Evaluation of the intraoperative human papillomavirus test as a marker of early cure at 12 months after electrosurgical excision procedure in women with cervical high-grade squamous intraepithelial lesion: a prospective cohort study.

OBJECTIVE: To evaluate if the intraoperative human papillomavirus (IOP-HPV) test has the same prognostic value as the HPV test performed at 6 months after treatment of high-grade squamous intraepithelial lesion (HSIL) to predict treatment failure. DESIGN: Prospective cohort study. SETTING: Barcelona, Spain. POPULATION: A cohort of 216 women diagnosed with HSIL and treated with loop electrosurgical excision procedure (LEEP). METHODS: After LEEP, an HPV test was performed using the Hybrid Capture 2 system. If this was positive, genotyping was performed with the CLART HPV2 technique. The IOP-HPV test was compared with HPV test at 6 months and with surgical margins. MAIN OUTCOME MEASURE: Treatment failure. RESULTS: Recurrence rate of HSIL was 6%. There was a strong association between a positive IOP-HPV test, a positive 6-month HPV test, positive HPV 16 genotype, positive surgical margins and HSIL recurrence. Sensitivity, specificity, and positive and negative predictive values of the IOP-HPV test were 85.7, 80.8,24.0 and 98.8% and of the HPV test at 6 months were 76.9, 75.8, 17.2 and 98.0%. CONCLUSION: Intraoperative HPV test accurately predicts treatment failure in women with cervical intraepithelial neoplasia grade 2/3. This new approach may allow early identification of patients with recurrent disease, which will not delay the treatment. Genotyping could be useful in detecting high-risk patients. TWEETABLE ABSTRACT: IOP-HPV test accurately predicts treatment failure in women with CIN 2/3.

Resistance to bacillus thuringiensis Cry1Ac toxin in three strains of heliothis virescens: proteolytic and SEM study of the larval midgut

In a previous study, we demonstrated that resistance to Bacillus thuringiensis toxins in Heliothis virescens might be related to differences in the composition of the proteolytic extracts from insect midgut. There, we found specific proteolytic bands present in the gut extracts of the resistant strain and absent from the susceptible one. Here we report related facts using a new resistant strain (KCB) and a cross between the two strains used in our previous study. As would be expected, no quantitative differences in total proteolytic activity were found between the strains, although qualitative differences related to the presence or absence of specific proteolytic activity bands using SDS-PAGE could be responsible for the observed resistance phenomenon. Moreover, an SEM study made at different time intervals after intoxication shows that in the initial hours following intoxication, both the susceptible and the resistant strains show significant damage to the midgut epithelium. In the interval between 3 and 48 h, however, the resistant strain recovered such that by 48 h it had fully recovered whereas the susceptible strain did not. Arch. Copyright 1999 Wiley-Liss, Inc.

[Atypical locations of tuberculosis of the colon]. / Localizaciones atípicas de la tuberculosis en el colon.

We present four cases of tuberculosis of the colon in the form of multiple segmental lesions located in the ascendant, transverse and descendant colon. We comment on the rarity of these locations and how they are easily confused with other diseases, like adenocarcinoma or Crohn's disease. For a correct diagnosis, affectation of the cecum and terminal ileum is useful. In cases in which these zones are not involved, differentiation is very difficult and can only achieved by bacteriological and histological studies after colonoscopy and biopsy.