Search

Copyright of Salud Uninorte is the property of Fundacion Universidad del Norte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Nursing & Health is the property of Journal of Nursing & Health (JONAH) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract High-risk human papillomavirus (HPV) infection is associated with cervical cancer while low-risk HPV strains mostly cause benign lesions. Multiple studies have also associated HPV with coronary artery (CAD) disease in women. Furthermore, the climacteric period in women, triggers chronic inflammation and has major implications for CAD and associated lipid disorders. The association of HPV with coronary artery disease in climacteric women has few studies, and the objective of this review is to gather and analyse scientific data on the subject. This is an integrative review performed on PubMed and Google Scholar using the keywords “HPV”, “coronary heart disease” and “climacteric”, among these keywords the boolean operator AND and the publication date filter. (2018 onwards). Five articles were found, whose main results show presence of high-risk vaginal HPV in climacteric women. Climacterium and HPV were associated with a three-fold increased risk of CAD, as well as with factors related to menopause that promote atheroma formation, lipid disorders and chronic inflammation. Thus, these results support the association between HPV infection and CAD in climacteric women, possibly via chronic inflammation, hormonal factors related to menopause and dyslipidemia.

Introdução: Mulheres vivendo com HIV/AIDS possuem maior frequência de neoplasias anogenitais decorrentes da infecção pelo papilomavírus humano (HPV). A Organização Mundial da Saúde recomenda que o rastreio de câncer do colo do útero seja utilizado por testes moleculares que amplificam o material genético viral, como o HPV-DNA. Além da coleta por profissionais da saúde, a autocoleta de amostras vaginais consiste em uma ferramenta útil para ampliação do acesso à testagem. Objetivo: Descrever os resultados do estudo piloto que avaliou a aceitabilidade da autocoleta de amostra vaginal e aplicabilidade da oferta de testes HPV-DNA com autocoleta de amostras vaginais para mulheres vivendo com HIV/AIDS no Brasil. Métodos: Estudo transversal descritivo envolvendo mulheres vivendo com HIV/AIDS atendidas em oito serviços ambulatoriais distribuídos em todas as regiões do país no período de maio/2021 a maio/2022 e um laboratório central. Realizou-se a oferta de autocoleta vaginal e uma entrevista com as participantes sobre dados sociodemográficos e impressões da autocoleta. Resultados: No total, 1.919 mulheres vivendo com HIV/AIDS com média de 45 anos participaram do estudo. Houve detecção de algum tipo de HPV em 66% (1.267) dos casos. A maioria (71,9%) afirmou preferir a autocoleta à coleta de amostras por profissionais da saúde. Apenas 53,8% das participantes realizaram citologia na periodicidade adequada, conforme recomendação do protocolo. Conclusão: Os resultados poderão apoiar a implementação dos testes de biologia molecular para detecção de HPV em mulheres vivendo com HIV/AIDS, incluindo a possibilidade de autocoleta vaginal, promovendo a ampliação do acesso ao rastreamento de câncer do colo do útero. Palavras-chave: Soropositividade para HIV. Papillomavírus humano. Programas de rastreamento. Neoplasias do colo do útero. Serviços de saúde.

Objetivo: produzir e validar um guia ilustrado como recurso tecnológico de informação para meninos e meninas sobre a vacina contra o Papilomavírus Humano. Método: estudo metodológico, conduzido em ambiente virtual guiado pelo modelo ADDIE (Analysis, Design, Development, Implementation e Evaluation) e pelo Design Instrucional Contextualizado. Participaram da validação de conteúdo e aparência 35 experts da área da saúde e 35 de outras áreas. Na avaliação semântica, participaram 20 meninos e 22 meninas. Resultados: a tecnologia educacional desenvolvida foi um guia ilustrado, constituído de 13 tópicos. A validação de conteúdo global foi 0,91; a validação de aparência, 0,95. Na avaliação, os textos tiveram 94,8% e as ilustrações, 88,8% de acordo total. A versão final constituiu-se de 18 páginas nas versões impressa e digital. Considerações finais: o guia mostrou-se válido e adequado para veicular informações com potencial enquanto recurso didático, para mediar práticas educativas com meninos e meninas sobre a vacina contra o Papilomavírus Humano.

Introdução: O papilomavírus humano (HPV) é um vírus sexualmente transmissível que pode levar ao desenvolvimento de lesões na pele e mucosas. Uma infecção persistente pode cursar com lesões precursoras ou câncer em diferentes regiões, entre elas, lesões vulvares. Relato do caso: Caso descritivo de intervenção fisioterapêutica com light emiting diode (LED) terapêutico em paciente com lesões vulvares induzidas por HPV, que realizou um extenso procedimento de vaporização nas lesões. Após vaporização, realizou tratamento fisioterapêutico com LED terapêutico visando acelerar o processo cicatricial, regeneração tecidual e minimizar a dor. Foi utilizada manta de LED com 18 diodos de LED vermelho – 660 nm e 13 diodos de LED infravermelho 850 nm, sendo a energia entregue por LED de 1 J a cada três minutos, permanecendo por dez minutos. Foram realizadas duas aplicações durante a internação hospitalar, uma no primeiro e outra no segundo dia após a cirurgia. Após alta hospitalar, mais duas aplicações, uma por semana. Após duas primeiras aplicações de LED realizadas no ambiente hospitalar, foi possível observar, de maneira subjetiva, uma melhora da vascularização local. Houve também uma melhora relatada pela paciente, em relação à dor local, facilidade para urinar após as aplicações e redução do edema. Após duas aplicações ambulatoriais, uma vez por semana, ocorreu cicatrização satisfatória. Conclusão: O LED parece ser um recurso promissor na cicatrização de lesões na vulva ocasionadas após vaporização com laser, porém estudos clínicos controlados são necessários para confirmação dessa hipótese.

Background: Cervical cancer (CC) is associated with persistent high-risk human papillomavirus (HPV) infection and it causes about 265,000 deaths per year worldwide, thus becoming an important public health problem. Objective: This study aimed to describe the epidemiological profile, clinical history, and cytological findings of 55 women infected with HPV living in remote areas in Amazonas, Brazil. Method: The samples were obtained by self-collection using the Rovers® Evalyn® Brush for HPV detection through PCR. The cytological examination was performed by liquid-based cytology. Results: The mean age of participants was 35 years (SD=14). Most of the women presented low or no schooling (52.7%), lived in stable relationship with a partner (74.5%), and had three to five children (32.7%). Inconsistent use of condoms by most of the participants (“never” — 34.5% and “sometimes” — 41.8%) was observed. Cytopathological examinations showed that 14 (25.4%) women had cytological alterations: 7 atypical squamous cells of undetermined significance (50.0%), 5 low-grade squamous intraepithelial lesions (35.7%), and 2 high-grade squamous intraepithelial lesions (14.3%). Conclusion: As cervical lesions have been caused by persistent HPV infection over the years, CC Prevention Programs use effective strategies to follow up on HPV-positive women living in remote areas. [ABSTRACT FROM AUTHOR]

Copyright of RGO: Revista Gaúcha de Odontologia is the property of RGO: Revista Gaucha de Odontologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Baiana de Enfermagem is the property of Universidade Federal da Bahia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

With the purpose of analyzing women’s perceptions and classifying their modes of understanding a positive human papillomavirus (HPV+) test, we conducted 38 in-depth interviews with women who had received an HPV diagnosis (normal and abnormal Pap smear), screened in Jujuy’s public health system in 2016. A typology based on women’s understandings of the result was developed: 1) understanding; 2) lack of understanding; a) underestimation; b) overestimation; c) confusion. The interviewees who experienced confusion over the results reported contradictory perceptions in relation to a positive HPV test and its severity; those who underestimated it tended to mention the absence of symptoms and expressed little concern over the result; while those who overestimated it considered themselves sick and described concern, narrating a biographical disruption and physical pain. These findings confirm the need to improve the delivery of results and the provision of information in order to decrease psychosocial impact and increase follow-up adherence in HPV-positive women. [ABSTRACT FROM AUTHOR]

As verrugas genitais são lesões epiteliais induzidas pelo Papillomavirus Humano (HPV). Atualmente, as técnicas utilizadas para tratamento dessas lesões são dolorosas e as recidivas costumam acontecer em um curto espaço de tempo. Diversos estudos têm demonstrado a eficácia do cidofovir no tratamento de HPV entre outras infecções virais. O objetivo dessa revisão de literatura é fazer uma abordagem sobre o fármaco e a sua utilização clínica no tratamento de HPV, apresentando a forma farmacêutica, posologia, reações adversas e dados sobre sua eficácia. Os resultados da pesquisa bibliográfica mostraram que o uso intralesional e epidérmico do cidofovir em formulações extemporâneas tem se mostrado eficaz no manejo dos condilomas. A utilização tópica do cidofovir se apresenta, portanto, como uma alternativa clínica aos tratamentos convencionais, minimizando os efeitos colaterais locais e evitando a ocorrência de efeitos adversos sistêmicos. Diante disso, faz-se necessária a padronização de uma formulação tópica através de estudos de pré-formulação e demais ensaios clínicos visando a obtenção de uma preparação estável, segura e eficaz para tratamento das lesões associadas ao HPV.

Objetivo: explorar qué se ha investigado sobre la experiencia de ser diagnosticado y el vivir con la infección por Virus del Papiloma Humano (VPH) en personas adultas. Metodología: se realizó una revisión de literatura basada en el diseño de scoping review de Arksey y O´Malley. Resultados: la experiencia de la persona adulta con la infección por VPH implica considerar principalmente cuatro áreas: la psicosocial, la sexual, la cognitiva y la atención a la salud. Discusión: aunque la mayoría de los hallazgos se centran en aspectos negativos del VPH, algunos muestran evidencia de beneficios o aspectos positivos a partir del diagnóstico. Conclusiones: el VPH conlleva un impacto considerable desde el momento de su detección hasta el tratamiento, lo que implica afecciones en las distintas áreas de la vida de las personas que van desde cuestiones emocionales hasta el seguimiento adecuado del proceso de atención.

Objective: This work aims to describe the experience of Primary Health Care professionals in actions to prevent Human Papilloma Virus (HPV), the most prevalent sexually transmitted infection in the world. We sought to attract students aged between nine and fourteen years to adhere to the HPV vaccine, according to the protocols recommended by the National Immunization Program. Method: A considerable number of students who were vulnerable to the involvement of this agent in the selected school were identified as the scenario of the experiences. Previous educational moments were held with students from the 7th to the 9th grade of elementary school, as well as health education events aimed at those responsible. Then, vaccination actions were carried out for the target audience, having the school as its initial environment, and, later, the attached health unit. Results: It was observed that, after the intervention, the result of the students' vaccination was positive, but not completely satisfactory, thus confirming the importance of carrying out continuing educational and preventive actions. Conclusion: It was noticed how much young people are in need of information regarding the virus and the vaccine, making it necessary for more actions directed at this public by the integrated health and education professionals. [ABSTRACT FROM AUTHOR]

ABSTRACT: Introduction: Human papillomavirus (HPV) is considered a necessary causative agent for developing oropharyngeal, anal and cervical cancer. Among women in Ecuadorian population, cervical cancer ranks as the second most common gynecological cancer. Not many studies about HPV burden have been published in Ecuador, and genotypes distribution has not been established yet. The little data available suggest the presence of other genotypes different than 16 and 18. Objectives: In the present study, we attempt to estimate the prevalence of HPV 16, HPV 18 and other 35 genotypes among Ecuadorian women undergoing cervical cancer screening. The overall prevalence of HPV infection was also estimated. Methods: Routine cervical samples were analyzed using Linear Array(r) HPV Genotyping test (Roche). Results: A total of 1,581 cervical samples obtained from Ecuadorian women undergoing cervical cancer screening were included in this study. HPV DNA was detected in 689 cervical samples (43.58%). Of these samples, 604 (38.20%) were positive for a single HPV genotype, while another 85 (5.37%) samples were positive for multiple HPV types. Genotype 16 (5.50%) resulted in the most frequently detected type in both single and multiple infections. HPV 33 (4.55%) and HPV 11 (3.80%) occupied the second and the third place in frequency among all detected genotypes. Conclusions: Viral genotypes different from HPV 16 and HPV 18 are frequently detected among Ecuadorian women. The overall prevalence of HPV resulted higher than the one reported in other South American countries with a greater burden in the second and third decades of life.

Objective: To explore the risk factors associated with vaginal infections and squamous intraepithelial lesions of the cervix in university students in Medellín, Colombia. Materials and methods: Cross-sectional study; a convenience sample of 176 students from the health care field were included. Data were obtained through an anonymous survey that included demographic, clinical, and academic variables, as well as those pertaining to sexual habits. Cervical cytology and direct gram stain of vaginal fluid were taken. The statistical association for vaginal infections and squamous intraepithelial lesions of the cervix was explored through the odds ratio and the 95% confidence intervals (95% CI). A p value <0.05 was considered statistically significant. Results: Atypical squamous cells of undetermined significance (ASCUS) was found in 9.1% of participants; low-grade cervical squamous intraepithelial lesions in 4.5%, and vaginal infections in 30.7%; bacterial vaginosis was the most common infection. Previous history of HPV has a statistical association with ASCUS OR = 36.69 95% CI (3.56-378.15) and vaginosis by Gardnerella OR = 10.57 CI 95% (1.07-104.64), whereas urinary infections had a statistical association for candidiasis OR = 4.46 CI 95% (1.21-16.5). Conclusions: Our findings can be used as descriptive information regarding the frequency of vaginal infections and squamous intraepithelial lesions of the cervix in university populations, to continue or improve programs for the promotion and prevention of sexual and reproductive health in young populations. [ABSTRACT FROM AUTHOR]

Objective. To determine the willingness to pay of parents of teenage daughters for a vaccine against human papillomavirus in the Maule Region, Chile. Materials and methods. A sample of 386 parents with daughters between 12 and 18 years old, representing the five largest cities of the Region of Maule, socioeconomically stratified. WTP was obtained using the contingent valuation method in double bounded format. Results. Parents are willing to pay an average of US$ 252.71 to vaccinate their daughters against virus, where the price and number of daughters negatively affects the probability of willingness to pay, and family income positively affects the probability. Conclusion. There is a possibility of using shared funding between the government and the parents of potential daughter to be affected by the human papillomavirus to reduce cervical cancer events.

Background: Human Papilloma Virus has been considered as the precursor of flat lesions in the cervical epithelium which develops Cervix uterine cancer. Objectives: to analyze risk factors associated to infections due to human papilloma virus. Method: An ambispective, descriptive study was carried out from January 2003 to January 2004, taking 60 patients whose Papanicolaou smears were abnormal. All these patients belonged to health area V, in Cienfuegos, Cuba. A guide for interview with different variables was used. Results: infected predominant ages were from 30 to 39 years old. 55% of the patients are married women or with stable sexual relationships. 6 patients comprised between 40 to 59 years old were observed with association to intra epithelium cervix neoplasias. For a 10 % of them, they have had from 3 to 12 sexual partners. The starting age to have sexual intercourse is from 15 to 19 years old. 75 % of the patients are smokers. Conclusions: results coincide with the medical literature reviewed regarding risk factors and its important relationship with NIC and so the cervicouterine cancer genesis.

El Herpes simple genital, el Condiloma acuminado y el Síndrome de inmunodeficiencia adquirida son infecciones de transmisión sexual viral no curable, con aumento de su incidencia en el área de salud del policlínico “Dr. Gustavo Aldereguía Lima”, lo cual motivó a realizar un estudio, con el objetivo de determinar, por orden de frecuencia, los factores de riesgo que guardan asociación causal con este fenómeno. La investigación analítica de casos y controles se llevó a cabo durante el período de enero a diciembre de 2011. El grupo de enfermos estuvo formado por 20 pacientes diagnosticados clínicamente y el grupo control estuvo constituido por 40 individuos no afectados, escogidos al azar. Estadísticamente se determinó odds ratio con su nivel de confianza, Chi-cuadrado, probabilidad y Fisher. Se pudo determinar que las personas, en las que concomitan otras infecciones de transmisión sexual, las prácticas sexuales de riesgo, los grupos con vida sexual potencialmente activa y la promiscuidad constituyen los factores de riesgo que guardan relación causal con esta problemática.

Copyright of Cuadernos Médico Sociales is the property of Colegio Medico de Chile (A.G.) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The objective was to describe the prevalence and factors associated with uterine cervical cancer (CA) and high-grade squamous intraepithelial lesions (HSIL) in adolescents. A cross-sectional study was carried out with 702 sexually active adolescents treated at a general hospital in Rio de Janeiro, Brazil, from 1993 to 2002. Screening was performed by cytopathology and colposcopy and confirmation by biopsy. Exposure variables were socio-demographic characteristics and those related to reproductive health, habits, and sexual behavior. Adjusted odds ratios were estimated using multivariate logistic regression analysis. Based on histopathology, the prevalence of HSIL/CA was 3% (95%CI: 1.8-4.6). There was one case of invasive cancer. With each additional pregnancy, the odds of HSIL/CA increased by 2.2 (95%CI: 1.1-4.4). Age was also associated with this outcome, doubling the odds of acquiring this degree of disease with each year of age (OR = 2.0; 95%CI: 1.2-3.4). The prevalence of lesions suggests the importance of including sexually active adolescent females in cervical cancer screening programs aimed at early detection and treatment of these lesions.O objetivo foi descrever a freqüência e os fatores associados ao câncer cervical (CA) e lesões escamosas intra-epiteliais de alto grau (HSIL) entre adolescentes. Realizou-se estudo transversal com 702 adolescentes sexualmente ativas, assistidas em um hospital geral no Rio de Janeiro, Brasil, entre 1993 e 2002. A investigação foi realizada através de citopatologia e colposcopia, e a confirmação por biópsia cervical. As variáveis de exposição foram características sociais e demográficas, e aquelas relacionadas à saúde reprodutiva, hábitos e comportamento sexual. Baseado nos achados histopatológicos, a freqüência de HSIL/CA foi 3% (IC95%: 1,8-4,6). Houve um caso de câncer invasivo. A cada nova gestação, a chance de HSIL/CA aumentava 2,2 vezes (IC95%: 1,1-4,4). A idade também esteve associada com este resultado (OR = 2,0; IC95%: 1,2-3,4), dobrando a cada ano de idade a chance de adquirir este nível da doença. A freqüência de lesões cervicais intra-epiteliais sugere a importância de incluir adolescentes sexualmente ativas nos programas de prevenção do câncer cervical, com o objetivo de detectar e assegurar o tratamento precoce destas lesões.

Objective: implement a project aimed at the promotion of sexual health as an alternative to the risk of Human Papillomavirus (HPV) in adolescents. Materials and methods: A participatory action research study was carried out in three phases. In the first, topics and strategies were defined for the promotion of sexual health and the risk of HPV, with the participation of adolescents in discussion groups. During the second phase, a two-stage intervention program was conducted: the first consisted of information sessions by institutions, non-governmental organizations and sexual health professionals; in the second stage, activities aimed at promoting sexual health were carried out to avoid the risk of HPV with the support of adolescents. The last phase evaluated the limitations and the scope during the development of the project. Results:the participation of the members of the community allowed the definition of priority topics in sexual health and made it possible to approach them from a comprehensive and multidisciplinary perspective. Conclusion: There is an urgent need to define the concept of sexual health promotion in order to clearly understand the role of adolescents and how genuine participation can be positioned. [ABSTRACT FROM AUTHOR]

Objective: to determine the prevalence and types of HPV in women with low-grade squamous intraepithelial lesions (LSIL). Methods: ninety-six women were sequentially enrolled from the colposcopy clinic. The presence of HPV DNA in the biopsies was determined by L1 consensus primer polymerase chain reaction assay. The samples were co-amplified with biotinylated MY09/MY11/HMB01 and GH20/PC04 beta-globin primers. Reverse line blot hybridization was used for typing the samples. Results: HPV DNA was detected in 28/96 (29.1%) patients. From these, 21/28 (75%) had a single HPV infection and 7/28 (25%) had multiple infection; 29/39 (74.3 %) had high-risk subtypes and 10/39 (25.7%) had low-risk. Thirteen different types were found; most of them were high-risk HPV subtypes (9/13, 69.2%). HPV 58 was the most frequently found subtype. Conclusions: the HPV prevalence in women with LSIL was lower than expected; these results suggest a misclassification in the diagnosis.Objetivo: determinar la prevalencia y los genotipos de los papillomavirus humanos (PVH) en mujeres con lesiones escamosas intraepiteliales de bajo grado (LEIBG). Métodos: noventa y seis mujeres de la clínica de colposcopia fueron incluidas. La presencia del ADN de los PVH en las biopsias fue determinada por ensayo de reacción en cadena de la polimerasa (RCP) con oligonucleótidos para el gen L1. Las muestras fueron coamplificadas con MY09/MY11/HMB01 e iniciadores para betaglobina GH20/PC04. Para tipificar se utilizó hibridación reversa en línea. Resultados: el ADN de PVH fue detectado en 28/96 (29,1%) pacientes, de las cuales 21/28 (75%) tuvieron infección con un solo tipo y 7/28 (25%); infección múltiple. En 29/39 (74,3%) fueron de alto riesgo y 10/39 (25,7%) de bajo riesgo. Encontramos 13 diferentes tipos, 9/13 (69,2%) de ellos de alto riesgo. PVH 58 fue el tipo más frecuente. Conclusiones: La prevalencia de VPH en mujeres con diagnóstico citológico de LEIBG fue menor que la esperada; este resultado sugiere una clasificación inadecuada de los diagnósticos.

Human Papilomaviruses (HPV) are a group of viruses associated with benign and malignant lesions of cutaneous and mucosal epithelia. Some "high risk" HPV types, especially HPV 16 and 18, are strongly correlated with cervical and anogenital cancers and are also related to the genesis of oral squamous cell carcinomas (OSCC). The aim of this work was to investigate the incidence of HPV infection in 40 paraffin-embedded or fresh specimens of OSCC, using PCR amplification of the viral DNA. Literature based primers (GP5+/GP6+) were used in order to amplify HPV DNA from the L1 gene, present in more than 22 types of HPV. A condyloma case with HPV 16 and 18 detected by in situ hybridization was used as a positive control. Amplification of HPV was observed only in the positive control. No squamous cell carcinoma cases showed DNA viral amplification. Absence of HPV DNA amplification by PCR in the analyzed specimens of OSCCs suggests that this virus not always plays a role in the carcinogenesis process. Discrepancy with some studies found in the literature may be related to methodology or population differences.O papilomavírus humano (HPV) constitui um grupo de vírus associados com lesões benignas e malignas do epitélio da pele e das mucosas. Alguns tipos de HPV, ditos oncogênicos, especialmente os HPVs 16 e 18, estão fortemente correlacionados com os cânceres cervical e anogenital, e também têm sido implicados na gênese do carcinoma epidermóide de boca. O objetivo deste estudo foi investigar a incidência de infecção pelo HPV, em 40 casos de carcinoma epidermóide de boca emblocados ou não em parafina, utilizando-se para isso a amplificação do DNA viral por PCR. Foram utilizados os iniciadores GP5+/GP6+, que amplificam parte da região L1 do vírus, comum a mais de 22 tipos de HPVs. Como controle positivo para as reações, foi utilizado um caso de condiloma, o qual foi positivo para os HPVs 16 e 18 na hibridização in situ. A amplificação para o HPV foi constatada apenas no controle positivo; nenhum dos casos de carcinoma epidermóide em estudo mostrou amplificação para o DNA viral. A ausência de amplificação de DNA do HPV nos casos de carcinoma epidermóide estudados sugere que esse vírus nem sempre participa do processo de carcinogênese. Essa diferença em relação a outros estudos provavelmente se dá por questões populacionais, ou mesmo de metodologia entre os diferentes trabalhos citados na literatura.

OBJETIVOS: testar a hipótese de que o polimorfismo no códon 72 do gene TP53 é fator de risco para as lesões pré-malignas e malignas cervicais associadas ou não ao papilomavírus humano (HPV). MÉTODOS: foram incluídas amostras de cérvice uterina, para pesquisa de DNA de HPV e do polimorfismo no códon 72 da p53 com o uso da reação em cadeia da polimerase (PCR), de 155 pacientes que se submeteram à biópsia cervical. Foram formados três grupos de acordo com o diagnóstico histológico: lesão escamosa intra-epitelial de baixo grau (LSIL), lesão escamosa intra-epitelial de alto grau (HSIL) e carcinoma cervical. Aquelas pacientes sem alterações displásicas, citológicas e histológicas, foram consideradas controles. Para testar a associação entre o polimorfismo no códon 72 do gene TP53 e os grupos, foi utilizado o teste de chi2. Considerou-se como significativo o intervalo de confiança no nível de 95% (alfa=0,05). RESULTADOS: quarenta pacientes tiveram o diagnóstico histológico de carcinoma cervical, 18 tinham HSIL, 24 tinham LSIL e 73 foram consideradas controles. O genótipo Arg/Arg p53 foi encontrado em 60,0% das pacientes com câncer, 50,0% dos casos com HSIL, 45,8% dos casos com LSIL e em 45,2% dos controles. Não houve diferença significativa entre as proporções de cada genótipo da p53 nos diferentes grupos independente da presença do HPV (chi2: 3,7; p=0,716). CONCLUSÕES: nossos dados não suportam a hipótese de que o polimorfismo no códon 72 do gene TP53 é importante no desenvolvimento de lesões cervicais pré-malignas e malignas associadas ou não ao HPV.PURPOSE: to test the hypothesis that gene TP53 codon 72 polymorphism is a risk factor for premalignant and malignant cervical lesions associated or not with human papillomavirus (HPV). METHODS: uterine cervical samples were collected for HPV DNA and TP53 codon 72 polymorphism tests from 155 patients who underwent cervical biopsy. Three groups were formed according to histological diagnosis: low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL) and cervical carcinoma. Subjects without cytological and histological displasic changes were considered controls. To verify the association between the gene TP53 codon 72 polymorphism and the groups, the chi2 test was applied. Confidence interval was considered significant at 95% (alpha=0.05). RESULTS: forty subjects were found to present cervical carcinoma, 18 had HSIL, 24 had LSIL and 73 were grouped as controls. The genotype Arg/Arg p53 was found in 60% of the patients with cancer, in 50.0% of the cases with HSIL, 45.8% with LSIL, and in 45.2% of the controls. No significant differences were identified in the frequencies of p53 genotype between all groups, independently of the presence of HPV (chi2: 3.7; p=0.716). CONCLUSIONS: our data do not support hypothesis that the gene TP53 codon 72 polymorphism is important for the development of pre-malignant and malignant cervical lesions associated or not with HPV.

OBJETIVO: avaliar a prevalência do HPV e seus genótipos, utilizando a técnica de reação em cadeia de polimerase (PCR), em pacientes soropositivas e soronegativas para o HIV. MÉTODOS: estudo transversal no qual foram avaliadas 79 mulheres. Dentre elas, 41 eram portadoras do vírus HIV constituindo o grupo estudado, e 38 soronegativas para o HIV, atendidas em uma Unidade Básica de Saúde, e compuseram o grupo controle. Todas as participantes foram submetidas a teste sorológico para detecção do HIV e procuraram de forma espontânea, e pela primeira vez, o atendimento de ginecologia nos serviços mencionados. Estas mulheres responderam ao questionário padrão e foram submetidas a exame ginecológico, com coleta de material da cérvice uterina para citologia oncótica e para detecção do DNA-HPV e seus genótipos. Para análise estatística realizaram-se os testes de Kruskal-Wallis, do chi2 ou o exato de Fisher. Foi considerada significância estatística p0,05) da infecção múltipla por HPV nas soropositivas (50,0%), e a combinação mais freqüentemente encontrada foi a dos tipos 6, 11 e 16. A infecção simples por HPV nas soronegativas ocorreu em 66,6% das pacientes. O tipo 16 foi o mais freqüentemente encontrado, representando 44,4% do total das infecções simples nos dois grupos. CONCLUSÕES: as mulheres soropositivas pelo HIV apresentaram maior prevalência do DNA-HPV na cérvice uterina, em relação às soronegativas. Não houve maior predominância de tipos específicos de HPV quando os dois grupos foram comparados. Houve tendência de infecção por múltiplos tipos de HPV nas portadoras de HIV, ao passo que a infecção simples predominou nas soronegativas.PURPOSE: to estimate the prevalence of HPV and its genotypes in HIV-infected and non-infected women, using the Polymerase Chain Reaction (PCR) technique. METHODS: a sectional study with 79 enrolled women: a study group, with 41 HIV-infected women, and a control group, with 38 non-infected women attended at a Basic Health Unit. All were submitted to a serologic test for the detection of HIV and spontaneously looked for gynecological attendance at those units, for the first time. They answered a standard questionnaire and were submitted to a gynecological examination with a cervical swab and specimen for the detection of DNA-HPV and its genotypes. Statistical analysis was performed using Kruskal-Wallis, chi2 or Fisher's exact tests. Statistical significance was considered at p0.05) was detected in the HIV-infected women (50.0%) and the most frequently found combination was of types 6, 11 and 16. HPV simple infection occurred in 66.6% of HIV-non-infected patients. The most frequent type found in both groups was 16, representing 44% of all the simple infections in both groups. CONCLUSIONS: HIV-infected women showed higher DNA-HPV prevalence in the uterine cervix, as compared to non-infected women. There was no difference in the predominance of specific types of HPV when both groups were compared. There was a tendency to HPV multiple infections in the HIV-infected women, whereas simple infection predominated in the non-infected patients.

Avaliar as alterações na citologia oncológica, na captura híbrida II e na inspeção visual com ácido acético (IVA) a 5% em 684 mulheres atendidas em uma unidade de saúde, e avaliar o desempenho e a concordância entre os exames. Procurar descrever as características sócio-demográficas e reprodutivas (SDR) destas mulheres e sua associação com a presença de doença. As mulheres foram submetidas à coleta de citologia, captura e IVA, e as com exame positivo foram submetidas à colposcopia com biopsia, se necessário. Foi calculado o desempenho dos testes e a associação dos fatores SDR com o diagnóstico histológico foi avaliada por intermédio do cálculo do odds ratio. Embora 198 mulheres apresentassem pelo menos um teste alterado, apenas 21 apresentaram lesão histológica. A sensibilidade dos testes foi semelhante enquanto as especificidades da IVA e da citologia foram maiores que a da captura híbrida II. Apenas a ausência de citologia esteve associada à presença de doença. O desempenho da citologia foi maior que o da IVA, que foi maior que o da captura. A ausência de citologia foi associada com doença histológica.

Experimental, clinical, and epidemiological evidence strongly suggests that genital Human Papillomaviruses (HPVs) are predominantly sexually transmitted. Epidemiological studies in virginal and HPV-negative women clearly indicate that sexual intercourse is virtually a necessary step for acquiring HPV. As with any other sexually transmitted disease (STD) men are implicated in the epidemiological chain of the infection. Penile HPVs are predominantly acquired through sexual contacts. Sexual contacts with women who are prostitutes play an important role in HPV transmission and in some populations sex workers may become an important reservoir of high-risk HPVs. Acting both as "carriers" and "vectors" of oncogenic HPVs male partners may markedly contribute to the risk of developing cervical cancer in their female partners. Thus, in the absence of screening programs, a woman's risk of cervical cancer may depend less on her own sexual behavior than on that of her husband or other male partners. Although more rarely than women, men may also become the "victims" of their own HPV infections as a fraction of infected men are at an increased risk of developing penile and anal cancers. Male circumcision status has been shown to reduce the risk not only of acquiring and transmitting genital HPVs but also of cervical cancer in their female partners. More research is needed to better understand the natural history and epidemiology of HPV infections in men.Evidencia experimental, clínica y epidemiológica demuestra que los papilomavirus humanos (VPH) genitales son predominantemente de transmisión sexual. Estudios experimentales en mujeres vírgenes y en mujeres VPH-negativas indican de forma clara que el coito es virtualmente un paso necesario para adquirir el VPH. Como ocurre con cualquier otra infección de transmisión sexual (ITS) los varones están implicados en la cadena epidemiológica de la infección. Los VPH en el pene son predominantemente adquiridos a través de contactos sexuales. Los contactos sexuales con mujeres que ejercen el sexo comercial juegan un papel importante en la transmisión de los VPH y en algunas poblaciones estas mujeres pueden convertirse en un importante reservorio de VPH de alto riesgo. Actuando ambos como "portadores" y "vectores" de los VPH oncogénicos los hombres pueden aumentar de forma substancial el riesgo de propiciar cáncer de cérvix en sus parejas. En ausencia de programas de detección precoz, el riesgo de cáncer de cérvix en una mujer puede depender menos de su conducta sexual que de la de su marido u otras parejas sexuales. Aunque más raramente que en las mujeres, los hombres pueden también convertirse en "víctimas" de sus propias infecciones por el VPH, pues una fracción de hombres infectados tiene un riesgo aumentado de desarrollar cáncer de pene y de ano. Se ha mostrado que la circuncisión masculina puede reducir el riesgo no sólo de adquisición y transmisión del VPH genital, sino también de cáncer cervical en las parejas de hombres circuncisos. Se requieren más estudios científicos para entender mejor la historia natural y la epidemiología de las infecciones por el VPH en el hombre.

FUNDAMENTOS: A epidermodisplasia verruciforme (EV) é genodermatose rara, caracterizada por infecção disseminada por tipos específicos de vírus papiloma humano (HPV), desenvolvimento de tumores cutâneos malignos e distúrbios imunológicos. OBJETIVOS: Correlacionar aspectos clínicos em 13 doentes com EV, na tentativa de contribuir para melhor conhecimento da enfermidade. MÉTODOS:Avaliação clínica de 13 doentes com EV durante o período de três anos. O diagnóstico clínico foi confirmado pelo exame histopatológico e imuno-histoquímico. RESULTADOS: A EV teve início na infância com lesões de verruga plana-símile e/ou máculas eritematosa na face e região cervical. A consangüinidade foi observada na maioria dos doentes (12/13). Clinicamente, o polimorfismo das lesões foi intenso, caracterizado por lesões de verruga plana-símile, pitiríase versicolor-símile, máculas eritematosas e lesões de queratose seborréica-símile. A transformação maligna das lesões foi observada em oito doentes (62%). O crescimento tumoral provocou perda tecidual importante em 50% dos casos, e em 25% foi registrado óbito pelas metástases. CONCLUSÃO: A EV apresenta alta incidência familiar e provável transmissão autossômica recessiva. O intenso polimorfismo clínico das lesões não afeta o couro cabeludo e mucosas. A apresentação clínica "maligna" foi a mais freqüente (62%), seguida pela "benigna" (23%) e "mista" (15%). Os tumores cutâneos malignos são freqüentes, múltiplos, destrutivos, geram metástases e provocam morte.BACKGROUND: Epidermodysplasia verruciformis (EV) is a rare genodermatosis characterized by disseminated infection caused by specific types of human papillomavirus (HPV), development of cutaneous malignant tumors and immunological disturbances. OBJECTIVE: To correlate the clinical features of a group of 13 patients with EV aiming to contribute to knowledge of disease. METHOD: The clinical evaluation of 13 EV patients during 3 years. The clinical diagnosis was confirmed by histopathological and immunohistochemical findings. RESULTS: The EV began in childhood with flat warts and/or erithematous macules on the face and neck. The parental consanguinity was observed in most patients (12/13). Clinically the lesions were highly polymorphic with flat wart-like lesions, pityriasis versicolor-like lesions, erithematous macules and seborrheic keratoses-like lesions. The malignant conversion of lesions occured in 8 patients (62%). The tumor growth provoked heavy tissue loss in 50% of patients, and metastatic tumors caused death in 25%. CONCLUSION: The EV presents high familial incidence and an autosomal recessive mode of inheritance. The high polymorphism clinical doesn't affect the scalp and mucous membrane. The most frequent clinical manifestation is the "malignant" (62%), followed by "benignant" (23%) and "mixed"(15%). The cutaneous tumors are frequent, multiple, destructive, metastasize and cause death.

Copyright of Universidade Estadual Paulista. Revista de Odontologia is the property of Universidade Estadual Paulista. Revista de Odontologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: the study aims to identify possible competence deficits for self-care and to develop health education strategies to contribute to healthy sexual behaviors, in the prevention and control of HPV. Methodology: convergent-assistential research based on the theory of Orem's Self-Care. There was a participation of eleven women aged 25 to 64 years with changes to HPV. Results: it was possible to identify competency gaps for self-care and ratify the need to apply care-educational technology in acquiring skills for sexual practices. Conclusion: the educational strategy contributes to women's learning, showing signs of skills and abilities acquisition for self-care, in healthier sexual practices. [ABSTRACT FROM AUTHOR]

OBJETIVO: Comparar o resultado da colpocitologia oncológica (CO) de encaminhamento com o resultado da CO coletada no serviço de referência, e avaliar as alterações da colposcopia e o resultado da biópsia. MÉTODOS: Foram selecionadas 213 mulheres atendidas de janeiro de 1989 a abril de 1991 de um centro especializado de atenção à saúde da mulher, com seguimento até julho de 1998. Noventa foram encaminhadas por CO sugestiva de lesão induzida pelo vírus do papiloma humano (HPV) ou neoplasia intra-epitelial cervical (NIC) grau 1 e 123 por CO sugestiva de NIC 2 ou 3. RESULTADOS: Das mulheres encaminhadas por CO HPV/NIC 1, 49% apresentavam NIC 2 ou 3 na CO do serviço. Na colposcopia, 16 não apresentavam lesões suspeitas e em 10 não se via a junção escamo-colunar. Ao diagnóstico histológico, 42 (46%) apresentavam NIC 2 ou 3. Das 123 mulheres encaminhadas com CO NIC 2 ou 3, 54% apresentaram NIC 2 ou 3 na CO do serviço. Na colposcopia, 24 mulheres não apresentavam lesões suspeitas e em 12 não se via a junção escamo-colunar. Na histologia, 61 (49%) apresentavam NIC 2 ou 3. CONCLUSÕES: A conduta expectante nos casos de CO HPV/NIC 1 deve ser criteriosa, envolvendo profissionais capacitados na coleta do exame, e conscientizar a população para retornos periódicos de controle.OBJECTIVE: The study was designed to compare the Pap smear results, performed on the public health service, with: the results of Pap smear collected on the reference service; the colposcopy and punch biopsy results. METHODS: The total of 213 women assisted at the women's hospital ¾ from January 1989 to April 1991, and followed until July 1998 were selected. Ninety were referred because a Pap smears suggestive of Human Papillomavirus (HPV) induced lesion or cervical intraepithelial neoplasia (CIN) grade 1, and 123, CIN 2 or 3. RESULTS: Among the 90 women referred because of HPV/CIN 1.49% presented CIN 2 or 3 in the Pap smears performed at this service. At the colposcopy, 16/90 women did not present suspicious lesions, and in 10 women, the scamous colunar junction was not observed. At biopsy, 42 (46%) presented CIN 2 or 3. Out of the 123 women referred with Pap smear of CIN 2 or 3.54% presented CIN 2 or 3 at this service. At the colposcopy, 24 women did not present suspicious lesions and the scamous colunar junction was not observed in 12. About biopsy, 61 (49%) presented CIN 2 or 3. CONCLUSIONS: The expectant conduct in cases of Pap smear with HPV/CIN 1, should follow a criterion, involving qualified professionals to collect the Pap smear, and should provide people awareness as to control follow-up.

OBJETIVO: Comparar o resultado da colpocitologia oncológica (CO) de encaminhamento com o resultado da CO coletada no serviço de referência, e avaliar as alterações da colposcopia e o resultado da biópsia. MÉTODOS: Foram selecionadas 213 mulheres atendidas de janeiro de 1989 a abril de 1991 de um centro especializado de atenção à saúde da mulher, com seguimento até julho de 1998. Noventa foram encaminhadas por CO sugestiva de lesão induzida pelo vírus do papiloma humano (HPV) ou neoplasia intra-epitelial cervical (NIC) grau 1 e 123 por CO sugestiva de NIC 2 ou 3. RESULTADOS: Das mulheres encaminhadas por CO HPV/NIC 1, 49% apresentavam NIC 2 ou 3 na CO do serviço. Na colposcopia, 16 não apresentavam lesões suspeitas e em 10 não se via a junção escamo-colunar. Ao diagnóstico histológico, 42 (46%) apresentavam NIC 2 ou 3. Das 123 mulheres encaminhadas com CO NIC 2 ou 3, 54% apresentaram NIC 2 ou 3 na CO do serviço. Na colposcopia, 24 mulheres não apresentavam lesões suspeitas e em 12 não se via a junção escamo-colunar. Na histologia, 61 (49%) apresentavam NIC 2 ou 3. CONCLUSÕES: A conduta expectante nos casos de CO HPV/NIC 1 deve ser criteriosa, envolvendo profissionais capacitados na coleta do exame, e conscientizar a população para retornos periódicos de controle.

La alta prevalencia del papilomavirus humano (PVH), referida a nivel mundial, en lesiones genitales de ambos sexos, el rol del varón como reservorio pasivo del virus, y el incremento de la mortalidad por cáncer genital en la mujer en nuestro país, motiva la detección y correlación de los oncogenes de los PVH de alto riesgo con la neoplasia de pene. Informamos de diez casos de biopsias de carcinoma escamoso de pene, incluidos en parafina, los cuales fueron investigados para la presencia de los oncogenes E6-E7 de PVH de alto riesgo, utilizando cebadores tipo específico para los PVH -16 y 18, mediante la reacción en cadena de la polimerasa (PCR). El 40% de los casos mostró un producto de amplificación ADN E6-E7 de los PVH estudiados, correspondiendo el 75% de ellos a detección simple por PVH-18 y el 25% presentó detección mixta ADN E6 - E7 del PVH-16 y 18 simultáneamente. El producto de amplificación fue sometido a comprobación por análisis de restricción específico. La prevalencia obtenida de los oncogenes E6-E7 de los PVH de alto riesgo, usando un método tan sensible como la PCR, apoya el rol de estos virus en el proceso de carcinogénesis de la neoplasia de pene.

Cervical cancer is a major public health problem, as it is the second most common cancer in women world-wide after breast cancer. About 80% of the half a million cases estimated to occur annually in the world, occur in developing countries. The epidemiological evidence linking human papillomavirus (HPV) to cervical cancer is reviewed. It is concluded that over 90% of cervical cancers can be attributed to certain HPV types. HPV 16 accounts for the highest proportion (50%) followed by HPV 18 (12%), HPV 45 (8%) and HPV 31 (5%). The associations with these HPV types are very b and consistent with odds ratios over 15 in all case-control studies in high- and low-risk countries for cervical cancer. However, HPV is not a sufficient cause of this malignancy; certain cofactors are necessary for a proportion of HPV persistent infections to eventually progress to cancer. These include host factors such as histocompatibilidad types and immunological response, hormonal influences and infections with other sexually transmitted agents such as Chlamydia trachomatis. In addition, results from our studies carried out in Spain and Colombia support the hypothesis that male carriers of HPV play an important role in the development of cervical cancer in their wives. The recognition of the central role of HPV in cervical cancer has far-reaching implications for the primary and secondary prevention of this malignancy. Prophylactic and therapeutic HPV vaccines are now under development and HPV typing is being integrated into screening programmes in pilot studies in a few developed countries. In developing countries, well conducted conventional screening programmes remain the best approach for the control of cervical cancer until a safe and efficient HPV vaccine can be used in the general population.El cáncer del cérvix constituye un problema importante de salud pública y es el más común en el mundo, después del de mama. Aproximadamente 80% de los 500 000 casos que se calcula se presentan anualmente en el mundo, corresponde a los países en desarrollo. Actualmente se revisa la evidencia epidemiológica que relaciona al virus del papiloma humano (VPH) con el cáncer del cérvix. Se ha concluido que alrededor de 90% de los cánceres de cérvix pueden atribuirse a ciertos tipos de VPH. Así, el VPH 16 representa la mayor proporción (50%), seguido por el VPH 18 (12%), el VPH 45 (8%) y el VPH 31 (5%). Las asociaciones con estos tipos de VPH son bastante fuertes y consistentes con razones de momios más allá de 15 en todos los estudios de casos y controles en los países con alto y bajo riesgo de cáncer cervical. No obstante, el VPH no constituye una causa suficiente de esta enfermedad; son necesarios ciertos cofactores para que un porcentaje de infecciones persistentes por VPH logre, en algún momento, progresar y dar lugar al cáncer. Entre ellos están los factores del huésped como los tipos de antígenos de histocompatibilidad y la respuesta inmonológica, las influencias que ejercen las hormonas y otros agentes de transmisión sexual, como por ejemplo la Chlamydia trachomatis. Por otra parte, los resultados de los estudios que se llevaron a cabo en España y en Colombia permiten sostener la hipótesis de que los portadores masculinos de VPH desempeñan un papel importante en el desarrollo del cáncer de cérvix que presentan sus esposas. El reconocimiento del sitio tan destacado que ocupa el VPH en el cáncer cervical ha rebasado en mucho las implicaciones de la prevención primaria y secundaria de este padecimiento. Hoy en día se están desarrollando vacunas terapéuticas y profilácticas contra el VPH y su tipificación se está integrando a los programas de detección en estudios piloto de algunos países desarrollados. En las naciones en desarrollo, los programas de detección convencionales y que cuentan con un buen manejo siguen siendo el mejor enfoque para controlar el cáncer del cérvix hasta que pueda utilizarse una vacuna segura y eficaz contra el VPH en la población en general.

Durante el desarrollo del cáncer cervicouterino se inducen mecanismos para evadir el sistema inmune, como son la disminución de la expresión de moléculas de antígeno mayor de histocompatibilidad I y la secreción de citocinas por las células tumorales. Como consecuencia de ello, la estimulación de linfocitos T citotóxicos (LTC) y cooperadores (TC), de células asesinas naturales (AN) y macrófagos es muy deficiente. Para inducir una respuesta inmune efectiva contra el tumor, se requiere la estimulación simultánea de múltiples componentes del sistema inmune: por vía sistémica la estimulación de LTC y TC contra epítopos del virus del papiloma humano, y en un nivel local, la inducción de la secreción de citocinas por el tumor, para aumentar el procesamiento y la presentación de blancos tumorales, así como la estimulación de los linfocitos, AN y macrófagos que infiltran el tumor.Several mechanisms to evade the immune system are induced during cervical cancer development, including the decrease of expression of class I HLA molecules and secretion of specific cytokines by tumoral cells. Consequently, the stimulation of cytotoxic (CTL) and helper (TH) T lymphocytes, as well as the natural killer (NK) cells and macrophages is very poor. The induction of immune response against tumors needs the stimulation of multiple components of the immune system: systemic stimulation of CTL and TH against Human Papilloma Virus epitopes and directly in the tumor the secretion of specific cytokines to increase the antigen processing and presentation of tumoral targets, and the stimulation of lymphocyte, NK cells and macrophages that infiltrate tumors.

The potential use of vaccines for the human papillomavirus (HPV) in the prevention and treatment of cervical cancer is a possibility in the near future. Close to 20 genotypes of HPV, of the 75 that have been identified, infect the femine genital tract, but four subtypes (16, 18, 31 and 45) have been associated in close to 80% of cervical cancers. this article proposes that in order to design an effective prophylactic vaccine against HPV infection, an adequate immune response should be guaranteed through four goals; a) activation of antigens present in the cell; b) overcoming the host response and viral genetic variability in the T cell response; c) generation of high levels of T and B memory cells; and d) persistence of antigens.El potencial uso de vacunas de virus del papiloma humano (VPH) en la prevención y tratamiento del cáncer cervical posiblemente será implementado durante los próximos años. Cerca de los 20 genotipos de VPH de los 75 que se encuentran identificados infectan el tracto genital femenino, pero son cuatro subtipos: 16, 18, 31 y 45 los que se han asociado en cerca de 80% a cáncer cervical. En este ensayo se plantea que para poder diseñar una vacuna profiláctica contra la infección de VPH, efectiva, se debe garantizar una adecuada respuesta inmune a través de cuatro metas: a) activación de antígenos presentes en la célula; b) superar la respuesta del huésped y la variabilidad genética viral en la respuesta de células T; c) generación de altos niveles de células T y B de memoria, y d) persistencia de antígenos.

Durante el desarrollo del cáncer cervicouterino se inducen mecanismos para evadir el sistema inmune, como son la disminución de la expresión de moléculas de antígeno mayor de histocompatibilidad I y la secreción de citocinas por las células tumorales. Como consecuencia de ello, la estimulación de linfocitos T citotóxicos (LTC) y cooperadores (TC), de células asesinas naturales (AN) y macrófagos es muy deficiente. Para inducir una respuesta inmune efectiva contra el tumor, se requiere la estimulación simultánea de múltiples componentes del sistema inmune: por vía sistémica la estimulación de LTC y TC contra epítopos del virus del papiloma humano, y en un nivel local, la inducción de la secreción de citocinas por el tumor, para aumentar el procesamiento y la presentación de blancos tumorales, así como la estimulación de los linfocitos, AN y macrófagos que infiltran el tumor.

Copyright of Revista de Salud Pública is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Accurate diagnosis about knowledge, behavior and risk perception relative to the HPV virus is a cornerstone to design effective interventions related to the promotion, prevention and reduction of the individual vulnerability to HPV among adolescents and young adults. Objective: Obtain evidence related with content validity of a questionnaire that measures knowledge and willingness to act preventively against HPV in adolescents and young adults. Method: 16 experts evaluated the questionnaire conceptual structure as well as the degree of agreement on items clarity and wording. Additionally, 42 college students underwent a cognitive interview in order to adjust instructions, vocabulary, and wording of items. Results: The experts' agreement index estimated for wording and clarity of the questionnaire items was 0.88 and for the four dimensions was between 0.81 to 0.96. The estimated experts' agreement index for wording and clarity of the questionnaire items was 0.88 and for the four dimensions range from 0.81 to 0.96. The questionnaire conceptual structure was determined by applying the concept mapping methodology, using an alternating least-squares algorithm (ALSCAL) to perform non-metrical multidimensional scaling (MDS) technique with a two-dimension solution (Stress = 12%), and a hierarchical cluster analysis (HCA) using Ward's method; also it estimated a bridging statistic for each item in relationship to its cluster. The obtain data suggest that the questionnaire measures four dimensions: socio-demographic profile, sexual behavior, knowledge of transmission and prevention knowledge. Conclusions: The findings for content validity support that the questionnaire measures knowledge and willingness to act preventively against HPV in adolescents and young adults from the vulnerability perspective. [ABSTRACT FROM AUTHOR]

Copyright of Salud Pública de México is the property of Instituto Nacional de Salud Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)