RESUMEN Introducción: A nivel mundial, el cáncer de cuello uterino es el cuarto cáncer más frecuente en la mujer. Objetivo: Describir las coberturas anuales de vacunación contra VPH y ESAVI. Material y Métodos: Estudio observacional descriptivo transversal, realizado en Paraguay, periodo 2013-2023, variables analizadas: coberturas de vacunación contra VPH en niñas de 10 años, según esquema: 3 dosis (2013-2016), 2 dosis (2017-2023), coberturas de vacunación de seguimiento a los 15 años (1ª dosis y Dosis Final), ESAVI grave y no grave. Resultados: Los intervalos de coberturas de vacunación contra VPH 1ª dosis: 55-73% (periodo no pandémico), 33-53 % (periodo pandémico), mientras que para Dosis Final: 1-64% (periodo prepandémico) y 5-31 % (periodo pandémico). Al analizar las coberturas de vacunación contra VPH Dosis Final según esquema el promedio de deserción fue mayor en esquema de 3 dosis: 42 vs 25% (valor p= 0,001). El intervalo de coberturas de seguimiento a los 15 años Dosis Final: 66 a 77%. Hubo un recupero importante en los años 2019-2021: 71%, 65% y 59% respectivamente. La Tasa de ESAVI: 2,5 x 100.000 dosis administradas. Conclusión: Las coberturas de vacunación de seguimiento a los 15 años fueron < 90%. La tasa de ESAVI por 100.000 fue baja.

ABSTRACT Introduction: Worldwide, cervical cancer is the fourth-most frequent cancer in women. Objective : To describe HPV vaccination coverage and Adverse Events Following Immunizations (AEVF). Material and Methods: This was a cross-sectional, descriptive and observational study, carried out in Paraguay during 2013-2023; the variables analyzed were: HPV vaccination coverage in 10-year-old girls, according to the recommended vaccination schedule: 3 doses (2013-2016), 2 doses (2017-2023), follow-up vaccination coverage at 15 years (1st dose and Final Dose), AEVF classification during 2013-2023. Results: The coverage intervals for the 1st dose of the HPV vaccine were: 55-73% during the pre-pandemic period (2013-2019) and 33-55% during the pandemic years (2020-2023); Final HPV Vaccine dose coverage: 1-64% during the pre-pandemic period and 5-31% during the pandemic period. The average dropout was higher during the use of a 3-dose schedule: 42 vs. 25% (p value = 0.001). Follow-up vaccination coverage at 15 years for Final Dose: 66-77%. A significant catch-up was achieved from 2019-2021: 71%, 65% and 59% respectively. Regarding the safety of the vaccine the AEFV rate: 2.1 x 100,000. Conclusions: HPV Vaccination coverage at 15 years was below 90%; the AEFV rate per 100,000 dose was low.

Abstract Background: Persistent infection by high-risk human papillomavirus (HR-HPV) genotypes is the main cause of cervical cancer worldwide. Genotypes 16 and 18 are associated with progression to cervical cancer, however other genotypes also present high oncogenic risk. There is little evidence regarding the distribution of HR-HPV genotypes in the national population, being an issue that should be addressed in the context of a growing increase in immigration and implementation of the immunization program in Chile since 2015. Aim: To show the distribution of HR-HPV genotypes detected in women and men, attended at the private care network of Clinica Davila, Santiago City, between 2014 and 2021. Methods: Genital and anal samples from 3,642 patients were studied, including both sexes. Genotyping was performed by real-time polymerase chain reaction (PCR) (HPV AnyplexTM II HPV28 detection, Seegene, Korea). Results: The global distribution of genotypes in women (percentage) was: 16 (14.34%) - 31 (6.20%) - 39 (5.94%) - 58 (5.94%) - 51 (5.68%) - 53 (5.64%) - 52 (5.30%) - 56 (5.27%) - 68 (5.19%) - 66 (4.97%) - 18 (3.36%) - 59 (3.29%) - 73 (2.80%) - 35 (2.54%) - 45 (2.13%) - 33 (1.53%) - 82 (1.38%) - 26 (0.49%) and 69 (0.41%). In men was: 16 (8.52%) - 58 (4.39%) - 51 (8.44%) - 26 (0.42%) - 18 (3.21%) - 52 (4.47%) - 39 (5.40%) - 53 (4.56%), 33 (1.69%) - 35 (2.03%) - 73 (2.19%) - 69 (0.59%) - 45 (2.11%) - 59 (4.22%) - 68 (3.04%) - 66 (5.06%) - 31 (4.64%) - 56 (4.81%) and 82 (1.10%). Conclusions: The distribution of HPV genotypes was consistent with previous national studies. A tendency to reduce genotype 16 over the years was observed, which could be related to the vaccination, implemented in recent years in Chile. It is remarkable that other HR-HPV genotypes had a high frequency in the population studied, so it would be advisable to evaluate an expanded screening for HR-HPV genotypes to assess the oncogenic risk, for diagnostic and therapeutic purposes.

Resumen Introducción: La infección persistente por genotipos de virus papiloma humano de alto riesgo (VPH-AR) es la principal causa del cáncer cérvico-uterino en todo el mundo. Los genotipos 16 y 18 están asociados a la progresión hacia el cáncer de cuello uterino; sin embargo, otros genotipos también presentan alto riesgo oncogénico. Existe escasa evidencia respecto a la distribución de genotipos VPH-AR en la población nacional, siendo un tema que debiese ser abordado en el contexto de un creciente aumento de la inmigración e implementación del programa de inmunización en Chile desde 2015. Objetivo: Dar a conocer la distribución de genotipos de VPH-AR detectados en pacientes de ambos sexos, atendidos en la red de atención privada de Clínica Dávila de Santiago, entre los años 2014 y 2021. Metodología: Se estudiaron muestras genitales y anales provenientes de 3.642 pacientes, incluyendo ambos sexos. La genotipificación fue realizada mediante reacción de la polimerasa en cadena (RPC) en tiempo real (HPV AnyplexTM II HPV28 detection, Seegene, Korea. Resultados: La distribución global de genotipos en mujeres (porcentaje) fue: 16 (14,34%) - 31 (6,20%) - 39 (5,94%) - 58 (5,94%) - 51 (5,68%) - 53 (5,64%) - 52 (5,30%) - 56 (5,27%) - 68 (5,19%) - 66 (4,97% - 18 (3,36%) - 59 (3,29%) - 73 (2,80%) - 35 (2,54%) - 45 (2,13%) - 33 (1,53%) - 82 (1,38%) - 26 (0,49%) y 69 (0,41%). En hombres fue: 16 (8,52%) - 58 (4,39%) - 51 (8,44%) - 26 (0,42%) - 18 (3,21%) - 52 (4,47%) - 39 (5,40%) - 53 (4,56%) - 33 (1,69%) - 35 (2,03%), 73 (2,19%) - 69 (0,59%) - 45 (2,11%) - 59 (4,22%) - 68 (3,04%) - 66 (5,06%) - 31 (4,64%) - 56 (4,81%) y 82 (1,10%). Conclusiones: La distribución de los genotipos de VPH fue concordante con estudios previos nacionales. Se observó una tendencia a la reducción del genotipo 16 en el tiempo, lo cual podría relacionarse a la vacunación, implementada en los últimos años en Chile. Destaca que otros genotipos de VPH-AR tuvieron una alta frecuencia en la población estudiada por lo que sería recomendable evaluar la pesquisa ampliada de genotipos de VPH-AR para valorar el riesgo oncogénico, con fines diagnósticos y terapéuticos.

Abstract The great majority of malignant lesions of the cervix is associated with human papilloma virus (HPV) positivity and/or altered cytology. We describe a case of cervical cancer with a normal co-test, in which the occurrence of hematometrocolpos in postmenopause led to the correct diagnosis.

Resumo A maioria das lesões malignas cervicais uterinas associa-se a vírus do papiloma humano (HPV) e/ou citologia alterada. Descrevemos um caso de cancro do colo do útero com co-teste normal, cujo estudo diagnóstico foi desencadeado pela presença de hematometrocolpos na pós-menopausa.

Abstract The great majority of malignant lesions of the cervix is associated with human papilloma virus (HPV) positivity and/or altered cytology. We describe a case of cervical cancer with a normal co-test, in which the occurrence of hematometrocolpos in postmenopause led to the correct diagnosis. HPV (HPV andor and or cytology cotest, cotest co test, test co-test diagnosis

Resumo A maioria das lesões malignas cervicais uterinas associa-se a vírus do papiloma humano (HPV) e/ou citologia alterada. Descrevemos um caso de cancro do colo do útero com co-teste normal, cujo estudo diagnóstico foi desencadeado pela presença de hematometrocolpos na pós-menopausa. associase associa se HPV (HPV eou e ou alterada coteste co teste normal pósmenopausa. pósmenopausa pós menopausa. menopausa pós-menopausa

ABSTRACT Introduction: Precancerous conditions known as cervical intraepithelial neoplasia (CIN) can occur between 10-15 years before the development of invasive cervical cancer (ICC). Aim: To determine the frequency of precancerous conditions of the cervix in biopsy samples received in the Pathological Anatomy Laboratory belonging to the Medical Research Center at the National University of the East in the period from 2013 to 2019. Methods: A descriptive, retrospective cross-sectional study with a quantitative approach was performed. The data were obtained from the results of biopsy samples received in the Pathological Anatomy Laboratory belonging to the Medical Research Center at the National University of the East. Results: Of the total sample (n=3801), the frequency of positivity for precancerous conditions of ICC was 21.31% (n=810), of which 52.83% (n=428) belonged to LSIL and 26.29% (n=213) to HSIL. The average age of women with low-grade precursor lesions was 34±12 years, for high-grade precursor lesions was 39±12 years and for invasive carcinoma was 49±13 years. Conclusion: The highest percentage of injuries obtained in this study was the finding of low-grade injuries (LSIL) in young women of reproductive age. The diagnosis and monitoring of precursor lesions could be increased to avoid the spread of ICC.

RESUMEN Introducción: Las lesiones preneoplásicas conocidas con el nombre de neoplasia cervical intraepitelial (CIN), pueden presentarse entre 10-15 años antes de la aparición del cáncer del cuello uterino invasor (CCU). Objetivo: Determinar la frecuencia de lesiones preneoplásicas de cuello uterino en muestras de biopsias recibidas en el Laboratorio de Anatomía Patológica del Centro de Investigaciones Médicas de la FACISA-UNE en el periodo 2013 a 2019. Métodos: Se realizó un estudio descriptivo, retrospectivo de corte transversal con enfoque cuantitativo. Los datos fueron obtenidos de resultados de muestras para biopsias recibidas en el Laboratorio de Anatomía Patológica del Centro de Investigaciones Médicas de la Facultad de Ciencias de la Salud de la Universidad Nacional del Este. Resultados: Del total de muestras (n=3801), la frecuencia de positividad para lesiones preneoplásicas de CCU fue de 21,31% (n= 810), de los cuales el 52,83% (n= 428) pertenecen a LSIL y 26,29% (n=213) a HSIL, mientras la edad promedio de las mujeres con lesiones preneoplásicas de bajo grado es de 34±12 años, de alto grado es de 39±12 años y carcinoma invasor 49±13 años. Conclusión: El mayor porcentaje de lesiones obtenidas en este estudio fue el hallazgo de lesiones de bajo grado (LSIL) en mujeres jóvenes en edad de reproducción. Se podría aumentar el diagnóstico y seguimiento de las lesiones preneoplásicas a fin de evitar la diseminación del CCU.

ABSTRACT Human papillomavirus (HPV) infection is one of the most common sexually transmitted viral diseases. A descriptive cross-sectional study was conducted with the purpose of clinically and epidemiologically characterizing anal HPV infection in patients who attended the Benign Orificial Pathology Consultation of the Coloproctological Unit at the Dr. “Antonio María Pineda” Central University Hospital, during the period March 2022 -February 2023, by selecting 288 patients whose average age was 47.09 ± 14.61 years, being the 41-50 years old group (29.17%) and the 51-60 years old group (19.44%) the most affected groups by pathologies of the anal region, with a predominance of male (54.17%). The sociodemographic characteristics with the highest frequency included married (48.61%) and single (47.22%); secondary level of education (44.44%) and traders (18.05%) and housewives (15, 28%) as predominant occupations. The risk factors were represented by onset of sexual intercourse between 16-20 years of age (65.28%), heterosexuality (91.67%), 22.22% reported having anal sex and 5.56% oral sex. Likewise, 5.56% were reported with a history of genital HPV and 4.17% were HIV positive. In addition, 48.61% stated not to use condoms. The initial clinical diagnosis included hemorrhoidal disease (30.55%), anal fistula (25%) and anal fissure (18.05%), and one patient (1.39%) with anal HPV infection. Anal cytology results showed 8.33% flat epithelial cells with cytopathic changes suggestive of HPV infection and 1.39% squamous cells with cytopathic changes suggestive of HPV infection: 50% mild inflammatory negative for malignancy and 33.33% flat epithelial cells without atypia. In conclusion, the anal cytology investigation should continue to determine the actual frequency of anal HPV infection. (HPV diseases crosssectional cross sectional Dr Antonio Pineda Hospital 202 February 2023 28 4709 47 09 47.0 1461 14 61 14.6 4150 41 50 41-5 29.17% 2917 29 17 (29.17% 5160 51 60 51-6 19.44% 1944 19 44 (19.44% region 54.17%. 5417 54.17% . 54 (54.17%) 4861 48 (48.61% 47.22% 4722 22 (47.22%) 44.44% 4444 (44.44% 18.05% 1805 18 05 (18.05% 15, 15 (15 28% occupations 1620 16 20 16-2 65.28%, 6528 65.28% , 65 (65.28%) 91.67%, 9167 91.67% 91 67 (91.67%) 2222 22.22 556 5 56 5.56 Likewise 417 4 4.17 positive addition 48.61 condoms 30.55%, 3055 30.55% 30 55 (30.55%) 25% 25 (25% 18.05%, 139 1 39 (1.39% 833 8 33 8.33 1.39 3333 33.33 atypia conclusion 2 470 0 47. 146 6 14. 415 41- 29.17 291 (29.17 516 51- 19.44 194 (19.44 541 54.17 (54.17% 486 (48.61 47.22 472 (47.22% 44.44 444 (44.44 18.05 180 (18.05 (1 162 16- 652 65.28 (65.28% 916 91.67 9 (91.67% 222 22.2 5.5 4.1 48.6 305 30.55 3 (30.55% (25 13 (1.39 83 8.3 1.3 333 33.3 29.1 (29.1 19.4 (19.4 54.1 (54.17 (48.6 47.2 (47.22 44.4 (44.4 18.0 (18.0 ( 65.2 (65.28 91.6 (91.67 22. 5. 4. 48. 30.5 (30.55 (2 (1.3 8. 1. 33. 29. (29. 19. (19. 54. (54.1 (48. (47.2 44. (44. 18. (18. 65. (65.2 91. (91.6 30. (30.5 (1. (29 (19 (54. (48 (47. (44 (18 (65. (91. (30. (54 (4 (47 (65 (91 (30 (5 (6 (9 (3

RESUMEN La incidencia del cáncer anal ha presentado un incremento en los últimos 10 años, sobre todo en población considerada vulnerable. Las mujeres con antecedentes de infección por Virus del Papiloma Humano (VPH) en el tracto genital, tienen mayor riesgo de este tipo de cáncer. Se ha demostrado que, la infección con genotipos de VPH de alto riesgo (AR), en la región anogenital, desempeña un papel en la etiopatogenia de dicho cáncer. Se desconocen muchos aspectos de la historia natural de las lesiones anales, pero se considera que la zona de transición anal presenta un alto recambio celular, por lo que se ha planteado un mecanismo fisiopatológico de infección por VPH-AR y desarrollo de lesiones invasoras, similar al del cáncer cervical. El objetivo de este trabajo fue mostrar el estado actual sobre la información epidemiológica que vincula el riesgo de desarrollar cáncer anal en mujeres con lesiones precursoras de cáncer cervical asociadas a la infección por VPH. La relevancia de dicha información es proporcionar una base de recomendaciones para la detección oportuna de cáncer anal en mujeres consideradas de AR de padecerlo y, favorecer la realización de estudios prospectivos en la población.

ABSTRACT The incidence of anal cancer has increased in the last 10 years, especially in the population considered to be at risk. Women with a history of infection in the genital tract by Human Papillomavirus (HPV) have higher risk of developing this type of cancer. The presence of high-risk (HR) HPV genotypes in the anogenital region has been shown to play a role in the etiopathogenesis of anal cancer. Many aspects of the natural history of anal lesions are unknown, but the anal transition zone is considered to have a high cell replacement. This is why a pathophysiological mechanism of HR-HPV infection and development of invasive lesions similar to those of cervical cancer has been suggested. The aim of this work was to show the current status of the epidemiological information that links the risk of developing anal cancer in women with cervical cancer precursor lesions associated with HPV infection. The relevance of this information is to provide a basis of recommendations for the timely detection of anal cancer in women considered to be at HR of suffering it, and to encourage more prospective studies in this population.

Resumen Introducción. Los helechos del género Pteridium se caracterizan por su amplio hábitat y poder adaptativo, que permite su establecimiento en diversos tipos de suelos y altitudes; estos poseen la capacidad de producir una toxina denominada ptaquilósido. Objetivo. Conjuntar un cuerpo de conocimientos actualizados sobre la toxina ptaquilósido presente en helechos del género Pteridium. Desarrollo. Los helechos del género Pteridium, contienen la biotoxina ptaquilósido, en especial en estados fenológicos jóvenes y en las frondas. La hidrólisis de esta toxina a nivel biológico, genera compuestos con propiedades citotóxicas y genotóxicas. El ptaquilósido puede producir hematuria enzoótica bovina, depositarse en la leche del animal que lo ingiere y afectar la salud de los consumidores de lácteos. La biotoxina tiene un efecto inmunosupresor en bovinos, lo que puede favorecer al virus del papiloma, además, genera ceguera en ovejas; se relaciona con el cáncer de esófago y gástrico en seres humanos que habitan en áreas pobladas por helechos del género Pteridium. El efecto cancerígeno del ptaquilósido se genera porque causa una alquilación del ADN en el N3 de la adenina o en el N7 de la guanina, 24 h después de la ingestión. Para la erradicación de los helechos en las pasturas destacan: control mecánico, control biológico y control químico. Conclusión. La biotoxina ptaquilósido representa un riesgo para la salud humana y animal, que se puede propagar al suelo, a los cuerpos de agua y a los alimentos. Se requiere más investigación para tomar medidas que disminuyan sus efectos.

Abstract Introduction. The ferns of the genus Pteridium are characterized by their wide habitat and adaptive power that allows their establishment in various types of soils and altitudes. They have the ability to produce a toxin called ptaquiloside. Objective. To gather a current body of updated knowledge on the ptaquiloside toxin present in ferns of the genus Pteridium. Development. The ferns of the genus Pteridium produce ptaquiloside biotoxin, especially in young phenological stages and in the fronds. The hydrolysis of this toxin at the biological level generates compounds with cytotoxic and genotoxic properties. Ptaquiloside can produce enzootic bovine hematuria, be deposited in the milk of the animal that consumes it and affects the health of dairy consumers. The biotoxin has an immunosuppressive effect in cattle, which can favor the papilloma virus, and also causes blindness in sheep. It is associated with esophageal and gastric cancer in humans living in areas populated by ferns of the genus Pteridium. The carcinogenic effect of ptaquiloside is generated because it causes DNA alkylation at N3 adenine or N7 guanine, 24 h after ingestion. For the eradication of ferns in pastures, mechanical control, biological control, and chemical control, are the most important. Conclusion. The biotoxin ptaquiloside represents a risk to human and animal health, which can spread to soil, water bodies, and food. More research is needed to take measures to reduce its effects.

RESUMEN La papilomatosis respiratoria recurrente es una enfermedad neoplásica causada por el virus del papiloma humano y caracterizada por el crecimiento de lesiones proliferativas exofíticas que afectan la mucosa de las vías respiratorias. En su epidemiología se presenta una distribución bimodal, con una forma juvenil en menores de 20 años, más agresiva, con múltiples lesiones papilomatosas y alta frecuencia de recurrencia, en comparación con la forma adulta. El compromiso pulmonar es poco frecuente y su manejo es un desafío. Se presenta el caso de un varón de 13 años con antecedente de papilomatosis laríngea desde los dos años. El paciente mostró dificultad respiratoria y múltiples nódulos estenosantes en laringe y tráquea, y varios quistes pulmonares visualizados en la tomografía de tórax. Se le realizó exéresis de las lesiones papilomatosas y traqueostomía. Recibió dosis única de bevacizumab 400 mg intravenoso y terapias respiratorias con evolución favorable, sin recurrencias en el seguimiento.

ABSTRACT Recurrent respiratory papillomatosis is a neoplastic disease caused by the human papillomavirus and characterized by the growth of exophytic proliferative lesions affecting the mucosa of the respiratory tract. This condition has a bimodal age distribution; the juvenile form affects those under 20 years of age, is more aggressive and presents multiple papillomatous lesions and high frequency of recurrence, compared to the adult form. Pulmonary involvement is rare and challenging to treat. We present the case of a 13-year-old male with a history of laryngeal papillomatosis since the age of two years. The patient showed respiratory distress and multiple stenosing nodules in the larynx and trachea, as well as several pulmonary cysts identified on chest CT. The patient underwent excision of the papillomatous lesions and tracheostomy. Then, the patient received a single dose of intravenous bevacizumab 400 mg and respiratory therapies with favorable evolution, without recurrences during follow-up.

ABSTRACT Recurrent respiratory papillomatosis is a neoplastic disease caused by the human papillomavirus and characterized by the growth of exophytic proliferative lesions affecting the mucosa of the respiratory tract. This condition has a bimodal age distribution; the juvenile form affects those under 20 years of age, is more aggressive and presents multiple papillomatous lesions and high frequency of recurrence, compared to the adult form. Pulmonary involvement is rare and challenging to treat. We present the case of a 13-year-old male with a history of laryngeal papillomatosis since the age of two years. The patient showed respiratory distress and multiple stenosing nodules in the larynx and trachea, as well as several pulmonary cysts identified on chest CT. The patient underwent excision of the papillomatous lesions and tracheostomy. Then, the patient received a single dose of intravenous bevacizumab 400 mg and respiratory therapies with favorable evolution, without recurrences during follow-up.

RESUMEN La papilomatosis respiratoria recurrente es una enfermedad neoplásica causada por el virus del papiloma humano y caracterizada por el crecimiento de lesiones proliferativas exofíticas que afectan la mucosa de las vías respiratorias. En su epidemiología se presenta una distribución bimodal, con una forma juvenil en menores de 20 años, más agresiva, con múltiples lesiones papilomatosas y alta frecuencia de recurrencia, en comparación con la forma adulta. El compromiso pulmonar es poco frecuente y su manejo es un desafío. Se presenta el caso de un varón de 13 años con antecedente de papilomatosis laríngea desde los dos años. El paciente mostró dificultad respiratoria y múltiples nódulos estenosantes en laringe y tráquea, y varios quistes pulmonares visualizados en la tomografía de tórax. Se le realizó exéresis de las lesiones papilomatosas y traqueostomía. Recibió dosis única de bevacizumab 400 mg intravenoso y terapias respiratorias con evolución favorable, sin recurrencias en el seguimiento.

Resumen: La prevalencia de infección por virus Papiloma Humano (VPH) es desconocida en niños, niñas y adolescentes (NNA) chilenos. En 2014 se incorporó en Chile la vacuna VPH al Programa Nacional de Inmunizaciones en niñas y en varones el 2019. Objetivo: Determinar la prevalencia, genotipos y características de la infección por VPH en NNA con lesiones anogenitales no vacunados contra VPH. Pacientes y Método: Se estudiaron NNA con lesiones anogenitales que consultaron en el Hospital Calvo Mackenna entre 2013 y 2017. Se registró motivo de consulta, edad, sexo, antecedentes de fami liar portador de lesiones por VPH, antecedente de vulneración sexual, y actividad sexual consentida. Se detectó VPH por PCR y tipificación mediante hibridación reversa en línea del gen L1. Las muestras se analizaron en la Sección de Virus Oncogénicos del Instituto de Salud Pública. Resultados: Se estu diaron 110 pacientes; 44.5% niños/as. Se detectó VPH en 34 (30,9% [IC95% 22,4- 40,4]); 22 (44,9%) niños/as y 12 (19,7%) adolescentes. Once (91,7%) adolescentes tenían antecedente de contacto sexual (p < 0,005); 4 (18,2%) niños/as develaron vulneración sexual. 25% de las lesiones genitales y 50% de las perianales eran VPH (+) (p 0,015). Los genotipos más frecuentes fueron 59, 58, 16, 18, 6 y 11. En niños/as se detectó sólo genotipos de bajo riesgo. En 91.7% de las adolescentes VPH (+) se detectaron genotipos de alto riesgo. Conclusión: La prevalencia de infección por VPH fue 30%. En adolescentes la infección estuvo relacionada a contacto sexual y a VPH de alto riesgo. En niños/as se asoció a ge notipos de bajo riesgo. Las lesiones perianales se asociaron con mayor frecuencia que las genitales a infección por VPH. La inspección visual no permite precisar la etiología de las lesiones genitales, por lo que es necesario realizar test de PCR para virus papiloma humano.

Abstract: In Chilean children and adolescents, human papillomavirus (HPV) infection prevalence is unknown. In 2014, the HPV vaccine was incorporated into the National Immunization Program for girls, and since 2019 for boys. Objective: To determine the prevalence, genotypes, and characteristics of HPV infection in children and adolescents with anogenital lesions not vaccinated against HPV. Patients and Method: Children and adolescents with anogenital lesions who consulted at the Luis Calvo Mackenna Children’s Hospital between 2013 and 2017 were studied. The reason for consultation, age, sex, family history of HPV lesions, history of sexual abuse, and consensual sexual activity were recorded. HPV was detected by PCR and typification by reverse hybridization of the L1 gene. The samples were analyzed in the Oncogenic Virus Section of the Institute of Public Health. Results: 110 patients were studied; 44.5% were children. HPV was detected in 34 cases (30.9% [CI95% 22.4- 40.4]), 22 (44.9%) were children and 12 (19.7%) adolescents. Eleven (91.7%) adolescents had a history of sexual contact (p < 0.005); 4 (18.2%) children disclosed sexual abuse. HPV was found in 25% of patients with genital lesions and 50% with perianal lesions (p < 0.015). The most frequent genotypes were 59, 58, 16, 18, 6, and 11. Only low-risk genotypes were detected in children and high-risk genotypes were detected in 11/12 (91.7%) of HPV (+) adolescents. Conclusion: The prevalence of HPV infection was 30%. In adolescents, the infection was related to sexual contact and high-risk HPV. In children, it was associated with low-risk genotypes. Perianal lesions are more frequently associated with HPV infection than genital lesions in children and adolescents. The visual inspection does not allow to specify the etiology of the genital lesions, so it is necessary to perform a PCR test for HPV.

ABSTRACT In equatorial Brazil, the association of Burkitt lymphoma and Epstein–Barr virus manifests at high rates. Here, we report, for the first time, amplifications of aurora kinase genes (AURKA/B) in a patient with a history of periodontal abscess and the presence of a remaining nodule, diagnosed with Burkitt lymphoma and Epstein–Barr virus, and /HIV positive. The patient was a 38-year-old man who presented with a 2-week-old severe jaw pain and a 3-day-old severe bilateral headache. He had a history of human papilloma virus. Interphase FISH analysis showed AURKA and AURKB amplification. The patient’s condition worsened, progressing to death a month after the initial care. Changes in the MYCC and AURKA pathways are directly associated with genomic instability. Thus, MYCC rearrangements and higher expression of AURKA/B may be associated with therapy resistance, highlighting the importance of AURKA/B evaluation in Burkitt lymphoma. Brazil EpsteinBarr Epstein Barr rates Here report time AURKAB B (AURKA/B nodule HIV positive 38yearold yearold 38 year old 2weekold weekold 2 week 3dayold dayold 3 day headache amplification patients s worsened care instability Thus resistance

Abstract Background & Aims Perianal fistulizing Crohn's disease is the main risk factor for anal cancer in patients with inflammatory bowel disease. Whether this occurs due to a higher frequency of human papillomavirus remains unclear. The authors aimed to evaluate the prevalence of HPV and high-risk HPV in patients with perianal Crohn's disease, compared with a control group. Methods The authors conducted a two-center cross-sectional study in which perianal fistulizing Crohn's disease patients were matched for age and sex with patients with anorectal fistula without Crohn's disease. Biopsy specimens were obtained from fistulous tracts during examination under anesthesia for both groups. The samples were sent for HPV detection and genotyping using the INNO-LiPA test. Results A total of 108 subjects (54 in each group) were recruited. The perianal fistulizing Crohn's disease group showed a statistically higher frequency of HPV in the fistulous tract than the control group (33.3% vs. 16.7%; p = 0.046). Separate analyses on high-risk types demonstrated that there was a numerically higher frequency of HPV in the perianal fistulizing Crohn's disease group. In multiple logistic regression, patients with perianal fistulizing Crohn's disease were found to have a chance of HPV 3.29 times higher than patients without Crohn's disease (OR = 3.29; 95% CI 1.20‒9.01), regardless of other variables. The types most frequently identified in the perianal fistulizing Crohn's disease group were HPV 11 (12.96%) and HPV 16 (9.26%). Conclusion Perianal fistulizing Crohn's disease is associated with a higher prevalence of HPV than in patients with anorectal fistula without Crohn's disease. Crohns Crohn s unclear highrisk high twocenter two center crosssectional cross sectional groups INNOLiPA INNO LiPA test 10 54 (5 recruited 33.3% 333 33 3 (33.3 vs 16.7% 167 7 0.046. 0046 0.046 . 0 046 0.046) regression 329 29 3.2 OR 95 1.20‒9.01, 120901 1.20‒9.01 , 1 20 9 01 1.20‒9.01) variables 12.96% 1296 12 96 (12.96% 9.26%. 926 9.26% 26 (9.26%) 5 ( 33.3 (33. 16.7 004 0.04 04 32 2 3. 12090 1.20‒9.0 12.96 129 (12.96 92 9.26 (9.26% 33. (33 16. 00 0.0 1209 1.20‒9. 12.9 (12.9 9.2 (9.26 (3 0. 120 1.20‒9 12. (12. 9. (9.2 1.20‒ (12 (9. 1.20 (1 (9 1.2 1.

Resumen: Objetivo: nuestro objetivo principal fue evaluar la prevalencia de citología anal patológica en mujeres con antecedentes de neoplasia intraepitelial cervical. Métodos: se trata de un estudio de cohorte transversal desde mayo de 2018 a agosto de 2020 en el Centro Hospitalario Pereira Rossell. Se estudiaron dos cohortes: una de mujeres que tenían diagnóstico de neoplasia intraepitelial cervical y otra de control de mujeres sanas que asistieron al control, con una proporción de 2:1. Se calculó un tamaño muestral total de 205 pacientes, siendo 135 pacientes con NIC con un IC del 95%, suponiendo una prevalencia del 10% de lesiones preneoplásicas anales. El tamaño muestral de la cohorte control fue de 70 pacientes según la relación preestablecida. Resultados: se encontró asociación entre la presencia de lesiones premalignas cervicales y anomalías epiteliales detectadas en la citología anal, con un cociente de prevalencia de 1,77 (IC del 95%: 1,19-2,62) y un odds ratio de 2,69 (1,36-5,30). No se encontraron diferencias significativas en las variables de raza, tipo de relación sexual o tabaquismo. Conclusiones: nuestro estudio concluye que existe una asociación entre la neoplasia intraepitelial cervical relacionada con el VPH y la citología anal patológica.

Abstract: Objective: the main objective of the study was to assess the prevalence of anal cytology in women with a history of cervical intraepithelial neoplasia. Method: cohort transversal study conducted from May, 2018 until August, 2020 at Pereira Rossell Hospital. Two cohorts were studied, one of which included women with a diagnosis of cervical intraepithelial neoplasia and the other one included healthy women who attended their routine follow up, in a 2:1 ratio. The total size of the sample was 205 patients, 135 of which were patients with cervical intraepithelial neoplasia (confidence interval being 95%), presuming a 10% prevalence of anal pre-neoplasic lesions. The sample size of the control cohort was 70 patients as per the pre-defined ratio. Results: a association was found between the presence of malignant lesions of the cervix and epithelial anomalies detected in the anal cytology, with a prevalence coefficient of 1.77 (CI: 95%: 1,19 - 2,62) and odds ratio of 2,69 (1,36 - 5,30). No significant differences were found between race, type of sexual relationships or smoking variables. Conclusions: our study concludes there is an association between cervical intraepithelial neoplasia related to HPV and pathological anal screening.

Resumo: Objetivo: Avaliar a prevalência de citologia anal patológica em mulheres com história de neoplasia intraepitelial cervical. Métodos: Trata-se de um estudo de coorte transversal de maio de 2018 a agosto de 2020, no Hospital Pereira Rossell. Foram estudadas duas coortes, uma de mulheres com diagnóstico de neoplasia intraepitelial cervical e outra de controle de mulheres saudáveis que compareceram ao controle na proporção de 2:1. Foi calculada uma amostra total de 205 pacientes, 135 pacientes com NIC com um IC de 95%, assumindo uma prevalência de 10% de lesões pré-neoplásicas anais. O tamanho da amostra da coorte controle foi de 70 pacientes de acordo com a relação pré-estabelecida. Resultados: Foi encontrada associação entre a presença de lesões pré-malignas cervicais e anormalidades epiteliais detectadas na citologia anal, com razão de prevalência de 1,77 (IC 95%: 1,19 - 2,62) e odds ratio 2,69 (1,36-5,30). Não foram encontradas diferenças significativas nas variáveis raça, tipo de relação sexual ou tabagismo. Conclusões: Nossos resultados mostram uma associação entre neoplasia intraepitelial cervical relacionada ao HPV e citologia anal patológica.

RESUMEN: Objetivo: Determinar el nivel de conocimiento de las estudiantes de enfermería sobre el Virus del Papiloma Humano en una universidad privada en el norte del Perú. Método: Cuantitativa, descriptivo, transversal; la muestra fue censal constituida por 90 estudiantes de enfermería del final de la carrera universitaria, se aplicó un instrumento ya validado internacionalmente con un Alpha de Cronbach de 0,76 de 15 preguntas aplicadas vía cuestionario Google por la emergencia sanitaria; se tuvo en consideración los criterios de inclusión y exclusión establecidos. Resultados: El nivel de conocimiento general de los estudiantes universitarios de enfermería fue muy bueno (43.3%). el 92.2% del total fueron mujeres y el 7.8% fueron varones; el 71.4% de varones y 41.0% de mujeres han tenido más de una pareja sexual. El 75% de estudiantes de enfermería que fueron de la selva reportan más de una pareja sexual, contrario al 33.8% de estudiantes de enfermería de la costa reportan más de una pareja sexual. Conclusión: El conocimiento que predominó entre las estudiantes universitarias de enfermería fue bueno y muy bueno; sin embargo, llama la atención que la mayoría tuvo más de una pareja sexual situación que conlleva a desarrollar programas para fomentar la concientización de la salud sexual responsable y libre de riesgos entre las futuras enfermeras.

ABSTRACT: Objective: To determine the level of knowledge of nursing students about the Human Papilloma Virus in a Private University in northern Peru. Method: Quantitative, descriptive, cross-sectional; the sample was census constituted by 90 nursing students at the end of the university career, an instrument already validated internationally was applied with a Cronbach's Alpha of 0.76 of 15 questions applied via Google questionnaire for the health emergency; the established inclusion and exclusion criteria were taken into consideration. Results The level of general knowledge of the university nursing students was very good (43.3%). 92.2% of the total were women and 7.8% were men; 71.4% of men and 41.0% of women have had more than one sexual partner. 75% of nursing students who went from the jungle report more than one sexual partner, contrary to 33.8% of nursing students from the coast report more than one sexual partner. Conclusion The knowledge that prevailed among the university nursing students was good and very good; however, it is noteworthy that the majority had more than one sexual partner, a situation that leads to the development of programs to promote awareness of responsible and risk-free sexual health among future nurses.