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Human Papilloma Virus (HPV) infection represents the most common sexually transmitted infection worldwide. The best weapon to control the HPV infection is the primary prevention that includes interventions related to lifestyle and sexual habits and HPV-vaccination. HPV vaccination must be recommended not only for young girls, but also for boys, MSM and HIV-infected people. People Living with HIV (PLWHA) have high rates of persistent HPV infection if compared with HIV-uninfected people. Several data from HIV negative population have confirmed vaccine safety and efficacy, but there is limited data available on the efficacy of the vaccine among HIV-infected people. In this review, we considered the studies published about anti-HPV vaccination in PLWHA that we found performing a research on PUBMED (Bethesda, MD, USA) with the aim to point out the main aspects of vaccination in this particular population.

The introduction of ART had a significant impact on PWLH survival. The incidence of AIDS-defining cancers has decreased, but the risk is still higher than general population. Women living with HIV have a high prevalence of HPV infection and related disease, including cervical cancer. HIV-related risk factors, such as immunodeficiency and chronic persistence of infection play an important role in its pathogenesis. HPV vaccine, screening and early antiretroviral therapies, are recommended to reduce the risk of developing cervical cancer. In this review, we considered the studies published about cervical cancer in PLWHA that we found performing a research on PUBMED (Bethesda MD, USA) with the following research terms “Papillomavirus”, “Cervical Cancer”, “HIV infection”, “Screening”, “Vaccination” with the aim to point out the main aspects of cervical cancer in HIV infected women, its management and prophylaxis.

One of the major handicaps in rhinoplastic surgery has always been the lack of a wide view of the nose's osseocartilaginous structures. In the past, this problem was solved by an open approach, following incision of the columella. This method is not, however, universally accepted since it causes an additional external scar. The open rhinoplasty technique without incision of the columella was adopted in fourteen cases, selected according to type of defect and the need to obtain a wider view of the nose's internal structures. Satisfactory cosmetic and functional results were achieved. No major complications occurred and in all cases the only problem arising was transitory edema in the tip. The authors maintain that the advantage of open rhinoplasty, with wide exposure of the operating area and a more direct view of the alar cartilages and quadrangular cartilage, is that it makes correction of tip and nasal septum defects easier and more precise. This technique also avoids discomfort and the danger of a scar on the columella.

Sixty-eight patients submitted to carotid endarterectomy for carotid stenosis have been studied periodically by B-mode real time ultrasonography. This non-invasive investigation allows to detect not only a recurrent stenosis, but also minor changes following endarterectomy, including suture, lesions from clamps, myointimal proliferation, and intimal flaps. We think that all patients submitted to carotid endarterectomy must be explored periodically by duplex scanning, in order to follow-up the normal and pathological changes of the arterial wall.

Four cases of large paramedian hourglass epidermoid tumors extending both in the middle and posterior cranial fossa are reported and other 16 cases from the literature are reviewed. The length of the clinical history and the triviality of neurological symptoms in spite of the size of the tumor are emphasized. CT scanning well documents the extension of these epidermoids and usually consents to differentiate them from the arachnoid cysts. The subtemporal transtentorial approach is more advisable, although a two-stage operation by subtemporal and suboccipital route can be necessary in some cases. Nevertheless the difficulties and the risk of the surgical treatment make very hard the complete removal of the tumor in most cases.

The role of ubiquitin-proteasome system in the accelerated atherosclerotic progression of diabetic patients is unclear. We evaluated ubiquitin-proteasome activity in carotid plaques of asymptomatic diabetic and nondiabetic patients, as well as the effect of rosiglitazone, a peroxisome proliferator-activated receptor (PPAR)-γ activator, in diabetic plaques. Plaques were obtained from 46 type 2 diabetic and 30 nondiabetic patients undergoing carotid endarterectomy. Diabetic patients received 8 mg rosiglitazone (n = 23) or placebo (n = 23) for 4 months before scheduled endarterectomy. Plaques were analyzed for macrophages (CD68), T-cells (CD3), inflammatory cells (HLA-DR), ubiquitin, proteasome 20S activity, nuclear factor (NF)-κB, inhibitor of κB (IκB)-β, tumor necrosis factor (TNF)-α, nitrotyrosine, matrix metalloproteinase (MMP)-9, and collagen content (immunohistochemistry and enzyme-linked immunosorbent assay). Compared with nondiabetic plaques, diabetic plaques had more macrophages, T-cells, and HLA-DR cells (P < 0.001); more ubiquitin, proteasome 20S activity (TNF-α), and NF-κB (P < 0.001); and more markers of oxidative stress (nitrotyrosine and O 2- production) and MMP-9 (P < 0.01), along with a lesser collagen content and IκB-β levels (P < 0.001). Compared with placebo-treated plaques, rosiglitazone-treated diabetic plaques presented less inflammatory cells (P < 0.01); less ubiquitin, proteasome 20S, TNF-α, and NF-κB (P < 0.01); less nitrotyrosine and superoxide anion production (P < 0.01); and greater collagen content (P < 0.01), indicating a more stable plaque phenotype. Similar findings were obtained in circulating monocytes obtained from the two groups of diabetic patients and cultured in the presence or absence of rosiglitazone (7.0 μmol/l). Ubiquitin-proteasome over-activity is associated with enhanced inflammatory reaction and NF-κB expression in diabetic plaques. The inhibition of ubiquitin-proteasome activity in atherosclerotic lesions of diabetic patients by rosiglitazone is associated with morphological and compositional characteristics of a potential stable plaque phenotype, possibly by downregulating NF-κB-mediated inflammatory pathways. © 2006 by the American Diabetes Association.