Human papillomavirus and HIV coinfection and the risk of neoplasias of the lower genital tract: a review of recent developments

ONE OF THE RISK FACTORS FOR HUMAN PAPILLOMAVIRUS (HPV) INFECTION and subsequent lower genital tract neoplasias and cancers is impaired cell-mediated immunity. HIV-positive women with severe immunosuppression are 5 times more likely than HIV-negative women to have lower genital tract neoplasias. A corresponding increase in the risk of invasive vulvar and anal cancers, but not of cervical cancer, has also been observed among HIV-positive women. Treatment failure and recurrence of neoplasia occur much more frequently among HIV-positive than among HIV-negative women. In this review, we discuss recent advances in the understanding of the relation between HIV and HPV coinfection and the development of lower genital tract neoplasias and cancers in women. In addition, we present strategies for monitoring and treating noninvasive and invasive neoplasias of the lower genital tract in HIV-positive women.     

Misdiagnosed fibrosarcoma of the mandible mimicking temporomandibular disorder: a rare condition.

The jawbones can be sites of various neoplastic conditions. Given the variety of processes affecting this particular anatomical area, formulation of a precise diagnosis can be challenging to clinicians. Limited jaw movement, pain, and facial asymmetry are common signs among patients, especially those with temporomandibular disorder (TMD). This paper reports a case of primary fibrosarcoma affecting the mandible and surrounding structures in a 14-year-old girl presenting signs and symptoms similar to TMD. Her condition was misdiagnosed, and she was treated for TMD over an extended period before the correct diagnosis was made for fibrosarcoma. The patient underwent surgical resection with postsurgical radiotherapy and chemotherapy and now is being followed up. Although malignant lesions are rare in the temporomandibular joint (TMJ) region, dentists are advised to be aware of the condition and to keep in mind that patients who are admitting for TMD can also possibly be affected from neoplasms. Hence, those patients have to be examined meticulously to avoid misdiagnosis and mistreatment.     

Bulk polymerization of lactides initiated by aluminium isopropoxide, 3. Thermal stability and viscoelastic properties

The thermal stability of poly(L -lactide) and L /D -lactide stereocopolymers polymerized in bulk with aluminium isopropoxide as initiator was investigated by thermogravimetric analysis, and time and temperature dependence of molecular weight and polydispersity. Compared to poly(L -lactide) prepared with stannous octoate as catalyst the thermal stability of polylactides is remarkably enhanced when the ring-opening polymerization is initiated by aluminium alkoxide. Ultimate mechanical properties and viscoelasticity of these melt-stable thermoplastics have also been studied in relation to the polyester enantiomeric composition.     

Low back pain and physical exercise in leisure time in 38-year-old men and women: A 25-year prospective cohort study of 640 school children

A cohort of 38-year-old men and women were studied for leisure time physical exercise in relation to low back pain (LBP), education, work, social class and smoking by a self-administered questionnaire. At the age of 14 years, the subjects had been interviewed by their school doctor regarding history of LBP and radiographs of the thoracic and lumbar spine were taken. The results show no positive correlation between radiographic changes and LBP in the adolescent period and decreased physical activity in adulthood. Physical activity for at least 3 h/week reduces the risk of LBP measured as lifetime, 1-year and point prevalence. Eighty-five percent of the subjects who reported taking physical exercise for at least 3 h/week had participated in sports activity almost constantly since their school days and these reported being in better condition than the rest of the cohort. Otherwise they did not have a healthier mode of life. No physical exercise during leisure time was associated with a short school education, un-skilled work, unemployment and sickness, low social class, divorce, living in an apartment and smoking. Sixty percent had never or not for many years been interested in participating in sports. Badminton and tennis were the most common sports practised (36%), followed by gymnastics (32%), ball games — soccer and team handball - (25%), running (20%) and swimming (18%). Gymnastics and swimming seem to reduce LBP significantly. Our results show a falling interest in participating in sports activities over time, with 68% of the subjects being members of an athletic association previously, but only 29% currently. Women were more physically inactive during leisure time, probably because of their dual role. Logistic regression analysis indicates that physical activity is related to a long school education, high social class and regular sports activity over time.     

Local variations in the cerebral microcirculatory response to hypercapnia and haemorrhage

Summary This study evaluates local variations of the cerebral vasomotor responses to hypercapnia and haemorrhagic hypotension in a pig model. Four laser Doppler flow probes were used in each pig. There was considerable variation in laser Doppler signals between the four probes in baseline recordings. The increases in flow after CO₂ administration in 7 pigs had a mean coefficient of variation of 0.43 ± 0.31, and the flow changes after blood loss in another 7 pigs had a mean coefficient of variation of 0.45 ± 0.34. The range of flow changes within each animal was large; the probe with the highest CO₂ response showed on the average a 273% ± 157% larger CO₂ response than the probe with the lowest CO₂ response. Correspondingly, the probe with the best preserved blood flow after blood loss had on the average a flow value of 93% ± 12% of the baseline value, while the probe that changed most with haemorrhage had a flow value of 44% ± 24% of the baseline value. Single laser Doppler recordings have been used for the monitoring of cerebral blood flow in neurosurgical critical care, but our results suggest that a single laser Doppler flow probe is not an adequate method to monitor vasoreactivity in neurosurgical patients because flow signals from one probe may be unrepresentative for other sites in the brain.     

Anatomic variations of the spermatic vein and endovascular treatment of left varicoceles: a pediatric series]

OBJECTIVE: To report on the high incidence of anatomical variants of the origin and course of the internal spermatic vein (ISV) discovered at the time of percutaneous embolization of left varicoceles in a pediatric population. METHODS: We reviewed retrospectively the 65 cases of left varicocele treated by percutaneous embolization (grade II and III) in our institution between 1990 and 2000. The course of the left renal vein (LRV), the origin of the ISV, and the number of ISVs and their pathway were recorded in all cases, according to the B?hren classification. RESULTS: In 37/65 (57%), the ISV was single and arose from a normal LRV (type I). The following variants were encountered: type V--circumaortic LRV 9/65 (14%); type IVb--intrarenal origin of ISV 8/65 (12%); type II--multiple ISV 5/65 (8%); and pelvic collaterals 6/65 (9%). CONCLUSION: Venous anatomical variants are frequently encountered (43%) at the time of left varicocele embolization in children. Such variants often impose some adjustments to the technique of embolization and, at times, hamper the procedure.     

Pharmacokinetics of intravenously administered 125I-labelled human alpha 1-acid glycoprotein

The volumes of distribution of many acidic drugs have been shown to be close to that of their binding protein, i.e. serum albumin. The distribution of basic drugs mainly bound to alpha 1-acid glycoprotein (AAG) can be questioned with respect to its dependency upon the distribution of this plasma protein. So, a pharmacokinetic study was performed in 7 subjects with human 125I-labelled alpha 1-acid glycoprotein. The steady-state volume of distribution was found to be 5.37 +/- 0.82L. The central volume was 3.23 +/- 0.33L, close to that of plasma volume and the peripheral volume was 2.14 +/- 0.63L. These data allowed the establishment of an equation giving access to the volume of distribution of a basic drug by relating its unbound fraction to physiological distribution of alpha 1-acid glycoprotein. The values yielded by this equation show that the actual and calculated volumes of distribution of basic drugs mainly bound to AAG are discrepant. This protein is thus not the main factor controlling the distribution of basic drugs within the body.