Publications by authors named "Cuschieri"

Background: Human papillomavirus (HPV) is a common infection of the anogenital tract. Although most infections clear, persistent infections with oncogenic types can predispose to cancer. While the natural history of anogenital HPV infection in cisgendered women is relatively well understood, there are significant knowledge gaps regarding HPV prevalence and clinical implications of genital HPV infection in transgender women (TGW) with neovagina(s).

View Article and Find Full Text PDF

Background: Self-sampling is now a key component within HPV-based cervical screening programmes to engage individuals and enhance participation. As self-sampling is relatively new, information on the influence of pre-analytical parameters such as transit-temperature and time between sampling and testing on HPV test results requires detailed investigation.

Methods: FLOQSwabs® and Evalyn Brushes® were used to assess HPV and cellular stability over a 30-week period (0w,4w,12w,30w) at 4 °C, ambient, and 37 °C.

View Article and Find Full Text PDF

Background: Human papillomavirus (HPV) testing of self-collected vaginal samples has potential to improve coverage of cervical screening programmes, but current guidelines mostly require those HPV positive on a self-sample to attend for routine screening.

Methods And Findings: A pragmatic modified stepped-wedge implementation feasibility trial was conducted at primary care practices in England. Individuals aged 25 to 64 years who were at least 6 months overdue for cervical screening could provide a self-collected sample.

View Article and Find Full Text PDF

The introduction of self-sampling in cervical cancer screening has raised the importance of HPV test validation on self-collected samples. This study aimed to evaluate the clinical accuracy of the OncoPredict HPV Screening (SCR) assay on self-collected vaginal and first-void urine (FVU) samples, relative to cervical specimens, using the VALHUDES Framework. FVU and vaginal self-samples followed by a clinician-collected cervical brushing were collected from 500 women referred to colposcopy and tested using OncoPredict HPV SCR assay.

View Article and Find Full Text PDF
Article Synopsis
  • The VALHUDES initiative aimed to evaluate the effectiveness of self-collected urine and vaginal samples for detecting cervical precancers compared to traditional clinician-collected cervical samples using the OncoPredict HPV Quantitative Typing assay.
  • A study involving 490 women showed that the clinical sensitivity for detecting cervical intraepithelial neoplasia (CIN2+) was comparable between self-collected samples and cervical samples, but specificity was lower for both self-collection methods.
  • After optimizing the testing criteria, the OncoPredict HPV QT assay showed similar accuracy in diagnosing cervical precancers from self-collected samples as from clinician-collected cervical samples.
View Article and Find Full Text PDF

The COVID-19 pandemic has been associated with a general decline in well-being. However, there is limited evidence on the effect of the pandemic on the general population, and especially among the ageing population. We assessed the overall impact of the pandemic on the well-being of middle-aged and older adults residing in 27 European countries, focusing on the time-period before summer 2021.

View Article and Find Full Text PDF

Background: At least 10% of Covid-19 recovered individuals experience persistent symptoms (Long Covid). Primary healthcare and general practitioners (GPs) are at the forefront in their care. In this study, GPs' knowledge, perceptions and experiences with Long Covid, and the definition used in two countries, are investigated to provide insight into GPs' care for Long Covid patients at a cross-country level.

View Article and Find Full Text PDF
Article Synopsis
  • The response rate for returning the kits was 20.5%, with older women showing higher participation; 12% tested positive for HPV mRNA.
  • Findings suggested that while self-sampling is feasible, only 1 in 5 women responded, indicating a need for future research on the effectiveness of reaching out to women who initially declined to engage.
View Article and Find Full Text PDF
Article Synopsis
  • This review compares traditional and digital methods for assessing marginal gaps in fixed dental prostheses, highlighting the advantages and limitations of each technique.
  • Traditional methods like Cross-Sectional Method (CSM) and Silicone Replica Technique (SRT) are established but have drawbacks, while newer digital techniques like Triple-Scan Method (TSM) and Optical Coherence Tomography (OCT) provide more detailed evaluations.
  • The study indicates a knowledge gap in the literature, emphasizing the need for further exploration of digital methods for clinical applications in dental assessments.*
View Article and Find Full Text PDF
Article Synopsis
  • The study analyzed data from the National Trauma Databank (2017-2020) to understand the characteristics of genitourinary self-inflicted injuries (GU SII) and compare differences between genders.
  • Out of 56,463 SII cases, 1508 (2.7%) involved GU injuries, with a majority being young white males (77.3%), and kidney injuries were the most common.
  • Many patients had pre-existing mental health issues (54.9%), and despite a high survival rate, 15.4% of cases were fatal, particularly those with kidney injuries and other non-GU injuries.
View Article and Find Full Text PDF
Article Synopsis
  • Non-communicable diseases (NCDs) are serious health problems around the world, making it hard for health systems to cope and costing a lot of money.
  • The study looked at NCDs in South Asia, the Caribbean, and parts of Africa to find out what causes these diseases and how they can be treated better.
  • It found that factors like lifestyle, poverty, and healthcare resources affect the number of people who get NCDs, and suggested that better planning and education could help reduce these diseases.
View Article and Find Full Text PDF
Article Synopsis
  • Multiple organ failure (MOF) poses serious challenges for acute care surgeons and is linked to negative patient outcomes.
  • The review examines the causes, effects, symptoms, diagnosis, treatment, and prevention methods related to MOF and chronic critical illness.
  • A thorough understanding of MOF's complex causes and effects is crucial for creating effective treatment plans that address inflammation, immune issues, and microvascular problems to help patients recover.
View Article and Find Full Text PDF

While HC2 and GP5+/6+ PCR-EIA were pivotal in test validation of new HPV assays, they represent the first generation of comparator tests based upon technologies that are not in widespread use anymore. In the current guideline, criteria for second-generation comparator tests are presented that include more detailed resolution of HPV genotypes. Second-generation comparator tests should preferentially target only the 12 genotypes classified as carcinogenic (IARC-group I), and show consistent non-inferior sensitivity for CIN2+ and CIN3+ and specificity for ≤CIN1 compared to one of the first-generations comparators, in at least three validation studies using benchmarks of 0.

View Article and Find Full Text PDF

High-risk human papillomavirus (HPV) infections can progress to cervical cancer which is the fourth most common cancer in women globally. In Scotland, the incidence of cervical cancer has a strong socioeconomic deprivation gradient disproportionately affecting women from more deprived areas. An HPV vaccination programme was initiated in Scotland in 2008 targeting girls aged 12-13 years with a catch-up campaign running for the first three years for girls aged up to 18 years.

View Article and Find Full Text PDF

We present a rare case of a 40-year-old nulliparous lady, with no past medical or surgical history, who was diagnosed with metastatic squamous cell carcinoma of the right ovary that originated from a mature cystic ovarian teratoma. Our patient underwent debulking total abdominal hysterectomy, bilateral salpingo-oophorectomy and partial omentectomy followed by postoperative carboplatin and paclitaxel chemotherapy. Rapid disease progression ensued, complicated by severe parathyroid hormone-related protein-induced hypercalcaemia resistant to medical therapy.

View Article and Find Full Text PDF

Background: Sleep quality is affected by a plethora of different factors, although its relationship with chronic diseases is still unclear. This study explored perceived sleep quality and its associated determinants among the adult population of Malta. A cross-sectional study.

View Article and Find Full Text PDF

The aim of this paper is to contribute technical arguments to the debate about the importance of health examination surveys and their continued use during the post-pandemic health financing crisis, and in the context of a technological innovation boom that offers new ways of collecting and analysing individual health data (e.g. artificial intelligence).

View Article and Find Full Text PDF
Article Synopsis
  • The study aims to enhance the analysis of cervical diseases by detecting protein biomarkers from both human and microbial sources in cervical samples.
  • Researchers collected both non-frozen tissue biopsies and exfoliative cytology samples to compare the detection of human proteins, finding specific proteins like Lumican and Galectin-1 in biopsies, and IL-36 and IL-1RA in cytologies.
  • The study identified Lactobacillus spp. as the most prevalent microbial protein and suggests that future research can use these methods to investigate the relationship between human and microbial proteins in cervical conditions, including cancer and pre-cancerous lesions.
View Article and Find Full Text PDF

Background: Patients with hemorrhagic shock and trauma (HS/T) are vulnerable to the endotheliopathy of trauma (EOT), characterized by vascular barrier dysfunction, inflammation, and coagulopathy. Cellular therapies such as mesenchymal stem cells (MSCs) and MSC extracellular vesicles (EVs) have been proposed as potential therapies targeting the EOT. In this study we investigated the effects of MSCs and MSC EVs on endothelial and epithelial barrier integrity in vitro and in vivo in a mouse model of HS/T.

View Article and Find Full Text PDF

The evaluation and workup of fever and the use of antibiotics to treat infections is part of daily practice in the surgical intensive care unit (ICU). Fever can be infectious or non-infectious; it is important to distinguish between the two entities wherever possible. The evidence is growing for shortening the duration of antibiotic treatment of common infections.

View Article and Find Full Text PDF

The use of prophylactic measures, including perioperative antibiotics, for the prevention of surgical site infections is a standard of care across surgical specialties. Unfortunately, the routine guidelines used for routine procedures do not always account for many of the factors encountered with urgent/emergent operations and critically ill or high-risk patients. This clinical consensus document created by the American Association for the Surgery of Trauma Critical Care Committee is one of a three-part series and reviews surgical and procedural antibiotic prophylaxis in the surgical intensive care unit.

View Article and Find Full Text PDF

Background: Despite the high incidence of blunt trauma in older adults, there is a lack of evidence-based guidance for computed tomography (CT) imaging in this population. We aimed to identify an algorithm to guide use of a pan-scan (head/cervical spine [C-spine]/torso) or a selective scan (head/C-spine ± torso). We hypothesized that a patient's initial history and examination could be used to guide imaging.

View Article and Find Full Text PDF