Abstract the methodologies for calculating market risk have been mainly applied to economies in developed countries. In this research work, it is proposed to use the CAPM to determine the market risk and minimum expected return of companies in the corporate sector of Ecuador in the period 2009-2019. An average of 48,667 companies were analyzed, based on information obtained from the Superintendence of Companies, Securities and Insurance (SCSI). The sectors were analyzed according to the International Standard Industrial Classification (ISIC). An accounting Beta was used in the calculations considering the incipient development of the country’s stock market; an estimation was made through ordinary least squares and an adjusted ROE was proposed. In addition, the minimum expected return of the sector was calculated through the CAPM. Among the main findings of this work, it is highlighted that sectors B, C, G, H, J, M and N had a Beta greater than 1, i.e., these sectors are more sensitive to a change in the market. It is also important to mention that sectors P, G, C, E, J and Q perform better than expected. The information provided constitutes a support for organizations or other interest groups, considering the high level of uncertainty existing in the market.

Resumen las metodologías para el cálculo del riesgo de mercado han sido aplicadas principalmente a economías de países desarrollados. En este trabajo de investigación se propone utilizar el CAPM para determinar el riesgo de mercado y rendimiento mínimo esperado de las empresas del sector corporativo de Ecuador para el periodo 2009-2019. En promedio se analizaron 48 667 empresas, con base en la información obtenida de la Superintendencia de Compañías, Valores y Seguros (SCVS). Los sectores que fueron analizados de acuerdo con la Clasificación Industrial Internacional Uniforme (CIIU). En los cálculos se utilizó un Beta contable, considerando el incipiente desarrollo de la bolsa de valores del país; se realizó una estimación por mínimos cuadrados ordinarios y se propuso un ROE ajustado. Además, se calculó el rendimiento mínimo esperado del sector por medio del CAPM. Entre los principales hallazgos se destaca que los sectores B, C, G, H, J, M, y N tienen un Beta mayor a 1, es decir, estos sectores son más sensibles ante una variación en el mercado. También es importante mencionar que los sectores P, G, C, E, J y Q tienen un desempeño mejor al esperado. La información proporcionada sirve como apoyo para las organizaciones u otros grupos de interés, considerando el alto nivel de incertidumbre en el mercado.

Resumen Descripción del caso: Se describió la etiología, presentación y diagnóstico de un paciente con divertículo de la uretra prostática que se sometió a prostatectomía total asistida por robot para la resolución de cuadro complicado de abscesos parauretrales y perineales recurrentes. Relevancia: Primer caso realizado en nuestro centro de trabajo de prostatectomía total asistida por robot para el tratamiento del divertículo prostático. La mejora sintomática y en calidad de vida a corto plazo son beneficios de esta técnica. Implicaciones clínicas: La prostatectomía total asistida por robot debe considerarse una opción eficaz en pacientes con una evolución previa complicada de divertículo prostático. Conclusiones: Cada paciente debe ser individualizado, siendo la prostatectomía total asistida por robot una opción en casos complejos, sin embargo, es necesario identificar más pacientes candidatos para la estandarización de la técnica.

Abstract Case description: It was described the etiology, presentation and diagnosis of a patient with a diverticulum of the prostatic urethra that underwent total robot-assisted prostatectomy for resolution of a complicated history of recurrent paraurethral and perineal abscesses. Relevance: First case performed in our work center of total robot-assisted prostatectomy for prostatic diverticulum treatment. Improvement symptomatic and quality of life at the short term are benefits of this technic. Clinical implications: Total robot-assisted prostatectomy should be considered as an effective option in patients with a prior complicated evolution of prostatic diverticulum. Conclusions: Each patient must be individualized, being the total robot-assisted prostatectomy an option in complex cases, however, more patient candidates need to be identified for standardization of the technique.

Background: In the field of health, the year 2020 will be remembered for testing (stressing) all health institutions and their forms of management (centralised and decentralised). The everyday activity of primary and hospital care was significantly altered by the introduction of telephone consultations, which reduce the number of visits to health centres or hospitals and are still relevant today in the face of successive waves of the pandemic. Objective: To analyse whether population confinement due to the COVID-19 pandemic had an impact on the dispensing of medications in community pharmacies and the associated spending during the period March-July 2020 in Andalusia (Spain). Methods: A time series analysis applying econometric model analysis techniques to confirm or rule out whether the lockdown caused by the COVID-19 pandemic had an impact on the dispensing of medications by community pharmacies and the associated expenditures. The variables used were the number of medication containers dispensed by community pharmacies (charged to the public funds of the Spanish National Health System) and the expenditure on prescription drugs, both in relation to the population. The analysis was performed within the region of Andalusia, which has 8,464,441 inhabitants. Results: The data obtained from the time series confirmed that there were no significant differences during the studied period between the number of medication containers actually dispensed and the number that would have been expected to be dispensed according to the trend in this variable for the sample period. The expenditure results followed the same pattern. Conclusions: The health crisis produced by the COVID-19 lockdown had no impact on medication consumption in Andalusia.

ABSTRACT Gender differences in behavior problems and their relationship with family burden in severe mental disorders were analyzed. The Behavior Problems Inventory (BPI) and two items related to family burden (FB 1: "Do you feel able to endure the illness or disorder and the problems it causes?" and FB 2: "How often are you overwhelmed by these behavior/illness problems?") were administered to 235 key informants under treatment in a community mental health unit. The results show that men presented more behavior problems and family burden, with significant differences in impulse dyscontrol and severe behavior problems. A positive correlation was found between behavior problems and family burden, where the inactivity/social withdrawal dimension was the best predictor of family load for men and women. We conclude that men have more behavior problems and that the inactivity/social withdrawal dimension has the most explanatory power for family burden in both men and women.

RESUMEN Se analizan las diferencias de género en problemas de conducta y su relación con la carga familiar en trastornos mentales graves. El Inventario de Problemas de Conducta (BPI) y dos ítems relativos a la carga familiar ("¿Se siente usted capaz de sobrellevar la enfermedad o trastorno y los problemas que ocasiona?" y "¿Con qué frecuencia se ve usted desbordado/a por estos problemas de comportamiento/enfermedad?") se administraron a 235 informantes clave de pacientes en tratamiento en una unidad de Salud Mental Comunitaria. Los hombres presentaban mayores problemas de conducta y carga familiar, existiendo diferencias significativas en descontrol de impulsos y en problemas de comportamiento graves. Se halla una correlación positiva entre problemas de comportamiento y carga familiar, siendo la dimensión inactividad/aislamiento social la mejor predictora de carga familiar. Respecto a la carga familiar, es la dimensión inactividad/aislamiento social la que posee mayor capacidad explicativa en hombres y mujeres.

ABSTRACT The indications of minimal access surgery in children have increased and the spectrum of the entities resolved with this new technique has enhanced. In March 2017, these procedures began to be used systematically at the Teaching Pediatric Hospital “Eliseo Noel Caamaño”, of Matanzas. In this article, the authors pretend to describe the results of the minimally invasive surgery in Pediatrics during the first year in the before-mentioned province. A descriptive prospective study was conducted to present the achieved results. 77 patients underwent surgery. Female sex predominated and the age group of 15-19 years. The most common surgeries were appendectomy (50.6 %) and cholecistectomy (28 %). A 4 % of conversions and 4 % complications were recorded.

RESUMEN Las indicaciones de la cirugía de mínimo acceso en el niño han aumentado. Lo que ha traído consigo que aumente el espectro de las entidades resueltas por esta novedosa técnica. En marzo de 2017, se comenzaron a aplicar de manera sistemática estos procedimientos en el Hospital Docente Pediátrico “Eliseo Noel Caamaño”, de Matanzas. Con este artículo se pretende describir los resultados de la cirugía mínimamente invasiva en Pediatría, durante su primer año en la mencionada provincia. Se realizó un estudio descriptivo prospectivo para presentar los resultados durante el primer año. Se operaron 77 pacientes. Predominó el sexo femenino, y el grupo etario de 15-19 años. Las intervenciones más realizadas fueron la apendicectomía, 50,6 % y la colecistectomía, 28 %. Se registró un 4 % de conversiones y un 4 % de complicaciones.

ABSTRACT Background: The Spanish economic crisis began in 2008 and according to the Ministry of Economy, Industry and Competitiveness it concluded in 2014. During the crisis the main macro-economic indicators had an adverse evolution and the effects have lasted for more than six years to the present. Aim: To assess the influence on public spending (health and pharmaceutical) that the governing policies have had and the time of crisis suffered. Methods: Public expenditure per inhabitant (health and pharmaceutical) is compared according to the study period (pre, crisis and post), the political ideology of the ruling party (conservative / progressive) and each autonomous community in reference to GDP per inhabitant in each of they respect the national average (poor, average or rich) according to the quartiles. The sources of the data have been the National Statistics Institute (GDP and inhabitants of each Autonomous Community and study period) and the Ministry of Health, Social Services and Equality (public health and pharmaceutical expenditure). The statistical procedures (SPSS v24) included descriptive and inferential analysis for public healthcare and pharmaceutical expenditure according to the period of study and ideology. There was also a regression fit to know the relative importance of predictor varibles. Results: During the crisis period there were differences in public health expenditure per inhabitant in the different types of Autonomous Communities (poor / medium / rich) and according to political ideology (p <0.05). Public pharmaceutical expenditure was € 327 / inhab (pre-crisis) to € 366 / inhabitant in the final period of the study. There were statistically significant differences in pharmaceutical expenditure according to the different types of CCAA. Likewise, differences were found in per capita pharmaceutical expenditure between the Autonomous Communities run by conservatives and type of Autonomous Communities throughout the study period. Conclusions: The community pharmaceutical expenditure per capita has decreased by more than 13% since 2006 until 2017, while the hospital pharmaceutical expenditure has increased by more than 84%. Rich regions invest more in the health care costs and the poor more than drugs.

RESUMEN Fundamentos: La crisis económica española se inició en el año 2008 y según el Ministerio de Economía, Industria y Competitividad concluyó en el año 2014. Durante la crisis los principales indicadores macro-económicos tuvieron una evolución adversa y los efectos se han prolongado durante más de seis años hasta la actualidad. El objetivo de este trabajo fue valorar la influencia en el gasto público (sanitario y farmacéutico) que han tenido las políticas gobernantes y el tiempo de crisis sufrido. Métodos: Se compara el gasto público por habitante (sanitario y farmacéutico) según el período de estudio (pre, crisis y post), la ideología política del partido gobernante (conservador/progresista) y cada comunidad autónoma en referencia al PIB por habitante en cada una de ellas respecto de la media nacional (pobres, en la media o ricas) según los cuartiles. Las fuentes de los datos han sido el INE (PIB y habitantes de cada CCAA y periodo de estudio) y del Ministerio de Sanidad, Servicios Sociales e Igualdad (gasto público sanitario y farmacéutico). El examen estadístico (SPSS 24) incluyó análisis descriptivo e inferencial del gasto sanitario y farmacéutico publico según el período de estudio e ideología, también se realizó un ajuste de regresión para conocer la importancia relativa de las variables predictoras. Resultados: Durante el período de crisis hubo diferencias en el gasto sanitario público por habitante en los distintos tipos de CCAA (pobres/medias/ricas) y según ideología política gobernante (p<0,05). El gasto farmacéutico público pasó de 327 €/hab (pre-crisis) a 366 €/hab en el período final del estudio. Hubo diferencias estadísticamente significativas en el gasto farmacéutico según los distintos tipos de CCAA. De igual forma se encontraron diferencias en el gasto farmacéutico por habitante entre las CCAA regentadas por conservadores y tipo de CCAA a lo largo de todo el período de estudio. Conclusiones: El gasto farmacéutico comunitario por habitante ha disminuido en más del 13% desde 2006 hasta 2017, mientras que el gasto farmacéutico hospitalario se ha incrementado en más del 84%. Las CCAA ricas invierten más en gasto sanitario y las pobres más de medicamentos.

ABSTRACT Background: The Spanish economic crisis began in 2008 and according to the Ministry of Economy, Industry and Competitiveness it concluded in 2014. During the crisis the main macro-economic indicators had an adverse evolution and the effects have lasted for more than six years to the present. Aim: To assess the influence on public spending (health and pharmaceutical) that the governing policies have had and the time of crisis suffered. Methods: Public expenditure per inhabitant (health and pharmaceutical) is compared according to the study period (pre, crisis and post), the political ideology of the ruling party (conservative / progressive) and each autonomous community in reference to GDP per inhabitant in each of they respect the national average (poor, average or rich) according to the quartiles. The sources of the data have been the National Statistics Institute (GDP and inhabitants of each Autonomous Community and study period) and the Ministry of Health, Social Services and Equality (public health and pharmaceutical expenditure). The statistical procedures (SPSS v24) included descriptive and inferential analysis for public healthcare and pharmaceutical expenditure according to the period of study and ideology. There was also a regression fit to know the relative importance of predictor varibles. Results: During the crisis period there were differences in public health expenditure per inhabitant in the different types of Autonomous Communities (poor / medium / rich) and according to political ideology (p <0.05). Public pharmaceutical expenditure was € 327 / inhab (pre-crisis) to € 366 / inhabitant in the final period of the study. There were statistically significant differences in pharmaceutical expenditure according to the different types of CCAA. Likewise, differences were found in per capita pharmaceutical expenditure between the Autonomous Communities run by conservatives and type of Autonomous Communities throughout the study period. Conclusions: The community pharmaceutical expenditure per capita has decreased by more than 13% since 2006 until 2017, while the hospital pharmaceutical expenditure has increased by more than 84%. Rich regions invest more in the health care costs and the poor more than drugs.

RESUMEN Fundamentos: La crisis económica española se inició en el año 2008 y según el Ministerio de Economía, Industria y Competitividad concluyó en el año 2014. Durante la crisis los principales indicadores macro-económicos tuvieron una evolución adversa y los efectos se han prolongado durante más de seis años hasta la actualidad. El objetivo de este trabajo fue valorar la influencia en el gasto público (sanitario y farmacéutico) que han tenido las políticas gobernantes y el tiempo de crisis sufrido. Métodos: Se compara el gasto público por habitante (sanitario y farmacéutico) según el período de estudio (pre, crisis y post), la ideología política del partido gobernante (conservador/progresista) y cada comunidad autónoma en referencia al PIB por habitante en cada una de ellas respecto de la media nacional (pobres, en la media o ricas) según los cuartiles. Las fuentes de los datos han sido el INE (PIB y habitantes de cada CCAA y periodo de estudio) y del Ministerio de Sanidad, Servicios Sociales e Igualdad (gasto público sanitario y farmacéutico). El examen estadístico (SPSS 24) incluyó análisis descriptivo e inferencial del gasto sanitario y farmacéutico publico según el período de estudio e ideología, también se realizó un ajuste de regresión para conocer la importancia relativa de las variables predictoras. Resultados: Durante el período de crisis hubo diferencias en el gasto sanitario público por habitante en los distintos tipos de CCAA (pobres/medias/ricas) y según ideología política gobernante (p<0,05). El gasto farmacéutico público pasó de 327 €/hab (pre-crisis) a 366 €/hab en el período final del estudio. Hubo diferencias estadísticamente significativas en el gasto farmacéutico según los distintos tipos de CCAA. De igual forma se encontraron diferencias en el gasto farmacéutico por habitante entre las CCAA regentadas por conservadores y tipo de CCAA a lo largo de todo el período de estudio. Conclusiones: El gasto farmacéutico comunitario por habitante ha disminuido en más del 13% desde 2006 hasta 2017, mientras que el gasto farmacéutico hospitalario se ha incrementado en más del 84%. Las CCAA ricas invierten más en gasto sanitario y las pobres más de medicamentos.

Abstract BACKGROUND: The incidence of urinary fistula after kidney transplantation presents in 1.2 to 8.9% of cases and has been associated with ischemic necrosis of the ureter. Double-J catheter use is recommended to reduce its incidence. CLINICAL CASE: A 42-year-old woman underwent a deceased-donor kidney transplantation with ureterovesical reimplantation through the Lich-Gregoire technique. Fourteen days after the procedure she presented with spontaneous urine leakage from the site of the surgical drain. Initial management was bladder diversion for four weeks. There was no improvement and so a 34 Fr x 65 cm (Boston Occluder®) ureteral occlusion balloon catheter was placed next to the bladder catheter and percutaneous nephrostomy was performed. Reduced urine output was achieved after one week. Antegrade pyelography was carried out at week 3 and showed no urine leakage. The occlusion balloon catheter was removed, and a double-J catheter was placed. The clamped nephrostomy and the bladder diversion through the transurethral catheter remained. The ureteral catheter was removed six weeks after the procedure. After 12 months of follow-up the fistula was completely closed, urine volume and serum creatinine, serum urea, and blood urea nitrogen levels were within normal parameters. There were no signs of a compromised kidney graft. CONCLUSIONS: The placement of a ureteral occlusion balloon catheter, in addition to nephrostomy, is a new alternative in the treatment of patients with high-volume proximal fistula.

Resumen ANTECEDENTES: La incidencia de fístula urinaria posterior a un trasplante renal varía de 1.2-8.9% de los caso, esta complicación se ha relacionado con necrosis isquémica del uréter. Se recomienda la aplicación de catéter doble J para disminuir su incidencia. CASO CLÍNICO: Paciente femenina de 42 años, quien recibió trasplante renal de donador cadavérico, con reimplante ureterovesical mediante la técnica Lich-Gregoir para anastomosis. Catorce días después del procedimiento inició con salida espontánea de orina por el sitio donde se localizaba el drenaje quirúrgico. El tratamiento inicial consistió en derivación vesical durante cuatro semanas, sin mejoría del cuadro clínico, por lo que se decidió la colocación de un balón de oclusión de 34 Fr x 65 cm (Boston Occluder®) junto al catéter vesical, además de nefrostomía percutánea. Se logró disminuir el gasto urinario después de una semana y en la tercera se realizó pielografía anterógrada sin evidencia de fuga urinaria; se le retiró el balón de oclusión y se colocó un catéter doble J, con permanencia del catéter de nefrostomía pinzado y la derivación vesical por catéter transuretral. A seis semanas del procedimiento se retiró el catéter ureteral. Luego de 12 meses de seguimiento se observó el cierre completo de la fístula, los volúmenes urinarios y las concentraciones de azoados se encontraron dentro de los parámetros normales, y no se evidenciaron datos de afectación del injerto renal. CONCLUSIONES: La colocación de un balón de oclusión ureteral, además de nefrostomía, representa una nueva alternativa en el tratamiento de pacientes con fistula proximal de alto volumen.

We describe two clinical cases and review the available literature on convergent elbow dislocation. Our first case shows how a delay in the diagnosis will lead to an open reduction and internal fixation with K-wires. On the other hand, an early diagnosis prompts a closed reduction without fixation as it is described in the second case. The diagnostic key for the convergent dislocation of the elbow lies in the correct interpretation of radiographs and the prono-supination block on physical examination. The use of indomethacin is recommended to avoid heterotopic calcifications. The final outcome is better when an early diagnosis is achieved regardless of the reduction method.

Se presentan dos casos clínicos y la revisión de la literatura actual sobre luxación convergente de codo. En el primer caso, se muestra cómo un retraso en el diagnóstico conducirá a una reducción abierta y fijación con agujas de Kirschner, mientras que un diagnóstico temprano permite la reducción cerrada y el tratamiento conservador como se describe en el segundo caso. La clave de diagnóstico para la luxación convergente de codo radica en la correcta interpretación de las radiografías y el bloque de prono-supinación en el examen físico. Se recomienda el uso de indometacina para evitar calcificaciones heterotópicas. El resultado final es mejor cuando el diagnóstico es precoz, independientemente del método de reducción.

ABSTRACT Traditionally, the treatment of overactive bladder syndrome has been based on the use of oral medications with the purpose of reestablishing the detrusor stability. The recent better understanding of the urothelial physiology fostered conceptual changes, and the oral anticholinergics – pillars of the overactive bladder pharmacotherapy – started to be not only recognized for their properties of inhibiting the detrusor contractile activity, but also their action on the bladder afference, and therefore, on the reduction of the symptoms that constitute the syndrome. Beta-adrenergic agonists, which were recently added to the list of drugs for the treatment of overactive bladder, still wait for a definitive positioning – as either a second-line therapy or an adjuvant to oral anticholinergics. Conservative treatment failure, whether due to unsatisfactory results or the presence of adverse side effects, define it as refractory overactive bladder. In this context, the intravesical injection of botulinum toxin type A emerged as an effective option for the existing gap between the primary measures and more complex procedures such as bladder augmentation. Sacral neuromodulation, described three decades ago, had its indication reinforced in this overactive bladder era. Likewise, the electric stimulation of the tibial nerve is now a minimally invasive alternative to treat those with refractory overactive bladder. The results of the systematic literature review on the oral pharmacological treatment and the treatment of refractory overactive bladder gave rise to this second part of the review article Overactive Bladder – 18 years, prepared during the 1st Latin-American Consultation on Overactive Bladder.

ABSTRACT Abstract: Overactive bladder syndrome is one of the lower urinary tract dysfunctions with the highest number of scientific publications over the past two decades. This shows the growing interest in better understanding this syndrome, which gathers symptoms of urinary urgency and increased daytime and nighttime voiding frequency, with or without urinary incontinence and results in a negative impact on the quality of life of approximately one out of six individuals – including both genders and almost all age groups. The possibility of establishing the diagnosis just from clinical data made patients' access to specialized care easier. Physiotherapy resources have been incorporated into the urological daily practice. A number of more selective antimuscarinic drugs with consequent lower adverse event rates were released. Recently, a new class of oral drugs, beta-adrenergic agonists has become part of the armamentarium for Overactive Bladder. Botulinum toxin injections in the bladder and sacral neuromodulation are routine modalities of treatment for refractory cases. During the 1st Latin-American Consultation on Overactive Bladder, a comprehensive review of the literature related to the evolution of the concept, epidemiology, diagnosis, and management was conducted. This text corresponds to the first part of the review Overactive Bladder 18-years.

Purpose Characterize persistence and adherence to phosphodiesterase type - 5 inhibitor (PDE5I) on-demand therapy over 6 months among Brazilian men in an observational, non-interventional study of Latin American men naïve to PDE5Is with erectile dysfunction (ED). Materials and Methods Men were prescribed PDE5Is per routine clinical practice. Persistence was defined as using ≥ 1 dose during the previous 4 - weeks, and adherence as following dosing instructions for the most recent dose, assessed using the Persistence and Adherence Questionnaire. Other measures included the Self - Esteem and Relationship (SEAR) Questionnaire, and International Index of Erectile Function (IIEF). Multivariate logistic regression was used to identify factors associated with persistence/adherence. Results 104 Brazilian men were enrolled; mean age by treatment was 53 to 59 years, and most presented with moderate ED (61.7%). The prescribed PDE5I was sildenafil citrate for 50 (48.1%), tadalafil for 36 (34.6%), vardenafil for 15 (14.4%), and lodenafil for 3 patients (2.9%). Overall treatment persistence was 69.2% and adherence was 70.2%; both were numerically higher with tadalafil (75.0%) versus sildenafil or vardenafil (range 60.0% to 68.0%). Potential associations of persistence and/or adherence were observed with education level, ED etiology, employment status, and coronary artery disease. Improvements in all IIEF domain scores, and both SEAR domain scores were observed for all treatments. Study limitations included the observational design, brief duration, dependence on patient self - reporting, and limited sample size. Conclusion Approximately two-thirds of PDE5I-naive, Brazilian men with ED were treatment persistent and adherent after 6 months. Further study is warranted to improve long-term outcomes of ED treatment.

Objective. Describe factors associated with aggressive forms of recurrent respiratory papillomatosis (RRP). Materials and methods. One hundred eighty-nine RRP cases diagnosed between 1985 and 2009 were identified in pathological records. HPV was detected by the SPF-10 method with broad spectrum primers, (version 1). Results. 113 patients had only one surgery (less aggressive) and 76, two or more interventions (more aggressive). The likelihood of aggressive lesions decreased with increasing age at diagnosis and HPV-11 was associated with no significant increase in the risk of aggressiveness. Conclusions. The age at diagnosis was the main determinant of RRP aggressiveness.

Objetivo. Describir factores asociados con formas agresivas de papilomatosis respiratoria recurrente (PRR). Material y métodos. Se identificaron 189 casos de PRR diagnosticados entre 1985-2009 en registros patológicos. VPH fue detectado por el método SPF-10 con cebadores de amplio espectro, (versión 1). Resultados. 113 casos presentaron una intervención quirúrgica (menos agresivas) y 76, dos o más intervenciones (más agresivas). La probabilidad de lesiones agresivas disminuyó con el aumento de la edad al momento del diagnóstico y el VPH-11 se asoció con aumento no significativo del riesgo de agresividad. Conclusiones. La edad al momento del diagnóstico fue el principal determinante de la agresividad de PRR.

Objective. Describe factors associated with aggressive forms of recurrent respiratory papillomatosis (RRP). Materials and methods. One hundred eighty-nine RRP cases diagnosed between 1985 and 2009 were identified in pathological records. HPV was detected by the SPF-10 method with broad spectrum primers, (version 1). Results. 113 patients had only one surgery (less aggressive) and 76, two or more interventions (more aggressive). The likelihood of aggressive lesions decreased with increasing age at diagnosis and HPV-11 was associated with no significant increase in the risk of aggressiveness. Conclusions. The age at diagnosis was the main determinant of RRP aggressiveness.

Objetivo. Describir factores asociados con formas agresivas de papilomatosis respiratoria recurrente (PRR). Material y métodos. Se identificaron 189 casos de PRR diagnosticados entre 1985-2009 en registros patológicos. VPH fue detectado por el método SPF-10 con cebadores de amplio espectro, (versión 1). Resultados. 113 casos presentaron una intervención quirúrgica (menos agresivas) y 76, dos o más intervenciones (más agresivas). La probabilidad de lesiones agresivas disminuyó con el aumento de la edad al momento del diagnóstico y el VPH-11 se asoció con aumento no significativo del riesgo de agresividad. Conclusiones. La edad al momento del diagnóstico fue el principal determinante de la agresividad de PRR.