Seroprevalence of HPV vaccine types 6, 11, 16 and 18 in HIV-infected and uninfected women from Brazil.

BACKGROUND: Information on vaccine-type HPV seroprevalence is essential for vaccine strategies; however, limited data are available on past exposure to HPV-quadrivalent vaccine types in HIV-infected woman in Brazil. OBJECTIVES: To assess the seroprevalence for HPV types 6, 11, 16 and 18 in HIV-infected and uninfected women, from Rio de Janeiro, Brazil and to investigate potential associations with age and pregnancy status. STUDY-DESIGN: 1100-sera were tested by virus-like particle (VLPs)-based ELISA for antibodies to HPV types 16, 18, 6 and 11. Statistical analysis was carried out by STATA/SE 10.1 and comparisons among HIV-infected and HIV-uninfected women were assessed by Poisson regression models with robust variance. RESULTS: HPV-6, 11, 16 and 18 seroprevalence was significantly higher among HIV-positive women (29.9%, 8.5%, 56.2% and 38.0%, respectively) compared to HIV-negative women (10.9%, 3.5%, 30.8% and 21.7%, respectively), when adjusted by age and pregnancy status. Overall, 69.4% of HIV-infected and 41.5% of HIV-uninfected women tested positive for any HPV quadrivalent vaccine type. However 4.7% and 1.1%, respectively, tested positive for all HPV vaccine type. In HIV-uninfected women who were pregnant, we found a higher HPV-11 seroprevalence (8.5% vs. 1.5%; P < 0.001) and a lower HPV 16 seroprevalence (22.6% vs. 34.2%; P = 0.010) compared to not pregnant women. HIV-uninfected women, aged 40 or more years old had a higher HPV 16 seroprevalence compared to women aged less than 40 years old. CONCLUSIONS: We did not observe a strong association between age and positive HPV antibodies nor an association between pregnancy and HPV seroprevalence. HPV seroprevalence was significantly higher among HIV-infected women compared to HIV negative women. In both populations the seroprevalence to all four HPV vaccine types was low suggesting that women may potentially benefit from the HPV vaccines.

Childhood soft tissue sarcoma: a 20-year experience.

PURPOSE: To evaluate the disease-free and overall survival of pediatric patients with nonrhabdomyosarcoma soft-tissue sarcomas. METHODS: We retrospectively analyzed the records of 67 pediatric patients with a diagnosis of nonrhabdomyosarcoma soft tissue sarcoma treated with curative intent between 1970 and 1992. Median follow-up time for the 52 survivors was 120 months (range, 7 to 277 months). Fifty-nine patients received external beam radiotherapy, in a median dose of 5400 cGy (range, 1800 to 6660 cGy.) All patients underwent an initial surgical procedure. Eighteen patients had gross residual disease, and 15 had gross total excision with microscopic residual disease or positive margins. Adjuvant chemotherapy was administered to 44 patients (65%). RESULTS: The actuarial 10-year freedom from progression or recurrence and overall survival rates were 76% and 75%, and the 20-year rates were the same. Of 18 patients with gross residual disease, 9 (50%) had local progression and 6 died of local-only disease. By contrast, only one patient with microscopic residual disease who received postoperative radiotherapy had a local recurrence. The disease-free survival rate also correlated with histologic grade. CONCLUSIONS: As with adult soft tissue sarcomas, gross residual disease predicts local failure. Our results suggest that pediatric patients with soft tissue sarcomas treated with surgery and postoperative radiotherapy generally have a favorable overall survival rate.

The Cuban immigration of 1980: a special mental health challenge.

The 124,769 Cubans who entered the United States from Cuba in a boatlift in 1980 included a small minority of people who needed mental health care. Some had been taken involuntarily from psychiatric hospitals, mental retardation facilities, jails, and prisons. The National Institute of Mental Health, Public Health Service (PHS), was responsible for mental health screening, evaluation, and treatment of the Cuban Entrants. Bilingual psychiatrists and psychologists found that many Entrants given preliminary evaluations showed evidence of transient situational stress reactions, not psychiatric illnesses. Entrants who had not yet been sponsored were consolidated into one facility in October 1980, and about 100 of those with severe problems were transferred to an Immigration and Naturalization Service-PHS evaluation facility in Washington, DC. Between March 1, 1981, and March 1, 1982, a total of 3,035 Entrants were evaluated at both facilities. Among the 1,307 persons who presented symptoms, there was a primary diagnosis of personality disorders for 26 percent, schizophrenic disorders for 15 percent, adjustment disorders for 14.5 percent, mental retardation for 8.6 percent, chronic alcohol abuse for 8.6 percent, and major depression for 7.2 percent. Only 459 Cubans with symptoms were found to be in need of further psychiatric care. As of October 1984, many Entrants with psychiatric illnesses remained under inpatient or community-based halfway house psychiatric care as a direct Federal responsibility. A PHS program for further placement in community-based facilities is underway.