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Effect of menstrual history and hormone use on bone mineral density in college-aged women
Use of a SpiraBrush Cx Biopsy for Transepithelial Cervical Biopsy* Neal M. Lonky, MD, MPH Southern California Permanente Medical Group, Kaiser Permanente Orange County, Anaheim, CA
Bradley J. Monk, MD, Juan C. Felix, MD, and Michael L. Cogan, MD OBJECTIVE: To compare a new spiral biopsy brush, SpiraBrush Cx, with a standard cervical punch biopsy. METHODS: Prior to local anesthesia and large loop excision of the transformation zone (LLETZ), women with a diagnosis of cervical intraepithelial neoplasia (CIN) underwent a SpiraBrush Cx sampling of at least 25% but not more than 75% of a colposcopically identified lesion followed by repeat cervical biopsy. SpiraBrush Cx samples were processed using cellblock techniques, and diagnoses were made by a consensus of three pathologists. A SpiraBrush Cx sample was adequate if basal cells were present. The histological diagnosis from the preLLETZ biopsy and the LLETZ specimen were compared with the SpiraBrush Cx sample. Patient-reported pain and physician-reported bleeding between the biopsy and SpiraBrush Cx were compared. RESULTS: There was significantly less pain (P ⬍ 0.001) and significantly less bleeding (P ⬍ 0.001) with the SpiraBrush Cx. Of the 37 patients evaluable, 31 had abnormal pathology (defined as including human papillomavirus [HPV]/CIN 1 or greater) as determined by the LLETZ specimen. The SpiraBrush Cx found 26 out of 31 detectable cases of pathology. (Two samples were inadequate). The punch biopsy found 16 out of 31 detectable cases when compared to LLETZ. CONCLUSION: SpiraBrush Cx is at least as reliable as a standard punch biopsy in detecting pathology of the cervix as determined by LLETZ with substantially less pain and bleeding.
Effect of Menstrual History and Hormone Use on Bone Mineral Density in College-Aged Women Mary K. Welch, MD New Hanover Regional Medical Center, Wilmington, NC
Sandra J. Diehl, MPH, and Mark M. Pasquarette, MD OBJECTIVE: Osteoporosis poses an important clinical challenge to physicians and patients alike. A cost-effective means of *This document includes a discussion of use of a product that is unapproved by the U.S. Food and Drug Administration.
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MONDAY POSTERS
identifying women who are at increased risk would greatly aid in the management of this disorder. The authors sought to determine if menstrual history or exogenous hormone use affect bone mineral density measurements in college-age women. METHODS: This cross-sectional observational cohort study included 84 women ages 18 –30 years. These volunteers were from a local university in southeastern North Carolina and agreed to answer a 30-item questionnaire and have their body mass index and calcaneal bone mineral density measured. Preliminary descriptive data are presented; additional analyses will be conducted. RESULTS: Eighty-four women participated in the study. Mean participant age was 21.0 years. Eighty-three percent of the sample was white. Four percent of the participants were noted to have osteoporosis, and 16.4% had osteopenia. Twenty-three percent of participants reported menstrual interruption of more than 60 days not related to pregnancy. Eighty percent of participants reported using contraception for birth control or other reasons; of those, 88% used oral contraceptives. Sixtytwo percent of women who reported menstrual interruption were noted to have decreased bone mineral density (osteopenia or osteoporosis). Eighty-four percent said they were either somewhat concerned or concerned about osteoporosis. CONCLUSION: College-aged women who report a history of menstrual interruption are at significant risk for decreased bone mineral density. Measurement of bone mineral density in at-risk college-aged women may prove useful in identifying individuals who require further evaluation and management.
ASCUS 2000: A Retrospective Study Mala Naraya, DO Bronx–Lebanon Hospital Center/Albert Einstein College of Medicine, Bronx, NY
Iliana I. Robinson, MD, MPH, Patrick Anderson, MD, and Magdy S. Mikhail, MD OBJECTIVE: To evaluate the follow-up of Pap tests reported as atypical squamous cells of undermined significance (ASCUS). METHODS: Out of 9,000 Pap tests done during the last year at the authors’ institute, 913 (10%) were reported as ASCUS. Of these, 456 patients had follow-up care. Data were analyzed according to age, type of follow-up, and progression or regression of cervical lesion. RESULTS: The follow-up of 456 patients consisted of repeat Pap test (73%) versus colposcopy (27%). Overall, 247 (54%) subjects showed regression, 111 (24%) showed progression to a higher grade, and 98 (22%) remained unchanged. The follow-up interval between original Pap test and repeat evaluation was as follows: 36% had their follow-up within 3 months, 34% between 3 and 6 months, and 30% between 6 and 12 months.
OBSTETRICS & GYNECOLOGY
Bradley J. Monk, MD, Juan C. Felix, MD, and Michael L. Cogan, MD OBJECTIVE: To compare a new spiral biopsy brush, SpiraBrush Cx, with a standard cervical punch biopsy. METHODS: Prior to local anesthesia and large loop excision of the transformation zone (LLETZ), women with a diagnosis of cervical intraepithelial neoplasia (CIN) underwent a SpiraBrush Cx sampling of at least 25% but not more than 75% of a colposcopically identified lesion followed by repeat cervical biopsy. SpiraBrush Cx samples were processed using cellblock techniques, and diagnoses were made by a consensus of three pathologists. A SpiraBrush Cx sample was adequate if basal cells were present. The histological diagnosis from the preLLETZ biopsy and the LLETZ specimen were compared with the SpiraBrush Cx sample. Patient-reported pain and physician-reported bleeding between the biopsy and SpiraBrush Cx were compared. RESULTS: There was significantly less pain (P ⬍ 0.001) and significantly less bleeding (P ⬍ 0.001) with the SpiraBrush Cx. Of the 37 patients evaluable, 31 had abnormal pathology (defined as including human papillomavirus [HPV]/CIN 1 or greater) as determined by the LLETZ specimen. The SpiraBrush Cx found 26 out of 31 detectable cases of pathology. (Two samples were inadequate). The punch biopsy found 16 out of 31 detectable cases when compared to LLETZ. CONCLUSION: SpiraBrush Cx is at least as reliable as a standard punch biopsy in detecting pathology of the cervix as determined by LLETZ with substantially less pain and bleeding.
Effect of Menstrual History and Hormone Use on Bone Mineral Density in College-Aged Women Mary K. Welch, MD New Hanover Regional Medical Center, Wilmington, NC
Sandra J. Diehl, MPH, and Mark M. Pasquarette, MD OBJECTIVE: Osteoporosis poses an important clinical challenge to physicians and patients alike. A cost-effective means of *This document includes a discussion of use of a product that is unapproved by the U.S. Food and Drug Administration.
38S
MONDAY POSTERS
identifying women who are at increased risk would greatly aid in the management of this disorder. The authors sought to determine if menstrual history or exogenous hormone use affect bone mineral density measurements in college-age women. METHODS: This cross-sectional observational cohort study included 84 women ages 18 –30 years. These volunteers were from a local university in southeastern North Carolina and agreed to answer a 30-item questionnaire and have their body mass index and calcaneal bone mineral density measured. Preliminary descriptive data are presented; additional analyses will be conducted. RESULTS: Eighty-four women participated in the study. Mean participant age was 21.0 years. Eighty-three percent of the sample was white. Four percent of the participants were noted to have osteoporosis, and 16.4% had osteopenia. Twenty-three percent of participants reported menstrual interruption of more than 60 days not related to pregnancy. Eighty percent of participants reported using contraception for birth control or other reasons; of those, 88% used oral contraceptives. Sixtytwo percent of women who reported menstrual interruption were noted to have decreased bone mineral density (osteopenia or osteoporosis). Eighty-four percent said they were either somewhat concerned or concerned about osteoporosis. CONCLUSION: College-aged women who report a history of menstrual interruption are at significant risk for decreased bone mineral density. Measurement of bone mineral density in at-risk college-aged women may prove useful in identifying individuals who require further evaluation and management.
ASCUS 2000: A Retrospective Study Mala Naraya, DO Bronx–Lebanon Hospital Center/Albert Einstein College of Medicine, Bronx, NY
Iliana I. Robinson, MD, MPH, Patrick Anderson, MD, and Magdy S. Mikhail, MD OBJECTIVE: To evaluate the follow-up of Pap tests reported as atypical squamous cells of undermined significance (ASCUS). METHODS: Out of 9,000 Pap tests done during the last year at the authors’ institute, 913 (10%) were reported as ASCUS. Of these, 456 patients had follow-up care. Data were analyzed according to age, type of follow-up, and progression or regression of cervical lesion. RESULTS: The follow-up of 456 patients consisted of repeat Pap test (73%) versus colposcopy (27%). Overall, 247 (54%) subjects showed regression, 111 (24%) showed progression to a higher grade, and 98 (22%) remained unchanged. The follow-up interval between original Pap test and repeat evaluation was as follows: 36% had their follow-up within 3 months, 34% between 3 and 6 months, and 30% between 6 and 12 months.
OBSTETRICS & GYNECOLOGY