Summary The prevalence of human papillomavirus (HPV) infection and other risk factors were studied in a high risk area for cervical cancer (Greenland) Epidemiological research has long pointed to cancer of the cervix uteri as a sexually transmitted disease (Brinton & Fraumeni, 1986). For more than a decade, human papillomavirus (HPV) has been suggested to play an important role in cervical carcinogenesis (zur Hausen, 1989). Not only has HPV DNA been detected in more than 90% of all cervical carcinoma samples tested, but it has also recently been shown that human keratinocytes immortalised with HPV DNA, turn malignant after prolonged cultivation (Hurlin et al., 1991;Pecoraro et al., 1991). If HPV is a main causal agent, one would anticipate a geographical accordance between incidence of cervical cancer and prevalence of HPV infection. On this background we were surprised that our population-based comparison showed that the prevalence of HPV 16/18 detection was higher in Denmark (13.0%) than in Greenland (8.8%) in spite of the cervical cancer incidence being five times higher in Greenland (Kjaer et al., 1988). By contrast, the high risk Greenlandic women were characterised by e.g. a higher number of sexual partners and earlier age at first intercourse compared with Danish women (Kjaer et al., 1989). Because of the surprising lack of correspondence between HPV 16/18 prevalence and incidence of cervical cancer and in view of the further development of new DNA hybridisation techniques, we decided to undertake a renewed comparative study in the same geographical areas. In addition, we reinvestigated the association between HPV and HSV infection and the number of sexual partners like in the previous investigation (Kjaer et al., 1990
Reactive thrombocytosis secondary to iron-deficiency anemia (IDA) is a rare but recognized cause of stroke. We report the case of a patient with iron-deficiency anemia presenting with multiple transient ischemic attacks (TIA) due to intraluminal thrombus of an internal carotid artery. The putative mechanisms underlying anemia and stroke syndromes are not completely understood, and it is believed that iron deficiency may cause ischemic stroke by several potential mechanisms. Thrombocytosis is often associated with iron deficiency, and microcytosis produces a reduction in the red cell deformability and could produce a hypercoagulable state. The platelet count and function observed in iron-deficiency anemia could act synergistically to promote thrombus formation, especially in the setting of an underlying atherosclerotic disease. The presence of floating thrombus in a patient with clinical and MRI evidence of stroke represents a significant therapeutic dilemma and requires immediate decision about treatment.
The causes of pupillary dilatation can be unilateral, bilateral, and transient. The clinical approach to dilated pupils requires stepwise evaluation, and based on the findings, unnecessary and costly procedures can be avoided.
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