[HPV infections in the lower genital tract in the female. Results of beta-interferon treatment]. / Lesioni da HPV del tratto genitale inferiore femminile. Risultati del trattamento con beta-interferone.

The Authors have analyzed the results obtained by treating 60 patients affected by HPV lesions of the lower female genital tract (flat vulvar, vaginal and cervical condylomatosis) with beta-interferon. At vulvovaginal level, the action of the drug is independent from the colposcopic aspect of the lesion but is closely correlated to its extension. The drug proved to be more efficacious at cervical level in case of condylomatous cervicitis rather than ANTZ with a reduction in the size of the lesion and disappearance, if present, of the dysplasia. The positive action of the beta-interferon has never occurred before 2-6 months from the end of the farmacologic treatment. The best results have been obtained in case of condylomatous cervicitis with complete remission in 58% of the cases, and in vaginal condylomatosis (CR at 6 months: 45%). On the basis of these results we may conclude that in these HPV lesions priority should be given to medical treatment whereas in vulvar condylomatosis (especially if extended greater than 1/3) where results are not very satisfactory (not more than 20% of CR) physical therapy is advisable.

[Diagnostic accuracy of thoracic radiography in infectious pathology]. / Contributo in tema di accuratezza diagnostica della radiografia del torace nella patologia infettiva.

It is widely recognized that there may be various different reports on the same radiography, because of every single radiologist's subjective interpretation of semiological findings. The authors retrospectively reviewed the X-ray findings of 110 patients (294 chest radiographs) affected by infective pulmonary diseases. A new diagnosis was made, which was compared to the previous one. The quality of each radiograph was judged too, using a grade scale from 0 to 3. The authors confirmed the previous diagnoses in 65.30% of cases. Most of the discrepancies were in case of suspected hilar-mediastinal node involvement, and in case of evident previous pleuropathies. Statistical studies proved the quality of the radiograph not to largely affect the accuracy of the diagnosis in an extemporaneous and discontinuous judgement (P = 0.085).

75Se HCAT test in the detection of bile acid malabsorption in functional diarrhoea and its correlation with small bowel transit.

The purpose of this study was to evaluate whether bile acid malabsorption assessed by the 75SeHCAT test, had a pathogenetic role in functional chronic diarrhoea and to ascertain whether the small bowel transit time (SBTT) could be correlated with the 75SeHCAT test results. The test was based on the counting of the abdominal retention of a 75-selenium labelled homotaurocholic acid. The 75SeHCAT test was carried out in a control group of 23 healthy adults and in 46 patients, 38 of whom were suffering from irritable bowel syndrome (IBS) of diarrhoeic form and eight patients who had undergone cholecystectomy and were suffering from chronic diarrhoea. Faecal bile acid loss was determined in nine patients, and in 14, serum bile acid increase after a standard meal was measured. In 17, SBTT was studied by hydrogen breath test after lactulose administration (21 g in 300 ml water). In 15 patients, choledochocaecal transit time was estimated by Tc99m-HIDA (111 MBq) cholescintigraphy. In 20 of 46 subjects, 75SeHCAT retention was below normal level, and in 19 cholestyramine administration relieved diarrhoea. 75SeHCAT results were related to faecal bile acid loss, while no correlation was found with serum bile acids and SBTT. The data suggest a possible wider use of the 75SeHCAT test in chronic diarrhoea to estimate bile acid malabsorption in irritable bowel syndrome, diarrhoeic form, and provide an effective treatment. In our patients small bowel transit velocity does not seem to be a pathogenetic factor of bile acid malabsorption.

Use of 23-selena-25-homocholyltaurine to detect bile acid malabsorption in patients with illeal dysfunction or diarrhea.

Abdominal gamma-counting after oral administration of 23-selena-25-homocholyltaurine (75SeHCAT) was carried out on 23 healthy volunteers and 66 patients: 33 with distal ileum resections, 3 with Crohn's disease of the ileum, 17 suffering from various intestinal diseases but with normal ileum, and 13 with chronic diarrhea syndrome but without evident intestinal or extraintestinal pathology. The percentage value of 75SeHCAT abdominal retention was assessed by analysis of the activity versus time curve, obtained by single exponential least-squares fit in five consecutive measurements (time zero and 1, 3, 5, and 7 days after 75SeHCAT administration) and directly by the gamma-camera countings on days 3, 5, and 7. The percentage values obtained from the curve on the third day were found to be the most suitable for differentiating between the groups, giving the 75SeHCAT test a 94% sensitivity and a 100% specificity. Our data show that this test is a valid indicator of bile acid loss: actually, it gave evidence of idiopathic malabsorption of bile salts in 6 patients with diarrhea of unknown origin who responded to cholestyramine and showed a correlation (correlation index = 0.585) with the residual ileum of the last meter in resected patients. Moreover, the 75SeHCAT test is easy to perform in any hospital with gamma-counting facilities and has negligible radiation risk.