Guidelines recommend that pregnant women be vaccinated against pertussis between gestational weeks 26 and 36. We show that this narrow window can be widened, as optimal neonatal antibody concentrations and expected infant seropositivity rates are elicited between weeks 13 and 33.

BackgroundPolymerase chain reaction-based Xpert human papillomavirus (HPV) assay is a rapid test that detects high-risk HPV (hrHPV) infection. This point-of-care test is usually performed by collecting a cervical specimen in a vial of PreservCyt® transport medium. We compared HPV test positivity and accuracy between self-collected sample with a dry swab (s-DRY) versus physician-collected cervical sampling using a broom like brush and immediate immersion in PreservCyt (dr-WET).MethodsIn this cross-sectional study, we recruited 150 women ≥ 18 years old attending the colposcopy clinic in the University Hospital of Geneva. Each participant first self-collected a vaginal sample using a dry swab and then the physician collected a cervical specimen in PreservCyt. HPV analysis was performed with Xpert. Part of the PreservCyt-collected sample was used for hrHPV detection with the cobas® HPV test. HPV test positivity and performance of the two collection methods was compared.ResultsHPV positivity was 49.1% for s-DRY, 41.8% for dr-WET and 46.2% for cobas. Good agreement was found between s-DRY and dr-WET samples (kappa±Standard error (SE) = 0.64±0.09,), particularly for low-grade squamous intraepithelial lesions (LSIL+) (kappa±SE = 0.80±0.17). Excellent agreement was found between the two samples for HPV16 detection in general (kappa±SE = 0.91±0.09) and among LSIL+ lesions (kappa±SE = 1.00±0.17). Sensitivities and specificities were, respectively, 84.2% and 47.1%(s-DRY), 73.1% and 58.7%. (dr-WET) and 77.8% and 45.7% (cobas) for CIN2+ detection. The median delay between sampling and HPV analysis was 7 days for the Xpert HPV assay and 19 days for cobas. There were 36 (24.0%) invalid results among s-DRY samples and 4 (2.7%) among dr-WET (p = 0.001). Invalid results happened due to the long interval between collection and analysis.ConclusionSelf-collected vaginal dry swabs are a valid alternative to collecting cervical samples in PreservCyt solution for HPV testing with the Xpert HPV assay.ImpactHPV self-collection with dry cotton swabs might assist in the implementation of an effective screening strategy in developing countries.Trial registrationInternational Standard Randomized Controlled Trial Number Registry ISRCTN83050913

BackgroundAbscesses located in the cesarean-section (CS) induced isthmoceles are rarely encountered and are usually treated surgically, mostly by hysterectomy.Case descriptionWe here report the case of a 40-year-old primiparous woman presenting a symptomatic abscess in the isthmocele 10 years after a CS. She was treated by antibiotics and was closely monitored by clinical evaluation, ultrasonography, and pelvic magnetic resonance imaging. This treatment led to complete resolution of symptoms and a disappearance of the abscess at imagery.ConclusionOur report shows that a conservative medical management of isthmocele abscesses can be an effective approach in women wishing to preserve their uterus.

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Krukenberg tumors are rare cases of metastatic ovarian tumors. Generally, they are bilateral and 70% originate in the stomach, but they can also originate in other organs. They are normally found in young women, on average at 45 years of age, and normally present symptoms due to ovarian involvement: abdominal pain, bloating, nonspecific gastrointestinal symptoms or ascites with malignant cells. They can also be asymptomatic. The diagnosis of the primary tumor can be made before surgery, during further investigations, or during the months following operative surgery. CT and MRI allow the diagnosis and the follow up. The best exam is surely the PET-CT to evaluate an extension (metastasis). Post-surgical and post-therapeutic monitoring is provided by these images. The primary tumor is often too small to be detected and diagnosis depends on meticulous radioscopic and endoscopic exploration. They're usually found in young women. Our two cases imposed a difficult discovery but a good survival for both.