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Dysplasia; Screening; HIV-infected Displasia; Cribado; Infectado por el VIH Displàsia; Cribratge; Infectat pel VIH Background: HIV-infected men who have sex with men (MSM) are at high risk to develop human papilloma virus (HPV)-related oropharyngeal cancer. The aim of our study was to assess the usefulness of a pilot oral dysplasia screening program and its correlation with an anal dysplasia screening program. Methods: This was a prospective study with HIV-infected MSM. Oral and anal screenings were performed based on HPV determination, liquid cytology, direct and microscopy oral examinations, high-resolution anoscopy and biopsies, if necessary. Results: A total of 103 patients were included. The mean age of the patients was 44.6 years, 55.3% were smokers, and 57.3% had a history of previous anal high-grade squamous intraepithelial lesions (HSILs). The prevalence of oral HPV infections was 14% (9% HPV-high risk), the prevalence of abnormal cytology was 25.2%, and in 4.8% of the patients, oral examinations showed suspicious HSILs. Oral microscopy did not detect additional lesions that visual inspection. Five oral biopsies were performed and the results were normal. No risk factors for oral HPV infections were identified. The prevalence of anal HPV infections was 88.3% (76.7% HPV-high risk), 52.9% of the patients had altered cytology, and in 45.6% anoscopy showed changes suggestive of HSILs. Seventy-two anal biopsies were performed, detecting 25 cases of HSILs (24.3%). A poor correlation was observed between oral and anal HPV infections (κ = 0.037). Conclusions: The prevalence of oral HPV infections, abnormal cytology and lesions in HIV-infected MSM was low, and their correlation with anal HPV-related lesions was slight. These results confirm the current barriers to oral dysplasia screening techniques. Study funded by program MISP of MSD (Merck HPV Investigator Study Program). MISP project code 58237.

Physiological methods that can be similarly recorded in humans and animals have a major role in sensory toxicology, as they provide a bridge between human sensory perception data and the molecular and cellular data obtained in animal studies. Vestibular toxicity research lags well behind other sensory systems in many aspects, including the availability of methods for functional assessment in animals that could be robustly translated to human significance. Here we review the methods available for the assessment of vestibular function in both humans and laboratory animals, with an emphasis on their similarity or divergence, to highlight their potential utility for the predictive assessment of vestibular toxicity.

In vivo studies are needed to study cisplatin ototoxicity and to evaluate candidate protective treatments. Rats and mice are the preferred species for toxicological and pharmacological pre-clinical research, but systemic administration of cisplatin causes high morbidity in these species. We hypothesized that trans-tympanic administration of cisplatin would provide a good model for studying its auditory and vestibular toxicity in the rat. Cisplatin was administered by the trans-tympanic route in one ear (50μl, 0.5-2mg/ml) of rats of both sexes and two different strains. Cochlear toxicity was corroborated by histological means. Vestibular toxicity was demonstrated by behavioral and histological analysis. Cisplatin concentrations were assessed in inner ear after trans-tympanic and i.v. administration. In all experiments, no lethality and only scant body weight loss were recorded. Cisplatin caused dose-dependent cochlear toxicity, as demonstrated by hair cell counts in the apical and middle turns of the cochlea, and vestibular toxicity, as demonstrated by behavioral analysis and hair cell counts in utricles. High concentrations of cisplatin were found in the inner ear after trans-tympanic administration. In comparison, i.v. administration resulted in lower inner ear concentrations. We conclude that trans-tympanic administration provides an easy, reproducible and safe model to study the cochlear and vestibular toxicity of cisplatin in the rat. This route of exposure may be useful to address particular questions on cisplatin induced ototoxicity and to test candidate protective treatments.

Resumen Introduccion y objetivos Comparar los resultados obtenidos en la reseccion de 21 schwanomas vestibulares gigantes, mediante via retrosigmoidea y combinada retrosigmoidea/translaberintica en cuanto a complicaciones intra y postoperatorias, preservacion del nervio facial y secuelas posquirurgicas. Metodos Se realiza un estudio retrospectivo de 21 pacientes a los que se practico reseccion de neurinoma vestibular gigante segun la escala de Tos & Thomsen (igual o mayor a 4 cm), en un hospital de tercer nivel en el periodo entre 2000 y 2008. Se presentan las caracteristicas mas significativas de la serie estudiada, y se analizan las ventajas e inconvenientes de los distintos abordajes, comparando los resultados obtenidos. Asimismo, se analizan los resultados en cuanto a la preservacion de la funcion del nervio facial. Resultados Destaca la ausencia de mortalidad en el grupo de 21 pacientes estudiado. No hubo complicaciones intraoperatorias importantes. Se consiguio la reseccion total de la lesion en el 87% de los casos, con una preservacion anatomica del nervio facial del 73% en el abordaje combinado retrosigmoideo/translaberintico, respecto a un 40% en el retrosigmoideo. La funcion del nervio facial a los dos anos fue aceptable o buena en un 67% (incluyendo los resultados de las anastomosis heteronerviosas). Se observo un porcentaje global del 14,3% de fistula de liquido cefalorraquideo y un 9,5% de meningitis. Conclusiones nuestros resultados demuestran que el abordaje combinado retrosigmoideo translaberintico para el tratamiento de schwannomas gigantes ofrece mayor preservacion del nervio facial y disminucion de la morbilidad, siendo una importante opcion en el tratamiento de estos tumores, gracias a un enfoque multidisciplinar.

To compare the results obtained in the resection of 21 giant vestibular schwannomas via retrosigmoid (RS) and combined retrosigmoid/translabyrinthine (RS/TL) approaches with respect to intra- and postoperative complications, facial nerve preservation and postsurgical sequelae.This was a retrospective study of 21 patients who underwent a resection of a giant vestibular neuroma according to the TosThomsen Scale (greater than or equal to 4 centimetres) in a tertiary care centre in the period between 2000 and 2008. We present the most significant characteristics of the series studied and the analysis of the advantages and inconveniences of each approach. We also analyse the results regarding facial nerve function preservation.We highlight the absence of mortality in the 21-patient group. There were no important intraoperative complications. Total resection of the lesion was achieved in the 87% of the cases, with facial nerve preservation of 73% using the combined RS/TL approach, in comparison to 40% using the RS. Facial nerve function after two years was acceptable or good in 67% (including those with heteronerve anastomosis). A global percentage of 14.3% of cerebrospinal liquid fistula was observed, as well as 9.5% of meningitis.The results of the study demonstrate that the combined retrosigmoid translabyrinthine approach for giant schwannoma treatment offers increased facial nerve preservation and lower morbidity, constituting an important option in the treatment of this kind of tumours thanks to a multidisciplinary approach.

Cisplatin is a chemotherapeutical agent that is highly effective in the treatment of solid organ tumours, such as ovarian, testicular, bladder, non-small cell pulmonary, and head and neck tumours. The main side effects associated with the use of cisplatin are gastrointestinal toxicity, nephrotoxicity, myelotoxicity, peripheral neurotoxicity and ototoxicity. Ototoxic lesions cause bilateral neurosensory hearing loss, which is irreversible, cumulative and dosage-dependent from