Impacto del envejecimiento sobre la incidencia y mortalidad de los cánceres urológicos: proyección a 20 años en España / Impact of aging on the incidence and mortality of urological cancers: 20-year projection in Spain

Introducción En el año 2020, en España, se diagnosticaron 282.421 nuevos casos de cáncer, encontrándose las neoplasias urológicas (NU) entre las más frecuentes. El tratamiento del cáncer en personas mayores es todo un reto, debido a su fragilidad y comorbilidades. Para responder a las necesidades que plantean las NU en las personas mayores, es necesaria una adecuada planificación de la enfermedad, comenzando por analizar los registros de cáncer. El objetivo fue, considerando a la población española de más de 65 años, proporcionar un análisis detallado de incidencia y mortalidad de las NU en el año 2020, así como las estimaciones para el año 2040. Material y métodos Las NU que se incluyeron fueron: testículo, vejiga, pene, riñón y próstata. Las estimaciones de incidencia y mortalidad fueron obtenidas de la base de datos GLOBOCAN. Resultados En el año 2020 se diagnosticaron en España 63.278 NU. Exceptuando la neoplasia de testículo, todas las neoplasias se diagnosticaron con mucha mayor frecuencia en el grupo de mayores de 65 años. Para el año 2040 se estima un aumento del 41,5%, alcanzando los 89.507 nuevos casos por año, de los cuales aproximadamente tres cuartas partes tendrán lugar en mayores de 65. El número de fallecidos mayores de 65 aumentará un 60,15% en 2040. Conclusión En las próximas 2 décadas es esperable que los nuevos casos de NU en mayores de 65 años aumenten por encima del 50%. Mayores recursos económicos y humanos, además de equipos multidisciplinares con experiencia y formación geriátrica, serán necesarios (AU)

Introduction In 2020, 282,421 new cases of cancer were diagnosed in Spain, and urological neoplasms (UN) were among the most frequent ones. Cancer treatment in elderly people is challenging due to frailty and comorbidities. Healthcare resources must be optimized in order to meet the needs of treating UN in the elderly, and deep analysis of cancer registries becomes mandatory. The objective of this work was to provide a detailed analysis of the incidence and mortality of UN in patients over 65 years old in the last year 2020 in Spain, as well as the estimates for the year 2040. Material and methods Incidence and mortality estimates were obtained from the GLOBOCAN database. The UN included were testicle, bladder, penis, kidney, and prostate. Results In 2020, 63,278 cases of UN were diagnosed in Spain. Most UN were much more frequent among patients > 65 years old, except for testicular cancers. For the year 2040, an increased incidence of 41.5% is estimated, reaching 89,507 new cases of UN per year, with approximately 3 out of 4 patients over 65 years of age. Deaths in people over 65 will increase by 60.15% in 2040. Conclusion In the next two decades, it is expected that new cases of UN in people over 65 years will rise above 50%. More financial and human resources, as well as multidisciplinary teams with experience and geriatric training, will be necessary (AU)

Impact of aging on the incidence and mortality of urological cancers: 20-year projection in Spain.

INTRODUCTION: In 2020, 282,421 new cases of cancer were diagnosed in Spain, and urological neoplasms (UN) were among the most frequent ones. Cancer treatment in eldery people is challenging due to fragility and comorbidities of these patients. To meet the needs of treating UN in the eldery, it is necessary to optimize healthcare resources, for which a deep analysis of cancer registries becomes mandatory. The objective of this work was to provide a detailed analysis of the incidence and mortality of UN in Spanish people over 65 years old in the last year 2020, as well as the estimates for the year 2040. MATERIAL AND METHODS: Incidence and mortality estimates were obtained from the GLOBOCAN database. The urological neoplasms that were included were: testicle, bladder, penis, kidney and prostate. RESULTS: In 2020, 63,278 cases of UN were diagnosed in Spain. Most UN were much more frequent among patients >65 years old, except for testicular cancers. For the year 2040, an incidence increase of 41.5% is estimated, reaching 89,507 new cases of UN per year, with approximately 3 out of 4 patients being over 65 years old. Deaths in people over 65 will increase by 60.15% in 2040. CONCLUSION: In the next two decades, it is expected that new cases UN in people over 65 years will increase above 50%. For Healthcare systems to face it, greater financial and human resources, as well as multidisciplinary teams with experience and geriatric training will be necessary.

Distribution of human papillomavirus genotypes in women with cervical alterations from north Argentina.

BACKGROUND: Cervical cancer remains a major public health problem in northern Argentina, showing the highest mortality rate in the country (approximately 22 cases/100000 women). OBJECTIVE: The aim of this study was to provide epidemiological data on the prevalence and type distribution of human papillomavirus (HPV) in women with pre-neoplastic lesions before the massive introduction of HPV vaccination in the country. MATERIALS AND METHODS: Exfoliated cervical cells were collected to screen for HPV using the widely known MY09/11 PCR, followed by the restriction fragment-length polymorphism (RFLP) technique from a total of 714 women with previously diagnosed atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LG-SIL) and high-grade squamous intraepithelial lesion (HG-SIL). RESULTS: Overall HPV prevalence was 48.2% in ASCUS (24 different HPV types detected), 66.5% in LG-SIL (37 HPV types detected) and 82.6% in HG-SIL (16 HPV types detected). HPV-16 was the most prevalent type among all cases. With respect to multiple HPV infections, 9.6% were observed in ASCUS, 14.3% in LG-SIL and 11.4% in HG-SIL. CONCLUSION: The major strength of our study is the assessment of a large series of women with cytological alterations in this region. The information attained will be useful as a regional baseline for future epidemiological vigilance, in the context of the national HPV vaccination program.

Position of the Spanish Menopause Society regarding the management of perimenopause.

Perimenopause is an imprecise period in woman over 40 years of age, which comprises the time between the moment that the first changes in the menstrual cycle appear and the year following the definitive cessation of the menses. Besides irregular bleeding, many women also complain of hot flashes and other characteristic symptoms of postmenopause. Moreover, most of them are concerned about the future impact that these events may have on their health, such as needing health exams or continuing to use contraceptive methods. A panel of experts from the Spanish Menopause Society has met to establish diagnostic and therapeutic guidelines for this period based on the best available evidence.

[Reported prevalence of family history of colorectal cancer in the city of Gijon (Spain)]. / Prevalencia declarada de antecedentes familiares de cáncer colorrectal en la población de Gijón.

INTRODUCTION: The objective of this study was to determine the prevalence of family history of colorectal cancer (CRC) in a population between 40 and 75 years-old, as well as acceptability and early diagnosis tests made. MATERIAL AND METHODS: Cross-sectional study. LOCATION: El Coto and El Llano (Gijon) primary care health centres. A total of 800 individuals aged between 40 and 75 years participated, selected by simple random sampling. Key measurements: questionnaire conducted by telephone with previous notice by newsletter. The variables studied were: family history (FH) of CRC, age at diagnosis, performance of faecal occult blood test (FOBT)/colonoscopy, reason for doing it or refusing it, and sociodemographic data. RESULTS: A total of 664 questionnaires were valid. The prevalence of FH was 15.8% (confidence interval 12.9 to 18.6), with 8.8% with at least one first degree relative. An FOBT screening had been performed on 7.1%, and 17.9% had undergone colonoscopies, mostly on clinical grounds. Acceptability was 90.7% for FOBT and 65.2% for colonoscopy. Main reason for the refusal of an FOBT was the belief that early diagnosis would not alter prognosis. Main reason for rejection of colonoscopy was discomfort or fear of the test. CONCLUSIONS: There was a low rate of testing for FH, and a high acceptability for FOBT and a low acceptability for colonoscopy. Aspects affecting the general population (causes for rejection, need for clear information), as well as a correct coordination between Primary Care, specialized care, and public health, need to be reviewed.

[Spontaneous rupture of the spleen secondary to intrasplenic aneurysm]. / Rotura de bazo espontánea secundaria a aneurisma intraesplénico.

Spontaneous rupture of the spleen is an uncommon emergency that usually occurs in a spleen affected by hematologic, neoplastic, or infectious diseases or as a complication of acute or chronic pancreatitis. This condition requires early diagnosis and appropriate treatment. Intrasplenic aneurysms are rare and rupture of the spleen secondary to intrasplenic aneurysm is extremely rare. We present the imaging findings for a case of splenic rupture secondary to an intrasplenic aneurysm. The patient was treated by percutaneous embolization, with excellent results. We review the literature on this entity and its endovascular treatment.

Rotura de bazo espontánea secundaria a aneurisma intraesplénico / Spontaneous rupture of the spleen secondary to intrasplenic aneurysm

La rotura espontánea del bazo es una urgencia infrecuente. Se suele producir en un bazo afectado por enfermedades hematológicas, neoplásicas o infecciosas, o como complicación de una pancreatitis aguda o crónica. Ha de ser diagnosticada y tratada con precisión y rapidez. Los aneurismas intraesplénicos son raros y la rotura de bazo secundaria a los mismos es excepcional. Presentamos los hallazgos por imagen de una rotura de bazo secundaria a un aneurisma intraesplénico, tratado mediante una embolización percutánea, con un resultado excelente. Revisamos la bibliografía de esta entidad y de su tratamiento endovascular (AU)

Spontaneous rupture of the spleen is an uncommon emergency that usually occurs in a spleen affected by hematologic, neoplastic, or infectious diseases or as a complication of acute or chronic pancreatitis. This condition requires early diagnosis and appropriate treatment. Intrasplenic aneurysms are rare and rupture of the spleen secondary to intrasplenic aneurysm is extremely rare. We present the imaging findings for a case of splenic rupture secondary to an intrasplenic aneurysm. The patient was treated by percutaneous embolization, with excellent results. We review the literature on this entity and its endovascular treatment (AU)

Función eréctil y calidad de vida en pacientes hipertensos tratados con nebivolol en Atención Primaria / Erectile function and quality of life in hypertensive patients treated with nebivolol in Primary Health Care

Objetivo. El objetivo es evaluar la función eréctil en pacientes hipertensos tratados con nebivolol. Método. Se trata de una investigación cuasi-experimental de cohortes prospectiva, de pacientes hipertensos con disfunción eréctil (DE) tratados con nebivolol, con dos grupos control: el primer grupo estaba compuesto de pacientes hipertensos con DE tratados con un medicamento distinto al nebivolol y el segundo de pacientes no hipertensos pero con DE. Resultados. Durante 24 semanas 53 pacientes han participado en el grupo del nebivolol, 51 en el grupo control (con DE e hipertensión [HTA]) y 52 en el grupo 2 (con DE sin HTA). La media de edad de los pacientes es de 55,21 años y el 92,32 % de ellos estaba casado o tenía una pareja estable. Al finalizar la investigación se observaron diferencias entre la media inicial y final de la presión arterial sistólica (PAS) (d = 7,8; t = 4,8; p < 0,001) y la presión arterial diastólica (PAD) (d = 6,16; t = 1,87; p < 0,05) en el grupo del nebivolol. En el grupo control 1 (DE + HTA) se observaron diferencias entre la media inicial y final de la PAS (d = 4,8; t = 5,11; p < 0,001), pero no en la PAD. En el grupo del nebivolol se observaron diferencias entre la puntuación media del total inicial y la puntuación media del total final del índice internacional de función eréctil (d = 19,81; t = 20,830; p < 0,001). También se observaron diferencias de menor intensidad en el grupo control 1 (DE + HTA; d = 5,95; t = 9,192; p < 0,01) y en el grupo control 2 (DE sin HTA; d = 9,30; t = 14,068; p < 0,001). Conclusiones. Los cambios mostrados en la función sexual de los pacientes que pertenecen al grupo de los tratados con nebivolol y el de los no hipertensos con trastorno eréctil (grupo 2) han demostrado ser similares y son más acusados en los pacientes hipertensos con DE tratados con otro antihipertensivo. De ahí que podamos concluir que el tratamiento con nebivolol no interfiere en la función sexual de los pacientes que lo toman, pudiendo incluso mejorarla

Objective. The objective is to evaluate erectile function in hypertensive patients treated with nebivolol. Method. Quasi-experimental research of prospective cohorts of hypertense patients (HBP) with erectile dysfunction (ED) treated with nebivolol, with two control groups: the first one made up of hypertense patients with ED treated with a medication other than nebivolol and the second of non-hypertense patients but with ED. Results. During a period of 24 weeks, 53 patients participated in the nebivolol group, 51 in the control group (with ED and HBP) and 52 in group 2 (with ED without HBP). Mean age is 55.21 years and 92.32 % of them were married or had a stable partner. When the research ended, differences were observed between the initial and final mean of the systolic blood pressure, SBP (d = 7.8; t = 4.8; p < 0.001) and diastolic blood pressure (d = 6.16; t = 1.87; p < 0.05) in the nebivolol group. In control group 1 (ED + HBP), differences were found between the initial and final mean of the SBP (d = 4.8; t = 5.11; p < 0.001), but not in the DBP. In the nebivolol group, differences were observed between the mean score of the initial total and mean score of the final total of the International Index of Erectile Function (d = 19.81; t = 20.830; p < 0.001). Differences having less intensity were also observed in control group 1 (ED + HBP; d = 5.95; t = 9.192; p < 0.01) and control 2 (ED without HBP; d = 9.30; t = 14.068; p < 0.001). Conclusions. The changes demonstrated in the sexual function of the patients who belong to the group treated with nebivolol and that of the non-hypertensive with erectile disorder (group 2) have been demonstrated to be similar and are greater in the hypertense patients with erectile dysfunction treated with another antihypertensive drug. Thus, we can conclude that treatment with nebivolol does not interfere in the sexual function of the patients who take it and can even improve it

Estudio de prevalencia de isquemia crónica de miembros inferiores y de aneurisma de aorta abdominal en mayores de 65 años / A study of the prevalence of chronic ischaemia in the lower limbs and abdominal aortic aneurysms in persons over the age of 65

Introducción. El aumento de la expectativa de vida ha conducido a que patologías vasculares, especialmente prevalentes en el segmento de población con más edad, se hayan constituido en problemas de salud. Objetivo. Determinar la prevalencia de la isquemia crónica (IC) y de los aneurismas de aorta abdominal (AAA) infrarrenal en la población mayor de 65 años del Área Sanitaria V (Gijón) del Servicio de Salud del Principado de Asturias. Pacientes y métodos. Se diseña un estudio descriptivo transversal, incluyendo finalmente 232 pacientes, 114 hombres y 118 mujeres, seleccionados aleatoriamente a partir de los datos de la tarjeta sanitaria. Se les explora, se realiza un eco-Doppler de la aorta abdominal y se calcula el índice tobillo-brazo. Resultados. La prevalencia de la IC es del 9,9% y de un 2,6% para el AAA. Se desagregan los resultados por sexos y dos grupos de edad, de 65-74 años y mayores de 75. La prevalencia de la IC está seis puntos por encima en el grupo de los mayores de 75 años (13,4%) y la del AAA es más de siete veces superior (5,2%). Conclusión. La prevalencia es más elevada en los mayores de 75 años y los varones para la IC y el AAA, con diferencias estadísticamente significativas. Este estudio abre las puertas a un seguimiento de los integrantes de la muestra, que permita determinar la incidencia de las diversas patologías

Introduction. As life expectancy has increased, vascular pathologies, which are especially prevalent in the most elderly segment of the population, have become a health problem. Aim. To determine the prevalence of chronic ischaemia (CI) and infrarenal abdominal aortic aneurysms (AAA) in a population of persons over 65 years of age from Health Care District V (Gijón) of the Principality of Asturias Health Service. Patients and methods. A cross-sectional descriptive study was designed, which finally included 232 patients (114 males and 118 females) who were selected at random from the data contained in their health card. They were examined, submitted to a Doppler ultrasound scan of the abdominal aorta and their ankle-brachial index was calculated. Results. The prevalence of CI was found to be 9.9% and 2.6% for AAA. Results were broken down by sexes and two age groups: 65-74 years and over 75 years of age. The prevalence of CI was six points higher in the group of over 75s (13.4%) and that of AAA was seven times higher (5.2%). Conclusions. For CI and AAA, prevalence was higher in persons over 75 years old and males, with statistically significant differences. This study opens the way to a follow-up of the participants in the sample, which would allow us to determine the incidence of several different pathologies

Rara complicación de una prótesis metálica esofágica en el árbol traqueobronquial / Rare complication of metallic esophageal prosthesis in tracheal bronchial tree

No disponible

SyDSF-AP: un cuestionario de 21 ítems para aproximarnos a la salud sexual y detectar las disfunciones sexuales femeninas en Atención Primaria / SyDSF-AP: a 21-item questionnaire to approach sexual health and detectfeminine sexual dysfunctions in Primary Health Care

OBJETIVO. Desarrollar un instrumento que valore la función sexual femenina y la correlacione con su ciclo vital, situación sociofamiliar y estado de salud. MÉTODO. Estudio longitudinal multicéntrico para evaluar la validez del cuestionario para la Salud y Disfunciones Sexuales Femeninas en Atención Primaria (SyDSF-AP). Se siguieron tres etapas para desarrollar el SyDSF-AP: de identificación de los ítems para las disfunciones sexuales, de desarrollo del cuestionario y de evolución de sus propiedades psicométricas. Se diseñó un cuestionario autoevaluativo de 21 ítems, con un dominio descriptivo sociodemográfico y del estado de salud y otro de función sexual. Su análisis ha consistido en: a) validez de contenidos: consenso del comité de la Asociación para la Investigación de las Disfunciones Sexuales en Atención Primaria (AIDSAP) y correlación intraobservadores (CCI); b) fiabilidad test-retest, con 2 semanas de diferencia, mediante el análisis de concordancia con índice kappa y análisis de coeficiente de correlación intraclase (CCI), y c) análisis de consistencia interna mediante * de Cronbach. RESULTADOS. Participaron 160 mujeres mayores de 18 años que acudieron consecutivamente a las consultas de 4 Centros de Salud por cualquier motivo. La consistencia interna, medida con el * de Cronbach, fue de 0,95. La reproducibilidad entre test y retest (CCI) fue de 0,93 (intervalo de confianza [IC] 99%). Respecto a la correlación intraobservadores, el CCI en el dominio sobre función sexual demostró un acuerdo muy alto con valor global de 0,941 (0,928-0,953, IC 95%). CONCLUSIONES. El cuestionario auto-administrado SyDSF-AP es adecuado para aproximarnos globalmente a la salud sexual de la mujer y detectar las disfunciones sexuales femeninas en Atención Primaria

OBJECTIVE. Develop an instrument that evaluates feminine sexual function and correlates it with their life cycle, social familiar situation, and health status. METHOD. Multicenter longitudinal study to evaluate the validity of the questionnaire for Health and Feminine Sexual Dysfunctions in Primary Care (SyDSF-AP). Three stages were followed-up to develop the SyDSF-AP: identification of the items for sexual dysfunctions, development of the questionnaire and evolution of their psychometric properties. A 21-item self-evaluation questionnaire, with descriptive sociodemographic and health status domain and another one of sexual function was designed. The analysis consisted in: a) validity of contents: consensus of AIDSAP committee and inter-observer correlation (CCI); b) test-retest reliability, with two week's difference, by concordance analysis with kappa index and intraclass correlation coefficient (CCI) analysis, and c) analysis of internal consistency by means of Cronbach's *. RESULTS. A total of 160 women over 18 years of age who came to the consultation of 4 Health Care Sites for any reason consecutively participated. Internal consistency, measured with Cronbach's *, was 0.95. Reproducibility between test and retest (CCI) was 0.93 (99% CI). Regarding intraobserver correlation, the CCI in the domain on sexual function had a very high at agreement with the global value of 0.941 (0.928-0.953, 95% CI). CONCLUSIONS. The self-administered SyDSF-AP questionnaire is adequate to make a global approach to the sexual health of the woman and to detect feminine sexual dysfunctions in Primary Health Care

El perfil de los pacientes con patrón hipertensivo no dipper y su implicación en la práctica clínica en Atención Primaria / Profile of patients with non-dipper hypertensive pattern and its implication in the primary care clinical practice

OBJETIVO. Analizar el perfil de los pacientes hipertensos con patrón circadiano no "reductor" (no dipper), valorando el riesgo añadido para eventos cardiovasculares. DISEÑO. Estudio naturalístico, longitudinal, con monitorización ambulatoria de la presión arterial. EMPLAZAMIENTO. Centros de Salud PARTICIPANTES. Cien pacientes en programa de hipertensión por sospecha de HTA de bata blanca, HTA límite/lábil, HTA de alto riesgo y HTA refractaria; seleccionados de forma consecutiva. MEDICIONES PRINCIPALES. Datos sociodemográficos, patrón circadiano de HTA y riesgo cardiovascular. RESULTADOS. Tres de cada 4 pacientes son varones de 61,88 años de promedio y de 5,64 años de evolución de su HTA. El índice de masa corporal es de 29,04 (IC: 27,62-31,02); el colesterol total de 236 (IC 95%: 213-254) y un 12% son fumadores. El 72% presentaba más de una patología asociada a la HTA: dislipemia 60%, síndrome metabólico 32%, diabetes mellitus tipo 2 el 32%, HPB 24%, y otras el 62%. La monitorización ambulatoria de la presión arterial no fue válida en 4 pacientes (4%); 46 presentaban patrón dipper (46%) y 50 diferente a dipper (50%), distribuidos en 38 no dipper (76%), 10 tenían un patrón riser (20%) y 2 presentaban un patrón extra dipper (4%). En cuanto al riesgo de los no dipper conforme al modelo SCORE fue: normal 4 (8%), ligero 10 (20%), moderado 8 (16%), elevado 24 (48%), y muy elevado 4 (8%). Por último un 36% de los varones presentaba disfunción eréctil (según IIEF). CONCLUSIONES. Los pacientes hipertensos con HTA de alto riesgo y refractarios al tratamiento son los que con más frecuencia presentan un patrón diferente a dipper, tienen un riesgo añadido elevado y más comorbilidad asociada

OBJECTIVE. Analyze the profile of hypertensive patients with non-dipper circadian pattern, assessing the added risk for cardiovascular events. DESIGN. Naturalistic, longitudinal study with ambulatory blood pressure monitoring (ABPM). SITE. Health Center PARTICIPANTS. 100 patients in hypertension programs due to white coat HBP suspicion, borderline/labile HBP, high risk HBP and refractory HBP, consecutively enrolled. PRINCIPAL MEASUREMENTS. Sociodemographic data, circadian pattern of HBP and cardiovascular risk. RESULTS. Three out of every 4 patients are male with average age of 61.88 years and 5.64 years of evolution of their HBP. BMI is 29.04 (CI: 27.62-31.02); total cholesterol 236 (95% CI: 213-254) and 12% smoked. A total of 72% had a disease associated to the HBP: dyslipidemia 60%, metabolic S. 32%, type 2 diabetes mellitus 32%, HBP 24% and others 62%. ABPM was not valid in 4 patients (4%); 46 had dipper pattern (46%) and 50 different from dipper (50%), distributed in 38 non-dipper (76%), 10 had a riser pattern (20%) and 2 an "extra dipper" pattern (4%). Regarding the risk of the "non-dipper" according to the SCORE model, it was normal in 4 (8%), mild in 10 (20%), moderate in 8 (16%), elevated in 24 (48%) and very high in 4 (8%). Finally, 36% of the males had erectile dysfunction (according to IIEF). CONCLUSIONS. Hypertensive patients with high risk and refractory to treatment HBP are those who most frequently had a pattern different from dipper. They had an added elevate risk and more associated comorbidity

[Cervical infection epidemiology of human papillomavirus in Ushuaia, Argentina]. / Epidemiología de la infección cervical por virus papiloma humano en Ushuaia, Argentina.

Genital infection with human papillomavirus (HPV) is decisive in the causation of cervical cancer. In order to evaluate the epidemiology of HPV infection in Ushuaia, Province of Tierra del Fuego, Argentina, 132 endocervical cytobrushes from preneoplastic and neoplastic cases and controls were studied. Detection and typing of the viral genome was performed by polymerase chain reaction, combined with a restriction fragment length polymorphism assay or hybridization. The overall prevalence of HPV infection was 41% in the population examined, with a frequency of 26% in the controls and 71% in the cases under study. The 14-24 age group showed the highest HPV prevalence. The most common viral types in the infected population were HPV 16 (23%), HPV 18 (11%), HPV 33 (8%) and HPV 35 (8%), while high risk viral types were detected in 30% of the samples, 16% of the controls and 60% of the cases. This study provides the first data on the predominant viral types in Ushuaia. Our results show lower levels of infection than in regions with a high incidence of cervical cancer, HPV 16 being the most prevalent viral type. This research may be useful for selecting a specific vaccine targeting the population examined.

Epidemiología de la infección cervical por virus Papiloma humano en Ushuaia: Argentina / Cervical infection epidemiology of human papillomavirus in Ushuaia: Argentina

El virus Papiloma humano (HPV) es un factor necesario para el desarrollo del cáncer cervical. El objetivo del estudio fue conocer la epidemiología de dicha infección en Ushuaia, Provincia de Tierra del Fuego, Argentina. Se realizó un estudio de caso-control de 132 cepillados endocervicales. La detección y tipificación del genoma viral fue realizada por la reacción en cadena de la polimerasa, con posterior análisis de polimorfismos de fragmentos de restricción o hibridación. La prevalencia general de la infección fue 41%, correspondiendo 26% a los controles y 71% a los casos. El grupo etario con mayor prevalencia de HPV fue el de 14 a 24 años. Los tipos virales más frecuentes en la población infectada fueron HPV16 (23%), HPV18 (11%) y HPV33/35 (8% cada uno), resultando infectados con tipos virales de alto riesgo el 30% de las muestras, 16% de los controles y 60% de los casos. El trabajo aporta los primeros datos sobre los tipos virales predominantes en Ushuaia. Los resultados demostraron una prevalencia menor que en regiones con alta incidencia de cáncer cervical, siendo el HPV16 el más frecuente. La información obtenida permitiría estimar la efectividad de las vacunas en vías de aprobación, en la población estudiada.

Genital infection with human papillomavirus (HPV) is decisive in the causation of cervical cancer. In order to evaluate the epidemiology of HPV infection in Ushuaia, Province of Tierra del Fuego, Argentina, 132 endocervical cytobrushes from preneoplastic and neoplastic cases and controls were studied. Detection and typing of the viral genome was performed by polymerase chain reaction, combined with a restriction fragment length polymorphism assay or hybridization. The overall prevalence of HPV infection was 41% in the population examined, with a frequency of 26% in the controls and 71% in the cases under study. The 14-24 age group showed the highest HPV prevalence. The most common viral types in the infected population were HPV 16 (23%), HPV 18 (11%), HPV 33 (8%) and HPV 35 (8%), while high risk viral types were detected in 30% of the samples, 16% of the controls and 60% of the cases. This study provides the first data on the predominant viral types in Ushuaia. Our results show lower levels of infection than in regions with a high incidence of cervical cancer, HPV 16 being the most prevalent viral type. This research may be useful for selecting a specific vaccine targeting the population examined.

Bovine herpesvirus 4-associated postpartum metritis in a Spanish dairy herd.

In more than 10 Spanish dairy cows, a bovine herpesvirus 4 (BHV4) associated postpartum metritis was confirmed by virus isolation, BHV4-glycoprotein B (gB) PCR and/or serology. In this study, 12 cows with, and, at the time of sampling, 3 cows without clinical signs of acute postpartum metritis from one large dairy herd in Spain were examined for bacterial and viral infections. Blood, placenta/caruncles and uterine contents were collected between day 1 and day 20 post-calving, and examined for the presence of bacteria and for viruses by virus isolation, BHV4 DNA by BHV4-gB PCR and/or BHV4 antibody titres. Bovine herpesvirus 4 was detected in 83% of the cases with clinical signs of acute postpartum metritis by virus isolation and/or BHV4-gB PCR. An increase of BHV4 antibodies was detected in all examined postpartum metritis cows and in the 3 cows without clinical metritis. Two of these 3 cows developed severe metritis a few dayss after collecting the first blood sample. A concurrent infections of BHV4 and bacteria, mainly Arcanobacterium pyogenes and Streptococcus sp., were detected in 73% of the examined uterine contents collected from postpartum metritis affected cows. This case-report study showed a clear association between BHV4 infections and acute postpartum metritis in dairy cows. In addition, the BHV4-associated postpartum metritis appeared to be an emerging syndrome in this Spanish herd.

Epidemiological study of Rickettsia typhi infection in two provinces of the north of Spain: analysis of sera from the general population and sheep.

Data relating to Rickettsia typhi infection in Spain are scarce. A serological survey of 383 serum samples (184 males, 199 females) from the general population and 120 sera from sheep were studied by immunofluorescence assay (IFA). The human serum samples were collected from the general population of Palencia and Burgos provinces, and sheep serum samples were collected from Palencia province. Of the 383 human serum samples studied, 29 were positive for antibodies against R. typhi (7.5%) No statistical differences were found according to age, sex, origin (rural vs. urban) or geographic distribution, but a significant difference was observed related to occupation. In addition, 69 serums were found positives for R. typhi in sheep samples (57.5%). Our results indicated the circulation of R. typhi infectious for humans and sheep in Palencia and Burgos provinces. This study indicates that sheep may be infected with R. typhi, and that animals can, therefore be used as indicators of the presence of this organism.

[Prevalence of cervical infection by human papilloma virus (HPV) in the Caucasian and Guaraní populations residing in the province of Misiones, Argentina]. / Prevalencia de la infección cervical por virus papiloma humano (HPV) en población caucásica y guaraní, residente en la provincia de Misiones, Argentina.

A genital infection with human papillomavirus (HPV) of a high risk type is necessary for the development of cervical carcinoma. HPV viral distribution among diverse world populations is not homogeneous, viral reservoirs having been detected in particular regions that can interact when humans engage in active contacts. Such viral dynamics alters the population cervical cancer relative risk, particularly when the prevalence of HPV oncogenic risk types is high. We have compared women exposed to different social, cultural and environmental conditions regarding cervical HPV infection, analyzing two populations from Misiones, Argentina: White urban women and--Guarani indian women living in the rain forest. Demographic, clinical and sexual behavior data were collected and cytological, colposcopical and virological analysis performed. Detection and genotypification of HPV was performed by PCR-RFLP. The prevalence for generic HPV infection found was high in both populations, urban women: 43%, Guarani indians: 60%, with a statistically significant difference. These values were positively associated to age of first intercourse, number of male partners and smoking history. HPV type-specific prevalences showed a relative homogeneity between populations when the main representatives of the high risk (16 and 18: 23%) and low risk (6 y 11: 12%) types were grouped together. However, the presence of other viral types was notoriously different, representing only 9% in urban women and 29% in Guarani indians with particularly high risk HPV types (33, 35, 39, 45, 51, 52, 58, 67, 68). This situation might be of importance for future viral dynamics, phylogenetic and vaccine formulation studies.

Prevalencia de la infección cervical por virus papiloma humano (HPV) en población caucásica y guaraní, residente en la provincia de Misiones, Argentina / [Prevalence of cervical infection by human papilloma virus (HPV) in the Caucasian and Guaraní populations residing in the province of Misiones, Argentina]

A genital infection with human papillomavirus (HPV) of a high risk type is necessary for the development of cervical carcinoma. HPV viral distribution among diverse world populations is not homogeneous, viral reservoirs having been detected in particular regions that can interact when humans engage in active contacts. Such viral dynamics alters the population cervical cancer relative risk, particularly when the prevalence of HPV oncogenic risk types is high. We have compared women exposed to different social, cultural and environmental conditions regarding cervical HPV infection, analyzing two populations from Misiones, Argentina: White urban women and--Guarani indian women living in the rain forest. Demographic, clinical and sexual behavior data were collected and cytological, colposcopical and virological analysis performed. Detection and genotypification of HPV was performed by PCR-RFLP. The prevalence for generic HPV infection found was high in both populations, urban women: 43

, with a statistically significant difference. These values were positively associated to age of first intercourse, number of male partners and smoking history. HPV type-specific prevalences showed a relative homogeneity between populations when the main representatives of the high risk (16 and 18: 23

) types were grouped together. However, the presence of other viral types was notoriously different, representing only 9

in urban women and 29

in Guarani indians with particularly high risk HPV types (33, 35, 39, 45, 51, 52, 58, 67, 68). This situation might be of importance for future viral dynamics, phylogenetic and vaccine formulation studies.

) and low risk (6 y 11: 12

Prevalencia de la infección cervical por virus papiloma humano (HPV) en población caucásica y guaraní, residente en la provincia de Misiones, Argentina. / [Prevalence of cervical infection by human papilloma virus (HPV) in the Caucasian and Guaraní populations residing in the province of Misiones, Argentina]

A genital infection with human papillomavirus (HPV) of a high risk type is necessary for the development of cervical carcinoma. HPV viral distribution among diverse world populations is not homogeneous, viral reservoirs having been detected in particular regions that can interact when humans engage in active contacts. Such viral dynamics alters the population cervical cancer relative risk, particularly when the prevalence of HPV oncogenic risk types is high. We have compared women exposed to different social, cultural and environmental conditions regarding cervical HPV infection, analyzing two populations from Misiones, Argentina: White urban women and--Guarani indian women living in the rain forest. Demographic, clinical and sexual behavior data were collected and cytological, colposcopical and virological analysis performed. Detection and genotypification of HPV was performed by PCR-RFLP. The prevalence for generic HPV infection found was high in both populations, urban women: 43

, Guarani indians: 60

, with a statistically significant difference. These values were positively associated to age of first intercourse, number of male partners and smoking history. HPV type-specific prevalences showed a relative homogeneity between populations when the main representatives of the high risk (16 and 18: 23

) and low risk (6 y 11: 12

) types were grouped together. However, the presence of other viral types was notoriously different, representing only 9

in urban women and 29

in Guarani indians with particularly high risk HPV types (33, 35, 39, 45, 51, 52, 58, 67, 68). This situation might be of importance for future viral dynamics, phylogenetic and vaccine formulation studies.