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Mathilde E Boon

Publications and source records attributed to Mathilde E Boon.

24 records · Page 2Linked to original sources
PubMed2002

Urbanization and baseline prevalence of genital infections including Candida, Trichomonas, and human papillomavirus and of a disturbed vaginal ecology as established in the Dutch Cervical Screening Program.

OBJECTIVE: An overgrowth of coccoid bacilli in the absence of lactobacilli (bacterial vaginosis) is considered a sign of a "disturbed" vaginal ecologic system. The aim of this study was to establish the baseline prevalence of genital infections and of a disturbed vaginal ecologic system and their relationship to urbanization. STUDY DESIGN: More than 190,000 cervical smears were screened by 1 cytology laboratory in the context of the Dutch national screening programs. The women who were symptom free and had been registered in the statutory files of municipal units were screened by invitation. Urbanization (place of residence) was derived from the postal code. To investigate a trend in prevalence in relation to urbanization, Schaafsma's method was used. RESULTS: Bacterial vaginosis had the highest score per 1000 screened women (36.1), followed by Candida (12.6). Higher prevalence of human papillomavirus, bacterial vaginosis, and Trichomonas was related to urbanization as was, whereas Candida was not. CONCLUSION: Human papillomavirus and Trichomonas are more frequently found in women who live in the large cities, which in The Netherlands also harbor the high-risk population for premalignant cytologic evidence. Our findings concerning the baseline prevalence pattern of bacterial vaginosis support the hypothesis of the importance of a disturbed bacterial ecologic system in cervical carcinogenesis.

Adult↗
PubMedDate not supplied

Progression of abnormal MIB-1 staining patterns of reserve cells in cervical smears from women ultimately developing high grade squamous intraepithelial lesions.

OBJECTIVE: To assess, in a longitudinal study in women diagnosed with high grade squamous epithelial lesion (HSIL), the progression over time of proliferative activity in reserve cells using population screening cervical cytology specimens. STUDY DESIGN: Twenty consecutive, unselected patients with HSIL lesions were part of the national cervical screening program. From the archives, for each patient, the last prior normal population screening smear was included in the study. Concurrent sets of cervical smears from 80 age-matched women without pathology formed the controls. The original slides were stained using MIB-1 monoclonal antibody. The fraction of MIB-1-positive reserve cells was assessed using systematic random sampling and running progressive means assessment to ensure a sufficient sample size. RESULTS: The proliferation fraction in reserve cells of HSIL patients was significantly raised (mean, 65.0%; range, 53.5-94.1%; p < 0.01) as compared with that in concurrent controls (mean, 12.8%; range, 1.9-45.4%). Prior smears from HSIL patients, although without morphologic abnormalities, had abnormally high proliferation fractions (mean, 59.1%; range, 1.0-94.7%), significantly raised over those from concurrent controls (mean, 9.4%; range CONCLUSION: In population-based cervical smear screening, HSIL patients already have abnormally raised proliferation fractions of reserve cells, even without morphologic changes in squamous cells, 1-5 (mean, 3.6) years prior to diagnosis.

Biomarkers, Tumor↗
PubMedDate not supplied

Pap smear quality parameters of 3 sampling devices used by auxiliary nurse midwives on symptomatic rural Indian women.

OBJECTIVE: To determine whether auxiliary nurse midwives (ANMs) could make good-quality Pap smears after focused training and to determine which sampling device is most effective in their hands in field practice areas. STUDY DESIGN: In a downstaging cervical cancer screening program, 394 symptomatic rural Indian women between the ages of 35 and 60 were identified by the ANMs in 2 villages, with a total population of 14,747, and were invited to have a smear taken. Two hundred of these symptomatic women responded. The ANMs were educated to render information on screening for cervical cancer and to take smears with 3 sampling devices--Ayre spatula, modified spatula (with extended tip) and Cytobrush (Medscand AB, Malmö, Sweden). The smears were evaluated for 6 adequacy parameters. Smears made by gynecologists were used as controls. To establish the superiority of a method, chi2 tests were used. RESULTS: All smears made by the ANMs could be used to render a cytologic diagnosis. The adequacy parameters of all the smears made by ANMs at least matched those of the gynecologists. The best results were obtained with modified spatula (with extended tip) and combination of Cytobrush with modified spatula. CONCLUSION: Since only 50% of symptomatic rural women came for Pap testing, we conclude it is not easy to motivate women for such testing, even if a large-scale educational effort is made. ANMs can be taught to take reasonably good qualisuperior sampling device for ANMs is ty Pap smears. The superior sampling device for ANMs is the modified spatula (with extended tip).

Adult↗
PubMedDate not supplied

Diagnostic parameters in liquid-based cervical cytology using a coagulant suspension fixative.

OBJECTIVE: To evaluate in detail the morphology of cervical cell samples suspended in the coagulant fixative BoonFix (Finetec, Tokyo, Japan) in liquid-based Papspin slides (Thermo Shandon, Pittsburgh, Pennsylvania, U.S.A) to detect shifts in diagnostic parameters for infections and neoplasia. STUDY DESIGN: Split samples of 1,010 cases were collected. All Papspin slides were scanned with neural network technology. In 849 cases the diagnosis was "within normal limits"; in 22 cases it was preneoplasia. In 151 special cases conventional smears were compared with thin-layer slides. RESULTS: In 85% of the 151 special cases, a shift of the diagnostic parameter was observed in the Papspin slide. The parameter adhesion of inflammatory cells to epithelial cells was easier to discern in 94% of the cases, and adhesion of microorganisms varied 43-100%. Koilocytosis was more visible in 79%. Prominent nucleoli in atypical and malignant cells were enhanced in 50-100% of cases with preneoplasia. The fact that the cells on the Papspin slide were no longer present in diagnostic streaks posed a problem only in the case of follicular cervicitis. CONCLUSION: The shifts in parameters facilitated the diagnostic process. BoonFix permits the screening of liquid-based Papspin slides, which have proven to be well suited to automated neural network scanning.

Bacterial Infections↗
PubMedDate not supplied

Population-based cervical screening with a 5-year interval in The Netherlands. Stabilization of the incidence of squamous cell carcinoma and its precursor lesions in the screened population.

OBJECTIVE: To evaluate the outcome of population-based cervical screening at 5-year intervals. STUDY DESIGN: Results from the west region of the Netherlands (population 2 million) were used. The 1995-2000 round was compared with the first 2 years of the second (2001-2002). All results were prospectively collected in a central database. Positive cytologies and histoscores per 1,000 screened for preinvasive squamous cervical intraepithelial neoplasia (CIN) lesions and invasive squamous cell carcinoma were calculated. RESULTS: In the first round, 378,081 women were screened; in the second round, 100,561 women were screened. In both rounds the youngest screenees had the highest cytoscores. Cytoscores in the first round did not differ significantly from those in the second. The histoscore for CIN 1 and 2 was 1.42 per 1,000 in the first round and 1.18 per 1,000 (NS, P < .01) in the second. The histoscore for CIN 3 was 2.07 per 1,000 in the first round and 2.13 per 1,000 (NS, P < .01) in the second. Histoscores for invasive squamous cell carcinoma remained virtually the same (0.16 per 1,000 in the first, 0.14 per 1,000 in the second round). CONCLUSION: Population-based screening at 5-year intervals in the Netherlands may result in stabilization of positive cytology and of the incidence of CIN and (histologic) invasive squamous cell carcinoma. The program seems more cost effective than that of 2 decades ago, with a screening interval of 3 years.

Adult↗