Detection and genotyping of HPV in urine samples from Chilean women attending primary health care centers.

Cervical cancer is the second most common malignant neoplasm in women worldwide representing approximately 10% of all types of cancers. Triage of women through cervical cytology has been an important strategy for the surveillance and control of new cases of cervical cancer. However, in many regions around the world cervical cytology has a low coverage compared to developed countries. The molecular detection of HPV is the most effective method to increase the screening sensitivity of women at risk of developing cervical cancer. There are very few studies about the efficacy of urine testing for detection of HPV in women followed up in primary health care centers. Consequently, the efficacy of using urine HPV screening in these populations has not been addressed yet. Here, we compared the detection of HPV in simultaneous urine and cervical samples of women followed up in primary health care centers. Urine and cervical samples were analyzed in 543 women attending at primary health care centers. HPV was detected by real time PCR, and HPV typing performed by PCR-RLB. A general HPV concordance of 86.2% (κ = 0.72) was determined between urine and cervical samples. The concordance for HPV-16 and 18 was almost perfect (κ = 0.82) and strong (κ = 0.77), respectively. The sensitivity and specificity for all HPV genotypes in urine using cervical samples as reference were 82.1 and 93.7%, respectively. The results showed that urine is a good alternative as clinical sample for HPV screening in women attending primary health care centers. Therefore, urine should be used as an alternative sample for increasing triage coverage either in refractory women participating in Pap surveillance programs or when cervical samples are not available.

Prevalence of Human Papillomavirus infection among Chilean women from 2012 to 2016.

Here, we evaluated the prevalence of Human Papillomavirus (HPV) in two groups of Chilean women. The first group consisted of 3235 women aged 18-64 years attended in six primary care centers of Santiago. The second group consisted of 456 women 18-85 aged who consulted the Gynaecology Department of the Reference Hospital of Santiago. Samples were collected from October 2012 to February 2016. Cervical swabs were analyzed both HPV genotyping by PCR and Reverse Line Blot, and cervical cytology by Pap testing. Results showed a prevalence of 12.0% HPV positive, 10.3% high-risk (HR) HPV types positive, 3.9% low-risk (LR) HPV types positive, and 1.0% Pap positive in group 1. The most frequent types were 16, 66, and 59, with a prevalence of 3.0%, 1.6%, and 1.5%, respectively. The prevalence were 71.9% HPV positive, 67.3% HR-HPV types positive, 13.6% LR-HPV types positive, and 62.5% Pap positive in group 2. The most frequent types were 16, 31, and 58, with prevalence of 33.6%, 10.5%, and 7.0%, respectively. Among infected women with HPV: 7.6% were infected with HPV16 or HPV18, 3.0% with HPV31, HPV33 or HPV45, and 6.7% with any other HR-HPV. These findings show great difference in HPV prevalence and types between primary care and reference center, and provide useful epidemiological information to assess the impact of HPV vaccination in the future.

Prevalence of human papillomavirus infection among women presenting for cervical cancer screening in Chile, 2014-2015.

Cervical cancer is the fourth most common malignancy in women worldwide. In Chile, cervical cancer is the second leading cause of death among women of reproductive age, causing more than 600 deaths annually. This study was carried out to determine the burden and confirm the predominant human papillomavirus (HPV) genotypes among women presenting for cervical cancer screening in public health services in Chile. Women aged 18-64 years residing in the north and central areas covered by six primary care centers of Santiago, Chile, were invited to participate from March 2014 to August 2015. Cervical swabs were examined both HPV genotyping by PCR and Reverse Line Blot, and cervical cytology by Pap testing. A total of 1738 women were included in this study: 11.1 % were HPV positive, 9.7 % were high-risk types positive, 3.2 % were low-risk types positive, 1.4 % were Pap positive and 0.9 % were positive by both tests. The four most predominant genotypes were 16, 66, 51 and 59, with prevalence of 2.8, 1.4, 1.2 and 1.2 %, respectively. Multiple HPV infections were detected among 3.8 % participants. Age-specific prevalence of HPV showed a peak in HPV infection at younger ages (≤30 years), declining to a plateau in middle age. Among women with normal cytology, the 9.4 % were HPV positive, while 58.3 % of women with abnormal cytology were HPV positive. These findings show new epidemiological data confirming HPV 16 and 66 as the most predominant genotypes in Chile. These data are important for design successful strategies for prevention of cervical cancer in Chile.

Comparación del HOMA IR con el modelo mínimo para medir sensibilidad a la insulina en el síndrome de ovarios poliquísticos / Comparison of HOMA-IR with minmod for measure insulin sensitivity in policystic ovary syndrome

Introducción. - El síndrome de ovarios poliquísticos (SOP) es la alteración más común en mujeres en edad reproductiva. Estas mujeres presentan resistencia a la insulina independientemente de la obesidad; y la resistencia a la insulina se reconoce como un factor de riesgo para desarrollar diabetes mellitus tipo 2, hipertensión arterial y enfermedad cardiovascular. Propósito. En este estudio evaluamos la correlación entre una sola medición en ayuno para sensibilidad a la insulina (Modelo homeostático) y el Modelo-mínimo en este síndrome. Métodos . Se estudiaron 33 pacientes con diagnóstico de SOP y edad promedio de 22.7 ñ 6.2 años e Indice de Masa Corporal (IMC) 29.1 ñ 5.4 a quienes se les efectuó la prueba de tolerancia iv a la glucosa (modelo-mínimo). Resultados. El 51.5 por ciento (17 pacientes) tuvo sensibilidad a la insulina menor de 1.5 x 10 -4 min. -1 µU -1 mL -1. El grupo con IMC > de 27 (20 mujeres obesas), presentó mayor resistencia a la insulina que aquellas con IMC = de 27 (p= 0.004). La correlación entre sensibilidad a la insulina (Si) del Modelo Mínimo y HOMA IR fue significativa con p = 0.0001 y R RANK = -0.76 para todo el grupo de estudio; R RANK = -0.77 para las pacientes con IMC = 27 (p=0.00006) y R RANK = -0.43 para aquellas con IMC = 27 (p = 0.13). Conclusión. El HOMA IR es una prueba útil para medir la sensibilidad a la insulina en el grupo de las mujeres obesas o con sobrepeso y SOP, pero no en las delgadas.

Proyecto de nutrición infantil sostenible: niños / Maintainable infant feeding project: children

Apunta a mejorar el estado nutricional de los niños menores de cinco años pertenecientes a comunidades rurales en extrema pobreza de Piura, Cajamarca, Puno y Huaraz, mediante la capacitación intensiva de sus madres en aspectos de nutrición y salud materno-infantil, la puesta en marcha de un sistema de vigilancia nutricional y de salud en cada una de las comunidades participantes y mediante la motivación del esfuerzo colectivo de las comunidades rurales en favor de la salud de la niñez