Distribución de variantes del virus del papiloma humano 16 (VPH 16) en mujeres con y sin neoplasia intraepitelial cervical grado 3 y cáncer cervical / Distribution of variants of the human papilloma virus 16 (HPV 16) in Women with and without grade 3 cervical intraepithelial neoplasia and cervical cancer

Objetivos: Describir la distribución de variantes del virus del papiloma humano 16 en mujeres con y sin neoplasia intraepitelial cervical grado 3 y cáncer cervical. Métodos: Se determinaron las variantes moleculares en casos de carcinoma escamocelular, adenocarcinoma cervical y en mujeres sin anormalidades citológicas de alto grado y positivas para el virus del papiloma humano 16. Para la detección de las variantes moleculares se amplificó el marco abierto de lectura del gen E6 del virus del papiloma humano 16 y se utilizó una técnica de hibridación reversa para la detección de los principales cambios de nucleótidos que identifican las ramas filogenéticas y las clases de variantes. Resultados:Hubo diferencias estadísticamente significativas en la distribución de variantes de virus del papiloma humano 16. Los controles no presentaron infecciones con variantes no europeas, mientras que ellas estuvieron presentes en el 30% de los casos de carcinoma escamocelular o neoplasia intraepitelial cervical grado tres. En adenocarcinoma, el 65% de las infecciones fueron del tipo no europeo. Conclusiones: La prevalencia de variantes no europeas de virus de papiloma humano 16 fue de 31,2% en neoplasia intraepitelial cervical grado 3 y cáncer escamocelular, y de 64,1% en adenocarcinoma de cérvix, mientras que estas no se observaron en mujeres sin cáncer.

Objectives: To describe the distribution of the variants of the human papilloma virus 16 in women with and without grade 3 cervical intraepithelial neoplasia and cervical cancer. Methods: Molecular variants were established in cases of squamous cell carcinoma, cervical adenocarcinoma and in women with high grade Pap smear abnormalities who tested positive for human papilloma virus 16. For the detection of molecular variants the open reading framework for the E6 gene of the human papilloma virus 16 was amplified and a reverse hybridization technique was utilized for the detection of major changes in the nucleotides which identify the phylogenetic branches and classes of variants. Results: There were statistically significant results in the distribution of the variants of the human papilloma virus 16. Control cases showed no infections with non European variants, but they were present in 30% of squamous cell carcinoma or grade three cervical intraepithelial neoplasia. For adenocarcinoma, 65% of infections were of non European type. Conclusions: The prevalence of non European variants of the human papilloma virus 16 was 31.2% in grade 3 cervical intraepithelial neoplasia and squamous cell cancer, and 64.1% in cervical adenocarcinoma; however, these were not observed among women without cancer.

An open-label, double tympanocentesis, single-center study of trimethoprim sulfametoxasole in children with acute otitis media.

Trimethoprim sulfamethoxasole has been recommended for the treatment of acute otitis media. In this double tympanocentesis study, children aged 3 to 48 months with acute otitis media received trimethoprim sulfamethoxasole twice daily (40 mg/kg/d) for 10 days. All children had a baseline tympanocentesis and in culture-positive children, tympanocentesis was repeated at the on-therapy visit. Of 89 children enrolled, 51 (57%) were clinically and bacteriologically evaluable. Bacteriologic eradication was achieved in 80% (42 of 52) of children, and overall clinical response at the end of therapy was 78%. Clinical success was 69% for culture-positive children versus 91% for culture-negative children at baseline tympanocentesis (P = 0.03). In this study, trimethoprim sulfamethoxasole clinical response was unsatisfactory, especially among culture-'positive children.

Activity of trimethoprim-sulfamethoxazole against middle ear fluid pathogens obtained from Costa Rican children with otitis media.

For many years, trimethoprim-sulfamethoxazole (TMP-SMX) has been recommended as an alternative antimicrobial agent for the treatment of children with otitis media (OM). This study analyzed the in vitro activity of TMP-SMX against respiratory pathogens obtained from middle ear fluid of Costa Rican children 6-60 months of age with acute OM, recurrent OM, therapeutic failures and acute OM at risk for having a resistant pathogen. Between 2002 and 2003, a total of 124 middle ear fluid bacterial isolates were analyzed and compared with historic data from 1992 to 1997. A significant increase in the number of TMP-SMX Streptococcus pneumoniae (P = 0.00008)- and Haemophilus influenzae (P = 0.04)-resistant strains was observed during 2002-2003 when compared with strains from 1992-1997.