Farida Shah

A comparison of risk factors in juvenile‐onset and adult‐onset recurrent respiratory papillomatosis

The clinical triad of a firstborn delivered vaginally to a young (teenage) mother has been previously noted among juvenile onset recurrent respiratory papillomatosis (JO‐RRP) patients. This study was based on a questionnaire survey of JO‐RRP patients, adult onset recurrent respiratory papillomatosis (AO‐RRP) patients, and juvenile and adult controls. The survey results revealed that the complete or partial triad was observed in 72% of JO‐RRP patients, 36% of AO‐RRP patients, 29% of juvenile controls, and 38% of adult controls. As compared with juvenile controls, JO‐RRP patients were more often firstborn (P <.05), delivered vaginally (P <.05), and born to a teenage mother (P <.01). Among adult participants, AO‐RRP patients reported more lifetime sex partners (P <.01) and a higher frequency of oral sex (P <.05) than reported by adult controls.

Antibodies to HPV-16 E6 and E7 proteins as markers for HPV-16-associated invasive cervical cancer

Transforming proteins E6 and E7 of human papillomaviruses (HPVs) are consistently expressed in HPV-associated cervical cancers. In ELISA with four HPV-16 E6-E7 peptides, patients with HPV-16-associated invasive cervical cancer (group 1) had a greater seroreactivity than all other groups, which included patients with HPV-16-associated cervical intraepithelial neoplasia, invasive cervical cancer patients without HPVs, and unaffected controls. A larger proportion of group 1 sera, as compared to sera of all other groups, was reactive with at least one peptide (49% vs 17-27%), and with two or more peptides (22% vs 0-6%). A clear difference between group 1 and all other groups was also found for high ELISA absorbance values to at least one peptide (22% vs 0-8%). This high seroreactivity of group 1 sera was confirmed by a radioimmunoprecipitation assay with in vitro transcribed and translated HPV-16 E7 protein. Sera from 50% of group 1 but only 3% of controls were reactive in this test. Antibodies to HPV-16 E6 and E7 proteins appear to be virus-specific and disease state-specific markers of HPV-associated cervical cancer.

Low birth weight and neonatal mortality rate related to maternal smoking and socioeconomic status

Abstract Neonatal deaths occurring over a 10 year period among infants born to nonsmoking and smoking mothers enumerated in a nonofficial census of Washington County, Maryland, were compared with a sample of live births from the same population. In addition to maternal smoking, low birth weight, and neonatal mortality rate, a considerable number of demographic and socioeconomic characteristics were studied. Smoking mothers consistently had a higher proportion of small babies regardless of almost all other characteristics. Neonatal mortality rate was approximately 40 per cent higher among infants born to smokers than among those born to nonsmokers. The excess among smokers was most marked among families who ranked low on socioeconomic characteristics. The hypothesis is advanced that hypoxia resulting from increased maternal and fetal carboxyhemoglobin levels is the factor responsible for both the decrease in birth weight and the increase in neonatal mortality rate among infants born to smoking mothers.

Risk factors for juvenile onset recurrent respiratory papillomatosis

Background.Children born to condylomatous mothers are at risk for developing juvenile onset recurrent respiratory papillomatosis (JORRP). We inquired whether the triad of vaginal delivery, being firstborn and maternal age of <20 years are also risk factors for JORRP.Methods.Data for JORRP and adu

Human papillomavirus investigation of patients with cervical intraepithelial neoplasia 3, some of whom progressed to invasive cancer.

The major objective of the study was to determine if the contrasting frequencies (1.5% vs. 22%) of progression of cervical intraepithelial neoplasia (CIN) 3 lesions to invasive cervical carcinoma in two groups of patients in a previously published study from New Zealand had a virologic basis. Archival tissues on which the original diagnosis of CIN 3 was made were examined. Paraffin sections of 81 CIN 3 lesions from each group were tested for the presence of human papillomavirus (HPV)-6, -11, -16, and -18 DNA sequences by a combination of in of in situ hybridization for viral transcripts and polymerase chain reaction for viral DNA. The virologic profiles of the two groups were similar; HPV-16 and HPV-18 were identified, respectively, in 62% and 6% of CIN 3 lesions of group 1 and in 60% and 2% of CIN 3 lesions of group 2. additional tissues were examined for 17 women of group 2, who progressed from CIN 3 invasive cancer. Progression to invasive cancer was not associated with infection with specific HPV types. It is concluded that the contrasting frequencies of progression to invasive carcinoma in two groups of New Zealand women were not attributable to differences in HPV type distribution in the original CIN 3 lesions of these two groups.

Risk Factors for Juvenile-Onset Recurrent Respiratory Papillomatosis |[dagger]| 909

BACKGROUND Children born to condylomatous mothers are at risk for developing juvenile onset recurrent respiratory papillomatosis (JORRP). We inquired whether the triad of vaginal delivery, being firstborn and maternal age of <20 years are also risk factors for JORRP. METHODS Data for JORRP and adult onset recurrent respiratory papillomatosis cases were obtained from questionnaires answered by patients or their parents for the Recurrent Respiratory Papillomatosis Foundation. The observed numbers of cesarean births, first order births and births to mothers <20 years old were compared with expected numbers for the same variables, which were computed by distributing the cases by year of birth and then applying to them national annual statistics for the year of birth. In addition observed and expected numbers of first order births to mothers <20 years old were compared with corresponding numbers in mothers 20 years old or older. RESULTS In JORRP cases the relationships be tween observed and expected numbers of cases were as follows: cesarean births, 4.6-fold less; first order births, 1.6-fold greater; maternal age <20 years old, 2.6-fold greater. All these differences were statistically highly significant. The observed parity effect was mediated to a large extent by maternal age. In contrast there were no significant differences between observed and expected numbers of adult onset recurrent respiratory papillomatosis cases with respect to any of the above variables. CONCLUSIONS Young primiparous mothers with condylomas are at a high risk for transmission of JORRP to their infants. The option of cesarean delivery should be discussed with a mother who has condyloma at the time of delivery.