Shared and persistent asymptomatic cutaneous human papillomavirus infections in healthy skin

Cutaneous human papillomavirus (HPV) types are commonly found in normal skin, and some of them have been suspected to play a role in the development of non-melanoma skin cancer. This present study is divided into three sections, the aims of this study were to examine if certain HPV-types persist over time and if HPV-types are shared within families. From the first part of the study, swab samples from foreheads were collected for three longitudinal studies from one family with a newborn baby. Five specific HPV-types were isolated from the family with a newborn, with HPV-5 and FA67 being found at various time points and prevalence rates in all four members of the family. Part 2 consisted of a followed up study from two families with a 6 years interval. Six of the family members were found to have at least one of the HPV-types identified in the family 6 years earlier. Many of the HPV-types identified were shared within the families studied. Part 3 of this study involved weekly samples from four healthy females for 4 months. Among the four healthy individuals, 11%, 65%, and 56% of the weekly samples were HPV-DNA positive with one individual HPV-negative. All specimens were tested for HPV-DNA by PCR using the broad range HPV-type primer pair FAP59/64. The positive samples were HPV-type determined by cloning and sequencing. Specific cutaneous HPV-types persist over long periods of time in healthy skin in most individuals investigated and certain HPVs are shared between family members.

Two year analysis of treatment efficacy and cosmesis by the American Society of Breast Surgeons (ASBS) MammoSite Breast Brachytherapy Registry Trial in patients treated with accelerated partial breast irradiation (APBI)

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Background: This report presents 2-year data on treatment efficacy and cosmesis for patients enrolled on the ASBS sponsored MammoSite Registry trial. Methods: 1449 patients were treated with the MammoSite device to deliver APBI. 924 patients have been followed ≥ 12 months, 586 ≥ 18 months, 316 ≥ 24 months and 52 ≥ 36 months. Median follow-up for surviving patients was 14 months. Results: Eleven patients (0.8%) developed an ipsilateral breast tumor recurrence (IBTR) as some component of their initial failure (prior to distant metastases [DM]) for a 2-yr actuarial rate of 1.2%. The 2-yr actuarial rate of isolated IBTR was 0.8% (n=8). Six patients (0.4%) developed an axillary failure (AF) as some component of their initial failure (prior to DM) for a 2-yr actuarial rate of 1.0%. The 2-yr actuarial rate of isolated AF was 0.6% (n=3). The only variable associated with the development of an isolated IBTR (n=8) included an extensive intraductal component (p=0.073) (patient age, margin status, grade, histology, tumor size, nodal status, use of systemic therapy and method of device placement were not associated with IBTR). The only variable associated with the development of all IBTRs (n=11) was tumor location (inner quadrant, p=0.079). The percentage of patients with good/excellent cosmetic results at 6, 12, 18, 24 and 36 months were as follows: 95.1% (n=769 patients), 93.7% (n=621 patients), 91.3% (n=344 patients), 93.5% (n=248 patients), and 90.4% (n=52 patients) (p=NS). For the 174 patients with both a 12-month and 24 month cosmetic assessment, the rate of good/excellent cosmetic results was 94% at 12 and 24 months. At 24 months (n=248 patients), factors associated with good/excellent cosmetic results included increased skin spacing as a categorical variable (94.8% versus 86.1%, p=0.064), no infection (94.8% versus 85.7%, p=0.057), and no systemic chemotherapy treatment (95.3% versus 82.4%, p=0.012). Conclusions: Treatment efficacy and cosmesis 2 years after treatment with APBI using the MammoSite device are excellent and appear similar to those reported with standard whole breast RT.

No significant financial relationships to disclose.

Early diagnosis of bubonic plague using F1 antigen capture ELISA assay and rapid immunogold dipstick

Plague is still prevalent in more than 20 countries. Two F1 antigen diagnostic assays (an immunocapture ELISA and an immunogold chromatography dipstick) were evaluated using bubo aspirates, serum and urine specimens from patients suspected with plague. The specificity of the two F1 assays was found 100%. Using bacteriology as a gold reference diagnostic assay, 52 patients were Yersinia pestis culture positive and 141 negative. The sensitivity of the F1 ELISA test was 100% in bubo, 52% in serum and 58% in urine specimens. In culture negative patients, the F1 antigen could be found in 10% bubo aspirates, 5% serum and 7% urine specimens of culture negative patients for whom a seroconversion for anti-F1 antibodies was also observed. The sensitivity of the dipstick assay was 98% on bubo aspirates specimens. Compared to the ELISA test, the agreement rate was 97.5% and the correlation coefficient tau = 0.90 (p < 10(-3)). In conclusion, the diagnosis of bubonic plague has to be performed on bubo fluid rather than on serum or urine specimens. Both the F1 ELISA and the dipstick assays are valuable tools for an early diagnosis and for the surveillance of plague.