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Biomedical subjects

L A Denny

Publications and source records attributed to L A Denny.

5 recordsLinked to original sources
PubMed2005

Human papillomavirus testing and screening.

Cervical cancer is a largely preventable disease through the detection, treatment and follow-up of its precursors. Traditionally, this has been accomplished through screening women with cervical cytology, and referring women with abnormal cytology for colposcopy, histological sampling and treatment. In organized programmes that achieve wide coverage of the target population at frequent intervals, this approach has resulted in a considerable reduction in cervical cancer. Recently, however, the development of reliable and reproducible tests for the detection of human papillomavirus (HPV) infection of the cervix (which is now accepted to be causally associated with the development of almost all cervical cancers) has led to the evaluation of HPV de-oxyribonucleic acid (DNA) testing as either an alternative or adjunctive test to cytology for the detection of cervical cancer and its precursors. There is now a large body of data supporting the clinical utility of HPV DNA testing for the prevention of cervical cancer, particularly in the settings of primary screening of women older than 30 years, in the triage of women with equivocal cytology and for the follow-up of women post-treatment.

Adult↗
PubMed1996

The influence of hormonal status on excision margins after large loop excision of the transformation zone (LLETZ).

To evaluate the influence of the type of contraception used and post-menopausal status on the involvement of excision margins with CIN after Large Loop Excision of the Transformation Zone (LLETZ), the authors reviewed a computerised database and the clinical files of 451 sequential women treated by LLETZ, for CIN diagnosed on cytology and colposcopy. There was a statistically significant association between both the use of Long Acting Injectable Progesterone (LAIP) and post menopausal status with histological report of incomplete excision of CIN on the endocervical excision margin. Therefore, the authors conclude that both progesterone-only containing contraception and menopause induced atrophy of the endocervical epithelium significantly increase the risk of involvement of the endocervical excision margin with CIN in the treatment by LLETZ. This parameter is of particular importance, as it is one of the known factors for recurrence.

Contraception↗
PubMed1995

Placental site trophoblastic tumor: three case reports and literature review.

The clinical features of three patients with placental site trophoblastic tumour (PSTT) are presented. Two patients had probable nephrotic syndrome, which was unrecognized at the time. The nephrotic syndrome disappeared after hysterectomy in one patient and the other demised after one cycle of chemotherapy. The use of hysteroscopy in one patient and the management of a pulmonary metastasis in another are described.

Adult↗
PubMed1995

Does colposcopically directed punch biopsy reduce the incidence of negative LLETZ?

OBJECTIVE: To evaluate the role of punch biopsy in reducing the occurrence of negative histology provided by large loop excision of the transformation zone in the management of cervical intraepithelial neoplasia. DESIGN: Retrospective review of computerised data base and clinic files. SETTING: Colposcopy Clinic, Groote Schuur Hospital, Cape Town, South Africa. SUBJECTS: Two hundred and ninety-eight women considered suitable for the local outpatient management of cervical intraepithelial neoplasia. METHODS: Two groups of patients were identified: group A consisted of women who had cervical intraepithelial neoplasia confirmed colposcopically and who underwent directed punch biopsy; group B consisted of women who had cervical intraepithelial neoplasia confirmed colposcopically and were referred for large loop excision of the transformation zone without confirmatory punch biopsy. RESULTS: In Group A (n = 184) 123 women had cervical intraepithelial neoplasia diagnosed on punch biopsy. Large loop excision of the transformation zone was performed on 116 women and 7 were lost to follow up. The procedure confirmed cervical intraepithelial neoplasia in 95 cases (82%), but there was no cervical intraepithelial neoplasia in 21 cases (18%). Sixty-one women had negative punch biopsies. Of these, 13 underwent large loop excision of the transformation zone, 31 had persistently negative follow up cytology, and 9 had positive cervical smears of which 7 were treated with large loop excision of the transformation zone, and 8 were lost to follow up. Overall, 25% of all negative punch biopsies were falsely negative. In group B 114 were treated with large loop excision of the transformation zone and cervical intraepithelial neoplasia was confirmed in 97 cases (85%); one woman had unsuspected microinvasion (1%) and 16 women (14%) had no cervical intraepithelial neoplasia. Negative histology after large loop excision of the transformation zone was not statistically different in groups A and B. CONCLUSION: Punch biopsy does not reduce the occurrence of negative histology after large loop excision of the transformation zone.

Adult↗