17 research outputs found
Human papillomavirus in amniotic fluid
BACKGROUND: There is evidence to suggest that human papillomavirus (HPV) can cross the placenta resulting in in-utero transmission. The goal of this study was to determine if HPV can be detected in amniotic fluid from women with intact amniotic membranes. METHODS: Residual amniotic fluid and cultured cell pellets from amniocentesis performed for prenatal diagnosis were used. PGMY09/11 L1 consensus primers and GP5+/GP6+ primers were used in a nested polymerase chain reaction assay for HPV. RESULTS: There were 146 paired samples from 142 women representing 139 singleton pregnancies, 2 twin pregnancies, and 1 triplet pregnancy. The women were 78% Caucasian, 5% African American, 14% Asian, and 2% Hispanic. The average age was 35.2 years with a range of 23â55 years. All samples were ÎČ-globin positive. HPV was not detected in any of the paired samples. CONCLUSION: Given the age range, race, and ethnicity of the study population, one would anticipate some evidence of HPV if it could easily cross the placenta, but there was none
Tratamento do papiloma vĂrus humano na infĂąncia com creme de imiquimode a 5% Treatment of human papillomavirus in childhood with imiquimod 5% cream
LesĂ”es decorrentes da infecção pelo papilomavĂrus humano na infĂąncia, em especial as verrugas anogenitais, sĂŁo um importante problema epidemiolĂłgico e terapĂȘutico. O tratamento das verrugas anogenitais na infĂąncia Ă© um desafio terapĂȘutico. Os tratamentos convencionais geralmente sĂŁo dolorosos e necessitam de anestesia geral. O imiquimode, um imunomodulador tĂłpico, constitui uma alternativa terapĂȘutica. SerĂŁo descritos quatro casos tratados com sucesso utilizando creme de imiquimode a 5% aplicado topicamente.<br>In children, lesions caused by the human papillomavirus (HPV) constitute a significant epidemiological issue and a therapeutic dilemma, particularly in the case of anogenital warts. The treatment of anogenital warts in children is a challenge, since standard treatments are generally painful and require the patient to be anesthetized. Imiquimod, a topical immune response modifier, constitutes an alternative therapeutic agent for the treatment of HPV. The present report describes four cases in which treatment with topically applied imiquimod 5% cream was implemented with successful results
Weight discordance and perinatal mortality in monoamniotic twin pregnancy: analysis of MONOMONO, NorSTAMP and STORK multipleâpregnancy cohorts
Objectives
The primary objective was to quantify the risk of perinatal mortality in nonâanomalous monochorionic monoamniotic (MCMA) twin pregnancies complicated by birthâweight (BW) discordance. The secondary objectives were to investigate the effect of inpatient vs outpatient fetal monitoring on the risk of mortality in weightâdiscordant MCMA twin pregnancies, and to explore the predictive accuracy of BW discordance for perinatal mortality.
Methods
This analysis included data on 242 MCMA twin pregnancies (484 fetuses) from three major research collaboratives on twin pregnancy (MONOMONO, STORK and NorSTAMP). The primary outcomes were the risks of intrauterine (IUD), neonatal (NND) and perinatal (PND) death, according to weight discordance at birth from â„ 10% to â„ 30%. The secondary outcomes were the association of inpatient vs outpatient fetal monitoring with the risk of mortality in weightâdiscordant pregnancies, and the accuracy of BW discordance in predicting mortality. Logistic regression and receiverâoperatingâcharacteristicsâcurve analyses were used to analyze the data.
Results
The risk of IUD was significantly increased in MCMA twin pregnancies with BW discordance â„ 10% (odds ratio (OR), 2.2; 95% CI, 1.1â4.4; P = 0.022) and increased up to an OR of 4.4 (95% CI, 1.3â14.4; P = 0.001) in those with BW discordance â„ 30%. This association remained significant on multivariate logistic regression analysis for BWâdiscordance cutâoffs â„ 20%. However, weight discordance had low predictive accuracy for mortality, with areas under the receiverâoperatingâcharacteristics curve of 0.60 (95% CI, 0.46â0.73), 0.52 (95% CI, 0.33â0.72) and 0.57 (95% CI, 0.45â0.68) for IUD, NND and PND, respectively. There was no difference in the risk of overall IUD, single IUD, double IUD, NND or PND between pregnancies managed as an inpatient compared with those managed as an outpatient, for any BWâdiscordance cutâoff.
Conclusions
MCMA twin pregnancies with BW discordance are at increased risk of fetal death, signaling a need for increased levels of monitoring. Despite this, the predictive accuracy for mortality is low; thus, detection of BW discordance alone should not trigger intervention, such as iatrogenic delivery. The current data do not demonstrate an advantage of inpatient over outpatient management in these cases