RESUMEN
This study aimed to determine the effectiveness of photodynamic therapy (PDT), using δ-aminolevulinic acid (5-ALA), in the elimination of premalignant cervical lesions in Mexican patients with human papillomavirus (HPV) infection and/or cervical intraepithelial neoplasia (CIN). Thirty women diagnosed with CIN I and/or positive for HPV participated in the study. Topical 6% 5-ALA in gel form was applied to the uterine cervix; after 4 h, the lesion area was irradiated with a light dose of 200 J cm-2 at 635 nm. This procedure was performed three times at 48-h intervals. Clinical follow-up was performed at 3, 6, and 12 months after the initial PDT administration, by colposcopy, cervical cytology, histopathological analysis, polymerase chain reaction, and hybrid capture. Of HPV-infected patients without evidence of CIN I, 80% cleared the infection, while HPV associated with CIN I was eliminated in 83% of patients (P < 0.05). At 12 months, CIN I had regressed in 57% of patients, although this response was not statistically significant. PDT using 6% 5-ALA is concluded to be effective in eliminating HPV infection associated or not with CIN I.
Asunto(s)
Ácido Aminolevulínico/uso terapéutico , Papillomavirus Humano 16/efectos de los fármacos , Papillomavirus Humano 18/efectos de los fármacos , Infecciones por Papillomavirus/tratamiento farmacológico , Infecciones por Papillomavirus/virología , Fotoquimioterapia/efectos adversos , Fármacos Fotosensibilizantes/uso terapéutico , Displasia del Cuello del Útero/tratamiento farmacológico , Adulto , Ácido Aminolevulínico/farmacología , Femenino , Humanos , México , Fármacos Fotosensibilizantes/farmacología , Resultado del Tratamiento , Displasia del Cuello del Útero/virologíaRESUMEN
The Weinreb amides 2a,b were prepared from the α,α-dimethoxyacetic acids 1c,d. A number of representative nucleophilic additions (RMgX and RLi) on 2 afforded α-ketoacetals 3a-j in 70-99% yield. These compounds represent a versatile arrangement of functional groups of significant synthetic value, as demonstrated in the synthesis of (±)-salbutamol.