Search PubMed⌕ Search

Biomedical subjects

J Paavonen

Publications and source records attributed to J Paavonen.

226 records · Page 13Linked to original sources
PubMedDate not supplied

Subcutaneous interferon alpha in the treatment of refractory condylomata.

Fifteen patients (mean age 24, range 19-46) referred for refractory vulvar warts were treated with subcutaneous interferon alpha-2a, 3 million units 3 times a week for 3 weeks. The cumulative rate of complete response was 14% at 2 weeks, 27% at one month, and 36% at three months. The response was independent of the duration of warts. The mean number of vulvar warts was 7 (range 3 to 9) among patients with complete response, 11 (range 4-20) among patients with partial response, and 23 (range 4-35) among patients with no response. The presence of cytologic or colposcopic abnormality of the cervix also predicted poor response. Adverse effects were usually mild. One patient developed progression of warts at one month and was dropped from the study. Future studies should explore the use of interferon as an adjuvant to other treatment modalities.

Adult↗
PubMedDate not supplied

Treatment of genital HPV infection with carbon dioxide laser and systemic interferon alpha-2b.

BACKGROUND AND OBJECTIVES: Treatment of genital warts is problematic. Numerous treatment modalities are available, but response to any therapy often is unsatisfactory. Recently, studies have suggested that interferons would be effective in the treatment of some genital warts. GOAL OF THIS STUDY: To compare carbon dioxide laser with or without adjuvant subcutaneously administered interferon alpha-2b in the treatment of genital human papillomavirus infection. STUDY DESIGN: One hundred randomized women with genital HPV infection were treated with carbon dioxide laser and adjuvant systemic interferon alpha-2b or carbon dioxide laser and placebo. Patients were followed colposcopically, cytologically, and by HPV DNA testing for 6 months. RESULTS: Complete response was seen in 62% patients who received adjuvant interferon, and in 68% patients who received placebo. However, recurrence was less common in patients treated with interferon who were infected with HPV 16/18. CONCLUSION: Only a subgroup of patients, women infected with HPV DNA 16/18, benefited from adjuvant systemic interferon treatment.

Adolescent↗
PubMedDate not supplied

Prophylactic human papillomavirus vaccines: the beginning of the end of cervical cancer.

Persistent infection with one of the oncogenic human papillomavirus (HPV) types is a necessity for the development of cervical cancer. By HPV vaccination, cervical cancer could become a very rare disease. Two types of HPV vaccines can be distinguished: (i) therapeutic vaccines which induce cellular immunity targeted against epithelial cells infected with HPV and (ii) prophylactic vaccines inducing virus-neutralizing antibodies protecting against new but not against established infections. At present, several vaccines have been developed and tested in clinical trials. The vaccines are generally well tolerated and highly immunogenic. The current clinical data indicate that prophylactic vaccines are very effective against new persistent infections and the development of cervical intraepithelial lesions. The protection is type specific. However, the follow-up of the vaccination trials is still short. The effect of HPV vaccines on future cancer incidence will only be known after decades of follow-up. This article will address the status of recently terminated phase II and currently running phase III trials with prophylactic HPV vaccines.

Antibodies, Viral↗
PubMedDate not supplied

Human papillomavirus DNA is not transmitted by semen.

We studied by dot blot DNA hybridization semen samples of 17 regular partners of women with proven HPV infection and 16 controls, to find out whether the human papillomavirus (HPV) DNA is transmitted via semen. Although all women were positive for HPV DNA, the semen samples from their partners and controls were negative. This suggests that HPV DNA is not transmitted via semen.

DNA, Viral↗
PubMedDate not supplied

Significance of mild cervical cytologic atypia in a sexually transmitted disease clinic population.

While the clinical management of patients with cytologic atypia consistent with cervical intraepithelial neoplasia (CIN) is well established, the management of so-called nondyskaryotic or benign atypias is controversial. The natural history of such atypias was prospectively studied in 124 patients attending a sexually transmitted disease clinic. The benign atypias were subdivided into different categories according to the cell type involved, and the patients were followed cytologically and colposcopically without cervical biopsy until they reached one of the study end points. Benign atypias often signified the presence of CIN: 17% of the patients had a smear consistent with CIN on the first study visit, and an additional 24% had such a smear by six months of follow-up. After 30 months of follow-up, the overall cumulative rate of biopsy-confirmed CIN 2 to CIN 3 was 13.5%; it was 12.5% among those with two consecutive smears showing benign atypias. Of the ten patients who reached biopsy-confirmed CIN 2 to CIN 3, a cytologic smear consistent with CIN was obtained in less than one year of follow-up in all but one case; however, colposcopic evidence of progression was seen in only half of the ten cases, suggesting a sampling error rather than true progression in many cases. Patients with metaplastic cell atypia had a higher progression rate to biopsy-confirmed CIN 2 to CIN 3 (21%) than did those with nonmetaplastic cell atypia (3%). This study provides direct evidence of the potential significance of metaplastic atypia as a marker of CIN. We conclude that patients with mild atypia are often found to have CIN and warrant further investigation by colposcopy and biopsy.

Adult↗
PubMedDate not supplied

Adenovirus infection and cytopathic alterations of human cervical epithelial cells in vitro.

The effect of adenovirus infection was studied in monolayer cultures of human ecto- and endocervical epithelial cells. In both types of cultures adenovirus type 1 resulted in a slowly progressing lytic infection with persistent production of infectious virus, viral antigens and of cytopathic alterations in a fraction of cells. The changes were similar in ecto- and endocervical epithelial cells. Although many of the alterations detected may represent unspecific lesions, nuclear changes consisting of lobulated nuclear inclusion bodies seemed to be characteristic. These alterations differ from those observed during infection with the herpes group of viruses and may serve as indicators of cervical adenovirus infection in cytologic screening.

Adenoviruses, Human↗
PubMedDate not supplied

Enzyme immunoassay for serum antibody to Mycoplasma hominis in women with acute pelvic inflammatory disease.

A sensitive, four-layer modification of an enzyme immunoassay was developed for the determination of serum antibodies to Mycoplasma hominis. The suitability of the test for diagnostic use was studied with women who had acute pelvic inflammatory disease (PID). Twenty (23%) of 86 women with PID from whom paired sera were obtained demonstrated a significant change in levels of IgG antibody, a finding suggestive of recent infection with M. hominis. The occurrence of such change was not related to the isolation of Chlamydia trachomatis or Neisseria gonorrhoeae from the lower genital tract. Women with PID had significantly higher levels of IgG and IgA antibody to M. hominis, whereas the amount of IgM antibodies present did not differ between the groups. Levels of IgG antibody increased and those of IgM antibody decreased with increasing age. This change was found both among women with PID and among controls.

Acute Disease↗
PubMedDate not supplied

Mycoplasma hominis in nonspecific vaginitis.

The prevalence of nonspecific vaginitis was 24% among 98 randomly selected women examined at a clinic for sexually transmitted diseases and 32% among 135 women with suspected cervicitis at the same clinic. Mycoplasma hominis was isolated more often and serum antibody levels to M. hominis were higher in women with nonspecific vaginitis than in women without nonspecific vaginitis. Similarly, the rate of isolation of Gardnerella vaginalis and the quantitative growth of G. vaginalis were higher for women with nonspecific vaginitis. Abnormal results of gasliquid chromatographic analysis of vaginal fluid and the presence of abnormal diamines in the vaginal fluid also were associated with nonspecific vaginitis and with the isolation of M. hominis, whether or not G. vaginalis was isolated. Further studies of the ecologic interactions among M. hominis, G. vaginalis, and anaerobes in nonspecific vaginitis are needed for a better understanding of the pathogenesis of this syndrome.

Adolescent↗
PubMedDate not supplied

Mycoplasma hominis in cervicitis and endometritis.

The presence of serum IgG antibody to Mycoplasma hominis was studied by enzyme immunoassay in 150 women with suspected cervicitis at a clinic for sexually transmitted diseases. Positive levels of antibody were associated with gravidity and parity but not with age, method of birth control, or sexual behavior. Women from whom M. hominis was isolated had higher antibody levels than those from whom M. hominis was not isolated, regardless of the presence or absence of mucopurulent cervicitis. In women with mucopurulent cervicitis, M. hominis did not interact synergistically with Chlamydia trachomatis to affect the severity of cervicitis or the number of polymorphonuclear leukocytes on gram-stained cervical tissue. A striking association was found between plasma cell endometritis and the prevalence and level of serum antibody to M. hominis. Similarly, clinical findings suggesting endometritis were associated with the prevalence and level of this antibody. In contrast, endometritis was not associated with the isolation of M. hominis from the cervix, although it was associated with the isolation of C. trachomatis and Neisseria gonorrhoeae. Urethritis in male sexual partners of women with mucopurulent cervicitis was associated with the isolation of C. trachomatis but not of M. hominis from the women.

Antibodies, Bacterial↗