Effect of a Multi-Ingredient Coriolus-versicolor-Based Vaginal Gel in Women with HPV-Dependent Cervical Lesions: The Papilobs Real-Life Prospective Study.

Human papillomavirus (HPV) is responsible for virtually all cervical cancers in women. HPV infection and persistency may lead to different-grade squamous intraepithelial lesions that can result in high-grade lesions and cancer. The objective was to prospectively evaluate the results of using a Coriolus-versicolor-based vaginal gel (Papilocare®) on HPV-dependent low-grade cervical lesion repair in a real-life scenario. HPV-positive women ≥ 25 years with ASCUS/LSIL cervical cytology results and concordant colposcopy images were included, receiving the vaginal gel one cannula/day for 21 days (first month) + one cannula/alternate days (five months). A 6-month second treatment cycle was prescribed when needed. Repair of the cervical low-grade lesions through cytology and colposcopy, HPV clearance, and level of satisfaction, and tolerability were evaluated. In total, 192 and 201 patients accounted for the total and safety analyses, respectively, and 77.1% repaired cervical lesions at 6 or 12 months (76.0% for high-risk HPV). Additionally, 71.6% achieved HPV clearance throughout the study's duration (70.6% for high-risk HPV). Satisfaction level was rated 7.9 and 7.5 out of 10 at 6 and 12 months, respectively. Only three mild-moderate product-related adverse events were reported, and all of them were resolved by the end of the study. In our study, we observed higher regression rates of low-grade cervical lesions in women treated with Papilocare® vaginal gel than spontaneous regression rates reported in the literature.

Influence of intrauterine dispositive in human papillomavirus clearance.

INTRODUCTION: An important inverse relation between IUD use and risk of cervical cancer has been proved. Women who used IUD had half the risk of developing cervical cancer. The mechanism how IUD is a protector factor is still unknown. Could be improving the clearance of HPV infection or stopping progression to cancer from preneoplasic lesion. The aim of the study is to check if IUD increases HPV clearance, that is, checking if after 1 year HPV infection disappears in more patients using IUD than those not using it. STUDY DESIGN: This is a cohort case-control prospective study, carried out in Universitary Hospital La Zarzuela in Madrid, Spain, performed between October 2015 and April 2018. No pregnant women between 25-50 years old, with HPV cervical infection were enrolled. We separated the participants into two groups: an IUD group, with women starting using IUD and non IUD group, with women using any other contraceptive method or none. HPV genotyping of cervical cytology samples were performed initially on enrolment day and one year after. RESULTS: 254 participants were enrolled at the beginning of the study, 85 in the IUD group and 169 in the control group (non IUD). 179 participants completed the study, 54 (31%) in IUD group and 120 participants in non IUD group (69%). 38 women from IUD group cleared HPV infection (69.5%) and 65 women from control group cleared it (54.2%) (p = 0.044). An association in logistic regression was observed in HPV clearance with different factors. Firstly, higher percentage of patients with IUD clear the HPV infection than those in control group significantly associated (OR = 0.698, CI 95%; 0.251-0.998, p = 0.046). Clearance was higher in patients with low-risk HPV infection comparing with high risk HPV (OR = 1.078, CI 95%; 1.126-4.6.281, p = 0.026) and in patients with only one HPV type than those with more than one (OR = 0.194, CI 95%; 0.084-0.403, p < 0.001). CONCLUSIONS: In Spanish women with HPV infection, the HPV clearance between IUD and non IUD groups show results with statistical significance, patients with IUD have higher clearance rates. There were differences also between suffering one HPV type or more than one, and having low-risk HPV or high-risk HPV infection.

Malaria y gestación: complicaciones, prevención y tratamiento / Malaria and pregnancy: complications, prevention and treatment

La malaria es una enfermedad emergente en Occidente debido a la inmigración y el turismo. Si se da en el embarazo, se asocia a resultados desfavorables, como anemia, bajo peso al nacimiento, aborto, muerte neonatal y materna. Por eso la Organización Mundial de la Salud aconseja un tratamiento de prevención en todas las gestantes que vivan en zonas endémicas. Dichos fármacos están cambiando debido al aumento de resistencias. Se presenta el caso de una gestante que presentó malaria en el primer trimestre de gestación con diversas complicaciones. También se revisan los resultados de nuevos fármacos para el tratamiento y la prevención de esta enfermedad (AU)

Malaria rates are increasing in western countries due to immigration and tourism. Malaria infection in pregnant women is a major risk for anemia, low birth weight, miscarriage, and maternal and perinatal mortality. The World Health Organization recommends intermittent preventive treatment in pregnant women in endemic areas. This treatment is changing because of increasing resistance. We report a case of a pregnant woman with malaria in the first trimester and its adverse outcome. We also review different drugs for the treatment and prevention of this infection (AU)

Linfoma cervical primario: presentación de un caso y revisión de la literatura / Primary lymphoma of the uterine cervix: a case report and literature review

El linfoma primario cervical es una enfermedad muy infrecuente que se presenta clínicamente como un carcinoma de cérvix. El diagnóstico del linfoma de cérvix requiere una biopsia profunda, ya que la citología puede ser negativa. Aunque no existe consenso en el tratamiento, tradicionalmente se empleaba radioterapia. Sin embargo, últimamente se sugiere realizar tratamiento quimioterápico, pudiendo completarse con cirugía. Se presenta el caso de una paciente con linfoma cervical que requirió varias tomas de biopsia para su diagnóstico y en la que se empleó con éxito quimioterapia neoadyuvante seguida de cirugía (AU)

Primary lymphoma of the uterine cervix is extremely rare and the clinical presentation is similar to that of carcinoma of the cervix. Diagnosis is made with a deep cervical biopsy because smear tests can show false negative results. The standard treatment has not yet been established but used to be radiotherapy. Currently, combination chemotherapy is used with or without surgery. We report a case of cervical lymphoma that needed several biopsies to establish the diagnosis and was successfully treated with neoadjuvant chemotherapy and surgery (AU)