Background: The aim of this multicentric study was to identify human papillomavirus (HPV) type distribution in invasive cervical cancer and high-grade cervical intraepithelial neoplasia 2/3 (CIN2/3) in Italy.Methods: Cases were sampled through the electronic databases at the pathology units of eight centers in six regions from central and southern Italy. HPV types were detected from paraffin-embedded tissue samples and cervical specimens through amplification of HPV DNA with GP5+/GP6+ primers, followed by genotyping with reverse line blot (RLB). Untyped HPV-positive samples were sequenced. HPV-negative samples underwent nested PCR, followed by either RLB or sequencing. Finally, the remaining HPV-negative samples were amplified with primers targeting the virus E6 to E7 regions.Results: From 1,162 cases initially selected, 722 samples were further analyzed: 144 CIN2, 385 CIN3, 157 invasive squamous carcinomas, and 36 adenocarcinomas. Samples (6.9%) were HPV negative. The proportion of HPV16/18 was 60.8%, 76.6%, and 78.8% in CIN2, CIN3, and invasive cancers, respectively (P trend = 0.004). There was a significant decreasing trend of HPV16/18 with age in invasive cancers, going from 92% in women <35 years to 73% in women >55 years (P = 0.036). The proportion of coinfections was 16.8%, 15.5%, and 10.0% in CIN2, CIN3, and invasive cancers, respectively (P trend = 0.07).Conclusions: The proportion of invasive cancers caused by HPV16/18 decreases with age at diagnosis. Impact: The absolute risk of an invasive cancer due to non-HPV16/18 in women under 35 is extremely low. This finding might prompt us to rise the age at which public HPV screening for vaccinated women should start. Cancer Epidemiol Biomarkers Prev; 19(9); 2389-400. ©2010 AACR.
BackgroundThis multicenter study describes the type-specific prevalence of HPV infection in the general population from central and southern Italy, comparing the data with previously published Italian studies.MethodsWomen aged from 25 to 65 who attended cervical cancer screening in five different Italian regions were tested for HPV infection with Hybrid Capture II (HCII) low and high risk probes. Women repeating Pap-test upon unsatisfactory or positive results, or as a post-treatment and post-colposcopy follow-up analysis, were excluded from our study. High risk (HR) HPV positive samples were typed using GP5+/GP6+ primed PCR, followed by Reverse Line Blot for 18 high/intermediate risk HPV types, while low risk (LR) HPV positive samples were tested with type specific primers for HPV6 and HPV11.Results3817 women had a valid HCII test: 350 of them (9.2%) were positive for HR probes, 160 (4.2%) for LR probes, while 57 women were positive for both. Multiple infections were detected in 97 HR HPV positive women. The most common types were HPV 16 (3%), 31 (1.2%), 51 (1%). HPV6 ranked fifth (0.6%), HPV18 ranked tenth (0.5%) and HPV11 sixteenth (0.3%).In Sardinia the prevalence of high-risk infection was 13%, significantly higher than the mean value (p < 0.00005).The distribution of the most frequent types did not significantly differ by centre (p = 0.187) and age (p = 0.085).ConclusionsBecause cervical cancer incidence and Pap test coverage is lower in southern than in northern Italy, a lower prevalence of high-risk infections in the general population was expected in the south. However, prevalence detected in this study for the south of the country is slightly but significantly higher than the rest of Italy. The consequence may be an epidemic of cervical cancer in the next decades if adequate screening programs are not implemented there.
BackgroundHPV type distribution by cytological status represents useful information to predict the impact of mass vaccination on screening programs.Methodswomen aged from 25 to 64 who attended cervical cancer screening in five different Italian regions were tested for HPV infection with Hybrid Capture II (HCII) low and high risk probes. Women repeating Pap-test upon unsatisfactory or positive results, or as a post-treatment and post-colposcopy follow-up analysis, were excluded from our study. High risk (HR) HPV positive samples were typed using GP5+/GP6+ primed PCR, followed by Reverse Line Blot for 18 high/intermediate risk HPV types, while low risk (LR) HPV positive samples were tested with type specific primers for HPV6 and HPV11.Results3410 women had a valid HCII and Pap-test. The prevalence of HR and LR infections was 7.0% and 3.6%, 29.1% and 13.7%, 68.1% and 31.9%, 60.0% and 0.0%, 65.0% and 12.0%, for negative, ASC-US, L-SIL, ASC-H and H-SIL cytology, respectively. The fraction of ASC-US+ cytology due to HPV 16 and 18 ranged from 11.2 (HPV 16/18 alone) to 15.4% (including HPV 16/18 in co-infection with other virus strains), and that due to HPV 6 and 11 ranged from 0.2% (HPV 6/11 alone) to 0.7% (including HPV 6/11 in co-infection with other LR virus strains).Conclusionsmass vaccination with bivalent or quadrivalent HPV vaccine would modestly impact on prevalence of abnormal Pap-test in screening.
Nalidixic acid (" negram ") is one of a new series of 1,8-naphthyridine derivatives with antibacterial properties which have been synthesized by Lesher et al. (1962). Chemically it is 1-ethyl-7-methyl-1,8-naphthyridine-4-one-3-carboxylic mg./kg. throughout pregnancy and for one week afterwards. On these dose levels there were no adverse effects on the course of pregnancy or on the growth and survival capacities of the offspring. At the highest dose level of 300 mg./kg., which is that approaching the limit of rat tolerance, there was maternal mortality and interference with the course of pregnancy of the survivors. At the end of the study there was no evidence of gross disease among survivors at all dose levels. Doses of 200 mg. /kg./day were given to three pregnant monkeys. One animal was medicated for two months and others for one month prior to delivery. The drug was given to all animals during the first two weeks post partum. No untoward reactions were noted. Each mother delivered one normal offspring, and mothers and offspring were observed for three months after stopping medication and appeared normal during this time. The body weight of the mothers was normal throughout the study. The Somers test has been repeated using pregnant rabbits; no teratogenic changes or other congenital malformations were observed. Human VolunteersThe drug was given to 13 men and 9 women four times a day for up to 180 successive days. The maximum sustained dose was 8 g./day for 56 days. An initial single 4-g. dose was well tolerated by most volunteers. Clinical TrialMid-stream specimens of urine were collected in both sexes except when a specimen was taken at the time of cystoscopy. The urines were refrigerated and cultured within an hour of arrival in the laboratory.
Correspondence MEDICAJORNAL are due to 8 haemolytic streptococci. There is usually dramatic improvement four to six hours after the first dose of the drugs, so if it is possible to avoid the establishment of an artificial airway during this period the crisis is over.Tracheostomy and nasotracheal intubation by a skilled anaesthetist are both satisfactory methods for the relief of the airways obstruction. The choice of method will be determined by the skill of the team responsible for the care of these patients.-We are, etc
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