[Anticipated efficacy of HPV vaccination in prophylaxis against nongenital cancers]. / Predpokládaná úcinnost HPV vakcinace v profylaxi nongenitálních karcinomu

BACKGROUND: There is a considerable number of studies on the efficacy HPV (human papillomavirus) vaccination against different cancers but relevant information is scattered in diverse journals. This paper is a review summarizing current knowledge of the potential of HPV vaccination against all HPV related cancers. AIM: HPV infection is probably the most frequent sexually transmitted disease. At least 13 HPV genotypes are classified as carcinogenic or probably carcinogenic in respect to cervical cancer. Almost 100% of cervical cancers are linked to HPV infection. HPV 16 and HPV 18 are the most frequently involved genotypes and account together for approximately 70% of cervical cancer in the world. Persistent high risk HPV infection is responsible for a significant proportion of vulvar, vaginal, anal and penile carcinomas. The virus has also been implicated in oncogenesis of head and neck cancers, including oropharyngeal cancers. HPV infection can play an important role in cancerogenesis of lung, esophagus, breast, and colon and rectum. On the contrary, published results indicate that HPV infection is not associated with prostate oncogenesis. Strong predominance of HPV 16 has been reported for all HPV associated cancer sites. Generally, it is estimated that approximately 5.2% of all cancers are associated with oncogenic HPV infection. Currently, there are two vaccines on the market; quadrivalent Silgard® (Gardasil®) and bivalent CervarixTM. Large trials for both vaccines have shown efficacy against HPV related infection and disease. Efficacy has been very high in HPV naive subjects to vaccine related types. While HPV vaccination is currently approved for the prevention of cervical cancer, it also has the potential in the prevention of all HPV associated malignancies. The Czech republic belongs to countries that cover HPV vaccination of girls at the age of 13- 14 years by general health insurance. Overall impact of this vaccination remains to be evaluated. The new issues of the role of HPV in oncogenesis, as well as the potential effect of HPV vaccination against HPV related nongenital cancers are discussed. CONCLUSION: Approximately 5.2% of all human cancers are associated with oncogenic human papillomavirus infection. HPV vaccination against the most risky HPV oncotypes may cause a significant reduction of these cancers mainly in the HPV naive population.

First detection of Chlamydia trachomatis LGV biovar in the Czech Republic, 2010-2011.

We present four cases of proctitis in HIV-infected men having sex with men (MSM) living in the Czech Republic. The causative agent in all cases was the lymphogranuloma venereum (LGV) biovar of Chlamydia trachomatis. The spread of proctitis caused by C. trachomatis serovars L1­3 among MSM has been observed in several European countries, the United States and Canada since 2003. To our knowledge, no LGV cases in eastern Europe have been published to date.

[Cohort of lymphedema patients followed at the Lymphology Centre of the Dermatovenerologcal Clinic of the 2nd Faculty of Medicine University Hospital Na Bulovce Prague in years 2000 to 2005. A retrospective study]. / Soubor nemocných s lymfedemem sledovan'ch v lymfologickem centru dermatovenerologicke kliniky 2. LF UK a FN na bulovce praha v letech 2000-2005. Retrospektivni analyza.

BACKGROUND: The aim of the study was an analysis of a cohort of lymphedema patients followed at the Lymphology Centre of the Dermatovenerologcal Clinic of the 2nd Faculty of Medicine University Hospital Na Bulovce Prague in years 2000 to 2005. METHODS AND RESULTS: Altogether 329 patients with lymphedema (291 women and 38 men) were included into the study. The type of lymphedema, its localization, cause of secondary lymphedema and the incidence of complications in correlation with sex were analysed. The duration of disease till the beginning of therapy, therapeutical method and the following home care were evaluated. The most frequent cause of the secondary lymphedema was the ablation mammae with axilar exenteration (45 % from the total), other surgical treatment without the axilar exenteration usually do not result in lymphedema. Second most frequent cause of lymphedema was a gynaecological surgery (9 % of total), namely radical gynaecological surgery of a tumor, often combined with radiotherapy. Sole radiotherapy of hypogastrium can also cause lymphedema. CONCLUSIONS: The complex therapy of lymphedema, which includes manual and instrumental lymph drainage together with compressive therapy, represents the only effective treatment of lymphedema. Equally important is the patient's education and collaboration (subsequent life-long care).

[Combined immunosuppressive therapy in patients with pemphigus vulgaris and its side effects]. / Kombinovaná imunosupresivní terapie u pacienta s pemfigus vulgaris a vedlejsí úcinky lécby.

Pemhigus vulgaris is an autoimmune bullous disease of the integument. When not treated, it has a high mortality, the treatment with corticosteroids and immunosuppressives has serious side effects. Our casuistry gives a case of patients with histologically verified diagnosis of pemphigus vulgaris. In this case the stabilization of the disease was difficult and side effects of the combined immunosuppressive therapy developed very early.