The Bethesda Classification for Squamous Intraepithelial Lesions
ABSTRACT In applying the Bethesda System of classification to cervical squamous lesions, we evaluated the Papanicolaou smears, cervical biopsies, and human papillomavirus (HPV) DNA status of 76 clinic patients. The biopsy specimens and concurrent Papanicolaou smears were analyzed using criteria for low-grade and high-grade squamous intraepithelial lesions, and the biopsies were analyzed for HPV DNA by in situ hybridization. Two independent observers produced good agreement in both cytologic (kappa = 0.62) and histologic (kappa = 0.71) diagnoses. Predictive values of high-grade cytology (for high-grade histology) were high (0.95 for reviewer 1; 0.97 for reviewer 2), and both high-grade cytology and histology correlated strongly with certain "high-risk" HPV types. In contrast, the predictive value of low-grade cytology for either low-grade histology or HPV types other than "high risk" was poor. This study supports the use of certain histologic criteria for distinguishing squamous intraepithelial lesions into two grades. Limitations in cytologic-histologic correlation appear to reflect the absence of cytologic criteria for distinguishing well-differentiated precursor lesions associated with high-risk HPV types.
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- "At baseline and after the last gel application, a colposcopy was performed . Cervical Pap smears were assessed according to the Bethesda classification  "
ABSTRACT: Invisible Condom gel formulations being developed as microbicides to prevent the sexual transmission of HIV are advancing through the phases of clinical trials. The objectives of this study were to evaluate, after 8 weeks of vaginal application, the extended safety and acceptability of two Invisible Condom vaginal gel formulations: (i) the polymer alone and (ii) the polymer containing sodium lauryl sulfate (SLS) compared to placebo. This study is a randomized, doubled-blind, placebo-controlled Phase II extended safety study in healthy sexually active women from Yaoundé, Cameroon. Women were randomized into three gel arms: (i) placebo, (ii) polymer alone and (iii) polymer/SLS. Women applied gel intravaginally twice daily for 8 weeks. A total of 194 sexually active women applied placebo (n=41), polymer alone (n=76) and polymer/SLS (n=77). Invisible Condom gel formulations were well tolerated with no reported serious adverse events. The majority of reported adverse events were mild or moderate and mostly similar in all three arms, except for pelvic pain that was 10% higher in the polymer and polymer/SLS arms compared to placebo. Colposcopy showed neither genital ulceration nor mucosal lesions. Nugent score, H(2)O(2)-producing lactobacilli and vaginal pH were not affected by the study products. The gel formulations and applicator were generally acceptable and comfortable. This extended safety study showed that the Invisible Condom gel formulations and applicator were well tolerated and acceptable when applied intravaginally twice daily for 8 weeks. Thus, further phases of clinical development of Invisible Condom as a potential microbicide to prevent sexual transmission of HIV are warranted.Contraception 01/2010; 81(1):79-85. DOI:10.1016/j.contraception.2009.07.002 · 2.34 Impact Factor
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ABSTRACT: El diagnostico del cuello uterino por VPH se basaba en criterios citologicos, colposcopicos, histopatologicos y de biologia molecular. Se ha descrito que el punteado inverso es la imagen colposcopica inicial de la infeccion por VPH, e histologicamente representa una paraqueratosis perivascular. El presente estudio plantea el patron histopatologico del punteado inverso y su relacion con la infeccion con la infeccion por VPH, al estudiar 23 pacientes que consultaron al Servicio de Ginecologia de la Maternidad Concepcion Palacios, (Caracas), presentando la lesion Logramos determinar en el 65.22 de los casos de infeccion por VPH, a traves de PCR, y el estudio histopatologico demostro cambios tales como: la acantosis, la paraqueratosis y la hiperplasia de celulas basales entre otras. Por tanto concluimos que el punteado inverso parece ser un expresion vascular del VPH(AU). Especialista -- Universidad Central de Venezuela. Facultad de Medicina. Comision de Estudios de Postgrado, Caracas, 1997.