Molecular analysis of genital HPV: results of a study made in the years 2005-2008

Background: Human Papilloma virus (HPV) infection is the main cause of cervical cancer and cervical intraepithelial neoplasia (CIN) worldwide. Consequently, it would be useful to evaluate HPV testing to screen for cervical cancer. Recently several molecular biological tests able to detect different HPV types and to classified them into high and low-risk groups have been developed. In this study we examined HPV prevalence and genotype distribution in a group of 346 patients, some women undergoing cytological screening for prevention, others with abnormal cytological and/ or clinics. Methods: HPV detection and genotyping were done using a polymerase chain reaction based assay with the use the HPV Typing kit (Nuclear Laser Medicine).The tests can detect and differentiate 14 types of human papilloma virus, classified them into low, medium and high risk. Results. During the period 2005-2008, a total of 346 samples were analysed.The results of this study show that in this series, HPV infection were detected in 43.35% with a prevalence of 83.3% in patients of 16-20 years. Over the years there weren’t an increase of the infection. Among patients with condylomas, the genotype most frequently detected were HPV 6 (79%) followed by HPV 11 (25.5%) while among the eso-endocervical swabs were HPV 16 (34.5%) and HPV 6 (26.1%). Conclusions: Our work shows how is high the incidence of HPV infection in people especially young, thus the importance of HPV molecular test for diagnosing the presence of high risk HPV oncogenes.This epidemiological study can better understand the incidence of HPV in local and identification of the virus strain that maintains the infection, in order to assume a growing importance in prevention programs

Prevalence of Fabry disease and GLA variants in young patients with acute stroke: The challenge to widen the screening. The Fabry-Stroke Italian Registry

Background: Fabry disease (FD) is a treatable X-linked lysosomal storage disorder caused by GLA gene variants leading to alpha-galactosidase A deficiency. FD is a rare cause of stroke, and it is still controversial whether in stroke patients FD should be searched from the beginning or at the end of the diagnostic workup (in cryptogenic strokes). Methods: Fabry-Stroke Italian Registry is a prospective, multicentric screening involving 33 stroke units. FD was sought by measuring α-galactosidase A activity (males) and by genetic tests (males with reduced enzyme activity and females) in patients aged 18-60 years hospitalized for TIA, ischemic stroke, or intracerebral hemorrhage. We diagnosed FD in patients with 1) already known pathogenic GLA variants; 2) novel GLA variants if additional clinical, laboratory, or family-derived criteria were present. Results: Out of 1906 patients, we found a GLA variant in 15 (0.79%; 95%CI 0.44-1.29) with a certain FD diagnosis in 3 (0.16%; 95%CI 0.03-0.46) patients, none of whom had hemorrhage. We identified 1 novel pathogenic GLA variant. Ischemic stroke etiologies in carriers of GLA variants were: cardioaortic embolism (33%), small artery occlusion (27%), other causes (20%), and undetermined (20%). Mild severity, recurrence, previous TIA, acroparesthesias, hearing loss, and small artery occlusion were predictors of GLA variant. Conclusion: In this large multicenter cohort the frequency of FD and GLA variants was consistent with previous reports. Limiting the screening for GLA variants to patients with cryptogenic stroke may miss up to 80% of diagnoses. Some easily recognizable clinical features could help select patients for FD screening