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Thanasuwat B, Leung SOA, Welch K, Duffey-Lind E, Pena N, Feldman S, Villa A. Correction: Human Papillomavirus (HPV) Education and Knowledge among Medical and Dental Trainees. J Cancer Educ 2024; 39:213-215. [PMID: 38225459 DOI: 10.1007/s13187-024-02398-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Affiliation(s)
- Burinrutt Thanasuwat
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA, USA.
| | - Shuk On Annie Leung
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, McGill University Health Center, Montreal, QC, Canada
| | | | - Eileen Duffey-Lind
- Team Maureen, North Falmouth, MA, USA
- Division of Pediatric Oncology, Dana Farber Cancer Center, Boston, MA, USA
| | - Nancy Pena
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sarah Feldman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Alessandro Villa
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA, USA
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Thanasuwat B, Leung SOA, Welch K, Duffey-Lind E, Pena N, Feldman S, Villa A. Human Papillomavirus (HPV) Education and Knowledge Among Medical and Dental Trainees. J Cancer Educ 2023; 38:971-976. [PMID: 36002641 PMCID: PMC9402407 DOI: 10.1007/s13187-022-02215-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/17/2022] [Indexed: 06/02/2023]
Abstract
Persistent human papillomavirus (HPV) infection is responsible for the majority of oropharyngeal and cervical cancers in the USA. Currently, HPV curricula within medical and dental schools are not standardized. As such, we implemented a brief online educational intervention to increase medical and dental trainees' knowledge of the HPV vaccine and the association between HPV and cancer. The objectives of this study were to (1) assess medical and dental trainees' baseline knowledge regarding HPV and HPV vaccine, (2) determine the willingness to recommend the HPV vaccine to patients, and (3) evaluate the impact of an online intervention on HPV-related knowledge. Medical and dental trainees from two large academic centers in the USA were asked to fill out an online pre-intervention questionnaire, followed by a 10-min HPV educational intervention based on the Center of Disease Control and Prevention (CDC) resources, and then a post-intervention questionnaire. There were 75 participants (67.4% females; median age 18-30 years). When asked about HPV-related cancer types, the correct response increased from 28.4% (pre-intervention) to 51.9% (post-intervention; p < 0.01). When asked about the prevalence of HPV infections, the correct response improved from 36 to 72% (p < 0.01). There was also a 25.2% improvement in identifying the correct HPV vaccination dosing schedule (p < 0.01). Eighty-seven percent of the participants mentioned that the online education improved their HPV knowledge, and 68.5% reported that they were more likely to recommend HPV vaccine after the online intervention. The proposed online educational intervention was effective at improving HPV-related cancer and HPV vaccine knowledge as well as attitudes towards vaccine recommendation among dental and medical trainees and could be implemented in medical and dental school curricula in the future.
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Affiliation(s)
- Burinrutt Thanasuwat
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA USA
| | - Shuk On Annie Leung
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, McGill University Health Center, Montreal, QC Canada
| | | | - Eileen Duffey-Lind
- Team Maureen, North Falmouth, MA USA
- Division of Pediatric Oncology, Dana Farber Cancer Center, Boston, MA USA
| | - Nancy Pena
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA USA
| | - Sarah Feldman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA USA
| | - Alessandro Villa
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA USA
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Alimena S, Manning-Geist B, Pena N, Vitonis AF, Feldman S. Outcomes by Race Among Women Referred to an Academic Colposcopy Clinic with a Patient Navigation Program. J Womens Health (Larchmt) 2020; 30:902-909. [PMID: 32960144 DOI: 10.1089/jwh.2020.8381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Although minority women are at higher risk of cervical cancer in the United States, little is known about differences in rates of colposcopy and loop electrosurgical excision procedure (LEEP) by race once patients present for care. Materials and Methods: A prospective registry of patients presenting to an academic colposcopy clinic was queried from 2008 to 2018. Women with missing race or cytology results, prior hysterectomy, or prior history of cervical, vulvar, or vaginal cancer were excluded. Poisson and logistic regression models were performed to evaluate the associations between race and colposcopy, LEEP, and cancer rates, adjusting for referral Papanicolaou (Pap), human papillomavirus (HPV) result, year of visit, age, insurance, pregnancy, number of sexual partners, and smoking status. Results: A total of 4506 women were included (56.1% white and 43.9% non-white). Referral for high-grade cytology was more likely among white compared to non-white women (22.5% vs. 17.5%, p < 0.001), as well as positive HPV testing (white 7.8% vs. non-white 6.0%, p < 0.001). The colposcopy rate was slightly higher among black (incidence rate ratio [IRR]adjusted 1.11, 95% confidence interval [CI] 1.03-1.19, p = 0.006) and Hispanic women (IRRadjusted 1.13, 95% CI 1.06-1.21, p = 0.0003) compared to white women. Hispanic women were significantly more likely to undergo LEEP (odds ratioadjusted 1.26, 95% CI 1.01-1.58, p = 0.04). However, no significant difference in cancer, adenocarcinoma in situ, or high-grade histology was noted by race. Conclusions: Black and Hispanic women referred for abnormal Pap or HPV results underwent a greater number of colposcopies compared to white women, and Hispanic women underwent a greater number of LEEPs. Although cancer is rare in our cohort, there was no statistical difference in rate of cancer by race.
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Affiliation(s)
- Stephanie Alimena
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Beryl Manning-Geist
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Nancy Pena
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Allison F Vitonis
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Sarah Feldman
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Division of Gynecologic Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA
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Luckett R, Pena N, Vitonis A, Bernstein MR, Feldman S. Effect of patient navigator program on no-show rates at an academic referral colposcopy clinic. J Womens Health (Larchmt) 2015; 24:608-15. [PMID: 26173000 DOI: 10.1089/jwh.2014.5111] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patient navigators have been used successfully to guide vulnerable patients through barriers to cancer care and reduce disparities in cancer outcomes. This study evaluated the effect of a patient navigator program on no-show rates at a tertiary care referral colposcopy center and explored factors associated with missed appointments. METHODS No-show rates prior and subsequent to implementation of the intervention were compared by chi-square test. We compared patient demographic, lifestyle, and diagnostic characteristics between patients who had ever and never missed appointments. We described patient-reported barriers to care. RESULTS Of 4,199 women evaluated in our clinic from January 2006 to December 2013, 2,441 (58%) had at least one missed appointment. African American, Hispanic, and publicly insured women tended to miss appointments more frequently than did white and privately insured women (p<0.0001). Patients who missed appointments tended to have more abnormal cytology (p<0.0001), cervical pathology (p=0.007), and vulvar pathology (p=0.001). No-show rates declined from 49.7% to 29.5% after implementation of the patient navigator program (p<0.0001). We found that 45% of patient no-shows were anticipated or a result of patient misunderstanding and could be mediated with targeted education by the patient navigator. CONCLUSIONS Patient navigator programs at referral centers reduce no-show rates, thus improving patient follow-up, which may reduce disparities in cervical cancer screening and treatment.
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Affiliation(s)
- Rebecca Luckett
- 1 Department of Obstetrics and Gynecology, Brigham and Women's Hospital , Boston, Massachusetts
| | - Nancy Pena
- 2 Department of Gynecologic Oncology, Dana Farber Cancer Institute , Harvard Medical School, Boston, Massachusetts
| | - Allison Vitonis
- 1 Department of Obstetrics and Gynecology, Brigham and Women's Hospital , Boston, Massachusetts
| | - Marilyn R Bernstein
- 2 Department of Gynecologic Oncology, Dana Farber Cancer Institute , Harvard Medical School, Boston, Massachusetts
| | - Sarah Feldman
- 1 Department of Obstetrics and Gynecology, Brigham and Women's Hospital , Boston, Massachusetts
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Pena N, Campos PSF, de Almeida SM, Bóscolo FN. Determination of the length of zygomatic implants through computed tomography: establishing a protocol. Dentomaxillofac Radiol 2009; 37:453-7. [PMID: 19033430 DOI: 10.1259/dmfr/16676031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to establish and verify an examination protocol using CT to estimate the length of zygomatic implants, thus rendering the surgical process safer and more predictable, and exposing the patient to a minimal level of radiation. METHODS Paracoronal CT scan was carried out on ten dry human crania (n = 20) and the zygomatic implant sites were measured (L(CT)) bilaterally. A standard surgical zygomatic implant placement procedure was carried out and the actual lengths (L(Real)) and clinical lengths (L(Clin)) determined. RESULTS The averages of the L(CT), L(Clin) and L(Real) were 45.73 +/- 4.82 mm, 42.63 +/- 4.33 mm, and 44.73 +/- 4.53 mm, respectively. Student's t-test revealed no statistically significant differences between the L(Real) and L(CT) averages (P = 0.1532), whereas the L(Real) and L(Clin) averages were statistically different (P < 0.0001). CONCLUSIONS The proposed protocol proved to be precise and efficacious in the determination of zygomatic implant length, with the advantage to the patient of a relatively low level of exposure to radiation due to the small quantity of tomographic slices used. Although there were no major repercussions, the clinical probe in the zygomatic implant kit commonly used in this surgical procedure proved to be a rather imprecise tool.
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Affiliation(s)
- N Pena
- FAPESB (Fundação de Amparo a Pesquisa do Estado da Bahia, Bahia, Brazil.
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Campos PSF, Freitas CE, Pena N, Gonzalez MOD, Almeida SM, Mariz ACR, Lorens FGL. Osteochondritis dissecans of the temporomandibular joint. Dentomaxillofac Radiol 2005; 34:193-7. [PMID: 15897292 DOI: 10.1259/dmfr/59267138] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A case is reported of a 43-year-old female patient presenting bilateral osteochondritis dissecans (OCD) of the temporomandibular joint (TMJ), in different stages for each side, associated with avascular necrosis (AVN) of the right condyle. Additionally observed was anterior disk displacement without reduction for both sides. We have proposed an adaptation of the previous classification of OCD for cases affecting the TMJ. We have also stressed the fundamental role of panoramic radiography on the diagnosis of stage 3 and stage 4 OCD of the TMJ. In relation to MRI, we have recommended sagittal (slice thickness of 2 mm) and coronal (slice thickness of 1 mm) fast spin-echo proton density-weighted sequences to better identify bone lesions (stage 1 and 2) and also localize osteochondral loose bodies; and coronal (slice thickness of 1 mm) fat-suppressed fast spin-echo T2 weighted sequence to better evaluate OCD (stable or unstable) and the features of the occasionally associated AVN (acute or chronic).
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Affiliation(s)
- P S F Campos
- Department of Radiology, Faculdade de Odontologia, Universidade Federal da Bahia, Brasil.
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Abstract
Mandibular bone depressions located on the lingual/buccal aspect of the mandibular ramus are the rarest variants of the so-called Stafne's bone cavities, or major salivary gland-related depressions, with only 17 cases reported in the literature including both clinical cases and archaeological specimens. We report the case of a 14-year-old male patient who sought clinical assistance complaining of a hard expansion on the lower left premolar-molar region. Apart from a unilocular radiolucent lesion between the lower left second premolar and first molar, a panoramic radiograph showed another radiolucent lesion located in the right mandibular ramus, at the level of the mandibular foramen. Computed tomography (CT) revealed an expansile lesion in the left mandibular body, later diagnosed as a simple bone cyst through surgical exploration. The three-dimensional CT volume rendering reconstructed image showed that the second lesion, located on the lingual aspect of the ascending ramus, was an actual cortical bone defect, which was diagnosed as a mandibular ramus-related Stafne's bone cavity. Considering the young age of the patient, the size of the defect, the recognizedly slow development of mandibular bone defects and, above all, the location of the bone defect under discussion, we believe it to have a congenital rather than a developmental origin (i.e. it was caused by a focal failure during intramembranous ossification of the mandible). If this is the case, mandibular bone depressions should not be seen exclusively as salivary gland-related bone defects.
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Affiliation(s)
- P S F Campos
- Department of Radiology, Escola de Odontologia, Universidade Federal da Bahia, Brazil.
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