Screening de lesiones orales malignas y potencialmente malignas en funcionarios de Universidad de Valparaíso y Universidad Viña del Mar durante los años 2016 - 2017 / Screening of malignant and potentially malignant oral lesions in employee of the University of Valparaíso and the University of Viña del Mar during 2016 - 2017

El objetivo de este estudio es determinar la prevalencia de lesiones orales malignas y potencialmente malignas (LPM) en funcionarios de la Universidad de Valparaíso y de Viña del Mar durante los años 2016 - 2017. Fueron citados 161 funcionarios, quienes accedieron a una encuesta que evaluaba factores de riesgo de cáncer oral (tabaco y alcohol) y si habían escuchado de la patología, sumado a un examen clínico. De los pacientes examinados, se diagnosticaron 121 lesiones de las cuales 2 fueron diagnosticadas como lesiones potencialmente malignas: Liquen plano y Leucoplasia, con una prevalencia de 1,7 %. El 50,3 % de los pacientes sabía de la existencia de cáncer oral. El Screening es una medida que permite dar a conocer a la población la existencia de cáncer oral y alertarlos sobre la importancia de su examen para su identificación de manera temprana.

The objective of this study is to determine the prevalence of malignant and potentially malignant oral lesions (PML) in University of Valparaíso and Viña del Mar employees, during the years 2016 - 2017. We cited 161 employees, who accessed a survey evaluating risk factors for oral cancer (tobacco and alcohol) and if they had heard of the disease. In addition, a clinical examination was carried out. Of the patients examined, 121 lesions were diagnosed, of which 2 were diagnosed as potentially malignant lesions: Lichen planus and Leukoplakia, with a prevalence of 1.6 %. 50.3 % of patients knew of the existence of oral cancer. Epidemiological designs are needed to better establish causality between risk factors and malignant or, potentially malignant lesions.

El impacto de la prueba de VPH en los programas de tamizaje en América Latina: el caso de Argentina / The impact of the HPV test in screening programs in Latin America: The case of Argentina

Resumen: Objetivo: Evaluar el impacto de la prueba de VPH (prueba de VPH) en los problemas que históricamente afectaron al tamizaje de cáncer cervical en América Latina, tomando como caso al Proyecto Demostración para la Introducción de la prueba de VPH en Jujuy (PDJ), Argentina. Material y métodos: Se sintetizó la evidencia sobre los problemas del tamizaje cervical en la región. Se analizó el impacto en los problemas a partir de la introducción de la prueba de VPH. El impacto se clasificó en directo/indirecto y positivo/negativo. Resultados: El impacto directo-positivo se dio en los problemas de adherencia a la edad/frecuencia de tamizaje, laboratorios de citología, baja/moderada sensibilidad de la citología y baja cobertura. El impacto directo-negativo se vinculó con el triaje de autotoma y el envío/etiquetado de muestras. El impacto indirecto-positivo se relacionó con la reorganización programática realizada para introducir la prueba de VPH. Conclusiones: La prueba de VPH representa una ventana de oportunidad para el mejoramiento del tamizaje pero no resuelve los problemas programáticos.

Abstract: Objective: To assess the impact of HPV testing on longstanding problems faced by screening programs in Latin America, using the case of the Jujuy Demonstration Project (JDP) in Argentina. Materials and methods: The study measured the level of impact produced by the introduction of HPV-testing on problems faced by cytology programs by analyzing modifications on specific problems produced during the JDP. Impact was classified as direct/indirect, and positive/ negative. Results: Direct/positive impact was found in issues concerning age and screening frequency, cytology laboratories and screening sensitivity, and low coverage. Direct/negative impact was mainly related to the adherence to triage cytology by HPV+ women with self-collected-tests, and the delivery and labelling of samples. Indirect impact of HPV-Test was mostly positive, and related to the programmatic reorganization which was facilitated by the introduction of HPV testing. Conclusions: HPV testing provides an opportunity window for improving primary screening, but does not solve programmatic problems.

Oral lesions detected during a population screening for prevention and early diagnosis of oral cancer and potentially malignant disorders / Lesões orais detectadas durante uma triagem populacional para prevenção e diagnóstico precoce de câncer de boca e lesões potencialmente maligniziveis

Objective: In this paper, we describe the results of an oral cancer prevention campaign for early detecting and diagnosing oral cancer and potentially malignant disorder. Subjects and method: The population screening was performed in one day in which population was recruited by local mass media communication means. Patients with suspicious lesions were referred for final diagnosis with a specialist in oral medicine and pathology. Results: Of 1.282 patients screened, 104 were referred for specialized care and 94 attended for final diagnosis. Of those, only one (1.06%) patient was diagnosed with oral squamous cell carcinoma and 25 (26.5%) with oral potentially malignant disorders, while the diagnosis rates for benign conditions and normality variations were, respectively, 78.7% and 32.9%. Conclusion: These results suggest low awareness regarding oral cancer within this population, flaws in the knowledge regarding oral cancer by dentists, and the need for improvements in the access to the at-risk population for oral cancer.(AU)

Objetivo: neste artigo, descrevemos os resultados de uma campanha de prevenção do câncer de boca para detectar e diagnosticar precocemente câncer de boca e lesões bucais potencialmente maligniziveis. Sujeitos e método: uma triagem populacional foi realizada em um dia em que a população foi recrutada por meios de comunicação de mídia local. Pacientes com lesões suspeitas foram encaminhados para diagnóstico final com especialista em Estomatologia e Patologia Bucal. Resultados: dos 1.282 pacientes selecionados, 104 foram encaminhados para atendimento especializado e 94 atendidos para diagnóstico final. Desses, apenas um (1,06%) paciente foi diagnosticado com carcinoma espinocelular de boca e 25 (26,5%) com lesões bucais potencialmente maligniziveis, enquanto as taxas de diagnóstico para condições benignas e variações de normalidade foram, respectivamente, 78,7% e 32,9%. Conclusão: esses resultados sugerem baixa conscientização sobre o câncer bucal nessa população, falta conhecimento sobre o câncer bucal por dentistas e a necessidade de melhorias no acesso à população em risco de câncer bucal.(AU)

Dermatosis precancerosa y cancerosa en pacientes ingresados en hogares de ancianos, Guantánamo 2016-2017 / Dermatose pré-cancerosa e cancerosa em pacientes internados em asilos, Guantánamo 2016-2017 / Precancerous and cancerous dermatosis in patients admitted to nursing homes, Guantanamo 2016-2017

Introducción: en Guantánamo no está esclarecida la frecuencia de las lesiones cutáneas en pacientes ingresados en los hogares de ancianos. Objetivo: determinar la frecuencia de dermatosis precancerosas y cancerosas en pacientes de los hogares de ancianos Caridad Jaca, Santa Catalina y San José del municipio Guantánamo en el período 2016-2017. Método: se realizó un estudio observacional, prospectivo, descriptivo y transversal con todos los ancianos (N=318) y en los afectados (n=70) se precisó el sexo, edad, fototipo cutáneo, tipo y localización de las lesiones. Resultados: el 22,1 por ciento de los ancianos presentó dermatosis precancerosas y cancerosas. Estas fueron más comunes en hombres (56,0 por ciento), con 70 a 79 años de edad (42,8 por ciento), fototipo cutáneo III (50,0 por ciento) y se localizaron en la cara (32,8 por ciento). Se diagnosticaron dermatosis precancerosas en el 84,3 por ciento de los pacientes y la más común fue la queratosis actínica (78,6 por ciento) y dermatosis cancerosas en el 15,7 por ciento de ellos y la más frecuente fue el carcinoma basocelular (8,6 por ciento). Conclusiones: en los pacientes ancianos que se estudiaron se diagnosticaron las dermatosis precancerosas y cancerosas que no se habían documentado con anterioridad, lo que revela la importancia de las acciones dirigidas al pesquisaje de estas lesiones cutáneas(AU)

Introduction: the frequency of skin lesions in patients admitted to nursing homes is not clarified in Guantanamo. Objective: to determine the frequency of precancerous and cancerous dermatoses in patients of the "Caridad Jaca", "Santa Catalina" and "San José" nursing homes of the Guantánamo municipality in the 2016-2017 period. Method: an observational, prospective, descriptive and cross-sectional study was carried out with all the elderly (N=318) and in those affected (n=70) the sex, age, cutaneous phototype, type and location of the lesions were specified. Results: 22.1 percent of the elderly presented precancerous and cancerous dermatoses. These were more common in men (56.0 percent ), with 70 to 79 years of age (42.8 percent ), skin phototype III (50.0 percent ) and were located on the face (32.8 percent ). Precancerous dermatoses were diagnosed in 84.3 percent of the patients and the most common was actinic keratosis (78.6 percent ) and cancerous dermatoses in 15.7 percent of them and the most frequent was basal cell carcinoma (8.6 percent ). Conclusions: in the elderly patients who were studied, precancerous and cancerous dermatoses were diagnosed that had not been previously documented, which reveals the importance of actions aimed at screening these skin lesions(AU)

Introdução: em Guantánamo, a frequência de lesões de pele empacientes internados em asilos não é esclarecida. Objetivo: determinara frequência de dermatoses pré-cancerígenas e cancerígenas em pacientes das casas de repouso Caridad Jaca, Santa Catalina e SanJosé do município de Guantánamo no período 2016-2017. Método: foirealizado um estudo observacional, prospectivo, descritivo e transversalcom todos os idosos (N=318) e naqueles afetados (n=70) foram especificados sexo, idade, fotótipo cutâneo, tipo e localização das lesões. Resultados: 22,1 por cento dos idosos apresentaram dermatoses pré-cancerosas e cancerígenas. Estes foram mais comuns em homens (56,0 por cento), com 70 a 79 anos (42,8 por cento), fototipo III (50,0 por cento) e estavam localizados na face (32,8 por cento). Dermatoses pré-cancerosas foram diagnosticadas em 84,3por cento dos pacientes e a mais comum foi a queratose actínica (78,6 por cento) e dermatoses cancerígenas em 15,7 por cento delas e a mais frequente foi o carcinoma basocelular (8,6) por cento) Conclusões: nos idosos estudados, foram diagnosticadas dermatoses pré-cancerosas e cancerígenas que não haviam sido previamente documentadas, o que revela a importância de ações voltadas para o rastreamento dessas lesões de pele(AU)

Prevalencia de lesiones precursoras de cáncer de cuello uterino y antecedentes sexuales/reproductivos de indígenas de Caaguazú, Paraguay 2015-2017 / Prevalence of precursor lesions of cervical cancer and sexual/reproductive antecedents of natives of Caaguazú, Paraguay 2015-2017

Introducción: El cáncer de cuello uterino es una de las patologías más graves en la vida de las mujeres. Causó 266 000 muertes en mujeres por esta patología en el año 2012, un 85% en los países de ingresos bajos y medianos. Objetivo: Determinar la prevalencia de lesiones precursoras de cáncer de cuello uterino y antecedentes sexuales/reproductivos de indígenas de Caaguazú durante los años 2015 a 2017. Materiales y métodos: Se realizó un estudio observacional, descriptivo, de corte transversal con muestreo no probabilístico. Se estudió a indígenas que se encuentran registrados en el Programa de Patología Cervical. Los datos obtenidos se ingresaron en Microsoft Excel© 2016, para el análisis se utilizó STATA® 14.0. Los resultados fueron presentados en tablas y gráficos. Resultados: Ingresaron en el estudio 129 indígenas con una edad media de 26±10 años. La prevalencia de lesiones precursoras de cáncer de cuello uterino fue de 13,18%. Las lesiones más frecuentemente encontradas en orden de frecuencia fueron ASCUS 10,08%; CIN I 2,32%; CIN II 0,77%; no se observó CIN III, ni carcinoma in situ. Las edades en las que se presentaron con mayor frecuencia fueron entre 25 a 44 años en un 70,59%. El 58,8% de las que presentaron lesiones cervicales tuvo menarca< 12 años; 76,5% relaciones sexuales < 15 años y el 82,35 % son gran multíparas. Conclusión: La prevalencia de lesiones precursoras de cáncer de cuello uterino es similar a estudios de otros países y menor a algunos estudios que se realizaron en Paraguay en población no indígena. Se encontró mayor porcentaje de lesiones en las edades medias, menarca temprana, inicio precoz de vida sexual y en multíparas. Palabras clave: Lesión intraepitelial cervical; cáncer de cérvix; citología; Paraguay; Servicios de Salud del Indígena.

Introduction: Cervical cancer is one of the most serious pathologies in the life of women. It caused 266 000 deaths in women due to this pathology in 2012, 85% in low and middle income countries. Objective: To determine the prevalence of precursor lesions of cervical cancer and sexual/reproductive antecedents of natives of Caaguazú during the years 2015 to 2017. Materials and methods: An observational, descriptive, cross-sectional study with non-probabilistic sampling was carried out. Indigenous people registered in the Cervical Pathology Program were studied. The data obtained were entered in Microsoft Excel © 2016, STATA® 14.0 was used for the analysis. The results were presented in tables and graphs. Results: The study included 129 indigenous people with an average age of 26 ± 10 years. The prevalence of precursor lesions of cervical cancer was 13.18%. The most frequently found lesions in order of frequency were ASCUS 10.08%; CIN I 2.32%; CIN II 0.77%; no CIN III was observed, nor carcinoma in situ. The ages in which they occurred most frequently were between 25 and 44 years in 70.59%. 58.8% of those who presented cervical lesions had menarche <12 years; 76.5% sexual intercourse <15 years and 82.35% are large multiparous. Conclusion: The prevalence of precursor lesions of cervical cancer is similar to studies from other countries and less than some studies that were conducted in Paraguay in a non-indigenous population. A higher percentage of lesions was found in the middle ages, early menarche, and early onset of sexual life and in multiparous women. Keywords: Cervical intraepithelial lesion; cervical cancer; cytology; Paraguay; Indigenous Health Services.

Infección por el virus del papiloma humano en adolescentes y adultas jóvenes / Infection with human papillomavirus in adolescents and young adults

La infección por el virus del papiloma humano (VPH) se encuentra asociada a diferentes lesiones que van desde benignas hasta malignas. Los mayores picos de prevalencia de dicha infección se encuentran en mujeres entre los 15-24 años de edad. El objetivo es realizar una revisión de la literatura científica actual sobre la prevalencia de la infección por el VPH en mujeres menores de 25 años a nivel mundial. Para este fin se utilizaron las bases de datos, PubMed, MedLine, BioMed Central y SciELO. En este grupo etario se observó una alta frecuencia de infección por VPH, así como un elevado riesgo de desarrollar lesiones premalignas. La edad de la primera relación sexual, el número de compañeros sexuales, el tipo de VPH infectante y la persistencia viral, mostraron ser factores de riesgo significativos para la transformación maligna. La prevención, como un método para evitar la infección por estos virus, es un arma promisoria en la lucha contra el cáncer cérvico uterino(AU)

Human papilloma virus (HPV) infection is associated with different lesions ranging from benign to malignant. The highest prevalence peaks of this infection are found in women between 15-24 years of age. To conduct a review of the current scientific literature on the prevalence of HPV infection in women under 25 years of age worldwide. Databases, PubMed, MedLine, BioMed Central and SciELO were used for this purpose. In this age group a high frequency of HPV infection was observed, as well as a high risk of developing premalignant lesions. The age of first intercourse, the number of sexual partners, the type of HPV infection and viral persistence, were significant risk factors for malignant transformation. Prevention, as a method to avoid infection by these viruses, is a promising weapon in the fight against cervical cancer(AU)

La alta prevalencia de lesiones premalignas gástricas y el bajo rendimiento diagnóstico de la visión endoscópica son argumentos a favor de la toma sistemática de biopsias gástricas por Protocolo Sydney / The high prevalence of gastric premalignant lesions and the low diagnostic performance of endoscopic vision advocate towards a systematic gastric biopsy sampling using Sydney Protocol

Background: Atrophic gastritis (AG) and intestinal metaplasia (IM) are stages that appear in the process of gastric carcinogenesis. Their presence requires programmed endoscopic vigilance. Objectives: To determine the frequency of AG and IM in gastric biopsies (GB) taken according to Sydney Protocol and to correlate them with endoscopic findings. Methods: Retrospective descriptive analysis of 233 upper gastrointestinal endoscopies with GB per Sydney Protocol. OLGA (Operative Link for Gastritis Assessment) and OLGIM (Operative Link for Gastric Intestinal Metaplasia Assessment) scores were calculated based on the GB description. Endoscopic findings were analyzed for atypical findings and compared to the GB report. Statistic analysis for Kappa and ANOVA was performed via Stata 12. Results: Mean age of patients was 58 ± 12 years. 69% were women. The frequency of AG and IM was 44% and 33% in the antrum, 31% and 20% in the angular incisure and 14% and 9% in the body, respectively. AG and IM were more frequent in the antrum (p < 0.05). AG and IM were more severe in the angular incisure and body (p < 0.05). We were unable to calculate OLGA and OLGIM in 6% and 9% of cases, respectively, due to absence of severity description in GB. 53% were OLGA 0, 42% OLGA I-II and 5% OLGA III-IV. 70% were OLGIM 0, 25% OLGIM I-II and 5% OLGIM III-IV. Agreement between endoscopic and histological findings was best for IM in the antrum (75.5%, Kappa 0.4). Sensitivity and specificity of endoscopic findings were 39% and 70% for AG, and 30% and 85% for IM, respectively. Conclusion: AG and IM are frequent findings in our patients. Due to the low endoscopic sensitivity for AG and IM, we suggest a systematic GB sampling using Sydney Protocol in patients over 40 years old.

Introducción: La gastritis crónica atrófica (GCA) y la metaplasia intestinal (MI) son etapas en el proceso de carcinogénesis gástrica, su presencia requiere control endoscópico programado. Objetivos: Determinar la frecuencia de GCA y MI en biopsias gástricas (BG) por protocolo de Sydney y relacionarlas con el hallazgo endoscópico. Métodos: Estudio descriptivo mediante revisión de 233 endoscopias digestivas altas con BG por Protocolo Sydney. Se graduó puntaje OLGA (Operative Link for Gastritis Assessment) y OLGIM (Operative Link for Gastric Intestinal Metaplasia Assessment) según la descripción de la BG. Se definió el hallazgo endoscópico según su informe y se comparó con BG como patrón de referencia. Estadística: Stata 12 para Kappa y ANOVA. Resultados: Edad promedio 58 ± 12 años, 69% mujeres. La frecuencia de GCA y MI en antro fue de 44 y 33%, en ángulo 31 y 20% y en cuerpo 14 y 9%, respectivamente. Hubo mayor frecuencia de GCA y MI en antro (p < 0,05). La graduación de GCA y MI fue mayor en ángulo y cuerpo (p < 0,05). No se obtuvo OLGA en 6% y OLGIM en 9% por ausencia de graduación. La frecuencia de OLGA 0 fue de 53%, OLGA I-II 42%, OLGA III-IV 5%, OLGIM O 70%, OLGIM I-II 25% y OLGIM III-IV 5%. La mejor correlación se observó entre la MI antral endoscópica con la histológica (75,5%, Kappa 0,4). La sensibilidad y especificidad endoscópica fue de 39 y 70% para GCA y 30 y 85% para MI. Conclusión: GCA y MI son hallazgos frecuentes en nuestros pacientes. Por la baja sensibilidad endoscópica en la identificación de GCA y MI sugerimos la toma sistemática de BG por protocolo de Sydney en pacientes mayores de 40 años.

Situación del cáncer gástrico en el mundo y en Chile / Situation of gastric cancer in the world and in Chile

Resumen El cáncer gástrico es uno de los cánceres más frecuentes en el mundo. Recientes estudios han contribuido en la comprensión de esta enfermedad. El objetivo de este artículo es revisar de manera crítica y actualizada distintos aspectos del cáncer gástrico tanto a nivel mundial como a nivel chileno. Este artículo revisa algunos aspectos relacionados con el cáncer gástrico, tales como epidemiología, dieta, estudio histológico, búsqueda de lesiones precancerosas, prevención, Helicobacter pylori, estilos de vida, factores metabólicos y tratamiento.

Abstract Gastric cancer is one of the most common cancers in the world. Recent studies have contributed to the understanding of this disease. The aim of this article is to critically review various aspects of gastric cancer both globally and Chilean. This article reviews some aspects related to gastric cancer, such as epidemiology, diet, histology, screening of precancerous lesions, prevention, Helicobacter pylori, lifestyles, metabolic factors and treatment.

Frecuencia de lesiones de la mucosa oral en el servicio de urgencias y orientación de pacientes de la facultad de odontología de la Universidad de Buenos Aires / Frequency of oral mucosal lesions at the emergency service and patient orientation of the school of dentistry, University of Buenos Aires

Objetivo: estimar la frecuencia de lesiones que afectan la mucosa oral, en una muestra de pacientes que concurrieron por demanda espontánea al Servicio de Urgencias y Orientación de Pacientes (SUYOP) de la Facultad de Odontología de la Universidad de Buenos Aires, a fin de valorar las características de esta población y poder adoptar conductas preventivas adecuadas. Materiales y métodos: Un operador único perteneciente al SUYOP evaluó a todos los pacientes que ingresaron al estudio (n=503) yposteriormente un especialista único, perteneciente a la Cátedra de Estomatología, examinó a aquellos pacientes que presentaron lesiones(n=208) a fin de determinar el diagnóstico de certeza de las mismas. Todos los diagnósticos fueron confirmados mediante biopsia, estudiode cultivo, o seguimiento clínico de la enfermedad. Resultados: 41,35 por ciento (n=208) de los pacientes examinados presentaron al menos una lesión estomatológica en la mucosa oral. 89 por ciento (n=185) de los pacientes con lesiones desconocía la existencia de las mismas y solamente el 11 por ciento (n=23) se presentó a la consulta con una derivación u orientación estomatológica. 23 por ciento (n=48) de los pacientes que presentaron lesiones fueron considerados de gravedad diagnostica. Conclusión: Los datos obtenidos en el presente estudio revelan la importancia de las campañas para concientizar a la sociedad acerca de la necesidad de realizar consultas de rutina, pero también, y muy especialmente, concientizar a estudiantes y profesionales de la salud en el examen exhaustivo de la mucosa oral de todos los pacientes.

Objective: to estimate the frequency of lesions affecting the oral mucosa in a sample of patients seeking unscheduled care at theEmergency and Patient Referral Service (EPRS), School of Dentistry, University of Buenos Aires, with the aims to evaluate thecharacteristics of the studied population and thus adopt appropriate preventive measures. Materials and Methods: A single operatorfrom the EPRS assessed all the patients included in the study (n=503), after which a single specialist from the Oral MedicineDepartment examined patients presenting oral mucosal lesions (n=208) to establish definitive diagnosis. All diagnoses were confirmedby biopsy, culture studies, or clinical follow-up. Results: 41.35% of studied patients (n=208) had at least one oral mucosal lesion; 89%(n=185) of patients who had a lesion were unaware that they had a lesion, and only 11% (n=23) of patients knew they had a lesion.23% who had a lesion were considered as gravity diagnosis patients. Conclusion: All the obtained data show the importance of conducting campaigns in the community to increase the awareness of the need for regular routine dental visits, and particularly, to create an awarenessamong dental students and health care professionals of the importance of thoroughly examining the oral mucosa of all patients.

Prevalencia de queilitis actínica en pescadores artesanales,Valdivia, Chile / Prevalence of actinic cheilitis in artisanal fishermen, Valdivia, Chile

El objetivo de este trabajo consistió en determinar la prevalencia de Queilitis Actínica en pescadores artesanales de la ciudad de Valdivia, Chile. Se realizó un estudio observacional descriptivo de corte transversal durante los meses de noviembre 2014 a abril 2015. La muestra fueron 180 pescadores previamente seleccionados a través de una muestra aleatoria simple, quienes fueron evaluados mediante un examen clínico y además completaron un cuestionario referente a datos personales y hábitos de salud. El 38,8 % de los pescadores artesanales presentó Queilitis Actínica. El 64,4 % de los pescadores revisados no utiliza protección solar mientras trabaja y todos los casos se ubicaron en el labio inferior. Los pescadores artesanales de la ciudad de Valdivia presentaron una prevalencia de Queilitis Actínica superior a las reportadas a nivel nacional. Nuestros resultados sugieren la implementación de políticas de salud pública centrados en la prevención de Queilitis Actínica en pescadores artesanales de la ciudad de Valdivia.

The aim of this study was to determine the prevalence of actinic cheilitis in fishermen in the city of Valdivia, Chile 2015. A descriptive observational cross-sectional study was realized from November 2014 to April 2015. The sample included 180 fishermen, previously selected through a simple random sample. The subjects were evaluated by clinical examination and also completed a questionnaire on personal data and health habits. Of the total fishermen surveyed 38.8 % presented Actinic cheilitis. Furthermore, 64.4 % of the fishermen interviewed reported they do not use sun protection while working and all cases were located in the lower lip. The fishermen in Valdivia showed a higher prevalence of Actinic cheilitis than that found nationally. Our results suggest the implementation of public health policies focusing on the prevention of actinic cheilitis in artisanal fishermen in the city of Valdivia.

Epidemiological aspects of endoscopic resections of colorectal polyps in patients at an endoscopy training center in the Santos region, Brasil / Aspectos epidemiológicos de las resecciones endoscópicas de los pólipos colo-rectales en un centro de entrenamiento de endoscopía en la región de Santos, Brasil

Introduction: Colorectal polyps are structures that project from the surface of the mucosal layer of the large intestine. They are classified as neoplastic or non-neoplastic. Early detection of pre-neoplastic lesions is important for preventing colorectal cancer. These can be resected so as to decrease the morbidity and mortality rates. Colonoscopy is the gold-standard procedure for diagnosing and resecting precursor lesions. Objective: To evaluate the epidemiological, endoscopic and histological aspects of endoscopic resection of lesions of the colon and rectum at a training center. Materials and method: A search was conducted in the database of our institution covering the period from January 2011 to July 2014. Cases that underwent endoscopic resection of polyps and/or colorectal lesions were selection. The following variables were defined: general data on the patients (age, gender and indication from the examination) and data on the polypoid lesion (number, histological type and topographic distribution). Results: 678 lesions were identified in 456 examinations. Regarding sex, 242 (53.1%) were female and 214 (46.9%) were male. The mean age was 64.54 years, with extremes of 5 and 94 years. The most frequent locations were the rectum (21%) and sigmoid (20%). Histologically, 34.7% were hyperplastic polyps and 58.9% were adenomatous polyps, of which 74.1% were tubular, 10.6% tubulovillous, 2% villous and 13% indeterminate; and 1.7% were adenocarcinomas. In 65.4% of the cases, the examination showed that only one polyps was present, while 34.6% had two or more lesions. Conclusion: In our clinic, with a mean of 250 examinations/month, the parameters evaluated were compatible with the results reported in the literature.

Introducción: Los pólipos colorrectales son estructuras que se proyectan en la superficie de la capa mucosa del intestino grueso. Son clasificados en neoplásicos y no neoplásicos. La detección precoz de lesiones preneoplásicas es relevante en la prevención del cáncer colorrectal. Pueden ser resecados y reducir los índices de morbimortalidad. La colonoscopia es el patrón de oro para el diagnóstico y resección de lesiones precursoras. Objetivo: Evaluar aspectos epidemiológicos, endoscópicos e histológicos relacionados a las resecciones endoscópicas de lesiones de colon y recto en un centro de entrenamiento. Matariales y métodos: Fue realizada una búsqueda en la base de datos de nuestra institución durante el período de enero de 2011 a julio de 2014. Se seleccionaron aquellos sometidos a las resecciones endoscópicas de pólipos y/o lesiones colorrectales. Las siguientes variables fueron definidas: datos generales de los pacientes (edad género e indicación del examen) y datos de la lesión polipoidea (número, tipo histológico, distribución topográfica). Resultados: Fueron identificadas 678 lesiones en 456 exámenes. Con relación al sexo, 242 (53,1 %) eran del género femenino y 214 (46,9 %) masculino. El promedio de edad fue de 64,54 años, con extremos de 5 y 94 años. La ubicación más frecuente fue en el recto (21 %) y sigmoide (20 %). Histológicamente, 34,7% eran pólipos hiperplásicos y 58,9% adenomatosos, siendo 74,1% tubulares, 10,6% tubulovellosos, 2% vellosos y 13% indeterminados y, 1,7% correspondieron a adenocarcinomas. En el 65,4% de los casos existía solamente un pólipo al hacer el examen, 34,6% presentaban dos o más lesiones. Conclusión: En nuestro trabajo, con un promedio de 250 exámenes/mes, los parámetros evaluados fueron compatibles a los resultados encontrados en la literatura.

Potentially malignant oral lesions: clinicopathological correlations / Lesões orais potencialmente malignas: correlações clínico-patológicas

ABSTRACT Objective To determine the incidence of potentially malignant oral lesions, and evaluate and correlate their clinical and pathological aspects. Methods The sample consisted of cases clinically diagnosed as oral leukoplakia, oral erythroplakia, erythroleukoplakia, actinic cheilitis, and oral lichen planus treated at a diagnostic center, between May 2012 and July 2013. Statistical tests were conducted adopting a significance level of 5% (p≤0.05). Results Out of 340 patients, 106 (31.2%) had potentially malignant oral lesions; and 61 of these (17.9%) were submitted to biopsy. Actinic cheilitis was the most frequent lesion (37.5%) and the lower lip was the most affected site (49.6%). Among 106 patients in the sample, 48 (45.3%) reported nicotine consumption, 35 (33%) reported alcohol intake and 34 (32.1%) sun exposure while working. When clinical and histopathological diagnoses were compared, oral erythroplakia and atypical ulcer were the lesions that exhibited greater compatibility (100% each). Conclusion In most cases, clinical and histopathological diagnoses were compatible. An association between the occurrence of erythroplakia, leukoplakia and erythroleukoplakia with smoking was observed. Similarly, an association between actinic cheilitis and sun exposure was noted. Erythroleukoplakia presented the highest malignancy grade in this study. Finally, dental surgeons should draw special attention to diagnosis of potentially malignant oral lesions, choose the best management, and control the lesions to avoid their malignant transformation.

RESUMO Objetivo Verificar a incidência das lesões orais potencialmente malignas, e avaliar e correlacionar seus aspectos clínico-patológicos. Métodos A amostra foi composta pelos casos diagnosticados clinicamente como leucoplasia oral, eritroplasia oral, eritroleucoplasia, queilite actínica e líquen plano oral em um serviço de diagnóstico no período entre maio de 2012 e julho de 2013. Foram realizados testes estatísticos adotando-se nível de significância de 5% (p≤0,05). Resultados Dos 340 pacientes examinados, 106 (31,2%) se apresentaram com lesões orais potencialmente malignas; destes, 61 (17,9%) biópsias foram realizadas. A lesão mais frequente foi a queilite actínica (37,5%), e o sítio anatômico mais acometido foi o lábio inferior (49,6%). Entre os 106 pacientes da amostra, 48 (45,3%) relataram consumo de nicotina, 35 (33%) ingeriam bebidas alcoólicas e 34 (32,1%) trabalhavam expostos ao sol. Comparando o diagnóstico clínico com o histopatológico, as lesões que apresentaram maior compatibilidade foram a eritroplasia oral e a lesão ulcerada atípica (100% ambas). Conclusão Na maioria dos casos, houve compatibilidade do diagnóstico clínico com o histopatológico. Notou-se correlação entre a ocorrência de eritroplasia, leucoplasia e eritroleucoplasia com o hábito de fumar, e entre a queilite actínica com a exposição solar. A eritroleucoplasia foi a lesão que demonstrou maior grau de malignização neste estudo. Diante do exposto, recomenda-se maior atenção por parte dos cirurgiões-dentistas ao diagnóstico das lesões orais potencialmente malignas, para aplicação da melhor conduta e controle da lesão, impedindo sua transformação maligna.

Frecuencia de displasia epitelial y carcinoma escamoso en mucosa oral y orofaríngea en Chile, entre los años 1990 y 2009 / Frequency of oral squamous cell carcinoma and oral epithelial dysplasia in oral and oropharyngeal mucosa in Chile

Background: Oral cancer in Chile corresponds approximately to 1.6% of all cancer cases. There are few studies about oral epithelial dysplasia and oral squamous cell carcinoma in the Chilean population. Aim: To determine the frequency of hyperkeratosis, mild, moderate and severe oral epithelial dysplasia, in situ carcinoma and squamous cell carcinoma of the oral and oropharyngeal mucosa in a registry of the Oral Pathology Reference Institute of the Faculty of Dentistry, Universidad de Chile, in a ten years period. Material and Methods: Review of clinical records and pathological plates of 389 patients, obtained between 1990 and 2009. Cases were selected according to their pathological diagnosis, including hyperkeratosis, oral epithelial dysplasia, in situ carcinoma, squamous cell carcinoma and verrucous carcinoma. Results: Forty four percent of cases were squamous cell carcinoma, followed by hyperkeratosis in 37% and mild epithelial dysplasia in 11%. Squamous cell carcinoma was more common in men aged over 50 years. Most of the potentially malignant disorders presented clinically as leukoplakia and squamous cell carcinoma were clinically recognized as cancer. Conclusions: In this study, men aged over 50 years are the highest risk group for oral cancer. Early diagnosis is deficient since most of these lesions were diagnosed when squamous cell carcinoma became invasive. Leukoplakia diagnosis is mostly associated with hyperkeratosis and epithelial dysplasia, therefore biopsy of these lesions is mandatory to improve early diagnosis.

High-risk human papillomavirus and cervical lesions among women living with HIV/AIDS in Brazilian Amazon, Brazil

ABSTRACT OBJECTIVE: The goal of this study was to determine the prevalence of human papillomavirus infection infection and cervical lesions and its associated factors among HIV infected women attending an AIDS clinic in Amazonas state, Brazil. METHODS: Cross-sectional study. Women attending an AIDS clinic in the city of Manaus between March and December 2011 for gynecological examination were invited to participate. Enrolled patients answered a standardized interview including demographical, behavioral, and clinical data. Additionally, patients underwent a gynecological evaluation with collection of cervical samples for cytological analysis and high-risk human papillomavirus infection hybrid capture. A blood sample was also obtained to determine CD4 and viral load levels. RESULTS: A total of 310 (82.9%) women participated in the study. High-risk human papillomavirus infection was detected in 191 (61.6%) cases; 24 (13.5%) had low-grade squamous intraepithelial lesion (SIL) and 4 (2.2%) high-grade SIL. No invasive cervical cancer was diagnosed. Median age was 32 (interquartile range (IQR): 27-38) years and median of education was 8.5 (IQR 4-11) years of schooling and 56.1% had a monthly income up to US$180. In multivariate analysis, being less than 30 years old [OR = 1.7 (95% CI: 1.2-2.4,p = 0.005)], high-grade SIL [OR = 6.5 (95% CI: 1.6-23.0, p = 0.009)], and CD4 counts <200 cells/mm3 [OR = 1.6 (95% CI: 1.2-2.0, p < 0.001)] were associated with high risk human papillomavirus infection infection. CONCLUSIONS: In the present study high-risk human papillomavirus infection was frequent and it was associated to high-SIL. These results show the importance of gynecologic examinations in routine care and follow-up required by those who present with cervical lesions.

Blood Pressure and Hemodynamic Adaptations after a Training Program in Young Individuals with Down Syndrome / Pressão Arterial e Adaptações Hemodinâmicas após Programa de Treinamento em Jovens com Síndrome de Down

Background: Cardiovascular diseases affect people worldwide. Individuals with Down Syndrome (DS) have an up to sixteen-time greater risk of mortality from cardiovascular diseases. Objective: To evaluate the effects of aerobic and resistance exercises on blood pressure and hemodynamic variables of young individuals with DS. Methods: A total of 29 young individuals with DS participated in the study. They were divided into two groups: aerobic training (AT) (n = 14), and resistance training (TR) (n = 15). Their mean age was 15.7 ± 2.82 years. The training program lasted 12 weeks, and had a frequency of three times a week for AT and twice a week for RT. AT was performed in treadmill/ bicycle ergometer, at an intensity between 50%-70% of the HR reserve. RT comprised nine exercises with three sets of 12 repetition-maximum. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP) and hemodynamic variables were assessed beat-to-beat using the Finometer device before/after the training program. Descriptive analysis, the Shapiro-Wilk test to check the normality of data, and the two-way ANOVA for repeated measures were used to compare pre- and post-training variables. The Pearson’s correlation coefficient was calculated to correlate hemodynamic variables. The SPSS version 18.0 was used with the significance level set at p < 0.05. Results: After twelve weeks of aerobic and/or resistance training, significant reductions in variables SBP, DBP and MBP were observed. Conclusion: This study suggests a chronic hypotensive effect of moderate aerobic and resistance exercises on young individuals with DS. .

Fundamento: As doenças cardiovasculares atingem as pessoas em todo o mundo. Pessoas com Síndrome de Down (SD) apresentam um risco até dezesseis vezes maior de mortalidade por doenças cardiovasculares. Objetivo: Avaliar os efeitos do exercício aeróbio e resistido na pressão arterial e variáveis hemodinâmicas de jovens com SD. Métodos: Participaram do estudo 29 jovens com SD, divididos em dois grupos: (TA) Treinamento Aeróbio (n = 14) e (TR) Treinamento Resistido (n = 15), idade 15,7 ± 2,82 anos. O programa de treinamento teve doze semanas, frequência de três vezes por semana para TA, e duas vezes, para TR. TA foi realizado com esteira/bicicleta, intensidade entre 50%-70% da FC de reserva. TR teve nove exercícios com três séries de doze repetições máximas. Avaliações de Pressão Arterial Sistólica (PAS), Pressão Arterial Diastólica PAD), Pressão Arterial Média (PAM) e variáveis hemodinâmicas foram realizadas batimento a batimento por meio do Finometer antes/após o programa de treinamento. Foram usados estatística descritiva, teste de Shapiro-Wilk para verificação da normalidade dos dados e teste ANOVA two-way para medidas repetidas para a comparação das variáveis pré e pós-treinamento. Para correlacionar as variáveis hemodinâmicas, foi calculado o coeficiente de correlação de Pearson. Utilizou-se o programa estatístico SPSS versão 18.0, adotando nível de significância (p < 0,05). Resultados: Após doze semanas de treinamento, aeróbio e/ou resistido, ocorreram reduções significativas pós‑intervenção nas variáveis de PAS, PAD e PAM. Conclusão: Sugere um efeito hipotensivo crônico do exercício aeróbio e resistido moderado em jovens com SD. .

Genotyping of High Risk Human Papillomavirus (HPV) Among Cervical Precancer and Cancer Patients.

Introduction: Human papillomavirus (HPV) is a DNA virus which has tropism for epithelial cells, is the major etiological factor for development of cervical precancerous and cancerous lesions. Nearly 100 diff erent types of HPV have been characterized and thereare a large number of other types. HPV infection is one of the most common causes of sexually transmitted disease in both men and women worldwide. It is associated with a variety of clinical conditions that range from innocuous lesions to cancer. Genital HPV types are divided into high and low-risk types, according to the oncogenic potential. Molecular and epidemiologic studies have solidifi ed the association between high risk HPV types (especially HPV-16 and HPV-18) and cervical squamous cell carcinoma. HPV infection is often transient and self-limiting but infection may persists and progress to high grade lesions and cancer. In addition to persistent high-risk HPV infection, other viral factors such as high viral loads, HPV variants, infections with multiple high-risk HPV types and genetic predisposition contribute to the development of cervical cancer. Th e aim of the present study was to detect HPV DNA and identify high risk HPV genotype among women having cervical intraepithelial neoplasia and carcinoma and to evaluate potential effi cacy of prophylactic HPV vaccine. Methods: Cervical swab from histopathologically diagnosed CIN (n=51) and carcinoma (n=39) patients were taken and high risk HPV DNA was detected by HC II assay. Polymerase Chain Reaction was used to identify high risk HPV genotype. Result: HPV DNA was detected in 41 (45.56%) patients by HC II assay. HPV type 16 was detected in 27 (81.82%) followed by type 18 in 3 (9.09%) and type 45 in 2 (6.06%) cases of cervical carcinoma. Among precancerous cases, only type 16 was detected. Conclusion: Knowledge based on HPV prevalence and genotype could be used to predict the effi cacy of cost eff ective prophylactic vaccine, introduction of newer generation vaccine and management of cervical carcinoma.

Premalignant and malignant lesions in endometrial polyps in patients undergoing hysteroscopic polypectomy / Lesões precursoras e câncer em pólipos do endométrio de pacientes submetidas à polipectomia histeroscópica / Lesões precursoras e câncer em pólipos do endométrio de pacientes submetidas à polipectomia histeroscópica

Objective : To evaluate the incidence of premalignant lesions and cancer in endometrial polyps, in patients undergoing hysteroscopic polypectomy. Methods : The results of 1,020 pathological examinations of patients submitted to hysteroscopic polypectomy were analyzed, as well as their diagnostic and surgical hysteroscopy findings. As to their menstrual status, 295 (28.9%) patients were in menacme. Of the total, 193 (65.4%) presented abnormal uterine bleeding, and 102 (34.6%) were asymptomatic with altered endometrial echo on transvaginal ultrasound. Out of 725 (71.1%) postmenopausal patients, 171 (23.6%) were symptomatic (abnormal uterine bleeding), and 554 (76.4%) were asymptomatic with endometrial echo >5.0mm. Results : Twenty-one (2.0%) patients presented premalignant lesions in the polyps, 13 had simple glandular hyperplasia, of which 5 had no atypia, and eight presented atypia. Eight polyps presented focal area of complex hyperplasia: 4 with atypia and 4 without lesions. Cancer was diagnosed in 5 (0.5%) polyps. Of the 21 polyps that harbored premalignant lesions, 12 were interpreted as benign in diagnostic and surgical hysteroscopy. Of the polyps with cancer, 4 were also histeroscopically interpreted as normal. Conclusion : Symptomatic polyps in menacme and in all postmenopausal women should be resected and submitted to histopathological examination, since they may have a benign aspect, even when harboring areas of cellular atypia or cancer. .

Objetivo : Avaliar a incidência de lesões precursoras e câncer em pólipos do endométrio de pacientes submetidas à polipectomia histeroscópica. Métodos : Análise dos resultados de 1.020 exames anatomopatológicos de pacientes submetidas, em hospital público, à polipectomia histeroscópica, e achados em suas histeroscopias diagnóstica e cirúrgica. Em termos de estado menstrual, 295 (28,9%) pacientes encontravam-se na menacme. Do total, 193 (65,4%) apresentavam sangramento uterino anormal e 102 (34,6%) eram assintomáticas, com alteração da medida do eco endometrial à ultrassonografia transvaginal. Das 725 (71,1%) pacientes na pós-menopausa, 171 (23,6%) eram sintomáticas (sangramento uterino anormal) e 554 (76,4%) assintomáticas, com eco endometrial >5,0mm. Resultados : Vinte e uma (2,0%) pacientes apresentaram lesões precursoras nos pólipos, 13 com hiperplasia glandular simples, das quais 5 sem atipias e 8 com atipias. Oito pólipos apresentavam área focal de hiperplasia complexa, quatro com atipias e quatro sem lesões. Câncer foi diagnosticado em cinco (0,5%) pólipos. Dos 21 pólipos que abrigavam lesões precursoras, 12 foram interpretados como benignos nas histeroscopias diagnóstica e cirúrgica. Quatro dos pólipos com câncer também foram interpretados histeroscopicamente como normais. Conclusão : Os pólipos sintomáticos na menacme, bem como todos na pós-menopausa, devem ser ressecados para realização de exame anatomopatológico, por poderem apresentar aspecto benigno, mesmo quando abrigam áreas de atipia celular ou câncer. .

Queilite actínica: estudo epidemiológico entre trabalhadores rurais do município de Piracaia - SP / Actinic cheilitis: epidemiological study in the rural municipality of Piracaia - SP

A queilite actínica é uma lesão de lábio inferior definida como uma condição degenerativa do epitélio de revestimento, causada pela ação da radiação ultravioleta do sol sobre os lábios sendo considerada uma lesão cancerizável que pode evoluir para carcinoma. Em geral, os pacientes são assintomáticos e os sinais clínicos não refletem a gravidade histopatológica da lesão. O objetivo do trabalho foi realizar um levantamento epidemiológico da queilite actínica entre trabalhadores rurais do município de Piracaia, São Paulo, por meio de questionário e observação clínica. Aspectos como gênero, faixa etária, exposição solar, grau de alfabetização, uso de protetores solares, tabagismo, etilismo e características clínicas foram avaliados. Os resultados mostraram que o perfil epidemiológico dos 120 pacientes avaliados era composto de homens (73,3%1, com idade entre 20 e 44 anos (68,3%). Destes, 35,8% apresentavam quadro de queilite actínica e, segundo os parâmetros clínicos utilizados, 30,8% apresentavam grau leve a moderado de alterações teciduais. O uso de protetor solar labial foi relatado por 15,83% da população estudada. Os dados obtidos nesta pesquisa reforçam a necessidade de orientação aos trabalhadores rurais quanto aos malefícios da radiação solar e conscientização do uso de fotoproteção, não só aos que já apresentam as características clínicas da queilite actínica, como também aos pertencentes ao grupos de risco, estando os profissionais de saúde, em especial os cirurgiões-dentistas, responsáveis pelo diagnóstico, prevenção e tratamento.

The actinic cheilitis is a lesion located at lower lip defined as a degenerative condition of the lining epithelium. It is caused by the action of ultraviolet radiation from the sun. It is considered a carcinogenic lesion that can progress to carcinoma. In general, patients are asymptomatic and clinical signs do not reflect the severity of histopathological lesions. The aim of this study was an epidemiological survey of actinic cheilitis among rural workers at Piracaia - São Paulo using questionnaires and clinical observation. Some aspects were assessed as gender, age, sun exposure, degree of literacy, use of sunscreens, smoking, alcohol consumption and clinical characteristics. The results showed that the epidemiological profile of the 120 patients evaluateí was composed of 73.3% by men with ages between 20 and 44 years (68.3%). Of these, 35.801; were diagnosed with actinic cheilitis. According second clinical parameters used, 30.8% patients had mild to moderate tissue changes. The use of sunscreen lip was reported by 15.83% of this sample. The data obtained in this study reinforce the need for guidance the rural workers to the harmful effects of solar radiation. It is important to use the sunscreen, not only people who already have clinical features of actinic cheilitis but ali belonging to risk groups, with the health professionals, especially dentist, responsible for the diagnosis, prevention and treatment.

Clinical and laboratorial study of HPV infection in men infected with HIV

OBJECTIVES: To determine the prevalence of precursor lesions of penile cancer, to establish the concordance of diagnostic techniques (PCR, Hybrid Capture (HC) and peniscopy with acetic acid 5%) in the diagnosis of Human Papilloma Virus (HPV) of the penis of men infected with HIV and to evaluate the influence of the immune status. PATIENTS, METHODS AND RESULTS: 276 men were studied, with a median age of 34.6 years. Prevalence of High Risk HPV, Low Risk HPV and infection with both, according to HC, was 43%, 32% and 22%, respectively. PCR showed 50% of positivity for HPV DNA. Peniscopy was positive in 27% of individuals. Peniscopy showed good specificity and low sensitivity for the detection of penile HPV, and low concordance with PCR. Men with white lesions had a 3.6 higher relative risk of positivity for HPV. The most common clinical lesion observed was vegetation, identified in 29% of patients. PCR and HC techniques showed high sensitivity for HPV DNA and there was an excellent correlation between them. Immunosuppressed individuals with CD4< 200 cells/mm3 had the highest prevalence of pre-malignant lesions that were observed in 10% of the studied individuals. CONCLUSIONS: Peniscopy was important for identification and treatment of subclinical lesions. PCR and HC techniques were sensitive methods for the detection of HPV DNA with high concordance. Severely immunosuppressed individuals showed a higher prevalence of pre-malignant lesions of the penis.

Prevalencia de lesiones de bajo y alto grado de cuello uterino en una ciudad colombiana / Prevalence of lesions of low and high grade cervical in a Colombian city

Objetivo: Determinar la prevalencia de las lesiones de bajo y alto grado de cuello uterino en una Institución Prestadora de Servicios de Salud de Tuluá, Colombia, entre los años 2008-2010. Métodos: Se realizó un estudio descriptivo retrospectivo en el que se incluyeron mujeres entre los 15 y 75 años, residentes en el Municipio de Tuluá. Se evaluó la normalidad de las variables cuantitativas, empleándose la mediana o el promedio con sus varianzas según su distribución, y frecuencias y proporciones para las variables categóricas. Resultados: Se incluyeron 3.539 mujeres. La mediana de la edad fue 38 años con rango intercuartil (RI: 29-46 años), la mediana del número de partos 1 (RI: 0-3). En relación a la seguridad social y uso de métodos anticonceptivos, la mayoría eran particulares y no utilizaban ningún método. El 87,5 por ciento de las citologías se reportaron como negativas, 8,2 por ciento lesión de bajo grado (LSIL), 2,6 por ciento células escamosas atípicas de significado indeterminado (ASC-US), 0,9 por ciento lesiones de alto grado (HSIL), 0,4 por ciento células escamosas atípicas de significado indeterminado de alto grado ASC-H, 0,4 por ciento células glandulares atípicas de significado incierto (ASGUS) y 0,2 por ciento carcinoma invasor. Conclusión: La prevalencia de las anormalidades citológicas fue baja en todos los grupos analizados, sin embargo, existe un mayor número de LSIL hacia la cuarta década de la vida y en aquellas que iniciaron su vida sexual después de los 40 años. De igual manera se encontró una relación inversa entre el número de partos, planificación familiar hormonal y aparición de lesiones pre neoplásicas.

Objective: To determine the prevalence of lesions of low and high grade cervical in a Lender Institution Health Services, Tuluá, Colombia, 2008-2010. Methods: We performed a retrospective study which included women between 15 and 75 years living in Tuluá. We evaluated the normality of quantitative variables, using the median or average with their variances for quantitative variables according to their distribution and frequencies and proportions for categorical variables. Results: 3539 women were included. The median age was 38 years with interquartile range (IR: 29-46 years) and the median parity was 1 (IR: 0-3). In relation to social security and family planning birth control, most were private and did not use any method. The 87.5 percent of smears was reported as negative, low-grade squamous intraepitelial lesions (LSIL) 8.2 percent atypical squamous cells of undetermined significance (ASC-US) 2.6 percent, high-grade squamous intraepitelial lesions (HSIL) 0.9 percent, atypical squamous cells cannot rule out a high grade lesion (ASC-H) 0.0 percent, atypical squamous glandular cells of undetermined significance (ASGUS) 0.4 percent and invasive carcinoma 0.2 percent. Conclusion: The prevalence of cytological abnormalities was low in all groups studied, however, a greater number of LSIL to the fourth decades of life and those who began their sexual life after 40 years. Similarly, an inverse relationship was found between parity, hormonal family planning and pre-neoplastic lesions.