Navegando por Palavras-chave "Condiloma acuminado"
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- ItemAcesso aberto (Open Access)Análise comparativa do tratamento do condiloma acuminado anal e perianal utilizando plasma de argônio e eletrofulguração em doentes HIV positivo e negativo(Universidade Federal de São Paulo (UNIFESP), 2017-07-31) Braga, Eduardo Angelo [UNIFESP]; Lopes Filho, Gaspar de Jesus [UNIFESP]; Saad, Sarhan Sydney [UNIFESP]; http://lattes.cnpq.br/8646840760424911; http://lattes.cnpq.br/3518607824692081; http://lattes.cnpq.br/2072176749270040; Universidade Federal de São Paulo (UNIFESP)Introduction: Human papillomavirus (HPV) infection is the sexually transmitted disease most frequently diagnosed in Brazil, in both men and women and its incidence has been increasing over recent years. It may occur in association with the human immunodeficiency virus (HIV) in up to 62% of the cases1,2. Despite various forms of treatment for Condylomata, relapses are frequent and both the immediate and the long-term results are unsatisfactory. Use of argon plasma is an attractive option because its results are effective. However, further studies comparing this with the standard treatment are still needed. Purpose: To compare the efficiency and complications of treatments for anal and perianal condyloma using argon plasma and electrofulguration and the recurrence rates of these treatments. Methods: From January 2013 to April 2014, in 37 cases of perianal and anal condyloma, the patients’ anal region was divided into two semicircles. Treatment with argon plasma coagulation or electrofulguration was then randomly assigned (one method for each semicircle). The therapeutic sessions were repeated until clinical signs of HPV infection had been eliminated. Tissue samples were taken for cytological, histological and PCR evaluations. Results: The HPV genotype, presence of more than one genotype per patient, oncological potential per genotype and cytological and histological results were analyzed. There was no significant difference in effectiveness between the argon and fulguration methods, based on recurrence and disease-free interval (p > 0.05). In relation to argon application, the variables studied were not associated with recurrence of condyloma (p > 0.05). However, the areas treated with electrofulguration in HIV-positive patients presented more relapses, with a significant difference (p = 0.01). Conclusion: Use of argon plasma was less influenced by presence of HIV than was use of electrofulguration. With regard to efficacy, the methods were statistically equivalent, however, the areas treated with electrofulguration in HIV-positive patients presented worse results with more relapses.
- ItemSomente MetadadadosContribuição ao estudo ultra-estrutural das células de Langerhans no condiloma acuminado(Universidade Federal de São Paulo (UNIFESP), 1993) Enokihara, Mauro Yoshiaki [UNIFESP]; Paschoal, Luiz Henrique Camargo [UNIFESP]
- ItemSomente MetadadadosDiagnóstico da infecção por papilomavírus humano: relação entre a peniscopia e a histopatologia das lesões acetobrancas da genitália masculina(Universidade Federal de São Paulo (UNIFESP), 1997) Nicolau, Sergio Mancini [UNIFESP]A infecção genital masculina pelo papilomavírus humano tem especial importância, pois freqüentemente é assintomática. Na maioria das vezes o não apresenta lesão clínica. Por isso, comporta-se como importante reservatório do vírus, exercendo papel especial na transmissão e perpetuação da doença. Até hoje não se estabeleceu um método ideal de rastreamento da infecção no homem. Pelas razões expostas, estudaram-se 433 parceiros de mulheres com infecção genital por papilomavírus humano, associada ou não à neoplasia epitelial cervical. A maioria dos pacientes era assintomática. Apenas 21 diziam ter lesão (5,24O/o). Trezentos e dezesseis não referiam lesão ou ela não era visível à olho nu. Do total, 43 pacientes referiam antecedentes de condiloma acuminado. A solução de azul de toluidina corou a maior parte das lesões observadas. O teste de SCHMLER na uretra distal foi positivo em 45 casos. A coilocitose foi observada em 20 das biópsias dessas áreas. Foram realizadas 1279 biópsias de lesões acetobrancas, sendo que a coilocitose foi encontrada em 301 (23,53 por cento). A região mais acometida foi a parte interna do prepúcio, onde foram feitas 853 biópsias. A lesão mais encontrada foi a mácula, biopsiada 447 vezes. A coilocitose foi descrita em 100 delas (22,37 por cento). Foi pouco freqüente o comprometimento da bolsa testicular, sendo submetida a 14 biópsias e a mácula foi a imagem mais freqüente. A coilocitose foi detectada em 8,70 por cento das vezes. A neoplasia intra-epitelial do pênis foi encontrada em 10 pacientes ou 12 das l279 biópsias (O,94 por cento) e muitas das imagens não foram diferentes de outras lesões acetobrancas em que não se encontraram sinais histológicos de infecção viral. Conclui-se que a peniscopia é freqüentemente positiva, porém sem relação com o resultado anátomo-patológico. Os resultados demonstram que o exame é pouco específico, porém, auxilia no diagnóstico, especialmente nos casos assintomáticos e com infecção subclínica.
- ItemAcesso aberto (Open Access)Estudo comparativo de métodos de detecção de lesões precursoras de carcinoma espinocelular anal pós-tratamento de condilomas acuminados anais.(Universidade Federal de São Paulo (UNIFESP), 2018-04-26) Nadal, Luis Roberto Manzione [UNIFESP]; Lopes Filho, Gaspar De Jesus [UNIFESP]; http://lattes.cnpq.br/3518607824692081; http://lattes.cnpq.br/5912011772216422; Universidade Federal de São Paulo (UNIFESP)Objective: To evaluate the presence of remaining anal canal and margin subclinical HPVinduced lesions with cytology, anal colposcopy and HPV genotyping by PCR in newly treated individuals with no macroscopically visible HPVinduced lesions, and to verify the influence of the immunological status on the results. Methods: A prospective study of 79 male patients over 18 years of age consecutively included after 30 days of anal warts treatment by topical medication or surgery, with no visible macroscopic lesions. During a single appointment, they were submitted to the collection of two brush samples for cytopathological study of the anal canal and another for PCR, then to anal colposcopy with 3% acetic acid in the margin and in the anal canal. The individuals were grouped according to HIV infection status: I) HIVnegative; II) HIVpositive with a CD4 T lymphocyte count above 350 cells/mm3; III) HIVpositive CD4 Tlymphocyte count below 350 cells/mm 3. After that we regrouped: A) satisfactory CD4 T lymphocytes (Groups I + II vs Group III), B) HIV seropositivity (Groups I vs Groups II + III) and C) presence of detectable HIV viral load. We compared the presence of oncogenic types of HPV detected by PCR with the finding of high grade cytology lesions (HSIL) and acetowhite lesions at colposcopy and biopsy guided by it, within and between groups. Results: There were no differences in cytological, colposcopic or histopathological findings between groups. HPV DNA was isolated in 69 (92%) of the 75 subjects from whom samples were analyzed for this test. The most frequent HPV type was 6, followed by 16. The presence of HIV infection was associated with a higher number of oncogenic HPV types (p=0.038). All six patients with negative PCR had negative anal colposcopy and cytology. The only two cases of NIAA with histological confirmation were positive for anal colposcopy and had oncogenic HPV types on PCR. Conclusion: The association of the results of cytopathology, anal colposcopy and genotyping of the HPV virus increased the diagnostic sensitivity of HPVinduced lesions, with PCR genotyping with findings corresponding to those of the anal colpocytological examination. In this study, the degree of immunodeficiency shown by the T CD4 count was not associated with the increase in remnant HPVinduced anal lesions.
- ItemSomente MetadadadosImportância da peniscopia, citologia oncológica e da histopatologia no diagnostico da infecção peniana pelo papilomavírus humano(Universidade Federal de São Paulo (UNIFESP), 1992) Nicolau, Sergio Mancini [UNIFESP]