Genital human papillomavirus infection in Panama City prostitutes

Little is known of the natural history of genital human papillomavirus (HPV) infections in women from high-risk populations. Samples were collected from 183 Panama City prostitutes and assessed for HPV (filter in situ DNA hybridization) and for sexually transmitted agents. The cohort was followed for 8 mo; 51% of subjects completed four monthly return visits and 16% were sampled eight times. The proportion of women found infected with HPV increased significantly with increasing numbers of consecutive samples tested; 38 (21%) of 183 women were positive after one visit and 46 (82%) of 56 who completed six visits were infected. The pattern of viral detection over time was not random, which implied that most prostitutes were persistently infected with genital HPVs and that either scattered foci of infection or periodic reactivation of latent virus occurred. Our findings suggest that multiple sampling is necessary to accurately estimate HPV infection rates and to define whether patterns of DNA expression are present.     

Epidemiology,clinical picture and long-term outcomes of FIP1L1-PDGFRA-positive myeloid neoplasm with eosinophilia: Data from 151 patients

FIP1L1-PDGFRA-positive myeloid neoplasm with eosinophilia (F/P+ MN-eo) is a rare disease: robust epidemiological data are lacking and reported issues are scarce, of low sample-size and limited follow-up. Imatinib mesylate (IM) is highly efficient but no predictive factor of relapse after discontinuation has yet been identified. One hundred and fifty-one patients with F/P+ MN-eo (143 males; mean age at diagnosis 49 years; mean annual incidence: 0.18 case per million population) were included in this retrospective nationwide study involving all French laboratories who perform the search of F/P fusion gene (study period: 2003-2019). The main organs involved included the spleen (44%), skin (32%), lungs (30%), heart (19%) and central nervous system (9%). Serum vitamin B12 and tryptase levels were elevated in 74/79 (94%) and 45/57 (79%) patients, respectively, and none of the 31 patients initially treated with corticosteroids achieved complete hematologic remission. All 148 (98%) IM-treated patients achieved complete hematologic and molecular (when tested, n = 84) responses. Forty-six patients eventually discontinued IM, among whom 20 (57%) relapsed. In multivariate analysis, time to IM initiation (continuous HR: 1,01 [0.99-1,03]; P = .05) and duration of IM treatment (continuous HR: 0,97 [0,95-0,99]; P = .004) were independent factors of relapse after discontinuation of IM. After a mean follow-up of 80 (56) months, the 1, 5- and 10-year overall survival rates in IM-treated patients were 99%, 95% and 84% respectively. In F/P+ MN-eo, prompt initiation of IM and longer treatment durations may prevent relapses after discontinuation of IM.     

Lessons from case studies of metals: investigating exposure,bioavailability, and risk

Since metals are widely distributed in environmental matrices, humans are exposed to them by either anthropogenic activities or inadvertently by necessity. Selected metals: arsenic, mercury, iron, tin, lead and chromium were chosen on the basis of their economic and public health importance to illustrate the diversity of exposure pathways and differences in factors governing bioavailability. Bioavailability is central to the toxicity of metals and this is discussed from the health risk paradigm standpoint of risk assessment and risk management and the impacts of including or excluding bioavailability in such assessment. The lessons from the case studies of arsenic, mercury, tin and chromium provide a unified concept of methods that can be used in investigating and controlling outbreaks due to metal poisoning in other similar situations.     

Case studies of the impact of understanding bioavailability: arsenic

Arsenic is a metalloid that occurs in virtually all environmental matrices. The inorganic forms of arsenic occurring as As(III) and As(V) are toxic and may pose a health risk to human population. Although exposure can occur in various settings, ingestion of contaminated ground water is more widespread. The toxicity of arsenic is dependent to a large extent on its bioavailability or its ability to be liberated from various matrices and be internalized in the target organs of the host. This article reviews the main health impacts of arsenic and the methodologies for measuring bioavailability, and interprets the bioavailability studies conducted so far. It is argued that, because the bioavailability of arsenic varies with environmental matrices, a single default value is not recommended for risk determination and management in all environmental settings. Precise site-specific knowledge of bioavailability of arsenic is critical for both setting the maximum contaminant levels and directing site-specific cleanup operation in a cost-effective manner. Finally, molecular geochemical knowledge is combined with epidemiological observation to propose a model for disease in which the bioavailability of arsenic plays a determinant role together with other host and environmental factors.     

Human papillomavirus and cervical intraepithelial neoplasia in women who subsequently had invasive cancer.

In a retrospective case-control study biopsy specimens of cervical intraepithelial neoplasia (CIN) lesions from 47 women in whom invasive cancer subsequently developed (cases) and from 94 control subjects in whom CIN was diagnosed within 6 months of the diagnosis for the matched case subject but invasive disease did not develop were tested for human papillomavirus (HPV) DNA with tissue in-situ hybridization. There were no significant differences in the frequency of detection of HPV DNA between the two groups. In a cross-sectional survey the prevalence of HPV DNA was found to be 11% in specimens without CIN, 27% in those with CIN I, 49% in those with CIN II and 56% in those with CIN III. The positivity rates for HPV 16/33 DNA increased with the severity of CIN, but this was not observed for HPV 6/11 and 18 DNA. A comparison of the results of the case-control and cross-sectional studies suggested that the younger cohort of women had higher prevalence rates of HPV DNA than the older cohort.