THE USE OF IONTOPHORESIS WITH HYALURONIC ACID ASSOCIATED WITH GOLD NANOPARTICLES ACCELERATES WOUND HEALING IN RATS

This study aimed to investigate the effects of iontophoresis with HA associated to GNPs solution in an epithelial lesion model. Fifty Wistar rats (n=10/group) were randomly assigned to the following groups: epithelial lesion (EL); (EL+MIC); (EL+MIC+HA); (EL+MIC+GNPs); (EL+MIC+HA-GNPs). The animals induced to an epithelial lesion and treatment started 24 hours after injury with microcurrents (300µA) containing gel with HA (0.9%) and/or GNPs (30mg/Kg) in the electrodes (1mL) for seven days. The animals were sacrificed 12 hours after the last treatment application. Results demonstrated a reduction in the levels of pro-inflammatory cytokines (IFNϒ, IL-1β, TNFα, IL6) in the group in which the therapies were combined; an increase in the levels of anti-inflammatory cytokines (IL-4, IL-10) and growth factors (FGF, TGFβ) in EL+MIC+HA and EL+MIC+HA-GNPs groups. As for dichlorofluorescein (DCF) and nitrite levels, decreased in the combined therapy group when compared to the control group, as well as the oxidative damage (carbonyl and sulfhydryl). In antioxidant defense, there was an increase in glutathione (GSH) and a decrease in superoxide dismutase (SOD) in the combination therapy group. Histological analysis showed a reduction in the inflammatory infiltrate in groups treated with MIC and in the combination therapy group. An increase in contraction of the wound area was obtained in all treated groups when compared to the control group, proving that the proposed therapies are effective in the process of epithelial healing. The results of this study demonstrated that the associated therapies favor the tissue repair process more significantly compared to the isolated therapies.

Phyllodes tumor in an adolescent female

Phyllodes is a tumor of breast. This fibro-epithelial lesion occurs in less than 1% of all breast tumors in female. They can be benign, borderline or malignant. It commonly occurs in age group of 45-50 years. It is also known as cystosarcoma phyllodes/ serocystic disease of Brodie. Treatment can be either wide local excision or mastectomy to achieve histologically clear margin. Palpable axillary lymphadenopathy can be identified in up-to 10-15% of patients but less than 1% has pathological positive nodes. Mammography and ultrasonography are main imaging modalities. Here, we present a case of a 14-year-old female presenting with a rapidly enlarging breast mass, which was ultimately found to be a Phyllodes tumor.

Struck by Lightning and Bitten by Snake

Introduction The simultaneous occurrence of a benign as well as malignant epithelial lesion, albeit incidental, is a rare occurrence. A multi stage procedure had to be adopted for the appropriate management of this patient. Case Report We report one such case of a 65 year old male who presented with a small black lesion on the left side of the nose and complains of left sided nasal obstruction on a much later date. Discussion The decision to address the benign pathology initially followed by the malignant pathology owing to its indolent course formed the cornerstone in the management of this patient.

Subfoveal retinal pigment epithelium inflammatory lesion presenting as a sign of reactivation of tubercular multifocal choroiditis

Multifocal choroiditis (MFC) can be associated with ocular tuberculosis (TB). Inflammatory peripapillary choroidal neovascular membrane (PPCNVM) is uncommon in TB MFC. Subretinal pigment epithelial inflammatory lesions are suggestive of acute inflammation or reactivation of inflammation in the setting of MFC. We present a case of MFC, of tubercular aetiology, during course of treatment of PPCNVM developed a subfoveal retinal pigment epithelial lesion. Clinical examination suggested a recurrence of PPCNVM, with the new macular lesions posing a dilemma of new onset inflammatory choroidal neovascular membrane (CNVM) at the macula versus reactivation of choroiditis at the posterior pole. Multimodal imaging helped differentiate the lesion from CNVM and give the appropriate antitubercular treatment to prevent future recurrences.

HPV Positivity and Risk of Cervical Cancer according to HIV-Infection: A Comparative Assessment in the Population of Cameroonian Women

Background Cervical cancer, caused by the human papillomavirus (HPV), remains a global health challenge. In HIV highly-burdened settings, it would be relevant to understand the severity of cervical cancer in case of co-infection with HPV. We therefore sought to determine the effect of HPV on the occurrence of cervical lesions among women with versus without HIV-infection. Methods A cross-sectional analytical study was conducted throughout 2012 among 257 women living in Yaoundé, Cameroon. HIV serology, genotyping of high-risk oncogenic HPV and cervical vaginal smear (CVS) were performed for all participants; among those reported to be HIV seropositive, HIV plasma viral load and CD4 count were measured. Results of the CVS were interpreted following the Bethesda 2001 guidelines. Statistical analyses were performed using Graph Pad version 6.0; p < 0.05 was considered statistically significant. Results The mean age of our study participants was 37 ± 6.5 years. According to HIV serology, 184 (71.59%) were HIV-positive vs. 73 (28.40%) HIV-negative women, with a similar age distribution respectively (36 ± 2.80 years versus 42 ± 8.48 years). Among HIV-positive women, median CD4 was 438 [IQR: 317–597] cells/mm3 and median viremia < 40 [IQR: <40 − 2318] copies/mL. Following successful genotyping, the prevalence of high-risk oncogenic HPV was 36.32% (73/201), with a significantly higher proportion among those with HIV-infection (41.98% [55/131] vs. 25.71% [18/70]; p = 0.02; OR = 2.1). CVS revealed 31.74% (97) normal cervix; 38.91% (100) inflammation; 16.34% (42) low-grade squamous intra-epithelial lesion; 6.34% (18) high-grade squamous intra-epithelial lesion. Overall rate of cervical lesions was 23.34% (60/257), with a non-significantly higher proportion in HIV-infected participants (25.00% [46/184] versus 19.17% [14/73]; p = 0.31). Of relevance, the presence of high-risk oncogenic HPV was significantly associated with cervical lesions (p < 0.0001; OR = 5.07), with a higher risk of cervical lesion among HIV-positive (p < 0.0001 and OR = 5.67) versus HIV-negative (p = 0.03 and OR = 3.83). Conclusion Though oncogenic HPV appears as an independent factor of the occurrence of cervical lesions, the risk of cervical lesion is substantially higher among HIV/HPV co-infection compared to HPV-infection alone. Thus, prevention of cervical cancer should be prioritised for women living with HIV-infection in HPV-endemic settings.

Characterization of vaginal microbiota in Chinese women with cervical squamous intra-epithelial neoplasia

ObjectivesAlthough persistent human papillomavirus (HPV) infection is a major cause of cervical squamous intra-epithelial neoplasia, the relationship between vaginal microbiota and different grades of squamous intra-epithelial neoplasia is not well established. We explored the possible relationship between the vaginal microbiota and the progression of cervical squamous intra-epithelial neoplasia.MethodsWe evaluated 69 women who attended the Obstetrics and Gynecology Hospital of Fudan University. The vaginal bacterial composition of three groups of women was characterized by deep sequencing of bar-coded 16S rRNA gene fragments (V3–4) using Illumina MiSeq. Exclusion criteria were any previous hysterectomy, history of cervical or other lower genital cancer, and/or destructive therapy of the cervix. Women who had autoimmune disorders, who were HIV positive, who received antibiotics within 15 days of sampling, or who had engaged in sexual intercourse or douching within 48 hours prior to sampling were also excluded. P values for age and proportions of organisms were calculated using one-way ANOVA and p values for HPV status and community state types (CSTs) were calculated using a χ2 test.ResultsThe vaginal bacterial composition of three groups of women, those without an intra-epithelial lesion or malignancy (n=31), those with a low-grade squamous intra-epithelial lesion (LSIL) (n=22), and those with a high-grade squamous intra-epithelial lesion (HSIL) (n=16) were analyzed. Lactobacillus was the most dominant genus overall. Prevotella and Streptococcus were increased in the HSIL group. Cervical disease progression was associated with the prevalence of high-risk HPV infection. Squamous intra-epithelial neoplasia converted the vaginal bacterial community structure from CSTs IV to II. Microbiota diversity was more pronounced in CST types II and IV (p<0.001), especially in type II. We found a significant enrichment in the Peptostreptococcaceae family, Pseudomonadales order, and other types of bacteria in the group of women without intra-epithelial lesions or malignancy compared with women with squamous intra-epithelial neoplasia. We found enrichment in Delftia in the LSIL and HSIL groups compared with the group without an intra-epithelial lesion or malignancy.ConclusionsOur results show that the vaginal microbiota is directly or indirectly related to the progression of squamous intra-epithelial neoplasia, and Delftia might be a microbiological hallmark of cervical pre-cancerous lesions.