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[Title] Anal cytology screening in HIV-positive men who have sex with men: what's new and what's now?

PURPOSE OF REVIEW: This review will discuss current and future anal cytology screening programs to detect anal dysplasia in HIV-positive men who have sex with men (MSM), in addition to other interventions aimed at early detection of anal cancer in this population.

RECENT FINDINGS: Evidence of progression from high-grade anal dysplasia to anal cancer has been recently demonstrated and strengthens the clinical imperative to diagnose and treat this lesion in at-risk populations.

The use of adjunct molecular techniques that improve specificity of anal cytology screening may have the potential to rationalize current screening referral pathways and focus resources on those at highest risk of progressing to cancer.

Candidate biomarkers that are currently being investigated include protein surrogates of cell cycle deregulation (such as p16ink4a and minichromosomal maintenance proteins), DNA damage biomarkers (53BP1) in addition to testing for human papillomavirus genotype, gamma tubulin and beta defensin levels.

SUMMARY: Anal cytology, although sensitive for the detection of any anal dysplastic abnormality, has poor specificity to detect high-grade anal dysplasia.

As new molecular techniques are evolving, the most important immediate clinical intervention is to educate HIV-positive MSM in order to increase awareness of both risk and clinical symptoms suggestive of progression to anal cancer.

[MeSH-major] Anal Canal / pathology. Anus Neoplasms / pathology. Anus Neoplasms / virology. Early Detection of Cancer / methods. HIV Infections / pathology. Homosexuality, Male

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(PMID = 19935419.001).

[ISSN] 1473-6527

[Journal-full-title] Current opinion in infectious diseases

[ISO-abbreviation] Curr. Opin. Infect. Dis.

[Language] eng

[Publication-type] Journal Article; Review

[Publication-country] United States

[Number-of-references] 46

   

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The role of steroid treatment in drug-induced acute interstitial nephritis (DI-AIN) is controversial.

We performed a multicenter retrospective study to determine the influence of steroids in 61 patients with biopsy-proven DI-AIN, 52 of whom were treated with steroids.

The final serum creatinine was significantly lower in treated patients while almost half of untreated patients remained on chronic dialysis.

After withdrawal of the presumed causative drug, we found that when steroid treatment was delayed (by an average of 34 days) renal function did not return to baseline levels compared to those who received steroid treatment within the first 2 weeks after withdrawal of the offending agent.

Our study shows that steroids should be started promptly after diagnosis of DI-AIN to avoid subsequent interstitial fibrosis and an incomplete recovery of renal function.

[MeSH-major] Creatinine / blood. Nephritis, Interstitial / drug therapy. Steroids / administration & dosage

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[CommentIn] Nefrologia. 2009;29(2):95-8 [19396312.001]

[CommentIn] Kidney Int. 2008 Oct;74(7):971-2; author reply 972-3 [18794832.001]

[CommentIn] Kidney Int. 2008 Nov;74(10):1360; author reply 1360-1 [18974767.001]

[CommentIn] Nat Clin Pract Nephrol. 2008 Jun;4(6):298-9 [18398413.001]

[CommentIn] Kidney Int. 2008 Apr;73(8):905-7 [18379525.001]

(PMID = 18185501.001).

[ISSN] 1523-1755

[Journal-full-title] Kidney international

[ISO-abbreviation] Kidney Int.

[Language] eng

[Publication-type] Journal Article; Multicenter Study

[Publication-country] United States

[Chemical-registry-number] 0 / Anti-Inflammatory Agents, Non-Steroidal; 0 / Steroids; AYI8EX34EU / Creatinine

   

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[Title] Penile squamous cell carcinoma: anatomic, pathologic and viral studies in Paraguay (1993-2007).

In developed countries, penile squamous cell carcinoma (SCC) account for < 1% of all malignancies in men.

In Paraguay, approximately 30-40 new cases are diagnosed per year.

It is important for surgical pathologists to know the anatomy of the penis and possible routes of tumor spread because negative resection margins are crucial to avoid local recurrences.

Probable precursor lesions of penile carcinoma include squamous hyperplasia, low and high grade squamous intraepithelial neoplasia and lichen sclerosus.

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(PMID = 17879626.001).

[ISSN] 0884-6812

[Journal-full-title] Analytical and quantitative cytology and histology

[ISO-abbreviation] Anal. Quant. Cytol. Histol.

[Language] ENG

[Publication-type] Journal Article; Review

[Publication-country] United States

[Number-of-references] 43

   

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[Title] Primary immunodeficiency diseases in Egyptian children: a single-center study.

INTRODUCTION: Sixty-four primary immunodeficiency patients were registered at the Pediatric Allergy and Immunology Department, Children's Hospital, Ain Shams University, Cairo, Egypt.

DATA: Predominantly antibody deficiencies were the most common category (35.9%) followed by combined T- and B-cell immunodeficiencies (29.7%), other well defined immunodeficiency syndromes (18.7%), congenital defects of phagocyte number, function or both (12.5%), and diseases of immune dysregulation (3.1%).

The most frequent disorder was common variable immunodeficiency (18.7%).

The mean age at diagnosis was 29.9 months.

CONCLUSIONS: Primary immunodeficiency disorders are not rare in Egyptian children.

It is a prerequisite to establish a national registry of primary immunodeficiency in Egypt.

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(PMID = 19002574.001).

[ISSN] 1573-2592

[Journal-full-title] Journal of clinical immunology

[ISO-abbreviation] J. Clin. Immunol.

[Language] eng

[Publication-type] Journal Article

[Publication-country] Netherlands

   

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Two sets of color optical images were acquired from prostate tissue sections stained with a double-chromogen triple-antibody cocktail combining alpha-methylacyl-CoA racemase, p63, and high-molecular-weight cytokeratin.

The first set of images consisted of 20 training images (10 malignant) used for developing the computer technique and 15 test images (7 malignant) used for testing and optimizing the technique.

The computer technique identified image segments of alpha-methylacyl-CoA racemase-labeled malignant epithelial cells (red), p63, and high-molecular-weight cytokeratin-labeled benign basal cells (brown), and secretory and stromal cells (blue) for identifying prostate cancer automatically.

The sensitivity and specificity of the computer technique were 94% (16/17) and 94% (17/18), respectively, on the first (training and test) set of images, and 88% (79/90) and 97% (136/140), respectively, on the second (validation) set of images.

If high-grade prostatic intraepithelial neoplasia, which is a precursor of cancer, and atypical cases were included, the sensitivity and specificity were 85% (97/114) and 89% (165/185), respectively.

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(PMID = 19417626.001).

[ISSN] 1533-4058

[Journal-full-title] Applied immunohistochemistry & molecular morphology : AIMM

[ISO-abbreviation] Appl. Immunohistochem. Mol. Morphol.

[Language] ENG

[Grant] United States / NIBIB NIH HHS / EB / R21 EB006466; United States / NCI NIH HHS / CA / R21 CA97308; United States / NCI NIH HHS / CA / R21 CA097308-01; United States / NCI NIH HHS / CA / CA097308-02; United States / NCI NIH HHS / CA / R01 CA092361; United States / NCI NIH HHS / CA / CA097308-01; United States / NIBIB NIH HHS / EB / EB006466-02; United States / NIBIB NIH HHS / EB / EB006466-01A1; United States / NIBIB NIH HHS / EB / R21 EB006466-01A1; United States / NIBIB NIH HHS / EB / R21 EB006466-02; United States / NCI NIH HHS / CA / R21 CA097308; United States / NCI NIH HHS / CA / R21 CA097308-02

[Publication-type] Journal Article; Research Support, N.I.H., Extramural

[Publication-country] United States

[Other-IDs] NLM/ NIHMS100571; NLM/ PMC2836393

   

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[Title] Perianal squamous cell carcinoma with high-grade anal intraepithelial neoplasia in an HIV-positive patient using highly active antiretroviral therapy: case report.

CONTEXT: Highly active antiretroviral therapy (HAART) has turned human immunodeficiency virus (HIV) infection into a chronic condition, and this has led to increased incidence of anal dysplasia among HIV-positive patients.

Routine anal evaluation including the anal canal and perianal area is recommended for this population, especially for patients infected by oncogenic human papillomavirus (HPV) types.

CASE REPORT: A 54-year-old homosexual HIV-positive man presented with a six-year history of recurrent perianal and anal warts.

He presented some condylomatous spreading lesions occupying part of the anal canal and the perianal skin, and also a well-demarcated slightly painful perianal plaque of dimensions 1.0 x 1.0 cm.

Both anal canal Pap smears and biopsies guided by high-resolution anoscopy revealed high-grade squamous intraepithelial lesion.

Biopsies of the border of the perianal plaque also revealed high-grade squamous intraepithelial lesion.

HPV DNA testing of the anus detected the presence of HPV-16 type.

The patient underwent local full-thickness excision of the lesion.

Histological analysis on the excised tissue revealed high-grade squamous intraepithelial lesion with one focus of microinvasive squamous cell cancer measuring 1 mm.

The patient showed pathological evidence of recurrent anal and perianal high-grade squamous intraepithelial lesions at the sixth-month follow-up and required further ablation of those lesions.

However no invasive squamous cell carcinoma recurrence has been detected so far.

[MeSH-major] Antiretroviral Therapy, Highly Active / adverse effects. Anus Neoplasms / pathology. Carcinoma, Squamous Cell / pathology. HIV Seropositivity / drug therapy. Human papillomavirus 16 / isolation & purification. Papillomavirus Infections / pathology

[MeSH-minor] Anal Canal / pathology. Anal Canal / virology. DNA, Viral / analysis. Humans. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Recurrence, Local / diagnosis

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(PMID = 18094898.001).

[ISSN] 1516-3180

[Journal-full-title] São Paulo medical journal = Revista paulista de medicina

[ISO-abbreviation] Sao Paulo Med J

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] Brazil

[Chemical-registry-number] 0 / DNA, Viral

   

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[Title] Blast injuries of large tyres: case series.

BACKGROUND: Severe blast injuries of large tyres are similar to those resulting from landmine explosions with neither thermal nor chemical effects.

Little has been written about the destructive nature of these blasts.

PATIENTS AND METHODS: All patients who had tyre blast injuries and were admitted to Al-Ain or Tawam Hospitals between March 2003 and September 2009 were retrospectively studied.

On arrival to the hospital, two patients were unconscious with GCS of 3/15.

Three patients had multiple injuries to different body parts (43%).

Five patients were admitted to the ICU with a median (range) ICU stay of 2 (1-2) days.

[MeSH-major] Blast Injuries / etiology. Motor Vehicles. Multiple Trauma / diagnosis. Multiple Trauma / mortality

[MeSH-minor] Abdominal Injuries / diagnosis. Abdominal Injuries / mortality. Abdominal Injuries / therapy. Adult. Air Pressure. Cohort Studies. Combined Modality Therapy. Craniocerebral Trauma / diagnosis. Craniocerebral Trauma / mortality. Craniocerebral Trauma / therapy. Explosions. Fracture Fixation / methods. Humans. Injury Severity Score. Male. Middle Aged. Prognosis. Reconstructive Surgical Procedures / methods. Retrospective Studies. Risk Assessment. Surgical Procedures, Operative / methods. Survival Analysis. United Arab Emirates. Wound Healing / physiology

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[Copyright] Copyright 2009 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

(PMID = 20006742.001).

[ISSN] 1743-9159

[Journal-full-title] International journal of surgery (London, England)

[ISO-abbreviation] Int J Surg

[Language] eng

[Publication-type] Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] England

   

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OBJECTIVES: The authors described their experience with the therapy with pegylated interferon and its safety in patients with hepatitis C virus (HCV) induced liver cirrhosis treated at First Department of Medicine, Medical School, University of Pécs and at Tawam Hospital, Al Ain, United Arab Emirates.

Liver cirrhosis was diagnosed by abdominal ultrasound and/or histological examination of liver biopsy.

RESULTS: Different genotypes of HCV were detected: genotype 1 in 7 cases, genotype 2 in 1 person, genotype 3 in 3 cases.

Thirteen of 24 patients were not treated earlier, 6 persons were non-responders to previous interferon monotherapy, pegylated interferon was administered to 5 patients because of relapse.

Biochemical parameters showed improvement in 16 cases (16/24, 66.66%), but did not in 5 patients.

Temporary dose reduction was needed in 13/24 cases (54.16%).

CONCLUSIONS: Pegylated interferon treatment is well tolerated by patients with compensated liver cirrhosis (Child-Pough stage A).

Frequent side-effects (half of all cases) were usually mild or moderate requiring discontinuation only in 2 of 24 patients.

The incidence of neutropenia and thrombocytopenia emphasizes the need of frequent blood cell count tests and patients follow up.

[MeSH-minor] DNA, Viral / isolation & purification. Drug Resistance, Viral. Female. Genotype. Humans. Hungary. Male. Middle Aged. Neutropenia / chemically induced. Polymerase Chain Reaction. Recombinant Proteins. Severity of Illness Index. Thrombocytopenia / chemically induced. Treatment Outcome. United Arab Emirates

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(PMID = 16408382.001).

[ISSN] 0030-6002

[Journal-full-title] Orvosi hetilap

[ISO-abbreviation] Orv Hetil

[Language] hun

[Publication-type] Clinical Trial; English Abstract; Journal Article; Multicenter Study

[Publication-country] Hungary

[Chemical-registry-number] 0 / Antiviral Agents; 0 / DNA, Viral; 0 / Interferon-alpha; 0 / Recombinant Proteins; 0 / peginterferon alfa-2a; 0 / peginterferon alfa-2b; 30IQX730WE / Polyethylene Glycols; 76543-88-9 / interferon alfa-2a; 99210-65-8 / interferon alfa-2b

   

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[Title] Expression of proliferative biomarkers in anal intraepithelial neoplasia of HIV-positive men.

BACKGROUND: Anal intraepithelial neoplasia (AIN), a human papillomavirus (HPV)-associated precursor lesion of anal carcinoma, is highly prevalent among HIV-infected individuals, especially in men having sex with men (MSM).

Early diagnosis and treatment of AIN might prevent development of anal cancer.

OBJECTIVES: We aimed to evaluate the expression of 8 promising proliferative biomarkers in anal dysplasia and to compare the efficacy of these markers in diagnosing high-grade AIN.

METHODS: Immunohistochemical analysis of minichromosome maintenance proteins (MCM3, MCM4, MCM6, and MCM7), p21, Ki-67, p16, and proliferating cell nuclear antigen (PCNA) was performed in a total of 49 specimens of normal anal mucosa and high- and low-grade anal dysplasia.

HPV typing for 36 high- and low-risk HPVs was performed, and high-risk HPV-DNA loads were determined by real-time polymerase chain reaction (PCR) for HPV-types 16, 18, 31, and 33.

RESULTS: A total of 392 immunohistochemical slides were analyzed in this study.

In the progression from normal epithelium to high-grade dysplasia, we found significant differences in the expression of all biomarkers.

A cutoff of 25% or 50% lesional immunopositivity for the 4 MCMs, Ki-67, and p16 resulted in 100% sensitivity and 100% specificity to diagnose high-grade AIN.

Sensitivity and specificity of PCNA and p21 for a high-grade AIN diagnosis were lower.

HPV-DNA was detectable in 100% of high-grade AIN and 87.5% of low-grade AIN lesions.

All MCMs, p16, Ki-67, and PCNA, but not p21 correlated with cumulative lesional high-grade HPV-DNA loads.

LIMITATIONS: The relatively small number of samples is a limitation, especially for adequate subgroup analyses.

CONCLUSIONS: MCMs, Ki67, and p16 are reliable immunohistochemical adjuncts for diagnosing high-grade AIN.

[MeSH-major] Anus Neoplasms / pathology. Biomarkers, Tumor / analysis. Carcinoma in Situ / pathology. HIV Infections / diagnosis. Proliferating Cell Nuclear Antigen / metabolism

[MeSH-minor] Adult. Aged. Analysis of Variance. Antiretroviral Therapy, Highly Active / methods. Biopsy, Needle. DNA, Viral / analysis. HIV Seropositivity. Homosexuality, Male. Humans. Immunohistochemistry. Intestinal Mucosa / metabolism. Intestinal Mucosa / pathology. Male. Middle Aged. Neoplasm Staging. Papillomavirus Infections / complications. Papillomavirus Infections / diagnosis. Polymerase Chain Reaction / methods. Precancerous Conditions / pathology. Reference Values. Risk Assessment. Sensitivity and Specificity. Viral Load. Young Adult

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[Copyright] Copyright 2009 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

(PMID = 20006407.001).

[ISSN] 1097-6787

[Journal-full-title] Journal of the American Academy of Dermatology

[ISO-abbreviation] J. Am. Acad. Dermatol.

[Language] eng

[Publication-type] Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] United States

[Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / DNA, Viral; 0 / Proliferating Cell Nuclear Antigen

   

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This provided the rationale for the development of a multicolor fluorescence in situ hybridization (FISH) probe set as a diagnostic tool for the direct detection of TERC gains in Pap smears.

We previously used this probe set to show that cervical intraepithelial neoplasia (CIN) 2 and CIN3 lesions could be distinguished from normal samples, atypical squamous cell of undetermined significance (ASCUS) and CIN1, with a sensitivity and specificity exceeding 90%, independent of the cytomorphological assessment.

In the current study, we explored whether gain of 3q and amplification of TERC could predict progression from CIN1/CIN2 to CIN3 and invasive carcinoma.

Of note, 3q gain was found in 33% of cytologically normal Pap smears from women who were diagnosed with CIN3 or invasive cervical carcinoma after a short latency.

[MeSH-major] Biomarkers, Tumor / analysis. Cervical Intraepithelial Neoplasia / genetics. Cervical Intraepithelial Neoplasia / pathology. RNA / genetics. Telomerase / genetics. Uterine Cervical Neoplasms / genetics. Uterine Cervical Neoplasms / pathology

[MeSH-minor] Adult. Disease Progression. Female. Humans. In Situ Hybridization, Fluorescence. Middle Aged. Papanicolaou Test. Retrospective Studies. Sensitivity and Specificity. Vaginal Smears

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(PMID = 15793301.001).

[ISSN] 0002-9440

[Journal-full-title] The American journal of pathology

[ISO-abbreviation] Am. J. Pathol.

[Language] eng

[Publication-type] Journal Article

[Publication-country] United States

[Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / telomerase RNA; 63231-63-0 / RNA; EC 2.7.7.49 / Telomerase

[Other-IDs] NLM/ PMC1602397

   

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[Title] Risk of anogenital cancer after diagnosis of cervical intraepithelial neoplasia: a prospective population-based study.

BACKGROUND: The first vaccine against human papillomavirus (HPV)-related disease is now available.

Associations between HPV and vaginal, vulvar, and anal cancers are well established, but the full extent in terms of age and time since diagnosis of these associations is not well known.

Using national registration numbers, we linked this cohort to nationwide population, migration, cancer, and death registers.

The incidence rate ratios (IRRs) of vaginal, vulvar, anal, and rectal cancer in women with a history of a cervical intraepithelial neoplasm (CIN), grade 3, compared with women with no such history were estimated by use of multivariate Poisson regression.

FINDINGS: Women with a history of grade 3 CIN had increased risks of cancer of the vagina (6.74 [95% CI 5.24-8.56]), vulva (2.22 [1.79-2.73]), and anus (IRR 4.68 [3.87-5.62]).

For all four anatomical sites, the IRRs varied substantially with the amount of time that had elapsed since the date of first diagnosis of grade 3 CIN.

Analyses stratified by attained age during follow-up showed that the risk of cancer conferred by a history of diagnosis of grade 3 CIN was highly age dependent.

The observed increased risks were not explained by smoking or socioeconomic status.

INTERPRETATION: This study confirms the known association between history of CIN, presumed HPV infection, and increased risk of cancers of the vagina, vulva, and anus by use of large and complete databases, but also shows that this risk varies both by the time from initial diagnosis of grade 3 CIN and by the age of the individual.

[MeSH-major] Anus Neoplasms / complications. Cervical Intraepithelial Neoplasia / complications. Genital Neoplasms, Female / complications. Uterine Cervical Neoplasms / complications

[MeSH-minor] Adolescent. Adult. Age Factors. Cohort Studies. Female. Humans. Incidence. Middle Aged. Multivariate Analysis. Prospective Studies. Registries / statistics & numerical data. Regression Analysis. Risk Factors. Sweden / epidemiology. Time Factors

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[CommentIn] Lancet Oncol. 2007 Apr;8(4):281-2 [17395100.001]

(PMID = 17395104.001).

[ISSN] 1470-2045

[Journal-full-title] The Lancet. Oncology

[ISO-abbreviation] Lancet Oncol.

[Language] eng

[Publication-type] Journal Article

[Publication-country] England

   

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[Title] Anal dysplasia screening: an evidence-based analysis.

OBJECTIVE: This review considered the role of the anal Pap test as a screening test for anal dysplasia in patients at high risk of anal SCC.

High-resolution anoscopy (a method to view the rectal area, using an anoscope, a lighted instrument inserted into the rectum) rather than routine anoscopy-guided biopsy, is also now considered to be the diagnostic standard.

CLINICAL NEED: TARGET POPULATION AND CONDITION Anal cancer, like cervical cancer, is a member of a broader group of anogenital cancers known to be associated with sexually transmitted viral HPV infection.

Sexual practices involving receptive anal intercourse lead to significantly elevated risk for anal dysplasia and cancer, particularly in those with immune dysfunctions.

Anal cancer is rare.

It is the least common of the lower gastrointestinal cancers, representing about 4% of them, in contrast to colorectal cancers, which remain the third most commonly diagnosed malignancy.

Certain segments of the population, however, such as HIV-positive men and women, other chronic immune-suppressed patients (e.g., after a transplant), injection drug users, and women with genital dysplasia /cancer, have a high susceptibility to anal cancer.

Those with the highest identified risk for anal cancer are HIV-positive homosexual and bisexual men, at a rate of 70 per 100,000 men.

The risk for anal cancer is reported to be increasing dramatically in HIV-positive males and females, particularly since the introduction of highly active antiretroviral therapy in the mid-1990s.

The introduction of effective viral therapy has been said to have transformed the AIDS epidemic in developed countries into a chronic disease state of long-term immunosuppression.

About 28% of the newly diagnosed HIV infections are in women, a doubling since 1999.

It has also been estimated that 1 of 3 people living with HIV do no know it.

HEALTH TECHNOLOGY DESCRIPTION: Anal Pap test screening involves the blind insertion of a swab into the anal canal and fixing cells either on a slide or in fluid for cytological examination.

Anal cytology classified by the standardized Bethesda System is the same classification used for cervical cytology.

It has 4 categories: normal, atypical squamous cells of uncertain significance, or squamous intraepithelial lesions which are further classified into low- or high-grade lesions.

Several HPV deoxyribonucleic acid detection technologies such as the Hybrid 11 Capture and the polymerase chain reaction are available to detect and differentiate HPV viral strains.

Unlike cervical cancer, there are no universally accepted guidelines or standards of care for anal dysplasia.

The New York State Department of Health AIDS Institute has recently recommended (March 2007) annual anal pap testing in high-risk groups.

That is, there is no reimbursement for anal Pap testing in men or women, and HPV screening tests for cervical or anal cancer are also not reimbursed.

Assessments of current practices were obtained through consultations with various agencies and individuals including the Ministry of Health and Long-Term Care AIDS Bureau; Public Health Infectious Diseases Branch, Ministry of Health and Long-Term Care; Cancer Care Ontario; HIV/AIDS researchers; pathology experts; and HIV/AIDS clinical program directors.

FINDINGS: No direct evidence was found for the existence of controlled studies evaluating the effectiveness of anal Pap test screening programs for impact on anal cancer morbidity or mortality.

In addition, no studies were found on the use of HPV DNA testing in the screening or diagnostic setting for anal dysplasia.

The reported prevalence of HPV infection in high-risk groups, particularly HIV-positive males, however, was sufficiently high to preclude any utility of HPV testing as an adjunct to anal Pap testing.

Nine reports involving studies in the United States, United Kingdom, and Canada were identified that evaluated the performance characteristics of anal Pap test screening for anal dysplasia.

All studies involved experienced pathologists, so the results generally represent best-case scenarios.

Estimates of anal Pap test sensitivity and specificity were highly variable, and depended on the varying prevalence of cytology abnormality and differential thresholds for abnormality for both cytology and histopathology.

In the largest study of HIV-positive males, sensitivity varied from 46% (95% confidence interval [CI], 36%-56%) to 69% (95% CI, 60%-78%).

In the only study of HIV-negative males, sensitivity ranged from 26% (95% CI, 5%-47%) to 47% (95% CI, 26%-68%).

In comparison, cervical Pap testing has also been evaluated mainly in settings where there is a high prevalence of the disease, and estimates of sensitivitykij and specificity were also low and highly variable.

CONCLUSIONS: No direct evidence exists to support the effectiveness of an anal Pap test screening program to reduce anal cancer mortality or morbidity.

Sexually transmitted HPV viral infection is currently the acknowledged common causative agent for both anal and cervical cancer.

Anal cancer rates in high-risk populations are approaching those of cervical cancer before the implementation of Pap testing.

The anal Pap test, although it has been mainly evaluated only in HIV-positive males, has similar operating characteristics of sensitivity and specificity as the cervical Pap test.

In general, the treatment options for precancer dysplasia in the cervix and the anus are similar, but treatment involving a definitive surgical resection in the anus is more limited because of the higher risk of complications.

A range of ablative therapies has been applied for anal dysplasia, but evidence on treatment effectiveness, tolerability and durability, particularly in the HIV-positive patient, is limited.

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(PMID = 23074504.001).

[ISSN] 1915-7398

[Journal-full-title] Ontario health technology assessment series

[ISO-abbreviation] Ont Health Technol Assess Ser

[Language] eng

[Publication-type] Journal Article

[Publication-country] Canada

[Other-IDs] NLM/ PMC3377578

   

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[Title] Application of alpha-methylacyl coenzyme A racemase immunohistochemistry in the diagnosis of prostate cancer: a review.

Since its discovery, AMACR has gained wide acceptance for use in the diagnosis of prostatic adenocarcinoma in conjunction with morphology and immunohistochemical staining for basal cell markers.

This review focuses on AMACR expression in prostate cancer and its morphologic variants, high grade prostatic intraepithelial neoplasia, adenosis and benign conditions of the prostate.

We also focus on the utility and technical aspects of the now-popular "triple stain" immunohistochemical antibody cocktail, consisting of antibodies to high-molecular-weight keratin, p63 and AMACR.

Finally, we emphasize diagnostic pitfalls in the application of AMACR to small, atypical foci of glands seen on prostate needle core biopsy and project future diagnostic as well as clinical applications for the protein.

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(PMID = 16566275.001).

[ISSN] 0884-6812

[Journal-full-title] Analytical and quantitative cytology and histology

[ISO-abbreviation] Anal. Quant. Cytol. Histol.

[Language] ENG

[Publication-type] Evaluation Studies; Journal Article; Review

[Publication-country] United States

[Chemical-registry-number] 0 / Biomarkers, Tumor; EC 5.1.- / Racemases and Epimerases; EC 5.1.99.4 / alpha-methylacyl-CoA racemase

[Number-of-references] 63

   

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[Title] Human papillomavirus-associated diseases in HIV-infected men who have sex with men.

This review summarizes recent data on papillomavirus-induced anal intraepithelial neoplasia and anal cancer in these patients.

Moreover, data are provided on penile and oral HPV-associated diseases, for which only limited information is available in the literature.

RECENT FINDINGS: The incidence of anal intraepithelial neoplasia rises in HIV-positive men who have sex with men despite the introduction of highly active antiretroviral therapy.

Increasing evidence indicates that high-grade lesions can progress to anal cancer over time.

Anal cytology has been recommended as the primary screening tool for anal dysplasia in the at-risk population.

Anal cancer has become one of the most common non-AIDS-defining tumors in HIV-infected individuals.

In the era of highly active antiretroviral therapy, the outcome of combined chemoradiotherapy in HIV-positive individuals with anal cancer is similar to that in HIV-negative persons.

Penile and oral HPV-associated diseases seem to be more frequent in HIV-positive men than reported for HIV-negative heterosexual men.

SUMMARY: Diagnostic and therapeutic guidelines should be implemented for at-risk populations for anal dysplasia/anal cancer, such as HIV-positive men who have sex with men.

More study is required to get better insights into the natural history of penile and oral HPV-associated benign and malignant lesions.

[MeSH-major] Anus Neoplasms / epidemiology. Anus Neoplasms / virology. HIV Infections / complications. Papillomaviridae / isolation & purification. Papillomavirus Infections / complications. Papillomavirus Infections / epidemiology

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(PMID = 19276878.001).

[ISSN] 1473-6527

[Journal-full-title] Current opinion in infectious diseases

[ISO-abbreviation] Curr. Opin. Infect. Dis.

[Language] eng

[Publication-type] Journal Article; Review

[Publication-country] United States

[Number-of-references] 40

   

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[Title] The fear factor: drivers and barriers to follow-up screening for human papillomavirus-related anal cancer in men who have sex with men.

Human papillomavirus (HPV)-related anal cancer incidence is rising in men who have sex with men (MSM).

Retrospective chart review identified MSM with anal dysplasia.

From June 2007 to March 2008, subjects completed a questionnaire in-person at the time of screening or via telephone (LTF).

Questionnaires were completed after anal dysplasia diagnosis.

RF were more likely to describe their HPV diagnosis as 'upsetting' (P = 0.003).

MSM with high-grade intraepithelial lesions (HSIL) were more likely to be RF versus those with low-grade intraepithelial lesions (P = 0.001.

Positive predictors for screening compliance include an upsetting experience during the HPV diagnosis, physical symptoms driving the initial visit and HSIL.

[MeSH-major] Anus Neoplasms / diagnosis. Anus Neoplasms / psychology. Early Detection of Cancer / psychology. Homosexuality, Male. Papillomavirus Infections / diagnosis. Patient Compliance / statistics & numerical data

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(PMID = 20852198.001).

[ISSN] 1758-1052

[Journal-full-title] International journal of STD & AIDS

[ISO-abbreviation] Int J STD AIDS

[Language] eng

[Publication-type] Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] England

   

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[Title] Detection of pre-neoplastic and neoplastic prostate disease by MALDI profiling of urine.

Existing prostate cancer screening paradigms have relatively poor specificity for cancer relative to other prostate diseases, commonly benign prostatic hyperplasia (BPH).

A method for discrimination of BPH, HGPIN, and PCa urine proteome was developed through testing 407 patient samples using matrix assisted laser desorption-mass spectrometry time of flight (MALDI-TOF).

The high throughput, low-cost assay method developed is amenable for large patient numbers required for supporting biomarker identification.

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(PMID = 17194448.001).

[ISSN] 0006-291X

[Journal-full-title] Biochemical and biophysical research communications

[ISO-abbreviation] Biochem. Biophys. Res. Commun.

[Language] ENG

[Grant] United States / NCI NIH HHS / CA / R21 CA098348; United States / NCI NIH HHS / CA / CA098348-02; United States / NCI NIH HHS / CA / P30 CA068485; United States / NIGMS NIH HHS / GM / K12 GM068543-04; United States / NIGMS NIH HHS / GM / K12 GM068543; United States / NCI NIH HHS / CA / CA68485; United States / NIGMS NIH HHS / GM / GM068543-04; United States / NCI NIH HHS / CA / CA98348; United States / NIGMS NIH HHS / GM / 5K12GM068543; United States / NCI NIH HHS / CA / R21 CA098348-02

[Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.

[Publication-country] United States

[Chemical-registry-number] 0 / Peptides

[Other-IDs] NLM/ NIHMS16682; NLM/ PMC2562600

   

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[Title] Screening HIV-infected individuals for anal cancer precursor lesions: a systematic review.

Individuals with human immunodeficiency virus (HIV) infection are at increased risk for human papillomavirus-related squamous cell cancer of the anus.

Screening HIV-infected patients for squamous cell cancer of the anus and human papillomavirus-related anal dysplasia may prevent excess morbidity and mortality.

We have conducted a systematic review of the indirect evidence in the literature regarding the utility of anal Papanicolau (Pap) smear screening of HIV-infected individuals in the highly active antiretroviral therapy era.

Although there are no published studies evaluating the efficacy of anal Pap smear screening for preventing squamous cell cancer of the anus or anal intraepithelial neoplasia, we reviewed data regarding the burden of disease, anal Pap smear sensitivity and specificity, the prevalence of anal dysplasia, and 1 cost effectiveness study.

The available evidence demonstrates that HIV-infected individuals have an increased risk for squamous cell cancer of the anus and anal intraepithelial neoplasia.

This review identifies important areas for further study before routine anal Pap smear screening can be recommended.

[MeSH-major] Anus Neoplasms / diagnosis. Carcinoma, Squamous Cell / diagnosis. HIV Infections / complications. Papanicolaou Test. Papillomavirus Infections / diagnosis. Precancerous Conditions / diagnosis. Vaginal Smears

[MeSH-minor] Antiretroviral Therapy, Highly Active. Carcinoma in Situ / diagnosis. Carcinoma in Situ / etiology. Female. Humans. Male. Mass Screening. Papillomaviridae

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(PMID = 16779751.001).

[ISSN] 1537-6591

[Journal-full-title] Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

[ISO-abbreviation] Clin. Infect. Dis.

[Language] eng

[Grant] United States / NIMH NIH HHS / MH / K23MH67505

[Publication-type] Journal Article; Research Support, N.I.H., Extramural; Review

[Publication-country] United States

[Number-of-references] 100

   

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INTRODUCTION: Antibiotics-induced acute interstitial nephritis (AIN) is a rare disorder in children, and the diagnosis is often delayed.

PATIENTS AND METHODS: We reviewed the medical records of 6 children, age range from 10 months to 14 years, with biopsy-confirmed antibiotics-induced AIN.

RESULTS: Symptoms of AIN started 2-4 weeks after antimicrobial therapy with beta-lactam antibiotics in 5 children and with gentamicin in 1 child.

The glomerular filtration rate was dramatically reduced in 2 cases and mildly reduced in 4 patients.

Two of our patients had supportive treatment, 2 received corticosteroid therapy, and 2 children remained under peritoneal dialysis for 12 and 22 days, respectively.

Five patients had a full recovery of their renal function, and 1 child, 2 years later, still presented impairment of the renal function.

CONCLUSION: AIN should be considered in case of acute renal failure in children, mostly when other common causes have been excluded, and there is a history of drug exposure.

[MeSH-minor] Acute Disease. Adolescent. Child. Female. Humans. Infant. Male

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[Copyright] 2006 S. Karger AG, Basel.

(PMID = 16679839.001).

[ISSN] 0042-1138

[Journal-full-title] Urologia internationalis

[ISO-abbreviation] Urol. Int.

[Language] eng

[Publication-type] Journal Article

[Publication-country] Switzerland

[Chemical-registry-number] 0 / Anti-Bacterial Agents

   

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While much is known about the natural history of cervical human papillomavirus (HPV) infection and its consequences, including cervical intraepithelial neoplasia and cervical cancer, relatively little is known about the natural history of anogenital HPV infection and diseases in men.

Anal HPV infection and disease also remain poorly understood.

Although HPV is transmitted sexually and infects the genitals of both sexes, the cervix remains biologically more vulnerable to malignant transformation than does the penis or anus in men.

However, it is also important due to the burden of disease in men, who may develop both penile and anal cancer, particularly among HIV-positive men who have sex with men.

Improved sampling techniques of the male genitalia and cohort studies in progress should provide important information on the natural history of anogenital HPV infection and disease in men, including risk factors for HPV acquisition and transmission.

[MeSH-major] Genital Diseases, Male / etiology. Papillomavirus Infections / etiology

[MeSH-minor] Anus Neoplasms / diagnosis. Anus Neoplasms / etiology. Anus Neoplasms / virology. Carcinoma in Situ / etiology. Carcinoma in Situ / virology. Condylomata Acuminata / etiology. Condylomata Acuminata / virology. Female. Humans. Male. Papillomaviridae / genetics. Papillomaviridae / isolation & purification. Papillomaviridae / pathogenicity. Penile Neoplasms / diagnosis. Penile Neoplasms / etiology. Penile Neoplasms / virology. Sexual Partners

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(PMID = 17627061.001).

[ISSN] 0278-0240

[Journal-full-title] Disease markers

[ISO-abbreviation] Dis. Markers

[Language] eng

[Publication-type] Journal Article; Review

[Publication-country] Netherlands

[Number-of-references] 78

[Other-IDs] NLM/ PMC3851123

   

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[Title] Malignant transformation of high-grade anal intraepithelial neoplasia.

BACKGROUND: The natural history of anal intraepithelial neoplasia (AIN) is uncertain.

METHODS: All patients were diagnosed with high-grade AIN (AIN III) between 1994 and 2003.

Diagnosis was by full-thickness biopsy and histopathological examination.

Excision of localized high-grade AIN was carried out in 28 patients with minimal morbidity.

Six patients were systemically immunosuppressed at diagnosis, all of whom had multifocal perianal lesions.

Three immunosuppressed patients developed invasive anal squamous carcinoma during follow-up.

By contrast, no invasive carcinomas were identified among immunocompetent patients with either localized or multifocal perianal disease.

CONCLUSION: AIN III appears to have a relatively low potential for malignant transformation in the immunocompetent patient.

However, immunosuppressed patients are more likely to have extensive AIN III and a greater risk of malignant change.

[MeSH-major] Anus Neoplasms / pathology. Carcinoma in Situ / pathology. Cell Transformation, Neoplastic / pathology

[MeSH-minor] Adult. Carcinoma, Squamous Cell / pathology. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Invasiveness / pathology. Neoplasm Recurrence, Local. Prospective Studies

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[Copyright] Copyright 2005 British Journal of Surgery Society Ltd.

(PMID = 16044425.001).

[ISSN] 0007-1323

[Journal-full-title] The British journal of surgery

[ISO-abbreviation] Br J Surg

[Language] eng

[Publication-type] Journal Article

[Publication-country] England

   

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[Title] Detection of anti-neutrophil antibodies in autoimmune neutropenia of infancy: a multicenter study.

Primary AIN is characterized by neutrophil count < 500 ml and a benign self-limiting course.

Detecting specific antibodies against the polymorphic human neutrophil antigen usually confirms the diagnosis.

METHODS: We evaluated 120 children with a clinical suspicion of AIN, whose sera were analyzed by flow cytometry for the presence of autoantibodies using the indirect granulocyte immunofluorescence test.

RESULTS: Our method showed specificity of 85%, sensitivity of 62.5%, and a positive predictive value of 91.8%, values quite similar to those obtained by more traditional methods.

[MeSH-major] Antibodies, Antineutrophil Cytoplasmic / blood. Autoimmune Diseases / immunology. Neutropenia / immunology

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(PMID = 20550032.001).

[ISSN] 1565-1088

[Journal-full-title] The Israel Medical Association journal : IMAJ

[ISO-abbreviation] Isr. Med. Assoc. J.

[Language] eng

[Publication-type] Journal Article; Multicenter Study

[Publication-country] Israel

[Chemical-registry-number] 0 / Antibodies, Antineutrophil Cytoplasmic

   

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[Title] Outcome of treated anogenital intraepithelial neoplasia among human immunodeficiency virus-infected women.

OBJECTIVE: To determine characteristics and clinical course of high-grade anogenital intraepithelial neoplasia (AIN) in human immunodeficiency virus (HIV)-infected women.

STUDY DESIGN: HIV-positive women with biopsy-proven high-grade (II and III) vulvar (VIN), vaginal (VAIN) or perianal intraepithelial neoplasia (PAIN) were identified in the electronic databases of 2 colposcopy clinics.

Of the patients, 77.4% had VIN, 12.9% VAIN and 9.7% PAIN at first diagnosis.

Age at diagnosis of IN was 36.2 years (SD +/- 5.2; range, 23.5-47.0).

Ninety percent of patients received antiretroviral therapy at first diagnosis of IN; 65% (13 of 20) of patients with a follow-up of > 2 years required a second treatment, and 2 developed invasive vulvar cancer (10%).

CONCLUSION: AIN among HIV-positive women shows a high relapse rate despite treatment modality used and a substantial invasive potential.

[MeSH-major] Anus Neoplasms / therapy. Carcinoma in Situ / therapy. HIV Infections / complications. Vaginal Neoplasms / therapy. Vulvar Neoplasms / therapy

[MeSH-minor] Adult. Cohort Studies. Disease-Free Survival. Female. Humans. Middle Aged. Retrospective Studies. Young Adult

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(PMID = 19160654.001).

[ISSN] 0024-7758

[Journal-full-title] The Journal of reproductive medicine

[ISO-abbreviation] J Reprod Med

[Language] eng

[Publication-type] Journal Article

[Publication-country] United States

   

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Diseases that cause small bowel perforation vary in different areas of the world.

OBJECTIVE: To highlight difficulties in the diagnosis and management of non-traumatic perforation of small bowel.

MATERIAL AND METHODS: The medical records of four patients who have presented with non-traumatic perforation of the small bowel and were treated at Al-Ain Hospital during the last 5 years were studied retrospectively.

Erect chest X-ray has shown free air under diaphragm in 3 patients.

Leukocytosis was present in only one patient.

HIV was confirmed in one patient.

Patients were diagnosed to have typhoid, HIV, hook worms and tuberculosis.

Only the HIV patient died while the others were discharged home in a good condition.

CONCLUSION: Clinical findings of small bowel perforation are usually non specific and diagnosis is usually reached after surgery.

[MeSH-major] Cytomegalovirus Infections / complications. Hookworm Infections / complications. Ileal Diseases / etiology. Intestinal Perforation / etiology. Typhoid Fever / complications

[MeSH-minor] Adult. Aged. Anti-Bacterial Agents / administration & dosage. Anti-Bacterial Agents / therapeutic use. Antinematodal Agents / administration & dosage. Antinematodal Agents / therapeutic use. Crohn Disease / complications. Crohn Disease / diagnosis. Diagnosis, Differential. Fatal Outcome. Humans. Laparotomy. Male. Mebendazole / administration & dosage. Mebendazole / therapeutic use. Middle Aged. Retrospective Studies. Time Factors. Treatment Outcome. Tuberculosis / complications. Tuberculosis / diagnosis. Tuberculosis, Gastrointestinal / complications. Tuberculosis, Gastrointestinal / diagnosis

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[Cites] Am Surg. 2000 Feb;66(2):219-22 [10695758.001]

[Cites] Hepatogastroenterology. 2002 Jul-Aug;49(46):1017-22 [12143191.001]

[Cites] Jpn J Surg. 1985 May;15(3):205-8 [4032865.001]

[Cites] J Gastroenterol Hepatol. 1994 May-Jun;9(3):291-303 [8054532.001]

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[Cites] Br J Surg. 1997 Apr;84(4):558-9 [9112919.001]

(PMID = 19357730.001).

[ISSN] 1729-0503

[Journal-full-title] African health sciences

[ISO-abbreviation] Afr Health Sci

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] Uganda

[Chemical-registry-number] 0 / Anti-Bacterial Agents; 0 / Antinematodal Agents; 81G6I5V05I / Mebendazole

[Other-IDs] NLM/ PMC2408541

   

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[Title] Prevalence of food allergy among children in Al-Ain city, United Arab Emirates.

However, the prevalence of FA in the United Arab Emirates (UAE) has not yet been determined.

This cross-sectional study was carried out to assess the prevalence of FA among school children aged 6-9 years in Al-Ain city, UAE.

METHODS: We used multistage random sampling in order to get a sample of 397 school children whose parents completed a self-administered questionnaire designed to assess the presence or absence of physician diagnosis of FA and other allergic diseases.

RESULTS: The study showed that the prevalence of physician-diagnosed FA in children was 8% (95% CI 5.4-10.8%).

FA was independently related to a family history of FA, to a small sibship size and to a personal history of other atopic diseases.

CONCLUSIONS: The prevalence of FA in Al-Ain city was 8%.

A history of FA in first-degree family members and a small sibship size were associated with a higher risk of FA in children.

FA was related to a personal history of other atopic diseases.

[MeSH-minor] Child. Cross-Sectional Studies. Female. Fish Products / adverse effects. Humans. Male. Prevalence. Risk Factors. Surveys and Questionnaires. United Arab Emirates

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[Copyright] 2009 S. Karger AG, Basel.

(PMID = 19851075.001).

[ISSN] 1423-0097

[Journal-full-title] International archives of allergy and immunology

[ISO-abbreviation] Int. Arch. Allergy Immunol.

[Language] eng

[Publication-type] Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] Switzerland

[Chemical-registry-number] 0 / Allergens

   

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A case of mesalazine-induced acute interstitial nephritis (AIN) in a 41-year-old patient with ulcerative colitis (UC) is reported here.

Clinical symptoms such as fever and arthralgia, and laboratory findings such as eosinophilia and renal failure suggested AIN, which was confirmed by biopsy.

With withdrawal of mesalazine and intravenous methylprednisolone the patient's renal function was recovered.

Delayed diagnosis may lead to permanent renal function impairment.

[MeSH-minor] Acute Disease. Adult. Humans. Male

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(PMID = 15877665.001).

[ISSN] 1320-5358

[Journal-full-title] Nephrology (Carlton, Vic.)

[ISO-abbreviation] Nephrology (Carlton)

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] Australia

[Chemical-registry-number] 0 / Anti-Inflammatory Agents, Non-Steroidal; 4Q81I59GXC / Mesalamine

   

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[Title] P16 and Ki67 immunostaining is a useful adjunct in the assessment of biopsies for HPV-associated anal intraepithelial neoplasia.

P16 is a tumor suppressor gene product, shown to be overexpressed in most cervical carcinomas and dysplasias associated with high-risk human papilloma virus (HPV) infection.

HPV is also associated with anal squamous dysplasias and carcinomas.

Significant interobserver and intraobserver variation exists in the interpretation of biopsies for anal intraepithelial neoplasia (AIN).

This study was undertaken to assess the potential role of p16 and Ki67 immunohistochemical expression in refining the diagnosis and grading of AIN.One-hundred and four anal biopsies from 74 patients were retrieved from the surgical pathology files of the department.

After discrepancies were resolved and concurrence was achieved by at least 2 of 3 reviewing pathologists, the diagnoses were as follows: 37 negative, 12 condylomas without overt dysplasia, 14 AIN I, 25 AIN II, and 16 AIN III. p16 and Ki67 expression was evaluated by ABC immunoperoxidase staining whereas the presence of the high-risk subtypes of HPV virus was determined by in situ hybridization on a subset of the biopsies.

Results were reviewed by 2 pathologists and positive and negative staining was correlated with H&E diagnoses.

Nuclear and/or nuclear and cytoplasmic staining was considered as positive for p16 when present in >10% of squamous cells.

A band-like pattern of p16 immunoreactivity was seen in 21.4% AIN I, 80% AIN II, and 87.5% AIN III cases.

None of the condylomas and only 1 of the negative cases showed a band of p16 positive staining.

Spotty p16 immunoreactivity was observed in 8.1% negative, 8.3% condyloma, 14.3% AIN I, 12.0% AIN II, and 12.5% AIN III cases.

More than 50% of nuclei stained positive for Ki67 in 28.6% AIN I, 48.0% AIN II, and 75.0% AIN III cases but in none of the negative or condyloma cases.

On the basis of these results, a band-like pattern of p16 staining and Ki67 positivity in >50% of the squamous cell nuclei were strongly associated with high-grade AIN.

Most AIN I lesions stained similar to the nondysplastic cases.

A small subset of biopsies studied did not conform to the pattern described above: 4 of 14 (28.6%) AIN I lesions showed a band-like pattern of p16 staining and/or >50% Ki67 positive nuclei.

4 of 25 (16.0%) AIN II lesions comprising 9.8% of the 41 high-grade AINs (AIN II and III) showed spotty p16 positivity and <50% Ki67 positive nuclei.

We conclude that when used together and evaluated in conjunction with H&E stained sections, p16 and Ki67 immunoexpression is a useful adjunct in the diagnosis and grading of AIN.

[MeSH-major] Anus Neoplasms / pathology. Carcinoma in Situ / pathology. Cyclin-Dependent Kinase Inhibitor p16 / metabolism. Ki-67 Antigen / metabolism. Papillomavirus Infections / pathology. Precancerous Conditions / pathology

[MeSH-minor] Adult. Aged. Biomarkers, Tumor / metabolism. Biopsy. Cell Nucleus / metabolism. Cell Nucleus / pathology. DNA, Viral / analysis. Female. Humans. Immunoenzyme Techniques. In Situ Hybridization. Male. Middle Aged. Papillomaviridae / genetics. Papillomaviridae / isolation & purification

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(PMID = 16819320.001).

[ISSN] 0147-5185

[Journal-full-title] The American journal of surgical pathology

[ISO-abbreviation] Am. J. Surg. Pathol.

[Language] eng

[Publication-type] Journal Article

[Publication-country] United States

[Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Cyclin-Dependent Kinase Inhibitor p16; 0 / DNA, Viral; 0 / Ki-67 Antigen

   

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[Title] p16 Improves interobserver agreement in diagnosis of anal intraepithelial neoplasia.

OBJECTIVES: Evaluation of anal intraepithelial neoplasia (AIN) is subjective.

Previous studies have shown p16 and Ki-67 expressions to correlate with AIN grade.

The objectives were (1) to determine the extent of interobserver agreement in evaluating AIN on routine hematoxylin and eosin (H&E) sections and (2) to test whether p16 and/or Ki-67 staining improve interobserver diagnostic agreement.

MATERIALS AND METHODS: Seventy-seven anal specimens were retrieved.

Blind to the original diagnoses, 4 pathologists assessed H&E alone, p16 alone, Ki-67 alone, and all 3 simultaneously.

Diagnoses were normal/reactive, AIN I/HPV, AIN II, and AIN III.

Fair agreement was observed using H&E diagnosis alone (kappa = 0.38, S = 0.56).

The p16 diagnostic evaluation demonstrated the highest agreement (kappa = 0.57, S = 0.73).

When the pathologists' diagnoses for all diagnostic evaluations were compared with consensus diagnoses, the lowest average magnitude of disagreement was seen with Ki-67 alone, followed by p16 alone, H&E/p16/Ki-67 combined, and H&E alone.

CONCLUSIONS: Interobserver agreement for diagnosis of AIN was fair when based solely on H&E preparation. p16 alone improved interobserver agreement and demonstrated superior agreement when compared with H&E, Ki-67, and H&E/p16/Ki-67 combined.

[MeSH-major] Anus Neoplasms / diagnosis. Carcinoma in Situ / diagnosis. DNA, Neoplasm / analysis. Gene Expression Regulation, Neoplastic. Genes, p16 / physiology

[MeSH-minor] Adult. Aged. Aged, 80 and over. Antigens, Neoplasm / analysis. Biopsy. Clinical Competence. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Observer Variation. Retrospective Studies

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(PMID = 19550211.001).

[ISSN] 1526-0976

[Journal-full-title] Journal of lower genital tract disease

[ISO-abbreviation] J Low Genit Tract Dis

[Language] eng

[Publication-type] Comparative Study; Journal Article

[Publication-country] United States

[Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / DNA, Neoplasm

   

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[Title] Pulmonary hemorrhage with acute renal injury in a patient with IgA nephropathy.

IgA nephropathy (IgAN) is a form of glomerular diseases which is usually aggravated by infection in respiratory or gastrointestinal systems.

Acute interstitial nephritis (AIN) has been previously described as an unusual cause of acute renal injury in IgAN.

We reported a patient who presented with fever hemoptysis from diffuse pulmonary hemorrhage, and acute renal injury.

Renal biopsy revealed IgAN concomitant with AIN which was the cause of renal dysfunction.

Renal biopsy is a mandatory investigation to make the correct diagnosis.

[MeSH-major] Glomerulonephritis, IGA / diagnosis. Hemoptysis / drug therapy. Lung Diseases / diagnosis. Nephritis, Interstitial / diagnosis

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(PMID = 19702073.001).

[ISSN] 0125-2208

[Journal-full-title] Journal of the Medical Association of Thailand = Chotmaihet thangphaet

[ISO-abbreviation] J Med Assoc Thai

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] Thailand

[Chemical-registry-number] 0 / Anti-Bacterial Agents; 75J73V1629 / Ceftriaxone; N12000U13O / Doxycycline

   

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[Title] P16 and Ki67 Immunostains Decrease Intra- and Interobserver Variability in the Diagnosis and Grading of Anal Intraepithelial Neoplasia (AIN).

BACKGROUND: Significant variation is reported in the diagnosis of HPV-associated AIN.

We previously observed that band-like positivity for p16 in >90% of contiguous cells coupled with Ki67 positivity in >50% of lesional cells is strongly associated with high grade AIN.

This study was undertaken to determine if addition of p16 and Ki67 immunostaining would reduce inter- and intraobserver variability in diagnosis and grading of AIN.

DESIGN: H&E stained slides of 60 anal biopsies were reviewed by three pathologists and consensus diagnoses were achieved: 25 negative, 12 low (condyloma and/or AIN I) and 23 high (9 AIN II and 14 AIN III) grade lesions.

The H&E stained slides were diagnosed independently by three additional ("participant") pathologists.

RESULTS: Addition of p16 and Ki67 immunostains reduced intra- and interobserver variability, improved concurrence with consensus diagnoses and reduced two-step differences in diagnosis.

Negative and high grade AIN diagnoses showed the most improvement in concurrence levels.

CONCLUSION: Addition of p16 and Ki67 immunostains is helpful in the diagnosis and grading of AIN.

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[Cites] Semin Oncol. 2000 Aug;27(4):471-9 [10950374.001]

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(PMID = 21876646.001).

[ISSN] 1178-1181

[Journal-full-title] Clinical medicine. Pathology

[ISO-abbreviation] Clin Med Pathol

[Language] eng

[Publication-type] Journal Article

[Publication-country] New Zealand

[Other-IDs] NLM/ PMC3159996

[Keywords] NOTNLM ; Ki67 / P16 / anal intraepithelial neoplasia (AIN) / condyloma / human papilloma virus (HPV) / interobserver variability / intraobserver variability

   

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A 74-year-old woman diagnosed with Churg-Strauss syndrome (CSS) complained of difficulty in flexing her left thumb and index finger.

Electromyography demonstrated isolated anterior interosseous nerve (AIN) palsy, with no other peripheral neuropathy.

We diagnosed this case as spontaneous AIN palsy complicated with CSS, the first case of this kind.

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(PMID = 20458608.001).

[ISSN] 1439-7609

[Journal-full-title] Modern rheumatology

[ISO-abbreviation] Mod Rheumatol

[Language] ENG

[Publication-type] Journal Article

[Publication-country] United States

[Chemical-registry-number] 0 / Glucocorticoids; VB0R961HZT / Prednisone; X4W7ZR7023 / Methylprednisolone

   

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[Title] Editorial comment: screening for anal dysplasia--are we on the same page?

[MeSH-major] Anus Neoplasms / diagnosis. Carcinoma in Situ / diagnosis. HIV Infections / diagnosis. Mass Screening. Precancerous Conditions / diagnosis

[MeSH-minor] Anal Canal / pathology. Carcinoma, Squamous Cell / diagnosis. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / prevention & control. Humans. Male. Washington / epidemiology

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[CommentOn] AIDS Read. 2009 May;19(5):178-86 [19554736.001]

(PMID = 19554737.001).

[ISSN] 1053-0894

[Journal-full-title] The AIDS reader

[ISO-abbreviation] AIDS Read

[Language] eng

[Publication-type] Comment; Editorial

[Publication-country] United States

   

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[Title] Trends in HIV care, Part 1: new antiretrovirals, anal dysplasia, and reimbursement for diagnostic testing--a roundtable discussion.

[MeSH-major] AIDS-Related Opportunistic Infections. Anti-Retroviral Agents / therapeutic use. Anus Diseases. Diagnostic Techniques and Procedures / economics. HIV Infections / diagnosis. Insurance, Health, Reimbursement. Papillomavirus Infections

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(PMID = 19123280.001).

[ISSN] 1053-0894

[Journal-full-title] The AIDS reader

[ISO-abbreviation] AIDS Read

[Language] eng

[Publication-type] Journal Article

[Publication-country] United States

[Chemical-registry-number] 0 / Anti-Retroviral Agents

   

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[Title] BD ProEx C immunostaining in extramammary Paget's disease and perineal melanoma.

The differential diagnosis of perineal biopsies can include squamous intraepithelial lesions, extramammary Paget's disease, and melanoma.

Immunostaining for ProEx C has been validated in cervical cytology and positive staining has also been shown to be strongly associated with human papilloma virus (HPV)-induced cervical and anal intraepithelial neoplasia in biopsies.

We observed positive staining for ProEx C in Paget cells in all of 26 cases of Paget's disease irrespective of tissue site (extramammary, mammary) and in melanoma cells in all of 12 cases of primary perineal melanoma with immunostaining in >50% of malignant cells in 73% of Paget disease cases and 43% of perineal melanoma cases.

Positive staining was heterogeneous and exclusively nuclear in all cases.

[MeSH-major] Antigens, Neoplasm / analysis. Anus Neoplasms / enzymology. Cell Cycle Proteins / analysis. DNA Topoisomerases, Type II / analysis. DNA-Binding Proteins / analysis. Melanoma / enzymology. Nuclear Proteins / analysis. Paget Disease, Extramammary / enzymology. Perineum / pathology. Reagent Kits, Diagnostic. Vaginal Neoplasms / enzymology. Vulvar Neoplasms / enzymology

[MeSH-minor] Adult. Aged. Aged, 80 and over. Alphapapillomavirus / genetics. Alphapapillomavirus / isolation & purification. Biopsy. DNA, Viral / isolation & purification. Diagnosis, Differential. Female. Humans. Immunoassay. In Situ Hybridization. Male. Middle Aged. Minichromosome Maintenance Complex Component 2. Mucous Membrane / enzymology. Mucous Membrane / pathology. Mucous Membrane / virology. Predictive Value of Tests

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(PMID = 18931649.001).

[ISSN] 1530-0285

[Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc

[ISO-abbreviation] Mod. Pathol.

[Language] eng

[Publication-type] Journal Article

[Publication-country] United States

[Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Cell Cycle Proteins; 0 / DNA, Viral; 0 / DNA-Binding Proteins; 0 / Nuclear Proteins; 0 / Reagent Kits, Diagnostic; EC 3.6.4.12 / MCM2 protein, human; EC 3.6.4.12 / Minichromosome Maintenance Complex Component 2; EC 5.99.1.3 / DNA Topoisomerases, Type II; EC 5.99.1.3 / DNA topoisomerase II alpha

   

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[Title] [Anal intraepithelial neoplasia and anal carcinoma: an increasing problem in HIV patients].

[Transliterated title] Anale intraepitheliale Neoplasie und Analkarzinom : Ein zunehmendes Problem bei Menschen mit HIV-Infektion.

Anal dysplasia is common in HIV patients, especially in HIV-positive men having sex with men (MSM).

High-grade anal dysplasia can progress to invasive anal cancer.

As in cervical carcinoma, there is a cause and effect relationship between anal cancer and human papillomavirus (HPV) infection, especially with high-risk types such as HPV16.

Several experts have recommended screening programs for anal cancer, including anal cytology along the lines of the Pap smear in women.

Such screenings should only be performed if pathological findings result in further diagnostic steps and, if necessary, appropriate treatment.

Clinical inspection, lesion biopsy, and treatment of anal dysplasia are performed under high-resolution anoscopy.

Anal cancer is divided into cancer of the anal margin and cancer of the anal canal.

This classification is important because of the difference in treatment regimens.

Early cancer of the anal margin is excised akin to squamous cell cancer of the exposed skin, whereas cancer of the anal canal is treated by radiochemotherapy.

Physicians working in the field of HIV/AIDS should regularly screen their patients for the presence of anal dysplasia and anal cancer.

Basic diagnostic workup includes clinical inspection of the perianal area, digital rectal examination, and anal cytology.

[MeSH-major] Anus Neoplasms / diagnosis. Anus Neoplasms / prevention & control. Carcinoma in Situ / virology. HIV Infections / complications. Precancerous Conditions / diagnosis. Precancerous Conditions / prevention & control

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(PMID = 19967333.001).

[ISSN] 1432-1173

[Journal-full-title] Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete

[ISO-abbreviation] Hautarzt

[Language] ger

[Publication-type] English Abstract; Journal Article

[Publication-country] Germany

   

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By brushing it is possible to reach deeper layers of the oral mucosa where squamous intraepithelial neoplasia (SIN) begins.

The biological potential of the oral epithelial cells obtained can be evaluated by the following additional methods: computer-assisted image analysis (OralCDx), DNA cytometry, immunohistochemistry, monolayer cytology, and molecular biological analysis.

Nevertheless, there are reports that oral epithelial carcinomas were not identified.

No comparative study exists allowing conclusions to be drawn about the value of the single methods.

Oral brush biopsy as a non invasive diagnostic method can be useful for the early detection of oral mucosal lesions.

Positive findings or progression of the lesion despite negative findings are indications to refer the patient to a specialized clinic where a surgical biopsy should be performed, followed by histopathological analysis.

Histopathology remains the gold standard for the definitive diagnosis of oral malignant lesions.

[MeSH-major] Carcinoma in Situ / pathology. Carcinoma, Squamous Cell / pathology. Cytological Techniques / methods. Mouth Neoplasms / pathology

[MeSH-minor] Biomarkers, Tumor / analysis. Biopsy / methods. Cell Adhesion Molecules / analysis. DNA, Neoplasm / analysis. Humans. Image Processing, Computer-Assisted. Immunohistochemistry. Mouth Mucosa / pathology. Sensitivity and Specificity

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(PMID = 17177045.001).

[ISSN] 1432-9417

[Journal-full-title] Mund-, Kiefer- und Gesichtschirurgie : MKG

[ISO-abbreviation] Mund Kiefer Gesichtschir

[Language] ger

[Publication-type] English Abstract; Journal Article; Review

[Publication-country] Germany

[Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Cell Adhesion Molecules; 0 / DNA, Neoplasm; 0 / kalinin

[Number-of-references] 107

   

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[Title] Risk factors predicting outcome in patients with pneumonia in Al-Ain, United Arab Emirates.

OBJECTIVE: To determine the predictive value of commonly used clinical and laboratory factors for mortality in patients with pneumonia in the Arab world.

METHODS: We retrospectively analyze the data collected from all inpatients over the age of 16 years with a diagnosis of pneumonia in Tawam Hospital, Al-Ain, United Arab Emirates between the years 1997 and 2002.

The most common comorbid risk factors were diabetes mellitus in 23.7% and chronic obstructive pulmonary disease in 19.5%.

Simple logistic regression analysis showed increasing age, presence of comorbidity, low systolic blood pressure, confused mental status, low serum albumin, high serum creatinine, raised blood urea nitrogen and raised partial pressure of carbon dioxide at the time of admission were associated with higher mortality.

On the Stepwise-multilogistic regression analysis, the most significant factors influencing mortality were: older age, altered mental status, low systolic blood pressure, low serum albumin and raised serum creatinine.

Older age, altered mental status, low systolic blood pressure, low serum albumin concentration and raised serum creatinine at admission were predictive of poor outcome in this cohort of patients.

[MeSH-major] Pneumonia / diagnosis

[MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Diabetes Mellitus, Type 2 / complications. Female. Humans. Male. Middle Aged. Prognosis. Pulmonary Disease, Chronic Obstructive / complications. ROC Curve. Retrospective Studies. Risk Factors. United Arab Emirates / epidemiology

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(PMID = 16830028.001).

[ISSN] 0379-5284

[Journal-full-title] Saudi medical journal

[ISO-abbreviation] Saudi Med J

[Language] eng

[Publication-type] Journal Article

[Publication-country] Saudi Arabia

   

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BACKGROUND: The use of laparoscopy while performing an abdominal dissection for the mobilization of rectovesical fistula should have an impact on anorectal function, as compared to the original posterior sagittal anorectoplasty, where muscle complex was not cut and the rectum was pulled in a way similar to the old techniques for the abdominoperineal pull-through.

MATERIALS AND METHODS: A prospective case study included 15 patients treated with a laparoscopic-assisted pull-through for high anorectal malformation.

After the approval of the Ethical Committee for Medical Research in the Department of Surgery at Ain Sams University (Cairo, Egypt) and obtaining an informed consent from the parents, they were subjected to a full clinical history and a checklist about motions and soiling to be filled in over 1 month, a barium enema to check for any dilatation, anorectal manometry to evaluate resting pressure, maximum squeezing pressure, and sphincter relaxation, and MRI (magnetic resonance imaging) to evaluate the central situation of the rectum within the sphincter and the degree of development of the sphincter.

RESULTS: Six of 9 patients are clean without any attacks of fecal soiling or incontinence, and they evacuate spontaneously but need the application of a rectal suppository for evacuation from time to time.

Manometry showed a high resting pressure that decreased on straining in the 7 clean patients and low in 2.

The resting pressure did not increase on squeezing and all showed weak rectoanal inhibitory reflex (RAIR).

One patient developed dysurea and constipation 1 year after surgery, as diagnosed by VCUG (voiding cystourethrogram) to have a diverticulum at the site of excised fistula causing rectal and urethral obstruction treated by a transabdominal excision with a good functional result.

CONCLUSION: The state of continence with the laparoscopic technique in high anorectal malformations in this study showed acceptable results but needs bigger series with longer follow-up for a proper evaluation of this technique.

[MeSH-major] Anal Canal / abnormalities. Laparoscopy. Rectum / abnormalities

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(PMID = 19281419.001).

[ISSN] 1092-6429

[Journal-full-title] Journal of laparoendoscopic & advanced surgical techniques. Part A

[ISO-abbreviation] J Laparoendosc Adv Surg Tech A

[Language] eng

[Publication-type] Journal Article

[Publication-country] United States

   

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[Title] [Anal intraepithelial neoplasia].

[Transliterated title] Neoplasia intraepitelial anal.

Human papillomavirus (HPV) is responsible for anal condylomata, anal intraepithelial neoplasia (AIN) and anal squamous cell carcinoma.

AIN is a premalignant condition that can progress to invasive carcinoma through different grades of severity of the disease called AIN I, AIN II and AIN III.

This paper looks at the current definition, diagnostic methods and management of AIN.

The incidence of AIN has increased significantly in the last decades.

The groups at risk are mainly patients with infection with human immunodeficiency virus, immunossuppressed patients and patients affected by HPV related diseases (e.g., cervical cancer or anal condyloma).

Accurate diagnosis of AIN lesions consists of accurate grading and disease extension.

Low grade AIN (AIN I) or in extensive lesions, follow-up is advised to determine the possible evolution to anal squamous cell carcinoma.

In cases of more severe and localized lesions (AIN II and AIN III), surgical resection should be considered if the predictive postoperative morbidity is low.

Screening programs for AIN are not currently in place and there might be much effort to study the management of HPV in these patients.

[MeSH-major] Anus Neoplasms / pathology. Carcinoma in Situ / pathology

[MeSH-minor] Anal Canal / pathology. Anal Canal / surgery. Humans

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(PMID = 17198654.001).

[ISSN] 0025-7753

[Journal-full-title] Medicina clínica

[ISO-abbreviation] Med Clin (Barc)

[Language] spa

[Publication-type] English Abstract; Journal Article; Review

[Publication-country] Spain

[Number-of-references] 58

   

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The study was carried out at Al-Ain Medical District, United Arab Emirates, between August 2004 and December 2004.

The difference in cesarean section rate was not statistically significant.

Observers' interpretation and cCTG did not correlate well with Apgar score at 5 minutes and admission to special care baby unit.

[MeSH-minor] Adult. Diagnosis, Computer-Assisted. Female. Humans. Infant, Newborn. Predictive Value of Tests. Pregnancy. Pregnancy Outcome

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(PMID = 16127519.001).

[ISSN] 0379-5284

[Journal-full-title] Saudi medical journal

[ISO-abbreviation] Saudi Med J

[Language] eng

[Publication-type] Comparative Study; Journal Article

[Publication-country] Saudi Arabia

   

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[Title] Comparison of patient- and clinician-collected anal cytology samples to screen for human papillomavirus-associated anal intraepithelial neoplasia in men who have sex with men.

BACKGROUND: Human papillomavirus (HPV)-associated anal cancer is increasing in prevalence and is more common among men who have sex with men and HIV-positive individuals than cervical cancer is among women in the United States.

Cytology screening can detect the anal cancer precursor, anal intraepithelial neoplasia (AIN).

Little is known about self-collected samples for AIN screening, and few community-based AIN estimates exist.

OBJECTIVE: To compare the sensitivity of self-collected versus clinician-collected anal cytology specimens to detect biopsy-confirmed AIN and the prevalence estimate of AIN in a community sample.

DESIGN: Cross-sectional study.

Participants were mailed anal cytology self-collection kits with instructions.

Clinicians repeated anal cytology and performed high-resolution anoscopy with biopsies as the diagnostic reference standard.

MEASUREMENTS: Prevalence of anal HPV and AIN.

Sensitivity and specificity of self-collected and clinician-collected anal cytology specimens to diagnose AIN were calculated.

RESULTS: Biopsy-proven AIN was diagnosed in 57% of HIV-positive and 35% of HIV-negative participants (P = 0.04), and 80% provided adequate self-collected specimens for interpretation.

The sensitivity of cytology to detect AIN in HIV-positive men was 75% (95% CI, 51% to 93%) when self-collected and 90% (CI, 68% to 99%) when clinician-collected; respective values in HIV-negative men were 48% (CI, 26% to 70%) and 62% (CI, 38% to 82%).

The specificity of cytology to detect AIN in HIV-positive men was 50% (CI, 22% to 78%) when self-collected and 64% (CI, 36% to 86%) when clinician-collected; respective values in HIV-negative men were 86% (CI, 71% to 94%) and 85% (CI, 72% to 93%).

LIMITATIONS: The study sample was from a narrowly defined geographical area.

CONCLUSION: In a community-based sample, a high proportion of HIV-positive and HIV-negative men who have sex with men have AIN.

The sensitivity of cytology to detect AIN is higher for clinician-collected versus self-collected specimens and for HIV-positive versus HIV-negative men.

The specificity of cytology to detect AIN is higher in HIV-negative versus HIV-positive men.

However, the probability of AIN in a patient with a negative cytology result may not be low enough (23% for HIV-negative men and 45% for HIV-positive men with a patient-collected specimen) for clinicians to be comfortable recommending no anoscopy for those with a negative cytology result if done as a one-time test.

Given limited resources and the limited number of clinicians trained in anoscopy, cytology screening may be the best current approach to identifying disease in the at-risk population.

[MeSH-major] Anus Neoplasms / pathology. Carcinoma in Situ / pathology. Cytological Techniques / methods. Homosexuality. Papillomavirus Infections / pathology. Specimen Handling / methods

[MeSH-minor] Adult. Aged. Anal Canal / pathology. Biopsy. Endoscopy, Gastrointestinal. HIV Seronegativity. HIV Seropositivity / epidemiology. HIV Seropositivity / pathology. HIV Seropositivity / virology. Humans. Male. Middle Aged. Prevalence. San Francisco / epidemiology. Sensitivity and Specificity

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[CommentIn] Ann Intern Med. 2009 Feb 17;150(4):283-4; author reply 284-5 [19221387.001]

[SummaryForPatientsIn] Ann Intern Med. 2008 Sep 2;149(5):I38 [18765696.001]

(PMID = 18765699.001).

[ISSN] 1539-3704

[Journal-full-title] Annals of internal medicine

[ISO-abbreviation] Ann. Intern. Med.

[Language] eng

[Grant] United States / NCRR NIH HHS / RR / 5 M01-RR-00079; United States / NIAID NIH HHS / AI / K23 AI054157; United States / NIAID NIH HHS / AI / R01 CA/AI 88739; United States / NCI NIH HHS / CA / R01 CA54053; United States / NIMH NIH HHS / MH / R01 MH54320

[Publication-type] Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

[Publication-country] United States

   

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The major steps in cervical carcinogenesis include infection of the metaplastic epithelium of the cervical transformation zone with one or more of the 12-18 carcinogenic types of human papillomavirus (HPV) infection, viral persistence, clonal progression of the persistently-infected epithelium to cervical precancer, and invasion.

The importance of the transformation zone in cervical cancer has been extended to other HPV-induced cancers such as anal or tonsillar cancers.

Natural history studies show that HPV with normal cervical cytology and cervical intraepithelial neoplasia (CIN) grade 1 behave similarly, with the majority of both showing regression.

Whether equivalent lesions diagnosed later differ in their natural history remains unknown.

[MeSH-major] Anus Neoplasms / virology. Genital Neoplasms, Female / virology. Genital Neoplasms, Male / virology. Neoplasms / virology. Papillomavirus Infections / complications

[MeSH-minor] Age Factors. Female. Humans. Male. Papillomaviridae / classification. Papillomaviridae / isolation & purification. Time Factors. United States

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(PMID = 16950017.001).

[ISSN] 0264-410X

[Journal-full-title] Vaccine

[ISO-abbreviation] Vaccine

[Language] eng

[Grant] United States / NCI NIH HHS / CA / R37 CA051323

[Publication-type] Journal Article; Review

[Publication-country] Netherlands

[Number-of-references] 45

   

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[Title] Methylation of human papillomavirus genomes in cells of anal epithelia of HIV-infected men.

Intra-anal malignancies disproportionately affect individuals who engage in anal intercourse because of infection with human papillomaviruses (HPVs), with an increased risk attributed to infection with HIV because of a declining immunity against HPvs. Long-term persistence of HPVs suggests yet other mechanisms that determine the clinical outcome, however.

Because methylation of HPV DNA represses oncogene expression in cervical samples, we investigated whether this mechanism also occurs in HIV-positive men and studied the methylation of CpG dinucleotides overlapping with the HPV-16 enhancer and promoter in 16 anal samples.

In low-grade anal intraepithelial neoplasia (AIN), methylation was high in CpGs overlapping the viral enhancer but rare in promoter positions, whereas methylation was high in promoter regions in high-grade AIN, especially in samples with a high load of viral genomes.

We also detected de novo methylation at methylated (me) CpA, meCpT, and meCpC dinucleotides.

Our study expands the observation and mapping of HPV DNA methylation to anal infections and the HIV-positive patient population.

DNA methylation, taken together with virus load, may be useful to diagnose the emergence of a population of tumor cells.

[MeSH-minor] Anal Canal / virology. Base Sequence. Biopsy. DNA Primers. DNA, Viral / genetics. DNA, Viral / isolation & purification. Dinucleoside Phosphates / analysis. Enhancer Elements, Genetic. Homosexuality, Male. Humans. Male. Polymerase Chain Reaction. Virus Latency. Virus Replication

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(PMID = 15905729.001).

[ISSN] 1525-4135

[Journal-full-title] Journal of acquired immune deficiency syndromes (1999)

[ISO-abbreviation] J. Acquir. Immune Defic. Syndr.

[Language] eng

[Grant] United States / NCI NIH HHS / CA / CA-91964; United States / NCI NIH HHS / CA / R01 CA-91964

[Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.

[Publication-country] United States

[Chemical-registry-number] 0 / DNA Primers; 0 / DNA, Viral; 0 / Dinucleoside Phosphates; 2382-65-2 / cytidylyl-3'-5'-guanosine

   

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INTRODUCTION: The aim of this study was to evaluate our recent clinical management of mesenteric vascular occlusion (MVO) at Al-Ain Hospital, United Arab Emirates.

METHODS: A retrospective study was performed including all patients who were diagnosed to have MVO from December 2001 to May 2005.

The records were studied with regard to clinical features, risk factors, diagnosis, treatment, and outcome.

The main risk factor for MAO was ischaemic heart disease with atrial fibrillation in four patients (80 percent).

No predisposing factors were identified in three patients with MVT (primary MVT 43 percent).

Contrast-enhanced computed tomography was performed in all patients and was diagnostic in 12 (86 percent) patients.

One patient died on the ninth postoperative day (overall mortality rate 7 percent).

CONCLUSION: Early diagnosis and prompt initiation of anticoagulation therapy, with operative intervention when indicated, are essential for a favourable outcome.

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(PMID = 18418524.001).

[ISSN] 0037-5675

[Journal-full-title] Singapore medical journal

[ISO-abbreviation] Singapore Med J

[Language] eng

[Publication-type] Journal Article

[Publication-country] Singapore

[Chemical-registry-number] 0 / Anticoagulants

   

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[Title] Domestic violence among women attending out-patient clinics in Ain Shams University Hospitals, Cairo, Egypt.

A descriptive cross sectional study was conducted to determine the prevalence of domestic violence among ever married females presenting to out patient clinics in Ain Shams university hospitals and to identify factors affecting it.

Out of a total number of 509 women, 89.8% had experienced one or more episodes of violent behavior by their husbands of which 56%, 88.4% and 47.9% suffered physical, control and threat violence.

The most common form of violence among the study group was husband's shouting followed by being kept short of money.

This proposes the importance of effective screening, diagnosis and management of domestic violence victims.

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(PMID = 17187746.001).

[ISSN] 0013-2446

[Journal-full-title] The Journal of the Egyptian Public Health Association

[ISO-abbreviation] J Egypt Public Health Assoc

[Language] eng

[Publication-type] Journal Article

[Publication-country] Egypt

   

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The aim of this study was to determine the prevalence and risk factors for foot complications among diabetic patients in Al-Ain district, United Arab Emirates (UAE).

METHODS: The study was part of a general cross-sectional survey carried out to assess the prevalence of DM complications in Al-Ain district, UAE.

All completed an interviewer-administered questionnaire and underwent medical assessment including foot examination and assessment of presence of peripheral neuropathy (PN) and peripheral vascular disease (PVD).

RESULTS: Forty nine percent of the study populations were diagnosed to have DM without presenting with symptoms of diabetes and 35% had hypertension.

There were no cases of amputation and only one case had previous history of lower extremity ulceration.

Significant risk factors for PN and PVD were: male gender, poor level of education, UAE nationality, increased duration of diabetes, type 2 DM, presence of hypertension and microalbuminuria (MA).

CONCLUSION: Despite the low prevalence of foot ulceration and amputation among the study population, nevertheless, a substantial proportion had potential risk factors for foot complications.

[MeSH-minor] Adult. Aged. Albuminuria / complications. Albuminuria / epidemiology. Cross-Sectional Studies. Educational Status. Female. Humans. Hypertension / complications. Hypertension / epidemiology. Male. Middle Aged. Peripheral Nervous System Diseases / complications. Peripheral Nervous System Diseases / epidemiology. Peripheral Vascular Diseases / complications. Peripheral Vascular Diseases / epidemiology. Prevalence. Process Assessment (Health Care) / methods. Risk Assessment. Risk Factors. Sex Factors. Surveys and Questionnaires. United Arab Emirates / epidemiology

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(PMID = 17927826.001).

[ISSN] 1471-2296

[Journal-full-title] BMC family practice

[ISO-abbreviation] BMC Fam Pract

[Language] eng

[Publication-type] Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] England

[Other-IDs] NLM/ PMC2174471

   

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[Title] Pattern of renal diseases among elderly Egyptians patients with acute or chronic renal diseases in Ain Shams University and Nasser Institute Hospitals, Cairo, Egypt.

This study among elderly renal Egyptian patients (n=220) with only 20 of them were subjected to renal biopsy.

Other cardiovascular risk factors and smoking are reported by previous workers to be HS related to renal diseases.

Age was significantly related to GFR, BUN and Cr. but sex difference was not significantly related to renal diseases.

Multiple myeloma, lupus nephritis, vasculitis and hepatitis B were all recorded in few numbers of elderly Egyptians.

HCV was more common and more likely to cause renal diseases.

Abdomino-pelvic ultrasound was confirmatory to clinical renal diseases diagnosis.

Ultrasound results among the biopsy group were confirmatory to clinical diagnosis.

[MeSH-major] Kidney Diseases / diagnosis. Kidney Diseases / pathology

[MeSH-minor] Acute Disease. Aged. Chronic Disease. Diagnosis, Differential. Egypt / epidemiology. Female. Humans. Kidney Function Tests. Male

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(PMID = 16333899.001).

[ISSN] 1110-0583

[Journal-full-title] Journal of the Egyptian Society of Parasitology

[ISO-abbreviation] J Egypt Soc Parasitol

[Language] eng

[Publication-type] Comparative Study; Journal Article

[Publication-country] Egypt