PubMed · 1732603
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
O Aynaud. 1992. Meatal spreader.. https://doi.org/10.1016/s0022-5347(17)37251-8
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
In general, condylomata acuminata can be diagnosed and treated by the general practitioner. Condylomata are caused by certain types of human papillomavirus (HPV). According to their carcinogenicity HPVs are classified as high risk and low risk HPV. The benign condylomata are an infrequent sign of an infection with low risk HPV, while cervical cancer is a rare and late complication of an infection with high risk HPV. Because high and low risk HPV are different viruses, the risk of cervical cancer is not increased by condylomata. Anogenital HPVs are predominantly transmitted sexually. It is useful to discriminate between sexually transmitted diseases (STDs) that are ubiquitous, like infections with HPV or herpes simplex virus (HSV), and rare STDs like syphilis, gonorrhoea and HIV infection: infections with HPV and HSV are also common with unriskful sexual behaviour, while syphilis, gonorrhoea and HIV infection are almost exclusively associated with riskful sexual behaviour. It has been shown that double infections with HPV and Chlamydia trachomatis are not more frequent than may be expected by chance. The literature indicates that the presence of condylomata acuminata by itself is no reason to screen patients for other STDs.
With the availability of new patient-applied treatments for genital and perianal warts, medical providers, physician groups, and health systems are reassessing the role of physician-administered therapies. Two key questions are: how cost-effective are physician- versus patient-administered therapies and, given patient preferences for the convenience and privacy associated with the latter therapies, which of the 2 presently available treatments-imiquimod and podofilox-is most appropriate? The purpose of this article is to examine, from the perspective of the health care purchaser, these questions and to undertake a pharmacoeconomic analysis of the direct cost-effectiveness of therapy options, given targets being set for the outcomes of genital warts therapy. The analysis employs a synthetic, decision-modeling framework in which data on sustained clearance and the direct costs of treatment are drawn from both clinical studies and previous studies on the resources used to support treatment. Once targets are set-and it is proposed here that physicians should aim for at least a 50% sustained clearance rate for genital warts--it becomes clear that in cost per sustained clearance terms, imiquimod, as first-line therapy, is the most cost-effective intervention. If we compare imiquimod with podofilox as first-line therapy (with cryotherapy as the second-line option), the cost per sustained clearance for the imiquimod treatment sequence is $1367 compared with the podofilox-initiated sequence of $1508.
Human papillomaviruses comprise a large family of double stranded DNA viruses that are the etiologic agents of benign warts and anogenital cancers. At least 82 different human papillomavirus types have been identified and many remain yet uncharacterized. The development of new molecular techniques in recent years has led to an increased understanding of human papillomaviruses and their roles in carcinogenesis. Several clinicopathologic entities arising from human papillomavirus infection encountered by the dermatologist are the subject of the article. The epidemiology, molecular biology, clinical presentation, histologic findings, and treatment of each disorder, where applicable, is discussed.