Group B streptococcal colonization and the risk of pre-eclampsia.

To determine if there was an association between recto-vaginal group B streptococcus (GBS) colonization and pre-eclampsia, two cross-sectional studies were conducted using statewide hospital databases. The first study analysed data from the state of Florida, USA, and included 190 645 women who were discharged in 2001. This dataset was used to generate the hypothesis that GBS colonization is associated with pre-eclampsia. The second study tested the GBS hypothesis using the records of 577 153 women who delivered in 2004 or 2005 in Texas, USA. Adjusted odds ratios (aOR) for the outcome of pre-eclampsia comparing GBS-positive to GBS-negative women were calculated using logistic regression. The aOR for the association between GBS carriage and pre-eclampsia was 0.71 [95% confidence interval (CI) 0.65-0.77] in the Florida dataset. In the Texas dataset, the overall prevalence of GBS carriage was 14.1% while the overall prevalence of pre-eclampsia was 4.0%. GBS carriers were 31% less likely than non-carriers to have pre-eclampsia (aOR 0.69, 95% CI 0.66-0.72) in Texas. In two large statewide analyses, GBS carriage was inversely associated with pre-eclampsia. A sensitivity analysis revealed that misclassification of GBS status is not a likely explanation of our findings.

Association of variants of the TCF7L2 gene with increases in the risk of type 2 diabetes and the proinsulin:insulin ratio in the Spanish population.

AIMS/HYPOTHESIS: The gene encoding transcription factor 7-like 2 (TCF7L2) has been related to type 2 diabetes in multiple ethnic groups. Here, we investigate whether three single nucleotide polymorphisms (SNPs) in the TCF7L2 gene are associated with an impaired proinsulin:insulin ratio. METHODS: In this study we examined the associations between SNPs rs7901695, rs7903146 and rs12255372 in the TCF7L2 gene and metabolic variables affecting type 2 diabetes in a population-based study of 706 unrelated individuals (47% men and 53% women; aged 35-74 years) from the province of Segovia in central Spain (Castille), including 180 individuals with type 2 diabetes. RESULTS: The minor allele frequency of rs7901695, rs7903146 and rs12255372 was significantly higher in diabetic patients compared with that in non-diabetic individuals. The T (minor) allele of the variant rs7903146 was significantly associated with a greater OR for type 2 diabetes adjusted for age, sex and BMI in logistic regression analysis: OR 1.29 (95% CI 1.06-1.57, p = 0.01). This risk allele was also associated with an increased proinsulin:insulin ratio after OGTT. Similar results were obtained for the other TCF7L2 SNPs. CONCLUSIONS/INTERPRETATION: Our results provide further evidence supporting the belief that the TCF7L2 gene is a major determinant of type 2 diabetes risk in Spain, as in other southern European populations. The association with increased proinsulin:insulin ratio after an OGTT suggests that TCF7L2 might be involved in insulin synthesis and processing.

The 4G/4G PAI-1 genotype is associated with elevated plasma PAI-1 levels regardless of variables of the metabolic syndrome and smoking status. A population-based study in Spanish population.

Reported data about the effect of the 4G/5G PAI-1 polymorphism on plasma PAI-1 levels are controversial. This study was designed to determine the relative effect of the 4G/5G PAI-1 polymorphism on high plasma PAI-1 levels after adjustment for metabolic syndrome - related variables, and to test if this effect is modified by the smoking status. Six hundred and thirty one unrelated subjects (292 men; 35-74 years), from a cross-sectional population-based epidemiological survey in the province of Segovia (Spain) were studied. The higher frequency of high PAI-1 levels was found in 4G/4G subjects (5G/5G 19.4%, 4G/5G 21.6%, 4G/4G 33.7%, p = 0.003). A multiple regression model, adjusted for gender, age, BMI, waist circumference, triglycerides, HDL-cholesterol, HOMA IR and leptin, showed this adjOR: 4G/4G vs 5G/5G: 2.22, p = 0.008. When smoking status - 4G/5G PAI-1 interaction was included as an independent variable these results were not modified. Our results indicate that the 4G/4G PAI-1 genotype might be strongly associated with high PAI-1 levels regardless of metabolic syndrome-related variables and smoking status.

Human papillomavirus-specific viral types are common in Mexican women affected by cervical lesions.

Cervical cancer (CC) is the most common in Mexican female population. The human papillomavirus (HPV) 16 and 18 frequencies in worldwide may be different due to geographical distribution. We analyzed the prevalence of HPV types and determinated their association in cervical lesion in a Mexican population. One hundred fifty-nine normal cervical smears, 95 low-grade squamous intraepithelial lesions (LGSIL), 59 high-grade squamous intraepithelial lesions (HGSIL), and 108 CC samples of the patients were collected. HPV types were determined by sequencing. We detected 11 high-risk types, four low-risk types, three not determinated, and two probably high risk. HPV were present in 12%, 57%, 88%, and 92% from normal, LGSIL, HGSIL, and CC samples, respectively. HPV 16 was the most common in all cervical lesions (71.6% in CC). HPV 58 was present in 18.6% of HGSIL, and the HPV 18 in 4.6% of CC. The 76% of all detected viruses belong to A9 species branch. Control women showed high percentage of HPV high-risk infection, suggesting that this is a high-risk group. High frequency of HPV 16 compared with a low incidence of HPV 18 was observed. HPV 58 is frequently detected in HGSIL but low frequency is found in CC. These findings might be considered for HPV screening.

Regression of papilloma high-grade lesions (CIN 2 and CIN 3) is stimulated by therapeutic vaccination with MVA E2 recombinant vaccine.

Human papillomavirus (HPV) is the etiologic agent for cervical cancer. In Mexico, a women dies every 2 h, and since 1990 the statistics have shown that the numbers of deaths are increasing. We conducted a phase II clinical trial to evaluate the potential use of the MVA E2 recombinant vaccinia virus in treating high-grade lesions (CIN 2 and CIN 3) associated with oncogenic papillomavirus. Fifty-four female patients with high degree lesions were treated either with an MVA E2 therapeutic vaccine or with conization. Thirty-four women received the therapeutic vaccine, at a total of 10(7) virus particles per dose injected directly into the uterus once every week over a 6-week period. Twenty control patients were treated with conization. By colposcopy, 19 patients out of 34 showed no lesion, in three patients the lesions were reduced by 85-90%, in eight other lesions had reduced by 60%, and in four more patients, they were reduced by 25%. Histological analysis showed total elimination of high-grade lesions in 20 out of 34 patients after treatment with MVA E2. Eleven patients had a 50% reduction in lesion size. In two other patients, the lesion was reduced to CIN 2 and in one more patient the lesion was reduced to low grade (CIN 1). All patients developed antibodies against the MVA E2 vaccine, and generated a specific cytotoxic response against papilloma-transformed cells. DNA viral load was significantly reduced in MVA E2-treated patients. Conization eliminated the lesions in 80% of the patients, but patients did not develop cytotoxic activity specific against cancer cells and did not eliminate the papillomavirus. In addition, three patients treated with conization had recurrence of lesions 1 year later. These results show that therapeutic vaccination with MVA E2 proved to be very effective in stimulating the immune system against papillomavirus, and in generating regression of high-grade lesion.

The glutamine 27 glutamic acid polymorphism of the beta2-adrenoceptor gene is associated with abdominal obesity and greater risk of impaired glucose tolerance in men but not in women: a population-based study in Spain.

OBJECTIVE: Given the important role of the beta2-adrenoceptor (beta2-AR) in lipid mobilization and the lack of studies in Southern European countries, the aim of this study was to investigate the role of the glutamine 27 glutamic acid (Gln27Glu) beta2-AR polymorphism in the susceptibility to obesity and its metabolic complications in a population-based nationwide multicentre study in Spain, especially focusing on the hypothetical influence of gender. DESIGN: Cross-sectional population-based study. PATIENTS: We studied 666 nonrelated adults (47.9% men and 52.1% women), aged 35-64 years, chosen randomly from a nationwide population-based survey of obesity, and related conditions including insulin resistance and cardiovascular risk factors. MEASUREMENTS: Body mass index (BMI), waist-to-hip ratio (WHR), sagittal abdominal diameter (SAD), systolic and diastolic blood pressure, fasting and 2-h post-glucose load glycaemic levels, total cholesterol, high density lipoprotein (HDL)- and low density lipoprotein (LDL)-cholesterol, triglycerides, insulin, proinsulin and leptin plasma levels were measured. Beta2-AR Gln27Glu genotypes were determined by restriction fragment length polymorphism (RFLP)-polymerase chain reaction (PCR). RESULTS: Glu27 homozygous obese men had significantly higher BMI and SAD mean values than both heterozygous and Gln27 homozygous obese men. Two-hour post-load plasma glucose concentration was higher in Glu27 homozygous than in Gln27 homozygous in the whole population and only in men when stratified by gender. No differences according to the genotype were found for the rest of the parameters studied, including homeostasis model assessment (HOMA), insulin, proinsulin and leptin levels, but for total and LDL-cholesterol these increased in men. We did not find differences in the anthropometrical and biochemical parameters according to the genotype in women. Multivariate logistic regression analysis showed that Glu27 homozygosity after adjustment for SAD was associated with type 2 diabetes mellitus. CONCLUSIONS: Our results suggest that the glutamic acid 27 allele of the beta2-adrenoceptor may be a risk factor in men but not in women for the accumulation of visceral fat and for its association with the development of type 2 diabetes mellitus.

Effect of the Pro12Ala polymorphism of the peroxisome proliferator-activated receptor gamma-2 gene on adiposity, insulin sensitivity and lipid profile in the Spanish population.

OBJECTIVE: To investigate the role of the Pro12Ala peroxisome proliferator-activated receptor (PPAR) gamma-2 polymorphism in the susceptibility to the insulin resistance syndrome and its metabolic complications in a population-based nationwide multicenter study in Spain. DESIGN: 464 unrelated adults (45.3% men and 54.7% women) aged between 35 and 64 years were randomly chosen from a nationwide population-based survey of obesity and related conditions including insulin resistance and cardiovascular risk factors. METHODS: Anthropometric determinations included: body mass index (BMI), waist-to-hip ratio, sagittal abdominal diameter; biochemical determinations included: fasting plasma glucose concentration and concentration 2 h after an oral glucose tolerance test (OGTT), total cholesterol, high and low density lipoprotein-cholesterol, triglycerides, leptin and insulin. Systolic and diastolic blood pressure were also measured. Genotyping of the PPARgamma-2 Pro12Ala polymorphism was determined by polymerase chain reaction and single strand conformation polymorphism analysis. RESULTS: The Ala12 allele frequency was higher in obese men than in lean men (0.15 vs 0.08, P=0.03). Men carriers of the Ala12 allele had a higher BMI than non-carriers (38.9% vs 21.3%; adjusted odds ratio 2.36, 95% confidence interval 1.10-5.05, P=0.03). However, despite higher BMI obese men carriers of the Ala12 allele had lower sagittal abdominal diameter than Pro12 homozygotes (24.1+/-3.2 vs 26.3+/-2.5 cm, P=0.01). The Ala12 allele was associated with lower total triglycerides levels in the overall population and it was also associated with lower fasting insulin levels and a higher insulin sensitivity by homeostasis model assessment (HOMA) in women. CONCLUSIONS: Our results suggest that the Pro12Ala polymorphism of the PPARgamma-2 gene promotes peripheral deposition of adipose tissue and increased insulin sensitivity for a given BMI. The results in women might be due to their different adipose tissue distribution.

[Value of estrogen and progesterone receptors in the management of intraepithelial squamous lesions of low grade]. / Valor de los receptores a estrógeno y a progesterona en el manejo de las lesiones escamosas intraepiteliales de bajo grado.

UNLABELLED: The objective of this study was to know the prognostic value of estrogen receptors and progesterone receptors positives (ER+, PR+) in the management of low grade squamous intraepithelial lesions [(LGSIL), human papillomavirus (HPV) and cervical intraepithelial neoplasia grade 1 (CIN 1) and menopausal status]. MATERIAL AND METHODS: From January 1995 to January of 1999, was studied in 144 women with abnormal citology to HPV and CIN grades 1, 2 or 3. Colposcopy was carried out and two biopsies were taken from the suspicious lesion, they were sent for histopathological study, and for ER/PR by the dextran-coated charcoal technique. In addition to the receptor status information, histological type of squamous intraepithelial lesions (SIL), and menopausal status were recorded and analyzed and were correlated later. RESULTS: In normal cervix, 89% and 60% of specimens were ER+, PR+ (+6 fmol/mg protein) There was significant difference in ER status between the normal cervix con HPV and CIN, (P < 0.003), but no with PR (P > 0.53). ER levels in premenopausal and postmenopausal patients there was no significant difference (P > 0.27) but PR levels there was significant difference (P < 0.04). ER/PR levels in HPV o CIN grade no correlated to the histologic grade and menopausal status (P > 0.35, > 0.97, respectively). CONCLUSION: The women with levels ER+ were significant higher in the normal cervix than SIL, ER+, PR+ levels no correlated to the prognostic value in the management of LGSIL and menopausal status.

Randomized placebo-controlled evaluation of intramuscular interferon beta treatment of recurrent human papillomavirus.

OBJECTIVE: To evaluate the effectiveness and safety of interferon beta in women with recurrent cervical human papillomavirus (HPV) lesions. METHODS: Women with recurrent HPV of the cervix were assigned randomly to received either 3 million IU of interferon beta daily for 5 days, followed by 2 days of rest for 3 weeks, or placebo on the same schedule (N = 61 in each group). They were evaluated at 6 and 12 months after cytology, colposcopy, and directed punch biopsy. Comparison between groups was carried out by chi(2), Fisher exact test, and Student t test, depending on the variable. Multivariable logistic regression was used to evaluate influence of variables to treatment and categorical and continuous variables were compared by Mantel-Haenszel and Wilcoxon tests. RESULTS: When treatment success rates for all patients at 6 and 12 months were compared, a highly significant statistical difference was found in the treated group compared with the placebo group [48 of 61 (79%) versus 33 of 61 (54%), P =.001, and 43 of 61 (70%) versus 26 of 61 (43%), P =.002, respectively]. Multivariable analysis showed treatment success rates with interferon beta were higher between the group with initial histopathology of cervical intraepithelial neoplasia (CIN) (odds ratio 4.86; 95% confidence interval 1.75, 13.49), and the group receiving placebo (P =.002). Side effects treatments were minimal in 70% of women; the most severe events were headaches and flulike symptoms that did not interfere with the treatment. No clinically significant changes were found in laboratory measurements of glucose or transaminases during treatment or follow-up. CONCLUSIONS: Intramuscular injections of interferon beta were effective for treating recurrent HPV lesions, particularly when associated with CIN. The only side effects were mild and controllable.

[Progesterone receptors in the prognosis after therapy of pre- and post-menopausal patients with squamous intraepithelial lesions and cancer of the uterine cervix]. / Receptores a progesterona en el pronóstico de la terapia en pacientes pre y posmenopáusicas con lesiones escamosas intraepiteliales y por cáncer cérvico uterino.

The objective of this study was to know if there is a correlation in contents progesterone receptors (RPg) in biopsies from patients pre and postmenopausal, with normal cervix, Low-Grade squamous intraepithelial lesions (LGESIL) and High-Grade (HGSIL), and invasive cancer. Sixty three patients with abnormal cytology; colposcopy was carried out and two biopsies were taken from the suspicious lesion, they were sent for histopathological study, and for RPg; both studies were correlated later. Both pre and postmenopausal with LGSIL, the RPg the mean values were 16.81 fmol/mg, protein, and values negative, respectively. With regard to HGSIL, the RPg content, the mean values was 20.31 fmol/mg, protein in pre-menopausal patients, whereas it was 3.8 fmol/mg, protein in postmenopausal patients. It was seen that RPg concentration is higher in invasive cancer than to LGSIL and HGSIL patients in pre and postmenopausal. It is concluded that this study on quantification to RPg receptor level measurement may well be to select poor prognostic groups of patients for inclusion in the management of squamous intraepithelial lesions and invasive cancer.

[Cytologic correlation between the Bethesda system and colposcopic biopsy]. / Correlación citológica con el sistema Bethesda y la biopsia dirigida por colposcopia.

Bethesda system is useful in the citologic diagnosis of premalign diseases of cervix. It was determined the correlation between citologic report using Bethesda system and combined colposcopic index (CCI) or Reid, to diagnose premalign diseases of cervix by histologic diagnostic of punch biopsy by colposcopy. A total of 118 patients come to the colposcopy clinic having smear anormal citology to cervical intraepithelial neoplasia (CIN), only o associated to HPV. It was taken to all of them a new cervical smear, colposcopy and punch biopsy. We analized the findings for citology with Bethesda system and colpospic with CCI of Reid, using histologic diagnosis of punch biopsy by colposcopy. Diagnosis correlation between Bethesda system and the punch biopsy by colposcopy was 98.5% for 82 patients with low grade squamous intraepithelial lesions with a concordance of 100% for HPV and 97% for CNI I (p < 0.05). In the other hand 92% from 36 patients classified as high grade squamous intraepithelial lesions with a concordance of 84% to CIN II and 100% to CIN III (p < .05) Sensibility of 93%, especifidad and positive predictive value of 96% and negative predictive value of 98%. We conclude correlation between citologic report with Bethesda system and the Combined Colposcopic Index of Reid which are effective to diagnose premalign disease of cervix.

Effectiveness of 5-Fluorouracil in the treatment of vaginal intraepithelial neoplasia in a mexican population.

OBJECTIVE: Our purpose was to determine the effectiveness of 5-fluorouracil (5-FU) in the treatment of vaginal intraepithelial neoplasia (VaIN) in a Mexican population. MATERIALS AND METHODS: The study was performed in 30 patients with a mean age of 54 years and previous diagnoses from reviewed records and histopathology slides selected from a group of 65 patients with VaIN from 1980 to 1997. Patients received intravaginal treatment with 5-FU, 1.5 g once weekly for 10 weeks, and all patients were followed up for a 1-year minimum. Papanicolaou smear and colposcopy were performed, as was biopsy when indicated. RESULTS: Twenty-eight (93%) patients with VaIN had prior or concurrent anogenital squamous neoplasia, including 5 with invasive cervical carcinoma and 23 with cervical intraepithelial neoplasia. In 23 of 30 treated patients (77%), VaIN went into remission after a single treatment; in 3, (10%), it went into remission after two treatments; 3 (10%) had recurrent VaIN 3; and in 1 (3%), it progressed to invasive vaginal cancer. The treatment was well tolerated. CONCLUSIONS: We conclude that 5-FU is an option choice for VaIN treatment. It is effective, with minimal side effects. Its use should be confined to treating extensive or multifocal high-grade VaIN.

[Estradiol receptors in cervical intraepithelial neoplasia and cervico-uterine cancer]. / Receptores a estradiol en neoplasia intraepitelial cervical y cáncer cervicouterino.

The objective of this study was to know if there is a correlation in contents o (R + E) in biopsies from patients pre and post-menopausal, in normal cervix with cervical intraepithelial neoplasia (NIC) and invasive cancer. Thirty four patients with abnormal cytology; colposcopy was carried out, and two biopsies were taken from the suspicious lesion, they were sent for histopathological study, and for estrogenic receptors; both studies were correlated later. It was seen that (R +/- E) concentration is higher in intraepithelial lesions of low and high degree than in control patients; and it was not so in premenopausal with invasive cancer where (R +/- E) are much lower, as to postmenopausal (R + E) concentration is higher specially in invasive cancer. It is concluded that the study on quantification to (R + E) in cervical pathology means a good alternative in hormonal treatment, as it has been seen in mammary pathology, and so, more research has to be done.

[Association of Chlamydia trachomatis and human papilloma virus as predisposing factors in cervical intraepithelial neoplasia]. / Asociación de Chlamydia trachomatis y virus del papiloma humano como factores predisponentes en la etiopatogenia de la neoplasia intraepitelial cervical.

Human papilloma virus (HPV) has a predisposing association as cofactor in etiopathology of cervicouterine cancer; it is known also that viral infection is not enough, and there are other agents, as Chlamydia trachomatis. The objective of this study was to investigate the association of these cofactors as predisposal for intraepithelial cervical neoplasia (NIC). Prospectively, at Clinica de Colposcopia, Hospital de Ginecología y Obstetricia "Luis Castelazo Ayala", IMSS, 37 patients with cytologic, colposcopic and histological diagnosis of CIN pure or associated to HPV, underwent endocervical cytologies, and by immunofluorescence method, using monoclonal antibodies of conjugated fluoresceine, it was tried to demonstrate Chlamydia trachomatis, presence. From all patients, 12(32,4) were positive for Chlamydia trachomatis, significant percentually, and with Xi square of 0.32, non significant for this group of population. It is concluded that there is an important association of Chlamydia trachomatis and HPV, which should be taken into consideration in diagnosis and treatment of intraepithelial cervical neoplasia.

[Comparative study of cryosurgery and hysterectomy in the treatment of cervical intraepithelial neoplasia]. / Estudio comparativo de criocirugía e histerectomía en el tratamiento de la neoplasia intraepitelial cervical (NIC).

The purpose of this study was to compare the results of conservative management with cryosurgery and with hysterectomy in different stages of NIC. The records of 235 treated patients from 1984 to 1991, were reviewed; 140 patients were treated with cryosurgery and 95 with total hysterectomy. Cure rate was for stage I in 34 patients (94.5); for stage II in 54 patients (98.2%), and for stage III in 46 patients (93.9%). For hysterectomy in NIC I in 5 patients (100%); for NIC II in 15 (100%), and for NIC III in 74 (98.66%). Statistical study with square Chi showed a not significant P which means that there is no difference in the results of Cure and No Cure in both procedures. It is concluded that intraepithelial cervical neoplasia may be managed with both procedures, provided that the established criteria for cryosurgery and hysterectomy, are followed.

[Vaginal intraepithelial carcinoma. Diagnosis and management]. / Neoplasia intraepitelial vaginal (NIVa). Diagnóstico y manejo.

At the Colposcopy Clinic, Hospital "Luis Castelazo Ayala", from January 1990 to May, 1991, 24 cases of vaginal intraepithelial neoplasia, were diagnosed. The average age of the patients was 54.2 years. Twenty had antecedents of previous hysterectomy; seven (29%) with benign pathology, and twelve (50%) with malignant pathology. Only four patients (17%) presented with symptomatology. In all the cases it was suspected by abnormal cytology. Colposcopy was done, as well as directed biopsy, finding that the pointillism and white epithelium, were the most frequent findings, with localization mainly in the vaginal cupule and vaginal upper third. Histopathological correlation showed NIVa I in three cases (13%) NIVa II in six cases (25%), and NIVa III in 15 (62%). Treatment was done with cryotherapy in 10 patients; with 5-fluorouracil in eight; cryotherapy plus 5-fluorouracil in three; radiotherapy in two, and it was not done in one. It was found persistent lesion in two cases treated with cryotherapy, and in one case with radiotherapy; there was a complication in one case after cryotherapy (retrovaginal fistula). Vaginal cytology should be done in every patient after hysterectomy, by benign or malignant pathology. In NIVa the colposcopic study is mandatory for the adequate diagnosis. 5-Fluorouracil showed to be an adequate treatment.

[The combined colposcopic index as a diagnostic method in human papillomavirus infection and cervical intraepithelial neoplasia]. / El índice colposcópico combinado (ICC) como método diagnóstico en la infección por papilomavirus humano y la neoplasia intraepitelial cervical.

This is a prospective, comparative study of 142 patients of combined colposcopic index according to Reid's criterium and the index used at the Clinics of Colposcopy, Gyn-Ob Hospital "Luis Castelazo Ayala", IMSS. Seventy two patients were studied with the Hospital Index, and 70 with the CCI. This constituted by neatness of peripheral edges, the color, characteristics of vessels and iodine tinction; a score of 0, 1, 2 was given, the sum of which gave a final qualification, and it was traspolated to a colposcopic diagnosis. The CCI correlated with the histological diagnosis in 64 patients (91.42%); while for the Hospital Index it was in 61 cases (84.7%). The indexes showed a good sensitivity (0.95), a high positive predictive value (0.95 vs 0.88), and adequate accuracy (0.91 vs 0.84), as well as a good prevalence (0.90 vs 0.85). It is concluded that the CCI is reliable for the colposcopic diagnosis of human papillomavirus and for CIN.

[The treatment of cervical human papillomavirus (HPV) infection with trichloroacetic acid]. / Tratamiento de la infección cervical por el virus del papiloma humano (VPH) con ácido tricloroacético.

Ever since the alterations caused by the HPV on the cervix were discovered, countless treatments have been employed but the ideal method still remains unknown. The objective of the experiment was to assess the efficiency of handling the cervical infection caused by the HPV, by means of trichloroacetic acid, 85% rate. During the period comprised between April 1989 and March 1990, 60 patients were subject to close analysis. The general diagnosis drawn cytology, colposcopy, and histopathology was cervical condyloma, lacking any collateral evidence of intraepithelial cervical neoplasia. The treatment consisted of 3 weekly applications of trichloroacetic acid at 85% rate directly upon the cervix. They were all assessed through cytology and colposcopy every 3 months, during a year's period. After the first 3 months, a 73.4% healing rate was observed, which decreased to 68% after 6 months and to a 65% after 9 months; this last healing rate remained unchanged after 12 months. Pregnant patients showed higher healing rates. We have drawn the conclusions that the trichloroacetic acid is an efficient agent to treat the referred injuries, and it offers as well the advantages of low costs, no secondary effects and an easy application and handling.