Photodiagnosis and treatment of condyloma acuminatum using 5-aminolevulinic acid and homemade devices

Background: The objective of this study was to improve the feasibility of applying topic 5-aminolevulinic acid (ALA) in photodiagnosis (PD) and treatment of condyloma caused by human papillomavirus (HPV) using two homemade handheld devices and to discuss the photodynamic therapy (PDT) as a suitable alternative for each of the cases studied. Both, protoporphyrin IX production and photodegradation were analyzed, and the pain experienced during the illumination was correlated with the light intensities. Methods: A total of 40 women with different grades of lesions caused by HPV were chosen from patients of the School of Medicine of Ribeirao Preto (University of Sao Paulo) and of the Unit of Public Health of Araraquara, Sao Paulo. Results: We did not encounter any unexpected difficulties using our devices during the treatment. The existence of an easily observable reddish fluorescence with large intensity concentrated on the Lesions is the clinical indication of the penetration and the selective concentration of protoporphyrin IX in the clinical and subclinical lesions rather than in the healthy tissue. The aesthetic results were much better than those obtained by conventional techniques as surgery or cryogenics, with no recurrence reported after two years of treatment. Conclusions: Our results are proof for the various advantages using ALA cream for the PD and PDT in many different cases of condyloma by HPV. This study will be continued to investigate the PpIX photobleaching and the irradiance and fluence rate to optimize conducting the clinical trials, to improve the devices and therefore increase the treatment response. (c) 2011 Elsevier B.V. All rights reserved.

Giant condyloma acuminatum quickly growing. Case report

Background. Giant Condyloma Acuminatum (GCA) is a rare, slow growing, large cauliflower tumor of the penile foreskin and perianal region with benign histologic appearance but high propensity for local invasion and recurrences. GCA is associated with Human Papilloma Virus (HPV) types 6 and 11 and it also has considerable risk of neoplastic transformation into fully invasive squamous cell carcinoma into about 5 years. Objective. Because of the rarity of perianal GCA, to date there is no general agreement on the best method for treatment. We wanted to know if surgical approach only was a good method to treat our case. Case report. A 28 years old man, HIV-negative, with a 4 years history of perianal GCA quickly growing underwent full tickness local excision at least 0,7 cm margin of normal tissue with skin grafting taken from the thighs. Fecal contamination was avoided by diet and loperamide per os. At two years follow-up no recurrence was detected. Conclusion. Surgical approach with full tickness excision and immediate skin-grafting and regular follow-up demonstrated effective to treat GCA and to minimize disease recurrence.

Effect of the human papillomavirus (HPV) quadrivalent vaccine in a subgroup of women with cervical and vulvar disease: Retrospective pooled analysis of trial data

Objectives To determine the effect of human papillomavirus (HPV) quadrivalent vaccine on the risk of developing subsequent disease after an excisional procedure for cervical intraepithelial neoplasia or diagnosis of genital warts, vulvar intraepithelial neoplasia, or vaginal intraepithelial neoplasia. Design Retrospective analysis of data from two international, double blind, placebo controlled, randomised efficacy trials of quadrivalent HPV vaccine (protocol 013 (FUTURE I) and protocol 015 (FUTURE II)). Setting Primary care centres and university or hospital associated health centres in 24 countries and territories around the world. Participants Among 17 622 women aged 15–26 years who underwent 1:1 randomisation to vaccine or placebo, 2054 received cervical surgery or were diagnosed with genital warts, vulvar intraepithelial neoplasia, or vaginal intraepithelial neoplasia. Intervention Three doses of quadrivalent HPV vaccine or placebo at day 1, month 2, and month 6. Main outcome measures Incidence of HPV related disease from 60 days after treatment or diagnosis, expressed as the number of women with an end point per 100 person years at risk. Results A total of 587 vaccine and 763 placebo recipients underwent cervical surgery. The incidence of any subsequent HPV related disease was 6.6 and 12.2 in vaccine and placebo recipients respectively (46.2% reduction (95% confidence interval 22.5% to 63.2%) with vaccination). Vaccination was associated with a significant reduction in risk of any subsequent high grade disease of the cervix by 64.9% (20.1% to 86.3%). A total of 229 vaccine recipients and 475 placebo recipients were diagnosed with genital warts, vulvar intraepithelial neoplasia, or vaginal intraepithelial neoplasia, and the incidence of any subsequent HPV related disease was 20.1 and 31.0 in vaccine and placebo recipients respectively (35.2% reduction (13.8% to 51.8%)). Conclusions Previous vaccination with quadrivalent HPV vaccine among women who had surgical treatment for HPV related disease significantly reduced the incidence of subsequent HPV related disease, including high grade disease.

Prevalence and Risk Factors of Chlamydia trachomatis Cervicitis in Pregnant Women at the Genital Tract Infection in Obstetrics Unit Care at Botucatu Medical School, São Paulo State University - UNESP, Brazil

Objective. To evaluate the prevalence of and risk factors for Chlamydia trachomatis cervicitis in pregnant women seen at the Genital Tract Infection in Obstetrics Unit Care in Botucatu Medical School, São Paulo State University - UNESP.Materials and Methods. Between June 2006 and February 2008, 101 pregnant women were included in this study. During the gynecologic examination, cervical secretions were collected using cytobrush Plus GT (CooperSurgical Inc) to assess C. trachomatis using polymerase chain reaction. Vaginal flora were examined by Gram stain, and socio-demographic data were extracted from medical records.Results. of the 101 patients, 26 (25.7%) were positive for C. trachomatis. The median age of the infected group was 24 years (range = 13-40 y), and 48.5% of them had abnormal vaginal flora. The presence of chlamydial infection was associated with smoking (odds ratio [OR] = 2.67, 95% confidence interval [CI] = 1.01-7.19), residing in a city with fewer than 100,000 inhabitants (OR = 2.86, 95% CI = 1.03-7.94), presence of condyloma acuminatum (p = .03), and presence of discreet inflammation on Pap smear (p = .02).Conclusions. The prevalence of C. trachomatis is high in pregnant women seen at the Genital Infection Unit Care, UNESP, and is related to many risk factors. Therefore, its screening is extremely important in reducing obstetrical and neonatal complications.

Nucleotide and phylogenetic analysis of human papillomavirus types 6 and 11 isolated from recurrent respiratory papillomatosis in Brazil

There are few studies about the distribution of natural molecular variants of low-risk HPVs. Our aim was to evaluate the E6 early gene variability among HPV-6 and HPV-11 isolates detected in recurrent respiratory papillomatosis (RRP) samples obtained in a cohort of Brazilian patients. We also performed a phylogenetic analysis in order to compare nucleotide sequences identified in our study with previously reported isolates from different anatomic sites (laryngeal papillomas, genital warts, cervical cancer and anal swabs) obtained from other parts of the world to determine the phylogenetic relationships of variants detected in Brazil. The complete coding region of the E6 gene of 25 samples was cloned and sequenced: 18 isolates of HPV-6 (72%) and 7 isolates of HPV-11 (28%). A total of four different HPV-6 genomic variants and two HPV-11 genomic variants was identified. It was not possible to correlate specific variants with disease severity. Phylogenetic trees for both HPV types were constructed enclosing both E6 sequences detected in our study and formerly published sequences. In both phylogenetic trees, the sequences from Brazil did not group together. We could not establish a geographical association between HPV-6 or HPV-11 variants, unlike HPV-16 and HPV-18. © 2013 Elsevier B.V.

Condyloma acuminata in the tongue and palate of a sexually abused child: a case report

Condyloma acuminata caused by human papilloma viruses, (HPV) is a sexually transmitted disease (STD) appearing most frequently as soft, pink cauliflower like growths in moist areas, such as the genitalia, mouth and other places. The disease is highly contagious, can appear singly or in groups, small or large. In children, the isolation of a sexually transmitted organism may be the first indication that an abuse has occurred. Although the presence of a sexually transmissible agent from a child beyond the neonatal period is suggestive of sexual abuse, exceptions do exist. The authors report the clinical case of a five-year-old Caucasian male with lesions located in the dorsal surfaces of the posterior tongue and palate. Both lesions had a firm consistency, reddish appearance and presence of whitish areas and regions of ulceration. During the interview, the mother reported that the boy had been sexually abused. Sexually transmitted disease may occur during sexual abuse. Dentists as well as pediatricians have a role to play in identifying and treating these children. The diagnosis is essentially clinical (anamnesis and physical examination), but also the use of cytology eventually resorts to biopsy of the suspicious lesions for histological examination. The therapeutic option was the excision of the lesions.

Phylogenetic analyses and toxigenic profiles of Fusarium equiseti and Fusarium acuminatum isolated from cereals from Southern Europe

Fusarium equiseti and Fusarium acuminatum are toxigenic species that contaminate cereal crops from diverse climatic regions. They are common in Spanish cereals. The information available on their phylogenetics and toxigenic profiles is, however, insufficient to assist risk evaluation. In this work, phylogenetic analyses were performed using partial sequences of the translation elongation factor gene (EF-1a) of F. equiseti and F. acuminatum strains isolated from barley and wheat from Spain and other countries. The Northern and Southern European F. equiseti strains largely separated into two phylogenetically distinct clusters. This suggests the existence of two distinct populations within this species, explaining its presence in these regions of markedly different climate. Production of type A and B trichothecenes by the Spanish strains, examined in wheat cultures using a multitoxin analytical method, indicated that F. equiseti could produce deoxynivalenol and nivalenol and other trichothecenes, at concentrations that might represent a significant risk of toxin contamination for Southern European cereals. F. acuminatum showed low intraspecific genetic variability and 58% of the strains could produce deoxynivalenol at low level. Neither species was found to produce T-2 or HT-2 toxins. The present results provide important phylogenetic and toxigenic information essential for the accurate prediction of toxigenic risk.

Modulation of in vitro platelet 5-HT release by species of Erythrina and Cymbopogon

Extracts of Australian plants were screened to detect constituents affecting adenosine di-phosphate (ADP) induced platelet aggregation and [14C]5-hydroxytryptamine (5-HT) release. Extracts of four tested plants including, Eremophila gilesii, Erythrina vespertilio, Cymbopogon ambiguus, and Santalum acuminatum, were found to cause significant inhibition of platelet 5-HT release. Inhibition levels ranged from 56-98%, and was not due to the non-specific effects of protein binding tannins. These extracts, and those we have previously identified as being active, were examined further to determine if they affect epinephrine (EPN), arachidonic acid (A.A) or collagen stimulated platelet aggregation and 5-HT release. Among those extracts investigated, we found that both the methanolic extract of E. vespertilio and the dichloromethane (DCM) extract of C. ambiguus were most potent and caused significant inhibition of platelet activation induced by EPN, A.A and to a lesser extent by collagen. Inhibition of ADP induced platelet 5-HT release by both of these extracts, was dose-dependent, with IC50 values for E. vespertilio and C. ambiguus estimated to be 20.4 microl (1.855 mg/ml) and 8.34 microl (0.758 mg/ml), respectively. Overall, C. ambiguus exhibited most activity and also caused dose-dependent inhibition of A.A induced platelet activation. These results indicate that inhibition may occur specifically at a site within the A.A pathway, and suggest the presence of a cyclo-oxygenase inhibitor. Both E. vespertilio and C. ambiguus are reported to be traditional headache treatments, with the present study providing evidence that they affect 5-HT release.

Characterising insect plant host relationships facilitates understanding multiple host use

Weed biocontrol relies on host specificity testing, usually carried out under quarantine conditions to predict the future host range of candidate control agents. The predictive power of host testing can be scrutinised directly with Aconophora compressa, previously released against the weed Lantana camara L. (lantana) because its ecology in its new range (Australia) is known and includes the unanticipated use of several host species. Glasshouse based predictions of field host use from experiments designed a posteriori can therefore be compared against known field host use. Adult survival, reproductive output and egg maturation were quantified. Adult survival did not differ statistically across the four verbenaceous hosts used in Australia. Oviposition was significantly highest on fiddlewood (Citharexylum spinosum L.), followed by lantana, on which oviposition was significantly higher than on two varieties of Duranta erecta (‘‘geisha girl’’ and ‘‘Sheena’s gold’’; all Verbenaceae). Oviposition rates across Duranta varieties were not significantly different from each other but were significantly higher than on the two non-verbenaceous hosts (Jacaranda mimosifolia D. Don: Bignoneaceae (jacaranda) and Myoporum acuminatum R. Br.: Myoporaceae (Myoporum)). Production of adult A. compressa was modelled across the hosts tested. The only major discrepancy between model output and their relative abundance across hosts in the field was that densities on lantana in the field were much lower than predicted by the model. The adults may, therefore, not locate lantana under field conditions and/or adults may find lantana but leave after laying relatively few eggs. Fiddlewood is the only primary host plant of A. compressa in Australia, whereas lantana and the others are used secondarily or incidentally. The distinction between primary, secondary and incidental hosts of a herbivore species helps to predict the intensity and regularity of host use by that herbivore. Populations of the primary host plants of a released biological control agent are most likely to be consistently impacted by the herbivore, whereas secondary and incidental host plant species are unlikely to be impacted consistently. As a consequence, potential biocontrol agents should be released only against hosts to which they have been shown to be primarily adapted.

Relative host plant species use by the lantana biological control agent Aconophora compressa (Membracidae) across its native and introduced ranges

Aconophora compressa Walker (Hemiptera: Membracidae) was released in 1995 against the weed lantana in Australia, and is now found on multiple host plant species. The intensity and regularity at which A. compressa uses different host species was quantified in its introduced Australian range and also its native Mexican range. In Australia, host plants fell into three statistically defined categories, as indicated by the relative rates and intensities at which they were used in the field. Fiddlewood (Citharexylum spinosum L.: Verbenaceae) was used much more regularly and at higher densities than any other host sampled, and alone made up the first group. The second group, lantana (Lantana camara L.: Verbenaceae; pink variety) and geisha girl (Duranta erecta L.: Verbenaceae), were used less regularly and at much lower densities than fiddlewood. The third group, Sheena’s gold (another variety of D. erecta), jacaranda (Jacaranda mimosifolia D. Don: Bignoniaceae) and myoporum (Myoporum acuminatum R. Br.: Myoporaceae), were used infrequently and at even lower densities. In Mexico, the insect was found at relatively low densities on all hosts relative to those in Australia. Densities were highest on L. urticifolia, D. erecta and Tecoma stans (L.) Juss. ex Kunth (Bignoniaceae), which were used at similar rates to one another. It was found also on a few other verbenaceous and non-verbenaceous host species but at even lower densities. The relative rate at which Citharexylum spp. and L. urticifolia were used could not be assessed in Mexico because A. compressa was found on only one plant of each species in areas where these host species co-occurred. The low rate at which A. compressa occurred on fiddlewood in Mexico is likely to be an artefact of the short-term nature of the surveys or differences in the suites of Citharexylum and Lantana species available there. These results provide further incentive to insist on structured and quantified surveys of non-target host use in the native range of potential biological control agents prior to host testing studies in quarantine.

Cymbellaceae and Gomphonemataceae (Bacillariophyta) from the Hengduan Mountains region (southwestern China)

We present a species list of the Gomphonemataceae and Cymbellaceae occurring in the Hengduan Mountains re-ion. These two families were found to be presented in the area by 117 species, varieties and forms belonging to four genera (Amphora, Cymbella, Didymosphenia and Gomphonema). Size, striae density, habitat and distribution in China are given for each taxon. The common taxa were Cymbella aequalis var. piscicultis. C. affinis, C. cesatii, C. cistula var. gibbosa, C. delicatula. C. gracilis, C. hustedtii, C. minuta f. latens, C. minita var. silesiaca, C. naviculiformis, C. parva. C. turgidida, Gomphonema acuminatum var. acuminatum, G. gracile, G. intricatum, G. olivaceum. G. parvulum and G. truncatum var. capitatum. Some morphological features of Cymbella cistula var. capitata, Cymbella sinica var. miyiensis, Gomphonema hedinii and G. kaznakowii were found to differ from previously published descriptions. Taxa typical of high latitude climates encountered during the present study were Cymbella affinis, C. alpina, C. cistula var. cistida, C. delicatula. C. naviculiformis. Didymosphenia geminata, Gomphonema acuminatum var. pusillum, G. constrictum var. capitatum f. turgidum, G. kaznakowii, G. olivaceum, G. subtile var. subtile, G. tergestinum and G. ventricosum.

中国裂叶苔科植物的研究-分类、区系和生态

裂叶苔科（Lophoziaceae）是叶苔目植物中的一个大科，其植物体形态变化较大，分类较为困难。中国在裂计佩一苔科下已记录的植物有23属、106种、2变种和2变形。本论文在大量文献考证和对国内外3000余份标本深入研究基础上，对中国裂仆佩一苔科进行了较系统全面的分类修订，记录了中国裂价卜苔科植物共有11属45种3变种1变形，提供了种属形态特征描述和41幅图版。发现中国新记录2种1变型：异瓣裂叶苔（Lophozia diversiloba Hatt），毛口挺叶苔（Anastrophyllum piligerm (Nees.) Steph.）和密叶三瓣苔小叶变形（Tritomaria quinquedentata fo. gracilis (Jens.) Schust.）；新组合名1个：小挺叶苔尖变种（Anastrophyllum minutum (Schreb. in Cranz.) Schust var. acuminatum (Horik.) Cao & Sun comb. nov.），还有省区新分布记录16个。采用聚类分析方法分析了裂叶苔科种属间的关系，结果支持广义裂汗卜苔属和挺口一卜苔属的概念。 区系成分的分析研究表明：中国裂计佩一苔科植物的地理成分主要以泛北极分布类型为主，占79.6%.东北地区、秦岭地区、西南地区和台湾省为我国裂p_佩一苔科植物种类最丰富的地区。在国内首次开展了苔类专科的生态学研究，并采用CCA方法对结果进行分析。研究表明：裂叶苔科植物在长白山分布上表现出明显的垂直地带性，可分为三类：（1)分布在2000米以上苔原带的种类，主要有小挺叶苔A. minutum、石生挺叶苔A. saxicola、密叶三瓣苔T. quinquedentata、高山裂叶苔L. sudetica，圆叶裂叶L. wenzelii；（2）分布在1730米到2000米苔岳桦林带的种类，主要有：方叶无褶苔L. bantriensis，细裂瓣苔B. barbata，阔瓣裂叶苔L. excisa；（3）分布在1150-1730米以下暗针叶林的种类，主要有：三瓣苔T. exsecta，多角胞三瓣苔T. exsectiformis、囊苞裂叶苔L. ventricosa，秃瓣裂叶苔L. obtusa和倾立裂叶苔L. ascendens。影响裂叶苔科植物分布的主要坏境因子是海拔高度。 对处于不同纬度三个地区的同种裂叶苔科植物的比较分析说明：随纬度的升高其分布的海拔高度逐步降低。

Identificação dos principais fungos das sementes de trigo.

Procedimento para identificação dos fungos das sementes de trigo; Descrição diagnostica dos principais fungos das sementes de trigo; Sclerotium Tode; Rhizoctonia DC; Chaetomium Kunze; Pleospora Rabenh; Sporobolomyces Kluy. & Niel; Rhodotorula Harrison; Phoma Sacc.; Septoria tritici Rob; Stagonospora nodorum (Berk.) Cas. & Germ.; Stagonospora avenae (Frank) Bisset f. sp. triticae; Colletotrichum graminicola (Ces.) Wilson; Fusarium tricinctum (Corda) Sacc; Fusarium moniliforme Sheldon; Fusarium avenaceum (Fr.) Sacc; Fusarium acuminatum Ell. & Kellerm; Fusarium equiseti (Corda) Sacc.; Fusarium graminearum Schw.; Mucor Micheli; Rhizopus Ehrenb; Aspergillus Link.; Penicillium Link.; Alternaria Nees; Epicoccum Link; Cladosporium Link; Nigrospora Zimm; Curvularia Boedijn; Drechslera tritici-repentis (Died.) Drech; Bipolaris sorokiniana (Sacc. in Sorok.) Shoem; Chave sistemática dos principais fungos de sementes de trigo; Ilustrações dos principais fungos encontrados em sementes de trigo.

Identificação dos principais fungos das sementes de trigo.

Procedimento para identificação dos fungos das sementes de trigo; Descrição diagnostica dos principais fungos das sementes de trigo; Sclerotium Tode; Rhizoctonia DC; Chaetomium Kunze; Pleospora Rabenh; Sporobolomyces Kluy. & Niel; Rhodotorula Harrison; Phoma Sacc.; Septoria tritici Rob; Stagonospora nodorum (Berk.) Cas. & Germ.; Stagonospora avenae (Frank) Bisset f. sp. triticae; Colletotrichum graminicola (Ces.) Wilson; Fusarium tricinctum (Corda) Sacc; Fusarium moniliforme Sheldon; Fusarium avenaceum (Fr.) Sacc; Fusarium acuminatum Ell. & Kellerm; Fusarium equiseti (Corda) Sacc.; Fusarium graminearum Schw.; Mucor Micheli; Rhizopus Ehrenb; Aspergillus Link.; Penicillium Link.; Alternaria Nees; Epicoccum Link; Cladosporium Link; Nigrospora Zimm; Curvularia Boedijn; Drechslera tritici-repentis (Died.) Drech; Bipolaris sorokiniana (Sacc. in Sorok.) Shoem; Chave sistemática dos principais fungos de sementes de trigo; Ilustrações dos principais fungos encontrados em sementes de trigo.

Verrucous Carcinoma of the Vulva: A Case Report and Review of the Literature.

Verrucous carcinoma of the vulva is a rare lesion (1). Affecting essentially postmenopausal women, this lesion is a distinct and particular entity in vulval carcinoma classification and its scalability is uncertain and unpredictable. Here, we present a case concerning a 48-year-old patient, without follow-up after a condyloma acuminate of the vulva (large left lip). The origin of this case will be discussed in this article. The treatment decided was only surgical. A review of literature shows the rarity of this lesion of the female genital tract.