Distribution of high-risk HPV types in Yugoslav women with cervical neoplasia.

PURPOSE: The purpose of this study was to determine the frequency of high-risk types of human papillomavirus (HPV) infection, namely type 16, 18, 31 and 33, among Yugoslav women diagnosed with different grades of squamous intraepithelial lesion (SIL), as well as to investigate the relationship between HPV infection and age, parity, age at first intercourse, number of sexual partners and residence of the patients, all of which are considered risk-factors. PATIENTS AND METHODS: DNA was isolated from cervical swabs of 72 women using phenol/chloroform/isoamylalcohol extraction. Detection of HPV DNA in patients' genomic DNA was performed using the polymerase chain reaction (PCR) method with type-specific primer pairs, and amplification products were analyzed using 2% agarose and 10% polyacrylamide gel electrophoresis. RESULTS: Thirty out of 72 (41.7%) patients with cervical intraepithelial neoplasia (CIN) were HPV-positive and 8 of them were double positives. HPV31 was the most frequent high-risk HPV type in this group of patients (13.9%). Eighty percent of the high-grade SIL (HSIL) patients were HPV-positive and 38.8% of the low-grade SIL (LSIL) patients were HPV-positive. Compared to HPV-negative women, the HPV-positive ones were younger, had started sexual activity earlier, and overall had more sexual partners. CONCLUSION: Our study showed that oncogenic HPV types are responsible for the transition of LSIL to HSIL, and for its further progression to an invasive carcinoma of the cervix. Thus, HPV typing should become a widely used method for identifying women with increased risk for developing HSIL and invasive cervical cancer. We also concluded that sexual behavior is connected with the frequency of HPV infection. Henceforth, introduction of prophylactic measures could reduce the incidence of HPV infected women in our country.

[Value of the association of normovolemic dilution and hyperbaric oxygenation in the treatment of sudden deafness. A retrospective study]. / Intérêt de l'association hémodilution normovolémique-oxygénothérapie hyperbare dans le traitement des surdités brusques à partir d'une étude rétrospective.

The multiple treatments of sudden deafness shows how this pathology still remains quite unknown. The authors present a retrospective study of 87 patients treated by normovolemic hemodilution associated to hyperbaric oxygenation. They obtain a total à 60% of significant recovery (ratio between hearing gain and initial hearing loss, above 25%) and in severe hearing loss (threshold between 70 and 90 dB) 60% of good results (ratio above 50%). The importance of the initial form of audiogram and the presence of dizziness as prognostic factors is not confirmed. On the other hand, the evolution of tinnitus is correlated with the deafness and it is a supplementary means to evaluate the therapeutic efficiency. Moreover the persistence of tinnitus represents an important after effect. Sudden deafness still remains a medical emergency and the delay for carrying out any treatment should be as short as possible. On the other hand it is possible to reduce hospital stay by two sessions of hyperbaric oxygenation per day.

[Sudden deafness: a randomized comparative study of 2 administration modalities of hyperbaric oxygenotherapy combined with naftidrofuryl]. / Surdités brusques: étude comparative randomisée de deux modes d'administration de l'oxygénothérapie hyperbare associée au Naftidrofuryl.

Hyperbaric oxygen therapy is one of the numerous therapies which have been proposed in the management of sudden deafness. It is presumptuous to claim the efficiency of any treatment in a pathology where both the origin and the actual rate of spontaneous recovery are unknown. The grounds of therapies are therefore empirical but the need of urgent therapy is dictated by ethics. This study compares the effects of hyperbaric oxygen therapy in two groups of patients; according ot their order in randomization the subjects were treated either at a rate of 1 session or 2 sessions per day. Hyperbaric oxygen therapy was associated with infusion of Naftidrofuryl to counteract the vasoconstrictive effect of increased oxygen pressure in blood. Steroids were also administered simultaneously to avoid, for the same reasons, cerebral oedema. Normovolemic hemodilution (Dauman et al. 1983) was systemically performed in all the patients preliminarily to hyperbaric oxygen therapy, in order to reduce the haematocrit and thus facilitate blood supply. The efficiency and the side effects were similar in the two groups, provided that some principles in the selection and the monitoring of the patients were respected. The rate of 2 sessions of hyperbaric oxygen therapy per day has obvious advantages in view of health policy, but it requires the hospitalization of the patient and should be restricted to the younger subjects.

[Normovolemic hemodilution in the treatment of sudden deafness]. / Apport de l'hémodilution normovolémique au traitement des surdités brusques.

After the apparition of a sudden deafness, 45 patients (22 men and 23 women, with a mean age of 44 +/- 14.9 years) were treated with normovolaemic haemodilution performed with dextran 60. They were placed into 4 groups depending on their hearing loss: total loss: 10 cases; severe loss: 90 to 70 db. 13 cases; moderates loss: 65 to 40 db, 14 cases, slight loss: less than or equal to 35 db, 8 cases. The mean time between the onset of the hearing loss and treatment was 9.3 +/- 12.4 days. The initial mean haematocrit was 44.8 +/- 3.8% and mean haematocrit after haemodilution was 33.1 +/- 2.8%. For 51% of the patients, an almost total recovery was obtained. In 15.5% of cases, recovery was between 25 to 50% of the hearing loss, and in 33.3% of the patients recovery was negligible. We did not find any relationship between hearing recovery and initial haematocrit. The best results were obtained in the group of patients treated early. Hearing gain was significatively better if delay in starting treatment was less than 7 days. There was a relationship between the initial hearing loss and the final recuperation. These results suggested that haemodilution increased labyrinth microcirculation and oxygenation of the cochlear sensory cells, reversing the ischaemic insult to these cells.