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Objective: To determine the accuracy of high‐risk human papillomavirus (HPV) DNA samples on filter paper in comparison to specimen transport medium (STM). Methods: This was a cross‐sectional diagnostic study of 42 consecutive women who were prospectively recruited. Each had self‐collected vaginal samples on filter paper, physician‐collected cervical samples on filter paper, and physician‐collected cervical samples in STM. HPV DNA testing was performed with a Hybrid Capture 2 system (Qiagen). Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and agreement of filter paper methods with the standard procedure were calculated. Results: The overall prevalence of HPV in STM was 67.5%. Detection of HPV DNA in the physician‐collected cervical samples on filter paper had a sensitivity of 77.8%, a specificity of 100%, a PPV of 100%, and an NPV of 68.4%. The patient's self‐sampling on filter paper had a sensitivity of 66.7%, a specificity of 100%, a PPV of 100%, and an NPV of 59.1%. The agreement between STM method and physician‐collected sample on filter paper was substantial, (κ = 0.695, P < 0.001), while the agreement between STM and self‐collected samples on filter paper was moderate (κ = 0.565, P < 0.001). Most patients reported that self‐collection was acceptable (100%), painless (95%), and not embarrassing (95%). Conclusion: Filter paper, with dried self‐collected vaginal samples, can be used to detect high‐risk HPV with acceptable accuracy. Synopsis: Self‐collected vaginal samples on filter paper, to detect high‐risk human papillomavirus, is better for women, easier to transport to central laboratories, and has acceptable accuracy. [ABSTRACT FROM AUTHOR]

Enhanced recovery protocols consist of a bundle of concepts including early feeding, opioid-sparing multimodal pain management, and euvolemia, with the overarching goal of hastening postoperative recovery. Enhanced recovery after surgery has been shown to reduce hospital length of stay, reduce costs, and decrease perioperative opioid requirements in benign and oncologic gynecologic surgery. Interventions without supporting evidence of benefit, such as the use of mechanical bowel preparation, routine use of nasogastric tubes and surgical drains, caloric restriction, routine use of intravenous opioid analgesics, and over-vigorous intravenous hydration should be discouraged to improve broader endpoints such as patient satisfaction and overall recovery. Successful implementation requires engagement from a multidisciplinary team including surgeons, anesthesiologists, nurses, and pharmacists. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence and study the association of ovarian, uterine, and breast cancers with endometriosis. Methods: A cross‐sectional study of all women with a tissue‐proven diagnosis of endometriosis postoperatively in a tertiary care hospital between January 1, 2010, and December 31, 2019, was conducted to determine the prevalence of coexistent malignancy. Patient details were obtained from electronic clinical records. Univariate analysis followed by multivariate analysis was done to find independent risk factors associated with malignancy. Results: Out of 800 patients, 104 (13.0%) were found to have coexistent malignancy: ovarian (50, 6.2%); endometrial (33, 4.1%); synchronous ovarian and endometrial (7, 0.9%); and breast (14, 1.8%). Increasing age (odds ratio [OR] 1.13; 95% confidence interval [CI] 1.09–1.16), higher levels of cancer antigen 125 (CA 125) (OR 1.002; 95% CI 1.001–1.005), postmenopausal status (OR 6.2; 95% CI 2.0–19.2), duration of endometriosis over 5 years (OR 4.7; 95% CI 2.5–9.0), and endometriomas larger than 8 cm (area under the curve 0.83) were predictive of coexistent malignancy. Conclusion: Endometriosis is associated with an increased risk of ovarian, endometrial, and breast malignancy. Increasing age, postmenopausal status, higher levels of CA 125, larger endometrioma, and long‐standing disease are predictive risk factors. Synopsis: Endometriosis is associated with increased risk of breast and gynecologic malignancies. Increasing age, postmenopausal status, larger endometriomas, and long‐standing endometriosis are the predictive risk factors. [ABSTRACT FROM AUTHOR]