Publications by authors named "Ordi J"

Background: Female recipients of allogeneic hematopoietic stem cell transplantation are at high risk of developing human papillomavirus (HPV)-associated lesions and (pre)cancer. We describe the results of a cervical cancer screening program in these women.

Methods: From 2010 to 2022, 70 female recipients of allogeneic hematopoietic stem cell transplantation in our institution entered a standardized protocol of gynecological evaluation.

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Objective: Endocervical curettage (ECC) is the gold standard for predicting the persistence of high-grade squamous intraepithelial lesions (HSIL) after cervical conization. However, ECC has a high rate of unsatisfactory samples and may be uncomfortable for women. Endocervical sampling with brush (ECB) has been proposed as an alternative to ECC, which, in addition to the cytological evaluation, allows performing HPV testing using the same sample.

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Article Synopsis
  • Perinatal mortality is notably high in low- and middle-income countries, with accurate fetal gestational age assessment essential for differentiating between prematurity and intrauterine growth restriction for better management strategies.
  • The study conducted in Barcelona sought to validate post-mortem ultrasound measurements of the cerebellum as a method for estimating gestational age in cases of fetal and perinatal deaths.
  • Findings demonstrated a strong correlation between various cerebellar measurements and gestational age, with the extrauterine transcerebellar diameter emerging as the most reliable predictor, regardless of the trimester in which the measurement was taken.
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Background: SARS-CoV-2 infection during pregnancy is known to be associated with poor pregnancy outcomes, including pre-eclampsia (PE), prematurity, perinatal and maternal mortality. Data on the burden of SARS-CoV-2 infection among pregnant women and their offspring in Sub-Saharan Africa is limited. We aimed to estimate SARS-CoV-2 seroprevalence and determine PE biomarkers in Mozambican pregnant women with perinatal loss.

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  • The study aimed to investigate liver histopathology in children who died of acute illness in Malawi, specifically looking at nutritional status and its effects on liver mitochondria and peroxisomes.
  • Researchers collected liver tissue from eleven children under five, categorizing them into non-wasted, severely wasted, and edematous malnutrition groups to analyze histological differences using advanced microscopy techniques.
  • Results showed that children with edematous malnutrition had significantly fewer and more abnormal mitochondria compared to the other groups, indicating that targeting liver metabolic functions could help improve outcomes for children suffering from severe malnutrition.
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Stillbirth, one of the most common adverse pregnancy outcomes, is especially prevalent in low and middle-income countries (LMICs). Understanding the causes of stillbirth is crucial to developing effective interventions. In this commentary, investigators working across several LMICs discuss the most useful investigations to determine causes of stillbirths in LMICs.

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Women with high-grade squamous intraepithelial lesions/cervical intraepithelial neoplasia (HSIL/CIN) are at high risk of anal human papillomavirus HPV infection, and it has also been suggested that self-inoculation of the virus from the anal canal to the cervix could explain HPV recurrence in the cervix after treatment of HSIL/CIN. We aimed to evaluate the bidirectional interactions of HPV infection between these two anatomical sites. We evaluated 68 immunocompetent women undergoing excisional treatment for HSIL/CIN.

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Importance: Survivors of breast cancer present more severe symptoms of genitourinary syndrome of menopause (GSM) than patients without history of breast cancer. Recently, new treatments, such as vaginal laser therapy, have appeared, but evidence of their efficacy remains scarce.

Objective: To assess the safety and efficacy of carbon dioxide (CO2) vs sham vaginal laser therapy after 6 months of follow-up in survivors of breast cancer with GSM receiving aromatase inhibitors.

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The Manhiça Health Research Centre (Manhiça HDSS) was established in 1996 in Manhiça, a rural district at Maputo Province in the southern part of Mozambique with approximately 49,000 inhabited households, a total population of 209.000 individuals, and an annual estimated birth cohort of about 5000 babies. Since 2016, Manhiça HDSS is implementing the Child Health and Mortality Prevention Surveillance (CHAMPS) program aiming to investigate causes of death (CoD) in stillbirths and children under the age of 5 years using an innovative post-mortem technique known as Minimally Invasive Tissue sampling (MITS), comprehensive pathogen screening using molecular methods, clinical record abstraction and verbal autopsy.

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Penile squamous cell carcinomas (PSCC) are classified by the World Health Organization into two categories based on their relationship with the human papillomavirus (HPV): HPV-associated and HPV-independent. We compared a cohort of PSCC from Mozambique, a sub-Saharan country in southeast Africa with a high prevalence of HPV and HIV infection, and Spain, a country in southwestern Europe with a low prevalence of HPV and HIV, to study the distribution of the etiopathogenic categories of these tumors in both sites. A total of 79 PSCC were included in the study (28 from Mozambique and 51 from Spain).

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Cervical carcinoma remains one of the most common cancers affecting women worldwide, despite effective screening programs being implemented in many countries for several decades. The International Collaboration on Cancer Reporting (ICCR) dataset for cervical carcinoma was first developed in 2017 with the aim of developing evidence-based standardized, consistent and comprehensive surgical pathology reports for resection specimens. This 4th edition update to the ICCR dataset on cervical cancer was undertaken to incorporate major changes based upon the updated International Federation of Obstetricians and Gynecologists (FIGO) staging for carcinoma of the cervix published in 2018 and the 5th Edition World Health Organization (WHO) Classification of Female Genital Tumors published in 2020 and other significant developments in pathologic aspects of cervical cancer.

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A cogent and comprehensive pathologic report is essential for optimal patient management, cancer staging, and prognostication. This article details the International Collaboration on Cancer Reporting (ICCR) process and the development of the vulval carcinoma reporting data set. It describes the "core" and "noncore" elements to be included in pathology reports for vulval carcinoma, inclusive of clinical, macroscopic, microscopic, and ancillary testing considerations.

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Article Synopsis
  • Two pathways for vulvar squamous cell carcinomas (VSCC) are identified: one linked to HPV and the other not; the study compares cases from Mozambique, which has high HPV and HIV prevalence, to Spain with lower rates.
  • In the study, 97% of VSCC cases in Mozambique were HPV-associated, compared to only 19% in Spain, highlighting a significant difference (P < .001).
  • Additionally, the average age of patients was much younger in Mozambique (45 years) than in Spain (72 years), emphasizing the differing demographics and potential implications for VSCC prevention strategies worldwide.
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We report the first pediatric disease in which the use of minimally invasive autopsy (MIA) confirmed severe dengue as the cause of death. During the COVID-19 pandemic, a previously healthy 10-year-old girl living in north-eastern Brazil presented fever, headache, diffuse abdominal pain, diarrhoea, and vomiting. On the fourth day, the clinical symptoms worsened and the patient died.

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Several questions regarding the role of vaccination in women treated for high-grade cervical intraepithelial lesion (HSIL) have not been clarified. One of the main queries is whether the time at which the vaccine is administered (before or after treatment) influences the protection against post-treatment HSIL. A second unanswered question is whether the vaccine has any effect in women with persistent HPV after treatment.

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Primary carcinomas of the vagina are uncommon and currently detailed recommendations for the reporting of resection specimens of these neoplasms are not widely available. The International Collaboration on Cancer Reporting (ICCR) is developing standardized, evidence-based reporting data sets for multiple cancer sites. We describe the development of a cancer data set by the ICCR expert panel for the reporting of primary vaginal carcinomas and present the core and noncore data elements with explanatory commentaries.

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Article Synopsis
  • The study focuses on HPV-independent penile squamous cell carcinomas (PSCCs) and their possible origins from an intraepithelial precursor known as differentiated penile intraepithelial neoplasia.
  • Out of 55 surgical PSCC specimens from 2000 to 2021, 36 (65%) were found to be HPV-independent, with 26 of those containing a precursor lesion and 5 of them showing features similar to high-grade squamous intraepithelial lesions (HSIL) typically associated with HPV.
  • The research highlights the importance of using p16 immunohistochemical staining to identify these unique lesions in PSCC, which are morphologically similar to HPV-associated HSIL, an aspect not previously detailed
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Article Synopsis
  • Penile squamous cell carcinoma (PSCC) is a rare and aggressive type of cancer that can be linked to the human papillomavirus (HPV) or occur without it.
  • Researchers reviewed genetic changes in PSCC, looking at DNA mutations and differences in gene numbers but found that studies varied a lot in methods and results.
  • The study suggests that treating PSCC might work better if different biological pathways are targeted together, and more comprehensive research is needed to understand this cancer better.
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Background: Minimally invasive tissue sampling (MITS), an alternative to complete diagnostic autopsy, is a pathology-based postmortem examination that has been validated in low- and middle-income countries (LMICs) and can provide accurate cause of death information when used with other data. The MITS Surveillance Alliance was established in 2017 with the goal to expand MITS globally by increasing training capacity, accessibility, and availability in LMICs. Between January 2019 and May 2020, the MITS Surveillance Alliance convened a multidisciplinary team of technical advisors to attain this goal.

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Background: Infectious diseases' outbreak investigation requires, by definition, conducting a thorough epidemiological assessment while simultaneously obtaining biological samples for an adequate screening of potential responsible pathogens. Complete autopsies remain the gold-standard approach for cause-of-death evaluation and characterization of emerging diseases. However, for highly transmissible infections with a significant associated lethality, such as COVID-19, complete autopsies are seldom performed due to biosafety challenges, especially in low-resource settings.

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Background: Available information on the causes of death among people living with human immunodeficiency virus (PLHIV) in low- and middle-income countries (LMICs) remains scarce. We aimed to provide data on causes of death in PLHIV from two LMICs, Brazil and Mozambique, to assess the impact of clinical misdiagnosis on mortality rates and to evaluate the accuracy of minimally invasive tissue sampling (MITS) in determining the cause of death in PLHIV.

Methods: We performed coupled MITS and complete autopsy on 164 deceased PLHIV (18 children, 36 maternal deaths, and 110 adults).

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Article Synopsis
  • Minimally invasive tissue sampling (MITS) is a postmortem procedure that can replace complete autopsy (CA) for analyzing COVID-19 deaths, especially in high-infection settings.
  • The study involved 12 COVID-19 positive deceased individuals and showed that MITS effectively matched CA diagnoses, confirming COVID-19's role in causing lung damage in most cases.
  • MITS is deemed a safe and effective alternative to CA, with all medical personnel testing negative for COVID-19 throughout the study.
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Purpose: Indocyanine green (ICG) is frequently used for the detection of the sentinel lymph node (SLN) in gynecology, but it carries the loss of the presurgical SLN mapping provided by [Tc]-based colloids. Hybrid tracers such as ICG-[Tc]Tc-albumin nanocolloid combine the benefits of both components. The aim of this study was to evaluate the feasibility and applicability of this hybrid tracer injected by transvaginal ultrasound-guided myometrial injection of radiotracer (TUMIR) approach in the detection of SLNs in patients with intermediate- and high-risk EC.

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Article Synopsis
  • Minimally invasive tissue sampling (MITS) is a post-mortem method providing a reliable alternative to full autopsies, especially useful for understanding causes of death in resource-limited areas like Mozambique.
  • A study comparing hypothetical and actual acceptability of MITS among relatives of deceased children revealed that while 93% would hypothetically agree to MITS, cultural norms and confidentiality concerns posed barriers to real-life acceptance.
  • Key factors influencing acceptance included the desire to understand causes of death for preventive measures, alongside challenges such as traditional burial practices and perceptions of confidentiality surrounding results.
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