Day 1 :
Keynote Forum
Igor Jeremić
Radio Access Dermatosurgery and Dermatoestetike, Serbia
Keynote: Severe forms of Condilomata (Genital Warts) in the Genitoanal region: The new Radio wave technique as the most effective therapeutic and ethetic solution
Time : 10:00-10:45
Biography:
Igor Jeremic has completed his Medical Doctor degree at the Faculty of Medicine in Belgrade in 1999 and Specialization in Obstetrics & Gynecology in 2006 with the highest grade 10 at the Medical Faculty in Belgrade. He has also completed specialization in Radio Wave Dermatosurgery in New York in 2008. In 2010, he was appointed as a Licensed Educator of radio wave surgery for Europe: Turkey and Russia in the field of gynecology and dermatosurgery by an expert team of doctors in New York. He is the Founder and the Owner of “Polyclinic Jeremic” the Educational Center of radio wave surgery for Europe.
Abstract:
Background: Condyloma epidemic in the recent time as the consequence of low risk HPV type 6 and 11 infection, affecting primarily younger generation, girls from 18 to 23 years of age. High incidence of HPV infection, accompanying by condylomata is the result of very easy transmittance since it is a sexually transferred illness STD. Only one unprotected intercourse (without protection of condom) is sufficient since it is sexually transmitted disease. The awareness of changes in the genital and anus area with young girls is a cause of fear and concern. This calls for additional responsibility in diagnostic approach and choice of best therapy.
Methods: The study has been conducted on 150 patients from 16 to 50 years of age, both sexes, including pregnant women and immune deficient patients with medium to heavy forms of condylomata in the entire region of genitals, anus an intra-anus in men. This all present a huge therapeutic challenge on account of sensibility of the genitals and anus area to forced trauma, inaccessibility of approach, high vascularization of vagina, cervix and hemorrhoid circle area and exposure to infection, bacteria flora (vagina and colon).
Results: New technique of radio waves of 4 Mhz combines in a special way excision and vaporization which result in almost bloodless work area and ensures precision in total removal of condylomata in one medical procedure and in severe cases, 20% with very heavy and some of Buschke Loewenstien forms, two procedures in local anesthesia. The time for the intervention is from 5 to 30 minutes without hospitalization. Thanks to new procedure technique and specially designed attachments, the lateral damage to healthy tissue is less than10 microns. Insignificant lateral damage to the tissue and minimum bleeding do not affect the local immunity which is key to speedy recovery without infection and relapses percentage of less than 3% in the follow up period from 3 to 18 months. With young girls, the absence of esthetic status is paramount since there are no scars and traces of intervention on the treated area and the functionality of the same is not affected at all.
Conclusion: RW 4 Mhz system and described technique is a new, effective, painless, safe and bloodless method with maximum therapeutic and esthetic effect and the least known rate of relapses, below 3% with these forms of condylomata. The ease of technique in local anesthesia makes this as a therapy of choice even during pregnancy. It takes approximately 5 weeks of total recovery and abstention after intervention from sexual intercourse, regardless of the gravity of case in question.
Biography: I took my Medical Doctor degree at the Faculty of Medicine in Belgrade as the best in class in 1999. Specialization in Obstetrics & Gynecology enrolled in 2001 - ended in 2006 with the highest grade 10, at the Medical Faculty in Belgrade. 2008 – Completed specialization of radio wave dermatosurgery in New York. In 2010- I was appointed Licensed Educator of radio wave surgery for Europe - Turkey and Russia in the field of gynecology and dermatosurgery by an expert team of doctors in New York. I joined this team in 2012. Total number of publications from SCI (SSCI) is 12. Case studies are also presented at Medical Faculties in the USA as examples of treatment of first choice. The founder and the owner of "Polyclinic Jeremić" the Educational Center of radio wave surgery for Europe.
Keynote Forum
Jacqueline Louwers
Diakonessenhuis, Netherlands
Keynote: Performance of dynamic spectral imaging colposcopy depends on indication for referrals
Time : 11:05-11:50
Biography:
Jacqueline Louwers has been trained as a Gynecologist in the VU University Medical Center in Amsterdam and in the Diakonessenhuis in Utrecht, both in the Netherlands. She has been working on various research projects on colposcopy and premalignant cervical lesions since 2012. Currently she is working as a Gynecologist in the Diakonessenhuis in Utrecht and specializes in colposcopy and minimal invasive surgery.
Abstract:
Objective: Dynamic Spectral Imaging (DSI) colposcopy increases the sensitivity of the colposcopic examination in women with an indication for colposcopy as previous studies have demonstrated. In this study we have re-analyzed the performance of DSI and conventional colposcopy for low grade cytology referrals versus high grade cytology referrals and for two new referral conditions.
Methods: The performance of DSI in different cytology groups was assessed using data from the previous validation trial. We analyzed the clinical performance by appropriate filtering of patients to replicate two different referral strategies currently being implemented in screening programs. Furthermore, women referred with BMD (borderline and mild dyskaryosis) or with >BMD cytology either hrHPV positive or negative were separately analyzed.
Results: The sensitivity of DSI and conventional colposcopy to detect high grade (CIN2+) lesions in women referred with BMD cytology is 82% and 44% respectively (p=0.001) and in the >BMD group 77% and 64% respectively (p=0.24). If the two techniques are combined the sensitivity is 85%. When the conditions of new screening strategies are applied DSI colposcopy has a higher sensitivity to detect CIN2+ than conventional colposcopy.
Conclusion: We found that in most cases DSI colposcopy has a higher sensitivity than conventional colposcopy, even when referral criteria are changed. Unlike conventional colposcopy, the sensitivity of colposcopy with DSI in low grade cytology referrals was found similar to the sensitivity in high grade cytology referrals. This suggests that baseline colposcopy sensitivity may be possible with the adjunctive use of the DSI map, irrespective of referral cytology.
- Condylomata Acuminate | Advances in HPV Test | Human Papillomavirus | HPV Vaccines
Chair
Igor Jeremić
Radio Access Dermatosurgery and Dermatoestetike, Serbia
Session Introduction
Piyush Gupta
Cancer Aid Society, India
Title: Sufferings inflicted by HPV and Palliative Care
Biography:
Piyush Gupta has founded Cancer Aid Society in 1987 having Special Consultative Status of United Nations ECOSOC since 2012. He has completed his BSc, LLB, MA, PGDIRPM, PhD degrees and 29 years of rich experience in fight against cancer, authored 100 copyright documents including 24 booklets on different types of cancers. He is currently the Chief Representative of Cancer Aid Society at the offices of United Nations and Member of various national & international government and non government organizations.
Abstract:
HPV infection is a silent killer and more than that it is often considered as a taboo due to lack of awareness in developing countries like India on account of its linkage with sex and playing havoc on the females causing cancer cervix which has emerged as the leading one leaving the breast cancer behind which was supposed to be more common in Urban area on account of the prevalent life style. Early marriage, early pregnancy and multiple births further deteriorate the scenario. Females who have been inflicted with cancer cervix need moral support other than the treatment itself thus emphasizing on the role of palliative care which is often lacking. While post exposure to HPV it takes years to cause Cancer Cervix it was really puzzling that most patients came to the doctors in advance stages due to lack of awareness about the killer which can easily be restrained by improving the immunity and early detection. Community awareness in an introvert society poses a challenge which has been effectively handled through specially designed awareness campaigns by Cancer Aid Society. Role of HPV in vulvo-vaginal, anal and oral cancer cannot be ignored however it has not been prominent in the data sampling covered, may be due to cultural differences.
Guoliang Fu
Genefirst Limited, UK
Title: Performance evaluation of Papilloplextm HR – HPV kit – A novel multiplexing assay for genotyping all 14 HR HPV types in a single closed tube Real- Time PCR reaction
Biography:
Guoliang Fu has completed his PhD from Moscow State University in 1995 and is a Chief Scientist and Founder of GeneFirst Limited, UK. He has held several research positions within Cambridge University, Imperial College London, Oxford University and Oxitec Limited. He is also a Founder for 360 Genomics Limited (acquired by EFK Diagnostics in 2012). He has invented several patented technologies relating to the application of qPCR in medical diagnostics. His technologies allow detection of multiple targets in single closed tube and his interests are to develop further applications while collaborating with industry and academia.
Abstract:
Multiplex Probe Amplification (MPA) technology dramatically expands multiplexing ability of a real-time PCR reaction. It was used to develop a quick, easy-to-use, sensitive and affordable genotyping assay that detects all 14 HR-HPV types in a single reaction Papilloplex™ HR-HPV test. In the present study, we carried out a comparative analysis of the performance of Papilloplex™ HR-HPV test with four well established assays on a panel of liquid based cytology (LBC) samples. Analytical specificity of the assay was also interrogated using the WHO HPV LabNet proficiency panel (2015). The Papilloplex™ HR-HPV test was used to test 500 diseases enriched cervical LBC samples obtained from the Scottish HPV Archive, Edinburgh with known concurrent pathology results. Samples were also tested by the Abbott rT HPV assay, the Qiagen Hybrid Capture 2 Assay, the Diamex Optiplex HPV Genotyping kit and Roche Linear Array HPV Genotyping test. Concordance between the comparator assays vs. Papilloplex™ was performed using binomial test and McNemars test of proportions. As the samples were enriched for CIN2+ the applicability of clinical performance measures to screening settings are limited however these were assessed in terms of sensitivity and specificity for underlying CIN2+. These data indicate that the analytical performance of Papilloplex™ HR-HPV assay is comparable to established HPV assays at the level of generic HR-HPV detection and at the type specific level. The assay shows potential promise for both disease management and epidemiological applications. Further data on the clinical performance of the assay will be presented.
Jasmina Vranes
Dr. A. Stampar Institute of Public Health, Croatia
Title: Comparison of high-risk HPV infection characteristics in women from two Croatian counties
Time : 13:30-14:00
Biography:
Jasmina Vranes has completed her PhD from Zagreb University, School of Medicine. She is the Head of Clinical Microbiology Department at Zagreb Institute of Public Health, Croatia and Professor at Zagreb University, Medical School, specialized in Clinical Microbiology and Pediatrics. She has published more than 80 papers in reputed journals and has been serving as an Editorial Board Member of several medical journals. She is a Member of several professional associations such as: Croatian Medical Association, International Society for Infectious Diseases, European Society for Clinical Microbiology and Infectious Diseases etc.
Abstract:
The aim of this study was to compare the prevalence of high-risk HPV (hrHPV) infection between women from two biggest Croatian counties: The City of Zagreb (CZ) and the Split-Dalmatia County (SDC), considering their age, severity of cervical lesions and distribution of the most important hrHPV types. The study included all women, who were during the eight-month period on their Gynecologist's request, tested on hrHPV infection with molecular cobas HPV Test. The examinees were divided in two age groups (<30 years and ≥30 years). No significant difference was determined in the overall prevalence of hrHPV infection between the two counties. Among 3542 cervical swabs analyzed in the CZ, 39.7% was hrHPV positive, while in the SDC the positivity rate among 1594 tested samples was 36.2%. While in the population of women aged ≥30 years no significant difference in hrHPV prevalence between two counties was observed (CZ 32.9%, SDC 34.7%), in younger women the difference in prevalence was statistically significant (CZ 52.8%, SDC 39.1%; p<0.01). Analyzing the population of hrHPV positive women, the highest prevalence of HPV16 was observed. In the CZ, further analysis showed that genotype 51 was the second most prevalent HPV type in younger women (HPV16 32% and HPV51 27%), associated with low grade cervical abnormalities. The presence of HPV16 and HPV18 in cervical samples significantly increased with the severity of cervical lesions. Significant epidemiological differences of hrHPV infection in population of adolescent and young women in two studied regions were detected.
Kwang Poo Chang
Rosalind Franklin University of Medicine and Science, USA
Title: Photodynamically inactivated Leishmania for safe and effective delivery of vaccines for immunotherapy of infectious and malignant diseases
Biography:
Kwang Poo Chang has completed his PhD from University of Guelph, Ontario, Canada and Postdoctoral studies from Rockefeller University. He has worked as an Assistant and Associate Professor at the Rockefeller University for ~10 years. Thereafter, he became a tenured Professor at Rosalind Franklin University of Medicine and Science, USA. He has published more than 120 papers in reputed journals and has been serving as an Editorial Board Member of repute. He is the Organizer of many national and international scientific activities and research collaborations.
Abstract:
A universal platform is under development to deliver multi-valent vaccines by using Leishmania. These are trypanosomatid protozoa, which naturally infect dendritic cells and parasitize macrophages exclusively as their host cells. The molecular attributes of these parasites are exploitable for homing natural and transgenically introduced vaccines to these antigen-presenting cells (APC). The efficacy of vaccine delivery by this APC-homing platform can be substantially preserved by using oxidatively photo-inactivated Leishmania to ascertain their safety. This is referred to as photodynamic vaccination, which has been shown to safely and effectively deliver naturally occurring vaccines of Leishmania against experimental visceral leishmaniasis. High capacity of Leishmania of transcription/translation activities makes this platform particularly attractive for expressing multiple transgenes as vaccines for immunotherapy against heterogeneous viral infections and tumors.
Sudhakar Jha
Cancer Science Institute of Singapore, Singapore
Title: Hacking of TIP60.com by human papillomaviruses: How and why?
Biography:
Sudhakar Jha is currently working in Yong Loo Lin School of Medicine, Singapore and is a Junior Principal Investigator in Cancer Biology Program, Cancer Science Institute of Singapore. His research focuses on understanding the function of TIP60 (a histone acetyltransferase) as a tumor suppressor. He has discovered TIP60 to be down-regulated by E6, a viral oncogene expressed by human papillomavirus (HPV). Using TIP60 as a candidate molecule, he also plans to investigate how deregulation of this chromatin remodeling complex can lead to cancer.
Abstract:
TIP60 is an essential lysine acetyl transferase, involved in transcriptional regulation, checkpoint activation and p53-directed pro-apoptotic pathways. The cellular levels, stability and activity of TIP60 are tightly regulated. In the case of cervical cancers, we have earlier shown that human papillomavirus (HPV) E6 oncogene of both high and low-risk categories destabilize TIP60. This in turn relieves cellular promoters from TIP60-initiated repression and abrogates p53-dependent activation of apoptotic pathway. Degradation of TIP60, therefore, allows high and low-risk HPV to promote cell proliferation and cell survival. In this conference, I will discuss our efforts to identify the mechanism of TIP60 destabilization by E6 and its implications in cervical cancer progression. Briefly, we have discovered EDD1 (also known as UBR5), an E3 ligase generally overexpressed in cancers as a novel interacting partner of TIP60 and show that EDD1 negatively regulates TIP60’s stability through the proteasome pathway. Interestingly, HPV E6 utilizes this function of EDD1 to destabilize TIP60. By using in vitro cell culture models and in vivo mouse models we show that gain of function of TIP60 or depletion of EDD1 in HPV positive cervical cancer cells significantly inhibits cell growth. In summary, we have discovered a novel ligase through which E6 destabilizes TIP60. Currently, in the absence of an effective therapeutic vaccine, cervical cancer still remains to be a major disease burden. Hence, our studies implying a distinct tumor suppressor role for TIP60 in cervical cancers shows that reactivation of TIP60 could be of therapeutic value.
- Special Session on "Performance evaluation of Papilloplextm HR HPV kit A novel multiplexing assay for genotyping all 14 HR HPV types in a single closed tube Real Time PCR reaction"
- Workshop on "Advancements in Colposcopy"