Helena Lucia Barroso dos Reis

Oral squamous papilloma and condyloma acuminatum as manifestations of buccal-genital infection by human papillomavirus

Genital infection by human papillomavirus (HPV), a sexually transmitted disease (STD), has increased considerably due to the changes in sexual behaviour and an increase in the practice of oral sex. HPV, in a parallel manner, has been closely studied due to its oncogenic potential. We present the case of a 27-year-old patient, with a multi-partner sexual history and frequent practice of oral sex, who suffered from warts lesions on the genitalia and tongue. Squamous papilloma was diagnosed from a tongue biopsy. The treatment of the oral lesion was by way of surgery, without relapse in the first two years. Our discussion in this report is regarding the HPV infection in the oral cavity.

Endometrial Assessment: When Is It Necessary?

Background Endometrial cancer is the fourth most common cancer among women and the most common malignant neoplasm of the female genital tract in the USA. The onset is usually after the age of 50 and prognosis depends on the stage of disease at diagnosis. We aimed at determining the prevalence of high-risk endometrial lesions in women of different ages to establish a protocol for the indication of invasive diagnostic procedures. Methods A retrospective study was conducted based on the descriptive and statistical analysis of histopathological records of 2,931 patients who underwent uterine curettage between January 2001 and December 2011 at our institution. Results The risk of endometrial malignancy was about 10 times higher in patients aged 50 years or older than that in younger women. However, women with abnormal uterine bleeding had a higher prevalence of high-risk conditions, regardless of age. Conclusion Atypical and complex endometrial hyperplasia and carcinoma can affect women of all ages, but are more common in patients 50 years of age or older. Thus, endometrial sampling is recommended as a routine procedure for all women 50 years of age or older with clinical indications of the disease and as a screening procedure for those undergoing hysterectomy.

Recurrent herpes simplex infections: laser therapy as a potential tool for long-term successful treatment

Herpes simplex virus types 1 and 2 are the main infectious agents associated with oral and genital ulcerations. These infections are now widely recognized as sexually transmitted diseases. Among treatment options, low-level laser therapy (LLLT) has shown promising clinical results as a longer-lasting suppression therapy. Two clinical cases are described with recurrent labial herpes for which LLLT was used. Following treatment, both patients remained symptom free during the 17-month clinical follow-up period.

Validation study of a scale of life quality evaluation in a group of pediatric patients infected by HIV

With the advent of potent antiretroviral therapy and the increase in life expectancy of pediatric patients infected with HIV, the quest for the promotion of enhanced quality of life should currently be the main focus in care of children with HIV/Aids. The scope of this study was to validate the Scale of Childrens Quality of Life in a group of children infected with HIV receiving clinical care in Aids Service Units in Rio de Janeiro, Brazil. This scale consists of 26 questions and was tested on 100 children, with ages varying between 4 and 12, and their respective parents or guardians. Statistical analysis was conducted using canonical correlation and confidence interval analysis and the X² test. The results showed that the cut-off point obtained was 49; the internal consistency with Cronbachs alpha was 0.73 for the children and 0.67 for parents or guardians. The response profile revealed marked satisfaction with aspects such as vacations and birthdays, though less satisfaction with items including hospitalization and playing alone. The conclusion was that the scale revealed satisfactory psychometric measurements, proving to be a reliable, consistent, valid and recommended instrument for measuring the quality of life of children infected with HIV.

Genital and oral human papillomavirus infection in a patient from the group of women who have sex with women

A 21-year-old self-declared lesbian patient of Africandescent was referred to a sexually transmitted disease (STD)center at the Federal Fluminense University (UFF) from aprivate clinic with a case of genital warts of 1 year’sduration. The patient, who denied tobacco use but admittedsocial alcohol use, had been in a stable homosexualrelationship for the previous 16 months, and routinelyperforms unprotected oral sex on her partner. She had beenpreviously treated with trichloroacetic acid (TCA) 90%throughout the year with no signs of improvement. Shepresented with multiple, large, and hardened genital warts(Fig. 1) and a single, small lesion on her lower lip (Fig. 2).The lower lip lesion was first noticed by the patientapproximately 30 days before her consultation. She hadbeen treated with TCA 90% applied to the genital area for 4weeks, without any noticeable clinical improvement; abiopsy was then carried out on both the genital area andthe lips. Twenty-one days after the procedure, the genitallesions disappeared completely. Laboratory examinationswere ordered (anti-HIV and Venereal Disease ResearchLaboratory), both of which tested negative; an examinationof the larynx was also normal. The patient’s partner wasalso tested. Her hymen was found to be intact and noalterations were found in the colposcopy examination.Both women denied past history of STDs and hetero-sexual intercourse; although they did declare previousrelationships with digital–vaginal and digital–anal prac-tices, as well as vulvar and oral-to-oral contact. Biopsyresults for lesions of the lips and vulva revealed condylo-mata acuminata (Figs 3 and 4). Polymerase chain reaction(PCR) tests for human papillomavirus (HPV) were per-formed on both lesions but the viral subtype was notdefined. Specific orientations were offered to these womenwho are now symptom-free, and follow-up was undertakenby the STD center.

Quality evaluation of cone biopsy specimens obtained by large loop excision of the transformation zone.

Background Large loop excision of the transformation zone (LLETZ) has been used for the diagnosis and treatment of precancerous cervical lesions, and it is the first choice of treatment in the majority of cervical pathology services. The aim of this study was to evaluate the presence of thermal artifacts, the need for serial sections, the percentage of clear and involved resection margins and the relationship between endocervical gland involvement and the severity of the lesion in samples resected using LLETZ. Methods A retrospective study was performed at Santa Casa de Misericordia School of Science (HSCMV), Vitoria, Espirito Santo, Brazil with a sample of 52 histopathology slides from patients submitted to conization because of abnormal cytology findings and a biopsy result of cervical intraepithelial neoplasia (CIN) 2, CIN 3 and adenocarcinoma in situ. Statistical analysis was performed using Student’s t-test. Results Serial sections were required to confirm diagnosis in four of 52 cases. Thermal artifacts were present in all cases, with grade I being the most common (94.2% of cases). Clear margins were found in 96.2% of cases. No association was found between glandular involvement and CIN 1 (P > 0.05); however, there was an association with CIN 2 and CIN 3 (P < 0.05). Conclusion The amount of excised tissue was sufficient, thermal artifacts were slight, resection margins were clear in most of cases, and a possible association was found between glandular involvement and the severity of the lesion.

The challenge to diagnose a clinical case of inflammatory linear verrucous epidermal nevus: Is there any ILVEN associated with human papillomavirus infection?

Address to: Dr. Dennis de Carvalho Ferreira. Programa de Mestrado em Odontologia/Universidade Veiga de Almeida. Rua Ibituruna 108, Maracanã, 20271-020 Rio de Janeiro, RJ, Brasil. Phone: 55 21 2574-8888 e-mail: denniscf@gmail.com Received 8 April 2014 Accepted 14 May 2014 The challenge to diagnose a clinical case of infl ammatory linear verrucous epidermal nevus: Is there any ILVEN associated with human papillomavirus infection?

Congenital syphilis neonatal alterations in a university hospital in niterói - rJ

Introduction: Syphilis is a sexually transmitted disease caused due to bacterium Treponema pallidum. The prevalence of this infection decreased significantly by the use of penicillin, but it is observed that it reappears particularly in cases of congenital syphilis (CS). Objective: to describe the effects of neonatal CS in newborns (NB) in a public hospital in Niteroi - RJ, from January 2005 to June 2006 and to observe the birth weight and serology of newborns with CS notification. The purpose of this study is also to describe the CS treatment in each case. Methods: a sample of 35 CS notifications was recorded from the Center for Hospital Surveillance at the Antonio Pedro University Hospital (HUAP), Niteroi - RJ, from January 2005 to June 2006. Data from the notifications was used and home visit was done to collect blood samples. Results: the study population is comprised of 29 live birth patients, four miscarriages and two stillbirths. Only two cases (6.9%) had evidence of CS bone abnormalities. The VDRL test performed in cerebrospinal fluid (CSF) of the cases proved to be non-reactive for all patients. VDRL serum of newborns at birth was positive for 23 (79.31 %) patients. The crystalline penicillin G was administered in 26 (89.65 % cases,) procaine penicillin G in two (6.9%) and for one individual both crystalline penicillin G and procaine penicillin G was used. Conclusion: fetal death and abortion were the most ominous outcome and impact of CS. Long bones alterations were scarcely found in few samples. Low birth weight was observed in a few cases. CSF VDRL was not reactive in all cases. The use of several antibiotic regimens was in disagreement with the proposed protocol issued by the Ministry of Health.

Recurrent Oral Squamous Papilloma in a HIV Infected Patient: Case Report

The Human Papillomavirus (HPV) is a DNA virus of the Papilomaviridae family that cannot be cultivated. It is a small, non-enveloped virus of about 55nm in diameter. It is comprised of 72 capsomers in one capsid of icosahedral symmetry.(1) It presents considerable tropism for epithelial and mucous tissues having a variable incubation period that can last from three weeks to an indeterminate period (2, 3). This virus may be associated to sexual transmission ranging from oral lesions to the formation of cervical cancer, constituting high-impact pathology (4).