option for the management of patients with these complex müllerian anomalies.

Surgical and Reproductive Outcomes in Patients with Complete Septate Uterus and Cervical Anomalies after Metroplasty

<h3>Study Objective</h3> to evaluate surgical and reproductive outcomes in patients with complete uterine septa with or without cervical anomalies undergone hysteroscopic metroplasty. <h3>Design</h3> Multicenter prospective observational cohort study. <h3>Setting</h3> Gynecological departments of participating centers. <h3>Patients or Participants</h3> 64 infertile women with ultrasonographic and hysteroscopic diagnosis of complete septate uterus with or without cervical anomalies (group A: U2bC1 + U2bC2 (n=34); group B (n=30): U2bC0 according to ESHRE/ESGE classification system) from January 2018 to December 2021. <h3>Interventions</h3> in-patient hysteroscopic metroplasty with 26Fr or 15Fr resectoscope or 5mm hysteroscope with 5Fr instruments; a second surgical step was performed when at postsurgical 3D ultrasonography a residual septum was detected (Y + Z > 15 mm). <h3>Measurements and Main Results</h3> Surgical outcomes (operative times; intra- and post-operative complications; surgical satisfaction); Reproductive outcomes (clinical pregnancy rate [CPR], live birth rate [LBR], miscarriage rate [MR]). All the surgical procedures were performed without any significant complication. 18/27 (67%) patients in group A and 9/18 (50%) in group B required a second surgical step. Operative times were statistically lower in group B (12.4 min ± 2 SD vs 27min ± 8 SD, p-value:0.034); less surgical difficulty was reported by clinicians in group B. Reproductive outcomes were evaluated for 36 patients (mean follow-up 20 months) and have shown significant differences between two groups; indeed, CPR was 36% in group A and 64% in group B (p. value 0.01). <h3>Conclusion</h3> Hysteroscopic metroplasty is an effective and safe procedure for the treatment of complete septate uterus with or without cervical abnormalities; a second surgical step is often required for the optimal treatment of these anomalies. Surgical outcomes are better in the group of patients without cervical anomalies, regardless of the instrumentation used. The presence of cervical anomalies seems to significantly affect reproductive outcomes.

Raman Spectroscopy of Individual Cervical Exfoliated Cells in Premalignant and Malignant Lesions

Cervical cancer is frequent neoplasia. Currently, the diagnostic approach includes cervical cytology, colposcopy, and histopathology studies; combining detection techniques increases the sensitivity and specificity of the tests. Raman spectroscopy is a high-resolution technique that supports the diagnosis of malignancies. This study aimed to evaluate the Raman spectroscopy technique discriminating between healthy and premalignant/malignant cervical cells. We included 81 exfoliative cytology samples, 29 in the “healthy group” (negative cytology), and 52 in the “CIN group” (premalignant/malignant lesions). We obtained the nucleus and cytoplasm Raman spectra of individual cells. We tested the spectral differences between groups using Permutational Multivariate Analysis of Variance (PERMANOVA) and Canonical Analysis of Principal Coordinates (CAP). We found that Raman spectra have increased intensity in premalignant/malignant cells compared with healthy cells. The characteristic Raman bands corresponded to proteins and nucleic acids, in concordance with the increased replication and translation processes in premalignant/malignant states. We found a classification efficiency of 76.5% and 82.7% for cytoplasmic and nuclear Raman spectra, respectively; cell nucleus Raman spectra showed a sensitivity of 84.6% in identifying cervical anomalies. The classification efficiency and sensitivity obtained for nuclear spectra suggest that Raman spectroscopy could be helpful in the screening and diagnosis of premalignant lesions and cervical cancer.

1247 Fusobacterium Necrophorum - A Rare Thyroglossal Cyst Habitat That Can Be Lethal

Abstract Thyroglossal cyst is the most frequent developmental cervical anomaly with a prevalence of 7% in the population. Infection and abscess formation are common complications. Isolation of Fusobacterium Necrophorum (F. Necrophorum) made the management of this case challenging. An 18-year-old male presented to the emergency department with a 3-day history of a neck mass, sore throat, cachexia, dysphagia and fever. Clinical examination revealed an erythematous 4 x 5 fluctuant swelling in the midline of the neck with evident lymphadenopathy on level II on the left-hand side. A CT neck that was undertaken nine months ago was suggestive of a thyroglossal cyst and the patient was placed in the waiting list for surgical excision under general anaesthesia. He reported three episodes of midline neck swelling since then. Upon admission, ultrasound guided drainage was arranged, and a pus sample obtained. The presence of F. Necrophorum was reported by microbiology with instructions of urgent admission and strict antibiotic regime. Excision of the cyst was scheduled after the completion of the antibiotic course. Fusobacterium Necrophorum is a rare microorganism with increased virulence and a significant mortality rate. It has been involved in oropharyngeal infections complicated by Lemierre’s syndrome, necrobacillosis, post anginal sepsis and septic jugular thrombophlebitis making this case of particular interest.

Ultrasound Imaging of Cervical Anatomic Variants.

Embryologic developmental variants of the thyroid and parathyroid glands may cause cervical anomalies that are detectable in ultrasound examinations of the neck. For some of these developmental variants, molecular genetic factors have been identified. Ultrasound, as the first-line imaging procedure, has proven useful in detecting clinically relevant anatomic variants. The aim of this article was to systematically summarize the ultrasound characteristics of developmental variants of the thyroid and parathyroid glands as well as ectopic thymus and neck cysts. Quantitative measures were developed based on our findings and the respective literature. Developmental anomalies frequently manifest as cysts that can be detected by cervical ultrasound examinations. Median neck cysts are the most common congenital cervical cystic lesions, with a reported prevalence of 7% in the general population. Besides cystic malformations, developmental anomalies may appear as ectopic or dystopic tissue. Ectopic thyroid tissue is observed in the midline of the neck in most patients and has a prevalence of 1/100,000 to 1/300,000. Lingual thyroid accounts for 90% of cases of ectopic thyroid tissue. Zuckerkandl tubercles (ZTs) have been detected in 55% of all thyroid lobes. Prominent ZTs are frequently observed in thyroid lobes affected by autoimmune thyroiditis compared with normal lobes or nodular lobes (P = 0.006). The correct interpretation of the ultrasound characteristics of these variants is essential to establish the clinical diagnosis. In the preoperative assessment, the identification of these cervical anomalies via ultrasound examination is indispensable.

Rare case of unilateral hypertrophy of left lamina and spinous process of C6 with associated C2-C3 block vertebra: A case report

We report a rare case of congenital cervical anomaly in a 32 yr old female, who was referred in our department for the complaints of chronic cervical and shoulder pain with a hard cervical mass. Antero-posterior and lateral radiographs of the cervical spine were performed, which show a rib like bony projection, in the left side of neck and on the lateral radiograph, it was corresponding to a hypertrophied C6 spinous process. CT study was done for better delineation of this congenital anomaly, which showed hypertrophied left lamina of C6 and spinous process, crossing midline and towards the left side, extending inferiorly up to the level of thoracic inlet. There was associated fusion of C3 and C4 vertebrae, resulting in block vertebra (Klippel- Feil syndrome Type 1) and unfused spinous process of C6 vertebra.This case report is the first case, where hypertrophied lamina and spinous process of C6 with unfused spinous processes and block vertebra, congenital cervical anomalies were seen in the same patient.

Cross-sectional analysis of associated anomalies and vertebral anomaly location in 1289 surgical congenital scoliosis.

This study systematically analyzed and assessed the interrelationships among vertebral anomaly location, congenital scoliosis (CS) type and associated abnormality prevalence. We retrospectively extracted medical records of 1289 CS inpatients surgically treated in our institute from January 2010-December 2019. All patients underwent spinal X-ray, CT, MRI, echocardiogram, urogenital ultrasound and systemic physical examination. We analyzed information on demographics, CS type, associated anomalies and vertebral anomaly location. Cervical, thoracic and lumbar vertebral anomalies were found in 5.7%, 78.1% and 33.6% of patients, respectively. 82.7% had one region involved. 59.5% with cervical malformations had mixed defects and 61.1% with lumbar malformations exhibited failure of formation. The musculoskeletal defect prevalence was 28.4%, 19.1% and 9.0% in patients with cervical, thoracic and lumbar anomalies. The intraspinal defect prevalence was 33.4% and 20.7% for thoracic and lumbar anomalies. 86.5% of patients with cervical anomalies had more than one region involved, while 78.1% and 62.2% with thoracic and lumbar anomalies, respectively, had only one region involved. Cervical malformations had higher prevalence of mixed defects, musculoskeletal and intraspinal defects and multi-region involved. Thoracic malformations had higher prevalence of intraspinal and musculoskeletal defects and more involvement of only one vertebral region. Lumbar vertebral malformation patients had much lower prevalence of intraspinal and musculoskeletal defects and more involvement of only one vertebral region. Cervical malformation was a risk factor for more associated anomalies and more severe vertebral anomalies, which deserves more attention from surgeons in outpatient clinic.

Posterior midline cleft of the atlas – a crucial anatomical variation in vertebral fractures

The anatomy of the first vertebra, namely atlas, has significant clinical implications. Atlas is situated between the occipital bone and the second cervical vertebra (axis) and is one of the main points of head movement. Most congenital anomalies of the vertebra are diagnosed incidentally during imaging investigations and can be associated with cervical spine anomalies. The neurological symptoms may include weakness in the four limbs, acute neurologic deficits such as transient quadriparesis, paraparesis, Lhermitte's sign, chronic neck pain, and headache. This anomaly is also commonly seen in gonadal dysgenesis, Klippel-Feil syndrome, Arnold-Chiari malformations, and Turner and Down syndrome. Unlike other variations, which arise due to disturbances of ossification posterior midline clefts of the atlas, are different since they are a developmental failure of chondrogenesis. We therefore present an anatomical case and analysis of the literature about posterior arch clefts of atlas.

Congenital Obstructive Müllerian Anomaly: The Pitfalls of a Magnetic Resonance Imaging-Based Diagnosis and the Importance of Intraoperative Biopsy.

A retrospective cohort study of the concordance between the magnetic resonance imaging (MRI) diagnosis and final diagnosis in patients with Müllerian duct anomalies (MDAs) was conducted, and diagnostic clues were suggested. A total of 463 cases of young women who underwent pelvic MRIs from January 1995 to February 2019 at Seoul Asan Medical Center were reviewed. Interventions consisted of clinical examinations, abdominal or transvaginal/rectal ultrasound, MRI, and operative procedures, including hysteroscopy and laparoscopy. The concordance of the diagnosis between the results obtained with MRI and those obtained with surgeries was evaluated. It was found that a total of 225 cases (48.6%) showed genital tract anomalies on MRI. Among them, 105 cases (46.7%) underwent reconstructive surgery. Nineteen cases (8.4%) revealed discrepancies between the final diagnosis after surgery and the initial MRI findings and eleven cases (57.9%) had cervical anomalies. Incorrect findings associated with the MRIs were particularly evident in biopsied cases of cervical dysgenesis. A combination of physical examination, ultrasound, and MRI is suitable for preoperative work-up in the diagnoses of congenital obstructive anomalies. However, it is recommended that a pathologic confirmation of tissue at the caudal leading edge be made in obstructive genital anomalies, in cases of presumptive vaginal or cervical dysgenesis.

Development and evolution of a robotic surgical technique for the treatment of thoracic outlet syndrome

ObjectiveWe describe the development and evolution of a surgical technique that uses the robotic da Vinci Surgical System (Intuitive Surgical, Inc, Sunnyvale, Calif) for the transaxillary approach to repair the disabling thoracic outlet syndrome (TOS). We report our patient outcomes associated with the use of this robotic technique. MethodsWe present a retrospective review and analysis of data collected from a 16-year experience of a single surgeon using a robotic surgical system and technique for TOS surgery. From the initial design of an endoscope attached to a microvideo camera in 1982 to the adoption of the monorobotic arm with integrated voice in 1998, the main objective of the transaxillary approach has always been to improve visualization of congenital cervical anomalies of the scalene muscles. From February 2003 to December 2018, we performed 412 transaxillary decompression procedures using the robotic da Vinci Surgical System. The surgical procedure has been described in further detail and includes the following steps: (1) positioning of the patient into a lateral decubitus position and using a monoarm retractor; (2) creation of a mini-incision in the axillary area and creation and maintenance of the subpectoral anatomic working space; (3) placement of endoscopic ports and engagement of the robotic instrumentation; (4) dissection of extrapleural and intrapleural soft tissue; (5) creation of the “floater” first rib; (6) excision of the cervical bands and first rib; and (7) placement of thoracostomy tubes for drainage and closure of the incisions. ResultsNone of the patients died, and no patient experienced permanent neurovascular damage of the extremity. Of the 306 patients, 22 (5% of 441 operations) experienced complications. One patient developed postoperative scarring that required a redo operation with a robotic-assisted transaxillary approach. ConclusionsWith its three-dimensional visual magnification of the anatomic area, the endoscopic robotic-assisted transaxillary approach offers safe and effective management of disabling TOS symptoms. The endoscope facilitates observation of the cervical bands and the mechanism (pathogenesis) of the neurovascular compression that causes TOS, thereby allowing complete excision of the first rib, cervical bands, and scalene muscle. We sought to develop and perfect this robotic approach. The present study was not intended to be a comparative study to nonrobotic TOS surgery.

Design and implementation of a portable colposcope Mueller matrix polarimeter.

.Significance: Mueller matrix polarimetry can provide useful information about the function and structure of the extracellular matrix. A portable and low-cost system could facilitate the clinical assessment of cervical anomalies in low-resource settings.Aim: We introduce a low-cost snapshot Mueller matrix polarimeter that does not require external power, has no moving parts, and can acquire a full Mueller matrix in , to conduct a feasibility study for cervical imaging in the low-resource setting.Approach: A snapshot system based on two sets of Savart plates, a ring illuminator with polarizing elements (generating four polarization states), and one camera is introduced. Stokes vectors are formulated to recover the polarization properties of the sample. Then, using Mueller matrix decomposition, the depolarization and retardance information is extracted.Results: We report the results on 16 healthy individuals (out of 22 patients imaged), whose Pap smear showed no malignant findings from mobile clinics in rural region of Mysore, India. The depolarization and retardance information was in agreement with previous reports.Conclusions: We introduce an imaging system and conducted a feasibility study on healthy individuals. This work could futurely translate into diagnostic applications to provide a quantitative platform in the clinical environment (e.g., cervical cancer screening).

Klippel–Feil Syndrome with Multiple Cervical Anomalies Discovered Following Trauma

AbstractThe approach to the upper cervical spine is a challenge for surgeons, not only for its complex anatomy but also for the great variety of pathologies. Klippel–Feil syndrome (KFS) is a congenital disease characterized by the fusion of two or more cervical segments and is associated with various musculoskeletal and vascular malformations. However, there is no consensus on the type of surgery, approach, level of fixation or fusion. We report the case of a KFS, associated with multiple anatomical variants, who suffered a traumatic cervical injury and underwent surgical treatment.

Cervical Abnormalities in Severe Spinal Deformity: A 10-year MRI Review.

ObjectiveTo investigate the incidence of cervical anomalies (CA), including cervical intraspinal neural axis abnormalities (CIINAA) and/or cervical osseous abnormalities (COA), and the clinical relevance in severe spinal deformities (SSD) at a single center.MethodsA retrospective study of SSD admitted for spinal surgery from January 2003 to January 2015 was conducted at a single center. Inclusion criteria: patients who present with coronal Cobb over 90° (and/or sagittal cobb ≥90°); and patients with complete imaging and clinical data preoperatively. Exclusion criteria: ankylosing spondylitis, adult onset scoliosis, scoliosis secondary to bone destruction. There were 108 SSD patients who fulfilled the criteria in this research (41 males and 67 females). The mean age of the patients was 18.1 ± 2.7 years (range, 10–45 years). The clinical and radiological data of these patients were reviewed to identify CA and to analyze the relationship between clinical and radiographic characteristics in the population of SSD.ResultsThe major curves of scoliosis and segmental kyphosis were 109.1° ± 24.7° and 91.2° ± 29.1°. Cervical abnormalities were detected in 56 patients (51.85%) with 9 different CA, including 28 patients (25.9%) with 6 different COA, 21 patients (19.4%) with 3 different CIINAA, and 7 patients (6.5%) with a combination of COA and cervical intraspinal neural axis abnormalities (CINAA). Basilar invagination and Klippel–Feil syndrome were the most frequent COA. Syringomyelia was the most frequent CINAA. SSD with COA in upper vertebral levels (UVL) had a higher incidence of CINAA than those in subaxial vertebral levels (SVL) (P = 0.024) and SSD with multiple COA (mCOA) in UVL had a higher incidence of CINAA than those with single COA (sCOA) (P = 0.029). In the present study, 83.9% of the SSD with CA were asymptomatic.ConclusionThe incidence of CA in SSD was 51.85%, with most presenting with intact neurologic status. As the diversity of COA increased, we found a higher incidence of CINAA, especially in UVL.

Association of congenital missing of maxillary lateral incisors with cervical vertebral body fusions and/or atlas posterior arch deficiency

To evaluate the association between congenital missing of maxillary lateral incisor (MLI) with cervical vertebral body fusions, posterior arch deficiency, and both anomalies. A total of 64 subjects (24 males and 40 females; mean age 16 ± 4.5 years) were detected to have congenital missing of MLI and selected as a study group. Two hundred and fifty-six subjects (87 males and 169 females, mean age 18.1 ± 3.2 years) were assigned to the control group. In the congenital absence of MLI, 53.7% revealed cervical column body fusion, 11.1% indicated a posterior arch deficiency, and 9.3% showed cervical column body fusion with posterior arch deficiency. Morphological deviations of the cervical column showed significant associations with congenital absence of MLI compared to control group (p < 0.001). There were no significant differences in gender among the study and control groups (p > 0.05). Subjects with congenial MLI tend to have an increased frequency of cervical anomaly.

Breast and cervical cancer screening: A survey of university employees

Background: There is an increasing occurrence of non-communicable diseases worldwide. Among them, breast and cervical cancers are notable among females. These diseases often present late with adverse outcomes. Only early detection offered by screening of disease offers the hope of cure. Hence, we undertook a breast and cervical cancer screening education and exercise among female workers of a university community. Methods and Methods: This was part of a non-communicable disease survey among members of the university community. Structured questionnaires were administered on participants after a talk. Screening was carried out using the Papanicolau test for cervical cancer and clinical breast examination for breast cancer. Results: A total of 210 participants were screened. 42 (10.8%) and 23 (10.8%) had family history of breast cancer and previous breast lump, respectively. Only one participant (0.48%) had a breast lump. Abnormal Pap smear result was present in 59 (30.1%) (Inflammation [59.32%], high grade squamous intraepithelial lesion (HSIL) [10.17%], low grade squamous intraepithelial lesion (LSIL) [6.78%], atypical squamous cell of undetermined significance (ASCUS) [10.17%], Atypical squamous cells- cannot exclude HSIL’ (ASC-H) [11.86%] and atypical glandular cells of undetermined significance (AGUS) [1.69%]). Conclusion: The uptake of screening was low, the yield for cervical anomalies was also low, but a reasonable proportion of the participants had risk factors for breast and cervical cancers and so would benefit from further screening over time.

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Design Presentation of clinical cases and literature analysis. Material and methods Clinical observation of patients with congenital cervical spine and shoulder girdle anomalies operated on with neuromonitoring was performed. Operative treatment of Sprengel’s deformity was produced with the use of neuroimaging. Results Surgical treatment resulted in good clinical outcomes without neurological adverse events and good aesthetic and radiological appearance at the descended scapula. Discussion Consideration for intraoperative neuromonitoring should be given to prevent neurological complications at lowering the elevated scapula. Conclusion Review of outcomes showed efficacious application of the most valid methods used to descend the scapula with neuromonitoring. This was supported by clinical and radiological findings of the extent of cranial transposition after appropriate correction and absence of neurological adverse events early postsurgery and at a long-term follow-up. No recurrence of scapular dislocation was observed at a long-term follow-up.