1
|
Yusuf H, Purwoko MIH. Successful combination therapy of trichloroacetic acid, podophyllin, and electrocautery on giant condylomata acuminata. Int J STD AIDS 2024:9564624241276574. [PMID: 39194148 DOI: 10.1177/09564624241276574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
Introduction: Giant condylomata acuminata (GCA) is a rare presentation of anogenital wart (AGW), invasive locally but does not metastasize. Combination therapy for GCA is suggested based on modalities and experiences. The combination of TCA and podophyllin has showed good efficacy, followed by electrocautery to eradicate warts. Case: A 24-year-old male had a chief complaint of large warts on the base of the penis that had started to bleed for 4 weeks. The initial lesion appeared 8 months prior as a small varucose papule. The patient is unmarried and has history of sexual contact with sex workers. Physical examination showed multiple verrucous papules, flesh-coloured, cauliflower-like shaped, 5 × 2 × 1 cm in size. The patient tested negative for HIV infection. Histopathological examination showed acanthosis, exophytic growth, parakeratosis, and koilocytosis with no signs of malignancy. This patient received a combination of TCA 90% and podophyllin 25% to initially reduce the tumor size, followed by electrocautery to eradicate the remaining lesions. The tumor showed complete clearance. Discussion: There is no definitive evidence that one therapy is superior to completely eliminating warts. Combination therapy of TCA and podophyllin leads to complete wart clearance, followed by electrocautery to destroy smaller warts.
Collapse
Affiliation(s)
- Hasbiallah Yusuf
- Department of Dermatology, Venereology, and Aesthetics, Dr Mohammad Hoesin General Hospital, Faculty of Medicine Universitas Sriwijaya, Palembang, Indonesia
| | - Muhammad Izazi Hari Purwoko
- Department of Dermatology, Venereology, and Aesthetics, Dr Mohammad Hoesin General Hospital, Faculty of Medicine Universitas Sriwijaya, Palembang, Indonesia
| |
Collapse
|
2
|
Mawardi P, Kamilah L, Fauziyyah Heryadi F, Arrosyid A. The Effectiveness of Chemical Cautery and Electrosurgery on Anogenital Wart: Systematic Review. Clin Cosmet Investig Dermatol 2023; 16:2773-2780. [PMID: 37818198 PMCID: PMC10561614 DOI: 10.2147/ccid.s426851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/20/2023] [Indexed: 10/12/2023]
Abstract
Introduction Anogenital warts (AGW) is one of the sexually transmitted infections (STIs) caused by human papillomavirus (HPV). Treatment modalities of AGW yield low clearance and recurrence rate, so that chemical cautery with trichloroacetic acid (TCA) and electrosurgery are widely used to remove the lesions without any severe side effects. Objective To investigate the efficacy of chemical cautery with TCA and electrosurgery in AGW based on clinical trials or case series. Methods The systematic review was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) but not registered to the International Prospective Register of Systematic Review (PROSPERO). To acquire proper and accurate information from relevant literature, two databases PubMed and the Cochrane Library were searched from January 2013 to March 2023. Results Thirteen studies were included in this systematic review, comprising seven articles on chemical cautery and six electrosurgery articles. The highest cure rate of chemical cautery with TCA was 94.1% while electrosurgery was 100%. A relatively low recurrence rate during 1 year follow-up was observed in electrosurgery with 14.6%, whereas the chemical cautery was 27.6%. Conclusion Electrosurgery for AGW treatment had higher cure rate with lower recurrence rate compared to chemical cautery with TCA. Numerous adverse effects of electrosurgery were reported include bleeding and scar formation as high risk of HPV infection.
Collapse
Affiliation(s)
- Prasetyadi Mawardi
- Department of Dermatology and Venereology, Faculty of Medicine, Sebelas Maret University/Dr Moewardi General Hospital, Surakarta, Indonesia
| | - Lian Kamilah
- Department of Dermatology and Venereology, Faculty of Medicine, Sebelas Maret University/Dr Moewardi General Hospital, Surakarta, Indonesia
| | - Fanny Fauziyyah Heryadi
- Department of Dermatology and Venereology, Faculty of Medicine, Sebelas Maret University/Dr Moewardi General Hospital, Surakarta, Indonesia
| | - Azhar Arrosyid
- Department of Dermatology and Venereology, Faculty of Medicine, Sebelas Maret University/Dr Moewardi General Hospital, Surakarta, Indonesia
| |
Collapse
|
3
|
Kore VB, Anjankar A. A Comprehensive Review of Treatment Approaches for Cutaneous and Genital Warts. Cureus 2023; 15:e47685. [PMID: 38022045 PMCID: PMC10673707 DOI: 10.7759/cureus.47685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Cutaneous and genital warts are common in both developed as well as developing countries. Human papillomavirus (HPV), which is a double-stranded DNA virus, is the causative agent of wart infection. Different types of HPV viruses are responsible for the different severity of diseases. Some types are associated with malignancy of the anal region and cervix. HPV is a common sexually transmitted disease in the United States. The incidence is most common in the younger age groups and the elderly population. Our main goal is to describe the different treatment modalities available for warts. Treatment modalities are divided into primary, secondary, and tertiary options. Topical medications, and physical excision of warts via cryotherapy, electrocautery, lasers, or photodynamic therapy are all common forms of treatment. Various clinical trials and randomized control trials have been seen as effective treatment against HPV infection. Higher remission rates are seen irrespective of different treatment options. Warts can be treated but the HPV virus cannot be completely removed. Older age, immunocompromised state, diabetes mellitus, and HIV are the predisposing factors for the disease. There is currently a large variety of medicines in use, all of which can differ significantly in terms of price, side-effect profiles, dosing regimens, length of therapy, and overall effectiveness. The best course of treatment has not yet been identified, and patients are often treated according to their unique needs.
Collapse
Affiliation(s)
- Vaibhav B Kore
- Dermatology, Jawaharlal Nehru Medical College, Datta Meghe Institute Higher Education and Research, Wardha, IND
| | - Ashish Anjankar
- Biochemistry, Jawaharlal Nehru Medical College, Datta Meghe Institute Higher Education and Research, Wardha, IND
| |
Collapse
|
4
|
Scornajenghi CM, Asero V, Bologna E, Basile G, De Angelis M, Moschini M, Del Giudice F. Organ-sparing treatment for T1 and T2 penile cancer: an updated literature review. Curr Opin Urol 2023; Publish Ahead of Print:00042307-990000000-00098. [PMID: 37377374 DOI: 10.1097/mou.0000000000001109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
PURPOSE OF REVIEW Penile cancer (PeCa) is an orphan disease due to its rare incidence in high-income countries. Traditional surgical options for clinical T1-2 disease, including partial and total penectomy, can dramatically affect patient's quality of life and mental health status. In selected patients, organ-sparing surgery (OSS) has the potential to remove the primary tumor with comparable oncologic outcomes while maintaining penile length, sexual and urinary function. In this review, we aim to discuss the indications, advantages, and outcomes of various OSSs currently available for men diagnosed with PeCa seeking an organ-preserving option. RECENT FINDINGS Patient survival largely depends on spotting and treating lymph node metastasis at an early stage. The required surgical and radiotherapy skill sets cannot be expected to be available in all centers. Consequently, patients should be referred to high-volume centers to receive the best available treatments for PeCa. SUMMARY OSS should be used for small and localized PeCa (T1-T2) as an alternative to partial penectomy to preserve patient's quality of life while maintaining sexual and urinary function and penile aesthetics. Overall, there are different techniques that can be used with different response and recurrence rates. In case of tumor recurrence, partial penectomy or radical penectomy is feasible, without impacting overall survival.
Collapse
Affiliation(s)
- Carlo Maria Scornajenghi
- Department of Maternal Infant and Urologic Sciences, 'Sapienza' University of Rome, Policlinico Umberto I Hospital, Rome
| | - Vincenzo Asero
- Department of Maternal Infant and Urologic Sciences, 'Sapienza' University of Rome, Policlinico Umberto I Hospital, Rome
| | - Eugenio Bologna
- Department of Maternal Infant and Urologic Sciences, 'Sapienza' University of Rome, Policlinico Umberto I Hospital, Rome
| | - Giuseppe Basile
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute
- Division of Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Mario De Angelis
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute
- Division of Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Marco Moschini
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute
- Division of Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Del Giudice
- Department of Maternal Infant and Urologic Sciences, 'Sapienza' University of Rome, Policlinico Umberto I Hospital, Rome
- Department of Urology, Stanford University School of Medicine, Stanford, California, USA
| |
Collapse
|
5
|
Lau WC, Lau CB, Frangos JE, Nambudiri VE. Intralesional cidofovir for the management of refractory cutaneous verrucae: a review of applications and opportunities. Ther Adv Infect Dis 2023; 10:20499361231165862. [PMID: 37056449 PMCID: PMC10088403 DOI: 10.1177/20499361231165862] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 03/09/2023] [Indexed: 04/15/2023] Open
Abstract
Viral warts - manifestations of cutaneous infection by human papilloma virus - can be a significant physical and emotional burden for patients when common treatments fail, particularly for individuals who are immunocompromised or with multiple lesions. Cidofovir, an antiviral agent typically used for the treatment of cytomegalovirus infection, has emerged as an alternative treatment option for viral warts when administered topically or intralesionally. In this review, we highlight the scientific rationale, published evidence, and practical clinical uses of intralesional cidofovir for the management of cutaneous warts as well as ongoing questions requiring further research and exploration of this emerging therapy for refractory verrucae.
Collapse
Affiliation(s)
| | | | - Jason E. Frangos
- Department of Dermatology, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | | |
Collapse
|
6
|
Eilbert W, Chan C. Febrile seizures: A review. J Am Coll Emerg Physicians Open 2022; 3:e12769. [PMID: 36016968 PMCID: PMC9396974 DOI: 10.1002/emp2.12769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/25/2022] [Accepted: 05/31/2022] [Indexed: 01/23/2023] Open
Abstract
Febrile seizures are common, occurring in up to 5% of children in the United States. Frequently perceived by caregivers as a life-threatening event, febrile seizures are a common cause of emergency department visits. The concern for permanent neurologic sequelae and future epilepsy after febrile seizures has resulted in a significant amount of research on these topics. The development of childhood vaccines over the past several decades has led to a significant reduction in childhood bacterial meningitis. This in turn has led to a dramatic change in the evaluation and treatment of febrile seizures. In this review, the different types of febrile seizures as well as the evaluation and prognosis of each are discussed.
Collapse
Affiliation(s)
- Wesley Eilbert
- Department of Emergency MedicineCollege of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Chuck Chan
- Department of Emergency MedicineCollege of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| |
Collapse
|
7
|
Efficacy and Safety of Clinacanthus nutans Lindau Cream vs. Podophyllin for the Treatment of Adults with Condyloma Acuminata. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1577716. [PMID: 35783521 PMCID: PMC9246565 DOI: 10.1155/2022/1577716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/31/2022] [Indexed: 11/30/2022]
Abstract
Human papillomavirus (HPV) infection causes condyloma acuminata (CA). Podophyllin is the standard treatment. Clinacanthus nutans Lindau (C. nutans), a medicinal plant, has potent anti-inflammatory and antiviral effects. C. nutans cream is widely used in Thailand to treat the herpes simplex virus. We proposed that C. nutans might also induce CA clearance. There are no studies of C. nutans treatment of CA. This randomized controlled trial at Siriraj Hospital, Thailand, was conducted between January 2018 and December 2019. CA samples were obtained from 10 men with at least two CAs 1 centimeter apart. Each wart was randomized to a 4-week treatment with either C. nutans or podophyllin. The participants were 24 to 72 years old. Most HPV types were low-risk HPVs (HPV 11, HPV 6). Median CA clearance with podophyllin was a 97% CA clearance with podophyllin and 82% with C. nutans. C. nutans may be an alternative treatment for CA.
Collapse
|
8
|
Mitsuda N, J-P NA, Hosokawa T, Eitoku M, Fujieda M, Suganuma N. Breastfeeding and risk of febrile seizures in the first 3 years of life: The Japan Environment and Children's Study. Brain Dev 2022; 44:203-209. [PMID: 34776268 DOI: 10.1016/j.braindev.2021.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 10/18/2021] [Accepted: 10/21/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Our study was conducted to examine the association between breastfeeding and febrile seizures (FS) in the first 3 years of life. METHODS We analyzed the dataset of the Japan Environment and Children's Study (JECS), which is a birth cohort study undertaken to elucidate the influence of environmental factors on children's health during the fetal period and early childhood. Information on feeding duration and feeding pattern, as well as information on febrile seizures, were obtained from questionnaires sent to mothers/caregivers. We categorized a child as having experienced FS if the child was reported as having been diagnosed with FS in the first 3 years. Modified Poisson regression with a robust error variance was used to estimate the effect of duration of breastfeeding and the risk of FS. RESULTS Of the 84,321 children included in the analysis, 6264 (7.4%) were reported to have experienced FS at least once in the first 3 years of life. Multivariate analyses showed that the risk of FS during the first 3 years of life tended to decrease as the duration of breastfeeding increased. Male sex and frequent fever episodes were also associated with an increased risk of FS. CONCLUSIONS Continued breastfeeding until 2 years of age, the most susceptible age for FS, had a small but protective effect on FS.
Collapse
Affiliation(s)
- Naomi Mitsuda
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Japan.
| | - Naw Awn J-P
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Japan
| | | | - Masamitsu Eitoku
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Japan
| | - Mikiya Fujieda
- Department of Pediatrics, Kochi Medical School, Kochi University, Japan
| | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Japan
| | | |
Collapse
|
9
|
Brody EI, Genuini M, Auvin S, Lodé N, Brunet SR. Prehospital capillary lactate in children differentiates epileptic seizure from febrile seizure, syncope, and psychogenic nonepileptic seizure. Epilepsy Behav 2022; 127:108551. [PMID: 35051869 DOI: 10.1016/j.yebeh.2021.108551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 12/15/2021] [Accepted: 12/31/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of the study was to examine prehospital capillary lactate in children as a diagnostic biomarker to differentiate epileptic seizures from febrile seizures, syncope, and psychogenic nonepileptic seizures (PNES). METHODS Capillary lactate concentrations taken in a pediatric prehospital setting within 2 h of the paroxysmal event were compared retrospectively between patients with epileptic seizure, febrile seizure, syncope, and PNES, based on the final diagnosis from the hospitalization report. RESULTS One hundred and two patients were included, 53 (52%) with epileptic seizures, 41 (40%) with febrile seizures, and 8 (8%) with syncope or PNES. Capillary lactate in patients with a final diagnosis of epileptic seizure was significantly increased in comparison to the concentrations in patients with febrile seizure (p < 0.0007) and in comparison to the concentrations in patients with syncope or PNES (p < 0.0204). The area under the ROC-curve was 0.71 (95% CI 0.61-0.80). For a cutoff concentration of prehospital capillary lactate >3.9 mmol/l (Youden index), the sensitivity was 49% and the specificity 92%. CONCLUSION Prehospital capillary lactate concentrations are a useful tool for differentiating the nature of a paroxysmal event in children.
Collapse
Affiliation(s)
| | - Mathieu Genuini
- APHP, Robert-Debré, Service Mobile d'Urgence et de Réanimation Pédiatrique, Université Paris Diderot, 48 boulevard Sérurier, 75019 Paris, France
| | - Stéphane Auvin
- Université de Paris, INSERM NeuroDiderot, Paris, France; APHP, Robert Debré University Hospital, Pediatric Neurology Department, Paris, France; Institut Universitaire de France, (IUF), Paris, France
| | - Noella Lodé
- APHP, Robert-Debré, Service Mobile d'Urgence et de Réanimation Pédiatrique, Université Paris Diderot, 48 boulevard Sérurier, 75019 Paris, France
| | - Stéphanie Rose Brunet
- APHP, Robert-Debré, Service Mobile d'Urgence et de Réanimation Pédiatrique, Université Paris Diderot, 48 boulevard Sérurier, 75019 Paris, France; APHP, Necker-Enfants Malades, Service de Pédiatrie et Réanimation Néonatale, Université Paris Descartes, 149 rue de Sèvres, 75015 Paris, France
| |
Collapse
|
10
|
Soluble Factors and Receptors Involved in Skin Innate Immunity-What Do We Know So Far? Biomedicines 2021; 9:biomedicines9121795. [PMID: 34944611 PMCID: PMC8698371 DOI: 10.3390/biomedicines9121795] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/25/2021] [Accepted: 11/27/2021] [Indexed: 12/25/2022] Open
Abstract
The pattern recognition receptors, complement system, inflammasomes, antimicrobial peptides, and cytokines are innate immunity soluble factors. They sense, either directly or indirectly, the potential threats and produce inflammation and cellular death. High interest in their modulation has emerged lately, acknowledging they are involved in many cutaneous inflammatory, infectious, and neoplastic disorders. We extensively reviewed the implication of soluble factors in skin innate immunity. Furthermore, we showed which molecules target these factors, how these molecules work, and how they have been used in dermatological practice. Cytokine inhibitors have paved the way to a new era in treating moderate to severe psoriasis and atopic dermatitis.
Collapse
|
11
|
Del Zingaro M, Cochetti G, Zucchi A, Paladini A, Rossi De Vermandois JA, Ciarletti S, Felici G, Maiolino G, Renzetti R, Gaudio G, Mearini E. Holmium:YAG Laser for the Treatment of Genital and urethral Warts: Multicentre Prospective Evaluation of Safety and Efficacy. J Lasers Med Sci 2021; 12:e34. [PMID: 34733757 DOI: 10.34172/jlms.2021.34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/06/2021] [Indexed: 01/30/2023]
Abstract
Introduction: Genital condylomatosis is a highly contagious disease caused by the human papilloma virus (HPV). The aim of this prospective multicentre study was to evaluate the safety and efficacy of the Holmium:YAG (yttrium-aluminium-garnet) laser in the treatment of genital and intra-urethral warts; the secondary aim was to assess the patients' postoperative satisfaction and cosmetic results. Methods: From December 2016 to March 2019, patients with genital warts were prospectively enrolled in three hospitals. The inclusion criteria were male gender, age over 18 years-old and treatment-naïve. External and urethral genitalia warts were treated by the Holmium YAG laser. The follow-up analysis consisted of physical examination, flexible urethro-cystoscopy in case of meatal lesions, and administration of Dermatology Quality of Life Index (DLQI) and Patient Global Impression of Improvement (PGI-I) questionnaires at 1, 3, 6 and 12 months after surgery and subsequently yearly. Results: Sixty patients were enrolled. The single treatment was effective in 57/60 patients (95%). At a mean follow-up of 26 months, recurrences occurred in 8 patients (13.3%). No peri- or post-operative complication occurred. An improvement in pre-operative condition was highlighted with PGI-I and DLQI questionnaires. Conclusion: Our prospective multicentre study showed that holmium laser surgery seems to be a safe and effective treatment for external genital and urethral warts. Good dermatological outcomes aid to further improve patient satisfaction.
Collapse
Affiliation(s)
- Michele Del Zingaro
- Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, Italy
| | - Giovanni Cochetti
- Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, Italy
| | | | - Alessio Paladini
- Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, Italy
| | | | - Sara Ciarletti
- Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, Italy
| | - Graziano Felici
- Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, Italy
| | - Giuseppe Maiolino
- Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, Italy
| | - Roberto Renzetti
- Department of Surgeries, Urology, Presidio Ospedaliero Pescara, Pescara, Italy
| | - Gianluca Gaudio
- Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, Italy
| | - Ettore Mearini
- Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, Italy
| |
Collapse
|
12
|
Affiliation(s)
- Madison S Hill
- Department of Dermatology, University of Maryland Medical Center, Baltimore, Maryland
| | - Risa M Jampel
- Department of Dermatology, University of Maryland Medical Center, Baltimore, Maryland
| |
Collapse
|
13
|
Correlation of the ALA-PDT Treatment Efficacy and the HPV Genotype Profile of Genital Warts after Cryotherapy Failure and Podophyllotoxin Therapy in Male Patients. Life (Basel) 2021; 11:life11020146. [PMID: 33672889 PMCID: PMC7918501 DOI: 10.3390/life11020146] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/01/2021] [Accepted: 02/10/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Genital warts are the manifestation of the human papillomavirus (HPV) infection, which may last for weeks or months before the clinical presentation. The primary aim of the study was the correlation of the DNA HPV genotypes eradication with the treatment response in male patients with persistent genital warts. Methods: Twenty-one male patients (age range: 22–58) after failure of cryotherapy and podophyllotoxin treatment were enrolled in the study. Genetic tests (Real Time - PCR method) analyzed the presence of DNA-HPV before and 6 months after four sessions (4 weeks apart) of photodynamic therapy with 5-aminolaevulinic acid (ALA-PDT). The treatment efficacy was evaluated before each PDT session and at the end of the study. Results: The single HPV DNA type was present in 15/21 of the patients (13/15 HPV6). The high-risk HPV types were found in 8/21 subjects, of which 6/8 had several types. Six months after four sessions of PDT, complete response was found in 16/21 (76.19%; p = 0.0007) of patients, and DNA HPV clearance was found in 66.67% (p = 0.03). The eradication rate differed among patients with primary low-risk and high-risk HPV types—76.92% (10/13; p = 0.0003) and 50% (4/8; p = 0.05) respectively. Conclusion: ALA-PDT is an effective treatment even after the failure of previous modalities. The persistence of clinical lesions and high oncological risk HPV types should be an indication for treatment prolongation.
Collapse
|
14
|
Rai A, Patil SJ, Srivastava P, Gaurishankar K, Phadke SR. Clinical and molecular characterization of four patients with Robinow syndrome from different families. Am J Med Genet A 2021; 185:1105-1112. [PMID: 33496066 DOI: 10.1002/ajmg.a.62082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/28/2020] [Accepted: 12/30/2020] [Indexed: 11/11/2022]
Abstract
Robinow syndrome (RS) is a rare heterogeneous disorder characterized by short stature, short-limbs, craniofacial, oro-dental abnormalities, vertebral segmentation defects, and frequently genital hypoplasia. Both autosomal dominant and recessive patterns of inheritance are observed with many causative genes. Here, we present the phenotypes and genotypes of four children with RS from different Indian families. Sequence variants were identified in genes ROR2, DVL1, and DVL3. Our results expand the mutational spectrum of RS and we also highlight the radiological changes in the radius and ulna in patients with ROR2 sequence variants which are primarily characteristic for ROR2 related RS but have been reported in WNT5A related RS.
Collapse
Affiliation(s)
- Archana Rai
- Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Siddaramappa J Patil
- Division of Medical Genetics, Narayana Hrudayalaya Hospitals, Mazumdar-Shaw Medical Center, Bangalore, India
| | - Priyanka Srivastava
- Genetic Metabolic Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kalpana Gaurishankar
- Department of Medical Genetics, Apollo Hospitals and Kanchi Kamakoti Childs Trust Hospital, Chennai, India
| | - Shubha R Phadke
- Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| |
Collapse
|
15
|
Boddu SHS, Kumari S. Design and In Vitro Evaluation of Intranasal Diazepam for Treating Acute Repetitive Seizures: a Technical Note. J Pharm Innov 2020. [DOI: 10.1007/s12247-020-09519-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
16
|
Abstract
Penile cancers are rare malignancies. Traditional surgical options, including partial and total penectomy, can dramatically affect a patient's quality of life and mental health. In select patients, penile sparing techniques (PST) have the potential to remove the primary tumor with comparable oncologic outcomes while maintaining penile length, sexual function, and urinary function. In this review, we aim to discuss the indications, advantages, and outcomes of the various PST currently available for men seeking an organ-preserving option for their penile cancer.
Collapse
Affiliation(s)
- Andrew Fang
- The University of Alabama, Birmingham School of Medicine- Urology , Birmingham, AL, USA
| | - James Ferguson
- The University of Alabama, Birmingham School of Medicine- Urology , Birmingham, AL, USA.,The University of Alabama, Birmingham School of Medicine- O'Neal Comprehensive Cancer Center , Birmingham, AL, USA
| |
Collapse
|
17
|
Korkmaz S, Şirin FB, Erturan I, Büyükbayram HI, Yildirim M. Coenzyme Q10, Zinc and MDA levels in verruca vulgaris. Turk J Med Sci 2020; 50:1387-1392. [PMID: 31999408 PMCID: PMC7491259 DOI: 10.3906/sag-1909-12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 01/29/2020] [Indexed: 01/05/2023] Open
Abstract
Background/aim Verruca vulgaris is a benign disease characterized with papillomas on the skin and mucosa. The aim of this study was to investigate the serum levels of coenzyme Q10, MDA, and zinc as well as the lipid profile of verruca vulgaris patients and examine the relationship between these parameters and clinical manifestations of the disease. Materials and methods The study included 49 verruca vulgaris patients (mean age: 32.01 ± 14.20 years; 22 males, 27 females) and 40 healthy volunteers (mean age: 31.63 ± 8.98 years; 21 males and 19 females). Coenzyme Q10 levels were assessed by using an enzyme-linked immunosorbent assay. Serum MDA levels were measured spectrophotometrically. Zinc levels were measured using a Perkin Elmer AAnalyst 800 atomic absorption spectrometer with a deuterium background correction and additional standard techniques. Results The coenzyme Q10 levels were found to be higher in the verruca vulgaris group compared to the healthy volunteers. However, this increase was not statistically significant (P = 0.195). Zinc levels were significantly lower in the verruca vulgaris group compared to the healthy volunteers (P = 0.002). In the patient group, MDA levels and HDL levels were significantly higher compared to the healthy volunteers (P = 0.023 and P = 0.004, respectively). Additionally, there was no statistically significant difference between the groups in the CoQ10/Total cholesterol ratio (P = 0.433). Conclusion Reduced serum zinc levels and increase of oxidative stress in verruca vulgaris may be a factor responsible for development of verruca vulgaris.
Collapse
Affiliation(s)
- Selma Korkmaz
- Department of Dermatology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Fevziye Burcu Şirin
- Department of Biochemistry, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Ijlal Erturan
- Department of Dermatology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | | | - Mehmet Yildirim
- Department of Dermatology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| |
Collapse
|
18
|
Wang S, Lévesque M, Avoli M. Effects of Diazepam and Ketamine on Pilocarpine-Induced Status Epilepticus in Mice. Neuroscience 2019; 421:112-122. [PMID: 31704492 DOI: 10.1016/j.neuroscience.2019.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 02/07/2023]
Abstract
Status epilepticus (SE) is a life-threatening condition needing immediate care to prevent brain damage. SE with electrographic and behavioral features similar to those seen in humans is reproduced in rodents by i.p. pilocarpine injection, and can be terminated by diazepam and ketamine treatment but only behaviourally, not electrographically. Little is known on the behavioral and EEG effects induced by a delayed administration of ketamine (25 mg/kg) after diazepam (10 mg/kg) or vice versa. Therefore, we analysed behavior and EEG activity recorded from the mouse hippocampal CA3 region before, during SE and after anticonvulsant treatments. In the first group (n = 4), diazepam was administered one hour before ketamine whereas in the second group (n = 4) ketamine was administered one hour before diazepam. The EEG SE did not disappear after each of the two treatments but progressed within 4 h to a pattern of interictal discharges. However, diazepam administration before ketamine significantly shortened the time of behavioral recovery compared to when ketamine was administered before diazepam (p < 0.05). The two protocols were also associated to distinct EEG changes in gamma and high frequency oscillations. In conclusion, although diazepam and ketamine are not effective in stopping EEG SE, diazepam administration one hour before ketamine shortens behavioral recovery in pilocarpine-treated mice.
Collapse
Affiliation(s)
- Siyan Wang
- Montreal Neurological Institute and Departments of Neurology & Neurosurgery, and of Physiology, McGill University, 3801 University Street, Montréal, Qc H3A 2B4, Canada
| | - Maxime Lévesque
- Montreal Neurological Institute and Departments of Neurology & Neurosurgery, and of Physiology, McGill University, 3801 University Street, Montréal, Qc H3A 2B4, Canada
| | - Massimo Avoli
- Montreal Neurological Institute and Departments of Neurology & Neurosurgery, and of Physiology, McGill University, 3801 University Street, Montréal, Qc H3A 2B4, Canada.
| |
Collapse
|
19
|
Xu H, Ling Y, Xi Y, Ma H, Wang H, Hu HM, Liu Q, Li YM, Deng XT, Yang SX, Delwart E, Zhang W. Viral metagenomics updated the prevalence of human papillomavirus types in anogenital warts. Emerg Microbes Infect 2019; 8:1291-1299. [PMID: 31495287 PMCID: PMC6746260 DOI: 10.1080/22221751.2019.1661757] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 08/22/2019] [Indexed: 11/01/2022]
Abstract
To investigate the composition of human papillomavirus (HPV) types in anogenital warts (AGWs), viral nucleic acid in 110 AGWs, pooled into 11 specimen pools, were subjected to viral metagenomic analysis. After finding HPV7 in AGWs, conventional PCR screening was performed for HPV7 in other 190 individual AGW specimens. Viral metagenomic results indicated that 29 different types of HPV were recovered, with HPV11 and HPV6 showing the highest proportion of sequence reads. HPV7 was detected in 7 of 11 pools, 5 of which contained abundant HPV7 sequence reads. 24 complete genomes of HPV were acquired in viral metagenomic analysis, including 5 HPV7 genomes, based on which phylogenetic analysis and pairwise sequence comparison were conducted. PCR screening for HPV7 in other 190 individual AGW specimens revealed 25 positive cases (13.16%), of which the amplified fragments were sequenced and confirmed to be HPV7 sequences. Although HPV7 was generally found in hand warts and recently also in warts in toe webs, our data suggested that the role of HPV7 in AGW should be considered in the future clinical test and vaccine development for AGWs.
Collapse
Affiliation(s)
- Hui Xu
- Department of Dermatology, the Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Yu Ling
- Department of Microbiology, School of Medicine, Jiangsu University, Zhenjiang, People’s Republic of China
| | - Yuan Xi
- Department of Microbiology, School of Medicine, Jiangsu University, Zhenjiang, People’s Republic of China
| | - Hong Ma
- Department of Dermatology, the Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Hao Wang
- Department of Microbiology, School of Medicine, Jiangsu University, Zhenjiang, People’s Republic of China
| | - Hui-Min Hu
- Department of Dermatology, the Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Qi Liu
- Department of Microbiology, School of Medicine, Jiangsu University, Zhenjiang, People’s Republic of China
| | - Yu-Mei Li
- Department of Dermatology, the Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Xu-Tao Deng
- Vitalant Research Institute, San Francisco, CA,USA
| | - Shi-Xing Yang
- Department of Microbiology, School of Medicine, Jiangsu University, Zhenjiang, People’s Republic of China
| | - Eric Delwart
- Vitalant Research Institute, San Francisco, CA,USA
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA,USA
| | - Wen Zhang
- Department of Microbiology, School of Medicine, Jiangsu University, Zhenjiang, People’s Republic of China
| |
Collapse
|