High prevalence of genital human papillomavirus type 52 and 58 infection in women attending gynecologic practitioners in South Taiwan

BACKGROUND: We attempted to determine the prevalence of genital human papillomavirus (HPV) infection in women attending gynecologic practitioners in South Taiwan. METHODS: The population included 4383 women aged 16-78 seeking HPV testing at primary gynecologic practitioners regardless of their cervical cytology results. HPV DNA was identified from cervical swabs using semi-nested polymerase chain reaction with MY11, MY09/HMB01, and MY11/bioGP6+ primers. Genotyping for high-risk HPV (HR-HPV) was done separately by a HR-HPV chip, which contained 13 type-specific oligonucleotides on a nylon membrane. RESULTS: The overall HPV prevalence was 19.3% (849/4383), 11.1% (488/4383) were confirmed as HR-HPV positive. Among the women with HR-HPV infection, HPV-16 was the most prevalent type (22.1%; 108/488), followed by HPV-52 (21.3%; 104/488), and HPV-58 (19.9%; 97/488). Multiple infections were detected in 73 women (15.0%; 73/488). For women with age 30 or younger, the overall HPV and HR-HPV prevalence were 32.0% and 20.7%, respectively, which were significantly higher than those of women age older than 30 (17.2% and 9.5%, P < 0.001). More multiple infections (22.1% vs. 12.4%) were also found in women with age 30 or younger (P = 0.021). However, the relative contribution of types to the overall HR-HPV positive among different age groups remains the same. CONCLUSIONS: Our results showed an HPV prevalence that is similar compared with worldwide levels. HPV prevalence and multiple infections rate were decreasing across the age groups. Unlike most previous studies, the relative high prevalence of HPV 52 and 58 among South Taiwan women has important implications in vaccine prophylaxis.     

The Prevalence of DPYD*9A (c.85T&gt;C) Genotype and the Genotype-Phenotype Correlation in Patients with Gastrointestinal Malignancies Treated With Fluoropyrimidines: Updated Analysis

IntroductionThe dihydropyrimidine dehydrogenase gene (DPYD)*9A (c.85T>C) genotype is relatively common. The correlation between DPYD*9A genotype and dihydropyrimidine dehydrogenase (DPD) deficiency phenotype is controversial. In a cohort of 28 patients, DPYD*9A was the most commonly diagnosed variant (13 patients [46%]) and there was a noticeable genotype-phenotype correlation. In this study we genotyped a larger cohort of a mixed racial background to explore the prevalence of DPYD*9A variant and to confirm the genotype-phenotype correlation.Patients and MethodsBetween 2011 and 2018, in addition to genotyping for high-risk DPYD variants (DPYD*2A, DPYD*13 and DPYD*9B), genotyping for DPYD*9A variant was performed on 113 patients with gastrointestinal malignancies treated with fluoropyrimidines. Fluoropyrimidines-associated toxicity was graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 5.0). Fisher exact test was used for statistical analysis.ResultsHeterozygous and homozygous DPYD*9A genotypes were identified in 46 (41%) and 11 (10%) patients, respectively. Among patients with DPYD*9A genotypes (n = 57), men and women represented 30 (53%) and 27 (47%) patients, respectively. Caucasian, African American, and other ethnicities represented 29 (50.9%), 26 (45.6%), and 2 (3.5%) patients, respectively. Grade 3/4 toxicities were experienced in 26 patients with DPYD*9A genotype (3 patients had homozygous status) and in 20 patients with wild type DPYD*9A (P = .4405). In patients who received full-dose fluoropyrimidines (n = 85), Grade 3/4 toxicities were experienced in 22 patients with DPYD*9A genotype (2 patients had homozygous status), and in 17 patients with wild type DPYD (P = .8275).ConclusionIn our updated analysis, the prevalence of heterozygous and homozygous DPYD*9A genotypes were 41% and 10%, respectively. The correlation between DPYD*9A genotype and DPD clinical phenotype was not reproduced. The noticeable correlation that we previously reported is likely because of small sample size and selection bias.     

Strategies for cardiopulmonary exercise testing of pectus excavatum patients

The purpose of this paper is to provide strategies for cardiopulmonary exercise testing of pectus excavatum patients. Currently, there are no standardized methods for assessing cardiovascular and pulmonary responses in this population; therefore, making comparisons across studies is difficult if not impossible. These strategies are intended for physicians, pulmonary technicians, exercise physiologists, and other healthcare professionals who conduct cardiopulmonary exercise testing on pectus excavatum patients. By using the strategies outlined in this report, comparisons across studies can be made, and the effects of pectus excavatum on cardiopulmonary function can be assessed with greater detail.     

Yellow nail syndrome in an elderly sudanese female: A case report

Yellow nail syndrome is a rare lymphatic abnormality without clear pathogenesis. Hereby, we report a 70‐year‐old Sudanese female patient who presented with recurrent cough, recurrent lower limb swelling, and yellowish nail discoloration diagnosed as yellow nail syndrome but unfortunately passed away due to acute respiratory distress syndrome (ARDS).