Topic and systemic administration of natural alfa interferon in the treatment of female and male HPV genital infections.

The aim of the study was to evaluate the effectiveness and tolerance of topic and systemic administration of natural alfa-interferon from normal human leukocytes in the treatment of HPV lesions of the lower genital tract. From May 1991 through May 1992, 70 women (mean age = 29; range 16-42) and 51 men (mean age = 28; range 18-48) with histologically proven HPV genital lesions were studied. 43 patients and 32 male partners with subclinical infection underwent cream therapy (4 applications/day for 30 days) composed of natural alfa interferon and containing 1,000,000 IU/gr. 27 women and 19 men affected by florid infection underwent systemic i.m. therapy with natural alfa interferon in doses of 3,000,000 IU on alternate days for 30 days. The percentage of therapeutical success amounted to 55.8% for women and 78.1% for men subjected to topic therapy; for the 27 patients and 19 male partners treated with systemic therapy the final percentages of success were 70.3% respectively. Natural alfa interferon from normal human leucocytes seems to be a drug of good efficacy and tolerance in the treatment of HPV genital pathology.

[Blue nevus of the endocervix]. / Nevo blu dell'endocervice.

We report a case of blue nevus of the uterine cervix discovered in a cone removed for other reasons. The lesion can be interpreted as a visceral analogue of the cutaneous blue nevus. Histological and Immunohistological studies suggest the melanocytic nature of the lesion.

Cervical intraepithelial neoplasia: carbon dioxide laser vaporization and conization. Our experience.

Between 1984 and 1992, the CO2 laser was used to treat 341 patients affected by CIN of various degrees. On the basis of specific indications these patients underwent vaporization or conization. Two hundred and twenty eight patients underwent vaporization of intraepithelial lesions, 221 (96.92%) of whom were free of disease after one laser treatment, as observed during the subsequent years of follow-up. In 105 out of the 113 patients treated with conization the cone margin was free of disease. One hundred and one (96.19%) of the these 105 patients had no evidence of disease after one year of follow-up. In the remaining 8 (7.07%) cases examination of the cone revealed the presence of invasive carcinoma. The major complication was vaginal discharge observed in 115 (33.72%) patients. The CO2 laser is a very effective therapeutic procedure for the treatment of intraepithelial lesions of the cervix and permits to preserve reproductive function and anatomic integrity.

Management of human papilloma virus vulvo-perineal infection with systemic beta-interferon and thymostimulin in HIV-positive patients.

OBJECTIVES: To evaluate the effect of a combined therapy based on beta-interferon and thymostimulin in HIV-seropositive women with florid vulvoperineal condylomatosis. METHODS: Nineteen HIV-seropositive women affected by HPV florid vulvo-perineal infection were studied. Their ages ranged from 19 to 32 years (mean = 26); all were smokers; 11 (57.89%) were intravenous drug users with a mean period of drug addiction of 5 years. No patient was on AZT therapy. All patients underwent a combined medical therapy based on beta-interferon administration with doses of 3,000,000 IU i.m. daily for 7 days and subsequently on alternate days for 2 weeks associated with the administration of 70 mg i.m. of thymostimulin per day on alternate days for 30 days. RESULTS: Seven (36.84%) patients showed complete recovery at the end of follow-up; 5 (26.31%) patients showed partial recovery and 7 (36.84%) did not respond to therapy. CONCLUSION: A pro-host immunotherapy seems to be indicated in patients affected by immunodeficiency syndrome.

Persistent vulvovaginal candidiasis: systemic treatment with oral fluconazole.

52 patients affected by persistent vulvovaginal candidiasis underwent systemic therapy with oral Fluconazole at a dose of 150 mg once a week for 3 weeks. 31 (59.61%) patients were cured at the first control after therapy. Of the remaining 21 patients, 4 (7.69%) were lost at follow-up and 17 (32.69%) underwent a second cycle of systemic therapy with complete recovery confirmed at the further controls. The overall percentage of recoveries was equal to 92.30%. The results suggest that Fluconazole is very effective in mycotic vulvovaginitis with irrelevant side effects.

Pain evaluation during carbon dioxide laser vaporization for cervical intraepithelial neoplasia: a randomized trial.

63 pts affected by CIN of various degrees were randomly divided into 3 groups in order to evaluate the pain experienced during laser vaporization of the lesion. All pts were premenopausal and ages ranged between 19 and 39 years. 21 pts received Naproxene Sodium (550 mg) 30 minutes before surgery; 21 pts received placebo and 21 pts received no drug. Laser vaporization was performed with a Coherent System 451 CO2 laser with a power setting of 28 W/cm2 and a spot size of 1.8 mm. The severity of pain was assessed by means of a Visual Analogue Scale. The mean VAS value was 19 for the group treated with Naproxene Sodium; the mean VAS value was 20 for the placebo group and 23 for the group which received no pre-operative drug. Analysis of data from the 3 groups showed no statistically significant difference. Analgesia or anaesthesia before laser surgery for CIN is not a necessity.

Vulvar and penile HPV lesions: laser surgery and topic anaesthesia.

Treatment of genital warts (HPV lesions) by Laser-surgery was performed in 90 patients and 90 male partners under topical anaesthesia with 1-3 gr EMLA cream and in 45 patients and 45 males (control groups) under 1-2 ml 2% Carbocaine infiltration. EMLA cream was applied to warts 5-18 minutes (median = 7) before operation. Pain from application of anaesthetic and Laser surgery was significantly less (p < .001) in the groups treated by EMLA. Side effects were minimal in the EMLA groups. The results suggest that EMLA cream could be the anaesthetic of choice in Laser surgery of genital warts.

[Colpo-cyto-histological correlations in intraepithelial lesions of the uterine cervix]. / La correlazione colpo-cito-istologica nelle lesioni intraepiteliali della cervice uterina.

The aim of this study was to assess the clinical efficiency of colposcopic findings as diagnostic tests for intraepithelial lesion using the analysis of colpo-cyto-histological correlations. The results of 3340 colposcopic tests performed in the Colposcopy Unit of the Second Clinic of Obstetrics and Gynecology between March 1990 and May 1991 were analysed, taking into account 326 (9.7%) cases of Abnormal Transformation Zone (ANTZ). The colpo-histological correlation in ANTZ 1 cases (52 cases of white epithelium, 92 standard mosaic, 42 standard dotted and 61 mixed cases) was 65.2% (52.3%) for HPV; 12.9% for CIN). The colpo-histological correlation in ANTZ 2 cases (30 cases of thickened white epithelium, 5 irregular mosaic, 4 irregular dotted, 2 atypical vessels, 4 thickened gland outlets and 6 mixed cases) was 70.5% (43.3% for HPV; 27.2% for CIN an and Ca). In this retrospective study colposcopy showed a diagnostic accuracy of 64.6% in the cases examined and played a decisive role in the diagnosis of intraepithelial lesions of the uterine cervix.

[Laser CO2: results of treatment of HPV lesions in male the partner]. / Laser CO2: risultati del trattamento delle lesioni virali da HPV nel partner maschile.

Hundred-fifty-seven male partners of patients affected by Human Papillomavirus (HPV) lesions, underwent CO2 Laser vaporization between January 1989 and January 1990. The age ranged between 18 and 45 (median 28.2). The vaporization was performed with a Coherent System 451 CO2 Laser equipment, at a power of 16 watt in continuous mode, depth of 2 mm and a free margin of 2 mm. First Laser treatment proved successful in 129 patients (82.1%); 17 out of 28 patients with persistent or relapsed pathology underwent a second CO2 Laser vaporization with a total cure percentage equal to 92.9%. Laser-surgery is the method of choice in the treatment of HPV genital lesions.