Perianal fistulizing Crohn's disease is associated with a higher prevalence of HPV in the anorectal fistula tract. A comparative study.

Background & Aims: Perianal fistulizing Crohn's disease is the main risk factor for anal cancer in patients with inflammatory bowel disease. Whether this occurs due to a higher frequency of human papillomavirus remains unclear. The authors aimed to evaluate the prevalence of HPV and high-risk HPV in patients with perianal Crohn's disease, compared with a control group.

Comparison between anal cytology, high-resolution anoscopy and HPV DNA genotyping by polymerase chain reaction in the post-treatment follow-up of condylomata acuminata.

Aim: to evaluate the presence of subclinical HPV-induced anal lesions with anal cytology, High-Resolution Anoscopy (HRA) and HPV genotyping by polymerase chain reaction (PCR) in the follow-up of treated condylomata acuminata (CA).

Methods: seventy-nine male patients were included. One month after anal CA eradication, the patients underwent brush samples collection for anal cytology and PCR, and HRA with biopsy of acetowhite lesions.

Local control of human papillomavirus infection after anal condylomata acuminata eradication.

Objective: To verify whether the eradication of anal condylomata acuminata was effective for local control of HPV infection using anal colposcopy and anal brush cytology.

Methods: We evaluated 147 patients treated for anal margin and/or anal canal condyloma, with 108 HIV-positive and 39 HIV-negative individuals. The average age for males was 40 years for HIV-positive and 27.

Genital warts: comparing clinical findings to dermatoscopic aspects, in vivo reflectance confocal features and histopathologic exam.

Genital warts can be diagnosed through physical examination and confirmed by histopathology. Noninvasive methods are useful for ruling out other diagnoses with no harm to the patient. In this study the clinical findings were compared to dermoscopy, reflectance confocal microscopy (RCM), and to histopathology findings, in order to determine possible patterns that can aid diagnosis of the lesion.

Evaluation of Langerhans cells counts comparing HIV-positive and negative anal squamous cell-carcinoma patients.

Purpose: To investigate the differences in Langerhans cells (LCs) populations between HIV-positive and negative anal squamous cell carcinomas patients.

Methods: Twenty five patients (14 HIV-positive and 11 HIV-negative) were evaluated. Paraffin-block transversal thin sections from biopsies of anal squamous cell carcinomas (ASCC) were stained using the anti-CD1A antibody that identifies activated LCs.

Buschke -Loewenstein tumor: identification of HPV type 6 and 11.

The authors report a case of exuberant giant condyloma acuminatum of Buschke-Loewenstein in a male patient, slow-growing, progressive and with locally destructive behavior in the inguinal, body of the penis, scrotum, perineal and perianal regions. After surgery he showed no signs of recurrence in 20 months of follow-up. The identification of HPV types 6 and 11 was performed using in situ hybridization.

Prevalence of anal cytological abnormalities in women with positive cervical cytology.

The objective of this study was to estimate the prevalence of cytological abnormalities of the anal mucosa in women with positive cervical cytology, but without macroscopic anal lesion. Ultimately we postulated if the anal mucosa may be a reservoir of HPV, which would allow the reinfection of cervix. Forty-nine patients with abnormal cervical cytology were selected for this work.

The importance of oxygen free radicals in the etiopathogenesis of diversion colitis in rats.

Purpose: Quantify the levels of oxidative DNA damage of epithelial colon cells comparing segments with and without fecal stream.

Methods: Sixty Wistar rats were subjected to deviation of fecal stream by proximal colostomy and a distal mucosal fistula. Animals were divided into three experimental groups that were sacrificed 6, 12 and 24 weeks after surgery.

[How far into the anal canal should the brush be introduced for more efficient cytological evaluation?].

Objective: In literature, sensitivity of Pap smears ranges widely from 45 to 98%. Possibly this is because there is no standard for how far the brush should be introduced into the anal canal. The aim was to evaluate whether the sampling site has an influence on the results of anal Pap smears.

Comparison of perianal diseases in HIV-positive patients during periods before and after protease inhibitors use: what changed in the 21st century.

Purpose: Highly active antiretroviral therapy has enabled better control over HIV infection. Thus, the immunologic status of such patients has been improving and we believe that changes in their perianal diseases also have been occurring. This study was designed to compare anorectal disease incidence among HIV-positive patients attended in two eras: prehighly active antiretroviral therapy and highly active antiretroviral therapy.

[Outcome of treatment of anal squamous cell carcinoma and its precursor in HIV-infected patients].

Objective: Incidence of anal squamous cell carcinoma is increasing mainly among HIV-positive patients. Treatment consists of radiotherapy and chemotherapy, sometimes followed by tumor resection. The objective was to evaluate the follow-up of such patients to verify recurrences and evolution from HAIN to cancer.

[Anal cytology for screening of pre-neoplasic lesions].

Background: High grade intra-epithelial neoplasias (HAIN) are probable precursors of anal carcinoma, with association to high-risk types of Human Papillomavirus (HPV). This progression could be related to severity of the dysplasia and, albeit not yet confirmed, treatment of these lesions would prevent the evolution to cancer. Standardization and improvement of screening methods should therefore be essential to treat or prevent precursor lesions, mainly in patients at risk such as seropositives to Human Immunodeficiency Virus (HIV).

Hypertrophic herpes simplex simulating anal neoplasia in AIDS patients: report of five cases.

Five patients (4 males; mean age, 46.4 years) with painful verrucous perianal lesions caused by herpes simplex virus are described. All patients had had AIDS for a long time and were using highly active antiretroviral therapy.

[Human papillomavirus oncogenicity and grade of anal intraepithelial neoplasia in HIV positive patients].

Objective: We decided to evaluate if grade of anal intraepithelial neoplasia (AIN) was associated to the HPV type in HIV positive patients, since this group of patients has immunodeficiency over long periods. We identified HPV types by PCR (polimerase chain reaction) and histological examination to determine the AIN grade in 39 HIV positive males with anal condylomata acuminata.

Results: We observed high grade AIN (HAIN) in 9 (23.

Effects of long-term administration of Senna occidentalis seeds in the large bowel of rats.

Plants of the genus Senna that contain anthranoides derivatives are frequently used as cathartics. Radiological studies have demonstrated that patients with chronic constipation who have used stimulant laxative have colonic redundancy and dilatation more frequently than patients who have not. The objective of the present work was to study morphological and histochemical changes of the lower gut after administration of Senna occidentalis seeds for a long period to rats, as observed in skeletal muscle fibers.

Postoperative follow-up of anal condylomata acuminata in HIV-positive patients.

Purpose: The purpose of this study was to analyze the postoperative follow-up of HIV-positive patients with anal condylomata acuminata, associating recurrence to the AIDS status.

Methods: Ninety-seven male, homosexual patients with anal condylomata were submitted to surgical treatment from August 1992 to December 1997. Specimens were obtained for histologic investigation of Ki-67 cell proliferation marker and for polymerase chain reaction to define the human papillomavirus type.

[Adenocarcinoma of the duodenum].

Purpose: To revise literature data about adenocarcinoma of the duodenum comparing to our results.

Methods: Six patients with this kind of cancer, excluding periampullary lesions, were treated from 1991 to 1999 in the Department of Surgery, Santa Casa of São Paulo Medical School. Five of them were males in theirs fifties.