Carotid body tumors are rare, but represent the most common form of head and neck paraganglioma. We present 17 surgically treated patients. The present study reviews our experience in the diagnosis and treatment of these uncommon lesions. At surgery, 11 tumors were classified as Shamblin Class II and six as Class III. A cerebral angiogram was obtained in all cases before surgery. A cervical approach was the method of choice in 16 cases; in one case with mediastinal extension of the tumor we used a combined cervical and transsternal approach. Complete excision of the tumor was accomplished in all cases. Subadventitial tumor excision was performed in eight cases whereas internal carotid artery reconstruction was obtained in eight cases (three saphenous interposition vein grafts, two polytetrafluoroethylene (PTFE) 6 mm grafts, and end-to-end anastomosis in three cases). Resection of the left common carotid artery and reconstruction with a Dacron 8 mm graft was performed in the case with mediastinal tumor extension. Duplex scan along with angiography is effective in making the diagnosis. Excision is indicated for most tumors, and best results are achieved by an experienced vascular surgeon.

The high prevalence of human papillomavirus (HPV), the most common sexually transmitted infection, arises from the coexistence of over 200 genetically distinct types. Accurately predicting the impact of vaccines that target multiple types requires understanding the factors that determine HPV diversity. The diversity of many pathogens is driven by type-specific or "homologous" immunity, which promotes the spread of variants to which hosts have little immunity. To test for homologous immunity and to identify mechanisms determining HPV transmission, we fitted nonlinear mechanistic models to longitudinal data on genital infections in unvaccinated men. Our results provide no evidence for homologous immunity, instead showing that infection with one HPV type strongly increases the risk of infection with that type for years afterwards. For HPV16, the type responsible for most HPV-related cancers, an initial infection increases the one-year probability of reinfection by 20-fold, and the probability of reinfection remains 14-fold higher two years later. This increased risk occurs in both sexually active and celibate men, suggesting that it arises from auto-inoculation, episodic reactivation of latent virus, or both. Overall our results show that high HPV prevalence and diversity can be explained by a combination of a lack of homologous immunity, frequent reinfections, weak competition between types, and variation in type fitness between host subpopulations. Due to the high risk of reinfection, vaccinating boys that have not yet been exposed may be crucial to reduce prevalence, but our results suggest that there may also be large benefits from vaccinating previously infected individuals.

The aim of this study was to evaluate the effect of topical administration of corticosteroid beclomethasone dipropionate on common nasal symptoms in moderate allergic and non-allergic hyperreactive eosinophilic rhinitis, and in allergic and non-allergic hyperreactive eosinophilic rhinitis associated with bilateral moderate nasal polyposis. The study was prospective and controlled. During the study 106 patients were examined, out of whom 66 were treated, while 40 had no therapy. Beclomethasone diproprionate nasal spray was administered in the daily dose of 400 micrograms. Patients with isolated rhinitis underwent 3 otorhinolaryngologic examinations during the six-week treatment. Patients with nasal polyposis underwent 4 otorhinolaryngologic examinations during six-month treatment. One-week therapy showed highly significant decrease of the average score of symptoms of isolated rhinitis in relation to basal condition. No further significant change was noted after six-week therapy. Six-week therapy of nasal polyposis exerted significantly reduced score of symptoms in relation to basic condition. During further treatment no significant reduction of symptoms was noted. Follow-up period of all control subgroups showed no significant change of symptom scores. Topical therapy with beclomethasone dipropionate represented a significant medication of the first therapeutic line in moderate isolated eosinophilic rhinitis, as well as in moderate bilateral eosinophilic nasal polyposis.